A few weeks ago, I was talking with a friend who was in the throes of a breakthrough Covid-19 infection. He was pretty sick with a high fever and a lot of coughing and was also somewhat short of breath. He had checked in with his doctor, who told him that because he was vaccinated, he should be fine—and that’s true overall. Though many of us know someone who has had a breakthrough infection, the vast majority of such patients have minor symptoms or no symptoms at all, and the vaccines are still remarkably effective in preventing hospitalization and death.

My friend did do okay, but he became ill enough for his doctor to consider hospitalization at one point, and I was quite worried about him. He is in his mid-70s—an age that put him at increased risk for a poor outcome, even though he was up to date with the vaccine.

I was frustrated, too. If he had been better informed, he could have markedly shortened the course of his illness and avoided even the possibility of being hospitalized.

But while it was too late for him to take action that would have helped him better weather the disease, you can do things differently to prepare for the just-in-case scenario of a breakthrough infection—especially if you are 65 or older, have a chronic condition like heart disease or obesity, or are immunocompromised, all of which put you at increased risk. That is, don’t wait until you get sick; instead, be proactive: Below, I outline three steps you should take right now, regardless of your vaccination status. You don’t want to be struggling with what to do if you become ill. Time is of the essence especially in high-risk people when it comes to turning things around. 

1. Know your testing options and how to get tested if you think you might have Covid.

There are two options for testing. You can choose an antigen test sold in pharmacies and online or administered at community and healthcare settings. It detects an antigen, specifically a piece of the virus that causes Covid. The test is done by swabbing the inside of your nose, and the results are available within about 15 minutes. Home tests typically come in packages of two. If you’re symptomatic, it’s unlikely that you’ll get a false negative test, especially if you do it twice. The test is quite good for letting you know if your symptoms are in fact due to Covid. If you’re asymptomatic, however, an antigen test is less sensitive, and a negative result doesn’t rule out Covid (although it still gives good assurance that you’re not contagious for the next several hours and so is useful to take right before socializing).

Or you can opt for the gold-standard PCR test, which detects genetic material of the virus. While there is a rapid-result version that gives you an answer within a few hours or sometimes sooner, it’s not often readily available. Most of the time, the sample must be sent to a lab and the results are not available for 24 to 48 hours or longer, creating a significant delay in diagnosis. If you choose to go to a community testing center or other place for PCR testing, you can get locations and details from your county or city health department or from your doctor’s office. PCR tests are now also available over the counter but are much more expensive. If you buy an at-home PCR kit, you have to mail the swab to the lab yourself.

Whichever test you choose, don’t delay. If you think you might have Covid, find out for sure right away. Waiting even one extra day if you are in a high-risk group can make you much sicker and put you at greater risk for complications than you need to be.

2. Buy a pulse oximeter—now.

When placed on a finger, this little device gives you an instant reading of how much oxygen you have in your bloodstream—your blood oxygen saturation level. Think of a pulse oximeter the way you do a thermometer—something to have at home that provides information that can help you gauge how sick you are and that can be used by your doctor to monitor you from afar if needed. If your blood oxygen saturation level falls too low, you may need medical attention, even if you don’t feel short of breath. While normal blood oxygen saturation levels vary, a reading below 93 percent is generally the beginning of cause for concern. If my friend had had a pulse oximeter, he would have been able to alert his doctor about his respiratory function before it got worse. Pulse oximeters are available at many pharmacies and on the internet for about $15 and up.

3. Know about monoclonal antibody treatment and find out where you can get it.

This treatment quickly turned around the former president’s health status once he was admitted to the hospital after his Covid diagnosis. Even though monoclonal antibodies reduce hospitalization and death in high-risk people with Covid by about 70 percent, they have been underused.

Why do the antibodies work so fast? They act as antibody supplements. When you first become infected with a disease you’ve never had before, you can get sick during the first few days because your body hasn’t yet produced the antibodies to fight off the illness. And in the case of breakthrough infections in people who have been vaccinated, the antibodies created by the vaccination may not remain at a high enough level to prevent you from developing symptoms. But if you receive monoclonal antibodies as quickly as possible, they can turn the infection around by mounting the same fight your own immune system would. They just do it immediately. If my friend had gotten them, he wouldn’t have become so sick and would have recovered sooner.

These days, you don’t have to be admitted to the hospital for monoclonal antibodies. They can be given in the ER or at a local infusion center where they are administered either subcutaneously (under the skin) or through an intravenous (IV) line. Ask your doctor or check with your county or city health department for the location of an infusion center in your community.

Bear in mind that in the ever-changing world of Covid, two of the three types of monoclonal antibody treatments used in the fight against the illness do not appear to work against the new Omicron variant, and the one that is effective (sotrovimab) is in limited supply. Scientists are in the process of developing other monoclonal antibodies against Omicron. If you are a candidate for monoclonal antibody treatment, talk with your doctor about the current possibilities for you.