In vaccinated and boosted humans, breakthrough covid-19 cases can often be quite mild, akin to an annoying cold; these relatively manageable symptoms can result in infected people rejecting a slightly scratchy throat and perhaps refraining from testing. The "what is a symptom" issue also affects those who test positive, with new federal guidelines relying on symptoms as a determining factor in whether you return to work or stay home after being tested positive for Covid-19 - especially for important workers and those who have not paid time off.
In December 2021, the Centers for Disease Control and Prevention changed its recommendations for isolation after a positive test, in which the number of days someone has to isolate largely depends on the presence of symptoms. Now people who test positive but do not develop symptoms should isolate themselves for only five days; if they remain asymptomatic, they may complete isolation after five days (but continue to wear a mask around others at home and in public for another five days).
To help you better understand what "counts" as a symptom, Vox spoke with three experts.
"No symptoms" means you feel best
Defined by the CDC as "when a person is infected with a virus and will never feel any symptoms at all", asymptomatic has become a collective phrase for those who are well and do not show any of the common markers of Covid-19 - lack of taste or smell, dry cough, fever - but still tests positive and seems to be able to spread the virus.
In the age of omicrons, where symptoms can be almost imperceptible, asymptomatic means absolutely no snuff, cough or soreness of any kind. "Asymptomatic means you feel in your best shape ever," says Jorge Salinas, assistant professor of medicine and hospital epidemiologist at Stanford University. "You make it great. You feel great, nothing bothers you."
Because community transfer is so high right now, it's best to assume you've been exposed to someone who has Covid-19 if you've been to a public place recently, Salinas says. Everyone should behave as if they have come in contact with the virus and are potentially infected, and if anything feels beyond your normal pain (like your chronic low back pain or common migraine), you should consider it a symptom.
Tolerance to pain or illness varies from person to person - what one person considers a mild cold may feel like a more disturbing flu to another - and a small tickle in the throat may not ping so "sick" for you under normal circumstances . But these are not ordinary circumstances. Regardless of the severity, any cough, sneezing, headache or body ache should be seen as a symptom.
"What we often find in people who are vaccinated and get Covid is that they think they are asymptomatic, but when you talk to them, they have had a mild cough, they thought it was an allergy, they had a little bit runny nose, they had a little sore throat, "says John D. Goldman, a specialist in infectious diseases at the University of Pittsburgh Medical Center." There are many people who either really have no symptoms or have such small symptoms that they do not think they are sick enough to have Covid. "
Part of the problem is that doctors are struggling to offer more concrete guidelines on how to categorize "asymptomatic." "Currently, there is no data available to define 'asymptomatic', which can be different in different people, as many have chronic respiratory symptoms as a baseline, from congestive heart failure to allergies," said Michael David, assistant professor of medicine and epidemiology at Perelman. School of Medicine at the University of Pennsylvania.
The key is to determine any differences between how you are feeling in your best days and right now. Experts, however, admit that this comparison is no easy task. If you typically have a runny nose after cycling to work in the cold, it is difficult to assess whether the current runny nose is normal or an indicator of something more serious. “If you really start thinking about it, we all have one little thing here and there,” Salinas says. "It's extremely difficult to say that someone is asymptomatic."
Make sure you know what Covid-19 symptoms may look like
Knowing the signs of Covid-19 is crucial to monitoring your own symptoms or lack thereof. According to the CDC, symptoms of Covid-19 include fever, shortness of breath, cough, loss of taste or smell, fatigue, body aches, headache, sore throat, congestion, nausea or vomiting, and diarrhea. Omicron symptoms tend to differ slightly, with data from South Africa indicating that people with omicron experience a itchy or sore throat, stuffy nose, dry cough and muscle aches, including low back pain. Other experts have said they need to take care of a runny nose and / or headache.
It is also wise to take note of the total number of symptoms you are experiencing. "The more symptoms you have, the more likely it is a respiratory infection," says Salinas. A combination of sore throat, headache and sniffles is probably not a coincidence.
While monitoring how you feel from day to day can help you capture symptoms when they occur, ironically, by thinking too much about how you feel, you can start fooling yourself into manifesting symptoms. The combination of anxiety and overthinking can make you magnify every little pain and ache, says Salinas. The only way to know for sure is to get tested; if you have already tested positive, the best way to measure your symptoms is to test again five days after the first test is positive.
If you need medication to manage your symptoms, you have symptoms
Congestion that you treat with DayQuil or a headache that necessitates taking painkillers is a red flag you are experiencing a symptom of, Goldman says. Not only do you feel less than your best, you also hide the crucial information from your family, colleagues, roommates - and yourself.
"If you mask the symptoms, you are more likely to go to work, you are more likely to do things that will spread the disease," he says. "Taking Tylenol and doing something to manage the symptoms will certainly not hurt you. It may just be that you are going outside and you are not aware that you are sick and spreading it to someone else." He recommends being tested to confirm (insurers now have to pay for eight home tests a month per family member, and Americans will soon be able to order free home tests) and do everything you can to avoid others while feeling sick.
Continue to rely on proven and true mitigation methods
For people who think they may be experiencing symptoms but need to leave the house, the safest way to move around in society is to wear a high-quality mask around others, says Salinas, and isolates in the extent one can. At this stage of the pandemic, Americans desperately need universal paid sick leave and free and easily accessible testing; until that happens, individuals will unfairly remain responsible for interpreting their symptoms as best they can.
Unless you are able to test regularly, take note of how you feel every day and continue to mask yourself in public. If you feel healthy without painkillers and colds, you can safely assume you are asymptomatic, given your own circumstances and history, experts say. Anything less than your best means you should take every snuff, pain or cough seriously.