Your top questions about Covid-19 and vaccines
Does a vaccine need to be fully approved by the FDA for an employer or business to mandate vaccination?
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If I’ve already had Covid-19, should I still get vaccinated? What if I got monoclonal antibody treatment?
“Yes, you should be vaccinated regardless of whether you already had COVID-19,” the CDC said in August 2021.
“Evidence is emerging that people get better protection by being fully vaccinated compared with having had COVID-19. One study showed that unvaccinated people who already had COVID-19 are more than 2 times as likely than fully vaccinated people to get COVID-19 again,” the CDC’s website said.
“If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.”
“Many of the vaccines that we’ve made in history are actually stronger than the virus is itself at creating immunity,” epidemiologist Dr. Larry Brilliant said.
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When will the Pfizer vaccine be fully approved by the FDA for children ages 12 to 15?
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When will the other Covid-19 vaccines get fully approved by the FDA?
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Do we need Covid-19 vaccine booster shots? If so, when should we get another dose?
Americans vaccinated with the two-dose Moderna or Pfizer/BioNTech vaccines may be eligible for a third dose starting September 20, pending independent review of the safety and efficacy of a third dose, several US health officials said in a joint statement August 18.
“We are prepared to offer booster shots for all Americans beginning the week of September 20 and starting 8 months after an individual’s second dose,” said the health officials, who include CDC Director Dr. Rochelle Walensky.
The FDA has already authorized third doses for some immunocompromised people.
For Americans who got the single-dose Johnson & Johnson vaccine, “We also anticipate booster shots will likely be needed for people who received the Johnson & Johnson (J&J) vaccine. Administration of the J&J vaccine did not begin in the U.S. until March 2021, and we expect more data on J&J in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well.”
The health officials said the Covid-19 vaccines used in the US “continue to be remarkably effective in reducing risk of severe disease, hospitalization, and death, even against the widely circulating Delta variant.”
But immunity can wane over time, and additional vaccine doses could be needed to provide long lasting protection, the health officials said.
With “the dominance of the Delta variant, we are starting to see evidence of reduced protection against mild and moderate disease,” the statement read.
“Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout. For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability.”
The CDC and others say vaccination is still the best weapon in the fight against Covid-19.
“Nearly all the cases of severe disease, hospitalization, and death continue to occur among those not yet vaccinated at all,” the joint statement said.
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Should pregnant women get vaccinated?
“COVID-19 vaccination is recommended for all people 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future,” the US Centers for Disease Control and Prevention said.
“Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing,” the CDC said in an August 11 update.
Scientists say Covid-19 — not the Covid-19 vaccine — can put a woman at higher risk of severe illness during pregnancy.
Covid-19 can lead to “adverse pregnancy outcomes, such as preterm birth,” said Sascha Ellington, team lead for emergency preparedness and response in the CDC’s Division of Reproductive Health.
“This vaccine can prevent Covid-19, and so that’s the primary benefit.”
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Do vaccines still work against the Delta variant?
Full vaccination significantly reduces the chances of severe illness, hospitalization and death from the Delta variant, though breakthrough infections are possible.
“Vaccines continue to reduce a person’s risk of contracting the virus that cause COVID-19, including this variant,” the CDC said in a August 2021 update.
“Vaccines are highly effective against severe illness, but the Delta variant causes more infections and spreads faster than earlier forms of the virus that causes COVID-19.”
Vaccine effectiveness against coronavirus infection dropped from 91% to 66% once the Delta variant accounted for the majority of circulating virus, according to a study published August 24 by the US Centers for Disease Control and Prevention.
The study is in line with others from the US and around the world showing Delta’s increased tendency to cause largely minor infections among fully vaccinated people.
Still, the effectiveness of vaccines against severe disease — including hospitalization and death — has remained high against all known variants.
Health experts say it’s important to take both doses of any two-dose vaccine.
Two doses of the Pfizer/BioNTech vaccine offered 88% protection against symptomatic Covid-19 caused by the Delta variant, according to a study published in May by Public Health England.
But those who got only one dose of the Pfizer/BioNTech vaccine had just 33% protection against the Delta variant three weeks later, according to the study.
“The key is: Get vaccinated. Get both doses,” US Surgeon General Dr. Vivek Murthy said.
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With the Delta variant spreading, how much does vaccination reduce infection, hospitalization and death?
Compared to unvaccinated people, “If you’re (fully) vaccinated now, your chances of getting infected go down by 3 1/2-fold,” National Institutes of Health Director Dr. Francis Collins said August 1.
“Your chances of having symptoms go down by 8-fold. Your chance of ending up with illness significant enough to be in the hospital goes down 25-fold.”
Such decreases in infections, illnesses and hospitalizations are “fantastically good for any vaccine,” Collins said. “We didn’t really have a right to dare they would be this good in the real world, and they are — even against Delta.”
Still, more than 99.99% of people who were fully vaccinated against Covid-19 have not had a breakthrough case resulting in hospitalization or death, a CNN analysis of August 2 CDC data suggests.
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Why do some people get breakthrough infections after being fully vaccinated? Are they getting Covid-19 from the vaccine?
It’s impossible to get Covid-19 from a vaccine because there is no coronavirus in any of the vaccines used in the US.
The vaccines can’t prevent people from breathing in the virus. What they can do is ensure that the body mounts a fast response to clear the virus if someone does get exposed. During that time, some people might actually become infected.
But more than 99.99% of people who are fully vaccinated against Covid-19 have not had a breakthrough case resulting in hospitalization or death, a CNN analysis of CDC data suggests.
As of August 2, more than 164 million people in the US were fully vaccinated, according to CDC data.
