COVID-19

The World Health Organization declared the novel Coronavirus (COVID-19) to be a global health emergency.  Medcor has updated our clinic guidelines and triage algorithms to include assessment criteria for COVID-19 and will make additional updates as necessary. We continue to reach out to clients with information relevant to their workplaces. Our advocates continue to be updated on steps to take if COVID-19 presents itself in their Medcor clinics and in the communities near them. We also continue to monitor recommendations from authoritative sources, such as the CDC and WHO.

Medcor’s Clinical Affairs team will send updates to our clients, advocates, and partners as new relevant information becomes available on how to manage COVID-19 in the workplace.

Prior FAQs and updates are shown below.

COVID-19 Resources for Employers

CDC

State Health Department – Contact Information

U.S. Equal Employment Opportunity Commission – Coronavirus and COVID-19


October 2, 2020

2019 Novel Coronavirus (COVID-19) Frequently Asked Questions

What is COVID 19?

COVID-19 is a respiratory disease caused by a newly identified coronavirus known as SARS-CoV-2. The virus was first identified in December 2019 in Wuhan, China and quickly spread world-wide. In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Research is taking place worldwide to better understand the SARS-CoV-2 virus, COVID-19, what measures help to limit the spread of disease and treatment options.

How does COVID 19 Spread?

The COVID-19 virus (SARS-CoV-2) is most commonly spread when a person infected with the virus coughs, sneezes, talks, or sings, creating respiratory droplets that can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. The virus can live on surfaces or objects. As such, the virus can be transmitted when a person touches the contaminated objects and then touches their mouth, nose or eyes.

How long does it take to get COVID 19?

The incubation period, the time it takes for you to develop symptoms after you were exposed, is thought to be between 2 to 14 days after exposure. However, for most people, the average time from exposure to development of symptoms is between 5-6 days.

What are the symptoms of COVID 19?

The main symptoms seen with COVID-19 are fever, cough, shortness of breath, chills, extreme fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and/or diarrhea. But not all people have all these symptoms, and people experience a wide range of symptoms with COVID-19. The vast majority of people remain asymptomatic or have mild to moderate symptoms and fully recover. Some have severe symptoms that require hospitalization, and a small percentage of people with COVID-19 die. People with obesity (BMI>30), chronic medical conditions and older adults are at higher risk for severe illness and death.

How is COVID 19 diagnosed?

The diagnosis of SARS-CoV-2 can be suspected in anyone who has symptoms consistent with COVID-19, but a definite diagnosis requires testing. There are two kinds of tests available for COVID-19, one which tests for a current infection (PCR viral tests and antigen tests) and one which tests for a past infection (antibody tests).

PCR viral tests test for a current infection by testing for the presence of the actual COVID-19 virus. In such a test, a sample is taken from the person suspected to be infected, such as a nasal or a very deep nasal swab (i.e. nasopharyngeal), and this is analyzed by a lab to determine if the virus is present. Such tests can take a day to several days to result.

Antigens are structural components of the virus. Antigen tests test for the presence of these structural components, like the spikes on the outside of COVID-19 virus. Antigen tests are typically quicker and less expensive, but they are also less accurate.

An antibody test might be helpful to tell if the person tested had a past infection with COVID-19 but does not accurately show if this person has a current infection as it can take 1-3 weeks after an infection for a person’s body to develop antibodies. Having antibodies to COVID-19 may protect you against another infection with COVID-19 (immunity) but it is still unknown how much protection these antibodies may provide or how long this protection may last. Antibody tests should not be used to diagnose a current COVID-19 infection, and a viral PCR test is needed to determine if a current infection is present.

Is COVID-19 serious?

COVID-19 can cause serious symptoms and even death in certain people. People at higher risk for severe symptoms are people with obesity (BMI >30) and people with underlying health issues. Of note, this same population has an increased risk of serious illness from any respiratory or fever illness such as the flu (influenza).

At this time, the COVID-19 death rate varies by region and age group from 0% in children to 20% in older adults with pre-existing conditions. In the US the average case fatality rate (the rate of death in people diagnosed with COVID-19) among all age groups is 3.5%. The overall mortality rate (the rate of death from COVID-19 in the population as a whole) in the US among all age groups is 0.04%. Worldwide the case fatality rate among all age groups is 3.9%. Although all of these percentages are based on incomplete data as not all people are being tested for COVID-19.

