We’ve been sheltering in place for weeks. So why are the “peaks” of hospitalizations and deaths still yet to come?
“There is a delay because the way it goes, you have people who get exposed; they get infected; the number of new infections, hospitalizations, critical care and deaths (follow),” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“So even when you suppress or stabilize the number of new infections, it’s still going to take a while before you see a decrease in hospitalizations, a decrease in intensive care, and a decrease in deaths. And in fact, deaths are the last thing that lag. So you could be doing well (with mitigation measures) and still see the deaths go up.”
Work/life transmission treatment & prevention
Should I wear a face mask in public? If so, how do I make one?
The CDC recently changed its guidance on wearing face masks as more studies about asymptomatic spread pile up.
Now, the CDC “recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies).”
But there are several important caveats and key points:
- The public should NOT buy surgical masks or N95 respirator masks. Those are desperately needed by health care workers who are in close contact with coronavirus patients every day.
- Instead, make your own cloth mask — it’s easy, and you don’t have to sew. US Surgeon General Jerome Adams shows how to make face masks with just a T-shirt and rubber bands in this CDC video. You can also use a bandana and a coffee filter.
- Don’t be fooled: The main benefit of wearing masks in public isn’t to protect you from getting sick. Rather, it’s to protect others from yourself if you’re sick or you’re an asymptomatic carrier. “This is more for people who might be infected and don’t know it, and to try and lower the likelihood that they will spread this to somebody else,” CNN Chief Medical Correspondent Dr. Sanjay Gupta said. The CDC agreed.
- You can definitely still get coronavirus even if you wear a mask. The virus can stay alive on surfaces for up to 3 days, and it’s easy to touch your face whenever you’re not wearing a mask. Also, people often adjust face masks frequently, leading to more touching of the face — a common way that coronavirus spreads.
- It’s important to wash your cloth mask after every use. Here’s how.
- Wearing cloth masks is just “an additional, voluntary public health measure,” the CDC said. To protect yourself from getting coronavirus, it’s critical to stay 6 feet away from others, wash your hands frequently for at least 20 seconds each time, and stop touching your face.
transmission work/life myths & misinformation
Should all Americans be under stay-at-home orders?
“We really should be,” said Dr. Anthony Fauci, a member of the White House Coronavirus Task Force.
“If you look at what’s going on across the country, I just don’t understand why we’re not doing that.”
President Donald Trump has declined to give a nationwide stay-at-home order.
As of April 3, more than 40 states have stay-at-home orders, which generally allow exceptions for grocery shopping, helping a sick loved one or getting outdoor exercise away from other people.
But states with fewer cases of coronavirus also need to be on high alert, Fauci said.
“If you just look at those (places) and say, ‘There are very little infections in this area or that area, we don’t have to worry about it,’ you’re making a big mistake,” he said. “Those are tinders that can turn into big fires.”
work/life transmission treatment & prevention
Is it safe to eat takeout from restaurants?
Yes.
There’s no evidence to suggest coronavirus is transmitted through food, the CDC says. It’s mainly spread through respiratory droplets.
Even if coronavirus does get into your food, your stomach acid would kill it, said Dr. Angela Rasmussen, a virologist at Columbia University.
“When you eat any kind of food, whether it be hot or cold, that food is going to go straight down into your stomach, where there’s a high acidity, low-pH environment that will inactivate the virus,” she said.
But it’s a good idea to disinfect the takeout containers, Dr. Sanjay Gupta said. Coronavirus is a respiratory virus, and it’s easy to touch your face without realizing it.
If you don’t have disinfecting wipes, use your own plates or bowls to serve the food. Just make sure to wash your hands after transferring food from the containers.
transmission family work/life
If there’s no cure, why go to the hospital unless you have a breathing problem?
Most coronavirus patients don’t need to be hospitalized. “The vast majority of people – about 80% – will do well without any specific intervention,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
Those patients should get plenty of rest, hydrate frequently and take fever-reducing medication.
“The current guidance – and this may change – is that if you have symptoms that are similar to the cold and the flu and these are mild symptoms to moderate symptoms, stay at home and try to manage them,” said Dr. Patrice Harris, president of the American Medical Association.
But about 20% of coronavirus patients get advanced disease. “Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their physician early in the course of even mild illness,” the CDC says.
The CDC also says you should get immediate help if you have:
- Trouble breathing
- Persistent pain or pressure in the chest
- Sudden confusion
- Bluish lips or face
“This list is not all inclusive,” the CDC says. “Please consult your medical provider for any other symptoms that are severe or concerning.”
Treatment & prevention family
Why is everyone stocking up on bottled water? Is the water supply at risk?