Among them, 7,101 people – or less than 0.005% – were hospitalized with Covid-19, and 1,507 people — or less than 0.001% — died, according to the CDC data.
Those who get breakthrough infections generally have milder symptoms than unvaccinated people or no symptoms at all, CDC research shows.
Because few people get tested after they’ve been fully vaccinated, there’s limited data on how many vaccinated people get mild or asymptomatic infections.
But about half of states have reported data on Covid-19 breakthrough cases – and in each of those states, less than 1% of fully vaccinated people had a breakthrough infection, according to a Kaiser Family Foundation analysis published July 30.
More than 90% of people who end up in the hospital or who die from Covid-19 have not been fully vaccinated, according to the CDC.
It’s important to remember you’re not fully vaccinated until 2 weeks after your final dose of Covid-19 vaccine, so you’re still vulnerable in the first few weeks of vaccination.
“Keep taking all precautions until you are fully vaccinated,” the CDC says.
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Do fully vaccinated people also need to wear masks because of the more contagious Delta strain?
The US Centers for Disease Control and Prevention updated its guidance on July 27:
- If you are fully vaccinated, you can participate in many of the activities that you did before the pandemic.
- To maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.
- Wearing a mask is most important if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated. If this applies to you or your household, you might choose to wear a mask regardless of the level of transmission in your area.
The guidance is stronger than in May, when the CDC said fully vaccinated people could unmask in most situations. But back then, the highly contagious Delta variant represented only about 1% of reported infections. By late July, at least 83% of sequenced samples were from the Delta variant.
“The Delta variant behaves uniquely differently from past strains of the virus that cause Covid-19,” CDC Director Dr. Rochelle Walensky said July 27.
“This new science is worrisome and unfortunately warrants an update to our recommendations,” she said. “This is not a decision that we or CDC has made lightly.”
Fully vaccinated people are less likely to get infected and also less likely to get severely sick if they do get a breakthrough infection. But new research suggests those with breakthrough cases might have as much viral load as unvaccinated people who are infected — meaning they might also be able to transmit the virus, Walensky said.
States with below-average vaccination rates had, on average, almost triple the rate of new Covid-19 cases compared to states with above-average vaccination rates, according to data from Johns Hopkins University.
For those not fully vaccinated, the CDC says it’s crucial to mask up:
“Unvaccinated people should get vaccinated and continue masking until they are fully vaccinated. With the Delta variant, this is more urgent than ever,” the CDC says.
“Getting vaccinated prevents severe illness, hospitalizations, and death.”
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Why should anyone care whether I’m vaccinated if they’re already vaccinated?
Avoiding vaccination can harm loved ones and the country as a whole, doctors say.
Full vaccination reduces the chances of getting and spreading the highly contagious Delta variant. Children too young to be vaccinated and those who are immunocompromised also rely on the vaccination of others to help protect them, said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center.
But vaccination is also important to help prevent more contagious or more dangerous variants from forming — such as one that might evade vaccines and harm those who are fully vaccinated.
“If we are going to continue to allow this virus to spread, we’re going to continue to allow … variants to be created,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital in Philadelphia.
Viruses frequently mutate as they replicate among infected people. If the mutations are significant, they can lead to a more contagious variant like the Delta variant, which is now the dominant strain in the US.
“Think of a virus as a necklace full of different-colored beads,” board-certified internist Dr. Jorge Rodriguez said.
“In position No. 1, you need a red bead. Position No. 2 is a green bead. That’s the genetic code – that sequence of bead colors,” he said.
“When a virus replicates, it is supposed to make an exact replica of those bead colors. But every once in a while, maybe a green bead gets into where a red bead is supposed to be.”
When mutations give the virus an advantage — such as the ability to replicate faster or to hide from the immune system – that version will outcompete others.
The only way to get rid of variants is to lower the number of infections, said Penny Moore, an expert in viruses at South Africa’s National Institute for Communicable Diseases.
That’s a big reason why doctors say people should get vaccinated as soon as they can. Those who don’t get vaccinated aren’t just risking their own health — they’re also jeopardizing the health of others.
“Unvaccinated people are potential variant factories,” Schaffner said. “The more unvaccinated people there are, the more opportunities for the virus to multiply.”
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Is it true the Covid-19 vaccines don’t work as well in immunocompromised people? Can they get a third dose or a booster shot?
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What should I do if I’m wearing a mask but have to sneeze?
If there are tissues nearby, you can take your mask off and sneeze into the tissue before putting your mask back on, CNN Chief Medical Correspondent Dr. Sanjay Gupta said.
For kids in school — or anyone else who might have to wear a mask all day — keep a backup mask in a baggie in case the first mask gets dirty. You can put the dirty mask in the baggie.
It’s also a good idea to keep backup masks in your car in case of any mask accidents.
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Is it safe to go on vacation?
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When can younger kids get a Covid-19 vaccine?
One vaccine is already available for children ages 12 and up, and clinical trials are underway for younger children.
Pfizer/BioNTech’s vaccine is the only one currently authorized for people ages 12 and up. The vaccine is now being tested in children between 6 months and 11 years old. If all goes well, Pfizer said, it plans to ask the US Food and Drug Administration in September to authorize the vaccine for children ages 2 to 11 years.
Moderna’s vaccine is currently authorized for adults 18 and older. In May, the company said early trial data showed the vaccine is safe and appears to be effective in 12- to 17-year-olds. In June, Moderna said it has asked the FDA to authorize its vaccine for the 12-to-17 age group.
Moderna is also testing various doses of its vaccine in younger children between ages 6 months through 11 years. If all goes well, Moderna said, children under age 12 could be eligible for the vaccine this winter or in early 2022.
