Exposed to COVID-19 at a holiday gathering? Here's what to do next

What should you do if you suspect COVID-19 caught up to you this holiday season? 

Perhaps you attended a party and have learned someone there has tested positive. Or maybe you were among the thousands of passengers who spent extra time at an airport Christmas weekend in the midst of flight cancellations and delays, and are worrying about potential exposure. 

The highly contagious omicron variant accounted for more than 73 percent of new cases in the United States as of Christmas day and health experts have warned of a new resurgence in cases and hospitalizations. 

Adding to the challenges, omicron appears to be resistant to antibody treatments that were effective against earlier strains and more effective at defeating vaccines currently in use, increasing the possibility of breakthrough infections among those who are vaccinated. 

On Monday, the Centers for Disease Control and Prevention reported that data from South Africa and the United Kingdom measure 35 percent effectiveness against infection by the omicron variant of two-dose mRna vaccines such as those developed by Pfizer-BioNTech and Moderna. That effectiveness increases to 75 percent with a booster dose.

The vaccines also offer protection against severe illness, hospitalization and death in the event of breakthrough infections.

Although booster doses afford more protection against the new variant, as of Monday just 32 percent of the U.S. population and 33.3 percent of New Mexico adults had received the additional dose. 

This "what now?" guide is based on current guidance from the CDC and the New Mexico Department of Health. 

Quarantine and test

Were you in close contact with someone who tested positive? The CDC considers "close contact" to be at least 15 minutes over a 24-hour period within six feet of someone who has COVID-19. 

On Dec. 27, the agency announced it was shortening its recommended quarantine and isolation periods for those without symptoms, based on findings that "the majority of SARS-CoV-2 transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after."

If you are not fully vaccinated and have had close contact with a positive case, the CDC recommends quarantining at home for five days starting from the last contact with that person. This means avoiding household members and, in particular, those with risk factors for more serious disease, while waiting for test results and watching for symptoms. After five days of quarantine, the CDC recommends an additional five days of consistent mask-wearing around other people. 

That guidance also applies to people who completed a primary vaccination course more than six months ago (or two months following the Johnson and Johnson vaccine) but have not received a booster. 

If the five-day quarantine "is not feasible," the updated CDC guidance calls for 10 days of strict mask use. 

New Mexico's health department largely follows CDC guidance, but on Monday had not updated its recommendations in response to the federal changes. 

For those who have completed a primary vaccination course, no quarantine period is indicated unless you are showing symptoms of illness; but consistent mask use is advised for a 10-day period.

Regardless of vaccination status, the CDC recommends getting tested five to seven days after the suspected exposure, preferably five, and masking up indoors in public. (Note: New Mexico has a mask mandate for all residents ages 2 and up for indoor public spaces in effect through Jan. 7, unless it is extended.) 

If symptoms typical of COVID-19 disease develop — including fever, cough or shortness of breath — the CDC instructs you, as of Monday's advisory, to isolate yourself from others for five days beginning from the onset of symptoms and to contact your healthcare provider. 

More: Omicron may resist treatments that reduce hospitalizations

Depending on the circumstances, you might be a candidate for monoclonal antibody treatments, which state health officials say have been highly effective at cutting down the number of COVID-19 patients admitted to hospitals. One such treatment in use in New Mexico, sotrovimab, reportedly remains effective against the omicron strain. 

Supplies of sotrovimab are in short supply, however.

PCR vs. antigen tests

New Mexico considers lab-confirmed PCR tests as the standard for a true positive result. If you are symptomatic and get a negative result from a rapid antigen test, the DOH recommends following up with a PCR test. 

The antigen tests deliver quick results but can miss the presence of SARS-CoV-2, the coronavirus that causes COVID-19. Additionally, antigen tests administered in the home without professional supervision may be compromised if the individual does not carefully follow the directions. 

The New Mexico health department's directory of testing sites across the state is online at http://cvprovider.nmhealth.org/directory.html. President Joe Biden has promised to send a half-billion coronavirus test kits to U.S. households as well as open federal testing centers. 

Although the CDC suggests the quarantine period can be shortened to seven days if a test administered five days after exposure comes back negative, the New Mexico health department states: "A negative COVID-19 test should not be used to end quarantine early."

My PCR test was positive. Now what?

The state health department features a page on its coronavirus website, http://cv.NMhealth.org, with detailed guidance for what to do if you test positive. New Mexico generally follows CDC guidance following review by the state's medical advisory team.

No symptoms? Following CDC guidance, stay home and isolate yourself from others for five days starting from the day of your positive test followed by five days of wearing a mask around other people. 

Got symptoms? The isolation clock begins when symptoms appeared, rather than when you got tested. Isolation is for at least 10 days from that date, plus at least 24 hours after fever has passed without medication and symptoms have improved.

Hospitalized? A 20-day isolation period applies if you were in an intensive care unit, are undergoing chemotherapy, or have been diagnosed with uncontrolled HIV virus or a severe immunocompromising condition. Additionally, as above, at least one day should have passed since fever abated without medication and symptoms have improved.

I'm negative! How about that New Year's Eve party?

You're kidding, right?

On CNN Monday, Fauci recommended smaller gatherings among people you know are fully vaccinated but discouraged larger gatherings including individuals whose vaccination status is unknown to you. 

“When you are talking about a New Year's Eve party — where you have 30, 40, 50 people celebrating, you do not know the status of the vaccination – I would recommend strongly, stay away from that this year," he said.

New Mexico offers a number of outdoor events on New Year's Eve, and it might feel safer, rather than attending an indoor party, to celebrate at an outdoor event around the state, such as the Las Cruces Chile Drop (which is back this year after being held virtually last year).

Still, large outdoor gatherings that bring you in close proximity to others can still present risks. Notably, El Nuevo Día recently reported that a two-day concert event at an outdoor stadium in San Juan, Puerto Rico earlier in December is suspected by local health officials of having led to the infections of more than 2,000 attendees. Proof of vaccination was required for admittance to the show. 

Algernon D'Ammassa can be reached at 575-541-5451, adammassa@lcsun-news.com or @AlgernonWrites on Twitter.