Hey Ray, thanks so much for joining us here
on 9 News Plus I'm here with our Nine News,
medical extraordinaire, expert.
Technically Doctor Pyle Cooley for a bit
more on what you should do if you test,
pause for code that so this
is really important.
Obviously, unfortunately we're seeing
the increase in cases right now,
so for a bit more on what you should do,
Doctor Coy first of all testing.
Let's start things out there
because if you get that,
let's say a rapid test back positive,
what's the maybe first thing
you should do right after
that you know? This were in such
a different place than we were a
couple of years with testing positive
and what we're supposed to do.
So I'm so glad that we're
having this conversation.
If you get a rapid test that's
positive and you're symptomatic,
you're confirmed COVID.
So there's really no need to
follow up with the PCR test.
Now, let's say you get a rapid
test and you're not symptomatic.
Then I might recommend a
PCR test for confirmation,
because there's a small possibility that
the test could have been contaminated,
especially if you live with somebody
whose COVID positive the test
could have gotten contaminated,
and that's why it's testing positive.
So a positive test you can
pretty much hang your hat on.
Now the opposite if you have symptoms and
you do a rapid test and it's negative,
you don't stop there 100% of the time.
You have to follow that with the
PCR test because of the vaccines
we're in a different place now
than we were a couple of years ago,
so a couple of years ago when we
tested positive and we had symptoms,
the symptoms were a result of
a very high viral load.
So the minute that you have symptoms,
there's a lot of virus around
now because we're vaccinated,
it takes just as.
Few small viral particles to
tickle our immune system.
The immune system goes to war and
the symptoms are actually coming
from the immune systems response,
and so it could come out negative
on a rapid test because there's
not that much virus around,
but if you got that PCR test where you
amplify the viruses genetic material,
you'll actually see that it's positive.
So definitely follow up if if you're
symptomatic and get a negative test.
The other thing you might want to do
is to do serial rapid testing if you're
symptomatic with a negative test means,
do a rapid test.
Every day until your symptoms resolve
OK, so let's say you come back
positive on the PCR or with
that series of rapid tests.
What's the next step we should do?
So the first thing I tell people to do is
don't panic because it's not at this point.
If you're vaccinated and boosted,
it's very unlikely that you're
going to get super duper sick,
but the second thing I tell people to
do is to replay the last five to seven
days of their life in their head and
make a list of all their potential.
Contacts and as a courtesy just call
everybody that you might have come
into close contact with and just let
them know that you tested positive
and that they ought to get tested,
because that's something we still
very much need to do now.
If you're on public transportation or
something where you don't know who
you might have come into contact with,
that's a little bit out of your control.
It's usually a good idea to report
it to the state because they are
tracking the positive tests, so if you,
especially if you do it at home test
and you're not doing it in a lab,
you should call up the state and
let them know.
And then the last question,
and probably most importantly,
to ask yourself.
Should do I qualify for
antivirals because most people,
if they miss that five day window
from the onset of symptoms,
won't be able to get the antivirals again.
But there are subset of people that
qualify for antivirals and should get them.
What's that group of people?
So that's usually the people
who are at high risk.
They have mild to moderate illness,
so most people who are in the outpatient
setting mild to moderate illness and
they're at high risk for progression
to severe illness or hospitalization.
Now we normally think about the high risk.
Oops,
as the immunocompromised or those
with cancer or chronic disease,
or but one we forget about
often is just being old.
So over the age of 65 is considered a
high risk for hospitalization because
of your age being the risk factor.
So if you're over the age of 65,
even if you're otherwise pretty healthy,
you're likely to benefit from taking
packs of it, which is that antiviral,
because it reduces the duration of symptoms.
It reduces your infectivity,
meaning your risk of infecting.
Others, and it reduces your risk.
Of course,
of you know getting into the hospital,
there's some new data that it
may actually reduce your risk of
developing long COVID as well,
potentially so I think all of
those factors put together make
a call to your doctor.
Let them know you're tested
positive and ask them whether or
not you qualify for the antiviral.
And if you're not sure,
always a good idea to call your doctor.
So call a doctor.
Let's say, hypothetically,
let's ask for a friend here and
you're 34 reasonably healthy.
Do you consider?
And those options those
treatment options.
So you may still want to consider
it if you live with somebody who's
at high risk for having COVID.
Because remember,
I mentioned it decreases your infectivity.
There's some new studies about prophylaxis,
so let's say you got exposed to
COVID-19 or you live with somebody
who's got COVID-19 and you're high risk,
should you prophylactically or
preventively take the PAX livid?
Unfortunately,
they didn't hit statistical significance,
so there was a lower rate of infection
in the in the contacts who took Paxil.
But it was only a small difference and
it didn't hit statistical significance,
so it's not clear whether they started
it too late for it to be effective,
because by the time they got the medicine,
they had already been exposed to their
partner and already kind of developed COVID.
But I think for the most most healthy young
people who have no other medical problems.
If you're living alone or living with
somebody who's also very healthy,
you probably don't have to worry
about the antiviral.
But again,
and when in doubt,
just make a phone call to your
doctor and check,
let's say, hypothetically.
You get COVID and your partner,
or you're living with somebody,
or you've got roommates or something.
They are not testing that.
I mean, obviously you isolate in
a room anything else you can do.
Is it wiping down counters?
What do you do in that situation?
