What are the symptoms?
Fever, dry cough and difficulty breathing are hallmarks of coronavirus.

Symptoms may appear anywhere from two days to two weeks after exposure, the CDC says, though some patients haven’t shown symptoms at all.

The illness varies in its severity, and many patients can recover at home in isolation.


How does it spread?
It primarily spreads between people through respiratory droplets — think coughs, sneezes and spittle.

You can also get coronavirus by touching infected surfaces, then touching your mouth, eyes or nose.

How long does coronavirus stay “alive” on surfaces?
Up to three days, depending on the surface. According to a study funded by the US National Institutes of Health:

The new coronavirus is viable up to 72 hours after being placed on stainless steel and plastic.
It was viable up to four hours after being placed on copper, and up to 24 hours after being put on cardboard.
In aerosols, it remained viable for three hours. (CNN Health)
Why is the disease called COVID-19?
On Feb.11, the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan China. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV”. (CDC)

Is there a cure? Why is it taking so long?
There’s currently no cure for the novel coronavirus. And while research is underway, it could be more than a year before a vaccine becomes available.

An antiviral drug must be able to target the specific part of a virus’ life cycle that is necessary for it to reproduce, according to Harvard Medical School.

“In addition, an antiviral drug must be able to kill a virus without killing the human cell it occupies. And viruses are highly adaptive.” (CNN Health)

Once you have coronavirus, will you have it forever?
The American College of Physicians found it takes five to 12 days for symptoms to show. They said more than 97% of people will show symptoms within 12 days. This fits the CDC recommended 14-day quarantine to show symptoms and then take time to recover from illness. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

Can we kill it by inhaling boiling water steam?
Like in India they use this during flu and cold or cough.
The WHO says this will not work to kill a virus that’s already entered your body.

Myth-busting: Which of these DIY home remedies for coronavirus are actually effective? (Haley Hernandez, KPRC Channel 2 Health Reporter)

Can you have coronavirus without upper respiratory symptoms?
“Every human has a unique biology that will react to the virus in its own unique way,” wrote Nriagu. “So, Yes, you can have COVID-19 without classic upper respiratory symptoms. Symptoms associated with COVID-19 are generally ‘flu-like,’ which encompasses a broad range of symptoms including fever, headache, muscle aches, cough, runny nose, and fatigue.” (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

HEALTH QUESTIONS
How do you know someone is recovering from coronavirus?
According to Harris County Public Health, the patient has to be free and clear of any symptoms. Then, the patient has to have a negative test result for the virus and then be tested again in 24 hours. After the patient tests negative both times, they are considered recovered. (Haley Hernandez, Health Reporter)

I have a mammogram, sleep study, dental visit, etc. should I reschedule?
The Centers for Disease Control and Prevention encourages the people in our community most vulnerable to coronavirus to stay home as much as possible, avoid crowds and reschedule nonessential doctor appointments. The vulnerable population includes people 60 and older, people who have weakened immune systems and people with underlying health conditions such as heart disease, lung disease or diabetes.

For them, the CDC said appointments like general physicals, check-ups, follow-ups for a stable condition or an elective procedure can be rescheduled, or make the appointment virtual instead, meaning they encourage calling a telemedicine doctor from home.

As for dental visits, check out this report. (Haley Hernandez, Health Reporter)

Will ibuprofen worsen the virus?
There was a lot of concern after the French Minister of Health tweeted to avoid anti-inflammatories because they might worsen an infection. However, the World Health Organization told NBC News they are not aware of data that’s true.

If you are concerned, experts say you can take acetaminophen to control a fever, one of the main symptoms of the virus. (Haley Hernandez, Health Reporter)

Is coronavirus especially harmful to pregnant women?
Long story short: There’s not enough data yet, considering this coronavirus just emerged in humans a few months ago.

The vulnerability of “older adults” has been well documented, but researchers “do not have information from published scientific reports about susceptibility of pregnant women” to this coronavirus, the CDC says.

“Adverse infant outcomes” like premature births have been reported among infants born to mothers who’ve tested positive for coronavirus during pregnancy, the CDC says. But it’s not clear if these outcomes were related to maternal infection, so the risk is unknown. (CNN Health)

What are the hospital CEO’s doing to provide beds ... will they be ready if there is a spike of coronavirus patients?
That’s exactly why these drastic measures are being taken. When you hear “flatten the curve,” it is because leaders need to bring down the number of potential coronavirus cases (below the curve) to a number that hospitals can handle. This entire “hype” is because of hospital beds. We see this happening in other countries and it’s the reason China has a high number of deaths. There were not enough hospital beds and there may not be enough in America either. Click here to learn more about flattening the curve. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

If I visited an emergency room in the past couple of weeks, how would I know if I’m at risk?
Rest assured that over the last few weeks, most hospitals have been working to monitor and isolate patients and visitors with travel-related risk factors or potential contact with infected people.

If you develop symptoms consistent with COVID-19 and visited an ER within the last two weeks, contact your local medical provider for guidance.

Does donated blood get infected by the coronavirus?
At least 4.5 million Americans need donated blood every year, but this is the first time novel coronavirus has been a concern in the nation’s blood supply.

