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HomeMy WebLinkAbout2020-03-13 FAQs on Coronavirus -- from DOH Page 1 of 12 Coronavirus Disease 2019 (COVID-19) Frequently Asked Questions Revised March 12, 2020 Acronyms and abbreviations used in this document: • 2019-nCoV: 2019 Novel Coronavirus • CDC: US Centers for Disease Control & Prevention • COVID-19: Coronavirus Disease 2019 • HDOH: State of Hawaii Department of Health • MERS: Middle East Respiratory Syndrome • SARS: Severe Acute Respiratory Syndrome • SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2 • WHO: World Health Organization • HNL: Daniel K. Inouye International Airport This document provides reliable and up-to-date information to the general public during the continuing outbreak of COVID-19. Key messages are the importance of preventive measures, such as frequent hand- washing, practicing social distancing when there is community spread of COVID-19, avoiding touching your face with dirty hands, and in particular staying home when you are sick (i.e., do not go to work, school, and other activities if you are feeling ill). Symptoms of COVID-19 include fever, cough, and shortness of breath or trouble breathing. OVERVIEW What is COVID-19? COVID-19 (formerly called “2019 Novel Coronavirus,” abbreviated as “2019-nCoV”) is a new respiratory virus that was first identified in the central Chinese city of Wuhan, in Hubei Province. It has since spread to other cities across China as well as at least 80 other countries, including the United States. On January 30, 2020, the WHO declared a Public Health Emergency of International Concern. At this time, there are no confirmed cases of COVID-19 in Hawaii. What is the correct name of this outbreak’s disease and the virus that causes it? Isn’t it called 2019-nCoV? Global experts on viruses have officially named the virus causing the outbreak “SARS-CoV-2.” This is an abbreviation of “Severe Acute Respiratory Syndrome Coronavirus 2.” After researching the new coronavirus, scientists determined it is closely related to the virus that caused the SARS epidemic in 2002 and 2003. The virus that caused SARS is known as SARS-CoV, so this new coronavirus is called SARS-CoV-2. Although the virus is known as SARS-CoV-2, the illness it causes is now officially called COVID-19 (short for coronavirus disease 2019). Shortly after the outbreak first started in Wuhan, China, the virus and illness were often referred to as “2019 Novel Coronavirus,” which was usually Page 2 of 12 abbreviated as “2019-nCoV.” The name “COVID-19” is expected to replace “2019 Novel Coronavirus” and “2019-nCoV,” although for a while the older names may still be in use. Am I at risk for COVID-19 in the United States? This is a rapidly changing situation and the risk assessment may change daily. Hundreds of people are confirmed to have been infected across the country, with dozens of deaths associated with COVID-19. The latest updates are available at CDC’s COVID-19 website and HDOH’s COVID-19 website. For the general public in the United States, who are unlikely to be exposed to the virus at this time, the immediate risk to their health from COVID-19 is considered low. Nevertheless, public health authorities such as CDC and HDOH want everyone to be prepared for the likelihood that COVID-19 will spread more widely in the United States. There have also been 49 cases of COVID-19 among persons repatriated to the United States, including 3 from Wuhan, China, and 46 who were on the Diamond Princess cruise ship that had been quarantined in Yokohama, Japan. CDC is taking COVID-19 very seriously. Risk, however, depends on exposure; healthcare workers and family members or close household contacts caring for people with COVID-19 are likely at greater risk of infection than the general public. Current global circumstances suggest it is likely that this virus will cause a pandemic (a global outbreak of a disease). CDC expects that more cases are likely to be identified in the coming days, and person-to-person spread will likely occur in the United States. Is COVID-19 a danger in Hawaii? As of March 6, there have been two cases of COVID-19. One was a Hawaii resident who had been infected with the virus while on vacation aboard the Grand Princess cruise ship in Mexico. The resident has remained at home while showing symptoms and had no contact with other people. The second case is a Hawaii resident who felt ill in Washington State and returned home to Honolulu. CDC has been notified and close contacts of the case are being identified and informed of their exposure. Despite these two cases, there is no community spread of COVID-19 in Hawaii, and the health risk is low at this time. Nevertheless, federal, state, and local officials in Hawaii recognize the seriousness of the situation and are working diligently with federal officials around the clock to