General FAQ

 Transmission of COVID-19 is happening throughout Virginia.  Check the VDH Website for daily updates of cases, hospitalizations and deaths associated with COVID-19 as well as outbreak and testing information. VDH uses standard case definitions for consistent reporting.

VDH has a VDH Geography Locator Tool online which can help you identify your health district and health region. If you choose your city or county on the drop down menu at the top, the maps automatically update to show the health district and health region for the locality you select. You can also hover over or click on the maps to see the names of the various localities, health districts and health regions.

The Virginia Department of Health (VDH) continues to work closely with local, state and federal government partners, community partners, first responders, healthcare providers, and emergency management partners, to respond to this public health threat.

VDH is also working with state and local health departments, health care systems, businesses, schools, colleges and universities, and the general public to reduce widespread transmission of COVID-19.

When illness is reported to VDH, our health experts investigate. VDH assists with testing for COVID-19 through our state public health lab and private laboratories. If a case of illness is identified, VDH works to identify those who have had close contact with the patient and monitor their health closely.

VDH works to rapidly identify persons with COVID-19 and others who have been in close contact with that person. VDH is isolating people sick with COVID-19 and quarantining people assessed as being at high-risk of exposure to the virus that causes COVID-19. Contacts are assessed based on the types of interactions they have had with an infected person.

Unvaccinated or partially vaccinated people with close contact with a known infected person should stay home, monitor for symptoms and follow all recommendations (e.g., wear a mask, watch their distance, and wash hands frequently) for 14 days after their last exposure.

This is the safest option. If you are not able to stay home for 14 days and do not have symptoms, you may leave home earlier:

• Counting your date of last exposure as Day 0, after Day 10 without testing; OR
• After Day 7 with a negative PCR or antigen test performed on or after Day 5.

Close contacts should monitor for symptoms and follow all recommendations (e.g., wear a mask, watch their distance, and wash hands frequently) for 14 days after their last exposure.

Viral testing is recommended for unvaccinated individuals who are close contacts of persons with COVID-19. These individuals should be tested immediately after being identified, and if negative, tested again in 5–7 days after last exposure or immediately if symptoms develop during quarantine.

If you have been fully vaccinated against COVID-19, you do not need to quarantine or be tested following an exposure to someone with suspected or confirmed COVID-19, if you show NO symptoms:

• You should however monitor for any symptoms of COVID-19 for 14 days following the exposure.
• If you experience any symptoms during this period then you should isolate, get tested if indicated, and inform your healthcare provider of your vaccination status at the time of presentation to care.
• There are noted exceptions where one needs to be tested (not quarantined) after exposure, even after they are fully vaccinated.

If a fully vaccinated person starts to show symptoms of COVID-19 after an exposure to someone with suspected or confirmed COVID-19, then they should isolate themselves from others, be clinically evaluated for COVID-19, and tested for SARS-CoV-2 if indicated.

• If you do have COVID-19 then, you should inform your provider about your vaccination status at the time of presentation to care. More information on isolation, quarantine and public health monitoring is available here.

COVIDWISE is the official Virginia Exposure Notification System (ENS) app created by the Virginia Department of Health in partnership with Google and Apple. This free smartphone app is now available to all Virginians on Google Play and in the App Store. You can use your phone in the fight against COVID-19 to be notified quickly if you’ve likely been exposed. Using the app is voluntary and your privacy is protected. Location is never used and the app has a new feature that can now take symptom onset date into consideration. Virginia is the first state to utilize this technology.

COVIDWISE now has a “Vax Info” button, which allows users to find local vaccination providers and schedule an appointment, as well as other valuable vaccination-related information and resources from VDH and the CDC.

Information on COVIDWISE can be found here.

FAQs regarding COVIDWISE can be found here.

VDH will send a series of text messages to people who received a positive COVID-19 viral test. The texts will come from 804-336-3915 and will only be sent between 8 a.m. and 8 p.m. The texts will provide rapid notification and encourage anyone who has tested positive for COVID-19 to stay home and away from other people. The texts will also provide a link to the new COVIDWISE Verification Code Portal. This portal will allow individuals who have tested positive for COVID-19 to obtain a verification code, which will let them anonymously submit their test result through COVIDWISE, Virginia's free Exposure Notification app.

If you receive an exposure notification from COVIDWISE or COVIDWISE Express, that means your device was in close contact with a device of someone who tested positive for COVID-19. VDH recommends that you stay at home and away from others, especially from those at a higher risk of severe illness, as much as possible. Get tested at least 5 days after your exposure and monitor your health. For more information on what to do following a potential exposure, please visit VDH's Exposed to COVID-19 website.

Sara Alert is an online tool that the health department uses to monitor the health of people who are sick with COVID-19 or may have been exposed to it. Sara Alert allows the individual to report how they are feeling daily through text, email or phone.

Information on Sara Alert can be found here.

Sara Alert is a tool used by public health professionals to monitor people who are sick with COVID-19 or may have been exposed, through daily health checks. COVIDWISE is an early notification tool that individuals can use to notify contacts, or be notified themselves of an exposure.

Since it takes time to conduct laboratory testing and for the laboratory or physician to report the case to VDH, there may be delays in reporting. These delays in reporting can cause the number of COVID-19 cases reported on previous days to increase.

The Virginia Department of Health (VDH) displays COVID-19 cases by two dates on our website as they both provide important information. Report Date (when the case was reported to VDH) and Event Date (date closest to when the case’s symptoms began or lab specimen was collected for testing if symptom onset is not known).

Using June 12 as an example, a Report Date of June 12 means a case was reported to VDH on June 12. An Event Date of June 12 means that a case had symptom onset on June 12 but may have a Report Date to VDH of June 18.

The data on the VDH COVID-19 webpage are available for download. Below the data dashboard icon, you will find a heading that reads “Data Download.” Clicking on this heading will reveal several links to files containing data. Read the “Instructions for COVID-19 Data Virginia Open Data Portal” at the top of the page for an explanation of how to download the files. If you have any questions about the data or would like additional information, please email vdh_epi_comments@vdh.virginia.gov.

Long-term care facilities that have experienced a COVID-19 outbreak can be found on the Virginia Long-Term Care Task Force page. The list of facilities included in the report represent nursing, assisted living, or multi-care facilities.  This information is intended to provide awareness of COVID-19 outbreaks among a vulnerable population. The presence of an outbreak does not indicate a facility's given capacity to care for their residents.

Information regarding these outbreaks can be found here.

Recovery information is not data that the Virginia Department of Health collects. Our data reflect a snapshot in time when the case is reported to us and we are not currently performing subsequent interviews or data collection.  Most cases occur in people who do not need to be hospitalized, so it is safe to assume that many of these people recover at home. There is not a reporting structure in place to track their recovery.

The Virginia Department of Social Services (VDSS) is able to assist you with services such as food, rent, and utilities. For more information visit the COVID-19 response page for VDSS.

If you are fully vaccinated, you do not have to wear masks or practice physical distancing in most indoor or outdoor settings except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance. 

You will still be required to wear a mask in certain situations, even if you are vaccinated. On planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in indoor U.S. transportation hubs such as airports and stations. Travelers are not required to wear a mask in outdoor areas of a conveyance (like on a ferry or the top deck of a bus)  or while outdoors at transportation hubs.

As of July 26, 2021, school divisions have the ability to make local mask policies based on community level conditions and public health recommendations. This is from the Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools.
Recommendations from the Interim Guidance for  school divisions to adopt  for the 2021-2022 school year include:

• Elementary schools (including PreK classrooms) should require students, teachers, and staff to wear masks indoors, regardless of vaccination status. This recommendation should stay until vaccination is available for children under 12 years old and there has been enough time for children younger than 12 years old to be fully vaccinated. 
• At a minimum, middle and high schools should require students, teachers, and staff who are not fully vaccinated to wear masks indoors. 
• All schools may want to consider universal masking (regardless of vaccination status) for specific reasons as outlined by the CDC.

Masks should still be worn, regardless of vaccination status, in healthcare settings (including hospitals, doctor’s offices, long-term care facilities, acute care facilities, inpatient rehabilitation facilities, nursing homes and assisted living facilities, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities, such as dialysis centers,), as well as by staff, visitors, and people living in correctional facilities and homeless shelters.

If you are unvaccinated and partially vaccinated, you should continue to wear masks and practice physical distancing in most indoor and outdoor settings in accordance with CDC recommendations. 

You should also take the following prevention steps:

• Get vaccinated against COVID-19. People who are fully vaccinated can safely take part in certain activities. For more information, visit here.  
• Avoid contact with sick people
• Stay home and rest, if you are sick, even if illness is mild
• Avoid touching your eyes, nose, or mouth with unwashed hands
• Clean your hands often by washing them with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer that contains 60%–95% alcohol, when soap and water are not readily available. Do not use any hand sanitizer that is methanol based.
• Clean the items and surfaces you touch often.  
• Disinfect surfaces if someone in your home is sick or if someone who is positive for COVID-19 has been in your home within the last 24 hours. 
• Practice physical distancing, staying at least 6 feet from others, if you have to go out.
• Prepare your home and family for COVID-19, by having a household plan of action.    

For more information read VDH’s prevention tips.

COVID-19 spreads most often when attached to respiratory droplets produced when people cough, sneeze, sing, talk (especially loud talking), or breathe.

Masks act as a physical barrier to the spread of those droplets - and as a barrier to spread of COVID-19 - to uninfected people from already infected people. NOTE: Many infected people are unaware of their infection because they have not developed symptoms.

The masks seem to be protective in both directions. First, by reducing the amount of COVID-19 virus that infected people – even those who are infected but still without symptoms - shed into their environment. And second, when properly designed and properly worn, masks can also directly protect uninfected people by reducing the chance that they will breathe in enough virus particles shed by infected people to actually become infected themselves.

Several COVID-19 investigations highlighted by CDC provide convincing data adding to the evidence for the prevention effectiveness of masking for individuals with high risk exposures. To mention a few:

• Two symptomatically ill hairstylists who were later proven to have COVID-19 interacted for prolonged periods with dozens of customers over an eight day period. Stylists and customers all wore masks as was required locally. None (0%) of 67 customers later consenting to an interview and SARS-CoV-2 test developed infection.
• In a study of 124 Chinese households with at least one laboratory-proven COVID-19 infection, those households in which the index (first) case was using a mask before she/he developed symptoms had a 79% lower COVID-19 transmission rate to other people in their household.
• In a Thailand study of >1000 contact persons interviewed as part of COVID-19 contact tracing investigations, those contacts who reported always wearing a mask during high-risk exposures had a 70% lower COVID-19 infection rate than contact persons who did not always wear masks in those situations.

Available data also shows that improving mask fit improves protection for the person wearing the mask.