“Individuals are not at risk of contracting COVID-19 through the blood donation process or via a blood transfusion since respiratory viruses are generally not known to be transmitted by donation or transfusion,” said the AABB, formerly the American Association of Blood Banks. (CNN Health)

What if you do have some of the symptoms?
Like a cough and sore throat? No fever. No runny nose. Do you go to a doctor? Call the health department?
No, do not go to the doctor. You are considered low risk. Low to moderate risk patients are not being tested for Covid-19 at this time. Self quarantine is recommended until tests become available, but contact your local primary care provider for guidance. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

I am wondering why the CDC isn’t testing more for the coronavirus?
The tests, labs and equipment necessary to run tests for COVID-19 are limited. Production is ramping up, though. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

Food for thought

Thank you very much! This is really helpful
I hope they find the cure soon

Could we all be silent carriers at this point?
Clinical research supports the idea of “sub-clinical” carriers ... patients with mild disease. But silent carriers have not been identified. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

How do we know if we need to be tested for COVID-19? It is flu and allergy season right now.
If you have symptoms consistent with COVID-19 (runny nose, sore throat, cough, fever, shortness of breath) and have been in contact with an individual with a known case of COVID-19 then you should assume that you have COVID-19, self-isolate and contact your local (health) provider for guidance. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

If I get a pneumonia vaccine, will that help protect me from coronavirus?
Some cases of coronavirus do lead to pneumonia. But the pneumonia vaccine won't help.

“Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B (Hib) vaccine, only help protect people from these specific bacterial infections,” according to Harvard Medical School. “They do not protect against any coronavirus pneumonia.” (CNN Health)

Can I have the flu and coronavirus at the same time? If I test positive for the flu, does that mean I don’t have coronavirus?
Lots of readers are asking this since it’s difficult to get coronavirus testing in many areas.

But there’s no reason why you can’t have both the flu and coronavirus. So a positive test for the flu doesn’t mean you can’t have coronavirus as well. (CNN Health)

If a person gets well after having COVID-19, could their blood be used to make a vaccine since they have antibodies now?
Currently, there are no vaccines or drugs available to treat COVID-19. There are many in rapid development and some may be available in a short time. Human convalescent serum is an option for the prevention and treatment of COVID-19 and that could be rapidly available when there are sufficient numbers of people who have recovered and can donate immunoglobulin-containing serum. (Vivian Nrigu, MD, Partner/Owner Memorial Village Emergency Room)

Can the flu vaccine be helpful for one’s immune system with the coronavirus?
The flu vaccine is designed to prevent infections with the influenza virus which are very different from the coronaviruses. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

If you go to a Quest lab for a blood test for other reasons do you run the risk of being at the lab with someone being tested for COVID-19?
Quests in-office phlebotomists do not collect respiratory specimens, including those from patients suspected of having COVID-19. Patients’ samples can only be collected by a healthcare provider. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

I’m pregnant and worried. Can COVID-19 be passed from a pregnant mother to a newborn?
The Centers for Disease Control and Prevention is working to find answers about this. Here is what they say about it: We still do not know if a pregnant woman with COVID-19 can pass the virus that causes COVID-19 to her fetus or baby during pregnancy or delivery. No infants born to mothers with COVID-19 have tested positive for the COVID-19 virus. In these cases, which are a small number, the virus was not found in samples of amniotic fluid or breastmilk. (Haley Hernandez, Health Reporter)

Can pets carry the virus on their skin and fur?
At this time, there is no evidence that the virus that causes COVID-19 can spread to people from the skin or fur of pets. Talk to your veterinarian about the best ways to care for your pet. There is no reason at this time to think that any animals, including pets, in the United States might be a source of infection with this new coronavirus that causes COVID-19. The CDC has not received any reports of pets or other animals becoming sick with COVID-19 in the United States. (Haley Hernandez, Health Reporter)

FAMILY QUESTIONS
Will spraying yourself or your children with disinfectant help?
A viral video from CNN affiliate WHBQ showed a man spraying a student with what appeared to be disinfectant spray after school.

But spraying alcohol or chlorine all over your body "will not kill viruses that have already entered your body," the World Health Organization says.

“Spraying such substances can be harmful to clothes or mucous membranes (i.e. eyes, mouth). Be aware that both alcohol and chlorine can be useful to disinfect surfaces, but they need to be used under appropriate recommendations.” (CNN Health)

Should I social distance from my spouse?
The U.S. Dept of Health and Human Services says kissing is likely the easiest way to spread the virus but it is not sexually transmitted. Therefore, they advise people to still practice social distancing at home but I understand how unrealistic that can be. Just be aware that if one of you got Coronavirus the other would be at a greater risk of getting/having it and you would certainly need to self-isolate if you tested positive.

My favorite guide on how to self-isolate is here. (Haley Hernandez, KPRC Channel 2 Health Reporter)

Seniors are the most vulnerable to coronavirus, doctors say. The concern is those with underlying medical problems face a greater risk of developing severe life-threatening complications if they catch coronavirus.
How should they decide whether or not to go to the doctor’s office?
They should call their doctor first. They will walk through their symptoms with them and let them know whether it’s time to seek care from their physician in the office or if they need to go to the hospital to be seen. (Dr. Angela Shippy, Memorial Hermann Hospital)

If you have to self-quarantine in your home with family in a separate room, can the virus travel through the duct system?
“There is no evidence that suggests that COVID-19 can spread through duct systems,” wrote Nriagu. “Preliminary studies are showing that the main way the virus is spread is through respiratory droplets spread through coughing, touch, and sneezing within a fairly close range of people.” (Vivian Nrigu, MD, Partner/Owner Memorial Village Emergency Room)

