If you develop symptoms of coronavirus disease 2019 (COVID-19) and you’ve been exposed to the virus, contact your doctor. Tell him or her if you’ve traveled to any areas with ongoing community spread of COVID-19 according to CDC and WHO. Also let your doctor know if you’ve had close contact with anyone who has been diagnosed with COVID-19.
Your doctor may determine whether to conduct tests for COVID-19 based on your signs and symptoms. To decide whether to conduct tests for COVID-19, he or she may also consider whether you have had close contact with someone diagnosed with COVID-19 or traveled to or lived in any areas with ongoing community spread of COVID-19 in the last 14 days.
To test for COVID-19, your doctor may take samples, including a sample of saliva (sputum), a nasal swab and a throat swab, to send to a lab for testing.
inks you can be treated at home, he or she may give you special instructions, such as to isolate yourself as much as possible from family and pets while you’re sick and to stay home for a period of time. If you’re very ill, you may need to be treated in the hospital.
Coping and support
You may feel stress during the COVID-19 outbreak. You may feel fear and anxiety or have trouble sleeping.
Here are some tips that can help you cope with stress during the COVID-19 outbreak:
Avoid watching or reading news about COVID-19 that makes you feel anxious.
Limit reading or watching news about COVID-19 to once or twice a day.
Get the facts about COVID-19 and share them with others. Check reputable sites such as CDC and WHO for information.
Take care of yourself — eat healthy, get enough sleep and get regular exercise. Consider deep breathing, stretching and meditation exercises.
Avoid alcohol and drugs.
Do something you enjoy, such as reading a book, watching a movie or going on a walk.
Keep connected with family and friends. Share your feelings with them.
Aim to be positive and optimistic.
Show appreciation for health care workers who care for those with COVID-19 in your community.
If stress is affecting your daily life after several days, contact your doctor. He or she may suggest that you talk to a mental health professional.
You may start by seeing your primary care doctor. Or you may be referred immediately to a doctor trained in treating infectious diseases. If you think you have COVID-19, tell your doctor or clinic before coming in. The doctor and medical team can then:
Contact infection prevention and control and public health officials
Prepare to move you to a room quickly
Have a mask ready for you
Here’s some information to help you get ready for your appointment.
Preparing for an appointment
When you make the appointment, ask if there’s anything you need to do in advance. Make a list of:
Your symptoms, including any that seem unrelated to the reason for your appointment
Your recent travels, including any international travels
Key personal information, including major stresses, recent life changes and family medical history
All medications, vitamins or other supplements you take, including the doses
Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you’re given. Avoid bringing more than one or two people.
Some basic questions to ask your doctor include:
How likely is it that the new coronavirus is causing my symptoms?
What are other possible causes for my symptoms?
What tests do I need?
What course of action do you recommend?
Are there restrictions I need to follow?
Should I see a specialist?
What to expect from your doctor
Your doctor is likely to ask you several questions, such as:
The Food and Drug Administration has approved the first rapid point-of-care COVID-19 test, that can deliver results in less than an hour.
Cepheid, a Silicon Valley diagnostics company, made the announcement on Saturday, saying it has received emergency authorization from the government to use the test.
While the agency has approved about a dozen other COVID-19 tests in response to the public health emergency caused by the coronavirus pandemic, this is the first one that can be used at the point of care.
Cepheid said the test kits will be available by the end of the month.
Until now, to get test result, a health care worker would take a swab from the back of a person’s nose, and send it off to a public health, commercial or hospital lab, or to a lab at the Centers for Disease Control and Prevention in Atlanta. The process can take days.
The newly approved test kit still involves taking a nasal swab, but the test can be done in a doctor’s office or clinic with a detection time of approximately 45 minutes, according to Cepheid.
“During this time of increased demand for hospital services, Clinicians urgently need an on-demand diagnostic test for real-time management of patients being evaluated for admission to health-care facilities,” said Dr. David Persing, chief medical and technology officer at Cepheid.
He added: “An accurate test delivered close to the patient can be transformative — and help alleviate the pressure that the emergence of the 2019-nCoV outbreak has put on healthcare facilities that need to properly allocate their respiratory isolation resources.”
State and local government leaders have been putting pressure on the Trump administration and the coronavirus task force led by Vice President Mike Pence to address widespread testing shortages. In response, the administration has turned to the private sector to help develop tests, vaccines and therapeutic medicines to help stem the pandemic.
On Saturday, Pence confirmed more than 195,000 people have been tested for the respiratory virus, not including those who were tested in county hospitals or health care labs around the nation. Of those, roughly 19,350 have tested positive for the coronavirus.
CDC Laboratory Testing for Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
CDC works closely with state and local public health departments, travel industry partners, and others to identify and test people who may be infected with MERS-CoV. CDC conducts several different laboratory tests to detect MERS-CoV infection.
In general, these lab tests fall into two categories:
Serology tests, which look for previous infection by detecting antibodies to MERS-CoV. Serology tests are for surveillance or investigational purposes and not for diagnostic purposes.
Molecular tests are used to diagnose active infection (presence of MERS-CoV) in people who are thought to be infected with MERS-CoV based on their clinical symptoms and having links to places where MERS has been reported.
