COVID-19

COVID-19

Have a question about COVID-19? We will ask the experts.

Send questions to tribdem@tribdem.com.

Note: Due to the volume of questions submitted, we will not be able to answer them all. Any questions of an urgent nature should be directed immediately to your primary care physician.

Readers of The Tribune-Democrat asked the following questions:

“Do you have to have a negative COVID-19 test to receive vaccine?”

The answer:

This is a great question and one that I am sure many others have.

Current recommendations do not require a negative COVID-19 test to receive the Pfizer or Moderna vaccines.

However, if you are symptomatic for COVID-19, it is advised that you wait until your symptoms resolve before you receive the vaccination.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“On Dec. 21, I went to a local testing site for a rapid test in Hauppauge, New York. The person administering my nasal swab test had a mask on, but it looked like a typical surgical one and not a tight-fitting N95. She had no additional protective equipment such as a visor on while administering the test. Because she may have seen a lot of patients so far, am I at risk of potentially being exposed to COVID-19 from her? Are all test administrators required to take a test themselves (or at this point, be vaccinated?).”

The answer:

In my opinion, your risk is probably low.

At our medical center, test administrators are not required to be routinely tested. COVID-19 vaccination is strongly encouraged, but not mandatory at our medical center.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I had the Pfizer COVID vaccine this morning and get COVID tested tomorrow for surgery in a week. Will this be a problem?”

The answer:

No.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I obtained the vaccine, do I need to quarantine away from my 70-year-old husband and wear a mask around him?”

The answer:

Thank you for your questions. I appreciate your concern for your family members.

The Pfizer and Moderna vaccines for COVID-19 do not contain any virus. 

Instead, they contain a biological molecule called messenger RNA. This molecule will be made into the viral spike protein and your body will mount an immune response to it.

The lack of virus in the vaccine means that you are not contagious. It is safe to interact with members of your household without a mask after the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“What happens if your spouse gets the COVID-19 vaccine and you don’t? Can you get sick from your spouse?”

The answer:

The vaccine for COVID-19, whether it is from Pfizer or Moderna, contains no virus. 

Instead, what these vaccines contain is RNA. RNA is a biological molecule that is nucleic acid. Most of us are familiar with DNA, the biological molecule that holds all our genetic material and is a nucleic acid. 

DNA is used to make RNA in a process called transcription. Think of it like this, if you wanted to write “Hello” in Spanish, you’d write “Hola.” They are the same word with the same meaning, just using a different set of letters. That is what happens with DNA and RNA, same message different make-up.

That RNA is then translated into proteins, another type of biological molecule that does the work.

If you wanted to turn “Hola” into a gesture, you’d wave. That is like what occurs in translation of RNA into proteins. You turn a word into an action.

The COVID-19 vaccines have a bit of SARS-CoV-2 RNA in them, the bit that makes the spike protein. The spike protein is what the virus uses to get into our cells.

Our bodies will take the RNA and translate it into this spike protein. Then our immune system will recognize that spike protein as something to be destroyed and mount a response to it. This response will generate antibodies that will protect us, with 95% certainty, from infection with SARS-CoV-2.

Some vaccines have what is called live virus contained in them and can result in someone who receives that vaccine being contagious with the pathogen. Since the COVID-19 vaccine is only RNA, it cannot be transmitted. There is no risk of acquiring the infection from someone who has been vaccinated.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Could these new vaccines help those already infected? Someone should be trying it on some of those seriously infected? Would help hospital immensely.”

The answer:

CDC 2020 recommendation is that defer vaccination in persons with known current COVID-19 infection until the person has recovered from acute illness and no longer requires isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • •

“My husband became symptomatic on Dec. 25 and tested positive on Dec. 27. My youngest son, 12, started with GI symptoms on Dec. 27. They have both been isolating in separate bedrooms since symptom onset. I have been quarantined downstairs bringing supplies up masked and distanced. I am an optometrist and have had Type 1 diabetes for 33 years. I have been extremely diligent in my precautions to avoid this virus. However, Tennessee is currently a global hot zone. I could get my vaccine this week by our health department. Is that advisable or should I wait until quarantine period is over?”

The answer:

I am very happy to hear that you are following isolation protocols for your sick family members.

Since you are in the medical profession, you can get the vaccine in accordance with the Tier One roll-out. Guidance from the CDC suggests that your possible exposure does not preclude you from getting the vaccine. However, if you become symptomatic, it is advised that you wait to get the vaccine until your symptoms resolve.

You will need to contact your local hospital to arrange vaccination. The roll-out for healthcare workers is being coordinated by each state’s health department.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My girlfriend is a 39-year-old nurse. She contracted COVID-19 at work. She is almost over it now. But now, she keeps falling asleep very randomly. I mean literally in the middle of a sentence.

“She has no history of narcolepsy either. She’s mostly laying down when it happens though. But when she’s up and walking around, she’s fine. My question is: is that a normal side effect?”

The answer:

Narcolepsy is a sleep disorder which often includes periods of excessive daytime sleepiness.

According to researchers, evidence suggests that narcolepsy arises from the interaction of genetic, environmental and triggering that then lead to an immune-mediated loss or dysfunction of neurons in the brain.

In other words, COVID-19 infection may trigger an immune system reaction that can attack brain neurons leading to narcolepsy.

I recommend your girlfriend consult either a sleep specialist or neurologist for further evaluation and treatment.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • •

“After receiving the COVID-19 inoculation, is there a delay of 10 to 30 minutes before departure?

“This would cover a shot reaction to the recipient.”

The answer:

Vaccine side-effects are generally minor, including mild soreness at the injection site. However as a precaution, the person should be observed 15 to 30 minutes after vaccination for a remote chance of a severe allergic reaction.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I do not live with my parents. My dad tested positive for coronavirus/COVID-19. He and my mom quarantined at home. 

“My mom had three tests (the full test with nasal swab, not the rapid) during a 14-day timeframe when my dad was ill and tested negative each time. My dad’s symptoms fully subsided and he then had a follow-up, full nasal swab test and tested positive again – his PCP let him know that people can still test positive for some time after infection and recommended he not get another test. After 20 days, on his physician’s guidance, he ended his period of isolation at home.

“My parents would like myself and my boyfriend to spend some time with them in their home, masks off. We did frequently see them pre-COVID-19 diagnosis given we have parallel, strict approaches to living in the pandemic. Is my dad still infectious from his previous bout with COVID-19? What is the level of risk in being in their home? I am unsure of whether and for how long the home/air in the home can hold the virus.”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. However, households are, and will continue to be, important venues for transmission of SARS-CoV-2 (COVID-19). Therefore, studies have recommended preventative actions such as increased mask-wearing at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • • 

“My mom began having COVID symptoms on Nov. 23. Her boyfriend in the same household had symptoms before her but wasn’t tested initially. After my mom became sick, they both got tested and both came back positive. My sister then started having symptoms on Nov. 26. She also tested positive and tested positive for the flu as well. They have all done their 10-plus day quarantine. They have gotten tested since and still have tested positive. I want to visit my family. Is there any way they could still be contagious? My sister went to the ER twice for her symptoms. I do not live in my parents’ home. Should I wear a mask at all times if I do? Is there anything specifically I should avoid in my house?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. If none of them are immunocompromised, they may stop isolation after 10 days and resume normal activities. If any are immunocompromised, then 20 days of isolation is recommended.

I also recommend wearing a mask and other preventative actions including social distancing (which is difficult with family) and good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Both my wife and I tested positive for COVID this past Sunday. We are taking vitamin D3, zinc hydrochlorine and vitamin C. My question is: Can we cross infect each other if one recovers sooner than the other one?”

The answer:

Since both of you are infected with the same pathogen, SARS-CoV-2, you need not worry about infecting each other if one recovers first.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

 “My husband received the Pfizer vaccine. 

“I’m assuming because this isn’t a live virus vaccine, there would be no shedding? I realize following distancing and masking is still mandatory, but, would that help give me any potential benefit/immunity to COVID-19 since we live in the same house?”

The answer:

What a great question. I am sure others in your situation are wondering the same thing.

Both the Pfizer and Moderna vaccines are mRNA vaccines. This means that they use our cell’s own process to make the spike protein of SARS-CoV-2, the virus that causes COVID-19. 

This spike protein is then broken down by the cell and shown to the cells of the immune system in a process called antigen presentation (think of it like an introduction to the body). The immune system will then mount a response to that spike protein causing the individual to possibly have injection site pain, tiredness, and after about a week a swollen lymph node in the armpit closest to the injection site.

Since there is no virus in the vaccine, there will be no natural infection and no possibility of contagiousness. However, you are correct in your assertion that your husband will still need to wear a mask in public and continue to maintain social distance and hand-washing. Science does not yet know if a vaccinated individual will be capable of being a carrier for the virus.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

 “Thank you for your feature where experts answer questions related to COVID-19. (These questions provide valuable understanding for how COVID-19 works and how we should think about COVID-19 scenarios that are more specific than you can find in a general article on the internet. I have enjoyed reading through many of them.)

“I have read through most or all of the questions and have not seen one that addresses my question so I would like to see if an expert can weigh in on it.

“My question is regarding transmission from outdoors to indoors. Virtually all articles out there are for outdoor-outdoor transmission or indoor-indoor transmission. Let’s say that you are having a landscape company do some improvement to your yard which would require several workers to be in your back or front yard for many hours and possibly multiple days. Due to the aerobic nature of the work and being outside none of the workers wear masks. Is there any risk of an ‘outdoor-to-indoor transmission’ if one of the workers is actively shedding the live virus and the house is directly downwind? How much would open windows versus closed windows play a role in the answer? Would the risk be classified as virtually zero, extremely low, low, medium? 

“Does the risk change with factors such as distance to the house, time, HVAC parameters, etc.? This hypothetical scenario would also have application to so-called ‘window visits’ that many people are doing at nursing homes to see older friends and family, where they visit for potentially multiple hours and possibly without masks on for both the inside and outside people. I have tried to find information that may help provide input to this question but have not found anything of value or substance. Any information you can provide on this scenario would be great.”

The answer:

Your question is a good one. There have been many studies looking at how transmission of SARS-CoV-2 and its variants, are occurring. 

These studies show that less than 10% of transmission of the virus is occurring in outdoor settings where mitigation efforts are in place (mask-wearing).

There have been studies that look at ventilation systems and how the virus is spread due to airflow inside. Airflow direction certainly plays a role in airborne transmission inside. If we consider the physics of the situation you describe, there are many factors that must be considered (windspeed, amount of humidity, respiration rate of the contagious person, distance from the house, amount of sunlight and the intake of air into the house).

Airborne transmission means that the virus is surrounded in small lightweight mucus debris. That particle has mass and will eventually be pulled to the ground due to gravity. 

In windless conditions inside, the particle can travel about 6 feet. When you factor wind outside into that, it can increase the distance the particle can travel before it reaches the ground. However, outside, you must consider all the other factors that would affect the virus. Humidity comes into play, more humid, the virus will be viable longer. Sunlight also comes into play, the UV light from the sun can decrease the viability of the viral genome. 

Plus, consideration must be given to the other factors I mentioned.

Taken together, I would hypothesize that the risk is very low for outside-to-inside transmission.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“If one has had a past single occurrence of Guillain Barre Syndrome – obviously excluding recurrent/chronic forms – is there any one of the upcoming COVID vaccines that may be better to take? It is understood that a conversation with your medical provider would be warranted, but it does not seem at this point that such a provider would have enough legacy data to help guide this decision, and it also seems that contracting COVID could present greater risk.”

The answer:

A large epidemiological study in the United Kingdom found no association between COVID-19 and Guillain-Barre Syndrome.

Dr. Anthony Fauci recently said people who’ve had Guillain-Barre Syndrome, should not get the COVID-19 vaccine “because you might trigger a similar, serious response.” Dr. Fauci’s recommendation was made out of an abundance of caution.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband became infected with COVID earlier this week. We isolated him to the upstairs master bedroom and I moved downstairs/slept on the couch. Unfortunately, a few days later I tested positive for the virus. 

“My symptoms are less severe than his, but we both definitely have COVID. Since we both are positive with the virus, can we sleep in the same room again? Or is it possible he has a more severe version of COVID than me and I should continue to isolate from him?”

The answer:

You and your husband can isolate together, as long as, we’re sure you’re both positive.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was exposed to COVID-19 about 31/2 weeks ago and was under quarantine for 14 days with no symptoms. Yesterday, I woke up with symptoms. Is it possible to get symptoms after 31/2 weeks? I’m concerned I was unknowingly exposed after quarantine and now have exposed others. I have a call into my PCP and will probably be tested.”

The answer:

I agree you were probably exposed a second time after your quarantine.

If you are not immunocompromised, I recommend you self-isolate for 10 days after symptom onset and follow-up with your primary care physician.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive for the COVID-19 virus. I have had fever, nausea and no appetite. I am scheduled for a total knee replacement on Jan. 15. Is it safe to have that surgery after recently having the COVID-19 virus?”

The answer:

If you are not immunocompromised, I recommend at least 10 days of isolation since symptoms first appeared. If you are immunocompromised, at least 20 days of isolation is recommended since symptoms first appeared.

I advise you to contact your primary care physician and orthopedic surgeon as soon as possible for further instructions and discuss whether to cancel your elective total knee replacement surgery. You also need to get checked for possible COVID-19 pneumonia.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I recently got out of quarantine. Do I have to wait to get the shot? I’m a health-care worker.”

The answer:

An important question.

SARS-CoV-2 (COVID-19) infection or exposure (CDC 2020):

• Persons with current COVID-19 or asymptomatic SARS-CoV-2 infection: Defer vaccination in persons with known current COVID-19 infection until the person has recovered from the acute illness and no longer requires isolation. Based on current evidence, that reinfection is uncommon within 90 days following initial infection, vaccination may be delayed until near the end of the 90-day period.

• Persons with history of COVID-19 or asymptomatic SARS-CoV-2 infection: Based on Pfizer clinical trials, vaccination is safe and likely effective in persons with evidence of prior COVID-19 infection. Vaccination should be offered to persons regardless of history of symptomatic or asymptomatic infection. 

Viral testing for acute or prior infection for the purpose of vaccine decision making is not recommended.

• Persons with known SARS-CoV-2 exposure: Vaccination following exposure is not likely to be effective for preventing the disease from the exposure. Persons with known exposure should wait to seek vaccination until after their quarantine period has ended. For persons in congregate settings (long-term facilities, correctional facilities), residents with known exposure may be vaccinated; however, if COVID-19 is strongly suspected and viral testing results are pending, consider deferring vaccination.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I was wondering how long after a COVID-19 vaccine would antibodies show in an IgG test?”

The answer:

If your body develops an immune response, which is the goal of vaccination, there is the possibility you may test positive on some antibody tests. Antibody tests indicate you had a previous infection and that you may have some level of protection against the virus. Experts are currently looking how COVID-19 vaccination may affect antibody testing results.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Our 26-year-old son moved into his own apartment on Dec. 17. He and his best friend were exposed to the virus on Dec. 19. His friend has not had any symptoms but tested positive on Dec. 24. My son had nausea and vomiting on Dec. 23 and body aches and chills beginning that night. He also tested positive on Dec. 24. He had a fever for three days. He never lost his sense of smell or taste. He has been symptom free now for 30-plus hours. Can we see him on New Year’s Eve and/or New Year’s Day or is that too early?”

The answer:

I understand the desire to see family at this time of year. We have traditions and are all craving a sense of normalcy. However, since it has not been 10 days since symptoms have begun, it is risky to visit with your son. He is very likely still shedding the virus and may spread it to you.

I wish I had better news for you.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I keep hearing people say that they/their friend/family member never left the house and yet contracted COVID-19. Are these likely just not true statements or are there documented cases like this? I suspect that maybe they never left the house but had visitors or perhaps got too close to a delivery person. 

“What I’m trying to understand is the actual prevalence of this happening or the actual prevalence of the virus transferring from food packaging or other delivered items. Everything science-based that I have read says that this risk is low and yet I also read anecdotes from a lot of people saying that they are sheltering in place and still caught it.”

The answer:

Experts believe the SARS-CoV-2 (COVID-19) virus spreads mainly from person to person. I agree that visitors may be the source. Masks are more important than originally thought.

Another way to catch the new coronavirus is when you touch surfaces that someone who has the virus has coughed or sneezed on. You may touch a counter top or doorknob that’s contaminated and then touch your nose, mouth or eyes.

The virus can live on surfaces such as plastic and stainless steel for two or three days. To stop it, clean and disinfect all counters, knobs, and other surfaces you and your family touch several times a day.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband and I disagree about spending time with our grandchildren and extended family. The grandkids’ parents are in regular contact with at least five other households. 

“My grandson is 3 months old and had open heart surgery when he was 3 weeks old to have a narrow part of his aorta removed. He has other heart issues that will need further surgery when he is older. He is not on immunosuppressant medication. My husband thinks it is perfectly OK to go hang out with the grandkids. The parents have 10-minute COVID tests that they received from the hospital and he is of the opinion that if the test is negative, he can spend time there without a mask.

“I disagree and refuse to go over there. My husband says he is going without me. They only live about a mile away, so he plans on going over at least once a week (and is not happy about my decision to not go for Christmas).

“My concern is if I need to isolate and stay away from him if he is spending time at another household?”

The answer:

Negative rapid antigen COVID test results does not rule out infection. There is risk associated with outside home visitors and considering the number of your grandkids parents’ exposures.

Social distancing is very difficult with family members. I do recommend wearing a mask and good hand-washing hygiene when visiting.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“At the grocery store, or any store, which is safer to use – the regular register checkout line, or the self-checkout?”

The answer:

When you are out in public, it is best to keep your distance from others and to wear a mask. If there is a self-checkout available, that will reduce your contact with others. Remember to wash your hands often.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I was exposed to COVID-19 on Nov. 26, became symptomatic on the 29th, and tested positive on the 30th. I luckily had only a mild case and am feeling better. I have isolated from my family since my symptoms began. They have tested negative three times and are symptom-free. I tested again on Dec. 8 and unfortunately, my results are still positive. Does this mean I am still contagious? I am hoping to end isolation, but don’t want to infect my family. I read that sometimes patients who were symptomatic will test positive for three months after getting better. Help!”

The answer:

Sometimes, the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

If you are not immunocompromised, you may stop isolation and resume normal activities after at least 10 days have passed since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms have improved.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had a PCR COVID-19 test on Oct. 26 that came back negative, then a PCR test on Oct. 29 that came back positive and a PCR test on Nov. 1 that came back negative. Was my positive a false positive or just low viral load that didn’t amount to anything? I have several autoimmune diseases and have been extremely careful, but I work in senior living where we have positive cases (I’m not a caregiver though). I’m just trying to figure out if it was a true positive or if the PCR can still throw out false positives?”

The answer:

A positive PCR (molecular Polymerase Chain Reaction) test result is highly accurate, and I believe you were infected with the SARS-CoV-2 (COVID-19) virus. The negative PCR test on Nov. 1 was probably in the late or recovery stages of infection, or that PCR was a false negative. You could consider a blood test for SARS-CoV-2 IgG antibodies. If that blood test is positive, it indicates you were previously infected with COVID-19, but it doesn’t give the exact date.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband tested positive on Dec. 11 and 12. He had both a rapid test and regular test. I had a regular test on Dec. 11 that was negative. I had another regular test that I am awaiting results from. He developed mild cold symptoms a few days ago, but has had no fever. How long should we both quarantine? I have been in the same room with him and using the same bathroom as him. We have been disinfecting everything that is touched after each contact with the surface. When he is cleared to return to work, do I need to spray the entire house with disinfecting air spray or how long will the germs be able to infect us in our home?

“I know he should be isolated to one room but I know he will not agree to that and he will get upset if I suggest it. I will continue to disinfect all surfaces, keep distance within the same room and wash hands frequently. We have been sleeping in separate rooms since Dec. 11. When will we be OK to resume sleeping together and normal activities?”

The answer:

If your husband is not immunocompromised, his isolation can end 10 days after symptoms first appeared, and he can then resume normal activities. Ideally, you should quarantine separately. Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Or your quarantine can end after Day 7 if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if

no symptoms were reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband was exposed to COVID on Dec. 7, and started showing symptoms about four to five days ago. He tested positive, and I tested negative. We have been sleeping in the same bed every night (except tonight), and been around each other without masks. For how long should I self-isolate/quarantine? And same with him? We have two very little boys so logistics are challenging. I already had to stop work since we now don’t have childcare while we’re in isolation. Just trying to figure it all out. Because I tested negative, do you think that means I have the antibodies or that I wasn’t exposed long enough?”

The answer:

If your husband is not immunocompromised, his isolation can end 10 days after symptoms first appeared, and he can then resume normal activities. If you are immunocompromised, then 20 days of isolation is recommended since symptoms first appeared. Ideally, you should quarantine separately. Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring.

Or your quarantine can end after Day 7 if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if no symptoms have been reported during daily monitoring. Regarding your negative test results, there are several possibilities. First, you may have had a robust neutralizing antibody response to the virus. Secondly, your test was a false negative. Lastly, you may have tested too early. The incubation period for the SARS-CoV-2 (COVID-19) virus can be two to 14 days, with an estimated mean of five days.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Our daughter and son-in-law had COVID-19 with symptoms beginning the Sunday prior to Thanksgiving. They both fully recovered and they and the children are now symptom-free except that the kids all have perpetual allergies and frequently do not cover sneezes. They are not tidy nor clean people, and their house is always dirty. They are offended we don’t want to come and visit. They would not want to wear masks if we visit, either. 

My husband and I are older than 60 and we will be visiting my mom-in-law, who is 83, in a few weeks. Are we being overly cautious or should we just try to get over our concerns that we could still catch the virus from them?”

The answer:

I recommend continuing preventative actions, including wearing a mask. At this time, I do not advise visiting your elderly mother-in-law who is 83 because of increasing COVID-19 cases and related deaths.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“An employee had been off work with COVID and has just been given the green light to return to work. However, her husband just tested positive. Can she still carry the virus and expose other employees at work if she returns? Just trying to keep everyone safe.”

The answer:

The employee was released back to work. All employees should continue preventative actions, including masking and good hand-washing hygiene.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband became infected with COVID earlier this week. We isolated him to the upstairs master bedroom and I moved downstairs and slept on the couch. Unfortunately, a few days later, I tested positive for the virus. My symptoms are less severe than his, but we definitely have COVID. Since we both are positive with the virus, can we sleep in the same room again? Or is it possible he has a more severe version of COVID than me and I should continue to isolate from him?”

The answer:

You and your husband can isolate together, as long as you’re sure you’re both positive.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter is having a group of friends for Christmas Eve. My daughter husband and three grandkids want to come visit us Christmas Day. My husband has cancer and I am on dialysis, 72 years old. 

“Is this risky?”

The answer:

Oh my yes! It is risky. The majority of cases of COVID-19 are coming from small group gatherings in individual homes.

I know it can be hard to talk to family about these issues, I suggest that you offer for them to visit outside and distant while wearing masks.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Hello, I was reading your answers to questions about COVID and I was wondering if I can ask a couple of my own as I can’t find this info anywhere and would like to more accurately judge our risks.

“1. How much of a risk is grocery or other shopping or similar activities – being indoors with other people in fairly large buildings with masks mandated for everyone and generally keeping 6 feet apart and not touching face etc? Can you still catch it through the eyes or by passing too close to someone or is the risk minimal if both are in masks? Does there need to be some time limit, such as 10-15 minutes to get infected or would walking through a potential ‘cloud’ of virus be enough?

“2. I keep hearing people say they have no idea how they got infected, even those who followed all precautions, wore masks and goggles, stayed home and had everything delivered and sanitized with gloves etc. It’s really scaring me. How do you believe these cases can happen?

“3. How much of a risk are children’s activities outdoors such as soccer or just playing, where they are wearing masks but not necessarily distancing far enough due to age? How much can the virus spread between two masked individuals outdoors?”

The answer:

These are very relevant and important questions. I understand your concern and realize how the barrage of information and ever-changing situation can cause anxiety.

This global pandemic has showed the power of science and has allowed the general public to see behind the laboratory doors (so to speak). In many other situations, science has the answer and provides it. This time the public is learning right along with the scientists. It isn’t like they show on TV, right?

I see a common theme in your questions, what risks should I be taking? We all have a risk bank, just as a coin bank, we can choose where to spend that risk based on situation analysis.

Grocery stores and other areas where people gather masked and distant present a level of risk depending on the level of community spread of SARS-CoV-2, the virus that causes COVID-19, in your area. 

Carnegie Mellon University has an excellent tool to help determine the level of community spread in your area. You can find it by Googling CMU Covidcast. I cannot say for certain what the risk is in your particular area. That tool will help. 

Higher levels of community spread will mean greater risk in public.

SARS-CoV-2 has a long incubation period coupled with a period before symptoms start of a few days where individuals appear healthy and are spreading virus like wildfire. This is how people get sick with COVID-19 and can’t place where they got it. Think of it like this, do you remember every item of good you consumed last week? Thinking about all your contacts in the past four days can be difficult.

As for children’s activities, research shows that children have as high or higher viral loads as adults, but with milder symptoms. The main symptoms I children involve gastrointestinal issues and a mild fever.

If community spread is high in your area, children are at risk, too.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My family of three traveled to a private condo for Thanksgiving week at the beach on Nov. 21. We brought our own groceries, we drove straight through for 14 hours only stopping for gas and restrooms. We were vigilant with mask-wearing, hand-washing and using hand sanitizer consistently. 

“We did not gather and did not have any contact with anyone other than buying coffee/takeout twice while masked and distanced. The condo had been empty the week prior to our arrival and when we entered, I immediately Lysol-sprayed every room and Lysol-wiped all hard surfaces. We all tested on Nov. 25 to prepare to return home and all tested negative. It was a thorough nasal swab, but we noted it was not as deep or pointy as the tests we have had prior – were not sure if this was a PCR test, our results came back one to two days later (all negative). We returned home on Nov. 28 and all tested again Nov. 29 with PCR swab test and on Nov. 30, two of the three of us were positive and our teenage daughter was negative. We have isolated in part of the house for 10 days, our daughter has been quarantining upstairs for 14 days from Dec. 1. We were fortunately all asymptomatic the entire time. 

“Now that our isolation and her quarantine are over, can we stop wearing masks in our home and can we all sit together again at the dinner table and on the couch or do we need to continue to mask at home? We are fully following measures inside and outside of the home, and practicing good handwashing and sanitizing at home but want to move about the house without masks if possible.”

The answer:

In my opinion, your family of three does not need to mask at home. Outside of your home, everyone should mask. If you have visitors or outside family members in your home, everyone should mask and socially distance.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My boyfriend visited his family on Thanksgiving and tested positive (PCR) shortly after. He did not have a fever but he did experience mild symptoms (cough, chest tightness/difficulty breathing, stuffy nose) and only very recently stopped coughing Dec. 13. I’m wary about seeing my boyfriend even though his isolation period has ended. However, I miss him and it is likely that I won’t be able to see him until the new year if I go home to my family without visiting him this week. Is it wrong/dangerous if we hang out?”

The answer:

Your boyfriend’s isolation has ended, and he can resume normal activities. I do advise him to wear a mask and practice other preventative actions.

Gatherings with family members who do not live with you can increase the chances of getting or spreading COVID-19 or the flu. 

As cases and deaths continue to increase rapidly across the United States, the safest way to celebrate holidays, is to celebrate at home with the people you live with.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter and I both became ill with sore throat, fever, chills, headache – just like the flu. 

“On Day 5, my daughter lost her sense of taste and we had her and my son tested via nasal swab for COVID (he had no symptoms; I was too sick to leave the house and test). She was positive – so it is an assumption I was positive as well since we had the same symptoms, although I was much sicker and still recovering almost three weeks later. Per the health department, we remained in quarantine for 10 days after the first symptom date and my son remained in self-isolation for an additional two weeks. My son tested negative on the first test – and has consistently been negative through several additional tests. My daughter is required to test negative before she can return to certain activities – she has tested inconclusive twice in the past eight days. We are now almost three weeks out from the initial symptom/illness. Is she considered contagious? I have read that inconclusive should still be interpreted as positive and she should not be around others, but other articles indicate she is no longer contagious.”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Thank you for this forum. My husband and I have followed every guidance since the beginning of the pandemic. He is 64 and in excellent shape (triathlete) and the only medical issue he has is asthma. He goes to work every day, where he has a private office and his own lounge area and restroom. And because he is out in the world, he also shops for the items we cannot get delivered.

“Everything we get is wiped down with Clorox wipes before entering our home. I am 56 and retired. I’m fairly healthy having had to retire because I had a viral attack five years ago that made me very sick with inflamed lymph nodes. Otherwise, I take no medications and keep active by walk/running my dog in middle of day when no one is outside. We don’t socialize, we don’t go to bars or restaurants, and celebrated Thanksgiving by ourselves as recommended.

“On Dec. 8, my husband had to use his rescue inhaler in the middle of night (first time in a few years) and was having restless sleep. 

“On Dec. 9, he came home midday feeling sick with flu-like symptoms. I sent him straight upstairs to isolate and began to disinfect all the surfaces, change bedding, etc.

“On the morning of Dec. 10, he was still symptomatic (night sweats, body aches, fever) so we got us both rapid tested for flu and COVID. We were both flu negative, but he was COVID positive. I tested negative for both. 

“In the afternoon of Dec. 10, I began to have a cough, severe headache. Then on Dec. 11, I had a virtual visit with Teledoc because I developed shortness of breath, low-grade fever (100.3) and muscle aches. She said my test was most likely false negative. I will have PCR test and antibodies checked.

“If I test positive, can my husband and I begin to share a space again? Or do we stay separate, because we were infected at different times with potentially different viral loads? I’m very confused about what to do inside our house when both are sick.”

The answer:

There is no problem isolating together, as long as we’re sure you’re both positive. 

Duration of isolation is at least 10 days since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms have improved. Therefore, your husband’s isolation can end on Dec. 19, and your isolation can end on Dec. 20, if no fever and symptoms are improved.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My husband and I took a trip to Disney World with our two daughters and their respective husbands and children. Upon our return, four of the six adults and two of the children tested positive for COVID-19, and the other two adults who had no symptoms whatsoever did not get tested immediately.

“My question is, if my husband and son-in-law’s tests come back positive, do I need to extend my quarantine until he is finished with his? And if they are negative, could they still get sick from the rest of us? Is it common for family members who have not been isolated from sick ones, do not get the virus? I’d like to add that my husband had an antibody test done which came back negative.”

The answer:

Since your husband and son-in-law were exposed to positive individuals, they will need to quarantine for at least a week, even with a negative test result. If they test positive, they will need to self-isolate for at least 10 days from the time symptoms start.

I gather from your question that you are positive. If your husband and son-in-law are self-quarantining away from positive individuals, they are reducing their exposure and along with that, their risk. You will need to maintain your isolation until it has been at least 10 days since your symptoms have begun, you have been fever free for at least 24 hours without medication, and your symptoms have improved.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 • • • • •

“Is there anything you can take for COVID-19 besides the vitamin C DB zinc to help with the healing?

The answer:

I assume you are referring to oral meds and not intravenous remdesivir or monoclonal antibodies.

Dexamethasone (a potent oral or intravenous steroid) is for investigational use, potential clinical benefit for hospitalized patients with suspected or confirmed severe COVID-19 requiring supplemental oxygen or mechanical ventilation.

Olumiant (baricitinib) received emergency use authorization (EUA) by the FDA for use with remdesivir in hospitalized patients with suspected or confirmed COVID-19 patients requiring supplemental oxygen or mechanical ventilation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband started showing symptoms of COVID-19 on the Saturday after Thanksgiving and got tested. I was not really experiencing symptoms, but my employer told me to get tested. Both of our tests were negative. 

“I returned to work. My husband found out he was in direct contact with a positive case, tested again, and came back positive. I then came home to quarantine. My employer told me there was ‘no need’ to get tested due to the fact I live with my husband. She said I was a ‘probable’ case. They started my quarantine on the day I got tested. Ten days later, I returned from work and saw my family immediately. Now I am wondering if there was any chance I did not catch the virus from my husband until the last day of his quarantine (two days before my quarantine ended). Could I be walking around positive? I never developed any symptoms. It feels like an impossible question to answer. I just want to know if I put my family at risk by visiting them the day my quarantine ended.”

The answer:

I can understand your concern for your family. This pandemic has created much worry and anxiety about our loved ones. It is difficult to discern your timeline from what you wrote, but from what you have stated, the risk to your family from the visit is low. The incubation period for SARS-CoV-2 is 14 days, if it has been that long since you have seen your family and you are not sick, then all is well.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Monoclonal antibody treatment seems to be an actual cure for those treated early. It stops the progression of the disease and would certainly stop all deaths and hospitalizations if it was available to everyone. It has been reported that celebrities, the well-connected and very rich people have been privileged to receive this and recover quickly. Why isn’t this available to everyone and why hasn’t this been manufactured so that it is available. People don’t have to die every single day. I have rarely seen this mentioned in the news and am terribly disturbed that we have a way to stop people from dying and nobody is talking about it.”

The answer:

The investigational intravenous monoclonal antibodies have been granted an Emergency Use Authorization (EUA) by the FDA. These monoclonal antibodies will be allocated to state health departments by the U.S. Department of Health and Human Services (HHS) based on case counts and severity of outbreaks. These state health departments will be responsible for allocating the antibody to local health facilities.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My dad presumably got COVID-19 from his brother on Nov. 21. 

“The day after Thanksgiving, my mom was the first person in the household to begin exhibiting symptoms, then my brother, then my dad. Everyone started getting better and my dad’s symptoms peaked on Dec. 9 – since then everyone in the house has been on the up. I want to go home to spend Christmas with them but my dad just took a COVID test on Dec. 17 that came back positive – is it safe for me to visit? I’m also concerned that there might be a living virus lingering in the house on surfaces and such. Is it safe for me to visit so soon after they’ve all just recently started recovering? If my dad did get it from his brother on Nov. 21 – it will have been a month since the initial infection happened. Can I go home on the 24th and not get sick?”

The answer:

I understand how much you want to see your family. The situation that occurred with your family members as a result of the Thanksgiving get together is what Public Health officials are hoping to prevent by asking people to forgo visits over the winter holidays.

Most transmission is occurring when families get together in small groups and don’t practice social distance, wear their masks or wash their hands on the regular. It is easy to feel safe and secure in your familial home.

SARS-CoV-2 thrives in that exact environment. It is a virus that is transmitted via airborne droplets and aerosols. It has a long incubation period before symptoms start and individuals who are infected are contagious days before symptoms start.

Most individuals will be non-infectious after about 10 days of symptoms. There are individuals who are infectious longer, but that is rare.

Your father is likely shedding the virus but is not infectious. The virus causes a significant amount of damage to the body. That takes time to clean up. One infected cell can release between 8,000 and 10,000 viruses. That clean up, done by the body’s immune system, can take weeks. Think of it like this, if you held a party with 20,000 people in your house, it would take some time to clean

up. The party is over, but the garbage remains.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had the virus in March. I was tested for antibodies in June and again in September. I had more than 2,500 antibodies. My husband was just diagnosed positive for the virus. Questions: Can I carry the virus even if I have antibodies? Can I get the virus again? 

“Do I have to be quarantined from him and others?”

The answers:

Excellent questions!

There is not enough information currently available to say if or how long after infection someone is protected from getting COVID-19 again. This is called natural immunity. Early evidence suggests natural immunity from COVID-19 may not last very long, but more studies are needed to better understand this.

It is also not known at this time if you have natural immunity or if after receiving the COVID-19 vaccine, can you transmit the virus to someone who has not been vaccinated or who has no natural immunity. This is why it’s still important to wear a mask, socially distance and practice good hand-washing hygiene after being vaccinated. I’m hopeful that these questions will be soon answered after more people are vaccinated.

Since your husband was diagnosed positive for COVID-19, I recommend you self-quarantine separately. Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Quarantine can end after Day 7 if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if no symptoms have been reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My husband is 74 with heart disease. He has a pacemaker. He had back surgery seven weeks ago because he could barely walk. I take care of him and the household. I am a fairly healthy 60-year-old woman. 

“He will probably be able to get the vaccine early on in the distribution cycle because of his high risk health issues. Will I be able to get vaccinated at the same time he does, because I am his primary source of help? I am basically his caregiver.”

The answer:

I commend you for all you are doing for your family.

Each state has regulations and a distribution plan for the COVID-19 vaccine. I cannot say what the distribution plan is for your state. Given your age, you may have to wait on the vaccine. I suggest you contact your primary care physician for more information regarding your state’s plan.