If you end up with the coronavirus, do you isolate yourself in a room in your house?
Or do you just keep yourself at home with your family?
Disease experts estimate that each COVID-19 sufferer infects between two to three others. Distance yourself from family members infected with coronavirus. Wash hands and disinfect surfaces regularly. (Vivian Nriagu, MD, Partner/Owner Memorial Village Emergency Room)

Can I get coronavirus from my pet, or vice versa?
“No. There is no evidence that companion animals or pets such as cats and dogs have been infected or could spread the virus that causes Covid-19,” the World Health Organization says. (CNN Health)

Is door to door testing possible?
You could knock out testing, census and blood draw all in one. And cruise ships as hospitals?
I think this could potentially open the door to people being robbed by scammers. It also has the potential to exponentially increase the spread of Covid-19 if the phlebotomist is infected with Covid-19.

My child’s school is closed, and now we need a babysitter. How do I keep my family safe with someone new in the house?
The Harvard Medical School offers several tips, including:

choosing a babysitter who has minimal exposures to other people besides your family
limiting the number of babysitters. If you can keep it to one, that’s ideal. But if you need multple babysitters, keep the number as low as possible
making sure the babysitter understands he or she needs to practice social distancing and limits physical interaction with your children as much as possible
telling the babysitter that he or she must not come to your house if feeling even the slightest bit sick, or has had known exposure to coronavirus
making sure everyone washes their hands frequently throughout the day, especially before eating. (CNN Health)

Why can’t the Astrodome be used to quarantine first responders?
First responders are going to be exposed to Patients with Covid. Exposure does not equate to active infection. The answer is minimizing risk by:

(A) making sure first-responders are properly equipped with personal protected equipment, or PPE.

(B) The public can play a role to keep first responders safe by informing emergency response operators if someone in the home is experiencing flu-like symptoms, such as coughing or fever.

STAY-AT-HOME ORDER QUESTIONS
I am still not sure if I work for an essential business. How can I tell?
It’s understandable that you might have a question about what is considered an “essential” business. The list of what businesses are considered essential is long. Anyone who still has a question about whether they work for an essential business can call a hotline set up by Harris County at stayhome@cjo.hctx.net.

Will my trash still get picked up?
Yes, your trash service should continue going without disruption. Trash and recycling collection are considered essential services under the order. Essential government functions for all local cities in Harris County are also protected, including public works, law enforcement and jail operations.

Can I get arrested if I break any of the stay-at-home order rules?
Harris

County Judge Lina Hidalgo made it clear during her March 24th press conference that we are not a police state. She said they are relying on people to do their part and trusts that they will, but added that if someone willingly violates the order in a way that puts other people at risk, they will work with law enforcement.



I’m still confused. What activities can I leave my house to do?
We are getting a lot of questions from people asking what exactly is OK to leave the house to do? The order states people can leave their homes for activities deemed essential. In part, these include obtaining medical supplies or medication; visiting health care professionals; obtaining supplies needed to work from home; obtaining or delivering necessary supplies, such as food, pet supplies or sanitary supplies; caring for a family member or pet in another household; and performing work duties as a part of an essential business.

As we answered yesterday, you are allowed to go to public parks and outdoor recreational areas, but playgrounds have been closed. You are also asked to avoid touching picnic tables or benches.

I grocery shop for my mother who does not drive. Am I able to continue to do that and deliver them to her?
Yes, since you are allowed to go to the grocery store for essentials you can still shop for family or friends. You can also visit her home for deliveries. However, consider leaving the packages at the door. It’s been advised to clean off anything you bring into your home and that includes groceries and to-go food containers.

Can I visit the post office to mail something?
The post office will remain open during the stay home, work safe order. You are allowed to visit the post office to mail something.

Do those that get disability SS benefits get any help from the package they passed?
If you’re not required to file a tax return due to being on Social Security, the government will use the information on your Form SSA-1099, Social Security Benefit Statement, or Form RRB-1099, Social Security Equivalent Benefit Statement.

Can I still hire movers and move during my stay at home order?
Yes, you can still plan on moving during this time. Moving companies fall under the Transportation Systems category of essential businesses that can remain open. The transportation sector includes trucking and moving of necessary goods as well as public transportation. Of course, if you are planning a move, everyone should practice social distancing and self-isolate after arriving in their new home.

Can I go for a walk around my block?
We’ve had a lot of questions from people asking if they can go for a walk in their neighborhood or walk on the trails near their home. Yes, you can as long as you are maintaining proper social distancing from other people you may come across. Per the order, parks remain open but the use of benches, playgrounds and workout equipment is prohibited.

my employer says I have to show up. What do I do?
Legislators just passed two new acts that will allow employees to get paid leave due to coronavirus issues and concerns. Your employer can not retaliate by firing you or demoting you for taking advantage.