However, it’s important to remember that the COVID-19 protection provided by masks is not absolute and that following other public health guidelines about physical distancing, minimizing time in indoor spaces, handwashing, etc. can reduce your infection risk even further.

Current research supports that mask wearing has no significant adverse health effects for wearers, and is also safe to use during exercise.

Additional information on masks and mask use can be found here and here.

According to research, masks do offer some level of protection for the wearer. The amount of protection you get from a mask probably depends in part on the kind of fabric - and its thread count - used in the mask, the number of mask layers, and how well (or tightly) the mask fits.

The dose or number of viral particles that initially infects a person is called the viral inoculum. Protection for a mask wearer can come from the mask’s partial filtering out of some - but not all - virus-containing droplets. Even if a mask does not totally protect the wearer and the partially-protected wearer still comes in contact with some COVID-19 viral particles, the mask wearer’s infection would be caused by a smaller number of viral particles – a smaller viral inoculum - than without a mask. That smaller inoculum is important because studies with influenza and other viruses have suggested that coming in contact with a smaller viral inoculum leads to a milder infection.

If you are unvaccinated or partially vaccinated and you always wear a mask, it’s important to remember that following other public health guidelines about physical distancing, minimizing time in indoor spaces, handwashing, etc. can reduce your COVID-19 infection risk even farther.    

If you are fully vaccinated, you do not have to wear masks or practice physical distancing in most indoor or outdoor settings except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.

More information on protection from COVID-19 by masks or other face coverings can be found on the VDH website and on the CDC website. CDC provides easy to read material on wearing a mask here.

According to CDC’s advice to the general public, wearing gloves is not necessary in most situations, such as when running errands or using an ATM. However, in these and most other situations outside of your home, frequent handwashing or use of a hand sanitizer can help protect you from COVID-19.  The two exceptions are (1) when caring for someone who is sick and (2) when routinely cleaning or disinfecting your home or other space.

Disposable gloves should be worn when caring for or cleaning around any person or animal who is sick at home or in any other non-healthcare site, including when handling dirty clothes, towels, or other laundry from a sick person. The trash from a sick person or animal should be discarded in a disposable trash bag. 

Disposable gloves should be worn whenever a cleaning or disinfection supply label includes glove wearing as a recommendation. Be sure to follow the glove-wearing instructions, if any, on the label of cleaning or disinfecting solution(s) and be sure to use a fan or other method of getting fresh air into the space being cleaned.

When finished with disposable gloves, remove them carefully and throw them out in a lined trash container. Be sure to wash or clean your hands after using and disposing of the gloves and after handling the trash container and trash bags. 

Guidelines and recommendations for glove use in healthcare or other work settings differ from recommendations given to the general public. Gloves are considered an integral aspect of personal protective equipment (PPE) for health workers. Infection control guidelines for healthcare settings can be found on the CDC website. Joint CDC and Environmental Protection Agency (EPA) guidelines for cleaning and disinfecting public spaces, workplaces, businesses, schools, etc., can be found here.

No, they do not. Protective eyewear is not routinely recommended for COVID-19 prevention for the general public. Although SARS-CoV-2 may rarely cause an infection through the conjunctiva (the mucous membrane of the inner eyelids), and although the SARS-CoV-2 virus has been found in tears, becoming infected that way appears far less common than infection from particles breathed in by nose or mouth or from touching contaminated surfaces. Thus, maintaining physical distancing, avoidance of indoor spaces away from home, use of masks, cleaning your hands, and avoidance of touching around your eyes remain the most important COVID-19 prevention steps.

In addition, although a face shield or goggles could provide a slight extra bit of protection from COVID-19, neither one is a substitute for a mask under the Virginia State Health Commissioner’s Public Health Emergency Order.

If you are fully vaccinated you may dine in restaurants (both indoors and outdoors) without wearing a mask.

The more an unvaccinated individual interacts with others, and the longer that interaction, the higher the risk of COVID-19 spread. Masks may reduce the risk of COVID-19 spread when they are consistently used by customers and employees, especially when social distancing measures are difficult to maintain. The risk of COVID-19 spread increases in a restaurant or bar setting as interactions within 6 feet of others increase, as described below. Masks may reduce the risk of COVID-19 spread when worn in any of these risk scenarios.

• Lowest Risk: Food service limited to drive-through, delivery, take-out, and curb-side pick up.
• More Risk: Drive-through, delivery, take-out, and curb-side pick up emphasized. On-site dining limited to outdoor seating. Seating capacity reduced to allow tables to be spaced at least 6 feet apart.
• Higher Risk: On-site dining with indoor seating capacity reduced to allow tables to be spaced at least 6 feet apart. And/or on-site dining with outdoor seating, but tables not spaced at least six feet apart.
• Highest Risk: On-site dining with indoor seating. Seating capacity not reduced and tables not spaced at least 6 feet apart.

For more information on this topic, please see here.

Yes, alcohol-based hand sanitizer kills the virus (known as SARS-CoV-2) that causes COVID-19. CDC recommends use of hand sanitizer that contains 60% or more alcohol. It takes at least 30 seconds for hand sanitizer to kill the virus. Pour hand sanitizer (about the size of a quarter) into one hand. Rub hands together for a minimum of 30 seconds (longer is fine) so that the gel gets all over hands, in between fingers, on fingertips, under nails, etc. Then, let hands dry on their own. Do not wipe away hand sanitizer gel.

FDA Warning: FDA continues to find issues with certain hand sanitizer products. FDA test results show certain hand sanitizers have concerningly low levels of ethyl alcohol or isopropyl alcohol, which are active ingredients in hand sanitizer products. The agency urges consumers not to use these subpotent products and has expanded its list to include subpotent hand sanitizers, in addition to hand sanitizers that are or may be contaminated with methanol or 1-propanol.

Is Your Hand Sanitizer on FDA’s List of Products You Should Not Use?

If you have been fully vaccinated you do not have to wear a mask or practice physical distancing in most indoor or outdoor settings except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance. 

If  you are not fully vaccinated, you should continue to wear masks and practice physical distancing in most indoor and outdoor settings, in accordance with CDC recommendations. 

Additionally, CDC has issued an order that requires masks to be worn by all travelers (irrespective of vaccination status) while on public transportation, such as airplanes, ships, buses (including school buses), trains (which includes all passengers and all personnel operating conveyances), and when in indoor n transportation hubs. Travelers are not required to wear a mask in outdoor areas of a conveyance (like on a ferry or the top deck of a bus) or while outdoors at transportation hubs.

CDC recommends that travelers who are not fully vaccinated continue to wear a mask and maintain physical distance when traveling.

You can continue to wear a mask if you choose to. You might want to do this to get even more protection against variants, including the Delta variant. 

You should wear a mask, regardless of vaccination status, when in healthcare settings, correctional or detention facilities, homeless shelters,in child care settings and while inside elementary schools. 

Masks should be washed after each use, if they are the washable, non-disposable type. Masks should not be placed on children younger than 2 years of age, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the cover without assistance.

The mask can be purchased or made at home. Surgical or medical-grade masks or N95 respirators should NOT be used in place of a cloth face covering--these medical supplies are greatly needed and reserved for healthcare providers.

Considerations for Wearing Masks

More information on mask recommendations available here.

Yes. CDC recommends that people who are unvaccinated practice routine cleaning and disinfection of frequently used surfaces with household cleaners and EPA registered disinfectants that are appropriate for the surface, respectively. In most situations, cleaning alone with a household cleaner that contains soap or detergent removes most virus particles on surfaces. You should clean AND disinfect to reduce transmission of COVID-19 when someone in your home is sick or if someone who is positive for COVID-19 has been in your home within the last 24 hours. Please see CDC’s guidance on cleaning and disinfecting your home here. CDC provides easy to read material here.

No, mouthwash can not be used to treat COVID-19.There have been studies which have shown in a laboratory setting, that products such as over the counter nasal rises and mouthwashes have the ability to inactivate viruses such as coronavirus. However, these study findings do not translate to being a treatment option for persons infected with SARS-COV-2, the virus that causes COVID-19. You should speak with your healthcare provider for treatment options. 

Using mouthwash should not replace proven methods of preventing COVID-19. Masks, physical distancing, and hand hygiene are essential prevention tools to control the spread of COVID-19. 

Portable air cleaners (also known as air sanitizers or purifiers) can help achieve a high clean air delivery rate (CADR) by using a high-efficiency particulate air (HEPA) filter. A HEPA filter is a type of pleated mechanical air filter that can likely remove at least 99.7% of dust, pollen, mold, bacteria, and any airborne particles with a size of 0.3 microns as the most penetrating particle size (MPPS). Particles that are larger or smaller than 0.3 microns are trapped at an even higher rate.

 When used properly, portable air cleaners and HEPA filters can help reduce airborne contaminants. Portable HEPA filters may be particularly helpful when additional ventilation with outdoor air is not possible without compromising indoor comfort (temperature or humidity), or when outdoor air pollution is high. Portable air cleaners and HEPA filters can be used along with other best practices recommended by CDC and VDH, as part of a plan to protect households. But by itself, portable air cleaning or HEPA filtration is not enough to protect people from exposure to the virus that causes COVID-19. It is important to physical distance, wear a mask, wash hands frequently, and treat frequently touched surfaces with disinfectants. It is very important to get vaccinated against COVID-19 when it becomes available to you. 

Additional household precautions and other best practices recommended can be found here:

VDH Living with Someone with COVID-19

CDC Living in Close Quarters

CDC Caring for Someone Sick

 The United States Environmental Protection Agency (EPA) provides information about Air Cleaners, HVAC Filters, and Coronavirus (COVID-19) and also provides a Guide to Air Cleaners in the Home

SARS-CoV-2 viral particles spread between people more readily indoors than outdoors. Consult experienced heating, ventilation, and air conditioning (HVAC) professionals when considering changes to HVAC systems and equipment.

The following tools identify ways to improve ventilation:

• Increase the introduction of outdoor air
• Use fans to increase the effectiveness of open windows
• Ensure ventilation systems operate properly and provide acceptable indoor air quality for the current occupancy level for each space.
• Rebalance or adjust HVAC systems to increase total airflow to occupied spaces when possible.
• Turn off any demand-controlled ventilation (DCV) controls that reduce air supply based on occupancy or temperature during occupied hours. In homes and buildings where the HVAC fan operation can be controlled at the thermostat, set the fan to the “on” position instead of “auto,” which will operate the fan continuously, even when heating or air-conditioning is not required.
• Improve central air filtration
• Ensure restroom exhaust fans are functional and operating at full capacity when the building is occupied.
• Inspect and maintain exhaust ventilation systems in areas such as kitchens, cooking areas, etc. Operate these systems any time these spaces are occupied. Operating them even when the specific space is not occupied will increase overall ventilation within the occupied building.
• Use portable high-efficiency particulate air (HEPA) fan/filtration systems to enhance air cleaning (especially in higher risk areas such as a nurse’s office or areas frequently inhabited by people with a higher likelihood of having COVID-19 and/or an increased risk of getting COVID-19). 
• Generate clean-to-less-clean air movement by evaluating and repositioning as necessary, the supply louvers, exhaust air grilles, and/or damper settings. 
• Use ultraviolet germicidal irradiation (UVGI) as a supplemental treatment to inactivate SARS-CoV-2 when options for increasing room ventilation and filtration are limited. 
• In non-residential settings, run the HVAC system at maximum outside airflow for 2 hours before and after the building is occupied.