In comparison, COVID-19 is far less lethal than some other outbreaks like SARS (10% case fatality rate), MERS (34% case fatality rate) Bird Flu (60% case fatality rate) and Ebola (70% case fatality rate).

What if someone in my family gets sick with COVID-19?

If your family member does not need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms while also keeping as much distance as possible. According to guidelines issued by the CDC, the sick family member should stay in a separate room and use a separate bathroom, if space allows. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Remember to wash your hands frequently. Additionally, the CDC recommends that if you live in the same household with a person who is known to have COVID-19 that you home-isolate for 14 days after your last contact with the person known to have COVID-19 or for 14 days after the person who is sick meets the criteria to end their own home isolation.

If I was exposed to a person with COVID-19, why should I home-isolate?

If you were exposed to a person with COVID-19, it might take up to 14 days after the exposure for symptoms to develop. You can spread COVID-19 before you have symptoms. As well, there are people with COVID-19 who never have symptoms but can still spread the virus. For these reasons, the CDC has recommended 14 days of home isolation if you have been in close contact with a person who has known or suspected COVID-19.

The CDC defines “close contact” as:

  • You were within 6 feet of someone sick with COVID-19 for a total of 15 minutes or more
  • You provided care at home to someone who is sick with COVID-19
  • You had direct physical contact with a person (hugged or kissed them) who is sick with COVID-19
  • You shared eating or drinking utensils with a person who is sick with COVID-19
  • You were sneezed on, coughed on, or somehow got the respiratory droplets of a person sick with COVID-19 on you

Additionally, the CDC recommends that if you live in the same household with a person who is known to have COVID-19 that you home-isolate for 14 days after your last contact with the person known to have COVID-19 or for 14 days after the person who is sick meets the criteria to end their own home isolation.

The CDC allows “essential workers” who are exposed to COVID-19 but do not themselves have any symptoms of COVID-19, to continue to work, but requires them to take additional precautions and to closely monitor for COVID-19 symptoms.

Should I wear a mask?

The CDC has recommended that all Americans wear a mask or cloth face covering if they go out in public. Masks don’t replace hand washing and social distancing.

Is there a vaccine available for COVID-19?

There is no FDA-approved vaccine for COVID-19. However, early stages of vaccine testing have begun.

Can I have flu and COVID-19 at the same time?

Flu and COVID-19 are both respiratory diseases but are caused by different viruses. Both can have serious symptoms and can even lead to death. It may be possible for you to have both flu and COVID-19 at the same time. There is a vaccine available to protect you against the flu but a vaccine for COVID-19 is not yet available.

Where can I find out more about COVID-19?

Centers for Disease Control – https://www.cdc.gov/coronavirus/2019-ncov/index.html

Source Materials: U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization


August 2020

2019 Novel Coronavirus (COVID-19) Frequently Asked Questions

What is COVID 19?

COVID-19 is a respiratory disease caused by a newly identified coronavirus known as SARS-CoV-2. The virus was first identified in December 2019 in Wuhan, China and quickly spread worldwide. In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Research is taking place worldwide to better understand the SARS-CoV-2 virus, COVID-19, what measures help to limit the spread of disease and treatment options.

How does COVID 19 Spread?

The COVID-19 virus (SARS-CoV-2) is most commonly spread when a person infected with the virus coughs, sneezes, talks, or sings, creating respiratory droplets that can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. The virus can live on surfaces or objects. As such, the virus can be transmitted when a person touches the contaminated objects and then touches their mouth, nose or eyes.

How long does it take to get COVID 19?

The incubation period, the time it takes for you to develop symptoms after you were exposed, is thought to be between 2 to 14 days after exposure. However, for most people, the average time from exposure to development of symptoms is between 5-6 days.

What are the symptoms of COVID 19?

The main symptoms seen with COVID-19 are fever, cough, shortness of breath, chills, extreme fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and/or diarrhea. But not all people have all these symptoms, and people experience a wide range of symptoms with COVID-19. The vast majority of people remain asymptomatic or have mild to moderate symptoms and fully recover. Some have severe symptoms that require hospitalization, and a small percentage of people with COVID-19 die. People with obesity (BMI>30), chronic medical conditions and older adults are at higher risk for severe illness and death.

How is COVID 19 diagnosed?