Johnson & Johnson said it plans to start testing its Covid-19 vaccine in adolescents starting this fall. Its single-dose vaccine is currently authorized for adults ages 18 and up.
J&J said it’s planning four late-stage vaccine trials for children. This first trial will focus on 12- to 17-year-olds, and the others will expand to include younger children. In total, J&J plans to enroll a minimum of 4,500 pediatric participants up to age 17.
“To keep children safe, and ultimately to achieve herd immunity, it is imperative that COVID-19 vaccine clinical trials continue to move forward in this population,” J&J said in a July 1 email to CNN.
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My kids don’t want to wear a mask. What should I do?
Children can be more reluctant because they’re more sensitive to new things than adults are, said Christopher Willard, a psychiatry lecturer at Harvard Medical School.
“There’s also the weird psychological aspect of not being able to see their own face or other people’s faces and facial expressions,” which can hinder their feelings of comfort or safety, he said.
To ease your child’s mask hesitancy, try buying or making masks with fun designs on them. Or have your child customize his or her own masks by drawing on them with markers.
You can also order children’s face masks with superheroes on them or show your kids photos of their favorite celebrities wearing masks.
It’s also a good idea to set an example by wearing a mask yourself.
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What’s the difference between the Delta and Delta Plus variants?
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What should I tell friends, family or coworkers who are hesitant to get vaccinated?
“It is a normal human reaction to be afraid,” pediatrician Dr. Edith Bracho-Sanchez said. “They’re having a normal reaction, and perhaps they haven’t been able to sit down with their physician.”
She suggests finding a time to have a calm, rational conversation — when neither person is angry or likely to start a fight.
“The first thing I would say is ‘I get it. I totally get where you’re coming from and I understand that you’re concerned about this,’” Bracho-Sanchez said.
It’s also important to cite scientific data — like the truth about side effects, the safety of Covid-19 vaccines and why it’s important for young, healthy people to get vaccinated.
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How long does immunity last if you recover from Covid-19?
Research is still evolving, but a recent study examining antibodies suggests you could be immune for months after infection.
“Although this cannot provide conclusive evidence that these antibody responses protect from reinfection, we believe it is very likely that they will decrease the odds ratio of reinfection,” researchers from Mount Sinai wrote.
“It is still unclear if infection with SARS-CoV-2 [the scientific name for the novel coronavirus] in humans protects from reinfection and for how long.”
There have been some reports of people getting infected twice within several months. Doctors said a 25-year-old Nevada man appeared to be the first documented case of Covid-19 reinfection in the US. He was first diagnosed in April 2020, then recovered and tested negative twice. About a month later, he tested positive again.
A separate team of researchers said a 33-year-old man living in Hong Kong had Covid-19 twice, in March and August of 2020.
Last year, an 89-year-old Dutch woman – who also had a rare white blood cell cancer – died after catching Covid-19 twice, experts said. She became the first known person to die after getting reinfected.
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Will Americans be required to get a Covid-19 vaccine? What happens if I don’t get vaccinated?
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How much does a Covid-19 vaccine cost?
“It’s all free. The government is paying for this,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital in Philadelphia.
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What are the side effects of the vaccines?
Some people have reported feeling temporary, flu-like symptoms. Don’t freak out if this happens to you, health experts say.
“These are immune responses, so if you feel something after vaccination, you should expect to feel that,” said Patricia Stinchfield of Children’s Hospitals and Clinics of Minnesota.
“And when you do, it’s normal that you have some arm soreness or some fatigue or some body aches or even some fever,” Stinchfield said.
Read more about what to do if you do get side effects and why side effects are often a good sign.
The Pfizer/BioNTech vaccine has shown no serious safety concerns, Pfizer said. Pfizer has said side effects “such as fever, fatigue and chills” have been “generally mild to moderate” and lasted one to two days.
Moderna said its vaccine did not have any serious side effects. It said a small percentage of trial participants had symptoms such as body aches and headaches.
With the Johnson & Johnson vaccine, the most common side effects were pain at the injection site, headache, fatigue and muscle pain. While the CDC recommends the Johnson & Johnson vaccine, “women younger than 50 years old especially should be aware of the rare but increased risk of thrombosis with thrombocytopenia syndrome (TTS),” the agency says. “TTS is a serious condition that involves blood clots with low platelets. There are other COVID-19 vaccine options available for which this risk has not been seen.”
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What is aerosolized spread? What’s the difference between aerosols and droplets?
Aerosolized spread is the potential for coronavirus to spread not just by respiratory droplets, but by even smaller particles called aerosols that can float in the air longer than droplets and can spread farther than 6 feet.
Respiratory aerosols and droplets are released when someone talks, breaths, sings, sneezes or coughs. But the main difference is size.
“If you have droplets that come out of a person, they generally go down within 6 feet,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
But aerosols (aka droplet nuclei) are smaller – less than 5 microns in diameter, according to the World Health Organization.
“Aerosol means the droplets don’t drop immediately,” Fauci said. “They hang around for a period of time.”
This becomes “very relevant” when you are indoors and there is poor ventilation, he said.
Multiple case studies suggest coronavirus can spread well beyond 6 feet through airborne transmission, such as during choir practices, said Dr. Amy Compton-Phillips, chief clinical officer of Providence Health System.
In Washington state, for example, 53 members of a choir fell sick and two people died after one member attended rehearsals and later tested positive for Covid-19.
Last July, 239 scientists backed a letter urging public health agencies to recognize the potential for aerosolized spread.
