Symptoms, spread, testing and terminology: Answering your coronavirus questions

  • Lisa Wardle
With our coronavirus coverage, our goal is to equip you with the information you need. Rather than chase every update, we’ll try to keep things in context and focus on helping you make decisions. See all of our stories here.

What you should know
» Day-by-day look at coronavirus disease cases in Pa.
» It’s time to get serious about social distancing. Here’s how.

Here are some answers to common questions. We will continue to update this resource as we learn more about the coronavirus and the disease it causes, COVID-19.

The basics

What is a coronavirus?

A worker cleans his goggles to spray disinfectant as a precaution against the coronavirus at a shopping street in Seoul, South Korea, Thursday, Feb. 27, 2020.

Ahn Young-joon / AP Photo

A worker cleans his goggles to spray disinfectant as a precaution against the coronavirus at a shopping street in Seoul, South Korea, Thursday, Feb. 27, 2020.

Coronaviruses are a large family of viruses that can cause illness in animals and people. Some of those are responsible for the common cold, while others can lead to severe diseases such as Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) or COVID-19.1

The coronavirus first identified in December 2019 is the SARS-CoV-2 virus.2  You may have seen it referred to as a “novel coronavirus” or “the new coronavirus,” meaning it had not been previously identified.2

What is COVID-19?

The SARS-CoV-2 virus causes a disease that has been named coronavirus disease 2019, abbreviated as COVID-19 by the World Health Organization. COVID-19 was first identified in December 2019. 1

Symptoms & spread

What are the symptoms?

Symptoms of the coronavirus include fever, cough, shortness of breath and diarrhea. Some people may show little to no symptoms. 3

How does the virus spread?

The first infections were linked to a live animal market, but the coronavirus is now spreading from person to person. 1

The coronavirus can be transmitted through small droplets from a patient’s nose or mouth — for example, as the result of a cough or sneeze. A healthy person could contract the virus after touching an object or surface where those droplets landed, then touching their eyes, nose or mouth.1

It can also be transmitted through close contact with a sick person, even if they are not showing symptoms. Health officials offer different guidance on exactly how close that is. The World Health Organization recommends staying at least 3 feet away from a person who is sick, while the Centers for Disease Control and Prevention recommends staying at least 6 feet apart. 2

How do I protect myself and my family?

Practice basic hygiene:

  • Wash your hands regularly for at least 20 seconds
  • Cough and sneeze into your elbow, not your hands
  • Clean frequently-touched surfaces often, such as light switches, cellphones and countertops
  • If you are sick, stay home 3

See this guide for how to prepare your home.

Should I wear a mask?

The CDC and Pennsylvania Department of Health initially said the general public did not need to wear masks, but on April 3 issued new guidance: Everyone should wear cloth face coverings in public settings, such as grocery stores.

Recent studies have shown the virus can be spread by people showing no symptoms (asymptomatic or pre-symptomatic) through regular actions, such as talking.

A cloth mask adds a layer of protection for everyone near the wearer, but it does not protect the wearer themselves. This one-way protection is why health officials recommend broad usage–the more people wearing masks, the more protection. 2

How long does the coronavirus last on surfaces?

Editor’s note: This section was updated on March 14 to include details from a new study.

The World Health Organization says SARS-CoV-2 appears to behave like other coronaviruses and may last on surfaces for a few hours or up to several days, under certain conditions.1 Research conducted at Rocky Mountain Laboratories in Montana found this coronavirus remained viable for up to three days on plastic and stainless steel surfaces.

The CDC says contaminated surfaces are not the main way the virus has been spreading, but it is possible someone could get sick after touching an object that has the virus on it, then touching their own face. 2

If you think a surface may be infected, clean the surface and wash your hands.

Will warm weather kill the virus?

Some viruses spread more during the winter, but it is still possible to become sick with a cold or the flu during warmer months. Because this virus is new, the CDC says it is not known if warm weather will affect its spread.2

Does sunlight kill the virus?

