A Very COVID Christmas

The last thing anyone wants over the holidays is to be homebound and sick. Omicron is the latest strain of Covid and is more contagious than the original strain and the Delta variant. Our family did the right things to prevent COVID. We got COVID and flu vaccines and avoided big gatherings. Three out of four of us were even able to get COVID boosters.After an annual Christmas Eve visit with another vaccinated family of four, my daughter without the booster got COVID. Then the dominos fell in our house.Symptoms – cold, flu, or COVID?Her initial symptom was a sore throat, which is a common cold and flu symptom. In addition, she complained of “the worst headache of her life.” Mind you, my daughter is prone to drama, so I figured this was just her way of communicating a need for attention.Knowing COVID was so contagious, she isolated early and I scheduled a test for her and my remaining family members. We cancelled seeing my in-laws on Christmas and our annual trip to their aunt’s house later that week.By the day after Christmas, I started sneezing frequently and felt stuffed up. I also developed a wicked headache, but still retained my sense of smell and taste. I wasn’t sure if I had COVID or not. Symptoms for Omicron are not the same as for the initial variants.The soonest available COVID test was a few days out, which we figured was a good thing. Testing too early could result in a false negative result -- the testee may not have enough viral load in their system yet. Plus, every pharmacy nearby was out of COVID home test kits.My daughter’s sore throat got worse before we were able to get her tested. A doctor’s visit confirmed an ear infection in addition to a positive COVID test. Poor girl. She was miserable! A round of amoxicillin, homemade soup and several boxes of tissues were in order.But Which Test?Since the symptoms of Omicron are a bit different than the Delta variant, most health experts advise testing for COVID to be sure. But which test should you use?A rapid home test is similar to a pregnancy test. It’s available over the counter at most pharmacies or online stores. It tests for viral antigens (proteins) and provides results within 10 to 20 minutes of testing.Most rapid test kits come with 2 tests, which are to be used a few days apart. If you test negative but still have symptoms, it’s best to test again within 48 to 72 hours.A PCR test stands for polymerase chain reaction and also measures the pathogen and genetic material in a sample. This type of test is provided through pharmacy drive-thrus as well as at healthcare offices and clinics. The PCR test is considered more sensitive than a rapid test and takes 24 to 72 hours for results.If you go to a doctor or clinic for a test, you may get a nucleic acid amplification test, or NAAT. This type of test also looks for genetic material of the virus but uses multiple techniques to “amplify” the pathogen. It’s considered the most reliable COVID test. Similar to the other tests, a nasal swab is taken in each nostril and tested for the presence of the virus. The deeper you go with the swab (higher up), the better the test.In my case, my initial PCR test came back negative, so I thought I was in the clear. My older daughter and husband had minimal (if any) symptoms. As the week progressed, my sneezing and stuffy nose continued, which led me to retest with a home test. This time, my test was positive. I had COVID.How We’ve Managed COVID:For starters, we got vaccinated and boosted before most of us got sick. I get vaccinated to prevent the flu each year and have been vaccinated for shingles. My children were vaccinated against Mumps, Measles, Chickenpox and HPV. I treated this no differently.Having an autoimmune disease (rheumatoid arthritis), I didn’t want to take any chances on catching COVID. Besides my daughter’s ear infection, my symptoms have lasted the longest.We wear masks -- everywhere. My college freshman has to wear masks and the one in high school is “mask optional.” She’s very aware of her classmates’ absences due to COVID.We’re washing our hands and not shaking any new ones. I’m fine with giving someone an elbow bump or thumbs up when I meet them. No European kissing on the cheek here.Now that we have COVID, we’re isolating. The CDC guidelines (as of December 27) have reduced the number of days required to isolate after a positive COVID test  from 10 down to 5. According to Dr. Fauci, head of the National Institute of Allergy and Infectious Disease, the likelihood of transferring COVID to another person is reduced after 5 days of isolation.The duration and severity of symptoms can vary from person to person. In addition, the CDC does not see retesting after COVID as necessary. However, if you do a test and the result is positive, isolation should continue for 5 days after the symptoms started and if you still have symptoms, you should continue isolation.Testing is still advised prior to travel, before family (and other) gatherings, returns to schools and colleges as well as to businesses, especially if symptomatic. If you’ve tested positive for COVID, you may not need a retest for 90 days unless you’re symptomatic.What About Medications?As I mentioned above, my family’s experience with COVID was very similar to having a bad cold. Headache, mild cough, sore throat, runny nose, and congestion were all common symptoms. None of us had fevers, loss of taste or smells, or fatigue.Medications containing phenylephrine (for nasal congestion) or diphenhydramine (an antihistamine and cough suppressant) are meant to clear symptoms, but often have side effects like dizziness or drowsiness. In my case, they leave me green with nausea.Sneezing, runny nose, and watery eyes were my main symptoms. I tried a low dose (5 mg) of Zyrtec (antihistamine), which kept me comfortable throughout the week of isolation.Tylenol or NSAIDs (non-steroidal anti-inflammatory drugs) could be used for fever or aches, which none of us experienced. NSAIDs should be taken with food or milk to prevent stomach upset and the risk of gastrointestinal bleeding.Supplements:Everyone and their brothers advised us to take vitamin C, zinc, selenium, and vitamin D as well as baby aspirin, Mucinex, Elderberry syrup, and the like.The only one I took was vitamin D as I have a history of vitamin D deficiency. I continued to eat citrus, berries, and green leafy veggies daily for vitamin C, along with lean meat, whole grains, brown rice, and oatmeal for selenium and zinc. If I can get nutrients from my diet, it’s my primary source.There is data to support that individuals with vitamin D deficiency fair worse with a COVID infection than those with normal levels. A small study of 185 COVID-positive patients found that those with vitamin D deficiency (defined as a level below 12 ug/DL) had higher mortality and more severe cases of COVID. 2Reviews of limited studies on supplementation of zinc, selenium, and vitamin D suggest that these may be considered for high-risk groups and should be used in conjunction with medical therapy. These are needed to provide resistance to infection and reduce inflammation More research is needed here.3In Conclusion:No one expected COVID for Christmas. We were lucky to have mild cases and fast recoveries, for which we credit the vaccine. We will continue to wash our hands, wear masks, and stay away from large crowds. On the upside, we had lots of family bonding time while my daughter was home (a little longer than she liked) from college. Life could be much worse.By Lisa Andrews, MEd, RD, LDReferences:

1. Polymerase Chain Reaction (PCR) Fact Sheet (genome.gov)
2. Radujkovic A, Hippchen T, Tiwari-Heckler S, Dreher S, Boxberger M, Merle U. Vitamin D Deficiency and Outcome of COVID-19 Patients. Nutrients. 2020 Sep 10;12(9):2757. doi: 10.3390/nu12092757. PMID: 32927735; PMCID: PMC7551780.
3. Alexander J, Tinkov A, Strand TA, Alehagen U, Skalny A, Aaseth J. Early Nutritional Interventions with Zinc, Selenium and Vitamin D for Raising Anti-Viral Resistance Against Progressive COVID-19. Nutrients. 2020 Aug 7;12(8):2358. doi: 10.3390/nu12082358. PMID: 32784601; PMCID: PMC7468884.

PDF Handout: Want to put some of Lisa's tips in your next newsletter or email blast? Here's a handout that you can download to use however you'd like!