We're keeping you informed
Coronavirus has become widespread throughout the U.S., with some communities experiencing greater impact than others. Staying informed and prepared is the best way to minimize risk and protect yourself and your family. The Centers for Disease Control and Prevention (CDC) recommends practicing physical distancing, wearing face masks and exercising good hygiene as the most effective ways to mitigate exposure to the virus—keeping you, your family and your community safe.
Brad Younggren, MD
98point6 Chief Medical Officer
Why virtual care?
Virtual care is one of the most impactful tools available in the fight against COVID-19, and we’re as dedicated as ever to providing the diagnosis, treatment and reassurance you need from home. Text-based care allows us to evaluate symptoms without you risking exposure—or potentially passing the illness to others—and is key during this time of physical distancing, helping to flatten the curve and prevent further spread of the virus.
Frequently asked questions about coronavirus
Coronaviruses are a common family of viruses that cause infections ranging from the common cold to more serious illnesses. Most people have had a coronavirus at some time in their lives. The most recently discovered type causes an infection called “coronavirus disease 2019” (abbreviated COVID-19).
Contact tracing is a way of identifying individuals who may have come in contact with a person who has been diagnosed with a virus or disease. Since COVID-19 is contagious and those infected may not be experiencing symptoms, this is a core disease control measure used to stop the spread.
As part of this process, public health and medical staff work with the patient who was/is infected to help them recall everyone with whom they have had close contact when they may have been contagious. Those individuals (contacts) are then informed of their potential exposure in a quick and sensitive manner by public health staff, who also offer essential education, guidance and support to ensure those individuals and their community are protected.
According to the Centers for Disease Control and Prevention (CDC), adults of increasing age and people who have serious chronic medical conditions like heart disease, diabetes and lung disease have a higher risk of developing complications from this illness.
Outside this high-risk group, a complete recovery is likely, although reports of complications in a subset of COVID-19 patients include Multisystem Inflammatory Syndrome (MIS-C) in children, as well as respiratory, neurological, kidney and vascular effects on adults. Also bear in mind that people of all ages and levels of risk can transmit the infection and increase the spread.
Click here for the most complete and updated list from the CDC of people at highest risk of severe illness from COVID-19.
In addition to staying home, washing hands frequently and practicing physical distancing, the CDC recommends adults of increasing age and/or those with chronic conditions like asthma, severe obesity and diabetes consider additional precautions such as:
- Reduce trips to the pharmacy: Speak to your healthcare provider, insurer and pharmacist about obtaining at least a 2-week supply of necessary prescription and nonprescription medications.
- Make sure essential vaccinations are up-to-date: If you don’t recall, your healthcare provider should have a record of your last inoculation against influenza and pneumococcal disease.
- Do not delay care under any circumstances: Emergency departments have contingency infection prevention plans to protect patients from contracting COVID-19, so seek help immediately if your underlying condition requires care. Similarly, if you have an underlying condition and think you may have COVID-19, contact your healthcare provider right away.
Click here to get additional recommendations from the CDC based on specific high-risk conditions.
It is believed that COVID-19 is spread mainly through small droplets from the nose or mouth that are expelled when an infected person coughs or exhales. When the droplets land on objects and surfaces, others can catch COVID-19 by coming into contact with these droplets and then touching their eyes, nose or mouth. Because some people without symptoms may be able to spread the virus (“asymptomatic spread”), the CDC recommends wearing a face covering in public as a cautionary measure. Since COVID-19 is still relatively new, we are learning more each day about the specifics of transmission and the severity of illness it causes.
The best way to prevent illness is to avoid being exposed to the virus, according to the CDC. You can do this by:
- Regularly and thoroughly cleaning your hands with an alcohol-based hand rub or washing them with soap and water, as this kills viruses that may be on your hands.
- Not touching your eyes, nose and mouth.
- Covering your cough or sneeze with a tissue and throwing the tissue away.
