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If you experience the early signs and symptoms of a respiratory infection — fever, cough, sore throat, congestion, or even abdominal pain or diarrhea — it may be a good time to get tested for Covid, local doctors say.

Although the numbers have dropped dramatically since the early days of the pandemic, cases of covid in western Pennsylvania are on the rise.

In Allegheny County, reported cases have been on the rise since June 9, when 132 cases were reported. In the last week of June, a total of 218 cases were reported in the county – which is likely just the tip of the iceberg, as most cases are tested at home and not always reported.

According to state data, Covid-related emergency room visits are still in the low range, but increased 22% for the week ending July 6, according to CDC data. Westmoreland County case numbers are not available because the county does not have a health department.

Official CDC protocols for covid-19 have changed this year. People are officially allowed to return to work or school if they have been fever-free for 24 hours without medication and if their symptoms are mild and improving. The CDC also recommends wearing a mask and social distancing for five days to limit the spread of the virus.

Knowing if you have Covid allows you to avoid contact with people who are at high risk, said Dr. Donald Yelley, UPMC’s chief medical officer.

“We know that covid is a very dangerous infection for people at the end of their lives, especially the elderly, and those whose basic immune system is not functioning well or (who) have underlying diseases,” he said. “It’s important (to know) so you can change your behavior, whether that’s staying away from people or masking yourself.”

Many healthcare professionals are still following stricter covid protocols of staying home for five days after a positive test and wearing a mask for five days after that, said Dr. Amy Crawford-Faucher, a family physician and vice president of the Primary Care Institute in AHN.

“This means minimizing contact with the people you live with and being away from work and other social gatherings for five days,” she said. “Basically, stay away from people until you feel better. If you live or work among high-risk people, the best thing to do to prevent the spread is to wear a mask and minimize contact.

“It may be overkill for the general public, but of course it makes sense in healthcare to be more careful.”

How best to test?

Taking a rapid home covid test is a good idea if you are experiencing symptoms. The tests are not perfect, doctors advise, so multiple tests over several days are preferred.

“If you have symptoms and get a negative test, you should repeat that test in 48 hours because you may not have had enough virus in your nose when you took the test the first time,” said Dr. Carol Fox, chief medical officer at Independence Health System.

Tests can sometimes show a positive result long after you’re no longer contagious, Yellie said.

“Their advantage is that they are readily available and can give a pretty good idea of ​​what you can do next,” Yelli said. “A good test that is sometimes readily available is more useful to the general population than an ideal test that is hard to come by.”

If you can’t pinpoint when the first day of your symptoms was, you can use the first day you tested positive, Crawford-Faucher said.

“No matter what you have, if it’s a respiratory illness, (it’s) going to be contagious,” she said. “The prudent thing to do for your loved ones and the people you work with is to minimize contact if you feel sick.”

Pittsburgh-based Dr. Amesh Adala, a senior scientist at the Johns Hopkins Center for Health Security, said home tests are still useful even for new covid variants. It is best to use a new test, but an expired test showing a positive result is still a good sign of covid. False negatives are more likely than false positives, he said.

“The variant has no impact on whether the test is positive or negative,” he explained. “Home tests are useful for people who want to know their status and people who want to be linked to drugs like Paxlovid.”

Testing — whether with a home test or a PCR test from a pharmacy or doctor — can be important if someone is at high risk and eligible for treatment with Paxlovid, which slows the replication of the virus in your body.

Other factors that make someone a candidate for Paxlovid include being overweight, being over 50 and having a chronic illness, Crawford-Faucher said, but the range can be wide in terms of who would benefit from it.

“If someone is 80 years old, I will recommend that they take Paxlovid. We know the data for this group is pretty darn good in terms of preventing hospitalization and death,” she said. “If you’re 55 and healthy and have a mild case, I think it’s more a case of personal preference.”

It is difficult to know what the impacts or risks of repeated infections are and what makes a person more likely to be infected repeatedly compared to someone who has been infected once or never.

“Not much is known yet about the risks of developing long-covid, except that we know that lack of immunization appears to increase the risk of long-covid,” Crawford-Faucher said. “There’s still a lot we’re learning about this virus in terms of why some people and not others are prone to re-infection.”

Vaccination or booster

The CDC recommended on June 27 that people get an updated Covid vaccine this fall. Updated vaccines will be available from Moderna, Novavax and Pfizer later in the year, the agency said.

Most people by this point have either had Covid at least once, or received some level of vaccination, or both, Crawford-Faucher said. Updating the vaccine to match current variants provides additional protection.

“The role of vaccines has always been to minimize the risk of severe infection and death,” Crawford-Faucher said. “People keep dying from covid. Not with the numbers we saw in 2021, but it’s still happening.”

Vaccination may not prevent all infections, but it helps make infections milder.

“It’s not a force field to protect you from any contact with the virus,” Yellie added. “It just means that when you come into contact, you’re going to put up a better fight.”

Some people may have had covid without realizing it, Adalya said.

“Some people may have very mild disease and not even notice it, and some people may have no symptoms at all,” he said. “You’ll only know they’ve been exposed to the virus by looking at specific antibodies, and most people don’t get those tests.”

People still sometimes come to the hospital with Covid, Fox said.

“When people visit and come in for things, we ask them if they have respiratory symptoms. … If they say they do, we want to separate them from other people,” she said. “We don’t do routine testing, but if people have respiratory symptoms, if you go to the emergency room with respiratory symptoms, covid is part of the differential diagnosis.”