More detailed information can be found here.

Recent reports show that the risk of getting COVID-19 from contaminated surfaces is low. The main way by which people are infected with the virus is through exposure to respiratory droplets from an infected person. Even though the coronavirus can survive for a short period on some surfaces, it is unlikely to be spread from domestic or international mail, products or packaging. However, it may be possible that people can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

A person is said to have a “case” of COVID-19 if the infection has been confirmed by a laboratory test. 

Close contact is defined as being within 6 feet of a person with COVID-19 for a total of 15 minutes or more over a 24-hour period or having exposure to the person’s respiratory secretions (for example, coughed or sneezed on; shared a drinking glass or utensils; kissing) while they were contagious. A person with COVID-19 is considered to be contagious starting from 2 days before they became sick, or 2 days before they tested positive if they never had symptoms. In indoor K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students are wearing masks and the school has other prevention strategies in place. This exception does not apply to teachers, staff, or other adults in indoor K-12 settings.

To be considered exposed to COVID-19, you have to have had close contact with someone who is suspected or confirmed to have COVID-19. Close contact includes:

• Being within 6 feet of a person with COVID-19 for a total of 15 minutes or more over a 24-hour period, or
• Having exposure to respiratory secretions from a person with COVID-19 (e.g., being coughed or sneezed on, sharing a drinking glass or utensils, kissing), or
• Caring for a person who has COVID-19, or
• Living with a person who has COVID-19 

In indoor K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students are wearing masks and the school has other prevention strategies in place. This exception does not apply to teachers, staff, or other adults in indoor K-12 settings.

A person with COVID-19 is considered to be contagious starting from 2 days before they became sick (or 2 days before they tested positive if they never had symptoms) until they meet the criteria to discontinue isolation.

COVID-19 spreads through close contact with an infected person. This can be either by being within 6 feet of a person with COVID-19 for a total of 15 minutes or more over a 24-hour period or having exposure to the person’s respiratory secretions (for example, coughed or sneezed on; shared a drinking glass or utensils; kissing) while they were contagious, caring for a person who has COVID-19, or living with a person who has COVID-19. Your local health department will reach out to you with more recommendations if you are identified as a close contact during contact tracing. Using COVIDWISE can help keep track of exposure. COVIDWISE is an early notification tool that individuals can use to notify contacts, or be notified themselves of an exposure.

•  Quarantine. VDH recommends that you self quarantine (stay home) for 14 days after the last time you saw that person and practice physical distancing. Do not go to work or school during this time period. Avoid all public spaces, public activities, and group gatherings and do not take public transportation. If necessary, your local health department can ensure that your basic needs (for example, food and medication) are being met while you have to be in quarantine.
• Monitor your health closely during this 14-day time period. When monitoring your health, be aware of the most common signs of COVID-19 (fever, cough, shortness of breath). Other signs of COVID-19 include chills, muscle pain, headache, sore throat and a new loss of taste or smell. Not everyone with COVID-19 will have all symptoms and fever might not be present. 
• Get tested. VDH recommends getting tested immediately and again 5 to 7 days after your exposure if your first test was negative. You might not need to get tested even if you have close contact with someone with COVID-19, if you have recovered from COVID-19 in the past 3 months or are fully vaccinated and do not have new symptoms. More information can be found on the VDH COVID-19 Testing page here. For easy to read information on COVID-19 testing, click here.
• Answer the call. Your local health department will reach out to you with more recommendations if you are identified as a close contact during contact tracing. If you know you were a close contact to someone with COVID-19 while they were contagious, stay home and monitor your health, even if the health department does not call you.
• Respond to notifications. If you use the COVIDWISE app and receive a notice that you have been exposed, stay home and monitor your health after the potential exposure.

Certain people are not required to stay home (quarantine) after exposure. This includes people who: 

• Have had COVID-19 within the past 3 months as long as they do not develop new symptoms. 
• People who have been fully vaccinated for COVID-19 as long as they have no symptoms or immunocompromising conditions (e.g., organ transplantation, cancer treatment) and do not live or work in a healthcare facility, correctional or detention facility, or homeless shelter, but should still get tested after close contact exposure.
  • Fully vaccinated incarcerated/detained people also do not need to quarantine at intake and after transfer. 
• People who have been fully vaccinated for COVID-19 and who have either traveled in the United States or arrived back in the United States after traveling internationally.
• People who have had close contact with a person who was a close contact to someone with COVID-19 (“contact of a contact”). If your contact tests positive for COVID-19, then you should stay home (quarantine). 

People who are not required to stay home (quarantine) after exposure must still watch for symptoms of COVID-19 for 14 days and continue to wear a mask, stay at least 6 feet away from others, avoid crowds, and wash hands often.

It can take up to 14 days after an exposure for you to develop COVID-19. It is safest to stay home (quarantine) for 14 days. If you are not able to stay home for 14 days after your last exposure and you do not have symptoms, you have 2 options*:

• Counting your date of last exposure as Day 0, you may leave home after Day 10; or

• If PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. If you receive a negative test result before Day 7, you should not leave home yet. 

Even if you do not stay home for the recommended 14 days, it is very important to continue monitoring for symptoms and follow all recommendations (e.g., wear a mask, stay at least 6 feet away from others, wash hands frequently, and avoid crowds) for the full 14 days after the last exposure. 

*These options to leave home (end quarantine) earlier than 14 days after exposure do not currently apply to healthcare workers or people in healthcare settings. People with certain jobs (e.g., critical infrastructure workers other than education sector workers) should stay home (quarantine) if they have been exposed, but they may be allowed to go to work if the business cannot operate without them. They can only go to work if they do not have any symptoms and if additional precautions are taken to protect them and the community. Learn more about VDH's recommendations for potential exposures for critical infrastructure workers.

If you have had close contact with a person with COVID-19, VDH recommends being tested immediately after being identified as a close contact and tested again in 5-7 days after last exposure if the initial test is negative or immediately if symptoms develop during quarantine.

More information can be found on the VDH COVID-19 Testing website here.

It can take up to 14 days after an exposure for you to develop COVID-19. This is why VDH and the Centers for Disease Control and Prevention (CDC) advise people to stay home (quarantine) for 14 days after their last contact. It is safest to stay home for 14 days. If you are not able to stay home for 14 days after your last exposure and you do not have symptoms, you have 2 options*:

• Counting your date of last exposure as Day 0, you may leave home after Day 10; or

• If PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. If you receive a negative test result before Day 7, you should not leave home yet. 

*These options to leave home (end quarantine) earlier than 14 days after exposure do not currently apply to healthcare workers or people in healthcare settings. People with certain jobs (e.g., critical infrastructure workers other than education sector workers) should stay home (quarantine) if they have been exposed, but they may be allowed to go to work if the business cannot operate without them. They can only go to work if they do not have any symptoms and if additional precautions are taken to protect them and the community. Learn more about VDH's recommendations for potential exposures for critical infrastructure workers.

Additionally, CDC recommends being tested immediately after being identified as a close contact and tested again in 5-7 days after last exposure if the initial test is negative or immediately if symptoms develop during quarantine. If you have been fully vaccinated or have tested positive for COVID-19 in the past 3 months, you may not need to be tested. More information can be found on the VDH COVID-19 Testing website here.

If you had or continue to have close contact with a contact of someone with COVID-19, you do not need to be tested or stay home (quarantine) just because you are a contact of a contact. But if your contact tests positive for COVID-19, then you should stay home (quarantine).

 Yes. You can lower your risk by staying at least 6 feet away, wearing a mask, and limiting the amount of time you spend in the room. Having good ventilation, such as by opening windows, can help, too.  

If you have been identified as a close contact you should be tested immediately. If you test negative, you should be tested again in 5-7 days after last exposure or immediately if symptoms develop. If you have been fully vaccinated or have tested positive for COVID-19 in the past 3 months, you may not need to be tested. More information can be found on the VDH COVID-19 Testing website here.  

Until you are fully vaccinated, you should continue to take COVID-19 precautions (e.g., wear a mask, practice physical distancing, avoid crowds and poorly ventilated areas, and wash your hands often). Even if you don’t have symptoms, it is important to stay at home for 14 days since your last exposure if you are able to if you have had close contact with someone with COVID-19. It can take up to 14 days after exposure to the virus for a person to develop COVID-19 symptoms. By staying home and away from others for 14 days, you lower the chance of passing COVID-19 to others in case you do get sick. 

If you are not able to stay home for 14 days after your last exposure and you do not have symptoms, you have 2 options*:

• Counting your date of last exposure as Day 0, you may leave home after Day 10; or

• If PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. If you receive a negative test result before Day 7, you should not leave home yet. 

*These options to leave home (end quarantine) earlier than 14 days after exposure do not currently apply to healthcare workers or people in healthcare settings. People with certain jobs (e.g., critical infrastructure workers other than education sector workers) should stay home (quarantine) if they have been exposed, but they may be allowed to go to work if the business cannot operate without them. They can only go to work if they do not have any symptoms and if additional precautions are taken to protect them and the community. Learn more about VDH's recommendations for potential exposures for critical infrastructure workers.

If you have been in close contact with a person with COVID-19, you should take your temperature twice daily and remain alert for signs of illness, including fever, cough, chills, muscle or body aches, headache, sore throat, new loss of taste or smell, shortness of breath or difficulty breathing, congestion or runny nose, nausea or vomiting and diarrhea. It is important to not eat, drink, or exercise for at least 30 minutes before taking your temperature.

It may take up to 14 days after an exposure for you to develop COVID-19, which is why it is important to stay home during this time period. Some people with COVID-19 have no symptoms, or have very mild symptoms. These people can still spread the disease. 

You can download VDH’s Daily Symptom Monitoring Log to help keep track of your symptoms. The health department might also use an electronic symptom monitoring program for those who have been assessed as exposed to COVID-19.

