Dear Patient,
We know many of you have more questions about COVID-19, as there are many people who are testing positive – often with home tests– recently. We hope the information below will help.
Please note that our practices are receiving an incredibly high volume of messages and calls. We are also experiencing staffing shortages. Response times may be delayed. We apologize for the delays and appreciate your understanding. Practices are working hard to reply to messages and calls as fast as they can.
I have symptoms that I think might be COVID. Do I need a test?
If you have symptoms, you should get tested. Massachusetts has many testing options. If you live somewhere else, check your state website for resources. You can also use a home testing kit (often called antigen tests). The Centers for Disease Control and Prevention (CDC) has more information about home testing here. Please do not go to the emergency room or urgent care only to get a COVID-19 test.
Please note that Mass General Brigham has limited capacity for testing at this time. We are no longer able to offer elective testing (for example, testing for travel). We are adding testing capacity. We hope to be able to offer elective testing again soon.
What is the difference between isolation and quarantine?
Isolation is for people who have tested positive for COVID-19. Quarantine is for people who have been exposed to someone with COVID-19. The CDC has more information here.
I have been in close contact with someone who has COVID. What does this mean?
“Close contact” refers to time you spent directly with an infected person. This means you were within 6 feet of an infected person for a total of 15 minutes or more within a 24-hour period. The 15 minutes do not need to be at the same time. For example, three separate 5-minute exposures over the course of a day would total a 15-minute exposure. If you were in close contact with an infected person, you should be notified either by the person, by the school, or by the health department, though community contract tracing efforts have recently been reduced.
Guidance around the need for quarantine and testing after an exposure is changing. See the CDC, Massachusetts Department of Public Health or your state website for the most up to date guidance.
Note that most Massachusetts public schools are following the Massachusetts Department of Public Health guidance. However, some schools may have different guidelines. Please call your child’s school to find out what their specific policy is on quarantining if your child has been exposed.
I tested negative after an exposure. What should I do?
If you tested negative with a home test, follow the current guidelines related to quarantine and other testing. If you develop symptoms, you should test again. If a home antigen test is negative and you have symptoms, public health experts recommend getting a PCR test or testing yourself again with a home test after a few days.
In Massachusetts, unless local health departments have chosen otherwise, schools may allow a child to test and stay in school if they are exposed in school. Please call your child’s school to understand the school’s policy.
I tested positive at home. Do I need to get a PCR test?
If you use a home testing kit and test positive, you have COVID-19. You do not need a PCR test for confirmation. Please start home isolation immediately and notify your close contacts of your positive test. This guidance may change over time depending on how much COVID is in our community. We will let you know if this changes.
Am I at high risk for severe COVID-19?
High-risk conditions for severe COVID-19 include undergoing treatment for cancer, currently taking medications for transplant, or immunosuppressant medications for other conditions. Other high-risk conditions, including having chronic lung, kidney, or liver disease; diabetes; HIV; obesity; and age 65 years or older, may pre-dispose you to worse symptoms from COVID-19 or influenza. The CDC has more information here.
I tested positive. I’m not at high risk for severe disease. I’m worried about my symptoms. What should I do?
Mild Symptoms – Stay Home and isolate
Mild symptoms are a temperature below 100.4 degrees (below 102.4 degrees for children older than 3 months), aches and pains, or a mild cough. If you have these symptoms, stay at home and isolate. Rest, drink plenty of fluids, and monitor your symptoms. Hopefully you will start feeling better within a few days. You do not need to contact your doctor to let them know you have COVID.
Moderate Symptoms – Call Your Care Provider
If you have moderate symptoms like a fever higher than 100.4 degrees, significant coughing, or shortness of breath, contact your primary care provider’s office. If you are receiving cancer treatment, please call your oncologist’s office.
For children ages 3 months and older who are not immunocompromised, a high fever is greater than 102.4 degrees. If your child has a fever, significant coughing or shortness of breath. you also should call their primary care provider’s office. You should also call if they are sleepier, if they have not gone to the bathroom in more than 10 hours (if 3 years or older) or more than 8 hours (if younger than 3 years old). Your child’s doctor can recommend next steps.
If you don’t have a primary care provider or you have symptoms that need immediate attention, try our Urgent Care options:
- Schedule an appointment with Mass General Brigham Virtual Urgent Care (for ages 3 and older)
- Visit one of our in-person Urgent Care centers (ages seen vary by site, check website for details)
Severe Symptoms – Emergency
Go to the Emergency Department if you have severe symptoms such as:
- Severe trouble breathing
- Persistent pain or pressure in the chest
- New confusion or dizziness
- Inability to wake or stay awake
- Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
If you cannot get to the emergency department, call 9-1-1.
I tested positive and I’m at high risk for severe disease. I am worried about my symptoms. What should I do?
Call your primary care provider’s office
You may be eligible for outpatient COVID treatment. Please note, we have limited supplies of these therapies.
For example, monoclonal antibody therapy (mAB), can help fight the infection. Call your primary care provider’s office to be referred. You are eligible if you are at high risk for severe COVID-19 and have either a positive antigen test or PCR test and are within 10 days of starting symptoms.
High-risk conditions include undergoing treatment for cancer, currently taking medications for transplant, or taking immunosuppressant medications for other conditions. Other high-risk conditions, including having chronic lung, kidney, or liver disease; diabetes; HIV; obesity; and age 65 years or older, may pre-dispose you to worse symptoms from COVID-19 or influenza. The CDC has more information here.
Note that mAB is not available at Urgent Care or the Emergency Department. If you are eligible, your primary care provider will refer you to a designated infusion clinic.
Also, the U.S. Food and Drug Administration has issued an emergency use authorizations (EUAs) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets) and Merck’s molnupiravir. These are pills that can be used to treat mild-to-moderate COVID-19. Paxlovid is available for adults and children 12 years of age and older weighing at least 40 kilograms. Molnupiravir is for adults only. Both are available by prescription only for patients who are at high risk for severe COVID-19. Both should be started as soon as possible after the diagnosis of COVID-19 and within five days of the start of symptoms. We do not yet have this treatment available but anticipate limited quantities soon. We will provide updates when it is available. Please do not call or message your primary care provider’s office to request these drugs as they are not available right now.
Please note that the flu is now spreading in our community too. If you have a negative COVID test but have moderate symptoms, including fever and body aches, contact your primary care provider’s office. They may test you for the flu or give you a medication for the flu, especially if you are in one of the high-risk groups listed above.
We will provide more information as it becomes available. Please continue to take precautions to keep yourself and others safe.
Sincerely,
Thomas Sequist, MD
Chief Medical Officer
Mass General Brigham