Avoiding Covid after exposure
May 16, 2024 7:35 AM   Subscribe

I learned this morning that I had my closest known Covid exposure yet on Tuesday night. I'm testing negative and have no symptoms. What can I do now that might help my husband and me keep it that way? I'd love specifics on whether and how to do DIY saline gargles/rinses, a reliable source for Enovid if it's advisable, scientifically-sound supplements or vitamins that at least don't hurt, etc.

My husband and I have been on the fairly extreme end of cautious about Covid, and haven't gotten it. We're both fully vaxed. Based on waste-water reports and state data, we decided it was finally time to let down our guard a bit until the numbers pick back up. So I uncharacteristically didn't wear a mask to a 6-person, 2-hour, indoor meeting on Tuesday night. I noticed most of the way through that one person had a stuffy/runny nose, and I just learned that he tested positive last night. I tested negative this morning and I don't have symptoms. I'll keep testing over the next several days.

I know there's no solid, US-approved preventative, but I'd like to do whatever I can to reduce the chances that I'll get it or my husband will. (He has some risk factors that make me worry more about him than me.) I'm isolating to the degree possible in our one-bathroom house, with fans and air filters, and masks when I leave the guest room. I've just been googling up a bit on sprays and gargles and supplements, and I'd love to know what's worth doing, and how. (I feel like I first learned about those here, in a version of this same question, but I couldn't find it -- can you?) E.g.:
- Enovid/VirX -- should I order some? From where?
- DIY saline gargle? Formula for mixing it up?
- DIY saline nasal rinse? I don't have a neti pot, and they intimidate me. Should I send my husband to go buy something like that, or an over-the-counter spray or something instead?
- We happen to have some Xlear nasal spray: water, xylitol, USP sodium chloride, grapefruit seed extract. Should I use that?
- Any vitamins or supplements that are studied enough to be in the won't hurt-might help category?
- What else?

We're in our 50s, and in Massachusetts. If this sounds like we're stuck in 2021, and you've long been over this level of caution, I get it, but we still want to be as careful as possible.
posted by daisyace to Health & Fitness (21 answers total) 8 users marked this as a favorite
Response by poster: If this sounds like we're stuck in 2021, and you've long been over this level of caution, I get it, but we still want to be as careful as possible.

E.g., If you think that surely I've had plenty of exposures like this before, and just haven't known it, don't be so sure. We don't have office jobs or kids in school, have continued avoiding restaurants, travel, and indoor events until very recently, still wore masks for shopping and appointments until this week, etc.
posted by daisyace at 7:43 AM on May 16 [8 favorites]

All of those nose sprays/gargles are preventative in a 'physically kill/trap the virus when it comes by'. None of those will make a difference at this point. You either did get some viral particles or didn't and your immune system either will or won't mount a good enough initial defense.

I'd focus on staying normally immune system healthy -- so get some sun, some fresh air, eat healthy, take some vitamins/ginger/garlic/lemons/whatever your traditional stave-off-sick thing is.
posted by so fucking future at 7:44 AM on May 16 [14 favorites]

I would add: get sufficient rest and keep your stress levels low. Give your immune system every chance to succeed.
posted by mskyle at 7:53 AM on May 16 [20 favorites]

Enovid appears to be available on Amazon (that's where I've gotten it from), albeit pricey, and I'd hella absolutely start it ASAP. It works to reduce viral load, so it's not the same as a gargle or barrier defense, which I also would not bother with at this point.
posted by Dashy at 7:56 AM on May 16 [1 favorite]

The nose sprays AFAIK are to lower your exposure load, so it would be too late for them. I haven't seen any studies that they reduce load post-infection.

There is some evidence that mouthwash with CPC and CHX reduce viral replication in the mouth and throat once you have covid, though. It's worth it I think, as it's a low-harm option - I forgot about it when I had covid and wonder now if it would at least have reduced that incredibly painful throat.

There are a suite of vitamins and supplements that allegedly help and I've definitely known people advised to use some of them by their doctors, particularly vitamin D, zinc, vitamin C. Easy to do, pretty common immune system boosters.

For what it's worth, I'm pretty certain based on timing that while my husband and I spent the whole weekend together when we got covid, I got it while we were traveling and gave it to him around day 3-4. We assumed we both got sick at the same time to start with, but it was obvious eventually that he was about 4 days behind me. The same thing happened later with some kind of hellcold my mother caught from a friend and infected me about 3 days after her symptoms began. Consider masking in the home. Also make your home Ventilation City - if you have HVAC run the fan 24/7, run room fans to keep air moving. Consider sleeping apart.

