Coronavirus

How common is anaphylaxis after COVID-19 vaccine?
A. Severe allergic reactions, including anaphylaxis, can occur after any vaccination. Anaphylaxis after COVID-19 vaccination is rare.If this occurs, vaccination providers can effectively and immediately treat the reaction.

Anaphylaxis after COVID-19 vaccination occurred in approximately 2 to 5 people per million vaccinated in the United States based on events reported to VAERS. This kind of allergic reaction almost always occurs within 30 minutes after vaccination. After you get a COVID-19 vaccine, you will be asked to stay for 15 minutes, so you can be observed in case you have a severe allergic reaction and provided treatment in the rare case it is needed. Fortunately, vaccination providers have medicines available to effectively and immediately treat patients who experience anaphylaxis following vaccination.
Can kids get other vaccines at the same time as the COVID-19 vaccine?
A. The Centers for Disease Control and Prevention updated its guidance to say other routine vaccinations can be given at the same time as the COVID-19 shots. It previously advised against other vaccinations within a two-week window so it could monitor people for potential side effects.

• COVID-19 and other vaccines may now be administered without regard to timing. This includes simultaneous administration of COVID-19 and other vaccines on the same day, as well as co-administration within 14 days.
• It is unknown whether reactogenicity is increased with co-administration, including with other vaccines known to be more reactogenic, such as adjuvanted vaccines.
• When deciding to co-administer with COVID-19 vaccines, providers should consider whether the patient is behind or at risk of becoming behind on recommended vaccines and the reactogenicity profile of the vaccines.

The American Academy of Pediatrics agrees with the position.

Q: Is breakthrough infection data reported anywhere?
A: Yes, the state of Idaho is reporting breakthrough case data on their COVID-19 data dashboard on coronavirus.idaho.gov.

Q. Is it really true that COVID-19 vaccines can protect me from getting sick with COVID-19?
A. Yes. COVID-19 vaccination works by teaching your immune system how to recognize and fight the virus that causes COVID-19, and this protects you from getting sick with COVID-19.

Being protected from getting sick is important because even though many people with COVID-19 have only a mild illness, others may get a severe illness, have long-term health effects, or even die. There is no way to know how COVID-19 will affect you, even if you don’t have an increased risk of developing severe complications.

Is it safe for me to get a COVID-19 vaccine if I would like to have a baby one day?
A. Yes. People who want to get pregnant in the future may receive the COVID-19 vaccine.
Based on current knowledge, experts believe that COVID-19 vaccines are unlikely to pose a risk to a person trying to become pregnant in the short or long term. Scientists study every vaccine carefully for side effects immediately and for years afterward. The COVID-19 vaccines are being studied carefully now and will continue to be studied for many years, similar to other vaccines.
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The COVID-19 vaccine, like other vaccines, works by training our bodies to develop antibodies to fight against the virus that causes COVID-19, to prevent future illness. There is currently no evidence that antibodies formed from COVID-19 vaccination cause any problems with pregnancy, including the development of the placenta. In addition, there is no evidence suggesting that fertility problems are a side effect of ANY vaccine. People who are trying to become pregnant now or who plan to try in the future may receive the COVID-19 vaccine when it becomes available to them.

Will individuals who have received the COVID-19 vaccine “shed” mRNA or spike protiens?
A. Claims that individuals who have received COVID-19 vaccines then “shed” mRNA or spike proteins are circulating widely on social media. Anti-vaccine organizations and other groups that embrace conspiracy theories and pseudoscience are asserting that this “shedding” puts unvaccinated individuals at risk of harm. One of several debunked claims includes the belief that an unvaccinated woman’s menstrual cycle can be altered simply by their being in proximity to a vaccinated individual. In reality, those vaccinated with a COVID-19 vaccine cannot and do not shed mRNA or spike proteins, or any other elements associated with these vaccines.

Are people dying after receiving the COVID-19 vaccine?
A. Over 230 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through April 26, 2021. During this time, VAERS received 3,848 reports of death (0.0017%) among people who received a COVID-19 vaccine. CDC and FDA physicians review each case report of death as soon as notified and CDC requests medical records to further assess reports. A review of available clinical information including death certificates, autopsy, and medical records revealed no evidence that vaccination contributed to patient deaths. CDC and FDA will continue to investigate reports of adverse events, including deaths, reported to VAERS.

