As coronavirus spreads, many questions and some answers
The rapid spread of the virus that causes COVID-19 has sparked alarm worldwide. The World Health Organization (WHO) has declared this rapidly spreading coronavirus outbreak a pandemic, and many countries are grappling with a rise in confirmed cases. In the US, the Centers for Disease Control and Prevention (CDC) is advising people to be prepared for disruptions to daily life that will be necessary if the coronavirus spreads within communities.
Below, you'll find answers to a number of questions about coronavirus and COVID-19. We will be adding new questions and updating answers as reliable information becomes available.
FAQs about Coronavirus and COVID-19
What is coronavirus? What is COVID-19?
What are the symptoms of COVID-19?
What can I do to prevent myself and others from getting coronavirus?
How can I prepare myself and family for possible quarantine or isolation?
What should I do if I feel sick?
If a loved one gets sick, how can I care for them?
What do phrases like "community spread" and "social distancing" mean?
Questions about coronavirus or COVID-19? Click here.
Podcast: How to conquer your anxieties during the COVID-19 outbreak (recorded 3/23/20)
Your feelings arise from a misaligned ratio of stress to resiliency. The more resilient you become the less stress you'll feel. Dr. Greg Fricchione, director of the Benson-Henry Mind Body Institute at Massachusetts General Hospital, describes the tools and techniques for building resilience into your life during stressful times so we can better manage our anxieties.
New questions and answers
I've heard that high-dose vitamin C is being used to treat patients with COVID-19. Does it work? And should I take vitamin C to prevent infection with the COVID-19 virus?
Some critically ill patients with COVID-19 have been treated with high doses of intravenous (IV) vitamin C in the hope that it will hasten recovery. However, there is no clear or convincing scientific evidence that it works for COVID-19 infections, and it is not a standard part of treatment for this new infection. A study is underway in China to determine if this treatment is useful for patients with severe COVID-19; results are expected in the fall.
The idea that high-dose IV vitamin C might help in overwhelming infections is not new. A 2017 study found that high-dose IV vitamin C treatment (along with thiamine and corticosteroids) appeared to prevent deaths among people with sepsis, a form of overwhelming infection causing dangerously low blood pressure and organ failure. Another study published last year assessed the effect of high-dose vitamin C infusions among patients with severe infections who had sepsis and acute respiratory distress syndrome (ARDS), in which the lungs fill with fluid. While the study's main measures of improvement did not improve within the first four days of vitamin C therapy, there was a lower death rate at 28 days among treated patients. Though neither of these studies looked at vitamin C use in patients with COVID-19, the vitamin therapy was specifically given for sepsis and ARDS, and these are the most common conditions leading to intensive care unit admission, ventilator support, or death among those with severe COVID-19 infections.
Regarding prevention, there is no evidence that taking vitamin C will help prevent infection with the coronavirus that causes COVID-19. While standard doses of vitamin C are generally harmless, high doses can cause a number of side effects, including nausea, cramps, and an increased risk of kidney stones.
Is the antiviral drug remdesivir effective for treating COVID-19?
Scientists all over the world are testing whether drugs previously developed to treat other viral infections might also be effective against the new coronavirus that causes COVID-19.
One drug that has received a lot of attention is the antiviral drug remdesivir. That's because the coronavirus that causes COVID-19 is similar to the coronaviruses that caused the diseases SARS and MERS — and evidence from laboratory and animal studies suggests that remdesivir may help limit the reproduction and spread of these viruses in the body. In particular, there is a critical part of all three viruses that can be targeted by drugs. That critical part, which makes an important enzyme that the virus needs to reproduce, is virtually identical in all three coronaviruses; drugs like remdesivir that successfully hit that target in the viruses that cause SARS and MERS are likely to work against the COVID-19 virus.
Remdesivir was developed to treat several other severe viral diseases, including the disease caused by Ebola virus (not a coronavirus). It works by inhibiting the ability of the coronavirus to reproduce and make copies of itself: if it can't reproduce, it can't make copies that spread and infect other cells and other parts of the body.
Remdesivir inhibited the ability of the coronaviruses that cause SARS and MERS to infect cells in a laboratory dish. The drug also was effective in treating these coronaviruses in animals: there was a reduction in the amount of virus in the body, and also an improvement in lung disease caused by the virus.
The drug appears to be effective in the laboratory dish, in protecting cells against infection by the COVID virus (as is true of the SARS and MERS coronaviruses), but more studies are underway to confirm that this is true.
Remdesivir was used in the first case of COVID-19 that occurred in Washington state, in January 2020. The patient was severely ill, but survived. Of course, experience in one patient does not prove the drug is effective.
Two large randomized clinical trials are underway in China. The two trials will enroll over 700 patients, and are likely to definitively answer the question of whether the drug is effective in treating COVID-19. The results of those studies are expected in April or May 2020. Studies also are underway in the United States, including at several Harvard-affiliated hospitals. It is hard to predict when the drug could be approved for use and produced in large amounts, assuming the clinical trials indicate that it is effective and safe.