Hydrate, use electrolyte supplements. It should help to have fully-hydrated immune systems, plus if you do turn positive you are going to want to start from a very hydrated position because the snot manufacture is just unbelievable.

Probably the most important thing you can do is not strain your immune system in ANY way right now. Avoid all avoidable stress, extra sleep, avoid foods you have any sort of reaction to. No exercise beyond walking, preferably outdoors. Be babies for the week.
posted by Lyn Never at 8:10 AM on May 16 [2 favorites]

The earlier studies on Enovid were post-infection.
posted by Dashy at 8:14 AM on May 16 [4 favorites]

I got envoid via Amazon as the official route takes about 5 days to arrive. My husband was exposed recently to a friend who he had lunch with and dodged it. Could have been luck, or the rinses. There’s also some info out there about xylitol nasal rinses which can be bought at a local cvs/walgreens. They also give me some peace of mind that I’m trying to do something rather than just sitting around and waiting.

I’m a huge fan of the neilmed sinus rinses which are easy to do at home and Amazon can deliver quickly. My allergies are awful this year and I also think the rinses help pass being sick quicker (research seems to suggest “we can’t fully prove it yet that it helps a current infection, but it won’t hurt you.” )
posted by raccoon409 at 8:45 AM on May 16

What can I do now that might help my husband and me keep it that way?

If I'm reading correctly, you were exposed but he wasn't? You could isolate from each other so if you get it he's protected - at least through I'd say 5 days after exposure if you're still testing negative and have no symptoms.
posted by DoubleLune at 9:23 AM on May 16 [1 favorite]

I'm seriously immunocompromised, my partner isn't -- in this scenario, she and I would isolate (me in the guest room and her in the bedroom, separate bathrooms, and I'd bring her food and leave it outside the bedroom for her). We always have air filters running so would keep doing that. We would probably wear masks indoors until she wasn't testing positive anymore for at least 2 days. This is the plan we've come up with, but we are privileged enough that we haven't been in this situation yet, so I'm not sure exactly how it would play out in practice. Best of luck to you and your spouse.
posted by twelve cent archie at 9:36 AM on May 16 [2 favorites]

Response by poster: I'm isolating to the degree possible in our one-bathroom house, with fans and air filters, and masks when I leave the guest room.

Because of a few of the replies so far, I'm just reiterating that I've already got this part covered.
posted by daisyace at 9:39 AM on May 16 [1 favorite]

Neilmed sinus rinse once or twice a day until you’re sure you didn’t get sick (and 2x a day if you do get sick) may reduce your odds of getting sick and reduce how sick you do get.
posted by congen at 9:56 AM on May 16

At this point, supplements/rinses/etc. are basically woo. If it makes you feel better or gives you more of a sense of control, go ahead, but there's not much hard evidence for efficacy two days post-exposure.

The most sensible thing you can probably do now is make sure your "supply chain" for getting paxlovid rapidly if necessary is intact. Do you know who to call to get the prescription? Do you know where you can go to physically acquire it? Do you have any conditions that would be contraindications for taking it, and, if so, what's the backup plan?
posted by praemunire at 10:13 AM on May 16 [9 favorites]

My thyroid doc recommended quercetin and zinc
posted by Czjewel at 10:19 AM on May 16

Paxlovid may not be needed, this Canadian article links to some studies on Paxlovid efficacy that showed underwhelming effects for most populations. Your time and money are important assets, do not squander them on non-evidence based missions. I agree with good general self-care, including lower stress and good sleep, as the way to go.
posted by shock muppet at 12:07 PM on May 16 [1 favorite]

One thing you can do now, that definitely has the potential to make a difference in the outcome, is to figure out how to get a Paxlovid prescription immediately after you or spouse has a positive test - or even get a prescription to have on hand for that eventuality, if your doctor will approve that & you can bear the cost.

Point is, if you can start the Paxlovid within a couple of hours of a positive test, that almost certainly has benefits in terms of reducing severity of symptoms, reducing possibility of transmission, and reducing possibility of long covid - for both you & spouse.

Just for example, once I had my positive test in hand, I started calling pharmacists, telehealth (neither of which could prescribe at that time due to some mildly complicated health issues), my specialist doctor (wouldn't prescribe because I hadn't had a kidney function lab test recently enough for her comfort), and my PCP (who was perfectly happy to prescribe but managed to muddle up the prescription delaying things for an extra 2 days). All that ended up delaying the start of Paxlovid for about 3 days beyond what it could have been.

