How Long Does It Take To Recover From COVID-19 Coronavirus And Return To Work?

You are not a Hot Pocket, at least in one way. When you get infected with the COVID-19 coronavirus, you can’t set a timer to then determine when exactly you will be ready. In this case, ready means fully recovered and ready to return to your normal activities, whatever “normal activities” happen to be these days with the pandemic.

As I have written previously for Forbes, COVID-19 can be a freaking confusing illness. It’s still a bit of an enigma, wrapped with uncertainty, surrounded by some really bad bacon that’s spoiled. There just haven’t been enough scientific studies to tell for sure how long you may have symptoms and how long you may be contagious when you’ve got a severe acute respiratory syndrome coronavirus-2 (SARS–CoV-2) infection. In fact, these durations seem to vary quite a lot from person to person. World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus had mentioned that recovery times tend to be about two weeks for those with mild disease and about three to six weeks for those with severe or critical disease. However, these seem to be only rough guidelines as studies have already shown a number of exceptions. For example, the symptoms of mild illness could easily extend into a third week, perhaps even longer.

Another issue is how much COVID-19 symptoms can fluctuate from day to day. Since your immune system has never seen this virus before, it can be like a guy on Tinder for the first time, just launching random things and seeing if anything will stick. You can feel better one day, only to feel worse the next, and vice-versa. Basically, your symptoms can hop around in type and severity, sort of like a really indecisive kangaroo. This disease is a lot less predictable than the seasonal flu, which typically make you feel worst during the first few days of symptoms before you subsequently steadily improve. With COVID-19, the trajectory can be a lot less clear. Add this fact to the growing list of “why COVID-19 is bleeping not the flu.”

So if you’ve got relatively mild COVID-19, you may want to give yourself at least a two-to-three week window for recovery. At the same time, continue to closely monitor your symptoms and be ready to quickly seek medical attention if they do get much worse. Of course, having more severe disease extends your expected recovery time, perhaps into the three to six week range, perhaps even longer. Damage to your lungs or other organs could stretch out recovery much, much further.

So how can you tell if you’ve recovered enough to return to your normal activities? It’s not as if a microwave bell goes ding and someone sings, “Hot Pocket,” when you are ready. Instead, the timing of your return depends on how your illness progresses and what those “normal activities” happen to be. If “normal” means going back to Zoom meetings with just the top half of you dressed then the bar may not be super high. If it means doing something more strenuous or even interacting more directly with people as an essential worker, the bar should be higher.

The Centers for Disease Control and Prevention (CDC) offers guidelines on when health care professionals can return to work. They offer two possibilities for someone who has COVID-19 with symptoms: a test-based strategy and a symptom-based strategy.

The test-based strategy requires, guess what, access to testing. Otherwise it would have been called something else. In this strategy, you need to get to a point where you no longer have a fever without taking fever-reducing medications and have had improvement in your respiratory symptoms such as cough or shortness of breath. But that’s not all. You also have to have negative results on a test that identifies the presence of SARS-CoV2 RNA test. This is the test where they stick a cotton swab way up your nose and another one to the back of your throat. Note that other more comfortable ways of testing are currently being developed and evaluated because no one really says, “gee, what I’d really like is a cotton swab to be stuck so far up my nose that it feels like my brain is being touched.” As always, make sure that the test that you are getting is legit, one that has received authorization from the U.S. Food and Drug Administration (FDA). After all, surprise, surprise, there are people out there trying to scam you with bogus tests.

For this strategy, having one negative test is not enough to return to work. That’s because these tests can give you false negatives. You’ve got to have at least two negative tests over a period of greater than 24 hours. This may sound straightforward, but for many, getting a test can be more difficult than finding flour in the supermarket these days. Plus, there can be delays in receiving test results. Being told two weeks later that you had a negative test may not really help your decision of when to return to work unless you’ve somehow mastered time travel.

If you don’t have ready access to timely testing, the only other option offered is the symptom-based strategy. Here you have to fulfill two criteria. One is that “at least 10 days have passed since your symptoms first appeared.” Ten days happens to be a little longer than the 9.5 days that was the median time from patients first having symptoms to finally testing negative for the virus RNA in a study published in the Chinese Medical Journal. The other criterion is that “at least 3 days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath).” Thus, don’t rush back to work the very first day that you don’t have any symptoms. That can be like going directly from sitting on the toilet to a full sprint without even checking even pulling up your pants. Plus, as the saying goes, one can be an accident, two can be a coincidence, and three times is a pattern. Waiting can help make sure that you’ve finally, actually, really recovered.

Although the above recommendations are for health care professionals, they could potentially apply to you even if you aren’t in health care. Keep in mind, though, that these are minimal criteria, as evidenced by the fact that the words “at least” appear in each criterion. “At least” means “at least” and not “that should be plenty.” When your significant says “at least remember when my birthday is”, simply writing an email that says “Happy Birthday! See I remembered” along with a thumbs up emoji is probably not enough. The response could be a not so nice emoji that involves a finger. Similarly, if you can give yourself even more time to rest before returning to work, try to do so. Four days after your symptoms are completely gone is better than just three days. Five days is better four days. You can probably figure out what six days is.

Also, ease yourself back into your daily routine. The first day back is probably not the time to resume power lifting. Instead, gradually test what you can handle and give yourself some slack. There have been reports of people not feeling quite right or having trouble thinking or sleeping for extended periods of time after the infection. In an article for NBC News, Erika Edwards described how some recovering patients were feeling a range of hard-to-pin-down symptoms, including a “weird forgetfulness,” fear, and nervousness. Forgetfulness is not a great thing to have when you are on a Zoom business call and not wearing any pants.

In fact, consider consulting others like family, friends, or health care professionals when deciding whether and when to return to work and other daily routines. Note that this list didn’t include random strangers on Facebook. The problem with not thinking straight is that you may not even realize that you are not thinking straight.

Of course, not everyone has the luxury to take time to return to normal activities. Little kids don’t tend to tell parents, “I got this. You just rest there while I make everyone dinner, take out the trash, and finish caulking the ceiling.” Also, your employer may have the sympathy and empathy of a toilet brush and push you to return to full working capacity immediately. Not everyone may really truly understand how new and how different this nasty COVID-19 coronavirus is. Once again, it is very different from the flu or anything that your immune system is used to seeing.

While you may know exactly what to expect when microwaving and eating a Hot Pocket, you don’t quite know what you are getting with the COVID-19 coronavirus. Therefore, everyone, including you, should give yourself a break.

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