• When you test positive for Covid-19, the instruction is to isolate yourself for 7 days and to repeat the test on D + 5.

  • If it is negative and you are vaccinated, you can end your isolation.

  • But if you're positive after a week, does that mean you're still contagious?

    Should we continue to isolate ourselves?

She's there.

Appeared almost instantly.

Leaving no room for doubt.

She, this damn second bar which indicates that we are still positive for Covid-19, a week after its screening and as many days of isolation.

How to interpret this result?

Are we still contagious?

Should we continue our isolation?

As the seventh wave of coronavirus sweeps across France under the effect of Omicron's highly contagious BA.5 sub-variant, and more than 150,000 new cases were identified on Wednesday, what is the best course of action to avoid? not sow the virus around oneself without for all that constraining oneself to a monastic life?

Higher symptomatology and longer infectiousness with BA.5

“Since the appearance of the Omicron variant, we have observed quite a few asymptomatic or slightly symptomatic contaminations.

However, with the BA.5 sub-variant, which is the majority in France, we are more symptomatic than with the previous sub-variants ”, notes Dr Benjamin Davido, infectious disease specialist and Covid-19 crisis referent doctor at Raymond-Hospital. Poincaré of Garches (Hauts-de-Seine).

Symptoms that everyone knows: fever, body aches, fatigue, cough, headache and sore throat.

But also “loss of smell and taste, which we no longer saw in recent months and which are again reported with BA.5”.

Not only “we have more symptoms, but we have them longer, underlines the infectiologist: on average 7 days for BA.5, against 4 to 5 in the event of contamination by BA.2”.

It is therefore not uncommon to be tested positive again during the test recommended by Health Insurance on D + 5. “It is normal and frequent: around 20 to 30% of patients are still positive one week after their screening", observes Dr. François Blanchecotte, president of the Syndicate of biologists.

A positive test but not necessarily a significant viral load

Why ?

“We are dealing with a virus which affects the upper airways more, and which remains in excretion for a long time.

So even several days after being tested positive, one can still have virus RNA fragments in the nasal cells, explains the biologist.

However, the screening tests precisely look for portions of the virus, viral RNA, which are proteins capable of being identified by a rapid, antigenic or PCR test.

Hence the tests that can be positive for days on end.

The problem is that “we have never really been able to reason about contagiousness in relation to screening tests: it is not because we have a new positive control test that we have a significant viral load, emphasizes Dr. Davido.

One can, despite this positive result, have a low viral load.

The tests are only a diagnostic tool, they are not intended to define contagiousness.

In practice, it is in the first five days of the disease that we are most contagious, it is the peak of the viral load ”.

We are generally “super contaminating about 48 hours after contamination, even before having the first symptoms, and this for three to four days, details Dr. Blanchecotte.

This is why we set the isolation period at 7 days.

Thereby,

“if the recommended test at D + 5 is negative and you no longer have symptoms, you consider that the patient is no longer contagious, reminds Dr. Davido, and that you can end your isolation .

If it is positive, we isolate ourselves for two more days”.

Barrier gestures again and again (yes, you have to put on the mask)

And after ?

“According to the instructions of the Health Insurance, if you are vaccinated, if there is no more fever or symptoms, you end the isolation and there is no indication to repeat the test” , recalls Dr. Davido.

Normally, “after 7 days, the quantities of virus excreted are not sufficient to contaminate, provided that barrier gestures are maintained.

But today, people are kissing and shaking hands again,” laments Dr. Blanchecotte.

On the other hand, “if after a week, you are still symptomatic, you have a temperature and you are coughing, then you are probably still contagious, adds Dr. Davido.

A potentially more frequent scenario with BA.5.

In this case, if you wish to return to work, which is permitted after 7 days, or if you do not have the possibility of teleworking, the best precaution is to wear a mask at work, in transport and other confined spaces, and to wash hands frequently.

So many precautions prescribed by Health Insurance: “When you leave isolation, you must respect the following instructions for 7 days: wear a surgical or general public mask with filtration greater than 90%, respect barrier gestures, reduce your contacts, especially with people at risk,

No need, therefore, to remain cloistered past 7 days, “nor to consume screening tests unnecessarily, it is a waste of resources, insists the infectiologist.

Since it is a virus capable of creating epidemic waves every two months and with which we must learn to live, the lesson to be learned is to decide on the return of the mask: wearing one is the best to continue its isolation. individual and to make the probability of infecting someone almost zero, without locking yourself in any longer".

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