Let’s Talk About the Novel Coronavirus

COVID-19 may be the defining (and scariest) global crisis of our time. Your best defense is knowledge and preparedness. Minus any fake news.

by Erin L. Boyle Health Writer

We're now into year two of the pandemic, and the novel coronavirus, a.k.a., COVID-19, has caused extraordinary loss and pain, with more than 600,000 Americans lost to it. The light at the end of the proverbial tunnel, however, is that more than half of all adult Americans (and counting) now have at least one vaccine shot, with nearly 45% fully vaccinated. Tweens and teens are now eligible, too, with the Centers for Disease Control and Prevention (CDC) clearing emergency use of one leading vaccine in kids as young as 12. Still, new cases continue in American states—with more transmittable variants soaring, unchecked, in other parts of the world—and children 11 and under remain unprotected. So it’s important to fight pandemic fatigue and keep up with strategies to help stop the spread. Schedule your vaccine (and, yes, wear a face mask in all social settings if you're not yet fully immune). Also, read up! Our coronavirus guide, complete with FAQs, comes from a panel of top pros and cites dozens of studies so you can protect yourself, and others, with the very latest information available.

COVID-19

Our Pro Panel

We went to some of the nation's top experts in infectious disease to bring you the most up-to-date information possible.

Amesh A. Adalja, M.D.

Amesh A. Adalja, M.D.

Internist specializing in infectious diseases and critical care

University of Pittsburgh Medical Center

Pittsburgh, PA

Jeanne D. Breen, M.D.

Jeanne D. Breen, M.D.

Infectious disease specialist, Assistant Clinical Professor, Laboratory Medicine

Yale School of Medicine

New Haven, CT

John Swartzberg, M.D.

John Swartzberg, M.D.

Clinical Professor, Emeritus

UC Berkeley - UCSF Joint Medical Program, Infectious Diseases & Vaccinology Division, UC Berkeley School of Public Health

Berkeley, CA

COVID-19
Frequently Asked Questions
Can coronavirus be carried by dogs or cats?

Yes, cats and dogs can get coronaviruses, but they can’t give you their versions. Although it's rare, there is some evidence that a dog, cat, or any pet for that matter may get COVID-19 from human contact. There was one reported case in Hong Kong of a dog infected with this new strain, and at least one case in the U.S.

How long is coronavirus contagious?

We don’t yet know. Clinicians found viral RNA—COVID-19's genetic material; so, like, its calling card—20 days after onset of symptoms in some COVID-19 patents, meaning those with the disease were still “shedding” the virus that many days out. And the virus was detectable until death in those who lost their lives to the illness. The longest time COVID-19 was detected in preliminary study? 37 days. According to the CDC, if you’ve had no fever for 72 hours (without needing medicine to reduce it), your symptoms have improved, and at least seven days have passed since your symptoms first appeared, you can leave home (even if you can’t get a follow-up test).

Where did coronavirus come from?

Bats. That’s the likely source of the novel, or new, strain of coronavirus called SARS-CoV-2. It’s possible that bats had the virus and passed it to another animal (possibly an animal called the pangolin), which then passed it to humans, who then passed it to each other. It might have originated at Huanan Wholesale Seafood Market or other area markets in Hunan, China, and first appeared in December 2019.

How can you avoid the novel coronavirus?

Wash your hands with soap and water for at least 20 seconds, making sure to soap every part of your hands, regularly! Which means: after going to the bathroom, before eating, after being out in public. Use hand sanitizer with at least 60% alcohol if you don’t have access to soap and a sink, making sure to cover your whole hands and rubbing them together until they feel dry. Avoid touching your eyes, nose, and mouth with unwashed hands. Cough or sneeze into your elbow, to prevent droplets from scattering 6 feet away from you. And finally, practice good social distancing. Maintain 6 feet from yourself and anyone else. Stay home, flatten the curve.

What Is a Coronavirus, Exactly?

So, just what is this illness? The novel coronavirus is a new disease strain in a family of viruses called “coronaviruses,” which were discovered in the late 1960s. They cause everything from mild to severe upper-respiratory tract illnesses (plus a range of other documented symptoms) and are zoonotic, meaning they’re transmitted from animals to people.

The name comes from the way the virus looks under a microscope: It has crown-like—or “corona,” the Latin word for crown—spikes on its surface, to better grab hold of our cells. Humans experience seven different strains of coronaviruses. Turns out, it’s quite likely you’ve already had one of them—the common cold.

This latest version—now a pandemic (meaning it’s spread around the world)—is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The illness that the SARS-CoV-2 virus causes is COVID-19. It was first reported in December 2019 in the city of Wuhan, China, in the Hubei province, and new research, published in Clinical Infectious Diseases in June 2021, suggests that SARS-CoV-2 may have been present in the U.S. earlier than first thought, also in December of that year. Most of us colloquially call it “the coronavirus,” and technically that’s accurate because it is a member of that viral family. But for the record, the correct name for the virus is COVID-19.

Terms describing the coronavirus include: coronavirus, COVID-19, 2019-nCoV, and SARS-CoV-2
Nikki Cagle

Two other severe strains of coronavirus—severe acute respiratory syndrome (SARS-CoV, or just SARS) and Middle East Respiratory Syndrome (MERS-CoV, or just MERS)—broke out in the last two decades in more than 20 countries, leading to some 1,600+ deaths. While COVID-19 seems more infectious than those two, it also seems less deadly, which is not always as great as it sounds… easier transmission results in more cases, making it harder to stop the infection, hence how it became a pandemic.

The transmission source of this coronavirus disease is currently under investigation, but it’s possible it started in bats. From there, it’s theorized, it moved to humans. In May 2021, President Joe Biden released a statement saying he’d asked intelligence officials to report back to him in 90 days regarding where the virus had originated.

What Are the Main Symptoms of the Coronavirus?

The World Health Organization (WHO) defines a suspected case of COVID-19 as a person who meets both clinical (which is fever AND cough; or any three or more of these symptoms: fever, cough, general weakness/fatigue, headache, myalgia, sore throat, coryza, dyspnoea, anorexia/nausea/vomiting, diarrhea, altered mental status) and epidemiological criteria (meaning you’re in an area with high transmission of the disease, or you work in any healthcare setting). According to the CDC, symptoms are often mild and begin gradually, and first appear two to 14 days after exposure to the virus. However, as you’ll see from the percentages below, not everyone who has COVID-19 experiences those symptoms, or even any of the symptoms.

Here’s the thing to understand about COVID-19: The severity and duration, or whether you get any specific symptom at all, is based on how your immune system handles the disease. It’s why it’s so difficult for doctors to give specifics about how long chills will last or how bad a cough might be. Maddeningly, the coronavirus likes to get personal.

According to the CDC, the most commonly cited symptoms of COVID-19 are:

Fever

This is the most prevalent symptom, occurring in about 88% of people in one of the largest collections of COVID-19 cases, a report from WHO of 55,924 laboratory-confirmed COVID-19 cases in Wuhan, China. These results are from earlier in the pandemic (February 2020), yet later results reported by the CDC (collected in 16 states from 199 patients from January to June 2020) still showed fever as a prominent symptom in COVID (80% in the CDC report). Our normal body temp is around 98.6 degrees Fahrenheit. A fever would be considered in the 101 to 104 range.

Cough

About 67% of people in Wuhan had this symptom, with 84% experiencing it in the CDC report later in the year, which has been described as a dry cough that happens intermittently. That said, your cough might be different. It might be dry and called “unproductive,” meaning with no mucus. Or it might be wetter, producing mucus whenever you cough. You might cough so much, it hurts. You might not. Another reason why this virus can be so difficult.

Shortness of Breath

This symptom was reported in about 18% of cases in Wuhan, but more in the CDC report (57%). According to the U.S. findings, shortness of breath was more commonly reported by hospitalized than non-hospitalized patients (82% versus 38%). Your immune system response and health risk factors will establish your baseline risk for this, as well. So, say you have emphysema: You might be short of breath during the day already. But if you’re an athlete, you wouldn’t feel winded until you ran a distance, or ran at top speed. Both are typical. What isn’t typical? If you have a hard time breathing while doing daily activities that don’t typically cause an issue. Then it might be COVID-19-related.

Fatigue

You know the deep exhaustion that can hit during the flu? This feels the same, and about 38% of people with COVID-19 experienced it in early Wuhan data, with 62% reporting fatigue in the newer CDC data.

Sputum Production

Occurring in 33% of cases in the WHO report in Wuhan (the CDC report didn’t include this symptom), this mix of saliva and mucus is coughed up from the respiratory tract.

Sore Throat

This is typical throat pain, like the kind you might have with a cold. About 14% of people in Wuhan with COVID-19 had a sore throat. (The CDC update didn’t include this symptom either, but by widely reported evidence, it happens).

Muscle Pain

Muscle aches occurred in 14.8% of cases in Wuhan, according to the WHO report on symptoms there, and far more in the CDC report of 16 U.S. states—63%. Called myalgia, the areas where you feel muscle pain and ache can vary. Inflammation could play a big role in this pain, according to a 2021 study in Skeletal Radiology. Imaging could help your doctor learn more about what’s going on to cause muscle pain after COVID, and send you to the right specialist to treat the pain, study authors say. Possible areas you might have musculoskeletal involvement/pain with COVID could include:

  • Hip pain

  • Knee pain

  • Shoulder pain

  • Neck pain

Joint Pain

Can COVID cause joint pain? The short answer: Yes. The long answer is, called arthralgia, data from China showed joint pain happened in 14.9% of cases, according to a study published in The Lancet Rheumatology on October 5, 2020.

However, study authors say that data on the rheumatic and inflammatory manifestations, including arthritis, of COVID-19 are still “scarce.” That’s confirmed in a blog on OrthoInfo, from the American Academy of Orthopaedic Surgeons, written by a physician who says that the virus might worsen existing arthritis—but long-term effects are as yet unknown for this symptom.

It’s been reported anecdotally that sore joints are a real issue of COVID, both during the acute part of the infection and as a long-term symptom. The 2021 study in Skeletal Radiology outlines how chronic rheumatologic diseases triggered by SARS-CoV-2 are reported in the literature, including systemic lupus erythematosus, dermatomyositis, Graves’ disease, rheumatoid arthritis, and psoriatic spondyloarthritis.