Is a lost sense of smell a symptom of COVID-19? What should I do if I lose my sense of smell?
Increasing evidence suggests that a lost sense of smell, known medically as anosmia, may be a symptom of COVID-19. This is not surprising, because viral infections are a leading cause of loss of sense of smell, and COVID-19 is a caused by a virus. Still, loss of smell might help doctors identify people who do not have other symptoms, but who might be infected with the COVID-19 virus — and who might be unwittingly infecting others.
A statement written by a group of ear, nose and throat specialists (otolaryngologists) in the United Kingdom reported that in Germany, two out of three confirmed COVID-19 cases had a loss of sense of smell; in South Korea, 30% of people with mild symptoms who tested positive for COVID-19 reported anosmia as their main symptom.
On March 22nd, the American Academy of Otolaryngology–Head and Neck Surgery recommended that anosmia be added to the list of COVID-19 symptoms used to screen people for possible testing or self-isolation.
In addition to COVID-19, loss of smell can also result from allergies as well as other viruses, including rhinoviruses that cause the common cold. So anosmia alone does not mean you have COVID-19. Studies are being done to get more definitive answers about how common anosmia is in people with COVID-19, at what point after infection loss of smell occurs, and how to distinguish loss of smell caused by COVID-19 from loss of smell caused by allergies, other viruses, or other causes altogether.
Until we know more, tell your doctor right away if you find yourself newly unable to smell. He or she may prompt you to get tested and to self-isolate.
Are chloroquine and hydroxychloroquine effective for treating COVID-19?
Recently, there has been considerable discussion of whether two related drugs — chloroquine and hydroxychloroquine — that have been available for decades to treat other illnesses might also be effective in treating COVID-19.
The drugs are primarily used to treat malaria and several inflammatory diseases, including systemic lupus erythematosus (lupus) and rheumatoid arthritis. No drug is perfectly safe, but these drugs are quite safe when used for just the several days they might be needed to treat COVID-19. They are also cheap, already available at our local drug stores, and relatively free of side effects.
The question, of course, is whether they are effective against the coronavirus that causes COVID-19. Are they effective in killing the virus in a laboratory dish? And are they effective in killing the virus in people? If the answer to the first question is "no," there's no point in getting an answer to the second question.
There is strong evidence that both drugs kill the COVID-19 virus in the laboratory dish. The drugs appear to work through two mechanisms. First, they make it harder for the virus to attach itself to the cell, inhibiting the virus from entering the cell and multiplying within it. Second, if the virus does manage to get inside the cell, the drugs kill it before it can multiply.
But do the drugs work in people with COVID-19? Many studies are underway to get an answer to this question, but as of March 24, 2020, only two have issued preliminary results.
One report, published in February 2020, claimed that chloroquine had been used in more than 100 patients in China who had COVID-19. The scientists stated that their results demonstrated that chloroquine is superior to the control treatment in inhibiting the worsening of pneumonia, improving lung imaging findings, eliminating the virus from the body, and shortening the duration of the disease.
These claims are exciting. However, the report provided virtually no evidence in support of the claims. First of all, this was not a randomized, double-blind controlled trial, the gold standard for research studies. Second, no evidence was presented as to how severe the pneumonia was, nor whether findings on lung x-rays or CT scans really improved. Third, although they claim the drug made the virus disappear, they didn't report what the levels of the virus were before versus after the treatment. In short, not much evidence.
Another small study was conducted by a group of scientists in southern France, a region hard hit by COVID-19. This, also, was not a randomized trial. Instead, the scientists compared 26 patients who received hydroxychloroquine to 16 who did not: after six days, the virus was gone from the body in 70% of those given the treatment, compared to only 12.5% of those who weren't. The drug appeared to be as effective in the sickest patients as in the least sick, but the study was too small to be sure about that. The study also was too small to say that people who received the treatment were protected against a prolonged illness or death.
There are many studies underway, and we should have more solid answers within a few months.
I heard that certain blood pressure medicines might worsen symptoms of COVID-19. Should I stop taking my medication now just in case I do get infected? Should I stop if I develop symptoms of COVID-19?
You are referring to angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), two types of medications used primarily to treat high blood pressure (hypertension) and heart disease. Doctors also prescribe these medicines for people who have protein in their urine, a common problem in people with diabetes.
At this time, the American Heart Association (AHA), the American College of Cardiology (ACC), and the Heart Failure Society of America (HFSA) strongly recommend that people taking these medications should continue to do so, even if they become infected.
Here's how this concern got started. Researchers doing animal studies on a different coronavirus (the SARS coronavirus from the early 2000s) found that certain sites on lung cells called ACE-2 receptors appeared to help the SARS virus enter the lungs and cause pneumonia. ACE inhibitor and ARB drugs raised ACE-2 receptor levels in the animals.
Could this mean people taking these drugs are more susceptible to COVID-19 infection and are more likely to get pneumonia?
The reality today:
- Human studies have not confirmed the findings in animal studies.