“There is significant potential for inhalation exposure to viruses in microscopic respiratory droplets (microdroplets) at short to medium distances (up to several meters, or room scale), and we are advocating for the use of preventive measures to mitigate this route of airborne transmission,” the letter said.
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This pandemic is taking a toll on my mental health. How can I get help if I’m feeling isolated and depressed?
The Crisis Text Line is available texting to 741741. Trained volunteers and crisis counselors are staffed 24/7, and the service is free.
The Substance Abuse and Mental Health Services Administration Disaster Distress Helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to disasters. Call 1-800-985-5990 or text TalkWithUs to 66746 to connect with a trained crisis counselor.
For health care professionals and essential workers, For the Frontlines offers free 24/7 crisis counseling and support for workers dealing with stress, anxiety, fear or isolation related to coronavirus.
For more resources, check out CNN’s guide to giving and getting help during the pandemic.
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What “underlying conditions” put people at higher risk of bad outcomes with Covid-19?
More than 40% of US adults have at least one underlying condition that can put them at higher risk of severe complications, according to the CDC.
Those conditions include obesity, chronic obstructive pulmonary disease, heart disease, diabetes, and chronic kidney disease, according to the CDC.
People who have cancer, an organ transplant, sickle cell anemia, poorly controlled HIV or any autoimmune disorder are also at higher risk.
Covid-19 patients with pre-existing conditions — regardless of their age — are 6 times more likely to hospitalized and 12 times more likely to die from the disease than those who had no pre-existing conditions, CNN Chief Medical Correspondent Dr. Sanjay Gupta said.
While young, healthy people are less likely to die from Covid-19, many are suffering long-term effects from the disease.
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What are the guidelines for riding in a car with someone from another household?
Unvaccinated people from different households in a car should wear face masks, said Dr. Aaron Hamilton of the Cleveland Clinic.
“You should also wear one if you’re rolling down your window to interact with someone at a drive-thru or curbside pickup location,” Hamilton said.
It’s also smart to keep the windows open to help ventilate the car and add another layer of safety, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
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Should we clean our cell phones daily?
Yes, that’s a good idea because cell phones are basically “petri dishes in our pockets” when you think about how many surfaces you touch before touching your phone.
You should regularly disinfect your mobile phone anyway, with or without a coronavirus pandemic.
“There’s probably quite a lot of microorganisms on there, because you’re holding them against your skin, you are handling them all the time, and also you’re speaking into them,” said Mark Fielder, a professor of medical microbiology at Kingston University.
“And speaking does release droplets of water just in normal speech. So it’s likely that a range of microbes – including Covid-19, should you happen to be infected with that virus – might end up on your phone.”
Watch the best ways to disinfect your cell phone here.
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Is it safe to go back to the gym?
There are certainly risks if you’re not vaccinated.
Coronavirus often spreads more easily indoors rather than outdoors — especially if you’re indoors for an extended period of time.
Researchers have also found that heavy breathing and singing can propel aerosolized viral particles farther and increase the risk of transmission.
During one fitness instructor workshop, about 30 participants with no symptoms trained intensely for four hours, according to research published by the CDC. Eight participants later tested positive, and more than 100 new cases of coronavirus were traced back to that fitness workshop.
To help mitigate the risk, many gyms are limiting capacity or requiring masks.
And while health experts have recommended staying 6 feet away from others, it’s smart to keep even more distance than that at the gym.
“With all the heavy breathing, you may even want to double the usual 6 feet to 12 feet, just to be safe,” CNN Chief Medical Correspondent Dr. Sanjay Gupta said.
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I heard you can get Covid-19 through your eyes. Should we wear goggles, too?
Doctors say wearing eye protection (in addition to face masks) could help some people, but it’s not necessary for everyone.
Teachers who have younger students in the classroom are “likely to be in environments where children might pull down their masks, or not be very compliant with them,” epidemiologist Saskia Popescu said. “There is concern that you could get respiratory droplets in the eyes.”
If you’re a health care worker or taking care of someone at home who has coronavirus, it’s smart to wear eye protection, said Dr. Thomas Steinemann, clinical spokesperson for the American Academy of Ophthalmology.
(Note: Regular glasses or sunglasses aren’t enough, because they leave too many gaps around the eyes.)
But if you’re vaccinated or not in a high-risk situation, wearing goggles isn’t necessary.
While it’s still possible to get Covid-19 through the eyes, that scenario is less likely than getting it through your nose or mouth, Steinemann said.
He said if a significant number of people were getting coronavirus through their eyes, doctors would probably see more Covid-19 patients with conjunctivitis, also known as pink eye (though having pink eye doesn’t necessarily mean you have coronavirus).
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Should people wear face shields instead of (or in addition to) face masks?
The CDC does not recommend using plastic face shields for everyday activities or as a substitute for face masks. There are a few exceptions, such as for those who are hearing-impaired and rely on lip-reading or those who have physical or mental health conditions that would be exacerbated by wearing a cloth face mask.
“Cloth face coverings are a critical preventive measure and are most essential in times when social distancing is difficult,” the CDC says.
Clinical and laboratory studies show cloth face coverings reduce the spray of droplets when worn over the nose and mouth – what the CDC refers to as “source control.” And many people are contagious even when they don’t have any symptoms and don’t know they’re infected.
Face shields worn in addition to masks can provide an added layer of protection and can also help people stop touching their faces. Workers who are around people for long periods of time, such as grocery store workers or hospital personnel, may want to wear face shields in addition to masks, to increase their protection.
If someone must use a face shield without a mask, the CDC says the shield “should wrap around the sides of the wearer’s face and extend to below the chin. Disposable face shields should only be worn for a single use. Reusable face shields should be cleaned and disinfected after each use.”