- Cleaning and disinfecting frequently touched surfaces and objects.
- Practicing physical distancing. This means avoiding crowded public places and large gatherings where close contact with others may occur. It’s recommended you aim for a physical distance of approximately 6 feet from others when possible.
- Wearing a face covering whenever you're in a public setting, especially in situations where physical distancing is a challenge.
As businesses, communities and activities open up again, experts, including the CDC, have reiterated there is no way to ensure zero risk of COVID-19 infection. Although lockdowns may be lifting, the prevention measures remain the same: everyone is encouraged to continue maintaining physical distance and wearing face coverings in public, be vigilant about hand hygiene and stay home if they feel sick. It’s also a matter of individual comfort level, which includes taking into consideration factors like your personal risk and your family risk (having someone in the household with an elevated personal risk of COVID-19-related complications).
For thought-starters around making the best decision for you and your family, as well as tips around specific activities such as going to the gym, traveling overnight, using public transportation and playing youth sports, visit the Centers for Disease Control and Prevention website.
Click here for the latest updates on COVID-19, including a state-by-state map from Johns Hopkins that shows reported cases and community transmission to date by county level.
Based on recent research, the CDC recommends people wear face coverings, including cloth masks, bandanas and scarves, any time they are in public settings. Masks have been shown to be effective at both protecting the wearer and preventing the spread of coronavirus to others. Since many people who are infected experience mild to no symptoms, it is important to seriously consider this voluntary public health measure for the safety and protection of your local community. Unless you already have them, surgical masks and N-95 respirators should not be purchased, since they are in short supply and are critically needed for healthcare workers. For more information on how to wear and make homemade face coverings, see the CDC guidance here.
General symptoms of COVID-19 for children are similar to those seen in adults. However, children tend to experience milder symptoms (resembling a common cold or low-grade flu) such as fever, runny nose and cough. Other potential symptoms include tiredness, sore throat, shortness of breath, body aches, headaches, vomiting and diarrhea with occasionally more severe illness, like pneumonia.
In rare cases, some children are experiencing a systemic inflammatory condition similar to Kawasaki disease with fever, eye redness and an unusual rash on the body (including the extremities). Currently being referred to as Multisystem Inflammatory Syndrome in Children (MIS-C), this can occur without the usual respiratory symptoms and in children who have recovered from a previous COVID-19 infection. If your child is experiencing any of the above, start a visit with us or contact your pediatrician to see if testing for COVID-19 or an in-person evaluation is appropriate.
Symptoms and Precautions
The most common symptoms of COVID-19 are fever, tiredness, shortness of breath and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild, begin gradually and can appear 2–14 days after being exposed. Individuals of increasing age and those with underlying medical conditions like high blood pressure, heart problems, lung conditions or diabetes are more likely to develop serious illness, as well as people with a history of smoking. For a more detailed look at symptoms, visit the CDC page here.
There is still a lot we don’t know about the novel coronavirus—even the CDC notes their list of symptoms, which also includes sore throat, diarrhea, fatigue and headache, is not exhaustive. That’s why if you are feeling unwell, you should stay home and start a visit with a virtual care provider or call your primary care physician to discuss what you’re experiencing and next steps. It’s likely that you will get referred to in-person or at-home testing to confirm or rule out COVID-19.
While well-intentioned, temperature screening in workplaces, airports and hospitals is far from a catch-all, since you can be fever-free and still infected—and capable of spreading—COVID-19. And it’s always good to bear in mind that up to 40% of patients with COVID-19 may actually have no symptoms, according to the CDC.
98point6 encourages widespread use of testing for COVID-19, and your physician may recommend it as part of your medical evaluation. You are also encouraged to discuss any concerns you might have about your personal risk or potential for exposure, as 98point6 doctors can order testing on the basis of these concerns, even in the absence of symptoms. Connecting with a physician will ensure your symptoms get assessed and you are guided towards the right next steps, which may include a visit to a testing center nearest you.
