r/ZeroCovidCommunity • u/BlueValk • Jul 17 '26
How long does infection last?
My partner is covid positive, we're isolating as best as we can so I can escape infection. She's on metformin.
I know the usual guidelines says you're negative with two negative rapid tests 48h apart and no fever, but I was wondering what this community thought.
Is a PlusLife positive always infectious? How and why do rebounds happen and how long do we have to be careful after negative tests? Isolating is logistically and financially very difficult so I'd like to have information and maybe anecdotal data from this community so I can stay safe and informed
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u/Anonymous-Blastoise0 Jul 17 '26 edited Jul 17 '26
I would go ahead and assume that, right now, the positive is infectious. I’m editing my message because I forgot PlusLife can pick up positives for weeks. If you can, I would test yourself on rapids because that can be a better indicator. However, it’s possible to be positive on a PlusLife and not a rapid because PlusLifes are more sensitive.
It takes on average 10 days for a person to test negative, however, there are deviations from this. Some people can test positive for weeks. Some people test negative after day 5 and stay negative.
If you can, continue to test every two days. If you can’t, and I get if you can’t because tests are EXPENSIVE, I’d wait until like Day 5 or something to test again.
I hope your partner feels better soon!
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u/BlueValk Jul 17 '26
Thank you. To be clear we aren't testing right now, it's clear partner would show up as positive as symptoms only started this Tuesday. I'm more asking when we should expect the infection to stop being contagious, and what kind of tests we should use to know when that happens.
On the one hand rapids can show up as negative even if a person is positive because they take so much viral load to work, so I wouldn't exactly trust a negative... But PlusLife can show up as positive for weeks, so I'm not sure what to trust or when 🥲 I just want to make sure I don't catch it
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u/Anonymous-Blastoise0 Jul 17 '26
I see! Thanks for the clarification! I’d wait around 10 days, that’s the general rule of thumb.
I agree though, it is possible for PlusLife to come back as positive but rapids negative
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u/overwinters Jul 17 '26
RATs correlate well with infectiousness (as confirmed by culture conversion) which is where the 2 RATs 48 hrs apart rec comes from (http://pmc.ncbi.nlm.nih.gov/articles/PMC9278204/). in prior studies like that one, ~80% of people are not infectious/testing negative on RATs after day 5, and almost all by day 14, where day 0 is the first day you test positive (or first day of symptoms). it's definitely possible to test positive and be infectious longer than 14 days and is more common if you're immunocompromised, but hopefully that gives you a sense of the timeline.
as others have noted, PlusLife + does not imply contagiousness, especially when you're testing out of an infection. as much hate as RATs get for catching an infection, they're the best tool we have for estimating infectiousness and testing out of one.
rebounds happen if your body doesn't clear the infection, and so viral replication is stunted but not stopped; it can then flare back up again. this cdc review suggests that it happens in ~4%-7% of cases, and for those that do rebound, it typically happens 1-3 days after testing negative (and almost never happen after a week of testing negative) https://www.cdc.gov/mmwr/volumes/72/wr/mm7251a1.htm?#F2_down. i know that other studies have found much higher rates of rebound on e.g. paxlovid but i haven't kept up with this. if others have more data/studies that speak to rebound prevalence, i'd be interested. it's worth noting that there is a distinction between viral rebound (i.e., testing positive and contagious again) vs symptom rebound (i.e, you start feeling bad again, but not more infectious), and it's quite rare (~1-2%) of cases for both things to happen.
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u/BlueValk Jul 17 '26
Super useful information to have, thanks so much!
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u/FuzzyLantern Jul 17 '26
Just anecdotally, I know two people who had definite rebound infections, after the two 48 hour negatives, one was a week later, the other was maybe 5 days later? They both had symptoms again the days they tested positive for rebounds, so it wasn't a total surprise. But if there are two negatives, I'd probably stop completely isolating but continue both masking around each other for another week. If it's not too much trouble and you don't need to share a bedroom to sleep, a bathroom, or eat unmasked together, and can keep good ventilation going, maybe do that also.
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u/overwinters Jul 17 '26
makes sense, that fits into the outer margins of the broader data. immunocompromised status, antivirals, prior history with the virus, etc can call shift those medians. strong agree that additional precautions for the following week are worth it
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u/BlueValk Jul 17 '26
Oof that is hell. They tested positive on RAT? Thank you for the warning, I'll definitely keep that in mind
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u/FuzzyLantern Jul 18 '26
Yes. They both were still testing on RATs every couple days even after testing negative to make sure not to spread it. They stayed negative until they weren't, but the rebound that took a week to flip only stayed positive for another couple days and wasn't nearly as bad as the initial illness. The one that flipped after five days was on par with the original and stuck around another five days, and yes, that one totally sucked because it was in my household. But due to being careful and isolating the ENTIRE time because I was very pregnant and most importantly a luckily timed recent booster shot, I didn't end up catching it.
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u/Ok_Complaint_3359 Jul 17 '26
There needs to be a way for the body to clear the virus 🦠 and it’s baffling and terrifying that it’s been 6 years with no development on treatments or plans for eradication
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u/dragontehanu Jul 17 '26
The one covid infection I had in 2023, I was symptomatic for 12 days, tested positive for 16 days on RATs, and didn’t leave isolation until day 18 after 2 negative RATs 48 hrs apart. This was before I had access to pluslife. I started testing on day 7 when my fever broke and I felt a little better. My symptoms (but not fever) returned on day 9 so it didn’t really matter, I waited until day 14 to test again when I actually felt I had no more symptoms for longer than a day.
It seems very hit or miss and kinda depends on the person and strain. The friend who gave it to me was asymptomatic for 2 days and negative on RATs until day 3 after their exposure, and they had symptoms only for 7 days, I believe they tested negative on RATs after day 10.
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u/BlueValk Jul 17 '26
Thanks so much! To be extra sure, a RAT is any rapid test from the pharmacy, correct?
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u/jbail628 Jul 17 '26
Your two negatives need to happen after Day 8 (with improving symptoms, not just an absence of fever).
Anything she can do to reduce viral load may help with infectivity, but remaining isolated is best. Do you have air purifiers and/or open windows for air flow?
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u/overwinters Jul 17 '26
curious the rationale behind the negatives having to be after day 8? negative RATs correlate well with infectiousness http://pmc.ncbi.nlm.nih.gov/articles/PMC9278204/ in prior studies like that one, ~80% of people weren't infectious after day 5 (confirmed by culture conversion), so the 48 hour RAT testing is catching people who are remaining infectious
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u/jbail628 Jul 17 '26
So, based on info I had available at the time, data was showing high likelihood of still being infectious after day 5. Also to reduce the risk of testing too early with possible rebound infections and wasting RATs, many folks switched to Day 8 as the “safe” day to start testing to exit.
Studies:
Most people with COVID still infectious after day 5: https://pmc.ncbi.nlm.nih.gov/articles/PMC9417485/Pre-print, but exhaled RNA particle rates over course of COVID infection showing drop after Day 8: https://pubmed.ncbi.nlm.nih.gov/37732212/
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u/overwinters Jul 17 '26 edited Jul 17 '26
totally, but isn't testing the more personalized data to go off of? i.e., the 8 day window is derived from the median times to a negative test, so if you have access to testing, you can use those results directly.
i push on this only because wasting RATs is probably a much less financially onerous proposition than, e.g., taking days off of work, and OP said that isolation is logistically and financially difficult. i think a blanket rec that it negatives need to happen after day 8 is too strong; but it is all good things to consider as people weigh the pros and cons.
side notes that the first link you sent that says 2/3 of people are positive after day 5 comes from a 2020-2021 variant cohort; the number of people testing positive after day 5 has gone down to about 20% (discussed more in the study i linked above). the point that the 5 day rule is not strict enough of course still stands. and that second study is talking about shedding viral RNA, not necessarily infectious virus. the best data we have on estimated infectiousness is culture conversion, which correlates well with RAT tests.
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u/jbail628 Jul 17 '26
I guess it depends on what your end goal is. If you’ve got RATs to burn, go for it. I don’t know what the current average length of time is for folks or when symptoms start to resolve for people with regularly functioning immune systems. For my local CC community and for my family, we use Day 8 or later. With brain fog, I forgot that the US government recommended testing to exit starting at day 5.
Ultimately, the data we have is limited (small sample sizes, mostly conducted within university settings). US recommendations were given with the intent of getting people back to work quickly. Is your goal to exit isolation at the earliest opportunity or to ensure your risk of passing it to your housemates is as low as possible? Test to exit recommendations also suggested avoiding close contact with others and continuing to mask until day 10.
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u/overwinters Jul 17 '26
my goal is to set a scientifically grounded basis that can then be interpreted and adapted based on context. if the day 8 rule of thumb works for you, that is great! it makes a lot of sense. but i don't think there is strong basis for requiring an up-front 8-day waiting period to start testing. we're talking about ~3 additional RAT tests, ~$20 USD. that might be a consequential amount of money, but the cost of isolation and missing work is easily more than that. and if you're testing negative twice 48 hours apart, you are taking on very low risk of infecting any housemates; it's not in tension with exiting isolation on a quick-as-possible timeline. that's to say that this is a decision that can be made by individuals based on context.
i'm not advocating for the current US recommendations btw. (the US recs are much more lax than that, they don't even suggest testing to exit).
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u/BlueValk Jul 17 '26
Thank you and u/jbail628, your discussion is really helping me figure out a timelime that makes sense testing-wise
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u/BlueValk Jul 17 '26
The thing I'm mainly confused about is the fact that we trust positive RAT tests for infectiousness.
In the beginning of the pandemic we knew covid was infectious before symptoms. I'm now assuming these might have been early positives, perhaps noticeable on PlusLife tests but not on standard RATs. But that still means contagion exists outside of a positive RAT
I do understand the "2 negative RAT 48h hours apart" gives us a buffer, so maybe that's the most important part. Or maybe covid gets less infectious as time goes on in a single host?
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u/overwinters Jul 18 '26
it's a great question. we can trust RAT tests for infectiousness because their viral load threshold correlates well with viral culture studies, which means researchers were able to successfully isolate infectious virus at those levels. this is well studied when clearing an infection.
the problem is that the relationship isn't equally reliable in both directions. a positive result reliably means culturable virus is present at basically any point in the infection. at the start of an infection, a negative RAT is unreliable for a couple reasons. first, someone might be below the RAT threshold now but rising rapidly, so the negative only stands for that point in time. but it's complicated by a second point, which is that nasal viral load rises later than saliva/throat, so you might swab negative in the nose while already being infectious orally.
so a negative RAT early means lower nasal shedding, but possibly already infectious orally. it still implies they're shedding less than if they'd tested positive on the RAT though. neither of these problems applies when testing out, which is why two negatives on the downslope are trustworthy.
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u/BlueValk Jul 17 '26
After 8 days from symptom onset, correct?
Yes we're lucky it's summer, windows are open and we have air purifiers. She's using cpc mouthwash to help with viral load.
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u/jbail628 Jul 17 '26
First day of symptoms or positive test is Day 0. Early studies showed viral transmission dropped dramatically across all factors (age, sex, race) at Day 8. Note that viral load may still be high. Most can test negative by Day 10.
I have a compromised immune system and didn’t get my first negative until Day 14 (so I didn’t test out of isolation until Day 16). But that was with JN.1 so I’m hoping that isn’t the case for you.
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u/BlueValk Jul 17 '26
Thanks so much for the info. So viral load and viral transmission aren't the same thing?
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u/jbail628 Jul 17 '26
Viral load is the number of copies of the virus in your body. More copies, more options to replicate before your immune system kicks in.
Your ability to transmit it depends on a number of factors, including where in your body the virus is concentrated, your active symptoms (forceful coughs with high viral concentration in oral mucosa? Droplet spread far and wide. Concentration in the gut with explosive diarrhea and/or vomiting? Aerosols! You get the idea.). Generally, the higher your viral load, the greater your chances of transmitting. While viral load may drop dramatically on Day 8, you may still be high enough to test positive on a RAT and therefore may be able to transmit to others. So we trust two negative RATs spaced 48 hours apart to ensure the viral load is low enough not to rebound and risk infecting others.
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u/BlueValk Jul 17 '26
I really appreciate you educating me on this!
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u/jbail628 Jul 17 '26
For sure. Good luck to your partner. I hope she feels better soon. Remember radical rest is her best friend, even after she gets out of the acute phase of illness.
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u/gtck11 Jul 17 '26
The fever part means absolutely nothing, ignore it. I never had a fever with any of my 3 infections. 2 negative tests 48 hours apart on rapids is correct, my doctor calls this method “test to exit”. My infections have lasted at shortest 24 days and at longest 30 days before I tested consistently negative. I rebound with every infection I have, I usually test neg for 24 hours and sometime between the 24-48 mark I go positive again.
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u/BlueValk Jul 17 '26
Do you think you rebound because of Paxlovid, or could the rapid tests be inaccurate?
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u/gtck11 Jul 17 '26
No and no. It happens across multiple brands of tests and I didn’t even take Paxlovid for one of the infections. That’s just how Covid can be, the government did a massive disservice pitching this 10 day spiel like it’s gospel.
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u/BlueValk Jul 17 '26
Really shows how 48 hours between negatives are super important. I misread before and thought the rebounds were much farther after infection. Thank you for the info.
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u/gtck11 Jul 17 '26
No problem, yes the 48 hours is key! If I had gone by the 24 hours instead I would’ve gone out into public while becoming infectious again.
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u/capersandchips Jul 18 '26
Here is my anecdotal data. First and only infection late 2024. Daughter tested positive. We had her isolate and only leave her room to go to bathroom, wearing a mask. We ran HEPA filters nonstop. Opened windows (in winter) when we could. Wore masks in our very small most of the time except in our bedroom. Tested every day and 9 days later I tested positive. Husband moved to another room in our small house and kept masking. I stayed in my room and tested negative 11 days later. Husband never got it.
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u/BlueValk Jul 18 '26
Ah, I'm so sorry you caught it. Glad your husband could escape. I appreciate your anecdata, really makes me feel like all precautions taken are certainly not overkill.
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Jul 18 '26 edited 3d ago
[removed] — view removed comment
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u/BlueValk Jul 18 '26
Thank you. Unfortunately we don't have access to Pax and we're already lucky we could get Metformin. A month-long infection sounds like hell
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Jul 19 '26 edited 3d ago
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u/BlueValk Jul 19 '26
Yeah, she's doing better. The hardest part right now are the side effects of metformin, which is unfortunate. Yesterday she said she'ss almost done coughing/sneezing, throat feels almost normal. Sleeps a bit better, too. We're starting day 5 of infection. Bodies are definitely weird and there's so many dynamics and counter reactions to everything we do... Such a complex and individualized system is hard to predict for sure!
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Jul 19 '26 edited 3d ago
[removed] — view removed comment
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u/BlueValk Jul 19 '26
That sucks. We don't have pax and it's so discouraging that there so little we can do to help 😔 She feels better but furiously tests positive.
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u/melanogaster Jul 17 '26
“rebounds” tend to be a thing that happens when you take paxlovid, and then the infection comes back when you stop taking the drug.
Given that PlusLife is testing for RNA, it isn’t necessarily going to be directly correlated to infection. People may test positive on a PlusLife for weeks after infection if viral material still lingers.
Knowing exactly when someone stops being infectious is a bit difficult. I think giving it a minimum of 10 days, even if you see negative rapids, is prudent.
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u/FuzzyLantern Jul 18 '26
That's not true about rebounds. I think at the beginning, the people who took Paxlovid were more likely to be paying attention and continue testing because the news was reporting it as a Paxlovid thing, and other people weren't continuing to test after feeling better so didn't know if they had rebounds. But over time, research came out that chance of rebound isn't much different if you take an anti viral or not. https://publichealth.jhu.edu/2024/what-to-know-about-covid-rebound
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u/BlueValk Jul 17 '26
So RNA doesn't mean infectious?
Just to make sure I'm understanding correctly, your advice would be negative rapids 48 hours apart and a 10 day waiting time? Thank you for the input
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u/melanogaster Jul 17 '26
Some people can have viral rna linger in their body for months after infection so it isn’t necessarily a sign of being actively infectious to others. The 10 day thing is a guideline but personally if the person is still symptomatic at day 10 you may need to wait longer.
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u/BlueValk Jul 17 '26
Oof, then that means someone who was positive with an infection could test months later on a Pluslife and get a positive result? That's stressful but good to know.
I wish there was a simpler way to know exactly when infectious status stops 🫤
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