We’ve received hundreds of questions in the past several weeks. Many of those questions had clear themes – we’ve attempted to address as many of those themes as possible below.
Thus far, I’ve held off on talking about fevers because fever ranges are so age-specific. But. We’ve received a lot of questions about fever-related concerns, so here’s the low-down:
Here’s the fever chart we use at Kinsa:
96.5° – 99.99°
100.0°- 100.99°101.0° – 102.99°103.0° – 106.99°
96.0° – 98.99°
99.0° – 99.99°100.0° – 101.99°102.0° – 106.49°
97.0° – 100.39°100.4° – 101.99°102.0° – 103.99°
104.0° – 107.49°
97.0° – 100.39°100.4° – 101.99°102.0° – 103.99°
104.0° – 107.49°
Mild to moderate fevers: Embrace them. They’re an indicator your body is working effectively to fight off a virus. You don’t actually need to medicate unless your fever is high, or if you are feeling really uncomfortable. In general, if you were running a fever for 3 days, I’d ask you to give your doctor a call.
High fevers: If your fever hits 103° (under the tongue) or 104° (in the bum or ear), give your doctor a call to touch base.
Fevers in the age of coronavirus: If you think you’ve been around someone with a confirmed case of coronavirus and you have a fever (mild, moderate or high), give your doctor a call. If you don’t think you’ve been exposed, follow the guidance above.
We got a lot of specific questions relating to chronic health conditions (everything from cancer to allergies to sleep apnea). The gist is this: if you have any official diagnosis at all, consider yourself higher risk. Anything that is well-controlled lowers your risk – even with something like diabetes or an autoimmune disease. If you had surgery as an infant but have been healthy since, I’d consider you low-risk. If you have sleep apnea but no other issues – lower risk. Those with allergies and asthma would be lower risk if it’s controlled, but with any flare-up of symptoms, be on high alert. If you are unsure about your own or family member’s risk category, assume that you are higher risk and take extra precautions.
Yes. There is very low risk associated with food. Dr. Ian Williams of the CDC notes that even if you did eat food with the virus in it, the harsh conditions in your digestive tract would get rid of it. If you’re really worried, ask for your food to be left on the doorstep, use gloves or a tissue to transfer it to a dish, then dispose of the packaging and your gloves. Wash your hands well and bon appétit!
Taking my baby to the doctor to get scheduled vaccines –
Yes. Regularly scheduled vaccines are always a good idea! Doctors have been taking extra precautions to limit their exposure, so be ready to be flexible if yours asks you to move your appointment based on closures, or to ensure there are minimal patients in the office at one time.
Breastfeeding my baby if I’m starting to feel sick –
Absolutely, yes. This virus spreads primarily via respiratory droplets and will not transfer through your milk or skin. Breastfeeding actually helps boost the immunity of your little babe. Make sure you wash your hands thoroughly before picking up your baby to feed, and do wear a mask during the feeding. No baby smooches until your symptoms pass.
Going outside for a walk –
YES, YES, YES. I encourage this. Remember, social distancing (keeping 6 ft of personal space) still applies, so don’t invite all your friends to hang out at the park together. You and anyone you live with should definitely go on a walk together though!
Using a disinfectant wipe on more than one surface –
What an interesting question! The manufacturer should have instructions on the bottle or canister. I just grabbed wipes from my shelf and they tell me that a wipe is effective if the surface I use it on remains visibly wet for at least 4 minutes. So it sounds like if your wipe is getting dry, it’s time to toss it and use a new one.
Wearing my CPAP machine if I’m starting to feel sick –
Absolutely, yes. This virus mostly compromises the lungs so shoot to keep your lungs as healthy as possible. The CPAP gently forces air into your airway and lungs while you’re sleeping to provide enough pressure to keep your airway open – this will do nothing but help your lung health!
Allowing my teen to have friends over –
What a perfect question. Can you imagine being a teenager again and having to interpret these rules while maintaining your social life? It’s impossibly hard.
If you’re in a state with a Stay At Home or Shelter In Place order (check here, if you’re unsure), people shouldn’t be going anywhere that is not considered essential. So teens, I apologize, but this means no group hangouts. Stick with the people that live in your household.
If you’re in a state that hasn’t issued those orders yet: consider following strict social distancing rules anyway. The more social distancing we do, the sooner we get this pandemic under control. Technically though, teens can be in groups under 10 people, while still keeping 6 feet of distance between each person. Unless you live in a very large house, this is more practical outdoors.
Seeing family/friends who I don’t live with after isolating for 14 days, symptom-free?
It depends what you mean by “seeing.” If you mean meeting them somewhere outside where there’s ample (6ft. +) of space around each of you, then yes. If you mean visiting them at home, avoid that for now.