For more information on what you should do if you have been exposed to COVID-19

VDH Exposure to COVID-19 Website

People with COVID-19 might not have any symptoms. If they do have symptoms, these can range from mild to severe illness. Symptoms can include fever, chills, cough, shortness of breath or difficulty breathing, fatigue (feeling very tired), muscle or body aches, headache, sore throat, or new loss of taste or smell, stuffy or runny nose, nausea or vomiting, and diarrhea. Not everyone with COVID-19 will have all symptoms and fever might not be present. These symptoms may appear 2-14 days after exposure. This list does not include all possible symptoms and will be updated as we learn more about COVID-19.

It is very important that people with even mild signs of illness stay home to prevent spreading illness to others!

Yes. It is possible to test positive for the flu (as well as other respiratory infections) and COVID-19 at the same time.

Both influenza (flu) and COVID-19 are contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by the SARS-COV-2 virus and flu is caused by influenza viruses. Symptoms of flu and COVID-19 can be similar, so testing may be needed during flu season to know which disease you have.

Both the flu and COVID-19 can cause symptoms such as fever or feeling feverish/chills, cough, shortness of breath or difficulty breathing, fatigue (tiredness), sore throat, runny or stuffy nose, muscle pain or body aches, and headache among others. Change in or loss of taste or smell is sometimes seen in COVID-19 but is not seen with flu.

If you have any of these symptoms, you should contact your Healthcare Provider for evaluation, treatment and possible testing. Since both the flu and COVID-19 are contagious and can lead to serious illness, it is important to stay home while sick and for the recommended length of time after symptoms improve.   

For more information regarding similarities and differences between flu and COVID-19, click here.

VDH has created a chart comparing the symptoms of seasonal allergies, the common cold, strep throat, flu, and COVID-19. Please click here. 

If you have concerning symptoms, you should contact your healthcare provider for evaluation, treatment and possible testing.

If you think you might have COVID-19, it is important for you to stay home and away from others as much as possible. Rest and take care of yourself. If you are concerned about the symptoms you are having or they get worse, call your healthcare provider.  If symptoms are severe, such as if you are having trouble breathing, call 9-1-1 and get emergency care. The recommendations provided here apply to anyone who is sick or tests positive for COVID-19, even if they are fully vaccinated. 

Tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours (or 2 days) before the person has any symptoms or tests positive. By letting your close contacts know they may have been exposed to COVID-19, you are helping to protect everyone. Visit Exposure to COVID-19 to learn more about how to monitor your health and protect your community if you’ve been exposed to a person with COVID-19.  

Call 9-1-1 if you have a medical emergency: If you have a medical emergency and need to call 9-1-1, notify the dispatch personnel that you might have COVID-19. If possible, put on a mask before emergency medical services arrive. Emergency warning signs include (but are not limited to): trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse a person, or pale, gray or blue-colored skin, lips or nail beds, depending on skin tone. This list does not include all possible symptoms. Please consult your healthcare provider for any symptoms that are severe or concerning.

If you have symptoms or a positive test for COVID-19, follow COVID-19 prevention steps to help prevent the disease from spreading to people in your home and community. Find more details on VDH’s What to do if You are Sick webpage.

If you have symptoms or a positive test for COVID-19, follow the steps below to help prevent the disease from spreading to people in your home and community:

• Stay home except to get medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-shares, or taxis. Stay in touch with your doctor. Be sure to get care if you feel worse or think it is a medical emergency. 

• Separate yourself from other people and animals in your home as much as possible and avoid contact with other household members, including pets. This is known as home isolation.

• Call ahead before visiting your healthcare provider if you think you might have COVID-19, so the healthcare provider’s office can take steps to keep other people from getting infected or exposed.

• Get tested if you have symptoms, even if you are fully vaccinated. 

• Wear a mask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. Make sure to remove your mask correctly, wash or store your mask properly  and wash your hands after touching a used mask.

• Cover your coughs and sneezes and dispose of any tissues in a lined trash can. If you are able, wash your hands with soap or use an alcohol-based hand sanitizer that contains at least 60% alcohol right away.

• Clean your hands often. Avoid touching your eyes, nose, and mouth. Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.

• Avoid sharing personal household items (e.g., dishes, drinking glasses, towels, etc.)

• Clean all “high-touch” surfaces every day and your “sick room.” Let someone else clean and disinfect common areas but not your bedroom and bathroom. Clean and disinfect any surfaces that may have blood, stool, or body fluids on them. Follow the instructions on the label to ensure safe and effective use of the product. 

• • Tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours (or 2 days) before the person has any symptoms or tests positive. Visit Exposure to COVID-19 to learn more about how to monitor your health and protect your community if you’ve been exposed to a person with COVID-19.  

• Call 9-1-1 if you have a medical emergency. Emergency warning signs include (but are not limited to): trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse a person, or pale, gray or blue-colored skin, lips or nail beds, depending on skin tone. Please consult your healthcare provider for any symptoms that are severe or concerning.

Find more details about what to do if you are sick at: What to do if you are Sick

Clean high touch surfaces everyday. Practice routine cleaning of high touch surfaces and your “sick room.” Let someone else clean and disinfect common areas but not your bedroom and bathroom. High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Clean the area or item with soap and water or another detergent if it is dirty. Then use a household disinfectant.

If a caregiver or other person needs to clean and disinfect a sick person’s bedroom or bathroom, they should do so on an as-needed basis. The caregiver should wear a mask and wait as long as possible after the person has used the bathroom. The caregiver/other person should wear a mask and disposable gloves while cleaning. Do not touch your face while cleaning and be sure to wash your hands with soap and water after cleaning. If possible, open doors and windows to increase air circulation.

Clean and disinfect  any surfaces that may have blood, stool, or body fluids on them. Visitors, other than caregivers, are not recommended. See CDC’s Caring for Someone Sick at Home for more advice for caregivers.

Be sure to follow the instructions on the label to ensure safe and effective use of the product. Many products recommend keeping the surface wet for several minutes to ensure germs are killed. Many also recommend precautions such as wearing gloves and making sure you have good ventilation during use of the product. Most EPA-registered household disinfectants should be effective.

For more information, visit CDC’s Cleaning and Disinfecting Your Home.

 Older people (≥65 years of age) and persons living in a nursing home or long-term care facility are at greater risk for serious illness. 

 People of any age with certain medical conditions and disabilities are at increased risk of severe illness from COVID-19. A list of specific medical conditions can be found here.

Systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting very sick and dying from COVID-19. See CDC’s website for steps you can take to reduce the risk of COVID-19.

  Most people with COVID-19 can be ‘released’ from isolation and can be around others after: 

• At least 10 days have passed since your symptoms first appeared AND
• At least 24 hours with no fever without fever-reducing medication AND
• Other symptoms have improved (Note: the loss of taste or smell might last for weeks or months after recovery. This should not delay the end of isolation)

If you tested positive for COVID-19 but never had any symptoms, you can be around others after 10 days have passed since the first positive diagnostic test.

For more information, see: 

What to do if you have confirmed or suspected coronavirus disease (COVID-19)? 

CDC Interim Guidance on Home Isolation 

With certain diseases, including sometimes with COVID-19, the amount of oxygen in our blood can sometimes fall below normal levels. When oxygen levels are too low, we may need to take extra oxygen in a process called oxygen therapy. An oxygen concentrator is a medical oxygen therapy device that can sometimes help get extra oxygen into the body but it should only be sold and used with a
doctor’s prescription.

Because there are risks involved in both getting too much oxygen and not enough oxygen, using an oxygen concentrator to get extra oxygen without talking with a doctor first can do more harm than good. On one hand, getting oxygen concentrations that are too high can damage your lungs. On the other hand, if you really do have COVID-19, using an oxygen concentrator on your own can lead to a delay in receiving the best available treatment.

Sometimes oxygen concentrators are sold online but buying or using any of these without a prescription is not approved by the FDA. Using an oxygen concentrator on your own should not replace staying alert for early COVID-19 symptoms such as fever and cough or seeking medical help when you need it.

The FDA provides information here.

A pulse oximeter is a device used by healthcare professionals to measure the oxygen level (oxygen saturation) of the blood. Low blood oxygen levels can be a sign of COVID-19, but it is only one of many signs and symptoms that may be present during illness. Use of a pulse oximeter should only be used under the direction and supervision of a physician. A pulse oximeter should not replace being alert for early COVID-19 symptoms such as fever and cough.

Any private medical information should be shared only at the discretion of the individual and with healthcare providers who need the information to provide necessary medical care services. In addition, a person suspected or confirmed to have COVID-19 should notify people who they have been in close contact with so that the contacts can follow public health recommendations and should follow any reporting policies set up where they work to help prevent the spread of disease. 

If you have a confirmed positive lab result, both the lab and your healthcare provider are required by state regulation to report your status to the local health department. Someone from the health department may get in touch with you.

Reinfection means a person was infected (got sick) once, recovered, and then later became infected again. Cases of reinfection with COVID-19 have been reported, but remain rare​.​ Based on what we know from similar viruses, some reinfections are expected. We are still learning more about COVID-19. At this time, whether you have had COVID-19 or not, the best way to prevent infection is to take steps to protect yourself.

For more information on reinfection, click here.

Although most people with COVID-19 get better within weeks to months of illness, some do not. CDC and experts around the world are working to learn more about short- and long-term health effects associated with COVID-19, who gets them, and why. CDC uses the term post-COVID conditions to describe health issues that persist more than four weeks after first being infected with the virus that causes COVID-19.

Experts do not know why or how often some people experience post-COVID conditions. Other infectious diseases can also cause longer-term symptoms for a variety of reasons. Some post-COVID conditions are likely to be similar to those seen in other infectious diseases, but others may be more specific to COVID-19.  Some post-COVID conditions involve symptoms similar to those caused by other health problems. Scientists are actively investigating the causes of post-COVID conditions.

More information on long-term effects of SARS-CoV-2 infection and COVID-19 illness can be found here.

Long COVID is also known as post-COVID conditions. Long COVID is a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19 or can appear weeks after infection. Long COVID can happen to anyone who has had COVID-19, even if the illness was mild, or they had no symptoms. People with long COVID report experiencing different combinations of the following symptoms:

• Tiredness or fatigue
• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Headache
• Loss of smell or taste
• Dizziness on standing
• Fast-beating or pounding heart (also known as heart palpitations)
• Chest pain
• Difficulty breathing or shortness of breath
• Cough
• Joint or muscle pain
• Depression or anxiety
• Fever
• Symptoms that get worse after physical or mental activities

Most post-COVID conditions can be diagnosed and managed by primary care providers, and if needed specialty care providers and support services (e.g., occupational therapy, physical therapy, social work) to maximize functional improvement and rehabilitation efforts. Healthcare professionals may also consider referral to multidisciplinary post-COVID care centers, where available, for additional care considerations. 