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How do I prevent my glasses or sunglasses from fogging up when I wear a mask?
First, make sure the top of your mask fits snugly against your skin. Then put your glasses over the snug-fitting top portion of your mask.
If that doesn’t do the trick, soap and water can create a barrier that prevents glasses from fogging up. Here’s how.
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Are cancer patients at higher risk of severe complications from Covid-19?
Yes. And the increased risk applies to cancer patients of all ages, the CDC says.
“Having cancer currently increases your risk of severe illness from COVID-19,” the CDC says. “At this time, it is not known whether having a history of cancer increases your risk.”
Researchers found that patients whose cancer was getting worse or spreading were more than five times more likely to die in a month if they caught Covid-19.
But there are steps cancer patients can take to stay as healthy as possible:
- Make sure you have at least a 30-day supply of your medications.
- Don’t delay any life-saving treatment or emergency care during this pandemic.
- Talk with your healthcare provider about your individual level of risk based on your condition, your treatment, and the level of transmission in your community.
- Don’t stop taking your medicines or alter your treatment plan without talking to your healthcare provider.
- Call your healthcare provider if you think you may have been exposed to the novel coronavirus.
- Read the CDC’s tips for preventing infections in cancer patients.
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Can central air conditioning spread Covid-19 in public places?
Technically, it can, but HVAC (heating/ventilation/air conditioning) systems are not thought to be a significant factor in the spread of coronavirus.
Many modern air conditioning systems will either filter out or dilute the virus. Ventilation systems with highly effective filters are a key way to eliminate droplets from the air, said Harvard environmental health researcher Joseph Gardner Allen.
Filters are rated by a MERV system – their “minimum efficiency reporting value” that specifies their ability to trap tiny particles. The MERV ratings go from 1 to 20. The higher the number, the better the filtration.
HEPA filters have the highest MERV ratings, between 17 and 20. HEPA filters are used by hospitals to create sterile rooms for surgeries and to control infectious diseases. They’re able to remove 99.97% of dust, pollen, mold, bacteria and other airborne particles as small as 0.3 microns.
For context, this coronavirus is thought to be between 0.06 to 1.4 microns in size.
But “HEPA filtration is not always going to be feasible or practical,” Allen said. “But there are other filters that can do the job. What is recommended now by the standard setting body for HVAC is a MERV 13 filter.”
High-efficiency filters in the 13-to-16 MERV range are often used in hospitals, nursing homes, research labs and other places where filtration is important.
“If you’re an owner of a home, building or mall, you want to have someone to assess your system and install the largest MERV number filter the system can reliably handle without dropping the volume of air that runs through it,” advised Erin Bromage, an associate professor of biology at the University of Massachusetts Dartmouth.
“In addition, virtually all modern air conditioning systems in commercial buildings have a process called makeup air where they bring in air from outside and condition it and bring it inside,” Bromage said. “It’s worse in regards to energy, but the more outside air we bring in, the more dilution of the virus we have and then the safer you are.”
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What does asymptomatic mean?
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How effective are different types of face masks? Which cloth masks work the best?
An N95 respirator provides the best protection. But throughout the pandemic, N95s have been in high demand and short supply.
As for other masks, different types have different levels of effectiveness, according to researchers at Florida Atlantic University.
They compared four types of face masks commonly used by the public: a stitched mask with two layers of fabric, a commercial cone mask, a folded handkerchief, and a bandana. Researchers tested each to see which would likely offer the most protection if someone coughed or sneezed.
— The stitched mask with two layers of fabric performed the best, with droplets traveling only 2.5 inches.
— With a cone-style mask, the droplets traveled about 8 inches.
— A folded handkerchief performed worse, with droplets traveling 1 foot, 3 inches.
— The bandana gave the least amount of protection of the cloth masks tested, with droplets traveling 3 feet.
— Still, any kind of cloth mask is better than none, the researchers found. Without any covering, droplets were able to travel 8 feet.
“People need to know that wearing masks can reduce transmission of the virus by as much as 50%, and those who refuse are putting their lives, their families, their friends, and their communities at risk,” said Dr. Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation.
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Can you get Covid-19 through sex?
The odds of transmitting coronavirus through sex hasn’t been thoroughly studied, though it has been found to exist in men’s semen.
But we do know Covid-19 is a highly contagious respiratory illness that can spread via saliva, coughs, sneezes, talking or breathing — with or without symptoms of illness.
So three Harvard physicians examined the likelihood of getting or giving Covid-19 during sex and made several recommendations.
For partners who haven’t been isolating together, they should wear masks and avoid kissing, the authors write.
In addition to wearing masks, people who have sex with partners outside of their home should also shower before and after; avoid sex acts that involve the oral transmission of bodily fluids; clean up the area afterward with soap or alcohol wipes to reduce their likelihood of infection.
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Why has the guidance on wearing face masks changed so much?
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How can I stay safe in an elevator?
Doctors say getting vaccinated is the best way to prevent coronavirus infection.
If you’re not vaccinated, it’s best to take the stairs if you can. But if you can’t, emergency room physician Dr. Leana Wen offers several tips:
- Wear a mask. Not only does wearing a mask reduce your risk of inhaling the virus — which can linger in the air for 8 minutes — it also helps reduce your chances of infecting others if you are an asymptomatic carrier.
- Use a tissue to push the elevator buttons. If you don’t have a tissue, use your elbow, then wash or disinfect that area when you can.
- Try to keep your distance from anyone else inside the elevator as much as possible.
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How safe are public restrooms?