No, the water supply is not at risk.
“The COVID-19 virus has not been detected in drinking water,” the CDC says. “Conventional water treatment methods that use filtration and disinfection, such as those in most municipal drinking water systems, should remove or inactivate the virus that causes COVID-19.”
So there’s no need to hoard drinking water, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci said he and his wife are still drinking tap water.
Work/life myths & misinformation
My child’s school is closed, and now we need a babysitter. How do I keep my family safe with someone new in the house?
The Harvard Medical School offers several tips, including:
- choosing a babysitter who has minimal exposures to other people besides your family
- limiting the number of babysitters. If you can keep it to one, that’s ideal. But if you need multple babysitters, keep the number as low as possible
- making sure the babysitter understands he or she needs to practice social distancing and limits physical interaction with your children as much as possible
- telling the babysitter that he or she must not come to your house if feeling even the slightest bit sick, or has had known exposure to coronavirus
- making sure everyone washes their hands frequently throughout the day, especially before eating.
Work/life family
Is it safe to go to the dentist?
Unless you have an emergency, the American Dental Association suggests rescheduling imminent appointments.
The ADA has urged dentists nationwide to postpone elective procedures.
“Concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments,” ADA said in a March 16 statement.
Transmission
If people can spread the virus without showing any symptoms, how can I tell who’s infected and who’s not?
You can’t, said Dr. James Phillips, chief of disaster and operational medicine at George Washington University Hospital.
“We’re so far behind on testing, there’s only one way we can be certain not to transmit the virus and be certain not to get it ourselves: We need to start treating every person as though they have this, ” Phillips said.
“And everyone needs to treat us like we have it, and socially distance ourselves in that manner. Because until we have (enough) testing, we don’t know who has this. And we’re not sure when they start spreading it.”
That’s why it’s so critical to avoid crowds, stay at least 6 feet away from others, wash or disinfect your hands, and stop touching your face.
Transmission travel work/life
How do I safely take care of someone who’s sick?
With the shortage of coronavirus testing nationwide, it may be difficult to know whether your loved one has coronavirus or another illness.
So it’s critical to play it safe and not infect yourself and, in turn, others. The CDC suggests:
- Giving the sick person their own room to stay in, if possible. Keep the door closed.
- Having only one person serve as the caretaker.
- Asking the sick person to wear a face mask, if they are able to. If the mask causes breathing difficulties, then the caretaker should wear a mask instead.
Transmission family
What are the symptoms?
transmission
No one from my family has been exposed to the virus, and no one is sick. Can we get together for a family dinner? There are 10 of us, ages 4 to 88.
Family
What exactly does ‘older’ adults mean? What is the age threshold?
Family
Are kids more at risk?
“Younger people, thankfully, seem to be insulated to some extent to protect (them) from getting particularly sick from this,” said CNN Chief Medical Correspondent Dr. Sanjay Gupta. “We don’t know entirely why.”
But while children might have mild to no symptoms with coronavirus, they can still get others sick.
“They can still carry the virus in their bodies,” Gupta said. “They could potentially still shed the virus and be a source of infection.”
Like everyone else, children should wash their hands frequently for at least 20 seconds, stay at least 6 feet away from anyone coughing or sneezing, and stop touching their faces – which is a lot harder than it sounds.
Family
Should I disinfect my groceries? If so, how?
“I would suggest wiping down external surfaces of canned or wrapped foods,” said Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center.
“You should be washing your vegetables (and) produce anyway,” she said. “But I think making sure you sanitize your hands, wash your hands after you do all that – after you unpack all your groceries – is also a key step.”
Work/life
The stores are all out of disinfectant sprays and hand sanitizer. Can I make my own?
Yes, you can make both at home.
“Unexpired household bleach will be effective against coronaviruses when properly diluted” if you’re trying to kill coronavirus on a non-porous surface, the US Centers for Disease Control and Prevention said.
The CDC’s recipe calls for diluting 5 tablespoons (or ⅓ cup) of bleach per gallon of water, or 4 teaspoons of bleach per quart of water.
You can also make your own hand sanitizer. The Nebraska Medical Center – famous for its biocontainment unit and treatment of Ebola patients – offers this recipe:
What you’ll need:
- 2/3 cup 91% isopropyl alcohol (rubbing alcohol)
- 1/3 cup aloe vera gel
- Mixing bowl
- Spoon or something for whisking
- Small container, such as a 3 oz. travel bottle
- Optional: essential oil to give your hand sanitizer a fragrance
Directions:
In a mixing bowl, stir isopropyl alcohol and aloe vera gel together until well blended.
