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Your guide to understanding coronavirus disease (COVID-19)

Welcome to Grand Rounds, your personal healthcare assistant and trusted source for timely information around coronavirus disease (COVID-19).

Experiencing symptoms?

Use our 2-minute symptom checker based on CDC guidelines to help you understand your risk and take the right next steps in case of exposure to the virus.

Coronavirus FAQs

Updated daily, our Chief Medical Officer and senior medical experts provide comprehensive, up-to-date answers on the most frequently asked questions about COVID-19.

DISCLAIMER: The advice in this article is intended for informational purposes only. It is not meant to replace or substitute for advice, diagnosis or treatment from a medical professional. Please consult with your doctor with questions you may have regarding a personal medical condition or treatment.

As the coronavirus (COVID-19) outbreak has now reached every continent except Antarctica and with daily news reports and information sharing, it can be hard to know what steps to take. Our senior medical experts answers the most frequently asked questions about COVID-19.  

Coronavirus FAQs

Understanding symptoms

What are the symptoms?

Fever and cough are the most common symptoms, but some experience shortness of breath and other symptoms such as nausea, vomiting or diarrhea. Symptoms appear between 2-14 days after exposure. Check your symptoms in just 2 minutes to learn whether you are at risk for COVID-19 and what to do next, all based on CDC guidelines.

How long after exposure do symptoms usually appear?

What we are seeing is that for most individuals who are exposed, symptoms usually do appear within five days (though may take as long as 14 days). They usually start as a regular cold, and then they evolve to cough. And then sometimes shortness of breath. When it evolves to shortness of breath or chest pain, that is when it is crucial to call a healthcare provider, or go in and seek care. Some people never develop symptoms (but they still can spread the virus).

I don't have a primary care doctor. Who do I call if I have symptoms?

If you have had a known exposure you should call your public health department to see if you are eligible for testing and where testing sites are located (most state health departments offer a hotline). If you are experiencing high fever and shortness of breath, you should call ahead to your local Emergency Room. If you have access to Grand Rounds, you can call us. If you don’t have Grand Rounds, but have access to another telemedicine/urgent provider, you could call them.

How long are most people actively ill?

Most people are actively ill for the normal course of viral illness, which tends to last about 10 to 14 days. Usually, one will be more ill during parts of that time period.

High risk factors

Who is at higher risk?

  • People aged 65 years and older
  • People with chronic lung disease or moderate to severe asthma
  • People who have serious heart conditions
  • People who are immunocompromised
  • People with severe obesity (body mass index [BMI] of 40 or higher)
  • People with diabetes
  • People with chronic kidney disease undergoing dialysis
  • People with liver disease

In addition new CDC information suggests that smokers may be at somewhat higher risk, and that pregnant women may as well, For more information on people who need extra precautions, go to the CDC page to learn more.

I work as a cashier. How likely am I to get COVID-19?

As a cashier, the most important thing is to keep six feet of distance from the people around you. Perhaps you can also wear gloves and a mask if you will be closer than 6 feet from people. Remember not to touch cash or the customer and then touch your face without washing or using hand sanitizer in the middle. If the cashier is someone with high-risk factors, they might want to take some more precautions and discuss options with their employer.

I have a young daughter with asthma. How concerned should I be?

There are many individuals with chronic respiratory illnesses, like asthma, and we do know that having a lung disease can put a person in a higher risk category. For our members with asthma, we are strongly recommending that they have access to two-month supply of their inhaler(s) easily accessible at home. Most parents of kids with asthma also know the signs and symptoms of their child when they have a more severe attack. That would be the time to call their provider or 911 for immediate higher level care.

What guidance do you have if a loved one who's considered high-risk is in a nursing home?

Many families are grappling with this right now. We are being asked: “Is it time to bring our loved family members home from nursing homes or assisted living facilities?” These will be personal family conversations. I strongly recommend having some of these conversations now, as opposed to waiting until it gets to the area where the loved one's lives or is in the nursing home. For some families, the right thing to do is to bring the family member into their home, and then keep them in a safe place where they are not going to be exposed. For some families, that is not an option, because they do not have space in their own home for their elderly grandmother where they could avoid contact with other individuals. This is going to be a family by family decision. The goal, of course, is to keep high-risk individuals away from other individuals who could be carrying and shedding SARS-CoV-2.