The diagnosis of SARS-CoV-2 can be suspected in anyone who has symptoms consistent with COVID-19, but a definite diagnosis requires testing. There are two kinds of tests available for COVID-19, one which tests for a current infection (PCR viral tests and antigen tests) and one which tests for a past infection (antibody tests).

PCR viral tests test for a current infection by testing for the presence of the actual COVID-19 virus. In such a test, a sample is taken from the person suspected to be infected, such as a nasal or a very deep nasal swab (i.e. nasopharyngeal), and this is analyzed by a lab to determine if the virus is present. Such tests can take a day to several days to result.

Antigens are structural components of the virus. Antigen tests test for the presence of these structural components, like the spikes on the outside of COVID-19 virus. Antigen tests are typically quicker and less expensive, but they are also less accurate.

An antibody test might be helpful to tell if the person tested had a past infection with COVID-19 but does not accurately show if this person has a current infection as it can take 1-3 weeks after an infection for a person’s body to develop antibodies. Having antibodies to COVID-19 may protect you against another infection with COVID-19 (immunity) but it is still unknown how much protection these antibodies may provide or how long this protection may last. Antibody tests should not be used to diagnose a current COVID-19 infection, and a viral PCR test is needed to determine if a current infection is present.

Is COVID-19 serious?

COVID-19 can cause serious symptoms and even death in certain people. People at higher risk for severe symptoms are people with obesity (BMI >30) and people with underlying health issues. Of note, this same population has an increased risk of serious illness from any respiratory or fever illness such as the flu (influenza).

At this time, the COVID-19 death rate varies by region and age group from 0% in children to 20% in older adults with pre-existing conditions. In the US the average case fatality rate (the rate of death in people diagnosed with COVID-19) among all age groups is 3.5%. The overall mortality rate (the rate of death from COVID-19 in the population as a whole) in the US among all age groups is 0.04%. Worldwide the case fatality rate among all age groups is 3.9%. Although all of these percentages are based on incomplete data as not all people are being tested for COVID-19.

In comparison, COVID-19 is far less lethal than some other outbreaks like SARS (10% case fatality rate), MERS (34% case fatality rate) Bird Flu (60% case fatality rate) and Ebola (70% case fatality rate).

What if someone in my family gets sick with COVID-19?

If your family member does not need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms while also keeping as much distance as possible. According to guidelines issued by the CDC, the sick family member should stay in a separate room and use a separate bathroom, if space allows. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Remember to wash your hands frequently. Additionally, the CDC recommends that if you live in the same household with a person who is known to have COVID-19 that you home-isolate for 14 days after your last contact with the person known to have COVID-19 or for 14 days after the person who is sick meets the criteria to end their own home isolation.

If I was exposed to a person with COVID-19, why should I home-isolate?

If you were exposed to a person with COVID-19, it might take up to 14 days after the exposure for symptoms to develop. You can spread COVID-19 before you have symptoms. As well, there are people with COVID-19 who never have symptoms but can still spread the virus. For these reasons, the CDC has recommended 14 days of home isolation if you have been in close contact with a person who has known or suspected COVID-19.

The CDC defines “close contact” as:

  • You were within 6 feet of someone sick with COVID-19 for a total of 15 minutes or more
  • You provided care at home to someone who is sick with COVID-19
  • You had direct physical contact with a person (hugged or kissed them) who is sick with COVID-19
  • You shared eating or drinking utensils with a person who is sick with COVID-19
  • You were sneezed on, coughed on, or somehow got the respiratory droplets of a person sick with COVID-19 on you

Additionally, the CDC recommends that if you live in the same household with a person who is known to have COVID-19 that you home-isolate for 14 days after your last contact with the person known to have COVID-19 or for 14 days after the person who is sick meets the criteria to end their own home isolation.

The CDC allows “essential workers” who are exposed to COVID-19 but do not themselves have any symptoms of COVID-19, to continue to work, but requires them to take additional precautions and to closely monitor for COVID-19 symptoms.

Should I wear a mask?

The CDC has recommended that all Americans wear a mask or cloth face covering if they go out in public. Masks don’t replace hand washing and social distancing.

Is there a vaccine available for COVID-19?

There is no FDA-approved vaccine for COVID-19. However, early stages of vaccine testing have begun.

Where can I find out more about COVID-19?

Centers for Disease Control – https://www.cdc.gov/coronavirus/2019-ncov/index.html

Source Materials: U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization

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April 2020

The Importance of Employee Screening in the COVID-19 Pandemic

By Robert E. Dooley, General Counsel, Medcor, Inc.

