What should you do if you’re still testing positive for COVID-19 after day 10?

We're now deep into cold and flu season in the U.S., and COVID-19 cases are also ticking up. That means now is the time to stock up on at-home tests. Make sure you know exactly how to use them — and how to interpret your results.

If you're one of the many people who has tested positive for COVID-19 recently, you may be wondering what to do with those results, how long you can expect to test positive for COVID-19 and what to do if you just keep testing positive — for 10 days or more.

While most people will clear the virus within 10 days, some people may keep testing positive for longer than that, experts tell TODAY.com. And, knowing that coronavirus cases are rising again now, it's important to know the basics of when to take a test and what to expect when you get your results.

Early indicators from the Centers for Disease Control and Prevention suggest the coronavirus is circulating at high levels right now — and cases are increasing.

A newer variant, known as JN.1, is already responsible for more than 44% of COVID-19 cases in the country, according to CDC estimates. This strain is closely related to the highly mutated Pirola variant (also called BA.2.86), which began circulating in the summer. Meanwhile, the highly infectious omicron subvariant HV.1 is still causing about 22% of cases right now.

So, how severe will this COVID-19 season ultimately be?

"Honestly, it really depends on how well we do as a community in trying to mitigate the spread," Dr. Diana Cardona, a member of the College of American Pathologists Board of Governors, tells TODAY.com.

Knowing that COVID-19 is still out there, it's important to resist "COVID fatigue" and to "still not become complacent," says Cardona, who is also the vice chair and director at Duke Health Anatomic Pathology Laboratories. "The worst thing for us to do as a society is forget about it."

The virus poses particularly serious risks for certain populations, including immunocompromised people and older adults. And even young, healthy people can develop potentially serious complications, such as long COVID. So now is the time to take advantage of precautions — updated COVID-19 vaccines, masks and testing — to keep yourself and those around you safe.

"Getting tested lets you know what you have, which can ensure you get the treatment that could save your life," Dr. Mandy Cohen, director of the Centers for Disease Control and Prevention, said in a call with reporters on Dec. 1, 2023.

Here's what to know about when to take a COVID-19 rapid test, how to correctly interpret the results and when it’s OK to stop isolating — even if you’re still testing positive at 10 days and beyond.

How long can you test positive for COVID-19?

Most people will stop testing positive on a rapid antigen COVID-19 test within about 10 days, Cardona says. "Within 10 days after your initial positive test, you should convert back to negative," she explains.

But it’s not unheard of for people to test positive for longer than that on a rapid COVID-19 test, even up to 14 days, Stephen Kissler, Ph.D., an assistant professor of computer science at the University of Colorado Boulder, tells TODAY.com.

“We see a ton of variation between people in how long they test positive,” says Kissler, whose work involves modeling the dynamics of epidemics. “While that average is closer to six to 10 days, there are people who will hang on for longer than that.”

The truth is that there are a lot of factors that can affect how long any given individual may test positive.

For one thing, there may be some confusion around when you start your COVID positivity clock. According to CDC guidelines, your Day 0 with COVID-19 should be the day you were tested (if you had no symptoms) or the day you first felt your symptoms if you have them. But, in practice, that can be surprisingly hard to keep track of, Cardona says.

The other major variable these days is what's known as COVID rebound, Cardona says. This occurs when people "pop back up as being positive even after a negative test," she explains. "It's not super common, but it does actually happen." This can occur with or without taking the antiviral medication Paxlovid, and it may come with or without the return of COVID-19 symptoms.

It’s also possible to get COVID-19 more than once — even four or five times. So if there’s a gap of weeks or months in between your positive tests, you might actually have a new infection.

And, when it comes to PCR tests, which look for the virus’s genetic material, people may test positive for much longer than they're contagious, Dr. Alberto Paniz-Mondolfi, associate professor at the Icahn School of Medicine at Mount Sinai, tells TODAY.com.

“You can still have positivity that may persist for weeks and even months,” he explains. “We know that (PCR tests) can definitely stay positive way, way longer than somebody is infectious, let alone symptomatic,” Cardona agrees.

When to take an at-home rapid test for COVID-19:

If you develop any symptoms that might signal COVID-19, you should take a home test immediately, the CDC says.

Despite changes in which coronavirus variants are circulating now, the most common symptoms remain largely the same. Be on the lookout for cold- and flu-like symptoms, including sore throat, sneezing, congestion, runny nose, cough, muscle aches, hoarse voice and an altered sense of smell.

Some of those symptoms — congestion, sore throat, cough, fever — might be easily confused with other common illnesses, such as the flu, allergies, RSV or the common cold. But it's a good idea to take a test to help rule out COVID-19 first, even if you may just be dealing with seasonal allergies.

If you've been exposed to COVID-19, you should take a test at least five days after your last contact with that close contact.

The CDC suggests getting tested for COVID-19 before and after traveling. Try to take a rapid test as close to the time of your departure as possible to get the most accurate reading. And, if you're in high-risk situations on a trip (like a crowded, indoor party), the CDC recommends taking a rapid test when you get back.