It’s important to get the care you need in a way that prevents the disease from spreading to others. Take advantage of virtual care or contact your healthcare provider (call before visiting). A physician will discuss your symptoms and your risk for COVID-19 and help you decide whether you need testing. It may be recommended you self-isolate in your home for a period of time.
If you live with family or roommates, this entails:
- Staying in a separate room and using a different bathroom, if possible.
- Avoiding the sharing of personal household items, including drinkware and towels.
- Wearing a mask if you do need to be in the same room for even a brief amount of time.
- Everyone in the household should be vigilant about hygiene, from covering coughs and sneezes to thoroughly washing hands with soap and water or using an alcohol-based hand sanitizer, plus cleaning frequently touched surfaces daily.
When to Seek Care
Unless you are in a high-risk group (older adults and people who have serious chronic medical conditions) for developing complications, the best thing you can do is self-isolate and monitor your symptoms carefully.
- Get rest and stay hydrated; this helps support your immune system.
- Use the same over-the-counter medications you would to treat the symptoms of a cold, such as acetaminophen for fever and aches and cough/cold medicine.
- For questions or peace of mind, take advantage of virtual care, as needed.
If you develop emergency warning signs for COVID-19, get medical attention immediately. Call your healthcare provider ahead of time and tell them your COVID-19 status. Emergency warning signs include*:
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion or difficulty waking up
- Bluish lips or face
- Severe and constant dizziness or lightheadedness
*This list is not all-inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.
The ever-evolving situation that is COVID-19 can be confusing and add to the anxiety we are all feeling right now. Looking to credible sources of guidance, like a 98point6 physician or your healthcare provider, and seeking answers to any questions you may have is always the right move.
Several factors, including test availability and delayed test results reporting, have influenced the CDC to recently revise their guidelines regarding who should be tested. Currently, testing is recommended for symptomatic individuals and for asymptomatic individuals who have been in “close contact” with a person who has COVID-19. Close contact is defined as being within 6 feet of a person who has a COVID-19 infection for at least 15 minutes. There are exceptions to this updated recommendation; for example, if you live with someone at high-risk of COVID-19 complications, such as an elderly person or an individual with an underlying health condition, you can discuss with your doctor whether testing might be helpful, even with no symptoms and a lesser degree of exposure.
Regardless of any of the CDC’s recommendations, you can get a COVID-19 test order from a physician at any time—none of these guidelines will prevent you from doing so. And no matter what your circumstances are, even if you just want reassurance, you can always speak with a 98point6 physician to determine if a test is right for you. 98point6 continues to order tests for patients who request one and/or when our physicians determine a test is warranted.
The FDA has created a web page describing the basics about testing for COVID-19. There are three main types of tests available today:
- COVID-19 diagnostic viral tests, also known as PCR (Polymerase Chain Reaction) tests, use a sample taken from the nose or mouth by swab or saliva to determine whether you have an active infection with the virus. PCR tests are considered the “gold standard” because they are the most sensitive and specific. This means you are less likely to get a false positive or a false negative result. If you have symptoms, a 98point6 physician can help determine if a PCR test is the appropriate next step.
- COVID-19 rapid diagnostic viral tests, also known as antigen tests, use a sample taken from the nose or mouth by swab or saliva to determine whether you have an active infection with the virus. Antigen tests have recently received an Emergency Use Authorization (EUA) from the FDA and are expected to become broadly available in September/October 2020. Rapid antigen tests provide results in less than 15 minutes and are much less expensive than diagnostic PCR tests. These tests are best suited for rapid diagnostic situations (e.g., in a doctor’s office, as well as screening testing (e.g., return-to-work or return-to-school programs). Although some antigen tests can be less sensitive and less specific than PCR tests, the recent antigen tests authorized by the FDA are on-par with PCR. If you have symptoms, a 98point6 physician can help determine if a rapid diagnostic test is the appropriate next step.
