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Insight

So yet again we find ourselves in the middle of a COVID-19 wave

Photo by Yoav Aziz on Unsplash

Aug 4, 2023, 07:19

So yet again we find ourselves in the middle of a COVID-19 wave

So yet again we find ourselves in the middle of a COVID-19 wave. Again. If this summer follows the previous three, we should expect ~10-15% of Americans and maybe slightly fewer Europeans to get infected:

False negatives at the beginning of infection are very common, thanks to the virus mutating. In a recent study, antigen and PCR tests only agreed 47-58% of the time. If they did agree, there was a 1-8 day delay between a PCR turning positive and an antigen test turning positive:

https://journals.asm.org/doi/10.1128/spectrum.01295-23

The higher we are in a wave, the more sceptical you should be of a negative result. There are two things you can do to help reduce scepticism (i.e., false negatives):

Swab throat and saliva. These are positive days before the nose.
Repeat testing. Two tests within 48 hours catch 92% of symptomatic cases and 39% of asymptomatic cases. Three tests 48 hours apart detected 94% of symptomatic and 57% of asymptomatic patients.

If you get a positive…Positives are positives. You’re infectious.

The faintness of a line provides clues, though:

Very bold line = you’re very contagious.
Barely see the line = you’re at the beginning or the end of your infection window.

I wouldn’t bother. Wastewater is where it’s at these days, and, fortunately, that doesn’t require you to do anything different.

Isolate for five days, at minimum.

When is Day 0? The first day of symptoms (not the day you get a positive test).
When do we leave isolation? Technically the CDC says Day 5. But 2 out of 3 people will still be infectious. It’s best to stay in isolation until you have a negative antigen test.
Where was I infected? Wherever you were ~48 hours before symptoms started.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00226-0/fulltext

A recent study found only 1 in 4 nursing home residents with COVID-19 were prescribed an antiviral. This isn’t very many:

https://jamanetwork.com/journals/jama/article-abstract/2807529

How long will I have symptoms? ~6-12 days. Maybe longer, maybe shorter. It depends on a lot of individual factors. But having symptoms doesn’t necessarily mean you’re infectious. A great way to know is to test to exit (if negative, you’re clear).
Pink eye with kids? According to the American Academy of Ophthalmology, the newer subvariants of COVID-19 are responsible for some cases of pink eye. In a small study in China, 25% of children aged 2-11 had pink eye during COVID-19 infection. Among adults, it’s much lower rates (1-2% of cases have pink eye).

Should I wear a mask?

In your house: Masks work. A recent study found that if the index case (i.e., infected person) was masked at home, household transmission was reduced by 67%. Not sharing a bedroom reduced risk by 78%.
Going outside. You don’t need to wear a mask to walk your dog.

Does this mean I’m in the clear for winter? Maybe. Data from the UK shows that, on average, people get 1-2 infections yearly. You’ll have good protection going into the fall respiratory season. (I would delay a fall booster by at least six months; more on this later).

I’ve never had an infection. Do I have superpowers? Maybe. Or, perhaps, an infection went undetected. Scientists recently discovered that if you have two copies of a specific gene (HLA-B*15:01), you are 8x more likely to remain asymptomatic. Unfortunately, there’s no way for the average person to know. So, harm reduction is still the name of the game: