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Expert Q&A

COVID-19 Questions & Answers

Vital Strategies

Vital Strategies is committed to offering clear, credible and current information on the COVID-19 pandemic to inform its staff, partners and the general public on how to protect themselves, their families and their communities.

Updated March 20, 2020

This Q&A will be updated regularly as new information becomes available to keep you informed and to counter misinformation. As public health experts, we know the critical importance of accurate information.

WHO’s 2019 coronavirus page and the U.S. Centers for Disease Control and Prevention coronavirus page are good sources of up-to-date information.

For updates tracking the spread of coronavirus visit the Prevent Epidemics coronavirus page.

How widespread is COVID-19?

Over 160 countries now have confirmed cases of COVID-19, some of which are imported due to travel and some through community transmission. The World Health Organization declared COVID-19 a pandemic on March 11, 2020. This is defined as when a new virus infects people easily and spreads easily from person to person in multiple locations around the world.

How serious is COVID-19?

Information is changing every hour and there is still much we don’t know. But here is what we do know.

  • We know that the virus can be passed from person to person even when infected people don’t know they have the virus and have no symptoms.
  • We also know that it can take between two days and two weeks for symptoms to appear after exposure.
  • We also know that there is a relatively high rate of serious illness when people contract the illness, especially people who are older and have other illnesses, including respiratory and cardiac conditions. Estimates of the mortality rate are changing as new data becomes available; WHO recently reported it may be as high as 3.4%. By comparison, during a 2002-2003 outbreak of another coronavirus, SARS (severe acute respiratory syndrome), about 10% of people who contracted the disease died as a result; however, SARS was less easily transmitted from person to person compared to this new coronavirus.

And we also know that unlike the flu, which has similar symptoms, we do not yet have a vaccine to prevent infection and reduce the spread of the virus, or a specific antiviral treatment for those who get sick.

What treatment is recommended for people who become sick?

There is currently no specific antiviral treatment recommended for this coronavirus. Most people (about 80%) infected with COVID-19 have mild symptoms and recover from the disease without needing special treatment. People who have mild illness similar to the cold or flu should follow standard advice to help relieve symptoms, such as rest, fluids, and medicine like ibuprofen or acetaminophen to reduce fever. For severe cases, treatment should include care in a health care facility. A small percentage of people are requiring care in an intensive care unit (ICU).

How does this coronavirus spread from person to person?

The modes of human-to-human transmission of the virus are still being determined, but given current evidence, it is most likely spread:

  • Through the air by coughing and sneezing
  • By touching an object or surface with the virus on it, then touching your mouth, nose or eyes before washing your hands

This video is a good overview of how the virus works and how it affects the body.

Can anyone contract COVID-19?

Yes, people of all ages and health situations can be infected. People with underlying health conditions (for example, asthma, diabetes, heart disease) seem to be more vulnerable. Evidence from China also suggests that smokers are at increased risk of severe illness. We are still learning about how the virus spreads and who is most affected.

What are the symptoms?

The most common symptoms are fever, fatigue, dry cough, muscle pain and difficulty breathing. Less common symptoms are headache, dizziness, abdominal pain, diarrhea, nausea and vomiting. At least 80% of those who do feel ill have only mild symptoms or no symptoms at all. While this is a serious condition for many, most people do fully recover from their illness.

Is it distinguishable from the flu or cold?

The new coronavirus appears to have similar symptoms to the flu as described above. Therefore, people who have flu-like symptoms and have recently traveled to a place with COVID-19 or been in contact with someone with such a travel history, should be tested for COVID-19.

What should I do if I or someone I am close to is showing symptoms?

If you or a family member develops a fever or symptoms of respiratory illness, such as a dry cough or shortness of breath, and have been in contact with someone with travel history to an affected area, you should call a health care professional and mention the recent travel history. Don’t go to your doctor’s office without contacting the office first, as recommendations on where to seek treatment may change. Your health care professional will work with your local government’s health department to determine if COVID-19 testing is warranted.

Who should get tested for COVID-19?

Diagnostic testing for COVID-19 is being performed on a case-by-case basis. If you or a family member has a fever or exhibits signs of respiratory illness, such as a dry cough or shortness of breath, call a health care professional who can evaluate the need for testing in consultation with your local health department.

When is COVID-19 contagious?

According to recent reports, people infected with COVID-19 can be infectious before showing symptoms or knowing they have the virus. The incubation period is estimated at two days to two weeks. This is the time within which symptoms can appear after you’ve been exposed to the disease.

