If you’re experiencing the early signs and symptoms of a respiratory infection (fever, cough, sore throat, congestion, even abdominal pain or diarrhea), it might be a good time to get a Covid test, local doctors say.
Although numbers have declined significantly since the early days of the pandemic, Covid cases are on the rise in western Pennsylvania.
In Allegheny County, the number of reported cases has been on the rise since June 9, when 132 cases were recorded. The last week of June saw a total of 218 cases in the county, which is likely just the tip of the iceberg, as most cases are tested at home and are not always reported.
According to state data, COVID-19-related emergency room visits are still in the minimum range, but increased 22% for the week ending July 6, according to CDC data. Westmoreland County figures are not available because the county does not have a health department.
The CDC’s official COVID-19 protocols have changed this year. People are officially allowed to return to work or school if they have been fever-free for 24 hours without medication and their symptoms are mild and improving. The CDC also recommends wearing a mask and staying away from others for five days to help stop the spread of the virus.
Knowing if you have COVID can help you avoid contact with people at high risk, said Dr. Donald Yealy, UPMC’s chief medical officer.
“We know that COVID is a very dangerous infection for people of advanced age, particularly older people, and those whose underlying immune systems are not working as well or who have underlying health conditions,” he said. “It’s important to know that so you can change your behavior, whether that’s staying away from people or wearing a mask.”
Many health care professionals are still following stricter Covid protocols of staying home for five days after a positive test and wearing a mask for five days after that, said Dr. Amy Crawford-Faucher, a family physician and vice president of AHN’s Primary Care Institute.
“That means minimizing contact with people you live with and refraining from work and other social gatherings for five days,” she said. “Basically, stay away from people until you feel better. If you’re around high-risk people who live or work with you, the best thing you can do to prevent spread is wear a mask and minimize contact.”
“This may seem excessive to the general public, but of course it makes sense that we should be more cautious in the health sector.”
What is the best way to test?
It is advisable to take a rapid Covid-19 home test if you are experiencing symptoms. Doctors advise that these tests are not perfect, so it is best to take multiple tests over several days.
“If you have symptoms and you test negative, you need to repeat that test in 48 hours because you may not have had enough virus in your nose when you first got tested,” said Dr. Carol Fox, chief medical officer of Independence Health System.
Tests can sometimes show a positive result long after you’re no longer contagious, Yealy said.
“Their advantage is that they are readily available and can provide good insight into what you can do next,” Yealy said. “A good test that is readily available is sometimes more useful for the general population than a perfect test that is difficult to obtain.”
If you can’t figure out the first day of your symptoms, you can use the first day you tested positive, Crawford-Faucher said.
“No matter what you have, if it’s a respiratory illness, it’s going to be contagious,” she said. “The most caring thing you can do for your loved ones and the people you work with is to minimize contact if you feel sick.”
Dr. Amesh Adalja, a senior scholar at the Pittsburgh-based Johns Hopkins Center for Health Security, said home testing is still useful even for new COVID variants. It’s best to use a recent test, but an expired test showing a positive result is still a good indication of COVID. False negatives are more likely than false positives, he said.
“The variant has no impact on whether the test is positive or negative,” he said. “Home tests are useful for people who want to know their status and for people who want to be linked to drugs like Paxlovid.”
Testing — whether it’s an at-home test or a PCR test done at a pharmacy or doctor’s office — can be important if a person is at high risk and is eligible for the treatment Paxlovid, which slows the replication of the virus in your body.
Other factors that make a person a candidate for Paxlovid include being overweight, being over 50 and having chronic illness, Crawford-Faucher said, but the range may be broad as to who would benefit.
“If someone is 80, I’m going to recommend that they take Paxlovid. We know that the data in that group is very good in terms of preventing hospitalizations and deaths,” she said. “If you’re 55 and healthy and have a mild case, I think it’s more of a personal preference.”
It is difficult to know what the impacts or risks of repeat infections are, and what makes a person more likely to be infected multiple times compared to someone who has been infected once or not at all.
“There’s still a lot we don’t know about the risks of developing long COVID, except that we know that never having been vaccinated seems to increase the risk of long COVID,” Crawford-Faucher said. “We still have a lot to learn about this virus, including why some people get reinfection and not others.”
Getting vaccinated or getting vaccinated
On June 27, the CDC recommended that people get vaccinated against COVID-19 starting this fall. Updated vaccines will be available from Moderna, Novavax and Pfizer later this year, the agency said.
Most people at this point have either had COVID at least once or received some dose of vaccination, or both, Crawford-Faucher said. Updating the vaccine to accommodate current variants offers additional protection.
“The role of vaccines has always been to minimize the risk of severe infection and death,” Crawford-Faucher said. “People are still dying from COVID. Not with the numbers we saw in 2021, but it’s still happening.”
Vaccination may not prevent all infections, but it helps make them less severe.
“It’s not a force field that protects you from coming into contact with the virus,” Yealy added. “It just means that when you do come into contact, you put up a better fight.”
Some people may have had Covid and not known it, Adalja said.
“Some people may have very mild disease and not realize it, and others may not have any symptoms,” he said. “You only know someone has been exposed to the virus by looking at specific antibodies, and most people don’t do those tests.”
People with COVID-19 still show up at the hospital, Fox said.
“When people come to visit us and come for care, we ask them if they have respiratory symptoms. (…) If they say they have respiratory symptoms, we want to separate them from other people,” she said. “We don’t do routine testing, but if people have respiratory symptoms, if you show up in the emergency room with respiratory symptoms, covid is in the differential diagnosis.”
Julia Maruca is a TribLive reporter covering health and the Greensburg and Hempfield areas. She joined TribLive in 2022 after working at the Butler Eagle covering southwest Butler County. She can be reached at jmaruca@triblive.com.