Yes, though they should wear a mask. Breakthrough infections happen, but despite how much you’re hearing about them they are actually still VERY rare. According to a report from the Kaiser Family Foundation last week, of the 25 states reporting on breakthrough cases, the average share of overall cases among those fully vaccinated was just 1.6%. Even in AZ, the state with the highest rate of breakthrough cases, 94% of all cases were in people who were unvaccinated. So while it feels a little counterintuitive to let someone work after exposure to someone who got sick after being fully vaccinated, it’s important to remember that they still have a much lower chance of getting sick themselves. Still, vaccinated people should wear a mask for 14 days after exposure and monitor themselves very closely for symptoms, and stay home if any develop, even if they’re mild.
Unfortunately, not really. Rapid tests are designed for symptomatic people, and they work best when that person has a high viral load and is at the height of their contagious period, usually in the first few days of symptom onset. While a rapid positive is almost certainly a true positive, a rapid negative is much more likely to have missed someone who’s actually positive but doesn’t have a very high viral load - like someone who is asymptomatic or someone whose symptoms haven’t started yet. In one CDC study published in January, rapid antigen tests missed one in five symptomatic COVID+ people, and missed three out of 5 (more than half!) of asymptomatic COVID+ people. The technology is improving over time, but it’s absolutely not there yet for asymptomatic people, which is why PCR tests remain the gold standard.
Actually we’re seeing PCR tests consistently come back in under 48 hours for the most part. As this surge takes off and testing sites are inundated with sick and exposed people, there’s been a bit of a slowdown, but we’re talking a matter of hours rather than days. Most are still coming back in under 48 hours. Again, rapid tests are much less reliable for asymptomatic people, so we definitely don’t want to discourage PCR tests since they’re still the most accurate test by far. One good solution if someone has symptoms and wants to know if they’re positive ASAP could be to arrange both a rapid and PCR test - if the rapid comes back positive, you can bet the PCR will, too. If the rapid is negative, that doesn’t mean anything yet - the person should still isolate and wait for those more-accurate PCR results. This method is less reliable for those who are asymptomatic because of the low sensitivity for rapid tests in those without symptoms.
There’s been no update from the CDC at this point. As time goes on, we have seen studies that indicate there might be a longer period of protection for those who had the virus. But at the same time, we’re seeing the Delta variant explode out of control and seeing breakthrough infections in those who are fully vaccinated and in those who recently had COVID. Our own clinical team has seen a number of cases where someone appears to have been re-infected within the three month window, including one where the doctor believes they were infected with two different variants of the virus. Public health officials are keeping a close eye on this and will likely share updated recommendations as more studies are completed on natural immunity and the new variants.
Yes. If you’re exposed and unvaccinated, you should be staying home in quarantine for the full 10 days and monitoring for symptoms for a full 14 days after your exposure. The reason the CVS and other pharmacies tell you to wait is more about protecting their staff and customers than about you. You can go to be tested because their testing staff are wearing full proper PPE and prepared for infectious people coming there, but their vaccination clinic is not set up for infectious people. If you do end up getting sick with COVID from your exposure, your new vaccine isn’t likely to help since it takes a while to kick in, anyway. It’s better to wait the 14 days and then go get vaccinated so you can protect the health