CORONAVIRUS DISEASE BASICS

What is “novel coronavirus”?

A novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease 2019 (COVID-19), is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold. A diagnosis with coronavirus 229E, NL63, OC43, or HKU1 is not the same as a COVID-19 diagnosis. Patients with COVID-19 will be evaluated and cared for differently than patients with common coronavirus diagnosis.

Why is the disease being called coronavirus disease 2019, COVID-19?

On February 11, 2020 the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV”. There are many types of human coronaviruses including some that commonly cause mild upper-respiratory tract illnesses. COVID-19 is a new disease, caused be a novel (or new) coronavirus that has not previously been seen in humans.

COVID-19 and Hypertension

Are people with high blood pressure (hypertension) at higher risk from COVID-19?

  • At this time, we do not think that people with high blood pressure and no other underlying health conditions are more likely than others to get severely ill from COVID-19. Although many people who have gotten severely ill from COVID-19 have high blood pressure, they are often older or have other medical conditions like obesity, diabetes, and serious heart conditions that place them at higher risk of severe illness from COVID-19.
  • If you have high blood pressure, it’s critically important that you keep your blood pressure under control to lower your risk for heart disease and strokes. Take your blood pressure medications as directed, keep a log of your blood pressure every day if you are able to take your blood pressure at home, and work with your healthcare team to make sure your blood pressure is well controlled. Any changes to your medications should be made in consultation with your healthcare team.

Should I continue to take my blood pressure medication?

  • Continue to take your blood pressure medications exactly as prescribed and make lifestyle modifications agreed upon in your treatment plan. Continue all your regular medications, including angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs), as prescribed by your healthcare team. This is recommended by current clinical guidelines from the American Heart Association, the Heart Failure Society of America, and the American College of Cardiology

HOW COVID-19 SPREADS

What is the source of the virus?

COVID-19 is caused by a coronavirus called SARS-CoV-2. Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats.  Rarely, animal coronaviruses can infect people and then spread between people. This occurred with MERS-CoV and SARS-CoV, and now with the virus that causes COVID-19. The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The sequences from U.S. patients are like the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir. However, the exact source of this virus is unknown.

How does the virus spread?

The virus that causes COVID-19 is thought to spread mainly from person to person, mainly through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Spread is more likely when people are in close contact with one another (within about 6 feet). COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in many affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.

Why are we seeing a rise in cases?

The number of cases of COVID-19 being reported in the United States is rising due to increased laboratory testing and reporting across the country. The growing number of cases in part reflects the rapid spread of COVID-19 as many U.S. states and territories experience community spread. More detailed and accurate data will allow us to better understand and track the size and scope of the outbreak and strengthen prevention and response efforts.

Can someone who has been sick with COVID-19 spread the illness to others?

  • The virus that causes COVID-19 is spreading from person-to-person. People are thought to be most contagious when they are symptomatic (the sickest). That is why CDC recommends that these patients be isolated either in the hospital or at home (depending on how sick they are) until they are better and no longer pose a risk of infecting others. More recently the virus has also been detected in asymptomatic persons.
  • How long someone is actively sick can vary so the decision on when to release someone from isolation is made using a test-based or non-test-based strategy (i.e. time since illness started and time since recovery) in consultation with state and local public health officials. The decision involves considering the specifics of each situation, including disease severity, illness signs and symptoms, and the results of laboratory testing for that patient.
  • Learn more about CDC’s guidance on when to release someone from isolation and discharge hospitalized patients with COVID-19. For information on when someone who has been sick with COVID-19 is able to stop home isolation see Interim Guidance for Discontinuation of In-Home Isolation for Patients with COVID-19.

Can the virus that causes COVID-19 be spread through food, including take-out, refrigerated and frozen packaged food?

  • Coronaviruses are generally thought to be spread from person to person through respiratory droplets. Currently, there is no evidence to support transmission of COVID-19 associated with food. Before preparing or eating food it is important to always wash your hands with soap and water for at least 20 seconds for general food safety. Throughout the day use a tissue to cover your coughing or sneezing, and wash your hands after blowing your nose, coughing or sneezing, or going to the bathroom.
  • It may be possible that a person can get COVID-19 by touching a surface or object, like a packaging container, that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
  • In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging. The CDC has further excellent information about the spread of COVID-19.

Can I get sick with COVID-19 if it is on food?

