*By: Dr. Pashko R. Camaj, Doctor of Public Health Sciences-
Eight months after the initial outbreak, in many places across the country and the world, cases of Covid-19 are on the rise and many questions remain unanswered. A friend of my recently tested positive for Covid-19 and after couple of weeks of moderate symptomology, she was tested again, and the results were still positive. Having senesced a tone of despair, I proceeded to explain that a positive test is not uncommon even after the symptoms improve. What happens after a positive test – and with no known cure and no vaccine yet, what to expect next – are some of the questions I will try to answer in this essay.
We have learned that finding trusted answers amid the widespread coverage of questionable claims and dubious data on treatments is not easy. The good news is there are clearer guidelines on how to better protect ourselves. In addition, we have seen significant improvement in effective treatments that have had a dramatic effect on Covid-19. Here is a snapshot of how this knowledge and guidance is likely to apply to anyone who has been tested positive with Covid-19 infection.
Testing positive-a daunting development: If you test positive, you must self-isolate at home. The public health service will contact you with advice and information about how long you will need to do so. If you are like most people with Covid-19, you will not need to go to a clinic or hospital and can safely self-manage the illness at home. Initially, you may experience flu-like symptoms such as cough, sore throat, fever, aches, pains, and headache. You might temporarily lose your sense of smell and taste; less common symptoms include nausea, vomiting and diarrhea. Whatever your symptoms, you will need plenty of rest, fluids and paracetamol for aches, pains, or fever. Take particular note of how you’re feeling from day five onwards, as this is the time some people begin to deteriorate significantly. Around 20% of people fall into this category, with older people and those with pre-existing health conditions more likely to require hospitalization.
How long are we contagious: A person with Covid-19 may be contagious 48 to 72 hours before starting to experience symptoms. In fact, we have learned that people without symptoms may be more likely to spread the illness, because they are unlikely to be isolating and may not adopt behaviors designed to prevent spread. People are thought to be most contagious early in the course of their illness, when they are beginning to experience symptoms, especially if they are coughing and sneezing. It is important to note that for some people it may take some time for the test to turn negative. Some people test negative within 10 days of becoming ill. Others experience a longer period of illness. Some people continue to test positive for weeks, and less commonly; even longer. In fact, about 30% to 40% of people will still test positive for several weeks after the symptoms have eased, but that does not mean we are contagious that entire time. This virus tends to be infective during the first seven to eight days after the onset of the infection. That is the reason people are supposed to quarantine for about 10-12 days if they have tested positive. A positive test after this period shows that we still have the virus, but it is not likely they could infect other people.
The most recent Centers for Disease Control guidance states that someone who has had Covid-19 can discontinue isolation once they have met the following criteria:
- It has been more than 10 days since symptoms began.
- Fever-free for more than 24 hours without the use of fever-reducing medications.
- Other symptoms have improved.
Recovery: Recovering from Covid-19 depends on many factors, including previous health and fitness, and the severity of the disease. The recovery phase is not yet fully understood, but we do know some people suffer prolonged symptoms, including fatigue, breathlessness, and joint and chest pains. As scientists continue to grapple with the complexities of understanding and treating this virus, we will have more questions than answers for some time yet. The time it takes to fully recover, and test negative appears to vary depending on the person, as well as their severity of illness. Most people who are infected with the virus produce antibodies, which are proteins that make it harder for the virus to infect cells. But antibodies are only one part of the body’s immune response. T-cells, for example, can destroy cells that are already infected-this way they do not continue to be a ‘factory’ for new viruses. And memory B-cells can quickly generate a strong antibody response to a virus the body has encountered before. We still cannot make any generalizations on how long that immune response may last.
Report on Vaccine: We know that several Covid-19 vaccine candidates have been in the final phase of clinical trials, and there is enthusiasm about the innovative and sophisticated technologies being used to develop a pandemic-changing vaccine. Vast investments have been made in developing safe and effective vaccines. The question “will we have a Covid-19 vaccine” has been replaced with “when” will we have it? Public health officials and scientists around the world are getting closer to providing an answer to that question-as the world waits for an effective and a safe vaccine that will soon start to change the course of this global pandemic. In the meantime, practicing a good hygiene and social distancing, using face covers such as surgical face masks, N95 respirators and even home-made face coverings can help lower the risk of spreading the virus or becoming infected and keeping you healthy.
**Vice-President of Pan-Albanian Federation of America -VATRA