COVID-19 (COVID) is making people and businesses sick. Both a vaccine and a cure seem like distant hopes. But employers can take steps now to protect themselves against a second wave of misery that is sure to come – COVID claims. This memo will discuss three types of claims likely to be faced by employers. And it will describe how Medcor’s screening services and data collection can provide valuable evidence that employers can use to defend against these claims. The claims discussed in this memo are:

CLAIM TYPE #1
Lawsuits against employers alleging failure to protect employees from COVID

CLAIM TYPE #2
OSHA recordability issues concerning employees acquiring COVID in the workplace

CLAIM TYPE #3
Workers Compensation claims against employers by employees who contract COVID at work

The following hypothetical fact pattern will illustrate these claims: John Jones works in a distribution warehouse for Acme Corporation, a large national grocery company. He is employed by Staff-Fast, Inc., a staffing company used by Acme to supplement its workforce. In John’s state, Acme is designated as an essential business and is permitted to continue to operate even though the Governor has issued a stay at home order. Employees of Acme and its subcontractors have not screened persons before entering the distribution center, either for body temperature or using CDC screening guidelines. One fellow worker was diagnosed with the disease and several others exhibited flu-like symptoms. John becomes infected with COVID and does not survive.

CLAIM TYPE #1 – Negligence Lawsuits

John’s survivors (the Plaintiff) file a wrongful death suit against Acme, alleging that his death was caused by the failure of Acme to protect the occupants of the facility from COVID. To establish an inference that COVID was present in the facility, the Plaintiff alleges that other workers at the facility exhibited symptoms of the disease and that one fellow worker was diagnosed with the disease.

In its negligence lawsuit, the Plaintiff must establish first that Acme had a duty to John to prevent the harm suffered, and then must define the standard of care to establish what the defendant should have done to prevent the harm. The Plaintiff would allege that Acme had a duty to exercise reasonable care to protect employees and subcontractors from contracting COVID in the workplace. As for the standard of care, the Plaintiff would claim that several guidance documents and official government pronouncements defined the standard of care and that the jury should compare Acme’s actions with the contents of these documents and pronouncements. The standard of care would be defined by:

1)

State and federal guidance concerning social distancing that the Plaintiff would claim Acme did not institute in the facility;

2)

CDC recommendations concerning PPE, facility cleaning, providing antibacterial soaps and wipes to employees, engineering controls and other recommendations from the CDC that the Plaintiff would allege were not implemented or followed by Acme; and

3)

OSHA’s “Guidance on Preparing Workplaces for COVID-19” and subsequent memorandums that the Plaintiff would allege Acme did not follow.

The Plaintiff will argue that, by not following those guidance documents, Acme was negligent, and Acme’s negligence was the proximate cause of John’s death. In addition, the Plaintiff could argue that the defendant failed to close the facility when it became apparent that individuals with COVID symptoms were in the facility, failed to train its employees and subcontractors properly, failed to interview and evaluate its employees and subcontractors for COVID and failed to prohibit individuals who exhibited symptoms from entering the facility.

But what if Acme had screened all individuals entering the facility for signs and symptoms of the disease, as defined by the CDC, using questions recommended by the CDC and recording body temperatures? What if Acme had available detailed records of every person who entered the facility during the time John was allegedly exposed to the disease at the facility, and through these records could show that no individual who was screened exhibited signs or symptoms of COVID before entering the facility? By conducting this screening, Acme would have valuable evidence that it could use to show that it did in fact exercise reasonable care by setting objective standards concerning who would be allowed into the facility and who would not.

CLAIM TYPE #2 – OSHA Recording and Reporting Issues

Staff-Fast, Inc., John’s employer, would be required to decide whether John’s death triggers OSHA reporting and recording requirements. OSHA’s new guidance on when to record a COVID case as a recordable illness states that COVID is a recordable illness if the case (1) Is confirmed as a COVID illness, (2) is work-related as defined by Section 1904.5, and (3) involves one or more of the general recording criteria in Section 1904.7, such as medical treatment beyond first aid or days away from work. In its guidance, OSHA points out that it will be challenging to make the work-relatedness determination (other than in healthcare settings, first responder settings, and correctional institutions) for most employers because of the full spread community transmission. Accordingly, OSHA will exercise discretion when enforcing its recordkeeping requirements for employers other than healthcare, first response, and correctional employers, except where (1) there is objective evidence that a COVID case may be work-related, and (2) the evidence was reasonably available to the employer.