- Some studies suggest that ACE inhibitors and ARBs may reduce lung injury in people with other viral pneumonias. The same might be true of pneumonia caused by the COVID-19 virus.
- Stopping your ACE inhibitor or ARB could actually put you at greater risk of complications from the infection, since it's likely that your blood pressure will rise and heart problems would get worse.
The bottom line: The AHA, ACC, and HFSA strongly recommend continuing to take ACE inhibitor or ARB medications, even if you get sick with COVID-19.
Should I go to the doctor or dentist for nonurgent appointments?
During this period of social distancing, it is best to postpone nonurgent appointments with your doctor or dentist. These may include regular well visits or dental cleanings, as well as follow-up appointments to manage chronic conditions if your health has been relatively stable in the recent past. You should also postpone routine screening tests, such as a mammogram or PSA blood test, if you are at average risk of disease. Many doctor's offices have started restricting office visits to urgent matters only, so you may not have a choice in the matter.
As an alternative, doctor's offices are increasingly providing telehealth services. This may mean appointments by phone call, or virtual visits using a video chat service. Ask to schedule a telehealth appointment with your doctor for a new or ongoing nonurgent matter. If, after speaking to you, your doctor would like to see you in person, he or she will let you know.
What if your appointments are not urgent but also don't fall into the low-risk category? For example, if you have been advised to have periodic scans after cancer remission, if your doctor sees you regularly to monitor for a condition for which you're at increased risk, or if your treatment varies based on your most recent test results? In these and similar cases, call your doctor for advice.
Should I postpone my elective surgery?
It's likely that your elective surgery or procedure will be canceled or rescheduled by the hospital or medical center in which you are scheduled to have the procedure. If not, then during this period of social distancing, you should consider postponing any procedure that can wait.
That being said, keep in mind that "elective" is a relative term. For instance, you may not have needed immediate surgery for sciatica caused by a herniated disc. But the pain may be so severe that you would not be able to endure postponing the surgery for weeks or perhaps months. In that case, you and your doctor should make a shared decision about proceeding.
Is it safe to take ibuprofen to treat symptoms of COVID-19?
Some French doctors advise against using ibuprofen (Motrin, Advil, many generic versions) for COVID-19 symptoms based on reports of otherwise healthy people with confirmed COVID-19 who were taking an NSAID for symptom relief and developed a severe illness, especially pneumonia. These are only observations and not based on scientific studies.
The WHO initially recommended using acetaminophen instead of ibuprofen to help reduce fever and aches and pains related to this coronavirus infection, but now states that either acetaminophen or ibuprofen can be used. Rapid changes in recommendations create uncertainty. Since some doctors remain concerned about NSAIDs, it still seems prudent to choose acetaminophen first, with a total dose not exceeding 3,000 milligrams per day.
However, if you suspect or know you have COVID-19 and cannot take acetaminophen, or have taken the maximum dose and still need symptom relief, taking over-the-counter ibuprofen does not need to be specifically avoided.
How reliable is the test for COVID-19?
Tests are becoming more widely available and are being processed in commercial labs and academic centers across the country. In the US, the most common test for the COVID-19 virus looks for viral RNA in a sample taken with a swab from a person's nose or throat. Currently, you can expect the test results within three to four days. Likely the turnaround time for results will be shorter over the next few weeks.
If a test result comes back positive, it is almost certain that the person is infected.
A negative test result is less definite. An infected person could get a so-called "false negative" test result if the swab missed the virus, for example, or because of an inadequacy of the test itself. We also don't yet know at what point during the course of illness a test becomes positive.
If you experience COVID-like symptoms and get a negative test result, there is no reason to repeat the test unless your symptoms get worse. If your symptoms do worsen, call your doctor or local or state healthcare department for guidance on further testing. You should also self-isolate at home. Wear a mask if you have one when interacting with members of your household. And practice social distancing.
More about COVID-19 and how to protect yourself
- Pregnant and worried about the new coronavirus?
- Grandparenting in the time of COVID-19
- What one study from China tells us about COVID-19 and children
- Can telehealth help flatten the curve of COVID-19?
- Apps to keep us connected in a time of social distancing
- Coping with the coronavirus pandemic for people with anxiety disorders
- Strategies to promote better sleep in these uncertain times
Podcast: The front lines of COVID-19: A doctor's eye view (recorded 3/20/20)
Dr. Todd Ellerin is an infectious diseases physician at South Shore Health in Weymouth Massachusetts, and an instructor in medicine at Harvard Medical School. He also serves as an associate physician at Boston's prestigious Brigham and Women's Hospital. He offers insight—and practical information-- from the front lines in the battle to stem COVID-19.
Podcast: Coronavirus status report: Harvard public health expert Dr. Ashish K. Jha fills us in on where we are headed (recorded 3/19/20)
The COVID-19 outbreak has caused markets to collapse and worldwide health systems to become overwhelmed. When there's a global pandemic, it's nice to hear from the steady, transparent and yes even reassuring voice of experts on the front lines. We spoke to Dr. Ashish K. Jha, faculty director of the Harvard Global Health Institute. Dr. Jha's recent appearance on the PBS Newshour caused reverberations throughout the federal and state response system. Here's his update.