Based on information about this novel coronavirus thus far, it seems unlikely that COVID-19 can be transmitted through food – additional investigation is needed.

What is community spread?

Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.

What temperatures kill the virus?

Generally, coronaviruses survive for shorter periods at higher temperatures and higher humidity than in cooler or dryer environments. However, we don’t have direct data for this virus, nor do we have direct data for a temperature-based cutoff for inactivation at this point. The necessary temperature would also be based on the materials of the surface, the environment, etc. Regardless of temperature please follow CDC’s guidance for cleaning and disinfection.

Can mosquitos and ticks spread the virus that causes COVID-19?

At this time, CDC has no data to suggest that this new coronavirus or other similar coronaviruses are spread by mosquitoes or ticks. The main way that COVID-19 spreads is from person to person.

HOW TO PROTECT YOURSELF

Am I at risk for COVID-19 in the United States?

This is a rapidly evolving situation and the risk assessment may change daily. The latest updates are available on CDC’s Coronavirus Disease 2019 (COVID-19) website.

How many cases have been reported in the U.S.?

How can I protect myself?

  • Wash your hands often with soap and water or an alcohol-based hand-sanitizer.
  • Avoid close contact with other people who are sick or have symptoms, and practice social distancing procedures between yourself and people from outside your home.
  • Cover your mouth and nose with a face mask or a cloth face cover when around others.
  • Cover your mouth when you cough or sneeze.
  • Clean and disinfect high contact surfaces regularly.

Am I at risk for COVID-19 from mail, packages, or products?

There is still a lot that is unknown about COVID-19 and how it spreads. Coronaviruses are thought to be spread most often by respiratory droplets. Although the virus can survive for a short period on some surfaces, it is unlikely to be spread from domestic or international mail, products or packaging. However, it may be possible that people can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Is it safe to get medical/dental care during this time?

It is important to continue taking care of your health and wellness. If you have a chronic health problem, you may be at higher risk for severe illness from COVID-19. Below are some things you can to do to take care of your health during this time.

  • Continue your medications, and do not change your treatment plan without talking to your healthcare provider.
  • Continue to manage your disease the way your healthcare provider has told you.
  • Have at least a 2-week supply of all prescription and non-prescription medications. Talk to your healthcare provider, insurer, and pharmacist about getting an extra supply of prescription medications, if possible, to reduce trips to the pharmacy.
  • Talk to your healthcare provider about whether your vaccinations are up-to-date. People aged 65 years or older, and those with some underlying medical conditions, are recommended to receive vaccinations against influenza and pneumococcal disease as soon as your provider tells you that
  • Call your healthcare provider:
    1. if you have any concerns about your medical conditions, or if you get sick.
    2. to find out about different ways you can connect with your healthcare provider for chronic disease management or other conditions. Ask about phone calls, video appointments, use of the patient portal, emails and mailings.
  • Do not delay getting emergency care for your health problems or any health condition that requires immediate attention.
  • If you need emergency help, call 911.
  • Emergency departments have infection prevention plans to protect you from getting COVID-19 if you need care for your medical condition.

Continue to practice everyday prevention: wash your hands often, keep space between yourself and others, cover your mouth and nose with a cloth face cover when around other people, cover coughs and sneezes, and clean and disinfect frequently touched surfaces often.

PREPARING YOUR HOME AND FAMILY FOR COVID-19

How can my family and I prepare for COVID-19?

Create a household plan of action to help protect your health and the health of those you care about in the event of an outbreak of COVID-19 in your community:

  • Talk with the people who need to be included in your plan, and discuss what to do if a COVID-19 outbreak occurs in your community.
  • Plan ways to care for those who might be at greater risk for serious complications, particularly older adults and those with severe chronic medical conditions like heart, lung or kidney disease.
  • Make sure they have access to several weeks of medications and supplies in case you need to stay home for prolonged periods of time.
  • Get to know your neighbors and find out if your neighborhood has a website or social media page to stay connected.
  • Create a list of local organizations that you and your household can contact in the event you need access to information, healthcare services, support, and resources.
  • Create an emergency contact list of family, friends, neighbors, carpool drivers, health care providers, teachers, employers, the local public health department, and other community resources.

What steps can be taken to reduce the risk of exposure to COVID-19?