You can also take a test before attending an indoor gathering, especially if you know you won't be wearing a mask. Taking a rapid test can also help you determine whether to spend time with people who are particularly vulnerable to severe COVID-19 symptoms, like those with certain underlying health conditions.

This winter, you can once again order free COVID-19 tests from the federal government via COVIDTests.gov. Orders reopened first in September and again on Nov. 20, allowing every household in the U.S. to order four free tests in each round.

That means that "households that haven’t already ordered tests this fall can place two orders for a total of eight tests," Dawn O’Connell, assistant secretary for preparedness and response with the U.S. Department of Health and Human Services, said on the CDC press call.

Many of the at-home tests the government sent out previously, as well as those you may have purchased, are good to use for six months or more. And some of their expiration dates have been extended even further, the Food and Drug Administration says. Check the expiration date for the particular test you're using to be sure you get accurate results.

And remember that even a faint line on a home COVID-19 test should be considered positive. If you’re not sure whether your test is truly positive, you should check with your doctor, get a PCR test or take a second rapid test the next day (and behave like you really do have COVID-19 in the meantime).

If you test positive for COVID-19...

If you test positive for COVID-19 on a rapid antigen test, you should trust that result. “If it actually is positive, that really does indicate that you are infectious and that your risk of spreading it to others is high,” Cardona says.

From there, you should follow instructions from your doctor and the CDC about isolation.

First, you should isolate from others for at least five full days after your positive test, current CDC guidelines state. It's during these first days that people tend to be at their most infectious, meaning you're most likely to spread the illness to others at this time.

If you have to be around other people, you should wear a high-quality mask, such as a N95 or KN95 respirator.

After five days, you can leave isolation if you never developed symptoms or if you had symptoms that are improving (for example, at least 24 hours without a fever without the use of fever-reducing medications), the CDC says.

But you should continue to wear a mask when around others for a full 10 days.

If your symptoms aren't improving after five days of isolation, you should stay isolated until you're feeling better — and you've gone 24 hours without a fever (without using fever-reducing medications). Again, you should keep wearing a mask when you're around other people for 10 days.

Regardless of when you end isolation, anyone who tests positive for COVID-19 should take certain precautions for 10 full days, the CDC says — including masking around others, avoiding travel and limiting contact with people who have a high risk for severe COVID-19.

If it’s challenging to figure out what all those guidelines mean for your specific situation, take a look at the CDC’s quarantine and isolation calculator tool.

After you test positive, does it make sense to keep taking at-home COVID-19 tests?

If you get a positive test on a home rapid antigen test, you can trust the result, experts tell TODAY.com, provided you performed the test correctly.

That means you probably don't need to keep testing yourself every single day throughout your illness. Just follow your symptoms and count the days — and continue to mask up around others.

But those with more moderate or severe cases, as well as those who are immunocompromised, may need to perform more tests to leave isolation based on advice from their medical team, the CDC says.

In the event that your test is negative even though you have noticeable COVID-like symptoms or you were exposed to someone with a confirmed case, the FDA now recommends taking a second test two days later. Depending on your symptoms and exposure, you may want to take a third rapid test another 48 hours after that, the FDA says.

"If you have high-risk features, such as (a known COVID-19) exposure or symptoms, and it's negative," Cardona says, "either repeat testing the next day or, better yet, just go to your doctor and get the more sensitive (PCR) tests that are available in doctors' offices."

Does a positive COVID-19 test after 10 days mean you're still contagious?

As long as you continue to test positive on a rapid at-home test, you should still consider yourself potentially contagious. “If you are still positive late in your disease or even though you’re symptom-free, that test is indicating that you still are shedding something,” Cardona says.

But, experts tell TODAY.com, that you are likely less infectious after 10 days than you were at the beginning of your infection.

"In theory, if you're getting better, your body's attacking the virus and getting rid of it," Cardona says. So you're less likely to spread the virus to others as your body clears it. That said, the safest strategy is to continue to isolate until you’re no longer testing positive, the experts say.

If you decide to see people after your 10 days and you're still testing positive, you should try to take other measures to prevent the spread of the virus.

"Is the risk zero? No," Cardona says. "But if you take the necessary precautions — wearing a mask, distancing yourself if possible from others — that would still be the recommendation."

Ideally, if you have access to enough tests, you wouldn’t stop masking until you get two consecutive negative rapid test results taken 48 hours apart, Dr. Emily Volk, past president of the College of American Pathologists, tells TODAY.com. But “this is asking a lot of folks,” she adds. And the CDC notes that this approach may mean you wear a mask around others for longer than 10 days.

The truth is that “not everybody’s going have access to serial antigen testing like that,” Volk says. “It’s probably not realistic that most of the population is going to follow those instructions, even though that would be the best scenario possible.”

If you must interact with others before testing negative, make sure to wear a high-quality mask, maintain distance from other people when you can and avoid spending time in enclosed spaces around other people.

After 10 days, it's likely that "you're good to go," Paniz-Mondolfi agrees, and he says you're "even better to go" if you keep practicing those precautionary measures — especially wearing a mask — until you get a negative test result. And, of course, if you're concerned about how long you've been testing positive, check in with a health care provider for guidance on your individual situation.

This article was originally published on TODAY.com