CLOSURES QUESTIONS
Do the closures include gyms?
The White House said states with evidence of community transmission should close bars, restaurants, food courts, gyms and other indoor and outdoor venues where groups of people congregate. Now online workouts are on the rise. (Haley Hernandez, Health Reporter)


What are the risks when daycares don’t close during this time?
Preliminary data suggests that children can be infected by COVID-19 but do not appear to become very ill when infected. The death rate in children between 0-9 years of age is currently at 0%. The death rate in children between 10-19 years is currently 0.2%. Children are definite spreaders of COVID-19. If we do not close daycares, kids may become infected with COVID-19, some kids (especially those with pre-existing conditions) may die and COVID-19 will continue to spread in the U.S. (Vivian Nrigu, MD, Partner/Owner Memorial Village Emergency Room)

EMPLOYMENT QUESTIONS

I work in retail where I come into close contact with customers and coworkers all day. My employee told me I am not allowed to wear a mask or gloves because it scares the customers. Can business owners legally do that?
Yes, unfortunately, they can. An employer can tell you not to wear a mask unless you have a disability. Let’s say you have some facial deformity or some issue with your face, you could wear a mask. An employer would have to allow a mask in that instance, but only if it was needed because of a disability. (Rogge Dunn)

My employer is making me report to work, even though I don’t feel it is safe. I worry about my own health and loved ones who have weakened immune systems. What can I do?
Legislators just passed two new acts that will allow employees to get paid leave due to coronavirus related issues and concerns.

The Employment Paid Sick Leave Act requires employers to pay employees for 10 days off (two work weeks) when they can’t work because of the coronavirus.

The Emergency Family Medical Leave Act gives employees 50 paid days off (after they take 10 days of unpaid leave) due to coronavirus related issues.

Both acts take effect on April 2. Dunn and others are still studying the acts, but he believes they can be stacked for a total of 60 paid days leave with a letter or call to human resources.

The acts are written fairly loose to allow employees to take advantage of them under the following circumstances:

The employee is quarantined, and/or experiencing COVID-19 symptoms, and seeking a medical diagnosis.
An employee who is unable to work because of a need to care for an individual subject to quarantine, to care for a child whose school is closed or child care provider is unavailable for reasons related to COVID-19
The employee is experiencing substantially similar conditions as specified by the U.S. Department of Health and Human Services can receive two weeks (up to 80 hours) of paid sick leave at 2/3 the employee’s pay.
Under these new acts, your employer can not retaliate by firing you or demoting you for taking advantage of the leave. Employers with fewer than 500 employees will receive a tax credit for paying employees who do take paid leave. (Rogge Dunn)

My employer gave me paperwork to sign that makes it appear I am agreeing not to file for unemployment. Is this legal?
Generally speaking you can not release your unemployment or workers’ compensation rights, so my gut is that those releases aren’t worth the paper they’re written on.

Still, employees may worry they’ll be fired if they don’t sign the documents. Dunn says you should ask some questions in writing. You could send an email to human resources and your manager. Be polite and not adversarial. You could write, “I have some questions about this document you want me to sign. It seems to say that I will agree not to file for unemployment if I am laid off. Is that correct?”or “You asked me to sign this. I don’t think it’s appropriate to sign.”

Dunn said this will help you get everything in writing if you are terminated for not signing. You will have that email as evidence that you inquired and it will show that the employer was trying to violate the law by not allowing employees to file for unemployment. You would have a retaliation claim if they fired you after you send that email. (Rogge Dunn)

When I told my employer I couldn’t work because I care for my spouse who is at risk, they gave me a document to sign that seems to change my pay from salary to hourly. There is no effective date on the paper. Should I sign it?
Dunn’s answer: Ask your employer in writing, ‘When is this effective? Why is this being done?’ Get some answers and document that.

It’s very important if someone asks you to sign something, everything they told you before you sign it is in that document and it’s crystal clear what this means and why it’s being done. My granddad used to say if it isn’t in writing, it didn’t happen. Unfortunately, in a courtroom, memories fade, time passes maybe some people have convenient memories.

Nice. Very educative. Frontpage

DAILY LIFE QUESTIONS
Can I still get my car serviced right now?
There are only restrictions for businesses where people congregate. Other organizations may recommend closing to keep people from gathering but there are no government orders to shut down across the state. (Haley Hernandez, Health Reporter)

Paper money/coins can still be used even though they’re dirty. What should I know about paying during the coronavirus crisis?
According to the Federal Reserve, the lifespan of certain bills can be up to 15 years, giving cash a lot of time to accumulate germs but with new concerns around the coronavirus, new questions are being raised over how you should pay for things without contracting or spreading any illnesses.

When it comes to cash, the World Health Organization did not issue any warnings over using cash but they do say it’s important to remember to disinfect after handling it. Part of the reason using cash isn’t anymore dangerous than other forms of payment is because according to doctors, if you stick to contactless payments but don’t wash your hands after touching your phone, credit card or a payment terminal, you are still at risk of contracting a potential infection. If you or the person handling your form of payment is wearing gloves, make sure to change them often and continue to wash your hands, otherwise you’re just spreading germs with your gloves instead of your hands. (Vivian Nrigu, MD, Partner/Owner Memorial Village Emergency Room)

What about placard and car registration renewals?
Governor Greg Abbott said to help keep people healthy and out of the public, he’s also waiving vehicle registrations, titles, and placard renewal rules. People can still renew their registration online.

How do I stay healthy when using Uber or Lyft?
Both rideshare companies said they’re actively trying to protect customers and drivers from coronavirus.

Uber said it is trying to give drivers with disinfectants to help keep their cars clean, and the company “may temporarily suspend the accounts of riders or drivers confirmed to have contracted or been exposed to COVID-19.”