What is a ‘breakthrough’ case?
A. A breakthrough case is someone who has been fully vaccinated, but tests positive for COVID-19 more than 14 days after receiving their second dose or their first dose of J&J. Vaccine breakthrough cases are expected. COVID-19 vaccines are effective and are a critical tool to bring the pandemic under control. However no vaccines are 100% effective at preventing illness.

Can I donate blood or plasma after receiving the COVID-19 vaccine?
A. Yes. If you receive the vaccine, you can still donate blood, platelets and AB Elite plasma. If you’ve received a COVID-19 vaccine, you’ll most likely need to provide the manufacturer name when donate. In most cases, there is no deferral time for individuals who received a COVID-19 vaccine as long as they are symptom-free and feeling well at the time of donation.

Should I receive the vaccine if I have allergies?
A. CDC recommends that people get vaccinated even if they have a history of severe allergic reactions not related to vaccines or injectable medications—such as food, pet, venom, environmental, or latex allergies. People with a history of allergies to oral medications or a family history of severe allergic reactions may also get vaccinated.

If you have had an immediate allergic reaction to other types of vaccine—even if it was not severe— ask your doctor if you should get a COVID-19 vaccine. Your doctor will help you decide if it is safe for you to get vaccinated.

What does ‘fully vaccinated’ mean?
A. People are considered fully vaccinated:

• 2 weeks after their second dose in a 2-dose series, like the Pfizer or Moderna vaccines, or
• 2 weeks after a single-dose vaccine, like Johnson & Johnson’s Janssen vaccine

If it has been less than 2 weeks since your shot, or if you still need to get your second dose, you are NOT fully protected. Keep taking all prevention steps until you are fully vaccinated.

Q: I heard the COVID-19 vaccines were developed with or contains controversial substances. Is this true?
A: The first two COVID-19 vaccines (Pfizer and Moderna) to be authorized by the FDA contain mRNA and other, normal vaccine ingredients, such as fats (which protect the mRNA), salts, as well as a small amount of sugar. These COVID-19 vaccines were not developed using fetal tissue, and they do not contain any material, such as implants, microchips or tracking devices.

The vaccine formula for the Johnson and Johnson vaccine also does not contain aborted fetal tissue. Rather, virologists created J&J’s vaccine — and many other immunizations to fight viral outbreaks — in part by growing a modified virus in cells originally derived from embryonic tissue from an abortion performed decades ago. However, that human cell line is physically and chemically separate from ingredients that end up in the final vaccine product. Historical fetal cell lines were derived in the 1960’s and 1970’s from elective abortions that have been used to create vaccines for diseases such as hepatitis A, rubella, and rabies. Abortions or spontaneous miscarriages from which fetal cells were obtained were elective and were not done for the purpose of vaccine development.

If I’m exposed to someone who tests positive for COVID-19 after I’m vaccinated, do I still need to quarantine?
A. You are considered immune 2 weeks after you receive your 2nd dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine. You do not need to self-quarantine if you are exposed AND it has been at least 2 weeks since your 2nd shot of the Pfizer-BioNTech or Moderna vaccine. If you are exposed before this time, you need to self-quarantine.

If I test positive for COVID-19 after I get vaccinated, do I still need to isolate?
A. You should isolate if you test positive for COVID-19 even after you have received the COVID-19 vaccine.

If I get symptoms of COVID-19 after I get vaccinated, do I still need to get tested?
A. If you have not received 2 doses of the COVID-19 vaccine and you have symptoms of COVID-19, you should get tested. Talk to a doctor or a healthcare provider if you have COVID-like symptoms after getting 2 doses of the COVID-19 vaccine.

Q: How many vaccines have been administered?
A: In Idaho, the number of vaccine doses that have been administered is reported at coronavirus.idaho.gov

Q: Can the COVID-19 vaccine give me COVID-19?
A: None of the COVID-19 vaccines currently in development in the United States use the live virus that causes COVID-19. There are several different types of vaccines in development. However, the goal for each of them is to teach our immune systems how to recognize and fight the virus that causes COVID-19.

Q: Do I still need to get the COVID-19 vaccine if I’ve already had COVID?
A: Yes. Vaccination should be offered to persons regardless of history of prior symptomatic or asymptomatic SARS-CoV-2 infection. At this time, experts do not know how long someone is protected from getting sick again after recovering from COVID-19. The immunity someone gains from having an infection, called natural immunity, varies from person to person. Some early evidence suggests natural immunity may not last very long.