Research shows that high-intensity ultra-violet light can disrupt the genetic material inside viruses, but the sun’s rays do not have the UV intensity needed for such purpose. Hospitals use specific types of UV lights designed for disinfecting surfaces. Those specialized lights can also be severely harmful to a person’s health, leading to conditions including cancer and cataracts, so they should only be used by trained professionals. 4

Will cold temperatures kill the virus?

Viruses are not living creatures, so environmental conditions we experience throughout the day or year will not affect them in the same ways they affect us humans. Cold temperatures don’t seem to stop the spread of viruses. A 30,000-year-old virus found in Siberian permafrost was still able to infect after researchers put it under the proper conditions. 5

How long is someone contagious?

Fourteen days is the longest incubation period recorded for similar coronaviruses, so that is the timeline health officials are using for quarantine periods. 2

Doctors and public health officials will decide when to release someone from isolation on a case-by-case basis. Current guidelines from the CDC require the patient has no fever, is no longer showing symptoms, and has tested negative for the disease on at least two consecutive tests taken at least 24 hours apart.2

The main way the disease spreads is through droplets resulting from a sick person’s cough. The risk of exposure is lower but still possible around people who are not showing symptoms. 1

Two women wearing masks walk away from the Life Care Center in Kirkland, Wash., near Seattle, where health officials are monitoring patients. An outbreak of the coronavirus is cited as the cause for two  deaths of patients who received care at the center.

Ted S. Warren / AP Photo

Two women wearing masks walk away from the Life Care Center in Kirkland, Wash., near Seattle, where health officials are monitoring patients. An outbreak of the coronavirus is cited as the cause for two  deaths of patients who received care at the center.

How soon after being exposed to the virus will a person start to feel symptoms?

“Two weeks is probably the maximum,” said Dr. John Goldman, infectious disease specialist at UPMC Pinnacle. “It generally occurs within the first week so if you contract the virus you probably start to get sick within the first week. If you’re not sick after two weeks, we consider them to be non-infected.”

How severe is the disease?

There is a wide range of how this disease presents. The CDC says the information so far indicates most COVID-19 illnesses are mild.2 A report published in the New England Journal of Medicine that analyzed 1,099 patients in China showed about 16% of those patients had severe illness. Those patients were older and more likely to have another health concern.

People who are older or who have chronic health conditions, such as heart disease or diabetes, seem to be at higher risk of developing severe illness from the coronavirus.

How long does COVID-19 last?

This can vary significantly, depending on how severe of symptoms a patient experiences. Harvard Health says people with mild cases recover in one to two weeks, while those with severe symptoms can take six weeks or more to recover. 7

Do you become immune to the coronavirus after you have it?

There is some evidence that a person who recovers from the illness can contract it again. Reinfections have been reported in China, Japan and South Korea, but it is rare. Scientists say testing errors — contaminated samples, human error and false negatives— are more likely than a patient recovering from the disease and later contracting it again. 8

How does the coronavirus mortality rate compare to the flu?

A staff member holds a sheet as a privacy screen as a person on a stretcher is taken to an ambulance from Life Care, a nursing facility where dozens of people are being tested for the COVID-19 virus in Kirkland, Wash., northeast of Seattle.

Elaine Thompson / AP Photo

A staff member holds a sheet as a privacy screen as a person on a stretcher is taken to an ambulance from Life Care, a nursing facility where dozens of people are being tested for the COVID-19 virus in Kirkland, Wash., northeast of Seattle.

Data available so far indicates the coronavirus is deadlier than seasonal influenza. The seasonal flu has a mortality below 0.1%. 9

The World Health Organization says death has occurred in 3% to 4% of reported cases of the coronavirus so far. Keep in mind that preliminary 3% to 4% mortality rate is a worldwide figure, not specific to the United States. 9

The true mortality rate of the coronavirus is likely lower, because health officials don’t know how many mild or asymptomatic cases are not being reported. 10

Is it safe to attend a funeral for someone who died from COVID-19?