The employer can determine its OSHA obligations to report and record by screening employees for signs and symptoms of the disease, by using questions recommended by the CDC, by recording body temperatures, and by refusing entry to the workplace by individuals who fail to meet the requirements for entry. If the screening process used by the employer keeps records of individuals who are screened, these records can be used as objective evidence by the employer that COVID was more likely contracted in the general population than in the workplace and that the illness was not work-related.

CLAIM TYPE #3 – Workers Compensation Claims

What if John filed a claim for workers compensation against Staff-Fast? States have started to look at shifting the responsibility for COVID costs to employers for employees still working. Recent emergency changes to the Illinois workers compensation commission rules of evidence created a rebuttable presumption that (1) if any person acquired COVID during the time that the Governor’s disaster declaration was in effect, and (2) that person worked in a business deemed essential by the Governor, then the COVID would be presumed to be causally connected to the exposures of that person’s employment. The rules were challenged in court and struck down and were then withdrawn. But the intent of the attempted change was clear. The use of the rebuttable presumption is common in workers compensation. In states where a rebuttable presumption is used to provide for COVID relief through the workers compensation system, unless the presumption can be overcome the employer may end up paying the costs of a COVID illness.

In this scenario also, the employer can help itself now by screening employees for signs and symptoms of the disease as defined by the CDC, using questions recommended by the CDC, and recording body temperatures with individuals who fail to meet the requirements for entry into the workplace being excluded from entry. If the employer uses the screening process and keeps records of individuals who are screened, these records can be used as evidence by the employer that COVID was more likely contracted in the general population than in the workplace. This is one of the only tools available to an employer that would allow it to rebut the presumption created by the changes to the evidence rules.

Conclusion

Employee screening provides the employer with the ability to categorize each employee before entry, by either screening the employee in person upon arrival at work or by telephone before arriving at work. Careful recordkeeping provides the employer with objective evidence that the employer took reasonable steps to prevent an employee who may carry the disease from entering the workplace, or that it required a symptomatic employee to leave. It also provides evidence for the employer to be able to show that it admitted into its facility only individuals who were free of COVID concerns.

Employee screening provides the employer with the ability to categorize each employee before entry, either by screening the employee in person upon arrival at work, or by screening the employee over the telephone before arriving at work. The EEOC permits employers to refuse entry into the workplace by an employee who may have contracted COVID. The EEOC also allows an employer to require an employee who becomes symptomatic at work to leave the workplace. It permits employers to ask employees about COVID symptoms and to take employee body temperatures to identify individuals with COVID symptoms. A robust screening program can leverage these tools into strong medicine for claims.

Robert E. Dooley joined Medcor in 2005 as General Counsel & Chief Legal Officer. In his role he oversees regulatory compliance, contracting, and government affairs for all of Medcor’s companies. Mr. Dooley also manages Medcor›s Special Operations, which includes work in the entertainment industry and all government clients. Mr. Dooley as a health care attorney has over 25 years’ experience in healthcare regulatory and compliance matters. He has represented hospitals, ambulance services and emergency medical services systems with regard to contractual and health care regulatory matters. He is a member of the Health Care Compliance Association and the American Health Law Association.

This report is prepared for educational purposes and does not constitute legal advice. The information should not be relied upon as legal advice in any particular fact situation. Any attorney should be consulted for advice on specific legal issues. The laws and regulations related to COVID-19 are evolving, and by the time this report is ready some of the information could be outdated.


March 19, 2020

Medcor Care Protocols and Triage Algorithms

As the situation with COVID-19 continues to evolve, Medcor continues to update our operations, care protocols, and algorithms according to the guidance of the CDC, WHO, and other accredited healthcare organizations. Our built-in QA process monitors the effectiveness of the screening tools used in our clinics and through our telephone Injury & Illness Triage service.

Quarantines and Cleanings

We are following CDC guidance for the quarantining and cleaning of clinics. Once a patient of concern for COVID-19 has been seen in the clinic and departs the clinic, the CDC now recommends that the room be quarantined for 46 minutes. Following the quarantine, the CDC recommends a “terminal cleaning” be performed by a person wearing all recommended personal protective equipment (PPE) for cleaning. A “terminal cleaning” is a deep cleaning that involves wiping down all surfaces and objects that the person of concern may have come in contact with using a product that is EPA-approved for “emerging viral pathogens.”