Practice everyday preventive actions to help reduce your risk of getting sick and remind everyone in your home to do the same. These actions are especially important for older adults and people who have severe chronic medical conditions:

  • Avoid close contact with people who are sick.
  • Stay home when you are sick, except to get medical care.
  • Cover your coughs and sneezes with a tissue and throw the tissue in the trash.
  • 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. Always wash hands with soap and water if hands are visibly dirty.
  • Clean and disinfect frequently touched surfaces and objects (e.g., tables, countertops, light switches, doorknobs, and cabinet handles).
  • Launder items, including washable plush toys, as appropriate and in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from an ill person can be washed with other people’s items.

What should I do if someone in my house gets sick with COVID-19?

Most people who get COVID-19 will be able to recover at home. CDC has directions for people who are recovering at home and their caregivers, including:

  • Stay home when you are sick, except to get medical care.
  • Use a separate room and bathroom for sick household members (if possible).
  • 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. Always wash hands with soap and water if hands are visibly dirty.
  • Provide your sick household member with clean disposable facemasks to wear at home, if available, to help prevent spreading COVID-19 to others.
  • Clean the sick room and bathroom, as needed, to avoid unnecessary contact with the sick person.
  • Avoid sharing personal items like utensils, food, and drinks.

Should I use soap and water or hand-sanitizer to protect against COVID-19?

Handwashing is one of the best ways to protect yourself and your family from getting sick. 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.

What cleaning products should I use to protect against COVID-19?

Clean and disinfect frequently touched surfaces such as tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.  If surfaces are dirty, clean them using detergent or soap and water prior to disinfection. To disinfect, most common EPA-registered household disinfectants will work.

SYMPTOMS & TESTING

What symptoms and complications can COVID-19 cause?

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

  • Cough
  • Shortness of breath or difficulty breathing
  • Fever
  • Chills
  • Muscle pain
  • Sore throat
  • New loss of taste or smell

Children have similar symptoms to adults and generally have mild illness.

*This list is not all inclusive. Other less common symptoms have been reported, including gastrointestinal symptoms like nausea, vomiting, or diarrhea.*

Is it possible to have the flu and COVID-19 at the same time?

It is possible to test positive for flu (as well as other respiratory pathogens) and the virus that causes COVID-19 at the same time.

Should I be tested for COVID-19?

Not everyone needs to be tested for COVID-19. For information about testing, see the Testing for COVID-19 page on the CDC website.

Where can I get tested for COVID-19?

The process and locations for testing vary from place to place. Contact your state, local, tribal, or territorial department for more information, or reach out to a medical provider. State and local public health departments have received tests from CDC while medical providers are getting tests developed by commercial manufacturers. While supplies of these tests are increasing, it may still be difficult to find someplace to get tested. See Testing for COVID-19 for more information.

Can a person test negative and then later test positive for COVID-19?

Using the CDC-developed viral test, a negative result means that the virus that causes COVID-19 was not found in the person’s sample. In the early stages of infection, it is possible the virus will not be detected. For COVID-19, a negative test result for a sample collected while a person has symptoms likely means that the COVID-19 virus is not causing their current illness.

What kind of test is being used to diagnose if I have COVID-19?

There are many tests being used to diagnose COVID-19 that the U.S. Food & Drug Administration (FDA) has authorized for use during the current emergency. All these viral tests identify the virus in samples from the respiratory system, such as from nasal or nasopharyngeal swabs. Some tests are conducted at the testing site you visit, and results are available to you within minutes. Other tests must be sent to a laboratory to analyze, a process that takes 1-2 days once the lab receives your samples. Two tests allow you to collect your own sample at home – either a nasal swab or a saliva sample – but you will still need to send the sample to a lab for processing. Locations and types of testing sites vary depending on where you live (see question: Where can I get tested). Check with your testing site to learn which test it uses. You can find a  patient information sheet about each test on the FDA website.

What is “anti-body testing”, and can I be tested using this method?

Antibody testing checks a sample of a person’s blood to look for antibodies to SARS-CoV-2, the virus that causes COVID-19. These antibodies are produced when someone has been infected, so a positive result from this test indicates that person was previously infected with the virus. The CDC is working with other federal agencies to evaluate the performance of commercially manufactured antibody tests that are becoming increasingly available from healthcare providers. This evaluation is expected to be completed in early May. We do not know yet if the antibodies that result from infection with SARS-CoV-2 can protect someone from reinfection with this virus (immunity) or how long antibodies to the virus will protect someone. Scientists are conducting research to answer those questions. Antibody tests may not be able to tell you if you are currently infected because it typically takes 1 to 3 weeks to develop antibodies to SARS-CoV-2. To tell if you are currently infected, you would need a test that identifies the virus in samples from your upper respiratory system, such as a nasopharyngeal swab.