Q: Can’t we build natural immunity against COVID-19?
A: Getting COVID-19 may offer some natural protection, known as immunity. But experts don’t know how long this protection lasts, and the risk of severe illness and death from COVID-19 far outweighs any benefits of natural immunity. COVID-19 vaccination will help protect you by creating an antibody response without having to experience sickness.

How much will the vaccine cost?
A. The vaccine is free. Enrolled providers can charge insurance an administration fee, but the consumer should not be billed.

Q: Can the COVID-19 vaccine change my DNA?
A: The COVID-19 vaccine’s currently seeking authorization are mRNA vaccines. They do not affect or interact with our DNA in any way.

• mRNA never enters the nucleus of the cell, which is where our DNA (genetic material) is kept.
• The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.

Q: Does the COVID-19 vaccine cause Bell’s Palsy?
A: The FDA briefing documents show that it is true that there were four cases of Bell’s Palsy among those who received the vaccine. Bell’s Palsy is a sudden weakness or freezing of muscles on one side of the face, which in most cases is temporary.

The briefing says that the frequency of Bell’s Palsy in the vaccine group is “consistent with the expected background rate in the general population”, adding there is “no clear basis upon which to conclude a causal relationship at this time”. The FDA said it would, however, recommend “surveillance” for cases of Bell’s Palsy as the vaccine is sent out to larger groups of people.

You can read the full FDA briefing here: www.fda.gov/media/144245/download

Q: Since both the Pfizer and Moderna vaccines require two doses (Pfizer 21 days apart, Moderna 28 days apart), could an individual receive one dose of Pfizer and one dose of Moderna?
A: That is not recommended. If you receive the Pfizer vaccine for your first dose, then you need to receive the Pfizer vaccine for your second dose. This is the same for the Moderna vaccine.
The 2^nd dose of Pfizer vaccine needs to be administered 21 days after the first dose and the Moderna vaccine 28 days after the first dose, but my second dose is scheduled earlier. Will this still be effective?

For the Moderna vaccine, persons age 18 years and older should receive 2 doses at least 28 days apart.

• Second doses administered up to 4 days before the recommended date (24 or more days after first dose) are considered valid. However, doses administered earlier do not need to be repeated.

For the Pfizer vaccine, persons age 16 years and older should receive 2 doses at least 21 days apart.

• Second doses administered up to 4 days before the recommended date (17 or more days after first dose) are considered valid. However, doses administered earlier do not need to be repeated.

1. Is it safe for my child to receive the Pfizer vaccine?
   A. The available safety data to support the EUA in adolescents down to 12 years of age, include 2,260 participants ages 12 through 15 years old enrolled in an ongoing randomized, placebo-controlled clinical trial in the United States. Of these, 1,131 adolescent participants received the vaccine and 1,129 received a saline placebo. More than half of the participants were followed for safety for at least two months following the second dose. Current safety and efficacy testing of the vaccines for children ages 2 and up may lead to authorization of one or more of the COVID-19 vaccines for younger kids in the months ahead.What side effects will my child possibly experience?
   A. The most commonly reported side effects in the adolescent clinical trial participants, which typically lasted 1-3 days, were pain at the injection site, tiredness, headache, chills, muscle pain, fever and joint pain. With the exception of pain at the injection site, more adolescents reported these side effects after the second dose than after the first dose, so it is important for vaccination providers and recipients to expect that there may be some side effects after either dose, but even more so after the second dose. The side effects in adolescents were consistent with those reported in clinical trial participants 16 years of age and older. It is important to note that as a general matter, while some individuals experience side effects following any vaccination, not every individual’s experience will be the same and some people may not experience side effects.

Q. Should I consider getting my child vaccinated for COVID-19?
A. Yes. Although COVID-19 in children is usually milder than in adults, some kids can get very sick and have complications or long-lasting symptoms that affect their health and well-being. The virus can cause death in children although this is rarer than for adults.

Like adults, children also can transmit the coronavirus to others if they’re infected, even when no symptoms are present. The COVID-19 vaccine protects against this potential harm to the child and others, including family members and friends who may be susceptible.

Another reason to consider a COVID-19 vaccine for your child is to protect the health of the broader community. Each child or adult infected with the coronavirus provides a chance for the virus to mutate and create a variant that might prove more dangerous or resistant to the available vaccines and therapies. Fewer overall infections among the population means less chance of dangerous coronavirus variants.