Social Distancing and PPE

As much as physically possible, Medcor is observing CDC guidance for social distancing. Regarding appropriate personal protective equipment (PPE), every patient who comes to a clinic, unless the patient has an obvious non-COVID-19 complaint, will be given a surgical mask to wear. Medcor clinicians are directed to wear masks, gowns, gloves, and goggles/face shields.

COVID-19 Workforce Recovery

During this unprecedented time for employers, Medcor is as we’ve always been: entirely engaged to make sure that workforces stay safe and healthy. For sites that have temporarily closed, we are likewise committed to making sure that when employees do return to work, they really are ready to do so. Learn more about our strategies for workforce recovery by contacting us.


February 28, 2020

Coronavirus Disease 2019 (COVID-19) Frequently Asked Questions

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What is COVID-19?

Coronavirus Disease 2019 or COVID-19 (formerly known as 2019 Novel Coronavirus (2019-nCoV)) is a new (“novel”) strain of Coronavirus that has not been previously identified in humans. Coronaviruses are a large family of viruses that are known to cause illnesses ranging from the common cold to more severe illnesses such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

COVID-19 originated in Wuhan, Hubei Province, China in December of 2019. Initially, most of the people infected were in the Hubei province. Since December, COVID-19 has been detected in over 50 countries internationally (on every continent except Antarctica).

In the U.S., as of February 27, 2020, a total of 60 people have been diagnosed with COVID-19. Twelve people contracted the virus through known travel-related exposure, and three people contracted the virus through person-to-person spread. There have been an additional 45 people with COVID-19 who were repatriated to the U.S. and quarantined from China and the Diamond Princess Cruise Ship.

How does COVID-19 Spread?

COVID-19 is spread from person to person, mostly through respiratory droplets from sneezing or coughing. It can also spread via close personal contact, such as touching or shaking hands; touching an object or surface with the virus on it, then touching the mouth, nose, or eyes before washing one’s hand. Prior reports suggest that there may be a connection to animal exposures, but this is still being investigated.

The CDC defines close contact as being within approximately 6 feet of a person with COVID-19 for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case OR having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).

How long does it take to get COVID-19?

The incubation period, the time it takes for you to develop symptoms after you were exposed, is thought to be between 2 to 14 days after exposure.

What are the symptoms of COVID-19?

The main symptoms seen with COVID-19 are fever, cough, fatigue, and shortness of breath.

How is COVID-19 diagnosed?

The CDC recommends that a careful travel history be obtained from anyone who presents with a cough, fever, and/or shortness of breath. COVID-19 should be considered in any person with these symptoms who has had any of the following exposures within 14 days of onset symptoms: (1) travel to a geographic area with known COVID-19 widespread or sustained transmission and (2) close contact with any person confirmed or suspected to have COVID-19.

If, based on the patient history, exposures, and symptoms, COVID-19 is suspected, the healthcare professional will contact the CDC or local health department for instructions on testing. Testing for the virus is possible using a CDC-developed, FDA-approved COVID-19 test, that tests samples from the nose, throat, or lungs for COVID-19. At this time, testing for COVID-19 is conducted by the local health department in Emergency Departments.

Is COVID-19 serious?

COVID-19 can cause serious symptoms and even death in certain people. People at higher risk for severe symptoms are older adults and adults with underlying health issues. Of note this same population has an increased risk of serious illness from any respiratory or fever illness such as the common cold and influenza.

At this time, per the CDC, the COVID-19 mortality rate is 2.3%; however, in some regions of the world the COVID-19 mortality rate appears to be lower. In comparison, COVID-19 is far less lethal than some other outbreaks like SARS (10% death rate) and Bird Flu (60% death rate) and Ebola (70% death rate). The vast majority of those infected with COVID-19 have reported mild-to-moderate symptoms and have fully recovered.

Can COVID-19 be treated?

Yes, COVID-19 is treated supportively, just like other respiratory or fever illness like a cold or flu. Fever control with Tylenol or Motrin, fluids, rest, and cold medication can help ease the symptoms. People with severe symptoms should promptly seek medical care. Antiviral medications are currently being investigated as a potential treatment, but they are not yet widely available.

Can COVID-19 be prevented?