prevent spread of COVID-19 within our state. At some point there may be more cases identified in Hawaii, and possibly even community spread of COVID-19. Therefore, HDOH wants the public to know and practice important preventive measures, such as frequent handwashing, with soap and water for 20 seconds or Page 3 of 12 with alcohol-based hand sanitizer, to prevent spread of COVID-19 when it may be introduced here. Even if COVID-19 does not become widespread in Hawaii, our access to certain resources could still be impacted by this outbreak. Hawaii residents should make sure they and their household are prepared with a family emergency kit that lasts at least 14 days, in case a family member is quarantined or if there is a shortage of certain goods, such as medicine and food, in the event of a continuing pandemic. You can learn more about preparing a family emergency kit at health.hawaii.gov/prepare/protect-your-family. HDOH is continually updating information as the situation evolves and federal guidance changes. We urge everyone to learn about COVID-19 by staying informed with credible sources, such as CDC’s and HDOH’s websites. What happens if there is person-to-person widespread transmission in Hawaii or elsewhere in the United States? While proactively carrying out prevention measures may slow the spread of COVID-19, it is important to be prepared for the possibility that it could still become widespread in Hawaii. According to CDC, if there is widespread transmission of COVID-19 in the United States, there would be large numbers of people needing medical care at the same time. Schools, childcare centers, workplaces, and other places for mass gatherings may experience more absenteeism. Public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths. Other critical infrastructure, such as law enforcement, emergency medical services, and transportation industry may also be affected. Health care providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions (such as social distancing or staying home if you’re sick) would be the most important response strategy. What are coronaviruses? Coronaviruses are a large family of viruses named for the crown-like spikes on their surface. They are common in many different species of animals, including camels, cattle, cats, and bats. Rarely, these animal coronaviruses can infect people and then spread between people. Human coronaviruses are also common throughout the world and can cause mild to moderate illness (for example, “the common cold”). Some coronaviruses that infect humans are known to cause severe illness, like the coronaviruses that cause MERS and SARS. COVID-19 is a pneumonia-type illness caused by a new (or novel) coronavirus called SARS-CoV-2 that originated in Wuhan, China. It may have originated in animals, but it can now be spread from person-to-person. So is COVID-19 the same as SARS and MERS? No, they are different coronaviruses. Page 4 of 12 How does COVID-19 spread? Although SARS-CoV-2 (the virus that causes COVID-19) likely came from an animal source, it can also spread from person-to-person. Some viruses are very contagious (like measles), while other viruses are less so. It’s not clear yet how easily COVID-19 spreads from person-to-person. The main way most coronaviruses (including the common cold) spread is through the droplets produced when an infected person coughs or sneezes. A person may be infected when those droplets land in one’s mouth or nose, or possibly eyes. How long is a person with COVID-19 infection contagious? At this time, CDC and others are studying available data to better understand this. Very likely, as with other coronaviruses, a person is infectious as long as they are ill. However, we continue to monitor the situation to update the information. Does HDOH release the names of confirmed cases or persons under investigation? HDOH protects patient privacy and does not release names or other information that could be used to identify a person infected with COVID-19 or who is under quarantine. At the same time, those who may have been exposed have a right to know and to protect themselves. When HDOH identifies a potential case of COVID-19, a detailed investigation is performed that includes tracing and contacting all close contacts of that person during the time that they were infectious. Since the virus is spread by prolonged close contact, people who have briefly been in the same indoor environment or had brief interactions are not considered to be at risk for infection. SYMPTOMS AND TREATMENT What are the symptoms of COVID-19? Patients with COVID-19 have reported mild to severe respiratory illness, including the following symptoms: • Fever • Cough • Shortness of breath or trouble breathing Some patients may not report fever, especially the very young, elderly, immunosuppressed, and people taking certain fever-lowering