Finally, schools sometimes require vaccinations (such as those for diphtheria or whooping cough), and your child’s school might require COVID-19 vaccination for students returning to in-person learning.

Q. Will getting the COVID-19 vaccine help my child go back to school, sports and other activities?
A. It is expected that when enough people are protected from the coronavirus, the risk of infection for your child — and the population in general — will begin to decline, even before vaccines are available for all children. Vaccines, along with mask-wearing, physical distancing and other precautions will help ensure your child’s return to school, sports and other group activities in the future.

Can my child catch COVID-19 from the vaccine?
A. The vaccine currently available to children and teens over age 12 (Pfizer) does not contain any live or dead parts of the virus. Instead, it is made up of nucleic acids, which are the building blocks of all our cells. Once they’ve done their job, they fall apart and exit the body.

Q. Do we even need to vaccinate children?
A. Children rarely develop severe forms of COVID-19, and deaths from the disease are rarer still. But on rare occasions — one estimate puts it at around one case in 1,000, although it could be even lower — kids who’ve experienced even mild infections can later develop a sometimes deadly condition called multi-system inflammatory syndrome in children (MIS-C).

Vaccinating children will have beneficial effects in the wider community. If we want to get back to normalcy, we need to achieve herd immunity across all the groups that potentially contribute to transmission.

Children, particularly younger kids, probably aren’t super-spreaders of SARS-CoV-2, as they are for viruses including influenza. But the emergence of faster-spreading variants, along with rising adult vaccination rates in some countries, means that children and adolescents might soon be contributing more to spread.

Will my child’s immune system be able to handle the COVID-19 vaccine?
A. When it comes to vaccines, children’s immune systems often do a much better job of developing a robust antibody response, than do adults’ immune systems. This is one of the reasons we give more vaccines in childhood than in adulthood. For example, the HPV cancer prevention vaccine is significantly more effective if given in pre-teen years than if given in early adulthood. The same is proving true for COVID vaccines. The Pfizer trials of 12-15 year olds showed an even greater antibody response in this age group than that seen in the 16-25 age group. To sum up, our kids’ immune systems are strong and are built to handle the challenge of a safe and effective vaccine!

If children are so great at dealing with germs they encounter, why have vaccines at all? Why not just let them develop immunity naturally?
A. Because viruses like polio, measles, flu, pertussis, and more can be highly deadly. It is MUCH safer to let their bodies build immunity through vaccination than to put them at risk of death or other serious consequences by trying to fight off a natural infection.

Will individuals under 18 need a consent form signed by a parent/guardian in order to receive the Pfizer COVID-19 vaccine?
A: Yes. All individuals under the age of 18 will be required to have a consent form signed by a parent or guardian to receive the Pfizer COVID-19 vaccine at PHD vaccine clinics. Consent forms will be available at PHD COVID-19 vaccine clinic sites and will also be posted on our website.

Can children under 16 years old received the COVID-19 vaccine?
A. The FDA expanded the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine for the prevention of COVID-19 to include adolescents 12 through 15 years of age. The Pfizer-BioNTech COVID-19 Vaccine is administered as a series of two doses, three weeks apart, the same dosage and dosing regimen for 16 years of age and older.

What vaccine should those who are under 18 years old receive?
A. The Pfizer COVID-19 vaccine is for persons 12 years or older. The Moderna and Johnson & Johnson COVID-19 vaccines are for persons 18 years or older. PHD will state what vaccine is being administered when individuals register for an appointment on their website once that age group is eligible.

Is there anywhere I can receive a free COVID-19 test if I do not have insurance?
A. Yes, Walgreens pharmacies are offering no-cost testing regardless of insurance.

Where is testing available in North Idaho?
A. Some of the testing sites in Idaho are listed on www.get-tested-covid19.org (I’ve discovered this is not a comprehensive list, but does list many testing sites).

Sites in North Idaho include:
Walgreens (walk-in, free)
Safeway (walk-in, cost $139.99)
Kootenai Health (provider referral required)
Heritage Health (provider referral required)
Albertsons (walk-in, cost $139.99)
Shoshone Medical Center (provider referral required)
White Cross Pharmacy (appointment required)
Northwest Pharmacy – Potlach (appointment required)
North Idaho VA Clinic (for Veterans enrolled in VA Health)
Active Family Healthcare (no referral required)
Bonner General Health (provider referral or their Emergency Physician can perform)
Boundary Community Hospital (referral required)
Benewah Community Hospital (referral required)
Costco (cost $119 available for purchase online, test kit sent via mail)

1. I’m traveling to Hawaii and need a COVID-19 test. Where do I go?
   A. Go to Walgreens. In Bonner and Boundary County, go to Bonner General Health.