The CDC says there is no known risk of simply being near someone who died of COVID-19. But the agency recommends avoiding kissing, washing or shrouding the body of someone who died of the disease. If those activities are important to the family, disposable gloves and other protective gear are encouraged. 2

But social distancing recommendations mean funerals might be much smaller than usual. The Pennsylvania Funeral Directors Association is encouraging funeral homes to limit services to just immediate family members and postpone memorials. 11

Testing

I think I’ve been exposed to the virus. What should I do?

Call your doctor or hospital if you know you had close contact with someone who tested positive for the virus, are showing symptoms, or if you have traveled from an area with an ongoing spread of the disease. During that phone call, be sure to tell them you may have COVID-19 so they can take proper precautions. 2

Healthcare professionals are working with state health officials and the CDC throughout this epidemic. If a test is deemed necessary, your doctor can take a sample and send it to the state laboratory or a commercial lab.

Isn’t the doctor’s office or ER the worst place to go if there are people there who may have the virus and could spread it?

Dr. John Goldman, infectious disease specialist at UPMC Pinnacle, says that is why officials are encouraging people to call their doctor first. “And that’s why we encourage people who are only mildly ill to call their doctor and not go directly to urgent care or go to an emergency room,” he said. “So, if someone only has a fever or mild respiratory, call their doctors first so they can get instructions – sometimes over the phone.” 6

Do typical blood results show coronavirus infection?

Currently, the only tests that can detect COVID-19 are conducted by obtaining a nasal swab from a patient and sending it to a laboratory for analysis. 12

Scientists are working to develop additional types of testing, including blood tests. 13

Pennsylvania Commonwealth microbiologist Kerry Pollard performs a manual extraction of the coronavirus inside the extraction lab at the Pennsylvania Department of Health Bureau of Laboratories on Friday, March 6, 2020.

Gov. Tom Wolf / Flickr

Pennsylvania Commonwealth microbiologist Kerry Pollard performs a manual extraction of the coronavirus inside the extraction lab at the Pennsylvania Department of Health Bureau of Laboratories on Friday, March 6, 2020.

Will my insurance cover a test?

Gov. Tom Wolf announced that all major health insurers in the commonwealth will cover medically appropriate testing and treatment for the coronavirus. This includes Highmark, UPMC Health Plan, Geisinger, Independence BlueCross, Capital Blue Cross, Aetna, Cigna, UnitedHealthcare, Pennsylvania Health & Wellness, and Oscar. 14

The Pennsylvania Department of Health answers more common questions about insurance coverage on its website.

Can I get tested if I don’t have insurance?

The Pennsylvania Department of Health is working to ensure that everyone who is tested for the coronavirus gets tested at no cost to them: “Testing sent to our state health lab is free of charge. If someone believes they were exposed and has symptoms, they should call 1-877-PA-HEALTH and we can help ensure they get tested.” 15

What testing options are available outside the state laboratory?

Commercial laboratories and hospital laboratories are also operating within the commonwealth, and began doing most of the testing after the first couple weeks. Health Secretary Levine said on March 17 that if a doctor believes a patient should be tested for COVID-19, they can order the test without first consulting the Pennsylvania Department of Health.

“If the provider consults with us [the Department of Health] and we don’t recommend a test because of CDC criteria, but the provider really wants to do a test, then order it and send it to a commercial laboratory,” Levine said. “You do not need our approval to send tests to the commercial laboratories.”

No labs in the commonwealth are currently doing broad, population-based testing. They are only testing people who show certain symptoms. 16

Does a delay in testing guarantee increased community transmission?

Pennsylvania Health Secretary Dr. Rachel Levine has said repeatedly there is no backlog of tests in Pennsylvania and that the state labs have capacity to test 125 people per day. On March 12, she said that the state is not triaging samples because of a shortage of tests. As of that afternoon, the Pennsylvania Department of Health reported that 219 tests have been completed or are in progress in Pennsylvania.

