General FAQ

Where can I learn more about the SARS-CoV-2 virus? (Last updated 8/29/22)

What are the most reliable sources of COVID-19 information? (Last updated 6/1/22)

Does natural immunity protect me as much as the COVID-19 vaccines do? (Last updated 1/12/22)

Both individuals who are up to date on their COVID-19 vaccines and individuals with previous SARS-CoV-2 infection have a low risk of reinfection in the first several months. People are considered up to date on their vaccines when they have received the appropriate booster dose after having completed their initial primary series of COVID-19 vaccinations.

Many studies indicate that SARS-CoV-2 infection leads to a robust immune response in terms of both antibodies and cellular immunity. However, the response varies depending on the severity of illness. People with more severe COVID-19 disease tend to have higher initial immunity levels than people with milder disease.

Although there appears to be varying evidence regarding the relative protection that occurs after surviving COVID-19 as compared with completing vaccination, there is substantial immunologic and increasing epidemiologic evidence that vaccination following infection further increases protection against subsequent illness among those who have been previously infected.

For most people, the “natural immunity” provided by COVID-19 illness alone provides good protection from reinfection for a short time after the illness. However, studies have shown that compared to the “natural immunity” in people who had COVID-19 illness before but have NOT been vaccinated yet, the immunity provided by COVID-19 vaccination after COVID-19 illness is both stronger (that is, provides higher antibody levels) and broader (that is, it can better protect against some of the new variant strains).

A good example of this issue is a report that discusses the results of COVID-19 vaccination after COVID-19 disease. Among all people who had previously had COVID-19 disease, those who did not get a COVID-19 vaccination later, after their COVID-19 disease, were more than twice as likely to get re-infected with the virus that causes COVID-19 compared to those who were vaccinated after their original COVID-19 disease.

In addition, as variants of COVID-19 continue to appear and to spread more widely, staying up to date on COVID-19 vaccinations becomes even more important for those previously infected with COVID-19. The Delta variant of COVID-19 is both more infectious and less likely to be prevented by antibodies against earlier forms of the SARS-CoV-2 virus. Fortunately, the available vaccines continue to work well against Delta and all other variants that have been identified so far.

While there is no recommended minimum interval between infection and vaccination, current evidence suggests that the risk of reinfection is low in the first 2-3 months after initial infection but, after that, may increase with time due to waning immunity.

For all these reasons, VDH and CDC recommend staying up to date on COVID-19 vaccinations for every unvaccinated person, regardless of whether or not they previously had a COVID-19 infection. As long as the individual has no medical reason (contra-indication) to not get vaccinated, has no symptoms, and is also out of the isolation period, they can and should get COVID-19 vaccinated.

How do I learn more about COVID-19 if I speak a different language? (Last updated 3/22/21)

¿Cómo puedo obtener más información sobre COVID-19 si hablo un idioma diferente? (Última actualización 3/22/21)

What is the current status of COVID-19 in Virginia? (Last updated 8/22/22)

What is VDH doing to monitor the status of COVID-19 in Virginia? (Last updated 4/29/22)

How can I find out which health district or health region my city or county is in?

How is VDH responding to COVID-19 cases, people who have come in contact with sick people and outbreaks in Virginia? (Last updated 1/31/22)

What is COVIDWISE? (Last updated 6/28/21)

What should I do if I receive an exposure notification from COVIDWISE or COVIDWISE Express? (Last updated 8/22/22)

What is Sara Alert™? (Last updated 3/9/22)

What prevention measures should individuals follow? (Last updated 8/29/22)

Regardless of community transmission levels, VDH encourages everyone to stay up to date on their COVID-19 vaccines, including boosters, and to increase ventilation in indoor spaces.

Mask guidance:

Situations where you should always wear a mask:

If you have symptoms of COVID-19.
Until 10 days after a positive COVID-19 test and are around other people. Visit CDC’s website to see how you might be able to stop wearing a mask earlier.

Situations where you may choose wear a mask:

After an exposure to someone with COVID-19, and are around others.

Masking based on COVID-19 Community Level:

Knowing the COVID-19 Community Level in your area will help you know what additional prevention measures to take when you are in the community.

Low Community Level:

Wear a mask based on your personal preference and your level of risk of developing severe illness.

Medium Community Level:

If you have a weakened immune system or at high risk for severe illness, talk to your healthcare provider about additional precautions, such as wearing masks or respirators indoors in public.
If you live with or have social contact with someone at high risk for severe illness , consider testing yourself for infection before you get together and wearing a mask when indoors with them

High Community Level:

CDC recommends that you wear a mask or respirator that provides you and others with greater protection, like an N95 or KN95, indoors in public.

Testing guidance:

At all COVID-19 Community Levels, get tested if you have COVID-19 symptoms.
After an exposure:
- If you choose to, get tested on Day 6 (5 full days after exposure).
- If you already had COVID-19 within the past 90 days, see specific testing recommendations.

For questions about travel, high-risk activities, and other testing guidance, access CDC’s testing page.

VDH has specific guidance for COVID-19 prevention for students, teachers and staff in child care, K-12 schools, and day camp settings.

You can visit COVID.gov for information on COVID-19 vaccines, tests, treatments, and masks, as well as getting the latest updates on COVID-19 in your area.

How can I get a free N95 mask? (Last Updated 3/17/22)

Where can I find guidance on cleaning and disinfecting surfaces in my home? (Last updated 1/24/22)

Can portable HEPA filters be used to protect the air in my household, while I am recovering from COVID-19? (Last updated 4/28/22)

How can I improve ventilation in my building or place of residence? (Last updated 4/28/22)

What are risk factors for COVID-19 exposure? (Last updated 8/22/22)

If I am a close contact of a person with COVID-19, what should I do? (Last updated 8/29/22)

What are common COVID-19 symptoms? (Last updated 9/3/21)

How do the symptoms of COVID-19 compare to other common illnesses?

What should I do if I have a positive test for COVID-19 or if I was instructed to isolate (stay home)? (Last updated 8/30/22)

If you have confirmed or suspected COVID-19, you should isolate (stay home and away from others) This applies when you have a positive COVID-19 test – even if you have been vaccinated and even if you do not have symptoms. It also applies to when you have symptoms and are waiting on a test result or are unable to get tested.

Stay home for at least 5 days (Days 0–5)

If you have symptoms, count the day that your first symptom appeared as Day 0

If you do not have symptoms, count the day that you got tested as Day 0

During isolation at home:

Monitor your health and contact your healthcare provider if your symptoms worsen
Separate yourself from other people and pets as much as possible
Wear a high-quality mask if you cannot separate from others
Stay in a separate “sick room” and use a separate bathroom, if possible
Do not go to public settings or travel
Take steps to improve air ventilation at home, if possible

If you have COVID-19 symptoms, you can end isolation (leave your home) after Day 5 if these things have happened:

At least 5 full days have passed since symptoms first appeared, and
You are fever-free for 24 hours without fever-reducing medication, and
Your other symptoms have improved
- Note that loss of taste and smell might persist for weeks or months and this should not delay the end of isolation.

If you did not have COVID-19 symptoms, you can end isolation (leave your home) after Day 5 if this has happened:

At least 5 full days have passed since you were tested

If you end isolation after Day 5, you should still follow these steps on Days 6–10:

Wear a high-quality mask around others at home and in public. Visit CDC’s website to see how you might be able to stop wearing a mask earlier.
Do not travel, avoid people who have weakened immune systems or who are at high risk for severe COVID-19, avoid places where you are unable to wear a mask, and avoid other people when you are eating.

This is based on CDC guidance for Isolation. This VDH guidance applies to general community settings, including K-12 schools, colleges and universities, and workplaces. Child care facilities may apply this guidance for children ages 2 years and older and staff who can consistently and correctly wear well-fitting masks. It does not apply to healthcare facilities or high-risk congregate settings (e.g., correctional and detention facilities, homeless shelters, or cruise ships). People with severe COVID-19 or weakened immune systems might need to isolate (stay home) longer than 10 days. They should talk with their healthcare provider about when it is safe to be around others.