If you are unable to get the vaccine but your husband is, he will be protected and you can protect yourself (until you can get vaccinated) by wearing a mask, washing your hands regularly and practicing social distance.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“Our 11-year-old grandson flew to Pennsylvania from Miami, Florida, to be with his father for Thanksgiving. He flew there with his other grandmother. In that family gathering, there were two other children (ages 1 and 8) who had been having fever off and on, but nobody knew this. Our grandson started with some symptoms two to three days later as well as the others.

“Our grandson is now positive and also the grandmother and the stepmother. His father is the only negative so far (I suspect it’s false negative). They will stay there and quarantine and wait to retest.

“I have a couple of questions. Should the father (negative and no symptoms yet) isolate and quarantine? Does the family have to isolate separately, from each other if they are all coronavirus positive? After 10 days or a negative test, can he fly back to Miami and does he have to isolate and quarantine again in Florida?”

The answer:

The father is a close contact, and he should self-quarantine separately according to the latest CDC guidelines below.

• Quarantine can end after 10 days without testing and if no symptoms have been reported during daily monitoring.

• When diagnostic testing resources are sufficient and available, then quarantine can end after day seven if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if no symptoms have been reported during daily monitoring.

Other family members who have tested positive for COVID-19 can isolate together, as long as, we’re sure they’re all positive.

In my opinion, your grandson may fly back to Florida after his 10 days of isolation, but he must wear a mask. I don’t recommend that he self-isolate again in Florida; however Florida may have specific requirements for returning residents.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“Can you shed the virus before testing positive? 

“My friend tested negative (PCR), but he lives with his parents who both tested positive yesterday. His parents already spread the disease to their grandchild, so I assume my friend just tested too early, has COVID, but it’s not showing yet on the PCR test. We met him five days ago, and I am worried he already had some viral load going on. Is it possible? I know a negative test doesn’t mean you won’t be contagious later, I’m really interested about the few days before a test turns positive.”

The answer:

SARS-CoV-2 has a process it uses to get into our cells, copy itself, and then leave our cells. This process involves the virus getting into our body and finding the cells that will allow it in. For SARS-CoV-2 it gets in via airborne droplets from our respiratory system or aerosols. It uses a specific protein on our cells called ACE2, this type of protein is a receptor, think lock and key. 

The ACE2 is the lock the virus uses its spike protein as the key. The virus then enters our cells and must remove its outer coating, such as when you come inside from the cold and take your coat off. 

Following this, the virus will begin to make copies of its genome and make the necessary components, the proteins, to form itself again. 

After the virus is formed, it will then escape our cells by taking small pieces of the membrane around the cell with it. Think of it like this, the virus comes into the cell and mounts a hostile takeover, all processes that were happening in the cell for normal life are redirected to make virus.

This whole process for SARS-CoV-2 takes a few days. Most individuals are shedding virus two to three days before they show symptoms. The genome test can detect the RNA of SARS-CoV-2 a few days before symptoms start, the average individual will begin symptoms within five to seven days of exposure, but some will not see symptoms until day 14.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“I apologize that this is long and complicated (at least it feels very complicated to me).

“The day before Thanksgiving, I had to have a COVID test for a routine colonoscopy I had scheduled for the following week. Our plan for Thanksgiving was to have my son, his girlfriend and his roommate home from a local college for the long holiday weekend, and they were all tested with negative results before coming home. I have been phenomenally cautious, seeing virtually no one, only venturing out every few weeks for groceries, always masked and obsessively hand-washing and sanitizing. 

“So no one was more surprised than I was when, on Dec. 1, the nurse called to tell me my results were positive so they would have to cancel a scheduled procedure. (She told me that it had been a PCR test.)

“By this time, my son and his friends had already gone back to school, but I had already spent the previous four days in close contact, indoors and unmasked, with all of them, and with my husband. 

“They all went in for testing that day, as soon as they heard that I was positive, and my husband and I started isolating from each other at home.

“I felt headachy and tired the day after Thanksgiving, with some stomach upset, but attributed it to the previous long days of shopping, cooking and eating. But then I felt completely fine again for another week. Toward the end of the next week, after I’d gotten my test result, I began to feel some very slight burning in my lungs, and a little shortness of breath. 

“On Dec. 7, I called my nurse about it, and she told me I needed to be seen at the ER. I spent five hours there, received blood work, an EKG and chest X-rays, and the hospital felt everything checked out and I was released. My symptoms eased up over the next few days and I had a follow-up in-office visit with the nurse on Dec. 9. She gave me a clean bill of health, told me I’d been lucky, and that I likely had some period of immunity and couldn’t spread the virus for as long as that lasted. Since then, everyone I spent Thanksgiving with have all had second tests, and have all still come up negative. I requested a second PCR test at my nurse’s visit and got the results back Dec. 12 and they were negative as well.

“I know that it is virtually unheard of for PCRs to give false positives, but I am wondering how reasonable it is for me to accept the scenario that I cooked and served Thanksgiving dinner to four people yet none of them contracted the virus. And that my followup test was negative even though the contact tracing nurse who called me after my initial positive told me I shouldn’t even retest for several months because I would probably keep testing positive due to low levels of the virus in my system. My symptoms were so mild, and could easily have been allergies, or anxiety. I was planning a visit to my elderly mother in another state in January, thinking that since I had immunity and couldn’t infect her, that now would be perfect timing. But now I am reconsidering it, and I am really questioning the likelihood that I even had COVID at all?

“What do you think?”

The answer:

A positive swab molecular Polymerase Chain Reaction (PCR) test for COVID-19 is highly accurate. 

You could consider a blood test for SARS-CoV-2 IgG antibodies. If that blood test is positive, it indicates you were previously infected with COVID-19, but it doesn’t give the exact date.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

If your elderly mother did not receive both doses of the COVID-19 vaccine, I advise not visiting her.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband is in his 70s and has cancer. I am in my 60s and in good health. Our 22-year-old son lives with us and is in excellent health. If my husband gets the COVID-19 vaccine, can he give the virus to my son and I, who live in the same house? I sleep in the same bed as my husband and this concerns me.”

The answer:

The vaccine for COVID-19, whether it is from Pfizer or Moderna, contains no virus. Instead, what these vaccines contain is RNA. RNA is a biological molecule that is nucleic acid. Most of us are familiar with DNA, the biological molecule that holds all our genetic material and is a nucleic acid. DNA is used to make RNA in a process called transcription.

Think of it like this if you wanted to write “Hello” in Spanish you’d write “Hola.” They are the same word with the same meaning just using a different set of letters. That is what happens with DNA and RNA, same message different make-up. That RNA is then translated into proteins, another type of biological molecule that does the work. If you wanted to turn “Hola” into a gesture, you’d wave. That is like what occurs in translation of RNA into proteins. You turn a word into an action.

The COVID-19 vaccines have a bit of SARS-CoV-2 RNA in them, the bit that makes the spike protein. The spike protein is what the virus uses to get into our cells. Our bodies will take the RNA and translate it into this spike protein. Then our immune system will recognize that spike protein as something to be destroyed and mount a response to it. This response will generate antibodies that will protect us, with 95% certainty, from infection with SARS-CoV-2.

Some vaccines have what is called live virus contained in them and can result in someone who receives that vaccine being contagious with the pathogen. Since the COVID-19 vaccine is only RNA, it cannot be transmitted. There is no risk of acquiring the infection from someone who has been vaccinated.

One last thought, while this type of vaccine has not been approved for infectious diseases before, it has been extensively studied in animal models with viruses such as Zika and Influenza. In fact, there is a Zika RNA vaccine in clinical trials currently. Also, this type of vaccine has been in use for cancer therapies for a few years now.

Anyone who is interested in more information on this, please read this review article: https://www.nature.com/articles/nrd.2017.24

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Our family has been very careful because my husband is a kidney transplant patient and is on immunosuppressants. He is 64. I am 60. My adult son lives with us and he would like his daughter to come for Christmas. She attends in-person school.

“All of us work, but we wear masks and social distance. Our house is a small three bedroom and we would have me and my husband, my daughter and her son (working and schooling at home) and then my 32-year-old son and his 14-year-old daughter. Is this safe or should we not do this?”

The answer:

Gatherings with family members who do not live with you can increase the chances of getting or spreading COVID-19 or the flu. As cases and deaths continue to increase rapidly across the United States, the safest way to celebrate holidays is to celebrate at home with the people you live with.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I work in a long-term care facility and am tested twice weekly. The second swab (PCR) I had on Nov. 26 came back positive. I began quarantine the day my results came back, but never had any symptoms. I decided to be tested again on Dec. 1. The rapid test came back negative as did the PCR.

“Is it possible the positive PCR was a false positive? I had zero symptoms during my entire quarantine. I would think I would still have some viral shedding at the time of my second test and it too would have been positive if I had the virus.”

The answer:

A positive molecular Polymerase Chain Reaction (PCR) swab test is highly accurate, and I doubt the positive PCR was a false positive. Studies have suggested that 40% to 45% of individuals infected with the SARS-CoV-2 (COVID-19) virus may have no symptoms at the time of testing.

If you are not immunocompromised, I recommend you self-isolate at least 10 days since the date of your positive PCR test result. If you are immunocompromised, then I advise you to self-isolate at least 20 days since the date of your positive PCR test.

– Dr. David Csikos, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“CDC guidelines currently state if you had COVID in the past three months and have had close contact, you do not need to quarantine. What would be the recommendation for someone who still has antibodies, but had COVID six to nine months ago and has had close contact with someone?”

The answer:

• Quarantine can end after 10 days without testing and if no symptoms have been reported during daily monitoring.

• When diagnostic testing resources are sufficient and available, then quarantine can end after day seven if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband had a routine colonoscopy on Nov. 2. He had to have a COVID test prior to that. He did on Oct. 30. It was negative. He received a phone call on Nov. 1 that a colleague he was around tested positive on Oct. 28. He had his colonoscopy on Nov. 2. After the procedure, he started feeling extremely fatigued. This got worse each day for six days. He couldn’t get out of bed. Had no appetite. Had chills and then would wake up in a sweat.

“I took him to the urgent care on Nov. 6 and he was again tested for COVID. They told us to just go home and for him to rest. At this time, I had put him in the spare room on Nov. 5. We also have a spare bathroom. He was no better on the 9th. I called his doctor. Was told to take him to the ER because he was severely dehydrated. His COVID test result still wasn’t in from the 6th. The hospital gave him a rapid test and it was positive.

“He was admitted into the hospital for four days. He never lost his sense of smell or taste, didn’t have any breathing issues, was just extremely fatigued with no appetite. The hospital did all kinds of blood work and chest X-rays. He had pneumonia and a small patch of the COVID in one of his lungs. They started him on the remdesivir drug and others. How did I not get it? I was tested a few days after his came back positive and I was negative. I also had the antibody test done. It was negative.”

The answer:

One possible explanation is your immune system neutralized the virus, and the SARS-CoV-2 (COVID-19) IgG antibodies did not stay long in your body.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’m a teacher, so I believe I am in the next phase to be vaccinated. If I am vaccinated and my husband is not, can I bring the virus home to my husband?”

The answer:

First, thank you for all you are doing. I am sure teaching in these times is challenging.

This is a great question. The COVID-19 vaccine is made of RNA, a nucleic acid that is like DNA. While DNA is used to house our genetic material, RNA is used to make proteins. When the immunization for COVID-19 is administered, RNA from SARS-CoV-2 is placed into the body.

This RNA is packaged in another type of biological molecule, lipids.

This packaging allows the RNA to get into our cells without being destroyed by our immune system.

Once inside our cells the RNA is made into proteins by a process called translation. Think of it like this, the RNA is a noun (let’s say it is the noun snow) the process of translation turns that RNA into a protein that can do something (the noun snow to the verb snowing). What that protein does is cause our immune system to make antibodies to it. These antibodies will protect us against the infection.

Since there is no virus, there can be no possibility of someone who receives the vaccine being contagious. You can safely get the vaccine and not be contagious, because this vaccine does not have the virus in it.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I recently was tested for COVID and my results came back negative.

“My other family members have isolated themselves to the main portion of the house away from my room to keep the distance as to not spread it to me as all three have tested positive. Once my two weeks of quarantine are over, is leaving my house and staying somewhere else the safest option?”

The answer:

When you are finished with your self-quarantine, your other family members should be out of isolation unless they are immunocompromised.

Wherever you might go, you may be at similar or higher risk. Hopefully, the COVID-19 vaccine will soon be available for you. I recommend you continue preventative actions including wearing a mask, practice social distancing and good-hand washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’m 47 and healthy. I was diagnosed with COVID-19 on Nov. 26. I have since tested negative. I have noticed shortness of breath sometimes, and some chest discomfort. I have a doctor’s appointment scheduled for early January. Should I be trying to reschedule sooner?”

The answer:

Yes. I’m always concerned when a patient has shortness of breath and chest discomfort because that may indicate something serious.

However, a study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at least one symptom, particularly fatigue and shortness of breath. Other persistent symptoms included chest pain, cough and loss of smell.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Class 10 ... Suppose, your friend has been diagnosed with COVID-19.

“He is in home quarantine. You have called him to know about his parent’s condition. Now, write a phone-based dialogue between you and your friend.”

The answer:

I am a college professor; I will not do your homework for someone else’s class.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My sister had COVID in Iowa (tested positive with PCR test on Nov. 4) and is on about Day 40 since symptoms began. Her symptoms have improved, she was cleared by the County Health Department after 10 days, and she received a negative rapid antigen test just last week, as did my 8-year-old niece (who was never tested for COVID, but had symptoms for one or two days the week of Halloween and is likely who gave it to my sister after getting it at school).

“My sister is moving to where I live in Texas permanently, and will be staying with me in our house for the time-being. She’s flying.

“She and my niece have appointments here in Texas to get PCR tests done to ensure they are negative as Iowa would not allow them to retest due to limited supplies. Do my sister and niece need to quarantine from the rest of our household until they get the PCR test results to ensure they have cleared the initial infection, quarantine for 14 days since she is traveling and also said goodbye to our immediate family last night (all wearing masks, but were in a closed space for several minutes with people outside the household)? Or is this a case of since she already had COVID in the last three months neither need to quarantine at all or wear masks in our house for 14 days?

“We are trying to be safe, but not overdo it or cause my sister and niece to feel stigmatized because they had COVID.”

The answer:

Thank you for your question. If we look at reinfection rates of the seven other coronaviruses, it is possible to predict how long immunity will last for SARS-CoV-2.

There are a total of seven coronaviruses that infect humans, four cause the common cold, one was SARS, one was MERS, and then SARS-CoV-2.

Of the coronaviruses that cause the common cold, we see immunity lasting about a year. To be abundantly cautious (because science is still learning about SARS-CoV-2), science suggest immunity to SARS-CoV-2 can last for six months.

This is an approximation and may change as more research is conducted.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I was waiting in line, outside a building, to get a COVID test. The person who was about 10 feet away from me informed the testing agent that he/his daughter were exposed to someone who was COVID positive (they didn’t seem to have any symptoms).

“Is it possible for me to get COVID from these individuals? We were outside for roughly 10 minutes and were all wearing masks and I never came near them.”

The answer:

I believe your risk was very low.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My two children and their families live in the same city as my husband and me.

“We are all healthy and being very careful. All of our grandchildren go to school and so far their schools have had no COVID cases. If each family quarantines at their home – no going out, even to the grocery store – from the last day of school, for seven days, are we safe to spend Christmas Day together?”

The answer:

I understand the desire to see family during the holidays. There is risk in gathering with people outside of our immediate households.

We all must decide how we want to spend our risk bank. It is known that a large portion of community spread is coming from small gatherings with people outside of your immediate household. Some states have limits on gatherings in family homes.

While your plan to self-isolate for seven days and then get together will decrease your risk, the incubation period (time from exposure to symptoms) is 14 days.

There is risk associated with your plan. Many public health experts are urging all to “Stop Swapping Air.”

If we stay home this holiday season, we are protecting next holiday season.

As always, the risk assumption is yours, but there are many ways to gather without being in the same place.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife of 42 years was positive for COVID-19. I’m negative, no isolation in our house. Second testing and I’m still negative, then she is also negative. I’ve been exposed to many viruses in my career as a respiratory therapist, for 32 years. ER, ICUs were my specialty. Could I have immunity?”

The answer:

Yes.

For you, I would consider a blood test for SARS-CoV-2 IgG antibodies. If that blood test is positive, it indicates you were previously infected with COVID-19, but it doesn’t give the exact date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“At the end of July, I got a COVID-19 test and the results came back and said ‘ruled out.’ Does that mean that I am immune to the virus or does that mean that I just didn’t have the virus at the time that I was tested?”

The answer:

I can’t answer your question because I don’t know the type of test you had.

I suggest you consider a blood test for SARS-CoV-2 IgG antibodies. If that blood test is positive, it indicates you were previously infected with COVID-19, but it doesn’t give the exact date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • •

“I am a teacher. My aide had COVID and her quarantine period is expired. However, her husband has now tested positive and is very sick and has been hospitalized. I am concerned because I have not had the virus and she will be working next to me in the classroom. My boss had made it mandatory for her and myself to work even though we have no students and have in the past worked from home via computer. Am I at risk? I have two daughters and a husband that I love and don’t want to bring risk to them.”

The answer:

I understand your concern. When someone has had COVID-19, their body will develop a response to SARS-CoV-2, the virus that causes the disease. This response allows the body to recognize and remember the virus. The body develops antibodies to the pathogen and has them ready to respond if exposure occurs again. Antibodies are made specifically to the pathogen and can react to neutralize the pathogen. 

These antibodies can prevent the virus from entering your cells and can aid in the removal of the virus from the body.

Given that you have recovered from COVID-19, you have antibodies to the infection. There is evidence of reinfection with SARS-CoV-2 in some individuals who have had COVID-19, but those numbers are very low. 

Most individuals who have recovered from COVID-19 are protected from reinfection for at least six months or more. This six-month number may change as more data on exposure and reinfection becomes known.

In the meantime, keep washing your hands, wearing your mask and practicing social distance.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • •

“I am a Type 1 diabetic and on Day 8 of COVID diagnosis. I have been in full isolation and starting to feel better. My daughter started having symptoms and is now isolating in her room awaiting test results. If she tests positive, can she join me in my room so I can care for her? And if yes, 1) do I need to restart my 10-day isolation; and 2) if she joins me, can my COVID recovery decline due to more exposure to the virus? I am not worried about getting sicker, but my family is very worried about having her join me since I am diabetic. I of course, will also ask my doctor, but appreciate your input if you are able.”

The answer:

Regarding your daughter:

People can be isolated together as long as we’re sure they’re all positive. There’s no problem in having multiple people isolate together.

Regarding yourself:

You do not need to restart your 10-day isolation period. There is not enough information currently available to say if or how long after infection someone is protected from getting COVID-19 again.

I agree that you need to speak with your doctor for further advice and instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

“I tested positive for COVID last week and accidentally exposed my boyfriend. (A nurse from my work accidentally read my PCR results wrong and told me I was negative, so I saw my boyfriend. She called me the next day to correct the mistake). My 10-day isolation ends tomorrow and I am returning to work at a skilled nursing facility where I will be working on our COVID unit (due to an outbreak).

“My boyfriend now needs to quarantine since I exposed him but cannot safely do so at home due to his large family. Is he OK to quarantine at my apartment, even though I will be returning to work? (Again, I just recovered). Is it possible he could reinfect me if he ends up getting sick, even though I was the one who got him sick?”

The answer:

Regarding your boyfriend:

Ideally, people should quarantine separately.

Regarding yourself:

There is not enough information currently available to say if or how long after infection someone is protected from getting COVID-19 again. This is called natural immunity.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My son had sinus infection symptoms for four days ... took the COVID test because a fever of 101 appeared ... was given dexamethasone 10 mg for days ... fever has been gone for three days. Today having tickle in his throat and bringing up mucous from his throat. Is he on his way to recovery? Out of the danger period?”

The answer:

It sounds like he is recovering.

If his PCR (molecular Polymerase Chain Reaction) test is positive for SARS-CoV-2 (COVID-19), 10 days of isolation is recommended since symptoms first appeared.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband’s job is out of town so he comes back home every two weeks. I am so terrified to have sex with him. What can I do?”

The answer:

I recommend the COVID-19 vaccine when available.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

“I have a question about the test my friend did back in Samoa. He said one side of his nose is negative and the other side is positive. Is it possible to get result like this?”

The answer:

Your question is difficult to answer because of several unknowns.

I don’t know the type of test that was done (molecular Polymerase Chain Reaction – PCR or rapid antigen). Did your friend have symptoms? Was your friend a contact of a person with SARS-CoV-2 (COVID-19) infection?

However, a positive test result is very concerning for COVID-19 infection.

A negative test result from the other nostril may be a false negative due to sampling error.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I share a very small office in a hospital with someone who tested positive for COVID-19. We job-share so we don’t work on the same days, so I was never in contact with him in person, but he worked on Friday in the office and I worked on Saturday in the same office. I cleaned all surfaces on the table, the computer keyboard and the phone. I did not clean the doorknob. I was in the office about 14 hours after him. 

“Could I have gotten it by breathing the air in the office? 

“I took off my mask to eat lunch in the room and to have a mask break. Please let me know the chances of me getting it if I was never in contact with my co-worker but I was in the same office he was in 14 hours after him. The door is usually closed and not left open.”

The answer:

In my opinion, your risk is low.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I just got a positive test result back from an RT PCR test, supposedly the most reliable. This was my third test over about a month’s time period and was done at Day 25 of having COVID, which puts me at Day 28 of quarantine as I write this. All three tests have been positive. My wife was traveling before I got this virus so she was not exposed to this virus by me, but since her five-day trip back on Oct. 30, she has not been back in the house. Main reason is that she cares for her elderly parents the next street over.

“I have been told that if I test positive, I am contagious. On the other hand, my symptoms seem to pretty much gone, but I can’t really tell what was COVID or my normal allergies. How long can this go on? I am on a month of quarantining. When can my wife come back home?”

The answer:

The guidance regarding when it is safe to leave isolation after COVID-19 is:

1. You are fever-free for at least 24 hours without medication; 2. It has been at least 10 days since symptoms have begun; and 3. Your symptoms have improved.

Some people will test positive for SARS-CoV-2 for a few weeks to months after the contagious period has passed. Our immune system can take some time to clear or clean up the infection. 

For some that clean up happens quickly and for others it can take a long time.

Since you reported a significant decrease in your symptoms and it has been 28 days, you can resume you post-isolation habits. Please continue to wear your mask, wash your hands regularly and maintain social distance.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My 70-year-old sister who stays home most of the time is in the hospital with COVID-19 and pneumonia. One of her daughters stays with her but she and her sisters think coronavirus is a big government lie and won’t wear masks. They won’t go get tested. So if my sister makes it out of the hospital, what can I do to protect her? I’m in Arizona and she is in Michigan.”

The answer:

I recommend you contact the social service worker at the hospital where your sister is admitted and request home health and elder protective services.

I also advise you to contact the local health department in the county of her residence for further information and help.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“If you got the vaccine, can you be around others who did not? Can you get them sick while your body adapts to the vaccine?”

The answer:

I’m anticipating the coronavirus vaccination guidelines will be released within two weeks.

I recommend continuing preventative actions including masking, social distancing and good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“My husband and I attended a funeral 14 days ago. We had symptoms six days ago and got two negative tests, needing one more to clear. We just learned a woman from the funeral tested positive, but I am not sure of her details. Should she contact all the people from the funeral?”

The answer:

In my opinion, that would be good stewardship.

If she tested positive for COVID-19, I anticipate the local health department will contact her and give instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I came across your page, and read more than 50 situational questions trying to look for an answer similar to my COVID experience, before I thought to just write in directly.

“On Oct. 21, I started feeling flu-like symptoms. Cold, high temperature, body aches, sore throat. And that lasted about five days, and I got tested once my symptoms stopped, which came back negative. 

“Then about a week later, I started to lose my senses of smell and taste, and I just knew what this was. I got a rapid test (nasal), and it came back positive. I quarantined for 10 days, and got tested again (throat), and it came back negative. 

“Cut to Nov. 24, I went to get a regular PCR (nasal), and it came back positive. Is it common to continue to get positive results although you do not feel any symptoms and it’s been well over 14 days? Is there a difference between being positive vs. being infectious (in this case)?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My wife had what we thought was a sinus infection in July, when she lost her sense of smell and taste for five days and we began to think COVID. We stayed home, no masks, no staying in separate rooms, ate together, slept together. In August, she had a physical and got an antibody test, it came back positive. My question is, why was I fine? No symptoms whatsoever, and in September I got an antibody test, came back negative. I will say, I am on a strict vitamin regiment, exercise regularly and am not overweight, with no medications.”

The answer:

One possible explanation is your immune system neutralized the virus, and the SARS-CoV-2 (COVID-19) IgG antibodies did not stay long in your body.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband developed cold symptoms in his sinuses. His boss told him he had to get a COVID test. He got a 24-hour test on Nov. 24 and was supposed to have the results on Nov. 26. Because he still didn’t have the results on Thanksgiving, he scheduled a 15-minute rapid test on Nov. 29. Since I work in a health care setting, I also scheduled a rapid test for the same day. My test was done at a different location than my husband’s. Both of our rapid tests were negative. Is there a chance we both have false negatives, or could it be that my husband had a false positive with the 24-hour test?”

The answer:

If your husband’s positive 24-hour test result was a molecular Polymerase Chain Reaction (PCR), that is highly accurate, and in my opinion, his negative rapid antigen result is a false negative.

I can’t say for certain if your negative rapid antigen test result is a false negative. However, you are a household contact and should self-quarantine separately. CDC currently recommends a quarantine period of 14 days. Quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My mom, who is 78, tested positive on Nov. 18 after first showing symptoms on Nov. 3 because she has diabetes and COPD. She had more severe symptoms and had complimentary oxygen at home for 11 days now; although she is much better she still needs oxygen from time to time. I live with her and tested negative on Nov. 23, although I couldn’t smell or taste anything from Nov. 3-16. I also took an antibody blood test which came back positive. My question is: when can we get in contact with people again?”

The answer:

Regarding your mother, 20 days of isolation since symptoms first appeared (Nov. 3) is adequate considering her diabetes, chronic obstructive pulmonary disease and severe symptoms.

You are a household contact. New onset loss of smell is a highly specific symptom of COVID-19. You didn’t mention the type of negative COVID test or which SARS-CoV-2 antibody was positive.

The possibilities include a false negative COVID test. If the positive COVID antibody blood test was IgG, that means you were previously infected with the SARS-CoV-2 (COVID-19) virus, but it doesn’t give the exact date.

If you are not immunocompromised, 10 days of isolation is recommended since symptoms first appeared.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If a person tests positive and has symptoms, when the illness is over will they test negative? Or does one continue to test positive even when they are well? 

“For instance would Donald Trump still test positive?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My 21-year-old daughter spends about two to three nights per week at her boyfriend’s house. She found out her boyfriend’s dad tested positive for COVID. He is a physical therapist and is rapid-tested every day for work. On Nov. 27, he tested negative – no work Saturday and Sunday 

– and tested positive Nov. 30. My daughter was with his dad for 10 to 15 minutes about 6 to 8 feet apart with no mask on Nov. 25 and Nov. 30. She had dinner with them on Nov. 17. He has no symptoms. His entire family is self-quarantining. Her boyfriend got a test on Dec. 3 but still isolated after. Does she need to quarantine for two weeks, even if she gets a negative test? I have heard the rapid tests are not reliable. Should she only do a PCR? And if her boyfriend tests positive, does she then need to isolate for 14 days from the last time she saw him? Should she go to work? Should we not eat together?”

The answer:

Your daughter is a contact of a person with SARS-CoV-2 (COVID-19) infection.

CDC currently recommends a quarantine period of 14 days. However, based on local circumstances and resources, the following options to shorten quarantine are acceptable alternatives.

• Quarantine can end after 10 days without testing and if no symptoms have been reported during daily monitoring.

• When diagnostic testing resources are sufficient and available, then quarantine can end after Day 7 if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I read through several of the answered questions until I just couldn’t read anymore. Would appreciate if someone could reply as I feel my circumstance is a little different from the answered questions.

“We are a family of four who live together in a single-family house – only one bathroom. On Nov. 13, my husband and 9-year-old went to grandma’s house. 

“On Nov. 16, grandma finds out she was exposed to someone who tested positive for COVID. On Nov. 17, the 9-year-old starts low-grade fever, gets tested via nasal swab at pediatrician’s office.

“On Nov. 21, I became very fatigued, severe headache, congestion, cough and loose BMs. It only lasted a few days. 

“On Nov. 23, results come back that the 9-year-old was positive. We were told about the quarantine – 10 days from the day she started symptoms and we continue and add 14 days from when she ends it. On Nov. 26, our other daughter (19) starts with congestion, overall not feeling well. No fever, little cough. Nov. 30, husband, 19-year-old and myself do a virtual call supervised saliva COVID test. I was already feeling better, 19-year-old still feeling crappy, husband with zero symptoms.

“The results come back on Dec. 2 and my 19-year-old is positive and my husband and I are negative. Does this mean we have to start quarantine all over again like the previous time? Meaning 10 days for the one who is positive and then we add another 14 days after she ends hers? 

“Also, could I have tested negative because I never had it or was it because it was no longer in my system? We weren’t given detailed information from the pediatric office about being 6 feet apart, isolating and/or wearing masks and gloves while indoors.”

The answer:

I do not wish to be the bearer of bad news, but since many members of your family are ill you will have to maintain your self-quarantining until 14 days after your daughter’s symptoms cease. Recent guidelines from the CDC suggest that if you cannot maintain the 14 day self-isolation to isolate for at least 7 seven days.

The incubation period for SARS-CoV-2, the time from exposure to symptoms, is 14 days. That is why the self-isolation is for 14 days. The recent change in the recommendation stems from compliance. Many cannot or will not isolate for 14 days, so at the very least the CDC is requesting individuals to isolate for seven days from exposure. The thought here is that some level of compliance is better than none.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I would like to know if you have tested any of the unused clean nasal swab test kits to see if they test positive without ever being used. There is growing speculation and concern that the nose swabs and other tests are the current means used by the virus perpetrators using this transport mechanism after media perpetrations of an upswing in cases and inciting fear to get tested. With the large amounts of testing now causing transmittal of COVID to normally healthy people, thus causing the huge virus upswing in this fall’s flu season.”

The answer: 

At our medical center, all testing kits and swabs received from manufacturers are labeled sterile and single use. We use only single, sterile wrapped and sealed swabs. All test kits are prepackaged, sealed, have stamped expiration dates, and are inspected for clear and uniform quantity in each tube.

After collection, the test samples are placed in a clean biobag and transported to the lab for testing. Test cartridges cannot be reused and there is no chance of cross contamination between tests.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband and I both tested positive for COVID-19 in early October. I had mild symptoms while my husband had moderate symptoms. We quarantined for 14 days and recovered. I had a small stroke in 2018, and my husband was diagnosed with COPD in 2010. My question is: Should someone who tested positive for COVID-19 get the new vaccine? Will the vaccine benefit someone who has already tested positive for COVID-19?”

The answer: 

Important and excellent new question concerning vaccination. 

There is not enough information currently available to say if or how long after infection someone is protected from getting COVID-19 again. This is called natural immunity.

Early evidence suggests natural immunity from COVID-19 may not last very long, but more studies are needed to better understand this. Until the vaccine is available and the Advisory Committee on Immunization Practice makes recommendations to CDC on how to best use COVID-19 vaccines, CDC cannot comment on whether people who had COVID-19 should get a COVID-19 vaccine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“I am a nurse who works with chemotherapy patients. My husband had a cough, so we both were tested. Surprisingly, he was negative and a few days later my test said I was positive (both PCR tests). So we both isolated for 10 days. He is still coughing even after an antibiotic for possible sinus infection. Now, he retested and is positive from another PCR test. Since his symptoms haven’t improved since isolation (same cough) and he now tested positive, I understand it’s best for him not to return to work. Does he isolate until the cough is gone and see MD again for possible steroids and inhaler? As for me, is it OK that I return to work now that my isolation is completed? (I have been asymptomatic). 

“Or do I need to isolate again now that my husband officially tested positive? Is it possible that first test my husband took was inaccurate? He also could have been exposed a couple days afterward when he was with a hunting group – two members later found they were positive.”

The answer: 

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with COVID-19 shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

If you and your husband are not immunocompromised, at least 10 days of isolation is recommended since symptoms first appeared and at least 24 hours have passed since your last fever without the use of fever-reducing medications, and symptoms have improved. If you or your husband are immunocompromised, then at least 20 days of isolation is recommended since symptoms first appeared.

A study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at least one symptom, particularly fatigue and shortness of breath. Other persistent symptoms included cough, loss of smell and distortion of taste.

I recommend your husband contact his physician as soon as possible for further instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter had COVID and recovered three weeks ago and is now home from college. She and her boyfriend went out dancing and now he is positive for COVID. I am wanting to know: even though she has had it, can we get it? Is it possible for her to be around someone who is actively positive for COVID and put the rest of family at risk?”

The answer: 

SARS-CoV-2 is spread via airborne droplets and aerosols. While data show that the virus can be found on surfaces for a time period, it is not the main route of transmission.

I suggest that you have your daughter avoid visits with her boyfriend until he is fever-free for 24 hours, it has been at least 10 days since his symptoms have started, and he has seen improvement in his symptoms. He should be self-isolating until the above are completed as well.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • • 

“My whole family was exposed to COVID when my niece got sick at Thanksgiving. They left immediately after they realized she was running a fever. 

“We quarantined, waiting to see if anyone was showing symptoms, but everyone remained asymptomatic. My son, who works as an RA at his university, had to be tested in order to return to work. He tested positive. So we went and got tested, too. About a week had gone by since the exposure. My two teenage sons and I tested negative but my husband tested positive. My brother and his whole family, my niece’s family, also all tested negative. 

“How is this possible? This goes against everything we’ve been told about COVID spread. Are there false positives?”

The answer: 

Several factors come into play when you are determining level of exposure and then infection. Just because you are exposed to an infectious disease does not mean you will become infected. An infectious dose is required to become infected.

Were you in the same room for 15 minutes or more without masks? Who was sitting closest to the niece? Was the niece coughing, SARS-CoV-2 is transmitted by airborne droplets and aerosols? Did you have adequate ventilation in the rooms?

It can be very confusing to hear the recommendations of public health professionals, scientists and physicians, and then see how they do (or don’t) apply to your specific situation. Think of it like this, the average body temperature for humans is 98.6 degrees Fahrenheit. Some people have a daily body temperature of 97 degrees Fahrenheit and some people have a daily body temperature of 99.7 degrees Fahrenheit. When you average all of humanity together, we get the 98.6 number.

Science can tell you the facts about the virus, but there are small nuanced differences to each situation.

What I can tell you is that the incubation period is 14 days. Since you mentioned that you were tested a week into the incubation period, it is possible that you (and others in your family) will still come down with symptoms.

You asked about the testing and false negatives. The genome test for SARS-CoV-2 is highly specific and sensitive if a person is 3-4 days away from symptoms.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I tested positive for COVID-19 on Nov. 5 (loss of smell was my only symptom). After my 10-day isolation period, I moved into a new house with my fiancé and her two kids (Nov. 15). Although I kept social distance by sleeping in a guest room, and continued to wear a mask, my fiancé tested positive Nov. 18 (only symptom was a headache and light cough).

“The two kids have been social distancing while my fiancé has been isolated in her room since her positive test. I have now tested negative. My question is, since I recently recovered, when is it safe to be around her? 

“And since the kids haven’t experienced any symptoms yet, when is it safe for them to be around her again?”

The answer:

Individuals are considered not contagious if it has been 10 days since symptoms have started, their symptoms have improved, and they have been fever-free for at least 24 hours without medication.

Since your fiancé tested positive on Nov. 18, if her case is not severe, it is safe to resume interactions on Dec. 2. You are clear of infection and should be OK to interact with anyone. 

Please continue to wear masks in public, practice social distancing, and wash your hands regularly.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My parents are recovering from COVID in Florida. They were not planning to travel here to spend Christmas with us in Minnesota before becoming infected with the virus for fear of getting sick. We have had no contact with them since March. Now they are wanting to come to Minnesota to spend Christmas with us because they think they will be immune for at least 60 days and there is no longer a risk. 

“We are unsure about whether or not there is a risk to us? Would you recommend allowing them to come? None of us are high risk but would not want to get sick. We are really not sure what to tell them.”

The answer:

I understand the desire to see family over the holidays. Data is still coming in regarding immunity and reinfection with SARS-CoV-2. This virus is a coronavirus and reinfections with the four coronaviruses that cause the common cold occur after an average of 12 months. Data on SARS-CoV-2 specifically suggest that individuals who have had COVID-19 are protected for six to eight months.