Headaches

Feels like your basic, pounding headache, but it’s coupled with other COVID-19 signs. (So you’d know it’s not just a stress headache from all the bad news.) Thirteen percent of cases include headaches as a symptom in Wuhan; 59% reported headaches in the CDC report.

Chills

Oh, that familiar feeling you get with the flu. It happens with COVID-19 too, in about 11% of people in Wuhan and 63% in the U.S., sometimes involving full-body shakes. Different people will have them for different durations.

New Loss of Sense of Smell (Called Anosmia) and Taste (Called Ageusia)

We don’t know why this happens yet (and it wasn’t reported in early data about symptoms), but many people have been talking about this issue with COVID—and according to the 199 patients in the U.S., those who had this symptom were less likely to go to the hospital than those who didn’t. Another study, published in Clinical Infectious Diseases in August 1, 2020, reported that of 59 hospitalized patients with COVID in Milan, Italy, 20 (33.9%) reported at least one taste or smell (a.k.a. olfactory) disorder, and 11 (18.6%) had both. Younger, female patients had a higher reporting rate for these issues then older, male patients.

Nausea or Vomiting

You can see why people keep saying the coronavirus is like the flu. The symptoms are similar. While nausea and vomiting happen with COVID-19, they’re not always routine: 5% of patients threw up or felt like they might in Wuhan and in the newer U.S. data, 13% experienced vomiting.

Nasal Congestion and/or Runny Nose

Stuffy noses can happen with COVID-19, but they’re not as typical as other symptoms, occurring in nearly 5% of cases studied in Wuhan.

Diarrhea

There’s no doubt about it, GI issues are a real problem with COVID, far more than we first realized: About 50% of people with the illness experience at least one or more GI problem. In Wuhan, about 7% had diarrhea, but in the U.S. group, it happened in 38% of patients. One study published on March 30, 2020, in the American Journal of Gastroenterology even found that some people with a mild form of COVID-19 experience diarrhea first—with COVID's typical respiratory symptoms not showing up till days later, or ever.

Symptoms of coronavirus include fever, shortness of breath, cough, sore throat, fatigue, joint pain, sputum production, and headaches
Nikki Cagle

There are other symptoms that have been reported anecdotally by doctors and people who’ve tested positive for COVID-19. They include:

  • Hemoptysis. This is an awful one. It’s when you cough up blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs. It occurred in 0.9% of cases in the large China patient group.

  • Conjunctival congestion. Otherwise known as "pink eye," this is when your eyes are red and a watery discharge keeps flowing out of them. A recent study out of Wuhan of 216 hospitalized children with COVID-19 showed how 22.7% (49 kids) had this symptom. There is a also a well-documented connection between pink eye and respiratory viral infections, according to the Cleveland Clinic.

  • Toe bumps. Dermatologists are researching a peculiar new skin rash that may be tied to COVID-19. Some coronavirus patients are reporting red and purple bumps on their toes, which are painful to the touch and can become inflamed within a matter of days. This condition, which most commonly occurs in young people and seems to appear before other symptoms, has been informally nicknamed “COVID toes.”

How Bad Is COVID? And What Is Long-term COVID?

The good news is, more than 80% of people with COVID-19 have mild, uncomplicated illnesses and don’t need to go to the hospital. The not-so-great news: About 14% develop severe disease requiring hospitalization and oxygen support, and, of those, up to 30% require admission to an intensive care unit (ICU).

Then there are the growing number of COVID-19 “long-haulers.” Also known as post-acute sequelae of COVID-19 (PASC), or in the patient community, long COVID or long-term COVID, we’re not exactly sure how many people have it. National Institute of Allergy and Infectious Diseases Director Anthony Fauci, M.D., has estimated 25% to 35%—or more—of those who have COVID might have symptoms beyond the acute stage of either mild or more serious infection (which is typically two to three weeks after illness onset).

A June 2021 white paper from FAIR Health (a health care nonprofit) looking at the private health care claims of nearly 2 million COVID-19 patients found that 23.2% had at least one post-COVID condition. The nonprofit’s analysis of these records also found that COVID cases of all severity—from those who were hospitalized with COVID to those who were asymptomatic—experienced post-COVID conditions. And all ages, from children to seniors, were impacted, results found. With long-term COVID, you have some symptoms that just don’t stop.

In fact, many hospitals in the U.S. are setting up COVID clinics to help patients receive multidisciplinary care for the wide range of symptoms people can face. One study, published in April 2021 in The Lancet Psychiatry, found that six months after a COVID-19 diagnosis, one in three patients had experienced a psychiatric or neurological illness, including anxiety, strokes, or dementia.

Dr. Fauci has said that lingering issues from COVID are “highly suggestive” of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), according to a JAMA article, which is a real concern. There’s no cure or U.S. Food and Drug Administration (FDA) -approved treatment for ME/CFS (which you might know from its former name, chronic fatigue syndrome).

In December 2020, Congress approved $1.15 billion in funding to the National Institutes of Health (NIH), for researchers to investigate long-term COVID. As scientists and doctors race to gain answers, to date some 166,000 long-haulers gather on Facebook forum Survivor Corps and other social media groups and platforms to discuss their experiences, offer support, and help collect patient-lead research into long-term symptoms.

One study in The Lancet looked at 1,733 Chinese patients with COVID and found that 76% of people (more women than men) still had at least one symptom six months after first getting sick with the virus. Symptoms included:

  • Fatigue

  • Muscle weakness

  • Sleep difficulties

  • Anxiety

  • Depression

According to the Mayo Clinic, other long-hauler COVID symptoms can include:

  • Shortness of breath

  • Cough

  • Headache

  • Chest pain

  • Fast or pounding heartbeat

  • Loss of smell or taste

  • Memory, concentration, or sleep problems

  • Rash or hair loss

People around the world are reporting that these COVID symptoms are lingering. Some are seriously ill months after first being sick. Others are struggling with COVID as a chronic illness, never fully rebounding from fatigue, cognitive issues (known as “cog fog”), unusual heart rhythms, shortness of breath, and additional documented ailments for weeks or even months after the initial onset of illness. No matter how you slice it, there is a growing community of people around the globe who are frustrated and struggling. Some are healthcare workers who were exposed to heavy viral doses with limited personal personal protective equipment (PPE) early on in the pandemic, according to a JAMA report.

As you can see, the way this illness plays out is a bit all over the place. COVID-19 can cause life-threatening symptoms, worsening to pneumonia; it may cause long-term, possibly chronic symptoms; or you can feel just fine and still have this virus.

How Do You Get COVID?

According to the CDC, the main way people are infected with COVID-19 is through exposure to respiratory droplets carrying infectious virus.

Exposure can occur in one of three ways:

  1. Droplet transmission. The virus spreads through close contact with those who have the infection, from exposure to small, medium, or large droplets of the coronavirus expelled into the air when an infected person coughs, sneezes, talks, shouts, or even sings, and you inhale their expelled mucus or salvia into your lungs. There is some evidence that suggests louder talking and singing (like one does at choir practice or in loud bars) puts more droplets into the air, creating a higher viral load and upping transmission risk. This type of transmission occurs when you are close to an infected person, generally within six feet. It’s possible you can be farther away from a person and still be exposed (one study, published in the Journal of Korean Medical Science in November 2020, found droplet transmission of more than 21 feet away between two people who were indoors but not interacting), showing all the more the importance of wearing a mask whenever possible around other people, and avoiding crowded areas and indoor areas with poor ventilation and air flow.

  2. Airborne transmission. This means that small droplets and particles of COVID-19 can become aerosolized and hang in the air across distances greater than six feet (think of it like invisible clouds of cigarette smoke) in poorly ventilated spaces for minutes up to possibly three hours, according to research published in the New England Journal of Medicine in March 2020. The CDC’s updated guidance on this, as of early May 2021, includes info on activities that raise this risk, such as being in areas with inadequate ventilation, around people who are increasing exhalation (like when singing or shouting or taking part in physical activity), and prolonged exposure to those things for more than 15 minutes. So if someone with COVID expels infected droplets (maybe by sneezing), walks away, and then you walk into those airborne droplets without knowing how someone infected was just there spreading the virus, there’s a possibility that you can catch COVID. Which is a sobering thought.

  3. Contact transmission. This infection pathway is exactly what it sounds like: People can pick up the virus by touching other infected people or surfaces that are contaminated , then touching their hands to their nose, eyes, or mouth. This is why the CDC recommends that you wash your hands after touching such surfaces, and avoiding shaking hands or physical contact with others outside your household. But contact transmission doesn’t seem to be a common way that the virus spreads (despite what experts first thought), the CDC reports. In fact, in April 2021, officials announced updated guidance on cleaning and disinfecting, saying that “in most situations, regular cleaning of surfaces with soap and detergent, not necessarily disinfecting those surfaces, is enough to reduce the risk of COVID-19 spread.” Disinfecting is only recommended in indoor settings (like schools and homes), where someone has COVID or is suspected of having COVID in the last 24 hours.

It’s important to note that these transmission pathways are not mutually exclusive, and that information about COVID-19 is ever-evolving. As more people around the world get the illness, health care professionals share what they’re learning in real time, and researchers and major health organizations rush to publish the latest accurate data, we’ll continue to share all updates with you.

Here’s how you may get it (but we’re not sure):

  1. Feces. Officials are recommending that anyone in your house with the virus use their own bathroom—if possible—to reduce potential infection of others in the house. Early research seems to indicate that the virus is “shedded,” or released, through your stool, and since one COVID-19 symptom is diarrhea, experts are studying whether it’s transmitted through feces.

  2. Urine. Nobody knows yet whether it’s a transmitter, either; it was one way the 2003-2004 SARS virus was shed, so more research is underway.

Here’s what’s unlikely (but uncertain):

  1. Sexually. While you can get this novel coronavirus from kissing—in which you share saliva droplets mouth-to-mouth—it is still a question mark whether it can be sexually transmitted. A small study found it in the semen of men diagnosed with the disease, but there was no evidence partners were infected this way.

  2. Mother-to-baby. When a pregnant woman passes a virus on to her baby, it's called vertical transmission. Studies on COVID-19 have found both positive and negative correlations in this regard. We’ll talk a little more about this later on.

  3. Blood. Unlike other viruses, like Hepatitis C, it doesn’t appear that you can be infected with COVID-19 through blood exchange.