Add 8-10 drops of scented essential oil (optional, but nice). Stir to incorporate.
Pour the homemade hand sanitizer into an empty container and seal.
Write “hand sanitizer” on a piece of masking tape and attach to the bottle.
Work/life Treatment & Prevention
Do I need to isolate myself if I’m not diagnosed?
It depends.
Adults 60 and older and people with severe chronic illnesses are more likely to get very sick if they’re infected with Covid-19, so the CDC recommends those people stay at home as much as possible if they live in communities where there are outbreaks.
Some communities, cities and even countries have issued wide quarantines to contain the virus, but if you don’t live in one of those areas, use caution when going in public. Avoid crowds and poorly ventilated buildings, and frequently wash your hands before, during and after your trip out.
If you suspect you’re sick or have recently returned from an area where an outbreak has been reported, stay home.
Work/life Treatment & prevention
Should I start stocking up on extra food and supplies?
Yes, because a family member may suddenly have to quarantine. Just don’t hoard more than you need because others need supplies, too.
Harvard Medical School recommends keeping a two-week to 30-day supply of nonperishable food at home. And if you don’t use them now, they may come in handy for power outages or extreme weather.
It’s also a good idea to keep at least a 30-day supply of prescription medications you may need, though it can be difficult to get them early. Consider mail-ordering medications.
Work/life
Should I avoid public transportation?
If you rely on public transportation, use caution. If you’re sick or live in an area where an outbreak has been reported, avoid it.
Mass transit could increase your risk of exposure to coronavirus. Luckily, transit systems are upping their cleaning regimens — notably the New York subway system.
Dr. Robyn Gershon, a professor of epidemiology at New York University’s School of Public Health, has some tips: When you ride a bus or subway, sneeze or cough into your elbow. Use a tissue to hold onto a pole. Avoid touching your face while you’re riding, and use hand sanitizer if you have it while you’re commuting.
Again, wash your hands before, during and after your trip.
New York Gov. Andrew Cuomo recommends letting crowded trains or buses pass and waiting for a less crowded one. It’s nearly impossible to maintain 6 feet of distance on a packed subway car.
If you have a chronic illness, find alternative means of transportation — being in a crowded subway car or bus will significantly increase your risk of infection.
Work/life travel
How do I stay healthy while using Uber or Lyft?
Both rideshare companies said they’re actively trying to protect customers and drivers from coronavirus.
Uber said it is trying to give drivers with disinfectants to help keep their cars clean, and the company “may temporarily suspend the accounts of riders or drivers confirmed to have contracted or been exposed to COVID-19.”
Lyft announced a similar policy: “If we are notified of a rider or driver testing positive for COVID-19, they will be temporarily suspended from using Lyft until they are medically cleared.”
Both Lyft and Uber also said they will protect drivers financially if they are asked to isolate themselves.
“Any driver or delivery person who is diagnosed with COVID-19 or is individually asked to self-isolate by a public health authority will receive financial assistance for up to 14 days while their account is on hold,” Uber said.
“We’ve already helped drivers in some affected areas, and we’re working to quickly implement this worldwide.”
Work/Life travel
Is it safe for me to vote at a polling location?
States have received guidance from the CDC on how to keep voting locations clean. It’s up to you whether you feel comfortable going.
Many states that already held elections imposed measures to reduce contact between voters, increasing the distance between voting booths and rigorously disinfecting voting equipment. But if you go, remember – wash your hands before, during and afterward.
Per the CDC: If it’s still possible to vote early, consider it. The crowds are typically smaller than they are on Election Day.
If you’re able to mail in your ballot, do – just don’t lick the envelope.
If you think you have a fever or respiratory symptoms, the CDC advises that you stay home. It’s unfortunate to skip out on your civic duty, but sick people shouldn’t visit crowded locations.
Work/life
Should I go to work?
If you can, you should stay home from work when you’re sick, whether or not you have coronavirus.
Many companies are increasingly flexible with work from home policies. If your company is allowing employees to work from home, consider it. Some companies have enforced working from home.
If you must go into work, maintain 6 feet of distance from your colleagues, wash your hands frequently and practice good respiratory etiquette by coughing or sneezing into your elbow.
Avoid handshakes, switch in-person meetings to teleconferences and disinfect your workspace with EPA-approved products at the start of your shift.
Work/life
Can I be fired if I stay home sick?
An employee can be fired if they don’t show up to work and they don’t have sick leave that would cover the absence, says Krista Slosburg, an employment attorney at Stokes Lawrence in Seattle.
But there are exceptions.
Employers that make workers with coronavirus come in may be violating Occupational Safety and Health Administration [OSHA] regulations, according to Donna Ballman, who heads an employee advocacy law firm in Florida.
