The global number of confirmed COVID-19 cases exceeded one million in early April, almost doubling in a week. Instead of lifting or relaxing the physical distance guidelines, we see curly playgrounds and extended school closings in order to smooth the curve and ease the burden on the health care system.
As people crouch at home, questions remain about COVID-19 infection, transmission, treatment and recovery. Here are answers to some of the common questions people are asking about the coronavirus pandemic.
Do I have to wear a mask?
Currently, the accepted science is that the wearing of masks is best preserved for frontline health workers. In other parts of the world, it is more common for the general public to wear masks, but the evidence for their usefulness remains inconclusive.
In general, a mask protects the wearer, such as a healthcare worker, from infection. When someone wears a mask in public, it’s usually to protect others from getting sick if they cough or sneeze. During the COVID-19 pandemic, sick people should isolate themselves at home and not venture out in public.
It is in our interest to continue provincial and federal efforts to preserve personal protective equipment, including masks, for the people who need it most: health care workers and their patients.
Many people make their own cotton masks at home. Wearing masks may well become a new cultural norm for North Americans. This practice is not harmful, as long as it does not become an excuse for a sick person to go out in public.
The safest and healthiest way to prevent the spread of COVID-19 is to stay at home when you are sick, to maintain physical distances of at least two meters from others, not to meet as a group and wash your hands often.
How long can you have the virus before showing symptoms?
Most estimates for this “incubation period” range from one to 14 days, with five days being common.
People infected with coronavirus are considered the most infectious when they have the most symptoms. But infection and transmission can sometimes occur when a person has the virus but has no symptoms (they are asymptomatic).
These people can unknowingly spread the coronavirus to other people because they don’t realize they are infected. This is why it is important to stay at home and maintain social distance – by limiting the number of people you come into close contact with. It works and can help protect vulnerable people in our communities.
Is there a test to tell me if I have ever had COVID-19?
When a person is infected with a virus, their immune system begins to produce antibodies against that virus. A test for specific antibodies to coronaviruses could determine if anyone has ever had COVID-19, and it could help scientists understand how common the disease is.
The United States Food and Drug Administration authorized the first antibody test for COVID-19 on April 1. We do not yet have this test in Canada.
Read more: FAQ on coronavirus: can people without symptoms spread COVID-19? How long does it live on surfaces? What cleaning products kill the virus?
Many university laboratories and medical companies around the world are working to produce these blood tests. They would be able to quickly identify antibodies in people who have already been infected with the virus, but who have had no symptoms or only very mild symptoms.
Can a person who has recovered from the virus still be a host?
It remains unclear. There are a small number of people who have been diagnosed with COVID-19, have stopped showing symptoms, have had two consecutive negative results two days apart, and have been discharged from hospital, but have subsequently tested positive for infection.
This suggests that some patients who have recovered may still be contagious, but this has yet to be confirmed.
Generally, “viral load” – a measure of the amount of virus the body carries – gradually decreases over time after the symptoms have gone. But in some cases, the genetic material of the virus (RNA) can be detected in people for three weeks or more since the onset of their symptoms.
The levels of viral RNA detected in these studies were low and likely represented remnants of viral RNA, not live virus. But we don’t have enough evidence yet to confirm it.
Can you get COVID-19 more than once?
Even mild cases should give recovered patients some immunity to the virus. But some patients have reported being infected a second time and showing symptoms again.
In a study of 55 patients in China, reactivation occurred in 9% of them. The clinical characteristics of these patients were not different from those of the first COVID-19 patients. The study did not identify any reliable markers that would allow doctors to predict the risk of reactivation of the SARS-CoV-2 coronavirus.
Can the blood of COVID-19 survivors help others to recover?
When people recover from a disease, their blood plasma remains rich in antibodies that have helped fight the disease. This “convalescent plasma” has been used as a treatment, called passive antigen therapy, for other people who fall ill with the same disease.
This approach was used as an emergency measure during the SARS epidemic in 2003 and for people with Ebola in 1995, but it is not used as standard treatment.
At present, the use of convalescent plasma to treat critically ill adults with COVID-19 is not recommended, largely because there is not yet enough data to show that it is safe and that it works. These recommendations may change with more data and studies.
How long can school and business closings last?
“Flattening the curve” has become a worldwide rallying cry. Epidemiologists are working extremely hard to model various scenarios that allow our governments to predict the course of the disease. It could tell us if – and when – we can relax the restrictions and other strategies implemented in March.
In Canada, the number of cases we see in the first weeks of April and the severity of these cases will give us an indication of the impact of travel restrictions and social distancing measures. With concrete numbers in hand, epidemiologists can adjust and refine the models to better understand how long our schools and businesses will remain closed.
A recent report predicts that the demand for intensive care beds for patients with COVID-19 could peak from early to mid-April in Ontario. This means that we must follow physical remoteness – and strict isolation for all those confirmed or suspected of having COVID-19 – for at least a few more weeks. This is why Ontario has extended its declaration of emergency and the schools remain closed until May 4.
We know that these emergency health measures have social and economic repercussions on our communities. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization, made some encouraging remarks when closing the press conference on March 30:
“With solidarity, humility and taking the best out of each other, we can – and we will – overcome this together.”