2019 novel coronavirus (COVID-19)

Dear Reader, 
Since early 2020, much has been learned about SARS-CoV-2, the virus that causes the illness known as coronavirus disease 2019 or better known as COVID-19. COVID-19 is mainly transmitted through contact with water droplets that are released when breathing. Transmission via this method often occurs when an infected person is in close contact—usually less than six feet—to others for an extended period of time. While transmission through water droplets is the most common method of transmission, people can also get sick, though less likely, by touching contaminated surfaces. The disease can spread even if an infected person is asymptomatic (doesn’t feel or express symptoms). When the disease was first discovered in Wuhan, China, the World Health Organization declared COVID-19 a Public Health Emergency of International Concern (PHEIC). The PHEIC went into effect in January 2020 and has been lifted as of May 2023. 

Symptoms of COVID-19 may range from mild to severe and typically appear between 2 to 14 days following exposure to the virus. Some people may be at a higher risk for more severe illness: adults over 50 years of age; those with certain chronic medical conditions like chronic kidney disease, chronic liver disease, and cancer; and those with weakened immune systems, either due to underlying conditions or use of immunosuppressive medications. It is important to note that symptoms of infection may also vary depending on the variant of the virus (more on this later), yet some of the most common symptoms of COVID-19 include: 

• Muscle or body aches 
• Fever or chills 
• Fatigue 
• Headache 
• Diarrhea 
• Nausea and vomiting 
• Difficulty breathing or shortness of breath 
• Congestion or runny nose 
• Loss of taste or smell 
• Sore throat 

List adapted from the CDC 

If you develop symptoms, it’s recommended to isolate yourself immediately and get tested. If you test negative, continue wearing a mask when you are indoors and around others for up to ten days from the date of your last exposure as a precautionary measure. Whether you’re experiencing symptoms or not, if you test positive, it’s recommended that you isolate for five full days starting on the first full day after exposure or symptom onset, regardless of vaccination status. If your symptoms are improving and you haven’t experienced a fever for 24 hours without the use of fever-reducing medication, you may end isolation after five full days and wear a mask when around others for five additional days (day 6 through day 10). You may resume normal activities on day 11. If your symptoms aren’t improving, it’s important to continue isolating until your symptoms improve and you aren’t experiencing fever for 24 hours without the use of fever-reducing medication. If one of your symptoms is difficulty breathing or shortness of breath, or if you have a weakened immune system or related hospitalization due to severity of the illness, it‘s recommended to isolate through day 10 and wear a high-quality mask if you must be around others in public or at home. 

If you test positive but don’t have any symptoms, you can end isolation after five full days, meaning you may resume normal activities on day 6. However, you might consider wearing a mask when you’re around others for five additional days (day 6 through day 10). It’s worth noting that if you have access to antigen tests and receive two negative tests conducted 48 hours apart, it’s often an indication that you may no longer be infectious and may remove your mask sooner than ten days. If you have been exposed to the COVID-19 virus, but don’t develop any symptoms, it’s still recommended to get tested at least five full days after your last exposure to COVID-19. 

As researchers continue to study the disease, several variants of COVID-19 have been identified. Variants occur as viruses change and mutate and may cause varying degrees of symptoms. The Centers for Disease Control and Prevention (CDC) and other public health agencies continue to closely monitor variants circulating in the United States. As new variants have emerged, recommendations for testing have changed. How often someone should get tested typically varies depending on whether they are showing or experiencing symptoms and whether they know they have been around someone who is sick. 

When it comes to tests, there are two main types: Polymerase Chain Reaction (PCR) tests and antigen tests. PCR tests are often considered the gold standard of diagnosis. They’re a form of Nucleic Acid Amplification Tests (NAATs) and are highly accurate and reliable in detecting viral genetic material. It may take up to three days to obtain the test results from a PCR test. On the other hand, antigen tests typically produce results in approximately 15 to 30 minutes. While they offer quick results, the antigen tests may not detect the virus in the early stages of the infection, particularly if a person isn’t displaying symptoms. Although a positive antigen result is often accurate and reliable, a negative antigen result doesn’t mean a lack of infection. In order to confirm a negative antigen result, the Food and Drug Administration (FDA) recommends two negative antigen tests for people with symptoms, or three negative antigen tests for those without symptoms. The tests should be conducted 48 hours after the first initial negative test. Alternatively, one can confirm the results of an antigen test by getting a PCR test. 

The most effective way to prevent getting sick with COVID-19 continues to be vaccination. CDC recommends vaccination for everyone age six months and older. In the United States, there are currently two main types of vaccines in use: messenger ribonucleic acid (mRNA) vaccines and protein subunit vaccines. mRNA vaccines tell cells in the body to make proteins similar to that of the virus , which triggers the body to create antibodies against it. On the other hand, protein subunit vaccines contain harmless parts of the protein unique to the virus to help stimulate the immune system. The original monovalent COVID-19 vaccines, as they are commonly known, were created to protect against the original strain of the virus, hence the name "monovalent". 

However, as COVID-19 continues to change, new vaccines are needed in order to protect against new variants. While there were initially four monovalent vaccines approved for use in the United States the FDA no longer authorizes use of the original monovalent vaccines. The CDC recommends getting one updated FDA approved vaccine for everyone aged 6 years and older, regardless of which vaccine they initially received. Older adults aged 65 years and older are advised to receive a second dose of the updated vaccine. There are also special recommendations for children aged 6 months to 5 years and people who are immunocompromised. 

In addition to staying up to date with vaccines and getting tested as needed, CDC recommends the following preventative measures to protect yourself and loved ones: 

• Try to avoid close contact with suspected or confirmed COVID-19 cases 
• When possible, remain at home if you suspect you are infected or have a confirmed COVID-19 diagnosis 
• Consider seeking treatment if infected 
• Follow precautionary guidelines if exposed 
• Try increasing the ventilation in your home 
• If possible, shift activities and events to outdoor settings 
• Check hospital admission levels in your county and consider wearing high-quality masks such as an N95 or respirators as well as maintaining distance in crowded settings, especially if your county’s hospital admission levels are high. 

Maintaining hand hygiene also remains an effective tool to not only reduce the risk of COVID-19 infections, but it also protects against other germs and respiratory infections. It’s also recommended to avoid touching your face with unwashed hands as the virus can penetrate through the mucous membrane around the nose, eyelids, and mouth. 

Consider checking out the CDC COVID-19 website for additional information and staying up to date on all the latest recommendations and guidance when it comes to COVID-19.