Who is at risk for serious illness from COVID-19? (Last updated 4/5/21)

Where can I find more information about symptoms and illness associated with COVID-19? (Last updated 8/30/22)

What is Long COVID? (Last Updated 11/9/22)

How can Long COVID be prevented? (Last updated 11/13/22)

How can Long COVID be treated?

Are there clinics in Virginia specifically dedicated to post COVID-19 conditions? (Last updated 11/9/22)

How can someone who needs a COVID-19 test or tests positive for COVID-19 get treatment if they do not have a primary care provider? (Last updated 9/27/22)

Are COVID-19 treatments free? (Last updated 11/13/22)

Are all healthcare providers able to prescribe COVID-19 therapeutics (medicines)? (Last updated 9/27/22)

What treatments are available in the US to treat COVID-19? (Last updated 9/27/22)

What is a monoclonal antibody? (Last updated 9/27/22)

Are there any other medications that can treat COVID-19? There are many products online that claim to prevent or treat COVID-19. (examples might include: hydroxychloroquine, chloroquine phosphate, ivermectin, antibiotics, or steroids) (Last updated 9/27/22)

What does FDA approved mean? (Last updated 9/27/22)

What is an emergency use authorization (EUA) and how is it being used to respond to COVID-19? (Last updated 9/27/22)

Are there COVID-19 medication shortages occurring? (Last updated 9/27/22)

If a patient contacts COVID-19 again, could they receive another round of COVID-19 therapeutics? (Last updated 9/27/22)

What is COVID-19 rebound? Does it mean Paxlovid did not work for me? (Last updated 9/27/22)

Where can I find more information about treating COVID-19? (Last updated 1/10/22)

Testing for COVID-19

Who should be tested for COVID-19? (Last updated 8/25/22)

If you have COVID-19 symptoms, you should test immediately.

If you were exposed to COVID-19 and do not have symptoms, wait at least 5 full days after your exposure before considering testing. If you test too early, you may be more likely to get an inaccurate result.

If you are in certain high-risk settings, you may need to test as part of a screening testing program.

Consider testing before contact with someone at high risk for severe COVID-19, especially if you are in an area with a medium or high COVID-19 Community Level.

The CDC provides guidance on when to get tested, types of tests, positive test results, negative test results, and testing for antibodies. Visit COVID-19 Testing: What You Need to Know.

For COVID-19 testing information from VDH, visit https://www.vdh.virginia.gov/coronavirus/protect-yourself/covid-19-testing/.

What COVID-19 tests are available to identify infections? (Last updated 10/7/22)

Two different categories of COVID-19 tests are currently available: viral (diagnostic) tests and antibody (serology) tests.

A viral (diagnostic) test tells if you have a current or very recent infection. Two different kinds of viral tests can detect the SARS-CoV-2 virus: (a) molecular tests (e.g., RT-PCR tests) look for the virus’s genetic material, and (b) antigen tests look for specific proteins that are part of the virus. How the clinical sample is collected depends on the specific brand of test that is used. Viral tests typically use a nasal swab, throat swab, or saliva sample. The sample may need to be collected by a healthcare provider, but can often be done by self-collection. COVID-19 antigen tests are typically easy to run and affordable, but are not always as accurate as PCR or other molecular tests. Currently, there are multiple COVID-19 antigen tests that can be completed by a person at home.

An antibody (serology) test of your blood can tell you if you had a past COVID-19 infection. An antibody test would probably not show if you have a current or very recent infection because it can take 1–3 weeks after an infection starts for your body to make detectable antibodies.

Antibody tests should NOT be used to identify an active (current) COVID-19 illness or to make decisions about returning to work or school, traveling, using personal protective equipment (PPE), or the need to stop disease prevention measures like wearing a mask, physical distancing, or avoiding crowded or poorly ventilated places.

Antibody test results should NOT be used to determine if someone should get vaccinated or boosted against COVID-19 or to assess the level of immunity a person has after vaccination. Similarly, for people who have a weakened immune system and are considering receiving the medication EVUSHELD for protection against COVID-19, antibody test results should not be used to decide whether to get the medication. Having a high level of antibodies to the virus that causes COVID-19 might provide protection from getting infected with the virus again but, even if it does, we do not know how much protection the antibodies might provide or how long it would last.

For more information about the different types of COVID-19 tests, please visit VDH’s Testing webpage or CDC’s COVID-19 Testing: What You Need to Know webpage.

How do viral antigen tests compare to viral PCR (molecular) tests? (Last updated 8/5/22)

PCR and antigen tests are two types of viral diagnostic tests for COVID-19. PCR tests are highly sensitive and specific, and usually do not need to be repeated. Antigen tests are also usually accurate, but false negative and false positive results can occur. Antigen tests are more likely than PCR tests to miss an active COVID-19 infection (a false negative test result). Your healthcare provider may order a PCR test if your antigen test shows a negative result but you have symptoms of COVID-19.

In a patient with typical COVID-19 symptoms and a positive COVID-19 antigen test, additional molecular COVID-19 testing is not generally needed or warranted.

CDC’s website COVID-19 Testing: What You Need To Know provides more information about the different types of COVID-19 tests.

Where can I get tested for COVID-19? (Last updated 8/30/22)

COVID-19 testing may be available at your doctor’s office, urgent care centers, pharmacies, other healthcare clinics, and community testing events.

To find testing sites in your area, visit the website Virginia COVID-19 Testing Sites. Each testing site has different policies and procedures for testing and for billing. Please reach out to the individual site for information about testing availability.

If you cannot get to a testing location, you and your healthcare provider might consider using either an at-home test kit. More information about currently available at-home self-tests can be seen on the FDA webpage. Contact your healthcare provider to see if one of these options is right for you and available in your area.

The Test to Treat program gives individuals rapid access, sometimes at no cost, to potentially lifesaving treatment for COVID-19. In this program, people are able to get tested and – if they are positive and treatment is appropriate for them – receive a prescription from a health care provider, and can have their prescription filled all in one location.

Where can I find guidance for COVID-19 testing, if I have already tested positive for COVID-19 in the last 90 days? (Last updated 8/25/22)

CDC provides guidance on if you should test, and the type of test you should use if you have already tested positive for COVID-19 in the last 90 days. Visit CDC COVID-19 Testing: What You Need to Know- Choosing a COVID-19 Test.

What does it mean if I have a positive antibody (serology) test result? (Last updated 11/15/22)

A positive antibody test result means you may have antibodies from a past infection with the SARS-CoV-2 virus that causes COVID-19 or from receiving a COVID-19 vaccine. However, there is also a small chance that a positive result means that you have antibodies from an infection with a different virus from the same family of coronaviruses, such as one that causes the common cold. Having antibodies to the virus that causes COVID-19 may provide some protection from getting infected with that virus again, but it’s not currently known how much protection the antibodies may provide or how long this protection may last.

You may also test positive for antibodies even if you have never had symptoms of COVID-19. This can happen if you had an infection without symptoms, which is called an asymptomatic infection.

Having an antibody to COVID-19 is NOT the same as having immunity to COVID-19. Antibody tests should NOT be used to evaluate a person’s level of immunity or protection from COVID-19 at any time. Antibody testing should NOT be used to determine whether a person should receive a COVID-19 primary vaccine series or a booster dose. In particular, it is not recommended for people to get antibody (serology) testing after vaccination.

If serology testing is done, please speak with your healthcare provider about the type of test you had and the test results to be sure that you understand what they mean.

FDA has released information about counterfeit COVID-19 at-home tests or problematic COVID-19 tests. Is more information available? (Last updated 8/25/22)

Yes, visit FDA Counterfeit At-Home OTC COVID-19 Diagnostic Tests for more information.

If you think you had a problem with a COVID-19 test, the FDA encourages you to report the problem through the MedWatch Voluntary Reporting Form.

Additional Resources

At-Home OTC COVID-19 Diagnostic Tests

Beware of Fraudulent Coronavirus Tests, Vaccines and Treatments

Fraudulent Coronavirus Disease 2019 (COVID-19) Products

How to avoid buying fake COVID tests online | Consumer Advice (ftc.gov)

Data and Surveillance

I am interested in where the COVID-19 data come from and what they mean. Where can I go to find this information?

