NYS COVID Guidelines: Testing, Treatment, Masking, and Sick Leave

New York State COVID guidelines now follow the CDC’s updated respiratory virus framework, which replaced the fixed five-day isolation rule in March 2024.¹ Broad emergency mandates have ended, but the state still enforces specific rules for healthcare facilities, requires labs to report positive results, and keeps antiviral treatments available through regular pharmacy channels. What applies to you depends on where you are: at home with symptoms, at work, in a hospital, or sending a child to school.

If You’re Sick or Test Positive

There is no longer a set number of days you must isolate. Under the CDC guidance New York follows, stay home and away from others when you have respiratory symptoms (fever, cough, fatigue, and the like) that aren’t explained by another condition. You can return to normal activities once both of these have been true for at least 24 hours: your symptoms are overall improving, and you have had no fever without using fever-reducing medication.²

For the next five days after you go back to your routine, take added precautions: wear a well-fitting mask around others, improve ventilation, keep physical distance when practical, wash hands, and test before being around people at higher risk for severe illness.² If your fever comes back or symptoms worsen, go home again, wait out another 24 fever-free hours with improving symptoms, and restart the five-day precaution window.

Tested positive but never developed symptoms? The CDC still treats you as potentially contagious. Take the same added precautions for five days from the date of the positive test.²

Testing, Reporting, and What It Costs

New York accepts both PCR tests and rapid antigen tests. You can pick up at-home rapid kits through local health departments or buy them at pharmacies, and the state keeps an online locator for clinical testing sites at urgent care centers, hospital labs, and some pharmacies.¹

A positive at-home result does not have to be reported to the state, though some local health departments offer self-reporting portals. Clinical laboratories are held to a stricter standard. They must report positive PCR or antigen results to the state’s Electronic Clinical Laboratory Reporting System within 24 hours. PCR negatives and inconclusive results must also be reported; reporting negative antigen results is optional.³

Since the federal public health emergency ended, free testing is no longer guaranteed. Some Marketplace health plans may not cover diagnostic COVID tests at a provider’s office or at-home kits bought at a pharmacy.⁴ If your plan has deductibles or copays, expect to pay them. Out-of-pocket costs for a PCR test without insurance generally run between $90 and $175. Call your insurer before testing so you know what you’ll owe.

Getting Antiviral Treatment

Paxlovid and Lagevrio (molnupiravir) have moved to standard commercial pharmacy channels as of November 2023. If you have insurance, your plan covers these drugs the way it covers other prescriptions, subject to your usual copay or coinsurance. Pfizer runs a co-pay savings program for commercially insured patients to lower out-of-pocket costs for Paxlovid.⁵

If you’re uninsured or underinsured, the Paxlovid Patient Assistance Program provides the drug at no cost to eligible individuals, including people on Medicare or Medicaid. Merck runs a similar program for Lagevrio, supplying the medication free for up to a year to eligible patients who can’t afford it.⁵ These treatments work best when started early, so test promptly after symptoms begin and ask your provider about antivirals the same day.

Masking in Healthcare and Congregate Settings

There is no statewide public masking mandate. Healthcare and congregate care facilities are a separate matter. New York regulation 10 NYCRR 2.60 gives the Commissioner of Health authority to require face coverings in hospitals, nursing homes, homeless shelters, schools, public transit, and correctional facilities based on current COVID incidence and transmission.⁶ That authority can be activated or lifted without new legislation.

Facility administrators also set their own policies. Hospital systems and nursing homes commonly require masks for staff and visitors to protect immunocompromised patients, and when a facility has an outbreak, the state can mandate PPE for all personnel. Visitors who refuse a facility’s posted masking rules can be turned away.

Vaccines and Employer Requirements

Anyone six months and older is eligible for a COVID-19 vaccine in New York. Staying up to date generally means one dose of the updated 2025–2026 vaccine. The groups with the strongest reason to get vaccinated include adults 65 and older, children aged 6 to 23 months, pregnant or recently postpartum individuals, people with underlying conditions that raise the risk of severe illness, and healthcare workers or residents of congregate settings like nursing homes.

