As the coronavirus epidemic continues in the US, you might be wondering just how long you'll be sick if you do contract COVID-19. Every case is different, but after months of scientific study and data collection, experts have a fairly good idea. Here are the symptoms you'll be dealing with, when they'll likely strike, and how long it will take until you're fully recovered and can safely emerge from self-isolation.
When do the first COVID-19 symptoms appear?
Not everyone who gets COVID-19 has symptoms—in fact, the World Health Organization (WHO) says 80% of infections are mild or asymptomatic. Yet those who do may develop fever and chills, a cough, muscle or body aches, fatigue, shortness of breath or difficulty breathing, or a loss of taste or smell. Other people with COVID-19 have reported headache, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.
The Centers for Disease Control and Prevention (CDC) says symptoms may appear 2-14 days after exposure to the virus. Yes, that’s a pretty large window. But a recent study by US immunologists, published in the Annals of Internal Medicine, narrowed it down. They analyzed more than 180 COVID-19 cases and found that, on average, it takes just over five days for COVID-19 symptoms to hit.
The research team also found that 97% of people who get the virus will develop symptoms within 11 days from the time they are first infected. Any of these symptoms can strike at any time during the course of the illness, from day one to the last days.
How long does it take to recover?
The COVID-19 recovery period depends on the severity of the illness. If you have a mild case, you can expect to recover within about two weeks. But for more severe cases, it could take six weeks or more to feel better, and hospitalization might be required.
According to the CDC, older adults and people who have severe underlying medical conditions, like heart or lung disease or diabetes, may be at risk for developing more serious complications from COVID-19.
What is ‘viral persistence,’ and how does that affect the course of the disease?
Sometimes the coronavirus sticks around longer than expected—and scientists are still trying to figure out why that happens in some patients, how it varies by individual, and exactly how long the virus stays alive inside the body. This is known as viral persistence, and it affects how long someone is contagious and therefore how long they should stay in isolation.
“Viral clearance is the disappearance of an infecting virus, either in response to a therapeutic agent or as a result of the body’s immune response,” Dr. Bailey explains. “This implies recovery from infection and lack of ongoing contagiousness. On the other hand, viral persistence is the continued presence of a virus, usually within specific types of cells, after resolution of symptoms of the acute viral infection.”
Viral persistence is seen in HIV, chronic hepatitis, chickenpox/shingles and herpes simplex, and Epstein-Barr. While it’s not typically a characteristic of acute respiratory infections such as COVID-19, research suggests that some people do have persistent COVID-19 infections. One study from China published in Quantitative Imaging in Medicine and Surgery demonstrates this: In the study, a woman had mild COVID-19 symptoms, which disappeared after 2–3 weeks. However, she retained a positive diagnosis status for over two months.
When can you safely go out in public?
The biggest risk of going out in public after having COVID-19 is transmitting the virus to others. If you follow the guidelines, however you can minimize the dangers.
“In most instances, contagiousness is negligible after 10 days, but this period may be more prolonged, e.g. two weeks or more, in those with an impaired immune system,” Charles Bailey, MD, medical director of infection prevention at St. Joseph Hospital and Mission Hospital in Orange County, California, tells Health. “If feasible, prolonging isolation for such people should be considered, perhaps to two or even three weeks, and they should be encouraged to wear a mask when they do venture out in public.” (As should everyone who goes outside and isn't able to socially distance.)
If you do come down with COVID-19, the best way to determine whether you’re still contagious is to get tested, but that’s not an option for everyone. “Currently, there is limited repeat testing ability due to supply shortages, so we rely on symptom-based resolution,” Jorge Vournas, MD, medical director of the Emergency Department at Providence Little Company of Mary Medical Center in Torrance, California, tells Health.
Your doctor will be able to advise you based on your overall health and the severity of your illness, but the CDC recommendation is to wait at least 10 days from the onset of symptoms and three days free without fever, provided your symptoms are improving.
And venturing out into the world again doesn’t mean throwing caution to the wind—far from it. Dr. Vournas advises being “extra cautious for several weeks.”
“Practice physical distancing, wear a mask, and wash hands regularly—these are the best practices at the moment,” he says. “There is no good reason to not be too careful. In addition to the common recommendations, be careful with who you interact with, especially high-risk elderly and those with comorbid conditions,” aka, health complications or impaired immunity.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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