DEAR DR. ROACH: My husband and I both came down with COVID. We had all of the usual symptoms and have since recovered. We have been in isolation and are even wearing masks around the house to keep our (so far) uninfected son safe. However, after 15 days for me and 17 days for my husband, we are still testing positive. We have used four different brands of at-home testing kits.

Are we still contagious? I haven’t been able to visit my 94-year-old father and really need to. Although we both have pacemakers, neither of us is taking medicines that affect the immune system. — J.R.

ANSWER: It is common for people to continue to test positive for COVID even after a person has recovered. In people who have normal immune systems, it is thought that these positive test results do not represent an infectious virus.

Early in the pandemic, stringent testing was performed on many people who were persistently positive despite resolution of their symptoms, and in none of those cases were they found to be infectious. The Centers for Disease Control and Prevention, as well as other authorities, do not insist on a negative test in order to stop isolation with people who don’t have an immune system disease and who only had mild or moderate COVID. Ten days is sufficient for this situation.

In people with a history of severe COVID (requiring hospitalization for very low oxygen levels) or with moderate to severe immune system diseases (such as advanced HIV, recent chemotherapy or some drugs that suppress the immune system), 20 days may be necessary. Consultation with an expert is appropriate.

COVID is still out there. If you haven’t gotten the new monovalent vaccine (which became available in September 2023), I recommend doing so. Even if you have had COVID before, immunity wanes over time. The new vaccine was made to counteract newer strains of the virus.

DEAR DR. ROACH: When I sneeze, a powerful force of air comes out of my mouth. If my mouth was covered and I could only sneeze through my nose, I believe it would injure my eyes and ears. Am I correct? — P.M.

ANSWER: As you correctly say, sneezing generates large pressures in the nose — even greater than systemic blood pressure — with airflows of over 100 mph. The reported complications in the eyes from sneezing include retinal hemorrhage, orbital emphysema (air around the eyeball) and acute glaucoma. Rib fractures are also reported, and I’ve seen several cases of those from coughing.

Damage to the ear from sneezing has also been reported, with cases of a ruptured eardrum, broken inner ear bones (the stapes), and vertigo. Some of these are reported with just an everyday sneeze, while others are from a “suppressed” sneeze, where you try to hold it in by covering your mouth and nose. If you have to sneeze, use a tissue, handkerchief or a mask. In an emergency, use your elbow. Don’t try to hold it in.

Of course, these case reports are extremely rare. On the other hand, it’s an urban legend that your eyes will pop out from a sneeze or suppressed sneeze.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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