When to self-test for Covid-19 and preparing to quarantine

The idea of self-isolation is to not only protect others from getting infected, but also allow yourself enough rest to recover well from the infection. — Filepic

Judging from the reported number of Covid-19 cases in Malaysia and around the world, the task to bring infections down to zero is near impossible.

In all honesty, we are all battle-weary since the pandemic started 18 months ago.

Covid-19 may never go away, but we can live with it, turning this pandemic into something less threatening.

Social responsibility, such as getting vaccinated, practising good hygiene and staying away from other people when unwell, will be a critical factor in this endeavour.

Another important factor is also to minimise the potential spread of the SARS-CoV-2 virus if you’ve come into contact with someone who is, or might be, positive.

To do this, self-testing and home isolation are two important strategies.

Two types of tests

Today, people can get themselves tested for Covid-19 with fast do-it-yourself tests.

If positive, they can then confirm it with a more accurate testing method and isolate themselves to recover at home, stopping the spread there and then.

Even if you test negative, it is best to remain in home isolation for at least 10 days.

Recovery at home is possible as long as your symptoms are mild.

This is especially so if you’ve already been fully vaccinated.

This will at least give our healthcare system some breathing space so that the more serious cases can get the medical attention they need.

There generally two types of Covid-19 tests available in Malaysia: PCR (polymerase chain reaction) and RTK-Ag (antigen rapid test kit).

PCR, which uses swab samples from your nose or throat, is the gold standard test as it is highly accurate in detecting viral genetic material.

In scientific terms, the sensitivity of a test refers to its accuracy in detecting an infection, while specificity refers to its accuracy in ruling out an infection.

The RTK-Ag, which uses saliva or swab samples from your nose, has a sensitivity between 91% to 95%, and a specificity between 98% to 100%.

Unlike the PCR test, the RTK-Ag detects spike proteins present on the coronavirus, rather than viral genetic material.

It is a less invasive and more affordable way to test for Covid-19.

Please note that the sensitivity and specificity scores are different across brands.

It is advisable to have a pulse oximeter handy to measure your blood oxygen saturation levels (SpO2) in order to detect happy hypoxia early if you are quarantining at home with Covid-19. — MedisanaIt is advisable to have a pulse oximeter handy to measure your blood oxygen saturation levels (SpO2) in order to detect happy hypoxia early if you are quarantining at home with Covid-19. — Medisana

Close contact

You might want to consider using a home test kit to detect Covid-19 if it is confirmed you are a close contact of a positive case.

Says consultant infectious diseases physician Prof Dr James Koh Kwee Choy: “By close contact, it means that you have been in very close proximity to a person who tested positive, for a significant period.

“You would need to establish when it was that you were in contact with the person.

“Two days prior and three days after a confirmatory test are when the virus is most contagious.

“So, if your friend tested positive on Thursday, and you were in close proximity with him or her two days before, which is Tuesday, up to three days after, which is Sunday, you are likely to have had significant risk of catching Covid-19.”

You may feel the need to test immediately after receiving news of being a close contact; this is not a good idea as it is still in the early days and the viral load may not be high enough to be detectable.

The best time to get tested is three to five days after the last contact with the infected person.

However, if in doubt and you were really a close contact, you can perform the test for ease of mind, but do take note of the recommended testing time.

In the meantime, you should assume you are positive and self-isolate while waiting for the best time to get tested.

Says Prof Koh: “The PCR test is generally recommended for those who manifest symptoms or those who have come in close contact with a Covid-19 positive patient.

“PCR tests are expensive, costing between RM200 to RM300 per test, and results may take between 24 to 48 hours to be available.

“Home RTKs may be a cheaper alternative for those who are concerned with their infection status, but exhibit no symptoms of Covid-19.

“It takes under 20 minutes for the results to become available.

“However, if the RTK self-test shows a positive result, it is best to confirm it with a PCR test.”

Home isolation

If you have tested positive, but can be classified under Category 1 (no symptoms) or 2 (mild symptoms), you can self-isolate at home.

However, Prof Koh notes that you need to consider two factors: Your home environment and the availability of caregivers.

The International Medical University (IMU) Division of Medicine head says: “Do you have a well-ventilated room with an ensuite bathroom?

“Otherwise, if you are sharing a bathroom, you will have to make sure you wipe down and sanitise after every use.”

While it is best to be alone during your home isolation, it may not be possible, especially if you have people depending on you, like young children or elderly parents.

It may be a challenge trying to stay away from them during isolation, so it’s best to arrange for their care while you are recovering.

Trying to go about your usual routine isn’t exactly possible given that your priority should be more rest.

“You need a caregiver – someone who is able and healthy to attend to your needs throughout the isolation period.

“More importantly, this caregiver should be someone who knows how to get you the help you need, should your condition deteriorate.”

Prof Koh explains: “It’s not just about staying at home.

“It’s about observing your condition for any signs of deterioration, and most of all, if you are living with others, you will want to make sure that you do not spread the infection.

“The idea of home isolation is to wait out the infectivity of the virus.”

The current practice is to quarantine for 14 days if you have symptoms, and 10 days if you have none, he notes.

During this period, you will be required to self-monitor and report your condition through your MySejahtera app so that healthcare authorities can perform follow-up action should your condition worsen.

Try to arrange alternative care for your children, elderly parents or other dependents so that you need not come into contact with them and risk spreading the disease. — FilepicTry to arrange alternative care for your children, elderly parents or other dependents so that you need not come into contact with them and risk spreading the disease. — Filepic

Check your symptoms

A crucial thing to take note of is low oxygen saturation, which refers to very low oxygen levels in the blood.

Some patients may not display any symptoms and appear (and feel) healthy, despite their oxygen level being less than 95%.

This is a sign of happy hypoxia – a potentially life-threatening condition for Covid-19 patients.

If undetected, it could result in a sudden collapse and death.

“Get a pulse oximeter to measure your blood oxygen saturation,” says Prof Koh.

“A healthy level of blood oxygen saturation is above 95%.

“Anything lower than 94% would be of concern.”

For an accurate reading, he suggests: “Do one reading first. It may be a normal reading.

“Then do this: Sit down and stand up from a chair as many times as you can in one minute and check again with the pulse oximeter.

“If there is a drop from your first reading of more than 4%, you should seek help.”

Aside from the MySejahtera app, there are also other daily assessments you can carry out yourself.

“Get a thermometer to check your temperature twice a day to detect the onset of a fever.

“Be mindful of Covid-19 symptoms: is your cough getting worse or your breathing becoming more difficult?

“Are you experiencing a new loss of smell and taste; do you have diarrhoea?” says Prof Koh.

He advises to get medical attention immediately if any of these occur.

Home isolation is not easy, but it is necessary to curb the spread of the virus.

It can be done properly with the right supervision and monitoring.

“Follow the SOPs. Test yourself.

“Home isolation can be inconvenient, and it can feel like a terrible, terrible 14 days.

“But you have to remember that it is for your own good, to give yourself some self-care so that you can heal,” says Prof Koh.

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