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What Happens After a COVID Diagnosis? (podcast)

Isolate, help prevent spread, know when to seek emergency care

Siu Ming Geary, MD, family medicine physician, Scripps Clinic, discusses what to do after testing positive for COVID-19.

Dr. Siu Ming Geary, Family Medicine, Scripps Clinic

Isolate, help prevent spread, know when to seek emergency care

A COVID-19 diagnosis comes with a lot of questions. What should I do now? When should I see my doctor? How can I prevent my illness from spreading to my loved ones? When can I reenter society? Can I still get vaccinated?

 

In this episode of San Diego Health, host Susan Taylor and Siu Ming Geary, MD, an internal medicine physician at Scripps Clinic Rancho Bernardo, discuss what happens after your COVID test comes back positive. The most important thing is to take care of yourself while also keeping the virus from spreading. That means isolating — even in your own household, if possible — and carefully following recommendations set by public health authorities and instructions given to you by your personal health care provider.

Listen to the episode about testing for COVID-19 and managing symptoms

Listen to the episode about testing for COVID-19 and managing symptoms

Podcast highlights

What should you do after testing positive for COVID-19? (0:43)

If you’ve been tested positive for COVID-19, we understand that’s very scary. There are two major principles to follow. One is to take care of your health. The second is to prevent the spread of COVID and that means you should isolate immediately. What does that mean? It means that you should stay at home and minimize your exposure to other people. It means that if you have a dedicated bedroom, a dedicated bathroom, you should actually stay there and separate yourself from the rest of the members of your family.


You should wear a mask if you’re in a communal space with your family in the householdand wash your hands as often as you can.


How long should you isolate for? If you’ve been diagnosed with COVID-19 and you have symptoms, you need to isolate for 10 days from the onset of your symptoms, and isolate until you actually are fever-free for 24 hours without taking any medicine to lower your fever and also that your symptoms are improving. So, all three criteria should be met before you stop isolating and come back into regular society.

How long should you isolate if you’re showing no symptoms? (1:51)

We know that there are people who get tested and have no symptoms at all. In those situations, then you need to isolate for 10 days from the date that you tested positive. After 10 days, you can come out of isolation.

How long should you isolate if you have a severe case of COVID or a compromised immune system? (2:12)

Typically, if you were very ill with COVID, you would be in the hospital. You might be intubated. You would be under doctor care.


If you have a compromised immune system, we would have you isolate for 10 or even up to 20 days.


I recommend that if you’re in those categories, that you talk to your doctor to determine what is the ideal time frame for you because you may be symptomatic and contagious longer than the average person who is not immunocompromised.

How should you isolate if you share a house or room with others? (2:49)

We know this affects a lot of people. In those situations, the principle of trying to minimize exposure and infecting other people still applies. But it does need to be modified a little bit. It means that if you don’t have access to your own room, and you share a bedroom, maybe the other person will need to sleep in the living room or another part of the house during your isolation period.


If you don’t have another bathroom and need to share a bathroom, the same principles apply: wear a mask, wash your hands a lot. If you’re using the same bathroom, the person who does not have COVID should wait a little while before going into the same bathroom after the person with COVID has used it.


If you flush the toilet, make sure the toilet lid is closed so that you don’t aerosolize virus particles. Wipe down all commonly touched surfaces at least twice a day and also every single time after somebody has used those areas.


So, what does that mean? Those high-use surfaces are typically doorknobs, remote controls, tables, anything that we’re touching often. We want to make sure those are sanitized in case they do become contaminated, so that they don’t actually help spread infection.

How should you handle eating if you have COVID? (4:12)

If you are diagnosed with COVID and you have somebody living in your home with you, have them prepare your meal. You stay in your room. They should bring you the meal to your door. You should eat your meal inside your room. When you’re done, you can put the dishes outside. Try not to eat in this shared space with somebody else in your household if you’ve been diagnosed COVID-19.


If you are living alone, then have your food delivered to you and eat in your home without other people.

How should you handle laundry if you have COVID? (4:50)

Most people don’t ask about that, but if you actually have COVID, you can actually wash your clothes with the clothes of other people who don’t have COVID. Whoever is doing the laundry should not pick it up and shake it because you can potentially aerosolize virus particles.


You should wash your clothes at the highest temperature setting that’s recommended by the manufacturer and dry them thoroughly.


Wear disposable gloves if you don’t have COVID and you’re doing the laundry of somebody who has COVID, Make sure you sanitize the hamper as well as your washing machine and controls and the door handle as well, so that anybody who’s using it after you can also be protected and not get contaminated.

Should people in your home quarantine if you have COVID? (5:41)

If you were diagnosed positive, you need to notify everyone else that you’ve been in close contact with and that always includes your household members. If they’ve been exposed to you, then we recommend that they quarantine for 14 days from when you were diagnosed, or when they were exposed to you.


Why 14 days if you’ve been tested and you’re actually isolated for 10 days? It’s because it can take anywhere from two to 14 days after exposure before you develop symptoms. But after 14 days, if that person who’s been exposed to you has not had any symptoms and has not had any positive tests, they can actually come out of quarantine at that point

What are mild, moderate and severe COVID symptoms like? (6:32)

We know that some people who have COVID are asymptomatic. Also, a lot of people can have very mild symptoms.


Mild symptoms can be congestion, sore throat, maybe mild muscle aches, a mild headache.


Moderate symptoms can be more severe versions of those and include thing other symptoms, such as nausea, vomiting, diarrhea and severe headache. Some people can have some mild shortness of breath, or mild chest discomfort.


