Omicron is exceptionally contagious. Here's what to do if you test positive

Yesenia Mata gives herself a COVID-19 test on Jan. 4, 2022, at Valley Shield COVID-19 Testing in Phoenix.
·10 min read

The omicron variant is good at evading vaccines, so even if you've been vaccinated and boosted, there's still a chance you'll test positive for COVID-19.

And now that omicron appears to be the dominant variant of the COVID-19 virus in Arizona, the risk of infection has increased significantly here.

"I would make the assumption that if someone was on the elevator before you and left and they had COVID-19, it's still floating around in the air in there," said Dr. Joshua LaBaer, executive director of Arizona State University's Biodesign Institute, during a Wednesday briefing. "And you are going to go in, and possibly get it."

The number of positive COVID-19 cases reported by the Arizona Department of Health Services was 10,679 on Thursday, which is nearly double the 5,687 cases reported one week prior.

Also, the reported cases are likely an undercount because of an increase in at-home tests that may not get reported to public health, and difficulties some people are having finding a COVID-19 test.

The number of people with suspected and confirmed COVID-19 seeking care at emergency rooms in Arizona spiked Wednesday to a pandemic record-high 2,371. The previous Arizona record was set more than a year ago: 2,341 visits on Dec. 29, 2020.

Public health officials say the best protection against hospitalization and death from omicron is to get a full COVID-19 vaccine series plus a booster shot, but it may not protect you from getting infected.

Data from South Africa and the U.K. shows that vaccine effectiveness against infection for two doses of a mRNA vaccine is approximately 35%, according to the Centers for Disease Control and Prevention. The early data indicates COVID-19 vaccine booster dose restores vaccine effectiveness against infection to 75%, the centers say.

It's unclear whether getting infected with the omicron variant while fully vaccinated and boosted will still put people at risk of a host of prolonged COVID-19 health problems often called Long COVID.

It's also unclear whether the omicron surge might spike severe COVID-19 illness in Arizona, given reports that it causes milder illness than prior variants. As of Thursday, hospitalizations of people in Arizona with confirmed or suspected COVID-19 had increased for five consecutive days.

Any small decrease in virulence likely will be offset by the large increase in caseload that's predicted, LaBaer said.

People who are immunocompromised, elderly, frail or not fully vaccinated and boosted are at particularly high risk.

In the United Kingdom, for example, there has been a dramatic rise in cases and hospitalizations, LaBaer said.

"Keep in mind that in the United Kingdom over 90% of people have been vaccinated and over 60% in the U.K. have had a booster," he said.

"So despite the fact that they are more vaccinated than we are here in Arizona and the fact that they have more booster shots than we do in Arizona, they're still seeing a rapid rise in hospitalization there. And that is likely something that could happen here and we should pay attention to."

Symptoms or not, there are steps you will need to take if you test positive for COVID-19 at this point in the pandemic that are critical to protecting yourself, your loved ones and the community at large.

Here's are seven things Arizonans need to know about testing positive:

Isolate for at least five days if you don't have any symptoms

Guidance from the CDC is coming so fast lately, it's hard to keep up.

The latest recommendations call for a shortened isolation period of five days (shortened from 10 days) when individuals who test positive yet develop no symptoms, followed by five days of wearing a mask when around others. The five days for asymptomatic people who test positive counts day one as the day of the positive test.

The guidance advises avoiding people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days.

Some medical groups and health providers have criticized the CDC's decision to shorten isolation and say it would be safer if individuals wait until they have a negative test to end isolation after testing positive.

"Reemerging without knowing one’s status unnecessarily risks further transmission of the virus," American Medical Association President Gerald E. Harmon said in a Jan. 5 statement.

Those exposed to COVID-19 who are fully vaccinated and boosted don't need to quarantine, the CDC says

The CDC also updated its quarantine guidance for people who were exposed to COVID-19.

Individuals who have received their booster shot do not need to quarantine following an exposure, but should wear a mask for 10 days after the exposure, the CDC says.

Isolation refers to behavior after a confirmed infection, whereas quarantine refers to the time following exposure to the virus or close contact with someone known to have COVID-19.

For people who are unvaccinated or are more than six months out from their second mRNA dose or more than 2 months after the Johnson & Johnson vaccine and not yet boosted, the CDC recommends quarantining for five days followed by mask use for an additional five days.

Alternatively, if a five-day quarantine is not feasible, it is imperative that an exposed person wear a well-fitting mask at all times when around others for 10 days after exposure, according to the updated guidance.

If you do have symptoms, isolate for at least five days, and avoid travel for 10

To calculate your five-day isolation period, day zero is your first day of symptoms and day one is the first full day after your symptoms developed. You can leave isolation after five full days if you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved, according to the latest guidance.

Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation​, the CDC says.

You should continue to wear a well-fitting mask around others at home and in public for five additional days (day six through day 10), and after the end of the five-day isolation period.

If you are unable to wear a mask when around others, you should continue to isolate for a full 10 days. Avoid people who are immunocompromised or at high risk for severe disease, and nursing homes and other high-risk settings, until after at least 10 days.

