Confused about some of NSW's COVID-19 rules? So are we

When the Omicron outbreak reached our shores none of us imagined we would be seeing 60,000+ infections in a day.

But here we are.

Now we've had to come to the realisation that many, if not most, of us will either catch COVID or know someone who has.

And despite the sheer amount of information out there, there is still a lot of confusion about the rules and what is expected if you are to test positive.

Testing responsibilities

PCR and RAT are acronyms that have become a part of our daily vernacular.

The two testing types have graced headlines regularly over the past two months.

But there is still some confusion over when we should get one and why. And when it comes to RATs, how do we get one when they are as rare as hen's teeth?

The general close contact rules, according to Australian Department of Health, apply "if you live in the same house as someone who tests positive, spent four hours or longer with someone in a home, or health or aged care environment, or are determined as one by your state or territory health department".

When one of my partner's relatives tested positive after a family dinner, we went into isolation but it wasn't long before he developed symptoms.

My mother was forced to do the impossible - find a RAT so that we could obey the government's rules.

After visiting several supermarkets, petrol stations and pharmacies she managed to score two tests (sold individually at a heinously marked up price, but that's another story for another day).

Sure enough, he was positive. I was asymptomatic and negative - but I won't lie I questioned whether to test myself and 'waste' an elusive RAT while I had no symptoms, just in case I developed symptoms later.

NSW Health says COVID-19 positive people only need a PCR test to confirm their rapid antigen test result if they are:

  • more than 20 weeks pregnant
  • Aboriginal or Torres Strait Islander
  • unvaccinated aged 16 or over
  • immunosuppressed
  • a worker, resident, patient, or client in a high-risk setting where there is no confirmed outbreak
  • asked by a registered medical practitioner, such as their GP, doctor or specialist

But what if you can't get a RAT at all, but believe you have COVID-19 or are a close contact?

South west Sydney RACGP representative and Macarthur GP Dr Ken McCroary says the rule of thumb here is simple: "if you are sick, stay at home and isolate."

"At the beginning of the pandemic 10 percent of cold symptoms were a result of COVID-19 and 90 per cent were the cold or flu - but now we can assume it is the opposite," he said.

"So stay home and isolate for seven days. Call your GP and if you are vulnerable person, pregnant, Aboriginal or Torres Strait Islander or at high risk, they may be able to help you to organise a test."

If a COVID positive person takes regular RATs, as directed by their employer, but they are still testing positive after leaving the seven day isolation period, are they expected to report it each time?

"Legally the answer is yes. You have to report each positive test via Service NSW," Dr McCroary said.

"In the numbers for today, for example, we could be seeing people double up on their results because they are still symptomatic and testing positive or because they are required to take regular tests."

Isolation responsibilities

My partner and I entered our seven-day isolation period, abiding by the rules set out by our state government and NSW Health.

A NSW Health Facebook post states that "it is important to exercise caution and avoid high-risk settings and large indoor gatherings for 14 days" after being in contact with someone who has COVID-19.

So why was the 14-day isolation period changed to seven days, if there is still a significant chance of developing symptoms after seven days, but within 14 days?

Dr McCroary says this is a result of the transition to learning to live with the virus.

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"This purely to do with getting back to work and the government balancing public health, the economy and finance," he said.

"My advice would be to isolate for 14 days after you test positive - but that's my opinion as a selfish physician.

"I don't have to worry about the economy - but I do care about your health.

"If we look at the health advice and we don't look at it in black and white, seven days is not a free invitation to go out to parties, visit high-risk settings or check into 20 shops.

"We should be continuing to isolate as much as possible and practicing social distancing and good hygiene practices.

"We really need to change the way we live, to put hygiene first."

A NSW Health Facebook post on January 10, 2022 stated that "household contacts must also self-isolate for seven days and have a rapid antigen test as soon as possible and again on day six. You can only leave self-isolation after seven days if you do not have a sore throat, runny nose, cough, or shortness of breath. You do not need to have a negative test to leave isolation."

But what happens if you test positive on day six, after your COVID positive household member has completed their seven-day isolation period? Do you all have to do an additional seven days of isolation together?

The short answer is no.

Dr McCroary said the person who initially tested positive is legally able to de-isolate as outlined by NSW Health - while the person who tested positive on day six must isolate for a further seven days.

"You still need to be cautious for at least another week," he said.

"It is rare for a person who was COVID positive to catch it again within 28 days but it can happen.

"It's not likely that you will catch the virus within a month of already having it but we know that there are other strains out there so it's important to remain cautious."

Caring for the sick

There is a lot of information out there about how to look after yourself if you have COVID, but what if you are incapable of doing the basics?

When you are nauseous, running a fever, suffering from headaches, coughing or experiencing shortness of breath (all COVID symptoms) - it can be hard to cook food, take meds, get water or just simply run a bath or shower.

So how do we care for others with COVID-19 when the advice is to isolate separately?

NSW Health advice is that "children who test positive for COVID-19 can be safely cared for at home by their usual household carers, even if they are not vaccinated".

They recommend wearing a mask in shared areas, cleaning shared bathrooms and areas after use by the COVID positive person and remaining isolated from the affected individual as much as possible.

But what if the sick person you are living with is in need of additional help?

Dr McCroary said it was important to follow good hygiene habits to the best of your abilities.

"Ideally having full PPE would be the best way to physically care for someone with COVID, but in practicality get the best you can get - wear a mask, gloves if possible and make sure you wash your hands and any surfaces the person may have come into contact with," he said.

"Normal run of the mill soap you buy over the counter does the job, but if you can't be bothered washing your hands thoroughly 50 times a day, some hand sanitiser will help to - whatever you can get.

"If you are going to get it by caring for a loved one, you are going to get it, but you can be super careful, and obviously you need to obey the isolation rules and make sure you get tested on day six."

We are hearing a lot about long ambulance wait times during this crisis. What should COVID-19 positive people in need of urgent support do to seek hospital care?

"Everyone should have a regular GP that they can contact," Dr McCroary said.

"Just last week I had to call an ambulance for a lady who was experiencing low oxygen levels and it took me four and a half hours to get the ambulance to her - and two weeks before that I was the first on the scene at a motorbike accident.

"The police and firefighters had arrived but we were still waiting for the ambulance while I held his helmet still so he didn't move his neck.

"If you are having trouble breathing and it is urgent - get to the hospital. If the only option is to go directly to the hospital yourself, then go.

"Unfortunately we've lost a lot of older people in this pandemic because they waited too long to get help.

"I know you hear that we are busy, but we are still here to help you. Don't leave it until it's too late."