With the highly contagious omicron variant of COVID-19 spreading throughout the U.S., even among vaccinated populations, now is the time to be cautious, get tested, and take care of yourself. Jillian Catalanotti, MD, vice chair for academic affairs, associate professor of medicine and of health policy and management at the George Washington University (GW) School of Medicine and Health Sciences, and director of the Division of General Internal Medicine at the GW Medical Faculty Associates (MFA), takes us through testing options and what you should do if you test positive for coronavirus.
What at-home tests are available?
Catalanotti: The most reliable test for COVID-19 uses a method called “PCR” to detect the virus. PCR, or polymerase chain reaction, tests have to be sent to a laboratory to run, so if you can test yourself without sending your swab sample out to a laboratory, it is not a PCR test.
At-home tests can give you fast results. They are generally reliable, but they are less reliable than PCR tests. There are many different brands of at-home tests available for self-testing. Meridian Bioscience’s Revogene SARS-CoV-2 test and Applied DNA Science’s Linea COVID-19 Assay Kit cannot identify the omicron variant of COVID, so those two brands should not be used at this time.
When should you take a test, and how reliable are they?
Catalanotti: This is complicated because it depends on whether you have symptoms and why you are taking a test. PCR tests are highly reliable. If you would like one, please visit the GW MFA website for links to DC, Maryland, and Virginia locations. You can also have one done at GW Immediate and Primary Care clinics during their COVID hours. To keep our waiting rooms as safe as possible, we do not offer PCR testing elsewhere at the GW MFA.
If you do not have COVID-19 symptoms, but you were exposed to someone with COVID-19, we recommend taking an at-home test the next day (or as soon as you learn about the exposure) and then again 5-7 days after the exposure. If you have been vaccinated and boosted, it is OK to leave your home and go to work, with masking, even if you have had an exposure, as long as your tests are negative and you do not develop symptoms.
Sometimes people take an at-home COVID-19 test when they feel healthy, but they want reassurance before seeing friends or family. Testing like this can give you some reassurance, but you should think about who you are hoping to see. If they are over age 65 or have conditions that might make them particularly vulnerable to COVD-19, you can consider the negative test as one part of your overall strategy to protect them, in addition to keeping the gathering as small as possible, gathering outdoors when possible, and gathering with people who are vaccinated, boosted, and wearing masks.
If you've tested positive for COVID-19 but aren't showing any symptoms, what should you do?
Catalanotti: The most important thing is that you stay home, isolated from others until 10 days after your positive test. If possible, stay in your own separate room and use your own bathroom. If you live with others, they can leave food in front of your door and walk away before you open it to take the food. If you cannot isolate from them, try to stay masked and with windows open when possible for ventilation.
If you've tested positive and are showing symptoms, what should you do?
Catalanotti: Same as the above! Stay home and isolated until 10 days after your symptoms started and your symptoms are improving for at least 24 hours. Stay hydrated, eat normally, and rest so your body can fight the virus. You can take aspirin or acetaminophen if needed for aches, pains, sore throat, headache, or fever; you can use your favorite over-the-counter cough treatments for cough. It’s best not to take ibuprofen (like Advil or Motrin) or naproxen (like Aleve) when you have COVID-19 because those medicines can be a little hard on kidneys and so can COVID.
Consider calling us [at 202-741-2222] for a telemedicine visit as soon as you learn you have COVID-19. You may have heard there are medications that can sometimes be given to try to prevent hospitalization; these are in very short supply and for now are being reserved for our highest-risk and most elderly patients. We can discuss whether this applies to you at a telemedicine visit if you would like. Right now, we also have a research study, called ACTIV-6, for some other medications for COVID-19. You can read more about COVID-19 treatment on the GW MFA website or the DC Department of Health website.
At what point are COVID-19 symptoms considered severe? Should patients go directly to the hospital or talk to their primary care provider first?
Catalanotti: If you have trouble breathing, you should go directly to the emergency room because you might need oxygen. If you have an oxygen monitor at home and it registers 92% or lower, go to the emergency room. Do not wait for your primary care provider. If you are nauseated or vomiting and can’t drink enough water to be hydrated so you feel lightheaded, go to the emergency room because you might need IV fluids.
The usual symptoms that might make you consider an emergency room (like strong chest pain or stomach pain, or a particularly severe headache) should still prompt you to go. If you don’t think you need the emergency room, but have questions about symptoms, call your primary care provider and schedule a telemedicine visit to discuss your symptoms. We can help you sort it out. Ideally, if you don’t need to be in an emergency room, it’s best to stay at home.
What else should GW MFA patients know?
Catalanotti: If you have not yet been vaccinated or boosted against COVID-19, we highly recommend you do so. There are almost no medical reasons not to get the vaccine! Visit the GW MFA website for information about our vaccine clinic.
To make an appointment with a primary care physician, visit GW Primary Care or call 202-741-2222. To get a COVID-19 vaccine shot, including a booster, and to learn more about testing, visit the GW Vaccine Clinic.