Woman coughing
Your guide to
understanding
coronavirus
disease (COVID-19)
Welcome to Grand Rounds, your personal healthcare assistant and trusted source for timely information around coronavirus disease (COVID-19).
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What do we know about the Delta variant?

The Delta variant that originated in India in December 2020 now makes up the majority of the SARS-CoV-2 variants circulating in the US currently. Dr. Thames, Senior Medical Director at Grand Rounds discusses what we know.

Coronavirus FAQs
Updated August 10, 2021.
General Information
Who is at higher risk of severe illness if they get COVID-19?
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As you get older, the risk for severe illness from COVID-19 increases. Those in their 50s are at a higher risk of severe illness than those in their 40s. Those in their 60x ar at greater risk than those in their 50s, and so on. People who are 85 or older are at the highest risk of developing severe COVID-19 illness. For more information about high-risk individuals, you can visit here.

People of any age with the following conditions are or may be at increased risk of COVID-19 severe illness: Cancer, Chronic kidney disease, COPD; asthma, pulmonary fibrosis, Cystic fibrosis, Diabete mellitus, Hypertension or high blood pressure, Immunocompromised state (weakend immune system from solid organ transplant), Liver disease, Obesity (body mass index of 30 or higher), Serious heart conditions (heart failure, coronary artery disease or cardiomyopathies, Sickle cell disease, Smoking, Stroke, neurologic conditions such as dementia, Thalassemia (a type of blood disorder).

Can I get COVID twice?
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Yes, there have been some documented cases of re-infection, but this remains infrequent. New strains of COVID-19 have increased the potential for re-infection.

How does it spread?
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The current scientific evidence indicates the virus spreads in these three ways:

1. Droplets come from people coughing or sneezing on you — they are larger particles that don’t travel very far before they are pulled down by gravity (typically not more than 6 feet). Physical distancing is key to preventing droplet spread.

2. Aerosols are smaller particles that are produced when talking or singing, and can travel far in poorly ventilated spaces (note: ventilation is good in airplanes). Something as simple as keeping windows open can bring in fresh air and dilute the amount of virus in an indoor space. Keeping your mask on and not talking to your neighbor, while it may feel impolite, is a good practice to reduce aerosol spread.

3. Contact spread occurs when coming into contact with surfaces that have virus on it, which can be mitigated with wipes and hand sanitizer.

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

If I get COVID-19 and recover, will I be immune?
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We know that those who have severe, mild, or even asymptomatic infection (do not develop symptoms) do develop antibodies to the novel coronavirus. Studies are continually underway to learn how strong this immune response is and for how long the antibodies last. Our current understanding is that they last for many months, with some studies showing that they last for six months or longer. But, based on what we know from other coronaviruses, it will not likely be a lifelong immunity which is one reason vaccination is needed.

Should I send my child back to in-person school?
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There is no right answer for everyone. A starting point would be to think through the following:

– Is my child at high risk for severe COVID-related illness? (kids at higher risk of hospitalization include those with compromised immune systems, cancer, moderate to severe asthma, diabetes, kidney disease, and certain heart conditions)

– Does my child live with someone who is high risk for severe COVID-related illness? (an older adult, someone with diabetes, obesity, etc)

– Is my community heavily affected by COVID? (Look at daily case rates, positivity rates, hospitalizations, etc.)

– Is my child’s school offering protective measures such as mask mandates, 6+ feet of distancing, outdoor classrooms, reduced classroom sizes, etc?

– Is it logistically feasible for the child to do online schooling at home? (do both parents work out of the home, have internet access at home, etc)

Everyone will need to think through these issues and come to a decision that’s right for their family.

What percent of the population will need to get vaccinated to get “back to normal”?
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Public health officials estimate that 70 to 75 percent of people need to be fully vaccinated before we can get back to “normal life” and move freely through society without masks and social distancing.

What do we know about the delta variant?
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The Delta variant that originated in India in December 2020 now makes up the majority of the SARS-CoV-2 variants circulating in the US currently. It has surpassed the Alpha variant in prevalence.
It is clearly more transmissible than the original virus, and is spreading quickly, especially in areas with low vaccination rates.

It is impacting children more than previous variants as this population is still largely unvaccinated.

It is also not clear at this time whether it is more virulent than the other variants, with some data suggesting it does cause more severe disease, while other data does not show this.

The typical symptoms caused by the Delta variant are a little different from the original (wild-type) virus and the other variants in that it causes less coughing, shortness of breath, loss of taste and smell, and more sore throat, runny nose, fever, and headache.

Infrequently, even those who have been fully vaccinated can get infected with the Delta variant, called a “breakthrough” infection, and transmit it to others, but the good news is that all three approved vaccines do protect against a breakthrough infection becoming serious and leading to hospitalization or death.

Testing
Should I get tested for COVID-19 if I feel fine or have mild symptoms? When should I get tested?
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Testing is more widely available now, so anyone with symptoms that could be consistent with CoVID are encouraged to get tested. If you are not vaccinated and have had a known exposure you should quarantine yourself away from others and get tested as soon as possible. If the test is negative, remain in quarantine and then get tested again 5-7 days after the exposure.