Lyft announced a similar policy: “If we are notified of a rider or driver testing positive for COVID-19, they will be temporarily suspended from using Lyft until they are medically cleared.” (CNN Health)

With all that is going on, I have not heard anything about helping the homeless.
The CDC is advising that people in shelters sleep head to toe and use temporary barriers, like curtains, between beds. Click here for more details on how this is impacting the homeless population. (CNN Health)

Should I start keeping extra food and supplies?
Yes, because you or a family member might suddenly have to quarantine. But it's a good idea to always have extra food and medication anyway.

"Consider keeping a two-week to 30-day supply of nonperishable food at home," Harvard Medical School says. "These items can also come in handy in other types of emergencies, such as power outages or snowstorms."

In addition, try to keep at least a 30-day supply of prescription medication and any needed over-the-counter medication. (CNN Health)

Why is everyone stocking up on bottled water? Is the water supply at risk?
No, the water supply is not at risk.

“The COVID-19 virus has not been detected in drinking water,” the CDC says. “Conventional water treatment methods that use filtration and disinfection, such as those in most municipal drinking water systems, should remove or inactivate the virus that causes COVID-19.”

So there is no need to hoard drinking water, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci said he and his wife are still drinking tap water.

How should you clean your cell phone?
You should regularly disinfect your cell phone. Despite previous warnings that harsh chemicals can damage the screen, Apple says now that disinfectants are OK to use on their products. If you’re concerned, they recommend a screen protector or case to cover the phone. (Haley Hernandez, Health Reporter)

People are encouraging take-out food but what if the handle is sick?
While the chances of that exact order having the virus on food is still low, these are the steps to keep food safe, according to CNN Dr. Sanjay Gupta:

- Have person put food at your door step, you not taking it from their hand

- Take container out of the bag

- Put the food on your plate

-Microwave food for 30 seconds would kill the virus

-Throw all packaging away

- WASH YOUR HANDS

(helpful hint: microwaving food for 30 seconds is also recommended to kill bacteria that could give you GI issues.) (Haley Hernandez, Health Reporter)

OUTDOOR AND TRAVEL QUESTIONS
Is it true that COVID-19 does not like warm/ hot weather? Like the climate we have here?
The temperature has an impact on people’s living environments and could play a significant role in social distancing. Officials at the WHO said on March 5 that there is no reason to believe temperature will play a role in the outbreak. (Vivian Nrigu, MD, Partner/Owner Memorial Village Emergency Room)

Can bugs and or insects carry the virus?
COVID-19 is new and there are a lot of unknowns. However, the health department said they do not believe insects will carry this virus. They make this prediction based on how other viruses in the Coronavirus family act. Examples of other Coronaviruses include SARS and MERS. (Haley Hernandez, Health Reporter)

Can you get coronavirus by eating food that was prepared in a room where someone with the virus sneezed or coughed?
“There is no evidence that COVID-19 is transmitted via food,” wrote Nriagu. “However, theoretically it could happen. There are strict guidelines that restaurants have to follow to ensure food safety and reduce the spread of all germs. These guidelines include washing hands and disinfecting surfaces.” (Vivian Nrigu, MD, Partner/Owner Memorial Village Emergency Room)

Can hand dryers kill coronavirus?
No, bathroom hand dryers can’t kill coronavirus, the World Health Organization says. Doctors say the best ways to protect yourself include:

Washing your hands with soap and water frequently for at least 20 seconds. If you can't wash your hands, use an alcohol-based hand santizer.
Not touching your face, which is a lot harder than it sounds.
Avoiding large crowds.
Staying at least 3 feet away from anyone who might be infected, especially if they’re coughing or sneezing. (CNN Health)

Is it safe to travel via plane considering the dangers of spreading the infection?
Transmission of infection in airplanes may occur between passengers who are seated in the same area of an aircraft. This is usually as a result of an infected individual coughing or sneezing or by touch. This is no different from any other situation in which people are in close proximity to each other. Travelers should disinfect the area where they are seated, wash their hands often, avoid touching their face and try to stay away from people who are coughing or sneezing. Most modern aircraft have re-circulation systems that recycle up to 50% of cabin air. The re-circulated air is usually passed through HEPA filters (used in hospitals and ICU’s). These filters can trap dust particles, bacteria, fungi and viruses. (Vivian Nrigu, MD, Partner/Owner Memorial Village Emergency Room)

Should I avoid public transportation?
If you rely on public transportation, use caution. If you’re sick or live in an area where an outbreak has been reported, avoid it.

Mass transit could increase your risk of exposure to coronavirus. Many transit systems are upping their cleaning regimens — notably Houston’s METRO. (CNN Health)

Is it safe to take kids to a playground?
“Children can be infected by COVID-19 (but do not appear to become very ill when infected) and are definite spreaders of COVID-19,” wrote Nriagu. “As such, consider play dates in the yard where there are fewer places for germs to collect, reduce interpersonal contact, consider outside activities like biking or hiking where sport equipment aren’t shared and its easier to keep a good distance from each other. Use bleach on all surfaces to disinfect.” (Vivian Nrigu, MD, Partner/Owner Memorial Village Emergency Room)


https://www.click2houston.com/health/2020/03/19/48-coronavirus-questions-on-family-health-travel-and-daily-life/

What can I do to protect myself?
Standard recommendations to reduce exposure to and transmission of a range of illnesses include maintaining basic hand and respiratory hygiene, and safe food practices  and avoiding close contact, when possible, with anyone showing symptoms of respiratory illness such as coughing and sneezing.