Severe symptoms are severe versions of mild and moderate symptoms, including high fever, severe chest pain, or severe difficulty breathing, or inability to hold down fluids. Other more severe symptoms may include confusion, inability to wake up, extreme fatigue. If you have severe symptoms, we recommend that you seek emergency medical attention.


For mild symptoms, you may not need any treatment. You just need to stay home; stay hydrated, maybe take some over-the-counter pain medicine or fever reducer; same thing for moderate symptoms.


If you are starting to get worse and needing care, we recommend you contact your primary care doctor to determine if you need additional treatment.


There are some treatment options for certain patients in high-risk groups that those patients may qualify for. If you’re a patient who qualifies, your doctor can actually direct you to the appropriate treatment.

How long do COVID symptoms last? (8:01)

We know that there are some people who may have symptoms for only a few days, while others can have symptoms for up to a week or even 10 days and some who may actually have symptoms up to 14 days.


There are some people that we’re finding who actually have what we call a post-COVID syndrome, or a long-hauler syndrome, where the symptoms may actually last for months. We’re still learning about this condition in terms of who gets it, how long it lasts and what kind of symptoms present.


If your symptoms last beyond 14 days, and you have questions, we recommend you reach out to your doctor to determine if your symptoms are due to COVID, or if they’re due to something else, and what other options or recommendations may be right for you.

When should you call your doctor or seek emergency care? (9:04)

It’s a good rule of thumb to contact your doctor if your symptoms are getting worse, if you are extremely uncomfortable with worsening shortness of breath or chest pain.


Any time you have emergency symptoms, such as difficulty holding down fluids, feeling very short of breath, or experiencing very severe tightness in your chest, we recommend that you go to the emergency room or call 911.

Can you do a virtual doctor visit if you are isolating? (9:38)

We recommend that if you have any respiratory symptoms, or you tested positive for COVID and your symptoms are not very severe, that it’s much preferable for you to do a video visit because that helps you get the care you need. It also protects everyone else from potentially getting exposed to the COVID virus in the medical offices.


You can also call your doctor's office and they can help you.

What if you have recovered from COVID but symptoms return? (10:29)

If you find that your symptoms are lasting a long time, not getting better, or suddenly get better and then they get worse again, I encourage you to contact your primary care doctor. Your doctor can determine if all your symptoms are due to post-COVID syndrome.


Contact your doctor immediately if you have new symptoms of weakness, slurred speech, or symptoms like sudden swelling in one leg or one arm, severe headaches, things like that.

Why is it important to stay hydrated if you have COVID? (11:19)

Staying hydrated allows your body functions to function appropriately. It also maintains your blood pressure and helps to support your immune system. We recommend that even when you don’t feel like drinking when you’re sick, that you do so.


I always recommend water. It’s the easiest and best for you. But you can pick your drink of choice. That could be diluted juices, coconut water, vitamin water, whatever it is that you like as long as you stay hydrated.


Things to minimize and not drink as much of would be things like coffee or diet sodas, or even regular sodas.

What should you do if you lose your appetite due to COVID? (12:06)

A lot of people have a loss of appetite when they have COVID because they’re tired, they’re not feeling well, they’re in bed, they have a fever. But it’s important to try to maintain your nutritional status by eating fruits and vegetables and lean protein. There are a lot of nutrients as well as water in them. They help to keep you full.


Things to avoid would be processed foods, things high in sodium.

What is the importance of deep breathing if you have COVID? (12:49)

A lot of people who get COVID have respiratory symptoms and shortness of breath. It’s important to keep the lungs open and aerated, meaning that all the air pockets are actually full. If you’re laying in bed because you’re tired or you’re isolated, it’s easier for those air pockets to actually collapse on themselves.


Taking those big breaths opens up the lungs and helps to prevent pneumonia and other complications. What does that mean? It means taking a big breath at least 10 times an hour. You can do that on your own. If you need help, you can purchase what we call an incentive spirometer. It’s a little device that you blow into and helps to visually see how big your breaths are. If you have one, make sure you don’t share it with anyone else in your household or anyone else in general.


If you are able to do so, try to get up out of bed. Don’t spend your whole time in bed. Make sure you’re sitting up in a chair. Sit up, lean forward if you can, take those big breaths. Leaning forward helps to take some of the pressure off the back of the lungs and helps them to aerate a little bit better.

How do you monitor COVID symptoms at home? (14:04)

Things that you could monitor at home would be your vital signs, your blood pressure, your oxygen, your pulse, which is your heart rate.


There are devices that you can buy over the counter, either online or in a store. We recommend that you order things online and not go out when you’re sick.


A blood pressure device has a cuff that helps take your blood pressure. You can monitor it at home and see if it becomes too high or too low. The pulse oximeter is a device that sits on your finger. It helps you monitor your heart rate and the oxygen in your blood. For most people, their oxygen is about 95 to 100 and that is considered normal. If you have an underlying lung disease, your baseline might be lower. The important thing is that if you’re monitoring, and it starts drifting down, then you know you might need to seek care from your doctor or maybe in the emergency room.

Should you get the COVID vaccine if you’ve had COVID already? (15:34)

Even if you do get the COVID infection, you can still get the COVID vaccine. Once vaccines are available in your area, we recommend that you get vaccinated so that you can protect yourself as well as everyone around you from spreading this infection in the future.

Watch the video on what to do if you test positive for COVID

Watch the San Diego Health video with host Susan Taylor and Dr. Geary discussing what to do if you have tested positive for the coronavirus.