There are a number of post-COVID care centers (PCCC) in Virginia. The following list may not include all centers. VDH does not recommend or endorse specific clinics.

INOVA Post COVID-19 Recovery and Rehabilitation (Northern Virginia)

UVA Post COVID clinic (Charlottesville, VA)

Sheltering Arms Post-COVID-19 (coronavirus) rehabilitation (Mechanicsville, VA)

Centra Health Post-COVID Recovery Care Program (Lynchburg, VA)

Sentara Heart Hospital Post-COVID Clinic (Norfolk, VA)

The VCU Health Long COVID-19 Clinic (Richmond, VA)

Check out the following website(s):

VDH What to do if you have confirmed or suspected coronavirus disease (COVID-19)?

CDC COVID-19 Symptoms Website

CDC also provides easy to read materials: 

Things to Know about COVID-19

10 Things to Know When You Have COVID-19

Staying Away from People When You Have COVID-19

People with mild illness should stay home, rest, drink plenty of fluids, and take over-the-counter (OTC) medications to relieve the symptoms they are having. Be sure to follow the instructions on the package of the OTC medication, and do not give OTC cough or cold medicine to children under 6 years old. A table of types of OTC medications you can take for each symptom is available here. Continue to monitor your symptoms and call your healthcare provider if they get worse or you are concerned.  Be sure to stay away from others (isolate) in the home to prevent the spread of disease.

For most persons with mild illness, these measures may be all that is needed. Healthcare providers may recommend treatment with a monoclonal antibody for mild illness in a person who is considered high risk for progression to severe COVID-19. Persons with medical conditions or disabilities that put them at high risk for severe COVID-19 should contact their healthcare provider as soon as symptoms start.

People with more serious illness should call their healthcare provider and follow their recommendations for treatment and self-care. 

People who develop emergency warning signs such as (1) trouble breathing, (2) persistent pain or pressure in the chest, (3) new confusion or inability to arouse or (4) bluish lips or face, need immediate medical attention and 911 should be called.  Please note this list is not all inclusive and any person who has other severe or concerning symptoms should contact his/her medical provider. If you need to call 911, notify the dispatch personnel that you have, or are being evaluated for, COVID-19. If possible, put on a mask before emergency medical services arrive. Do not place a mask of any kind on children under 2 years of age. Please see the American Academy of Pediatrics (AAP) recommendations on “Cloth Face Coverings for Children During COVID-19.”

Please consult a licensed physician or other healthcare provider for additional recommendations about disease treatment. Further information can be found here.

The FDA has approved remdesivir, an antiviral drug, to treat hospitalized adults and children aged 12 years or older. The use of remdesivir in children younger than 12 years is still being evaluated. Other medications are also being evaluated as potential treatments for COVID-19. Please consult a licensed physician or other healthcare provider for additional recommendations about disease treatment.

Remdesivir is an antiviral drug that can be used to treat some cases of COVID-19. Gilead Sciences Inc., the pharmaceutical company that makes remdesivir, received approval from the U.S. Food and Drug Administration (FDA) on October 22, 2020 to allow the medication to be used for hospitalized COVID-19 patients who are aged 12 years or older.  Healthcare providers can give remdesiver to children younger than 12 years of age through an Emergency Use Authorization (EUA) from the FDA. 

Yes. Other antiviral medications are being studied to see if they might help treat COVID-19. Therapies directed at a person’s immune system are also under study. The use of convalescent plasma, which involves taking the plasma from a person who has recovered from COVID-19 and infusing it into a person with the illness, is being studied. For information on how to donate plasma if you have recovered from COVID-19, please see information from the FDA here. For more information about therapies under investigation, please see here.

When a virus (or other germ) enters your body, your immune system responds by producing antibodies, which help the body fight off infection. Monoclonal antibodies are versions of these antibodies that your body naturally makes, but they are made in a laboratory.

FDA has issued an emergency use authorization for several monoclonal antibody combinations for individuals with mild to moderate symptoms of COVID-19 who are at higher risk of severe illness. This includes individuals over the age of 65 years and others with chronic medical conditions. Individuals must be 12 years of age or older and weigh at least 40 kilograms (about 88 pounds.) Information on specific therapies can be found here and here.

FDA has also issued an emergency use authorization for a monoclonal antibody that may be used in certain hospitalized individuals (aged 2 years or older).

There are clinical trials underway to see if monoclonal antibodies are safe and effective at preventing or treating COVID-19. For more information about monoclonal antibodies and COVID-19, visit the National Institutes of Health (NIH) websites here.

If you have fully recovered from COVID-19, you may be able to help patients currently fighting the infection by donating your plasma. Because you fought the infection, your plasma now contains COVID-19 antibodies. These antibodies helped your immune system to fight the virus when you were sick, so your plasma may be able to be used to help others fight off the disease.

For more information on convalescent plasma, eligibility, and where to donate, click here. The FDA also has information on plasma donation here.

There is currently no scientific evidence to show that taking ibuprofen while sick with COVID-19 will lead to worsening illness. For persons looking for a medication to reduce their fever, acetaminophen might be preferable. Both acetaminophen and ibuprofen, like any other medication, can have serious side effects. You should consult with your healthcare provider if you are unsure what the best medication is for you.

Check out the following websites:

VDH: If You Are Sick

CDC: What to Do If You Are Sick

CDC: Caring for Someone Sick at Home

CDC: Treatments Your Healthcare Provider Might Recommend for Severe Illness

Each member of the community plays an important role in preventing the community spread of COVID-19 by following these precautions:

• Get vaccinated 
• Avoid contact with sick people.
• Avoid touching your eyes, nose, or mouth with unwashed hands.
• Clean your hands often by washing them with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer that contains 60%–95% alcohol. Soap and water should be used if hands are visibly dirty.  Do not use any hand sanitizer that is methanol based.  More information about methanol based hand sanitizers can be found here.
• It is especially important to clean hands after going to the bathroom; before eating; and after coughing, sneezing or blowing your nose.
• If you are sick, stay home and rest, even if the illness is mild.
• Practice physical distancing, staying at least 6 feet from others, especially if you are not fully vaccinated 
• Wear a mask when you are in public if you are not fully vaccinated.

Social distancing, also called “physical distancing,” means keeping a safe space between yourself and other people who are not from your household. It is one one of the tools used to reduce the spread of COVID-19. To practice social distancing, you should be maintaining at least six feet (about two arms’ length) from other people who you do not live with.

This is when enough people are  immune to an infectious disease (because of a previous infection or vaccination) that the risk of infection in the population is lower.

This is unknown at this time.  Vaccines are now available to everyone 16 and older in Virginia. The more people who choose to get vaccinated, the closer we will get to achieving herd immunity.

COVID-19 mainly spreads from person-to-person through respiratory droplets. There is no evidence that you can get COVID-19 from food. Before preparing or eating food it is always important to wash your hands with soap and water for 20 seconds for general food safety. Throughout the day, wash your hands after blowing your nose, coughing or sneezing, or going to the bathroom.

In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at room temperature, refrigerated, or frozen temperatures.  More information on food and COVID-19 can be found on CDC’s website.

Virginia Department of Health provides Interim Recommendations for the Safe Operation of Libraries during the COVID-19 Pandemic.

Check out the following website(s):

CDC COVID-19 FAQs

VDH Prevention Tips

CDC How to Prevent Getting Sick from COVID-19

Vaccination is the leading public health prevention strategy to end the COVID-19 pandemic. Vaccinating teachers, school staff, and students when eligible for vaccination is a critical layer of prevention and protection for all. Achieving high levels of vaccination among eligible students, teachers and staff is one of the most critical strategies to help schools safely operate.

Additionally, encourage students and staff to take everyday preventive actions to prevent the spread of respiratory illnesses. These actions include staying home when sick; appropriately covering coughs and sneezes; cleaning and disinfecting frequently touched surfaces; and washing hands often with soap and water. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if they are visibly dirty. Watch young children when they use hand sanitizer to be sure they don’t swallow alcohol.

Each school division is deciding how to safely teach children by applying everyday prevention measures in the school setting.  Many decisions involve ways to minimize interactions and maximize distance between people within the school. . Please contact your local school division for more information regarding reopening of schools. Frequently asked questions are available at Virginia Department of Education FAQs.  

Many parents, caregivers, and guardians face new and difficult choices. . The Centers for Disease Control and Prevention (CDC) has designed a tool to help parents, caregivers, and guardians weigh the risks and benefits of each option and make this decision making process easier. It is organized to provide parents and caregivers with general information on COVID-19. The CDC has also developed checklists that are intended to help parents, guardians, and caregivers, plan and prepare for the upcoming school year. Parents may also consult the VDH’s list of resources for parents and students and the VDH Back to School Website to help them make an informed decision. Please discuss any concern you may have with your local school division.

The CDC and VDH do not recommend requiring a negative COVID-19 test in order for students or staff to return to school, instead only those who have met the CDC criteria for return to school should do so. The VDH created a release from isolation or quarantine guide(PDF) to determine when those exposed to or diagnosed with COVID-19 can return to work or school.

Students benefit from in-person learning. Safely returning to and maintaining in-person instruction during the 2021-22 school year is a priority. 

To help school districts make decisions, VDH and the Department of Education have updated the Interim-Guidance-to-K-12-School-Reopening. 

Additional Information for parents is available on the VDH Back to School Website. The AAP also offers guidance to families and their children returning Back to School in the fall.

Schools should avoid offering any self-serve food or drink options, such as hot and cold food bars, salad or condiment bars, and drink stations and serve individually plated or pre-packaged meals, while ensuring the safety of children with food allergies.

As feasible, schools should encourage physical distancing in food service lines and at tables while eating. Students and staff should wash their hands with soap and water for 20 seconds or use a hand sanitizer that contains at least 60% alcohol before and after eating. Schools should clean and disinfect food line areas, tables, and chairs between uses. CDC guidance and CDC FAQs.  Your individual school will decide how school lunches will be provided to students. VDOE has provided guidance to schools. Please discuss any concern you may have with your local school division.

For more information, see DOE reopening FAQ (under School Nutrition)

Make sure that you provide the school with health care provider documentation (HCP) of the child’s food allergy and treatment protocols. This includes HCP authorization and parental consent to administer medication to students in the event of anaphylaxis or illness due to exposure. 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.

Make sure that you provide the school with health care 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. 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.

The Virginia Department of Health is encouraging students and their families to prepare for attending school in person. Information for parents is available on the VDH Back to School Website. Many students will need updated immunizations, physicals for enrollment, medication administration, documentation for health conditions and emergency action plans for chronic conditions (asthma, allergy, diabetes and seizures). The AAP offers guidance to families and their children returning Back to School in the fall. Please contact your child’s health care provider to discuss your child’s medical needs.