Are health workers at risk from a novel coronavirus?
Yes, they can be, as health care workers come into contact with patients more often than the general public WHO recommends that health care workers consistently apply appropriate

What WHO recommendations for countries?
WHO encourages all countries to enhance their surveillance for severe acute respiratory infections (SARI), to carefully review any unusual patterns of SARI or pneumonia cases and to notify WHO of any suspected or confirmed case of infection with novel coronavirus.

Countries are encouraged to continue strengthening their preparedness for health emergencies in line with the International Health Regulations (2005).


How did the first human SAR-cov2 got affected?

The first human cases of COVID-19 were identified in Wuhan City, China in December 2019. At this stage, it is not possible to determine precisely how humans in China were initially infected with SARS-CoV-2.

However, SARS-CoV, the virus which caused the SARS outbreak in 2003, jumped from an animal reservoir (civet cats, a farmed wild animal) to humans and then spread between humans. In a similar way, it is thought that SARS-CoV-2 jumped the species barrier and initially infected humans, but more likely through an intermediate host, that is another animal species more likely to be handled by humans - this could be a domestic animal, a wild animal, or a domesticated wild animal and, as of yet, has not been identified.

Until the source of this virus is identified and controlled, there is a risk of reintroduction of the virus in the human population and the risk of new outbreaks like the ones we are currently experiencing.

The source of the coronavirus known yet?

Currently, the source of SARS-CoV-2, the coronavirus (CoV) causing COVID-19 is unknown. All available evidence suggests that SARS-CoV-2 has a natural animal origin and is not a constructed virus. SARS-CoV-2 virus most probably has its ecological reservoir in bats. SARS-CoV-2, belongs to a group of genetically related viruses, which also include SARS-CoV and a number of other CoVs isolated from bats populations. MERS-CoV also belongs to this group, but is less closely related.

Is it safe to receive packages from area reported to be affected?

Yes. The likelihood of an infected person contaminating commercial goods is low and the risk of catching the virus that causes COVID-19 from a package that has been moved, travelled, and exposed to different conditions and temperature is also low. 

Should i wear mask to protect myself ?

Only wear a mask if you are ill with COVID-19 symptoms (especially coughing) or looking after someone who may have COVID-19. Disposable face mask can only be used once. If you are not ill or looking after someone who is ill then you are wasting a mask. There is a world-wide shortage of masks, so WHO urges people to use masks wisely.

WHO advises rational use of medical masks to avoid unnecessary wastage of precious resources and mis-use of masks  (see Advice on the use of masks).

The most effective ways to protect yourself and others against COVID-19 are to frequently clean your hands, cover your cough with the bend of elbow or tissue and maintain a distance of at least 1 meter (3 feet) from people who are coughing or sneezing. See basic protective measures against the new coronavirus for more information.

Is COVID-19 the same as SARS?
No. The virus that causes COVID-19 and the one that caused the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003 are related to each other genetically, but the diseases they cause are quite different.

SARS was more deadly but much less infectious than COVID-19. There have been no outbreaks of SARS anywhere in the world since 2003.

Is there a vaccine, drug or treatment for COVID-19?
Not yet. To date, there is no vaccine and no specific antiviral medicine to prevent or treat COVID-2019. However, those affected should receive care to relieve symptoms. People with serious illness should be hospitalized. Most patients recover thanks to supportive care.

Possible vaccines and some specific drug treatments are under investigation. They are being tested through clinical trials. WHO is coordinating efforts to develop vaccines and medicines to prevent and treat COVID-19.

The most effective ways to protect yourself and others against COVID-19 are to frequently clean your hands, cover your cough with the bend of elbow or tissue, and maintain a distance of at least 1 meter (3 feet) from people who are coughing or sneezing. (See Basic protective measures against the new coronavirus).

Are antibiotics effective in preventing or treating the COVID-19?
No. Antibiotics do not work against viruses, they only work on bacterial infections. COVID-19 is caused by a virus, so antibiotics do not work. Antibiotics should not be used as a means of prevention or treatment of COVID-19. They should only be used as directed by a physician to treat a bacterial infection. 

Is there anything I should not do?
The following measures ARE NOT effective against COVID-2019 and can be harmful:

Smoking
Wearing multiple masks
Taking antibiotics
In any case, if you have fever, cough and difficulty breathing seek medical care early to reduce the risk of developing a more severe infection and be sure to share your recent travel history with your health care provider.

Are pregnant women at higher risk from COVID-19?
Research is currently underway to understand the impacts of COVID 19 infection on pregnant women. Data are limited, but at present there is no evidence that they are at higher risk of severe illness than the general population.

However, due to changes in their bodies and immune systems, we know that pregnant women can be badly affected by some respiratory infections. It is therefore important that they take precautions to protect themselves against COVID-19, and report possible symptoms (including fever, cough or difficulty breathing) to their healthcare provider.

WHO will continue to review and update its information and advice as more evidence becomes available.

I’m pregnant. How can I protect myself against COVID-19?
Pregnant women should take the same precautions to avoid COVID-19 infection as other people. You can help protect yourself by:

Washing your hands frequently with an alcohol-based hand rub or soap and water.
Keeping space between yourselves and others and avoiding crowded spaces.
Avoiding touching your eyes, nose and mouth.
Practicing respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.
If you have fever, cough or difficulty breathing, seek medical care early. Call before going to a health facility, and follow the directions of your local health authority.

Pregnant women and women who have recently delivered – including those affected by COVID-19 - should attend their routine care appointments. 