You know? I think, avoiding
sharing a bathroom would be key,
if that's possible,
because that's when if you think about it,
you know where our stabilizing droplets
where in the shower we're blowing our nose,
we're washing our hands,
a lot of contamination can occur,
especially in the bathroom,
so I think that's a big.
My touch surface that
would definitely wipe down.
You want to be careful not to share food,
of course, and not to share utensils.
If possible,
try to even wash your utensils a little bit,
sort of separately just to make sure
there's no cross contamination.
You know, using the same dishwasher,
what have you?
These are all very extreme
precautionary measures,
but most of the times if you're
living with somebody who's vaccinated
and boosted wearing a mask I think
is going to be the biggest way and
avoiding direct contact because
as we've talked about before,
the primary mode of transmission.
Person to person.
Very small amount of transmission
occurring through fomites or surfaces.
So we have to worry less about
wiping down stuff and more about
coming into close contact with
somebody coughing on somebody making
sure you open up the windows too.
Chris, that's a big one,
especially now that it's spring and
the weather is a little bit nicer.
You want to make sure there's
a lot of fresh air coming in.
Good ventilation wherever you're living
so that you're not sharing that same error.
So no stuffiness. I think that goes
probably with or without COVID,
but let's start getting out of COVID.
So you're. Starting to feel
maybe a little bit better.
You, by the way she should you
test on a daily basis even when
you have those worse symptoms
or when do you stop testing?
Great question.
So I would say that once your test positive,
if you don't need to keep testing.
OK so you you test positive you have it.
The time to start testing again
would be with the resolution of
symptoms or when there's been at
least 24 hours without a fever.
Whichever one sort of comes first and
you could start with a rapid because
if the rapid turns negative you at
least know that your infectivity or
viral load has probably gone down.
Your PCR may stay positive for several weeks.
Under COVID and it may not
necessarily be infectious particles.
It may just be fragments of the virus
that are left behind because your
cells are chewing up the virus and
breaking it down and you take little
pieces of the genetic material and you
amplify it and it looks like you're
positive when you're actually not.
So I think you know the first time
to test would be resolution of
symptoms or improvement in symptoms.
That's substantial,
and then once you're negative
on a rapid test,
you may or may not want to
follow it with the PCR test.
But if you do follow it with the PCR
at least wait for two weeks from day.
Zero,
which was the first day that
you had symptoms.
Before you get that PCR test.
OK, so when can you go back to work
and start doing normal things?
Yeah, so this is a tough one.
So in the current of the workforce when
we were down on staff in the hospital,
the CDC actually should guidance that
you can come back to work five days
after the onset of your symptoms.
As long as your symptoms are improving,
they don't even have to be resolved
and you've been fever free for
24 hours without fever medicine.
And you should probably wear a mask for
those five more days that you're at work,
so no testing, so this is called a
symptom based return to strategy.
Return to work strategy,
which basically means their
symptoms are getting better.
It's been 5 days you come back.
The downside of that, of course,
is that a lot of people,
a large proportion of people are infectious.
Still at 5 days,
because the average infectivity
can last nine to 10 days.
So you really want to be careful,
especially if you're in an environment
without a mask where you're
coming into close contact with.
People now,
if there's not a huge crisis
shortage of workforce at your office,
I would say the testing to return
to work strategy is a much more
conservative strategy and something
that I personally would recommend,
which is that symptoms are getting
better and you're testing negative on a
rapid test doesn't have to be the PCR,
but you're testing negative on a
rapid and your symptoms are better.
That would be the right time
to come back to work,
can I ask though?
Based on what you're saying.
I mean, you want to be concerned about it.
Let's say it's again,
you're saying it's not a
critical to be back to work,
is it isn't 9 to 10 days.
The best time to go back,
then nine to 10 days after?
Probably?
Yeah yes. And the reason that they're
saying 5 days is because you're
most infectious about one or two
days before your symptoms starts,
and about three days after your
symptoms start, and then your
infectivity really starts to go down.
And this is based on studies and
people who are vaccinated and boosted.
So these are people like us who have had.
If you've never had the vaccine,
then that whole timeline.
Gifts because your immune response
changes and all of that stuff.
But for people who are fully vaccinated,
that five day window two days before
and three days after your symptoms
is when the highest infectivity is.
But you're still infectious.
Like I said,
for an average of nine to 10 days,
some people can be up to 14 days because
the incubation period of the virus can
vary and it can vary in different people.
So the Omicron variant has a shorter
incubation period than the previous variants,
including the original and the delta.
But even in you versus me it
could be different because
it depends on how much viral.
Those were exposed to,
so how much initial virus did you get
really determines how quickly it divides
and then determines your infectivity.
Any final tips for people who've had
who have covered and what they should do
as the numbers I think start to go up.
We really I think, need to be sort
of proactive about our health.
One thing I would really advise people
not to do is to just say oh everybody's
going to get it and to if you're feeling
well and you're testing positive to
sort of live your life as usual,
I think that is not a good idea.
Right now, because it can, you know,
create more infection which can
create more variance and can create
really more problems down the line.
But just remember that if you do get it,
don't panic.
Don't be ashamed if you're
doing all the right things,
you know there's so much infection
around us right now that you
could still potentially get it.
I just have a low threshold to call
your doctor if you have any questions.
Low threshold, called Doctor.
Follow this stuff. So doctor Tyler.
Thanks so much for your time here
on the News Plus today my pleasure.