Depending on the type of surface, the virus can live for anywhere from a few minutes to several days. Because this virus behaves like other coronaviruses (like the one that causes the common cold), it likely lives longer on hard, non-porous surfaces (like tables, keyboards and doorknobs) for 2-3 days. Remember, transmission from surfaces is far less likely than from person-to-person, but the best thing to do is remain diligent about wiping down frequently-touched surfaces.
Start by cleaning the surface with soap and water, then disinfectant with an alcohol solution containing at least 70% alcohol, a bleach solution, or a disinfectant that’s registered on the Environmental Protection Agency’s list (you can check using the search bar here.)
You only need to change clothing if you’ve been taking care of someone known to have COVID-19 (ex. healthcare workers after their shift). If that’s you, here’s how to handle your laundry:
Note: it’s okay to mix “infected” laundry with “healthy” laundry.
Groceries (and other packages from outside your home) –
You don’t need to be concerned about mail or packages infecting you. You also don’t need to sanitize your groceries. Best practice here is this – wash your hands thoroughly after putting both away, especially before touching anything else (mostly your face!). Then, disinfect your cabinet handles.
If you’re feeling ill –
Stay away from your fur pal. Have a healthy member of your household care for your pet until your symptoms go away, if possible. If you live alone, try to limit unnecessary contact until symptoms disappear.
If you don’t have symptoms –
Be diligent about washing your hands after snuggling with your pet, but don’t agonize about catching the virus from her. If you and your partner are both snuggling your cat (cute), just keep your face away from her fur and wash your hands for 20 seconds with warm water and soap post-snuggle.
Similarly, don’t agonize about your dog tracking the virus in on his paws. As long as you’re disinfecting surfaces often, washing your hands after petting him and keeping your hands away from your face, you’re mitigating viral spread in your household.
Are there symptomatic differences in infants vs. children vs. adults?
Most cases in children have been more mild than adults and typically mimic an upper respiratory infection: fever, cough, sore throat, stuffy or runny nose.
There are some very early-stage studies surrounding COVID-19 and the possibility of rashes (hives, blisters, chickenpox-like, “COVID toes”). It’s still unclear if these are related to coronavirus. We’ll keep you updated as we learn more.
Also in the early stages of research is a new syndrome named multi-system inflammatory syndrome in children (MIS-C). Symptoms vary greatly but often present with a fever and include multi-organ dysfunction, such as the skin, heart, brain, kidneys, lungs, stomach and intestines.
This sounds very scary – and it is! – but keep in mind that these symptoms represent <1% of confirmed COVID-19 cases in children. Be aware of them but don’t panic, and if your child suddenly has something going on that you cannot explain, give the doctor a call.
Every time I feel something in my body these days, I worry it’s COVID-19. Are there other symptoms I should look out for?
Look out for anosmia (loss of smell) and ageusia (loss of taste). In many cases, these symptoms seem to appear before any others.
Other cases have presented with chills, muscle/body aches, sore throat, nausea, vomiting or diarrhea. Fatigue and lethargy are normal when you’re running a fever and are ill. If the lethargy is so extreme that someone isn’t waking up, isn’t hydrating or is acting confused, call your doctor to determine the best place to be seen. If your newborn is lethargic or running a fever, give your doctor a call as well.
Can you describe the cough more?
The cough caused by COVID-19 is typically dry, meaning there is no phlegm/mucus production. We have not been seeing croup-like coughs. If you’re prone to getting dry coughs (say, from allergies) but have no other symptoms, your symptoms are likely not due to coronavirus.
How long do symptoms take to appear and how long do they last?
If you’re exposed to the virus, symptoms will start showing within a 14-day window for most people. Some people may actually have the virus and show no symptoms at all.
The length of symptoms and severity of fever varies case-by-case. According to WHO-China Joint Mission, recovery has been about 2 weeks in more mild cases and 3-6 weeks for more severe cases.
How long do I need to stay at home if I have symptoms?
Per the CDC, you need to stay at home until all your symptoms are gone (without the help of medication) for at least 24 hours and ensure it’s been at least 10 days since your symptoms began. That means you’re looking at a minimum of 10 days cozied up at home.
*Some doctors may choose to test you for coronavirus and wait for two negative tests before you’re “released.” This is up to your doctor and local health department, so make sure you’re keeping in touch with them!
Let’s talk about contagiousness.
You’re most contagious 2-3 days before symptoms appear. That puts us in a weird spot, eh? You may be spreading the virus before even knowing you have the virus. The good news is this: staying at home and wearing a non-medical, cloth face mask when you’re out for essential activities (e.g. grocery shopping) where it may be difficult to maintain 6+ ft. of personal space are great ways of limiting risk that you’re spreading the virus unknowingly.
If you develop symptoms, consider yourself contagious until all symptoms have been gone for a full 3 days, sans medication.
What about the rate of spread?