With the immune response, the greater the severity of the infection the more robust the immunity to it. Becoming infected with any pathogen is going to mount some level of immunity to it. Several factors must be taken into consideration when determining the level of immunity generated: the person’s overall health, diet, lifestyle and age.

I hope this information helps you to make your decision.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband tested positive via a saliva test for COVID on Nov. 5 after having symptoms of a head cold and losing his taste and smell. He has been isolating in a separate room. I had a saliva test and was negative and have no symptoms. I have been quarantining since the date of his positive test. My question is, when his 10 days in isolation is done, can I be around him and just continue quarantining from others? Or do I need to continue quarantining from him as well?” 

The answer:

You are a household contact, and the CDC currently recommends a quarantine period of 14 days. Quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband was exposed directly between Nov. 4 to 7. When we found out, we both got tested Nov. 9 and received negative results back on the 10th. On Nov. 13, he started to show symptoms, so I scheduled him another test for Nov. 15 and he was positive this time. I decided to get retested so I would have a quarantine time line and got retested on Nov. 19 and just received negative results again. All of our tests were the PCR test. How is this possible, we have taken zero precautions at home between us? Also, how long do I have to quarantine if I have been exposed for over 16 days now.”

The answer:

Regarding your husband, if he is not immunocompromised, he can stop isolation after at least 10 days have passed since his symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms have improved. If your husband is immunocompromised, then at least 20 days of isolation is recommended since symptoms first appeared.

You are a household contact and should self-quarantine separately for 14 days. This will be 14 days from the date your husband with COVID-19 is released from isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I was dating a guy before the pandemic who works in retail. When the pandemic hit, we stopped dating because he was still interacting with customers on a daily basis. In May or June, he got COVID. I’m wondering if that means I could start dating him again or would I be at risk of him passing on germs from his customers even though he has already had the virus? I really liked the guy and it would be great to be able to see him again, but I definitely don’t want to put myself at risk and I also have roommates who I can’t in good conscience put at risk.”

The answer:

An interesting question, who’s safer?

Regarding the guy you previously dated, reported COVID-19 reinfection rates have been low to date. It is not known for certain how long antibodies stay in the body after infection, or how long protective immunity may last. And you may be at higher risk from your roommates.

Hopefully, the vaccine and broad immunization will soon be available.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I have a close friend who is a 30-year-old male. He was diagnosed with the COVID-19 while taking a flight. They sent him directly to ICU and then he started coughing up blood. That was almost two months ago. He has edema in his lower extremities. 

“He has tested again positive for the COVID-19. What is his chances of full recovery? Will he be a carrier all his life? Can he give it to someone that is 73 years old? Even if he’s tested negative attended some school last year? Will he always have a disability?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

His prognosis for full recovery depends upon his immune status, if he has any preexisting medical conditions, and whether he develops lung or heart problems from the COVID-19 infection. His young age is a good prognostic factor. I’m certainly hoping for a full recovery, and time will tell.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“Can a person with a severe urinary-tract infection with e-coli in his/her culture throw a false positive for a test?”

The answer:

No.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I work with people with autism. We try and keep their masks on as much as possible, but because they are people with disabilities, they are exempt from the mandate. On Monday, I worked with an elementary-aged patient with autism at their school. The patient did not have his mask on and I was within 6 feet for an hour and a half. 

“Tuesday, I was around the patient, but was able to socially distance. Again, the patient did not have his mask on for most of the time.

“On Wednesday, at around lunch time, the patient developed a fever. The fever stuck around with a sore throat for less than 24 hours. So, the patient was essentially sick for less than 24 hours. 

“The patient’s exposure was from six days prior. On Friday, the patient tested positive via a rapid test. Patient has been asymptomatic since Thursday afternoon. Patient’s mother and twin sibling both tested negative.

“I took a rapid test on Thursday as well as Sunday. Both of which returned as negative. I also took a PCR on Sunday. Do I need to still self-quarantine? This is day five with a negative COVID test and from what I understand most symptoms show up within five to six days.”

The answer:

Yes, you should self-quarantine separately for 14 days. You are a close contact of a person diagnosed with COVID-19. Negative rapid antigen test results do not rule out COVID-19 infection. Also, the mean incubation period for the SARS-CoV-2 (COVID-19) virus is estimated to be five days with a range of two to 14 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I am being treated for CLL with prednisone

(10 mg) and Rituxan intravenously every three months. Will I be able to take the vaccine when it becomes available.”

The answer:

The coronavirus vaccine immunization guidelines have not yet been approved and released. When the vaccine becomes available, I recommend you discuss vaccination with your treating medical oncologist.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I saw your website in which questions were being asked in regard to COVID and how certain situations should be handled and I wanted to pose a question from an employer perspective. We had an employee test positive for COVID-19 (via nasal swab) at the end of September. The employee was asymptomatic at the time and never showed any symptoms, but we had this employee work from home for a period of two weeks.

“This same employee got tested again with a nasal swab in the middle of November because this person was given a reward of some sort for getting tested with a local organization. The test results came back as ‘detected.’ Does this mean this person is positive for the coronavirus again or is this the same occurrence from two months ago? Also, is this person considered contagious and should we have the employee work from home again? Again, the employee is asymptomatic.”

The answer:

In your question you did not mention the type of test that was done. Both the rapid test and the genome test use nasal swabs.

The rapid test is good for detecting positive individuals who are symptomatic. It is less so for those individuals who are asymptomatic. The genome test can detect positive individuals from about three days after exposure and infection until the virus is cleared. The clearance in some individuals can last for a few weeks to months after the infection has resolved.

Think of it this way: If you have a large group of people, 800,000, in a field, it could take a few days to weeks to clean up after them. The same thing happens with your immune system. One cell can produce up to 10,000 viruses and many cells become infected in an infection. The clean-up can take time.

Several factors come into play when determining how long the clean-up will take. It is difficult to determine, from your question, if the individual is in the clean-up phase or if they were reinfected. 

Data shows that a small percentage, less than 1%, of individuals are reinfected with SARS-CoV-2. 

That number may change as new data is collected and more testing is done.

I cannot say for certain what the reason is for a positive test a second time, but the above options are two possibilities.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“My husband works in a school and was in the building until Nov. 23. I work from home and have worked from home since March. All of my children are attending school virtually. My husband and I have left home rarely and try to order groceries for curbside pickup, etc. When we do go somewhere public, we wear masks and socially distance. Three weeks ago, my daughter’s best friend spent the night (she and her mom have been isolating together) and my son spent the night at my sister’s house (she and her family had the virus a few months ago.)

“Last weekend all of my kids were sick with what I assumed was strep throat. Shortly after, I began to show symptoms. I was tested on Nov. 25 and my test came back positive on Nov. 27. On Nov. 28, my three kids and my husband were tested. My kids no longer feel sick but one has a lingering sore throat. We received their results last night and all four of them have tested negative.

“Until now my only explanation was that my husband is an asymptomatic carrier and infected the rest of us, as he is our primary connection to the outside world right now. How likely is it that he was asymptomatic and my kids were symptomatic and they are already testing negative after infection? 

“Or is it more likely that they just haven’t tested positive yet? We are all isolating at home together for the next few weeks but were operating under the assumption that we were all positive. I am puzzled, and now terrified that I have gotten all of them sick.”

The answer:

In your question you didn’t mention the type of test that everyone had. If you all had the rapid test, a negative result only means that you were negative at the time of the test. If you all had a genome test, it is more sensitive, and you can trust the negative results.

The rapid test is better at detecting positive patients when they are symptomatic. A negative result in an asymptomatic person only says that at the time of testing you were negative.

As for how you got SARS-CoV-2, I cannot say. There is a hypothesis that says approximately 15% of individuals with SARS-CoV-2 are asymptomatic and never develop symptoms, but that is just a hypothesis. We are not doing enough testing in the U.S. to determine if that hypothesis is true.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“Howdy from Missouri. I was tested on Nov. 10, came back positive on the 13th, was told to self-isolate until the 20th. I haven’t had any symptoms. I have one day left of my self-isolation. I live with a long-time girlfriend who hasn’t had any symptoms either. I had the long Q-Tip test up your nose. Is it possible that I got a false positive from that, or am I just very lucky to not have had any symptoms?”

The answer:

I assume your positive swab test was a molecular Polymerase Chain Reaction (PCR). A positive PCR test result is highly accurate.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive for COVID, quarantined and am now negative. However, my roommate tested positive two times after quarantining. What do I do?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

I’m assuming you and your roommate both completed the appropriate isolation period, e.g., 10 days if not immunocompromised and 20 days if immunocompromised.

I recommend both of you continue everyday preventative actions including masking, social distancing and good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My grandson, who is 14, came home and said 10 out of 20 kids were removed from class for possible contact with positive COVID persons. Do we need to isolate from our grandson? We are about 70 and we all live together.”

The answer:

The grandson should self-quarantine separately for 14 days from the date of his contact with the possible positive COVID-19 persons.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband tested positive for COVID on Nov. 6 and had started showing symptoms on Nov. 3. I have been tested three times, two PCR tests and one rapid results test, and all came back negative. All antibody tests have come back negative. My husband’s symptoms have been getting better and he has not had a fever since Nov. 4. He has been in isolation. We’re lucky enough to have a spare room with an on-suite bathroom. I’ve been placing food outside his door and washing his dishes, wearing gloves, goggles and a mask. 

“When is it OK for me to be around my husband? Like when can we sleep in the same bed? Also, when can I stop quarantining and feel confident I don’t have COVID-19 and won’t spread it to others?”

The answer:

If your husband is not immunocompromised, he can stop isolation after at least 10 days have passed since symptoms first appeared. If he is immunocompromised, then at least 20 days of isolation is recommended.

You are a household contact and should self-quarantine for 14 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My daughter went to an exam on a Thursday. She’s 81/2 months pregnant. Both she and the doctor wore masks. The doctor has since tested positive (I believe over the weekend). Should my daughter quarantine? She has a 20-month-old who attends day care.”

The answer:

In my opinion, her risk is low since she and the doctor were both wearing masks.

Pregnant women are more susceptible to severe manifestations from certain viral infections due to physiologic changes. 

Also, second- and third-trimester patients are considered immunocompromised.

I recommend your daughter discuss with her new obstetrician as soon as possible whether she needs to quarantine or not.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“On Nov. 2, I tested positive for COVID-19. I quarantined for two weeks. On the 14th day, I got retested. I had no symptoms since Nov. 7. No chest issues, no fever, etc. The second test also came back positive. Again, I have been symptom-free for about 10 days. How do I know it wasn’t just the normal flu. I’m still quarantining to be safe but I’m getting very antsy and I want to see my family! I have nieces and great-nieces, and if I expose them, I’ll never forgive myself!”

The answer:

You had two positive tests for COVID-19. 

It’s unlikely you also had the flu. You can stop isolation now and resume normal activities.

I recommend you wear a mask and continue other preventative actions including good hand-washing hygiene.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My oldest daughter tested positive for COVID-19 and she had spent three days in my home a week before she received the results. So, my middle daughter (she lives with me) and myself went and got tested five days after the oldest received her positive test. We both went in the same vehicle, the same person swabbed our noses (one right after the other). We both got our results back today. I tested negative for COVID, my middle daughter (the one who lives with me) tested positive. I’m confused!”

The answer:

Your middle daughter should self-isolate at least 10 days since her positive test.

You are a close household contact and should self-quarantine separately for 14 days. This will be 14 days from the date your middle daughter is released from isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I had and was hospitalized for COVID pneumonia four days after testing positive in August. I was still symptomatic after spending 16 days in the COVID unit and weeks after discharge. I had a CT scan that said I still had COVID in my lungs in September. A month later, I had a chest X-ray saying it was clear and didn’t need to be retested. On Nov. 20, my granddaughter tested positive with symptoms and she’s around me constantly. Should I be tested or just quarantine?”

The answer:

I recommend you self-quarantine for 14 days and notify your physician immediately. If you develop symptoms during those 14 days, you could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I had to have a COVID test done on a Monday after a co-worker tested positive that previous Saturday. I only work there on Fridays with her and we’re never around each other, so I was feeling pretty confident. I finally got my tests results back and they were negative, but I’ve been having some sinus pain ever since the test was administered. Is that a normal sign that will eventually go away?”

The answer:

The swab from the test can cause mucus production and sneezing for an hour or so after the test is administered. 

It is unlikely that sinus pain would result from the swab.

If you are concerned about a sinus infection, please speak to your medical provider.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“Can we safely gather over the holidays since all four of us – two college students and two parents – have already had COVID? We don’t all live together. Parents together in same house – students are at different campuses.”

The answer:

Reported COVID-19 reinfection rates have been low to date.

At this time, it is not known for certain how long antibodies stay in the body after infection, and if they provide immunity, either fully or partially from future infection with SARS-CoV-2 (COVID-19), or how long protective immunity may last.

There are no guarantees with the coronavirus.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter works on a COVID unit in a local hospital. She contracted the virus a couple of months ago and has since recovered. Can she still ‘carry’ the virus from patients at the hospital and expose the family to COVID or does her immunity protect us? I look forward to hearing your reply.”

The answer:

At this time, it is not known for certain how long antibodies stay in the body after infection, and if they provide immunity, either fully or partially from future infection with SARS-CoV-2 (COVID-19), or how long protective immunity may last.

Reported COVID-19 reinfection rates have been low to date, however there are no guarantees with the coronavirus.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have been wondering about this upcoming Christmas. My wife is immunocompromised from medication she takes. 

“We skipped Thanksgiving. Until now we have been really careful with anything. She has not gone anywhere besides the doctors appointments that she has to physically attend (MRI, infusions).

“I have been stripping down and washing my clothes immediately after I come home and shower before I see my wife. I also have been really strict trying to have nobody visit (unless it is outside with masks and social distancing) and nobody is allowed inside.

“Now the problem is that Christmas is of course very important to my wife as it is also her son’s birthday. I really don’t know what to do. My wife’s son doesn’t live with us. He is a teacher at a university and was already once exposed (did not test positive) recently. I just don’t like the idea of having someone else come inside the house and possibly bring this virus with them.

“What do you suggest we should do? 

“I have read a lot of different things but nothing really answered my most pressing questions. If the weather is OK, it might be possible to do something outside, but it will be most likely too cold.

The answer:

Without the arrival of an effective vaccine and broad immunization, there is no other answer to your question. You are already doing everything possible, and you’re doing a great job!

Even under the best of circumstances, there is risk associated with a teacher at a university visiting for the holidays because of their possible exposure history.

I’m hopeful that 2021 will be a better year and that there will be new, safe and effective antiviral treatments available then.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My boyfriend and I were exposed to someone who three days later tested positive for COVID with symptoms. We were outside with masks on the majority of the time. We are scheduled to get tested with the PCR test seven days post-exposure. If it comes back negative, do we need to complete the full 14-day quarantine? Also, we do have a dog in the home. How can we best protect him? Because we live in an apartment building, we have to take him outside through hallways.”

The answer:

Yes, because you did not wear masks the entire time and the incubation period for the SARS-CoV-2 (COVID-19) virus can be two to 14 days. Also, people should quarantine separately.

Until we learn more about how this virus affects animals, treat pets as you would other family members to protect them from possible infection.

• CDC recommends that pet owners limit their pet’s interactions with people outside their household.

• Walk dogs on a leash at least 6 feet away from others.

• Avoid public places where a large number of people gather.

• Do not put face coverings on pets. Covering a pet’s face could harm them.

• There is no evidence that the virus can spread to people from the skin, fur or hair of pets. Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide or any other products not approved for animal use.

• Talk to your veterinarian if your pet gets sick or if you have any concerns about your pet’s health.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I teach adults in two different locations, five days in one, two nights in the other. I have been in quarantine due to a positive student during the day. I have been teaching remotely in both places, and my quarantine was due to end Nov. 24. A family member in my home tested positive after mild symptoms starting Nov. 18 (thought it was flu and shingles vaccine after-effects). It’s just the two of us and the person is isolating in complete separate part of home. I have no symptoms and understand I need to quarantine for an additional 14 days. Outside of my immediate supervisor, at my night school, do I need to notify the district nurse who is the state liaison? I’ve had no contact with anyone at the school since Nov. 9.”

The answer:

Some schools are asking anyone who is positive to inform the school nurse, but that varies from school to school and state to state. If you are comfortable providing that information, alert the nurse.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My boyfriend and I saw a friend who was with us for over 30 minutes in a small enclosed space with no masks (we know, stupid). My boyfriend also shared a drink with him and took multiple sips. When he was leaving, he mentioned not feeling well and said he was getting a cold. Naturally, we freaked out and urged him to get tested. A week later, he gets test results back as positive.

“We have been quarantined for three days and both were tested after seven days since being exposed. We had some symptoms but no fevers, coughs or any of the main concerns. Since then, I tested negative, and we’re still waiting on my boyfriends, but we’ve been together the whole time and have had identical symptoms. How is that possible that we had that close of exposure and still didn’t test positive?”

The answer:

You didn’t mention the type of tests you and your boyfriend had.

A negative rapid antigen swab test result doesn’t rule out COVID-19 infection. Another possibility is that you tested too early. The incubation period for the SARS-CoV-2 (COVID-19) virus can be 2-14 days.

You and your boyfriend are close contacts and should self-quarantine separately for 14 days from the date of your last contact with the friend who tested positive.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My wife and I are 66 years old. I drove from Ohio back to my home in South Carolina on Nov. 15. No specific known exposure while in Ohio for a week with my daughter and her boyfriend. I wear a mask and greatly limit my activity. When I returned home that night, my wife and I stayed distant, wore masks in each other’s presence and we slept in separate bedrooms out of an abundance of caution. The next morning, I got the PCR test for COVID. On Nov. 19, I was notified that I had tested positive. I am asymptomatic so far. My daughter and her boyfriend, after getting the news, got rapid tests that night and both were negative.

“Questions: 1. I am bewildered that I am positive. Is it worth me getting another PCR test just to be 100% sure that I have the virus? 

“2. In more recent time periods, is it the case that most people who test positive, but are asymptomatic, can reasonably expect a milder version of the virus to take hold? 

“3. Assuming I retest positive, and remain asymptomatic, when can I end isolation and how long should my wife remain isolated? If I did retake the PCR test and it was negative, how should I respond to that?”

The answers:

1. Studies have suggested that 40% to 45% of individuals infected with the SARS-CoV-2 (COVID-19) virus may have no symptoms at the time of testing, and they may transmit the virus for 14 days or longer. Positive molecular Polymerase Chain Reaction (PCR) tests are highly accurate. 

You could repeat the swab PCR test and also consider blood tests for SARS-CoV-2 IgM and IgG antibodies.

2. Yes.

3. If you retest positive and you’re not immunocompromised, at least 10 days of self-isolation is recommended. If you are immunocompromised, then at least 20 days of self-isolation is recommended. Your wife is a household contact, and 14 days of self-quarantine is recommended. This will be 14 days from the date you are released from isolation. Ideally, people should quarantine separately.

If the repeat swab PCR test and the blood SARS-CoV-2 IgM and IgG antibodies are all negative, then you do need to self-isolate, and your wife does not need to self-quarantine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My sister says that a nurse friend of hers said that once you have COVID-19 you can never ever be around someone who has not had it before for the rest of our lives. Is that true?”

The answer:

My goodness, no this is not true. SARS-CoV-2, the virus that causes COVID-19 is not a chronic virus. Like other coronaviruses, it can be eliminated by the body’s immune response. Once that happens, the individual is not contagious.

Until the pandemic is under control, everyone – those who have recovered or those who have never been sick with COVID-19 – should continue to practice good hand hygiene, mask wearing and social distancing.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“We are a household of five, living in the country outside of New York City – my 101-year-old mother; her caretaker, who is in her 60s; me in my 60s; my husband in his 70s; and one of our adult children in her 20s. Everyone in our household is careful; most of us don’t go out at all, and my husband and daughter wear masks to shop. My mother’s helper goes to her home every now and then (in a hotspot) and is exposed to a roommate, but the helper had COVID-19 in March, and we all avoided it. My mother and I both have vulnerabilities – heart disease in my case.

“Three more of our adult children were planning to share Thanksgiving with us. We have a plan and would like to know how safe you think it is:

“One of my daughters came from Virginia on Nov. 15 to quarantine with her sister in a New York City apartment. My son came from Virginia to our home on Nov. 16 and has not left the second floor of our house, where he has a room and bathroom to himself. I leave meals for him on trays on the staircase, and the rest of us are all staying downstairs. These three adult children had not been isolating before the dates I gave you — one had been working in an office, another has several housemates and had attended a Friendsgiving party just before coming — but to our knowledge, none of us has been exposed to the coronavirus.

The plan is for the three visitors to be tested after seven or eight days of isolation. They will continue to isolate until the results arrive, which we hope would happen by Thanksgiving. That will not quite amount to 14 days of isolation — more like 10 or 11 –  but it was the best we could do, and we’re hoping that in conjunction with the tests, we’re safe. Thanks so much for you opinion.”

The answer:

Gatherings with family members who do not live with you can increase the chances of getting or spreading COVID-19 or the flu. As cases continue to increase rapidly across the United States, the safest way to celebrate Thanksgiving is to celebrate at home with the people you live with.

The precautions and preventative actions which you’ve outlined are good, but are not infallible. At this time, there are no guarantees with the SARS-CoV-2 (COVID-19) virus.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My daughter and I went on a five-day road trip and went everywhere together. We even stayed in the same hotel room with two beds but same room every night. On the last day, we drove home for 11 hours in the car breathing the same air and the windows were up the entire time. I dropped her off at 6 p.m. on Saturday night at her house. The next morning, she woke up will full-blown COVID symptoms and five days later it was confirmed via a test that she had the virus. It’s been two weeks and I haven’t experienced any symptoms. Eight days after I dropped her off I tested negative for COVID. Why didn’t I get the virus?”

The answer:

There can be many answers to this question. 

One is that your daughter was exposed on the second to last day of your trip. If that happened, her body would not have enough virus to be infectious to you until Sunday, the day she got sick. 

SARS-CoV-2 has an incubation period of 2-14 days. Some people are presymptomatic and infectious for 48 hours before they show symptoms and some people just get sick after two days with no presymptomatic infectious period.

Since you were negative, it is likely that your daughter was never presymptomatic and infectious while she was with you. 

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“Our school played a football game on Monday. On Friday, the team we played had a player test positive. Should our players be quarantined? If so, how long?”

The answer:

This is a difficult question to answer because it’s not known which player(s) had contact exposure with the football player who tested positive.

One option is that all players on both teams self-quarantine separately for 14 days from the date of the game. Another option is to contact your local health department, which has guidelines for schools.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“My daughter continues to go skating and to parties and hangs out with her friends. I have told her that she is not able to come to my home considering that she continues to expose herself. My daughter is 23. To date, she has not had a positive test. I would like to know how long should I wait to be around her after she has socializes with others in the manner in which I have mentioned above? And how long does she need to wait to be around others who are isolated and using the safe precautions that the state/city has asked us to do?”

The answer:

It is best to wait for 14 days after the last exposure to reunite.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My granddaughter finished her quarantine Nov. 11. She went to a friend’s house who just tested positive two or three days before. What are the odds she will catch it again? I just finished chemo treatments in July. Should I be cautious about being with my granddaughter?”

The answer:

You didn’t mention if your granddaughter previously tested positive for COVID-19, or if the quarantine was for prior exposure.

If she was wearing a mask, reinfection is unlikely, but not impossible.

I recommend your granddaughter self-quarantine for 14 days from the date of her contact at her friend’s house.

Adults of any age with a history of cancer are at increased risk of severe illness from the virus that causes COVID-19.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My nanny woke up symptomatic for COVID-19 on Nov. 4. I immediately quarantined myself and my two children, ages 10 and 6 (I am a single parent) and took them out of school. 

“My nanny took a COVID test on Nov. 6 that was positive. My children and I took a COVID test on Nov. 9. My two children were both positive and I was negative. My 6-year-old has been asymptomatic the whole time. My 10-year-old is symptomatic, and symptoms started on Nov. 9. On Saturday, Nov. 14 I took another COVID test and was still negative. All tests have been PCR tests. My children were be cleared to return to school on Nov. 20. 

“Assuming I continue to be negative and/or asymptomatic, I will need to quarantine until Saturday (this is all per our Board of Health).

“I had an antibody test previously that showed I did not have any antibodies. My kids and I quarantined together for 12 days. For half that time we didn’t do any distancing or mask-wearing because I assumed we would be all negative or all positive. My question is how could I possibly be negative?”

The answer:

Infection requires something called an infectious dose. Science is not yet sure what that does is for SARS-CoV-2. Just because we are exposed to the virus does not mean we will be infected. Perhaps you were not exposed to the infectious dose because of your precautions.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“M and C ride in a car together without masks for 20 minutes on Nov. 9, and then ride bikes together for a couple of hours. They next see each other on Nov. 20. 

“C tells M that shortly after the 9th he testified positive for COVID-19. They bike ride again. I see M on the 21st. We are together in a locker room about 10 feet apart. I’m wearing a mask. 

“M is without a mask for five minutes and then puts one on after he tells me about C. Should I be self-isolating? It doesn’t look as though M will get a test. If M makes it through the 23rd without symptoms is he in the clear, or should he isolate for 14 days after the bike ride on the 20th?”

The answer:

You will not need to quarantine as a result of your interaction with M. On the other hand M should be in quarantine until Friday as a result of his interaction with a COVID-19 positive person.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“Our 7-year-old son was playing with the neighbor’s 6-year-old daughter on Saturday. 

“We heard from our neighbors on Monday that the child’s mother (a nurse) had tested positive for COVID-19. We’re currently not allowing our son to interact with other neighborhood kids as a precaution. How likely is it that he was exposed and potentially contagious, and how long should we continue to quarantine him?”

The answer:

If the 6-year-old daughter was infected with COVID-19, then your son has an even chance.

I agree with being cautious, and I recommend 14 days of quarantine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My friend, who is a teacher, came over and we watched a movie outside on the projector last Saturday, no masks but social distanced. We eyeballed 6 feet apart. But it was many hours of contact. She did use our restroom, but with a mask when she went inside, and we masked up for any trips inside during the visit. Sunday she found out she had been exposed. Wednesday she tested positive. My partner is supposed to fly out to Texas on Monday to visit his grandma who just went into hospice. He got tested, but does not have his results back yet, and we’re also aware that a negative result is not highly reliable. My question is, since it was outside, does that even qualify as exposure? Is he safe to travel? If he isn’t, what would he need to do in order to feel safe making the trip (quarantine, two negative tests?)”

The answer:

Being outside for “many hours of contact” without masks does qualify as exposure. I recommend he self-quarantine separately for 14 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My two daughters (one is a university student) were planning to quarantine together for 14 days in a rental house (getting tested on Day 8 then awaiting results and/or waiting out the rest of the 14 days) before coming home to stay, but that rental house has now become unavailable. 

“My daughters have no symptoms and no known contacts. Is it safe for them to quarantine in our house – in our basement apartment, which has a separate kitchen, bathroom, bedroom, living space and separate entrance – though there is a (closed) door that connects the basement to the rest of the house? The house does share the same heating/ventilation system, but we have put in MERV 13 filters. My 83-year-old mother also lives with us, and will stay upstairs and not see the girls. We plan on not seeing them inside the house at all during their 14-day quarantine. If we see them at all, it will be distanced, masked and outdoors. Is this kind of quarantine “separate” enough to avoid aerosol – despite the shared ventilation system? The issue is university housing is closing, so they need to come home.”

The answer:

Since your daughters have no known exposure, sheltering in place in the basement apartment is fine. I suggest that you and your mother limit contact with them until the 14 days has passed.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

“Why do you wait 30 days to be retested, if you test positive?”

The answer:

Sometimes the SARS-CoV-2 (COVID-19) virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I travel during the week for business and am flying home this evening. My wife just called me and told me she was informed that she was exposed to someone who tested positive earlier this week. She intends to quarantine for the 14 days. However, she also said I should not come home or I will also have to quarantine. I am scheduled to be back out of town in a few days and at a bare minimum need to come home to repack and pick up essentials.

“My question is, would I still have to quarantine if I went home and my wife and I stayed apart and wore masks while in our house for a day or two? I am pretty cautious while traveling, but I am fairly certain that my exposure risk has been far greater on the road than a couple of mask-wearing distanced days at home. While I have never been tested, I would not be surprised if I had already had COVID and experienced no symptoms.”

The answer:

If your wife self-quarantines separately, you and your wife stay apart, both wear masks, high-touch surfaces are cleaned and sanitized, then you do not need to self-quarantine.

Regarding your past exposure history, I suggest you consider a blood test for SARS-CoV-2 IgG antibodies. If that test is positive, it indicates you were previously infected with COVID-19, but it doesn’t give the exact date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I work in a senior group home. All residents and two employees tested positive within five days of each other. Can these residents be around one another or do they need to stay in their rooms throughout quarantine?”

The answer:

There’s no problem having multiple people isolate together, as long as, we’re sure they’re all positive.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter had COVID-19 in August when she went to school at the University of Alabama. She just found out that a very close friend tested positive today (Nov. 17) and her flight home is on Saturday (Nov. 21). 

“Does she need to quarantine or can she still fly home?”

The answer:

Reported COVID-19 reinfection rates have been low to date. However, protection for most people who have recovered from COVID-19 is expected to wane. It is not known for certain how long antibodies stay in the body after infection, and if they provide immunity. More people could become susceptible to the virus again, and that could increase the risk of transmission.

Therefore, I advise your daughter not to fly home, and I recommend she self-quarantine separately for 14 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have two children in elementary school who ride the school bus, and I was informed that a child on the bus and the same child is in my daughter’s class at school tested positive for COVID. The school said they needed to be quarantined. I also have two children in middle school that have been around the other two who are in elementary school, so can you tell me if the two in middle school need to be quarantined along with the other two as well?”

The answer:

If your children in middle school were not in contact with a known positive case, then they do not have to quarantine. However, if your two in elementary school become positive, then anyone they were in contact with will need to be quarantined.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have a couple of questions about COVID-19 concerning my mother-in-law. She just got done quarantining after having the virus (no taste and smell). She was asking us our opinion on going to Bingo (might be where she got it). We suggested it might be better to just play it safe and not go. She just got through her 14 days and we will be seeing them and our pregnant sister-in-law for Thanksgiving. Is she safe from getting COVID for a couple of months (read you can’t re-get it right away)? And If she is, could she still be a carrier if in contact with it now, even though she couldn’t get it? (Me and my wife can’t really afford to get it as a teacher and as the only designer for a small newspaper and have to miss 14 days.) Also, does having high triglycerides and asthma make me more at risk of getting it bad, if I get COVID?” 

The answer:

Reported COVID-19 reinfection rates have been low to date. At this time, it is not known for certain how long antibodies stay in the body after infection, and if they provide immunity.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. However, I do not advise visiting your pregnant sister-in-law for Thanksgiving.

Pregnancy is linked to a higher risk for severe COVID-19. Therefore, it is important to emphasize the importance of infection prevention measures for these patients and their families.

Based on what we know at this time, adults with moderate to severe asthma might be at an increased risk for severe illness from the virus that causes COVID-19.

I’m not aware of any increased risk associated with high triglycerides.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“My friend tested positive for COVID 19. She isolated for 12 days then went back to work per the CDC guidelines. The next day she took another test and it was still positive. The CDC said she is more than likely not contagious, so we drove together and had lunch. We wore our masks. Three days after that, her son tested positive for COVID-19. I was not around him, but we are wondering if she is in fact still contagious?”

The answer:

It is possible to test positive for COVID-19 after the period where you would be contagious. Some of the virus may be leftover in the nasal passageway. This leftover virus is just in pieces. It is not infectious. Your co-workers son likely became infected from another person, not your friend.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband first developed symptoms on Nov. 8, came positive in rapid test on Nov. 9. He then has been quarantining at a hotel. I tested on Nov. 9 and Nov. 11 and came negative. My 1-year-old baby developed symptoms on Nov. 10, tested positive on Nov. 12. My parents, 56 and 61, had been taking care of him until Nov. 15 when we got his results. And we are all still in the same house (me, baby and parents) wearing masks. My parents saw some symptoms on Nov. 13 but got fully better in a few hours. 

“My question is, now since my parents have already been exposed to my baby, can they continue to be near him wearing masks? Or is more continued exposure worse?”

The answer:

In my opinion, your parents are close household contacts, and they should quarantine for 14 days. This will be 14 days from the date your 1-year-old baby (who tested positive) is released from isolation. Ideally, people should quarantine separately.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My partner and I, both elderly, have rented a home for a month this winter and invited our children and grandchildren to join us there. Our plan is to have everyone strictly quarantine in their family group for 14 days, have a PCR test on Day 12 of quarantine, then get together on Day 15. Traveling to the ‘pod’ home will be by car, with no one going inside any building for any reason. (We have already staked out spots where everyone can take care of business in the woods by the road.) When getting gas or charging an electric vehicle, everyone will wear masks, use gloves and then use hand sanitizer. While at the pod home, we will fully quarantine together. Groceries and other necessities will be brought with us, or delivered. Is there anything else we can do to increase our safety from COVID while allowing us to create an extended family pod?

“Also, my son’s fiancee, with whom he lives, will visit her mother (near our pod home) prior to joining our pod (because her dad just died). Her mother does not take COVID as seriously as we do – she still gets her nails done indoors, for example. She plans to get a separate apartment and then quarantine there, alone, before joining our pod. Two questions:

• During that quarantine period, would it be ok for us to see K outdoors, wearing masks, and staying at least 6 feet away?

• Could we reasonably shorten K’s quarantine period to 12 days if K had two negative PCR tests, on Days 8 and 10?

“Thank you for the great community service you are providing.”

The answer:

Ideally, people should quarantine separately.

Answers to your other questions include:

• These precautions are good, but social distancing at least 10 feet would be better.

• It’s reasonable, but not infallible. There are no guarantees with this virus (SARS-CoV-2 / COVID-19).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’m going to attend a small gathering of five people on Dec. 26 and want to safely rejoin a pod with my parents after that event. How many days should I quarantine before I get tested after that event to rejoin the pod? Example: get tested the next day and rejoin immediately, wait five days living elsewhere and then get tested and rejoin, what?”

The answer:

My best advice is not to attend the gathering.

Otherwise, self-quarantine elsewhere for at least eight days after attending the event before swab testing (molecular Polymerase Chain Reaction – PCR) for COVID-19. However, realize there are no guarantees with testing, and there is the possibility of false negative test results. The mean incubation period for the SARS-CoV-2 (COVID-19) virus is estimated to be five days, with a range of two to 14 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My 5-, 4- and 2-year-old, and I, got tested this Nov. 12. We received our tests back Nov. 15. All the kids tested negative and I was the only one positive. Our family has been extremely careful. We haven’t eaten out. We have taken the kids to parks or playgrounds only when they are not crowded. 

“The 5-year-old goes to a kindergarten and he has to wear a mask from 8 a.m. to 3 p.m. while in school.The 4- and 2-year-old had been staying at home with me this past week. I took them to the zoo, playground and park (all with masks on). 

“Since I’m the only on with a positive result, but have zero symptoms, should I be the only one quarantining for 14 days? Do the children who all tested negative also need to quarantine or can they go back to their school?”

The answer:

If you are not immunocompromised, you should self-isolate at least 10 days. If you are immunocompromised, then at least 20 days of self-isolation is recommended.

The children are all household contacts, and they should self-quarantine for 14 days. 

This will be 14 days from the date you are released from isolation. Ideally, people should quarantine separately.

• • • • •

“I live in Arizona. My husband and I had COVID-19 back in July and my father who lives in New Orleans also had COVID-19 back in April. 

“He wants to come visit us for Thanksgiving by driving through El Paso, Texas, which is a hot spot. My dad seems to think that because we have all been exposed that we should all be OK getting together. I don’t believe that makes us safe from not getting exposed to the virus again especially when the cases in Arizona are starting to go up again."

The answer:

Increased research is suggesting that immunity after infection with SARS-CoV-2 is likely to last months, possibly years. However, there is evidence of reinfection with the virus.

I can’t say what you should do, but if you do decide to get together, please take all precautions when traveling to visit. Drive if possible, wash your hands regularly and wear a mask in public.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My son and his girlfriend both tested positive over the summer for COVID-19. Neither developed symptoms, so must have been asymptomatic. They quarantined and then returned to work after 14 days. Our question concerns the holidays and if it is safe for them to visit us now. My husband has COPD and is 70 years old. 

“If they have the antibodies, is it still possible for them to carry the virus to us from someone else if they come in contact with it?”

The answer:

While there are some reported cases of individuals who were reinfected with SARS-CoV-2, that is unlikely. Recent research shows that those who have recovered may be protected for months to years.