New York repealed its statewide healthcare worker vaccine mandate (10 NYCRR 2.61) in October 2023.⁷ The repeal did not ban employer mandates; it returned the decision to individual facilities, and healthcare employers are now free to decide whether to require vaccination.⁸ Many hospital systems still do.

If your employer has a vaccination policy, you must provide documentation of your status or an approved exemption. Medical exemptions require documentation of a genuine contraindication. Religious exemptions fall under federal Title VII: your employer generally must accept that your belief is sincere unless there is an objective reason to question it, such as behavior clearly inconsistent with the belief or suspicious timing. An employer who denies an exemption request must show that accommodating it would cause undue hardship.⁹ Failing to comply with a valid employer health policy can result in termination and may complicate unemployment insurance claims.

Sick Leave and Long COVID at Work

New York’s general paid sick leave law covers time off for illness, COVID included, and COVID-specific paid sick leave provisions remain in addition to the general law.¹⁰ Your available hours depend on your employer’s size and net income. Most employees accrue sick time usable for any illness without needing a COVID-specific justification. If you run out of paid leave, check whether your employer offers short-term disability or whether you qualify for New York’s Paid Family Leave program for a longer recovery.

Workers often miss the protections that apply when COVID symptoms linger. If you have persistent brain fog, fatigue, shortness of breath, or chronic pain after an infection, you may qualify as having a disability under the Americans with Disabilities Act. Long COVID meets the ADA definition when symptoms amount to a physical or mental impairment that substantially limits a major life activity such as breathing, concentrating, walking, or working. The impairment does not have to be severe or permanent; intermittent symptoms qualify if they would substantially limit an activity when active.¹¹

If Long COVID qualifies as a disability in your case, your employer must provide reasonable accommodations unless doing so creates undue hardship. The EEOC has given examples of what that looks like in practice:

For brain fog, a quiet workspace, noise-canceling devices, or blocks of uninterrupted work time.
For headaches, alternative lighting or reduced screen glare.
For joint pain or shortness of breath, rest breaks or removal of physically demanding tasks that aren’t core to your job.
For fatigue, a flexible schedule or a telework arrangement.

Many of these cost little or nothing. The end of the public health emergency does not let your employer automatically pull accommodations already in place; any change requires an individualized conversation about whether the need still exists.⁹

Schools and Childcare

The New York State Education Department has adopted the same CDC-aligned approach used statewide. As of March 2024, NYSED recommends schools follow the updated NYSDOH and CDC respiratory virus guidance and work with their local health department if community transmission is high.¹²

Schools send symptomatic students home and apply the same return criteria as the general public: 24 hours fever-free without medication and symptoms improving. Schools are expected to maintain basic infection-control practices like ventilation and hand hygiene, and they are responsible for notifying parents and guardians when an exposure occurs. School districts are not required to collect or report vaccination status from teachers or other staff; whether to request that information is a local labor-management decision.¹² Individual school boards can still put stricter local policies in place if regional health data supports it.

1
New York State Department of Health. COVID-19
2
CDC. Preventing Spread of Respiratory Viruses When You’re Sick
3
Wadsworth Center. Health Advisory: Updated Reporting Requirements for Laboratory Results for SARS-CoV-2
4
HealthCare.gov. Marketplace Coverage and COVID-19
5
New York State Department of Health. Information for Providers
6
New York State Department of Health. Face Coverings for COVID-19 Prevention
7
Legal Information Institute. New York Code 10 NYCRR 2.61 – Prevention of COVID-19 Transmission by Covered Entities (Repealed)
8
New York Codes, Rules and Regulations. Removal of the COVID-19 Vaccine Requirement for Personnel in Covered Entities
9
U.S. Equal Employment Opportunity Commission. What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws
10
NY.gov. New York Paid Sick Leave
11
HHS.gov. Guidance on Long COVID as a Disability Under the ADA, Section 504, and Section 1557
12
New York State Center For School Health. COVID-19 (Coronavirus)