- Centers for Disease Control and Prevention
- World Health Organization
- Johns Hopkins University COVID-19 Interactive Map
Symptoms, spread, and other essential information
What is coronavirus and how does it spread? What is COVID-19 and what are the symptoms? How long does coronavirus live on different surfaces? Take a moment to reacquaint yourself with basic information about this virus and the disease it causes.
Click here to read more about COVID-19 symptoms, spread, and other basic information.
What can I do to protect myself and others from COVID-19?
The following actions help prevent the spread of COVID-19, as well as other coronaviruses and influenza:
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose, and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Wash your hands often with soap and water.
This chart illustrates how protective measures such as limiting travel, avoiding crowds, social distancing, and thorough and frequent handwashing can slow down the development of new COVID-19 cases and reduce the risk of overwhelming the health care system.
What do I need to know about washing my hands effectively?
Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
- Always wash hands with soap and water if hands are visibly dirty.
- The CDC's handwashing website has detailed instructions and a video about effective handwashing procedures.
Should I wear a face mask?
Follow public health recommendations where you live. As of February 26, 2020, face masks are not recommended for the general public in the US. Some health facilities require people to wear a mask under certain circumstances.
If you have respiratory symptoms like coughing or sneezing, experts recommend wearing a mask to protect others. This may help contain droplets containing any type of virus, including the flu, and protect anyone within three to six feet of the infected person.
The CDC offers more information about masks. The WHO offers videos and illustrations on when and how to use a mask.
Is it safe to travel by airplane?
Stay current on travel advisories from regulatory agencies. This is a rapidly changing situation.
Anyone who has a fever and respiratory symptoms should not fly if at all possible. Even if a person has symptoms that feel like just a cold, he or she should wear a mask on an airplane.
Is there a vaccine available?
No vaccine is available, although scientists will be starting human testing on a vaccine very soon. However, it may be a year or more before we even know if we have a vaccine that works.
Can a person who has had coronavirus get infected again?
While we don't know the answer yet, most people would likely develop at least short-term immunity to the specific coronavirus that causes COVID-19. However, you would still be susceptible to a different coronavirus infection. Or, this particular virus could mutate, just like the influenza virus does each year. Often these mutations change the virus enough to make you susceptible, because your immune system thinks it is an infection that it has never seen before.
Will a pneumococcal vaccine help protect me against coronavirus?
Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B (Hib) vaccine, only help protect people from these specific bacterial infections. They do not protect against any coronavirus pneumonia, including pneumonia that may be part of COVID-19. However, even though these vaccines do not specifically protect against the coronavirus that causes COVID-19, they are highly recommended to protect against other respiratory illnesses.
My husband and I are in our 70s. I'm otherwise healthy. My husband is doing well but does have heart disease and diabetes. My grandkids' school has been closed for the next several weeks. We'd like to help out by watching our grandkids but don't know if that would be safe for us. Can you offer some guidance?
People who are older and older people with chronic medical conditions, especially cardiovascular disease, high blood pressure, diabetes, and lung disease are more likely to have severe disease or death from COVID-19, and should engage in strict social distancing without delay. This is also the case for people or who are immunocompromised because of a condition or treatment that weakens their immune response.
The decision to provide on-site help with your children and grandchildren is a difficult one. If there is an alternative to support their needs without being there, that would be safest.
Can my pet infect me with the virus that causes COVID-19?
At present, there is no evidence that pets such as dogs or cats can spread the COVID-19 virus to humans. However, pets can spread other infections that cause illness, including E. coli and Salmonella, so wash your hands thoroughly with soap and water after interacting with pets.
What can I do to keep my immune system strong?
Your immune system is your body's defense system. When a harmful invader — like a cold or flu virus, or the coronavirus that causes COVID-19 — gets into your body, your immune system mounts an attack. Known as an immune response, this attack is a sequence of events that involves various cells and unfolds over time.
Following general health guidelines is the best step you can take toward keeping your immune system strong and healthy. Every part of your body, including your immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies such as these:
- Don't smoke.
- Eat a diet high in fruits, vegetables, and whole grains.
- Take a multivitamin if you suspect that you may not be getting all the nutrients you need through your diet.
- Exercise regularly.
- Maintain a healthy weight.
- Control your stress level.
- Control your blood pressure.
- If you drink alcohol, drink only in moderation (no more than one to two drinks a day for men, no more than one a day for women).
- Get enough sleep.
- Take steps to avoid infection, such as washing your hands frequently and trying not to touch your hands to your face, since harmful germs can enter through your eyes, nose, and mouth.
If you are at higher risk
Though no one is invulnerable, we've seen that older adults are at increased risk for severe illness or death from COVID-19. Underlying conditions, including heart disease, lung disease, and diabetes, increase risk even further in those who are older. In addition, anyone with an underlying medical condition, regardless of their age, faces increased risk of serious illness.