Pharmacists & telehealth providers can prescribe paxlovid, but they do have some restrictions which for example might apply to your spouse (maybe their medication situation is somewhat complex or the medical conditions they have require a physician to prescribe). You could call up local pharmacies now & see if they are generally willing to prescribe paxlovid (not all pharmacies may be participating in this program) and if they are able to do so given your and spouse's specific medical conditions & medication regimens.

And/or you could call your regular PCP with the same questions - are they willing to prescribe you paxlovid immediately if you have a positive test in hand, what is their procedure for getting that going immediately upon having the test, do you have any conditions or medications that will complicate things on their end? Same for spouse.

If you've already had this conversation with your PCP (or pharmacist or telehealth provider) you might be able to call or message them if you do have a positive test and have the paxlovid prescription within hours.

Similarly, figure out where your local 24 hour pharmacies are - ideally one of them is willing to do the pharmacist dispensed paxlovid & if you have a positive test at 11pm you could be there at midnight picking up your prescription. Just for example.

Besides the benefit of getting paxlovid earlier in the course of the disease, all this stuff is a whole lot easier to figure out when you're feeling well. I spent 3 days straight calling back & forth between different doctors & pharmacies getting things sorted out & prodding both ends to get issues sorted out (first setting up appointments & then holding them with pharmacists & telehealth only to be told "sorry, we can't prescribe in your case"), then the prescription was written incorrectly & so it was back & forth & back & forht numerous times with the doctors office & pharmacy to s-l-o-w-l-y get it sorted out), when I literally felt like I was on death's door with Covid. It all worked out OK in the end, but definitely Do Not Recommend.
posted by flug at 12:20 PM on May 16 [3 favorites]

You’re already doing the things I would do. Other than, if it were financially feasible, in my household we’d at least consider sending the other partner off to a hotel for a few days in the hopes of getting them out of your orbit before you become contagious if you do. But for you, you sound to me like you’re on top of it. I hope you get some rest and end up dodging the exposure!
posted by Stacey at 12:48 PM on May 16

Nthing the "get your plan in shape" about how to get paxlovid in a hurry. Essentially, who will you call if you get your positive test on Saturday at 9pm? Which pharmacy is 24 hour to have the prescription sent to? (Keep in mind that even though a CVS is "24 hour", that doesn't mean their pharmacy is 24 hour. Ask me how I know.)

Hope you don't get it!
posted by bluesky78987 at 12:48 PM on May 16 [2 favorites]

Paxlovid may not be needed, this Canadian article links to some studies on Paxlovid efficacy that showed underwhelming effects for most populations. Your time and money are important assets, do not squander them on non-evidence based missions.

I'm assuming that at least one member of a household taking such extreme steps is actually high risk.
posted by praemunire at 12:49 PM on May 16 [3 favorites]

I hope you don't come down with it! In our household of 4 people, we've each gotten it once and two of us have gotten it twice...all at different times! This includes my husband and I who share a bed. Obviously this isn't the case for everyone, but I do think our measures of early testing and isolation did help the spread and I don't think we ever caught it from each other. Maybe there's some solace in knowing that even if you had a close exposure, there's still plenty of chance you don't get it, or only one of you gets it (especially if boosted).
posted by LKWorking at 12:51 PM on May 16

If your spouse is at risk because they are immunocompromised, you should consider getting them on Pemgarda asap. This replaces Evushield as the recommended pre-exposure prophylactic for highly immunocompromised people. Far too people know about these highly effective prophylactics.

As for Paxlovid, Pfizer's own long-awaited, large study of its efficacy was just published in the NEJM. This is the first major clinical trial since the vaccines came out. Previous results had applied to older strains and unvaccinated participants. See Scientific American for a full discussion but the tl;dr is that Pfizer's study found that it has literally no measurable effect on "fully vaccinated patients with risk factors for severe disease and patients (vaccinated or unvaccinated) without such risk factors." That study included very few very very high risk (immunocompromised, old) subjects, so by all means talk to your doctor about your own situation.
posted by caek at 9:20 PM on May 16 [2 favorites]

Response by poster: Well, I nearly thought I was home free after testing negative each day through day 6, but then yesterday, I tested positive. I was isolating the whole time, so it has to have just taken that long -- there were no other exposures. No symptoms to speak of. I've decamped to a family member's empty apartment, which I wish I'd done before. But even when I was at home, I isolated as well as possible, so I'm hopeful that my husband may stay negative.

I did use Enovid, a CPC mouthwash, and a supplement called Wellness Formula that has some of the stuff in Lyn Never's link, in hopes that they might help and were unlikely to hurt.

I have Paxlovid in hand and am deciding whether to take it. Continuation here. Thanks all!
posted by daisyace at 5:06 AM on May 22 [1 favorite]

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