  4. Water. Certain diseases, such as cholera, can be caught by drinking water infused with harmful bacteria. COVID-19 doesn’t seem to transmit through H20.

  5. Food. It appears that food won’t give you the virus, so takeout should be OK—though if you want to double-down on safety, you can recook your eats and bring them up to temperature (depending on the specific kind of food) to ensure all pathogens are killed.

Is There a Vaccine for COVID-19?

Why, yes there are—three, actually, approved in the U.S., with more almost certainly on the way here (and others available worldwide). Operation Warp Speed—which includes the Department of Defense, the Biomedical Advanced Research and Development Authority (BARDA), and other U.S. government agencies—was created, in part, for the successful development and distribution of safe and effective vaccines. This initiative is helping accelerate the vaccine approval process, safely and effectively in the U.S. ... which may help explain why vaccine rollout seems to be happening so quickly for a virus that’s only a year old.

Originally, 125 potential vaccine candidates for COVID-19 were considered, but that’s been narrowed to the current offerings as more research was conducted and companies dropped out. The following vaccines are currently approved for emergency use authorization by the FDA for preventing COVID-19:

Pfizer-BioNTech COVID-19 Vaccine

This vaccination is manufactured by Pfizer, an American pharmaceutical company, and BioNTech SE, a German biotechnology company.

  • It’s called a messenger RNA (mRNA) vaccine and doesn’t have any live virus in it. Instead, it works by telling our cells how to make a spike protein that causes an immune response in our bodies.

  • This produces all-important antibodies to the virus (which then fight off the virus when you encounter it).

  • It’s given as two shots, ideally 21 days apart, in the muscle of the upper arm. In late January 2021, the CDC updated its guidelines to say the second dose could be delivered up to six weeks after the initial shot is given.

  • It’s now recommended and available for people 12 and older, with both the FDA and CDC recently clearing emergency use of this vaccine for kids ages 12 to 15. Expanded eligibility comes after a trial with 2,260 patients that found the vax had 100% efficacy against symptomatic disease in adolescents as young as 12. The vaccine was well-tolerated in this age group, with similar side effects to those in older age groups (read on for more info on these). The companies are now testing the vax in children ages 6 months to 11 years old now.

  • It doesn’t contain eggs, preservatives, or latex.

  • It can now be stored in a refrigerator at 2°C to 8°C (35°F to 46°F) for up to one month. In the early days of its distribution, thawed, undiluted vaccine vials could be stored in the refrigerator for only up to five days, so this change by the FDA definitely makes its administration less of a challenge than when it first rolled out.

So what should you expect once you have it?

The most common side effects are pain, swelling, or redness on the part of your arm where you received the injection, or chills, tiredness, and headache in the rest of your body. These typically happen within a day or two of receiving the vaccination, according to the CDC, and can happen within seven days as mild to moderate symptoms. Mild to moderate side effects like fever, chills, tiredness, and headache were most common after the second dose.

Another potential side effect that’s been reported in the media is a change in people’s menstrual cycles, something that’s likely not a concern unless vaginal bleeding/menstrual irregularities are unusual for you, like if you’re in menopause (and in that case, see your doctor, experts advise).

A small number of people did experience more severe side effects than those listed above, which were defined as impacting their ability to do their daily tasks.

Keep in mind that side effects in this case are a good thing—they’re typically your body’s immune system responding to the vaccine, developing immunity against the virus—the whole point of the vaccine.

If you have side effects, be sure to report them to a government vaccine safety monitoring system, so that info can help researchers know and understand what people are experiencing with not just Pfizer-BioNTech’s vax, but all the vaccines available. An easy and simple way to do that? The CDC’s V-Safe After Vaccination Health Checker, a smart-phone app that helps you track any and all side effects of COVID vax in real time. Someone from the CDC might even call and check on you and seek more info, depending on your responses to the app’s web surveys.

In clinical trials of the Pfizer-BioNTech vaccine, it was 95% effective at preventing laboratory-confirmed COVID-19 illness in those without evidence of previous infection. A study published in The New England Journal of Medicine in December 2020 found that COVID prevention protection with the Pfizer-BioNTech vaccine didn’t begin until 12 days after the first shot—a week later, it’s 52% effective. And then, a week after your second (and final) vaccination, it reaches its full effectiveness.

For those most vulnerable to the worst outcomes with COVID—those over 70—data from Public Health England shows that with the Pfizer-BioNTech and Oxford-AstraZeneca vaccines, protection against symptomatic COVID, four weeks after the first dose, ranged between 57% and 61% for one dose of Pfizer-BioNTech and between 60% and 73% for the Oxford-AstraZeneca vaccine. For those in the 80+ age range, results were even better: A single dose of either vaccine appeared to be more than 80% effective at preventing hospitalization, three to four weeks after people received the vax. And the Pfizer-BioNTech vaccine might lead to an 83% reduction in deaths from COVID-19.

The vaccine is showing good efficacy, in two shots, against the newer variants like the Delta variant, but researchers are still investigating the shots and newer mutations. (Keep reading to learn more about COVID's new strains.)

What about allergic reactions to the vaccine?

Very important to note: You shouldn’t have this vaccination if you’ve had a severe allergic reaction (anaphylaxis) or an immediate allergic reaction to any ingredient in an mRNA COVID-19 vaccine, or are allergic to polyethylene glycol (PEG) and polysorbate. You might have read about a statistically small (but still unsettling) number of allergic reactions to the vaccine. Here’s what we know: The CDC has reported that from December 14 to 23, 2020, the Vaccine Adverse Event Reporting System found 21 cases of anaphylaxis after 1,893,360 first doses of the Pfizer-BioNTech COVID-19 vaccine (or 11.1 cases per million doses) and of those, 71% happened within 15 minutes of vaccination. If you’ve had a reaction to a previous vaccine or experienced anaphylaxis previously, make sure to be observed by healthcare personnel with access to equipment and supplies to treat that for 30 minutes after the shot, according to the Cleveland Clinic. If you have other allergies (as long as they aren’t PEG or polysorbate), you can be observed for 15 minutes. This goes for both vaccines currently approved by the FDA.

Moderna’s COVID-19 Vaccine

This vaccination is manufactured by American pharmaceutical/biotech company ModernaTX, Inc.

  • It’s also a mRNA vaccine (and it works the same way as the Pfizer-BioNTech vaccine).

  • It’s given as two shots, ideally 28 days apart, also in the muscle of your upper arm. In late January 2021, the CDC updated its guidelines to say the second dose could be delivered up to six weeks after the initial shot is given.

  • It’s recommended for people 18 years and older, but new data in adolescents aged 12 to 17 shows that, with a milder case definition 14 days after the first dose, the vaccine has 93% efficacy. After two doses, the vaccine was 100% efficient, meaning none of the 3,732 participants had COVID. Company officials plan to bring the vax up for review with the FDA/CDC in early June.

  • It doesn’t contain eggs, preservatives, or latex.

  • It also needs to be shipped and used in the same way of the Pfizer-BioNTech vaccine—cold and quickly.

It has very similar potential side effects to the Pfizer-BioNTech vaccine for the same reason (your immune system is responding as it should). They include pain, swelling, and redness in the area of the arm where you receive the shot, and chills, tiredness, and headache throughout your body. They were common by seven days after the vaccine was given, and most were mild to moderate, though some severe effects were seen in a small group of people—and they were most common after the second dose.

In the company’s application for authorization filed on December 17, 2020, it reported that the immunization had a protection rate of 51% at two weeks after the first dose and 94% at two weeks after the second dose. Again, if you have a serious or immediate allergic reaction to the vaccine in the first dose, then you shouldn’t get the second shot. If you’re allergic to polyethylene glycol (PEG) and polysorbate, you shouldn’t have the vaccine, either. See info above about allergies in this type of vaccination.

Moderna is also the first vaccine to test the safety and effectiveness of their injection in children ages 6 months to less than 12 years old. The company announced the start of its "KidCOVE study" on March 16, 2021, in 6,750 children in the U.S. and Canada. Study participants will receive either a saline placebo or the vaccine in one of three doses in the phase 2/3 trial.

Johnson & Johnson’s Janssen’s COVID-19 Vaccine

This vaccine was developed by the U.S. multinational corporation’s Janssen Pharmaceuticals, a pharmaceutical company headquartered in Beerse, Belgium, that Johnson and Johnson (J&J) owns, in combination with Beth Israel Deaconess Medical Center in Boston.

It was approved for emergency use by the FDA in late February 2021 but on April 13, 2021, the CDC and FDA released a joint statement calling for a “pause” in the use of the vaccine “out of an abundance of caution” so officials could review six reported U.S. cases of a blood clot called cerebral venous sinus thrombosis (CVST), combined with low levels of blood platelets (thrombocytopenia), after receiving the shot. Key to note: Treatment for this particular blood clot isn’t typical, further complicating things. Per the CDC and FDA: “Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given.”

This blood clot, known as an “adverse event,” happened in women between 18 and 48 years of age, with symptoms occurring six to 13 days after they received the J&J vaccination. As of April 12, some 6.8 million doses of the J&J vax had been administered in the U.S. While only six cases out of this group are considered an “extremely rare” adverse event, the reactions were severe, and all such adverse vaccine events are taken seriously and investigated, officials say.

After review, on April 23 both agencies gave the green light for the J&J rollout to start up again, effective immediately, only with a warning to women 50 and under that they may be at higher risk for this very rare complication.

If you received the J & J shot and you’re concerned, what are the warning signs that something could be wrong? According to the CDC and FDA, contact your health care professional if you experience any of these symptoms after receiving the J&J vaccine:

  • severe headache

  • abdominal pain

  • leg pain

  • shortness of breath within three weeks after getting the vax

The “pause” came after vaccine sites in several states temporarily stopped administering the J&J vaccine in the spring 2021 due to the complication—and in Europe, officials at the European Medicines Agency (EMA) announced an investigation into post-vaccination blood clots with the vax there. But, again, this vaccine is no longer being "paused" and is now available to any American adult who wants it.

More info about the Johnson & Johnson vaccine:

  • This is a single-dose vaccine, so it’s injected into your arm once. That gives it a big advantage over all the other COVID-19 vaccines currently approved for emergency use in the U.S. (Pfizer-BioNTech's and Moderna’s) that each require two doses.