Click here to read more about what you can do if you are at increased risk for serious illness.
Preparing for social distancing, self-quarantine, or self-isolation:
What types of medications and health supplies should I have on hand for an extended stay at home?
Try to stock at least a 30-day supply of any needed prescriptions. If your insurance permits 90-day refills, that's even better. Make sure you also have over-the-counter medications and other health supplies on hand.
Medical and health supplies
- prescription medications
- prescribed medical supplies such as glucose and blood-pressure monitoring equipment
- fever and pain medicine, such as acetaminophen
- cough and cold medicines
- antidiarrheal medication
- fluids with electrolytes
- soap and alcohol-based hand sanitizer
- tissues, toilet paper, disposable diapers, tampons, sanitary napkins
- garbage bags.
Should I keep extra food at home? What kind?
Consider keeping a two-week to 30-day supply of nonperishable food at home. These items can also come in handy in other types of emergencies, such as power outages or snowstorms.
- canned meats, fruits, vegetables, and soups
- frozen fruits, vegetables, and meat
- protein or fruit bars
- dry cereal, oatmeal, or granola
- peanut butter or nuts
- pasta, bread, rice, and other grains
- canned beans
- chicken broth, canned tomatoes, jarred pasta sauce
- oil for cooking
- flour, sugar
- coffee, tea, shelf-stable milk, canned juices
- bottled water
- canned or jarred baby food and formula
- pet food
- household supplies like laundry detergent, dish soap, and household cleaner.
What is social distancing and why is it important?
The COVID-19 virus primarily spreads when one person breathes in droplets that are produced when an infected person coughs or sneezes. In addition, any infected person, with or without symptoms, could spread the virus by touching a surface. The coronavirus could remain on that surface and someone else could touch it and then touch their mouth, nose or eyes. That's why it's so important to try to avoid touching public surfaces or at least try to wipe them with a disinfectant.
Social distancing refers to actions taken to stop or slow down the spread of a contagious disease. For an individual, it refers to maintaining enough distance (6 feet or more) between yourself and another person to avoid getting infected or infecting someone else. School closures, directives to work from home, library closings, and cancelling meetings and larger events help enforce social distancing at a community level.
Slowing down the rate and number of new coronavirus infections is critical to not overwhelming hospitals, which could lead to large numbers of critically ill patients not receiving life-saving care. Highly realistic projections show that unless we begin extreme social distancing now — every day matters — our hospitals and other healthcare facilities will not be able to handle the likely influx of patients.
What should and shouldn't I do during this time to avoid exposure to and spread of this coronavirus? For example, what steps should I take if I need to go shopping for food and staples? What about eating at restaurants, ordering takeout, going to the gym or swimming in a public pool?
The answer to all of the above is that it is critical that everyone begin intensive social distancing immediately. As much as possible, limit contact with people outside your family.
If you need to get food, staples, medications or healthcare, try to stay at least six feet away from others, and wash your hands thoroughly after the trip, avoiding contact with your face and mouth throughout. Prepare your own food rather than going to a restaurant or even getting takeout. It's best to avoid the gym, but if you do go, be sure to wipe down anything you are about to touch, and once more after you use the equipment. Again try to keep a distance of six feet or more from others. Since the virus won't survive in properly treated pool water, swimming should be okay as long as you avoid close contact with other people.
Here are some other things to avoid: playdates, parties, sleepovers, having friends or family over for meals or visits, and going to coffee shops — essentially any nonessential activity that involves close contact with others.
What can I do when social distancing?
Try to look at this period of social distancing as an opportunity to get to things you've been meaning to do.
Though you shouldn't go to the gym right now, that doesn't mean you can't exercise. Take long walks or run outside (do your best to maintain at least six feet between you and non-family members when you're outside). Do some yoga or other indoor exercise routines when the weather isn't cooperating.
Kids need exercise too, so try to get them outside every day for walks or a backyard family soccer game (remember, this isn't the time to invite the neighborhood kids over to play). Avoid public playground structures, which aren't cleaned regularly and can spread the virus.
Pull out board games that are gathering dust on your shelves. Have family movie nights. Catch up on books you've been meaning to read, or do a family read-aloud every evening.
It's important to stay connected even though we should not do so in person. Keep in touch virtually through phone calls, Skype, video, and other social media. Enjoy a leisurely chat with an old friend you've been meaning to call.
If all else fails, go to bed early and get some extra sleep!
If you are sick or have been exposed to COVID-19:
What should I do if I think I or my child may have a COVID-19 infection?
First call your doctor or pediatrician for advice.
If you do not have a doctor and you are concerned that you or your child may have COVID-19, contact your local board of health. They can direct you to the best place for evaluation and treatment in your area.
It's best to not seek medical care in an emergency department unless you have symptoms of severe illness. Severe symptoms include high or very low body temperature, shortness of breath, confusion, or feeling you might pass out. Call the emergency department ahead of time to let the staff know that you are coming, so they can be prepared for your arrival.