Work/Life
What happens when workers don’t get paid sick leave?
If you work in a city or state that requires sick leave and you use it, you can‘t be terminated or disciplined.
But there is no federal mandate that requires companies to offer paid sick leave, and almost a quarter of all US workers don’t get it, according to 2019 government data. Some state and local governments have passed laws that require companies to offer paid sick leave.
The Family and Medical Leave Act (FMLA) can sometimes protect a worker’s job in the event they get sick, but it won’t guarantee they get paid while they’re out.
Employee advocates urge businesses to consider the special circumstances of the coronavirus, and some already have. Uber and Olive Garden are two that recently updated their sick leave policies to adjust to the pandemic.
Work/Life
Can managers send a sick worker home?
The Society for Human Resource Management recommends companies “actively encourage sick employees to stay home, send symptomatic employees home until they are able to return to work safely, and require employees returning from high-risk areas to telework during the incubation period [of 14 days].”
If a manager feels an employee’s illness poses a direct threat to colleagues’ safety, the manager may be able to insist the employee be evaluated by a doctor, said Alka Ramchandani-Raj, an attorney specializing in workplace safety at the law firm Littler Mendelson.
Work/Life
If traveling on a plane, how do I stay safe?
It’s not the cabin air you need to worry about. It’s keeping your hands clean.
Always be mindful of where your hands have been, travel medicine specialist Dr. Richard Dawood said.
Airport handrails, door handles and airplane lavatory levers are notoriously dirty.
“It is OK to touch these things as long as you then wash or sanitize your hands before contaminating your face, touching or handling food,” Dawood said.
“Hand sanitizers are great. So are antiseptic hand wipes, which you can also use to wipe down armrests, remote controls at your seat and your tray table.”
Travel
Since a plane’s cabin keeps circulating air, will I get sick if another passenger is sick?
Most viruses don’t spread easily on airplanes because of how the air circulates and is filtered, the CDC says.
Modern commercial jets recirculate 10-50% of the air in the cabin, mixed with outside air.
“The recirculated air passes through a series of filters 20-30 times per hour,” the CDC says.
“Furthermore, air generally circulates in defined areas within the aircraft, thus limiting the radius of distribution of pathogens spread by small-particle aerosols. As a result, the cabin air environment is not conducive to the spread of most infectious diseases.”
Still, try to avoid contact with anyone sneezing or coughing. And if you’re feeling sick, cover your entire mouth and nose with the inside of your elbow when you cough or sneeze.
Travel
I have plans to go on a cruise. Should I rebook or cancel?
“US citizens, particularly travelers with underlying health conditions, should not travel by cruise ship,” the US Department of State says.
Cruise ship passengers are at an increased risk of infection, the CDC says. The virus spreads more easily between passengers in tight quarters.
Several cruise ships have been linked to coronavirus, including the Diamond Princess, where more than 700 people were infected. At least seven of those patients have died.
Since the coronavirus outbreak started, some cruise lines have implemented more flexible rebooking or cancellation policies.
Travel
If I have a weakened immune system, should I cancel my travel plans?
People who are immunocompromised “are at higher risk from this illness, as well as other illnesses like the flu. Avoiding contact with ill people is crucial,” Washington state’s Snohomish Health District said.
“While rates of infection may not differ significantly between healthy and immunocompromised travelers, the latter are at greater risk for severe disease,” according to researchers from the Washington University School of Medicine.
Travel
Why doesn’t the US have enough medical supplies to handle this outbreak?
Top healthcare officials say the US does not have enough stockpiled medical equipment like masks, gowns and gloves to meet the anticipated need as this pandemic grows.
There are several reasons hospitals are on track to face dire shortages, said Dr. William Schaffner, an infectious disease expert and professor at Vanderbilt University Medical Center.
“About 20 or 30 years ago, we decided that we would not over-hospitalize,” Schaffner said.
Back then, hospitals often had empty hospital beds for new patients. But now, many hospitals are “absolutely full,” Schaffner said. “We have under-built hospital beds because they are very expensive.”
Also, Americans have grown accustomed to “just-in-time” ordering. But that becomes a huge problem when international supply chains are disrupted by an outbreak. “We didn’t anticipate international turbulence influencing this,” Schaffner said.
Now, some health care workers are making their own masks. They’ve also been told they can use bandanas or scarves as masks.
treatment & Prevention
Is there a cure?
There’s currently no cure for the novel coronavirus. And while research is underway, it could be more than a year before a vaccine becomes publicly available.
Treatment & Prevention
Why is a cure taking so long?