For those not fully vaccinated, try to avoid public restrooms if you can, said microbiologist Ali Nouri, president of the Federation of American Scientists. But he acknowledged that’s not always possible: “Sometimes when you gotta go, you gotta go.”
Close contact with others is the most significant risk in a public restroom, Nouri said. So if there’s a single-person bathroom available that doesn’t have multiple stalls, using that might be best.
If you do use a multi-stall public restroom, Nouri offers the following tips:
- Don’t use your freshly washed hands to turn off the water with the germ-laden faucet handle. Instead, use a paper towel to turn off the water and open the bathroom door. Throw away the paper towel immediately afterward.
- Wear a face mask. “Masks are one of the most effective ways to stop human-to-human transmission,” Nouri said. “If people in a public bathroom are not wearing masks, think twice before going in.”
- If the restroom looks crowded, wait until it clears out, if you can. “You’re reducing the risk of inhaling aerosolized particles from other people,” Nouri said.
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What’s the risk of having a maid service come to clean your house if you’re not home?
“It’s probably safe if you’re not at home,” emergency physician Dr. Leana Wen said. She suggested leaving the windows open to improve ventilation and asking the cleaners to use your own cleaning supplies so they don’t bring items that have been in other people’s houses.
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Can I disinfect my mask by putting it in the microwave?
That’s “not a great idea,” said Dr. Joseph Vinetz, a professor of infectious diseases at Yale School of Medicine. “We have no evidence about that.”
“If there’s a metal piece in an N95 or surgical mask and even staples, you can’t microwave them,” he said. “It’ll blow up.”
Vinetz said cloth masks can be washed and reused, and even disposable masks can be reused if you let them sit for several days.
To disinfect masks that you can’t wash, Vinetz recommends leaving them in a clean, safe place in your home for a few days. After that, it should no longer be infectious, as this coronavirus is known to survive on hard surfaces for only up to three days.
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Is it safe to perform CPR on a stranger?
Doctors strongly recommend performing CPR when someone needs it.
You could be hundreds of times more likely to save that dying person’s life than you are to die from Covid-19 if you contract it after performing CPR, according to a report published by a group of Seattle emergency room physicians in the journal Circulation.
But it’s important to act quickly for CPR to be effective.
“The chance of survival goes down by 10% for every minute without CPR,” said Dr. Comilla Sasson, vice president for science and innovation in emergency cardiovascular care at the American Heart Association. “It’s a 10-minute window to death in many cases.”
If you’re not certified in CPR, performing chest compressions could also buy more time until help arrives. Bystanders should “provide high-quality chest compressions by pushing hard and fast in the middle of the victim’s chest, with minimal interruptions,” the American Heart Association said.
If you’re not sure how “fast” to do to those chest compressions, singing any of these popular songs will help you get the right rhythm.
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I saw other countries spraying down sidewalks and other public places with disinfectant. Why haven’t we done that in the US?
Randomly spraying open places is largely a waste of time, health experts say.
It can actually do more harm than good. “Spraying disinfectants can result in risks to the eyes, respiratory or skin irritation,” the World Health Organization said.
“Spraying or fumigation of outdoor spaces, such as streets or marketplaces, is also not recommended to kill the COVID-19 virus or other pathogens because disinfectant is inactivated by dirt and debris, and it is not feasible to manually clean and remove all organic matter from such spaces,” the WHO said.
“Moreover, spraying porous surfaces, such as sidewalks and unpaved walkways, would be even less effective.” Besides, the ground isn’t typically a source of infection, the WHO said.
And once the disinfectant wears off, an infected person could easily contaminate the surface again.
Treatment & prevention myths & misinformation travel transmission
Can protests increase the spread of Covid-19?
And when people are “shouting and cheering loudly, that does produce a lot of droplets and aerosolization that can spread the virus to people,” said Dr. James Phillips, a physician and assistant professor at George Washington University Hospital.
So doctors and officials say its important to get vaccinated or wear a face mask and try to keep your distance from others as much as possible.
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Do I need to wash fruits and vegetables with soap and water?
No. The US Food and Drug Administration says you don’t need to wash fresh produce with soap and water, but you should rinse it with plain water.
But it’s still important to wash your hands with soap and water frequently because we often touch our faces without realizing it. And that’s a way coronavirus can spread.
You don’t have to worry about getting coronavirus by “eating” it, though. Even if coronavirus does get into your food, your stomach acid would kill it, said Dr. Angela Rasmussen, a virologist at Columbia University.
Treatment & prevention work/life transmission
Should I wash my hands and laundry in very warm or hot water?
Hot water is best for killing bacteria and viruses in your laundry. But you don’t want to use that kind of scalding hot water on your skin.
Warm water is perfectly fine for washing your hands — as long as you wash them thoroughly (like this) and for at least 20 seconds. (To time yourself, you can hum the “Happy Birthday” song twice or sing a couple of verses from any of these hit songs from the past several decades.)
Cold water will also work, “but you have to make sure you work really vigorously to get a lather and get everything soapy and bubbly,” said chemist Bill Wuest, an associate professor at Emory University. To do that, you might need to sing “Happy Birthday” three times instead of twice.
“Warm water with soap gets a much better lather – more bubbles,” Wuest said. “It’s an indication that the soap is … trying to encapsulate the dirt and the bacteria and the viruses in them.”
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Can you safely reuse a non-cloth mask that you can’t wash, like a disposable mask?
Work/life treatment & prevention
Will an antibody test show whether I’m immune and can go back to work or school?
Work/life treatment & prevention transmission schools/education
Can I use vodka as hand sanitizer?
Please don’t. The CDC advises using hand sanitizer that contains at least 60% alcohol.
Vodka typically contains between 35% and 46% percent alcohol.