  • Another way it differentiates itself from the first two vaccines on the market in the U.S.? Technology. It is a viral vector vaccine (similar to the AstraZeneca/University of Oxford vax) with a modified adenovirus instead of mRNA. The type of viral vector used in this case is the adenovirus, a common virus that’s like a cold. This vaccine type, first developed in the 1970s, delivers key instructions to our cells with a modified type of a different virus, called the vector. Here’s how the CDC explains it: “For COVID-19 viral vector vaccines, the vector (not the virus that causes COVID-19, but a different, harmless virus) will enter a cell in our body and then use the cell’s machinery to produce a harmless piece of the virus that causes COVID-19. This piece is known as a spike protein and it is only found on the surface of the virus that causes COVID-19.” Our immune system then kicks in, knowing that this spike protein virus doesn’t belong in the body and must be attacked. It launches a defense with antibodies and other immune cells to stop what it thinks is an infection. This teaches our bodies to protect against any future encounter with the actual spike protein COVID-19 virus. Again, per the CDC: “The benefit is that we get this protection from a vaccine, without ever having to risk the serious consequences of getting sick with COVID-19.”

  • This makes it more shelf-stable than mRNA vaccines, and can stay in a normal refrigerator for up to three months.

  • It was studied in people 18 years and older.

So what should you expect once you have it?

Side effects usually happened on the day of immunization or the next day, typically resolving within 24 hours, and were mostly mild-to-moderate. They included fatigue, headache, muscle pain and muscle ache, and injection site pain. Just like with mRNA vaccine technology, a response is a good thing, because it usually means your body’s immune system is creating the antibodies you need to fight a COVID infection.

Results from the company’s Phase 3 ENSEMBLE study show that the vaccine was 85% effective in preventing severe disease across all regions studied, and showed protection against COVID-19 related hospitalization and death 28 days after vaccination. This study, conducted in eight countries across three continents, found that the 28 days post-vaccination, level of protection against moderate to severe COVID-19 infection was 72% in the U.S., 66% in Latin America, and 57% in South Africa.

What about allergic reactions to the vaccine?

You shouldn’t have this vaccine if you’ve had a severe allergic reaction to any of its ingredients (it does not include any preservatives): o 5x1010 virus particles of the Ad26 vector encoding the S glycoprotein of SARS-CoV-2.

  • 2.19 mg sodium chloride

  • 0.14 mg citric acid monohydrate

  • 2.02 mg trisodium citrate dihydrate

  • 0.16 mg polysorbate-80, 25.5 mg 2-hydroxypropyl-B-cyclodextrin, 2.04 mg ethanol

  • Each dose may also contain residual amounts of host cell proteins (≤0.15 mcg) and/or host cell DNA (≤3 ng)

What Other Vaccines Are Pending Right Now?

These vaccinations are currently in study (and could be released if/when they’re deemed safe in the U.S.):

AstraZeneca/University of Oxford’s COVID-19 Vaccine (a.k.a, Vaxzevria in Europe)

This vaccine candidate, as yet unapproved in the U.S., was approved in the UK in January, and is now distributed in countries around the world under its newly minted name in Europe, Vaxzevria. It was developed by the British–Swedish multinational pharmaceutical and biopharmaceutical company in partnership with the University of Oxford in Oxfordshire, UK. If/when it’s approved in the U.S. (officials say they plan to apply for FDA emergency-use authorization in April), the U.S. government plans to buy 300 million doses for distribution. But, again, that's only if the vaccine gains the official FDA nod.

Multiple European countries temporarily suspended use of the AstraZeneca shot in mid-March 2021 after reports of 37 cases of dangerous blot clots in the more than 17 million people who’ve received the vaccine in the European Union and UK. Later in the spring, the EMA’s safety committee found that “unusual blood clots with low blood platelets should be listed as very rare side effects of Vaxzevria.”

“EMA is reminding healthcare professionals and people receiving the vaccine to remain aware of the possibility of very rare cases of blood clots combined with low levels of blood platelets occurring within two weeks of vaccination. So far, most of the cases reported have occurred in women under 60 years of age within two weeks of vaccination. Based on the currently available evidence, specific risk factors have not been confirmed,” officials say. They recommend that those who’ve received the vaccine receive immediate medical assistance if they develop symptoms including:

  • shortness of breath

  • chest pain

  • swelling in the leg

  • persistent abdominal pain

  • neurological symptoms, such as severe and persistent headaches or blurred vision

  • tiny blood spots under the skin beyond the site of injection

Vaxzevria continues to stay in the news, with data released by the company in late March finding that it had an overall efficacy of 79% against symptomatic COVID, while completely preventing severe disease or hospitalization. However, the company was soon after accused by U.S. medical officials of manipulating data to make the vaccine look more effective. In response, makers of the AZ vax officially corrected its efficacy rates to 76% at preventing COVID-19. Dr. Fauci described the slightly shifting rates as “an unforced error” before reassuring the public that despite all the drama, “this is likely a very good vaccine.”

More about this vax:

  • The AstraZeneca/University of Oxford vaccine is viral vector technology (like the J & J vax).

  • In the UK, the AstraZeneca/University of Oxford vax was approved for use in people 18 years or older in two doses given within four to 12 weeks of each other. It’s injected into the muscle of the upper arm.

  • Side effects were reported as typically mild, and resolved after several days. Very common symptoms (meaning they may happen in more than one in 10 people) include: tenderness, pain, warmth, redness, itching, swelling, or bruising at the injection site; feeling unwell; fatigue; chills or feeling feverish; headache; nausea; and joint pain or muscle ache. Common symptoms (meaning they may affect up to one in 10 people) include: a lump at the injection site; fever; vomiting; and flu-like symptoms (including high temperature, sore throat, runny nose, cough, and chills). Uncommon symptoms (so these may happen in up to one in 100 people) include feeling dizzy; decreased appetite; abdominal pain; enlarged lymph nodes; excessive sweating, itchy skin, or a rash. Like we’ve said before, while side effects are never fun, they’re typically a good thing, showing that our immune system has responded to the vax and is working as it should.

  • You shouldn’t have the shot if you’re allergic to any of its contents, according to officials. The vaccine in the UK contains:

    • L-histidine

    • L-histidine hydrochloride monohydrate

    • Magnesium chloride hexahydrate

    • Polysorbate 80

    • Ethanol

    • Sucrose

    • Sodium chloride

    • Disodium edetate dihydrate

    • Water for injections

Novavax’s COVID-19 Vaccine

This American vaccine development company has been moving right along with its NVX-CoV2373 vaccine. With excellent results reported in the company’s large clinical trial in late spring 2021, officials announced they plan to seek regulatory authorizations in the third quarter (so likely July, 2021).

More about this vax:

  • The vaccine is made from a stabilized form of COVID-19’s spike protein with the company’s recombinant protein nanoparticle technology. It also includes Novavax’ patented saponin-based Matrix-M adjuvant, an addictive that works to boost the body’s immune response.

  • The vaccine is injected into a muscle in the arm. It’s given in two doses, with the second dose administered 21 days after the first. It’s currently being studied in people 18 years and older.

  • One small study found the second shot had more side effects than the first, with swelling and pain at the injection site both cited as common side effects.

  • It’s easier to distribute and store than the mRNA vaccines because it can keep up to three months in a normal refrigerator.

  • In June 2021, officials announced results from PREVENT-19 (the PRE-fusion protein subunit Vaccine Efficacy Novavax Trial | COVID-19), a phase III trial. It found the vax had 100% protection against moderate and severe disease and 90.4% efficacy overall in 29,960 participants across 119 sites in the U.S. and Mexico.

  • As more data becomes available, we’ll have more information on side effects and possible allergy concerns, plus who shouldn’t have the vaccine.

CoronaVac COVID-19 Vaccine

Developed by Chinese biopharmaceutical company Sinovac Biotech, this vax is approved for emergency use in Indonesia, Turkey, Brazil, Chile, Colombia, Uruguay, and Laos (final results from its phase 3 trials are not yet available) as well as for the general public in China as of February 6.

More on this vax:

  • It’s an inactivated, or dead, version of a coronavirus strain isolated from a patient in China, chemically prevented from replicating in our cells, yet still causing an immune response. It’s given in a two-dose regimen in a two-week interval.

  • The most common side effect was pain at the injection site.

  • This vax is currently in stage III clinical trials in Brazil, Turkey, and Indonesia. In Brazil, it’s been found to be 50.65% effective against COVID-19 disease (results are from its use in 12,396 medical workers older than 18 years as of December 16, 2020, with 253 cases recorded), but had a 91.25% success rate in Turkey, from preliminary analysis of 29 cases, and a 65.3% efficacy rate in the Indonesia trial. (Results in Brazil might have been lower than the other two countries because of its current epidemic case load there, and emphasis on medical workers.)

Sputnik V COVID-19 Vaccine

Currently being developed in Russia, preliminary data on this vaccine was released in early 2021—and in April 2021, India approved the vax for use there.

More on this vax:

  • It’s a viral vector vax based on two different viruses belonging to the adenovirus family, Ad26 and Ad5, modified to contain the gene for making the SARS-CoV-2 spike protein.

  • It’s being administered in people 18 and older.

  • Researchers published findings in The Lancet of 20,000 people that show the vaccine to be about 91% effective.

Should I still wear a mask and social distance after getting a vaccine?

The CDC released new guidelines in mid-May 2021 to help you navigate social situations once you’re fully vaccinated and have achieved a high level of immunity.

According to the agency, you can resume most of your normal activities, including shopping and dining indoors, without a mask once you're fully immune. That means waiting two weeks after your vaccination dosage is complete. (Remember, both the Pfizer-BioNTech and the Moderna shots require two doses given several weeks apart. So, you're not in the clear until two weeks after the second shot.)

However, if you have an underlying health condition that puts you at high risk for severe illness from COVID-19, you should discuss with your doctor if going maskless is safe for you, even if you are fully vaccinated.

More good news? You don’t have to wear masks outside, even in public settings, when you jog, go biking, or gather in small groups if you’re vaccinated.

Once vaxxed, you also don’t have to quarantine if you’ve come into contact with someone who has tested positive for COVID-19 unless you show symptoms, according to the CDC. (A caveat to that is if you live in a group setting, like a correction facility or group home).

