My daughter tested positive for COVID on January 16 after complaining of a bad sore throat. Emily is a senior at Kingston High School, and even though she’s vaccinated and boosted, I wasn’t surprised she got sick. I mean, I’ve been paying attention, following news about the Omicron variant since December. I knew that it was causing breakthrough cases in fully vaccinated and boosted people. I knew that it was spreading much faster and infecting more people than previous variants.
I also knew that it appeared to be milder than previous iterations of the virus, at least in vaccinated people. Even so, the sheer number of cases burning through the US in December was alarming. My husband and I have been doing our best to avoid the virus, but having a child in school puts my entire family at risk for exposure. It seemed inevitable that we’d get sick, but I tried to stay vigilant.
The school district posts a rolling four-week tally of daily positive cases on its website. Since the data disappears thereafter, I started logging the number of cases at Kingston High School in my own spreadsheet back in October. That’s how I noticed cases at the school were rising fast in December, right before winter break. I ordered N95 masks for my daughter to wear instead of cloth masks.
After Emily tested positive, I informed the school and asked what we needed for her to return after isolation. The nurse said she could return after five days as long as her symptoms were improving and she was fever free without medication for 24 hours. These were the CDC guidelines as of December 27.
The nurse also said Emily didn’t need a negative test or doctor’s note, and that was that.
***
Two days after Emily tested positive, my throat felt scratchy, and I used one of my two remaining rapid tests on myself. It was positive. Then a day later, my husband got sick. His test was negative, but since he had symptoms and had obviously been exposed, he needed to isolate.
We were fresh out of tests and it was impossible to find more online or locally. Thus, per the nurse’s instructions, I hadn’t planned to retest Emily when her five days of isolation were up. But my cousin’s wife—a retired nurse practitioner who now works as a public health nurse doing contact tracing for a local board of health in Massachusetts—sent me four boxes of BinaxNow rapid antigen tests. The tests arrived the day before Emily planned to return to school. She felt much better, but still had mild symptoms, so I tested her. A bright red “positive” line appeared beneath the control line.
Unsure what to do, I looked for guidance on the CDC’s website and learned that a positive test after five days of isolation meant that Emily should isolate until day 10. Per the CDC:
If an individual has access to a test and wants to test, the best approach is to use an antigen test towards the end of the 5-day isolation period. Collect the test sample only if you are fever-free for 24 hours without the use of fever-reducing medication and your other symptoms have improved (loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation). If your test result is positive, you should continue to isolate until day 10.
I also found an article by Sarah Jacoby for Today about what to do if you test positive after five days with COVID. In the piece, Dr. Stephen Kissler, a postdoctoral fellow at the Harvard T.H. Chan School of Public Health, confirmed that a positive rapid test means you’re likely contagious. “As long as you continue to test positive on a rapid at-home test, you should still consider yourself potentially contagious,” he wrote.
I sent an email to the school nurse letting her know that Emily had tested positive again, which meant I needed to keep her home for five more days. I included links to the CDC guidelines and Today article. The nurse then called me to reiterate that it was fine for Emily to return because “tests can remain positive for up to three months.”
“No, that’s wrong,” I said. “You’re thinking of PCR (polymerase chain reaction) tests—the kind you send out to a lab. PCR tests can remain positive for weeks or months after getting COVID. But rapid antigen tests can’t, so when they’re positive, you’re probably contagious.”
The nurse repeated that I didn’t need to retest Emily and that it was fine for her to return to school, per the CDC guidelines. I didn’t feel great about sending Emily back, so I called the Ulster County COVID Recovery Service Center to clarify the guidelines. The person I spoke with repeated the same wrong information—rapid tests can remain positive for up to three months, so my daughter could return to school.
“That’s not true,” I said, truly horrified. The next day, I sent an email to the Recovery Service Center explaining my concerns about getting wrong information. I included a link to the CDC’s updated guidelines and the Today piece about the validity of rapid tests.
***
My daughter went back to school on January 25, nine days after her first positive test. She was stressed about missing so much school and feeling fine by then. She wore an N95 mask for the entire week, which I told her not to remove, not even for lunch.
This entire experience was unsettling. It suggests that kids at the high school—and likely across the entire district—are leaving isolation while still contagious. I don’t fully blame the nurse for the misinformation; she was attempting to follow the CDC’s confusing guidelines while dealing with a community-wide desperation to get back to normal. But I’m astonished that I got the same wrong information from the Ulster County COVID Recovery office.
