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You asked, we?re answering: Your top questions about Covid-19 and vaccines


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Positivity     39.00%   
   Negativity   61.00%
The New York Times
SOURCE: https://www.cnn.com/interactive/2020/health/coronavirus-questions-answers/#is-it-true-the-covid-19-vaccines-dont-work-as-well-in-immunocompromised-people-does-that-mean-they-need-more-doses
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Summary

That’s what I do,” said Murthy, the father of two toddlers.“I want to take every possible measure to protect my child — even though the risk is low — given that I live in an area where there’s a lot of virus being transmitted.” And with the dominance of the Delta variant, “it bears being cautious because this is being transmitted at a far higher rate than other versions of Covid-19,” the surgeon general said. At the University of Mississippi Medical Center, “We are seeing an increase in the number of hospitalizations of children,” Associate Vice Chancellor for Clinical Affairs Dr. Alan Jones said.“We’ve had infants as small as 6 to 8 months old up to the teenage years,” Jones said July 14.The more contagious Delta variant is now in all 50 states, hitting less vaccinated places the hardest.“We do know in Mississippi that the predominant strain that’s circulating — probably 88% to 90% of it — is the Delta variant,” Jones said. But it’s probably multifactorial and related to all of those things.” Last summer, more than half the children ages 6 to 10 who attended a Georgia summer camp and got tested for coronavirus tested positive, according to a study by the US Centers for Disease Control and Prevention.“This investigation adds to the body of evidence demonstrating that children of all ages are susceptible to SARS-CoV-2 infection and, contrary to early reports, might play an important role in transmission,” wrote the CDC study’s authors.And in Florida, the number of children hospitalized with Covid-19 surged 23% in eight days last summer – from 246 on July 16 to 303 on July 24.Some youngsters have suffered long-term effects from Covid-19 or multisystem inflammatory syndrome in children (MIS-C) – a rare but potentially serious condition that can happen in children weeks after a coronavirus infection.The vaccines require an immune system response to work, so millions of Americans who are immunocompromised or take drugs that suppress the immune system might not get as much protection from a vaccine as others do. People who are immunocompromised should be counseled about the potential for reduced immune responses to Covid-19 vaccines and follow prevention measures (including wearing a mask, staying 6 feet apart from others they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) to protect themselves against Covid-19 until advised otherwise by their healthcare provider, the US Centers for Disease Control and Prevention said in a July 16 update. In June, researchers from Johns Hopkins University suggested that an extra shot may help increase Covid-19 antibody levels for some organ transplant recipients who did not have a full response to their original vaccinations.If you think you might have Covid-19 symptoms, “please get tested regardless of your vaccination status,” US Surgeon General Dr. Vivek Murthy said. But Covid-19 vaccines don’t take full effect until 2 weeks after your final dose — “so a person could get sick if the vaccine has not had enough time to provide protection,” the US Centers for Disease Control and Prevention says. The vaccines require an immune system response to work, so millions of Americans who are immunocompromised or take drugs that suppress the immune system might not get as much protection from a vaccine as others do.The good news: When rare breakthrough infections do happen in vaccinated people, they’re less severe, CDC research shows.But it’s especially important for unvaccinated people who have Covid-19 symptoms to get tested. Unvaccinated people can spread coronavirus more easily than vaccinated people, the CDC says.“We have seen that many people are not getting tested around the country even though they have symptoms,” Murthy said July 13. “Many people are thinking, ‘Covid is over — why do I need to get tested?’ And this is particularly happening in areas, unfortunately, where the vaccination rates are low — which is where we want to be testing more.”“Fully vaccinated people should not visit private or public settings if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms,” the CDC says.“It’s possible a person could be infected just before or just after vaccination and still get sick.”But after a person is fully vaccinated — two weeks after their final dose — there is reduced risk of spreading Covid-19, the CDC says. Research shows vaccinated people who still get breakthrough infections have less detectable virus (viral load) than unvaccinated people who get infected.“Americans who have been fully vaccinated do not need a booster shot at this time,” said a July 8 joint statement from the US Centers for Disease Control and Prevention and the US Food and Drug Administration.“We continue to review any new data as it becomes available and will keep the public informed,” the CDC and FDA said. The vaccine was still 93% effective in preventing severe disease and Covid-19 hospitalizations, the Israeli government said, compared to 97% reported in the medical journal The Lancet in May.Pfizer said it’s working to develop a booster dose that will protect people from variants. In places of high Covid-19 spread, people who are fully vaccinated should still take precautions, such as wearing masks, a World Health Organization official said.