The best way to prevent infection is to avoid being exposed to this virus. However, the CDC recommends the following preventative actions to help prevent becoming infected and preventing the spread of respiratory viruses, including:

  • Wash your hands frequently with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • 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.
  • Wipe down surfaces and frequently touched objects and surfaces with water and detergent.
  • If there is a known outbreak in your area, stay 3-5 feet away from people who are sick and avoid crowded locations.
  • Avoid going out if you are sick.
  • Avoid traveling to areas where there are known outbreaks.

Where should I avoid traveling?

The CDC currently recommends that travel be limited or avoided in areas with widespread or sustained transmission. Specific travel recommendations include:

Travel Alert Level Definition of Warning Level Countries Affected
Warning Level 3 All non-essential travel should be avoided China, South Korea
Alert Level 2 Older adults and people with chronic medical conditions should postpone non-essential travel Iran, Italy, Japan
Watch Level 1 Canceling or postponing travel is not recommended, and usual precautions should be observed Hong Kong

Travel Guidance Updates can be found on the CDC Website’s “Coronavirus Disease 2019 Information for Travel” section

Is there a vaccine available for COVID-19?

Not yet. However, COVID-19 vaccine research and development work is taking place in countries throughout the world. There are early reports of potential vaccines, but further testing is required. At this point, researchers are estimating that it may take up to a year until a vaccine will be released.

Where can I find out more about COVID-19?

  • ID-19 Global Tracking Map: Johns Hopkins University Center for Systems Science and Engineering (CSSE) has created an interactive dashboard, to visualize and track reported cases of coronavirus disease 2019 (COVID-19) in real time. This publicly-available dashboard illustrates the location and number of confirmed COVID-19 cases, deaths, and recoveries for all affected countries. The global tracking map can be found through the Google search of “Global cases covid-19 and gisaid.org”.
  • Centers for Disease Control – https://www.cdc.gov/coronavirus/2019-ncov/index.html

Source Materials:  U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization


COVID-19 (Coronavirus) Guidance for Employers

As new information about COVID-19 (the new name for the 2019 Novel Coronavirus/ 2019-nCoV) becomes available, our goal is to keep you informed and up-to-date so you can best protect your companies and your employees.  

As of today, the U.S. has been effective in their COVID-19 containment efforts and the total number of people in the US with COVID-19 is 15 (this number does not the people evacuated from the Diamond Princess cruise ship who are currently being quarantined). While there is no reason in the U.S. to be alarmed at this time, this is the ideal time for companies to plan how they would handle the situation should the U.S. COVID-19 containment measures no longer be enough, and numbers of people infected with COVID-19 rise. 

The CDC released interim guidance to help prevent acute respiratory illness, including COVID-19, in non-healthcare settings. Below are the CDC’s recommended strategies for employers to use now:

Actively encourage sick employees to stay home:

  • Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.
  • Ensure that your sick-leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.
  • Talk with companies that provide your business with contract or temporary employees about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.
  • Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
  • Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.

Separate sick employees:

CDC recommends that employees who appear to have acute respiratory illness symptoms (i.e., cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately. Sick employees should cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).

Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees:

  • Place posters that encourage staying home when sickcough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other workplace areas where they are likely to be seen.
  • Provide tissues and no-touch disposal receptacles for use by employees.
  • Instruct employees to clean their hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol, or wash their hands with soap and water for at least 20 seconds. Soap and water should be used preferentially if hands are visibly dirty.
  • Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. Place hand rubs in multiple locations and in conference rooms to encourage hand hygiene.
  • Visit the CDC’s coughing and sneezing etiquette and clean hands webpage for more information.

Perform routine environmental cleaning:

  • Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
  • No additional disinfection beyond routine cleaning is recommended at this time.
  • Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.

Advise employees before traveling to take certain steps:

  • Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for each country to which you will travel. Specific travel information for travelers going to and returning from China, and information for aircrew, can be found at on the CDC website.
  • Advise employees to check themselves for symptoms of acute respiratory illness before starting travel and notify their supervisor and stay home if they are sick.
  • Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor and should promptly call a healthcare provider for advice if needed.
  • If outside the United States, sick employees should follow your company’s policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding an appropriate healthcare provider in that country. A U.S. consular officer can help locate healthcare services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medicines, vaccines, or medical care to private U.S. citizens overseas.

