Vaccination and the omicron variant have shaken the COVID game board. The first, for the better; the second, for the worse. Almost 80% of the Spanish population has completed the vaccination regimen, which, a priori, protects them against serious illness and death. But not against contagions. And less, with the growing threat of the omicron, which experts presume more transmissible and with a certain vaccine escape. With this scenario on the table, the contagion curve soared —511 cases per 100,000 inhabitants in the last 14 days— and hardly any social restrictions on the street, caution and individual responsibility make more sense than ever.
Health authorities had relaxed case control measures as vaccination progressed and, since June, vaccinated close contacts, for example, no longer had to quarantine. However, the rise of the variant forced the government to make a change in protocols in early December and reorder the isolation of close contacts of omicron cases. Catalonia has gone a step further this Friday and has returned the mandatory quarantine to all close contacts.
Above all, prudence, the experts insist. So are the recommendations to control the transmission of the virus.
I am vaccinated, but I have tested positive for covid. That I have to do?
Isolate yourself and consult with your doctor to start contact tracing and active surveillance of your case. Vaccination reduces the risk of serious hospitalization and death, but it is not sterilizing. Therefore, whether a positive case is vaccinated or not, they will have to do at least 10 days of quarantine from the onset of symptoms. If the clinical picture persists after the tenth day, the isolation will be maintained for three days from the resolution of the fever and the symptoms. The Ministry of Health indicates in its protocols that it will not be necessary to perform a PCR to lift the isolation or to return to work.
What do I do if my child has tested positive at school?
Your child will have to isolate himself because he has an active covid infection and you must quarantine for at least 10 days. As a general rule, partners (parents, siblings …), as close contacts that they are, can only avoid quarantine if they have completed the vaccination regimen, are not immunosuppressed and the positive case is not due to the beta, gamma or omicron variant . Although, yes, Health recommends these close contacts vaccinated avoid contact with vulnerable people, wear a mask in social interactions and avoid mass events.
In Catalonia, however, the Government toughened quarantines on Friday due to the rise in infections and has ordered that all close contacts (also vaccinated) of positive cases will have to comply with them. Salvador Peiró, epidemiologist at the Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (Fisabio), celebrates the measure: “It is drawer. When we look at viral loads, vaccinated and unvaccinated are the same. In the beginning [en junio, cuando se limitó la cuarentena a los contactos no vacunados] It seemed that it made sense because it was seen that he had some protection against contagion, but now we know that, as time passes after vaccination, the protection falls ”.
And what happens if my child is in close contact with a positive from the school?
If a child from the stable cohabitation group has tested positive, the rest of the group will have to quarantine 10 days at home and will not be able to go to class. As in adults, only minors who have completed the vaccination regimen will be exempt from isolation. Your child, of course, will have to undergo at least one diagnostic test to rule out infection, but not immediately, says Peiró: “It is better to have a PCR on the fourth or fifth day. There is no use doing them immediately because if the virus is incubating, it can be negative. “
Cohabitants of close contact (parents, siblings …) are not considered contacts. The contact of a contact is not a contact.
I am close contact of a positive, but I am vaccinated. Do I have to do isolation?
No. Unless you live in Catalonia – the Government has just restored the mandatory quarantine for all close contacts -, you have some type of immunosuppression or the positive case of your close contact has been infected with the beta, gamma or omicron variant. The latter is the one that is expanding through Europe and gaining ground to the delta, the currently predominant lineage.
What you will have to do is undergo at least one diagnostic test (preferably PCR) during those 10 days to rule out infection. “If an asymptomatic patient tests positive, he has to start quarantine from the moment the PCR was done. If it is symptomatic and tests positive, isolation will begin from the day of symptoms onset ”.
I think I have covid, but I cannot contact the health center. What I do?
When in doubt, isolate yourself and wait. If you do not have serious symptoms, such as a very high fever or difficulty breathing, you do not need to go to the health center immediately, and having a diagnostic test to determine the diagnosis of covid is not an emergency either. If you have symptoms, Peiró suggests doing a self-diagnostic test because if it is positive, it is reliable, although if it is negative and the clinical symptoms are suggestive of covid, it is better to have another diagnostic test. In any case, the epidemiologist warns: “If you have severe respiratory symptoms, go to the emergency room.”
María Fernández, spokesperson for the Spanish Society of Family and Community Medicine, admits that accessibility to health centers, for example, has been affected by the healthcare pressure derived from the pandemic: “If they don’t pick up the phone, try asking appointment by other means, such as the web. In any case, if you have mild symptoms, you don’t have to rush to the health center, you can wait 24 or 48 hours ”.
What happens if I test positive for covid self-diagnosis antigens?
From the outset, you will have to isolate yourself and communicate the result to the health authorities, the health center or the device authorized by your autonomous community as a point of reference for covid care. Yes indeed, the health system will have to confirm the result of the self-test with another diagnostic test, usually PCR.
What if the self-diagnosis test is negative?
That does not mean anything. Self-diagnostic tests are not infallible and, furthermore, they do not have the same sensitivity at all times of the infective process. In the first days of incubation, for example, when the viral load is lower, these tests are not able to detect a positive. The Alerts Report of the Ministry of Health warned last summer that a negative result does not exclude the possibility of infection and should not be used, in any case, “To shorten or end the period of isolation or quarantine.”
Peiró warns: “If it’s negative, it doesn’t guarantee anything. You have a while that you know that the viral loads are not high, but it is a few hours. A test does not free you from having to take the rest of the measurements. “
If I do an antigen test or a PCR a couple of days before going to dinner with the family on Christmas Eve and it is negative, is it a definitive result?
You reduce risks, but you don’t completely avoid them. The use of the mask in social interactions, social distance and adequate ventilation are essential measures in any case. Toni Trilla, Head of Epidemiology at Hospital Clínic de Barcelona, points out: “If you test negative, it is quite likely that you do not have the virus, but it is not 100% safe. You can have a low antigenic load and that the virus is growing and you arrive at the day of the family meal with the high load and infect ”.
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