medications. How long does it take for symptoms to appear? CDC believes the symptoms of COVID-19 may appear as early as 2 days after exposure and as long as 14 days after exposure. Page 5 of 12 Are there complications from COVID-19? Many patients with COVID-19 have developed pneumonia in both lungs. In some cases, death has occurred. How is COVID-19 treated? There are no specific antiviral treatments for COVID-19. People who are infected should receive supportive care to help relieve symptoms. Should I be tested for COVID-19 infection? If you have traveled to an area with widespread sustained community transmission in the past two weeks and have symptoms of respiratory illness (such as cough or shortness of breath), call ahead to a healthcare provider and mention your recent travel or close contact. The healthcare provider will work with the Hawaii Department of Health (HDOH) to determine if you need to be tested. People who have traveled to areas recognized by CDC as having community spread of COVID-19 (e.g., South Korea, Japan, most of Europe, Iran, and other countries) should monitor their health for 14 days after leaving those areas. If they develop a fever or cough, they should call their healthcare provider for guidance and tell them about their symptoms and travel history. You can find a list of countries with widespread sustained community transmission of COVID-19 at www.cdc.gov/coronavirus/2019-ncov/travelers. What is the test for SARS-CoV-2 or COVID-19? Can any laboratory in Hawaii test for it? SARS-CoV-2 (the virus that causes COVID-19) is detected through laboratory testing of respiratory specimens and serum (blood). Healthcare providers who think their patients may have COVID-19 can work with HDOH to have their specimens tested. Testing can be performed at the Hawaii State Laboratories Division, at CDC in Atlanta, Georgia, and at some commercial labs. Will HDOH tell us if there is a confirmed case in Hawaii and where the case is located? HDOH will inform the public if there is a confirmed case. HDOH respects the privacy of persons and their households and balances that against our mission to protect the public’s health. Therefore, only the county where the person is located will be identified. Wasn’t there a case involving a visitor from Japan? What happened with that? On February 14th, HDOH was informed by CDC that a traveler from Japan was hospitalized and tested positive for COVID-19 after visiting Hawaii. The traveler’s wife also became symptomatic after returning to Japan and tested positive for COVID-19. The couple visited Maui from January 28 to February 3, and Oahu from February 3 to February 6, 2020. Although HDOH cannot release information such as the name of the infected individuals due to privacy concerns, HDOH worked carefully with the Japanese consulate in Page 6 of 12 Honolulu and Japan’s Ministry of Health to understand where the couple had traveled while in Hawaii. HDOH reached out to those who may have been exposed and advised them to self-monitor their health for symptoms of infection for 14 days. After extensive investigation by HDOH, no one has been identified as having had close contact with the travelers and subsequently becoming ill. HDOH continues to monitor closely for any potential concerns related to this situation. PREVENTION AND PROTECTION How can I protect myself and my family? The best way to prevent transmission of any respiratory illness (including flu) is to follow everyday preventive actions: • Get your flu shot. With current seasonal flu activity, it is likely there will be confusion as persons with flu will exhibit some of the same symptoms as COVID-19, such as fever and cough. We strongly recommend residents ages 6 months and older protect themselves against flu by receiving the seasonal flu vaccination. • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty. • Avoid touching your eyes, nose, and mouth with unwashed hands. • Avoid close contact with people who are sick. • Stay home when you are sick. • Cover your cough or sneeze with a tissue; then throw the tissue in the trash. • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe. Is there a vaccine for SARS-CoV-2 / COVID-19? There is currently no vaccine to protect against this virus. The way to prevent infection is to practice preventive measures such as frequent handwashing. Does the flu shot provide any protection against COVID-19? The annual flu vaccination does not protect against COVID-19, but it is recommended for all persons ages 6 months or older to protect against getting influenza (the flu). Why should I get the flu shot then? Symptoms of COVID-19 are similar to symptoms of influenza (the flu). Reducing the number of flu cases (by getting the flu shot) not only helps decrease the burden on healthcare providers and facilities, having fewer patients with flu-like symptoms makes it easier