An antiviral drug must be able to target the specific part of a virus’s life cycle that is necessary for it to reproduce, according to Harvard Medical School.
“In addition, an antiviral drug must be able to kill a virus without killing the human cell it occupies. And viruses are highly adaptive.”
Treatment & Prevention
What do I do if I think I’m sick?
Stay home. Call your doctor to talk about your symptoms and let them know you’re coming for an appointment so they can prepare for your visit, the CDC says.
Only a Covid-19 test can diagnose you with the virus, but if you suspect you have it, isolate yourself at home. Limit close contact with other people and animals you live with – the CDC recommends keeping 6 feet of distance.
Many patients with coronavirus are able to recover at home. If you’ve been diagnosed and your illness is worsening, seek medical attention promptly. You may need to be monitored in a hospital.
Ask your physician to call the local or state health department, too, so they’re aware that you’re being monitored for the virus.
Treatment & Prevention
Should I spray myself or my kids with disinfectant?
No. Those products work on surfaces but can be dangerous to your body.
There are some chemical disinfectants, including bleach, 75% ethanol, peracetic acid and chloroform, that may kill the virus on surfaces.
But if the virus is already in your body, putting those substances on your skin or under your nose won’t kill it, the World Health Organization says. Not to mention, those chemicals can harm you.
And please – do not ingest chemical disinfectants.
Treatment & Prevention
I’ve heard that home remedies can cure or prevent the virus. Is that true?
There’s no evidence from the outbreak that eating garlic, sipping water every 15 minutes or taking vitamin C will protect people from the new coronavirus. Same goes for using essential oils, colloidal silver and steroids.
Treatment & prevention myths & misinformation
How long does it take to recover?
“It takes anything up to six weeks to recover from this disease,” said Dr. Michael Ryan of the World Health Organization.
“People who suffer very severe illness can take months to recover from the illness.”
Recovery is often marked by a patient no longer showing symptoms and having two consecutive negative tests at least one day apart, Ryan said. But there is no known cure for the novel coronavirus.
Treatment & Prevention
Why waste a test kit on a person without symptoms?
Some people with coronavirus have mild or no symptoms. And in some cases, symptoms don’t appear until up to 14 days after infection.
During that incubation period, it’s possible to get coronavirus from someone with no symptoms. It’s also possible you may have coronavirus without feeling sick and are accidentally infecting others.
So anyone who has had close contact with someone known to have coronavirus should ask a health care provider about getting tested, the US Centers for Disease Control and Prevention said.
Anyone who recently traveled to a part of the world where coronavirus is widespread should do the same.
Treatment & Prevention
Why is the US so far behind other countries with testing?
Experts say it’s due to cuts in federal funding for public health and problems with early testing.
Problems with public health infrastructure Two years ago, the CDC stopped funding epidemic prevention activities in 39 countries, including China. This happened because the Trump administration refused to allocate money to a program that started during the 2014 Ebola outbreak.
Former CDC director Dr. Tom Frieden warned that move “would significantly increase the chance an epidemic will spread without our knowledge and endanger lives in our country and around the world.”
Problems with the testing Malfunctions, shortages and delays in availability have all contributed to the slowdown.
In the first few weeks of the outbreak in the US, the CDC was the only facility in the country that could confirm test results — even though a World Health Organization test became available around the same time.
Some test kits that were sent around the country were flawed — a move that put the US behind about “four to five weeks,” says Dr. Rob Davidson, executive director of the Committee to Protect Medicare.
Treatment & Prevention
Did Dean Koontz predict this outbreak in the book “The Eyes of Darkness” almost 40 years ago?
No. There are some interesting coincidences in the 1981 fiction novel, which says “a severe pneumonia-like illness will spread around the globe” around the year 2020. Modern editions of the book call the biological strain “Wuhan-400,” and the current coronavirus outbreak started in Wuhan, China.
But there are important differences between the book and reality. The original version of the book called the strain the “Gorki-400,” in reference to a Russian locality, before it was later changed to the “Wuhan-400.” In the book, the virus was man-made, while scientists believe the novel coronavirus started in animals and jumped to humans. And in the book, the virus had a 100% mortality rate. Early estimates of the mortality rate for this coronavirus outbreak range from 2-4%.
myths & misinformation
I’ve heard that home remedies can cure or prevent the virus.
There’s no evidence from the outbreak that eating garlic, sipping water every 15 minutes or taking vitamin C will protect people from the new coronavirus. Same goes for using essential oils, colloidal silver and steroids.
Some posts have suggested that putting sesame oil on your body or spraying yourself with alcohol or chlorine will kill the virus. That’s also false.
Myths & misinformation