Studies show that people are contagious starting two to three days before they have symptoms of COVID-19. On average, people are no longer contagious about a week after symptoms start. Some people may not have any symptoms.

If you have mild or moderate symptoms, stay home except to get medical care.

• Get plenty of rest.
• Drink lots of fluids.
• Take over-the-counter medicines, like acetaminophen or ibuprofen, to reduce fever.
• Stay away from others in your home as much as possible. If you must be near others, wear a mask.
• Monitor your symptoms. If they get worse, contact a health care professional for advice. You can get advice virtually or in person through OHSU’s Immediate Care services.

The Centers for Disease Control and Prevention has guidelines for staying away from others.

You have long COVID-19 if you still have symptoms at least a month after testing positive for COVID-19. 

Studies show that long COVID-19 affects about 25% of people who get COVID-19. We can’t predict who will have long COVID-19 or how long it will last. Everyone who gets COVID-19 is at risk, including children and people who had mild cases or no symptoms when they tested positive.

Symptoms of long COVID-19 vary widely and can affect almost every organ system. They include:

• Extreme fatigue
• Brain fog
• Emotional challenges
• Shortness of breath or chest pain or discomfort
• Heart issues
• Digestive symptoms
• Nerve pain

Long COVID-19 that greatly limits a person's daily life can be considered a disability under the Americans With Disabilities Act.

Learn more:

• OHSU launches Long COVID-19 Program to better serve patients with chronic coronavirus symptoms
• To broaden long COVID care, OHSU prepares primary care providers

Health officials recommend getting vaccinated even if you’ve had COVID-19 because:

• It's possible to get infected again, risking serious illness. 
• Some people don’t develop immunity after infection, studies show.
• Studies suggest that vaccines provide better, longer protection than infection.

The FDA is considering annual COVID-10 vaccination, similar to flu vaccination. That could start in fall 2023. It’s safe to get the COVID-19 and flu vaccines at the same time.

People who are fully vaccinated (have received all recommended doses) are eligible for a booster dose.

A booster is an additional, smaller dose of vaccine that is given after the first vaccination series starts to wear off. Pfizer and Moderna updated their COVID-19 boosters in 2022 with a bivalent (two-part) formula that targets an earlier form of the virus and its omicron variant.

Second bivalent boosters are available for:

• People who are 65 or older and who got their first one at least four months before.
• Most people who have a weakened immune system (immunocompromised) and got an updated booster at least two months before.

Research shows that boosters protect people against:

• Infection or serious illness for four to six months.
• The XBB.1.5 variant that is now dominant in the U.S.

Research shows that protection against COVID-19 from vaccines, boosters and natural immunity (a previous infection) can last several months.

An OHSU study found that in people who got infected and vaccinated, the resulting "hybrid immunity" grew stronger with more time between infection and vaccination.

If you have had COVID-19 symptoms, wait until:

• It’s been at least 10 days since your symptoms appeared.
• You’ve had no fever for at least 24 hours, without using fever-reducing medication.
• Other symptoms are improving (not including loss of taste or smell, which can last weeks or months).

If you tested positive for COVID-19 but did not have symptoms: Wait at least 10 days after your positive test.

If you were treated with Paxlovid: Wait until you are well and no longer contagious.

If you were treated with remdesivir: Wait 90 days.

Paxlovid treats mild to moderate COVID-19 by stopping the virus from making copies of itself. Treatment is most effective early, and must start within five days of first symptoms.

Patients take three tablets twice a day for five days — 30 pills in all. In clinical trials, Paxlovid greatly reduced the risk of serious illness or death for people at high risk.

To qualify for Paxlovid treatment, you must:

• Be age 12 or older.
• Weigh at least 40 kilograms (about 88 pounds).
• Be at high risk of severe illness.
• Have mild to moderate symptoms of COVID-19 that do not require hospital care.
• Have symptoms that started less than five days before.

Paxlovid is not recommended for those with severe kidney or liver disease or for people with weakened immune systems (immunocompromised).

Paxlovid can cause complications for people who take heart-related medications, including blood thinners and some drugs that lower cholesterol (statins). It's best to talk with your doctor about possible interactions. You can pause using some drugs safely during Paxlovid treatment.

Remdesivir is an antiviral medication. The FDA has approved remdesivir for people who have mild to moderate cases of COVID-19 and are at high risk of developing severe illness. It seems most effective early in an infection, when the disease is mild.

OHSU is the only hospital in Oregon that offers remdesivir to people who aren’t in the hospital.

To get remdesivir if you are not in a hospital, you must:

• Have started having COVID symptoms in the prior seven days
• Be at high risk for serious illness
• Be unable to take Paxlovid for COVID because you:
  • Take other medications that would conflict with Paxlovid and cannot be adjusted
  • Have kidneys that don’t work well

In a 2021 study, unvaccinated people who got remdesivir had an 87% lower risk of being admitted to the hospital or dying than people who got a placebo.

Remdesivir is given as an injection three days in a row. After each dose, you need to stay at least one hour in case you have a strong reaction. Side effects can include nausea or liver inflammation.

Lagevrio is an antiviral medication that treats mild to moderate COVID-19. Treatment must start within five days after symptoms begin. It is most effective early.

You qualify for treatment with Lagevrio if you:

• Are 18 or older
• Have tested positive for COVID-19
• Are at high risk of serious illness
• Are not in the hospital
• Have symptoms that started less than five days before
• Are not recommended for or are not able to get other COVID-19 treatments

Patients take four capsules every 12 hours for five days — a total of 40 pills. In clinical trials, Lagevrio reduced the risk of serious illness or death for people at high risk.

There are two types of tests: viral tests and antibody tests.

To find out if you are infected, you need a viral test. Viral tests detect SARS-CoV-2, the virus that causes COVID-19.

There are two types of viral tests:

• Rapid antigen tests look for antigens (proteins) related to the coronavirus. Rapid tests are fast and easy to use. Self-tests can be used at home. They are more likely to give false negative results, especially if you don’t have any symptoms.
• Laboratory PCR tests look for genetic material from the virus. They take longer to produce results and must be done by a clinic or pharmacy. They are more accurate than rapid tests.

Learn more:

• COVID-19 Testing: What You Need to Know, CDC

At-home tests are widely available. Households can order one set of four free at-home tests from USPS.com. If you buy at-home tests and have health insurance, check with your insurer to see if they cover the cost.

Find a testing site near you with the CDC’s test locator.

Find testing for OHSU employees.

The CDC recommends that you get tested if you:

• Have symptoms of COVID-19.
• Come in close contact with someone with COVID-19.
  • If you are fully vaccinated, isolate yourself and get tested 5 to 7 days after exposure.
  • If you are unvaccinated, get tested right away. Isolate yourself and get tested again 5 to 7 days after exposure.
• Are in some high-risk settings where testing is required.
• Are in a community where COVID-19 is spreading (see a CDC map).

If you use an at-home rapid antigen test and get a negative result, the FDA recommends that:

• If you have COVID-19 symptoms, you test again at least 2 times over 3 days, waiting at least 48 hours between each test.
• If you do not have COVID-19 symptoms, you test again at least 3 times over 5 days, waiting at least 48 hours between each test.

Data shows that repeating tests after a negative result increases the chance of an accurate result. That can help keep people from spreading the virus without realizing it.

Learn more: When to Get Tested for COVID-19, CDC

Children can get free weekly COVID-19 PCR tests during the 2022-23 school year if they:

• Are in kindergarten through 12^th grade.
• Attend a participating Oregon school.

OHSU is the lab partner for schools in 16 Oregon counties.

Learn more about the Oregon K-12 screening testing program.