You can learn more about COVID-19 data sources and what data are included on all of the dashboards on the VDH About the Data page. The COVID-19 Data Insights page goes into more detail about specific data, such as Five Things to Remember When Interpreting Epidemiologic Data.

Where can I find COVID-19 case & testing data on the VDH website? (Last updated 11/10/22)

COVID-19 cases & testing data are available. Dashboards are available for Cases, Demographics, Outbreaks, and VHHA Hospital Census Data.

Where can I see COVID-19 vaccine data on the VDH website? (Last updated 5/17/22)

COVID-19 vaccine data are available. There are two dashboards to see data on COVID-19 vaccines: Summary and Demographics.

The Summary dashboard shows data on vaccine doses that were given to people (vaccine administered).

The Demographics dashboard shows data about people who have gotten the vaccine, including age group, sex, and race and ethnicity.

Vaccination

Vaccination FAQ

Vaccination FAQ Page

Community Questions and Concerns

What are the CDC Community Levels? (Last updated 4/8/22)

The CDC’s COVID-19 Community Levels are used as a measure of the impact of COVID-19 illness on health and healthcare systems in U.S. counties, cities or other communities. Community levels may identify localities that are more likely to experience more severe COVID-19 outcomes in the weeks ahead. This framework is a better tool to demonstrate the risk COVID-19 poses to communities and the people in them.

Community levels are determined for every locality in the United States and are ranked as “Low,” “Medium,” or “High.” The rankings are based on information about the number of new cases of COVID-19 in a locality, how many people in that area are sick enough to require hospital care, and if the area’s healthcare system has the resources to provide care for all patients, whether or not they have COVID-19. Based on the community level (low, medium, or high), CDC recommends or suggests actions that can be taken by individuals and communities to protect against COVID-19. The COVID-19 Community Levels website goes into detail about these actions.

NOTE: Regardless of the COVID-19 Community Level of the locality they live in, people in ALL communities should stay up to date on COVID-19 vaccinations and should also use strategies to improve ventilation where they live and work.

When is masking recommended for use in the community setting? (Last updated 10/17/22)

Knowing the COVID-19 Community Level in your area will help you know when CDC recommends wearing a mask.

People with COVID-19 symptoms, a positive COVID-19 viral test, or exposure to someone with COVID-19 should wear a mask.

For other people in areas where the COVID-19 Community Level is

Low: Wear a mask based on your personal preference and your level of risk of developing severe illness.

Medium: Wear a mask based on your personal preference, your level of risk of developing severe illness, and the risk of the people you live or spend time with. If you are at high-risk for severe illness, talk with your healthcare provider about whether you need to wear a mask and take other precautions against COVID-19.

High:

Everyone, regardless of vaccination status, should wear a mask indoors in public in areas where the COVID-19 Community Levels are high.

People at increased risk for severe COVID-19-related illness should wear a mask or respirator that provides them with greater protection, like an N95 or KN95.

People with weakened immune systems or who are at increased risk for severe illness should talk to their healthcare provider about extra precautions, like masks or extra vaccine doses, they may need.

People may choose to mask at any time.

The COVID-19 Community Level mask guidance does not apply to hospitals, clinics, or other healthcare settings. (Please see the next FAQ.)

These recommendations are for people aged 2 years and older. Masks should not be worn by children under the age of 2. Adults should use their best judgment in putting masks on children aged 2-4 while inside public areas.

See the VDH mask page for more information.

Do I need to wear a mask in healthcare settings? (Last updated 10/17/22)

When SARS-CoV-2 Community Transmission levels are high, source control (wearing a mask) is recommended for everyone in a healthcare setting when they are in areas of the healthcare facility where they could encounter patients.

When SARS-CoV-2 Community Transmission levels are not high, healthcare facilities could choose not to require universal source control (masking). However, even if source control is not universally required, it remains recommended for individuals in healthcare settings who:

Have suspected or confirmed SARS-CoV-2 infection or other respiratory infection (e.g., those with runny nose, cough, sneeze); or

Had close contact (patients and visitors) or a higher-risk exposure (HCP) with someone with SARS-CoV-2 infection, for 10 days after their exposure; or

Reside or work on a unit or area of the facility experiencing a SARS-CoV-2 outbreak; universal use of source control could be discontinued as a mitigation measure once no new cases have been identified for 14 days; or

Have otherwise had source control recommended by public health authorities

The CDC defines healthcare settings as places where healthcare is delivered and includes, but is not limited to, acute care facilities, long-term acute care facilities, nursing homes, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities such as dialysis centers, physician offices, dental offices, and others.

CDC provides Infection Prevention and Control Recommendations for Healthcare Personnel

What recommendations does VDH have regarding masks, including mask types and fit? (Last updated 2/28/22)

To protect yourself and others from COVID-19, CDC and VDH continue to recommend that, depending on the COVID-19 Community Level, you wear the most protective mask you can that fits well and that you will wear consistently.

When worn consistently and correctly, masks and respirators are effective at reducing transmission of the SARS-CoV-2 virus.

Some masks and respirators offer higher levels of protection than others, and some may be harder to tolerate or wear consistently than others. It is most important to wear a well-fitted mask or respirator correctly that is comfortable for you and provides good protection.

Additional VDH guidance for masks can be found on the Mask Webpage.

CDC's mask recommendations can be found on the Use and Care of Masks webpage.

Does the updated isolation and quarantine guidance apply in high-risk congregate settings? (Last updated 8/22/22)

No. The guidance does not apply to healthcare or high-risk congregate settings. Please refer to the following sites for more information:

VDH K12 Schools and Childcare

CDC Healthcare Settings

CDC Correctional and detention facilities

CDC Homeless shelters

How do public health recommendations apply to private organizations or businesses? (Last updated 7/12/22)

Private organizations and businesses create their own policies related to masks, testing requirements, symptom screening, or vaccination requirements for employees, customers, clients or visitors. VDH provides public health recommendations for general business (non-healthcare) settings in Virginia.

Although public health makes recommendations regarding appropriate time periods for isolation, private entities (including private child care settings) make the decisions about whether to exclude individuals from those settings for certain periods of time that may or may not align with public health recommendations.

The vast majority of organizations adhere to public health recommendations. If outbreaks occur in these settings, stricter recommendations may be employed.

For more detailed guidance and requirements for specific settings (such as schools, sports, camps, pools, etc), please see the VDH Website for Schools, Workplaces, and Communities and also CDC guidance.

I am planning a large event. Do you have any information I can post around my venue and any guidance for minimizing chances of COVID-19 transmission? (Last updated 4/8/22)

Example signage is available in the VDH COVID-19 Signage Toolkit.

Schools (K-12) and Child Care

Is there VDH guidance available for K-12 schools and child care facilities ? (Last updated 11/15/22)

Virginia schools and child care facilities should select appropriate, layered prevention strategies to decrease the transmission of COVID-19. School officials, together with public health officials, need to consider multiple factors when making decisions about layered prevention strategies.

Please refer to VDH Interim Guidance for COVID-19 Prevention for Students, Teachers and Staff in Child Care, K-12 Schools, and Day Camp Settings or visit the VDH K-12 Education and Child Care Guidance Webpage for more information.

Reducing the risk of exposure to COVID-19 by cleaning and disinfection is an important part of school operations. The CDC has developed guidance for cleaning and disinfecting schools and an infographic on cleaning your facility when someone has been diagnosed with COVID-19.

Ventilation is one component of maintaining healthy environments, and is an important COVID-19 prevention strategy for schools and childcare programs. Ventilation systems clean and disperse air, decreasing the likelihood that students will inhale particles suspended in the air that are contaminated with the virus that causes COVID-19. Please refer to CDC’s information on Ventilation in Schools and Child Care Programs, VDH Ventilation Best Practices, and EPA’s Clean Air in Buildings Challenge: Guidance to Help Building Owners and Operators Improve Indoor Air Quality and Protect Public Health.

What are the quarantine and isolation recommendations for students in schools and child care? (Last updated 8/23/22)

VDH provides COVID-19 quarantine and isolation guidance for COVID-19 prevention for students, teachers and staff in child care, K-12 schools, and day camp settings. Please contact your school or school district for details on their isolation and quarantine policies.