Your son and his girlfriend are not likely to bring infectious virus with them on their clothing. The main route of transmission for SARS-CoV-2 is airborne droplets or aerosols.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am a health care worker and my boyfriend is a restaurant manager in Minnesota. 

“We have two assisted-living facilities in the area and several of our residents moved from our facility to the sister facility the other day. 

“There were four men who moved them.

“On the second day of the move (these gentlemen having been in and out of both facilities) it was found that there were positive COVID tests at the other building. I had not been in any direct contact with any of these men once they began the move.

“My boyfriend’s boss pulled him out of work and made him go test and told him no matter what the results were, he couldn’t come back for 14 days. Is that correct? I was not directly exposed, neither was he. Doesn’t there have to be direct contact to be put in quarantine? And no, he has no symptoms.”

The answer:

A close contact is defined as being within 6 feet for 15 minutes or more, or being directly exposed to respiratory secretions, e.g., cough or sneeze.

If your boyfriend had no close contact, and he was wearing a mask, there is no need to self-quarantine for 14 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I recently got tested for COVID-19 with the rapid test. It was in an office where they rapid-test people all day. They sanitize before each person, but since it can be transmitted airborne and it’s doubtful that the staff changed their PPE between patients, is it likely to catch the virus from that room where I got tested? My test came back negative, but I’m worried if I could have picked it up there knowing they are testing positive people in that room prior to me.”

The answer:

If you were wearing a mask, it’s doubtful you were infected in the room where you were tested.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • • 

“My daughter developed GI issues Nov. 2 and was hospitalized Nov. 3 with Enteritis. She also tested positive for COVID-19 SARCOV2 and OC43. She was discharged from the hospital on Nov. 8. My daughter does live with my husband, son and I. She has been in isolation since arriving home. I am the only one that takes food to her and takes her temperature daily. She and I both wear masks when I stand in her doorway of her bedroom to take her temperature, and she has her own bathroom. 

“My husband, son and I all tested negative on the 5th. My son plays soccer and we had him tested again on 13th, and he is still negative. We have gotten mixed messages on when my son’s quarantine should end. Looking for some answers on when he can return back to soccer. None of us have any symptoms.”

The answer:

It is best for all in the household to remain in quarantine for 14 days beginning on the 10th day of your daughter having symptoms of COVID-19.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If my son has to self-quarantine for 14 days because he came in close contact at school with someone who tested positive, does that mean everyone in his household has to self quarantine as well?”

The answer:

Your son should use a separate bedroom and bathroom than others in the household. 

He should wear a mask when in open areas. 

If he develops symptoms, then others in the household will have to quarantine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I thought I had a sinus infection. All signs pointed that way. Watery eyes, ear pain and itchy, runny nose, pain across one eye. No fever, no cough – yet I was tested positive. Could this have been wrong? Now taking antibiotics for sinus infection.”

The answer:

No.

A positive test for COVID-19 is highly accurate and indicates you are infected with the novel coronavirus, SARS-CoV-2.

If you are not immunocompromised, you should self-isolate for at least 10 days since symptoms first appeared. If you are immunocompromised, then at least 20 days of isolation is recommended.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I completed my isolation after I tested positive for COVID-19. I started going to work. After a few days I started going to work, my mom who lives with me tested positive. According to CDC guidelines, I do not have to quarantine again. My employer said the same thing and I continue to go to work. I am scared if I become the carrier of this virus and spread at the workplace. I guess the CDC guideline is true. Can you explain how I am not carrying this virus in my clothes, hands or shoes?”

The answer:

SARS-CoV-2 is a virus with RNA as its genome and it is also has a lipid envelope (outer most covering, think of it like a cell membrane). RNA is not as stable as DNA and doesn’t last well in the environment. We have biological substances on our skin that can easily degrade RNA. The lipid covering, envelope, of the virus can be dried out by the air or any disinfectant. 

Also, SARS-CoV-2 is transmitted by airborne droplets or aerosols.

Taken together, these things make it highly unlikely that you will take infectious virus with you to work.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am a seafarer, and I went to Manila from our province on Oct. 25. I then stayed in a boarding house. I wasn’t aware that someone was suffering from sickness. We share only open air, so I guess that’s where the virus was spread. After Oct. 27, the one who was sick was taken to a separate room. I didn’t feel any symptoms. I thought I was OK. 

“So on Oct. 31, our company advised us to get a rapid test and I got a negative result. But on Nov. 2, they again advised us to take a swab test because our schedule to join the ship was Nov. 4. I tested positive. 

“So here I am now in the quarantine facility with all the asymptomatic patients. I’m worried because after the quarantine of 14 days and I report back to our company and they requested me again to take a swab I might end up being positive. 

“How many days after my 14 days quarantine to take a re-swab and is it possible for me to get a negative result?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with COVID-19 who are asymptomatic shouldn’t undergo virus testing within three months after initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My fiancé started having a fever Wednesday night, early Thursday morning. He took a test Friday,

Oct. 30, which came back Saturday, Oct. 31, as positive. We sleep in different rooms. His hasn’t had a fever since that Saturday. He has a small cough. He tested again Nov. 3 and got the results as positive Nov. 5 – still no symptoms, but a cough. 

“Are we OK to sleep in the same bed?”

The answer:

If your fiancé is not immunocompromised, at least 10 days of isolation is recommended and at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms have improved. If your fiancé is immunocompromised, then at least 20 days of isolation is recommended.

You are a household contact and should self-quarantine separately for 14 days. This will be 14 days from the date your fiancé is released from isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“We have been in court all this week and have been more than 6 feet apart and wore masks every day. The opposing party’s lawyer’s wife had a coworker’s spouse who tested positive and he got tested yesterday. Does he have to let us know what his test results were?”

The answer:

That would be good citizenship.

In my opinion, your risk is low because you wore a mask and were social distancing.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My 3-year-old was exposed to COVID-19 at day care. On Oct. 30, he was symptomatic so we had him tested Oct. 31 and it came back positive. That day, I became symptomatic and on Nov. 1, my husband became symptomatic. My husband and I were tested on Nov. 3 and Nov. 2, respectively, and our tests came back negative. What is happening? I feel so confused. 

“If my toddler does, in fact, have the virus and it is highly infectious, how do we not have it? He is literally coughing and snotting all over me for 12 hours a day.”

The answer:

You didn’t mention the type of test(s) you and your husband had. Negative rapid Antigen test results do not rule-out COVID-19 infection. Also, perhaps you tested too early.

You and your husband are household contacts, and both should self-quarantine for 14 days. This will be 14 days from the date your son is released from isolation. Ideally, people should quarantine separately. 

If you and your husband both retest positive, there’s no problem in having multiple people isolate together, as long as, we’re sure you’re both positive.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My wife and I went to Mexico. She started having symptoms with on Friday, Oct. 23. We both decided to test when we arrived home on Monday, Oct. 26. She tested positive and I tested negative for the rapid and extended test. We immediately remained quarantined from each other, her upstairs and me downstairs with no contact (other than putting food and picking up her trash afterward, outside her door. The washing and bleaching everything we may touched.) 

“I felt fine until Thursday, Nov. 5, mainly stuffy head and fatigued. I decided to be proactive and test Nov. 7 and was positive. I’m wondering if I caught it the same time as her or possibly from her even though we were completely separated. Do I need to worry for my own heath for 10 days since my first symptom on the 5th or assume I caught it same as her on Oct. 23?”

The answer:

One possible explanation is your exposure date was the same as your wife’s, but your incubation period was different.

In my opinion, it’s less likely that you were infected by your wife since you were completely separated and following adequate preventative actions.

If you are not immunocompromised, at least 10 days of isolation is recommended since symptoms first appeared (Nov. 5). If you are immunocompromised, then at least 20 days of isolation is advised since symptoms first appeared (Nov. 5).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I tested positive on Oct. 25, and my wife and I tried to isolate as best we could, but she ended up getting infected and tested positive on Oct. 31. 

“Do I need to quarantine away from her still? 

“Can I get reinfected from her if we didn’t isolate? Can I go out of the home without infecting other since I’m well beyond my 10 days but not isolating from her?”

The answer:

If you are not immunocompromised, you can stop isolation after 10 days and resume normal activities. If you are immunocompromised, then

20 days of isolation is recommended.

Regarding the risk of reinfection, there have been only five reported cases to date of COVID-19 reinfection worldwide, but I predict that will increase. Also, protection for most people who recover from COVID-19 is expected to wane.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My 14-month-old grandson got tested last Wednesday, and his parents and sister the day before him. I took mine this Monday and I’ve had him for four days up until Monday morning. The parents’ and sister’s test results came back Thursday all negative. Mine came back today negative. 

“And his came back today from last Wednesday positive. How can this be?”

The answer:

You didn’t mention the type of tests done. The possibilities include false negative results and testing too early. You are a close contact and should self-quarantine for 14 days from the date of your last contact with the grandson.

The parents and sister are household contacts and should also self-quarantine for 14 days. For household contacts, this will be 14 days from the date the grandson is released from isolation. Ideally, people should quarantine separately.

If any of the contacts develop symptoms, they could be swab retested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I have a resident here who was seen at her doctor’s office last Tuesday. Both had masks and we were informed today that the doctor tested positive for the

COVID-19. Does the resident have to go on quarantine and if so, how long?”

The answer:

In my opinion, the resident does not need to quarantine since both were wearing masks.

If the resident develops symptoms, then the resident should be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19 and self-isolate while awaiting test results.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

 

“Can you share a timeline for infection if I’m exposed to COVID-19 over Thanksgiving?”

The answer:

• Thanksgiving day exposure: Thursday.

• Presymptomatic and contagious: Sunday to Dec. 1.

• Symptoms start: Dec. 2 (still contagious).

• Contagious and symptomatic for up to 10 days: Dec. 12.

• Recovery begins: Dec. 13.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband and I are 78. One granddaughter is coming from New York for Thanksgiving. My other granddaughter will come from San Francisco. Will it be safe to distance outside for Thanksgiving with six people in attendance?”

The answer:

Gatherings with family who do not live with you can increase the chances of getting or spreading COVID-19 or the flu. As cases continue to increase rapidly across the United States, the safest way to celebrate Thanksgiving is to celebrate at home with the people you live with.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“On Nov. 1, I visited my neighbor. He, his wife, his son and his son’s girlfriend were there. I sat next to the girlfriend for about 45 minutes, chatting with the family. No one wore a mask. On Nov. 2, my neighbor called me to tell me the girlfriend’s dad had tested positive. The girl lives at home with her dad. I do not know the circumstances in which the dad went in for testing, if he was self-isolating or when he went for the test – only that he was positive.

“The girl was not sick or showing any signs of being ill. I do not know if the girl plans on going for a test herself. Should I be concerned now knowing she lives in a household with a positive member? I do not have any symptoms, but from what I’ve read, it takes at least 48 hours to 14 days before symptoms appear. Should I self-isolate and go get tested now? Or am I being overly concerned? I was not in direct contact with said infected person.”

The answer:

I recommend you self-quarantine separately for 14 days from the date of your last contact with the girlfriend. If you develop symptoms during those 14 days, you could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have recently tested positive for COVID-19. My husband and my children have been out of state for a week, so they have not had contact with me since I became positive. They are coming home. My question is this: since they have not been around me when I got sick, do they need to stay home or can they resume their normal activities? If I am positive, do I have to have no contact with them? I mean, can I even be in the same room as them at times or do I have to cut off all contact? And also when they’re at school, do I have to wear a mask when it’s just me around the house and can I do normal things like do their laundry and wash dishes?”

The answer:

If you are not immunocompromised, I recommend you self-isolate for at least 10 days since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms have improved. If you are immunocompromised, then I advise you to self-isolate at least 20 days since symptoms first appeared.

I also recommend you have no contact with your husband and children while you are in self-isolation. They can continue with their normal activities, as long as, they have no contact with you while you’re in self-isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“My co-worker’s daughter received a positive test result on Monday. She is asymptomatic. My co-worker is now quarantining and got a test. I was last in the office with her on Thursday. Desks are about 12 feet apart with metal cabinets between. At our desks, masks are off, but when we move from our desks we wear masks. Do I need to quarantine?

The answer:

At this time, you do not need to quarantine. If your co-worker becomes symptomatic, then you may need to quarantine depending on your interaction with her.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I was exposed in a classroom on Wednesday, Oct. 21, and was notified of the exposure on Saturday. I was tested and the results were negative, and I’ve never developed any symptoms. Is it OK for me to go back to school or do I still have to stay home for the entire 14 days?”

The answer:

The incubation period for SARS-CoV-2 is 14 days. For some, symptoms and a positive test will not occur until Day 14. I suggest that you maintain your quarantine.

The chance of getting a false negative test result decreases if you are tested three to four days after you were infected, or one to two days after symptoms start. 

In general, a positive test is more reliable than a negative test result due to the timing of the test.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“On Oct. 14, I took a PCR test at a local urgent care center that showed up negative three days later. However, on Oct. 15, I was having breathing problems and went to a local hospital where a PCR test showed I was positive and had pneumonia in my lungs. Is it possible that the urgent care messed up my first PCR test or maybe I got COVID in the hospital ER the following day?”

The answer:

The mean incubation period for the SARS-CoV-2 (COVID-19) virus is estimated to be three to five days. In my opinion, the first PCR test was too early.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“If I got COVID-19 from someone I was with on Oct. 24, then started getting symptoms on Oct. 27 and tested positive the 29th – when is it safe to go visit my boyfriend? I have regained my sense of taste and smell, haven’t had a fever in over four days.”

The answer:

If you are not immunocompromised, at least 10 days of self-isolation is recommended since symptoms first appeared. 

If you are immunocompromised, then at least 20 days of self-isolation is advised since symptoms first appeared.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I live in North Bergen, New Jersey. I was infected with COVID-19 in April. On Sept. 23, I took a test for antibodies and the results were IgG positive 35.32; then I took another test in October – IgG positive 40.00, the levels went up. The questions are why it went up and 35.32 to 40.00, are these percentages? Can you explain?”

The answer:

A great question! I can’t answer your question regarding percentages because I don’t know the instrumentation, methodology or standardization of the specific lab equipment used.

However, I can opine that your SARS-CoV-2 IgG antibody levels are stable over approximately eight months and implies immunity for now. I would not be concerned about the increase from 35 to 40. 

Protection for most people who recover from COVID-19 is expected to wane, and it is unknown how long protective immunity may last.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“We are going to visit my daughter at college. She tested positive and was done with her 10-day quarantine seven days ago. She has no symptoms. Now her roommate tested positive. Is there any way that my daughter would be able to spread the virus to us? They have separate rooms and separate bathrooms.”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

I do recommend everyone wear a mask and practice everyday preventative actions including good hand-washing hygiene and distancing.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My parents stayed with me Wednesday through Sunday, during a hurricane. I found out my boss tested positive. I got a negative rapid test Monday and a positive rapid test Tuesday. What’s the likelihood they’re infected if they left Sunday, a day before my negative test

and two days before my positive one?”

The answer:

I would suggest that your parents quarantine for 14 days. Since you had a positive COVID-19 test on

Tuesday and they were with you on Sunday, they were exposed. Most individuals are infectious 48 hours prior to symptoms starting. Your parents were with you during that time.

They should monitor themselves for symptoms of COVID-19 and if they become severe, then seek medical treatment.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband and I have both tested positive for COVID. It’s just the two of us in the house. We think his symptoms started around Oct. 23. He tested on Oct. 27, when he started quarantine, and he isolated in

one room. Since I almost never leave the house, I’m sure I got it from him – probably before we knew he had it. 

“My symptoms started around Oct. 30. Now (Nov. 4), he has a few lingering symptoms. He’s still quarantining at home, but no longer self-isolating. I’m mostly isolating from him, but not as strictly as he had been. We’re still sleeping in separate rooms, and we both wear masks whenever we’re out of our rooms. Is this still necessary? 

“Are we immune from each other? Or do we need to worry about viral load, and one of us making the other one sicker? I have Type 1 diabetes and a dysautonomia.”

The answer:

If you are the only two individuals in the home and you are both symptomatic, you do not need to isolate from each other.

Once you both are fever free for 24 hours without medication, it has been at least 10 days since your symptoms started, and you have seen symptom improvement, it will be safe to resume normal activities.

You do not need to worry about infecting each other, since you report you were infected by your husband.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My girlfriend and I don’t live together. We have not seen each other for over a month because we both have young kids, but mine are currently in school and hers are in virtual school. A student at my kids’ school tested positive for COVID-19, but the student was not in either of my kids’ classes. If my girlfriend and I each get a negative test result, how soon can we merge our bubbles again?”

The answer:

In my opinion, unless there is some other exposure history, which you did not mention, I don’t recommend testing or isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband was exposed at work to someone who tested positive. The last day he had exposure was on a Friday. He obviously would come home every day and bring that exposure to our household where we live with our two kids and my parents. 

“Sunday, I started symptoms and everyone else remained asymptomatic. I tested Monday and was negative yet continued to develop symptoms. 

“My husband tested on Tuesday and was positive and did not develop symptoms until Wednesday. 

“We isolated together (at this point he had not yet received his results), and the kids who had tested negative isolated away from us with my parents. I retested on Sunday a week from my initial symptoms and that came back negative, too, but I continued with symptoms. Is it possible to be positive and have 3 negative tests? I am also immunocompromised. I had to stay in isolation with him as I had no other area to isolate since the kids and my parents had no symptoms but I did. 

“My daughter has now developed symptoms and we await testing. When are we all officially able to say we are clear from quarantine? Also, if my daughter were to test positive and my spouse and I were finally starting to feel better can we reinfect ourselves by her?”

The answer:

There’s no problem in having multiple people isolate together, as long as we’re sure they’re all positive. But ideally, close contacts should quarantine separately.

Regarding your three negative tests, you didn’t mention the type(s) of tests performed. Negative rapid antigen test results do not rule out COVID-19 infection. It would be unusual to be infected with COVID-19 if the three negative test results were all molecular Polymerase Chain Reaction (PCR) test results.

You are immunocompromised and a household contact of your husband who tested positive. 

Therefore, I advise you to self-isolate for 20 days since your symptoms first appeared.

Regarding reinfection, there have been only five reported cases to date of COVID-19 reinfection worldwide, but I predict that will increase. 

Also, protection for most people who recover from COVID-19 is expected to wane.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was exposed in a classroom on Wednesday, Oct. 21, and was notified of the exposure on Saturday. I was tested and the results were negative, and I’ve never developed any symptoms. It is OK for me to go back to school or do I still have to stay home for the entire 14 days?”

The answer:

The incubation period for SARS-CoV-2 is 14 days. For some symptoms and a positive test will not occur until day 14. I suggest that you maintain your quarantine.

The chance of getting a false negative test result decreases if you are tested three to four days after you were infected, or one to two days after symptoms start. In general, a positive test is more reliable than a negative test result due to the timing of the test.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My son and I are positive, did the nasal PCR swab. A day later, my husband did same test and he’s negative. He’s asymptomatic but we have many mild symptoms. Could he really be negative? He was very ill in February, but I never was.”

The answer:

Your husband is a close household contact, and he should self-quarantine separately for 14 days. 

This will be 14 days from the date you and your son are released from isolation.

If your husband develops symptoms during those 14 days, he could be swab retested (molecular Polymerase Chain – PCR) or be advised to self-isolate.

You stated your husband was very ill in February. He could consider a blood test for SARS-CoV-2 IgG antibodies. If that test is positive, it indicates he was previously infected with COVID-19, but it doesn’t give the exact date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was exposed to someone who developed symptoms (two days later) and was diagnosed with COVID-19 two days after that. Her symptoms include exhaustion, aches, loss of taste and smell. I got tested seven days after our contact (We were both wearing masks; I was in her home for about 15 minutes). I tested negative, but a friend said I should continue to quarantine (tomorrow would be Day 10 after contact) and get two more negative tests before going outside my home or being near other people. I also should add that my husband has a lung condition.”

The answer:

The incubation period for COVID-19 is two to 14 days. Some people do not see symptoms until Day 14. I suggest that you quarantine for 14 days or wait until you have two consecutive negative tests at least 48 hours apart before breaking quarantine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My 28-year-old daughter had a sensation of losing her taste. At the time, we were redoing her room and putting in wood floors, so we attributed it to woodworking. That was Oct. 9. She tested positive on Oct. 19. We read she may test positive again as the virus lays dormant. Is it safe for her to come home now? She’s taking it bad not being home. Please help as it’s causing problems in our family.”

The answer:

Most people can stop isolation

10 days after COVID-19 symptom onset and resume normal activities if they are not immunocompromised. 

If the person is immunocompromised and/or has severe COVID-19 illness, then at least 20 days of isolation is recommended.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. 

For this reason, people previously diagnosed with symptomatic COVID-19 who have no symptoms after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

I do recommend wearing a mask and practicing other everyday preventative actions including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I saw a massage therapist on Oct. 24 for 45 minutes to work on an issue I was having. She was masked the entire time, washed her hands and used hand sanitizer before working on me. She did not touch my face or hands. I was masked for the majority of the time, and took my mask off only when I was laying on my stomach, at which point my face was in a towel on the headpiece of the table. After she left the room I stood up and retrieved my mask and put it on. She just texted me to tell me her husband tested positive after being exposed five days prior to our appointment. She tested negative. 

“They are both getting tested again. I am asymptomatic. My kids and I have had allergy symptoms since before the appointment and nothing has changed. Do I need to quarantine?”

The answer:

If the massage therapist tests positive, then you will need to quarantine for 14 days. You were in close contact with her for 45 minutes.

The massage therapist should quarantine for 14 days from her last exposure to her husband.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I am a nanny 20 hours a week, caring for an 8-year-old girl and 11-year-old boy whose mother is a dermatologist. There is a co-nanny who works with me also. She was the first to get tested positive for COVID-19; her symptoms were very mild. I immediately stopped work and got tested ASAP. I am negative. Now I found out that the mother and both children are positive. Does this mean my immune system is strong? If I unknowingly had it a while ago and got over it, I would still have infected my family. I am so grateful but I am so curious. I have to go back to work for this family. I will probably wait two weeks.”

The answer:

I agree you should self-quarantine separately for 14 days. If you develop symptoms during those 14 days, you could be swab retested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

At the end of 14 days, you could get a blood SARS-CoV-2 IgG antibody test. 

If the blood test is positive, that indicates you were previously infected with the novel coronavirus (COVID-19), but it doesn’t give the exact date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Six days ago, I visited an elderly relative who had seen her daughter the night before – about 12 hours earlier. I did not know this as the elderly relative has been trying to stay away from her adult children who don’t follow the current guidelines. On Wednesday, the elderly relative called to say the daughter had become sick and was rapid-tested for the virus with a positive result. The elderly relative then said she herself had been rapid tested Monday (negative) and also the more intense test and had received a positive result Wednesday morning. I immediately self-isolated yesterday and had the more invasive test this morning. I am having the quick test on Saturday. 

“What is my risk profile?”

The answer:

You were exposed to a COVID-19 positive individual. You should quarantine for 14 days.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My son was exposed to COVID-19 at a party at his house on Halloween and subsequently tested positive on Nov. 5. If he gets retested and has a negative test result before Thanksgiving, can he come home and spend Thanksgiving with us and not spread the virus?”

The answer:

Most people who are infected with COVID-19 will be safe to resume normal activities 21 days after exposure. 

Your son was exposed on Oct. 31. He will likely be healthy and able to visit by Thanksgiving. I urge you to tell him to monitor his health. If he has not been fever-free for 24 hours without medication or if his symptoms have not improved, then he should not visit.

While visiting, all individuals should wear a mask, maintain physical distance, and if possible open windows or eat outside. This will reduce your exposure risk.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am a 71-year-old female living with a boyfriend who first had symptoms Oct. 22, was tested the next day, and returned a positive test Oct. 26. His main symptom is a bad cough. I have no symptoms. We only have one full bathroom and sleep in different bedrooms. Do I need to quarantine if I have no symptoms? If so, for how long? Do we both wear masks in the home? I am beyond terrified because I give myself a Taltz shot once a month for psoriasis, and supposedly that can compromise my immunity.”

The answer:

You are a household contact of your boyfriend who tested positive for COVID-19. Yes, you should self-quarantine for 14 days from the date your boyfriend is released from isolation.

If your boyfriend is not immunocompromised, he should self-isolate at least 10 days since his symptoms first appeared. If he is immunocompromised, then at least 20 days of self-isolation is recommended since his symptoms first appeared.

Yes, both of you should wear a mask when entering general living areas. I also advise following other everyday preventative actions including good hand-washing hygiene, sanitize the single bathroom with a household disinfectant between uses, do not have visitors in the house, clean and sanitize the living space, especially high-touch surfaces (doorknobs, light switches, remote controls, etc.)

Finally, I recommend you inform your physician who prescribed Taltz.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My grandson was sick with a fever for two or three days a month and a half ago. He’s in college and he had a COVID-19 test before these symptoms started, which was negative. He thinks he had COVID-19 because during that time one of his roommates tested positive. Would it be unsafe for my husband and I to be around him now?”

The answer:

Your grandson could consider a blood test for SARS-CoV-2 IgG antibodies. If that test is positive, that means he was previously infected with COVID-19, but it doesn’t give the exact date.

Is it safe to be around him now? In my opinion, yes. Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Wonderful news that Pfizer’s vaccine is thought to be 90% effective against COVID-19. 

“But if people who have actually been infected with COVID-19 can become re-infected, what makes this vaccine more effective than actually having had COVID-19? Why will a vaccine have a longer lasting effect?”

The answer:

That is a great question. There is something called a molecular clock analysis that allows scientists to predict the rate of mutation of an RNA virus such as SARS-CoV-2. The enzyme the virus uses to make copies of its genome is called RNA dependent RNA polymerase. This enzyme makes mistakes at a rate that can be quantified. This rate of change would suggest that the virus changes every six months. These changes are small and may not be seen in the spike protein the vaccine was made against.

The Pfizer vaccine is promising. There are some concerns with the vaccine. It requires two doses, it must be kept very cold, and what the spectrum of disease symptoms were like in those that did get sick is not yet reported.

If the virus does begin to mutate in the spike proteins, then the COVID-19 vaccine could end up being like the annual flu shot. You will need one every year.

Vaccines to spike proteins, such as the Pfizer COVID-19 vaccine, give the body’s immune response a head start. If you have previously seen a pathogen, by vaccination or infection, then our bodies remember that infection. 

Memory in our immune response is a good thing. It allows our specific immune responses to start working within two to three days of infection (as compared to seven to 10 days for a novel infection).

With a pathogen such as SARS-CoV-2, starting to fight the virus faster, means less virus getting into our cells and less severe symptoms. 

To be clear, the Pfizer vaccine may do this, it remains to be seen yet. More data is needed.

For now, I am cautiously optimistic about the vaccine. 

The efficacy may decrease as the trial continues, but it will likely remain in the range that will give our population a fighting chance in ending this pandemic.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“A co-worker was sent home on Monday with COVID-like symptoms. The office was isolated and shut down, and contact with the employee was minimal for everyone – all while wearing masks. When the employee went to the hospital, they did not COVID test them, but instead gave her a medication and sent her home saying it was something else. To be safe, our workplace is making sure the employee takes a COVID test. In the meantime, I had minimal contact with the other employee – do I need to change my routine or isolate until her test result comes back?”

The answer:

Until you know if the individual was positive, you can continue to maintain social distance, wear a mask and practice good hand hygiene, but you do not need to quarantine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I am a dentist in New York. I am traveling to Florida with my wife for a long weekend. 

“Both my wife and I had COVID in March, and as of last month, still have both tested positive for antibodies. Do we both have to quarantine when we get back and if so for how long? Can I go back to work right away? Do either of us have to be tested when we get back?”

The answer:

In Pennsylvania, it is recommended that you quarantine for 14 days upon return from Florida. In my opinion, the recommendation for Healthcare Personnel (HCP) to self-quarantine after certain travel is a helpful recommendation, but not a required practice if there was no confirmed positive exposure.

New York may have different recommendations for travelers, and I suggest you contact your local health department for further advice and instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My 4-year-old granddaughter went to preschool Oct. 26-30, three hours a day, every other day. A child in her preschool class has now tested positive. She was in school with that child only on the 26th. I watched my granddaughter the week of the 26th. Do I need to worry about exposure. They did wear masks at school, but we did not wear a mask at my house. She cannot go back to school until Nov. 10.

The answer:

In my opinion, your risk is low since they wore masks at school.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My husband and I are 68. I had cancer treatments last year and my husband has high blood pressure. I haven’t hugged my 10-year-old granddaughter since March 8. A handful of distanced backyard visits and weekly Zoom. 

“Back in August, my son called me and said I needed to hear that I was burning a bridge with my granddaughter. They let her hug her other 92-year-old granny because she asked if it was OK. 

“So he now thinks she is going to think something is wrong with her because we haven’t hugged her. He said we were the only ones who weren’t touching her, she wasn’t dripping COVID and we needed to mask up and hug her. I cried and cried.

“My heart is broken, my family is broken. I emailed my doctor the situation and asked if we should mask up and go in for the hug. She said, ‘No, we were at high risk and unfortunately distancing was the safest for now.’ I sent my son her answer. My husband called him and asked if my granddaughter had said anything. She hasn’t. I feel my son and daughter-in-law should have told her they need to protect Granny for now so no hugging until we could all get a vaccination. My granddaughter had told me when she and I were taking a safe distance walk around her neighborhood that ‘this is how we walk at summer camp.’ Also, she asked me if the virus would be forever and I said no, but it would be awhile longer until doctors and scientists had a shot for us and she seemed good with that.

“In school, she is used to everyone in masks and distancing so she’s more aware I believe than my son thinks. He said she had never asked them about it at all. My husband let my son know how much he had hurt us and had no respect for our position and that we also worried about how this is affecting our granddaughter. My granddaughter and I were joined at the hip pretty much from the time she was born. She is my heart. Now my heart is sad and broken and even though my son apologized about ‘his approach’ and we still Zoom, I’m afraid she will drift away and these precious years can not be regained. Is there any safe way to do Christmas? She always spent Christmas Eve at our house.” 

The answer:

The holiday season will be especially difficult for all of us. 

However, when you combine masks with distancing (which is very difficult with family during the holidays) and other everyday preventative actions – including good hand–washing hygiene – that can make a difference.

You’ve already discussed your situation with your physician. The ultimate decision is yours. Your son should respect your decision, and I truly believe your granddaughter who is 10 years old will understand if the situation is correctly explained. You’re fortunate that your granddaughter lives close by.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“Our two sons, their wives and their children (ages 14, 14 and 19) have traditionally celebrated Christmas Eve at my wife’s and my house (age 75 and compromised immune systems). My wife and I do not feel safe having that celebration this year due to COVID-19. Our 19-year-old granddaughter suggested she thinks that if we all get tested, Christmas Eve is still possible. We can get tested a day or two before and quarantine until the actual night of. I’ve been tested a bunch so I’m super used to it, plus I plan on getting tested a few times when I’m home so I can be extra safe around everyone. I’m sure we all won’t mind the tests if it means getting to have Christmas Eve. I think it’s definitely possible to do it safely. Does this sound like a viable option for us?”

The answer:

The holiday season will be especially difficult for all of us. Unfortunately, there are no guarantees with negative testing. Risk is dependent upon age, immune status, when the exposure occurs, and the incubation period which for the SARS-CoV-2 (COVID-19) virus can be two to 14 days. In addition, negative rapid SARS Antigen tests do not rule out COVID-19 infection.

However, when you combine masks with distancing and other everyday preventative actions including good hand-washing hygiene, it’s hard to get COVID-19. 

We need to remind ourselves that we can make a difference.

The ultimate decision is yours. 

I’m sure your children and grandchildren will respect and understand your decision.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“I am wondering about all of us post-COVID individuals getting a flu shot. I am two months out from my first positive test on Sept. 5. I retested (pcr test) on Oct. 16 and got a negative, but was told I can still be expelling dead virus cells and this could continue up to three months before they’re all gone. I’m about 80-85% back to old self because I’m still dealing with some fatigue. So, should I wait another month, retest (pcr test), and if negative then get the flu shot? I just don’t know what a flu shot will do to us post-coronavirus individuals.”

The answer:

This is a great question. If you are not feeling well, you should wait on the flu shot. The influenza vaccine is designed to create an immune response, all be it with less magnitude, to the influenza virus. If you are still recovering from COVID-19, then you should delay the flu shot until you feel well.

I urge you to speak to your medical provider about any lingering symptoms of COVID-19.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My sister-in-law had COVID-19. 

“Later on my daughter contracted the virus. She visited my daughter. 

“My question is, can my sister-in-law transfer the COVID-19 virus from my daughter to a third person?”

The answer:

No, but your daughter can transmit the virus to a third person including you.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’m a photographer scheduled to do a Christmas session for a client this weekend. Her husband is a teacher and had a possible COVID exposure at school. He is asymptomatic. Would it be safe to photograph her and her son this weekend, provided the husband is still asymptomatic? We will be distanced by more than 6 feet. Thanks so much for any insight!”

The answer:

Since the father was exposed to COVID-19, he should be in quarantine for 14 days. He should not be interacting with others. If he becomes symptomatic, then his family should quarantine for 14 days from their last exposure to him.

I would not photograph the family. We quarantine to stop the spread of the virus.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“If an individual’s spouse or child has been exposed to coronavirus, what precautions should the individual’s employer take to protect others in the workplace.”

The answer:

The individual is a household contact, and this individual should self-quarantine for 14 days. This will be 14 days from the date the spouse or child is released from isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My husband and I donated blood to the Red Cross. I donated Oct. 1 and he donated Oct. 22. I am on Methyltrexate 25 mg sq for Reactive Arthritis. I developed Reactive Arthritis directly following a Cryptosporidium diarrhea infection June 5. 

“The Red Cross does antibody testing for COVID. My husband came back positive for antibodies and I came back negative. We have no idea when he may have had COVID. 

“I read some preliminary studies suggesting Methyltrexate may block RNA viral replication in COVID. Is it possible I just did not catch COVID from my husband or instead, maybe Methyltrexate stopped the virus from replicating in me?”

The answer:

There have been a few studies that investigate methotrexate and its effects on SARS-CoV-2. These studies show that he primary mode of action of methotrexate to stop folic acid pathways that lead to an inhibition of DNA synthesis. However, the anti-inflammatory effects of methotrexate are broad particularly at high dosages and the mechanisms are not fully understood. Methotrexate causes a significant decrease in inflammatory protein release (cytokine release) and it causes an increase the type of cell that can shut down the immune response, regulatory T-cells.

These studies suggest that individuals on methotrexate are less likely to have severe inflammatory symptoms with SARS-CoV-2.

It is difficult to say if you were protected because of methotrexate or if because you were on methotrexate, an immunosuppressive drug, you did not mount and immune response to it. Additionally, research shows that patients with autoimmune disorders are more likely to practice better social distancing, mask wearing, and hand hygiene.

Unfortunately, science does not have a good answer to your great question. More studies need to be conducted. I am glad you are healthy.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • • 

“My wife visited a friend 24 hours after her friend who unknowingly had corona and tested positive the next day was in the house; my daughter spent the night that night, (24 hours after person was in house); two days later people who live in the house are showing symptoms. Could my wife have picked it up off a surface or door knob or from the people who live there? Being in the house 24 hours after COVID positive person was there? It’s been two days we show no symptoms.”

The answer:

The coronavirus is mainly transmitted through the air. Masks slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.

Persons who test positive for COVID-19 are considered infectious 48 hours before the onset of symptoms. Persons testing positive but who do not have symptoms are considered infectious starting two days before the test date. The mean incubation period for SARS-CoV-2 (COVID-19) virus is estimated to be five days, with a range of 2 to 14 days.

Household contacts of persons diagnosed with COVID-19 should be instructed to self-quarantine for 14 days. This will be 14 days from the date the person with COVID-19 is released from isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My cleaning person (private residence) has tested positive for COVID. She began experiencing symptoms on Oct. 30. The test that she received on Nov. 2 came back positive. I learned of this today, Nov. 7. She was last in our home on Oct. 22 (I was there and neither of us wore masks). I have seasonal allergies of which I am experiencing symptoms. I am immune comprised. Should I quarantine? Should I get tested?”

The answer:

Most individuals are contagious 48 hours prior to symptoms of COVID-19 beginning. Since your cleaning person was symptomatic on the 30th of October and you had not been in contact with her since the 22nd, you were not exposed.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My daughter was at her cousin’s house on Nov. 6. She was dropped home immediately after the household was told a family member tested positive for Covid-19. This person was not at the house during this time. The family got tested the next day and results came back negative. My daughter is 14 and was at her cousin’s house for about three hours. As soon as she arrived home, she was sent to her room to self-isolate. I am closely monitoring her for symptoms as she is in isolation. So far there are no symptoms. Should I get her tested?”

