Question: My son has been traveling with Covid for almost two weeks and is still testing positive on antigen tests. He still has mild symptoms like any cold or virus – residual constipation and cough. Can he go back to school? I’m confused about the rules – like everyone else I speak to. Is he still contagious 12 days after his first positive test? He would have had symptoms before too.
dr Grant replies: Our knowledge of Covid-19 is constantly evolving and therefore the guidelines are updated regularly. The Omicron (BA1) variant of Covid-19 has a shorter incubation period (time between the first symptom) and significantly higher transmission rates than all other previous variants. The latest BA2 variant (currently circulating) is even more transmissible, similar to measles and chickenpox, and experts say it may be the most transmissible virus we’ve ever encountered.
It seems that your son has already passed his isolation phase and has now been absent from school for 12 days, which is commendable. Under current guidelines: you must self-isolate (stay in your room) for seven full days and may stop isolating after seven days if you have had no symptoms in the past 48 hours.
If you stop self-isolating after seven days, you need to be extra careful for a further three days to reduce the risk of transmission of Covid-19. You can also stop self-isolating if you have a mild cough or changes in your sense of smell, as these symptoms can last for weeks after the infection has cleared.
Most children without previous illnesses are considered to be fully immunocompetent. Therefore, on day 12, he is still non-infectious, although he has mild upper airway congestion and cough. From the early scientific data released from the first six months of 2020, before the introduction of vaccination programs, this was the last day on which Covid was detected, on day 10. In patients with mild to moderate disease If so, they are very unlikely to be infectious beyond day 10 of symptom onset.
Patients with severe to critical illness or with a weakened immune system may take longer to shed infectious viruses. This data was recently replicated in The Journal of Infectious Diseases October 2021 which revealed no viable Covid virus in any of the 35 people tested after 10 days from the onset of symptoms.
Considering all of the above, I would recommend your son’s return to school as he has no underlying health problems. Upon return, make sure he takes it easy as he returns to activities and daily routine. Perhaps also a chat with his teachers to ensure a smooth return and to assess how he is doing.
dr Jennifer Grant is a family doctor with Beacon HealthCheck
https://www.independent.ie/life/health-wellbeing/health-features/ask-the-doctor-my-son-is-still-testing-positive-for-covid-after-two-weeks-can-he-go-to-school-41516867.html Ask the doctor: “My son still tests positive for Covid after two weeks, can he go to school?”