Is wearing a face mask an effective preventive measure?

Respiratory protection is very important to prevent spread in health care settings. When sick people wear a mask, they reduce the risk to others. However, for individuals without respiratory symptoms, medical masks are not recommended, and there is limited evidence for their effectiveness in preventing influenza virus transmission. The best way to prevent infection is to follow the advice below for preventive measures. There is no recommendation for people who are not sick to use masks for protection except for health care providers and when caring for an ill family member. Because of the potential for mask shortages, it is important that supplies be preserved for health care providers and sick people. If medical masks are worn, appropriate use and disposal is essential to ensure that they are effective.

What preventive measures can I take?

CDC recommends that for this novel virus, or in cold and flu season generally, you should:

  • Wash your hands often and after being on contact with shared surfaces (e.g., transit, doorknobs, kitchen utensils). Wash with soap and water for at least 20 seconds, especially after going to the bathroom before eating, and after blowing your nose, coughing or sneezing. Always wash hands with soap and water if hands are visibly dirty.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol; let the sanitizer dry thoroughly on your hands.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Reduce social contact like handshakes and hugs.
  • Stay home when you are sick to protect yourself and others.
  • Cover your cough or sneeze with a tissue or your arm (not your hand), then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • The following behaviors are not recommended, don’t prevent the spread of COVID-19 and may be harmful: taking traditional herbal remedies, wearing multiple masks and taking self-medication such as antibiotics. Smoking may make you more susceptible to infection and more likely to become seriously ill if you are infected.

How long does the virus survive on surfaces?

According to the WHO, it is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment). If you think a surface may be infected, clean it with simple disinfectant to kill the virus and protect yourself and others. Clean your hands with an alcohol-based hand rub or wash them with soap and water. Avoid touching your eyes, mouth, or nose. (Source: WHO accessed March 6, 2020)

Is it safe to travel during this outbreak?

The situation is dynamic, and WHO, U.S. CDC, and other governments are constantly reviewing and revising their travel guidelines. Before traveling, you should review available guidelines from WHO, your government and the government of the place you plan to visit. It is wise to postpone planning or booking a trip too far ahead of time, as the situation may change. The U.S. State Department has issued some travel advisories; check here for the latest updates. Other areas may be restricted if/when the virus spreads further.

What precautions should I take while on an airplanes, public transportation or in other crowded places?

The U.S. CDC does not recommend that healthy travelers wear masks on airplanes, but rather practice measures to protect against cold or flu viruses, as described above, especially frequent handwashing and use of alcohol-based hand sanitizer. The same applies to traveling on public transportation or any time you are in a crowded indoor environment.

Can we expect schools and workplaces to be closed, or for big events or gatherings to be cancelled?

If many of those infected are becoming severely ill, it may be justified for governments or businesses to take actions to reduce social contact. At this point, it is highly likely that we will see some disruption to normal life: Some large international events have already been canceled, and schools have been closed in some places. Governments will make considered decisions to balance the risk of spread with social disruption concerns, based on local contexts.

How can we avoid stigma and discrimination related to COVID-19?

The prospect of disease and death is frightening to many people. Fear and anxiety can lead to social stigma, for example toward people of Chinese or other Asian descent or people who were in quarantine. Viruses do not target specific racial or ethnic groups.

 

Stigma is often caused by a lack of knowledge about how COVID-19 spreads, and people’s need to blame someone, as well as through gossip that spreads rumors and myths. People can fight stigma through learning and sharing facts from credible sources.

What are the possible scenarios for the course of this pandemic?

The impact of this is still not clear—the pandemic could be mild, much like a flu season, or could be more significant with higher rates of hospitalization and people becoming critically ill. We still don’t know for sure. What is clear is that we should take this time, before the widespread transmission of the virus, to prepare. We should anticipate some general disruption to work and social life including limitations on travel.

What can I do to prepare for the potential for more widespread transmission?

Now is the time to prepare, not panic. Most people, if infected, will suffer mild illness only. It’s useful to think through what you may need at home if you couldn’t leave the house for a week or so. There is some great and simple advice here.

What are other good sources of information about COVID-19?

• U.S. CDC (www.cdc.gov)
• World Health Organization (www.who.int)
• Prevent epidemics (www.preventepidemics.org)
• NYC Department of Health (www1.nyc.gov/site/doh/health/health-topics/coronavirus.page)
• US State Department (travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html)