The answer:

If your daughter was not exposed to the COVID-19 positive family member, she does not need to quarantine unless someone she was in contact with from the household tests positive.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I’m a little confused about exposure lines. So I had a friend stop by when our family was out of the house. She came in and used the bathroom. Today, she announced she tested positive. Should my family quarantine or was the risk low enough to not worry? We live just outside of Milwaukee.”

The answer:

Since you were not in direct contact with the infected person, the risk of exposure is low.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“Tested positive for COVID in early April. I thought I had allergies. Very runny nose, asthma-like symptoms, very tired, 87-94 blood oxygen levels often for two weeks, low grade off/on fever for two days, and had to use inhaler often for asthma. 

“X-ray and CT scan done of lungs. No pneumonia, yes bronchiectasis (never heard of before), and a 3mm nodule in right center lung were what showed. I had very rapid heart rates off and on, 130 for hours, which is why doctor ordered scan. I still have asthma symptoms more often, almost daily now, and before they were very seldom. My question is why did my antibody test in July show none? It was an IGg test. Did I or didn’t I have it, and should I repeat the antibody test? One doctor said I must not have had it, another said I probably did, but the antibodies didn’t last or didn’t produce enough to show. I’m so confused.”

The answer:

Positive tests for COVID-19 are reliable, sensitive and specific. What I mean is, if you test positive, you are positive for the virus. Negative test are not as reliable. The time of testing after infection/exposure and the type of test you received make negative results less valid.

Since you had a positive test for COVID-19 in April, you were infected with SARS-CoV-2. The negative antibody is less reliable. I see no reason why you need to retest, unless it would give you peace of mind.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“If I have had COVID-19 and get exposed to someone again, can I then potentially pass it to others or does my immunity keep me from carrying also?”

The answer:

Protection for most people who recover from COVID-19 is expected to wane. Without the arrival of an effective and safe vaccine and broad immunization, more people could become susceptible to the virus again, and that could increase the risk of transmission.

The most important question for reinfection is whether reinfected people can transmit the virus to others? The answer is unknown at this time.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’m just curious, as a person who just tested positive, is there a specific way I should be sleeping to maximize air to the lungs? I know sleeping on my back is probably best, should I be elevated?”

The answer:

It increases lung capacity. It is best to sleep on your back with a slight to 45-degree angle of incline. This takes pressure off the diaphragm and allows the lungs to get greater volume of air.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My daughter asked us, my husband and I, to Thanksgiving at her house this year. I am 71 and my husband is 66. She said they will all take tests for COVID before we visit. My question is: if they all test negative, would it be OK to go visit and all of us wear masks?”

The answer:

Many public health officials are urging families to consider having online Thanksgiving celebrations this year. In many places across our country, community spread of COVID-19 is occurring. Recent research shows that increasingly Americans are becoming infected from small gatherings.

The risk is yours to assume. If your family members can quarantine for two weeks before your visit and you can do the same, your risk is low. If you get tested and quarantine from the test date until visitor arrival, then your risk is low.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I was in the car with a friend for about 30 minutes super early on Oct. 31. We then hiked outdoors and then drove home together. She notified me on Monday that her mother tested positive for COVID. What is my risk for catching it? She hasn’t been tested yet but feels OK. Should I get tested or is it too early?”

The answer:

It’s an even chance if you weren’t wearing a mask.

I recommend you self-quarantine separately for 14 days. If you develop symptoms during those 14 days, you could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I was tested positive on Oct. 1, and quarantined myself for 26 days, then went for swab test on Oct. 26. The result showed again positive. I have no symptoms just weakness and dizziness. I am taking one Multivit tab and one Zinc tab per day. I have to resume to my work and my coworkers are afraid I am still positive. I was planning to go for test again on Friday. At least this time it must be negative. If it again turns to be positive how should I take it? I have to travel back to my home country by end of November. Can I lead a normal life with my wife and kids?”

The answer:

Some individuals will test positive for weeks after symptoms resolve.

You can return to normal activities when you have been fever free for at least 24 hours, it has been at least 10 days since symptoms have begun, and you have seen symptom improvement.

I would urge you to continue social distancing, wearing a mask in public and frequently washing your hands.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I showed symptoms and tested positive on Oct. 26. My family tested negative. I have isolated away from my family, but they started running a fever on the 30th. They didn’t get retested but assume they are now positive. 

“Does that change everyone’s quarantine dates or will they stay the same?”

The answer:

If you are not immunocompromised, at least 10 days of isolation is recommended since symptoms first appeared. If you are immunocompromised, then at least 20 days of isolation is recommended.

For household contacts, 14 days of self-quarantine is recommended from the date you are released from isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My partner’s family has tested positive for COVID-19 and we are around them constantly. My partner and I went to get tested and he came back positive and I am negative. I am high-risk because of my autoimmune disease lupus and anti phospholipid syndrome being prone to blood clots makes me high-risk for pregnancy. I am extremely nervous. I have other health issues such as asthma. We live together and I am wondering if I just came up false negative or am I a rare case?”

The answer:

I suggest that you speak with your physician.

A negative result is less reliable than a positive result. A negative test result could be due to testing too early or the kind of test taken (genome vs. rapid).

Since you are at high risk, please isolate from the positive members of your household.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“On Oct. 22, my boyfriend, his mother and his son all tested positive. We all live in the same house and are around each other. My boyfriend and his mom had a fever and got sick. His son who also tested positive showed no symptoms. I, myself, had a low-grade fever and diarrhea, vomiting for three days. I have taken four tests during our whole quarantine and have always tested negative. The local health department has moved my date to Nov. 20 to be at home. Why am I not testing positive and is it possible that I actually did have the virus?”

The answer:

I agree with the local Health Department’s decision.

You didn’t mention the type(s) of tests. 

There is the possibility of false negatives and/or the specimens were inadequate.

I suggest you consider a blood test for SARS-CoV-2 IgG antibodies in one to two weeks. If that blood test is positive, that indicates you were previously infected with COVID-19, but it doesn’t give the exact date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“It’s been a few months since my daughter (she is 20) was COVID positive. She was quite sick, but she is quite better now (she has been healthy for the last month). My question is, can she transmit the virus to us? Can she be a carrier even though she has antibodies?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

When you combine masks with distancing and other everyday preventative actions including good hand washing hygiene, it’s hard to get infected with COVID-19.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“Is there any action that can be taken regarding a medical provider that is not following the Pennsylvania state travel quarantine list? A local medical provider is traveling to states on the list and immediately returning to the office to treat patients without following a two-week quarantine guideline. They are in close contact with the patient and treating for well over 15 minutes. This seems to be putting patients at risk. The practice takes patient temperatures, asks all the common screening questions and requests that if the patient travels they not come in for the period of time. 

“However the providers in the practice do not follow the same rules. Is there anything that can be done about this? You would think a provider of medical services would know better and be more careful.”

The answer:

In my opinion, the recommendation for Healthcare Personnel (HCP) to self-quarantine after certain travel is a helpful recommendation, but not a required practice if there was no confirmed positive exposure.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“On Oct. 22, I hung out with a friend for about two hours. We ate in the car and went shopping at a couple of stores. The next day, the same friend calls me late in the afternoon that a relative, that she had visited about four days before the day we hung out, tested positive for COVID-19 that day.

"This same friend had the virus about two months ago. I got a rapid test on Oct. 24, which came back negative. But the thought of it being false is giving me so much anxiety that I can’t tell if my headache and sinus pressure are symptoms of anxiety or COVID.

"What is the likelihood that she could be infected again and what is the likelihood that I could be infected?”

The answer:

Persons who test positive are considered infectious 48 hours before the onset of symptoms. 

Persons testing positive but who do not have symptoms are considered infectious starting two days before test date.

There have been only five reported cases of COVID-19 reinfection worldwide.

In my opinion, your risk is low. 

However, since you are symptomatic, I suggest you retest (swab molecular Polymerase Chain Reaction – PCR), and that you self-quarantine to your home while you wait for your result.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My boyfriend started having classic symptoms of COVID (extreme fatigue/headache/fever/loss of smell and taste) starting on Oct. 14 lasting through Oct. 20. He took two tests (Oct. 17 and 21) both of which have been positive. We have not been in physical contact since Oct. 7, but are wondering when it will be safe to do so? Is he still contagious while testing positive even though he no longer has symptoms? Do we need to wait for an official negative test to be able to safely be together or when is it safe for me to be near him?”

The answer:

Individuals who are positive for COVID-19 can resume normal activities if it has been 10 days since their symptoms have begun, they have been fever-free for 24 hours without medication, and they have seen symptom improvement.

You report that your boyfriend began to see symptoms on 10/14, he is likely not contagious now.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I’m going to take care of my elderly parents, but to get to them I’ve got to take a four-hour flight. I will test a couple of days before I board the plane to make sure I’m negative, but I could get infected during the flight. If I stay at a hotel and test again the day after I arrive, would a negative result mean I won’t have a chance of infecting them?”

The answer:

No. The incubation period for SARS-CoV-2 is 14 days. It typically takes three to five days from the last exposure for a genome test to be positive if exposed. You would need to wait until Day 3 or 4 after your plane ride to be tested. This will give you a more realistic answer on your COVID-19 status.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My girlfriend and I were exposed to someone with COVID on either Saturday or Sunday. This is now Day 5/6 after exposure. We live together and today my girlfriend tested positive and I tested negative. Her only symptoms were sinus pressure and nasal congestion which has gotten better. I have no symptoms. 

“Is it possible for my immune system to fight it off and not get it at all? Or will I eventually get it? Any tips would be appreciated.”

The answer:

Since you are in close contact with a positive individual, you should be in quarantine for 14 days from the last exposure.

Recent evidence suggests that close contact that combines to 15 minutes in total without social distancing or wearing a mask, can lead to infection.

Science is still not certain what the infectious dose of SARS-CoV-2 is. That being said, the continual exposure that may be happening, if you are not self-isolating away from your girlfriend, could lead to infection.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“My fiancé, whom I live with, started to lose her sense of taste so we went to go get tested the next day. We did the rapid testing. 

“My fiancé’s result was positive but mine was negative. Do we need to quarantine separately or can we quarantine together?”

The answer:

If you are living with someone who has tested positive, that individual needs to self-isolate. 

“They should be using a separate bedroom and bathroom, if possible. If that is not possible, the non-positive person will need to quarantine for 14 days from the last date of exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My granddaughter, 14 years old was exposed to a soccer mate on Oct. 31 who has COVID-19. My granddaughter went to be tested today and quarantined until Nov. 4 waiting on results. I was at her soccer game and gave her a hug after the game. What should I do for myself?”

The answer:

In cases where an individual is with someone who was exposed to a positive patient, you need not self-isolate until or unless that exposed person begins to develop symptoms or tests positive for COVID-19.

In your case, you had a brief interaction with your granddaughter. Even if she tests positive, it is unlikely that you will need to self-isolate (if your interaction was a brief hug).

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My son was with some friends on Saturday for over two hours, not wearing masks. 

“Monday morning he spent about four hours with my husband, running errands, and out to breakfast. On Monday evening, my son was notified that the couple they were with on Saturday tested positive for COVID. He was tested on Tuesday with negative results on Friday. It’s been six days and he has no symptoms. Does my husband need to isolate? My husband got tested to be safe, and has no symptoms.”

The answer:

In cases where one family member is exposed and subsequently interacts with others, the exposed member of the family member should self-quarantine. Anyone who was in contact with the person who was exposed need not self-quarantine until and unless the exposed person tests positive or begins to express symptoms.

The family member who is exposed should self-quarantine and avoid contact with others in the household to the extent that they can.

In your case, your husband does not need to quarantine until or unless your son tests positive or begins to express symptoms.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My son recovered from COVID-19 last month and is now wanting to go out and work again. He is doing remote learning through his university and living at home. I’m concerned that although he may have antibodies, he can be exposed again and carry it back home to the rest of our family. Is it possible for a person who recovered to be a carrier and super spreader after they have recovered? Is it safe for him to go in and out of our home or are we at risk of exposure? I just want to know if he can pick it up and give it to us even if he doesn’t get reinfected?”

The answer:

The virus that causes COVID-19, SARS-CoV-2, is spread by airborne droplets and aerosols. It is unlikely that your son will bring it to you on inanimate objects.

Recent evidence suggests that reinfection is possible. A few individuals across the globe have been reinfected. Science is still unsure about how long antibodies to the virus will provide protection. This is because the virus undergoes a slow change.

If your son practices good hygiene, wears a mask when with others, and maintains his social distance, then he can resume normal activities.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I was exposed in a classroom on Oct. 21 and was notified of the exposure on Oct. 31. I was tested and the results were negative, and I’ve never developed any symptoms. It is OK for me to go back to school or do I still have to stay home for the entire 14 days?”

The answer:

The incubation period for SARS-CoV-2 is 14 days. For some, symptoms and a positive test will not occur until Day 14. I suggest that you maintain your quarantine.

The chance of getting a false-negative test result decreases if you are tested three to four days after you were infected, or one to two days after symptoms start. In general, a positive test is more reliable than a negative test result due to the timing of the test.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I tested positive for COVID-19 on Oct. 8. It is now Oct. 25 and I am still experiencing symptoms. Am I still contagious? Should I get retested?”

The answer:

Most individuals are no longer contagious after two weeks. Some individuals are contagious for 21 days. It is unlikely that you are still contagious; however, I urge you to speak with your medical provider with respect to your symptoms.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My daughter is a college student who went through weekly testing. She tested positive, was asymptomatic, isolated on campus for 10 days and then came home. 

“Are we OK to interact with her normally within the house without masks?”

The answer:

Since it has been 10 days since her positive test and she has not had symptoms, she is likely not contagious.

It is still good practice to wash your hands regularly, wear a mask in public and practice social distancing.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Today is Wednesday and I just found out that my husband’s son, whom we were with for about an hour on Sunday, has tested positive. He doesn’t have symptoms, but went to an urgent care because his sinuses were bothering him. My husband and I are both over 65, so what should we do? Get tested? Quarantine?”

The answer:

You should quarantine, separately if possible, for 14 days. If either of you develop symptoms, that person should self-isolate and the other (if not quarantined separately) should begin another 14 day isolation.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I’m from Connecticut and recently went to an indoor event in New Jersey which is not on our travel destination ban list. It was a seven-hour event and I walked out for at least five to 10 minutes multiple times. I wore a mask, but realized that there was only about 20% compliance with wearing masks in a room of 75 to 100 people. I wore mine and didn’t talk to anyone without, kept my hands washed or sanitized and didn’t touch my face, was mostly at least 3 feet away from others (there were chairs in front of me and people walking past me), and no one coughed or sneezed on me. I am not aware of anyone having had COVID. It’s been eight days and I’ve been symptom free, should I continue to quarantine for the full 14 days? I got a PCR COVID test on Day 5 after the event and waiting for results, if it comes back negative am I considered COVID free?”

The answer:

The incubation period for SARS-CoV-2, the virus that causes COVID-19 is 14 days. As of the writing on this answer, it has been 11 days. If your test came back negative, I feel it is safe for you to break quarantine. If you want to be abundantly cautious, you should wait the 14 days.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have not had a positive test but have experienced symptoms for two weeks and have only been outside to get tested. I tested negative last week and this week. My provider is shocked that my results are negative because my symptoms are “classic.” If I am testing negative, but still have COVID, am I contagious?”

The answer:

You didn’t mention the type(s) of negative tests. 

If the negative test results were rapid SARS Antigen, that does not rule out infection.

If you are not immunocompromised, at least 10 days of isolation is advised since symptoms first appeared and at least 24 hours have passed since the last fever without the use of fever-reducing medications and symptoms have improved. If you are immunocompromised, then at least 20 days of isolation is recommended since symptoms first appeared.

I would also recommend a swab molecular Polymerase Chain Reaction – PCR test if not already done. Finally, I would consider a blood SARS-CoV-2 IgG antibody test in one to two weeks. If the blood antibody test is positive, that means you were previously infected with COVID-19, but it doesn’t give the exact date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I clean homes. If my clients tested positive, he is negative now. When is it safe for me to go in the house?”

The answer:

It would be safe for you to return to cleaning your clients’ home

when it has been at least 10 days since his symptoms have started, he has been fever free for at least 24 hours and his symptoms have improved.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •  

“I have had symptoms for three weeks. Vomiting, diarrhea, cold sweats, stiff left arm, muscle aches, headache and dizzy. On Oct. 13, I got a test at CVS. Negative. Week 4 until now, my chest tightens. Headache and top of my right back behind shoulder blade has so much pain. Saturday, took test at Walgreens. Negative. I feel something is wrong with my body inside. I have autoimmune diseases.”

The answer:

You had two negative tests performed at pharmacies. You didn’t mention the type of tests, but if you received the results within 30 minutes, I suspect these were rapid SARS Antigen tests. Negative antigen tests do not rule out COVID-19 infection.

I’m concerned about your symptoms, including “chest tightness and heavy chest,” which may be heart or lung related. Therefore, I strongly advise you to contact your physician as soon as possible. 

If you have trouble breathing, persistent pain or pressure in the chest, or bluish lips or face, seek emergency medical care immediately.

I recommend a swab test (molecular Polymerase Chain Reaction – PCR) for COVID-19. Wear a mask and practice everyday preventative actions, including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Today, I have an electrician in my home. We are both wearing masks. While here he received a call from his wife that a co-worker of hers tested positive. She works at a bank where they all wear masks and she has not seen this co-worker for five days as she has been on vacation. I’m trying to determine my exposure risk as he is in my home and has been for several hours before he got the call from his wife.”

The answer:

You were not exposed. The electrician’s wife was not exposed if she has not been at work or in close contact with the infected individual.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I did a rapid test and a five-day test. The rapid was positive. I have quarantined, but I question the results of the rapid test that is why I did the other test. I have hot flashes and just stopped smoking, so having a cough is common. Is it possible the rapid test was wrong?”

The answer:

A positive rapid SARS Antigen test is highly accurate, but a negative rapid SARS Antigen result does not rule out infection.

Also, a positive rapid SARS Antigen result indicates that protein from SARS-CoV-2 (COVID-19) was detected, and the patient is infected with the virus and presumed to be contagious. Therefore, I recommend you self-isolate for 10 days if you are not immunocompromised and 20 days if you are immunocompromised.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My son participates in wrestling at his middle school. According to the school district, New Jersey Gov. Phil Murphy has stated that winter sports will continue with precautions put in place. Although they will be taking temperatures, wearing face masks before and after matches and eliminating spectators, I feel he is still at risk. Others believe that because you are exposed to the other athlete for less than 15 minutes, you are safe, I disagree. If all other precautions are taken, wouldn’t someone still be at risk if their opponent was asymptomatic and COVID-19 positive but close contact was less than 15 minutes?”

The answer:

Recent evidence suggests that repeated short-term exposure (in close contact without a mask) to a COVID-19 positive individual that accumulates to 15 minutes, increases your risk of contracting SARS-CoV-2, the virus that causes COVID-19.

Exercise increases the respiration rate. A virus that is spread via airborne droplet and aerosols is going to be expelled at a faster rate from increased respiration.

There is inherit risk of contracting SARS-CoV-2 involved in wrestling.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I got the virus three months ago. Now, I’m recovered, but I have not gotten my taste fully back. I can smell more than what I taste and I’m confused and don’t know how I can get my taste/smell back to before when I didn’t have it. Any advice or solutions to solve the problem? Any meds I can take?”

The answer:

A study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at least one symptom, particularly fatigue and shortness of breath. Other reported persistent symptoms included loss of smell and distortion or unpleasant taste. Continued monitoring for long-term effects is needed.

I’m not aware of any medications or specific treatments for this. I suggest you talk with your primary care physician about a referral to a specialist.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“I suddenly felt ill about a week ago. I thought nothing of it – just a fever/weather changes. I got better in a day, and went out for three days until I realized that I had lost my taste, but could still smell a little. I tested positive for COVID. Now, that I am quarantined and away from my family, my little brother who is 6 years old has a sore throat. I just realized that he slept with me the night before I got tested positive, and the day before he had a sip of my tea. Is it possible for him to have it?”

The answer:

Your brother was exposed to you. He will need to quarantine for 14 days from his last exposure to you.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I recently had to take a trip to the ER for a foot injury. I saw no other patients during my time there and was taken to an exam room quickly, but cumulatively spent well over 15 minutes with four different health care professionals in and out of my exam room, some within six feet. All of them noted the hospital was receiving a lot of COVID-positive patients that night. 

The hospital is quite small with only one intake area, waiting room and hallway for anyone coming in. I don’t know if there were designated exam rooms or staff specifically for non-COVID patients, but I got the impression that there were no such precautions. 

I know my exposure risk is low and I’ve had no symptoms, but I have an immunocompromised child and elderly parents, so I got a PCR test on day seven (still awaiting results) and have been quarantining in a spare room since the possible exposure. 

If the PCR test comes back negative and I continue to be symptom-free, would it be a mistake to see my parents on day 12 since my ER visit? What is the likelihood of people catching the virus in an ER setting? Should I wait the full 14 days even though I don’t technically meet the criteria of a close contact?”

The answer:

I agree that your exposure risk is low, however, waiting 14 days seems wise.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My boss tested positive for COVID-19 two weeks ago. His children and wife tested positive last week. Is he still contagious even though his symptoms are gone? He says it’s safe to be around him even though his wife and children are sick and have fevers?”

The answer:

Individuals who are positive for COVID-19 can resume normal activities if it has been 10 days since their symptoms have begun, they have been fever free for 24 hours without medication, and they have seen symptom improvement.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“On Tuesday, my granddaughter (age 5) was exposed at school to someone who tested positive for COVID-19. We were not informed of the exposure until Thursday evening. On Wednesday morning, I got her ready for school and shared some snuggles before she left the house. I picked her up after school on both Wednesday and Thursday and spent time with her (no masks) crafting, reading, snuggling, watching a movie, etc. My granddaughter is not showing any symptoms. I have seasonal allergies and use an inhaler daily, so any COVID symptoms could be mistaken for the seasonal allergies (or smoke in the air due to wildfires in the area). 

Do I need to quarantine? I went home to my husband each evening – does he need to quarantine? Should I get tested?”

The answer:

I do recommend the granddaughter, her parents, you and your husband all quarantine for 14 days. 

Ideally, people should quarantine separately.

If anyone develops symptoms during those 14 days, they could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber 

• • • • •

“Do I have to wear a mask to bed if I sleep with my 11-month-old son?”

The answer:

Were you exposed to someone with COVID-19, or are you symptomatic? If so, it is best to self-isolate. If that is not possible, you should wear a mask when around others and wash your hands regularly.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I saw my niece without a face mask and outside on Tuesday. Wednesday, I saw my parents outside with no mask and that day my niece tested positive, but with no symptoms (she was exposed one week ago). I’m worried about my parents, did I expose them?”

The answer:

In my opinion, your parents’ exposure risk is low since you were wearing a mask when you were with your niece. The risk is lower if your niece was also wearing a mask.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“So my son lives with his mom. He is 4. His day care on Monday had a report of a child/teacher test positive, then on Wednesday another child whom my son is friends with tested positive. Now, today, he is starting to get sick. Should I be worried about me and my new wife and our other kids because we had him last weekend before he started showing symptoms? We haven’t seen him at all this week.”

The answer:

Persons who test positive for COVID-19 are considered infectious 48 hours before the onset of symptoms. Persons testing positive, but who do not have symptoms, are considered infectious starting two days before test date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“A co-worker came to work wearing a mask on Oct. 19. Others in the office she was in contact with did not have masks on. She had a nasal swab come back positive for COVID-19 on Oct. 22. I was not working in the office on Oct. 19, but was around those the infected co-worker was talking to on Oct. 20 through Oct. 22. Is it possible I can get the virus?”

The answer:

The risk is lower since the co-worker who tested positive for COVID-19 was wearing a mask. If you were wearing a mask on Oct. 20-22, then your risk is low.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My son took his grandson to see his mom, who recently got out of jail six days before she showed symptoms of COVID-19. Could she have been contagious then and has this child been exposed?”

The answer:

Persons who test positive for COVID-19 are considered infectious 48 hours before the onset of symptoms.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My 6-year-old grandson’s teacher revealed that she has COVID. The kids don’t interact with each other or the teacher. The school said he needs to quarantine for two weeks. Now my question is, since I keep my grandson every weekend, should my husband and I worry and quarantine ourselves?”

The answer:

Yes, I recommend you and your husband also quarantine for 14 days since you keep your grandson on the weekends.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My mother-in-law was diagnosed with COVID on Oct. 23. It will be two weeks now that she has been in the hospital with it. She is diabetic and takes three shots a day. For a week while she was in the hospital, they couldn’t give her shots to her due to her sugar dropping in the 30s and blood pressure dropping into the 60s. On Oct. 20, they had to secure her to the bed because she was pulling her IV out and trying to fight with nurses and doctors. On Oct. 21, she was talking to them all and no problems. On Oct. 22, she can have her eyes open, and doctors and nurses will talk to her but she will not respond. They said it’s like she’s just ignoring us, but she will just look and not say anything or blink. The doctor called us and he said he has no idea what's going on with her. She’s 65 years old. Could someone please tell me what’s going with her?” 

The answer:

COVID-19 affects different people in different ways. Infected people have had a wide range of symptoms reported, from mild symptoms to severe illness. Low blood sugars (hypoglycemia) can cause unusual behavior.

COVID-19 can damage the brain’s blood supply, such as strokes and bleeding. 

COVID-19 can also cause altered mental status, such as confusion (“brain fog”) or unconsciousness, which is sometimes accompanied by inflammation and swelling of the brain.

I recommend a neurology consult as soon as possible. If a neurologist was already consulted, then I would consider transferring your mother-in-law to a university medical center.

I hope she improves and recovers.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My boyfriend’s aunt was exposed to COVID-positive people during a work event a few days ago. She now has a fever, but hasn’t gotten tested yet. She’s been in his house for two days so far. I slept there the two nights she was there, but the only time I was around her was during dinner. 

“My boyfriend drove her home from the airport. Neither me or my boyfriend have symptoms so far. I tested positive for COVID in March. I recovered since then. 

“I live with two elderly grandparents at home. My question is, should I quarantine from my grandparents and from work for 14 days at my boyfriend’s house or until we get tested? I know we don’t know if we can get it twice yet, but I just want to take every precaution in protecting others, especially my elderly grandparents.”

The answer:

I advise both you and your boyfriend to self-quarantine separately in private rooms for 14 days, and use private bathrooms if possible.

If the aunt tests positive for COVID-19 and she’s living with your boyfriend and you, then you and your boyfriend are household contacts and should continue to self-quarantine for 14 days from the date the aunt is released from isolation.

Everyone in both households should be wearing masks and practicing other everyday preventative actions, including good hand-washing hygiene, clean and sanitize high-touch surfaces (doorknobs, light switches, bathroom fixtures, remote controls, etc.)

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“My mother-in-law had open-heart surgery on Oct. 2, tested negative for coronavirus on Sept. 28 before entering the hospital, was very sick and had a fever on Oct. 11, retested on Oct. 11 and 12 and was positive. She also was found to have severe UTI, with EColi, treated with Rendesivir and many antibiotics. 

“The fever subsided in two days, so she was released from hospital on Oct. 20, and then came to my house with my husband and I. She then had a fever of 100.4 on Oct. 22, and subsided with Extra-strength Tylenol. Could this be from COVID? Should we and other family members be tested? 

“What are the chances we could get it, or should we quarantine?”

The answer:

I don’t know all the details involving your mother-in-law’s hospitalization and the medical decision making. However in view of her severe illness and immunocompromised status, I would have considered 20 days of isolation since the date of her first positive viral diagnostic test.

There could be multiple causes for the fever of 100.4 on Oct. 22 including COVID-19, other bacterial infection, inflammation, decreased air in the lungs, possible blood clots, etc. I recommend you contact, as soon as possible, her physician, cardiologist, and heart surgeon for instructions.

Regarding your family’s COVID-19 exposure risk, I suspect your risk is low. 

I recommend everyone wear a mask and practice everyday preventative actions including good hand-washing hygiene, clean and sanitize the living space, especially high touch surfaces (doorknobs, light switches, bathroom fixtures, remote controls, etc.)

Best wishes for her full recovery.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was informed by my employer that I’ve been in contact with someone who has tested positive and they’d like me to quarantine and get a test. I know the day of exposure, which was 48 hours ago. 

“When is the best time to test? Is 48 hours too early?”

The answer:

Close contacts of patients diagnosed with COVID-19 should be instructed to self-quarantine for 14 days from the date of their last contact with the patient. Ideally, people should quarantine separately.

If a close contact develops symptoms during those 14 days, they could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or they may be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“We just returned from Florida. Is there a time limit that we have to wait to get tested so we can return back to work?”

The answer:

If you travel to a state with a high number of COVID-19 cases (which includes Florida), it is recommended that you self-quarantine for 14 days upon your return. Ideally, people should quarantine separately.

If you develop symptoms during those 14 days, you could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

“I’m from Connecticut and recently went to an indoor event in New Jersey, which is not on our travel destination ban list. It was a seven-hour event and I walked out for at least 5 to 10 minutes multiple times. I wore a mask, but realized that there was only about 20% compliance with wearing masks in a room of 75 to 100 people. I wore mine and didn’t talk to anyone without one, kept my hands constantly washed or sanitized and didn’t touch my face, was mostly at least 3 feet away from others (there were chairs in front of me and people walking past me), and no one coughed or sneezed on me. I am not aware of anyone having COVID. It’s been eight days and I’ve been symptom free, should I continue to quarantine for the full 14 days? I got a PCR COVID test on Day 5 after the event and am waiting for results. If it comes back negative, am I considered COVID-free?”

The answer:

The incubation period for SARS-CoV-2, the virus that causes COVID-19, is 14 days. As of the writing on this answer, it has been 11 days. If your test came back negative, I feel it is safe for you to break quarantine. If you want to be abundantly cautious, you should wait the 14 days.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

“I have a few questions. In April, my daughter-in-law had a low fever and said she didn’t feel good. She was tested at a fire station because the doctor at the care center said symptoms weren’t enough to warrant a COVID-19 test. (Her husband is a volunteer firefighter). She was working from home, so since she didn’t feel too bad she just worked.

“Her husband tested positive and quarantined 14 days. X-ray showed damage to his lungs, but he wasn’t ever sick. It took about 24 days before she got a negative test back. He felt bad a month later, went to the doctor and tested negative for COVID, but positive for the flu. Two months later, he tested again, because of exposure at his job. The COVID test was positive again. He had to leave work for 14 days. Again, no symptoms.

“In the interim baby girl (6 months old) wasn’t feeling well and had an ear infection and tested positive, but recovered fine. 

“I’m assuming the other two kids probably got it but were fine also.

“Now here is a question nobody knows the answer to: Can you catch COVID-19 more than once? He has tested positive repeatedly with lung damage and now antibodies but is he truly sick with COVID? Is he a carrier? Do we need to stay away?

“I know for sure I don’t have it and haven’t had it. I was at hospital, just last week, for an arthritis flare-up and was having fatigue due to four weeks of pain and no relief and out of breath from trying to walk around in pain.

“The doctor at the emergency room insisted I had COVID-19. No fever, no cough, no sniffles. He justified it by saying I had all-over-body pain. Not once did he address my issues. I was in severe pain. I have several autoimmune conditions and i was worried. 

“Rapid test (40 minute test, nose swab) – negative. Chest X-ray – negative. Blood work was done and I was sent home to await results a few days later. Nose swab tested in lab – negative. Antigen test, antibodies test, molecular detection test – all negative. So not one test came back to prove doctor right.

“Was he getting paid to run these tests? Why would he try to convince me I had COVID when I knew i didn’t?

“He also did CBC, urine analysis, CBC with differential. Those showed a slight possibility of a bacterial infection in my body somewhere. He did not address this. Also showed anemia. Not a word. I saw all this on my blood work results after the fact. I am not a doctor, but I do know my body and I have had quite a bit of blood work done and am aware of what some results can lean toward. This doctor totally disregarded me.”

The answer:

Sometimes the SARS-CoV-2 (COVID-19) virus is persistent in detectable levels up to 12 weeks after the initial symptomatic infection, but likely isn’t infectious.

A young man in Nevada was recently the first reported case of COVID-19 reinfection in the United States, and the fifth case of reinfection worldwide. The genomes of the virus samples suggested that the patient was infected by two distinct COVID-19 infections.

I’m sorry that your ER encounter did not meet your expectations. I suggest you schedule a follow-up appointment with your primary care physician to discuss your symptoms, issues and recent ER lab results.

I hope you are feeling better.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“My wife and I both are coronavirus positive. Are we at risk during this period for a child and will it have any effect for pregnancy? Please give me suggestions regarding the subject.”

The answer:

A recent study done by the CDC suggests that pregnant individuals with COVID-19 are more likely to be hospitalized and are at increased risk for intensive care unit (ICU) admission and receipt of mechanical ventilation than people who are not. Risk of death is similar for both groups. But much remains unknown.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have been checked and am IGG positive for COVID. So I am assuming I had it and am asymptomatic for over two weeks. What is the risk of me traveling to Missouri to see my children who are negative? My concerns are can I be a carrier from traveling through the airport and can I carry the disease to them and my grandchildren? In other words, can I be an infectious carrier after having antibodies.”

The answer: The route of transmission for SARS-CoV-2, the virus that causes COVID-19, is airborne droplets and aerosols.

You are not a carrier of SARS-CoV-2.

Practice good hygiene and wear a mask.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

 “I tested positive on Monday, Oct. 12. I started feeling badly on Saturday night. My son who lives with me is 21 and has no symptoms. When should he get tested? If he tests positive, can we isolate and be in same room together? Do I have to get tested after 14 days again or when I’m better – no symptoms?”

The answer: Your son is a household contact. He should self-quarantine separately for 14 days, and this will be 14 days from the date you are released from isolation. If your son develops symptoms during those 14 days, he could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home. There’s no problem in having multiple people isolate together, as long as, they’re all positive.

Regarding yourself, you can stop isolation 10 days after COVID-19 symptom onset if you are not immunocompromised, and at least 24 hours have passed since the last fever without the use of fever-reducing medications and symptoms have improved.

If you are immunocompromised, then I advise at least 20 days of isolation since symptoms first appeared.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the symptom onset for the initial infection. This guideline is intended to prevent excessive use of lab tests.

Finally, I recommend you and your son wear a mask and continue other preventative actions, including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am a health care worker. I tested positive on Sept. 20. I was in quarantine alone at my home. Repeated testing on Oct. 20 and it again turned out positive at cycles 28 and 34. Today is my 20th day. Is it OK for my husband to join back with me at our home now. Do I have to isolate myself from him anymore?”

The answer: In my opinion, you can stop isolation and resume normal activities.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within this months after the date of symptom onset for the initial infection.

If you or your husband are severely immunocompromised, I would consult an infectious diseases expert if concerns exist for you being infectious for more than 20 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My boyfriend and I currently don’t live together. He had gotten COVID-19 about three months ago. I did not get the virus and I’ve been staying away from him because I am high risk. We want to move in together, but I’m worried about getting the virus, or when will it be safe again to be around him and to kiss again with out the worry of me getting the virus.”

The answer: If your significant other had COVID-19 three months ago, it is safe to see each other now. He is not contagious.

I urge you to practice good hygiene, wear a mask in public, and maintain social distance to decrease your risk of exposure (since you mentioned your high risk status).

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“How likely is it that we were exposed by family members who visited our home while a spouse was in their home sick and tested positive for COVID, getting the result the very next day after the visit to our home? We were not made aware of the illness until after they had been inside our home and in close proximity to our adult daughter with special needs, including a compromised immune system. They have all been quarantined now. We do not really know what to do at this point.”

The answer: If no one was wearing a mask, it’s an even chance.

I recommend your family also quarantine for 14 days. Ideally, people should quarantine separately. If any family member develops symptoms during those 14 days, they could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate.

If the daughter with special needs develops symptoms, I advise 20 days of isolation because of her immunocompromised status.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • •

“I visited a friend yesterday. She tested positive for COVID-19 today. She had become symptomatic three days ago but mild, so she assumed allergies. During our visit last light, she wore a mask and I wore a mask. We sat 6 feet apart on large sectional sofa with open windows. I tested negative today. Am I safe? When will I be contagious if, God forbid, I tested too early?”