to detect those persons who might have COVID-19 infection. Page 7 of 12 More importantly, the flu shot also prevents you from getting flu and spreading it to others, especially very young people, elderly people, and those with compromised immune systems. For these people, flu can be severe or even deadly. Will wearing a mask protect me from COVID-19? For healthy or well people, wearing a face mask is not recommended to prevent infection. The best preventive measures are to wash your hands (especially before touching your face, nose, or mouth), cover your nose and mouth with your elbow or a tissue when coughing or sneezing, limit your contact with sick people, and stay home if sick. If you are sick, wearing a face mask can help prevent others from being infected by the droplets from your cough or sneeze. TRAVEL TO/FROM CHINA AND AFFECTED COUNTRIES I recently traveled to China. What should I do? If you have returned to the United States from mainland China (excluding Hong Kong, Macau, or Taiwan) on or after February 3, 2020, you should stay home and monitor your health for the 14 days after leaving China: • Stay home and avoid group settings, including work and school. If possible, have another family member/friend, who didn’t travel from China, run any errands for you such as picking up food or medicine. Avoid using public transportation, taxis, or ride- shares if possible. • If you develop a fever (100.4°F/38°C) or cough, call HDOH for advice before seeking care. If you can’t reach HDOH or are having trouble breathing, call ahead to your doctor’s office or emergency room and tell them about your recent travel and symptoms. If you returned from mainland China (excluding Hong Kong, Macau, or Taiwan) before February 3, 2020, and do not have any symptoms, you can remain in school or work. If you left China less than 14 days ago and feel sick with fever, cough, or trouble breathing, you should: • Stay home and avoid contact with others except for seeking medical care. • Call HDOH for advice before seeking care. If you can’t reach HODH, before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms. Is it safe to go to China? On February 2, 2020, the U.S. Department of State issued a level 4 travel advisory for all of China and recommended against any travel to China because of the COVID-19 outbreak (U.S Department of State China Travel Advisory). • In response to an outbreak of respiratory illness, Chinese officials have closed transport within and out of Wuhan and other cities in Hubei province, including buses, subways, Page 8 of 12 trains, and the international airport. Additional restrictions and cancellations of events may occur. • There is limited access to adequate medical care in affected areas. • Travelers without U.S. citizenship or a green card who traveled in China within the past 14 days may be prohibited from re-entering the United States under the presidential directive effective February 2, 2020. I am planning to travel internationally, but not to China. Is it safe to travel internationally? The situation with COVID-19 continues to evolve and we cannot predict if other countries will still be considered “safe” for travel in the coming months. Anyone with plans to travel internationally should stay informed of the latest Traveler’s Health Recommendations for their specific destination, as this is an evolving situation. Currently there are Department of State travel restrictions and Level 3 CDC advisories for mainland China (excludes Hong Kong, Macau, and Taiwan), most of Europe and Iran. CDC recommends that travelers avoid all nonessential travel to mainland China (excluding Hong Kong, Macau, and Taiwan) and Iran. Also, foreign nationals with recent travel from these destinations are unable at this time to enter the United States. U.S. citizens and residents returning from mainland China and Iran should stay home for 14 days after leaving those countries and practice social distancing. If they are sick with fever, cough, or breathing difficulties, they should call ahead before seeking medical care. This information is subject to change; travelers should check wwwnc.cdc.gov/travel/notices for the latest information. CDC has upgraded the Travel Notice for South Korea and Italy to Level 3 (“Warning”) due to widespread ongoing community transmission of COVID-19. CDC recommends that travelers avoid all nonessential travel to South Korea and Italy. People who have been in South Korea or Italy within the past 14 days should stay home or in their hotel room for 14 days after leaving those countries and practice social distancing. If they are sick with fever, cough, or breathing difficulties, they should call ahead before seeking medical care. This information is subject to change; travelers should check wwwnc.cdc.gov/travel/notices for the latest information. The CDC has issued a Level 2 (“Alert”) Travel