But WESA reported on March 13 that health providers in Pittsburgh have wanted to test patients but had no way to do so. Across the state, Philadelphia Health Commissioner Thomas Farley said that limited availability of tests has made identifying cases difficult. 17

Changes to daily life & travel

Is it safe to go outside?

Yes, it is safe to take a walk in the park or go for a bike ride, as long as you follow certain precautions. The same recommendations apply as if you were going to any other public place:

  • stay at least 6 feet away from people who do not live with you
  • try to avoid touching objects or surfaces that other people may have touched (crosswalk buttons, doorknobs, etc.)
  • try to avoid touching your face
  • wash your hands 18

Is there a form of supplemental childcare or income for the parents or guardians that would need take time off of their jobs?

As of March 13, Pennsylvania has required closure of state-licensed day care centers only in Montgomery County, but other schools have begun to voluntarily close across the commonwealth. 19

At this point, the state legislature has not passed any bills addressing supplemental assistance to families. The U.S. Congress is working on a coronavirus bill that, according to a letter from House Speaker Nancy Pelosi, would include 14 days of paid sick leave and tax credits for small- and medium-sized businesses, as well as unemployment benefits and aid for food assistance programs. The House is expected to vote on the bill Friday. If it passes, it will head to the Senate early next week. 20

Will unemployment benefits be extended?

There are options for workers who are experiencing a loss of income, whether the result of decreased hours or not working at all, during this pandemic.

You may be eligible for unemployment compensation if:

  • Your employer temporarily closes or goes out of business because of COVID-19
  • Your employer reduces your hours because of COVID-19
  • You have been told not to work because your employer feels you might get or spread COVID-19
  • You have been told to quarantine or self-isolate, or live/work in a county under government-recommended mitigation efforts

Learn more and apply on the Office of Unemployment Compensation website. 21

Why are some businesses staying open after Gov. Wolf told all non-essential companies to shut down?

Gov. Wolf’s shutdown orders have involved asking non-“life-sustaining” businesses like gyms, hair salons and convert venues to close.

After initially trying to rely on businesses to “self-enforce” the order, the governor is now directing police to warn and fine business owners who violate the order. The administration recommends two main enforcement options:

  • a $10 to $50 fine for violating an order or regulation of the Department of Health;
  • a $25 to $300 fine for violating the state’s Disease Prevention and Control Law of 1955. 22

I know of a business that is still operating, but it should be closed. What should I do?

If you are aware of a business that’s operating even though it’s supposed to be shut down, tell the Department of Health through its website contact form.

Can self-employed people continue to work?

The governor’s order is meant to limit person-to-person interaction and potential exposure to the virus. Though the order refers to physical places of business, it applies just the same to independent contractors–like painters–who do not operate a storefront.

Business owners can request a waiver here: https://expressforms.pa.gov/apps/pa/DCED/Waiver-process-keeping-physical-locations-open. If you choose to pursue a waiver, remember that you are still subject to the shutdown order until that waiver is approved. 23

How are truckers supposed to work, eat and sleep with restaurants and rest stops closed?

Alexis Campbell from PennDOT stated that privately owned truck stops remain open, as well as gasoline and convenience stores. Some restaurants are staying open during this time for carry-out and delivery services. 24

The Pennsylvania Turnpike placed portable toilets at their rest stops. After outcry, the Turnpike Commission decided to reopen the bathrooms at all of its service plazas. 25

What organizations need monetary donations?

Thank you for wanting to help.

This article from The Washington Post details a range of nonprofits that could use your support during this crisis: https://www.washingtonpost.com/nation/2020/03/21/how-you-can-help-during-coronavirus/

If you prefer to keep your support focused on the central Pennsylvania community, you can donate to one of these organizations:

Will the April 28 primary still happen?

Editor’s note: This section was updated on March 27.

Lawmakers passed a bill that will postpone the primary to June 2, which the governor signed on March 27. With that move, Pennsylvania joins a dozen states that have postponed their presidential primaries in response to the coronavirus outbreak. 26

Should I cancel my international travel plans?

Check the CDC’s latest guidance on travel risks.