How do I know if I have COVID-19 or the regular flu?
COVID-19 often causes symptoms similar to those a person with a bad cold or the flu would experience. And like the flu, the symptoms can progress and become life-threatening. Your doctor is more likely to suspect coronavirus if:
- you have respiratory symptoms
- you recently traveled to countries with ongoing community spread of the COVID-19 virus, or
- you have been exposed to someone suspected of having COVID-19, or
- there has been community spread of the virus that causes COVID-19 in your area.
How is someone tested for COVID-19?
A specialized test must be done to confirm that a person has been infected with the virus that causes COVID-19. Most often a clinician takes a swab of your nose (or both your nose and throat). The sample is delivered to labs that have been approved to perform the test. The number of tests and testing sites available are rapidly increasing. Still, it will take weeks before the test is available to everyone who may be infected. Meanwhile, clinicians will primarily test those with respiratory symptoms who have recently traveled to certain countries, live in a community with many infected people, or likely have been exposed to someone known to have COVID-19.
How soon after I'm infected with the new coronavirus will I start to be contagious?
The time from exposure to symptom onset (known as the incubation period) is thought to be 14 days, though symptoms typically appear within four or five days after exposure. We don't know the extent to which people who are not yet experiencing symptoms can infect others, but it's possible that people may be contagious for several days before they become symptomatic.
For how long after I am infected will I continue to be contagious? At what point in my illness will I be most contagious?
People are thought to be most contagious early in the course of their illness, when they are beginning to experience symptoms. Researchers have detected viral genetic material in patients several weeks after they've recovered from COVID-19. Though the significance of these findings is not fully understood, it suggests the possibility that people may continue to be contagious for weeks after they are feeling better.
If I get sick with COVID-19, how long until I will feel better?
It depends on how sick you get. Those with mild cases appear to recover within one to two weeks. With severe cases, recovery can take six weeks or more. According to the most recent estimates, about 1% of infected persons will succumb to the disease.
How long after I start to feel better will be it be safe for me to go back out in public again?
We don't know for certain. Based on research that has detected viral genetic material in patients several weeks after they've recovered from COVID-19, it is safest to assume that you may be contagious for weeks after you recover.
What's the difference between self-isolation and self-quarantine, and who should consider them?
Self-isolation is voluntary isolation at home by those who have or are likely to have COVID-19 and are experiencing mild symptoms of the disease (in contrast to those who are severely ill and may be isolated in a hospital). The purpose of self-isolation is to prevent spread of infection from an infected person to others who are not infected. If possible, the decision to isolate should be based on physician recommendation. If you have tested positive for COVID-19, you should self-isolate.
You should strongly consider self-isolation if you
- have been tested for COVID-19 and are awaiting test results
- have been exposed to the new coronavirus and are experiencing symptoms consistent with COVID-19 (fever, cough, difficulty breathing), whether or not you have been tested.
You may also consider self-isolation if you have symptoms consistent with COVID-19 (fever, cough, difficulty breathing) but have not had known exposure to the new coronavirus and have not been tested for the virus that causes COVID-19. In this case, it may be reasonable to isolate yourself until your symptoms fully resolve, or until you are able to be tested for COVID-19 and your test comes back negative.
Self-quarantine for 14 days by anyone with a household member who has been infected, whether or not they themselves are infected, is the current recommendation of the White House task force. Otherwise, voluntary quarantine at home by those who may have been exposed to the COVID-19 virus but are not experiencing symptoms associated with COVID-19 (fever, cough, difficulty breathing). The purpose of self-quarantine (as with self-isolation) is to prevent the possible spread of COVID-19. When possible, the decision to quarantine should be based on physician recommendation. Self-quarantine is reasonable if you are not experiencing symptoms, but have been exposed to the COVID-19 virus.
What does it really mean to self-isolate or self-quarantine? What should or shouldn't I do?
If you are sick with COVID-19 or think you may be infected with the COVID-19 virus, it is important not to spread the infection to others while you recover. While home-isolation or home-quarantine may sound like a staycation, you should be prepared for a long period during which you might feel disconnected from others and anxious about your health and the health of your loved ones. Staying in touch with others by phone or online can be helpful to maintain social connections, ask for help, and update others on your condition.
Here's what the CDC recommends to minimize the risk of spreading the infection to others in your home and community.
Stay home except to get medical care
- Do not go to work, school, or public areas.
- Avoid using public transportation, ride-sharing, or taxis.
Call ahead before visiting your doctor
- Call your doctor and tell them that you have or may have COVID-19. This will help the healthcare provider's office to take steps to keep other people from getting infected or exposed.
Separate yourself from other people and animals in your home
- As much as possible, stay in a specific room and away from other people in your home. Use a separate bathroom, if available.
- Restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. When possible, have another member of your household care for your animals while you are sick. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a face mask.
Wear a face mask if you are sick
- Wear a face mask when you are around other people or pets and before you enter a doctor's office or hospital.