- Antibody tests (also known as serological tests) use a blood sample to reveal markers of immune response in the form of antibodies, which frequently show up in the blood more than a week after symptom onset. In addition to confirming a suspected case after a patient has recovered, antibody tests can also reveal who was infected but didn’t know it due to mild or no symptoms. If you have questions about antibody testing for COVID-19, a 98point6 physician can help determine if an antibody test is appropriate.
Our physicians can provide orders for viral, also known as PCR (Polymerase Chain Reaction) tests, and guide patients to testing locations and directly order antibody testing for COVID-19 if you meet the requirements necessary. We are working to help patients get access to appropriate testing where we can, and many areas are opening up more options to the general public. Be sure to ask your 98point6 physician about your interest in testing for the most up-to-date information and to see if you qualify.
Our bodies make specific antibody proteins in response to infections. A positive COVID-19 antibody test tells you that your immune system has responded to an infection or exposure by making a detectable amount of these antibodies. If you have a positive result and have questions, start a visit with one of our physicians. They can help you understand your next steps.
No. At this time, antibody tests cannot tell you whether or not you are immune to COVID-19. Because this is a new virus, it is not known how long the antibodies remain present after infection or exposure. Additionally, some people may have a prolonged period of viral shedding after recovery, which means you can still spread the infection to others. A positive antibody test is also unable to determine:
- How sick you may or may not become
- If you can get sick with the virus again
- If you are contagious
- If you can or should return to work or other activities
With a positive result, you should continue to practice social distancing, good hand hygiene and limit your exposure to others, as you may be contagious and may still be vulnerable to re-infection.
Per the Food and Drug Administration (FDA), you may be an eligible donor if you’ve had a prior diagnosis of COVID-19, documented by a laboratory test, and meet other general donor criteria. Individuals must have complete resolution of symptoms for at least 28 days before they donate or alternatively have no symptoms for at least 14 days prior to donation with a negative viral/PCR (Polymerase Chain Reaction) test for active COVID-19 disease. Please check with this website from the FDA to find out more.
We are still learning about the body’s response to COVID-19. This means that there is a possibility that you could have had the virus and, depending on when you took the test or other factors, you test negative for antibodies.
Some COVID-19 patients have developed antibodies, only for them to later be undetectable. Whether these patients retain immunity or resistance to reinfection, and to what degree, is not yet known or understood.
For this reason, it’s recommended that everyone, regardless of test results, continue to exercise precautions to reduce the risk of exposure and transmission. If you have a negative result and have questions, start a visit with one of our physicians, who can help you understand next steps.
At this time, there are no guidelines from the Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) for returning to work based on the results of viral/PCR (Polymerase Chain Reaction) tests or antibody tests for the general public. If you are a healthcare provider, we suggest that you check with your place of employment for further guidance on return to work.
If you’re receiving a viral or antibody test for COVID-19, it’s possible that your lab costs may be covered. As part of the Coronavirus Aid, Relief and Economic Security (CARES) Act, most insurance plans are covering or reimbursing for qualifying COVID-19-related testing costs. While some testing and lab locations may require payment at the time of testing, or bill you afterwards, it’s possible that these costs are reimbursable either through your insurance provider or your state (if you’re on Medicaid, a state-sponsored health plan or uninsured). If you do need to pay out-of-pocket for your test, know that the cost can vary. If you are billed by your lab, please contact your insurance provider or state health department to discuss how to get reimbursed for your labs related to COVID-19.
It is important to understand that the timing of when a person is tested has an impact on the test results. It can take several days after someone is exposed to the virus for there to be enough virus to be detected. For example, being tested on the day of your exposure or the next day will likely result in a negative (not infected) test result, even in individuals who may later go on to develop infection.