How susceptible are newborns who haven't received all their vaccines yet?

In general, children seem to be less symptomatic and have less significant symptoms than adults with COVID-19, however we are learning more about this every day. From a study of pregnant women in China, who are positive for COVID-19, the finding reveals newborns will experience shortness of breath or rash. Most newborns eventually have recovered without needing intensive treatments. However, we do know that newborns, in general, have immature immune systems. Their immune systems are not as robust as most adults or older children. So while children in general are low risk, newborns need the most protection. It is probably worth taking the usual precautions you would with a newborn — namely not exposing them to people who you know are sick, not taking them out as much, and keeping them home as much as possible.

How it spreads

How does it spread? Breathing or saliva?

COVID-19 is currently thought to be spread by droplets. Even when we are talking, there are small parts of our saliva that are spreading. Typically they are spreading within a very close distance. If a person has the COVID-19 virus, each little droplet would have viral particles which someone else could then breathe in. Social distancing works because if a person is talking and someone is more than six feet away from them, their droplets are not going to spread far. However, if a person is coughing or sneezing actively, those droplets spread more because they are spreading with velocity. We believe these droplets are spreading the virus. More research is being conducted to find more answers. Hospitals are taking airborne precautions because they must protect our healthcare workers from spreading the virus to patients.

If I have a cut on my hands, does that allow for easier transmission if I'm around an infected person?

No matter who you are, no matter what the illness is. If you have a cut on your hand, it is essential that you put a band-aid on it and cover it up, and wash your hands regularly. We do not know yet if that is how COVID-19 spreads with relation to a cut. However, if it were the flu, we would tell you the same thing. If you have got a cut on your hand, put a band-aid on it, cover it up. Do not expose others to it and do not let things come in through that cut.

Treating symptoms

If I get a fever, what medication should I take?

In early March, there was a study that indicated that individuals with the Coronavirus who took NSAIDs, nonsteroidal anti-inflammatory medications (example names: Ibuprofen, Aleve, and medications of that category) did not recover as swiftly as people who used acetaminophen (Common brand name: Tylenol) for their fevers. However recently the FDA issued a statement that there was not sufficient evidence to advise patients not to use NSAIDs If you take acetaminophen or ibuprofen be sure to stay within the dosing guidelines on the packages and if you have any chronic conditions such as liver or kidney disease, discuss with your doctor first.

If I feel symptomatic, what should I do?

If you are a member of Grand Rounds, feel free to call us. If you are not a Grand Rounds member and your symptoms are mild, you should stay home and try and not spread your illness to your family members. If your symptoms become more severe, please call your doctor or local health care system. To learn if you are at risk for COVID-19, check your symptoms here.

How bad do the symptoms need to be before I go to the hospital?

If you start to experience shortness of breath, are coughing so much that you cannot get a moment of sleep in, have a fever and the over the counter fever-reducers are not working, or are feeling light headed when you stand up, you must call your local doctor immediately. They will need to assess you to test for things like the flu and normal respiratory virals, and also to determine if you need testing for COVID-19.

How do you take care of yourself when you get it? What can I do to help beat it if I get it?

There are currently no treatments available today for mild/moderate COVID-19. If you do get Coronavirus, right now, we will take care of the symptoms that are caused by the disease. For most people, that will be taking over-the-counter medications, including fever reducers and cough suppressants. For those who have more severe symptoms who need to go to the hospital, the hospital will most likely give IV fluids, help them with supplemental oxygen, and may use hydroxychloroquine. The hospitals are testing new therapies through experimental trials. 

Lack of many treatment options is why you must do those preventive measures that you hear everywhere — the best thing to do is prevent getting the disease in the first place, and that includes things like social distancing. It means making sure that you are more than six feet away from people whenever possible. If your company can let you work from home, wiping down all hard surfaces as often as possible, washing your hands with soap and water for 20 seconds at a time — say your ABCs slowly, sing Happy Birthday twice, or count to 20 slowly.

Should I look into being tested if I feel fine or have mild symptoms? When should I get tested?

There are currently not enough testing kits available to test everyone who wants to get tested or who might have mild symptoms. What we want to be able to do is use the test kits for individuals where it might change their care management. For instance, for individuals that might need to go to the emergency room or go to the hospital for care. If you are experiencing mild symptoms or no symptoms, this would not be the time to rush and try to get tested. If you are experiencing severe symptoms, like shortness of breath, high fevers that cannot be controlled with over the counter medications, that is the time to call your healthcare provider and ensure that you can get tested.

