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The general consensus (right now, at least) is that it’s most common to test positive four days after your symptoms appear. According to a report from researchers at Emory University published in the fall of 2023, this is when your viral load, or the amount of virus harboring in your nasal passages, is at its highest, and therefore, most detectable, on an at-home test. This is slightly later than when people produced positive test results a year or two ago—with Omicron and Delta, for example, your test tended to show a positive two to three days after your symptoms popped up. The theory here (key word being theory) is the increased immunity people now have, thanks to past infections and previous vaccinations, prolongs the amount of time it takes for the virus to ramp itself up in your body, Dr. Hafer says. There’s also the possibility there’s something unique about JN.1 that delays when you test positive, he adds, but it’s too soon to know that definitively.
When should you test again if your first test is negative, but you know you were exposed, or you have COVID symptoms?
If you get a negative result after your first rapid test, when to try again depends on how you feel. If you have symptoms, the Food and Drug Administration (FDA) recommends taking a second test in 48 hours. If you don’t have symptoms, do the same thing, and if the first two tests are negative, take a third 48 hours after that—again, to allow the virus time to build up in your body. If you’re still negative after a few at-home tests spaced days apart, there’s a pretty slim chance you have COVID, Dr. Breining says. That said, you can head to your primary care doctor or an urgent care facility for a PCR test to be extra sure (these catch more infections than rapid at-home tests do, but it takes longer to get your results).
Getting a PCR test is a good idea if you’re at risk of serious complications from COVID and your rapid tests are negative, but you’re still feeling bad. This is important so you can start Paxlovid, the antiviral drug for COVID, ASAP—it’s most effective when taken early. (Also, “high risk” includes things like diabetes, depression, and pregnancy, and Paxlovid is broadly recommended for people 50 and older. Don’t worry that you’re not “sick enough;” it’s specifically intended even if you have mild symptoms.) If you don’t qualify, are testing negative over at least two tests spaced two days apart, and have mild symptoms that line up with the ones above, you can probably stay home and ride your symptoms out as you would a typical respiratory infection (think: rest, fluids, pain relievers, Netflix), Dr. Hafer says. If you still feel like crap after a few days and aren’t getting better, talk to your doctor—there’s always a chance you could have something else, like the flu, which we have effective treatments for. (Plus, co-infections with COVID and the flu, though rare, can happen, Dr. Hafer says.)
I’m still testing positive after five days of isolating—is it safe for me to be around other people yet?
COVID is incredibly contagious (that is, after all, how we found ourselves in a worldwide pandemic where hundreds of millions of people got sick). Based on the latest data from the CDC, it looks like the virus is still wildly transmissible. Less clear, though, is how long you’re contagious after you test positive (and keep testing positive, despite feeling better). The belief, per the CDC, is that people are most contagious during the first five days after they first have symptoms, after which point you can go about your daily activities—like work, school, and social commitments—again. (With precautions firmly in place, that is—more on this below.)