Q. Is there a requirement for proof of a negative COVID-19 test or recovery from COVID-19 for travelers?
A. Domestic travel (within the United States or to a U.S. territory)

·         Fully vaccinated travelers do not need to get a SARS-CoV-2 viral test before or after domestic travel, unless testing is required by local, state, or territorial health authorities.

• Fully vaccinated travelers do not need to self-quarantine following domestic travel.

International travel

• Fully vaccinated travelers do not need to get tested before leaving the United States unless required by their destination.
• Fully vaccinated air travelers coming to the United States from abroad, including U.S. citizens, are still required to have a negative SARS-CoV-2 viral test result or documentation of recovery from COVID-19 before they board a flight to the United States.
• All air passengers coming to the United States, including U.S. citizens and fully vaccinated people, are required to have a negative COVID-19 test result no more than 3 days before travel or documentation of recovery from COVID-19 in the past 3 months before they board a flight to the United States.
• Fully vaccinated travelers do not need to self-quarantine in the United States following international travel.Who is prohibited from entry to the US?
  A. Several Presidential proclamations prohibit entry to the US in an effort to help slow the spread of COVID-19:

• China
• Iran
• European Schengen area (Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, Monaco, San Marino, Vatican City)
• United Kingdom (England, Scotland, Wales, Northern Ireland)
• Republic of Ireland
• Brazil
• South Africa
• India

Q: Is data available on COVID-19 variant cases?
A:  Yes, the state of Idaho is reporting COVID-19 variant case data on their COVID-19 data dashboard on coronavirus.idaho.gov.

I’m having an event and would like to fill out a gathering plan and attestation. Where can I find that form?
A. The attestation for events is no longer needed since the Governor moved Idaho into Stage 4 and there is not a limit on event size.

Q: Have COVID-19 variants been identified in our area and are the vaccines effective against them?
A: We have identified variant cases in our district. Currently the data shows that the vaccines are effective against the variants.

Where can I receive a COVID-19 test?
A. We have a map of COVID-19 testing sites within our district. The map can be found here: panhandlehealthdistrict.org/covid-19/. Click the red button near the top right of the page.

Can I receive a test for a COVID-19 variant?
A. Currently, testing sites in our area are not sequencing for the variants, but Kootenai Health’s testing site is sending their labs to the Idaho Bureau of Laboratories (IBL) to be sequenced.

Right now there is limited but growing SARS-CoV-2 sequencing capacity within Idaho. IDHW is working to increase the number of Idaho labs that can perform this sequencing.

Can I receive a COVID-19 test through Kootenai Health?
Updated hours at the Kootenai Health Testing Center for COVID-19 testing.

Hours of Operation:

Hours of Operation:

• • Monday to Thursday – 8 a.m. – 4 p.m.
  • Friday – 8 a.m. – 1 p.m.
  • Saturday and Sunday – 8 a.m. to 11 a.m.

Note: Patients can also schedule a COVID-19 test online. Learn more at https://www.kh.org/covid-19/test/

Since the Board of Health rescinded the mask mandate, do I still need to require them for my business?
Wearing a mask when in public is still our recommendation along with physical distancing, frequent hand washing, staying home when you are sick, avoiding large gatherings, and receiving a vaccine. We know that masks are effective in preventing the spread of COVID-19.

Q: What medical conditions put you at increased risk of getting severely ill from COVID-19?
A: Medical conditions are listed below:

• Cancer
• Chronic kidney disease
• COPD (chronic obstructive pulmonary disease)
• Dementia or other neurological conditions
• Diabetes (type 1 or type 2)
• Down Syndrome
• Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• HIV infection
• Immunocompromised state (weakened immune system) from solid organ transplant
• Liver disease
• Obesity (body mass index [BMI] of 30 kg/m² or higher but < 40 kg/m²) & Overweight (BMI > 25 kg/m², but < 30 kg/m²)
• Pregnancy
• Sickle cell disease or Thalassemia (a type of blood disorder)
• Smoking (current or former)
• Solid organ or blood stem cell transplant
• Stroke or cerebrovascular disease, which affects blood flow to the brain
• Substance use disordersDid the CDC change the recommendation from 6ft of distancing to 3ft of distancing?
  A. The CDC revised physical distancing recommendations to reflect at least 3 feet between students in classrooms when all other safety precautions are being taken as well (masking, washing hands, staying home when sick, etc.). This is not recommended for the general public yet, just schools.