The answer: You may have tested too early. It is recommended that you test three to four days after exposure. I suggest that you quarantine for at least 10 days to see if symptoms begin.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“So my husband was directly exposed to a coworker on Oct. 6. He started symptoms the 10th. He never got tested because he had to quarantine anyway for 14 days. Of course I have been around him the four days after he was exposed. Then we isolated from each other. Work told him he could return the 20th of October. I was allowed to go to work using the proper PPE until I developed symptoms. I currently have no symptoms. He is better but not 100% due to fatigue. He never ran a fever. My question is, am I OK to be around him starting the 20th the same day he goes back to work or do I have to wait two more days? This is all so confusing. No one has straight answers and I get different ones with no real understanding.”

The answer: You are a close household contact. I recommend you continue self-quarantine separately for 14 days from the date your husband is released from isolation. Therefore, your self-quarantine must continue until Nov. 4. If you develop symptoms during that time, you may be swab tested (molecular Polymerase Chain Reaction - PCR) for COVID-19, or be advised to self-isolate.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If a staff member of a school tests positive and has to quarantine for 10 days, and his 11-year-old daughter tests positive on the ninth or 10th day, should he be released to come back to the school and resume normal activities or should he remain in quarantine as well?”

The answer: If the staff member tested positive and it has been at least 10 days since his symptoms have begun, his symptoms have improved, and he has been fever-free for 24 hours without medication, then he can return to work.

If his child develops symptoms during the quarantine, the child will need to self-isolate until the above is fulfilled.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“It has been 28 days since my father tested COVID positive. Seven days ago he came back home. Now the driver who dropped him home is having fever. Is my father still infectious? He has only cough no other symptoms.”

The answer: Your father likely isn’t infectious.

A recent study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at least one symptom, particularly fatigue and shortness of breath. Another reported persistent symptom was cough.

I recommend your father wear a mask and practice everyday preventative actions, including good hand-washing hygiene and social distancing.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was exposed by a coworker who tested positive for COVID-19. I immediately began a 14-day quarantine. On day 4, I tested and was negative. Have felt so-so with a continuous headache. Now, on day 9, I have been running a low-grade temp of 99.8 Should I be retested? I’m supposed to return to work Oct. 27.”

The answer: The incubation period for COVID-19 is 14 days. Since you have developed possible symptoms, you should self-isolate until your symptoms improve, you are fever-free without medication for 24 hours, and it has been at least 10 days until your symptoms have started.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband tested positive after being exposed. I got tested a day later than him and came back negative. Then I got tested again three days ago and now it came out positive. My husband is cleared to go to work Monday. Are we just going in circles now? I will now have to call work and let them know. Does my husband have to get retested now? We are not running fevers nor having headaches or cough; just feeling run down and not sleeping well. Could I have had it as long as he has had it? We have both quarantined ourselves for two weeks. I had not been to work since all this started because I had the days off anyway. So am I still able to pass this to anyone else?”

The answer: If you and your husband are not immunocompromised, then isolation may be discontinued after at least 10 days have passed since symptoms first appeared. For those who are immunocompromised, then continue isolation for at least 20 days since symptoms first appeared.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with COVID-19 shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

I do recommend that you and your husband wear a mask and practice other everyday preventative actions, including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“On Wednesday, and I found out that my husband’s son, whom we were with for about an hour on Sunday, had tested positive. He doesn’t have symptoms, but went to an urgent care because his sinuses were bothering him. My husband and are both over 65, so what should we do? Get tested? Quarantine?”

The answer: You should quarantine, separately if possible, for 14 days. If either of you develop symptoms, that person should self-isolate and the other (if not quarantined separately) should begin another 14 day isolation.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have fever – low grade, intermittent. I was tested for COVID yesterday and don’t know if I have been exposed to anyone with it. Is it best to self quarantine until I know the test results?”

The answer: Yes, self-isolate to your home while you wait for your test result.

If you live with others, self-isolate in a private room and use a private bathroom if possible.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“On Oct. 12, my daughter came by for five minutes in her car to say hello. She was on her evening break from the nursing home she works at. Wednesday, she calls me and says the lady in her building she and others care for tested positive for COVID-19 and was sent to the hospital. This lady could have had the virus Monday. Alexis kissed me and hugged me and my husband Chris on Monday. We both got tested – me Wednesday night, Chris Thursday afternoon. We are both negative. Her test is not back yet. I have missed two days of work. Am I safe to go back to work now. Neither of us have symptoms, its been six days.”

The answer: If your daughter was wearing a mask and appropriate personal protective equipment (PPE) when she was caring for the person who tested positive for COVID-19 at the nursing home, I believe your risk is low.

Out of an abundance of caution, I advise that you and your husband not return to work while you wait for your daughter’s test result.

If your daughter tests positive for COVID-19, then I advise you and your husband to self-quarantine for 14 days. Ideally, people should quarantine separately.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I will be going back to work on my 10th day of quarantine. My fiancé who lives with me started showing symptoms so I decided to leave the room where I was quarantining and be around him (I was feeling much better). My taste is back and I feel much better. On the contrary, he is having more COVID symptoms day by day. We decided he was going to quarantine himself away from me, in a room, because I will be going back to work. My question is, does it matter if he’s isolated in the room if he has COVID even though I may still have it?”

The answer: If your fiancé is not immunocompromised, I recommend he self-isolate for at least 10 days since his symptoms first appeared.

If he is immunocompromised, then I advise at least 20 days isolation since his symptoms first appeared.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“One of my husband’s coworkers tested positive on Friday, so they shut down the store for two weeks, and every employee has to be tested. Here’s where the question comes in. I have severe Lupus and in the middle of a flare with my temp holding strong at 100. If my husband tests negative do I need to get tested? I know there are numerous amounts of false negatives.”

The answer: Even if your husband feels healthy and tests negative, I recommend he self-quarantine separately for 14 days, because symptoms may appear 14 days after exposure.

Since you are severely immunocompromised, I recommend you to self-quarantine separately for at least 20 days. If you develop symptoms during that time, you could be swab tested (molecular Polymerase Chain Reaction - PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’m a massage therapist. A client who lives in Denver, her daughter, nanny and daughter’s boyfriend all tested positive for COVID beginning of October. She just flew in and called me to her house. She told me and said she’s now negative and had results on her phone to show me. I’m paranoid and have been extremely careful since February. I finally started working two months ago – private in homes, high-profile clientele. She never had fever – just no smell or taste and tired. She insisted she’s fine, not contagious and wouldn’t have come for her girls weekend and had to share info. I’m freaked out. Can I get it from her if she tested negative last week? Doesn’t she have to retest negative twice? She spent 30 minutes telling me it’s OK.”

The answer:

New-onset loss of smell is a highly specific symptom of COVID-19. You didn’t mention the type of negative test that your client had last week. 

If your client had a negative rapid SARS Antigen test, that does not rule out COVID-19 infection.

You were a close contact. Out of an abundance of caution, if you and your client were not wearing a mask, I recommend you self-quarantine for 14 days. If you develop symptoms during those 14 days, you could be swab tested (molecular Polymerase Chain Reaction - PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband was exposed to COVID from a coworker. He tested 4 days after exposure and was negative. Day 7 he came down with fever and body aches. 

“He went to get tested again on Day 8 while he had fever and body aches. It was negative. His fever broke on Day 9 and was fine. Today is day 10 and after being fever free for 22 hours he spiked a temp of 101. This seems more flu like to me. My question is what are the chances the second test that was negative was a false negative? It seems to me that if he had fever and symptoms and the test was negative that it is more likely flu.”

The answer:

It’s an even chance.

You didn’t mention the type of negative tests your husband had. 

If the two negative tests were rapid SARS Antigen, that does not rule out COVID-19 infection.

Because of your husband’s symptoms and exposure history to a coworker with COVID-19, I recommend your husband self-isolate and be retested with both a swab molecular Polymerase Chain Reaction (PCR) for COVID-19 and a rapid swab influenza test.

Since you are a household contact, I advise you to self-quarantine separately while you wait for your husband’s test results.

If your husband’s PCR test is positive for COVID-19, then I recommend you to self-quarantine for 14 days from the date your husband is released from isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was sick in early March with a few symptoms and suspected COVID (I had recently traveled and also had the symptom of lacking smell/taste). At the time, tests were scarce and my case was mild and I wasn’t able to be tested so I just self-quarantined. In June, I took an antibody test which came back positive for the antibodies. Fast-forward to September, my doctor sent me for blood work and including me retaking the antibody test, which again came back positive for antibodies (now six months later).

“Now in October, my aunt recently became very sick, tested positive for COVID, and is currently hospitalized. Her adult son lives with her and doesn’t drive, but needed to take a COVID test. Understandably, nobody wanted to drive him to the test site assuming he could be infected, so I volunteered to take him because I likely have some immunity. 

“I was wearing a mask, as was he, but he was in my car for quite some time. I’m not worried about myself, assuming I’m immune, but can I still get and share the virus with others? (The test was last night so he still hasn’t gotten his results).”

The answer:

The main route of transmission to others for SARS-CoV-2, the virus that causes COVID-19, is airborne droplets and aerosols. It is not likely that you will transmit the virus to others via in animate objects (or fomites).

There have been documented cases of individuals becoming reinfected with a variant of SARS-CoV-2 that produces the same disease, COVID-19. Please continue to practice social distancing, wear a mask, and practice good hygiene.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My husband felt ill during an overnight-hotel-stay with me and the children on Oct. 10, with sinus pressure, wet cough and achy feeling. I found out later, that he had been exposed to COVID-19 at his job earlier that week. I started to have body aches and sweats on Oct. 13. 

“So, we decided to both get tested. We did the rapid test at our local urgent care. His test came back positive, mine was negative. 

“He is in quarantine at home. His symptoms have improved; however, he mentioned new loss of smell.

“I still have slight body aches and sweats at night. No fever. No cough. No loss of smell or taste. No shortness of breath. Should I get another get another test?”

The answer:

You were exposed to a COVID-19 positive individual. You and your family need to quarantine for 14 days from the last day of exposure to prevent the spread to others.

It is possible that you too are COVID-19 positive. The rapid test is not as sensitive, gives false negatives, as the genome test.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My sister and I tested for COVID-19 on Oct. 11 and we got our results back on Oct. 15. I got negative and she got positive. Now the question is, is there a chance I got the virus, too, since we both live in the same room. That means I’ve lived with someone who has coronavirus for four days without taking precautions, because I didn’t think she would test positive.”

The answer:

Yes. If possible, you should quarantine for 14 days from your last exposure in a separate room from your sister. If that is not possible, each of your should wear a mask and keep as much physical distance as possible.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am currently awaiting my COVID-19 test results. As instructed by my school, I was tested about four and a half days after my initial exposure. My wife and I are always at least 6 feet apart when we do happen to run into each other within the house (e.g., eating dinner ‘together, but separately’ while about 10 feet apart on different couches). As of now, I am staying in the spare bedroom (but I sleep on the couch in the living room, since we don’t have an extra bed, but she does not sit on that couch) and only I am using the spare bathroom. I also wear my mask around the house except for when we’re eating. Our AC is off, and we have as many windows open as possible.

“I have not experienced any symptoms yet, and have been checking my temperature every morning and every afternoon, and it has not gone above 99 degrees Fahrenheit. The only symptom I am truly feeling is fatigue, but I am attributing that to my horrible sleep quality due to me sleeping on a couch that is too small.

“My main question is, if my results are negative, do my wife and I still need to be isolated from one another within our house? 

“Furthermore, can we go ahead and turn the AC back on to help keep the house cooled down? Don’t worry, my wife has also been monitoring her symptoms since we were together for a full day before me finding out I had been exposed, and she has yet to feel any symptoms.”

The answer:

Close contacts of persons diagnosed with COVID-19 should self-quarantine for 14 days from the date of their last contact with the person. Ideally, people should quarantine separately. Even if you test negative, I recommend you continue to self-quarantine for 14 days because symptoms may appear 14 days after exposure.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • •

“My husband hugged my sister-in-law and had less than 15 minutes exposure with her four days ago. 

“She just came back positive and on the day she was getting tested we took our 4-month-old out of the house to let my husband quarantine. He is getting tested and my son and I have had no contact with my sister-in-law for a long time and no physical contact with my husband since his exposure. What is our exposure risk? And if he comes back negative how long should he be isolated?”

The answer:

You exposure risk is low based on what you said. Your husband should quarantine for 14 days from his exposure date.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“My son developed flu/bronchitis symptoms, had testing done for COVID-19 came back negative, after 48 hours. He tried to go back to work and his boss said he had to have a second test, even though he never had a fever. The second COVID-19 came back positive. I don’t understand why the first would be negative, especially when he was sick and the second tested positive. Is there something wrong with test?”

The answer:

You didn’t mention the type of test(s) that were done. The first test was a false negative. A positive COVID-19 test result is usually highly accurate, however a negative test result doesn’t rule out COVID-19 infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“I babysit my grandkids. About three weeks ago, my stepson got sick with cold symptoms but didn’t get tested. He was sick about four days. Two days after he got sick, my daughter-in-law started having cold symptoms, but lost her sense of smell and taste. Her symptoms started on a Tuesday. On Saturday morning, I woke up with a terrible headache and really bad dry cough and sore throat. My daughter-in-law got a rapid test on Saturday and it was positive. On Sunday, I lost my taste and smell, sinuses started draining, fever about 100 degrees. I got a rapid test on Monday and my test was negative. They gave me a sinus cocktail, a shot of Rocephin and Z pack and Rx cough syrup. My daughter-in-law was better after about four or five days. It’s been two and a half weeks and I still have a cough but it is much improved, but I still can’t smell or taste. Both of my grandkids tested positive the week after their mother did. The 4-year-old only had a runny nose for two days. The 11-year-old ran a fever, had headache and lost smell and taste. They are all better now. I just wondered how likely it is that I really had the virus and the test was wrong.”

The answer:

In my opinion, based on your exposure history and symptoms (especially loss of smell), you were probably infected with SARS-CoV-2 (COVID-19). 

New-onset loss of smell is a highly specific symptom of COVID-19.

Also, if a rapid COVID-19 test result is positive, it is usually highly accurate. However, a negative rapid test result doesn’t rule out COVID-19 infection. Therefore, I believe your rapid test result was a false negative.

Finally, you could get a blood SARS-CoV-2 IgG antibody test in one to two weeks. If your blood IgG antibody test is positive, that means you were previously infected with the novel coronavirus (COVID-19), but it doesn’t give an exact date when the infection occurred.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I started to feel stomach pains on Oct. 13 in the evening. I went to work on the 14th got there at 7 a.m. and by 9:30 I was heading home after getting sick a couple times. That same day, I felt very fatigued body aches, migraine, chills, nauseous and stomach pains. 

“I pretty much slept the rest of Wednesday and all through Thursday started feeling better Friday and felt really good Saturday. I never developed a high temperature nothing over 97.3 F the entire time. It is now the 19th. I have no more of those symptoms and actually feel very well.

“My question is that I never went and got tested as I was too fatigued to drive. I had possibly eight symptoms out of the 11 the CDC gives, so I’m leaning toward I had COVID-19 but don’t know for sure. I feel great, have none of the symptoms that I did or the CDC lists. How much longer should I stay isolated? I haven’t been to work or out of my house since last Wednesday. Should I wait a couple more days with out symptoms or am I good to go?”

The answer:

You can return to normal activities if you have seen symptom improvement, you are fever-free for at least 24 hours, and it has been at least 10 days since your symptoms began. I suggest you remain isolated until at least Oct. 23 (to be abundantly cautious the 27th).

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I had exposure to the COVID-19 on Sept. 16, I felt tingling in my throat at the 29th with one night fever of 99.9. Then I tested on Oct. 1 and was positive. I did isolate in my room as the the health department representative told me 10 days from the symptoms started, I had no fever or any symptoms, I left my room at the day 11 of my isolation, and kept wearing mask around my family but I am still testing positive after 15 days of symptoms. Am I still contagious? What about my family? I am with them but wearing masks all the time. Shall I re-isolate?

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

If you are not immunocompromised, I do not advise repeat self-isolation.

If you are immunocompromised, then I recommend you self-isolate for an additional 10 days.

Finally, I agree with wearing a mask and continue other daily preventative actions, including good hand washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have a very unusual situation. An Amazon delivery driver tried to steal my packages from my porch. Before he could go back in his vehicle, I ran outside to stop him to try to retrieve my packages. 

“I tried to stay as far apart as I could from him. I think it was the distance of a car. I didn’t have a mask on. I was wondering since I ran outside right after he came to my porch without a mask is there a big risk. He wasn’t wearing a mask either. This whole interaction was probably less than five minutes. 

“Sadly i didn’t get back my packages either. I know this is probably a weird question but any information would be greatly appreciated.”

The answer:

I am sorry that happened to you. To effectively transmit the virus, you need to be in close contact with someone for 15 minutes or more without wearing a mask. This interaction was minimal. I do not think you need to worry.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My granddaughter is coming home to Odessa, Texas, from Delhi, India. She’s 26 and I am 69 with many issues. Will we need to quarantine?”

The answer:

It is a good idea for her to quarantine for 14 days. She could be exposed during her travels.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Hello, my son and I traveled out of town last weekend for a funeral due to a family member passing away from the coronavirus, and were exposed Sunday to someone who had COVID-19. I was not aware of it until Tuesday morning. I woke up with a sore throat not feeling very well. I immediately made a doctor’s appointment on Wednesday to be tested. My son and I both were tested on Wednesday. He was not feeling bad and was not sick; me on the other hand, I felt like death. My son’s test came back negative, but I still have not heard about my test. I have been very sick, very weak, short of breath dry, cough, nasty taste in my mouth, etc. Should I be worried that my test is positive?”

The answer:

Even though your son tested negative, he should quarantine for 14 days from the date of his contact with the person who had the coronavirus because symptoms may appear 14 days after exposure. Ideally, he should quarantine separately. If he develops symptoms during those 14 days, he could be swab retested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

Regarding yourself, I’m concerned because you are short of breath and “felt like death.” 

If you have trouble breathing, persistent pain or pressure in the chest, or bluish lips or face, seek emergency medical care immediately. Otherwise, self-isolate and follow-up with your physician as soon as possible.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“The school just called me and said my son was probably exposed to a kid that had a positive coronavirus test. They told him that he has to quarantine, and cannot come back to school until Oct. 22. Does that mean that me and his mom who are around him have to quarantine, too?”

The answer:

There are two families involved.

The mother of the child who tested positive for the coronavirus is a household contact. She should be instructed to self-quarantine for 14 days. This will be 14 days from the date her child with COVID-19 is released from isolation.

You (mom of the child exposed) do not need to quarantine, as long as, your child is self-quarantined separately. If your child cannot self-quarantine in a private room and use a private bathroom, then you must also quarantine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My grandson (who is 12) found out that his teacher tested positive for COVID, so he has to quarantine for two weeks. My question is, if he’s been exposed to the virus and he goes home, than isn’t everyone in the home been exposed as well – even though they weren’t around the teacher?”

The answer:

If the teacher who tested positive for COVID-19 and your grandson who was exposed to the teacher, both were not wearing a mask, then your grandson’s family could also be exposed.

Ideally, the grandson should quarantine separately.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My husband and I both have the coronavirus. He got sick on Friday and was tested positive on Sunday. I got tested the next day on Monday and my results came back positive on Thursday. I’m curious to know, could I have gotten the virus first and just got sick later than he did?”

The answer:

Yes. The incubation period, the time from exposure to symptoms starting from an infectious dose, is 14 days.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I was around my friend who, in turn, was around his friend the day before whose girlfriend just tested positive. Should I be concerned, because I am having surgery, but will be COVID tested before? My concern is that I could have been exposed and test positive later in week after my surgery.”

The answer:

In my opinion, your exposure risk is low. 

However, I do recommend you discuss this with your surgeon.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was around my mother last Wednesday night. She saw her grandchildren Wednesday day. The two children tested positive on Saturday. Should I be concerned contacting COVID and do I need testing?”

The answer:

Your mother was exposed and should be in quarantine for 14 days from her last exposure. It is unlikely that you were exposed to SARS-CoV-2 from your mother. She was exposed the day you saw her. That makes it highly unlikely that she was contagious.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have a colleague who earlier this year tested positive for COVID-19 and he ran the course to eventually having no symptoms while in self-quarantine for almost 21 days.

His positive tests and doctor-managed condition occurred in the beginning of May.

Recently, he had a weekend hunting trip in which other individuals staying in the same cabin tested positive.

“My question is, should he still follow quarantine guidelines even though he had his own experience with COVID-19? Does he pose a threat to others through his new and recent contact with another positive tested individual? I ask because I am to be on a trip with him and it has been less than 10 days with his most recent exposure, or is he safe because he has antibodies?”

The answer:

There have been a few documented cases of individuals becoming infected with SARS-CoV-2, the virus that causes COVID-19, more than once. The virus is undergoing something called antigenic drift. This is a gradual changing process that occurs naturally with RNA viruses (SARS-CoV-2 is an RNA virus). This change can result in what appears to your immune system as a new pathogen.

Most individuals who have recovered from COVID-19 have immune proteins called antibodies to the virus. This will provide protection for up to 6 months in most cases.

Thankfully, a recent study found the spike protein on SARS-CoV-2 is a very good target.

Two specific regions called glycans (sugars attached to proteins) help move the virus into position to infect our cells. The study showed that a SARS-CoV-2 virus with mutations causing those glycans to be to stop working properly caused a marked decrease in infectivity.

If we can target that in a vaccine, that would be fantastic.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I tested positive on Oct. 12. I started feeling badly on the 10th. My son, who lives with me, is 21 and no symptoms. When should he get tested? If he tests positive, can we isolate/be in same room together? Do I have to get tested after 14 days again or when I’m better – no symptoms?”

The answer:

It would be best for your son wait three or four days after his initial exposure to you. He should be quarantining if possible, in a room that is not with you until he tests or becomes symptomatic. This will prevent continual exposure to the virus.

If you are both positive, you can isolate together, but you will need to wait until after he sees symptom improvement to return to normal activities.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I tested positive for COVID on Sept. 9 and had symptoms. It is now Oct. 10 and I am still testing positive with no symptoms. I am visiting my boyfriend in two weeks and I’m wondering if I can still expose him to the virus even though I have no symptoms (through physical contact).”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who have no symptoms after recovery shouldn’t undergo virus testing within three months after the onset of symptoms for the initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My son who is living away at college just tested positive for COVID. Assuming by Thanksgiving, he will have some immunity to getting it again himself, could he still pass the virus to my husband and myself if he comes in contact with the virus again. In other words, I feel confident he would have immunity if he came in contact again to the virus but could he harbor the virus and pass it on to us? Or does immunity mean the virus couldn’t be harboured in his body to a degree as to pass onto others?

I’m worried he will want to hang out with high school friends and bring the virus home to us over the holiday.”

The answer:

At this time, it is not known for certain whether individuals infected with SARS-CoV-2 (COVID-19) who subsequently recover will be protected, either fully or partially, from future infection with SARS-CoV-2 or how long protective immunity will last.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband is a home inspector. We just received information that the owner of a home he inspected earlier this week has

tested positive for the virus. This person was not home during the inspection and my husband never came in contact with this homeowner.

However, he was inside the home for about 2 1/2 hours and touched many items throughout the home in order to do the inspection.

What are the chances of my husband contracting COVID from being inside this home?”

The answer:

The primary route of transmission for SARS-CoV-2 is airborne droplets and aerosols.

If your husband was wearing a mask, washed his hands regularly, and maintained good safety protocols, it is unlikely that he will develop COVID-19 from this incident.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I tested positive on Sept 22. I did my

quarantine. My fiancé tested negative on

Oct 8. I told my employer that my fiancé is now positive and I was forced to leave work.

Is there really any chance of me infecting my coworkers?”

The answer:

A young man in Nevada was recently the first reported case of COVID-19 reinfection in the United States, and the fifth case of reinfection worldwide. The genomes of the patient’s virus samples suggested that the patient was infected by two distinct COVID-19 infections.

In my opinion, you’re likely not infectious, but not impossible.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I talked to a neighbor whose health-care provider had been in contact with her young grandson for several days, and he just tested positive for COVID. I spoke to my neighbor a few days ago, no physical contact. I was in my walker and had a mask on and she was a few feet away with a mask and gloves on. I spoke to her for maybe 10 minutes, possibly less. Do I need to be in quarantine?”

The answer:

In my opinion, no.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My family and I tested positive on Sept. 8 after a family member we were around for the previous three days tested positive. We

all went into quarantine and cleared after

14 days. Can we get exposed again within the next three months? Another family member from out-of-town stayed in our home from Oct. 8-11 and started feeling sick on the 11th and went back to their town on the 12th and tested positive on Oct. 14. Do we need to isolate again? I’m confused because I thought we were safe for the next three months after exposure.”

The answer:

There have been a few documented cases of individuals becoming infected with SARS-CoV-2, the virus that causes COVID-19, more than once. The virus is undergoing something called antigenic drift. This is a gradual changing process that occurs naturally with RNA viruses (SARS-CoV-2 is an RNA virus). This change can result in what appears to your immune system as a new pathogen.

Most individuals who have recovered from COVID-19 have immune proteins called antibodies to the virus. This will provide protection for up to 6 months in most cases.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I tested positive in early September for COVID-19, along with my father. We both quarantined and are fine now. However, my sister is now positive and I was wondering if I could still get it? As well as if I have to quarantine, too, because I have been in contact with her?”

The answer:

There have been a few documented cases of individuals becoming infected with SARS-CoV-2, the virus that causes COVID-19, more than once. The virus is undergoing something called antigenic drift. This is a gradual changing process that occurs naturally with RNA viruses (SARS-CoV-2 is an RNA virus). This change can result in what appears to your immune system as a new pathogen.

Most individuals who have recovered from COVID-19 have immune proteins called antibodies to the virus. This will provide protection for up to 6 months in most cases.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Is it normal to have drastic sleep disturbances three months after recovering from coronavirus?”

The answer:

Sleep neurologists are reporting increased sleep disturbances and misuse of sleep medications in people recovering from COVID-19, and by people whose lives have been surrounded by fear and social isolation. Neurologists who specialize in sleep disorders are seeing an increase in sleep disorders associated with COVID-19, a surge they’re terming “COVID somnia.”

I recommend you consult a board certified sleep medicine physician, or you check the website for the Society of Behavioral Sleep Medicine, which offers a listing of trained therapists in every state.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My mom had a doctor’s appointment on Oct. 8. She wore a mask as did I. My contact with her was two hours. She has now tested positive for COVID. She is asymptomatic. I have no symptoms and will quarantine. Do my family (husband, children and grandchildren) who have had no contact with her, only contact with me, also quarantine?”

The answer:

In my opinion, no since you were wearing a mask.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter has the virus. She had the high temperature, now can’t smell anything or taste anything. She is staying with me. How likely is it that I get the virus?”

The answer:

It is very likely that you will become infected with SARS-CoV-2 if you have been in close contact with your daughter for 15 minutes or more without a mask.

You should be quarantining since she is in your household and is infectious.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I tested negative through a rapid test, but swear I have the virus because I’ve been having symptoms such as stomach issues and chest issues. My granddaughter, whom I see all the time, tested positive and I was just with her, but yet everyone, even her parents, tested negative. Why is this?”

The answer:

There are a good number of infectious diseases that have the symptoms you are experiencing. Since you are symptomatic, there is a greater chance that the rapid test for COVID-19 will produce true results.

However, if you feel you have COVID-19, I suggest that you self-isolate and contact your medical provider if your symptoms worsen.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband did not feel well Sept. 26. He was two hours away and we did not see each other. Monday he started sneezing and was achy. He isolated himself in the basement and used a separate bathroom. Wednesday, he video conferenced, but COVID testing was not recommended with no fever or other symptoms. He continued to isolate and the kids and I go to school then sports, so we had no close contact with him.

He is feeling better but decided to get tested for COVID. We still have only seen him in passing.

“If he tests comes back positive, I will get tested. I have no symptoms at all. It’s been 13 days and I have no symptoms. If my test comes back negative, do I still need to quarantine since the incubation or spreading phase has passed? I certainly don’t want to spread it, but if I’m negative and has been 11-14 days is a quarantine necessary?”

The answer:

Many infectious diseases have sneezing and aches that accompany them. The symptoms of COVID-19 are shortness of breath, loss of taste and smell, fever and difficulty breathing.

If your husbands test is positive, it is necessary to quarantine for 14 days from your last exposure to him.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have learned that I was exposed to a person in the past 14 days who has now been diagnosed with COVID. I had a routine nasal swab test at work that came back negative.

If I do develop COVID, is it possible that I was contagious at work, even though I tested negative?”

The answer:

It is difficult to determine your infection risk without knowing the details. However, if you were exposed 14 days ago to a positive individual, you are past the incubation period and are not infected from that exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband recently took a fishing trip on a charter boat in the Gulf. He rode with three other friends on about a six-hour drive down to the coast, then spent two days on the boat with eight other people. He is riding home today in his carpool for another six hours.

“My question is if I know that they were unmasked on this trip, and the participants come from more than one city (although all from the North Texas area), should I ask my husband to mask when he returns home and sleep in the spare bedroom? And if so, how long? I am a teacher, so not only do I want to keep myself healthy, but also must be cognizant of keeping the risks to the students in my classroom to a minimum.”

The answer:

If you are concerned about your husband’s exposure risk and believe he may have been exposed, then you can have him self-isolate in the house. If you both wear masks when in common areas and avoid close contact, it will greatly reduce your risk of infection (if he was exposed).

The incubation period for SARS-CoV-2 is 14 days. You will need to maintain this for two weeks to be abundantly cautious, or for 10 days at a minimum.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“About two months ago, I felt normal cold symptoms. I have been mostly self-isolated since March, except no-touch pickups and a few trips to grocery and retail stores since reopening. 

“Roughly six weeks ago, my symptoms were getting bad enough I was about to get a COVID test, but did not. Bad headaches, nasal congestion and dry throat, but never a fever. This past week I feel much better. 

“Should I still consider getting tested even if I may have had it and recovered?”

The answer:

If you chose to get tested, you should be tested using the antibody test. Since you are not symptomatic, I see no need to do so.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I live with my daughter, son-in-law and grandson. My daughter started showing mild symptoms on Oct. 6 and tested positive on Oct. 8. Myself, son-in-law and grandson all tested negative on Oct. 9. She has been totally isolated in her own room and bathroom since her test. We are quarantined at home away from her. Do we have to wear masks around each other if we all tested negative?”

The answer:

Even though you, your son-in-law, and grandson all tested negative, symptoms may appear 14 days after exposure. Therefore, yes – those in quarantine should wear masks when entering general living areas, and interact with others as little as possible. 

Ideally, people should quarantine separately.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“On Sept. 12, I had a casting call and I took my mask off. On Sept. 23, I had headaches. On Sept. 24-25, I had rehearsals and a fashion show with close contact to others. On Sept. 26 is when I started with a sore throat in the mornings. I went on until I got tested on Sept. 29 and came out positive. All that time I was around my family members, they all got tested on the 29th as well all came out negative, one of them had all symptoms and another had head aches and both got tested again on Oct. 2 and came out negative again. My doctor says that it’s just a matter for time till they come out positive.

”It’s now Oct. 9. I have had no fevers ever since the beginning, and have taken extreme measure with isolation and haven’t been around anyone since the 29th. 

“Should I be worried about my family and when can I come out of isolation I feel no symptoms?”

The answer:

If you’re not immunocompromised, you may discontinue isolation after 10 days have passed since symptoms first appeared. 

If you are immunocompromised, then continue self-isolation until at least 20 days have passed since symptoms first appeared.

After your isolation has ended, wear a mask and continue daily preventative actions including good hand washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“We are in our 70s. Our granddaughter has been staying with her boyfriend and wants to come home. If she quarantines at our home while we are gone for two weeks and then gets a negative test, can she join our ‘bubble’?”

The answer:

Yes. The incubation for SARS-CoV-2 is 14 days. If she is symptom free after the two-week quarantine, then she is free of the virus.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Saturday will be two weeks since I first noticed my symptoms of COVID-19. I was tested the following Monday, and when the results came back Tuesday night I was positive. I have had no fevers and no real signs of any symptoms for two days now. However, I live with someone who has been positive for about a week.

“My questions are, because we live in a small apartment and it’s very hard to isolate, do I still need to quarantine up until after they show no signs of infection? 

“Would I be safe to return to work as long as I follow safety guidelines? I am a chef in a restaurant and my boss keeps telling me he needs me back as soon as possible. I know that even after showing no signs, a test can still come back as positive for up to three months.

“But I’ve also been told I could be a liability because the body can still shed skin cells with the virus that could potentially infect someone at work who could be immunocompromised. Any information would be greatly appreciated.”

The answer:

If you have been fever-free for 24 hours, it has been at least 10 days since your symptoms have begun and your symptoms have improved, then you can return to work.

Skin cells do not harbor the virus, so you need not worry about that.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“What is this rapid test? It takes four to five or more days (I honestly would say wait a week) for COVID to show up after exposure. Is this rapid thing what Argonne National Laboratory is doing? How could that be accurate? Anyone who tests one to two days after exposure will be negative. In a week, he’ll be positive (but he’s not going to get another test) or dead.”

The answer:

The rapid test for COVID-19 will detect proteins from SARS-CoV-2. When a virus replicates it has a few stages to that process. They are (in order):

• Binding: The virus must bind to the cell it is going to infect. SARS-CoV-2 uses the ACE2 receptor on human cells.

• Penetration: The virus must breech the cell membrane to cause infection.

• Uncoating: The genome of a virus is enclosed in a protein coat. This protein coat has to “unzip” or open up to let the genome out.

• Synthesis: The genome of the virus must copy itself and make all of the proteins necessary for it to form back up.

• Assembly: The virus must put itself together with all the parts that were synthesized.

• Release: The virus will leave the cell it has infected in order to spread to other cells or hosts.

The rapid test requires the virus assembly stage to work. This can take up to a week after exposure (depending on how much virus you got in the exposure).

The rapid tests can produce more false negatives than the genome tests because of this time delay.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I was with my father about a week ago and he had gotten sent home from work because there was a COVID case there, he got tested and he is positive. Would I be able to get COVID as well even though it was a week before he had even known about his work having a case? I’ve been having some symptoms about two days before he had tested positive.”

The answer:

From your questions I am going to assume that your father was exposed at work a week after you were with him. If that is the case, you were not exposed to the virus from him.

If you are having symptoms, I suggest that you self-isolate, alert others you have been in close contact with, and monitor your symptoms. If they become severe, seek medical attention.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown

• • • • •

“I know an employee of Argonne National Laboratory was exposed to COVID-19 on Oct. 3. My cousin worked at Argonne with this person on Oct. 5 and maybe Oct. 6. 

“My cousin got tested on Oct. 7 and got the results Oct. 8 – negative, and he trusts this result. He also believes his coworker was not contagious yet on Oct. 5 and 6.

“This would be OK only here we go: My cousin went home to his 11-year-old son Monday night and got him ready for school Tuesday morning. That’s when he found out. It is very likely that his son went home to him after school on Tuesday, when my cousin sent his son to stay at my house, with my 70-year-old aunt who is not taking any precautions. I have been leaving early in the morning, coming home later, locking myself in my room, and wearing my mask if I leave my room at all. 

“But I can’t miss work or I will kill myself, and if I get COVID-19 I will die because the people in charge of me told me that if I get it, no hospital-no treatment, they will let me die.

“So after someone is exposed, how long until they become contagious? 

“No one seems to understand my question. 

“Oct. 3, this guy was exposed. Oct. 5-6, my cousin worked with him. Was he contagious? Not a hard question. I don’t want to know how many days before a person gets symptoms. I want to know: after exposure Day 1 after, Day 2 after, Day 3 after ...? 

“When would it from that person who was exposed start being transferred to other people? I really don’t think it’s a hard question to understand and nobody can answer the question I am asking.”

The answer:

The infection timeline for most individuals is this:

• Exposure (Day 1): Just because you were exposed does not mean you will be infected. Infection requires an infectious dose. This is likely to happen when you are within 6 feet of someone for 15 minutes or greater without a mask.

• Pre-symptomatic phase (up to Day 7 on average): Most adults who are infected will have a period of five to seven days where they are infectious, but have no symptoms. Within this time period, individuals are more likely to spread the infection in the 48 hours prior to symptoms starting.

If you feel you have been exposed to SARS CoV-2, it is best to get tested at Day 3 or later after exposure. The virus will likely be detectable between Days 3-7. If you test too early, it may result in a false negative.

Some individuals will be in this phase for 14 days. This will make all other phases shift by seven days.

• Symptomatic phase (Days 7-22): Once symptoms begin (dry cough, fever, loss of taste and smell, shortness of breath), most individuals will continue to have symptoms for 15 days.

Studies show that the amount of virus in the body takes on a bell-shaped curve, with the highest amount of virus being, on average, on Day 14 of the infection cycle. After that, the virus in the body begins to decrease.