My daughter has a runny nose and cough. We are on day four of this sickness. Should I get her tested?

Right now, testing supplies continue to be limited. So, you probably do not need to get your daughter tested. It is probably important, though, that your daughter, and I know this is hard with four-year-olds, is washing her hands even more frequently than she otherwise would have. Furthermore, especially if you are a high-risk person or anyone else in your family, you should be practicing social distancing with your daughter more than you normally would. If it is just a runny nose and a cough, the recommendations for most of the population would not be to try and get tested, given how much our testing resources are being used right now. If your daughter does get worse, you must call your regular doctor.

If there are no drugs for COVID-19, why does one need to be tested? Why not just follow the guidelines of the CDC and do self-quarantine?

The recommendation for most people who would get tested for the Coronavirus, is to quarantine themselves and take care of themselves at home. However, for many individuals, knowing whether or not they are positive might impact the lives of others around them. For example, if they are positive and they had recently gone to work, or been speaking with family members who might be at higher risk, it would be vital for them to know that they were exposed, so that they can then take similar precautions. While you are right that for most people who are tested, it will not change their course or their management plan, it could impact others that they might have been in contact with.

Protecting yourself

How can I protect myself?

Good hygiene! Wash your hands with soap and water for at least 20 seconds. Hand sanitizers (with at least 60% alcohol content) can be helpful too. Covering your mouth and nose when you may not be able to stay 6 feet away from others could also help.

Are there steps we can take to help our immune system get strong? Any specific foods or supplements you would recommend?

We know there are general things that individuals can do to protect themselves from all viruses. The steps include making sure that you are getting your usual vitamins and minerals that you need to keep your immune system strong. Most of the time, we get these nutrients by eating healthy fruits and vegetables. If you feel like you are not able to get your vitamins through regular food, then you may consider taking a multivitamin to make sure that you have your full daily supply of vitamins. Also, things that help your immune system stay strong are making sure you are getting an adequate amount of sleep and a moderate amount of exercise.

How do we protect ourselves when we're touching and buying things at a grocery store?

When you are going to the grocery store, make sure you are going when not very many people will be there. Try to time yourself to go early in the morning, at a random hour in the afternoon, or late in the evening. Make sure you can still keep six feet distance from other people that might be doing their grocery shopping as well. If this seems like it may be difficult, you may consider covering your nose and mouth. If you are going to be buying products packaged in plastic or wrappers, then when you come home, wipe down those external surfaces. While you are in the grocery store, avoid touching your face so that you are not touching things and then getting them close to your mouth or nose. And then coming home, do the disinfectant work on packages, and wash your hands right away.

Should I wipe down what's delivered to my home? What's too much?

I have been wiping down what is coming to my home. I think it is the right thing to do. The Coronavirus can live on plastic surfaces longer than a day. When we have been getting food delivered to us, we have been wiping down the external packaging. Remember also to wash your hands, don’t touch the package and then touch your face.

Should I buy a supply of masks for my family?

You need a mask if you are sick or coughing, and you are going to go out in public and could possibly expose others to a viral illness. Additionally, since there are many asymptomatic carriers, it may help others if you can cover your mouth and nose with a mask if you are out and can’t stay far from others. 

If I get COVID-19 and recover, will I be immune?

There are no good studies on this right now. This is a new pathogen. It is the first time we, as humans, are exposed to this particular coronavirus. We’re not sure if infection with SARS-CoV-2 results in long-lasting immunity. A recent study in rhesus monkeys suggests that at least short-term immunity is likely but more research needs to be done.

DISCLAIMER: The advice in this article is intended for informational purposes only. It is not meant to replace or substitute for advice, diagnosis or treatment from a medical professional. Please consult with your doctor with questions you may have regarding a personal medical condition or treatment.

Watch our previous Facebook Live events

Our Chief Medical Officer, Dr. Ami Parekh, answered questions  and addressed concerns regarding Coronavirus disease (COVID-19) at our Facebook live events.

What medications to take and avoid if you have a fever

What precautions to take if you are getting food delivered to your home

Tips for managing feelings of anxiety from having to stay home

"Ask me anything" with Dr. Parekh

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