Countries with widespread, ongoing spread of the coronavirus are designated with a Level 3 travel health notice. You should avoid nonessential travel to these destinations.

Level 2 travel notices indicate sustained community spread. Travelers at high risk of severe illness should consider postponing their plans. If you decide to keep your travel plans, avoid contact with sick people, wash your hands regularly, monitor your health and limit interactions with others for 14 days after returning home.

Level 1 travel notices mean there is limited community spread. If you travel to one of these countries, avoid close contact with others and wash your hands regularly. 27

Can I still travel within the United States?

The CDC does not generally issue travel advisories for within the United States, but it has issued some guidance to help limit the spread of COVID-19.

Before traveling to another region or state, you should consider these points:

  • Is the disease spreading where you live?
  • Is the disease spreading at your destination?
  • Will you be in close contact with others?
  • Is anyone in your travel group at higher risk of severe illness from COVID-19?
  • Do you live with someone at higher risk of severe illness?
  • Do you have a plan for if you do get sick?

If you must travel, practice the same precautions you would be doing at home. Wash your hands often with soap and water and try to avoid close contact with others. 27

Terminology

What is the difference between isolation and quarantine?

A housekeeping worker wears a mask as she cleans a room, Wednesday, March 4, 2020, at an Econo Lodge motel in Kent, Wash. King County Executive Dow Constantine said Wednesday that the county had purchased the 85-bed motel south of Seattle to house patients for recovery and isolation due to the COVID-19 coronavirus.

Ted S. Warren / AP Photo

A housekeeping worker wears a mask as she cleans a room, Wednesday, March 4, 2020, at an Econo Lodge motel in Kent, Wash. King County Executive Dow Constantine said Wednesday that the county had purchased the 85-bed motel south of Seattle to house patients for recovery and isolation due to the COVID-19 coronavirus.

Isolation separates people who are sick from people who are not. Patients can be in isolation at a hospital or at their home. Isolation is usually voluntary, but the Pennsylvania Department of Health has the legal authority to require someone to be quarantined.

Quarantine restricts the movement of people who have been exposed to a contagion but are not yet showing symptoms. It is designed to stop the spread of a contagion during the incubation period. A person in quarantine may not become sick at all. Like isolation, it is usually voluntary, but the Pennsylvania Department of Health has the legal authority to require someone to be quarantined.

People in isolation or quarantine are not being locked inside their homes, nor do they have a guard monitoring every action. They can go out in their yard, for example, but are told not to go to the store other public places. State health officials check on these people with regular phone calls. 28

OK. What about social distancing?

People who may have been exposed to the virus but are not yet showing symptoms may be directed to self-monitor their health and avoid social situations. 3

What is contact tracing?

After a person tests positive for the coronavirus, health officials reach out to people who may have been exposed. Those individuals will be assessed and may also be tested for the virus. 3

This is done to help control the spread of the virus.

Read more about how the process works.

What is community spread?

“Community exposure is when the person presents and we really can’t identify how they got sick,” Dr. Sharon Watkins said at a Pennsylvania Department of Health press conference. “Which means that — if they weren’t traveling internationally, if they weren’t somewhere in another state, if they didn’t have close contact with another case — they must have gotten it from virus circulating in the community that we haven’t been testing or identifying.” 28

As of March 10, all of Pennsylvania’s cases have known exposures.

Why does it mean for a test to be “presumed positive”?

Pennsylvania’s Department of Health is sending all positive tests to the CDC for confirmation. Health Secretary Dr. Rachel Levine has said she is not aware of any tests performed in any states that were later found by the CDC to be incorrect. 29

Tom Wolf

Courtesy Commonwealth Media Services

Gov. Tom Wolf speaks at a press conference in Harrisburg about the arrival of coronavirus in Pennsylvania. At rear is state Health Secretary Rachel Levine. (Courtesy Commonwealth Media Services)

Do you have a question not answered here?

Our reporters are regularly speaking with doctors, government officials and staff at the Pennsylvania Department of Health. We’ll try to help answer any questions you have.

