Although the mandated isolation period for people with Covid-19 has been shortened to seven days, it’s vital to keep looking after yourself beyond that. Charlotte Muru-Lanning asks experts for advice on how best to do so.

With an ever-increasing number of New Zealanders testing positive for Covid-19 and health experts warning of a wave of long Covid cases, many of us will be wondering what we do once we reach the end of our seven-day isolation period. Should we worry about ongoing symptoms? How do we avoid the debilitating symptoms of long Covid? And how can we support friends and whānau who are still not feeling their best? With the help of experts, we attempt to provide some answers. 

It’s been seven days since I tested positive. Is my isolation period over?

Yes, as long as you don’t have symptoms, the current guidance means you can end your isolation period after seven days – and you don’t need to be tested. But if you’re still feeling sick, you should stay home for at least 24 hours after your symptoms clear.

If you live with others, as long as your household contacts have no symptoms and tested negative on day seven, they can also finish their isolation periods. If they test positive, however, they’ll need to begin seven days of isolation from the beginning.

Will I have to isolate again if someone in my household tests positive?

If someone in your household tests positive less than three months after you have recovered from a Covid-19 infection, you don’t need to isolate again. This is because the chances of being reinfected during this period are low, as you develop some temporary immunity. If it has been more than three months, you’ll need to complete another stint of isolation.

What is long Covid and how do I know if I have it?

The formal definition of long Covid relates to a wide range of symptoms that persist 12 weeks or more after being infected with Covid-19. It’s estimated that around 10-30% of Covid-19-infected people experience long Covid. Post-acute Covid-19, meanwhile, means symptoms that persist four weeks or more after you’ve been infected with Covid-19.

University of Auckland senior lecturer and cellular immunologist Dr Anna Brooks says despite people talking about long Covid since early on in the pandemic, there’s still very little known about how to treat people for the debilitating condition. That’s because there hasn’t been enough attention on funding research, so a lot of understanding is based on the experiences of those with long Covid and understandings of other chronic illnesses.

It was announced this week that the government is establishing a group to figure out how the health system will deal with long Covid, along with setting aside funds for research and support for sufferers. 

What symptoms should I look out for after my seven days of isolation?

Signs of an incomplete recovery might include shortness of breath, fatigue, cough, headaches, brain fog, a racing heart, aches and pains. Children often complain of tiredness, sore tummies, headaches and aches and pains. All of these are “alarm bells”, says Brooks, adding that you definitely shouldn’t try to push through them.

Professor Harvey White, cardiologist and director of the Green Lane Cardiovascular Research Unit at Auckland City Hospital, says “specifically for the heart, if you have chest discomfort, palpitations, short breath, faintness, racing of the heart” you should seek advice from your GP or a medical professional, as “these can all be very serious”.

White adds that a general feeling of “losing your mojo” post infection might be the best sign that something isn’t quite right. If this is the case, it’s crucial to rest and to seek medical advice.

Is there anything I can do to avoid long Covid?

The best way to not get long Covid, says Brooks, is to not get Covid-19 in the first place. “We really don’t have the miracle cure to prevent long Covid,” she says. 

If you’ve already caught the virus, “all we can offer as advice, based on those who have been there, is to rest”, she says. Resting, especially during and for the weeks after  infection, is crucial, even if you’re feeling fine. While resting doesn’t preclude long Covid, it can potentially lessen the risk. That means immediately heading back to the gym or to a celebratory dinner with friends after your seven-day isolation period may not be the best idea – even if you feel better. 

So instead of going for a long run, consider a light stroll. “It’s about balance,” says Mona Jeffreys, senior research fellow in epidemiology at Victoria University. “What you definitely don’t want to be doing until you’re feeling completely better is pushing your body harder than is sensible.”

As well as limiting physical exertion, it’s important to avoid mental stress. Covid, Brooks says, “affects your nervous system, your blood flow, and your immune system”. Because all of those parts of your body take time to heal, pushing through may exacerbate the problem. 

How long before I’m in the clear post-infection?

“Take it easy for a week or two,” says Jeffreys. “Even if that means going back to work but cutting back on social things, or going back to school but not going to whatever club you normally go to after school.” 

If you’re still in the post-acute phase, which is between four to 12 weeks after your isolation period, and you’re not feeling great, “that’s the time to be really, really careful”, says Jeffreys. “What we want to do at that point is absolutely minimise the risk of it turning into something long term.”

Covid didn’t seem to hit me too hard – I should be in the clear for long Covid, right?

Not exactly. While it might mean you’re less likely to develop long Covid, Brooks explains that developing the condition isn’t linked to the severity of your infection and can develop even if you experienced only a mild or asymptomatic infection.

“Different bodies are going to recover at different rates,” says Jeffreys. “Some of that will be due to how well you were before you got Covid and some of it we don’t yet understand – we can’t yet predict who is going to get long Covid.”

Are there any foods I should avoid?

There’s no real hard data out there around whether diet plays a role in reducing the risk of long Covid, but choosing healthier foods is likely a good idea, Brooks says. “You might want to go for the comfort food because you feel rubbish and you want your junk food to feel better,” says Brooks, “but that’s probably the worst thing you can do.”

Jeffreys says staying hydrated is an important part of recovering from any illness, so “instead of relying on tea and coffee to give you a boost – drink water”.

Should I get vaccinated if I’ve already had Covid?

If you’ve had Covid-19 and are yet to be vaccinated or boosted, you should do so – but it’s recommended you wait before doing so. For the primary vaccine doses, you should wait for four weeks after recovering, and if you get Covid-19 before having your booster, you should wait three months until after recovery before getting it. For children, a three-month gap is recommended between infection and getting a first or second dose. 

How can I support friends, whānau, employees and colleagues who are recovering from Covid-19?

White believes the best place to start is simply “to ask people how they’re going”.

Jeffreys says it’s important to believe people if they tell you they’re not feeling well. “Just because you have somebody who was really fit and healthy a couple of months ago, but has been unable to return either to work or to their full level of work or social interaction – don’t assume that they’re suddenly just lazy,” she says.

“Offering practical help is really important: cooking a meal, offering to look after kids or sharing the workload,” says Jeffreys. Whatever you can do to “lessen the burden of what they have to do to get through the day, I think can be really, really helpful”.

Brooks reiterates that there needs to be “respect that this is a real illness”. And that as a result there will need to be tolerance and understanding in workplaces, classrooms and beyond when people are feeling unwell beyond their infections. 

“We want our workplaces to be understanding, we want our colleagues to be understanding, we want our family to be understanding.”