Can COVID-19 be passed from a woman to her unborn or newborn baby?
We still do not know if a pregnant woman with COVID-19 can pass the virus to her foetus or baby during pregnancy or delivery. To date, the virus has not been found in samples of amniotic fluid or breastmilk.

Can I touch and hold my newborn baby if I have COVID-19?
Yes. Close contact and early, exclusive breastfeeding helps a baby to thrive. You should be supported to

Breastfeed safely, with good respiratory hygiene; 
Hold your newborn skin-to-skin, and
Share a room with your baby
You should wash your hands before and after touching your baby, and keep all surfaces clean.

Are people living with HIV at increased risk of being infected with the virus that causes COVID-19?
People living with HIV with advanced disease, those with low CD4 and high viral load and those who are not taking antiretroviral treatment have an increased risk of infections and related complications in general.  It is unknown if the immunosuppression of HIV will put a person at greater risk for COVID-19, thus, until more is known, additional precautions for all people with advanced HIV or poorly controlled HIV, should be employed[1],[2].

At present there is no evidence that the risk of infection or complications of COVID-19 is different among people living with HIV who are clinically and immunologically stable on antiretroviral treatment when compared with the general population.  Some people living with HIV may have known risk factors for COVID-19 complications, such as diabetes, hypertension and other noncommunicable diseases and as such may have increased risk of COVID-19 unrelated to HIV.  We know that during the SARS and MERS outbreaks there were only a few case reports of mild disease among people living with HIV. 

To date, there is a case report of a person living with HIV who had COVID-19 and recovered[3] and a small study on risk factors and antiretrovirals used among people living with HIV with COVID-19 from China.  This study reported similar rates of COVID-19 disease as compared to the entire population and increased risk with older age, but not with low CD4, high viral load level or antiretroviral regimen[4]. Current clinical data suggest the main mortality risk factors are linked to older age and other comorbidities including cardiovascular disease, diabetes, chronic respiratory disease, and hypertension. Some very healthy people have also developed severe disease from the coronavirus infection[5]. 

PLHIV are advised to take the same precautions as the general population[6],[7]:

wash hands often
cough etiquette
physical distancing
seek medical care if symptomatic
self-isolation if in contact with someone with COVID-19 and
other actions per the government response   
People living with HIV who are taking antiretroviral drugs should ensure that they have at least 30 days and up to 6-month supply of medicines and ensure that their vaccinations are up to date (influenza and pneumococcal vaccines). Adequate supplies of medicines to treat co-infections and comorbidities and addiction should also be ensured.

How do we ensure human rights and reduce stigma and discrimination?
As the world scales up public health responses to the COVID19 pandemic, countries are being urged to take decisive action to control the epidemic. WHO has urged all countries to ensure an appropriate balance between protecting health, preventing economic and social disruption, and respecting human rights. 

WHO is working with partners including the UNAIDS Joint Programme and the Global Network of People Living with HIV to ensure that human rights are not eroded in the response to COVID-19 and to ensure that people living with or affected by HIV are offered the same access to services as others and to ensure HIV-related services continue without disruption.

To mitigate potential prison outbreaks of COVID19 and reduce morbidity and mortality among people in prisons and other closed settings, it is crucial that prisons and immigration detention centres are embedded within the broader public health response. This requires close collaboration between health and justice ministries and includes protocols for entry screening, personal protection measures, physical distancing, environmental cleaning and disinfection, and restriction of movement, including limitation of transfers and access for non-essential staff and visitors.  In the current context it is of critical importance that countries work toward developing non-custodial strategies to prevent overcrowding in closed settings[10]. Governance of prison health by a ministry of health, rather than a ministry of justice or similar, is likely to facilitate this[11].

 10] Effectiveness of interventions to address HIV in prisons. Geneva, World Health Organization, 2007(Evidence for Action Technical Papers) http://whqlibdoc.who.int/publications/2007/9789241596190_eng.pdf?ua=1

[11] Kinner S. Jesse T. Snow K. Southalan L.  et al. Prisons and custodial settings are part of a comprehensive response to COVID-19.  The Lancet Public Health. Published: March 17,2020; DOI:https://doi.org/10.1016/S2468-2667(20)30058-X

How large does a meeting or event need to be in order to be a “mass gathering”?
High profile international sporting events such as the Olympics or World Cups as well as international religious events such as the Hajj count as mass gatherings. However, lower profile conferences and events can also meet WHO’s definition of a mass gathering. An event counts as a “mass gatherings” if the number of people it brings together is so large that it has the potential to strain the planning and response resources of the health system in the community where it takes place. You need to consider the location and duration of the event as well as the number of participants. For example, if the event takes place over several days in a small island state where the capacity of the health system is quite limited then even an event with just a few thousand participants could place a big strain on the health system and then be considered a “mass gathering” event. Conversely, if the event is held in a big city in a country with a large, well-resourced health system and lasts just a few hours, the event may not constitute a “mass gathering” event.


How much physical activity is recommended?
 

