If you just tested positive for COVID-19, the most important steps are straightforward: stay home until your symptoms improve, manage your symptoms with over-the-counter medications, and figure out whether you qualify for antiviral treatment within the first few days. Most people recover at home without complications, but acting quickly on treatment and knowing the warning signs can make a real difference.
Stay Home Until Symptoms Improve
Current CDC guidance no longer requires a fixed isolation period. Instead, you can return to normal activities once your symptoms have been improving overall for at least 24 hours and any fever has been gone for at least 24 hours without fever-reducing medication. For many people, this means roughly three to five days at home, though it varies.
Once you’re back to your routine, take extra precautions for the next five days. That means wearing a well-fitting mask around others, keeping your distance when possible, improving ventilation in shared spaces, and washing your hands frequently. You’re still potentially contagious during this window even though you feel better.
If you want more certainty, rapid antigen tests can help gauge your infectiousness. Research from the Omicron wave found that about 54% of people still tested positive on a rapid test between days five and nine, with the likelihood of a positive result dropping significantly by day nine. A negative rapid test is a reasonable signal that your risk of spreading the virus is low, though it’s not a guarantee.
Find Out if You Qualify for Antiviral Treatment
Antiviral medication (Paxlovid) can reduce the risk of severe illness and hospitalization, but there’s a narrow window to start it. You need to begin treatment within five to seven days of your first symptoms. If you think you might qualify, contact a doctor or telehealth provider the same day you test positive.
You’re eligible if you have mild to moderate symptoms (not severe enough to need hospitalization) and you’re either 50 or older or have at least one condition that raises your risk. The list of qualifying conditions is long and includes many common ones:
- Diabetes (type 1 or type 2)
- Overweight or obesity (BMI of 25 or higher)
- Heart conditions (heart failure, coronary artery disease, possibly high blood pressure)
- Chronic lung disease (moderate to severe asthma, COPD, pulmonary hypertension)
- Chronic kidney or liver disease at any stage
- Cancer or a weakened immune system (from medication or a condition)
- Pregnancy
- Current or former smoking
- Mental health conditions (including depression and schizophrenia spectrum disorders)
- Physical inactivity
- Substance use disorders
That’s not the full list, but it covers the most common reasons people qualify. If you have any chronic health condition, it’s worth asking. Your doctor makes the final call based on your overall medical picture.
What About Paxlovid Rebound?
You may have heard that symptoms or a positive test can return after finishing Paxlovid. This does happen, but it’s less common than social media suggests. In clinical trials, viral rebound occurred in about 6% to 9% of people who took the drug, compared to about 6% of people who took a placebo. In other words, rebound happens at similar rates whether or not you take the medication. The benefits of treatment for high-risk individuals still outweigh this small possibility.
Managing Symptoms at Home
Most COVID symptoms respond to the same approach you’d use for a bad cold or the flu. Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can bring down a fever and ease body aches, headache, and sore throat. Follow the dosing instructions on the package.
Beyond medication, the basics matter more than people expect. Stay hydrated, especially if you have a fever or aren’t eating much. Water, broth, and electrolyte drinks all work. Rest as much as your body tells you to. Sleep is when your immune system does its heaviest work.
For congestion and cough, a humidifier or hot shower can loosen things up. Honey in warm water or tea can soothe a sore throat and may help with coughing. Prop yourself up with extra pillows if lying flat makes breathing feel harder.
Protecting People in Your Household
If you live with others, the first 48 hours after symptoms begin are when you’re most contagious. Wearing a mask at home, sleeping in a separate room, and using a different bathroom if available all reduce the chance of spreading the virus. One study of household transmission in Beijing found that face masks were 79% effective at preventing spread when all household members wore them before anyone developed symptoms. Even after symptoms appear, masking helps.
Open windows or run air filters in shared spaces. Don’t share towels, cups, or utensils. Wipe down surfaces in the bathroom and kitchen. These steps won’t eliminate risk entirely, but they meaningfully lower it, especially for anyone in your home who is older or has a chronic health condition.
Emergency Warning Signs
The vast majority of COVID cases resolve at home. But certain symptoms mean you need emergency care right away:
- Trouble breathing or shortness of breath at rest
- Persistent pain or pressure in the chest
- New confusion or difficulty thinking clearly
- Inability to wake up or stay awake
- Bluish lips or face
If you have a pulse oximeter at home, a reading consistently below 94% is a reason to call your doctor or go to the emergency room. These symptoms can develop suddenly, even in people who initially feel only mildly ill, so it’s worth checking in on yourself (or having someone else check on you) regularly during the first week.
What to Know About Long COVID
Most people recover fully within one to four weeks. A smaller percentage develop lingering symptoms, often called Long COVID, that can include fatigue, brain fog, shortness of breath, or exercise intolerance lasting weeks or months. Your risk is higher if you’re unvaccinated, if you had a more severe initial illness, or if you have underlying health conditions.
There’s emerging evidence that early treatment may help. Across multiple randomized trials, a 14-day course of metformin (a common diabetes drug) given during acute COVID infection prevented roughly one case of Long COVID for every 50 people treated. This isn’t standard practice yet, but it’s a conversation worth having with your doctor if you’re concerned about persistent symptoms, particularly if you already take metformin for another condition.
The most reliable things you can do right now to lower your Long COVID risk are to rest adequately during the acute phase, get antiviral treatment if you’re eligible, and avoid pushing yourself back into intense physical activity before your body is ready. If symptoms like fatigue or brain fog persist beyond four weeks, bring it up with your doctor rather than waiting it out.