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Just because your isolation period is over, it doesn’t mean you should stop taking it easy. (Archi Banal)
Just because your isolation period is over, it doesn’t mean you should stop taking it easy. (Archi Banal)

SocietyMarch 21, 2022

So you’ve recovered from Covid. What next?

Just because your isolation period is over, it doesn’t mean you should stop taking it easy. (Archi Banal)
Just because your isolation period is over, it doesn’t mean you should stop taking it easy. (Archi Banal)

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. 

It’s a good idea to rest even after your seven-day isolation period, especially if you still have symptoms (Photo: Getty Images)

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”.

It’s important to avoid mental stress when recovering from Covid-19 (Image: Getty Images)

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.”

Keep going!
Ukrainians take part in military training for civilians as part of the Don’t Panic! Prepare! campaign, amid threat of Russian invasion. (Photo: Mykola Tys/SOPA Images/LightRocket via Getty Images, additional design by Tina Tiller)
Ukrainians take part in military training for civilians as part of the Don’t Panic! Prepare! campaign, amid threat of Russian invasion. (Photo: Mykola Tys/SOPA Images/LightRocket via Getty Images, additional design by Tina Tiller)

SocietyMarch 20, 2022

Want to fight in Ukraine? You’re free to go – but don’t expect NZ legal protection

Ukrainians take part in military training for civilians as part of the Don’t Panic! Prepare! campaign, amid threat of Russian invasion. (Photo: Mykola Tys/SOPA Images/LightRocket via Getty Images, additional design by Tina Tiller)
Ukrainians take part in military training for civilians as part of the Don’t Panic! Prepare! campaign, amid threat of Russian invasion. (Photo: Mykola Tys/SOPA Images/LightRocket via Getty Images, additional design by Tina Tiller)

While there’s nothing in law preventing New Zealanders volunteering to fight, getting involved without adequate military training – including in the rules of war – carries very serious risk, writes international law expert Dr Marnie Lloydd.

News that a New Zealand army veteran is already in Ukraine helping train civilian fighters, and more are planning to travel to the war zone, raises important questions about what is lawful and what the risks of such actions might be.

As the number of volunteers for the International Legion for the Defense of Ukraine rises to a reported 20,000 from over 50 countries, how does New Zealand respond?

Firstly, there is a difference between “foreign enlistment”, where someone joins another country’s armed forces, and what is often called “foreign fighting”, where someone takes up arms as an individual or volunteer in a group.

Foreign enlistment generally poses little problem. Its lawfulness depends on the domestic law of the person’s home country (does it allow citizens to fight for another country’s armed forces?) and the law of the destination country – for instance, does it allow non-citizens to enlist?

New Zealand does not generally prevent people joining another country’s military. In Ukraine, a 2016 presidential decree made it possible for non-Ukrainian citizens to enlist in Ukraine’s armed forces, and in February this year it was announced the International Legion will form part of the nation’s armed forces.

In contrast to foreign enlistment, application of the law to foreign fighting – both internationally and domestically – has always been guided by the nature and context of the conflict, and has varied depending on what was at stake in different political moments in history.

Few barriers to volunteering

In New Zealand, mercenary activities are prohibited – but the law’s definition of a mercenary is relatively limited. Criteria include that a person must be motivated by private gain and be paid substantially more than local soldiers.

New Zealand’s terrorism suppression laws are also relevant to foreign fighting, but these only apply if the person engages in terrorism.

Apart from these two categories, there is no specific law governing foreign fighting, and therefore nothing that prevents someone from volunteering to fight in Ukraine.

This is in line with international legal provisions, which likewise do not explicitly prohibit “foreign fighting” in a general way, and different countries’ laws vary in their permissiveness.

Even if New Zealand has not taken stronger legislative steps to prevent volunteer fighting more generally, its government is certainly not encouraging it. New Zealand has advised against travel to Ukraine, and may not be able to provide consular assistance to citizens who choose to fight there.

Danger on all sides

Under the laws of war, someone fighting in Ukraine can be targeted by the other side. If they act only as a medic or first responder, they remain protected from direct targeting, but are nevertheless put at great risk of incidental harm.

Russia has also reportedly threatened to treat foreigners fighting in Ukraine as mercenaries and to refuse them prisoner of war status. Even if this is legally wrong, captured foreigners risk prosecution or worse by Russia.

War can also attract all sorts. There have been volunteers fighting on both sides in Ukraine since 2014, with both also claiming a heritage to the international brigades of the Spanish Civil War. Some of those foreign volunteer fighters in Ukraine have reportedly held right-wing extremist views.

There are also concerns that the experience of war may see volunteers bring violence back to their home country, as well as suffering long-term injury or other trauma.

Crucially, anyone fighting in Ukraine must follow international humanitarian law, including the Geneva Conventions. This requires respect for and protection of civilian populations, places such as hospitals, cultural property, neutral humanitarian workers and others protected by the laws of war (such as captured soldiers).

Risk of war crimes

People fighting without adequate military training – including in the rules of war – is a major concern. Despite good intentions or bravery, war crimes can be committed. Civilians, who are already bearing the brunt of the conflict, or other people protected by the laws of war, may end up being harmed.

In other words, foreign volunteer fighting can escalate and complicate a situation, and they could be prosecuted for the commission of war crimes upon their return to New Zealand. Because of its commitment to the Geneva Conventions, New Zealand is obliged to ensure respect for the laws of war in whatever feasible way it can.

New Zealand Defence Force soldiers are trained in the laws of war, so former military personnel volunteering may be of less concern. The same may apply where people are fighting as part of state armed forces, where command and control structures will be in place.

However, as Australia’s Brereton Report showed, even highly trained soldiers can become involved in alleged crimes amidst the heat and tragedy of war.

Thinkers like writer George Orwell and philosopher Simone Weil, who were both volunteer fighters in the Spanish Civil War, warned about the way war sees even those on the “good” side committing violence and abuse.

All these factors should give governments pause for thought. Even if we feel solidarity with a cause, we may feel torn by the idea of individuals taking up arms on their own prerogative, especially when there are other, non-violent alternatives.

Marnie Lloydd is a lecturer in law and associate director of the New Zealand Centre for Public Law at Te Herenga Waka — Victoria University of Wellington

This article is republished from The Conversation under a Creative Commons licence. Read the original article.

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