Additional Measures in Response to Currently Occurring Sporadic Importations of the COVID-19:

  • Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
  • If an employee is confirmed to have COVID-19 infection, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID-19 should refer to CDC guidance for how to conduct a risk assessment of their potential exposure.

2019 NOVEL CORONAVIRUS (2019-nCoV) Frequently Asked Questions

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What is 2019 Novel Coronavirus (2019-nCoV)?

The 2019 Novel Coronavirus (scientifically named: 2019-nCoV), and commonly known as Wuhan Coronavirus is a new (“novel”) strain of coronavirus that has not been previously identified in humans. Coronaviruses are a large family of viruses that are known to cause illnesses ranging from the common cold to more severe illnesses such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

The 2019-nCoV originated in Wuhan, Hubei Province, China in December of 2019. The majority of the people infected are in the Hubei province, but there are confirmed cases of 2019-nCoV in at least 10 other countries, including the U.S.

How does 2019 Novel Coronavirus (2019-nCoV) spread?

2019 Novel Coronavirus (2019-NCoV) is spread from person to person, mostly through respiratory droplets from sneezing or coughing. It can also spread via close personal contact, such as touching or shaking hands; touching an object or surface with the virus on it, then touching the mouth, nose, or eyes before washing one’s hands; and rarely, from fecal contamination.  Some have reported that there may be a connection to animal exposures, but this is still being investigated.

How long does it take to get 2019 Novel Coronavirus (2019-nCoV)?

The incubation period, the time it takes for you to develop symptoms after you were exposed, is thought to be between 2 to 14 days after exposure.

What are the symptoms of 2019 Novel Coronavirus (2019-nCoV)?

The main symptoms seen with 2019-nCoV are fever, cough, and fatigue.  Severe cases may have trouble breathing.

How is 2019 Novel Coronavirus (2019-nCoV) diagnosed?

There are tests that can evaluate for 2019 Novel Coronavirus (2019-nCoV). The CDC recommends focusing the 2019-nCoV testing on those that have fever, cough and/or difficulty breathing and have had any of the following exposures in the last 14 days: a history of travel from Wuhan City, China; close contact with a person who is under investigation for 2019-nCoV; or close contact with an ill, laboratory-confirmed 2019-nCoV.

Is 2019 Novel Coronavirus (2019-nCoV) serious?

2019 Novel Coronavirus (2019-nCoV) can cause serious symptoms and even death in certain people. People at higher risk for severe symptoms are elderly people and people with underlying health issues. Of note this same population has an increased risk of serious illness from any  respiratory or fever illness such as the common cold and influenza.

At this time, per the CDC the 2019-nCoV death rate is 2.5%.  In comparison, the 2019-nCoV far less lethal than some other outbreaks like SARS (10% death rate) and Bird Flu (60% death rate) and Ebola (70% death rate). The vast majority of those infected with 2019-nCoV have reported mild to moderate symptoms.

Can 2019 Novel Coronavirus (2019-nCoV) be treated?

There is no specific treatment for 2019 Novel Coronavirus (2019-nCoV) or any coronaviruses. 2019 Novel Coronavirus (2019-nCoV) is treated supportively just like any other respiratory or fever illness like a cold or flu. Fever control with Tylenol or Motrin, fluids, rest, and cold medication can help ease the symptoms. People with severe symptoms should promptly seek medical care.

Can 2019 Novel Coronavirus (2019-nCoV) be prevented?

The best way to prevent infection is to avoid being exposed to this virus. However, the CDC recommends the following preventative actions to help prevent becoming infected and preventing the spread of respiratory viruses, including:

  • Wash your hands frequently with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • 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.
  • Wipe down surfaces and frequently touched objects and surfaces with water and detergent. 
  • If there is a known outbreak in your area, stay 3-5 feet away from people who are sick and avoid crowded locations.
  • Avoid going out if you are sick.
  • Avoid traveling to areas where there are known outbreaks.

Is there a vaccine available for 2019 Novel Coronavirus (2019-nCoV)?

Not yet. However, 2019 Novel Coronavirus (2019-nCoV) vaccine research and development work is taking place in countries throughout the world.  There are early reports of potential vaccines, but further testing is required. At this point, researchers are estimating that it may take up to a year until a vaccine will be released. 

Where can I find out more about 2019 Novel Coronavirus (2019-nCoV)?

Centers for Disease Control

Source Materials:   U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization