A sign on a Portland shop window advises customers masks are required for entry on Tuesday Dec. 28, 2021. Credit: Troy R. Bennett / BDN

AUGUSTA, Maine — Maine’s COVID-19 case numbers have kept climbing as the omicron variant spreads rapidly across the state.

The emerging strain is both more contagious and better at evading prior immunity than previous variants. Since early December, about 1 in 45 Mainers have tested positive for the virus, with unvaccinated people about 3 1/2 times likelier than vaccinated people to test positive.

The omicron variant seems to cause less severe cases on average than previous versions of the virus, several studies suggest, but it is still severe enough that some end up hospitalized. As of Friday, a record 391 Mainers were in the hospital with COVID-19, according to the Maine Center for Disease Control and Prevention. About 70 percent are unvaccinated.

As more Mainers confront the virus, here is what to do and avoid doing if you test positive.

Isolate for 5 days or longer depending on symptoms

The U.S. Centers for Disease Control and Prevention recently updated recommendations on isolation for people who test positive for COVID-19. If you test positive, you still need to isolate – that means staying separate from other people, even people you live with. If you live with others, stay in a separate room and wear a mask when using common spaces. If you live alone, do not go anywhere and do not have anyone over.

Regardless of vaccination status, you should isolate yourself for five days. If after five days you have no symptoms, including no fever, and have not taken medication in the past 24 hours, you can leave your home. You should continue to wear a mask around others for at least five days.

If five days have passed but you are continuing to have symptoms such as a fever or cough, you should not end your isolation. Wait until your symptoms have resolved for at least 24 hours before you spend time around other people.

Do not seek a confirming PCR test

More people are using at-home COVID-19 tests to detect the virus if they are exposed or experiencing symptoms. While there have been concerns about possible false negatives with antigen tests in people who are not experiencing symptoms, false positives are rare.

For that reason, health care providers ask people who test positive for the virus at home not to seek a second test. Doing so makes it more likely that they might expose someone else to the virus and take up resources that others could use.

“At-home antigen tests are reliable if they’re positive and you have symptoms,” said Dr. Dora Mills, chief health improvement officer for MaineHealth. “There is no need to have a confirmatory PCR test.”

Notify your close contacts so they can seek testing

Because COVID-19 is highly contagious, people with whom you have spent time unmasked before developing symptoms or tested positive are potentially at risk. The U.S. CDC defines a close contact as being within six feet of someone for at least 15 minutes within two days of testing positive or experiencing symptoms.

Even if you contract only a mild case of COVID-19, someone else could get sick from it. Notifying people that they have been exposed allows them to get tested and potentially halts the chain of transmission, making it easier for them to get treatment if they need it.

Consult with a primary care provider to determine if you need further attention

If you have a primary care provider, you should inform them of your infection to determine if treatment is recommended. This is especially important if you are at higher risk for severe COVID-19 due to age, if you are pregnant, or if you have pre-existing conditions such as diabetes or a weakened immune system.

Outpatient COVID-19 treatments include monoclonal antibodies, which are administered intravenously, and Paxlovid, a pill available in some pharmacies. Because supplies are limited, these treatments are not recommended for most patients. Your doctor will let you know if you are eligible.

Monitor your symptoms in case your condition worsens

People who are unvaccinated or severely immunocompromised are at higher risk of developing severe COVID-19. Keeping track of your symptoms to ensure you know when to go to the hospital if your condition worsens.

A good tool to monitor symptoms is a pulse oximeter, said Dr. Peter Millard, a Belfast family doctor and epidemiologist. The device, which you can purchase for between $15 and $50, depending on the retailer, goes on your finger and measures the saturation of oxygen in your blood. Normal blood oxygen levels for most people are above 95. If it drops below 90, you should get medical attention, Millard said.

If you do not have a pulse oximeter, be aware of other symptoms that could indicate your oxygen levels are low. The most common one is shortness of breath, Millard said. More severe symptoms include confusion, inability to wake or stay awake or bluish lips, according to the U.S. CDC. Those are all reasons to seek medical care.

Don’t try to go back to normal if you are still sick

COVID-19 affects every person differently. While some people may be able to return to typical activities after five days of isolation, other people need longer to recover and could potentially infect others if they try to return to work, school or family life too soon.

Although the majority of people who contract COVID-19 recover fully, some may experience symptoms for much longer, a phenomenon known as long COVID. If you are continuing to experience symptoms several weeks after contracting the virus, consult a medical professional, who can help determine whether you are still contagious and what steps you should take.

Wear a mask in public when you leave isolation

If you leave isolation after five days, you should wear a mask in public settings in case you still have the potential to spread the virus to others. This recommendation means you should also avoid places where mask-wearing is not possible, such as restaurants.

Get vaccinated or boosted once you have recovered

Once you have recovered from a COVID-19 infection, getting vaccinated — or getting a booster shot — can make it less likely that you are reinfected. In most cases, you can get the COVID-19 vaccine once you are no longer experiencing symptoms or required to be isolated. If you received a monoclonal antibody treatment, you may have to wait several months. Consult your doctor if you have questions about when to get vaccinated.