Updated at 9:24 p.m.
The Vermont Department of Health announced Thursday evening that it adopted new recommendations for how long those who test positive for Covid-19 should avoid contact with others.
The new state guidance builds on recommendations issued this week by the federal Centers for Disease Control and Prevention but takes a slightly more conservative approach, urging an additional layer of testing.
The CDC announced Monday that those who are asymptomatic can leave isolation after five days but must wear a mask for the following five days whenever they are around other people. Dr. Mark Levine, Vermont’s commissioner of health, said Tuesday that the state had adopted the CDC’s guidance, but Gov. Phil Scott suggested that it might change course.
That course correction came late Thursday when the department issued its amended guidance.
Like the feds, Vermont now recommends a five-day isolation period for those who have not experienced symptoms or whose symptoms have improved, but it additionally recommends rapid testing before ending isolation. Those hoping to leave home should have two negative antigen tests at least 24 hours apart, starting at least four days after the start of isolation, according to the state.
These isolation guidelines apply regardless of vaccination status. However, the state explicitly exempted healthcare workers from Thursday’s updated protocol and chose to uphold federal guidance for that sector.
Previous guidance mandated at least 10 days of isolation, symptoms or not.
Many doctors and public health officials raised concerns that the CDC protocol, which did not recommend additional testing to exit isolation, would not do enough to curb infections. The agency’s decision came just days after Delta Airlines executives sent a letter to the director of the CDC requesting changes to the isolation policy for breakthrough infections.
CDC Director Rochelle Walensky told NPR on Tuesday that her agency made the changes in part to “keep the critical functions of society open and operating,” as Omicron drives an increase in cases.
A CDC press release said the decision was backed by science, given that most Covid-19 transmission happens in the first few days after infection.
What to do if you test positive
Though some recommendations have shifted in recent days, health officials advise the same first steps after you test positive.
Officials recommend that one of your first calls should be to your primary care doctor to let them know you have Covid-19. Your doctor may refer you for therapeutics, such as monoclonal antibody infusion, if you have mild-to-moderate symptoms and if you are 65 or older or have a pre-existing health condition on this list. These treatments can reduce your risk of severe illness and hospitalization, but there is a limited supply right now.
At the governor’s weekly press conference Tuesday, Levine urged Vermonters who are eligible for these therapeutics to start the process promptly.
“Timing is important to successful treatment,” Levine said.
The one treatment believed to work well against the Omicron variant is only approved for those age 12 and up, so these medications are primarily used on adult patients, said Dr. Benjamin Lee, a professor and pediatric infectious disease physician at the University of Vermont Medical Center.
If you don’t have a primary care doctor, the Department of Health recommends contacting one of the state’s free clinics listed here.
Maryann Caron, associate vice president of the Alice Peck Day Memorial Hospital in Lebanon, New Hampshire, said some patients without primary care doctors have called the hospital, and the hospital has connected them with a primary care provider.
People who test positive but are not severely ill should not seek care at their local emergency department, Levine said Tuesday.
Most Covid-19 infections in kids can be managed at home, according to Dr. Rebecca Bell, a pediatric critical care doctor at UVM Medical Center. She recommended infants, children and adolescents should see a health care provider if they have difficulty breathing or are unable to drink sufficient fluids.
“Remember that pediatricians and family medicine practices always have a provider on call, even on nights and weekends, and can discuss your child’s condition with you at any hour,” Bell wrote in an email to VTDigger.
The health department suggests a person infected with Covid-19 seek immediate medical care if they have trouble breathing, experience persistent chest pain or pressure, are unable to stay awake, become confused, or notice a change of color on the lips, gums, face, eye area or nails.
If you have tested positive, you also can request a pulse oximeter from the health department by calling 802-863-7240. A pulse oximeter clips to your fingertip to measure your pulse and oxygen levels, and can be another tool for identifying if you need medical care.
Who to contact next
The Department of Health asks that you notify any close contacts from your infectious period. Your infectious period, under state guidance, is two days prior to the onset of symptoms, if you have them. If you are asymptomatic, your infectious period is defined as two days before you got tested.
The state limited its contact tracing in November, focusing resources on cases impacting school-age children, older adults and people of color, so they may or may not call you.
Someone is a close contact if, within your infectious period, you were within 6 feet of each other for a total of 15 minutes or longer within a 24-hour period, according to the health department. A person counts as a close contact even if one or both of you were masked.
If you used an at-home test
If you got your positive result from an at-home rapid test, you do not need to confirm that result with a PCR test, Levine said at the press conference Tuesday.
If you are experiencing symptoms, but an at-home test comes up negative, then you should confirm with either a PCR or a second at-home test, Bell said. You also should isolate yourself while waiting for those follow-up test results.
The health department asks that anyone who gets a positive result from an at-home test reports that result using this online form.
If you get a positive result at home, Bell said, you should presume it is accurate and isolate yourself from others.
Liora Engel-Smith contributed reporting.
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