Children need to continue to get the recommended vaccines on schedule. Vaccines provide individual and community immunity. The Virginia Department of Education is requiring all public school students to have required immunizations to be enrolled in school. Please continue to focus on your child’s immunization..  

The Code of Virginia requires that children be adequately immunized (§ 22.1-271.2) before entering public kindergarten or elementary school. Other required immunizations include Human Papillomavirus (HPV) for girls and boys entering the seventh grade   Diphtheria, Tetanus, and Pertussis (Tdap) booster for entry into seventh grade and Meningococcal  Conjugate Vaccine (MenACWY) for entry into seventh and 12th grade. 

 Information for parents is available on the VDH Back to School Website.  

The COVID-19 vaccine is currently approved for use in those over 12 years of age.  We are constantly monitoring the vaccine guidelines, and this information will be updated as needed. Information for parents is available on the VDH Back to School Website. If your child is eligible to receive the COVID-19 vaccine, please discuss this vaccine with your healthcare provider.

Currently, the COVID-19 vaccine is not mandatory to return to school. The vaccine is one of the critical tools needed to reduce the spread of this virus. Vaccinating teachers, school staff, and students when eligible for vaccination is a critical layer of prevention and protection for all. Achieving high levels of vaccination among eligible students, teachers and staff is one of the most critical strategies to help schools safely operate. We encourage you to have a conversation with your child’s healthcare provider.  

For those that are eligible (12 years and older) to receive the COVID-19 vaccine  and other vaccines may now be administered without regard to timing. This includes simultaneous administration of COVID-19 and other vaccines on the same day, as well as co-administration within 14 days. Information for parents is available on the VDH Back to School Website.

Students enrolled in school for the 2021-2022 school year will need to be up to date on their school required immunizations. Please consult with your healthcare provider for school required vaccine guidance.   Information for parents is available on the VDH Back to School Website.  

The same public health recommendations will remain during the summer of 2021. Establish a school culture of adherence to prevention strategies both in and out of school. Staying home when sick and establishing environments in which vaccination is promoted, and people physically distancing, wearing masks correctly and consistently, practicing hand hygiene and respiratory etiquette, and cleaning frequently.

The risk of disease is lower when your child is outdoors compared to indoors, where there is less fresh air. School divisions have the ability to implement local mask policies based on community level conditions and public health recommendations. VDH recommends that individuals aged two and older who are not fully vaccinated wear a mask in crowded outdoor settings.

Ventilation is one component of maintaining healthy environments, and is an important COVID-19 prevention strategy for schools and childcare programs. Wearing a well-fitting, multi-layer mask helps prevent virus particles from entering the air or being breathed in by the person wearing a mask. Good ventilation is another step that can reduce the number of virus particles in the air. The risk of disease is lower when your child is outdoors compared to  indoors, where there is less fresh air.  Along with other preventive actions, ventilation can reduce the likelihood of spreading disease. The CDC has published guidance for schools on ventilation and can be found here:  ventilation in the school setting   

Drinking fountains should be cleaned and sanitized, but encourage staff and students to bring their own water to minimize use and touching of water fountains. For more information, click here.

Watch for signs of stress in your child. Some common changes to watch for include excessive worry or sadness, unhealthy eating or sleeping habits, and difficulty with attention and concentration. For more information, see the “For Parents” section on CDC’s website, Manage Anxiety and Stress. Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions and share facts about COVID-19 in a way that your child or teen can understand. Go to CDC’s Helping Children Cope with Emergencies or Talking with Children About COVID-19 for more information. The Virginia Department of education has resources for families: VDOE Support for Families. Schools are working to support mental health needs of students and staff.  Contact your local school division if you have questions or concerns. Information for parents is available on the VDH Back to School Website and Social Emotional Learning Resources for Parents.

School divisions have the ability to implement local mask policies based on community level conditions and public health recommendations. Virginia guidance strongly recommends divisions adopt the following for the 2021-2022 school year: 

• Elementary schools should implement a requirement that students, teachers, and staff wear masks indoors, regardless of vaccination status, until vaccination is available for children under 12 years old and there has been sufficient time to allow for children younger than 12 years old to be fully vaccinated. 
• At a minimum, middle and high schools should implement a requirement that students, teachers and staff who are not fully vaccinated wear masks indoors. 
• All schools may want to consider universal masking for specific reasons as outlined in certain circumstances by the CDC.
• All schools should be prepared to adjust local mask policies as local public health conditions evolve throughout the year. 

Please see the Department of Education FAQs for additional information.

Yes, on January 29, 2021, CDC issued an Order that required face masks to be worn by all people while on public transportation. This included the requirement for all individuals aged two and older to wear a mask on a school bus. Bus drivers are not required to wear a mask when alone on a bus. VDH should encourage and promote awareness of the federal order, but the federal order is not enforceable by VDH.

School divisions have the ability to implement local mask policies based on community level conditions and public health recommendations.

The American Academy of Pediatrics offers advice about helping children get accustomed to masks. The A.A.P.’s suggestions include putting a mask on a child’s favorite stuffed animal, decorating masks so they’re more personalized and drawing a mask on your child’s favorite book character.

Masks are not recommended for those under 2 years old, and anyone unable to remove the mask on their own. According to the A.A.P., children with “severe cognitive or respiratory impairments” might not be able to tolerate a mask. On the other hand, children who are at high risk for severe COVID-19, including those who are immunocompromised, might need more protection than cloth face coverings offer, and N95 masks are recommended for them. The AAP offers guidance to families and their children returning Back to School in the fall.

Wearing masks during physical activity may be considered. Some people may have a difficult time wearing a mask while exercising or playing a sport, and decisions to wear masks during play should be made on a case-by-case basis. Considerations may include the intensity of the sport, the likelihood of the mask getting caught on equipment or getting wet.

The CDC states that “people who are engaged in high intensity activities, like running, may not be able to wear a mask if it causes difficulty breathing. 

School divisions have the ability to implement local mask policies based on community level conditions and public health recommendations. If masks are required in the school setting, a  person may play a wind or brass instrument without a mask as long as 6 feet of physical distance can be maintained from other people.

CDC and VDH currently recommend children aged 2-4 wear a mask in schools, but it is not required. Parents and caregivers should use their best judgment when placing a mask on a child aged 2-4. The AAP offers guidance to families and their children returning  Back to School in the fall.

School divisions have the ability to implement local mask policies based on community level conditions and public health recommendations. Virginia guidance strongly recommends divisions adopt the following for the 2021-2022 school year: 

• Elementary schools should implement a requirement that students, teachers, and staff wear masks indoors, regardless of vaccination status, until vaccination is available for children under 12 years old and there has been sufficient time to allow for children younger than 12 years old to be fully vaccinated. 
• All schools may want to consider universal masking for specific reasons as outlined in certain circumstances by the CDC.
• All schools should be prepared to adjust local mask policies as local public health conditions evolve throughout the year.

CDC Guidance clarifies that child care providers should remove masks “before sleeping, napping, [and] when they may fall asleep (such as in a car seat or stroller).” Sleeping children may be unable to remove their masks if their breathing is obstructed, and children should not wear masks during nap time. 

Camps may follow CDC Guidance for Operating Youth Camps. 

At overnight camps taking place at K-12 schools, camps should follow CDC guidance for overnight camps.

The state recommends that schools follow CDC guidance on best practices for preventing the spread of COVID-19. To help school divisions decide how to best serve their communities, VDH and the Department of Education (VDOE) have updated Interim Guidance for K-12 School Reopening. The VDOE also advises local school divisions to work with local health officials and school board counsel on appropriate health and safety practices.

The CDC does not currently recommend universal symptom screening for K-12 schools. Parents or caregivers are strongly encouraged to monitor their children for signs of infectious illness every day and keep them home when they are sick. Screening procedures are available for students and staff who arrive with or develop symptoms during the course of the day.  The VDH has developed guidance for parents and school staff When Should a Child Stay Home From School and/or Child Care?.

Please discuss any concern you may have with your local school division.

• CDC does not currently recommend universal symptom screenings (screening all students grades K-12) be conducted by schools.
• Parents or caregivers are strongly encouraged to monitor their children for signs of infectious illness every day. Students who are sick should not attend school in-person.

For more information, the VDH has developed guidance for parents and school staff When Should a Child Stay Home From School and/or Child Care?

If a student or employee Experiences Symptoms of COVID-19 While at School, move the individual out of the classroom or group setting, isolate in a predetermined location, and inform the school nurse or school health staff member. School health staff must wear personal protective equipment (PPE), including a N-95 or surgical mask, goggles and gloves before entering into the room to evaluate the individual. Call the parent or family member of the employee to pick up and take home the ill person. If symptoms persist or worsen, or if laboratory testing might be warranted, they should contact their healthcare provider. If COVID-19 is suspected or confirmed, the ill person must stay home and be isolated from others for at least 10 days and until fever-free for at least 24 hours and others symptoms have improved. The VDH has developed guidance for parents and school staff When Should a Child Stay Home From School and/or Child Care? 

If there is a confirmed case of COVID 19 in school, the local health department will work closely with school administrators to determine a course of action for their schools. Schools should follow the CDC Operational Strategy for k-12 Schools for schools and use the Operating School During COVID-19 to determine school closing in collaboration with the local health department. Schools should follow CDC Operational Strategy for k-12 Schools and CDC Guidance for Cleaning and disinfection.  The VDH will work closely with the school to make environmental cleaning recommendations, conduct contact tracing, and investigate any potential exposures. Please discuss any concern you may have with your local school division.

Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. Parents of children who are medically fragile or have one or more chronic conditions should check with their health care provider about school attendance. In addition, employees that meet the criteria listed for ‘higher risk’ populations should check with their healthcare provider before returning to work. Schools should provide remote learning exceptions and teleworking options for students and staff who are at high risk of severe illness (as defined by the CDC). Please discuss any concern you may have with your local school division.

People who are not fully vaccinated who have had close contact with someone with COVID-19 need to stay home and distanced from others (quarantine) for 14 days from date of last exposure and monitor their health status closely. Close contact means being within about 6 feet for a total of 15 minutes or more over a 24-hour period. In indoor K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students are wearing masks and the school has other prevention strategies in place. This exception does not apply to teachers, staff, or other adults in indoor K-12 settings. These unvaccinated individuals who are close contacts of persons with COVID-19 should be tested immediately after being identified, and if negative, tested again in 5–7 days after last exposure or immediately if symptoms develop during quarantine. They can leave quarantine after 10 days if no symptoms develop or after 7 days if a COVID-19 test conducted on or after Day 5 is negative. VDH recommends a 14 day quarantine, as it is the safest option. 