Cover your coughs and sneezes
- Cover your mouth and nose with a tissue when you cough or sneeze and throw used tissues in a lined trash can.
- Immediately wash your hands with soap and water for at least 20 seconds after you sneeze. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.
Clean your hands often
- Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
Don't share personal household items
- Do not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home.
- After using these items, they should be washed thoroughly with soap and water.
Clean all "high-touch" surfaces every day
High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables.
- Clean and disinfect areas that may have any bodily fluids on them.
- A list of products suitable for use against COVID-19 is available here. This list has been pre-approved by the US Environmental Protection Agency (EPA) for use during the COVID-19 outbreak.
Monitor your symptoms
- Monitor yourself for fever by taking your temperature twice a day and remain alert for cough or difficulty breathing.
- If you have not had symptoms and you begin to feel feverish or develop measured fever, cough, or difficulty breathing, immediately limit contact with others if you have not already done so. Call your doctor or local health department to determine whether you need a medical evaluation.
- Seek prompt medical attention if your illness is worsening, for example if you have difficulty breathing. Before going to a doctor's office or hospital, call your doctor and tell them that you have, or are being evaluated for, COVID-19.
- Put on a face mask before you enter a healthcare facility or any time you may come into contact with others.
- If you have a medical emergency and need to call 911, notify the dispatch personnel that you have or are being evaluated for COVID-19. If possible, put on a face mask before emergency medical services arrive.
When can I discontinue my self-isolation or self-quarantine?
While many experts are recommending at least 14 days of self-isolation for those who are infected, the decision to discontinue these measures should be made on a case-by-case basis, in consultation with your doctor and state and local health departments. The decision will be based on the risk of infecting others.
Is there an antiviral treatment for COVID-19?
Currently there is no specific antiviral treatment for COVID-19.
Why is it so difficult to develop treatments for viral illnesses?
An antiviral drug must be able to target the specific part of a virus's life cycle that is necessary for it to reproduce. In addition, an antiviral drug must be able to kill a virus without killing the human cell it occupies. And viruses are highly adaptive. Because they reproduce so rapidly, they have plenty of opportunity to mutate (change their genetic information) with each new generation, developing resistance to whatever drugs or vaccines we develop.
What treatments are available to treat coronavirus?
Currently there is no specific antiviral treatment for COVID-19. However, similar to treatment of any viral infection, these measures can help:
- While you don't need to stay in bed, you should get plenty of rest.
- Stay well hydrated.
- To reduce fever and ease aches and pains, ake acetaminophen. Be sure to follow directions. If you are taking any combination cold or flu medicine, keep track of all the ingredients and the doses. For acetaminophen, the total daily dose from all products should not exceed 3,000 milligrams.
The World Health Organization (WHO) advises against using ibuprofen (Motrin, Advil, many generic versions) for COVID-19 symptoms based on reports of otherwise healthy people with confirmed COVID-19 who were taking an NSAID for symptom relief and developed a severe illness, especially pneumonia. While these are only observations and not based on scientific studies, it currently seems prudent to use acetaminophen to help reduce fever and ease aches and pains related to this coronavirus infection. No specific recommendation was made regarding naproxen (Aleve, Naprosyn). Given naproxen and ibuprofen have similar actions, it's best to avoid naproxen as well. For now, if you suspect or know you have COVID-19 and cannot take acetaminophen, or have taken the maximum dose and still need symptom relief, contact your doctor for advice.
Can I infect my pet?
There have not been reports of pets or other animals becoming sick with COVID-19, but the CDC still recommends that people sick with COVID-19 limit contact with animals until more information is known. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a face mask.
How can I protect myself while caring for someone that may have COVID-19?
You should take many of the same precautions as you would if you were caring for someone with the flu:
- Stay in another room or be separated from the person as much as possible. Use a separate bedroom and bathroom, if available.
- Make sure that shared spaces in the home have good air flow. Turn on an air conditioner or open a window.
- Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Use soap and water if your hands are visibly dirty.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- You and the person should wear a face mask if you are in the same room.
- Wear a disposable face mask and gloves when you touch or have contact with the person's blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, urine.
- Throw out disposable face masks and gloves after using them. Do not reuse.
- First remove and throw away gloves. Then, immediately clean your hands with soap and water or alcohol-based hand sanitizer. Next, remove and throw away the face mask, and immediately clean your hands again with soap and water or alcohol-based hand sanitizer.
- Do not share household items such as dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with the person who is sick. After the person uses these items, wash them thoroughly.
- Clean all "high-touch" surfaces, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe.
- Wash laundry thoroughly.
- Immediately remove and wash clothes or bedding that have blood, stool, or body fluids on them.
- Wear disposable gloves while handling soiled items and keep soiled items away from your body. Clean your hands immediately after removing your gloves.
- Place all used disposable gloves, face masks, and other contaminated items in a lined container before disposing of them with other household waste. Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after handling these items.
My parents are older, which puts them at higher risk for COVID-19, and they don't live nearby. How can I help them if they get sick?
