1. The CDC continues to recommend wearing masks in public, social distancing by at least 6 ft, and self isolation if you are sick a. Masks should also be worn around people who do not live in your household or when it is difficult to maintain adequate social distancing.
2. Protect yourself by washing your hands for at least 20 seconds, particularly after being in a public place, blowing nose, coughing, sneezing, handling mask, caring for anyone who is ill, touching animals or pets a. If soap and water are not available, use 60% alcohol containing hand-sanitizer.
3. Always avoid touching eyes, nose, and mouth with unwashed hands.
4. Symptoms of COVID-19 may begin anywhere from 2-14 days following exposure (the incubation period), with the average being 5-6 days. The most common ones are as follows: a. Fever b. Chills c. Cough d. Shortness of breath e. Fatigue f. Body aches g. Loss to taste or smell h. Sore throat i. Congestion or runny nose j. Nausea, vomiting, or diarrhea.
5. An individual with COVID-19 may be contagious 48-72 hours prior to experiencing any symptoms. a. It is thought the virus may spread most readily during this time period.
6. Those who are at increased risk for COVID-19 are individuals over 65 and those that have various underlying conditions: a. Cancer b. Chronic renal disease c. Cardiovascular disease (heart failure, coronary artery disease) d. Obese individuals (BMI over 30) e. Pregnancy f. Smokers g. Type-two diabetes h. Any form of compromised immune system.
7. It is recommended people screen themselves for temperatures each day prior to proceeding with ADLs.
8. If you become sick or experience any of the symptoms above, the CDC recommends to stay home and self-isolate for at least 14 days a. Most cases are mild and will resolve at home. Contact your doctor to keep them informed. b. Rest as much as possible, hydrate adequately, avoid all public spaces including public transportation c. If you have any of the emergency symptoms, including difficulty breathing, painful breathing, confusion, persistent chest pain, inability to stay away, or note bluish hue to lips or mouth, seek urgent care immediately.
9. Spreading of COVID 19
a. It is most commonly spread via respiratory droplets in direct or close contact (under 6 ft) with an individual who has COVID-19
i. Respiratory droplets are produced by speaking, coughing, sneezing, singing, breathing.
ii. Infection begins if a contaminated droplet comes into contact with a mucosal membrane, such as those that line the mouth or nose
b. Air-borne transmission and contact with infected surfaces are now shown to be much less common forms of infection
10. Testing for COVID-19
a. There are three major types of testing
i. PCR-diagnostic testing (molecular testing), commonly called the “standard” COVID test 1. Sample: nasopharyngeal / mid-turbinate swab 2. Turnaround time: 24-72 hours 3. Accuracy: Both highly sensitive and highly specific (nearly 100% for both!)
ii. Antigen testing, the “rapid” COVID test 1. Sample: nasal or throat swab, saliva 2. Turnaround time: less than 1 hour 3. Accuracy: a. Highly specific, nearly 100% b. Less sensitive at 83% being low end of the range, which means higher chance for false negatives i. Sensitivity will shift depending on when sample is taken during the course of infection as antigen levels 5-7 days past symptom onset drop significantly
iii. Antibody testing, a test showing if you had the virus and cleared it 1. Research is still unsure if having the antibodies imparts lasting immunity as the virus continues to mutate and there are known cases of COVID-19 reinfection
b. Testing window for PCR-diagnostic testing
The closer the test is to the initial exposure during the asymptomatic incubation phase, the higher the rates of false negatives
1. Most studies show 100% will test falsely negative on the first day following exposure a. This drops to 65-67% on day 4 of asymptomatic incubation phase
2. The rates of false negatives drop significantly once an individual begins exhibiting symptoms to roughly 20% on the first day of symptoms
3. This suggests testing on or after day 2 of exhibiting symptoms may be the best time to get tested
4. This is also why experts say a negative test result immediately following a suspected or known contact with COVID-19 should not be considered a clear bill of health to travel or visit elderly family members or friends
c. Testing in Portland, Oregon
i. Currently due to the limited availability, testing at some sites, such as Providence, is reserved for symptomatic individuals
1. Those that are asymptomatic with suspected contacts or known contact with COVID-positive people are encouraged to begin self-quarantine and monitor for symptoms This information was adapted from the CDC’s Coronavirus-19 page, the FDA, the National Center for Immunization and Respiratory Diseases (NCIRD), and Portland.gov
ii. Most testing sites will require a doctor’s order and appointment for testing, so it is best to call ahead of time to ensure you have everything you will need
iii. OHSU offers drive through testing without requiring a doctor’s order
iv. For a complete list of testing and local authority advice on COVID-19, visit the following: https://www.portland.gov/novel-coronavirus-covid-19 11. Above all, the best way to prevent the virus is to avoid exposure and through maintaining a strong immune system (rest, hydration, proper nutrition, stress reduction, and more!)
11. Above all, the best way to prevent the virus is to avoid exposure and through maintaining a strong immune system (rest, hydration, proper nutrition, stress reduction, and more!)