“People need to continue to use masks consistently, being in ventilated spaces, hand hygiene, respiratory etiquette – everything … even if you are vaccinated, when you have community transmission ongoing,” WHO Assistant Director-General Dr. Mariangela Simao said June 25.And because the vaccines are highly effective but not perfect, some health experts said they would keep wearing masks in certain places despite being fully vaccinated. “If you’re in a low-infection, high-vaccination area, you don’t need to be wearing a mask indoors if you’re fully vaccinated,” said Dr. Ashish Jha, dean of the Brown University School of Public Health.But the Delta variant is surging in parts of the US, including southwest Missouri — where Covid-19 patients are filling up hospital beds and getting transferred to other hospitals. “This is a dramatic increase, up from 50% for the week of July 3,” CDC Director Dr. Rochelle Walensky said.The Delta variant has a cluster of mutations, including one known as L452R, that helps it infect human cells more easily.“This variant is even more transmissible than the UK (Alpha) variant, which was more transmissible than the version of the virus we were dealing with last year,” US Surgeon General Dr. Vivek Murthy said. The researchers studied blood taken from eight vaccinated volunteers and tested it against an engineered version of the spike protein of the Delta variant.“A single dose of the Johnson & Johnson COVID-19 vaccine generated neutralizing antibodies against a range of SARS-CoV-2 variants of concern, which increased over time, including against the increasingly prevalent and more transmissible Delta (B.1.617.2) variant,” Johnson & Johnson said on July 1.But the Delta variant is more contagious than both the original strain of novel coronavirus and the Alpha (B.1.1.7) strain, the surgeon general said. That mutation affects the spike protein – the part of the virus that attaches to human cells it infects.The Indian government’s Covid-19 genome sequencing body said the Delta Plus variant exhibits several worrying traits such as increased transmissibility, stronger binding to receptors of lung cells, and a potential reduction in antibody response.It’s not yet clear what effect the mutation may have on vaccine efficacy. But every once in a while, maybe a green bead gets into where a red bead is supposed to be.”When mutations give the virus an advantage — such as the ability to replicate faster, or to hide from the immune system – that version will outcompete others.The only way to get rid of variants is to lower the number of infections, said Penny Moore, an expert in viruses at South Africa’s National Institute for Communicable Diseases.That’s a big reason why doctors urge people to get vaccinated as soon as they can. Those who don’t get vaccinated aren’t just risking their own health — they’re also jeopardizing the health of others, infectious disease specialists say.“Unvaccinated people are potential variant factories,” said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center. I totally get where you’re coming from and I understand that you’re concerned about this,’” Bracho-Sanchez said.It’s also important to cite scientific data — like the truth about side effects, the safety of Covid-19 vaccines and why it’s important for young, healthy people to get vaccinated.Research is still evolving, but a recent study examining antibodies suggests you could be immune for months after infection. And unlike the Moderna and Pfizer/BioNTech vaccines, which require two doses, the Johnson & Johnson vaccine requires only one dose.Dr. Anthony Fauci said he does not foresee a nationwide Covid-19 vaccine mandate.But if only half of all Americans are willing to get vaccinated, Covid-19 could stick around for years, said Dr. Francis Collins, director of the National Institutes of Health.Health experts say if you don’t get a vaccine, the consequences will extend far beyond yourself — even if you’re young and healthy now. The government is paying for this,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital in Philadelphia.There’s growing evidence suggesting vaccines could also help prevent you from spreading coronavirus. People who have cancer, an organ transplant, sickle cell anemia, poorly controlled HIV or any autoimmune disorder are also at higher risk.Covid-19 patients with pre-existing conditions — regardless of their age — are 6 times more likely to hospitalized and 12 times more likely to die from the disease than those who had no pre-existing conditions, CNN Chief Medical Correspondent Dr. Sanjay Gupta said. The letters and numbers in “Covid-19” come from “Coronavirus disease 2019.”About 2% to 5% of babies born to mothers with Covid-19 tested positive for coronavirus within the first four days of life, according to the American Academy of Pediatrics.But infected mothers are unlikely to pass coronavirus to their newborns when appropriate precautions are taken, according to a study published in The Lancet Child & Adolescent Health.In that study, researchers found no cases of viral transmission among 120 babies born to 116 mothers with coronavirus — even when both shared a room and the mothers breastfed.But the babies remained 6 feet apart from their mothers, except while breastfeeding. “With all the heavy breathing, you may even want to double the usual 6 feet to 12 feet, just to be safe,” CNN Chief Medical Correspondent Dr. Sanjay Gupta said.For symptomatic carriers: If it’s been at least 10 days since your symptoms started and at least 24 hours since you’ve had a fever (without the help of fever-reducing medication) and your other symptoms have improved, you can go ahead and stop isolating, the CDC says.Patients with severe illness may have to keep isolating for up to 20 days after symptoms started.