Caring from a distance can be stressful. Start by talking to your parents about what they would need if they were to get sick. Put together a single list of emergency contacts for their (and your) reference, including doctors, family members, neighbors, and friends. Include contact information for their local public health department.
You can also help them to plan ahead. For example, ask your parents to give their neighbors or friends a set of house keys. Have them stock up on prescription and over-the counter medications, health and emergency medical supplies, and nonperishable food and household supplies (see How to prepare for more detail). Check in regularly by phone, Skype, or however you like to stay in touch.
Coronavirus and kids:
So far, the vast majority of coronavirus infections have afflicted adults. And when kids are infected, they tend to have milder disease. Still, as a parent, you can't help but worry about the safety of your children. Many parents are also trying to find a balance between answering their children's questions about the pandemic and enforcing health-promoting behaviors and social distancing rules without creating an atmosphere of anxiety. Not to mention keeping kids engaged and entertained with schools closed and playdates cancelled.
Click here to read more about kids and the coronavirus outbreak.
Coping with coronavirus:
The news about coronavirus and its impact on our day-to-day lives has been unrelenting. There's reason for concern and it makes good sense to take the pandemic seriously. But it's not good for your mind or your body to be on high alert all the time. Doing so will wear you down emotionally and physically.
Click here to read more about coping with coronavirus.
Terms to know:
community spread (community transmission): is said to have occurred when people have been infected without any knowledge of contact with someone who has the same infection
contact tracing: a process that begins with identifying everyone a person diagnosed with a given illness (in this case COVID-19) has been in contact with since they became contagious. The contacts are notified that they are at risk, and may include those who share the person's home, as well as people who were in the same place around the same time as the person with COVID-19 — a school, office, restaurant, or doctor's office, for example. Contacts may be quarantined or asked to isolate themselves if they start to experience symptoms, and are more likely to be tested for coronavirus if they begin to experience symptoms.
containment: refers to limiting the spread of an illness. Because no vaccines exist to prevent COVID-19 and no specific therapies exist to treat it, containment is done using public health interventions. These may include identifying and isolating those who are ill, and tracking down anyone they have had contact with and possibly placing them under quarantine.
epidemic: a disease outbreak in a community or region
flattening the curve: refers to the epidemic curve, a statistical chart used to visualize the number of new cases over a given period of time during a disease outbreak. Flattening the curve is shorthand for implementing mitigation strategies to slow things down, so that fewer new cases develop over a longer period of time. This increases the chances that hospitals and other healthcare facilities will be equipped to handle any influx of patients.
incubation period: the period of time between exposure to an infection and when symptoms begin
isolation: the separation of people with a contagious disease from people who are not sick
mitigation: refers to steps taken to limit the impact of an illness. Because no vaccines exist to prevent COVID-19 and no specific therapies exist to treat it, mitigation strategies may include frequent and thorough handwashing, not touching your face, staying away from people who are sick, social distancing, avoiding large gatherings, and regularly cleaning frequently touched surfaces and objects at home, in schools, at work, and in other settings.
pandemic: a disease outbreak affecting large populations or a whole region, country, or continent
presumptive positive test result: a positive test for the virus that causes COVID-19, performed by a local or state health laboratory, is considered "presumptive" until the result is confirmed by the CDC. While awaiting confirmation, people with a presumptive positive test result will be considered to be infected.
quarantine: separates and restricts the movement of people who have a contagious disease, have symptoms that are consistent with the disease, or were exposed to a contagious disease, to see if they become sick
SARS-CoV-2: short for severe acute respiratory syndrome coronavirus 2, SARS-CoV-2 is the official name for the virus responsible for COVID-19.
social distancing: refers to actions taken to stop or slow down the spread of a contagious disease. For an individual, it refers to maintaining enough distance between yourself and another person to reduce the risk of breathing in droplets that are produced when an infected person coughs or sneezes. In a community, social distancing measures may include limiting or cancelling large gatherings of people.
virus: a virus is the smallest of infectious microbes, smaller than bacteria or fungi. A virus consists of a small piece of genetic material (DNA or RNA) surrounded by a protein shell. Viruses cannot survive without a living cell in which to reproduce. Once a virus enters a living cell (the host cell) and takes over a cell's inner workings, the cell cannot carry out its normal life-sustaining tasks. The host cell becomes a virus manufacturing plant, making viral parts that then reassemble into whole viruses and go on to infect other cells. Eventually, the host cell dies.
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Harvard Health Publishing Coronavirus Resource Center Experts
The Harvard Health Publishing team would like to acknowledge the Harvard Medical School experts who have contributed their time and expertise: Todd Ellerin, MD; Huma Farid, MD; Anthony Komaroff, MD; Douglas Krakower, MD; Howard E. LeWine, MD; Luana Marques, PhD; Claire McCarthy, MD; Babar Memon, MD, MSc; John Sharp, MD; Robert H. Shmerling, MD; Jacqueline Sperling, PhD.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.