Ask the Dr: What You Need to Know Now about At-Home COVID Tests, Omicron and Masks

At-home COVID tests are this year’s toilet paper — they’re the pandemic must-haves that everybody wants but they’re sold out everywhere. But can you rely on them and how and when should you test?

With Omicron, the answers are always changing so we checked in with Dr. Sejal Parekh, a family medicine doctor at Nuvance Health Medical Practice in the Wilton Wellness Center (249 Danbury Rd.) to ask the latest COVID related questions.

GOOD Morning Wilton: Since vaccinated people don’t seem to get as sick with the Omicron variant, if I’m vaccinated, do I really need to be worried if I catch it?

Dr. Sejal Parekh

Dr. Sejal Parekh: The way we’re seeing the surge, the numbers are outstanding and it’s not just affecting people who are unvaccinated. We’re seeing actually a lot of breakthrough cases. People who’ve gotten the primary vaccine series, we are seeing that they can contract this particular variant, the Omicron variant. Even those who are boosted can — I have had several cases where even patients who have been boosted are contracting the virus and having some breakthrough cases. So although you may be vaccinated, it may not completely protect you from the variant that’s circulating in the environment right now.

GMW: So even if I have had that third shot, that booster, I still need to consider taking those precautions — social distancing, masking, what have you?

Dr. Parekh: Yes. All those same type of precautions that we were taking in the start of this pandemic two years ago, they really need to be in place. I really do encourage people to get the booster because there is at least some coverage that can be seen for this Omicron variant, but it still is not foolproof. So, get the booster, but still take all the normal precautions that we’ve been taking — mask wearing, social distancing. If you don’t have to be indoors with your mask off, like in dining situations, try not to.

I understand that there are circumstances in which we will have to do those things. And there are some protocols that can be taken for safe gatherings. But if it can be avoided, it’s probably best, especially right now — we haven’t even seen potentially the peak yet. We’re still rising up to the peak.

GMW:  In Wilton, we’re up to a two week average of 30 cases a day — that’s over 160 cases per 100,000 people. Those numbers are just unbelievable to think about.

Dr. Parekh:  We’re seeing numbers that are reminiscent of the days when we first hit the awful surge with the Delta variant, or even when the pandemic first started. We’re seeing numbers on a daily case or every two weeks that are rising. These numbers are astronomical. And the mandates that used to be, I know they’re not quite in effect now, but those same precaution should be really adhered to.

GMW:  What about people who had COVID and have recovered? Here’s a hypothetical: let’s say my son came home from college with COVID, isolated for 10 days and has now recovered and tested negative. If he gets exposed to the COVID virus again two weeks later, can he bring home the virus to us, even though his body may fight it off with the antibodies he’s developed? Can he still be immune but still bring something home to us and get us sick?

Dr. Parekh:  It’s a tricky question. I don’t know if there’s a lot of research to prove what will occur, but we can think about it this way. Your son would probably be an asymptomatic carrier — he now has immunity because he experienced the infection and he’s got antibodies that fight it off. So he doesn’t experience symptoms when he’s been exposed two weeks later, but he still likely has the virus circulating. And there is research that shows that asymptomatic carriers may in fact transmit the virus to other healthy members of society. It’s not as likely just because they’re not coughing or sneezing, so it is more difficult for them to transmit it, but there are certain studies that show that asymptomatic carriers can bring it back to their family and their friends.

GMW:  So in other words, even if you’ve just gotten over COVID and you’re testing negative, you still need to follow those protocols for the benefit of the people around you.

Dr. Parekh: That’s correct. Absolutely. Absolutely. Just because you’re immune does not mean that you cannot bring it or spread it to other members of the community.

GMW: Let’s talk about masks — what do people really need to think about when it comes to masking?

Dr. Parekh: Especially because the new CDC guideline has truncated the time in quarantine from 10 days to five days, for those who are asymptomatic, or mildly symptomatic but improving. The CDC said that after the fifth day they can discontinue their quarantine, but they’re meant to be wearing a mask for the additional five days.

That mask that they’re talking about is a high-grade, quality mask. It’s not one of these simple cloth masks with a lot of holes up the top and onto the sides. You want a well-fitted mask. If you can get your hands on an N95 or KN95, those will do. And the appropriate way to wear it is also important — just because you have a mask, it doesn’t mean much if you’re not wearing it properly.

You’ve got to make sure you’re wearing it over the bridge of your nose. You’re under your chin. And even if it’s uncomfortable to talk in one, you don’t pull it down so that you can easily speak to other people. That’s exactly what you don’t want to do — you don’t want to expose your nose or your mouth.

So those quality masks that we’re talking about are really what the CDC had intended when they said you can truncate your quarantine. I know those were more difficult to gain access to two years ago when this all came out, but now it should be a little bit more easy to get your hands on a few really good, well-fitted, high-grade masks, like most hospital-grade masks, just to keep and use if you are symptomatic or coming out of quarantine.

GMW: Since at-home tests are more readily available, what about using a test to determine what you can do? Say, if I test negative today, does that mean I can get together with friends today because I just took a test and it was negative. Can people use tests in that way?

Dr. Parekh: If you’re asymptomatic and you’re intending to gather with people, I would recommend testing prior to, as close as you can to that gathering.