Are schools and child care facilities required to report outbreaks? (Last updated 8/25/22)

Schools are subject to Board of Health disease reporting regulations. Any person in charge of a school, summer camp, or child care center is required to report suspected outbreaks of any illness that might be spread from one person to another. Schools should refer to the Rules and Regulations of the Board of Health for requirements. If a known or suspected outbreak of COVID-19 occurs, the facility should call the local health department immediately to discuss the situation. The local health department will work with the facility to provide disease control and prevention recommendations to slow or stop the spread of COVID-19. Schools may also use the VDH outbreak reporting tool to report suspected outbreaks of COVID-19 or other communicable diseases.

Will a COVID-19 vaccination be a requirement for school? (Last updated 11/16/21)

No, currently, the COVID-19 vaccine is not mandatory. However, the vaccine is one of the critical tools needed to reduce the spread of this virus. Having teachers, school staff, and students be up to date with vaccination, including boosters when eligible, is a critical layer of prevention and protection to help schools safely operate. We encourage you to have a conversation with your child’s healthcare provider.

What guidance is there for athletes and spectators of school sports? (Last updated 8/26/22)

Schools and families should be aware that participating in team sports or other extracurricular activities, especially indoor activities involving shouting or singing, increase the risk of SARS-CoV2 transmission. Additional guidance and consideration can be found in the American Academy of Pediatrics Sports and Physical Activities Guidance..

The Virginia High School League governs athletic competitions; local school divisions may also have their own policies in place.

What should schools and child care facilities do if an individual is experiencing flu-like or COVID-19 symptoms? (Last updated 8/23/22)

For more information, please see VDH Interim Guidance for COVID-19 Prevention for Students, Teachers and Staff in Child Care, K-12 Schools, and Day Camp Settings.

Students or staff who come to school with symptoms or develop symptoms while at school should be asked to wear a well-fitting mask while in the building and be sent home and pursue medical evaluation and/or testing as appropriate. Some schools may have testing resources available at school. Symptomatic people should be separated from others as much as possible; children should be supervised by a designated caregiver who is wearing a well-fitting mask or respirator until they leave school grounds.

What can schools do to protect particularly vulnerable students and employees from COVID-19? (Last updated 8/24/22)

People with certain medical conditions are more likely to get very sick with COVID-19. These individuals and/or their parents should discuss school attendance with their healthcare provider. Parents should provide the school with healthcare provider documentation (HCP) of the child’s healthcare needs and treatment protocols. This includes HCP authorization and parental consent to administer medication or administer treatments to students. The CDC offers guidance for families of children needing extra precautions during COVID-19. Families are encouraged to meet with school staff, including teachers, school nurses and administrators, to discuss safety measures and establish/update a Section 504 plan. Please discuss any concern you may have with your local school division.

Schools may consider providing remote learning exceptions and teleworking options for students and staff who have been diagnosed with COVID-19 or are at high risk of severe illness (as defined by the CDC). Please discuss any concern you may have with your health care provider and local school division.

For children who require suctioning or need breathing treatments during school hours, do schools need to be concerned about aerosolizing the virus that causes COVID-19? (Last updated 8/25/22)

During the COVID-19 pandemic, asthma treatments using inhalers with spacers (with or without a face mask, according to each student’s individualized treatment plan) are strongly preferred over nebulizer treatments whenever possible in the school setting.

The CDC provides guidance for healthcare settings on what procedures are considered aerosol generating. The use of metered dose inhalers (MDIs), with or without spacers or face masks, is not considered an aerosol-generating procedure. At this time, CDC considers open suctioning of airways and nebulizer administration to be aerosol generating. However, it is uncertain whether aerosols generated from nebulizer treatments are infectious.

Use of nebulizers in school should be reserved for instances where children cannot use inhalers, do not have access to an inhaler, or for children who are in significant respiratory distress while awaiting emergency transport.

Because they are considered aerosol-generating procedures, suctioning and nebulizer treatments should be performed in a space that limits exposure to others and with minimal staff present, limited to the student and staff member performing the treatment. The staff member should use proper personal protective equipment (N95 respirator, goggles or face shield, gloves and gown). Rooms should be well ventilated or the treatment should be performed outside. After the student receives treatment, the room should undergo routine cleaning and disinfection. Routine cleaning and disinfecting of the room is adequate and the room does not need to be vacated for any period of time. A list of EPA-approved disinfectants can be found: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

Schools (K-12): Testing

What COVID-19 testing resources are available for K-12 Schools? (Last updated 11/15/22)

VDH offers K-12 schools resources for screening testing and distribution of at-home rapid antigen test kits for diagnostic testing. Please visit VDH K-12 Schools COVID-19 Testing Webpage or email testinginfo@vdh.virginia.gov for more information.

What is the difference between screening testing and diagnostic testing? (Last updated 11/15/22)

Please visit CDC Testing Strategies for SARS-CoV-2 for more information on the difference between screening testing and diagnostic testing. Screening testing means testing of people without COVID-19 symptoms or exposure to identify unknown cases so that actions can be taken to quickly prevent further spread of COVID-19. Screening testing can help promptly identify and isolate COVID-19 cases to help reduce the risk to students, teachers and staff, and control outbreaks before they expand to limit disruption to in-person education.

Diagnostic testing is intended to identify current infection in individuals and may be performed when an individual has signs and symptoms consistent with COVID-19 or is a close contact of an individual with COVID-19.

For more information about VDH Testing Resources for schools, please visit VDH K-12 Schools COVID-19 Testing or email testinginfo@vdh.virginia.gov.

What diagnostic testing resources, such as at-home rapid antigen test kits, are available to schools? (Last updated 11/15/22)

VDH is currently providing eMed-proctored BinaxNOW Antigen At Home Test Kits to K-12 schools. For more information, email testinginfo@vdh.virginia.gov.

Schools may distribute test kits to K-12 students, staff, and parents to have on hand if they need to consider testing, such as if they: have signs/symptoms of COVID-19; are exposed to an individual with COVID-19; are returning to school after vacation periods; or before or after attending a large school gathering. The test kits may be distributed to members of the school community for use at home or can be administered at school per school policy. For more information please refer to the VDH K-12 Testing Webpage and the diagnostic testing FAQ section.

Child Care Programs: COVID-19 Testing

What COVID-19 testing support is VDH providing to child care facilities? (Last updated 11/15/22)

Please see VDH Child Care Testing Website for more information. VDH is providing rapid antigen test kits to local health districts to distribute to child care facilities in their district. Child care facilities may distribute test kits to be sent home with students (age 2 and older), staff, and parents to have on hand if they need to consider testing. Examples include: developing signs/symptoms of COVID-19, being exposed to COVID-19, during an outbreak (under guidance of your Local Health District), returning to school after vacation periods, or before or after attending a large school gathering.

Child care facilities are recommended to send test kits home with parents, teachers, or staff. Child care facilities may also make it possible for families/caregivers to come to the facility to pick up a test kit for at-home testing.

For questions or more information, email testinginfo@vdh.virginia.gov.

How can child care facilities obtain test kits? (Last updated 5/17/22)

Local Health Districts will coordinate distribution of test kits to child care facilities in their districts. Test kits are provided free of charge.

For questions or more information, email testinginfo@vdh.virginia.gov.

Business and Workplaces: General

How can my business ensure workplace safety and prevent COVID-19 spread? (Last updated 7/11/22)

The Virginia Department of Labor and Industry (DOLI) has current guidance for minimizing the risks of COVID-19 in workplaces.

In addition, management can encourage employees to stay up to date on COVID-19 vaccines. See VDH General Recommendations for Businesses and other Establishments for additional guidance.

Further information can be found on the VDH Businesses website.

Are employees required to wear masks in non-healthcare workplace settings in Virginia? (Last updated 3/1/22)

No. However, since masks can help reduce the spread of the SARS-CoV-2 virus that causes COVID-19, employees and employers should refer to the VDH mask page for current mask recommendations.

What are additional VDH COVID-19 resources available to businesses? (Last updated 9/20/21)

Our resources page includes information on additional topics of interest to individuals.

