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Symptoms, Spread, Testing & Terminology: Answering COVID-19 Questions


By Lisa Wardle PA Post/WITF

Pennsylvania microbiologist Kerry Pollard performs a manual extraction of the coronavirus inside the extraction lab at the Department of Health Bureau of Laboratories last Friday.
Credit: PA Internet News Service

Here are some answers to common questions.

The basics

What is a coronavirus?

Coronaviruses are a large family of viruses that can cause illness in animals and people. Some of those are responsible for the common cold, while others can lead to severe diseases such as Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) or COVID-19.1

The coronavirus first identified in December 2019 is the SARS-CoV-2 virus. You may have seen it referred to as a “novel coronavirus” or “the new coronavirus,” meaning it had not been previously identified.2

What is COVID-19?

The SARS-CoV-2 virus causes a disease that has been named coronavirus disease 2019, abbreviated as COVID-19 by the World Health Organization. COVID-19 was first identified in December 2019. 1

Symptoms & spread

What are the symptoms?

Symptoms of the coronavirus include fever, cough and shortness of breath. Some people may show little to no symptoms. 3

How does the virus spread?

The first infections were linked to a live animal market, but the coronavirus is now spreading from person to person. 1

The coronavirus can be transmitted through small droplets from a patient’s nose or mouth — for example, as the result of a cough or sneeze. A healthy person could contract the virus after touching an object or surface where those droplets landed, then touching their eyes, nose or mouth. It can also be transmitted through close contact with a sick person. The World Health Organization recommends staying at least 3 feet away from a person who is sick. 1

How do I protect myself and my family?

Practice basic hygiene:

  • Wash your hands regularly for at least 20 seconds
  • Cough and sneeze into your elbow, not your hands
  • Clean frequently-touched surfaces often, such as light switches, cellphones and countertops
  • If you are sick, stay home 3

See this guide for how to prepare your home.

How long does the coronavirus last on surfaces?

The World Health Organization says it appears to behave like other coronaviruses and may last on surfaces for a few hours or up to several days, under certain conditions. If you think a surface may be infected, clean the surface and wash your hands. 1

The Centers for Disease Control and Prevention says contaminated surfaces are not the main way the virus has been spreading, but it is possible someone could get sick after touching an object that has the virus on it, then touching their own face. 2

Will warm weather kill the virus?

Some viruses spread more during the winter, but it is still possible to become sick with a cold or the flu during warmer months. Because this virus is new, the CDC says it is not known if warm weather will affect its spread.2

How long is someone contagious?

Fourteen days is the longest incubation period recorded for similar coronaviruses, so that is the timeline health officials are using for quarantine periods. 2

Doctors and public health officials will decide when to release someone from isolation on a case-by-case basis. Current guidelines from the CDC require the patient has no fever, is no longer showing symptoms, and has tested negative for the disease on at least two consecutive tests taken at least 24 hours apart.2

The main way the disease spreads is through droplets resulting from a sick person’s cough, so the risk of exposure is low around people who are not showing symptoms. 1

How soon after being exposed to the virus will a person start to feel symptoms?

“Two weeks is probably the maximum,” said Dr. John Goldman, infectious disease specialist at UPMC Pinnacle. “It generally occurs within the first week so if you contract the virus you probably start to get sick within the first week. If you’re not sick after two weeks, we consider them to be non-infected.” 

How severe is the disease?

There is a wide range of how this disease presents. The CDC says the information so far indicates most COVID-19 illnesses are mild.2 A report published in the New England Journal of Medicine that analyzed 1,099 patients in China showed about 16% of those patients had severe illness. Those patients were older and more likely to have another health concern.

People who are older or who have chronic health conditions, such as heart disease or diabetes, seem to be at higher risk of developing severe illness from the coronavirus.

How does the coronavirus mortality rate compare to the flu?

Data available so far indicates the coronavirus is deadlier than seasonal influenza. The seasonal flu has a mortality below 0.1%. 5

The World Health Organization says death has occurred in 3% to 4% of reported cases of the coronavirus so far. Keep in mind that preliminary 3% to 4% mortality rate is a worldwide figure, not specific to the United States. 6

The true mortality rate of the coronavirus is likely lower, because health officials don’t know how many mild or asymptomatic cases are not being reported. 6

Testing

I think I’ve been exposed to the virus. What should I do?

Call your doctor or hospital if you know you had close contact with someone who tested positive for the virus, are showing symptoms, or if you have traveled from an area with an ongoing spread of the disease. During that phone call, be sure to tell them you may have COVID-19 so they can take proper precautions.2

Healthcare professionals are working with state health officials and the CDC throughout this epidemic. If a test is deemed necessary, your doctor can take a sample and send it to the state laboratory — you will not need to personally go to the state laboratory.

