Though I have been writing about Covid-19 for The New York Times for the past two years, I still felt overwhelmed when my son was sent home from school sick in mid-March and tested positive. Suddenly, I was in a cluttered New York City apartment with my husband, first grader and third grader, a lot of virus particles and no clear plan.
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We did try to isolate positive from negative family members at first and wear masks, but we all got sick anyway. The rolling series of infections lasted for about three weeks, and my symptoms included a 102-degree fever, sore throat and congestion. We were all fully vaccinated, and my husband and I were boosted.
Could we have done a better job at limiting the virus’s impact on our household?
To answer this, I reached out to seven experts for practical tips for families with young children who test positive for Covid, as the highly transmissible Omicron subvariant BA.2 is circulating.
Here are answers to some of the questions that I grappled with.
Early detection is vital to slow down transmission, and in Canada and Britain many authorities recommend swabbing the throat, then nostrils to find the virus sooner. “A good five seconds on each spot, and each side, is best,” said Dr. Kashif Pirzada, an attending emergency physician in Toronto. “There’s some good research showing an improvement with the combined approach in the sensitivity of these tests.”
In the United States, however, there was disagreement. Several experts I spoke with recommended against using nasal rapid tests to swab the throat, largely because the Food and Drug Administration hasn’t authorized it. “We have seen false positives from throat swabs based on the acidity of recent food and beverage consumed,” said Dr. Eric Ascher, a family medicine doctor affiliated with Lenox Hill Hospital. Others backed trying the method.
If family members test positive on a rapid test, it is safe to assume they have Covid, and they should begin isolating and taking precautions, the experts agreed. If they test negative, they should retest frequently while exposed, if possible, and assume they are positive if symptoms begin.
“It is important to know that some people do not test positive during the first one to three days of infection,” said Dr. Michael Mina, an authority on Covid-19 testing and the chief science officer for Emed.
The experts disagreed about whether it was necessary to also get a P.C.R. test to confirm rapid test results; several said that rapid tests were sufficient. Dr. Pirzada said that confirming results with a P.C.R. is advisable when the first family member gets a positive rapid test or shows symptoms but is not necessary after that. Dr. Kevin Slavin, the head of pediatric infectious diseases at Joseph M. Sanzari Children’s Hospital said that he prefers the whole family to get the more sensitive P.C.R. test. The bottom line, though, is that people should not wait for positive P.C.R. results to begin isolating and taking precautions.
