A woman uses a COVID-19 test.Share on Pinterest
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  • As mask mandates end, many people may be confused about when to mask up and stay home.
  • This may especially be true for people who have tested positive for COVID-19 but don’t have symptoms.
  • The CDC recommends people isolate themselves for at least five days if they test positive for COVID-19.

As mask mandates end, figuring out what to do if you have a case of COVID-19 but no symptoms has been confusing for many in the U.S.

In California, officials recently lifted the five-day quarantine requirement for asymptomatic people who were exposed to COVID-19. But certain localities in the state have already announced they’ll continue following the current Centers for Disease Control and Prevention (CDC) guidelines. The CDC recommends staying at home in quarantine for at least five days whether or not you have symptoms.

Anyone who tests positive for COVID-19 should isolate at home for at least five full days and then test to see if they are still infectious.

William Holubek, MD, Chief Medical Officer at University Hospital in New Jersey, insisted that states, agencies, and industries with different masking and quarantine rules only cause confusion.

He explained that the mission of the CDC is to protect America from health threats by fighting disease and supporting communities and citizens to do the same.

“The CDC still recommends isolation for any individual who tests positive for COVID-19, whether they have symptoms or not,” he said. “For the health, protection, and well-being of our friends, family, and community, we should continue to follow these recommendations.

“When we don’t have a unified approach to a global pandemic, it is difficult to understand why things go wrong when they do,” noted Holubek.

Robert Lahita, MD, director of the Institute for Autoimmune and Rheumatic Disease at St. Joseph’s Health, said, ideally, you should stay home until symptoms are gone.

“Then, I would recommend they [isolate] for an additional five days,” he advised.

“That was what we did in 2020 and 2021, you were positive, and if you didn’t wind up in the hospital, and your fever abated, you stayed home for an additional five days, and you wore a mask wherever you went,” he continued.

If you interact with someone who has COVID-19, whether or not you need to quarantine depends on your vaccination status.

Current CDC guidelines specify that people who are not vaccinated and are exposed to the virus should stay home, quarantine for at least five full days, and test on day five.

But if you are vaccinated, you can avoid quarantine and just monitor yourself for symptoms.

“As a nurse scientist, I ascribe to the CDC’s guidelines of quarantine for five days after exposure to someone with COVID if you are unvaccinated,” said Catherine Curley, PhD, RN, Interim Director, Center for Global and Public Health, and Clinical Assistant Professor at the Fitzpatrick College of Nursing at Villanova University.

However, she said if someone is vaccinated, they should be “cautious” and look out for COVID symptoms. “Masking in that time period is also suggested,” she added.

“Despite lower cases we are still in a pandemic, and the more safety measures such as masking and isolating with exposure, the better the chances that we can stop the spread,” said Curley.

According to Lahita, we’re relying on the “honor system” that people adhere to isolation and quarantine rules and take steps to avoid exposing others to the illness if they have to go out.

“It’s this way; you get an upper respiratory infection, sore throat – it’s horrible, you’re running a slight temperature of about a hundred, you’re achy all over, but you need to go out for milk,” he said. “So you put the mask on, and you go.”

However, that isn’t the best way to prevent disease transmission.

“But the honor system is if that happens, your milk will have to wait. You shouldn’t go out at all,” said Lahita. “If they have the home test and they test positive, then for sure, they should not go out.”

In March, the Biden Administration launched a nationwide “Test to Treat” initiative to give people rapid, free access to potentially life-saving treatment for COVID-19. People can go to certain pharmacies for a COVID-19 test, and then if they qualify, they can get access to antiviral medications.

Due to limited supply, only people at high risk for severe COVID-19 are being given the anti-virals.

“If you test positive and you’re very symptomatic, it’s test to treat,” said Lahita.

These antiviral medications have been very successful in studies in reducing the risk of hospitalization. Paxlovid was found to be 90 percent effective at reducing the risk of severe COVID-19 in studies.

“You use it for five days and it keeps you out of the hospital and from using monoclonal antibodies,” said Lahita. “It keeps you from going to the emergency room.”

Figuring out who is truly asymptomatic can be difficult.

The symptoms of COVID-19, especially the dominant and highly infectious Omicron variant, can mirror those of more mild conditions, like colds or allergies.

According to a recent meta-analysis, of nearly 30 million people, a significant amount of people with COVID-19. They found among people with confirmed COVID-19, over 40 percent of cases were asymptomatic. The researchers said that the high percentage of asymptomatic infections “highlights” the potential transmission risk these cases can bring to communities.

Lahita said if you have a very bad cold or flu-like illness, which looks like COVID, it’s best to stay home and not mingle with other people you might infect even if you haven’t been tested yet.

“But when you’re dealing with the public, your belief system is that people will do the right thing, and that is not necessarily the case,” Lahita cautioned.

Lahita warned that we’re going to find out, although the Omicron variant presents some challenges to the reporting system.

“The unfortunate thing with Omicron is that you can test positive and stay home, and nobody will know that you’ve been positive,” he said. “Because you don’t go to the hospital, you don’t get admitted, you don’t go to your doctor’s office, so you’re just positive, and you’re staying home.”

Lahita said those numbers aren’t included in the official tally of positive cases.

He emphasized that wastewater testing will be the best indicator.

“The only way we know the numbers are really going through the roof is by measuring wastewater,” Lahita said.

California has lifted the five-day quarantine requirement for asymptomatic exposed individuals, causing confusion.

Experts say asymptomatic people can potentially still spread the disease and ideally should still isolate according to CDC guidelines.

They also say while this may be unnecessary for vaccinated people who test positive without symptoms, they should still mask around others and watch out for signs of COVID.