Now if you’re symptomatic and have a negative test, I would not rely on that negative test and go forward with your gathering. There is a certain level of issues that we have with our home test kits. They’re not really foolproof. We don’t have accuracy to such a high percentage. There is a false negative there [sometimes]. But if you’re asymptomatic and you intend to have a small gathering, I would recommend testing prior to getting together.

GMW: So now that we’ve hoarded all those at-home COVID tests, with every little sniffle, every headache, do I need to take a test? My school age kids often have colds in the winter. Do I just need to test them every day? What should I be doing?

Dr. Parekh:  If you’re getting a lot of the telltale signs, maybe you’ve got the congestion, a headache or sore throat, I would test on that first day that you notice your symptoms, and if you’re getting a negative result, I would actually repeat that test two or three days later. These home kits do have a false negative rate, and sometimes early on in the symptoms, it may not pick up on the virus or on the antigen. So it is best, if you have those symptoms, test right away. If it is negative, I would repeat the testing two to three days later.

It’s very challenging to tell the difference between a runny nose — [is it] just an allergy or a cold, a common cold versus the flu or a COVID? It’s hard to tell, but especially if you’re unvaccinated, test right away; if you’re vaccinated, it’s also more challenging because sometimes these symptoms present much more mildly. If you’ve got the runny nose, along with, [for example] feeling kind of fatigued, that would be your cause for testing.

GMW: With Omicron, knowing that the symptoms are very similar to symptoms with a cold or the flu, how can I be sure if I have one or the other?

Dr. Parekh: It’s so challenging. The symptoms that come with this particular variant affect a lot of the upper respiratory tract. So you’re going to have things like nasal congestion or runny nose, a sore throat, a dry cough or some people have a productive cough, headaches. A lot of those symptoms I just mentioned are very similar to the common cold or to the flu virus. Based on symptoms alone, it’s near impossible to tell what you have. So I’d say the only way to truly tell them apart is by testing.

GMW: Are people still losing their taste and smell with Omicron?

Dr. Parekh: It’s not as common in this variant. It’s mostly with the Delta variant that we see the sensory losses of smell and taste. It’s not as often seen in this Omicron variant. Of course, with nasal congestion, you may lose some sense of smell and taste, but it’s nowhere near as commonly reported as with this particular variant it now. So you can’t use it as a criteria. Some patients say, “Well, I can still smell. So it can’t be COVID.” But that’s just not the case this time around with Omicron.

GMW:  So, what is “flurona” and is it something I need to worry about?

Dr. Parekh: It’s a co-infection essentially, it’s the flu and COVID simultaneously occurring in one person. A person can have two infections at once with both viruses. Of course, it can be pretty awful.

It’s not necessarily new. In the initial COVID wave when we still had the flu going on, we did have many cases of “flurona.” But of course, last season, because of all the mandates of quarantining, people weren’t really out and about, and flu cases really went down. So we didn’t see this a lot last year.

But this year, it’s different, and so we do actually have co-infections of the flu and the coronavirus together. And again, the symptoms overlap. For the unvaccinated, this could be quite severe. Symptoms could lead them to the hospital, for hospitalization, potentially the ICU. But, for those who are vaccinated — specifically vaccinated against COVID and flu — the hope is that the protection given by both those vaccines will make overall symptoms milder. But it is possible to have both at the same time.

GMW: Speaking about hospitalizations, how are things right now in the hospital? Statewide the number of patients hospitalized with COVID is above 1,900, something we haven’t seen since the beginning of the pandemic. How are things in CT hospitals?

Dr. Parekh: The ER visits per day, the hospitalization rates per day are still quite high. When you’re comparing it to that first wave, there’s nowhere near as many ICU admissions as we were seeing back then. So in that way, I guess there’s some good news, there’s a silver lining there.

But the rates for unvaccinated people in the hospital are far greater than those who are, vaccinated. So while the situation is not anywhere near as dire as it used to be, the numbers are still pretty astounding. And really, it still remains a problem for those who are unvaccinated, because they’re the ones who end up in the hospital more readily.

GMW: And how is the fatigue level of the medical staff? 

Dr. Parekh: It remains intense. Not only at my site, but all throughout, we have short staff issues. Because of how transmissible this particular variant is, a lot of our staff are out sick themselves. If they’re not sick, they’re health-caring for either children or elderly family members who contracted the infection. And of course, because of the great demand to see and care for patients, they’re exhausted. Those who haven’t contracted it are here seeing patients, and there’s exhaustion and there’s overtime. So it is physically as well as mentally taking a toll on a lot of healthcare workers.

GMW: Is there one message you want to leave people with about testing at the moment? What do you want people to think about?

Dr. Parekh: The Biden administration put out a notice earlier this week about their upcoming plan to make home tests more readily available. I know there has been a shortage, but these home tests are probably the key to helping stop the transmission. Although they’re not foolproof yet, at least they do provide some kind of method for us to determine whether we have the infection within our own bodies. So testing is important. Getting access to these tests is really important at the first sign of symptoms. Test, and follow up with your primary healthcare provider if there is a question about whether this negative test is truly negative.

But I think testing is the key to stopping the transmission, because if we can stop transmission, we can stop the virus from replicating and creating new variants. So it is very important and I’m happy that at least there is a plan to get more testing available to people at large.

And get vaccinated, Encourage everyone to get the vaccination. I do encourage both the testing and the vaccines as they come out, just to help curb the spread.

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