The CDC provides guidance for people exposed to people with known or suspected COVID-19. VDH has developed algorithms to help guide schools VDH Algorithm for Evaluating Non-Critical Infrastructure Workers with COVID-19 Symptoms or Exposures and  When Should a Child Stay Home From School and/or Child Care? Please discuss any concern you may have with your local school division.

The CDC and VDH do not recommend requiring a negative COVID-19 test in order for unvaccinated students or staff to return to school. Unvaccinated individuals with suspected or confirmed COVID-19 should stay home and physically distance from others for at least 10 days and until at least 24 hours fever-free without the use of fever-reducing medicine and other symptoms have improved. More information is available in the CDC criteria for return to school  and the VDH guide for release from isolation or quarantine.  

Once the child meets the criteria to be released from isolation, the child may return to school and does not need to enter quarantine or be tested for a new exposure that occurs within the next 90 days.

An individual diagnosed with COVID-19 should not return to work or school until they meet all criteria to end isolation:
● At least 10 days have passed since symptoms first appeared and
● At least 24 hours have passed with no fever without the use of fever-reducing
medication, and
● Other symptoms have improved.

The VDH staff might need information about who was in different areas within the school or child care setting at a given time or contact information for children or staff associated with the facility and considered potentially exposed to a person with COVID-19. Staff of the school or child care facility will play an important role in supporting health department efforts to obtain this information. Similar collaboration occurs routinely for case and contact investigations of other communicable diseases and would be expected to continue seamlessly for COVID-19 investigations.  

Contact Tracing for COVID-19 in K-12 Schools: How to Prepare and What to Expect Infographic

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 preferred over nebulizer treatments whenever possible in the school setting. The use of asthma inhalers (with or without spacers or face masks) is not considered an aerosol-generating procedure.

CDC recommends that 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. 

 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 put on  proper personal protective equipment  (N95 mask, 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 here: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

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

Screening testing can help promptly identify and isolate cases, quarantine those who may have been exposed to COVID-19 and are not fully vaccinated, and identify clusters. This can help reduce the risk to students, teachers and staff, and controlling outbreaks before they expand can help limit any disruption to in-person education. Screening testing can also be used to help evaluate and adjust prevention strategies and provide added protection for schools that are not able to provide optimal physical distance between students. Screening testing should be offered to students who have not been fully vaccinated when community transmission is at moderate, substantial, or high levels; at any level of community transmission, screening testing should be offered to all teachers and staff who have not been fully vaccinated. If screening testing is not feasible, schools can adopt a referral-based diagnostic testing approach. VDH has a testing site locator which may be helpful for schools to use for testing referrals.  

Pooled testing is a form of screening testing that may be used in schools. Pooled testing involves mixing several individuals’ test samples together into one “pool” and then testing the pooled sample for COVID-19. This approach increases the number of individuals that can be tested at one time and allows regular testing in the school for COVID-19.   

Any screening test performed in the school setting is voluntary and requires parental consent prior to testing. Contact your local school division for additional information.

While generic messaging may be shared with the school community regarding a positive test in the school, neither the student’s name nor any other information that could potentially identify the ill person can be shared. The local health department will work with the student and their family to determine which individuals meet the close contact definition. The local health department will notify those individuals and provide information about disease prevention steps they should take, without disclosing personal identities.

This information helps school administrations and Local Health Departments make decisions based on the level of COVID-19 transmission rates in the community as well as the school's ability to implement the 5 Prevention strategies:  

• Consistent and correct use of masks
• Physical/Social distancing to the extent possible
• Hand hygiene and respiratory etiquette
• Cleaning and disinfection
• Contact tracing in collaboration with local health department

School administration and the local health department will work together to discuss the potential impact on in-person learning in the school setting.  Schools may need to make necessary changes to their individual school division educational plan depending on the level of transmission and the ability of a school to implement preventative measures.

The U.S. Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) have enacted measures that will help keep America’s nursing home residents safe from the virus that causes COVID-19. The measures direct nursing homes to significantly restrict indoor visitation for unvaccinated residents when the COVID-19 county positivity rate is greater than 10% and less than 70% of residents in the facility are fully vaccinated. Indoor visitation should also be restricted for residents with SARS-CoV-2 infection and residents in quarantine, until they have met criteria for discontinuation of transmission-based precautions or release from quarantine. Exceptions to these visitation restrictions may be made for compassionate care situations. While visitor restrictions may be difficult for residents and families, it is an important temporary measure for their protection. Indoor visitation is now allowed for fully vaccinated residents (at least two weeks after receiving the second dose in a two-dose series, or at least two weeks after receiving one dose of a single-dose vaccine).

Additionally:

1. If you are allowed to visit your loved one in a nursing home, make sure you are not sick. If you are sick, delay your visit until you can see your doctor and get checked out.
2. If you are not sick and visiting your relative in a nursing home, make sure to wash your hands and wear a mask during your visit. The CDC recommends that all people entering a health facility wear a mask to stop the spread of COVID-19. Maintain at least six feet of physical distance from staff and other residents in the facility. Look for posted signs in the facility with any special instructions.
3. If your loved one is sick, especially with a cough, fever, or difficulty breathing, inform the doctor or staff at the nursing home for further guidance.
4. Visitors should not visit more than one resident at a time. Visits should ideally be in the resident’s room. If the resident is in a shared room and the roommate is unvaccinated, the roommate should not be present during the visit if possible. If neither resident is able to leave the room for the visit, all present should maintain physical distance and wear a mask. If the resident and visitor are fully vaccinated, they may choose to have close contact and not wear masks while alone in the visitation space. If either the resident or their visitor is not fully vaccinated, they may choose to have close contact while wearing masks, though maintaining social distance is the safest option. More information on visitation is available in the updated recommendations from CDC.
5. There is limited information about vaccine protection for people who are immunocompromised. When caring for fully vaccinated residents with immunocompromising conditions, long-term care facilities should follow infection prevention and control recommendations for unvaccinated individuals.

Yes. Based upon available data, older adults and those with chronic illness or weakened immune systems are at greater risk for severe illness from COVID-19.

Immediately contact your local public health department for help and further guidance. All suspected clusters or outbreaks of any illness should be immediately reported to the local health department by the most rapid means available.

• Maintain these restrictions:
  • Residents, staff, and visitors should wear a well-fitted cloth mask or face mask, even if they are fully vaccinated. If all residents are fully vaccinated, they may have close contact and not wear a mask in a group setting.
  • When indoor visitation occurs for a fully vaccinated resident, ensure that the visitor is aware of the risks associated with visitation, maintains six feet of distance from other residents and staff, and performs hand hygiene before contact with the resident.
  • Develop a plan that manages visitation and visitor flow to make sure that physical distancing can be maintained at all times. This may include limiting the number of visitors per resident allowed at one time and total number of visitors allowed in the facility at one time.
  • Cancel group activities and communal dining when COVID-19 county positivity rate is more than 10% and less than 70% of residents are fully vaccinated.
  • If group activities and communal dining can be allowed and if there are unvaccinated residents present, all residents should wear a mask and the unvaccinated residents should maintain physical distance. If all residents are fully vaccinated however, they may choose to have close contact and not wear a mask.
  • Fully vaccinated residents should be allowed to leave the facility and are not required to quarantine when they return, as long as they have not had close contact with anyone who had COVID-19 in the past 14 days. Fully vaccinated residents who had close contact with someone with SARS-CoV-2 infection for 15 minutes or more should continue to quarantine.
  • Fully vaccinated residents who are newly admitted do not need quarantine upon admission as long as they have not had close contact with someone with SARS-CoV-2 infection in the previous 14 days.
  • Designate a location to isolate residents with suspected or confirmed COVID-19.

• Identify cases as early as possible by actively screening all residents daily for fever and respiratory symptoms (pulse oximetry). 
  • Long-term care residents with COVID-19 may show atypical symptoms including new or worsening malaise, new dizziness, diarrhea, or sore throat. Identification of these symptoms should prompt isolation and further evaluation.
• Institute staffing recommendations at the facility:
  • Screen healthcare staff for fever, respiratory symptoms, and possible exposures at the beginning of their shift. If they are ill, have them put on a mask (if they do not wear one already) and leave the workplace.
  • Implement universal use of masks for healthcare staff while in the facility, as supply allows. 
  • Designate healthcare staff who will be responsible for caring for COVID-19 patients. 
  • Asymptomatic healthcare personnel with high-risk exposures may continue to work if they are fully vaccinated. To mitigate staffing shortages, exposed healthcare staff who are not fully vaccinated may continue to work while wearing a mask as long as they remain asymptomatic. More information on work restrictions for staff is available here, under “Work restriction for asymptomatic healthcare personnel and quarantine for asymptomatic patients and residents.”
• Follow environmental cleaning and disinfection procedures consistently and correctly.
  • Management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures.
• Continue to regularly vaccinate any new admissions and staff who are not already fully vaccinated.

Routine testing of long-term care facility staff who do not have COVID-19 symptoms is required. How often this staff testing happens is based on community-level COVID-19 activity, which is classified as either low, medium, or high. Low community activity (a test positivity rate of less than 5%) means that staff will be tested at least once a month, medium community activity (a test positivity rate from 5 - 10%) means that staff will be tested at least once a week, and high community activity (a test positivity rate greater than 10%) means that staff will be tested at least twice a week. More information about community test positivity rates is available on the Virginia PCR test positivity dashboard. Staff who are fully vaccinated (≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine) and do not have COVID-19 symptoms or a high-risk exposure do not need to be routinely tested if there have been no new cases in the facility for the past 14 days. More information on testing fully vaccinated long-term care staff is available here.

Not necessarily. Depending on the severity of the illness and capabilities at the facility, your loved one may be able to stay in their current location to receive supportive care. Residents with more serious illness may require admission to a hospital for treatment.

Current CDC and CMS guidance/recommendations do not mention the use, or non-use, of either physical or chemical restraints for COVID-19 patients, or close contacts, who have dementia and may display agitation, restlessness and/or wandering. However, per CMS, physical and/or chemical restraints are indicated as safety measures of last resort for violent or overly aggressive residents whose behavior cannot be controlled by other means. The use of physical or chemical restraints for residents with COVID-19, or their close contacts, as a means of behavior control does not seem consistent with their intended purpose.  Moreover, physical and chemical restraints have potentially harmful adverse effects. The appropriate decision should be taken by their healthcare providers.

Yes, under certain circumstances, restricting residents to their rooms is recommended (not mandated). This type of restriction would apply to care of residents with an undiagnosed respiratory illness, or care of symptomatic residents who are awaiting transport to a facility that can provide a higher level of care which the patient needs. Residents diagnosed with, or suspected to have, COVID-19 are recommended to be isolated in their room(s) with the door closed, to the extent possible. If there are cases of COVID-19 in the facility OR if there is widespread transmission (greater than 10% positivity rate) of the virus in the community, residents who have not been diagnosed with COVID-19 are encouraged to be restricted to their rooms to the extent possible. If residents leave their rooms, they should wear a mask, practice social distancing and wash their hands. Residents who leave their rooms can be redirected back to their rooms. It may be helpful to engage the resident in light exercise in the facility – this may reduce restlessness, agitation and wandering. Residents with dementia might require additional assistance and supervision when they leave their rooms.

