Here’s a wrap-up of what has changed since the pandemic began and what you need to know now to keep you and your family safe.
Fever, cough and shortness of breath: The big three are still the most common symptoms, but the list has grown over the months. We now know many common cold and flu symptoms can also play a role, such as a sore throat, headache, body and muscle aches, chills and shivers, a snotty or congested nose, intense fatigue (which can last longer than the illness), diarrhea, nausea and vomiting.
New, bizarre symptoms: Skin rashes and “Covid-toes,” where the toes become red and swollen from tiny blood clots, are some of the newer symptoms that may be early warning signs of Covid-19.
More early signals include pink eye (a highly contagious eye condition also known as conjunctivitis), anosmia (a loss of smell that can also lead to a loss of taste), and a sudden, new onset of confusion, even to the point of delirium.
Emergency symptoms: An inability to wake or stay awake, chest pain or pressure, new mental confusion or delirium, blue-tinged lips or any sudden or severe breathing problems can all signal an emergency, warns the US Centers for Disease Control and Prevention, so call 911 immediately.
Who is most at risk?
Everyone: The virus can infect anyone, even babies in the womb. It’s how your body responds to the virus that is the key question. The answer appears to be a complex interplay between viral load — how much virus you were exposed to — and your age and health.
Others have been “knocked out on their back and brought to their knees pretty quick,” by Covid-19, said White House adviser Dr. Anthony Fauci in an interview Thursday with Facebook CEO Mark Zuckerberg. Fauci is the top infectious diseases expert in the US.
“There are many, many young people who get infected. They get sick. They feel horrible for weeks and weeks,” Fauci said, adding that he has noticed young people experiencing something similar to chronic fatigue syndrome after recovering from the virus.
“Even when they clear the virus, and they test negative — they don’t have any virus — they can feel out of sorts for weeks and weeks.”
Age and health are key: Science now knows that anyone — at any age — with at least one chronic health condition is at greater danger from Covid-19. The risk rises with increasing age, the number of underlying medical conditions you have and whether or not you are obese (body mass index or BMI over 30).
That’s a lot of people at risk: Just in America, more than 40% of the population are considered obese, according to the CDC, while some 60% of American adults have at least one chronic medical condition.
High-risk medical conditions: That list is long and growing. Currently, it includes diabetes, chronic lung disease or asthma, cardiovascular disease, cancer (or are undergoing chemotherapy), organ transplants, sickle cell anemia, kidney disease with dialysis, poorly controlled HIV infection, obesity and any autoimmune disorder.
Pregnancy raises risk: Early in the pandemic, expecting mothers and their fetus or newborn were not considered at high risk.
Nursing home, veteran’s home, long-term care facilities: Facilities which house the older and more infirm in society are typically more crowded, with fewer staff to care for the needs of inhabitants individually. In addition, adults in these facilities are older, weaker, and likely to have multiple health issues and frail immune systems.
How does the novel coronavirus spread?
Person-to-person: The vast majority of transmission of SARS Covid-2, the novel coronavirus’s scientific name, is person-to-person. The virus predominately spreads via respiratory droplets sprayed into the air as an infected person coughs, sneezes, sings or talks. For the most part, those droplets can travel in about a six-foot radius from the infected person.
Objects: Heavier droplets will fall more quickly to the ground, thus infecting surrounding objects with the virus, which can stay viable — to some degree — for days. While the virus does break down and become weaker as time goes on, studies have found traces of SARS Covid-2 after four hours on copper, 24 hours on cardboard, and two to three days on stainless steel and plastic.
Despite that, it’s highly unlikely you’d get the novel coronavirus from your groceries and next to impossible to get it from food, experts say.
Floating in the air? Recent studies show smaller respiratory droplets that sputter out of an infected person’s mouth can more quickly dry out, this possibly allowing the virus to become aerosolized and float away into the air. In extremely large, well ventilated areas and outdoors, air circulation will dilute the particles, thus greatly lowering any risk. That changes inside smaller, enclosed spaces, such as inside restaurants, offices, shops, cars, public transport and the like, experts say.
When and how long are you contagious?
Incubation period: Science now knows there is a lengthy (and somewhat uncertain) incubation period after exposure to Covid-19. Typically, symptoms will appear within five to seven days, but they can show up as early as two days after exposure and as late as 14 days — with a rare few taking even longer.
Contagious and don’t know it: Like many viruses, the novel coronavirus is contagious well before it makes itself known. Researchers estimate anyone infected can spread the virus to others 2 to 3 days before symptoms start, and may be the most contagious in the one to two days before they feel sick.
No symptoms: One of the deadliest discoveries researchers have made is that the virus can cause no symptoms or possibly such mild symptoms that a person has no idea they have the disease.
“Evidence shows that 25% to 45% of infected people likely don’t have symptoms,” Fauci told ABC’s “Good Morning America” in mid-June.
These asymptomatic — and presymptomatic — people go about their lives spreading the disease without knowing it. That’s a key reason wearing a mask when in public is so important.
No longer contagious: The CDC says that you can be around others when you meet these three milestones: You haven’t had a fever in 3 days AND your cough and shortness of breath have improved AND it’s been 10 days since your symptoms first appeared. If your immune system is compromised, however, you may need to extend that time table.
If you tested positive for Covid-19 but never had symptoms, you can be around others 10 days after the test — as long as no symptoms appeared.
If you’ve been exposed to someone who tested positive, you need to stay home for a full 14 days, the CDC says.
Can you get Covid-19 more than once?
Scientists around the world have been hoping that being infected with SARS Covid-2 will produce powerful antibodies and immunity against any future exposure to the virus — much like having measles, mumps and chickenpox protects you from ever getting any of those diseases again. Recent non-peer reviewed studies show good and bad news.
Good news: It does appear that people develop antibodies after recovering from Covid-19 — some develop more than others, possibly due to the amount of virus they were exposed to and their body’s immune response.
“Similar short-lived responses are seen against other human coronaviruses that predominantly cause only mild illness, meaning that we can be re-infected as time goes by and outbreaks can adopt seasonality,” said Stephen Griffins, associate professor in the University of Leeds School of Medicine in the United Kingdom, in a written statement.
“With the more serious, sometimes fatal, outcomes of SARS-COV2, this is troubling indeed,” Griffins added.
It’s possible that lingering memory immune cells may recognize and battle the virus the next time it invades, thus possibly leading to a milder case of But there’s no way of knowing that right now, experts say.
Vaccine development impact: How this lack of immunity will affect many of the vaccines under development is also unclear. Will they produce enough of an antibody response to last?
“It suggests vaccines will need to be better at inducing high levels of longer-lasting antibodies than the natural infection or that doses may need to be repeated to maintain immunity,” said Dr. Mala Maini, a professor of viral immunology and consultant physician at the University College London, in a statement.
How can I protect myself?
It’s not brain surgery: It’s a no brainer to stay six feet away from everyone else when you go out — that’s the social distancing golden rule. But other no-duh guidelines include:
- Staying away from large crowds (or even small ones)
- Avoiding the gym where people breathy heavy and sweat
- Inviting outsiders into your home — even if they are playmates for your kids
- Eating inside at a restaurant — they may be sitting you six feet from others, but it’s still inside where droplets gather
And please — no bars. Besides the close quarters, all that alcohol lowers inhibitions and removes common sense — something we could all use more of right now.
CNN’s Jacqueline Howard, Holly Yan and Lauren Mascarenhas contributed to this report.