PLRC COVID Guidelines

About Long COVID:

Long COVID is a condition that can develop in some people after a COVID infection. Anyone can get Long COVID, including children. There isn’t a cure for Long COVID and there aren’t currently any FDA-approved treatments for it. Long COVID is not a rare condition– about 18 million adults in the US are currently struggling with it– and many are profoundly ill and disabled by the condition. Even people who have recovered fully from previous COVID infections can get Long COVID after subsequent infections, and people who have Long COVID may experience significantly worsened health after reinfections.

The best thing you can do to prevent yourself and others from getting Long COVID is to take sensible precautions to avoid catching or transmitting COVID.

PLRC has therefore put together the following living guidelines on how to reduce the risk of COVID transmission, which will be updated periodically with the latest scientifically backed information. While it is difficult to fully eliminate the risk of contracting COVID, there are steps that we can take as individuals and collectively that, together, can lead to decreased burden of poor health and disability due to Long COVID.

What can be done to reduce COVID transmission?


Because COVID is an air-borne virus, wearing face masks can effectively reduce its transmission. However, the quality of the mask you wear matters. Face masks designated as “N95”, “KN95s”, “FFP2”, “FFP3”, or “KF94” are the best choices for your protection. These are high-quality medical masks that are designed to filter out the very small viral particles that hover in the air and can cause COVID, thereby significantly reducing your risk of contracting COVID.

While other types of masks, like surgical or cloth masks, offer some protection, they may not provide sufficient defense against COVID. However, surgical and high-quality cloth masks can still offer decent “source control.” This means that if someone infected with COVID wears one, these masks can help lower the chances of virus transmission. If everyone in a space is wearing a mask, even if their masks are not N95s, the chance of COVID transmission is significantly diminished.

Improve indoor air quality

COVID is primarily spread via airborne particles and droplets emitted when an infected person exhales. There are two ways to decrease the amount of infectious particles in the air: filtration and ventilation. Using air filtration units with HEPA filters can effectively improve indoor air quality. An alternative to store-bought air filters, which can be expensive, is constructing a DIY Corsi-Rosenthaler box using a box fan and HEPA air filters. Ventilation can be improved in an indoor space by simply opening a door or a window, and can be enhanced by additionally running a fan. If events or gatherings are held outdoors rather than indoors when possible, this can take advantage of natural ventilation and air movement to dramatically decrease the odds of COVID transmission.

Testing and distancing

People can transmit COVID even when they don’t feel sick. Home tests can be used to estimate if you are contagious. These can be purchased over the counter or ordered online. If you test positive for COVID or believe you have it, it is important to take steps to prevent transmission to others. While it is possible to be contagious with COVID without testing positive on a home test, it is very unlikely that you would test positive and not be contagious.

If you test positive for COVID on a home test, you are highly likely to be contagious even if you do not experience symptoms or only have very mild ones. It is possible to remain contagious for 10 days or more after your first positive test. You can determine if you are still contagious by conducting repeat testing using home tests. Once you have tested negative two days in a row you are unlikely to be contagious.

While you are contagious, you should do your best to stay away from public spaces such as work, school, and public transportation. However, PLRC recognizes that sick leave for those testing positive for COVID is no longer accessible to most Americans and many others worldwide. Additionally, because the CDC has dropped isolation recommendations for COVID, schools and workplaces may require attendance even when you test positive for COVID, putting others at high risk of catching the virus. If you must go out despite testing positive for COVID, it’s imperative to wear a high-quality mask to reduce the chances of spreading COVID to others.

Remember, you can be highly contagious with COVID without experiencing symptoms, or only experiencing mild symptoms like a runny nose. There are millions who are at high risk of complications of acute COVID, and everyone is at risk of developing Long COVID. Continuing to protect others from COVID is an expression of responsibility, care, and compassion.

Are you experiencing symptoms?

Test and rest

Unlike most respiratory infections, COVID symptoms can vary highly from one person to the next and from one infection to the next. Acute COVID symptoms may include a sore throat, cough, fever, runny nose, nausea, vomiting, fatigue, headache, body aches, chills, disorientation, passing out, loss of smell or taste, altered smell or taste, and more. These symptoms can overlap with those of other conditions and infections. Therefore, if you, your child, or a household member experience any new symptoms or are feeling generally unwell, it’s important to test for COVID.

Home tests are a quick and convenient way to determine if you have COVID. However, some people may have COVID but falsely test negative using home antigen tests. PCR tests, administered by healthcare providers, are more sensitive, but can be expensive and difficult to access, and these types of tests can still sometimes result in false negatives.

If you or a loved one tests positive for COVID or is experiencing COVID symptoms, it is important to reach out to a trusted healthcare provider to determine eligibility for accessing COVID treatments such as Paxlovid or other antivirals, and to assess the need for other forms of care. If symptoms are severe or worsening, it is essential to seek care from a healthcare provider, even if you do not test positive for COVID.

If you have COVID symptoms or test positive for COVID, it is very important to rest. Engaging in mentally or physically demanding activities such as work, sports, caregiving, excessive screen time or even routine housekeeping tasks while unwell can lead to worsened symptoms and
potentially increase the risk of developing Long COVID. It is important for employers and family members to understand that pressure to perform normal work or caregiving duties when sick may lead to a more protracted illness.

Some studies have found antihistamines and antacids helpful in reducing COVID symptoms, and investigations into other nutritional supplements for COVID are ongoing. Metformin has shown some promise in terms of reducing risk of Long COVID when taken during acute COVID. As with any illness, adequate hydration and good nutrition, as tolerated, are important to support recovery.

However, it is important to understand that no prescriptions, supplements, or over-the-counter medications are currently approved to prevent or treat Long COVID, and more research and clinical trials are urgently needed.

Reduce family and household transmission

To reduce the chance of spreading COVID within a household when one member is sick, it is best for the sick individual to largely isolate in a bedroom if possible, and ideally with a dedicated bathroom to themselves as well, and for all household members to wear masks in common areas.

However, following guidance to isolate when sick is not possible in many households, particularly those with limited space, elderly or disabled members who require monitoring and care, and families with children who cannot be left unsupervised and need continuous care and reassurance when they are sick.

When isolation is not possible, any uninfected household member or caregiver should wear a high quality mask such as an N-95. Shared areas such as bathrooms should be regularly cleaned and disinfected, and thorough hand-washing, especially after exposure to the bodily fluids of someone with COVID, is essential. The sick person should also wear a mask whenever possible to reduce the amount of virus in the air from exhaled droplets and particles. Meals should be taken separately to prevent unmasked household members from sharing the same space while eating.

Improving indoor air quality and boosting air circulation and filtration in homes can further decrease the chance of transmission between household members. Air filtration units with HEPA filters have been proven effective in doing so. However, if you do not own an air filtration unit, simply opening a window and running a fan can decrease the viral load in the air, thus
lowering the likelihood of COVID transmission, especially when combined with masking and distancing.

People are typically considered non-contagious after they have had negative home COVID tests two days in a row. This usually occurs within 5-10 days after symptom onset, but can sometimes be longer. Precautions against spreading COVID to household members and caregivers should
be followed until this time. By taking these steps, you can reduce the risk of Long COVID and support the well-being of your loved ones.

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