WHO has detailed recommendations on the amount of physical activity people of all ages should do to benefit their health and wellbeing (weblink)[1]. Here are the minimum levels we recommend:

Infants under the age of 1 year need to

be physically active several times a day.
Children under 5 years of age

should spend at least 180 minutes a day in physical activities, with 3-4 year-olds being moderately or vigorously active for an hour a day.
Children and adolescents aged 5-17years

all children and adolescents should do at least 60 minutes a day of moderate to vigorous-intensity physical activity, including activities that strengthen muscle and bone, at least 3 days per week.
Adults aged over 18 years

should do a total of at least 150 minutes of moderate-intensity physical activity throughout the week, or at least 75 minutes of vigorous-intensity physical activity throughout the week, including muscle-strengthening activities 2 or more days per week.
older adults with poor mobility should do physical activity to enhance balance and prevent falls on 3 or more days per week.
 

 

But any physical activity is better than none.  Start with small amounts and gradually increase duration, frequency and intensity over time.

Being active during the COVID-19 pandemic is challenging for us all.  Because the opportunities to be physically active seem to be more restricted, it is even more important to plan in every day the ways to be active and to reduce the time spent sitting for long periods. Put simply, it is a critical time to ensure we all move more and sit less.

How do I stay active in and around the home?
Try and reduce long periods of time spent sitting, whether for work, studying, watching TV, reading, or using social media or playing games using screens. Reduce sitting for long periods by taking short 3-5 minute breaks every 20-30 minutes. Simply stand up and stretch or even better, take a walk around the house, up and down the stairs, or into the garden. By just moving around and stretching you can improve your health and wellbeing. For more ideas and illustrations of healthy stretches see (EURO weblink[1])

Set up a regular routine to be active every day, by planning a physical activity or exercise break either by yourself, by joining an online class, or by setting up a time to be active online with your friends or colleagues. Making a specific time to be active helps ensure you get your daily physical activity. Put the time in your diary, and it will help remind you. Stick with it, as this will help you build a regular routine, and help you adjust to new ways of working, study and family life under COVID-19 restrictions

Be active with your family and friends, connecting with others can help you and your family in the home and elsewhere spend time together and be active. Planning time to be active with your children with active games at home, walks in the parks, or cycling can be a way the whole family can relax, be together and be active and healthy whilst at home.  

Set yourself and your family Be Active goals, by choosing a specific type of activity, time of day and/or number of minutes you will do every day. Get each family member to choose their own goal which sets a bit of a challenge but is realistic with help from family or friends and motivation. Record your progress on a weekly activity chart and, if you think it would help, reward yourself with something you value.


[1] http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov-technical-guidance/stay-physically-active-during-self-quarantine/_recache?fbclid=IwAR2RQYVYBnmpDCMjBwqmoz0hZxzmit_9yKzXu6ZhjGNywRTEzWOUQefU8V0

More physical activity ideas to help you stay active
For Infants under 1 year of age

Spend regular time doing floor-based play with your baby in a prone position (‘tummy time’) and spread this throughout the day while baby is awake.
For Children under 5 years of age

Active play in and around the home – invent games which involve being active and can develop skills in throwing, catching, kicking, as well as developing posture and balance.
Active play and games where children get out of breath, such as running around, skipping and jumping.
For Children and adolescents aged 5-17 years

Active games and active play with family.
Join in online active games or activity classes, also look for online physical education classes as well as exercise routines suitable for adolescents.
Set up playground games indoors such as Jump rope and hop-scotch – make up new games and challenges that involve being active.
Learn a new skill – for example try an learn to juggle.
Encourage doing some muscle strength training activities such as lifting weights or use improvised weight such as bottles full of water or sand.
For Adults

Climb up the stairs as much as you can, think of it as an opportunity to be active.
Use household chores as a way to be more physical activity.
Join in an online exercise class or make up your own routine to music you enjoy that uses the major muscle groups and raises you heart rate.
Do some muscle strengthening activities such as lifting weights or improvise using full bottles of water or simply use your own body weight and do sets of press ups, sit ups and squats. 
Make time for fun, such as dancing to music.

Are there any risks from interacting with animals or consuming animal products?
There is no evidence of any animal including pets playing a role in the spread of the virus. As a general practice when caring for any kind of animals, always wash your hands before and after interacting with them.

Meat from healthy animals that is cooked thoroughly remains safe to eat.

People should not handle, slaughter, dress, sell, prepare or consume meat that originates from wild animals or livestock that are sick or that have died from unknown causes. Raw wild meat or uncooked dishes based on the blood of wild animals should not be consumed. These practices place people at high risk of contracting any number of infections.

Any unusual morbidity or mortality of animals should be reported to the animal health authorities.

FAO urges animal owners to treat their animals humanely. Misleading information exists on the possible risks posed by animals in the virus’s spread.

Can I touch and hold my newborn baby if I have COVID-19?
Yes. Close contact and early, exclusive breastfeeding helps a baby to thrive. You should be supported to

Breastfeed safely, with good respiratory hygiene; 
Hold your newborn skin-to-skin, and
Share a room with your baby
You should wash your hands before and after touching your baby, and keep all surfaces clean.

Are smokers and tobacco users at higher risk of COVID-19 infection?
Smokers are likely to be more vulnerable to COVID-19 as the act of smoking means that fingers (and possibly contaminated cigarettes) are in contact with lips which increases the possibility of transmission of virus from hand to mouth. Smokers may also already have lung disease or reduced lung capacity which would greatly increase risk of serious illness.

Smoking products such as water pipes often involve the sharing of mouth pieces and hoses, which could facilitate the transmission of COVID-19 in communal and social settings.

Conditions that increase oxygen needs or reduce the ability of the body to use it properly will put patients at higher risk of serious lung conditions such as pneumonia.