I also got this same wrong information from the person who answered the phone at my dentist’s office. I called to reschedule an appointment and when I said I’d take a rapid test to make sure I was negative before my appointment, the receptionist told me that rapid tests could be positive for up to three months. It’s clear that the bad information is circulating through Ulster County. I wonder how many people it made sick.
On January 4, the CDC updated its isolation guidelines, saying that people can take a rapid antigen test around day five of isolation if they want to and if they have a test available. Admittedly, this is lukewarm guidance, but it was still out there and I think parents should know about it, especially now that tests are much more accessible. I also think that people in authority—people like school nurses and COVID hotline employees and dentist office receptionists—should know the difference between rapid antigen and PCR tests.
Rapid tests are one of the main tools we can use to mitigate the spread of COVID. Ignoring a positive rapid test means you’re likely going out into the world while you’re still contagious. And, you know, maybe don’t do that?
***
After my family was on the mend, I reached out to Kingston High School’s principal, Vincent DeCicco, for comment about my experience with the school nurse. I wanted to know what the school is currently communicating to parents about CDC guidelines and exiting isolation.
I also wanted to know if he was aware that there was a huge spike in positive cases at Kingston High School in January, including students, staff, and teachers. Did the school plan to do anything to mitigate the virus’s spread if the numbers continued to increase? I haven’t heard back from him, although his secretary confirmed he received my email.
The total number of cases at the high school in January, as of February 8, was 165, up from 37 cases in December. That’s an increase of 346 percent.
I also reached out to the Ulster County COVID-19 Hotline & Recovery Service Center to get their official advice about what parents should do if their child tests positive for COVID (e.g., should they test on day six to ensure the child isn’t contagious before returning to school? If not, why not?) Other than acknowledging my email, I haven’t received a response to my questions.
I understand that everyone’s tired of the pandemic. I truly get it. But I don’t think it’s asking a lot to remain vigilant. Do the bare minimum. Stay home when you’re sick.
***
There’s emerging evidence that Omicron is good at evading immunity, meaning you can get the virus more than once even if you’re vaxxed or had a past infection. According to one study, the risk of reinfection is 5.4 times greater with Omicron versus Delta. There’s also the real possibility of more variants creating new surges. Omicron variant BA.2 is already in the US and is 1.5 times more transmissible than the original Omicron strain, BA.1. It’s not known whether BA.2 can reinfect people who’ve already had Omicron. Hopefully it can’t. Until we know for sure, I advocate for being careful, especially around vulnerable people like my 75-year-old parents.
The school nurse eventually called me to apologize for the misinformation about Emily’s positive rapid test. I am grateful for that. I understand that it was an easy mistake to make. But I am also dismayed. I am disappointed. I am worried. Because COVID’s not done with us yet. US deaths are currently averaging above 2,000 a day. We reached the grim milestone of 900,000 deaths from Covid on February 4, 2022.
There’s still so much we can do to protect each other. If we’re eligible, we can get vaccinated and boosted. We can test ourselves and our kids on day six of COVID if we have a rapid antigen test available or if we’re planning to visit a vulnerable loved one. We can wear N95, KN95, or other comparable masks when we venture out into public spaces.
And, yes, I realize the needle is constantly moving about what’s mandated and what isn’t, which makes it difficult for ordinary citizens to know what to do. Last week, Governor Kathy Hochul let the statewide mask mandate expire for most indoor spaces, though (as of this writing) it remains in place for schools. In a New York Times piece about lifting the mandate, Hochul was quoted as saying, “Localities and businesses will no longer be required to enforce mask wearing or ask for proof of vaccination, but they are still free to do so if they so wish.”
As with the CDC guidelines about testing to exit isolation, this isn’t exactly clear. My guess—based on two years of living through this pandemic—is that most people will hear the part about businesses not being required to enforce masking, and not the part about them being free to enforce it if they wish.
This is why we need to take some agency about reducing the spread of COVID. It’s why it’s important to question things when they don’t make sense, when they’re confusing, or when they sound too good to be true.We can also listen to what doctors and nurses are trying to tell us. They’re at the front lines of this disease, putting their own lives at risk every day. They’re saying that the pandemic is still happening, people are still dying, and they’re beyond tired. I’m not saying we need to live in fear indefinitely. All I’m saying is that we need to keep paying attention.
This article appears in February 2022.
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