• Symptom relief phase (Days 22-25): Most adults will be free of the virus, test negative by the genome test, by Day 24.

Using these numbers to apply to your situation: Exposure: Oct. 5; pre-symptomatic: up to Oct. 12; symptomatic: up to Oct. 27; relief: up to Oct. 30.

I hope this helps.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My daughter and one of her college roommates both tested positive, likely exposed by the same mutual friends. They can isolate from each other (with separate bedrooms/bathrooms), but do they need to? Can either actually make the other sicker in the early stages?”

The answer:

It is recommended that individuals who are not symptomatic quarantine alone. If one is positive and the other not from the exposure, then the negative individual is continually being exposed to a positive person while in quarantine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My friend has COVID. She’s been in the hospital since last Thursday, getting released Tuesday. Is it safe for me to clean and disinfect her home?”

The answer:

I refer you to CDC’s website below which was updated on Sept. 8.

According to Google, Cleaning and Disinfecting Your Home | CDC (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/disinfecting-your-home.html)

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My ex traveled to Brazil for a week and returned five days ago. 

“He had a negative test just after returning. My understanding is he should 1. Self quarantine for 14 days 2. Be tested again if he is not self-quarantining again (he has access to testing). 

“Can you confirm? Is being in Brazil (airport, etc.) considered assumptive ‘close contact’ with someone with COVID-19?”

The answer:

CDC recommends travelers avoid all nonessential international travel to Brazil. COVID-19 risk in Brazil is high, and Brazil remains at a Level 4 Travel Advisory (Do Not Travel).

See CDC’s After Travel webpage for more information, and follow state and local recommendations or requirements after travel.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My wife and I tested positive. 

“If we still stay in same house, can we keep passing it back to each other?”

The answer:

Husband and wife can be isolated together, as long as, they’re both positive. There’s no problem in having multiple people isolate together. Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I work at in skilled nursing. As per policy all the staff are supposed to get tested using (rapid antigen test). I was positive on Sept. 11 and was asymptomatic at the time of testing. I was told to quarantine for 10 days if I stay asymptomatic – which I did and remained asymptomatic throughout. I was tested again on Sept. 21 (rapid antigen test), it came out positive, PCR test came back negative, I was tested again at a different facility on Sept. 23, rapid antigen test, PCR test done and was negative. 

“I tested again on Oct. 10, tested positive again (rapid antigen test). It is getting very upsetting that my rapid antigen test keeps coming positive. Why is that happening? How long it’s going to take to clear up?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. The cause of this persistence of detectable virus has yet to be determined, and one possibility is shedding non-infectious or dead virus particles.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive in a lab COVID-19 test on Oct. 3; no symptoms. Tested because three co-workers tested positive. On Oct. 8, my wife, two adult sons and I had COVID lab tests. All four were negative. Now I’m wondering if my first test was a false positive. All of our tests were done by the department of health. I’m over 60, diabetic and have heart disease. I think I would have had symptoms. Do we need to quarantine?”

The answer:

You didn’t mention the type(s) of tests that were done. A positive COVID-19 test result is usually highly accurate, and a negative test result doesn’t rule out COVID-19 infection. Also, three of your co-workers tested positive.

I recommend you self-isolate for at least 20 days since the date of your first positive viral test.

If your wife and two adult sons live with you, they are household contacts, and they should be instructed to self-quarantine for 14 days from the date you are released from isolation. Ideally, people should quarantine separately.

Finally, I recommend you get a blood SARS-CoV-2 IgG antibody test in two weeks. If that antibody test is positive, that means you were previously infected with the novel coronavirus (COVID-19), but it doesn’t give an exact date when the infection occurred.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter was COVID-19 positive in August and has little to no long-lasting effects. Within this last week, she’s been waking up with random red blotches that are swollen and itch. At first we thought it was bites, like a spider maybe, but she has one or two new spots every day she wakes up. We had her sleep in a different room, and last night was in a hotel and she is still waking up with them. As they heal, the redness and swelling goes away and a single small bump is left. My son, who was also COVID-19 positive in August, has seemed to wake up with two to three spots this week as well. Neither has a history of hives. Has there been any evidence of this happening with other COVID kids?”

The answer:

The three main types of skin rashes associated with COVID include: urticaria (hives), erythematous-papular rash (described as a red bumpy rash) or erythematous-vesicular rash (described as chicken pox-like rash) and chilblains. Chilblains tends to be more common in younger people, and the rash presents itself as reddish and purplish bumps on the fingers or toes and can affect many digits.

The photos you submitted don’t look like any of the above described rashes. Therefore, I recommend you schedule an appointment as soon as possible with a dermatologist.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“What does the percentage of the virus mean if I tested positive for COVID-19? Mine was 16%. Is it a high percentage or low? What should I expect? I’m already on my fourth day of quarantine and I already went through the symptoms.”

The answer:

Without knowing which test you had, I can give you this answer.

There are two things to consider when interpreting the result of a test for COVID-19.

• The accuracy of the test.

• The pre-test probability or estimated risk of disease before testing.

All genome tests are very specific for COVID-19. Therefore, a positive genome test for COVID-19 test has more weight than a negative test because of the test’s high specificity (can detect the virus and only the virus) but moderate sensitivity (needs more of the virus to be positive).

Because you received a positive test and are only in day four of your isolation, you are contagious. The current recommendation is to remain isolated until at least 10 days after symptoms began.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“After I got the virus, my smelling senses faded away and they’re not as strong as they were before. In fact, I can’t smell things that are supposed to smell good unless it’s really strong. Is that normal?”

The answer:

A recent study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at least one symptom, particularly fatigue and shortness of breath. Other reported symptoms included loss of smell, joint pain, chest pain, cough, headache, lack of appetite, sore throat, dizziness, diarrhea and muscular aching.

Doctors and researchers have focused on the acute phase of COVID-19, but continued monitoring for long-lasting effects is needed.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My question is, if you go to two different centers to do the COVID test the same day and one comes back negative and the next one comes back positive, what should I do?”

The answer:

You didn’t mention the type of test(s), if you have symptoms, or if you’re immunocompromised.

However, I would believe the positive test because positive COVID-19 test results are usually highly accurate, but negative test results don’t rule out COVID-19 infection.

Perhaps the negative test sample was inadequate or wasn’t collected properly.

If you had a positive COVID-19 test result, I advise you to self-isolate and contact your physician for further instructions, including the duration of self-isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I tested positive on Sept. 21. I then quarantined for two weeks. After quarantining, I tested positive again. Keep in mind I have not had any symptoms. I’m still young. What do I do next?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with COVID-19 shouldn’t undergo virus testing within three months after the date for the initial infection.

I recommend you wear a mask and practice everyday preventative actions including good hand-washing hygiene and social distancing.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had a rapid test on Sept. 29 and it came reactive. The next day, I went for a PCR swab test and it came back negative. However, I continued to self-isolate for four days as I have no symptoms. On Oct. 6, I had again rapid test and it again came as reactive. I still don’t have any symptoms and feel fit and fine. What should I do?”

The answer:

The PCR swab test may have been inadequate, and therefore a false negative in view of the two reactive rapid test results.

If you are not immunocompromised, I advise you to self-isolate for at least 10 days since the date of your first reactive rapid viral test. If you are immunocompromised, I advise 20 days of self-isolation since the date of your first reactive rapid viral test.

I also recommend a blood SARS-CoV-2 IgG antibody test in two weeks. If that blood antibody test is positive, that means you were previously infected with COVID-19.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

“I am a retail pharmacist for a large chain. 

“My daughter is being tested. Should I quarantine? My employer is telling me no, since I don’t have symptoms. I am afraid if I do contract I can spread unknowingly to an entire community, especially since I am giving flu shots every day.”

The answer:

Out of an abundance of caution, I do recommend that you self-quarantine for 14 days. 

Ideally, people should quarantine separately.

If your daughter tests positive, your quarantine will continue for 14 days from the date your daughter is released from isolation. If you develop symptoms during that time, you could be swab tested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Several of my family members have tested positive for COVID-19. However, I have not been around them for 18 days. Does this mean I have a chance of contracting it? Should I get tested? I’m not showing any symptoms but I am a live-in caregiver for my 80-year-old mom.”

The answer:

Since you have not been exposed to them for 18 days, the risk of transmission from them to you is low. I do not advise testing for you at this time.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If you have tested positive for COVID-19 with no symptoms, what should you do besides wearing your mask and keeping your distance?”

The answer:

If you are not immunocompromised, I advise self-isolation for at least 10 days since the date of the first positive viral test.

If you are immunocompromised, I recommend at least 20 days of self-isolation since the date of the first positive viral test.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I spent time with my boyfriend’s family on Sept. 27. The next day, a member of the family woke up with congestion and fever. He was tested on the 29th, and got his positive test results on Oct. 2. I went after work that same day and had a PCR test. My results were given to me as negative on Oct. 4. I did see my boyfriend on Oct. 3. No one in the family has shown any symptoms, and the young man who tested positive has been fever-free for four days now. Should I isolate or is it OK to be at work (keeping 6-foot distance, masking, hand sanitizing)?”

The answer:

You are a close contact of your boyfriend’s family member who tested positive. You are also a close contact of your boyfriend, who was exposed.

You and your boyfriend should self-quarantine for 14 days and not return to work even though you tested negative because symptoms may appear 14 days after exposure. Ideally, people should quarantine separately.

If you develop symptoms during those 14 days, you could be swab retested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I gave a COVID test to a positive person. I was double-masked N95 and Level 3. I was only around the person no more than five minutes. What is the chance I was exposed?”

The answer:

In my opinion, your risk is low.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was diagnosed with COVID-19 on Aug. 12 and now it’s October. If I get retested, will I come back positive or negative? I’m just curious for my sake and sanity.”

The answer:

If you are tested for COVID-19 antibodies, you will come back positive. Antibody tests show that you were infected and developed an immune response to the infection.

A genome test for COVID-19 (one that looks for the virus’ genetic material) will be negative. These tests are only positive when virus is in your system.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My father was in contact with a person who died and was also tested negative for COVID-19 after his death. When it was tested again the next morning, the results came back positive. Should my father stay in quarantine or not?”

The answer:

Yes, I recommend your father quarantine for 14 days from the date of his contact with the patient.

If your father develops symptoms during those 14 days, he could be swab tested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“So I tested negative through a rapid COVID-19 test, but swear I have it because I’m having symptoms such as stomach issues and chest issues. My granddaughter, whom I see all the time, tested positive and I was just with her, but even her parents tested negative. Why is this?”

The answer:

Great question!

The Rapid Antigen Tests work in the same manner as a pregnancy test. You must have enough levels of the viral proteins in your body to produce a positive result. These tests can identify people who are at the peak of infection, when virus levels in the body are likely to be high. 

Just like pregnancy tests can be negative if you test too early, the same can happen for COVID-19 rapid antigen tests.

Since you report being in close contact with a positive patient, you should quarantine. If you feel you are symptomatic, you should isolate until you are fever free for at least 24 hours without medication and it has been at least 10 days since your symptoms have begun. Please monitor your symptoms. If they become severe, seek medical attention.

Your family members who were in contact with your granddaughter also need to quarantine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“My sister went to a hospital to visit her friend, and her friend got tested and she found out she has COVID-19. My sister came over to my house. Should I self-quarantine?”

The answer:

If your sister was a close contact and not wearing a mask when she visited her friend in the hospital, then your sister should be instructed to self-quarantine for 14 days from the date of her last contact with the friend in the hospital who tested positive. A close contact is defined as being within 6 feet for 15 minutes or more, or being directly exposed to respiratory secretions (cough or sneeze).

If you were a close contact of your sister, and if you and your sister were not wearing masks, then you should also self-quarantine for 14 days from the date of last contact with your sister.

If either you or your sister develops symptoms during those 14 days, then you and/or your sister could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband, who is 55, presented with mild symptoms Friday and had positive test results on Monday. A person who resides with us – 79 years old – tested positive, no symptoms. Should they be quarantined separately, in their own rooms of the house, or is it safe to be together at the dinner table, TV room etc.? I have tested negative.”

The answer:

Since both your husband and father-in-law are positive, they can isolate together. You should avoid contact with them and quarantine in another part of the house.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My 5-year-old son was in close contact with a positive staff member at school on Sept. 17. I was told on Sept. 24 he had that close contact. I took him to get tested the 25th and he was positive. 

“He sleeps with me every night and has for years. I get different answers as to when he can leave isolation. We’re 10 days after test, yet he has never had symptoms. School’s original date said ‘Oct. 2.’ I did have a test Sept. 30 (rapid) with negative results. My 1-year-old who also sleeps in my room and is isolated with us was tested Oct. 2 (rapid) and was negative. He’s never had symptoms. 

“When does my 1-year-old and my quarantine start? And Is it possible that an asymptomatic COVID-19 positive person not infect others, even with constant contact such as mine with him?”

The answer:

Research is showing that children often have a milder case of the disease. Since his positive test was on Sept. 25 and he has been asymptomatic the entire time, you can stop your quarantine on Oct. 9.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My grandson was tested for COVID three days ago. I saw him right before he was tested. Waiting for results. He was not coughing or sneezing. I did give him a hug. Can I go back to work?”

The answer:

I advise you not to return to work at this time.

Out of an abundance of caution, I advise you to self-quarantine and not to return to work while you await your grandson’s test result.

If you live with others, self-quarantine in a private room and use a private bathroom if possible.

I recommend you wear a mask, and practice everyday preventative actions, including good hand-washing hygiene and social distancing.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If my husband had COVID, now has antibodies, can he still bring it home to me from work? I do not have the antibodies.”

The answer:

It is not known for certain whether individuals infected with SARS-CoV-2 (COVID-19) who subsequently recover will be protected either fully or partially from future infection with SARS-CoV-2 or how long protective immunity may last.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter tested positive almost a month ago with very mild symptoms (Sept. 8 via nasal swab and received her results on Sept. 11). We went through the quarantine process and then she returned to school and felt fine. Should I be concerned that she complains of more symptoms and also shows more symptoms starting Oct. 3 to present? She says she feels worse now than when she was supposedly infected.”

The answer:

Some individuals are experiencing long-term effect from COVID-19. These can persist for months. If you are concerned, please see your medical provider.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I was tested on Oct 3. When I told my sibling, she told me she tested positive on Sept. 20. I saw her Sept. 13 but she never told me she had tested positive. My question is: could she have exposed me? She thinks she was exposed on the 19th. Can someone contract it in less than 24 hours after exposure?”

The answer:

The mean incubation period for SARS-CoV-2 (COVID-19) is estimated to be five days, with a range of two to 14 days.

On average, it takes five to six days from when someone is infected with the coronavirus for symptoms to show, however it can take up to 14 days. Persons who tested positive are considered infectious 48 hours before the onset of symptoms. Persons testing positive but who do not have symptoms are considered infectious starting two days before test date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband and I have both tested positive, with no symptoms, and we have been quarantined. Can we walk in our neighborhood early in the morning or late in the evening for some fresh air and exercise?”

The answer:

When a positive test is returned, it is best to remain in isolation for at least 10 days. Even though you are not experiencing symptoms, you had enough virus in your system to return a positive test. 

This means that you can infect others.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I tested positive for COVID-19 so I stayed home with my husband and daughter. After three days, they did the PCR and it was negative. Why? They didn’t catch the virus from me?”

The answer:

Your husband and daughter are close household contacts, and they should be instructed to self-quarantine for 14 days. 

This will be 14 days from the date you are released from isolation.

Ideally, people should quarantine separately. Even though your husband and daughter tested negative and may feel healthy, symptoms may appear 14 days after exposure.

If your husband or daughter develops symptoms during those 14 days, they could be swab retested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive on Sept. 22, then after a week, I tested negative. I am 10 days from when my symptoms started. My boyfriend tested positive on Sept. 26. Can we be around each other? Or am I still at risk of getting reinfected?”

The answer:

You didn’t mention if your boyfriend has symptoms. If your boyfriend has no symptoms, and if he is not immunocompromised, his isolation may be discontinued when at least 10 days have passed since the date of his first positive viral test.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive on July 6, then after 14 days, I tested positive again. Then on Aug. 9, I tested negative, then positive again on Sept. 13. Why do I keep getting infected with this disease?”

The answer:

Some individuals can continue to test positive for 22 days after symptoms stop. This is likely what has happened here. You were not reinfected, but rather had some residual virus particles that had yet to be cleaned up by the immune response.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If a person was tested negative in the United States, then a week later tested positive twice while in another country, and waiting for yet another test by nasal swab, is it possible that last test by nasal swab can come out negative? If so, does that person quarantine because of the other two positive results?”

The answer:

Does the person quarantine because of two positive results? Absolutely yes!

In my opinion, the second positive test result and the third test were not needed.

On the basis of the first positive test result, my recommendation is self-isolation for at least 10 days if not immunocompromised, and 20 days if immunocompromised.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I work in a long-term care facility. Recently, we had 32 residents and approximately 20 staff test positive. I expect I was infected. Most rooms have two to three people. Some are private rooms. 

Out of approximately 25 staff, five were not infected so far and are still testing negative. To me that’s amazing. How could that be? Were we doing something the others where not?”

The answer:

My explanations are different individual immune systems, and some staff members were more diligent following infection control policies and protocols, and using appropriate personal protective equipment (PPE).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was wondering if you use a nasal spray before getting a coronavirus test done, will it possibly make it negative even if it’s a positive? I had to have one but have been using nasal spray to breathe.”

The answer:

Molecular swab tests for COVID-19 should not be used within 30 minutes of administering nasal or throat sprays.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Is it possible for somebody to test positive on Sept. 29, and then take another test and test negative on Oct. 3?”

The answer:

You didn’t mention the type(s) of tests. However, positive test results are highly accurate, and a negative test result doesn’t rule out an infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • 

“A friend of my son just told us his father tested positive. The friend was at our house yesterday. What should we do?”

The answer:

The friend is a household contact of his father who tested positive for COVID-19. The friend should be instructed to self-quarantine for 14 days, and this be 14 days from the date his father is released from isolation.

You didn’t mention if there was close contact, and if the friend or your family were wearing masks.

Close contact is defined as being within 6 feet for 15 minutes or more, or being directly exposed to respiratory secretions (cough or sneeze).

If no one was wearing masks and if there was close contact exposure, then there is risk of transmission.

In that scenario, my recommendation is that your family self-quarantine for 14 days from the date of your last contact with the friend.

Ideally, family members should quarantine separately.

If any family member develops symptoms during those 14 days, they could be swab tested (molecular Polymerase Chain Reaction - PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My 15-month-old grandson and daughter-in-law where exposed to a relative with COVID-19. They are self-quarantining for 14 days. I babysit my grandson, so should I be in quarantine also? He was with his cousin who came down with COVID-19 on a Saturday, and I was with him on Monday and Tuesday.”

The answer:

Since you were not exposed to the infected individual, you do not need to self-quarantine. Individuals who are exposed and develop COVID-19 typically are not infectious until 48 hours before symptoms start.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I saw my friend on Sept. 27. She started showing symptoms on Tuesday and tested positive on Wednesday. I am not showing symptoms. What do I need to do?”

The answer:

From your question, it appears that you were exposed to SARS-CoV-2. I suggest that you quarantine for 14 days. If you develop symptoms of COVID-19, monitor your symptoms and seek medical treatment if they become severe.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I traveled from a city with multiple COVID-19 cases to a province, so the province needed to test me for the virus. The result was IgG and IgM positive. It was the province’s policy that anyone who tested positive for IgM antibody should be swab-tested (nasal and throat swab sampling). I was swab-tested Sept. 3, and results were received Sept. 7 as COVID-positive. I have inconsistent cough with little phlegm. However, I produce white mucous consistently. I feel like there is something in my throat and I need to spit it out, but I do not feel the need to cough. I was brought to the hospital for medication, isolation and monitoring.

“After two weeks, my cough was gone. However, I still have the mucous problem. In the intention to self-medicate and help with the recovery, I unwittingly made a concoction that caused me diarrhea (Sept. 19). I fried apples in virgin coconut oil and added honey. Unfortunately, I added a broth made by boiling ginger and garlic for five minutes. This, I think, caused my diarrhea.

“For three days, I had no cough (but still has very wet stool). However, on the fourth day, I had a very bad cough with phlegm. I feel fine again two days after it but my fecal problem still continued so the hospital conducted stool test. On the third day, I had a bad cough again. The next day, I am scheduled to undergo rapid testing (antibody test). I was IgG positive and IgM negative (Sept. 28), and I still had cough and the mucous problem. Also, my fecal problem which started Sept. 19, is still on going up until now, however the stool test results were said to be OK.

“In my release papers, I have read moderate pneumonia second to COVID. I do not know if this is stating a medical history or an ongoing case. However, right now, I am taking NAC and carbocisteine for my cough. I also experience some time, body aches which are very mild. I am afraid that this would get worse. In addition, Sept. 28, I was released from the hospital after testing negative in IgM antibody test.

“Are my worries grounded? Should I go back to the hospital? Is it normal that I have this cough for so long already? Lastly, is it possible that I have recovered from COVID-19 (for testing negative in IgM antibody), but still have pneumonia?”

The answer:

Your last antibody test results (IgM negative and IgG positive) indicates you were infected in the past and have recovered.

A recent study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at least one symptom, particularly fatigue and shortness of breath. Other persistent symptoms included joint pain, cough, sputum production, diarrhea, and muscular aching or pain.

I recommend you follow up with your primary care physician. I also advise you to wear a mask and practice everyday preventative actions including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I got exposed at work on Sept. 22. Work made me test the same day. It was negative. I retested positive on the Oct. 1. I have been quarantined since the 22nd. What are the chances I’ve had it this whole time ? Do I still need to quarantine with no symptoms?”

The answer:

Testing too early, as you did, will result in false negatives. It is best to test three to four days after exposure. I suspect that the exposure on Sept. 22 is what resulted in your COVID-19 positive test on Oct. 1. I am glad to hear you quarantined after exposure.

If you have been fever free for 24 hours without medication, your symptoms have improved, and it has been 10 days since your symptoms have begun, then you are likely not contagious and can return to normal activities.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My brother and sister-in-law went to Oregon for a week. They live in Chicago and just returned from their trip. They were together the entire time on the trip. We wanted them to both quarantine for two weeks to be safe and then get a test. We have a 78-year-old mother and I’m immune compromised. Instead, they want to just go about their regular days for the next two weeks (no quarantine) and then my brother said he (only) would get a test in two weeks.”

The answer:

I understand your concerns since you are immunocompromised and considering your mother’s age.

However, Oregon is presently not on the list of of states where there are high amounts of COVID-19 cases.

Therefore, if they have no history of close contact exposure with patients diagnosed with COVID-19, and if they have no symptoms, I do not recommend quarantine or testing for your brother or sister-in-law.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“What are the chances of the following? I was unknowingly exposed to someone carrying the virus on Sept. 13. I tested positive on Sept. 18. I was with my girlfriend the entire time from Sept. 13-18. She tested negative on Sept. 18 and also tested negative on Sept. 25. She has never had symptoms and I’m eight days into the virus and my main symptoms are loss of smell/taste.”

The answer:

It’s an even chance.

Your girlfriend is a close contact and should be instructed to self-quarantine for 14 days from the date of her last contact with you.

If your girlfriend develops symptoms during those 14 days, she could be swab retested (molecular Polymerase Chain Reaction - PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had COVID first. Then six days later, my partner tested positive. I was symptom free on Day 10 and officially out of isolation. Must I quarantine another six days with him since we are in the same household and he still has symptoms?”

The answer:

I am glad to hear you are feeling better. You are not at risk of becoming infected by your partner, as you have just recovered from COVID-19. Many who have recovered are protected from acquiring the virus again for up to six months.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My co-worker’s daughter did not feel well and had a rapid test on Sept. 15, which was positive. He left work and had a test, which was not a rapid test. He did not come back to work. He got his results Sept. 17, negative, however he did say he developed a cough. On Sept. 18, he developed a fever. He had a rapid test which came back positive. He quarantined himself. Our entire office had rapid tests on Sept. 19-20. We all came back negative. I was the only person in the office who had any real contact with him – on Sept. 14, when he asked me to look at some documents on his cellphone. We do wear masks at the office, but most of us who are in a private offices more or less have the mask hanging below our mouths. His wife, who tested on Sept. 15 and Sept. 20 results were negative. My co-worker was hospitalized Sept. 26 and his wife now tested positive. My question is: should all of us at work test again?”

The answer:

According to your history, you were the only employee who had contact with him. Therefore, I do not recommend that the entire office staff retest again.

However, I do advise you to self-quarantine for 14 days from the date of your last contact with him. If you develop symptoms during those 14 days, you could be swab tested (molecular Polymerase Chain Reaction - PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive 25 days ago, before I went out again. I am asymptomatic. Is possible that a colleague of mine got the virus from me and had symptoms the same day I returned?”

The answer:

If you have been in self-isolation for 25 days, it is unlikely that your friend contracted the virus from you. She/he would have had to have been in close contact with you for greater than 15 minutes when you were symptomatic for you to have transmitted the virus to her.”

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife showed coronavirus symptoms on Sept. 14 and I did on Sept. 16 – both having same symptoms of fever and no smell. We go for test on Sept. 22. I was positive and my wife was negative. She still has problem with smell, but better than before. I think she was tested negative. I live with two sons and my father. My younger one is 6 months and elder one is 7 years, 11 months and my father is 72 years. Younger son is breast feeding regularly. Still today, all three have no symptoms. Until which date are they at risk for infection?”

The answer:

If you are not immunocompromised, your isolation ends after at least 10 days have passed (earliest Sept. 26) since your symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms have improved.

The other household contacts should be instructed to self-quarantine for 14 days from the date you are released from isolation. Therefore, their quarantine would end on Oct. 11.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was with my sister and her husband told her that he was in contact with his sister-in-law, who tested positive for COVID-19. Should I stay away from my daughter and grandchild? And should I be worried for myself?”

The answer:

Many variables go into determining whether or not you were exposed. From what you have written, it is unlikely that you were exposed to SARS-CoV-2.

However, if your brother-in-law was in contact with someone who was presymptomatic or symptomatic for greater than 15 minutes without a mask, then he should self-quarantine for 14 days.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I attended a family gathering of 12 people. The next day, one family member who is immunocompromised developed symptoms, and she tested positive for COVID-19 three days after the gathering (rapid testing). All 11 of us got tested either four or five days after the gathering (mixture of rapid testing and nose swabs). All 11 of us, including the person who lives with the infected family member, tested negative. Should we all self-quarantine for 14 days after exposure, or does that many negative results tell us that our family member was not infectious at the time of the gathering?

“We have a burial planned for the day after the infected individual’s quarantine ends. All of the same 12 family members will be in attendance. The family member who lives with the infected individual is staying in a separate room but the same house. Is this gathering safe?”

The answer:

Most will develop symptoms within five to seven days of exposure; however, some develop symptoms as late as 14 days. The rapid COVID-19 test works best when an individual is symptomatic. The genome test works best in the 48 hours prior to symptoms through the symptomatic phase.

Those that took the rapid COVID-19 test may have tested too early. Those that had the genome test are very likely negative.

If no one is symptomatic in the 14 days of the infected individuals isolation, then it is likely safe to have your gathering (since all of you have tested negative).

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“A friend of my son just told us his father tested positive. The friend was at our house yesterday. What should we do?”

The answer:

The friend is a household contact of his father who tested positive for COVID-19. The friend should be instructed to self-quarantine for 14 days, and this be 14 days from the date his father is released from isolation.

You didn’t mention if there was close contact, and if the friend or your family were wearing masks.

Close contact is defined as being within 6 feet for 15 minutes or more, or being directly exposed to respiratory secretions (cough or sneeze).

If no one was wearing masks and if there was close contact exposure, then there is risk of transmission. In that scenario, my recommendation is that your family self-quarantine for 14 days from the date of your last contact with the friend. Ideally, family members should quarantine separately.

If any family member develops symptoms during those 14 days, they could be swab tested (molecular Polymerase Chain Reaction - PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I just retired from hospital as a nurse. My question is: how long should my husband and I quarantine at home before we can go to visit my daughter, a 2-year-old and a newborn in another state?”

The answer:

If you feel that you were exposed, you should self-quarantine for 14 days. If no symptoms present themselves, it is likely safe to travel and visit.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife tested positive for COVID-19 after having symptoms. I went and got tested and was negative. Since we are in the same household, how often should I get retested? Should I only get tested if I start to show symptoms?”

The answer:

Close contacts of patients diagnosed with COVID-19 should be instructed to self-quarantine for 14 days. For household contacts (you), this will be 14 days from the date the person with COVID-19 (your wife) is released from isolation.

If you develop symptoms during those 14 days, you could be swab retested (molecular Polymerase Chain Reaction - PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have a good friend who is the secretary at a high school near Cincinnati. She, her daughter and son all had a terrible colds that started this past week. She will not get tested because she doesn’t have time. She is going to and from school activities and could be spreading it to many people. Is there anything that could be done?”

The answer:

I am sorry to hear about your friend. We are all in this together and if any of use suspect that we may have COVID-19, we should self-isolate for at least 10 days, until we are fever free for at least 24 hours, and until our symptoms improve.

In the meantime, Ohio has a phone number you can call to report possible cases: 1-833-4-ASK-ODH

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Four of us all in the same household have tested positive for COVID-19. We are all at different stages of the recovery. My symptoms started on Sept. 11. My son’s on Sept. 14, my daughter on Sept. 21 and husband on Sept. 23. Do we all need to isolate from each other or can we all be in the same room because we are all positive? Can some of us get sick again from the latest two family members who most recently tested positive?”

The answer:

Multiple family members can be isolated together, as long as they are all positive. There’s no problem having multiple people isolate together.

Isolation precautions should be individually discontinued on different dates based upon when symptoms first appeared for each family member.

If the person is not immunocompromised, isolation may be discontinued after at least 10 days have passed since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms have improved.

If the person is immunocompromised, then at least 20 days of isolation is recommended since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms have improved.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. I recommend wearing a mask and practicing other everyday preventative actions, including good hand washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I woke up on Sept. 5 with a sore throat, dry cough and nasal congestion. Two days prior, I had a bout of diarrhea. I went for a test and the results came back on Sept. 8 positive. I am a health-care worker. I believe I was exposed at work but I can’t be 100% positive. I was able to return to work on day 11 because my symptoms were improving and I never had a fever. Today is day 20 after the onset of symptoms, and my voice is still sounding raspy and I feel like I have phlegm going down my throat. I’ve been back to work for nine days and I am scheduled to work this weekend. My temperature is not feverish but elevated for me at 98.6. I usually run 97. I want to be retested but work says I don’t have to be. My anxiety is through the roof. I check my temperature way too much during the day. Not sure how accurate my O2 SATs monitor is, but I’m ranging 95 to 99%. Do you think I’m OK to continue working in the health setting and also to be around my family. My raspy voice in the phlegm going down my throat is making me nervous that I’m going to end up with pneumonia.”

The answer:

I am sorry you are not feeling well. It is very likely that you are no longer infectious as you do not have a fever and it has been nearly a month since symptom onset.

Some individuals are experience a significant amount of time for recovery after COVID-19. Physiologically, this has to do with how the body tissues heal and how much damage was done during the infection. It may take up to six months for a full recovery.

I would suggest that if you are feeling unwell, schedule a visit with your primary care provider.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My daughter and her 4-year-old son tested positive, but her husband and their 1-year-old daughter tested negative. How is that possible?”

The answer:

One possible explanation is that the husband’s and 1-year-old daughter’s tests were “false negatives.” Another possibility is that the husband and daughter tested too early. Sometimes it can take up to 14 days.

The husband and 1-year-old daughter are both close household contacts, and they should be instructed to self-quarantine for 14 days. This will be 14 days from the date the mother and son are released from isolation.

If the husband and 1-year-old daughter develop symptoms during those 14 days, they could be swab-tested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I feel like I have a congestion sickness. My granddaughter was tested for COVID and was negative. I’m around her almost daily. She was tested on Tuesday because she was having surgery. My question is: should I be test now or should I be fine?”

The answer:

May infectious diseases can cause respiratory congestion. Symptoms of COVID-19 are: shortness of breath, loss of taste/smell, fever above 100 degrees F and a dry cough. If you are experiencing these symptoms, I suggest that you self-isolate and monitor your symptoms. If your symptoms become more severe, please see your primary care provider.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My girlfriend first tested positive for COVID 26 days ago. She had a fever just on the first day and then mild symptoms for a few days and a slight headache. She also lost taste and smell. It has been 17 days since her last symptoms and she has full taste and smell back. The issue is that she is still testing positive. I wanted to know if it is safe to see her now. She feels perfectly fine and has her full taste and smell back. Is it safe to sleep in the same bed and is she still contagious?”

The answer:

Since your girlfriend is symptom- free, it has been over 14 days since she had symptoms, and her symptoms have improved, she is not contagious.

Some individuals will continue to test positive after the infectious period has passed.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My son spent the day with a friend on Sept. 19. On the 23rd, the friend tested positive. My son was tested on the 25th, and on the 26th was told he was negative. He has quarantined per doctor’s orders. He feels well, no symptoms. He visited me daily from the 20th to the 23rd, when he heard of his friend’s positive test. Should I quarantine?”

The answer:

Yes, you should self-quarantine for 14 days from the date (Sept. 23) of your last contact with your son.

If you develop symptoms during those 14 days, you could be swab-tested (molecular Polymerase Chain Reaction - PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I work in an organization where one of my friends was COVID-positive in PCR test. After that, we all did PCR test and my report was negative. But one of my colleagues’ report was positive – someone with whom I worked two days ago and we were near one-foot distance, both of us wearing masks. Should I need to test for COVID again or not?”

The answer:

In my opinion, you do not need to be retested now.

I recommend you continue to wear a mask and practice everyday preventative actions including good hand-washing hygiene and social distancing when possible.

If you develop symptoms in the next 12 to 14 days, you could be swab-retested (molecular Polymerase Chain Reaction - PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My mom, without having any symptoms, tested positive. We isolated her. She is home-quarantined. How much chance is there her next test would be negative?”

The answer:

It’s an even chance.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with COVID-19 shouldn’t undergo virus testing within three months after the date for the initial infection. This is intended to prevent excessive use of lab tests.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive for COVID-19 and I live in the same house with my mother – who tested positive a week after I did. Technically, based off CDC guidelines, I am able to be around people after 10 days from when symptoms first began. My quarantine/isolation time is considered done now; the 10 days have passed, symptoms have improved, and I feel totally healthy again. Since my mother is still in her quarantine period, am I still able to spread the virus to others since I am living with her? 

“We wear masks in the house and try to maintain a 6-foot distance, but I just don’t want to jeopardize spreading COVID to anyone even though I am considered no longer contagious.”

The answer:

Based on your history, you may resume normal activities. I agree you should wear a mask, maintain social distancing as much as possible, and continue to practice preventative actions including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Wednesday, Sept. 23, I had nasal swab to test for COVID-19. Sept. 25 results were positive. Sept. 25 I had another test done, and on Sept. 27, the results were negative. How can I go from positive to negative in two days? 

“Should I go get another test? I am to go see my 5-month-old grandson.”

The answer:

You didn’t mention if you have symptoms. The second test may be a “false negative.” I would not get another test, and I recommend you self-isolate.

If you are not immunocompromised and have no symptoms, self-isolation may be discontinued when at least 10 days have passed since the date of your first positive viral diagnostic test.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

“If I was in contact with someone who had COVID-19, how soon would I start seeing the effects and the symptoms?”

The answer:

On average, it takes five to six days from when someone is infected with the coronavirus for symptoms to show, however it can take up to 14 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My wife tested positive for the COVID-19. We did not isolate from each other. I took care of her while she was sick. After her 14 days were over and she was well, I also got tested and it came back negative. But they want me to isolate for 14 more day. Is it possible that I will not get the virus?”

The answer:

Close contacts of patients diagnosed with COVID-19 should be instructed to self-quarantine for 14 days. For household contacts,

this will be 14 days from the date the person (your wife) with COVID-19 is released from isolation.

If you develop symptoms during those 14 days, you could be swab tested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

Yes, it is possible that you won’t be infected with the virus.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was infected with coronavirus five days ago. I drove my car that day. What is the possibility of the car being contaminated?”

The answer:

Current evidence suggests that SARS-COV-2 (COVID-19) may remain viable for hours to days on surfaces made from a variety of materials.

Cleaning of visibly dirty surfaces followed by disinfection is best practice measure for prevention of COVID-19 and other viral respiratory illnesses.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive five times. I have been home since July 11 and feel awful. What can I do?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after initial infection, but likely isn’t infectious.