CDC officials also relaxed recommendations on traveling once you’re fully vaccinated (considered two weeks after your second shot with a two-dose vaccine or two weeks after a single-shot vax), stating that within the U.S.:

  • Fully vaccinated travelers don’t need COVID testing before or after travel unless their destination requires it.

  • Fully vaccinated travelers do not need to self-quarantine.

The CDC still recommends that you wear a mask and stay six feet away from others in large crowds (which you should still try to avoid). And while it seems pretty clear that airborne transmission is the leading cause of infection, it’s still a good idea to wash your hands often and/or use hand sanitizer. Finally, masks are required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in places like airports and stations.

However, the government agency advises delaying travel until you’re fully vaccinated, because travel “increases your chance of getting and spreading COVID-19.”

As of mid-May 2021, 34.8% of all Americans are fully vaccinated; more than 58% of Americans over the age of 18 have at least one dose. And 71.5% of Americans who are 65 years and older are fully vaccinated. So, you can see how we’re edging closer every month to the goal of 70% to 85% of all Americans vaccinated to achieve herd immunity, which essentially returns us to a new normal.

What could that new normal look like? Possibly returning to the office and seeing family and friends in ways we haven’t in more than a year (happy hour, anyone?). Less reliance on Zoom for everything might be the way of the future, with a return to in-person performances, live concerts, and events. Crossing fingers!

When Can You Get the Vaccine?

Now. That is, if you’re 12 years of age or over in the U.S. The CDC, in partnership with other institutions, has a helpful VaccineFinder, which can assist you in finding vaccines by zip code.

But what about if you’re pregnant or breastfeeding? Is it safe to have either of the approved immunizations? According to the American College of Obstetricians and Gynecologists, both pregnant and lactating individuals who meet the criteria we’ve outlined here should be able to safely receive either vax.

What Are the New Strains of the Virus?

Even as news of vaccinations brought hope to the world in returning to a “new normal” beyond the pandemic, we learned that COVID-19 had mutated in late 2020/early 2021—which can happen with a virus, especially when there are lots of cases to act as a kind of breeding ground, if you will, for new mutations to form. (To quote a movie about dinosaurs: “Life finds a way.”)

To avoid stigmatizing any country where a variant might be discovered (and perhaps not originate), the WHO announced in late May, 2021, that COVID mutations would be renamed to letters from the Greek alphabet.

New COVID strains are appearing in different parts of the world, including in countries such as the UK (B.1.1.7) variant, now called Alpha; South Africa (B.1.351) mutation, or Beta; Brazil (B.1.1.28.1, or P.1) variant, now known as Gamma; and India (B.1.617) variant, called Delta. In the U.S., there are documented mutations in California (B.1.427/B.1.429CAL.20C), or the Epsilon mutation; Ohio (various strains); and New York City (B.1.526), or Iota. The Alpha variant is up to 70% more transmissible than past COVID strains in the community—and is now the dominant strain in the U.S. as of April 2021, according to the CDC, and the Delta strain is also quickly gaining a foothold here. More easily transmitted virus strains lead to more cases, more hospitalizations, and possibly more deaths. Unfortunately, all of these strains have been detected in the country.

Another concerning thing? Something called a double mutant coronavirus variant, which has features of the Epsilon variant as well as the Gamma and Beta variants; it was found in the San Francisco Bay area. We’re still learning more about this strain and its implications, so it’s too early to tell what impact such a thing might have.

One mutation is causing a lot of issues: the E484K spike mutation. It’s not a new variant but instead occurs in different emerging strains, including in variants from around the world. Dubbed an “escape mutation,” it helps the virus get past our immune defenses. It might prove to be a real foe against monoclonal antibody treatments and current vaccines, so companies are racing to test their formulations against this formidable mutation. The good news in vaccines? Both Pfizer-BioNTech and Moderna vaccines should protect against this mutation, the companies report, while trials for the Johnson & Johnson vax in Latin America showed it was slightly less effective there than in the U.S. and elsewhere in the world, but still worked.

On February 17, The New England Journal of Medicine reported that Pfizer-BioNTech’s vax protects people against the new strains, including the Beta variant. And, back in late January, Moderna announced its vax also worked against the UK and South Africa strains.

One additional good piece of news: The AstraZeneca/University of Oxford vax (not yet approved in the U.S.) was almost 75% effective in mild to moderate cases of the UK variant of COVID-19 in phase II and III trials, according to a preprint study in The Lancet.

However, one truly concerning piece of news? Pfizer-BioNTech’s vaccine may not be as effective as researchers initially thought against the Beta variant, according to an Israeli study of 400 people who tested positive for COVID-19 14 or more days after receiving one or two doses of the vaccine, as well as an additional 400 unvaccinated people who also tested positive. The Beta variant was found in 1% of all those studied, yet was eight times higher among those who received two doses of the vaccine vs. those unvaccinated (5.4% and 0.7%, respectively). Researchers cautioned that the study had a small sample size of people with the variant, was not yet peer-reviewed, and was not designed to detect overall vaccine effectiveness against any one variant. While Pfizer-BioNTech didn’t comment on the study to Reuters, the companies have been testing a third dose of their vax, as a booster against new variants, if necessary. The National Institutes of Health has launched a Phase 1/2 clinical trial looking at boosters in fully vaccinated adults as of June 2021.

Here are some additional details about some new strains:

Alpha Strain (B.1.1.7)

There is some speculation that this strain, at least, may also be more serious. In late January 2021, scientists from the UK’s New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) concluded there was a “realistic possibility” that this particular variant had become more deadly, though the group is not yet ready to confirm it.

Gamma Strain (B.1.1.28.1, or P.1)

This strain might’ve been the cause of a sharp resurgence of COVID cases in the Brazilian city of Manaus in December 2020, according to researchers. It had been estimated that 75% of the population there already had COVID, which should’ve meant people in the city had immunity and, therefore, protection against the infection, but that did not prove the case against this new strain. It has traveled around the world since.

Beta Strain (1.351)

According to several 2021 studies, this strain may be able to evade detection by antibodies in the immune system, causing issues with treatments and vaccines. In February 2021, South African government officials announced that the AstraZeneca vaccine would no longer be distributed in the country because preliminary data showed it offered only minimal protection against mild to moderate illness thanks to this variant. The country turned, instead, to the Johnson & Johnson vaccination, which provided better results against the country’s COVID variant. In addition, Moderna is developing a booster vaccine against the Beta strain with the intention of (potentially) giving it down the line after the first round of immunizations are completed.

Delta (B.1.617)

The delta variant, which was discovered in India during the country’s spring 2021 COVID-19 surge, has been dubbed a new double mutant variant (though it actually has far more mutations than just two, at 13 in total). It has features of the variants first identified in California, South Africa, and Brazil.

Epsilon Strain (CAL.20C)

A strain was identified in Southern California that MIGHT be contributing to their spike in cases in early 2021, according to results from Cedars-Sinai. Called Epsilon, researchers there are not yet sure if it’s more deadly. This strain is independent of the UK and South Africa variants but appears to be just as transmissible. The study’s authors estimate that this variant likely emerged early in the pandemic to now account for half of all COVID cases in the U.S., and suggest it continues to be closely monitored to study its characteristics. It appears to be more transmissible because of a mutation that allows it to bind more easily to human receptor cells. It now makes up more than 50% of cases in 44 counties in California.

Ohio Strains

On January 19, Ohio State University announced it had identified what it calls the Columbus strain, or COH.20G/501Y. Yet another Ohio strain, called COH.20G/677H, has been identified as a new variant that is unique from the Columbus strain, according to researchers at Cold Spring Harbor Laboratory. Both strains are thought to have been circulating since December 2020. No specifics are yet known about either variant, but their genetic makeup is similar to the UK and South Africa strains, meaning they may be extra contagious.

Iota Strain (B.1.526)

This strain, first detected in the city and beyond in November 2020, is a cause for concern because it has that “unique set of spike mutations” (yep, the previously mentioned, and worrisome, E484K spike mutation) causing so much havoc with strains around the world, according to a 2021 pre-print study. These might cause issues for current interventions, researchers say, but we don’t know how much trouble this variant might cause—yet. Taken all together, these mutated strains of the virus mean that, even as we learn more about vaccine efficacy against them in real time, we need to remain vigilant by wearing face masks, avoiding crowds, maintaining social distancing, and frequently washing our hands, all to help stop the spread.

How Long Is the Incubation Period of the Coronavirus?

The signs and symptoms of COVID-19 set in between two and 14 days after first exposure. It’s this wide range that makes the virus so tricky to contain: People can be walking around with the virus and not know it.

And it appears that this disease can still be spread before you have symptoms, or even if you never show symptoms. We’re not sure exactly how many people are what’s called asymptomatic, or don’t have symptoms, but the CDC reports that data suggests “asymptomatic infections can be common.” All of which circles back to the three important ways to lessen the impact of the virus: Social distancing by 6 feet, wearing a mask, and avoiding crowds.

If you do get COVID-19 symptoms, researchers found that the median incubation period—the time between when you’re exposed to the virus and when the first signs appear—is just over five days, and that a person is most infectious four to seven days after they catch COVID-19, per a study published in the Annals of Internal Medicine in May 2020. The researchers also reported that 97.5% of people who develop symptoms do so within 11.5 days of infection.

Symptoms often start mild and gradually, then increase in intensity. Research from China of 44,000 people showed the disease course was:

  • Mild to moderate (mild symptoms up to mild pneumonia): 81%

  • Severe (dyspnea, hypoxia, or more than 50% lung involvement on imaging): 14%

  • Critical (respiratory failure, shock, or multiorgan system dysfunction): 5%

Why Does COVID-19 Seriously Impact Older Adults?

It’s true: People who are 60 and older are at high risk for serious complications from COVID-19, based on data from Wuhan. In the U.S. alone, 68.7 million Americans are 60 and above.

Why is age likely an issue with COVID-19? As you get older, your immune system responds more slowly to infections, which can increase your chance of becoming sick. Your immune system has fewer immune cells at 60 and above, so you heal more slowly, too. In the U.S.? A staggering eight out of 10 deaths from COVID-19 have been in those 65 and older.

Still, this doesn’t mean younger people shouldn’t remain vigilant, or do all they can to prevent from being infected. Out of the nearly 410,000 deaths reported in the U.S. by mid-January 2021, nearly 63,000 people under the age of 65 were included in that grim tally.