Isn’t the doctor’s office or ER the worst place to go if there are people there who may have the virus and could spread it?

Dr. John Goldman, infectious disease specialist at UPMC Pinnacle, says that is why officials are encouraging people to call their doctor first. “And that’s why we encourage people who are only mildly ill to call their doctor and not go directly to urgent care or go to an emergency room,” he said. “So, if someone only has a fever or mild respiratory, call their doctors first so they can get instructions – sometimes over the phone.” 4

Will my insurance cover a test?

Gov. Tom Wolf announced that all major health insurers in the commonwealth will cover medically appropriate testing and treatment for the coronavirus. This includes Highmark, UPMC Health Plan, Geisinger, Independence BlueCross, Capital Blue Cross, Aetna, Cigna, UnitedHealthcare, Pennsylvania Health & Wellness, and Oscar. 7

The Pennsylvania Department of Health answers more common questions about insurance coverage on its website.

Can I get tested if I don’t have insurance?

The Pennsylvania Department of Health is working to ensure that everyone who is tested for the coronavirus gets tested at no cost to them: “Testing sent to our state health lab is free of charge. If someone believes they were exposed and has symptoms, they should call 1-877-PA-HEALTH and we can help ensure they get tested.” 8

Terminology

What is the difference between isolation and quarantine?

Isolation separates people who are sick from people who are not. Patients can be in isolation at a hospital or at their home. Isolation is usually voluntary, but the Pennsylvania Department of Health has the legal authority to require someone to be quarantined. 9

Quarantine restricts the movement of people who have been exposed to a contagion but are not yet showing symptoms. It is designed to stop the spread of a contagion during the incubation period. A person in quarantine may not become sick at all. Like isolation, it is usually voluntary, but the Pennsylvania Department of Health has the legal authority to require someone to be quarantined. 9

People in isolation or quarantine are not being locked inside their homes, nor do they have a guard monitoring every action. They can go out in their yard, for example, but are told not to go to the store other public places. State health officials check on these people with regular phone calls. 9

OK. What about social distancing?

People who may have been exposed to the virus but are not yet showing symptoms may be directed to self-monitor their health and avoid social situations. 3

What is contact tracing?

After a person tests positive for the coronavirus, health officials reach out to people who may have been exposed. Those individuals will be assessed and may also be tested for the virus. 3

This is done to help control the spread of the virus.

What is community spread?

“Community exposure is when the person presents and we really can’t identify how they got sick,” Dr. Sharon Watkins said at a Pennsylvania Department of Health press conference. 9 “Which means that — if they weren’t traveling internationally, if they weren’t somewhere in another state, if they didn’t have close contact with another case — they must have gotten it from virus circulating in the community that we haven’t been testing or identifying.”

As of March 10, all of Pennsylvania’s cases have known exposures.

Why does it mean for a test to be “presumed positive”?

Pennsylvania’s Department of Health is sending all positive tests to the CDC for confirmation. Health Secretary Dr. Rachel Levine has said she is not aware of any tests performed in any states that were later found by the CDC to be incorrect. 10

SourcesWorld Health Organization, https://www.who.int/health-topics/coronavirus

Centers for Disease Control and Prevention, https://www.cdc.gov/media/dpk/diseases-and-conditions/coronavirus/coronavirus-2020.html

Pennsylvania Department of Health, https://www.health.pa.gov/topics/disease/Pages/Coronavirus.aspx

Smart Talk episode, March 9, 2020, https://www.witf.org/2020/03/06/the-coronavirus-in-pennsylvania-whats-the-latest/

World Health Organization update, March 6, 2020, https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_2

STAT News, March 3, 2020, https://www.statnews.com/2020/03/03/who-coronavirus-different-than-influenza-can-be-contained/

7Gov. Tom Wolf press release, March 9, 2020, https://www.governor.pa.gov/newsroom/gov-wolf-states-major-health-insurers-are-covering-covid-19-testing-resources-available-related-to-covid-19-and-insurance-coverage/

8 Pennsylvania Department of Health email, March 10, 2020

Pennsylvania Department of Health press conference, March 10, 2020

10 York Daily Record, March 6, 2020, https://www.ydr.com/story/news/2020/03/06/coronavirus-in-pa-first-covid-19-case-confirmed-in-pennsylvania-wayne-delaware-county/4966026002/

PA Post is a digital-first, citizen-focused news organization that connects Pennsylvanians with accountability and deep-dive reporting.


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