Q: Should I wear two masks for better protection?
A: According to the CDC, to have better fit and extra protection you can wear two masks. Wear a disposable mask underneath and a cloth mask on top.

How can a mask help if viruses are so small?
A. Viruses are very small. However, viruses don’t move on their own, they must be transmitted in some way. The novel coronavirus (COVID-19) is transmitted in droplets that come through the nose and mouth. Using a mask creates a barrier that greatly decreases the potential to transmit droplets that could be carrying virus. If everyone wears a mask, we can keep everyone’s germs (droplets) to themselves.

Just as we all cover our cough or sneeze with our elbow or a tissue to keep droplets with germs and viruses from spreading to others, masks also help keep the droplets with germs and viruses from spreading. Wearing a mask is about protecting others.

Can people get sick from increased carbon dioxide intake while wearing a mask?
A. No. There is enough filtration of air through a mask that wearers do not have increased carbon dioxide intake. Viruses, although very small, are much larger than molecules of oxygen or carbon dioxide which readily pass through masks.

CO2 makes up only about 0.04% of the air we breathe, and is considered life-threatening when its concentration is greater than about 10%.

A cloth mask does not provide an airtight fit across the face. The CO₂ completely escapes into the air through and around the sides of the cloth mask when you breathe out or talk. CO₂ is small enough to easily pass through any cloth mask material. In contrast, the virus that causes COVID-19 is much larger than CO₂, so it cannot pass as easily through a properly designed and properly worn cloth mask.

Q: Can I be re-infected with COVID-19?
A: In general, reinfection means a person was infected (got sick) once, recovered, and then later became infected again. Based on what we know from similar viruses, some reinfections are expected. CDC is actively working to learn more about reinfection to inform public health action. CDC developed recommendations for public health professionals to help decide when and how to test someone for suspected reinfection. CDC has also provided information for state and local health departments to help investigate suspected cases of reinfection.

Q: How does the virus spread?

A: The virus that causes COVID-19 is thought to spread mainly from person to person, mainly through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Spread is more likely when people are in close contact with one another (within about 6 feet).

COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in many affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Q: Can COVID-19 spread through airborne transmission?
A: Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours, this kind of spread is referred to as airborne transmission and is an important way that infections like tuberculosis, measles, and chicken pox are spread.

There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising.

• Under these circumstances, scientists believe that the amount of infectious smaller droplet and particles produced by the people with COVID-19 became concentrated enough to spread the virus to other people. The people who were infected were in the same space during the same time or shortly after the person with COVID-19 had left.

Available data indicate that it is much more common for the virus that causes COVID-19 to spread through close contact with a person who has COVID-19 than through airborne transmission.

Q: Can the virus be spread through food, including refrigerated or frozen food?

A: Coronaviruses are generally thought to be spread from person-to-person through respiratory droplets. Currently there is no evidence to support transmission of COVID-19 associated with food. Before preparing or eating food it is important to always wash your hands with soap and water for 20 seconds for general food safety. Throughout the day wash your hands after blowing your nose, coughing or sneezing, or going to the bathroom.

In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.

Q: How easily does the virus spread?

A: How easily a virus spreads from person-to-person can vary. Some viruses are highly contagious, like measles, while other viruses do not spread as easily. Another factor is whether the spread is sustained, which means it goes from person-to-person without stopping.

The virus that causes COVID-19 is spreading very easily and sustainably between people. Information from the ongoing COVID-19 pandemic suggest that this virus is spreading more efficiently than influenza, but not as efficiently as measles, which is highly contagious.

Q: When to end home isolation (staying home)?

A: People with COVID-19 who have stayed home (are home isolated) can stop home isolation under the following conditions:

• • They have had no fever for at least 24 hours (that is two full days of no fever without the use medicine that reduces fevers)
    AND
  • other symptoms have improved (for example, when their cough or shortness of breath have improved)
    AND
  • at least 10 days have passed since their symptoms first appeared