Information about COVID-19
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We are actively doing studies to improve and provide more COVID-19 testing. Your sample is valuable and can provide the means to provide better access for others.
What is a Coronavirus?
Coronaviruses are a large group of viruses that cause diseases in animals and humans. They often circulate among camels, cats, and bats, and can sometimes evolve and infect people.
In animals, coronaviruses can cause diarrhea in cows and pigs, and upper respiratory disease in chickens. In humans, the viruses can cause mild respiratory infections, like the common cold, but can lead to serious illnesses, like pneumonia.
Coronaviruses are named for the crown-like spikes on their surface. Human coronaviruses were first identified in the mid-1960s. They are closely monitored by public health officials.
How Does SARS-CoV-2 Compare With Other Coronaviruses?
Just like there are different types of related viruses that cause smallpox, chickenpox, and monkeypox, different coronaviruses cause different diseases in people. The Severe Acute Respiratory Syndrome (SARS) coronavirus causes SARS and the Middle East Respiratory Syndrome (MERS) coronavirus causes MERS. The novel coronavirus responsible for the current pandemic, SARS-CoV-2, is one of seven types of known human coronaviruses. SARS-CoV-2, like the MERS and SARS coronaviruses, likely evolved from a virus previously found in animals. The remaining known coronaviruses cause a significant percentage of colds in adults and children, and these are not a serious threat for otherwise healthy adults.
In January 2020, the novel coronavirus, SARS-CoV-2, was identified as the cause of an outbreak of viral pneumonia in Wuhan, China. The disease, later named coronavirus disease 2019 (COVID-19), subsequently spread globally. In the first three months after COVID-19 emerged nearly 1 million people were infected and 50,000 died.
Research evidence suggests that SARS-CoV-2 originated in bats. SARS-CoV-2 then spread from infected civets to people. Scientists are trying to determine how SARS-CoV-2 spread from an animal reservoir to people
What are the Signs and Symptoms of COVID-19?
People with Coronavirus Disease 2019 (COVID-19) can experience mild to severe respiratory illness. People with these symptoms or combinations of symptoms may have COVID-19:
Shortness of breath or difficulty breathing
Or at least two of these symptoms:
Repeated shaking with chills
New loss of taste or smell
Emergency warning signs and symptoms of COVID-19 that may suggest that you need urgent medical attention include:*
Persistent pain or pressure in the chest
New confusion or inability to be awakened (i.e., aroused)
Bluish lips or face
*This list is not all-inclusive. Consult your healthcare provider for any other symptoms that are severe or concerning.
Some infected healthcare workers have also reported experiencing a sore throat and lost sense of smell, but the relationship between these symptoms and SARS-CoV-2 infection is unclear.
What Should I Do if I Think I Have Been Exposed to or Infected with SARS-CoV-2?
Alert your healthcare provider immediately if you think you may be infected with SARS-CoV-2, including if you have been exposed to someone with COVID-19 and have signs/symptoms of infection. If you are experiencing symptoms, you should tell your healthcare provider about any suspected exposures you may have had. Although many communities are experiencing ongoing transmission, be sure to tell your healthcare provider about any recent travel to areas where SARS-CoV-2 is spreading.
If you believe you have been exposed to someone with COVID-19 or another source of SARS-CoV-2 on the job, alert your supervisor or occupational health clinic immediately.
If you are sick with COVID-19 or think you might have it, follow CDC recommendations, including the steps below, to help protect other people in your home, workplace, and community:
Stay home: People who are mildly ill with COVID-19 are able to recover at home. Do not leave, except to get medical care. Do not visit public areas.
Stay in touch with your doctor: Call before you seek medical care. Be sure to get care if you feel worse or you think it is an emergency.
Notify your supervisor: Your employer can take actions that will keep others in your workplace healthy and may be able to offer you additional schedule and leave flexibilities while you are away from work.
Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.
Call 911 if you have a medical emergency: If you have a medical emergency and need to call 911, notify the operator that you have, or think you might have, COVID-19. If possible, put on a facemask before medical help arrives.
How is COVID-19 Treated?
No vaccine or specific treatment for COVID-19 is available. Hospitals can provide supportive care for people who have serious cases of COVID-19.
Am I at High Risk for Complications from COVID-19?
Anyone can become infected with SARS-CoV-19, however, those with a higher risk of severe illness should exercise additional caution. People who have serious underlying medical conditions, such as heart or lung disease or diabetes, may be at increased risk of complications from COVID-19. Older adults (those 65 years of age or older) and those with immunosuppressive conditions like cancer, or taking immunosuppressive medications, are also at increased risk of severe illness.
Workers may consider discussing their medical conditions that could place them at higher risk of severe illness from COVID-19 with their supervisors, and work with their supervisors to determine appropriate steps to help prevent exposure to SARS-CoV-2 on the job.
The U.S. Department of Labor-funded Job Accommodation Network has information about workplace accommodations for people who may be at higher risk of COVID-19 due to age and/or chronic health conditions.
When Can I Return to Work After Having COVID-19?
CDC provides guidance about the discontinuation of home isolation for people with COVID-19. Generally:
If you have been isolating yourself at home: Your healthcare provider or state, local, tribal, or territorial health department can provide the best information about when you can discontinue isolation and return to essential activities, such as going to work.