Are Pregnant Women at Higher Risk From Coronavirus? What About Newborns?

Information about COVID-19 and pregnancy is evolving in real time. According to the latest findings published on the CDC website, when compared to those who aren’t pregnant, those who are expecting have an increased risk for severe illness from COVID-19 and death. If you’re pregnant, you also might be at an increased risk for adverse outcomes, including preterm birth (delivering your baby sooner than 37 weeks). Research is showing, too, that having gestational diabetes can worsen outcomes with COVID. This makes preventing COVID during pregnancy all the more important, CDC officials say, so make sure to follow all the recommended guidelines for staying safe from the virus if you are.

Based on the latest counts available, of the 20,798 women with COVID in the U.S., 44 have died, according to a report from the Pan American Health Organization in September 2020.

Newborns can get COVID. Just how, though, remains murky—the jury is out on transmission from mother to baby before, during, or after birth. For now, the likeliest transmission path is from a newborn’s exposure to respiratory droplets from a mother, other caregivers, visitors, or healthcare personnel with COVID-19, reports the CDC. Most newborns with the virus have had mild or no symptoms.

One thing to note: Breastfeeding does not seem to transmit COVID through breast milk. It’s recommended that if you have a newborn and COVID, if someone else can care for the child while you isolate and recover, that’s optimal (and you can wash your hands for 20 seconds, wear a mask, and hand express or pump breast milk, if you want to breastfeed)—but if you need to care for your newborn and you can while sick, be sure to wash your hands before touching the baby (or use hand sanitizer with at least 60% alcohol) and wear a mask when within 6 feet of the little one (you can also breastfeed your baby while doing this).

Just keep in mind that children younger than two should not wear a mask or face shield for safety reasons.

Is the Coronavirus Dangerous For Kids?

Many respiratory-based illnesses, such as the flu, are concerning for the oldest and youngest among us. While COVID-19 is a big worry for the elderly, it’s uncertain exactly how it affects toddlers, preschoolers, and school-age children. Researchers have found elevated levels of a biomarker related to blood vessel damage in children who had COVID, including those that had minimal or no symptoms, which they related in a study published December 8, 2020 in Blood Advances. They report that they’re not yet sure exactly what these results mean, but they merit more research to discover the short- and long-term side effects of this illness on children.

And about 12.5% of those with COVID in the U.S. are kids (for a total of 2.5 million), according to the American Academy of Pediatrics.

Researchers currently believe that while COVID-19 symptoms may be less serious among some kids (they account for about 1.2% to 2.8% of total reported hospitalizations, and between 0.2% to 2.8% of all child COVID-19 cases resulted in hospitalization), children may also experience the virus differently than the adult population, and be affected in ways we still are learning about.

The most troubling trend is the rise in cases of Multisystem Inflammatory Syndrome in Children, or MIS-C, with 1,659 cases reported in New York as of October 2020, including 26 deaths. MISC-C causes severe inflammation in the lungs and abdomen, with some children experiencing blood clotting and heart failure, too, according to a report in the journal Radiology. Symptoms vary and may take weeks—or potentially longer; no one yet knows—to show up. And while many of the hospitalized children tested negative for an active COVID-19 infection, they did test positive for antibodies. Fortunately, readily available corticosteroids can usually successfully treat most inflammatory symptoms of MIS-C.

The researchers in the December 2020 Blood Advances study also found a high proportion of children who had COVID met the clinical and diagnostic criteria for thrombotic microangiopathy (TMA), a rare, serious medical condition where the smallest blood vessels in our body’s organs, like the kidney and brain, are damaged.

Another concern: Reports of children experiencing long-term COVID symptoms, though there aren’t hard numbers yet for just how many children are (which is similar to adults). Some children’s hospitals are setting up long-term COVID clinics for young patients in the U.S., however, to help them recover.

It’s also possible that children can get the virus and become vectors, or transmitters of the disease, especially to people at high risk, including their grandparents and older relatives. Case in point: A large study from South Korea documents that while children under 10 tend to spread the disease at lower rates than adults, the same is not true for tweens and teens between 10 and 19, who transmit the virus at least as well as their parents, teachers, and other grownups do (even when the kids remain asymptomatic themselves). Another report in JAMA Pediatrics shares that while up to 40% of all those infected show no symptoms, asymptomatic children can shed virus, or potentially be contagious, for up to 21 days.

It’s important to note: As with adults, children who have underlying health conditions (we’ll talk more about this in the section below regarding adults) might be at increased risk, and the standard precautions against infection that adults take are also a child’s best protection.

How Does the Coronavirus Impact People With Medical Conditions?

In America, 60% of people wrestle with at least one chronic health condition—and six in 10 is no small group. Unfortunately, this puts you at higher risk of serious complications from the coronavirus. And according to the CDC, the more underlying medical conditions you’ve got, the greater your risk for severe illness from COVID-19.

Just what does severe illness mean, anyway? The CDC defines it as hospitalization, admission to the ICU, intubation, or mechanical ventilation, or… death (so clearly, not great). In one study based on Wuhan data, researchers found that people with COVID-19 who also had at least one additional medical condition—such as heart disease or diabetes—had a 79% greater chance of needing intensive care or a respirator (or both) to recover, or of dying. About one out of every five people who gets COVID-19 becomes seriously ill and might need to be hospitalized.

We know how scary this is. That’s why it’s so important to be informed and to practice preventative safety measures (which we’ll get into soon).

Cancer

If you have cancer, you’re at an increased risk for having severe illness with COVID. Again, as with so many things related to this virus, we’re learning more and new things every day. A study out of the UK published in The Lancet in August 2020 found that the type of cancer you have might impact how severe your experience with COVID is—they found worst cases in those with blood cancers, particularly leukemia (which comes with more than twice the risk of death from COVID). As of now, we’re not sure if having a history of cancer increases your risk.

Diabetes

Some 30.3 million Americans, or 9.4% of the population, have this condition. The American Diabetes Association is offering tools to keep yourself safe during this pandemic if you have diabetes. Which is important, in light of statistics. According to the Chinese Center for Disease Control, in Wuhan the fatality rate was 7.3% for people with diabetes, and the newest research points to severe illness in both types 1 and 2, the CDC reports. With diabetes, it’s tougher to fight any infection, and circulation issues can lead to organ issues, making it harder for you to heal when hit with something like this illness.

Cardiovascular Disease

The death rate for people in Wuhan with heart health issues and COVID-19: a staggering 10.5%. As we learn more about this virus and how it impacts the body, we’re finding that its inflammatory reaction can impact our blood vessels, causing blood clots, and heart damage (including heart attacks, even in young people). One study of 100 patients in Germany, published in JAMA Cardiology on July 27, 2020, found cardiac involvement in 78% of patients and ongoing myocardial inflammation in 60% of patients—and that didn’t even factor in the severity of the illness or co-existing conditions. Having high blood pressure (known as hypertension) might also raise your risk for severe COVID. An estimated 103 million Americans have high blood pressure, according to the American Heart Association (AHA), which is providing precautions for heart disease patients and others. Here are a few of the cardiovascular disease types that might be impacted, courtesy of the CDC:

  • Heart failure

  • Coronary artery disease

  • Cardiomyopathies

  • Pulmonary hypertension

Chronic Respiratory Diseases

A stat on just one of these: The fatality rate for people with chronic obstructive pulmonary disease (COPD) in Wuhan was 6%. Having moderate to severe asthma puts you in another at-risk population, because lung capacity is already compromised. If you have moderate to severe asthma, call your doctor and discuss whether you need an extra inhaler on hand in case you end up with COVID-19. Other chronic lung conditions that might increase your risk for severe disease include:

  • Cystic fibrosis

  • Pulmonary fibrosis

  • Other chronic lung diseases

Chronic Autoimmune Illnesses

Those that involve the lungs can run the risk of more serious cases of COVID-19. These include:

  • Scleroderma

  • Interstitial lung disease

  • Lupus

  • Pulmonary hypertension

Medically Weakened Immune Systems

Are you a cancer patient on immunosuppressive drugs, like some forms of chemotherapy? Or taking a biologic medication for Crohn’s disease or rheumatoid arthritis? You’re also at higher risk for COVID-19.

Others Who Are Immunocompromised

According to the CDC, this could include people: who’ve had bone marrow or organ transplantations; who have immune deficiencies or poorly controlled HIV or AIDS; who are on kidney dialysis (chronic kidney disease at any stage is believed to potentially heighten your risk for severe COVID); or who have prolonged use of corticosteroids or other immune-weakening medications. (Talk to your doctor if you’re concerned about your condition and medication.)

People Who Smoke or Vape

Smoking—whether it’s tobacco, marijuana, e-cigarettes, or vaping—can damage your lung’s natural defenses, making them more susceptible to respiratory illnesses like COVID-19, according to the Mayo Clinic. Long-term smoking compromises lung function and can cause lung disease.

So much is still unknown about COVID-19 and the risks of underlying medical issues, so we’re not sure if this applies just to current smokers or past smokers too, but the good news is that your lungs begin to heal as fast as a month after you stop smoking. Now is the time to pursue smoking cessation programs to help your lungs start that process.

People Who Are Overweight, Obese, or Severely Obese

The CDC’s at-risk guidelines include people of any age with severe obesity, or a body mass index of 40 or greater. More concerning, the CDC says that severe obesity is linked to severe COVID. Why? According to a small study published in Nature Reviews Endocrinology, it may have to do with respiratory dysfunction. Because obese people are more likely to have weaker respiratory muscles, lower lung volumes, and more airway resistance, it’s harder for them to fight off the respiratory distress brought on by COVID, which ups their chances of developing pneumonia.

Obese people are at additional risk if they have diabetes, renal failure, or liver disease, especially if uncontrolled. Even if you aren’t in a high-risk group for the virus, it’s still better not to have it. Clinicians conducted a 15-year prospective cohort study examining patients who had the first SARS virus, finding long-term bone and lung issues, which could very well be an issue with COVID-19, too. Preliminary data from Wuhan and Hong Kong appears to show potential long-term effects of the disease, too, with diminished lung capacity for some COVID-19 patients.