If the stores are out of hand sanitizer and you want to make your own, the Nebraska Medical Center offers this recipe:
What you’ll need:
- 2/3 cup 91% isopropyl alcohol (rubbing alcohol)
- 1/3 cup aloe vera gel
- Mixing bowl
- Spoon or something for whisking
- Small container, such as a 3-oz. travel bottle
- Optional: essential oil to give your hand sanitizer a fragrance
In a mixing bowl, stir isopropyl alcohol and aloe vera gel together until well blended.
Add 8-10 drops of scented essential oil (optional, but nice). Stir.
Pour the homemade hand sanitizer into an empty container and seal. Write “hand sanitizer” on a piece of masking tape and attach to the bottle.
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Are smokers or vapers at higher risk? What if I only smoke weed?
This is not a good time to be vaping or smoking anything, including weed.
“Vaping affects your lungs at every level. It affects the immune function in your nasal cavity by affecting cilia, which push foreign things out,” said Prof. Stanton Glantz, director of the Center for Tobacco Research Control and Education at University of California San Francisco.
When you vape, “the ability of your upper airways to clear viruses is compromised,” Glantz said.
Tobacco smokers are at especially high risk. In a study from China, where the first Covid-19 outbreak occurred, smokers were 14 times more likely to develop severe complications than non-smokers.
Even occasionally smoking marijuana can put you at greater risk.
“What happens to your airways when you smoke cannabis is that it causes some degree of inflammation, very similar to bronchitis, very similar to the type of inflammation that cigarette smoking can cause,” said pulmonologist Dr. Albert Rizzo, chief medical officer for the American Lung Association.
“Now you have some airway inflammation, and you get an infection on top of it. So yes, your chance of getting more complications is there.”
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My teenagers aren’t taking this seriously. Any advice?
Coronavirus isn’t just infecting young people. It’s killing young, healthy people as well.
Dimitri Mitchell, 18, admits he had a “false sense of security.” But he was later hospitalized with coronavirus and now wants everyone to take it seriously.
“I just want to make sure everybody knows that no matter what their age is, it can seriously affect them. And it can seriously mess them up, like it messed me up,” the Iowa teen said.
“Four days in, the really bad symptoms started coming along. I started having really bad outbreaks, like sweating, and my eyes were really watery. I was getting warmer and warmer, and I was super fatigued. … I would start experiencing the worst headaches I’ve ever felt in my life. They were absolutely horrible.”
Eventually, the teen had to be hospitalized. His mother said she worried he might “fall asleep and never wake up.”
Mitchell is now recovering, but has suffered from long-term effects.
“I just hope everybody’s responsible, because it’s nothing to joke about,” he said. “It’s a real problem, and I want everybody to make sure they’re following social distancing guidelines and the group limits. And just listen to all the rules and precautions and stay up to date with the news and make sure they’re informed.”
Family transmission treatment & prevention myths & misinformation schools/education
Does this pandemic have anything to do with the 5G network?
No. That’s just a hoax going around the internet.
“The theory that 5G might compromise the immune system and thus enable people to get sick from corona is based on nothing,” said Eric van Rongen, chairman of the International Commission on Non-Ionizing Radiation Protection (ICNIRP).
Learn more about how 5G really works and why this hoax makes no sense.
Myths & misinformation
My ex and I have joint custody of our kids. Is it safe for them to go between two homes?
Ideally, you should limit your children’s potential exposures to coronavirus and work out the safest plan possible with your ex.
The problem: Some state and county family courts might be closed, or open only for emergencies involving abuse or endangerment. So it might be difficult to formally modify pre-existing custody agreements.
But some states may be offering some flexibility during the pandemic. And there may be creative solutions, such as spending more time with one parent now in exchange for extra time with the other parent after the pandemic ends.
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If there’s no cure, why go to the hospital unless you have a breathing problem?
Most coronavirus patients don’t need to be hospitalized. “The vast majority of people – about 80% – will do well without any specific intervention,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
Those patients should get plenty of rest, hydrate frequently and take fever-reducing medication.
“The current guidance – and this may change – is that if you have symptoms that are similar to the cold and the flu and these are mild symptoms to moderate symptoms, stay at home and try to manage them,” said Dr. Patrice Harris, president of the American Medical Association.
But about 20% of coronavirus patients get advanced disease. “Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their physician early in the course of even mild illness,” the CDC says.
The CDC also says you should get immediate help if you have:
- Trouble breathing
- Persistent pain or pressure in the chest
- Sudden confusion
- Bluish lips or face
“This list is not all inclusive,” the CDC says. “Please consult your medical provider for any other symptoms that are severe or concerning.”
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How do I safely take care of someone who’s sick?
It may be difficult to know whether your loved one has coronavirus or another illness.
So it’s critical to play it safe and not infect yourself and, in turn, others. The CDC suggests:
- Giving the sick person their own room to stay in, if possible. Keep the door closed.
- Having only one person serve as the caretaker.
- Asking the sick person to wear a face mask, if it doesn’t cause breathing problems. It’s a good idea for the caretaker to also wear a secure face mask.
What are the symptoms?
Fatigue, fever, dry cough, difficulty breathing and the loss of taste or smell are some of the symptoms of Covid-19.
Symptoms can appear anywhere from 2 days to 2 weeks after exposure, the CDC says. But some people get no symptoms at all and can infect others without knowing it.
The illness varies in its severity. And while many people can recover at home just fine, some people — including young, previously healthy adults — are suffering long-term symptoms.
The stores are all out of disinfectant sprays and hand sanitizer. Can I make my own?
Yes, you can make both at home.
