Yes, You Can ‘Test Out’ Of COVID Isolation—Here Are The Rules
COVID cases are starting to creep up again in the U.S., and it’s understandable to have new questions about the virus and the newest CDC guidance on isolation after a positive test. After all, it’s probably been a minute since you have thought about COVID, let alone actually had to deal with an infection.
If you are sitting at home, staring at a positive COVID result, wondering how long you will continue to test positive, you're certainly not alone. A negative test usually means you can go about life as usual again, so it’s more than fair to want to get the go-ahead sooner rather than later.
It’s important to note that a negative COVID test isn’t the only way to end your isolation, but it can help you get out and about a little earlier than not testing. But more on that in a second.
So, how long will you test positive for COVID? Two infectious disease doctors break it down for Women's Health.
Meet the experts: Amesh A. Adalja, M.D., infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security.
Thomas Russo, M.D., is a professor and chief of infectious disease at the University at Buffalo in New York.
Do different tests show different results?
Yes, they can. COVID tests are generally broken down into two camps: polymerase chain reaction (PCR) tests and antigen tests.
PCR tests are considered the “gold standard” of COVID tests, and they’re more likely than other tests to detect SARS-CoV-2, the virus that causes COVID, the Centers for Disease Control and Prevention (CDC) explains. With a PCR test, a small amount of genetic material from a sample is copied multiple times, per Medline Plus. PCR tests are usually done in a doctor’s office or another medical setting, so it’s highly unlikely you’re using one of these at home.
Antigen tests are the ones you can typically buy at the drug store and use at home. These tests detect SARS-CoV-2 proteins, or antigens, and these tests usually give you results in 15 to 30 minutes, the Food and Drug Administration (FDA) says. Antigen tests are usually considered less sensitive than PCR tests.
“PCR tests will remain positive longer than antigen tests because they are detecting viral genetic material which will remain present for longer than the protein that antigen tests detect,” says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security.
So, you can get different results when you use different types of tests. Specifically, a PCR test is more likely to remain positive than a home antigen test, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York.
Are you still contagious if you’re testing positive?
This is where things get a little tricky, since you might get different results depending on which type of test you use. Specifically, Dr. Russo cites data that show PCR tests can stay positive for up to 90 days after you originally tested positive, but that doesn’t mean someone is infectious that long.
“On the front end, PCR is much more sensitive than home tests," he says. So, it can help you tell if you have an infection.
But if it’s been a few days, you’re feeling better, and you suspect that you may no longer be infectious, Dr. Russo says it’s best to reach for a home test (which, TBH, is more convenient anyway).
“On the back end, the general sense is that, if you test negative after you’ve been positive, your likelihood of being infectious is low,” he says. “Also, if you test positive on a home test and subsequently have a couple of negative tests, your confidence should be up that you’re not infectious. A positive PCR test over time doesn’t mean that.”
Can you still test positive for COVID after 7 days?
Yes, you can still test positive for COVID after seven days with either test.
While Dr. Adalja says that’s especially true with PCR tests, it also can be the case with antigen tests. “They may remain positive at seven days, but infectivity is likely diminished as viral replication is beginning to ebb,” he says.
In fact, Dr. Russo points out that since Omicron became the dominant strain of COVID, there isn’t a ton of data showing how many people are still infectious over time.
“In general, there’s no question that some people are infectious past 10 days, but that’s the minority,” he says.
Why am I still testing positive?
You can remove your mask sooner than 10 days if you have two negative antigen tests spaced 48 hours apart, the CDC advises. “If you’re negative on day five and you repeat the test on day seven and you’re negative, you’re considered not infectious and you can get out of jail, so to speak,” Dr. Russo says.
But if you’re still testing positive with an antigen test, Dr. Russo says you should assume you’re still infectious.
CDC guidance notes that people who don’t try to test out of COVID isolation should stay home for five days and wear a mask around others for an additional five days to try to lower the risk that they could infect others. And if you're still testing positive, you should mask up, too.
After 10 days, "most people—excluding the immunocompromised—are no longer contagious,” Dr. Adalja says. But if you do continue to test positive after 10 days, “I would assume you’re still infectious and you should behave appropriately,” Dr. Russo says. (That is, you should keep wearing a mask around others.)
When should I retest?
There's no hard and fast guidance on this, but the general rule of thumb is to try re-testing five days after you started showing symptoms or since you tested positive with no symptoms, Dr. Russo says. If you want to test your luck earlier, and you have plenty of tests, you can also try to test out of isolation.
In general, doctors say that testing to get out of COVID isolation is a good idea if you have enough tests handy. “I like the testing approach to guide your infectiousness,” Dr. Russo says. “It gives you more information.”
If you had a positive COVID test after you initially started showing viral symptoms, and then start to feel better, you can retest yourself, too.
“Someone should retest if they want to end their isolation and mask-wearing period early,” Dr. Adalja says.
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