By Dr. Vivek Sinha
For the past two years the world has lived under the shadow of the COVID-19 pandemic. When the pandemic started, there were many uncertainties that we had to face. How is it spread? How can we prevent it? Will we ever have any effective treatments? Will we ever have a vaccine against it?
While we still have much more to learn and still have far to go, we have made significant strides in understanding, preventing and treating COVID-19. Here’s what we do know.
Do masks work in helping to spread COVID-19?
Yes. Masks absolutely help reduce the transmission of COVID-19 and decrease your chance of catching and/or spreading the virus. In the very beginning of the pandemic, the Centers for Disease Control and Prevention had some variable guidance on mask wearing for the general public, however since then we have learned that masks can be directly correlated to decreased infection rates.
One question we are often asked is: What kind of mask is the best? The answer is that it depends on the situation. As we have learned more about the virus, the guidelines around masking have evolved. In talking about masks with my patients, I often categorize masks into three types: reusable non-medical masks, disposable medical masks and respirator/tight fitting medical masks.
When it comes to reusable non-medical masks, now that the supply of medical grade masks has improved, many experts are advising that the general public should consider not utilizing cloth masks for day-to-day use. This recommendation was reinforced by the appearance of highly infectious variants of COVID-19. The CDC does advise that if someone is wearing a cloth mask, they should pick one that has a proper fit over the mouth, nose and chin and has multiple layers of tightly woven, breathable fabric and a nose wire to assist with fit.
Disposable medical masks have become widely available and are often referred to as surgical masks. They often are composed of three layers of material with a filtration layer sandwiched in the middle. The World Health Organization strongly recommends that anyone who is at a higher risk of becoming seriously ill or dying from COVID-19 wears these types of masks rather than utilizing a reusable non-medical mask. Another very viable option that I often discuss with patients is to wear a disposable medical mask with a reusable non-medical cloth mask on top. This often will allow a better tight-fitting seal around the mask.
Respirators/tight-fitting masks, such as N95s and KN95s, are often used by health care workers while providing direct patient care. The CDC advises that the general public may opt to wear these types of masks if they are caring for someone who is sick with COVID-19, not up to date on their vaccines or riding on public transportation. The CDC also states that people who are at higher risk of severe illness or have underlying medical conditions should consider wearing a respirator or tighter fitting mask.
The biggest factor to think about when wearing this type of mask is to find a mask that fits you well. A tight seal is imperative for these masks to work properly. A well-fitting mask like this should filter out 95% of particles.
When do I need to test for COVID-19?
What type of test should I get? There are two main types of COVID-19 swabs tests that we are currently utilizing: the rapid antigen test and the PCR test. In addition, there is a rapid PCR test that is starting to become more available.
The PCR test is very useful in detecting small amounts of the virus. The ideal time a PCR test should be done is if someone has had a known or suspected exposure to COVID-19 and/or someone is having symptoms. Typically speaking, it takes three to five days for a viral load to be present enough for a test to be positive. The PCR test can often detect infection a few days earlier than a rapid antigen test. To that point, a PCR is often more helpful for determining infection as soon as possible. PCR tests usually take one to four days to return.
Rapid antigen tests also have a very valuable place in testing as well. They usually have results within 30 minutes. Generally speaking, the viral load must be higher for a rapid test to detect COVID-19, so oftentimes, a rapid test is useful if it is repeated over the course of a few days.
I’ve been vaccinated for COVID-19 already. Do I need a booster dose?
The short answer is yes. Infectious disease professionals are now starting to take the opinion that a person should consider themselves “fully vaccinated” only after they have received the booster dose. This approach has been shown to be effective against the newer Omicron variant of COVID-19. It is important to note that while the vaccine does not 100% prevent someone from catching the illness, it does decrease the chances that they will catch the virus. If a fully vaccinated person does become infected with COVID-19, then the chances of them having a severe case of the illness is much lower than if they were not vaccinated. In short, the vaccines decrease your risk of dying from COVID-19.
For more information on when to receive a booster dose, visit the vaccine page on the city’s website.
What should I do if I test positive for COVID-19?
The first thing to do is not to panic. If you are having symptoms and you perform an at-home test that returns positive, you should assume that the test is correct and you have COVID-19. In this scenario, you should not go to the E.R. just to confirm that you truly have COVID-19.
Once the diagnosis is made, you should start monitoring your symptoms and try to isolate from others in your household. Ideally you should stay in a separate room and avoid sharing common items like hand towels and cups/ kitchenware. If you have to be around household contacts, then you should wear a mask to limit their exposure.
However, if someone starts having severe symptoms, such as severe shortness of breath or chest, then they should seek medical attention ASAP.
The most important take home message is that the best treatment for COVID-19 is prevention. Masking, socially distancing when appropriate, getting vaccinated and appropriate handwashing are all part of a layered approach that has been shown to be effective in decreasing the transmission of COVID-19.
Like most things in healthcare, the best way to treat a condition is to first understand it and learn more about it. If you have more questions, visit the CDC’s website or speak to your health care provider.
Get vaccinated and boosted, wear your mask and look out for one another. We are still in this together!
The writer is chief medical officer of Belleview Medical Partners, an office and house call practice based in Old Town.