Do not go to places where you are unable to wear a mask, such as restaurants and some gyms, and avoid eating around others at home and at work until a full 10 days after your first day of symptoms. Also, avoid travel until a full 10 days after your first day of symptoms.

If you are severely immunocompromised, public health officials advise isolating at home up to 20 days from when symptoms first started.

The CDC's updated guidance is here: https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html#_Ending_isolation_for

The Maricopa County Health Department has an online tool for figuring out what you should do if you test positive. Find it here: https://maricopasneb.co1.qualtrics.com/jfe/form/SV_3wLf31Anb2yNAUZ.

Maricopa County residents may call the Maricopa CARES line at 602-506-6767.

Call the Arizona Department of Health Services' bilingual COVID-19 hotline at 844-542-8201 from 8 a.m. to 5 p.m. seven days a week. Select Option 8 to speak with a navigator.

If you test positive after an at-home test, report your case

To best assist public health officials with surveillance, report positive COVID-19 tests taken at home. Reports may be made to your primary care provider, who should report the case to public health.

If you do not have a primary care provider, Maricopa County residents may call 602-506-6767 to report a positive test. If you are a K-12 student or staff member, you also should report your positive result to your school.

The Pima County Health Department has an online form for reporting positive at-home tests: https://webcms.pima.gov/cms/One.aspx?pageId=787398

Pima County residents can call 520-724-7147 to report a positive at-home test.

If you need medical attention, consider alternatives to an emergency room

Emergency room care is for life-threatening health issues such as strokes, heart attacks, severe bleeding, severe breathing problems, severe trauma, loss of consciousness and severe allergic reactions.

Alternatives such as urgent care, primary care and virtual visits may be sufficient to take care of many health needs.

Consider urgent care if you need immediate attention for issues such as simple fractures and sprains, coughs, minor infections, cuts, sinus infections and urinary tract infections.

A primary care doctor's visit is likely to have the lowest out-of-pocket cost, while an emergency room visit usually has the highest co-payment, and often a longer wait than an urgent care or a primary care doctor's visit.

Phoenix-based Banner Health has a chart to help gauge whether you need primary care, emergency care or urgent care here: https://www.bannerhealth.com/healthcareblog/teach-me/urgent-care-emergency-room-or-doctors-office

Act quickly if you are a candidate for monoclonal antibodies

While they are not a substitute for vaccination, monoclonal antibody treatments have been an important weapon in Arizona's fight against overcrowded hospitals because they have proven effective in preventing severe illness and death from COVID-19.

Monoclonal antibodies are available across Arizona to certain patients who have tested positive for COVID-19, and early evidence shows the treatment nips COVID-19 in the bud if caught in time, blocking the virus from replicating and turning into severe illness.

The key is getting the infusions soon after symptoms begin.

Three different monoclonal antibody treatments have received emergency use authorization from the U.S. Food and Drug Administration. Two have shown reduced effectiveness against the omicron variant and one — sotrovimab — has shown effectiveness against omicron.

However, the supply of sotromivab has been low nationwide in recent weeks.

Phoenix-based Banner Health, which is Arizona's largest health care system, resumed its use of sotrovimab this week after a pause caused by the limited supply, spokesperson David Lozano wrote in an email.

"There is a limited supply of this medication and it’s only being administered at a few Banner Arizona locations at this time," he wrote. "If patients are interested in receiving this treatment, they should contact their primary care doctor or schedule a telehealth appointment with Banner Urgent Care to obtain a referral."

Based on limited supplies, not all eligible patients may receive the treatment, Lozano wrote, "which is why we continue to urge people to get vaccinated or get their booster shot if they have not done so already."

More information about monoclonal antibody treatments in Arizona is available from the state health department. For a list of providers go to https://www.azdhs.gov/covid19/index.php#mabs-find-treatment

Talk to your health provider about other COVID-19 treatments

Pfizer's new pill, Paxlovid, is the first oral antiviral for COVID-19 symptoms that has received a federal emergency authorization. It has shown effectiveness in preventing the progression of illness in people who have tested positive for COVID-19.

Arizona's Vaccine and Antiviral Prioritization Advisory Committee was scheduled to meet Friday to make a formal recommendation on who should be prioritized to get the initial limited supply of Paxlovid in Arizona. State health officials have said they want to prioritize the drug for those most vulnerable to severe outcomes from COVID-19.

Like monoclonal antibodies, Paxlovid could be an important tool in preventing COVID-19 hospitalizations and death in certain patients.

The FDA says Paxlovid should be initiated as soon as possible after a COVID-19 diagnosis and within five days of the onset of symptoms. The pill is not authorized for pre-exposure prevention, federal officials say.

People hospitalized with COVID-19 in Arizona are being treated with various therapies depending on their condition and the severity of their case.

Banner Health, for example, at various times uses the arthritis drug tocilizumab and also uses steroids and remdesivir to treat hospitalized COVID-19 patients.

Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes

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This article originally appeared on Arizona Republic: Omicron variant: What to do if you test positive for COVID-19

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