Real-time reverse-transcription polymerase chain reaction (rRT-PCR) assays are molecular tests that can be used to detect viral RNA in clinical samples. CDC’s current case definition for laboratory confirmation of MERS-CoV infection requires either a positive rRT-PCR result for at least two specific genomic targets, or a single positive target with sequencing of a second target.
Most state laboratories in the United States are approved to test for MERS-CoV by using an rRT-PCR assay developed by CDC. This test is done under authority of an Emergency Use Authorization because there are no FDA-cleared/approved tests available for this purpose in the United States.
The success of rRT-PCR testing depends on several factors, including the experience and expertise of laboratory personnel, laboratory environment (e.g., avoidance of contamination), and the type and condition of specimens being tested. For this rRT-PCR assay, CDC recommends collecting multiple specimens, including lower (bronchalveolar lavage, sputum and tracheal aspirates) and upper (e.g., nasopharyngeal and oropharyngeal swabs) respiratory samples, serum, and stool specimens.
CDC considers a person under investigation to be negative for active MERS-CoV infection following one negative rRT-PCR test on the recommended specimens. Since a single negative result does not completely rule out MERS-CoV infection, in some circumstances additional specimens may be tested.
CDC considers a known MERS patient to be negative for active MERS-CoV infection following two consecutive negative rRT-PCR tests on all specimens.
Serology testing is used to detect previous infection (antibodies to MERS-CoV) in people who may have been exposed to the virus. Antibodies are proteins produced by the body’s immune system to attack and kill viruses, bacteria, and other microbes during infection. The presence of antibodies to MERS-CoV indicates that a person had been previously infected with the virus and developed an immune response.
Evidence to date suggests there may be a broader range of MERS disease than was initially thought. For example, public health investigators have identified individuals who are PCR-positive but have no MERS symptoms; we do not know if MERS-CoV can be spread by these people. For this reason, public health scientists are working to learn more about how the virus is transmitted. One way to do this is through voluntary testing of blood samples from people who had close contact with people known to have MERS.
CDC has a two-phase approach for serology testing, using two screening tests and one confirmatory test to detect antibodies to MERS-CoV.
ELISA, or enzyme-linked immunosorbent assay, is a screening test used to detect the presence and concentration of specific antibodies that bind to a viral protein. CDC tests by ELISAS for antibodies against two different MERS-CoV proteins, the nucleocapsid (N) and spike (S).
If a clinical sample is determined to be antibody-positive by either ELISA, CDC then uses the microneutralization test to confirm the positive result.
The microneutralization assay is a highly specific confirmatory test used to measure neutralizing antibodies, or antibodies that can neutralize virus. This method is considered a gold standard for detection of specific antibodies in serum samples. However, compared with the ELISA, the microneutralization assay is labor-intensive and time-consuming, requiring at least 5 days before results are available.
If a clinical sample is positive by either ELISA, and positive by microneutralization, the specimen is determined to be confirmed positive.
If a clinical sample is positive by both ELISAs, and negative by microneutralization, the sample is determined to be indeterminate.
If a clinical sample is positive by only one ELISA, and negative by microneutralization, the sample is determined to be negative.
If a clinical sample is negative by both ELISAS, the sample is determined negative.
In the end, a final determination of a confirmed positive serology result requires a positive ELISA test and confirmation by microneutralization assay.
MERS-CoV serology tests are for surveillance or investigational purposes and not for diagnostic purposes—they are tools developed in response to the MERS-CoV outbreak.
Information is limited about MERS-CoV and how the virus is spread. As public health scientists learn more about MERS-CoV, the approach to conducting these types of laboratory tests might change.
Coronavirus, Social Distancing and Self Quarantine
Now that the new coronavirus and COVID-19, the illness it causes, are spreading among communities in the United States and other countries, phrases such as “social distancing,” “self-quarantine” and “flattening the curve” are showing up in the media.
What do they mean, and how might they apply to you, your family and your community?
Lisa Maragakis, M.D., M.P.H. , senior director of infection prevention at Johns Hopkins, helps clarify these concepts so you can understand better why they’re being recommended.
What is social distancing?
While it may be disappointing to hear that so many sports events, cruises, festivals and other gatherings are being cancelled, there is a public health reason for these measures. These cancellations help stop or slow down the spread of disease allowing the health care system to more readily care for patients over time.
Cancelling events that are likely to draw crowds is an example of social distancing. Social distancing is deliberately increasing the physical space between people to avoid spreading illness. Staying at least six feet away from other people lessens your chances of catching COVID-19.
Other examples of social distancing that allow you to avoid larger crowds or crowded spaces are:
Working from home instead of at the office
Closing schools or switching to online classes
Visiting loved ones by electronic devices instead of in person
Cancelling or postponing conferences and large meetings
Coronavirus: What do I do if I Feel Sick?
What is self-quarantine?
People who have been exposed to the new coronavirus and who are at risk for coming down with COVID-19 might practice self-quarantine. Health experts recommend that self-quarantine lasts 14 days. Two weeks provides enough time for them to know whether or not they will become ill and be contagious to other people.
