Can I still be contagious after COVID isolation? And should I bother wearing a mask once I’m better?

If you’re at home with COVID, you may be wondering how long you’ll really be contagious. You don’t want to be in isolation any longer than necessary, but you also don’t want to risk the health of your friends and colleagues – or vulnerable strangers for that matter.

In Australia, people with COVID needed to isolate for seven days, unless they have significant ongoing or new symptoms (then the fine print in the state and territory rules tells them to stay away longer).

So, what’s the risk of moving away from home after a week and still being contagious?

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What Does the Research Say About Omicron’s Contagious Period?

The incubation period of Omicron – the period from infection to developing symptoms – is about three days, with the person often becoming contagious a day or two before symptoms appear.

The average duration of Omicron symptoms is also quite short – often 5-6 days compared to 7-10 days with Delta and earlier variants. Omicron is more contagious because the increased number of mutations on the spike protein makes it better at evading the body’s immune system.

It seems that the Omicron variant causes milder disease and more asymptomatic infections, and it is better at evading our immune system – hence the high number of breakthrough cases with the Omicron variant is to be expected.

What if I still test positive for RAT on day 6 or 7?

Data on Omicron outbreak suggest rapid antigen testing (RATs) may not detect COVID until at least two days after exposure to the virus

And the Therapeutic Goods Administration (TGA) says RATs aren’t as accurate if you don’t have symptoms. So it is you probably don’t test positive on a RAT up to a few days after exposure. And if you don’t have any symptoms, you could get a false negative result in the following days.

PCR tests are more likely to detect the virus than RATs due to their high sensitivity, and PCR will also continue to detect virus particles for longer. Relying on this test can extend the isolation period, even if the person is not contagious. That said, a PCR test is still considered the “gold standard” for the detection of SARS-CoV-2 infection

Most states don’t require a clear RAT or PCR test to get out of isolation, but say those that still have: certain symptoms (such as sore throat, cough, shortness of breath, or runny nose) should prolong their isolation. If you have symptoms and take a RAT test, a positive result may indicate that you are still contagious to others.

The purpose of COVID testing is to identify people who are currently transmitting the virus. So RATs are capable of detecting the vast majority of infectious cases, and they work well in communal settings, such as long-term care facilities, workplaces or schools.

A positive RAT can be a sign of infectiousness.

Meanwhile, emerging science (including data from the [National Basketball Association’s extensive COVID testing program] suggests that with the Omicron variant, as many as half of infected people by day five (the end of the recommended isolation period in the United States) – and possibly beyond.

In Australian states and territories, isolation is for seven daysprovided the person has no symptoms.

It has has been suggested it may be safer to isolate and wear a mask for eight days to protect others for a total of ten days. In the Northern Territory, those leaving isolation are being told to wear masks for seven extra days† South Australians must mask for three days after isolation

What about masks after that?

So it’s possible for people to be contagious outside of their seven-day isolation if they’re still symptomatic. After ten days, most people are not contagious. Multiple studies have shown that there is very little or no transmission after day tenregardless of the variant.

However, for those who are immunocompromised, wait 20 days it is recommended to leave isolation as such patients have been shown to have a tendency to shed the virus longer.

woman with red umbrella walking

Once recovered, you probably won’t need to wear a mask for a while.
MONKEY Image/Bianca De Marchi

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Once people have fully recovered from the disease and have no symptomsthey are considered non-infectious because the virus load they carry is very low.

A person who has recently fully recovered from COVID does not need to wear a mask as there is no risk to them infected again with the same variant. Accordingly, they do not pose a COVID threat to others.

However, they will have to reconsider this advice later 12 weekswhen reinfection is possible.

The level of protection you have against vaccination or previous COVID infection may also depend on factors such as your age and immune status. It’s also worth noting that Omicron recovery won’t protect one from seasonal colds and flu or subsequent COVID variants — but a mask will.

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Advice for home when you have to leave the house

Protecting ourselves and the community from the communicable diseases, including COVID, depends on early detection of infection and implementation of the public infection prevention measures.

Until RAT tests are uniformly sensitive enough to detect with certainty the absence of the virus, we need to supplement these tests with preventative measures such as isolating until symptoms disappear and wearing masks in indoor spaces and at public events.

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