For vaccinated folks who get exposed to CoVID, you should get tested within 3-5 days after the exposure and if it is negative and you do not develop symptoms you can end quarantine.

We can help you find a nearby testing site. You may also call your healthcare provider or county health department for guidance. If you are experiencing severe symptoms, like shortness of breath, high fevers that cannot be controlled with over the counter medications, that is the time to call your healthcare provider for advice and to ensure that you can get tested.

If there are no drugs for COVID-19, why does one need to be tested? Why not just follow the guidelines of the CDC and do self-quarantine?
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The recommendation for most people who would get tested for the Coronavirus, is to quarantine themselves and take care of themselves at home. However, for many individuals, knowing whether or not they are positive might impact the lives of others around them. For example, if you are positive and you had recently gone to work or seen family or friends, it would be vital for your co-workers, family, or friends to know that they were exposed, so that they can then take similar precautions. While you are right that for most people who are tested, it will not change their course or their management plan, it could impact others that they might have been in contact with.

My kid has a runny nose and cough. We are on day four of this sickness. Should I get him/her tested?
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Yes, anyone with symptoms consistent with COVID, including runny nose and cough, should be tested. You should also call your healthcare provider for guidance or schedule a visit with one of our medical professionals. We can also help you find a nearby testing site. If your daughter is experiencing severe symptoms, like shortness of breath, high fevers that cannot be controlled with over the counter medications, that is the time to call your healthcare provider and ensure that you can get tested. Regardless of whether you get tested, keep your daughter at home and away from others, to avoid spreading the illness she has.

Understanding Symptoms
What are the symptoms of COVID-19?
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Fever, chills, cough, and shortness of breath are some of the most common symptoms, but other symptoms such as sore throat, nausea, vomiting, diarrhea, or loss of smell or taste have also been reported. For a list of frequently reported COVID-19 symptoms, or to do a self-assessment of your symptoms, please visit the CDC Symptoms page.

How long after exposure do symptoms usually appear?
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Symptoms usually appear within 2-14 days. Most people who develop symptoms can recover at home with supportive care (staying hydrated, resting, managing symptoms with medications, such as fever reduces like Tylenol). If symptoms evolve to shortness of breath or chest pain, it is crucial to call your healthcare provider, or go to an urgent care or emergency room to seek care. If you are unsure, book a visit with our medical team and we can help you decide what steps to take.

Of note, some people never develop symptoms but they still can spread the virus to others. If you believe you may have been exposed, please limit your exposure to others, use masking and social distancing precautions, and get tested when feasible.

How long are most people actively ill?
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Most people are actively ill for the normal course of viral illness, which tends to last about 10 to 14 days.

How bad do the symptoms need to be before I go to the hospital?
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If you start to experience shortness of breath, are coughing so much that you cannot get a deep breath in, have a fever and the over the counter fever-reducers are not getting the fever down, or are feeling lightheaded when you stand up — you must call your local primary care doctor immediately. They will need to assess you to test for things like the flu and normal respiratory virals, and also to determine if you need testing for COVID-19. If you do not have a primary care physician, you should seek care at an urgent care or emergency room.

I don't have a primary care doctor. Who do I call if I have symptoms?
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If you are experiencing severe symptoms, such as high fever and/or shortness of breath, you should try and call ahead to your local Emergency Room. If you have access to Grand Rounds, you can call us for guidance. If you don’t have Grand Rounds, but have access to another telemedicine/urgent provider, you could call them.

How do you take care of yourself when you get COVID-19? What can I do to help manage it if I get it?
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If you get mild COVID-19 symptoms, like fever and cough, you can manage the symptoms with over-the-counter medications. If you have severe COVID-19 symptoms (e.g. chest pain, shortness of breath, persistent vomiting), you may need to get treated at the hospital with IV fluids, supplemental oxygen, steroids, and/or anti-viral medication. If you need help understanding your treatment options or the severity of your symptoms, you can book a visit with our medical team.

If I get a fever, what medication should I take?
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You can take acetaminophen (Tylenol) or ibuprofen, be sure to stay within the dosing guidelines on the packages and if you have any chronic conditions such as liver or kidney disease, discuss with your doctor first.

Protecting Yourself
How can I protect myself?
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Effective vaccines are available to best protect yourself from COVID-19. Visit here for information and common questions and answers about the vaccines.

Outdoors is safer than indoors; masks are better than no masks. Avoid being close to people (especially face-to-face or closer than 6ft apart) for very long, particularly in an indoor setting. Hand hygiene is important. And take into account both your personal level of risk and the risk of those around you.

The CDC is also recommending wearing two masks for best protection.

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

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

What are the do’s and don'ts if I’m told to ‘quarantine’?
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It is very important to stay home and monitor yourself for symptoms if you might have been exposed to COVID-19. For comprehensive guidance, please refer to this CDC website for the most up-to-date guidance.

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

Important Resources
Learn How the CDC is Responding to Coronavirus Disease
Learn How the World Health Organization is Responding to Coronavirus Disease