(But it’s important to note symptoms typically don’t show up until several days after infection — and you can be more contagious during this pre-symptomatic time. At that point, it’s very unlikely they are still contagious.Doctors say wearing eye protection (in addition to face masks) could help some people, but it’s not necessary for everyone.Teachers who have younger students in the classroom are “likely to be in environments where children might pull down their masks, or not be very compliant with them,” epidemiologist Saskia Popescu said. “There is concern that you could get respiratory droplets in the eyes.”If you’re a health care worker or taking care of someone at home who has coronavirus, it’s smart to wear eye protection, said Dr. Thomas Steinemann, clinical spokesperson for the American Academy of Ophthalmology.(Note: Regular glasses or sunglasses aren’t enough, because they leave too many gaps around the eyes.)But if you’re vaccinated or not in a high-risk situation, wearing goggles isn’t necessary.While it’s still possible to get Covid-19 through the eyes, that scenario is less likely than getting it through your nose or mouth, Steinemann said.He said if a significant number of people were getting coronavirus through their eyes, doctors would probably see more Covid-19 patients with conjunctivitis, also known as pink eye (though having pink eye doesn’t necessarily mean you have coronavirus).The CDC does not recommend using plastic face shields for everyday activities or as a substitute for face masks. “Cloth face coverings are a critical preventive measure and are most essential in times when social distancing is difficult,” the CDC says.Clinical and laboratory studies show cloth face coverings reduce the spray of droplets when worn over the nose and mouth – what the CDC refers to as “source control.” And many people are contagious even when they don’t have any symptoms and don’t know they’re infected. There are other reasons why coronavirus can be more dangerous than the flu:“You can certainly get both the flu and Covid-19 at the same time, which could be catastrophic to your immune system,” said Dr. Adrian Burrowes, a family medicine physician in Florida.In fact, getting infected with one can make you more vulnerable to getting sick with the other, epidemiologist Dr. Seema Yasmin said. “Your defenses go down, and it makes you vulnerable to getting a second infection on top of that.”On their own, both Covid-19 and the flu can attack the lungs, potentially causing pneumonia, fluid in the lungs or respiratory failure, the Centers for Disease Control and Prevention said.“The two (illnesses) together definitely could be more injurious to the lungs and cause more respiratory failure,” said Dr. Michael Matthay, a professor of medicine at the University of California, San Francisco.And just like with Covid-19, even young, healthy people can die from the flu.Doctors say the easiest way to help avoid a flu/Covid-19 double whammy is to get vaccinated.Both the flu and Covid-19 can give you a fever, cough, shortness of breath, fatigue, sore throat, body aches and a runny or stuffy nose, the CDC said.“Some people may have vomiting and diarrhea, though this is more common in children than adults,” the CDC said.But unlike the flu, Covid-19 can cause a loss of taste or smell.And about half of coronavirus transmissions happen before any symptoms show up. “People need to know that wearing masks can reduce transmission of the virus by as much as 50%, and those who refuse are putting their lives, their families, their friends, and their communities at risk,” said Dr. Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation.Unlike SARS and swine flu, the novel coronavirus is both highly contagious and especially deadly, CNN Chief Medical Correspondent Dr. Sanjay Gupta said. And then you’ll touch other surfaces, and then you will be spreading virus if you are infected and shedding asymptomatically.”That’s why health officials suggests people wear face masks while in public and when it’s difficult to stay 6 feet away from others.The odds of transmitting coronavirus through sex hasn’t been thoroughly studied, though it has been found to exist in men’s semen.But we do know Covid-19 is a highly contagious respiratory illness that can spread via saliva, coughs, sneezes, talking or breathing — with or without symptoms of illness.So three Harvard physicians examined the likelihood of getting or giving Covid-19 during sex and made several recommendations. “The virus seems to be causing increased clotting in the large arteries, leading to severe stroke,” said Dr. Thomas Oxley, a neurosurgeon at Mount Sinai Health System in New York.“Most of these patients have no past medical history and were at home with either mild symptoms (or in two cases, no symptoms) of Covid.”Earlier in this pandemic, scientists didn’t know how easily this new virus spreads between people without symptoms, nor did they know how long infectious particles could linger in the air. “Alcohol is pretty effective at killing germs, but it doesn’t wash away stuff,” said Dr. John Williams, a virologist at the University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh.“If somebody’s just sneezed into their hand, and their hand is covered with mucus, they would have to use a lot more alcohol to inactivate that bacteria or virus.”A study published in The New England Journal of Medicine found that people with Type A blood have a higher risk of getting infected with coronavirus and developing severe symptoms, while people with Type O blood have a lower risk – but the study has caveats.The researchers cannot say if blood type is a direct cause of the differences in susceptibility. You never would tell somebody who was Type O that they were at smaller risk of infection.”The bottom line: “All of us are susceptible to this virus,” said Dr. Maria Van Kerkhove, technical lead for the World Health Organization’s Covid-19 response.