R0, pronounced R-naught, is a mathematical term used to estimate the number of people who could catch a virus from just one infected person. The R0 value for the flu is about 1.3, which means each person infected with the flu would likely spread it to 1.3 people.
For comparison, early studies of the R0 value for COVID-19 is between 2 and 3. Which means each infected person is infecting 2 to 3 other people. This snowballs into a much faster viral transmission than the flu.
Keep in mind that those numbers are not static. The R0 is different by location, social distancing measures, etc. For reference, the goal is to keep the R0 value below 1.
The short answer is: it’s too soon to know for sure. We do know that with other coronaviruses (like the one that causes the common cold, for example), we can be infected with the same virus more than once in the same year. The hope is, however, that our immune system will at least “remember” the virus and be better equipped to fight it.
Because it is too soon to know the lasting effects of this novel coronavirus, it would be irresponsible to suggest that everyone expose themselves to this bug. The level of immunity will remain unknown until the virus has been around long enough to study.
Researchers are working hard to develop antivirals and a vaccine, but they’re not yet available. Stay tuned for more information. According to the CDC, a vaccine likely won’t be ready for the general population for another 1-1.5 years. Getting the pneumonia or flu vaccine will help protect your overall health and can lower your risk of complications, but neither of them will protect you from COVID-19, unfortunately.
The good news is that most cases are mild and self-resolve at home. Current treatment focuses on alleviating your symptoms. A teaspoon of honey may help with your cough (for anyone older than 1 year old) and cool-mist humidifiers can help with dry or stuffy noses. Medication can help to bring your fever down if it’s uncomfortable, but remember that fevers help fight off infection. Don’t be afraid to let your temp hover in the mild to moderate range, medication-free. Eat and drink whatever you’d like – no special limitations. Increasing fluids (water, tea, ginger ale, popsicles, unsweetened sports drinks) is always a good idea to prevent dehydration and other complications.
Remdesivir is an antiviral medication that is showing some promise in speeding up the recovery time for those with COVID-19. The improvement is minimal so far but researchers are optimistic and studies are ongoing. Keep in mind that this medication does not prevent someone from catching the virus and it doesn’t reverse the virus’ effects. The primary objective of treating patients with Remdesivir is to stop the virus from replicating and getting worse.
Hydroxychloroquine is another medication you’ve likely heard about. It is being trialed in patients with COVID-19 as a potential treatment, but there’s not enough data available yet to determine if it’s helpful alone or in combination with other medications. It has been studied for decades as a possible treatment for many viruses, it hasn’t yet been proven successful. Absolutely do not take this medication unless your doc has approved its use.
There’s been a lot circulating about this. We’ll update you as the official verdict changes. Currently, the WHO does not recommend against the use of ibuprofen during this illness.
If you’ve used caution with ibuprofen in the past (ex. those with kidney disease or gastrointestinal issues), continue to do so.
Tylenol is a good alternative if you’re worried. (Again, if you’ve used caution with this in the past due to poor liver function, continue to do so.)
We see you, Long Island railroad workers! First off, thank you – so much – for your service.
These precautions are most applicable to healthcare workers who are in direct contact with patients who either have confirmed cases of COVID-19 or are suspected to have it. That said – grocery store workers, railroad workers, pharmacists, janitors, our other heroes – err on the side of caution. These measures will help to protect your families too. When you get home from work:
Whether it’s a loved one, a neighbor or that acquaintance on Facebook, we all know someone who is not taking “this coronavirus stuff” seriously. If you are taking it seriously, it can be extremely frustrating (and scary!) to witness others refusing to wear a mask or wash their hands. Even more so if this person lives in your household.
Here’s my recommendation:
Yes. BUT, the goal of social distancing right now is to slow down – not necessarily stop – the spread of the virus. You may have heard this referred to as “flattening the curve.” With more of us taking 6 ft. of personal space, the virus is less able to pass from person-to-person, meaning there are just fewer sick people overall.
With fewer sick people overwhelming local labs and hospitals, our healthcare providers and scientists can spend more time developing antivirals to treat the severe symptoms of coronavirus and vaccines to prevent us from developing the disease in the first place. Manufacturers can use this time to build and ship more ventilators and ICU beds to hospitals so every hospitalized patient can receive adequate care.
By choosing social distance now, we’re pressing pause on the virus’ spread, buying our healthcare system and economy precious time to adapt so – if and when coronavirus spreads again – we’re better equipped to handle it.
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This content has been reviewed by multiple licensed clinicians. All information has been aggregated from the U.S. Centers for Disease Control and World Health Organization, with contributions from medical centers like Stanford, Harvard and Johns Hopkins. We do not include information if we cannot fact-check it across at least two leading public health organizations. It is not intended as a substitute for professional medical advice, diagnosis, or treatment.
Blake Wageman, RN, BSN has over 11 years of nursing under her belt, primarily focused on NICU babies and, just as importantly, their worried parents.