Under the Businesses section, the resources available include information on relative risk levels in business settings, setting-specific resources and signage toolkits

Are employers required to report COVID-19 cases to the health department? (Last updated 4/7/22)

No. However, businesses may voluntarily report suspected outbreaks (2 or more cases) of COVID-19 using the VDH online reporting portal.

International Travelers

Where can I find information if I am planning to travel internationally? (Last updated 8/29/22)

For the most up-to-date information about international travel, please visit CDC International Travel.

Travelers who are up to date with their COVID-19 vaccines are less likely to get and spread COVID-19. However, international travelers may still face additional risks and should follow the recommended international travel guidance. Make sure you are up to date with your vaccines before you travel internationally.
To check a destination’s COVID-19 risk level see CDC's COVID-19 Travel Recommendations by Destination.

CDC recommends that international travelers leaving the U.S., regardless of vaccination status, consider getting tested no more than 3 days before travel.

CDC also recommends that travelers should make sure they are up to date with their COVID-19 vaccines before cruise ship travel. If you do decide to travel on a cruise, visit CDC’s COVID-19 and Cruise Ship Travel and Travelers Returning from Cruise Ship and River Cruise Voyages. These pages provide information for travelers.

For the most up-to-date information on travel advisories, please visit CDC's Travel Health Notices webpage.
You can also review the U.S. Department of State’s Travel Advisories and country specific COVID-19 recommendations.

What should I do if I have planned to travel and test positive or have symptoms of COVID-19? (Last updated 8/29/22)

Anyone with any symptoms of COVID-19, who has recently tested positive for COVID-19, or is awaiting COVID-19 test results should not travel.
If you recently had close contact with someone with COVID-19 you may choose to wear a mask when around others inside your home or indoors in public until day 10. (Day 1 is the first full day after your last exposure.)
If you choose to, get tested on Day 6.

For more information on guidance for travelers please visit CDC’s International Travel to and from the United States.

Are there vaccination requirements for international travelers coming to the U.S.? (Last updated 8/25/22)

Non-U.S citizens, who are non-immigrants and are traveling by air to the U.S. are required to be fully vaccinated against COVID-19 and show proof of vaccination before flying to the U.S. from a foreign country, if they are aged 18 years or older. There are some limited exceptions.
A booster dose is not needed to meet this requirement.

You can use the new CDC assessment tool to find out if you can board a flight to the U.S.

For the purposes of international travel to the U.S., the definition of fully vaccinated is slightly different from the existing domestic definition. You are considered fully vaccinated if:

It has been 2 weeks after your dose of an accepted single-dose COVID-19 vaccine.

It has been 2 weeks after your second dose of an accepted 2-dose series COVID-19 vaccine; or

It has been 2 weeks after you received the full series of an accepted COVID-19 vaccine (not placebo) in a clinical trial

If it has been 2 weeks after you received 2 doses of any “mix-and-match” combination of accepted COVID-19 vaccines administered at least 17 days apart (This combination strategy is increasingly common in many countries outside of the United States)
More information on the updated definition is available on CDC’s Requirement for Proof of COVID-19 Vaccination for Air Passengers page.

Are there recommendations for returning Virginia travelers? (Last updated 8/29/22)

Up to date recommendations for returning travelers are available on CDC’s International Travel page.

If you are returning to Virginia after international travel, VDH will be sending you an email message with health information and guidance. The email message provides information about monitoring for symptoms, staying home (quarantine or isolation), as well as testing recommendations. This email will also have links to helpful information and resources, as well as the option to request a home COVID-19 test kit from VDH.

Additional information about travel is available at CDC’s International Travel during COVID-19.

Should I wear a mask during international travel? (Last updated 5/5/22)

International travelers should check for mask recommendations and requirements at their destination. These may be different from recommendations and requirements in the United States. Information about mask requirements for your destination may be available from the Office of Foreign Affairs or Ministry of Health, or the U.S. Department of State, Bureau of Consular Affairs, Country Information webpage.

The requirement for all travelers aged 2 years and older to wear face masks while on public transportation into, within, or out of the U. S., and while indoors at U.S. transportation hubs, such as airports and stations ended as of April 18, 2022.

CDC, however, recommends that everyone aged 2 years and older (including passengers and workers ) wear a well-fitting mask or respirator over the nose and mouth in indoor areas of public transportation (such as airplanes, trains, etc.) and transportation hubs (such as airports, stations, etc.).

Masks should not be placed on children younger than 2 years of age, or on anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the cover without assistance.

Where can I find up-to-date travel information related to COVID-19? (Last Updated 8/1/22)

For the most up-to-date information on travel advisories, please visit CDC's Travel site. Additionally, visit the CDC's travel advisory website and the U.S. Department of State website.

You can also visit CDC’s Travel FAQs for more travel information.

Domestic Travelers

Where can I find COVID-19 information if I am planning to travel within the U.S. (Last updated 8/29/22)

Current considerations for domestic travelers are posted on the CDC’s Domestic Travel During COVID-19.

COVID-19 is still spreading within Virginia and across the United States. It is safe to travel in the U.S. if you are up to date with your vaccines. If you are not vaccinated and not up to date with your vaccines, travel can increase your risk of getting and spreading COVID-19.

If you decide to travel and want to know if COVID-19 is spreading at or near your destination, check the CDC’s COVID Data Tracker webpage for U.S. states, cities, and counties.
Get important information as you consider traveling to different cities and states across the U.S. on the CDC’s Health Department Directories page.
If you are planning to travel for an upcoming holiday, see CDC’s information about Holiday Celebrations.

All travelers should check with the state or local health department where you are, along your route, and where you will be visiting to get the most up-to-date information, in case there are travel restrictions, stay-at-home orders or quarantine requirements upon arrival, state border closures, or other requirements. Plan to keep checking for updates as you travel. If you plan to travel by air, check if your airline requires any testing, vaccination, or other documents.

You can also visit COVID.gov for the latest updates on COVID-19 in the area you are visiting.

Should I wear a mask during travel within the United States? (Last updated 5/5/22)

The requirement for all travelers aged 2 years and older to wear face masks while on public transportation into, within, or out of the U. S., and while indoors at U.S. transportation hubs, such as airports and stations ended as of April 18, 2022.

CDC, however, recommends that everyone aged 2 years and older (including passengers and workers) wear a well-fitting mask or respirator over the nose and mouth in indoor areas of public transportation (such as airplanes, trains, etc.) and transportation hubs (such as airports, stations, etc.).

Travelers should follow state and local mask recommendations and requirements at their destination.

People should follow recommendations as per the COVID-19 Community Levels guidance when at their destination.

Masks should not be placed on children younger than 2 years of age, or on anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the cover without assistance.

Where can I find up-to-date travel information related to COVID-19? (Last Updated 8/1/22)

Please visit the CDC COVID-19 Travel Website. You can also visit CDC’s Travel FAQs for more travel information.

Healthcare Providers: General Questions

What are the masking recommendations for healthcare settings? (Last updated 10/12/22)

When SARS-CoV-2 Community Transmission levels are high, source control is recommended for everyone in a healthcare setting when they are in areas of the healthcare facility where they could encounter patients.

HCP could choose not to wear source control when they are in well-defined areas that are restricted from patient access if Community Levels are not high.

When SARS-CoV-2 Community Transmission levels are not high, healthcare facilities could choose not to require universal source control. However, even if source control is not universally required, it remains recommended for individuals in healthcare settings who:

Have suspected or confirmed SARS-CoV-2 infection or other respiratory infection (e.g., those with runny nose, cough, sneeze); or

Had close contact (patients and visitors) or a higher-risk exposure (HCP) with someone with SARS-CoV-2 infection, for 10 days after their exposure; or

Reside or work on a unit or area of the facility experiencing a SARS-CoV-2 outbreak; universal use of source control could be discontinued as a mitigation measure once no new cases have been identified for 14 days; or

Have otherwise had source control recommended by public health authorities

HCP and healthcare facilities might also consider using or recommending source control when caring for patients who are moderately to severely immunocompromised.

Individuals might also choose to continue using source control based on personal preference.

For related information for healthcare settings, visit Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic.