“It’s probably safe if you’re not at home,” said Dr. Leana Wen, an emergency room physician. “Spraying disinfectants can result in risks to the eyes, respiratory or skin irritation,” the World Health Organization said.“Spraying or fumigation of outdoor spaces, such as streets or marketplaces, is also not recommended to kill the COVID-19 virus or other pathogens because disinfectant is inactivated by dirt and debris, and it is not feasible to manually clean and remove all organic matter from such spaces,” the WHO said.“Moreover, spraying porous surfaces, such as sidewalks and unpaved walkways, would be even less effective.” Besides, the ground isn’t typically a source of infection, the WHO said.And once the disinfectant wears off, an infected person could easily contaminate the surface again.Any large gathering can increase the spread because this coronavirus is transmissible by talking or even just breathing. And when people are “shouting and cheering loudly, that does produce a lot of droplets and aerosolization that can spread the virus to people,” said Dr. James Phillips, a physician and assistant professor at George Washington University Hospital.So doctors and officials say its important to get vaccinated or wear a face mask and try to keep your distance from others as much as possible.“To date, there is no evidence that very high vitamin D levels are protective against COVID-19 and consequently medical guidance is that people should not be supplementing their vitamin D levels beyond those which are currently recommended by published medical advice,” wrote Robin May, director of the Institute of Microbiology and Infection at the University of Birmingham in the UK. For anyone over 70 years of age in the US, the recommended daily intake goes up to 20 mcg/800 IU per day.But too much vitamin D can lead to a toxic buildup of calcium in your blood that can cause confusion, disorientation, heart rhythm problems, bone pain, kidney damage and painful kidney stones.“Viruses can live on surfaces and objects — including on money — although your chance of actually getting COVID-19 from cash is probably very low,” emergency medicine physician Dr. Leana Wen said.The new coronavirus can live for up to 72 hours on stainless steel and plastic, up to 24 hours after landing on cardboard, and up to four hours after landing on copper, according to a study funded by the US National Institutes of Health. If you can’t wash your hands immediately, use hand sanitzier or disinfectant.And since Covid-19 is a respiratory disease, make sure you avoid touching your face.It appears unlikely, but the CDC advises taking precautions.Experts believe coronavirus is mainly spread during close contact (about 6 feet) with a person who is currently infected, the CDC said.“This type of spread is not a concern after death,” the CDC said. So soap or alcohol are very, very effective against dissolving that greasy liquid coating of the virus.”By cutting through the greasy barrier, Williams said, “it physically inactivates the virus so it can’t bind to and enter human cells anymore.”Yes, coronavirus can live on the soles of shoes, but the risk of getting Covid-19 from shoes appears to be low.A report published by the CDC highlighted a study from a hospital in Wuhan, China, where this coronavirus outbreak began. Even if coronavirus does get into your food, your stomach acid would kill it, said Dr. Angela Rasmussen, a virologist at Columbia University.“When you eat any kind of food, whether it be hot or cold, that food is going to go straight down into your stomach, where there’s a high acidity, low-pH environment that will inactivate the virus,” she said.But it’s a good idea to disinfect the takeout containers, CNN Chief Medical Correspondent Dr. Sanjay Gupta said. 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.”For unvaccinated people, the CDC “recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies).”There are several key points: 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. “So that could happen in the case of health care workers who are exposed to a lot more Covid-19 as a result of their work — that they get more severely ill.”In one study, about 4 in 5 people with confirmed coronavirus in China were likely infected by people who didn’t know they had it, according to research published in the journal “Science.”“These findings explain the rapid geographic spread of (coronavirus) and indicate containment of this virus will be particularly challenging,” researchers wrote.In March 2020, the CDC said almost half of the 712 people with coronavirus who were on the Diamond Princess cruise ship didn’t have any symptoms when they tested positive.Other studies suggest 25% to 50% of coronavirus carriers don’t have symptoms.In the US, “I think it could be as many as 1 in 3 walking around asymptomatic,” said New Jersey primary care physician Dr. Alex Salerno.“We have tested some patients that have known exposure to COVID (coronavirus disease). “The vast majority of people – about 80% – will do well without any specific intervention,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.Those patients should get plenty of rest, hydrate frequently and take fever-reducing medication.“The current guidance – and this may change – is that if you have symptoms that are similar to the cold and the flu and these are mild symptoms to moderate symptoms, stay at home and try to manage them,” said Dr. Patrice Harris, president of the American Medical Association. “Even though the new coronavirus can stay on surfaces for a few hours or up to several days (depending on the type of surface), it is very unlikely that the virus will persist on a surface after being moved, travelled, and exposed to different conditions and temperatures,” WHO said.Additional reporters: Melissa Mahtani, Scottie Andrew, Katie Hunt and Harmeet Kaur

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