You’re an Index Case

You “count” as an index case if any of these are true:

  • You’ve developed symptoms of COVID and tested positive
  • You’ve developed symptoms of COVID and haven’t been tested yet
  • You tested positive, even without any symptoms

What should I do if I’m an index case?

The most important step is to isolate yourself. Stay inside, in your own home. Stay at least 6′ away from anyone you live with — even better, stay in a separate room, and use a separate bathroom. If you must share a room with someone, you should both wear a mask.

When did I become contagious?

You’re considered contagious for 2 days before you started having symptoms, or 2 days prior to your positive test, whichever is earlier. If you haven’t been tested, consider yourself contagious 2 days prior to your symptoms.

How long do I stay an index case?

You are a contagious index case until the longer of:

  • 10 days after your symptoms started and
  • 24 hours after you’ve recovered

If you never had any symptoms, you should stay in isolation for 10 days after your positive test. If you develop symptoms after your test was positive, follow the bullet points above (stay in isolation at least 10 days after your symptom start, or 1 day past recovery, whichever is longer.)

By “recovered”, we mean absolutely no fever, and your cough and all other symptoms are getting better. Other than fever, you do not have to wait until all of your symptoms are 100% gone to end your isolation, as long as it’s been 10 days.

Do I need to tell anyone?

Yes. If you have symptoms of COVID (and haven’t been tested yet), OR if you test positive, you must tell everyone who was in contact with you for the previous 48 hours. They will need to consider themselves “exposed” and follow appropriate guidelines.

What if I test negative?

Once you have a positive test, you are an index case. You have COVID. You should not be tested again. You should remain in isolation for at least 10 days. If you choose to have a second test done, even if it is negative you are still an index case, you still have COVID, and you should complete your isolation. There is no reason to do a second test.

It’s a different scenario if you have suggestive symptoms but you haven’t been tested yet, or you’re waiting for your test result. During this time, you should consider yourself positive and take all precautions. However, once your test comes back, if it is negative you can lift your restrictions. Note that a negative test isn’t perfect, especially a negative antigen-based test. If you have very suggestive symptoms and/or exposures, and test negative, it may still be best to consider yourself COVID positive and take the steps needed to protect yourself, your family, and your community.

Should I go see a doctor?

It may not be necessary for you to see a doctor — in fact, it is better if you do not go to a doctor’s office or hospital if you have no symptoms or if your symptoms are mild. Get plenty of rest, drink fluids, and control your fever with ibuprofen or acetaminophen.

You should call or go see your doctor if you have shortness or breath, chest pain, lethargy, confusion, marked weakness, or if you are worried and feel you need to see the doctor. You should be especially quick to call your doctor if you have COVID risk factors.

What are the symptoms of COVID?

Fever, chills, cough, shortness of breath (difficulty breathing), and body aches are the most common symptoms. Sometimes, there can also be headache, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea, but these symptoms are also seen in many other infections. If you’re living in an outbreak area or you suspect you’ve been exposed, even these non-specific symptoms suggest you could have COVID.

One specific, though uncommon, symptom of COVID is an abrupt loss of taste or smell. Since this symptom isn’t commonly seen with other conditions, it is quite suggestive of COVID infection.

Children are more likely than adults to have less-specific symptoms of COVID, and their illness may appear mostly with gastrointestinal symptoms like abdominal pain, vomiting, and diarrhea.

Am I at high risk of complications?

Older people are at much higher risk of complications and death from COVID. This risk increases with increasing age — those in their sixties are more at risk than those in their fifties, and the risk continues to increase with increasing age. There is some evidence that the very young (babies less than one year of age) may also be at elevated risk.

In addition, pre-existing medical conditions (such as asthma, diabetes, heart disease, liver disease, high blood pressure, diabetes, cancer, or other chronic illnesses) also increase risks, as does obesity. These risks multiply each other — with multiple risk factors, the risk shoots up very quickly.

What if I have a weakened immune system?

If you’re on medicine that weakens your immune system, or you have a health condition that weakens your immune system, you may have to stay in isolation longer. Talk with your doctor.

Photo by James Wheeler on
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