I tested positive for COVID. Do I have to tell people? How do I tell them?
Count me in. I’m one of the nearly 2 million Americans who tested positive for COVID-19 over the holidays even though I had both vaccine shots and the booster. Fortunately, I had no symptoms. Like so many others, I was completely shocked to read my test result and felt kind of ashamed. (I swear I had been vigilant and I had no idea how I’d become infected!) When the shocking news arrived, I had been on my way to finish my gift shopping before getting on a plane the next day to see family.
Do I really have to tell people? I wondered to myself. Honestly, I really didn’t want to spend the holidays alone, again.
Several friends who’ve tested positive had come up with various reasons for thinking it would be OK to keep mum on their infection: The omicron variant appears to be less virulent than earlier strains, meaning most people who get it won’t require hospitalization – or worse, die. The test result may be a false positive. Or, as one neighbor argued, “What about my right to privacy?”
The rapid-fire spread of the omicron variant has magnified our great national debate about individual liberty versus the greater good. But, as I knew, and then had affirmed by two medical ethicists, I had an obligation to tell others whom I might have put at risk.
Quarantining for the good of all
I texted my family. And then I made a list of everyone I knew that I had been in close contact with (which the Centers for Disease Control and Prevention defines as being less than 6 feet away for 15 minutes over a 24-hour period). I called those friends I knew to be infrequent email users, and then sent individual emails to about a dozen others.
One friend quickly wrote back, “You’re so courageous.” Another, “That’s integrity.” Honestly, I didn’t feel courageous or virtuous; I felt disappointed and sad. But I did what I hoped others would do in my shoes, which is to disclose their infection to those with a need to know, and to quarantine. That might mean canceling a vacation, taking time off from work, skipping a wedding or, as in my case, missing the holidays with family.
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Amy McGuire, director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine, insists that “we all must give up some individual liberties, including our privacy, for the benefit of the community … so that others can take precautionary measures to protect themselves and their loved ones.”
If you don’t tell the people you may have unwittingly infected, how can they in turn protect themselves and their own loved ones? That’s the very definition of the common good, and it’s what we mean when I say we’re all in this together.
Exposing others to the virus can have drastic consequences. For example, seven deaths in an Oregon community in late December 2020 were traced to someone who knowingly went to work after becoming infected, spreading the virus to his co-workers. Whatever that worker’s reasons – denial, hubris, lack of paid sick time – there is no excuse for such irresponsibility. Not having symptoms does not give you any cover, as was true in my situation, because you can develop them later (or never) but still infect others.
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The high transmissibility of the omicron variant makes it more critical, not less, to disclose infection. Arthur Caplan, professor of medical ethics at New York University, acknowledges that we don’t yet know how “nasty,” as he put it, omicron could be for the general population. But for those who are immune compromised, he says, “it just ups the ante on disclosure.” Ditto for those who are elderly, who are too young to be vaccinated, or who have any health condition that makes them more susceptible to infection.
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What about our privacy? I asked Caplan.
He says there’s no reason to disclose having high blood pressure or cancer, but contagious diseases are different. The duty to tell others about an infection has long been recognized, both legally and ethically. Think HIV, tuberculosis, mumps and measles. This is not about stigmatization, Caplan says. There’s no reason to paint a big “O” (for omicron) on your forehead. (Thank goodness.)
I know these decisions can be complicated, and I wondered – worried – about folks who can’t afford to stay home during a quarantine period. Yes, it might be tempting to keep quiet about a positive test, especially if you don’t have symptoms, if telling your employer translates into lost pay. I spoke with a CEO of a small business in Lexington, Kentucky, and she told me they’ve just come up with a solution: If an employee is vaccinated and still gets COVID-19, that person will get paid for lost days. If someone who is not vaccinated gets sick, the answer is no.
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While still in “COVID jail,” I was out walking my dog – permissible during quarantine as long as you’re masked, which I was – when a neighbor asked whether I were still in my isolation period. (Word traveled quickly in my town.) She thanked me for doing the right thing, even though there are no COVID police watching over us.
As Baylor’s McGuire told me, “We need to embrace an ethic of solidarity, which means to care for each other and about each other, now more than ever.”
As a postscript I’ll add this: On Christmas Day, my next door neighbors, whom I’d told I had COVID, invited me to have dinner with them, with me seated at the other end of their wide front porch, mask up except for eating and drinking. Not for a moment did I feel alone. In fact I felt loved. And the night before, our family had our Christmas Eve dinner together – on Zoom. The only downside? I missed my sister’s version of my late mom’s roast beef and Yorkshire pudding.
COVID-19 etiquette recap
Get tested: If you are going to a gathering that includes babies, the elderly and anyone with a health condition that increases their risk, volunteer first to get a rapid antigen or PCR test.
Disclose: If you test positive or have a known COVID-19 exposure, you must tell others with whom you’ve been in close contact. No ands, ifs or buts.
Stop the spread: That information will help others make informed decisions, get tested themselves and prevent the continued spread of this virus. And that will help us all find a new normal sooner – than later.
Steven Petrow, a writer on civility and manners and a member of USA TODAY's Board of Contributors, is the author of five etiquette books, including "Stupid Things I Won't Do When I Get Old." Follow him on Twitter: @stevenpetrow
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This article originally appeared on USA TODAY: Testing COVID positive: Do you disclose exposing someone to omicron?