HIGHER RISK

Who is at higher risk for serious illness from COVID-19?

COVID-19 is a new disease and there is limited information regarding risk factors for severe disease. Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. Based on what we know now, those at high-risk for severe illness from COVID-19 are:

  • People aged 65 years and older
  • People who live in a nursing home or long-term care facility
  • People of all ages with underlying medical conditions, particularly if not well controlled, including:
  • People with chronic lung disease or moderate to severe asthma
  • People who have serious heart conditions
  • People who are immunocompromised
    • Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
  • People with severe obesity (body mass index [BMI] ≥40)
  • People with diabetes
  • People with chronic kidney disease undergoing dialysis

People with liver disease

What should higher risk individuals do?

If you are at higher risk of getting very sick from COVID-19, you should:

  • Stock up on supplies
  • Take everyday precautions to keep space between yourself and others
  • When you go out in public, keep away from others who are sick
  • Limit close contact and wash your hands often
  • Avoid crowds, cruise travel, and non-essential travel
  • If there is an outbreak in your community, stay home as much as possible. Watch for symptoms and emergency signs. If you get sick, stay home and call your doctor.

Are people with disabilities at a higher risk for contracting COVID-19?

Most people with disabilities are not inherently at higher risk for becoming infected with or having severe illness from COVID-19.  Some people with physical limitations or other disabilities might be at a higher risk of infection because of their underlying medical condition.

People with certain disabilities might experience higher rates of chronic health conditions that put them at higher risk of serious illness and poorer outcomes from COVID-19. Adults with disabilities are three times more likely to have heart disease, stroke, diabetes, or cancer than adults without disabilities.

You should talk with your healthcare provider if you have a question about your health or how your health condition is being managed.

CLEANING AND DISINFECTING

What is the difference between cleaning and disinfecting?

Cleaning with soap and water removes germs, dirt, and impurities from surfaces. It lowers the risk of spreading infection. Disinfecting kills germs on surfaces. By killing germs on a surface after cleaning, it can further lower the risk of spreading infection.

Is cleaning alone effective against the virus that causes COVID-19?

Cleaning does not kill germs, but by removing them, it lowers their numbers and the risk of spreading infection. If a surface may have gotten the virus on it from a person with or suspected to have COVID-19, the surface should be cleaned and disinfected. Disinfecting kills germs on surfaces.

COMMUNITY MITIGATION

What is community mitigation?

Community mitigation activities are actions that people and communities can take to slow the spread of infectious diseases, including COVID-19. Community mitigation is especially important before a vaccine or drug becomes widely available.

What are community mitigation actions for COVID-19?

Some community mitigation actions may include:

  • Washing hands often
  • Avoiding close contact with people who are sick, and practicing social distancing
  • Covering mouth and nose with a cloth face cover when around others
  • Covering coughs and sneezes
  • Cleaning and disinfecting frequently touched surfaces daily

Who is involved in community mitigation actions?

Individuals, communities, schools, businesses and healthcare organizations all have a role to play in community mitigation. Policies*, which include limits on large gatherings, restrictions on businesses, and school closures are often needed to fully put in place community mitigation strategies.

Each community is unique. Because some actions can be very disruptive to daily life, mitigation activities will be different depending on how much disease has spread within the community, what the community population is like, and the ability to take these actions at the local level. To identify appropriate activities, all parts of a community that might be impacted need to be considered, including populations most vulnerable to severe illness, and those who might be more impacted socially or economically. When selecting mitigation activities, states and communities need to consider the spread of disease locally, characteristics of the people who live in the community (for example, age groups, languages spoken, overall health status), and the kind of public health resources and healthcare systems (like hospitals) that are available in the community. State and local officials may need to adjust community mitigation activities and immediately take steps to scale them up or down depending on the changing local situation.

Putting mitigation into practice is based on:

  • Emphasizing individual responsibility for taking recommended personal-level actions
  • Empowering businesses, schools, and community organizations to take recommended actions, particularly in ways that protect persons at increased risk of severe illness
  • Focusing on settings that provide critical infrastructure or services to individuals at increased risk of severe illness
  • Minimizing disruptions to daily life to the extent possible

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