You might be asked to practice self-quarantine if you have recently returned from traveling to a part of the country or the world where COVID-19 is spreading rapidly, or if you have knowingly been exposed to an infected person.
Using standard hygiene and washing hands frequently
Not sharing things like towels and utensils
Staying at home
Not having visitors
Staying at least 6 feet away from other people in your household
Once your quarantine period has ended, if you do not have symptoms, follow your doctor’s instructions on how to return to your normal routine.
What is isolation?
For people who are confirmed to have COVID-19, isolation is appropriate. Isolation is a health care term that means keeping people who are infected with a contagious illness away from those who are not infected. Isolation can take place at home or at a hospital or care facility. Special personal protective equipment will be used to care for these patients in health care settings.
What is “flattening the curve?”
Flattening the curve refers to using protective practices to slow the rate of COVID-19 infection so hospitals have room, supplies and doctors for all of the patients who need care.
This image was adapted from the CDC.
A large number of people becoming very sick over the course of a few days could overwhelm a hospital or care facility. Too many people becoming severely ill with COVID-19 at roughly the same time could result in a shortage of hospital beds, equipment or doctors.
On a graph, a sudden surge in patients over a short time could be represented as a tall, narrow curve.
On the other hand, if that same large number of patients arrived at the hospital at a slower rate, for example, over the course of several weeks, the line of the graph would look like a longer, flatter curve.
In this situation, fewer patients would arrive at the hospital each day. There would be a better chance of the hospital being able to keep up with adequate supplies, beds and health care providers to care for them.
Lessening Coronavirus Impact
It’s important to know what to do if you feel sick. The coronavirus pandemic is making everyone aware of handwashing and protecting others from coughs and sneezes. Along with those essential steps, practices such as social distancing, and self-quarantine and isolation when appropriate can slow the rate of infection in a city, town or community.
The pandemic can seem overwhelming, but in truth, every person can help slow down the spread of COVID-19. By doing your part, you can make a big difference to your health, and that of others around you.
Fauci: U.S. ‘looking very closely at’ severe coronavirus symptoms in younger Americans
Top U.S. health officials are “looking very closely at” reports that a much higher percentage of younger Americans are needing hospitalization as a result of contracting the novel coronavirus than expected, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Sunday.
Fauci was responding to new data from the Centers for Disease Control and Prevention which, after studying more than 4,000 cases in the U.S., showed that about 40 percent of those who were hospitalized for the virus as of March 16 were between ages 20 and 54. Among the most critical cases, 12 percent of ICU admissions were among those ages 20 to 44 while 36 percent were for those between 45 and 64.
About 80 percent of people in the U.S. who have died from COVID-19 were at or above the age of 65, with the highest percentage among those above the age of 85.
Asked about the new numbers on CBS’s “Face the Nation,” Fauci said they highlighted “a very important critical issue that we’re looking very closely at.”
“It looks like there is a big difference between that demography from China and what we’re seeing in Europe,” Fauci said. Data based on China’s outbreak suggested that older people were more at risk.
“Now, we have to look at the young people who are getting seriously ill from the European cohort and make sure that it isn’t just driven by the fact that they have underlying conditions.”
“Because we know that underlying conditions, all bets are off no matter how young you are,” Fauci added. “If you have an underlying, serious medical condition. You’re going to potentially get into trouble. But if they don’t have underlying conditions, that will be something we will have to really examine as to why we’re seeing it here but we didn’t see it in China. So we’re going to look at that very closely.”
Speaking on CNN’s “State of the Union,” Rep. Alexandria Ocasio-Cortez, D-N.Y., said young people need to be taking the risks of the virus seriously.
“I’ve been speaking about this for over a week now and if you are a young person in America today, you need to stay home,” she said. “There was so much messaging about how coronavirus is only impacting older people and that younger people don’t have to worry about it for their personal health. Well, let me tell you something, in the state of New York, about 55 percent of our cases are with folks 18 to 49.”
“And when you have that … you are able to be directly impacted,” she continued. “You’re going to get your mom sick, you’re going to get your grandparents sick. You’re going to get people you care for sick if you are asymptomatic. So you may not think that you have it, and you very well might. And you especially might if you continue to go out and live life as usual.”
Fauci told “Face the Nation” that he does not expect the U.S.’s experience with the outbreak turn into Italy’s, which has become one of the hardest-hit areas.
“I mean obviously things are unpredictable, you can’t make any definitive statement, but if you look at the dynamics of the outbreak in Italy, we don’t know why they are suffering so terribly, but there is a possibility that many of us believe that early on they did not shutout the input of infections that originated in China and came to other parts of the world,” Fauci said before touting the Trump administration’s move to restrict travel from China, and then parts of Europe, earlier this year.
“Again, I don’t know why this is happening [in Italy] to such an extent,” Fauci said. “But once you get so many of these spreads out, they spread exponentially and you can never keep up with this tsunami. And I think that’s what our colleagues and unfortunately our dear friends in Italy are facing.”
Italy was “so overwhelmed from the beginning,” Fauci said, “that they can’t play catch up.”