Since you feel awful, I recommend you consult an infectious disease specialist in your area or at a university medical school.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My mother was hospitalized for a non-COVID condition. She left the hospital on Sept. 14 and was tested the same day. They require her to be in isolation for 14 days, but her COVID-19 test came back negative. It is now Sept. 19.

“In an elderly person, if she got COVID, would she likely be showing symptoms by now?

“It is very trying for the elderly in nursing homes to be isolated for 14 days. She is on a different floor, with staff unfamiliar with her care and with the door closed and checked on only every 2 hours.

“She is non-verbal, and cannot move to ring the bell for assistance. These regulations put her at risk.

“Any studies to get the elderly out of isolation earlier would be beneficial. Do they have any studies on the elderly (over 80 years old) and when symptoms show up in this age group?”

The answer:

On average, it takes five to six days from when someone is infected with the coronavirus virus for symptoms to show, however it can take up to 14 days.

Isolation can have very real and serious health impacts for nursing home residents. However, older people are at higher risk

for COVID-19. So are people with chronic medical conditions such as heart disease, diabetes, kidney disease and respiratory illness. Both groups are heavily represented among the nation’s nursing home residents. That concentration is a key reason why deaths from COVID-19 have occurred in nursing homes and other long-term care facilities.

The Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and state Health Departments issued guidance on reducing the spread of COVID-19 in nursing homes.

CMS announced tougher rules on infection control in May 2020. Even in states that have authorized visits, individual nursing homes may remain locked down due to local or facility specific circumstances.

Please stay connected with your mother as best as possible.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“We had visitors from our church on Friday. On Saturday, someone at that church was hospitalized with COVID.

“Should we be tested or quarantine since our visitors were in close contact with the positive person?”

The answer:

Out of an abundance of caution, I recommend self-quarantine for 14 days. Ideally, you should quarantine separately.

If a close contact develops symptoms during those 14 days, they could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or they may be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was tested for COVID. Never had symptoms, I just wanted to be safe and get tested for my girlfriend. I stayed at home alone for five days after the test and never left.

“The sixth day I got the results, it was negative. My girlfriend is scared to be with me or be intimate. Can this prove to her I am safe?”

The answer:

Anyone can become infected with COVID-19 at any time. A negative test only means that you’re not infected at the time the test was done.

We all need to concentrate on avoiding infection. This includes wearing a mask, good hand-washing hygiene, social distancing whenever possible and practicing other everyday preventative actions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My brother had symptoms of COVID 16 days back. He isolated himself the very next day, then after six days he tested and was positive. After five days, my parents underwent testing and my mother tested positive, whereas my father tested negative.

“The test was done on Aug. 18  and we received the report on the 20th.

“Soon I brought my father to stay with me. Is it right to bring him? Can he get affected within these two days? Should I and my family go for testing?”

The answer:

Your father is a household contact of his wife who tested positive for COVID-19. He should self-quarantine for 14 days, and this will be 14 days from the date his wife is released from isolation.

You and your family should also self-quarantine for 14 days since you brought your father to stay with you.

Ideally, everyone should quarantine separately. Even though your father tested negative, your father, you and your family should quarantine for 14 days since symptoms may appear two to 14 days after exposure to the virus.

If anyone develops symptoms during those 14 days, they could be swab tested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

I recommend wearing a mask when entering general living areas and practicing other everyday preventative actions, including good-hand washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My final test is now negative, but I am still not feeling very well and not even able to work or even to do some walking. It’s already one week after my final test. Is it common despite all? I am still taking vitamin C and panadol (paracetamol) sometimes. I am 58 should. I keep on taking vitamins?”

The answer:

A recent study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at least one symptom, particularly fatigue and shortness of breath.

I recommend you follow-up with your physician for additional instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My partner and I tested positive for COVID-19. He got sick on Aug. 14, and tested positive on Aug. 21. I tested Aug. 24 and got the result on Aug. 29 – positive. We got tested again on Sept. 15 and both tested negative. My question is, we kissed all this time. But I’m worried we can get the virus again from each other. Is that possible?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My son was exposed to COVID-19 in college by friends, a suite mate and his roommate. Because we assumed he was already infected we let him be with his positive roommate for eight days – same dorm room, shared bathroom and no masks.

“He had three negative antigen tests and one negative PCR test all within 10 days of exposure. He was antibody negative. How is this possible?”

The answer:

Close contacts of persons diagnosed with COVID-19 should be instructed to self-quarantine for 14 days. For your son, this will be 14 days from the date the person with COVID-19 (his COVID-19 positive roommate) is released from isolation.

If your son develops symptoms during those 14 days, he could be swab retested (molecular Polymerase Chain Reaction

– PCR) for COVID-19, or be advised to self-isolate.

SARS-CoV-2 IgG antibody detection is a median of 14 days, with a range of 10 to 21 days. Therefore, I would consider repeating a blood test for SARS-CoV-2 IgG antibody in two to three weeks.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am positive for COVID-19, but my girlfriend has tested negative twice in the time we’ve been on quarantine. Can she still spread the virus if she were to go out somewhere – even being negative for the virus with me being positive?”

The answer:

Yes.

Even though your girlfriend tested negative and may feel healthy, symptoms may appear 14 days after exposure.

Therefore, close contacts of patients diagnosed with COVID-19 should be instructed to self-quarantine for 14 days.

Ideally, she should quarantine separately.

For your girlfriend, this will be 14 days from the date you are released from isolation.

If your girlfriend develops symptoms during those 14 days, she could be swab retested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

 

“My wife had possible COVID-19 exposure from a coworker on Sept. 11. The coworker tested positive on Sept. 14. My wife has had no symptoms. She was PCR tested Sept. 19. Her result was was returned “inconclusive” on Sept. 21. She was retested and that result on Sept. 22 was positive. When do you think her infection officially began? The date of her first test on Sept. 21 or the date of the second test on Sept. 22?”

The answer:

Individuals are most likely to test positive via a genome test 48 hours before symptoms start. She could have been exposed seven days prior to symptoms starting. The asymptomatic stage from two days after exposure until symptoms start.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Labor Day weekend, I picked up my son and his two friends from college. I took them back on that Monday, Sept. 7. Around Sept. 11, one young man developed COVID-19 symptoms. Days later, the other young man/his roommate developed symptoms as well. Both were tested on Sept. 18. Positive results came back on Sept. 21. I know my son should be tested. Since I was around both young men on the days that I picked them up, Sept. 4, and took them back, Sept. 7, should I self-quarantine?”

The answer:

Given the timing of symptoms of the first young man, it is possible that you were exposed (maybe by the same individual). Most individuals will develop symptoms within a week of exposure. Young man 1, the first to get sick, was symptomatic on Sept. 11. 

“You saw him on Sept. 7. The difference is four days. This young man was most likely in the asymptomatic stages, where he is contagious but not showing symptoms, starting on the 8th.

However, it is now Sept. 24, if you are not symptomatic now, you were likely not exposed to an infectious dose. I see no need for you to quarantine. 

The others, who were around young man 1, should absolutely quarantine and self-isolate if a positive test is returned.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My dad, who is 81, has been moved to an assisted living facility due to COVID-19. He is having difficulty breathing and is weak. He doesn’t want to get up and move around. He has been in the hospital or assisted living facility for five weeks. No one is allowed to go in and see him. I believe that if we could go in he would feel better and start healing. Why can’t we spend time with him since it has been so long?”

The answer:

Depending on where you live, there could be a ban on visitations to nursing homes. This is in place to protect the most vulnerable of our population.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have no spleen, due to car accident when I was 16. I also have thyroid problems. I am 38 years old. Four days after a grocery trip, I woke up with bad congestion in my head and a smothering feeling in my chest. That lasted for about 15 days at the worst and on and off for the next two weeks.

“I woke up one night covered in sweat, for a couple of days I ran a low-grade fever. I had a sore throat, headache, a really bad dizzy spell, nausea and diarrhea, no appetite and fatigue.

“Those symptoms we’re on and off again. I don’t have allergies and I hardly ever get sick, definitely not for over a month. I waited until a few days ago to get the antibody test and the results were negative. I don’t understand, especially when I have told so many doctors my symptoms and all told me they were COVID classic. Depression and anxiety is about to kill me.

“Please just tell me if you think I’ve had the virus and why my antibody test was negative.”

The answer:

I recommend a swab test (molecular Polymerase Chain Reaction – PCR). Perhaps you were infected with a different virus.

Another possibility is that your immune system neutralized the virus, and the SARS-CoV-2 (COVID-19) IgG antibodies did not stay long in your body.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My 13-year-old granddaughter

is attending hybrid schooling this year, where she is in class two

days a week, with the same nine other students (teachers move between classrooms for different subjects) and they all wear masks

and are socially distanced. They get their temperatures checked daily

and do not mingle with any other

students.

She is driven to and from school by her parent, and has basically no outside contact with others once home. Her father (divorced) has now told her that if she keeps going to school and happens to visit us, she could kill us.

“He thinks she should do only online classes, but our daughter has full custody and chose to try the hybrid system.

“Should we avoid all contact with our granddaughter? Since March, we have seen her twice at our home for limited times. None of us has had COVID nor any symptoms.”

The answer:

It appears that your granddaughter is doing all that is possible to reduce her risk of contracting SARS-CoV-2, the virus that causes COVID-19. Of course, the risk assumption is yours, but it does appear that she is being safe.

If you would like to visit there are things that can be done it reduce the risk, such as meeting outside while wearing masks. You could schedule your visit for day four after her last in-person school day.

For example, if her last day of in person schooling is Tuesday, then you could visit on Saturday or Sunday. If she was exposed on Tuesday, she would likely have symptoms by Sunday.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I got tested for COVID-19 and was negative. Then I got a symptom of loss of smell seven days after

and I went got tested and was positive. I retested four times and came back positive, but I have my sense of smell back and have no more symptoms – but I keep getting a positive result.

“I did a rapid test and got another positive and I feel great, but I keep getting positive results. What should I do?”

The answer:

It is possible for individuals to test positive for COVID-19 and be asymptomatic. In your question you mention the rapid test. This test detects pieces of the virus that we call antigens. It is possible that those pieces are in the process of being cleaned up by the immune response.

Sometimes that clean-up can take a few days or weeks after symptoms cease.

If you are fever-free and have been for at least 24 hours without medication, if it has been at least 10 days since your symptoms began, and you are seeing symptom improvement, then you are likely not infectious.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I live in Indiana and work at a hospital in housekeeping and want to go to Texas next month to visit my 98-year-old father (who is healthy). Is it safe for him if I go?”

The answer:

When determining if it is safe to visit a friend or family member who may be at a greater risk of contracting COVID-19, it is best to reduce your exposure risk.

In the week leading up to the visit, you want to be sure to wear a mask when out in public, wash your hands regularly and monitor yourself for symptoms of infection.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I tested positive for COVID-19 on Sept. 3. I live with and take care of my terminally ill mom, who also has COVID-19. Are there any funds out there that can possible help me out. I’m under quarantine until Sept. 17 – no car, no money, no nothing. Looking for help please.”

The answer:

I recommend you contact all of the following offices in the county which you reside:

• the local Health Department,

• the Department of Public Assistance, and

• the Department of Aging.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had COVID and quarantined for two weeks – stayed away from family members the whole time. I recently tested negative and have been back to work. My husband now is feeling bad and thinks he could have it.

“Can I go around other people or do I need to quarantine again?”

The answer:

Since you have had COVID-19, you are likely protected from the virus for a few months. I would recommend that you continue to wear a mask, practice social distancing and wash your hands regularly.

Your husband should self-isolate and monitor his symptoms.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had to have an emergency root canal done on Sept. 9. The dentist wore a mask and his assistant wore a mask. Since I was having a procedure, I was not wearing a mask. My question is, could I have been exposed to COVID since I was not wearing a mask?”

The answer:

References include:

CDC Releases Interim Reopening Guidance for Dental Settings (updated Aug. 28, 2020)

Dental Care – PA Department of Health – PA.gov

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter tested positive for coronavirus on Aug. 26. She had mild symptoms. The health department released her on Sept. 2. She tested again on Sept. 10 and was still positive with no symptoms. Her grandmother has Stage 4 lung cancer. Should she stay away until she tests negative?”

The answer:

It is possible for someone to test positive for the virus and be asymptomatic. Most individuals are not infectious after about two weeks. Out of an abundance of caution, you can limit her contact with individuals who are of high risk of infection for a month.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband was detected positive for COVID-19 and had no symptoms, but had been in home quarantine for 14 days. After 14 days, he got the igg and igm antibody tests. Is it safe for him to be with all people inside the home with no quarantine?”

The answer:

Your husband may be in the late or recovery stages of infection, based upon his antibody levels. If your husband is immunocompromised, 20 days of isolation is recommended since the date of his positive viral test.

I recommend wearing a mask, good hand-washing hygiene, and follow other safety precautions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My older daughter is away at college. She began experiencing symptoms of COVID (headache, low-grade fever, loss of taste and smell, etc.) on Sept. 4. She tested positive on Sept. 5. She has not had any symptoms since Sept. 11. My younger daughter was visiting her older sister at this time and was leaving to come back home on Sept. 4. She had no immediate symptoms, but was exposed to her older sister prior to returning to our home and has been in isolation. Since her return home, she has had very mild symptoms (occasional headache and occasional scratchy throat). She tested positive on Sept. 8. My wife and I both tested negative. The three of us re-tested on Sept. 11 with same results (2 negatives and 1 positive). My questions are:

“Is my older daughter out of isolation (and quarantine) as of Sept. 14 (10 days from symptoms) or Sept. 18 (14 days from symptoms)?

“Is my younger daughter out of isolation (and quarantine) on either of these days (14th or 18th)? Or does her window start from the date of the positive test (Sept. 8)? If so, is she out of isolation (and quarantine) on Sept. 18 (10 days from positive test) or Sept. 22 (14 days from positive test)?

“When do my wife and I get out of quarantine? On Sept. 18 (14 days after younger daughter came home) or on Sept. 22 (14 days after younger daughter tested positive)?

“We are trying to figure the correct dates based on CDC guidelines. Please advise.”

The answer:

• If your older daughter is not immunocompromised, she is out of isolation Sept. 14.

• If your younger daughter is not immunocompromised, her isolation ends after at least 10 days have passed since her symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms have improved.

• You and your wife are household contacts of your younger daughter who tested positive for COVID-19. You and your wife should self-quarantine for 14 days, and this will be 14 days from the date your younger daughter is released from isolation. Ideally, you and your wife should quarantine separately. If you or your wife develops symptoms during those 14 days, then you and/or your wife could be swab tested (molecular Polymerase Chain Reaction – PCR) for COVID-19, or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have been in isolation due to testing positive. It has been about two weeks and I will be retesting soon. I want to see my boyfriend who doesn’t live with me and has never caught the virus and was never in close contact with me when I had to quarantine. How soon after I test negative can I kiss him? I’m worried that any bit of virus still in me could infect him. What we generally do is quarantine for 14 days every time we see each other and 14 days if we see anyone outside our own household, so I know he will be cleared but I’m not sure how long until I’m cleared to be affectionate.”

The answer:

If you are symptomatic, I suggest that you refrain from kissing. The virus is transmitted via respiratory droplets and aerosols.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I was around someone who tested positive three days after I was around the person. We both had masks on and were in a sterile environment. Should I self-quarantine?”

The answer:

Most individuals are not infectious until the 72 hours prior to symptoms starting. From your questions, it appears that you are outside of that window. Good job on wearing your mask!

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If a family member has several of the symptoms, should a family member who does not live in that house go check on him”

The answer:

Certainly daily contact with the person is appropriate, either by phone call or FaceTime. Also, assist with food delivery and medicine drop-off at the door.

If an in-person visit is required, wear appropriate personal protective equipment (mask, gloves, and goggles) and/or contact local health care personnel if necessary.

If the person develops additional symptoms or if symptoms get worse, notify his physician for instructions.

Additional resources for assistance in the county which the family member resides include:

• the local Health Department,

• the Department of Public Assistance,

• the Department of Aging, and

• local Home Health Agency.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My roommate’s son just tested positive for COVID. My roommate has been around her son and he was at our apartment less than a week ago. Am I susceptible to COVID?”

The answer:

You and your roommate are close contacts of a person (roommate’s son) who tested positive for COVID-19.

You and your roommate should self-quarantine for 14 days from the date of your last contact with the son. Ideally, you and your roommate should quarantine separately.

If you or your roommate develops symptoms during those 14 days, you could be swab tested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My wife tested positive for a month. I didn’t bother to quarantine because she works in the medical field, however I tested every time she tested and three times she tested positive and three times I tested negative. I never get sick, flu, cold, etc. Now do I naturally have the COVID-19 antibodies or do I just have a really good immune system? Or can you give me a better explanation?”

The answer:

To become infected with any pathogen, you need to receive an infectious dose. It is possible that your infectious dose is higher than others. This would mean that you have a more robust innate, born with, response.

A word of caution regarding COVID-19. There is much we do not yet know about the virus and any long-term effects. I would strongly suggest that you don’t knowingly expose yourself to the infection.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

My granddaughter tested negative for COVID-19 the day after we saw her but tested positive four days later. Do we need to be tested?

The answer:

If you are not experiencing symptoms, I would not recommend being tested. It is unlikely that you were exposed to SARS-CoV-2 by your granddaughter.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am the 65-year-old uncle whose beautiful niece is getting married Oct. 10. I just read about a wedding in Maine that is the source of a super breakout of the coronavirus. This upcoming event is so important to all the family members and of course to the bride herself. I don’t want to miss this special day and I don’t want to die because of COVID-19. My mother is 91 and has COPD and she’s going. The event is in San Diego, California, and most of us live in Phoenix, Arizona. There’s no convincing anyone to change this date and I just don’t know what to do here. Can a wedding be pulled off safely with masks and social distancing? What other measures should be taken?”

The answer:

Wearing a mask and social distancing are certainly important, but there are risks especially for older persons and with pre-existing conditions (COPD).

Good hand-washing hygiene, avoid touching your face, clean and disinfect common surfaces and limiting the number of guests are also preventative actions.

As of Sept. 19, San Diego had reported 2,038 cases in the previous seven days, and 27 deaths in the previous seven days.

Of course, the final decision is yours.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I took an elevator and heard a person coughing as the elevator was going up to my floor. There was a person who probably just coughed in front of the elevator a few seconds before my elevator door opened. He wasn’t wearing a mask and the floor didn’t have the window open (indoor). It is a trapped small hallway. I was wearing a mask (not medical grade, just cloth mask). I stepped out and quickly avoided him as he entered into the other elevator (not the one I just got out). What is the risk of potential exposure for infection assuming the cough was fresh and small droplets might still lingering in front of the elevator or hallway and come in contact with my eyes or breathing as I stepped out and walked through it – assuming this person had COVID (infectious stage). Should I get tested?”

The answer:

I can’t give you an exact answer for your potential risk.

Should you get tested now? In my opinion, no.

If you develop symptoms in the next 14 days, then I would get a swab test (molecular Polymerase Chain Reaction – PCR), and I would self-isolate to your home while you wait for your result.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My son is 18. He woke up with a low-grade fever on Saturday. Sunday fever – 100.4. Monday he was tested and went for another test Tuesday. Both came back negative. My question is: was it to soon to be tested? I’m worried he had a false negative. Since now he has a fever of 101.9.”

The answer:

The viral genome test is highly specific. If your son was symptomatic and tested negative, it is likely not COVID-19.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife was in contact with a COVID-positive person 15 days ago. Within a day, she had symptoms. She isolated within our home away from me and the kids for 14 days. None of us have any symptoms. My wife has not had symptoms for the last three days prior to the test. She tested positive after her 14 days. We are getting tested today. If we test negative, are we good to go back to social distancing and going to work, etc.? I have read that even though my wife tested positive that after 10-14 days she should not be contagious.”

The answer:

Some individuals will continue to test positive even if they are not infectious. This is because of what the test detects. The genome test detects viral nucleic acids and those can remain in the body even after the individual is recovered. The rapid test looks for viral proteins. These can also remain in the body after an individual has recovered. The immune system needs time to clean up the body after an infection, similar to the way a host must clean up after a party. Clean up can take time.

Most individuals who are fever-free for 24 hours without medication, who have seen symptom improvement, and who have had at least 10 days of symptoms are no longer infectious.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My granddaughter was exposed to COVID-19 playing soccer on Sept. 12. She came to see us on the 13th, in the house. We were distanced but not wearing masks. Just found out today she was exposed. I’m high risk. As she left outside I hugged her from the back not front. All I can do I guess is wait?”

The answer:

Most individuals are not infectious until 72 hours after exposure. Since your granddaughter was exposed the day before visiting you, it is possible that she was not infectious.

I recommend for future meetings that you both wear masks.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My husband is going for a virus test because he has to have a procedure in the hospital. When he self-quarantines, do I have to self-quarantine as well?”

The answer:

No.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I am currently self-isolating for two weeks in order to visit my boyfriend who lives in another state (about a four-hour drive away). He works at a farm and lives with three roommates. I was planning on getting a test halfway through my self-isolation as an added safety precaution. 

“Unfortunately, I needed to go to the dentist due to a dental emergency, which of course compromises my two weeks of self-isolation. I would still be able to self-isolate for another 10 days after and would take a test three to four days after my dentist appointment. How much riskier is this trip with the dentist appointment, followed by only 10 days of true self isolation?”

The answer:

It is highly likely that you would experience symptoms within 10 days of exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife and I both were COVID-19 positive, and after two weeks, both turned negative and fully recovered. Please advise if we can have intimacy. It has been three weeks since onset of symptoms.”

The answer:

If you are both healthy, I see no reason why you can’t.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My roommate tested positive for COVID-19, but she didn’t inform me until she came back from a two-day weekend stay at her home. When do I quarantine? And should I get a test? I didn’t come into complete contact but we share things within the apartment.”

The answer:

If you live with the person, you should quarantine for 14 days from the time you are told of the exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My boyfriend, who lives in a different state, tested positive the other day. He is only supposed to have a 10-day quarantine. I am supposed to visit two days after his 10-day isolation ends. Is it safe for me to visit 12 days after he tested positive without getting infected? He moved to a different location to isolate, so I wouldn’t be in the same environment.”

The answer:

I would not visit unless he has been fever free for at least 24 hours without medication; he has had at least 10 days since his symptoms have begun; and his symptoms are improving

If these things are not happening, then he is likely infectious and you risk exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I saw a recommendation to use a vaporizer filled with hydrogen peroxide and breathe in the mist to prevent/cure COVID. This would appear to be a misuse of the chemical and perhaps cause respiratory irritation. Your thoughts?”

The answer:

Please don’t do this.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had COVID-19 and was hospitalized twice in April and went into May before it left me. I work in a nursing home where there were 14 deaths. I was not able to return to work until mid-May. 

“The nursing home was finally cleared of the virus. Unfortunately, some employees have tested positive. I tested negative early this morning, however, around noon I started to be nauseated, but finished the day. Now, I have started in with severe abdominal cramping and diarrhea. This is exactly like the first time. I have a slight chill but no fever for the moment. Is it possible, to have it again and have a negative test?”

The answer:

You tested negative. Was the result available in 30 minutes? If the test was a rapid SARS Antigen, it is possible for this test to give a negative result that is incorrect (false negative).

I advise you not to return to work at this time. I recommend that you retest with a swab molecular Polymerase Chain Reaction – PCR, and that you self-isolate to your home while you wait for your results. If you live with others, self-isolate in a private room and use a private bathroom if possible. Whoever else lives in your home should also stay at home. Wear a mask when you enter general living areas, interact with others as little as possible, and continue good hand washing hygiene.

Immediately inform the nursing home where you work. If you develop additional symptoms or if your symptoms get worse, notify your physician for instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was near someone who had coronavirus, but she isolated herself for the two weeks and I was by her for more than 30 minutes less than 6 feet apart. Does that mean I could get it within one day because I’m starting to get a sore throat already and she said that’s what started it all?”

The answer:

It is unlikely that you would develop symptoms within one day of exposure. It typically takes 72 hours after exposure for symptoms to develop.

Keep in mind that there are other infections that begin with a sore throat. I suggest that you monitor your symptoms and seek out treatment if they become severe.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My son had a fever and got tested. It was positive. He quarantined for 14 days got tested again. This also was positive, and he was told to quarantine another week. Then he got tested a third time, which was positive. He has quarantined another week, and went for a fourth) test ... and he is still testing positive. Is there a reason for the four positives?”

The answer:

It is possible for individuals to test positive for COVID-19 and be asymptomatic. If your son is fever-free and has been for at least 24 hours without medication, if it has been at least 10 days since his symptoms have begun, and he is seeing symptom improvement, then he is likely not infectious.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If my daughter who doesn’t live with me tested positive at the end of July and now has no symptoms, can she carry the virus and infect us? Since she works in downtown Las Vegas where she’s exposed to many people, I’m concerned that she could be exposed to people that could have the virus.”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. According to recent data, there have been only four reported cases to date of COVID-19 reinfection. It is not known whether reinfected people can transmit virus to others.

Until an effective and safe vaccine is available, people should concentrate on avoiding infection. This includes wearing a mask, good hand-washing hygiene, social distancing and practicing other everyday preventative actions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Is there any effect if negative patient touches a positive coronavirus patient?”

The answer:

SARS-CoV-2, the virus that causes COVID-19, is most commonly spread via airborne droplets and in some cases aerosols. Touching an infected person is unlikely to transmit the virus; however, the close proximity that comes with touching, if a mask wasn’t worn, could lead to exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have a question as I’m really confused. I took the COVID testing due to traveling and I was negative, then about a week later someone I had traveled with tested positive so I took the test and came back positive. After nearly 14 days, I took the test again just this past Tuesday and it’s still coming back positive. Mind you, during all this time that the tests are coming back positive, I have had not a single symptom whatsoever, but have kept myself isolated from my twins and my girlfriend and can’t go to work. Could it be that the test is providing inaccurate results now? Again, I have not had any symptoms, I have not been able to hug or kiss my kids and girlfriend and I have kept myself locked up. Is there any light you can shine?”

The answer:

Asymptomatic (no symptoms) persons seem to account for approximately 40% to 45% of SARS-CoV-2 (COVID-19) infections, and they transmit the virus to others for an extended period, perhaps longer than 14 days.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

Close contacts of persons diagnosed with COVID-19 should be instructed to self-quarantine for 14 days from the date of their last contact with the person who tested positive.

I advise you to wear a mask, continue other safety precautions including good hand-washing hygiene, and contact your local or state health department for further instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My granddaughter lives with me. She was in close contact with her mother for an hour, eight days ago. Her mother’s roommate received positive test results for COVID. The mother is going to get tested. Does my granddaughter need to be tested at this time?”

The answer:

No, but you and your granddaughter should self-quarantine until the mother’s test result is known.

If the mother tests negative, then you and the granddaughter may stop quarantine.

If the mother tests positive, then you and the granddaughter should continue self-quarantine for 14 days. If you or your granddaughter develop symptoms during those 14 days, then you and your granddaughter could be swab tested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Can my tenant ask me to do COVID-19 test and show her the test result before she lets me come to the apartment?”

The answer:

I will refer you to the Protecting Renter and Home Owner Rights During Our National Health Crisis | NHLP

I also suggest you contact your local or state health department for further information specific to your situation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My college daughter tested positive. We have a bedroom, bathroom and living room in our basement. She has not had any contact with any of the rest of the house. She can stay in the basement without any contact with the rest of the family. Food will be left at the outside door to the basement for her and everything will be on paper or plastic she can throw away.

“Can you rate the possible exposure to any of the rest of us? Low, very low? Medium? What should we do to the basement when she is sprung free? She has some Lysol spray and Clorox wipes with her. What about the couch and chairs, other soft surfaces?”

The answer:

It is difficult to rate the level of exposure without knowing what the ventilation systems are like in your home. If there are vents in the basement that would circulate air throughout the home, it is possible that everyone in the home has been exposed.

If no vents like that exist in the basement, then it is likely that those in the rest of the house at risk of slight exposure.

Please make sure that while your daughter is in self-isolation her symptoms are not worsening.

After her symptomatic phase is over and she is recovered, you can clean the basement with household disinfenctants with bleach.

The primary route of transmission is airborne droplets and in some cases aerosols.

It is best to let the disinfectant dry on the surface.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I deliver furniture for a living and two days ago I had to make a delivery to a house where I learned the woman’s husband was on his 34th day at the hospital. It was an adjustable bed and I had to set it up inside.

“Now I have a migraine, sore throat that keeps getting worse, and my nose is just leaking fluid like water. Can you still catch COVID after that long of a time span?”

The answer:

You didn’t mention the wife. Was anyone else inside? How long were you inside? How close were you to other household contacts?

You may have been exposed.

In view of your symptoms and possible exposure, I recommend you get a swab test (molecular Polymerase Chain Reaction – PCR), and that you self-isolate while you wait for your results.

If you live with others, self-isolate in a private room and use a private bathroom if possible. Wear a mask when you enter general living areas and interact with others as little as possible. If you develop additional symptoms or if your symptoms get worse, notify your physician for instructions. Continue to follow other safety precautions including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband had self-quarantined and then got tested. I have heart problems. When he talked to his doctor yesterday, she said that his test was a false negative and that he’s got COVID; he has been running a fever and chills and shaking. Now I’m back at home.

“Do I need to self-quarantine cause I’ve done been tested two times within two months. Last month was my last test and it was negative. But now we are both scared because they said when his test came back negative, I could come back home and he could go to work. So that was like almost two weeks ago.”

The answer:

You are a household contact of your husband who was diagnosed with COVID-19.

You should self-quarantine for 14 days. This will be 14 days from the date your husband is released from isolation. If you develop symptoms during those 14 days, you could be swab retested (molecular Polymerase Chain Reaction – PCR) or be advised to self-isolate at home.

If your husband was working, he should inform his employer that he has COVID-19. His close contacts at work should be instructed to self-quarantine for 14 days from the date of their last contact with your husband.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“We are high risk for COVID-19 complications. So we are strictly isolating at home, working from home, getting groceries delivered and dropped off at the porch, and sanitizing all groceries … We are wondering if we need to get flu shots still or not. Is it worth the exposure risk of leaving the house to get flu shots? If so what’s the safest type of place to get a flu shot? (pharmacy, doctor’s office, clinic) Our normal pharmacy is now an active COVID test site, so that doesn’t seem safe. We have been home for months.

“But I’m wondering if we need the flu shot to help protect us if something were to come up that forced us to leave the house. The risk of exposure vs. the balance of the mental health effects of exposure is being considered.”

The answer:

It’s likely that the flu viruses and the virus that causes COVID-19 will both spread this fall and winter, and the single best way to prevent seasonal flu is to get vaccinated.

Vaccination of people at high risk for flu complications is especially important to decrease their risk of severe flu illness. Many people at higher risk from flu also seem to be at higher risk from COVID-19. If you are at high risk, it is especially important for you to get a flu vaccine this year.

Ask your doctor, pharmacist, or health department if they are following CDC’s vaccination pandemic guidance. Any vaccination location following CDC’s guidance should be a safe place for you to get a flu vaccine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Wanted to know why I have the joint pain still after testing negative?”

The answer:

I’m assuming that you initially tested positive for COVID-19, and my answer below is based on that assumption.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. A recent study found that in patients who recovered from COVID-19, almost 90% reported persistence of at least one symptom, particularly fatigue, shortness of breath and joint pain.

I recommend you follow-up with your primary care physician because continued monitoring for long-lasting effects is needed.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My best friend has no family and is in the hospital for his diabetes and heart.

“We’ve known each other for 48 years. He’s being moved to an assisted living facility in a week. This may be the last time I get to see him. I am 63 and in good health, but do have underlying severe asthma.

“I’ve quarantined by myself seven months. I am COVID-free, according to my doctor’s test. So is my friend.

“Can I visit him safely for 20 minutes at the hospital if I keep my distance from him, wear a mask and a over-the-face plastic shield?”

The answer:

Visitors who are high risk for severe illness from COVID-19, such as older adults and those with underlying medical conditions, should be strongly discouraged.

Movement of visitors in the health care facility should be restricted.

I recommend you consider a virtual visit (FaceTime or Zoom).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I took a COVID-19 test today, because I was informed that a co-worker tested positive for the virus (he is currently asymptomatic).

“My questions are, should my husband and my 2-year-old child (with whom I reside and have very close contact) be tested as well? Or only if I receive a positive test result?

“Also, can I send my child to daycare while I await test results, or do I have to wait until I receive my results? And do I have to inform my daycare provider now, while I wait? Lastly, if I am asymptomatic, can I return to work before I receive my test results?”

The answer:

If you were a close contact of the coworker who tested positive, then you should self-quarantine for 14 days from the date of your last contact with the coworker.

A close contact is defined as being within 6 feet for 15 minutes or more, or being directly exposed to respiratory secretions (cough or sneeze), starting from two days before illness onset (or for patents with no symptoms, two days prior to positive test collection) until the time the patient is isolated.

Even if you test negative for COVID-19 or feel healthy, you should quarantine for 14 days since symptoms may appear two to 14 days after exposure to the virus.

Your husband and child should also self-quarantine for 14 days. If you test positive, this will be 14 days from the date you are released from isolation since your husband and child are close household contacts.

If they develop symptoms during those 14 days, they could be swab tested (molecular Polymerase Chain Reaction – PCR) or they may be advised to self-isolate at home. If your child has a fever or trouble breathing or seems sick, call your child’s pediatrician immediately for instructions or take the child to a hospital emergency department.

You and your husband should not return to work while in quarantine, and your child should not return to daycare while in quarantine.

Finally, yes you should inform the daycare provider.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My mother was diagnosed with non-Hodgkin’s lymphoma. On Aug. 21, my mom became weak and passed out. She was tested for COVID, because the hospital wanted her to go to rehab to help her get her strength back. Her test came back positive, but she is asymptomatic.

“Everyone that came in contact with my mother had tests that came back negative. My mother went to rehab and was quarantined for at least 12 days. She never showed any signs, she was released on Sept. 5. I’m here staying with my mother, who’s 85 years old. I myself have heart problems.

“Do I need to wear a mask around my mom or even be there?”

The answer:

Yes, you should wear a mask and practice every day preventative actions: good hand-washing hygiene, avoid touching your face with unwashed hands and frequently clean and disinfect surfaces. Wear gloves when you touch or have contact with the sick person’s blood, stool or body fluids, such as saliva, mucus, vomit or urine. The caregiver should ask the sick person to put on a mask before entering the room.

For further instructions visit: COVID19 – Caring for someone at home | CDC.

Your heart problems place you at risk, and I suggest you discuss this with your mother, other family members and your primary care physician. Then decide whether you can or should continue home care. This will be a difficult decision for everyone involved.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive on Aug. 20. I was recommended for 10 days strict isolation and seven days home quarantine. At the time of testing, I had a little bit of a cold – no other symptoms. Now it’s 17 days. I have a 15-month-old child.

“Can I live with him normally as I lived before being COVID positive? Can my positive affect him after 17 days? What precautions should I take so that he will be prevented from a virus transmission from me?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

In my opinion, you can resume normal activities. You should wear a mask and practice everyday preventative actions, including good hand-washing hygiene and frequently clean and disinfect surfaces.

I also recommend you discuss with your child’s pediatrician any other instructions or precautions that you should follow.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive on July 13 and was finally negative after three weeks; obviously I’m over it. Is it safe to pick up my 4-year-old grandson from his pre-kindergarten school? I have lots of fear of getting it it again.”

The answer:

In my opinion, you may resume normal activities. Although the risk of reinfection is low, I understand your fear. I recommend you discuss this with the grandson’s parents, and I’m sure they’ll understand whatever you decide.

I do recommend you wear a mask and practice everyday preventative actions, including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My son started having symptoms of coronavirus on Aug. 30. He was living in a college dorm. I picked him up Monday. We stayed in separate hotel rooms. Tuesday we drove home three hours with masks on. He tested positive with both rapid and three-day test.

“I have been quarantined with him now for seven days. He no longer has fever, and symptoms are improving. On day five, I had a test and results came back negative. I have no symptoms. We are both wearing masks when near each other. Should I get retested again? I am 50 years old, my son is 18.”

The answer:

Your son can stop isolation after at least 10 days have passed since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms have improved.

You are a close household contact and should self-quarantine for 14 days. This will be 14 days from the date your son is released from isolation. Even though you tested negative and feel healthy, you should quarantine for 14 days as discussed above since symptoms may appear two to 14 days after exposure to the virus.

If you develop symptoms during those 14 days, you could be swab retested (molecular Polymerase Chain Reaction – PCR), or be advised to self-isolate at home.

I do advise you and your son to wear a mask and practice everyday preventative actions, including good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

Have a question about coronavirus, also known as COVID-19? Send questions to tribdem@tribdem.com.

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