By Natan Schleider, M.D. Written 12/31/2021 3 Minute Read
DISCLAIMER: WRITTEN BELOW IS BASED ON CDC AND NIH GUIDELINES AS OF 12/31/2021. OBVIOUSLY THESE GUIDLINES CAN CHANGE AT ANY TIME.
‘Hi Dr. Schleider, I just tested positive for COVID19, now what should I do?’
Here are my suggestions for what to do when you call asking: I just tested positive for COVID19 [in 2022] now what should I do?’
You should be prepared to answer my questions so I can give you advice!
Dr. Schleider: What kind of test did you have, a rapid test (essentially the same as a home test) or a PCR test (which is the one sent to the lab)? I ask because the rapid / home tests are likely to test positive if you have asymptomatic COVID19 ONLY 35% of the time. If you have COVID19 symptoms you are likely to test positive 64.2% of the time. THIS MEANS THERE IS A FALSE POSITIVE RATE OF 35.8% ON HOME OR RAPID TESTS. However, there true negative rate is 92% which is reassuring. [SOURCE: Evaluation of Abbott BinaxNOW Rapid Antigen Test for SARS-CoV-2 Infection at Two Community-Based Testing Sites — Pima County, Arizona, November 3–17, 2020 | MMWR (cdc.gov)]
Patient: I had a home test and it tested positive for COVID19, you still haven’t told me what I should do?
Dr. Schleider: If you want to be certain that your home or rapid test is indeed accurate, go get a PCR test.
Patient: Will do but what should I do or take in the meantime?
Dr. Schleider: My personal advice and what I advise my own family is to treat any symptoms aggressively. For example, if you have a runny nose with post nasal drip that is a breeding ground for not only COVID19 but other nasty infections like flus or bacteria that cause bronchitis or pneumonia. Get yourself the following: Zyrtec-D, a decongestant like Sudafed, Flonase, and a nasal rinse and decongestant which are available over the counter. USE ALL OF THEM ROUND THE CLOCK UNTIL FOR AT LEAST 1-2 WEEKS (I WILL COACH YOU THROUGH THIS OR ASK YOUR PHARMACIST FOR DOSING).
Patient: Is there anything else I can do, for example, I am developing a bad cough, maybe another bug has moved in?
Dr. Schleider: Great point. Having an antibacterial antibiotic on hand and an antifly antibiotic on hand can’t hurt.
AND MY BIGGEST CURRENT PIECE OF ADVICE IS TO START A CORTICOSTEROID LIKE A MEDROL DOSE PACK IF YOU ARE HOME, TESTED POSITIVE FOR COVID19, WANT TO KNOW WHAT TO DO AND SYMPTOMS ARE WORSENING.
THE NATIONAL INSTITUTE OF HEALTH (NIH) SAYS DOES NOT RECOMMEND STARTING A CORTICOSTEROID (IE DEXAMETHASONE OR PREDNISONE) FOR HOSPITALIZED PATIENTs NOT REQUIRING OXYGEN CITING NOT ENOUGH DATA.
HOWEVER, IF A HOSPITALIZED PATIENT DOES REQUIRE OXYGEN THE NIH SAYS THEY SHOULD GET A CORTICOSTEROID.
WHY WAIT UNTIL THE PATIENT IS TURNING BLUE AND NEEDS OXYGEN? START A CORTICOSTERIOD AND SEE HOW THE PATIENT DOES. WORST CASE IT DOES NOT HELP SYMPTOMS AND YOU END UP GOING TO THE HOSPITAL. BEST CASE HOSPITALIZATION IS AVOIDED AND YOUR LIFE MAY HAVE BEEN SAVED.
