Can someone who had COVID-19 and recovered still spread it to others?
Anika H Ahmed, MD October 2020
This is a particularly important question and crucial to the well-being of the patient recovering from COVID-19 as well as the people around the patient. Scientifically there are two ways of handling this scenario.
The first method is dependent upon testing. Once a patient has fully recovered from the symptoms of COVID-19, he/she can be tested through a nasal or oral swab taken 24 hours apart. This would be the ideal situation but so far due to limited test kits available, most of the testing centers, hospitals, labs, and clinics are saving the testing kits for people with mild to severe symptoms. Presently the difficult reality is that scientists still lack complete knowledge of how much of the coronavirus a COVID-19 patient emits at different stages of infection and days after sickness, creating a clear risk of the patient infecting others. Guidelines from the Centers for Disease Control state that if testing kits are easily available, the doctors can test patients and see if they test negative from previously being positive in samples taken at least 24 hours apart, when symptoms subside and the patient appears completely recovered. But due to the nationwide shortage of test kits available, it is difficult for doctors and testing units to test patients in recovery with an oral or nasal sample. Many states have restricted testing to certain populations, such as hospitalized patients and health care workers.
The second method is more dependent upon observation of the symptoms of the COVID-19 patients. According to the Centers for Disease Control, they are considered to not be spreading the virus and safe to come out of isolation if there is no fever for at least three days even without fever-reducing medicines, there is an improvement in respiratory symptoms like coughing and shortness of breath, and at least seven days have elapsed after symptoms began or after diagnosis of COVID-19.
Another important point to keep in mind is that there may be carriers of the virus who are asymptomatic themselves and may continue to spread the virus before they become symptomatic; sometimes such carriers do not become sick at all. This is what makes it harder to control the COVID-19 virus as compared to the SARS and MERS viruses which only spread from symptomatic individuals after prolonged close contact. This novel Coronavirus is far more contagious.