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What happens after a positive COVID-19 test?

So, you live in the St. Louis metro area and you’ve just been tested for COVID-19. What happens now? Who’ll give you the test results? What if you test positive? What should you do?

Following are answers to these and other COVID-19-related questions, provided by Washington University infectious disease physician Hilary Babcock, MD, medical director of infection prevention for BJC HealthCare.

Q: Who will contact me about my test results?

A: You should be notified by whoever performed the test, either your physician, the lab or the urgent care center where the test was ordered. Whoever arranges the test should tell you at the time of testing when and how you will be notified of your test results.

Q: What if I test positive for COVID-19?

A: After receiving the test results from your testing center, if you test positive for COVID-19, you should be contacted by your local department of health. This could take a few days, however, because results are reported by the labs to the state and the state then forwards the results to local health departments. This is one of the reasons it is very important to self-quarantine while you await your results.

Q: Why does the department of health contact me?

A: It’s primarily for contact tracing to stop the spread of the virus to others in the community. The health department will ask you about your illness, where you might have caught it and any possible exposure from you to other people. You’ll be asked to name those you’ve been in contact with in the 48-hour period prior to the start of your symptoms — or, if you’re asymptomatic, in the 48 hours before your test was performed. It’s important to be very forthcoming with that information. The department will contact those individuals, let them know that they might have been exposed to the virus, assess them for symptoms, and advise them to get tested and to stay home until it’s known for sure whether they’re going to get sick or not. Discussions with health department staff are confidential. Your personal and medical information will be kept private and only shared with those who may need to know, like your health care provider. Your name will not be shared with those you came in contact with, even if they ask. The health department will only notify people you were recently around that they might have been exposed to COVID-19.

Q: Do I need to notify anyone of my illness?

A: The health department will notify everyone you tell them you’ve been in contact with. But, since it can take a few days to do that, you could tell people you feel comfortable informing that you tested positive for COVID-19, and were in contact with them in the 48 hours prior to the start of your symptoms — or, if you’re asymptomatic, in the 48 hours before your positive test. Advise them to stay home, and let them know they should be hearing from the health department.

Q: How long will I need to self-quarantine?

A: If you test positive, you will be told to stay home. That’s called isolation. You will need to isolate yourself at home until you’re cleared by the health department. Most people can recover and be cleared within 10 to 14 days. The health department will call you back and ask you about your fever and other symptoms. If it’s been at least 10 days since your symptoms started, and you haven’t had a fever for at least 24 hours, the health department usually can release you from isolation at home. But you need to wait until the health department gives you the official release from isolation, usually in the form of a letter.

Q: What’s the difference between quarantine and isolation?

A: The term “quarantine” is used for people who have been exposed but it’s not yet known whether they are infected or are going to be infected. So, after you’re notified of an exposure, you need to quarantine at home for at least 14 days from the date of your last contact with the infected person. The term “isolation” is used for people who have COVID-19. People with COVID-19 need to isolate at home to avoid spreading the virus to others. If you live with someone who has COVID-19, you stay on quarantine while the infected person you live with stays home on isolation. Once that person is released from isolation, you will probably have another 14 days of quarantine to make sure that you didn’t acquire the virus from that person on his or her last day of being infectious.

Q: What symptoms would indicate a need for hospitalization?

A: A lot of people with COVID-19 have mild symptoms that don’t require going to the hospital. Such symptoms could include a cough, fever, chills, muscle aches, soreness and, in some cases, losing your sense of smell or taste. All of these are fairly common. As long as you feel like you’re breathing comfortably, then you’re probably OK managing your illness at home. But, if you start experiencing shortness of breath or significant chest pain, or, if your illness seems to be getting progressively worse, call your doctor or head to the emergency room. And, if you do call an ambulance or go to the emergency room, be sure the first thing you say is, “I tested positive for COVID-19.” That helps protect other people in the waiting area and the people who will be taking care of you. Q: What are some of the lasting effects of COVID-19?

A: We’re still learning about lasting or persistent effects from COVID-19. There have been reports of heart damage to those who have recovered from COVID-19. Some studies have shown changes in the brain as well, with people reporting persistent headaches, decreased memory, confusion and what some call “brain fog” after COVID-19 infection. This virus has been circulating for less than a year, though, so it’s hard to know about long-term effects. We don’t know yet whether these issues will eventually resolve or whether they may be long-lasting. Q: If I’ve already had the coronavirus, will I need to get the COVID-19 vaccine once it’s available?

A: For those who have already had the COVID-19 infection, the vaccine will probably still provide benefit, even though there have been only a few documented cases of reinfection worldwide. Q: How about the flu vaccine?

A: Everyone should get the flu vaccine every single year — whether you’ve had COVID-19, whether you’ve had the flu, regardless of almost anything else. And this year is no different. Get a flu vaccine. It will be very helpful because it’s hard to sort out, based on symptoms alone, whether someone might have flu or might have COVID-19. So the fewer people who have flu in the community, the less we have to worry about sorting out who has influenza and who has COVID-19. It’s also important to control the flu this year to manage health care resources that are already busy managing patients with COVID-19.

Q: After I recover from COVID-19 should I donate plasma?

A: It would be great for people who have recovered from COVID-19 to donate plasma. We don’t have enough plasma to treat everyone who might be eligible for treatment. We’re still gathering information about how useful that treatment is and who it’s the most useful for, but it probably does have benefit for some patients. Anyone who has recovered can donate through the American Red Cross Greater St. Louis Chapter. There’s information online or you can call 314-516-2800.

Q: Is there anything else that’s important for people to know?

A: It’s always worth reiterating — we really need to keep ourselves and everyone around us safe. And the best ways to do that are to minimize our contact with other people, wear a mask whenever we plan to be around other people, and keep a distance of at least 6 feet between ourselves and others to minimize the risk of transmission.

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