If you have been hospitalized with COVID-19: Follow your healthcare provider's discharge and follow-up instructions, which should include information about when you can return to essential activities, such as going to work.
Employers should note that, because of the strain on the healthcare system associated with the ongoing pandemic, not all COVID-19 patients need medical attention in order to get better, and not all workers may be able to provide a doctor's note before returning to work after recovering from COVID-19. Sending a worker to a doctor when there is no need for medical care may place additional, and possibly unnecessary, strain on doctors' offices, urgent care facilities, and hospitals, and may contribute to the spread of the disease.
What tests are available for COVID-19?
Molecular (Swab) Test
This test uses a long swab to collect material, including physical pieces of virus, from the back of the nose where it meets the throat. A positive result indicates that viral genetic material is present, but it does not indicate that bacterial or other infections also are present.
A negative result indicates that the SARS-CoV2 virus that causes the COVID-19 disease was not found. It is possible to have a very low level of the virus in the body with a negative test result. This test is needed to identify the presence of the SARS-CoV-2 virus that causes the COVID-19 disease.
Antibody (Serology) Test
This is a blood test. It is designed to detect antibodies (immunoglobulins, IgG and IgM) against the virus that causes the disease called COVID-19. Antibodies are proteins produced by the immune system in response to an infection and are specific to that particular infection. They are found in the liquid part of blood specimens, which is called serum or plasma, depending on the presence of clotting factors. IgM and IgG may either be ordered together or separately.
Having an antibody test is helpful if:
• your health care provider believes you may have been exposed to the virus that causes COVID19 based on your current or previous signs and symptoms (e.g., fever, cough, difficulty breathing);
• you live in or have recently traveled to a place where transmission of COVID-19 is known to occur;
• you have been in close contact with an individual suspected of or confirmed to have COVID-19; or
• you have recovered from COVID-19
Or for peace of mind.
Why Do We Need Antibody Tests for COVID-19?
Diagnosing viral infections currently relies on two major methodologies: Reverse Transcription Quantitative Polymerase Chain Reaction (RT-qPCR) and serological immunoassays that detect viral-specific antibodies (IgM and IgG) or antigens.
Although, RT-qPCR is a highly sensitive test for SARS-CoV-2 (the virus that causes COVID-19) it has its limitations. RT-qPCR requires high-quality nasopharyngeal swabs containing sufficient amounts of viral RNA. This can be a challenge because the amount of viral RNA not only varies tremendously between patients, it can also vary within the same patient depending on the timing of the test and the start of the infection and/or the onset of symptoms.
In addition, nasopharyngeal swabs are not only very unpleasant to the patient, the sampling techniques vary significantly from nurse to nurse. Without sufficient viral RNA RT-qPCR can return a false negative test result. RT-qPCR also requires highly trained personnel to perform complex RNA extraction steps and PCR. Normally, this would not be a problem when testing a few thousand samples.
RT-qPCR becomes an issue when dealing with a global pandemic with potentially millions of people to test. This leads to delays in testing as medical facilities become overwhelmed with requests.
According to recent estimates, false negative results obtained with RT-qPCR are more common than initially thought. Some health care experts go as far as stating that, based on their own experience, one in three patients who has been infected with SARS-CoV-2 tests negative with the RT-qPCR method.
False negative results can have devastating impacts on the current efforts to contain the SARS-CoV-2 outbreak as infected patients are mistakenly given the green light to return home, return to work and possibly infecting others. Relying solely on nucleic acid tests to diagnose SARS-CoV-2 is a risky strategy. As such, calls to add independent testing methodologies to complement RT-qPCR are becoming increasing louder.
Why have serology testing?
IgG/IgM serological tests offer some advantages over RT-qPCR.
Firstly, serological tests detect human antibodies (proteins belonging to the immunoglobulin class) which are known to be much more stable than viral RNA. As a result, IgM/IgG serological specimens are less sensitive to spoilage during collection, transport, storage and testing than RT-qPCR specimens.
Secondly, because antibodies are typically uniformly distributed in the blood, serological specimens have much less variations than nasopharyngeal viral RNA specimens and can be easily
collected with minor phlebotomy discomfort to the patient.
Thirdly, unlike RT-qPCR, serological tests can detect past infection because virus-specific antibodies (unlike viral RNA) can persist in the blood for several weeks/months after onset of symptoms.
IgM/IgG serological tests also have some limitations, mainly related to the slow pace of the human antibody response to SARS-CoV-2. Although, several studies are still on-going, SARS-CoV-2 antibodies may not be detectable before 3 days after onset of symptoms (or at least 7 to 10 days after infection).
While IgM/IgG serological tests alone may not be enough to diagnose COVID-19, they can be a valuable diagnostic tool when combined with RT-qPCR (see section below).
In addition, because of their scalability, serological assays can be used in large-scale, whole-population, testing to assess the overall immune response to the virus and identify asymptomatic carriers of the virus. Indeed, 20-80% of COVID-19 cases are estimated to be asymptomatic.
Where can I go for updates and more information?
The most up-to-date information on COVID-19 is available at the Centers for Disease Control and Prevention website: https://www.cdc.gov/COVID19. In addition, please also contact your health care provider with any questions/concerns.