Sources

1 World Health Organization, https://www.who.int/health-topics/coronavirus

2 Centers for Disease Control and Prevention, https://www.cdc.gov/media/dpk/diseases-and-conditions/coronavirus/coronavirus-2020.html

3 Pennsylvania Department of Health, https://www.health.pa.gov/topics/disease/Pages/Coronavirus.aspx

4 Washington Post, March 23, 2020, https://www.washingtonpost.com/graphics/2020/health/coronavirus-sars-cov-2-structure/

5 , https://www.pnas.org/content/111/11/4274

6 Smart Talk episode, March 9, 2020, https://www.witf.org/2020/03/06/the-coronavirus-in-pennsylvania-whats-the-latest/

7 Harvard Health Publishing, March 15, 2020, https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center

8 Los Angeles Times, March 13, 2020 https://www.latimes.com/world-nation/story/2020-03-13/china-japan-korea-coronavirus-reinfection-test-positive

9 World Health Organization update, March 6, 2020, https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_2

10 STAT News, March 3, 2020, https://www.statnews.com/2020/03/03/who-coronavirus-different-than-influenza-can-be-contained/

11 Spotlight PA, March 18, 2020, https://www.spotlightpa.org/news/2020/03/pennsylvania-coronavirus-funeral-directors-recommendations/

12 CNN, March 4, 2020, https://www.cnn.com/2020/03/04/health/coronavirus-test-what-happens-explainer/index.html

13 The Guardian, March 17, 2020 https://www.theguardian.com/world/2020/mar/17/testing-for-coronavirus-what-being-done-in-uk

14 Gov. Tom Wolf press release, March 9, 2020, https://www.governor.pa.gov/newsroom/gov-wolf-states-major-health-insurers-are-covering-covid-19-testing-resources-available-related-to-covid-19-and-insurance-coverage/

15 Pennsylvania Department of Health email, March 10, 2020

16 Pennsylvania Department of Health press conference, March 13, 2020

17 Philadelphia Inquirer, March 12, 2020, https://www.inquirer.com/health/coronavirus/coronavirus-testing-denied-pennsylvania-state-lab-cdc-20200312.html

18 BBC, March 25, 2020, https://www.bbc.com/news/world-us-canada-52022743

19 Office of Governor Tom Wolf, March 12, 2020, https://www.governor.pa.gov/newsroom/gov-wolf-sec-of-health-outline-covid-19-mitigation-guidance-for-montgomery-county-commonwealth-of-pennsylvania/

20 New York Times, March 12, 2020, https://www.nytimes.com/2020/03/12/business/economy/coronavirus-response-wall-street.html

21 Office of Unemployment Compensation, https://www.uc.pa.gov/Pages/covid19.aspx

22 PA Post, March 24, 2020, https://papost.org/2020/03/24/coronavirus-and-business-restrictions-in-pennsylvania-possible-penalties-waivers-and-what-else-you-need-to-know/

23 Gov. Tom Wolf, March 24, 2020, Life-sustaining business FAQ

24 Pittsburgh Post-Gazette, March 17, 2020, https://www.post-gazette.com/news/transportation/2020/03/17/Truck-drivers-PennDOT-rest-stops-COVID-19-Owner-Operator-Independent-Drivers-Association/stories/202003170146 

25 Associated Press, March 20, 2020, https://www.witf.org/2020/03/20/your-morning-update-on-the-coronavirus-in-pa-governor-tom-wolf-orders-1000s-of-businesses-to-shut-down-over-virus/

26 PA Post, March 25, 2020, https://papost.org/2020/03/24/wolf-legislature-set-to-delay-primary-to-early-june/

27 Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

28 Pennsylvania Department of Health press conference, March 10, 2020

29 York Daily Record, March 6, 2020, https://www.ydr.com/story/news/2020/03/06/coronavirus-in-pa-first-covid-19-case-confirmed-in-pennsylvania-wayne-delaware-county/4966026002/

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