Note that CDC defines healthcare settings as “places where healthcare is delivered and includes, but is not limited to, acute care facilities, long-term acute care facilities, nursing homes, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities, such as dialysis centers, physician offices, dental offices, and others.” A laboratory that only processes samples, but does not have patient interactions would not be considered a healthcare setting. Additional considerations for determining when healthcare IPC recommendations apply to long-term care settings (excluding nursing homes) are outlined in the Nursing Homes and Assisted Living Facilities section of these FAQs.

The most up to date VDH mask guidance can be found on the VDH website. More guidance on protection from COVID-19 by masks or other face coverings can be found on the CDC mask website.

Where can a Healthcare Provider find more information about COVID-19? (Last updated 10/17/22)

The Virginia Department of Health regularly updates its websites with the latest information on COVID-19 in Virginia. For additional information, please see the VDH COVID-19 website for Health Professionals.

The CDC provides detailed and frequently updated COVID-19 resources for clinicians. The CDC’s Clinician Call Center is a hotline with CDC clinicians standing by to answer questions about COVID-19. Call the main CDC information line at 800-CDC-INFO (800-232-4636) and ask for the COVID-19 Clinician's Call Center.

Also visit CDC: Clinical Questions about COVID-19: Questions and Answers. The FDA website provides frequently updated information on COVID-19-related treatments, vaccines, and test materials.

How do healthcare providers report a person with suspected or confirmed COVID-19 to VDH? (Last updated 4/5/22)

As required by state regulations, clinicians should use VDH’s secure Confidential Morbidity Report Portal to report COVID-19 cases as soon as they are identified. Please include in your report symptoms and other critical epidemiologic fields, including race and ethnicity. VDH personnel with access to the data are required by state law to protect the anonymity of patients and healthcare providers.

Point of Care (POC) testing sites should go to the VDH COVID-19 Manual Reporting site to register for the POC Reporting Portal. Sites that have been reporting positive POC results through the Confidential Morbidity Portal no longer need to do so once they begin reporting through the POC Reporting Portal.

Healthcare providers’ reports of positive at-home COVID-19 tests will be treated as COVID-19 cases.

Laboratory reporting guidance from the U.S. Department of Health and Human Services (HHS) and CDC went into effect on April 4, 2022. The guidance requires reporting of all nucleic acid amplification test (NAAT) test results (both positive and negative) and all positive test results except for home tests and antibody tests. The guidance does not require reporting negative non-NAAT test results (e.g., rapid or antigen test results) and positive or negative antibody test results.

What resources are available for work restrictions and the quarantine of healthcare providers? (Last updated 9/29/22)

For complete recommendations, see CDC Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2.

Additional CDC guidance on this topic can be found in the following links:

Strategies to Mitigate Healthcare Personnel Staffing Shortages (updated Sept 23, 2022)

Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic (updated Sept 23, 2022)

Is training available for N95 fit-testing? (Last updated 3/8/22)

VDH periodically schedules train-the-trainer sessions for respirator fit testing. By the end of the training, attendees are able to train others in the proper procedures for fit-testing. Information on upcoming sessions (date, time, location) is available.

For facilities that need additional information on developing and implementing a respiratory protection program, VDH has posted a resource guide.

Healthcare Providers and Clinical Laboratory Staff: Testing for COVID-19

What specimens should I collect or recommend for COVID-19 testing and where can these specimens be sent? (Last updated 5/3/22)

Different COVID-19 laboratory tests use different clinical specimens. Viral tests typically use upper respiratory tract specimens such as a nasopharyngeal swab, nasal swab, throat swab, or saliva specimen.

In general, healthcare providers should send specimens for COVID-19 testing to commercial, private, or hospital laboratories. VDH recommends that healthcare providers work with laboratories that use viral tests granted an Emergency Use Authorization (EUA) by FDA or viral tests offered under the policies in FDA’s Policy for COVID-19 Tests. Always evaluate test performance measures. Contact your laboratory partner for specific information about specimen type, collection procedures, and submission protocols. CDC provides Interim Guidelines for Collecting and Handling of Clinical Specimens for COVID-19.

Many community testing sites collect specimens and either perform point-of-care (POC) tests or send specimens to a private or reference laboratory for testing. To find a site for your patient(s), visit Virginia COVID-19 Testing Sites. Each site has different policies and procedures for testing and billing.

Self-testing kits, also called at-home test kits, can be recommended for patients if testing at a local healthcare facility or community testing site is not feasible. For self-testing kits, the collected specimen is tested at home with a result in about 10-30 minutes depending on the test.

Self-collection kits can be used at home by people to collect a specimen (nasal swab, saliva) by themselves or from other people. Self-collection kits typically come with printed instructions on specimen collection or the instruction material may be available online. Once collected, the specimen is packaged and mailed back to the laboratory for testing.

Currently, for self-testing and self-collection kits, both prescription and non-prescription options are available. For more information about currently available self-test kits, visit the FDA webpage on At-Home OTC COVID-19 Diagnostic Tests or the CDC Self-Testing website.

When and how are patients tested through the Division of Consolidated Laboratory Services (DCLS) for COVID-19? (Last updated 6/9/22)

Testing at Virginia’s public health laboratory (Division of Consolidated Laboratory Services or ‘DCLS’) or an affiliated partner is available for (1) the detection or rule out of SARS-CoV-2 using polymerase chain reaction (PCR) or (2) variant identification by whole genome sequencing (WGS) for VDH-approved testing scenarios (i.e. outbreaks, point prevalence surveys, individual or other special requests). Clinicians should request public health laboratory testing for these scenarios by contacting their local health department.

Submitters must collect and package specimens and either deliver them to a DCLS courier site, self-deliver to the DCLS loading dock, or ship them to DCLS via commercial courier (e.g., FedEx). Specimens should be stored refrigerated and shipped to DCLS on ice packs to ensure refrigerated conditions. Specimens must arrive under refrigerated conditions within 72 hours of collection with the date and time of collection present on the submission form. If delayed shipping or longer storage is needed, samples should be stored at -70◦C or colder prior to shipment on dry ice.

What is the expected turnaround time for reporting SARS-CoV-2 diagnostic polymerase chain reaction (PCR) or whole-genome sequencing (WGS) results from DCLS? (Last updated 6/9/22)

DCLS Diagnostic PCR Testing: DCLS PCR result reports are released within 48 hours of sample receipt, though most are available sooner. Reports may be obtained immediately by authorized users of medical facilities and health departments with access to the DCLS Connect portal. All hard copy result reports are sent to submitters via a commercial carrier (next day delivery), Monday through Friday. Friday's positive results are faxed to submitters on Saturday.

Whole-genome sequencing testing (WGS): DCLS currently reports variant information determined by WGS within 7 – 14 days of sample receipt. The turnaround time for testing results is determined by the current workload of the laboratory, especially during COVID-19 surges. Results are reported to the submitter as a paper-copy report that includes variant lineage information for Variants of Concern and Variants Being Monitored per Centers for Disease Control and Prevention guidance. DCLS additionally issues WGS results as an electronic laboratory report to the Virginia Department of Health for integration into the Virginia Electronic Disease Surveillance System (VEDSS).

Most samples received through local health departments are retained at DCLS for WGS; however, the partner laboratory network for the Virginia SARS-CoV-2 Strain Surveillance (VAS3) initiative is utilized for surveillance specimens from Virginia hospitals. DCLS can triage samples to contracted VAS3 laboratories with the goal of maximizing sequencing capacity and timeliness. VAS3 Network laboratories provide results directly to VDH for integration into VEDSS. The VAS3 network was devised to improve surveillance and representation of the regions of Virginia in the surveillance system, but not for patient level reporting to hospitals or other non-public health entities. Therefore, samples sequenced by VAS3 partners cannot be reported to hospital and hospital laboratories.

Commercial, Private, or Hospital Laboratory Testing: Each laboratory determines its own turnaround time. Authorized assays for viral testing include those that detect SARS-CoV-2 nucleic acid or antigen. Some tests are point-of-care tests, meaning results may be available at the testing site in less than an hour. Other tests must be sent to a laboratory to analyze, a process that may take 1–2 days once received by the lab.