Polycystic Ovary Syndrome (PCOS)

Some experts are calling for this women’s health issue to be considered a risk factor for COVID. One study found that those with PCOS had a 51% higher chance of confirmed or suspected COVID-19 infection than those without.

Liver Disease

Speaking of liver disease, if you have chronic liver disease alone, like alcohol-related liver disease or nonalcoholic fatty liver disease, you might be at increased risk of severe COVID. Cirrhosis, which scarring of the liver, might put you at particular risk.

Genetic, Hemoglobin, and Cognitive Disorders

According to the CDC, a range of disorders may increase your risk for severe outcomes from COVID-19. They include:

  • Down syndrome. The CDC added this genetic chromosome disorder to the list of high-risk conditions in late 2020. There could be a multitude of reasons for severe COVID in those with the disorder, but outcomes are bleak regardless: Research looking at a cohort of 8 million people (4,043 of whom had Down syndrome) out of the UK, published on October 21, 2020, found that adults with Down syndrome were at nearly five times the risk to be hospitalization with COVID and 10 times the risk for related death.

  • Sickle cell disease (SCD). This new addition to the list puts you at potential risk for severe illness from COVID-19, according to the CDC. Other hemoglobin disorders, like thalassemia, potentially raise your risk for bad outcomes, as well.

  • Dementia. If you have dementia from Alzheimer’s disease or other dementia-related disorders, you could be at higher risk for infection and more severe COVID outcomes, the CDC says.

Are There Other People at High Risk for COVID-19?

Beyond age or pre-existing medical conditions, there are three additional things, per the CDC, that can elevate your risk of exposure:

  • Community spread: This means if you live in or just visited a place where lots of people have tested positive for the illness.

  • Being a healthcare worker: Medical professionals put themselves in harm’s way during infectious epidemics to care for the sick—it’s no different with COVID-19. This includes doctors, nurses, and anyone else working in hospitals, ERs, nursing homes, long-term care facilities, clinics, and other places with coronavirus patients.

  • Close contact: In other words, people who are taking care of someone or live in the same house as someone who’s tested positive for COVID-19.

What Should I Do if I Have the Coronavirus? (Or Suspect I Do?)

Say you have symptoms of COVID or know you’ve been around someone who does have COVID recently. What do you do next? These three steps can help.

  1. Calm yourself (as much as you can). As we’ve mentioned, about 80% of cases turn out just fine, without special treatment needed. And in those 20% of cases that are more serious, you can get better.

  2. Don’t rush out. Before you speed off to your doctor’s office or the local emergency room, stop. If you do have COVID, you could transmit it to others. We know this might be tough when you’re scared and feeling badly, but consider your own health, too: You don’t want to expose yourself to other illness if you’re already sick with something.

  3. Call your healthcare professional, aasking your doctor’s office, urgent care clinic, or emergency room what you should do in light of your symptoms and possible recent exposure to someone who had it. Another place you might be directed to: your local health department; they’re helping with testing. The National Association of County and City Health Officials has a handy directory of local health departments, by state, that can lead you to the right person to speak to about finding out if your symptoms are COVID-19 or the flu or a cold.

How Do You Get Tested and Diagnosed With COVID-19?

Testing got off to a bumpy start in the U.S., when the CDC had an initial issue with their test kits, and continues to be a tough thing to access in many areas of the country. Early on, it took time to roll out more tests across the U.S., and there have been delays across the country as healthcare professionals haven’t received tests or haven’t received enough tests. There are also delays in receiving test results because of a backlog of cases being processed in overwhelmed labs.

Depending on where you live, the severity of your symptoms, and your background (age, high-risk group, etc.), at this point you may not even be given a test. This is evolving as more tests are becoming available in the U.S., helped by research and testing capabilities from universities and private companies. Check out HealthCentral’s piece about COVID-19 hotline numbers state-by-state.

How Does Coronavirus Testing Work?

There are two kinds of tests for COVID: a viral/diagnostic test (tests for current infection) or antibody test (tests for past infection).

Of the viral tests for diagnosis, there are also two types, according to the National Institutes of Health:

An antigen test (or “rapid test”): This gives us results in about 15 minutes. But… while it’s fast, it’s also more likely to give you a false negative result. If you have COVID symptoms but a negative antigen test result, you might need this test…

Molecular test: Also called a PCR (which stands for polymerase chain reaction) test, it’s considered the “gold standard,” or the most accurate one available, because it’s the most reliable and accurate. This one can take up to a week to provide results.

If you get a viral diagnostic test outside of the hospital, you’ll likely receive a nasal swab (called a nasopharyngeal swab by the pros). For this one, the tester takes a sample from your nose using a special swab. You might’ve had this done for the flu. It can be unpleasant because it feels like the wire-like swab goes deep into your nose.

If you end up at the hospital without having been tested first, healthcare professionals might use a different method of testing. They’ll decide which test is best based on your abilities (if you’re unconscious, for instance, any test that requires your assistance, like coughing into a cup, isn’t possible) and their preferences. The testing options include:

  • Nasal aspirate. Your health care provider injects a saline solution into your nose. Then, they remove the sample with gentle suction. This might feel a little funny as it happens.

  • Tracheal aspirate. This one features a thin, lighted tube (called a bronchoscope) that’s put down your mouth and into your lungs for a sample to be collected there. There could be some discomfort with this test.

  • Sputum test. You cough into a cup for this test, releasing sputum, a thick mucus coughed up from your lungs. Easy enough, right? Or they might use a special swab to take a sample of mucus from your nose if you can’t cough anything up.

  • Blood. Known as a rapid serum antibody testing for IgM and IgG, this is done using a finger prick and results take about 10 min.

If you suspect you have COVID-19 and can find a surgical mask, it is advisable to wear one to see your doctor. (More on mask-wearing tips, below.)

Who Gets Tested for COVID-19?

Here are the CDC’s current guidelines for when you need to get tested for the virus:

  • If you have symptoms of COVID-19 (see list above).

  • If you are not fully vaccinated (meaning, fully immune) and you've have had close contact (within six feet for a total of 15 minutes or more over a 24-hour period) with someone with confirmed COVID-19. Please note: If you're fully vaccinated and show no COVID-19 symptoms, you don’t need a test following exposure to someone with COVID-19. If you've tested positive for COVID-19 within the past three months and recovered, you won't need a test, either, after exposure, as long as you don't develop new symptoms.

  • If you've done activities that place you at higher risk for COVID-19 because you couldn’t physically distance to avoid exposure, including: travel, attending large social or mass gatherings, or being in crowded or poorly-ventilated indoor settings.

  • If you've been asked or referred to get tested by your healthcare provider, or state, tribal, local, or territorial health department.

How Long Do I Need to Isolate?

So, you’ve tested positive for COVID-19. Hopefully your disease remains mild and doesn’t require any expert intervention. Here’s what to do now to protect other people: If you had no symptoms, mild symptoms, or moderate symptoms with COVID, isolate for:

  • At least 10 days since you first had symptoms and

  • At least 24 hours with no fever without fever-reducing medication and

  • Other symptoms of COVID-19 are improving (keep in mind that loss of taste and smell might linger for weeks or even months with long-term COVID and don’t need to dictate your isolation ending).

If you have severe symptoms (like, you were admitted to a hospital and needed oxygen), then isolate for possibly up to 20 days after you first got sick—talk to your healthcare professional about next steps.

Early in the pandemic, doctors required a test-based strategy to discharge a COVID-19 patient from the hospital–if you tested negative twice within a 24-hour period, you’d be free to leave. Over the summer 2020, guidelines had been updated based on research that shows a person is most contagious early on in their COVID-19 illness progression.

You should still quarantine for 14 days after an exposure to someone who has COVID-19. If you never develop symptoms nor test positive 10 days later, however, you’re in the clear (also, after day 7 from receiving a negative test result, with the test happening on day 5 or later, you can stop quarantine). Just keep watch for up to 14 days for symptoms.

What’s the Treatment for the New Coronavirus?

Thus far, there is only one drug approved (through emergency use authorization) for treating COVID-19 requiring hospitalization: Veklury (remdesivir). But there is no specific treatment for COVID-19 if your case is less severe. Nor is there a treatment specifically just for COVID-19 (Remdesivir predates the virus and was designed to treat other viral infections). And Remdesivir’s main benefit in COVID-19 seems to be in shortening hospital stays. The FDA has recommended using baricitinib (BIIa) or tocilizumab (BIIa), combined with dexamethasone alone, or dexamethasone plus remdesivir, for the treatment of COVID-19 for certain hospitalized patients because of scientific evidence supporting its use.

We can’t use existing antibiotics to treat the virus itself, because they’re for bacterial infections—there’s nothing in a virus that an antibiotic can target and attack. What’s needed is an antiviral. But currently there’s no antiviral specifically for this new disease.

Along with creating and rolling out effective vaccines (more on those in a moment), a solid, effective treatment could help. WHO officials launched the SOLIDARITY trial on March 23, 2020, a worldwide study aiming to uncover the best treatment, fast, for COVID-19.

Researchers and healthcare professionals in the field first investigated hydroxychloroquine sulfate, which was quickly determined to potentially cause serious side effects without providing promising results, as well as chloroquine phosphate, another medication originally developed to treat malaria but now commonly used to treat lupus. So far, it hasn’t shown much efficacy, either.

Other therapies include two HIV drugs (Ritonavir and lopinavir, currently not showing any benefit), and the use of convalescent plasma from COVID-19 patients who have recovered (which has been shown in various studies to quicken recovery among the seriously ill and decrease mortality rates).

In June 2020, UK researchers announced the welcome results of a major clinical trial: Dexamethasone, a cheap, widely available corticosteroid, significantly reduced mortality among severely ill people with COVID-19 by an astonishing one-third in patients who were already on ventilators, and by one-fifth among patients who’d been given supplemental oxygen. However, for those who were not sick enough to require respiratory support, no benefit (and even some harm) from the drug was reported. It appears timing this treatment to the right stage of the disease may be key.

And, as we learned in early October 2020 when President Donald Trump tested positive for COVID-19 and was treated at Walter Reed National Military Medical Center, experimental new therapies are in the works. This includes monoclonal antibodies, which are synthetic versions of the antibodies our immune systems use to ward off disease. (This treatment is not yet available to the public.)

So, What Happens if You’ve Got COVID-19 Now?