“Unexpired household bleach will be effective against coronaviruses when properly diluted” if you’re trying to kill coronavirus on a non-porous surface, the US Centers for Disease Control and Prevention said.
The CDC’s recipe calls for diluting 5 tablespoons (or ⅓ cup) of bleach per gallon of water, or 4 teaspoons of bleach per quart of water.
What you’ll need:
- 2/3 cup 91% isopropyl alcohol (rubbing alcohol)
- 1/3 cup aloe vera gel
- Mixing bowl
- Spoon or something for whisking
- Small container, such as a 3 oz. travel bottle
- Optional: essential oil to give your hand sanitizer a fragrance
In a mixing bowl, stir isopropyl alcohol and aloe vera gel together until well blended.
Add 8-10 drops of scented essential oil (optional, but nice). Stir.
Pour the homemade hand sanitizer into an empty container and seal.
Write “hand sanitizer” on a piece of masking tape and attach to the bottle.
Work/life Treatment & Prevention
Can I be fired if I stay home sick?
But there are exceptions. Employers who make workers with Covid-19 come in may be violating Occupational Safety and Health Administration [OSHA] regulations, said Donna Ballman, who heads an employee advocacy law firm in Florida.
What happens when workers don’t get paid sick leave?
But there is no federal mandate that requires companies to offer paid sick leave, and almost a quarter of all US workers don’t get it, according to 2019 government data. Some state and local governments have passed laws that require companies to offer paid sick leave.
The Family and Medical Leave Act (FMLA) can sometimes protect a worker’s job in the event they get sick, but it won’t guarantee they get paid while they’re out.
Employee advocates urge businesses to consider the special circumstances of the Covid-19, and some already have
Can managers send a sick worker home?
The Society for Human Resource Management recommends companies “actively encourage sick employees to stay home, send symptomatic employees home until they are able to return to work safely, and require employees returning from high-risk areas to telework during the incubation period (of 14 days).”
If a manager feels an employee’s illness poses a direct threat to colleagues’ safety, the manager may be able to insist the employee be evaluated by a doctor, said Alka Ramchandani-Raj, an attorney specializing in workplace safety.
If traveling on a plane, how do I stay safe?
Since Covid-19 is a respiratory disease, many airlines require passengers to wear face masks during the flight, except for while eating or drinking.
Health experts suggest eating, drinking and using the restroom before getting on the plane, to eliminate the need to take off your mask or go into a cramped lavatory on board.
And always be mindful of where your hands have been, travel medicine specialist Dr. Richard Dawood said.
Airport handrails, door handles and airplane lavatory levers are notoriously dirty.
“It is OK to touch these things as long as you then wash or sanitize your hands before contaminating your face, touching or handling food,” Dawood said.
“Hand sanitizers are great. So are antiseptic hand wipes, which you can also use to wipe down armrests, remote controls at your seat and your tray table.”
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What do I do if I think I’m sick?
Stay home. Call your doctor to talk about your symptoms and let them know you’re coming for an appointment so they can prepare for your visit, the CDC says.
Only a Covid-19 test can diagnose you with coronavirus, but if you suspect you have it, isolate yourself at home.
Many patients with coronavirus are able to recover at home. If you’ve been diagnosed and your illness is worsening, seek medical attention promptly. You may need to be monitored in a hospital.
Treatment & Prevention
Should I spray myself or my kids with disinfectant?
No. Those products work on surfaces but can be dangerous to your body.
There are some chemical disinfectants, including bleach, 75% ethanol, peracetic acid and chloroform, that may kill the virus on surfaces.
But if the virus is already in your body, putting those substances on your skin or under your nose won’t kill it, the World Health Organization says. And those chemicals can harm you.
Treatment & Prevention myths & misinformation
I’ve heard that home remedies can cure or prevent the virus. Is that true?
There’s no evidence from the outbreak that eating garlic, sipping water every 15 minutes or taking vitamin C will protect people from the new coronavirus. Same goes for using essential oils or colloidal silver.
Treatment & prevention myths & misinformation
Why was the US been so far behind other countries with testing?
Experts said cuts in federal funding for public health and problems with early testing forced the US to play catch-up.
Problems with public health infrastructure: Two years ago, the CDC stopped funding epidemic prevention activities in 39 countries, including China. This happened because the Trump administration refused to allocate money to a program that started during the 2014 Ebola outbreak.
Former CDC director Dr. Tom Frieden warned that move “would significantly increase the chance an epidemic will spread without our knowledge and endanger lives in our country and around the world.”
Problems with the testing: Malfunctions, shortages and delays in availability have all contributed to the slowdown.
In the first few weeks of the outbreak in the US, the CDC was the only facility in the country that could confirm test results — even though a World Health Organization test became available around the same time.
Some test kits that were sent around the country were flawed — a move that put the US behind about “four to five weeks,” says Dr. Rob Davidson, executive director of the Committee to Protect Medicare.
Treatment & Prevention
Did Dean Koontz predict this outbreak in the book “The Eyes of Darkness” almost 40 years ago?
No. There are some interesting coincidences in the 1981 fiction novel, which says “a severe pneumonia-like illness will spread around the globe” around the year 2020. Modern editions of the book call the biological strain “Wuhan-400,” and the current coronavirus outbreak started in Wuhan, China.
But there are important differences between the book and reality. The original version of the book called the strain the “Gorki-400,” in reference to a Russian locality, before it was later changed to the “Wuhan-400.” In the book, the virus was man-made, while scientists believe the novel coronavirus started in animals and jumped to humans. And in the book, the virus had a 100% mortality rate. Early estimates of the mortality rate for this coronavirus outbreak range from 2-4%.
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