Has FDA recalled or warned about any COVID-19 test kits? (Last updated 8/6/22)

Yes. COVID-19 tests are considered medical devices by the FDA. FDA maintains a webpage of medical device recalls–this page includes recalls of specific COVID-19 test kits.

How should COVID-19 diagnostic tests (molecular, antigen, and antibody) be interpreted? (Last updated 10/17/22)

Currently, there are three main COVID-19 diagnostic tests. Molecular SARS-CoV-2 and rapid antigen tests are known as “viral” tests and are used for the diagnosis of acute SARS-CoV-2 infection. COVID-19 antibody tests, which have limited utility, may be able to identify people who’ve had prior SARS-CoV-2 infection. Antibody testing is not meant for the diagnosis of acute COVID-19 and results do not indicate that a person is immune (or not immune) to the SARS-CoV-2 virus. Antibody test results should NOT be used to determine whether a person should receive the COVID-19 vaccine series (and any applicable booster dose(s)). Unless a person has a bonafide medical contraindication to vaccination, all people are recommended to be up to date with COVID-19 immunizations.

CDC’s webpages COVID-19 Testing: What You Need to Know, Overview of Testing for SARS-CoV-2, the virus that causes COVID-19 , and Guidance for Antigen Testing for SARS-CoV-2 for Healthcare Providers Testing Individuals in the Community provide detail about SARS-CoV-2 molecular, antigen, and antibody testing and interpretation of test results.

Is a CLIA certificate required to conduct onsite antigen testing?

Yes, a CLIA Certificate of Waiver, Certificate of Compliance, or Certificate of Accreditation is required for onsite antigen testing. Visit CMS’ CLIA website for information on CLIA regulations and obtaining a CLIA certificate.

Healthcare Providers: Infection Prevention and Control

When should healthcare facilities make changes to infection prevention and control interventions based on changes in community transmission levels? (Last updated 9/30/22)

Healthcare facilities should consider checking their local Community Transmission level weekly. When the Community Transmission level increases and the increase results in a change in recommended interventions, the new interventions should be implemented as soon as possible. When the community transmission level decreases into a category that leads to relaxation of an intervention (e.g., no longer recommending use of source control in all areas of the facility where patients could be encountered), facilities should consider confirming the reduction is sustained, by monitoring for at least two weeks, before relaxing the intervention.

Are healthcare facilities currently required to screen visitors and staff upon facility entry? (Last updated 10/6/22)

Per CDC recommendations, healthcare facilities are recommended to have processes in place to identify and manage individuals with suspected or confirmed SARS-CoV-2 infection. However, having someone stationed at a facility entrance to take temperatures and ask screening questions is not explicitly recommended.

Anyone entering the facility with (1) a positive viral test for SARS-CoV-2, (2) symptoms of COVID-19, or (3) close contact with someone with SARS-CoV-2 (or a higher-risk exposure for healthcare personnel) should be aware of the facility’s recommended actions to prevent transmission to others. Visual alerts like posted signs at entrances and communications to healthcare personnel about how to report any of the three above criteria can accomplish this.

Refer to the CDC healthcare infection prevention and control recommendations for more detail.

When a healthcare facility’s Community Transmission level is high, what are the recommendations for use of eye protection? (Last updated 10/3/22)

Facilities located in counties where Community Transmission is high should consider having healthcare personnel wear eye protection (i.e., goggles or a face shield that covers the front and sides of the face) for all patient care encounters. Regardless of Community Transmission level, eye protection should always be worn when splashes or sprays are anticipated, according to Standard Precautions.

What personal protective equipment (PPE) guidance should healthcare facilities be following at this time? (Last updated 2/8/22)

Given current availability of PPE supplies, conventional use strategies should be used related to PPE. CDC’s Infection Prevention and Control Recommendations for Healthcare Personnel outline what types of PPE are indicated for care of patients/residents with and without suspected or confirmed SARS-CoV-2 infection.

Does a healthcare facility have to supply PPE to visitors?

Visitors are required to wear a facemask or cloth mask for the duration of their visit. In case of PPE shortage, visitors should bring their own masks. If the patient or resident being visited is on transmission-based precautions (TBP), other PPE like gowns or gloves might be required for entering their room. In such a scenario, before giving permission to visit a patient or resident on TBP, the facility should ensure that enough PPE is available.

Can HCPs still extend the use of PPE, specifically N95 and eye protection, when facilities are using conventional strategies for PPE? (Last updated 10/12/22)

Extended-use of N95 respirators is recommended as a contingency strategy and not during conventional capacity. NIOSH-approved N95 respirator availability increased in 2021 and healthcare facilities should be following conventional PPE practices. Check the NIOSH Certified Equipment List to identify all NIOSH-approved respirators. More information on optimizing the supply of N95 respirators is available on the CDC website.

In areas of high Community Transmission level when healthcare facilities may consider using eye protection for all patient encounters, extended use of eye protection may be considered as a conventional capacity strategy. All other PPE should be removed upon exiting the patient/resident's room and hand hygiene performed. New PPE should be donned before entering a patient/resident's room. Eye protection should be cleaned and disinfected after each patient/resident encounter, per conventional capacity strategies. In addition, eye protection should be removed, cleaned, and disinfected if it becomes visibly soiled or difficult to see through.

Healthcare Providers: Treatment for COVID-19

Where can healthcare providers find information on treatment for COVID-19?(Last updated 8/30/22)

VDH summarizes information for healthcare providers on this page. Additional information on therapeutics may be found in the following:
NIH COVID-19 Treatment Guidelines

Coronavirus (COVID-19) | Drugs | FDA

Clinical Care Information for COVID-19 | CDC

American Academy of Pediatrics COVID-19 Interim Guidance

What is COVID rebound? (Last updated 5/31/22)

COVID rebound is characterized by a recurrence of COVID-19 symptoms or a new positive test after an original COVID-19 diagnosis and resolution of symptoms or negative test. This rebound has been reported to occur between 2 and 8 days after initial recovery, and there are no reports of severe disease in these cases. While COVID-19 rebound syndrome is mentioned in association with Paxlovid, the Centers for Disease Control and Prevention (CDC) has stated that COVID-19 rebound may be part of the natural infection process, regardless of Paxlovid treatment or vaccination status.

Paxlovid continues to be recommended for early-stage treatment of mild to moderate COVID-19 among persons at high risk for progression to severe disease. Currently, there is no evidence supporting the need for additional treatment in cases where COVID rebound is suspected.

Please see the CDC Health Alert from May 24, 2022 for more information.

What options are available to individuals who experience COVID-19 rebound? (Last updated 5/31/22)

Individuals may complete a COVID test after resolution of the original infection to ensure no rebound is occurring. If patients have a positive COVID test at this point, individuals should take precautions since they may be contagious. On May 24, the CDC issued official guidance regarding COVID rebound. The CDC states that there is currently no evidence to support additional treatment with Paxlovid, or any other COVID-19 treatment, in cases where COVID-19 rebound is suspected.

Other CDC recommendations include following CDC’s guidance on isolation, including taking other precautions to prevent spreading illness. Patients should re-isolate for at least five days. Per CDC guidance, they can end their re-isolation period after five full days if fever has resolved for 24 hours (without the use of fever-reducing medication) and symptoms are improving. The patient should wear a mask for a total of 10 days after rebound symptoms started.

The CDC encourages individuals to report a possible case of COVID-19 rebound after PAXLOVID treatment to Pfizer using the following online tool: Pfizer Safety Reporting.

Where can I find COVID-19 treatments? (Last updated 7/14/22)

The COVID-19 Treatment Locator Tool is available to help healthcare providers and the public locate certain COVID-19 treatments. Users can enter their zip code and check the box for the specific product they are looking for.

Patients should coordinate with their healthcare provider prior to contacting a location as a provider prescription is required for monoclonal antibodies, pre-exposure prophylaxis, and oral antiviral medication. Locations may require an appointment and treatment availability may be limited.

Paxlovid can now be prescribed by pharmacists in limited situations, in an effort to increase timely access to patients.

Are other resources available for clinicians caring for COVID-19 patients?

