Find answers to frequently asked questions about COVID-19, including how the virus is spread, risk factors for severe disease, and information on new monoclonal antibody treatments.
Coronavirus and COVID-19 are not the same thing, but sometimes these terms are used interchangeably. Coronaviruses are a family of viruses that have crown-like spikes on their surface. The scientific name for the new coronavirus that emerged from China in December 2019 is SARS-CoV-2, which stands for severe acute respiratory syndrome coronavirus 2.
COVID-19 is the disease caused by the new SARS-CoV-2 virus and stands for coronavirus disease 2019.
Fever, aches, and a cough are symptoms commonly found in patients with either COVID-19 or the flu. Both diseases can range in severity from mild to severe and may lead to the development of pneumonia. Although both viruses may be fatal, COVID-19 is associated with a significantly higher mortality rate than the flu. Estimates vary, but approximately 1% to 3% of people with COVID-19 will die from the disease.
There are several reasons why the coronavirus is more dangerous than the flu:
- Coronavirus is twice as contagious as the flu. Research indicates that a person with the flu infects an average of 1.28 other people. However, a person with coronavirus can infect between 2 to 3 other people.
- Coronavirus has a longer incubation period. The incubation period is the time between exposure to the virus and the onset of symptoms. People with coronavirus might not have symptoms for up to 14 days, and some may not develop symptoms at all. People with the flu usually develop symptoms within 2 days of infection. Since coronavirus has a significantly longer incubation period, infected individuals may unknowingly spread the virus for a longer period of time.
- There is an effective vaccine available for the flu. There is no vaccine available for COVID-19, but development and testing are in progress.
Based on currently available information, people aged 65 years and older and people of any age with serious underlying medical conditions may be at higher risk of severe illness from COVID-19. Preexisting medical conditions that increase the risk of serious illness include:
- Chronic lung disease or moderate-to-severe asthma
- Cardiovascular disease, hypertension (high blood pressure), and serious heart conditions
- Liver disease
- Chronic kidney disease and dialysis
- Severe obesity (body mass index [BMI] of 40 or more)
- Immunosuppression (bone marrow or organ transplantation, immune deficiencies, autoimmune diseases, poorly controlled HIV or AIDS, or long-term use of corticosteroids)
People who are at high risk of serious illness with COVID-19 should practice good hand hygiene and social distancing to minimize their chance of contracting the new coronavirus.
The new coronavirus is spread through respiratory droplets released into the air when an infected person coughs, sneezes, or talks. These droplets generally do not travel more than a few feet before falling to the ground. If you are in close proximity to someone who is infected, you may inhale the virus.
Coronavirus can also be transmitted from objects and surfaces that are contaminated with the virus. Studies suggest that the virus can live on surfaces for a few hours or up to several days, depending on the surface and environmental factors. A small amount of virus can be found on plastic for up to 3 days, on stainless steel for up to 2 days, and for up to one day on cardboard. It is important to practice good hand hygiene to minimize the risk of infection. It is recommended that you wash your hands for 20 seconds with soap and water or use an alcohol-based hand sanitizer that contains at least 60% alcohol to prevent the spread of the virus.
Symptoms could appear as soon as 2 days or as late as 14 days after exposure to the virus. The median time for symptoms to develop is about 5 days. If you believe you have been exposed to the new coronavirus, it is important to quarantine for 14 days to prevent the spread of the virus to others.
It is estimated that on average people with COVID-19 first develop symptoms approximately 5 days after exposure to the virus. However, symptoms may develop between 2 and 14 days after exposure. One study found that people with COVID-19 were contagious approximately 2 to 3 days before symptom onset and were most infectious the day before symptoms appeared.
People infected with the new coronavirus can be contagious without symptoms. It is estimated that up to 50% of people infected with coronavirus remain asymptomatic. However, these people are still contagious. One study found that people with no symptoms were the source of 44% of diagnosed COVID-19 cases.
A serologic test is a blood test that identifies antibodies against SARS-CoV-2, the virus that causes COVID-19. Antibodies are proteins created by your immune system to fight infections. Since it takes your body 5 to 10 days to produce enough antibodies to be detected in a test, serologic tests cannot be used to diagnose an active COVID-19 infection, even in patients with severe disease.
Serologic tests can be used to identify people who have been infected with the new coronavirus during the course of the pandemic. However, since the coronavirus that causes COVID-19 is new, there is still much we do not know about it. Scientists are working to determine if antibodies against SARS-CoV-2 provide protection against future infections by this virus. If antibodies do provide immunity, we do not know what amount, or titer, of antibodies would provide protection or for how long this protection would last.
There are currently no approved agents for the treatment or prevention of COVID-19.
In late April, the FDA issued a warning against the use of the anti-malarial medications hydroxychloroquine and chloroquine in patients not enrolled in clinical trials. Several studies have shown that these medications do not decrease the risk of death from COVID-19 and may increase the risk of life-threatening heart rhythms.
One clinical trial found that patients with COVID-19 who received remdesivir, an antiviral drug, recovered faster than patients who received a placebo. Several other drugs are also under investigation for the management of COVID-19. However, it may take up to a year before any drugs for the treatment of COVID-19 are available to the general public. Clinical trials must be performed to ensure that new medications are safe and effective and to determine what the proper dosage should be.
Some doctors in France advise people against using ibuprofen (i.e., Advil®, Motrin®) to manage the symptoms of COVID-19. There were several reports of healthy patients with COVID-19 who were taking ibuprofen and developed severe disease, particularly pneumonia. However, there were no scientific studies to support this advice.
The World Health Organization (WHO) initially recommended using acetaminophen (i.e., Tylenol®) instead of ibuprofen to reduce the fever, aches, and pains related to coronavirus infection. However, the WHO now states that either acetaminophen or ibuprofen can be used. It is important to make sure that you do not exceed the maximum daily dose of 3,000 milligrams of acetaminophen per day.
Centers for Disease Control and Prevention. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nature Med. 2020;26:675.
Geleris J, Sun Y, Platt J, et al. Observational study of hydroxychloroquine in hospitalized patients with COVID-19. N Engl J Med. 2020;May 7: Epub ahead of print.
Infectious Disease Society of America (IDSA). IDSA COVID-19 Antibody Testing Primer. Available at https://www.idsociety.org/globalassets/idsa/public-health/covid-19/idsa-covid-19-antibody-testing-primer.pdf
National Institutes of Health (NIH). NIH clinical trial shows remdesivir accelerates recovery from advanced COVID-19. Available at www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19
Silva Borba MG, Almeida Val FF, Souza Sampaio V, et al. Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Infection: a randomized clinical trial. JAMA Netw Open. 2020;3:e208857.
World Health Organization (WHO). The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. Available at https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19