Experts aren't quite sure what's in store for us this cold, flu and COVID season. But with a new flu variant beginning to spread in the U.S. and low COVID vaccination rates, this may be a more severe season than we've seen in recent years.
So how exactly are infectious disease experts thinking about COVID isolation after a positive test result these days? Some things have changed since early in the pandemic, they tell TODAY.com, but the basic guidelines remain the same.
Assuming you followed the instructions and took a rapid COVID test correctly, you should trust a positive result, Dr. Richard Martinello, professor of internal medicine and pediatric infectious diseases at the Yale School of Medicine, tells TODAY.com
After that, you should take some common sense precautions to help your body recover and keep those around you safe.
Previously, the most recent guidance from public health experts and organizations was to isolate -- meaning stay away from others as much as possible -- for five full days. That was followed by five days of returning to whatever normal activities you felt up to performing while taking additional precautions (like wearing a mask) around others.
And, generally, that's still good advice, Martinello says.
But when it comes to specific timing, the thinking "has sort of evolved, given that people are testing less, there's more immunity in the general population and we're not seeing the same kind of severe disease that we did before," Dr. Geeta Sood, an assistant professor of medicine and hospital epidemiologist at Johns Hopkins Bayview Medical Center, tells TODAY.com.
In hospitals and health systems these days, there's an effort "to standardize all respiratory viruses so they are similar in isolation (timing)," she explains.
But we can be contagious for up to five days before noticeable COVID symptoms develop, Martinello points out. And some people may test positive for COVID but never develop symptoms, or only ever have a fever. And our understanding of contagiousness "is very incomplete" when it comes to many other respiratory viruses, he notes.
That's why, for any illness, "it's always a good idea to keep yourself away from others if you feel sick," Martinello says.
And when it comes to COVID, "for up to five days, you should try to stay away from others as best you can," he says. If you're able, it's best to sleep in a room by yourself and use your own bathroom. Improving the ventilation where you're living, such as using HEPA filters, can also be helpful, he adds.
And, if you need to be around others while sick, while masks don't work perfectly, "we confidently know that they do provide some benefit," Martinello says.
When you can return to work and other normal life activities depends on how long you've spent recovering and how you feel. But the most important sign is whether or not you still have a fever.
As the Centers for Disease Control and Prevention note, you can start to return to your usual routine when, for at least 24 hours, your symptoms are getting better overall and you have not had a fever (without the use of fever-reducing medications).
After that, "most people recommend wearing a mask or having some sort of protective isolation for about five to seven days," Sood says. The CDC still recommends taking additional precautions, such as wearing a mask and prioritizing good ventilation, for an additional five days to help prevent transmission to others.
At one point during the height of the pandemic, some people opted for a "test to leave" strategy, meaning they would only leave isolation (or possibly leave isolation early) when they got a negative result on a rapid COVID test.
These days, that's no longer required.
"Testing in a serial manner to determine when you're no longer contagious has fallen out of favor a little bit," Martinello says, "and some of it is because our access to testing is not what it used to be."
So, if you want to keep testing to get a fuller picture of your possible level of contagiousness, you absolutely can. But know that tests are less available than they were previously. And waiting long enough -- especially if your fever has resolved -- means the risk of transmission is very low.
"For most people, the practical advice is to count the number of days rather than to retest," Martinello says.
Taking additional precautions, such as masking, when you return to work or school will also help reduce the likelihood of transmission.
If you're not feeling better after a few weeks or you're starting to feel even worse, you should get in touch with your doctor.
That's especially true if you have risk factors that make it more likely you'll develop severe COVID symptoms or you have specific symptoms, such as difficulty breathing or chest pain, which could indicate a medical emergency.
There's also evidence that a COVID-19 infection raises your risk for blood clots, which may cause swelling, pain, redness and warmth typically in just one limb. You should seek medical attention if you have symptoms like these.
It's normal for some COVID symptoms to last longer than others. But if you've fully recovered from the infection and, months later, still have issues such as brain fog, fatigue, chronic pain, rapid heartbeat or dizziness, those are signs you may actually have long COVID, a chronic condition that experts are still working to understand.