If your symptoms have just cropped up and are mild at the start and continue that way, here’s what you should do:

  • Let your doctor know what’s happening, and speak to her by phone regularly, especially if your symptoms worsen, you are concerned, or you’re at high risk for negative outcomes with COVID-19.

  • Isolate yourself from others for 10 days after symptom onset, as long as your disease remains mild to moderate. If your symptoms become more severe, needing hospitalization, the CDC advises a possible 20-day isolation period to ensure you do not infect others (talk to your doctor when you can about how long you might need to isolate).

  • Drink plenty of fluids to help your body maintain its overall health.

  • Rest. Rest. Rest. Did we mention you should rest?

  • Take over-the-counter pain meds, like acetaminophen (Tylenol) to combat the fever, joint pain, and headaches. There’s been controversy over the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), after French doctors observed worsening conditions in patients taking them with COVID-19. This is still anecdotal, meaning it hasn’t yet been investigated fully in a study, and WHO officials have said that it’s not yet clear if NSAIDs pose a substantial risk to all COVID-19 patients. To be safe, Tylenol might be preferable for now.

  • Eat anti-inflammatory foods, like frozen fruits, vegetables, green leafy things; and take your normal medicine and multivitamin. You need to keep your body as robust as possible to fight this virus, and research has shown that a healthy diet can have a positive effect on overall well-being.

  • Practice self-care. If you’re strong enough, meditate: It’s been shown to have many health benefits, including reduced blood pressure and decreased oxygen utilization. Many apps, including Calm and Headspace (which is offering some of its services free to people, including teachers and healthcare professionals), can help you with this.

  • Don’t drink alcohol. It can tamp down your body’s ability to fight infection.

You’ll likely do these things at home to help prevent overcrowding of hospitals if your case is mild or moderate. For many people, the symptoms eventually subside, and you get better without treatment. It can take time—up to two to three weeks (and, for some, longer) to feel better.

When Should You Seek More Medical Help? And How Should You Do So?

Contact your healthcare provider or emergency room immediately if you have severe symptoms:

  • Persistent pain

  • Pressure in the chest

  • New confusion or an inability to arouse

  • Bluish lips or face

  • A blood-oxygen reading (from a pulse oximeter) of 92% or below

This sounds morbid, but it’s need-to-know: In Wuhan, those who ended up dying of the coronavirus had severe trouble breathing. If you start to show symptoms of pneumonia—which include worsening cough, increased trouble breathing, and high fever (103 to 104 degrees and above)—call 911 and tell them that you have, or are being evaluated for, COVID-19.

However—and this is important—many ER docs across the U.S. have reported examining a high number of seriously ill COVID-19 patients who they describe as being “happy hypoxics,” meaning those admitted were not complaining of severe shortness of breath, dizziness, or confusion, even when their blood-oxygen levels were dangerously—sometimes, even life-threateningly—low. So, if you are sick at home with this virus, be sure to regularly check your own blood-oxygen levels with a pulse oximeter, which you can purchase online or from any drugstore. A normal reading is 94% to 100%. A reading of 85% is dangerously low so don’t wait—get to the ER. Anything under the 92% range is worth a call to your doctor. (But take a few consecutive readings first to make sure you’ve got an accurate reading.)

Be sure to put on a facemask before emergency medical services arrive to help reduce the risk of spreading the disease, as much as you can, for the emergency responders. At the hospital, you could be given oxygen or put on a ventilator depending on how intense your case is.

How Can I Prevent Getting COVID-19?

We’re not sure yet if having the virus once prevents you from getting it again: Experts say that past experience with coronaviruses suggests you’d develop an immunity to it, but that’s preliminary thinking that requires more research. First off, if you’re not vaccinated, always practice social distancing! Quarantining Wuhan, China, brought the number of cases down, so this strategy—staying home and in physical contact with as few people as possible—does help flatten the curve.

Then follow these tips for coronavirus prevention:

  • Wear a face mask whenever you are within six feet of others (outside of your quarantined household) and cannot maintain social distancing. As we’ve mentioned, if you’re fully vaccinated, you can skip the mask indoors with other fully vaccinated folks, per the CDC, and refrain from wearing one outside while you jog, bike, dine outdoors, or gather in small groups.

  • Avoid gathering in groups, large or small, indoors if you’re not yet vaxxed, especially in poorly ventilated spaces. Everyone should avoid gathering in large groups, indoors and outdoors.

  • Wash your hands—often!

  • Use hand sanitizer, with at least 60% alcohol, when you don’t have access to soap and water.

  • Avoid touching your face, especially your eyes, nose, and mouth.

Do Masks Actually Help Prevent the Spread of COVID-19?

They did (and do!) for anyone not yet fully vaccinated—meaning, two weeks after the second dose of two-dose vaccines, and two weeks after a single-dose vaccine—but on May 13, 2021, the CDC announced that if you are fully vaccinated, you can return to your normal, pre-pandemic activities, just with caveats. So, read the fine print: “Fully vaccinated people can resume activities without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.” We’ve added the emphasis here so you don’t miss this important part amid all the loud cheering.

Another key restriction from the CDC on going maskless once you’re fully vaccinated? If you have a medical condition or a weakened immune system from medications or other reasons, you should speak to your doctor about whether or not wearing a mask is best for you. “Even after vaccination, you may need to continue taking all precautions,” CDC officials advise for this group.

In addition, children under 11, who are not yet eligible for vaccinations, should keep their masks on in high-risk situations, including indoors in crowded situations. If vaccinated parents want to keep their masks on to model wearing them for their kids, that’s OK too, AAP officials say.

If you have COVID symptoms and are getting tested, it might be best to put a mask back on to protect others until you’re cleared.

And, when traveling on public transportation like buses, trains, and planes, or when visiting many other countries, mask mandates are still firmly in place. So keep a mask in your bag or back pocket, just in case.

Plus, if we’ve learned anything this past year, it’s how quickly things can change, especially with so many unknowns about COVID-19 variants, so while the current data look good for the efficacy of all approved vaccines, and coronavirus cases are dropping in the U.S., there is always the possibility the CDC could once again change or update these new guidelines. (Which means you should regularly check this page.)

Finally, if you’re still an unvaccinated adult—this includes the roughly third of the country who remain “vaccine hesitant”—wearing a face mask is still the best way to protect yourself and others. Doing so reduces the spread of the virus by helping block infected aerosolized droplets from both being expelled and being inhaled, especially among people who have COVID-19 and may not know it yet. How? Surgical masks and cloth face coverings help keep in check droplets from when you and others sneeze, cough, sing, shout, talk, or simply exhale, but may not offer much protection if you’re exposed to smaller droplets, which can make their way through more porous mask materials, or get into the loosened sides of any poorly fitting mask.

Last note: If you’re still wearing a mask with a plastic valve (the kind often seen on construction sites), chuck it. This type of mask is not ideal in the fight against COVID-19. While they do filter the air you’re inhaling, they don’t filter the air you’re breathing out. And the main reason we all wear masks is to protect other folks from our own exhaled respiratory droplets. The CDC even states that masks with valves should “not be used where a sterile field must be maintained” (such as an operating room) because of risk of air contamination. You’re better off skipping this type of mask and opting for a homemade cloth face covering, or simply use disposable surgical masks, which are now much easier to find for purchase online.

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What Are the Differences Between COVID-19 and the Flu?

It’s mind-boggling trying to self-diagnose when COVID-19’s symptoms are so similar to the flu, a cold, or even seasonal allergies. But we can’t stress enough, COVID-19 is not the flu. For these reasons:

  • More rapid spread: COVID-19 has been spreading more widely than the flu. How rapidly a disease spreads, or is transmitted, is measured with something called a reproductive number, called Ro (pronounced R-nought or r-zero). The Ro is how many people one infected person will transmit the disease to. For COVID-19? It appears to be between 1.4 and 2.5 people per person, according to the WHO. For the flu? It’s 1.3 people for every one person.

  • No immunity to stop it: The flu has been around for years—the first influenza pandemic was in 1580—and while flu strains mutate (which changes the flu’s viral structure, thus leaving more people at risk of catching it), COVID-19 is a brand-new virus. We are what’s called a virgin population to it, meaning we have no herd immunity (when enough people have an illness or receive a vaccine against it, they develop antibodies to it so they don’t all catch and spread it at once). Globally, everyone on earth could get COVID-19, all 7.5 billion of us—which isn’t true of the flu, because if you’ve had some strains of the flu, even years ago, you have antibodies/immunity to it—even if you’re exposed to it again, you won’t likely catch it.

  • Mortality rates are higher: You might hear people say, well, more people die from the flu than COVID-19. With more than 400,000 Americans dead in just 10 months (with social distancing and frequent lockdowns in place), that does not appear to be true. Remember, the flu season typically begins in October or November and ends in May each year in the U.S. Meanwhile, right now, it’s estimated that about 1% to 3.4% of people with COVID-19 are dying, and we don’t know when this pandemic will ease. The mortality rate for the regular seasonal flu is less than 1%.

The flu is actually the main point of reference for comparing one serious virus to another. In particular, the 1918 influenza, one of the deadliest pandemics in modern history. Caused by the H1NI flu virus, that disease struck an estimated 500 million people across the globe, killing an estimated 50 to 100 million people (675,000 of those were Americans) in a matter of months.

The differences between the 1918 influenza outbreak and COVID-19 are significant. Back in 1918, health authorities had no idea what was happening beyond that it was a bad flu—it wasn’t until 1933, 15 years later, that scientists even knew a virus caused the human wreckage.

With COVID-19, scientists in China had identified the sickness sweeping Wuhan as a coronavirus, sequenced its genome to better help find an effective treatment, and pinpointed bats as the likely animal hosts, within two weeks of the virus first appearing. To read more about how COVID-19 compares to other pandemics—such as Ebola, bird flu, and SARS—check out our story.

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Erin L. Boyle
Meet Our Writer
Erin L. Boyle

Erin L. Boyle, the senior editor at HealthCentral from 2016-2018, is an award-winning freelance medical writer and editor with more than 15 years’ experience. She’s traveled the world for a decade to bring the latest in medical research to doctors. Health writing is also personal for her: she has several autoimmune diseases and migraines with aura, which she writes about for HealthCentral. Learn more about her at erinlynnboyle.com. Follow her on Twitter @ErinLBoyle.