Yes. CDC maintains a COVID-19 Clinician On-Call Center which is available 24/7 and can respond to questions from health departments, healthcare providers, community organizations, and healthcare facilities. To reach the Clinician On-Call Center, call the CDC Emergency Operations Center Watch Desk at 770-488-7100 and ask for the Clinician On-Call Center. The U.S. Department of Health and Human Services (HHS) also responds to clinician questions about COVID-19 therapeutics. They can be reached by email at COVID19therapeutics@hhs.gov.

Where can clinicians find guidance for the management of Post-COVID Conditions? (Last updated 8/10/21)

CDC provides guidance: Evaluating and Caring for Patients with Post-COVID Conditions: Interim Guidance and Post-COVID Conditions: Information for Healthcare Providers.

As of July 2021, “long COVID,” also known as post-COVID conditions, can be considered a disability under the Americans with Disabilities Act (ADA). Learn more by reading the U.S. Department of Health and Human Services’ Guidance on “Long COVID” as a Disability Under the ADA, Section.

Healthcare Providers: Nursing Homes and Assisted Living Facilities (Long-Term Care Facilities)

How will the VDH Office of Licensure and Certification (OLC) be surveying nursing homes with respect to the new COVID-19 vaccination up to date definition? (Last updated 9/19/22)

Until the Centers for Medicare and Medicaid Services releases updated guidance for surveyors, current survey procedures remain unchanged. That is, OLC will not be surveying for compliance with testing and quarantine requirements based on the revised up to date vaccination definition at this time.

How should our facility follow COVID-19 testing and quarantine recommendations for our residents and staff? We do not yet have access to the bivalent booster so our residents and staff are not up to date with COVID-19 vaccination according to the updated definition. (Last updated 9/19/22)

For now, to aid with implementation of testing and quarantine recommendations, long-term care facilities may continue to consider residents and staff up to date if they have received all the recommended and currently available COVID-19 vaccine doses they are eligible for until the updated COVID-19 bivalent booster vaccine is available.

Are nursing homes recommended to continue daily monitoring of residents for signs/symptoms of COVID-19? (Last updated 10/12/22)

All healthcare facilities, including nursing homes, should have a mechanism in place to promptly identify if a patient/resident has signs/symptoms of any communicable disease. The mechanism and frequency of monitoring asymptomatic individuals is at the discretion of the facility.

What testing resources are available for long-term care facilities (LTCFs)? (Last updated 6/1/22)

The Department of Health and Human Services (HHS) distributes BinaxNow tests directly to specified long-term care facilities for required testing of staff. Questions regarding this HHS supply can be sent to email: hhsbinax@hhs.gov.

VDH encourages skilled nursing facilities and assisted living facilities to develop and prepare a sustainable plan for future testing needs by finding a vendor to purchase tests or contract with to perform tests on the facility’s behalf.

Are LTCFs required to notify anyone if they are operating under crisis staffing standards?

If using crisis staffing standards that may jeopardize the health, safety, and well-being of residents of the facility, then nursing facilities licensed by the VDH Office of Licensure and Certification (OLC) and assisted living facilities licensed by the Virginia Department of Social Services are required to notify their licensing entity (the OLC or the DSS regional licensing office, respectively) of the conditions and status of the residents and the physical plant as soon as possible.

Is visitation allowed in long-term care facilities (LTCFs) at this time? (Last updated 10/7/22)

Per the Centers for Medicare and Medicaid Services (CMS), visitation should be permitted for all nursing home residents at all times. However, visitors must comply with the core principles of COVID-19 infection prevention and follow guidance outlined in a CMS memo (9/23/2022).

Visitors with confirmed COVID-19 infection or compatible symptoms should defer non-urgent in-person visitation until they meet CDC criteria for healthcare settings to discontinue isolation. It is safest for visitors who have had close contact with someone with COVID-19 infection to defer non-urgent in-person visitation until 10 days after their close contact if they meet criteria described in CDC healthcare guidance (e.g., cannot wear source control).

In rare occasions during an outbreak investigation when other mitigation efforts have failed, restricting visitation may be considered for brief periods of time. Health district or regional public health staff should collaborate with the appropriate regional Office of Licensure and Certification long-term care supervisor prior to making a recommendation that a facility restrict visitation.

Does the facility have to supply PPE to VDH staff (e.g., OLC surveyors, local health department communicable disease nurses or epidemiologists)?

The facility under conventional conditions might supply all required PPE to VDH staff visiting the facility. However, during PPE shortage, VDH staff shall bring their own PPE. VDH staff should avoid entering a resident room without wearing the appropriate PPE.

What infection prevention and control practices should be implemented when serving a meal or delivering a food tray to a LTCF resident with a suspected or confirmed COVID-19 infection?

Facilities should develop policies for safely conducting food service activities. Only essential staff are permitted in units/care areas for suspected or confirmed COVID-19 cases, and food delivery can be done by nurses or nursing assistants, if staffing resources allow. When delivering food to a patient or resident with suspected or confirmed COVID-19, staff should perform hand hygiene, don PPE (gloves, gown, N95 respirator, eye protection), drop off food, take off and dispose of PPE and perform hand hygiene. Repeat this process between each room of a resident with suspected or confirmed COVID-19.

When delivering food to a patient/resident without suspected or confirmed COVID-19 infection, staff should perform hand hygiene and don gloves, then remove gloves and repeat hand hygiene if staff has contact with the patient/resident or any surfaces that have significant potential for being contaminated with infectious material in their room.

What should a LTCF do if a large number of symptomatic residents or positive COVID-19 cases have been identified?

When conducting facility-wide testing, a large number of residents might be identified with COVID-19 infection and cohorting them can be complicated and might increase the chances of cross-contamination, especially if the facility is experiencing staffing shortages. Consult with the local health department to determine the best approach to address this challenge. “Shelter in place” may be a practical solution in these circumstances if the following conditions are implemented:

In shared rooms, the distance between resident beds should be at least 6 feet and curtains can be used as a physical barrier. However, staff should don and doff the appropriate PPE between residents in the same room.

Increase the frequency of environmental cleaning and disinfection.

Do not cohort residents based on symptoms only.

What is the federal government doing to help provide oral antiviral medication to long-term care facilities? (Last updated 6/1/22)

On March 7, 2022, the U.S. Department of Health and Human Services (HHS) began distributing oral antiviral medications (Paxlovid and Lagevrio) directly to participating “Test to Treat” pharmacy-based clinics. HHS also directly distributes oral antiviral medications to pharmacies, such as Omnicare and others, that serve long-term care facilities (LTCFs). In the U.S., the greatest number of deaths from COVID-19 have been in older Americans. LTCF residents who develop COVID-19 are at high-risk for progressing to severe illness, including hospitalization and/or death. If a resident is eligible for oral antiviral therapy, it must be started within 5 days of symptom onset. Distribution of oral antiviral medications to LTCF pharmacies allows residents to get these medications as soon as possible once the diagnosis of COVID-19 has been made.

What is VDH doing to increase nursing homes’ access to Evusheld? (Last updated 8/4/22)

VDH recently established the Evusheld Access Program to support skilled nursing facilities by increasing access to Evusheld, a monoclonal antibody for COVID-19 pre-exposure prophylaxis. The program provides access to Evusheld via a mobile unit and VDH staff are available to support interested facilities in coordinating a site visit. The program is free of charge for facilities and eligible nursing home residents and staff.

An Evusheld Access Program fact sheet and frequently asked questions document are available for more information.

How do CDC COVID-19 healthcare infection prevention and control recommendations apply to assisted living facilities or group homes? (Last updated 10/27/22)

In general, assisted living facilities and other long-term care settings (e.g., group homes) whose staff provide non-skilled personal care (e.g., bathing, dressing) similar to what is provided by family members in the home should follow community prevention strategies based on COVID-19 Community Levels.

However, visiting or shared healthcare personnel who enter the assisted living facility to provide healthcare (e.g., physical therapy, wound care, intravenous injections, catheter care) to one or more residents should follow the healthcare IPC recommendations. Also, staff providing in-person services for a resident with SARS-CoV-2 infection should follow the healthcare IPC guidance.

The Virginia Department of Social Services provides additional guidance for assisted living facilities regarding implementation of the CDC recommendations including masking, screening, and visitation in a memo issued on October 26, 2022.

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