COVID-19 tests are mostly likely to detect an infection three (3) to seven (7) days after exposure. COVID-19 PCR tests, which test for virus DNA, are still considered the gold standard, but antigen tests, which test for viral proteins, are increasingly used for testing symptomatic patients and for screening asymptomatic patients. For those who develop symptoms, the CDC recommends getting tested no later than 7 days after symptom onset or exposure to the virus. A 98point6 physician or your healthcare provider can help you determine the best time to be tested. Whenever you have questions or concerns about COVID-19 exposure, symptoms or testing, a physician is your best source of information, guidance and reassurance.
The CDC recommends that close contacts of students or staff with COVID-19 be quickly identified and tested. To make sure this happens, school administrators should work with local health officials on contact tracing efforts.
If your child is attending in-person school or daycare, make sure you have a solid understanding of the policies surrounding cases, quarantines and closures. Open, transparent communication counts and goes both ways, so ask questions to make sure you are comfortable and aware.
Medications and Treatment
Ibuprofen is an over-the-counter non-steroidal anti-inflammatory drug (NSAID) commonly used to treat fever and mild to moderate pain. At some point, you may have heard news or rumors suggesting that this medication could aggravate COVID-19.
Based on currently available information, the World Health Organization (WHO) and the U.S. National Institute of Allergy and Infectious Diseases maintain there is no evidence that ibuprofen increases the risk of serious complications or of acquiring the virus that causes COVID-19. That said, if you are still uneasy, acetaminophen is an alternative medication that can be used for fever and pain.
Because COVID-19 is new and different, it needs its own vaccine. Research into a COVID-19 vaccine is ongoing, but it may be some time before it is ready.
Other vaccines, such as the flu shot and pneumococcal vaccine, do not provide protection against COVID-19. Depending on your medical history, these vaccinations may still protect you from other illness or complications of COVID-19, so discuss them with a physician if you have questions.
There has been talk in the media about the use of malaria drugs chloroquine and hydroxychloroquine; however, the Food and Drug Administration (FDA) has determined that these medications are unlikely to be effective in treating COVID-19. Our clinic does not prescribe these medications under any circumstances, and can provide suitable alternatives if you will be traveling to a destination where malaria is a consideration.
Currently, no medications have been approved by the Food and Drug Administration (FDA) for the treatment or prevention of COVID-19, including remdesivir, the safety and efficacy of which has not yet been established. The FDA has issued an emergency use authorization (EUA) of remdesivir to treat severe cases of COVID-19 in a hospital setting, but at this time, remdesivir is not available for prescription.
While dexamethasone, a steroid, and regeneron, an antibody cocktail, are getting significant media attention—including some positive outcomes in rare cases—firm scientific proof about the effectiveness and safety of both treatments remain early and mixed.
Steroids like dexamethasone work by suppressing your immune system in order to decrease the damage caused by an infection. While this seems unconventional, the treatment has been shown to protect patients from serious COVID-19 side effects by reducing excess lung inflammation. One large clinical trial demonstrated a benefit among hospitalized patients who were receiving respiratory support, whether with oxygen therapy or mechanical ventilation. However, that same study showed no benefit; in fact, it showed a trend toward worse outcomes with the use of dexamethasone in patients with milder disease who did not require oxygen.
The general conclusion, per the medical community, is that the drug could possibly cause “more harm than good” in some patients, particularly those with early or mild disease. The bottom line is that dexamethasone is widely available and can be prescribed by your doctor, but has only proven to help in patients who are sick enough to require hospitalization.
As far as regeneron, the antibody cocktail has yet to complete a peer-reviewed drug trial, and is not currently available outside of the manufacturer’s experimental trials.
Even several months in, the coronavirus pandemic is still a relatively new and evolving situation for experts in the medical community and the public at large. Bearing that in mind, firm conclusions about any treatments and vaccines remain somewhat limited and personal options need to be considered with the input of a trusted medical professional.
Bottom line: Be thoughtful about the messages you read on social media and in the news, validate your information with credible sources and empower yourself with the education and perspectives you need to have a productive dialogue with your physician.