Notice for Japan due to sustained community transmission of COVID-19 in those countries. This alert advises older adults and individuals with chronic medical conditions to consider postponing nonessential travel to these locations since they may be at higher risk for severe illness. Travelers should watch their health during travel and for 14 days after leaving Japan. This information is subject to change; travelers should check wwwnc.cdc.gov/travel/notices for the latest information. A Level 1 (“Watch”) Travel Notice for Hong Kong has also been issued, indicating that people should “practice usual precautions” when traveling to these locations. This emphasizes the importance of following basic precautions to prevent illness while traveling and to monitor the situation. Basic precautions include avoiding contact with sick people, avoiding touching your eyes, nose and mouth with unwashed hands, and cleaning your hands often by washing them Page 9 of 12 with soap and water for at least 20 seconds. This information is subject to change; travelers should check wwwnc.cdc.gov/travel/notices for the latest information. Hawaii residents are encouraged to check the U.S. Department of State and CDC websites for travel advisories to other countries. While there are no U.S. restrictions besides mainland China and Iran at this time, given the rapidly evolving situation surrounding COVID-19 in China and some of its neighbors in East Asia, Hawaii residents may want to reconsider their travel plans to the region because of restrictions and quarantine criteria that other countries have put in place or may put in place in the future. These restrictions may cause disruptions in travel and cause difficulties for Hawaii residents trying to return home. Should I be worried about products imported from China? There is no evidence you can become infected with COVID-19 from a product imported from China. COVID-19 appears to be related to coronaviruses like SARS and MERS which do not survive long on surfaces. Instead, they are usually spread from person-to-person through respiratory droplets. What about animal products from China? CDC currently has no evidence that animals or animal products imported from China pose a risk for spreading COVID-19. Information will be updated as it becomes available. Is my pet at risk of getting COVID-19? Do animals in Hawaii have COVID-19? Although this coronavirus seems to have come from an animal source, it is now spreading from person-to-person. There is no reason to believe animals or pets in Hawaii or elsewhere in the United States might be at risk for infection from COVID-19. SITUATION IN HAWAII What is HDOH doing to monitor the situation with COVID-19? HDOH is doing a number of things to closely monitor the situation with COVID-19: • At this time, there are no persons requiring investigation for potential COVID-19 infection in Hawaii; we are monitoring existing disease surveillance systems and reviewing response protocols with relevant in-state partners. • We are collaborating and frequently communicating with CDC and state public health partners to closely monitor the situation and ensure Hawaii is prepared should a person potentially exposed or infected with COVID-19 be identified in Hawaii. • We are working with healthcare facilities to ensure hospitals and healthcare providers are up to date on infection control recommendations in the event they encounter a person potentially infected with COVID-19. • We are communicating regularly with public and private travel partners to ensure the latest CDC guidance and information is being shared with all relevant personnel. Page 10 of 12 • We have been conducting illness surveillance of international travelers at the Daniel K. Inouye International Airport since October 2005 and continue to work with our airport partners on ongoing, regular surveillance. What are hospitals in Hawaii doing to get ready? HDOH is sharing with and updating infection control guidance to healthcare facilities to ensure hospitals and healthcare providers are prepared should they encounter a person potentially infected with COVID-19. Hospitals and healthcare providers, in turn, are reviewing their infection control policies. Hospitals and HDOH are in regular communication with federal partners to ensure supplies of personal protective equipment for healthcare workers are adequate. Are there any cases of COVID-19 in Hawaii? At this time, HDOH has identified two persons potentially infected with COVID-19. Are passengers being screened at Daniel K. Inouye International Airport? The White House issued a proclamation that starting at 5:00 p.m. EST (12:00 p.m. HST) on February 2, 2020, foreign nationals who have been in China (excluding Hong Kong, Macau, and Taiwan) or Iran in the past 14 days are barred from entering the United States. U.S. citizens, green card holders, and their immediate family with travel to China in the past 14 days are permitted to enter but must undergo special screening and may be subject to quarantine for up to 14 days. All US citizens and their close family members returning from China must enter through one of 11 airports in the United States (including HNL), where they will be screened by US Customs and Border Protection agents in collaboration with CDC. • If travelers are showing signs of respiratory illness, they will be sent to a healthcare facility for medical care. • If travelers were in Hubei Province at any time in the past 14 days, they will be quarantined at a secure location and monitored for illness for 14 days after their departure from China. • If travelers are returning from other places in China and have been in close contact with a confirmed case of novel coronavirus, they may also be subject to quarantine for 14 days from last exposure. • If travelers are returning from all other parts of China and they have not been in close contact with a confirmed case of COVID-19, they will be allowed to travel to their home or final destination where they will be monitored by their local public health department and asked to remain in their homes and avoid public places for 14 days after their departure from China. HDOH is communicating regularly with travel partners at HNL to ensure the latest CDC guidance and information is being shared with airport personnel. HDOH has conducted influenza-like illness surveillance at Daniel K. Inouye International Airport since October 2005 and continues to work with our airport partners on ongoing, regular surveillance. Page 11 of 12 All travelers from China will be given CDC’s Travel Health Notice, educating those travelers about what to do if they get sick with certain symptoms within 14 days after arriving in the United States. Will passengers on a quarantined cruise ship be quarantined again when they leave the ship and enter Hawaii? What are the quarantine requirements for passenger ship passengers? Cruise ships carrying passengers who have been to mainland China (excludes Hong Kong, Macau, and Taiwan) within the last 14 days are not allowed to enter U.S. waters, including waters off Hawaii. Their crew and passengers will not be able to disembark until after 14 days have passed since leaving China. Once persons have completed their required 14-day quarantine, they are free to return to their regular daily life. There is no reason to quarantine an individual again unless they are exposed to a person with COVID-19 infection. Are there quarantine restrictions for non-passenger commercial ships? Non-passenger commercial vessels that have been to, or have crew that have been to, mainland China, with no sick crew members will be allowed entry to the U.S., but their crew must remain aboard the vessel. If there were cases in Hawaii, how would they be isolated? What are the procedures and protocols? HDOH is coordinating closely with Hawaii’s healthcare facilities to ensure any clinic, hospital, or other healthcare setting is ready to care for a person infected or potentially infected with COVID-19 with appropriate isolation precautions. Cases not needing hospitalization will be subject to quarantine with close monitoring by public health and ready access to medical care. What is self-monitoring? People with travel history to countries other than China where there is widespread community transmission but who have no symptoms of COVID-19 may be asked to self- monitor for 14 days and check themselves for symptoms of COVID-19. If they develop a fever or cough, they should call their healthcare provider for guidance and tell them about their symptoms and travel history. If I think I or my family member has contracted COVID-19 but we have no health insurance due to a lost job or other situation, what should we do? Will we be turned away from a hospital? Hospitals in Hawaii do not turn away emergency cases, regardless of insurance coverage. However, any individual or family that has lost health coverage due to job loss or other Page 12 of 12 circumstances is encouraged to contact federal and Hawaii state resources to obtain health insurance, such as the federal government’s healthcare marketplace or Hawaii’s Quest. You can find out about your eligibility for free or subsidized healthcare coverage by visiting www.healthcare.gov/connect or humanservices.hawaii.gov/mqd or by calling Quest at 1-877- 628-5076. Where can I find out more information? For more information about COVID-19, visit the Centers for Disease Control and Prevention (CDC) website at http://www.cdc.gov/coronavirus/novel-coronavirus-2019.html. You can also visit the HDOH website at health.hawaii.gov/docd/advisories/novel-coronavirus-2019. Finally, you can call Aloha United Way at 211 from anywhere in Hawaii for information and referral services.