CDC has interim guidance for home care for clinically stable individuals who do not require hospitalization. VDH has also created a protocol for PPE for HCPs involved in COVID-19 active monitoring in residential settings.

CDC has guidance for preventing the spread of COVID-19 in LTCFs.

On March 9, the Centers for Medicare and Medicaid Services released guidance for LTCFs, including revised guidance for visitation, and guidance for home health agencies.

Because of different reporting requirements and surveillance definitions, timelines, and other factors, the CMS nursing home data will likely differ from data reported by VDH. CMS posts COVID-19 data submitted by nursing homes via the CDC's National Healthcare Safety Network (NHSN). As with any new reporting program, some of the data from early submissions to NHSN may be inaccurate. Retrospective reporting to NHSN before May 1, 2020 is optional, therefore, not all facilities reported their cumulative data from the beginning of the outbreak. VDH outbreak data are reported based on the state outbreak investigations, which are independently related to CMS reporting.

CMS nursing home data will be updated weekly and can be found at: https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg

Nursing homes/skilled nursing facilities fall under the Virginia Department of Health, Office of Licensure and Certification (OLC) for oversight and complaint reporting.

The contact number for complaints is:

Toll Free: 1-800-955-1819

Metro Richmond area: (804) 367-2106

More detailed information may be found here.

When Filing a Complaint via Telephone, Please Be Prepared To:

1. Provide your name, telephone number, and address.
   Anonymous reports must be made in writing.
2. Identify the name and address of the medical care entity being reported
3. Provide a detailed summary of concerns
4. Provide additional details as requested by the Hotline staff

Messages left after normal business hours, on weekends or holidays will be returned the next business day.

To File a Written Complaint:

1. Select from the 2 types of complaint forms:
   Nursing Facility Complaint Form| Other Licensed Entity Complaint Form
2. Complete the form in its entirety; be as thorough as possible.
3. Attach any available copies of documents related to your concerns.
4. Forward the written form and applicable documents as follows:

By US Mail:
Complaint Intake
Office of Licensure and Certification
Virginia Department of Health
9960 Mayland Drive, Suite 401
Henrico, VA 23233-1463

OR By FAX: 1-804-527-4503

Or By EMAIL: OLC-Complaints@vdh.virginia.gov

Assisted Living Facilities (ALFs) are regulated by the Virginia Department of Social Services. Their contact information is:

Statewide toll-free number: 1-800-543-7545. In the Richmond area, call 804-692-2394.

Home health organizations are also regulated by the VDH Office of Licensure and Certification. The process is the same as filing a complaint against a nursing home or skilled nursing facility. Please see the FAQ “How do I file a complaint against a skilled nursing facility / nursing home.”

Pregnant people are at an increased risk for severe illness from COVID-19 compared to non-pregnant people. A study found that pregnant women are more likely to be admitted to the intensive care unit (ICU), receive invasive ventilation and extracorporeal membrane oxygenation, and are at increased risk of death compared to nonpregnant women. But much remains unknown and the CDC is working with state, local, and territorial health departments and external partners to learn more about COVID-19 during pregnancy. Additionally, there may be an increased risk of adverse pregnancy outcomes, such as preterm birth (delivering the baby earlier than 37 weeks), among pregnant people with COVID-19. Having certain underlying medical conditions can further increase a pregnant person’s risk for developing severe illness as well. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick.

It is especially important for pregnant people, and those who live with them, to protect themselves from getting COVID-19. Consider the level of risk when deciding whether or not to go out. If you do go out, ensure you and the people who live with you are taking steps to protect themselves. Pregnant people should engage in preventive actions to avoid infection like limiting interactions with people that might have been exposed to or infected with COVID-19, washing hands often, covering your mouth and nose with a mask, staying at least 6 feet away from others outside your household, covering coughs and sneezes and frequent cleaning of frequently touched surfaces with soap or detergent. 

Much is still unknown about the risks of COVID-19 among newborns born to people with COVID-19. Preliminary data suggests people with COVID-19 are at increased risk for preterm labor (delivering earlier than 37 weeks) as well as other negative birth outcomes. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick.

Pregnant healthcare personnel (HCP) should follow risk assessment and infection control guidelines for HCP exposed to patients with suspected or confirmed COVID-19. Adherence to recommended infection prevention and control practices is an important part of protecting all HCP in healthcare settings. 

Information on COVID-19 in pregnancy is very limited; facilities may want to consider limiting exposure of pregnant HCP to patients with confirmed or suspected COVID-19, especially during higher risk procedures (e.g., aerosol-generating procedures) if feasible based on staffing availability. The COVID-19 vaccine is a safe and effective way to prevent COVID-19 infection among pregnant people.

Current evidence suggests that the risk of a newborn getting COVID-19 from its birthing parentis low, especially when they take appropriate precautions before and during care of the newborn, such as wearing a mask and practicing hand hygiene; however, newborns can be infected with the virus that causes COVID-19 after being in close contact with an infected person. Some babies have tested positive for the virus shortly after birth, but it is unknown if these babies got the virus before, during, or after birth. Most newborns who tested positive for the virus that causes COVID-19 had mild or no symptoms and recovered. However, there are a few reports of newborns with severe COVID-19 illness.

We do not know for sure if people with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggest this is not likely.

The COVID-19 vaccine is a safe and effective way to prevent COVID-19 infection among pregnant and parenting people.

While much is still unknown about the risks of COVID-19 to newborns born to birthing people with COVID-19, we do know that COVID-19 is uncommon in newborns born to these individuals. Some newborns have tested positive for the virus that causes COVID-19 shortly after birth. It is unknown if these newborns get the virus before, during, or after birth from close contact with an infected person. Most newborns who have tested positive for COVID-19 had mild or no symptoms and have recovered fully. However, there are a few reports of newborns with severe illness.

Adverse infant outcomes (e.g., preterm birth) have been reported among infants born to mothers positive for COVID-19 during pregnancy. It is unknown if these outcomes were related to the virus that causes COVID-19.

If you are still in isolation for COVID-19 and have returned home, take the following precautions until your isolation period has ended:

• Stay home to separate yourself from others outside your home.
• Isolate from other household members who are not infected and wear a mask in shared spaces.
• Have a healthy caregiver who is not at increased risk for severe illness provide care for your newborn.
  • Caregivers should wash their hands for at least 20 seconds before touching your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
  • If the caregiver is living in the same home or has been in close contact with you, they should wear a mask when they are within 6 feet of your newborn for the entire time you are in isolation and for two weeks after you complete isolation.

If a healthy caregiver is not available, you can care for your newborn if you are well enough.

• Wash your hands with soap and water for at least 20 seconds before touching your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Wear a mask when within 6 feet of your newborn and other people during your entire isolation period. The mask helps prevent you from spreading the virus to others.

Others in your household and caregivers who have COVID-19 should isolate and avoid caring for the newborn as much as possible. If they have to care for the newborn, they should practice hand hygiene and wear a mask.

Once your isolation period ends, you should still wash your hands before caring for your newborn, but you don’t need to take the other precautions.

CDC recognizes that the ideal setting for the care of a healthy, full-term newborn during the birth hospitalization is within the mother’s room (“rooming-in”). If you are diagnosed with or test positive for the virus that causes COVID-19, you should discuss with your healthcare provider the risks and benefits of having your newborn stay in the same room with you. This conversation should begin during prenatal care if possible. 

Having your newborn stay with you in the same room has the benefit of facilitating breastfeeding and maternal-newborn bonding. Potential risks may include giving the virus to the newborn, although current evidence suggests the risk of a newborn getting COVID-19 from their parents is low if precautions are taken. After discussing, make an informed decision of whether your newborn is staying in the same room with you while in the hospital.

If you are in isolation for COVID-19 and are sharing a room with your newborn, take the following precautions to reduce the risk of spreading the virus to your newborn:

• Wash your hands with soap and water for at least 20 seconds before holding or caring for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Wear a mask when within 6 feet of your newborn.
• Keep your newborn more than 6 feet away from you as much as possible.
• Discuss with your healthcare provider about using a physical barrier (for example, placing the newborn in an incubator) while in the hospital.

Once your isolation period ends, you should still wash your hands before caring for your newborn, but you don’t need to take the other precautions

At this time, there is no information on long-term health effects on infants with COVID-19, or those exposed to the virus that causes COVID-19 in utero.

Current evidence suggests that breast milk is not likely to spread the virus to babies.

If you have COVID-19 and choose to breastfeed: Wear a mask while breastfeeding and wash your hands before each feeding.

If you have COVID-19 and choose to express breast milk: Use a dedicated breast pump, wear a mask during expression and wash your hands before touching any pump or bottle parts and before expressing breast milk, follow recommendations for proper pump cleaning after each use, cleaning all parts that come into contact with breast milk and if possible, expressed breast milk should be fed to the infant by a healthy caregiver who does not have COVID-19, is not at high-risk for severe illness from COVID-19, and is living in the same home.

It is recommended that you do not skip your prenatal care appointments or postpartum appointments. If you are concerned about attending your appointment due to COVID-19, talk to your healthcare provider. Ask your healthcare provider how they are taking steps to separate healthy patients from those who may be sick. Some healthcare providers might choose to cancel or postpone some visits. Others may switch certain appointments to telemedicine visits, which are appointments over the phone or video. These decisions will be based on the circumstances in your community as well as your individual care plan.

Do not delay getting emergency care because of COVID-19.

Call your healthcare provider if you have an urgent medical question. In case of emergency, call 911 or go to your local emergency department. If you are not driving, call the emergency department on the way to explain that you are pregnant and have an emergency. They should have an infection prevention plan to protect you from getting COVID-19 if you need emergency care. 

Keep at least a 30-day supply of prescription and non-prescription medicines 

Talk to your healthcare provider about getting an extra supply of prescription medicines, if possible, to reduce your trips to the pharmacy.

Ensure your own social, emotional and mental health

Call your healthcare provider if you think you are experiencing depression after pregnancy. Ways to cope with stress and tips for caring for yourself during the pandemic can be found here.

Routine vaccines are an important part of protecting your health. Receiving some vaccines during pregnancy, such as the influenza (flu) and Tdap vaccines, can help protect you and your baby. Furthermore, the COVID-19 vaccine is a safe and effective way to prevent COVID-19 infection among pregnant people. If you are pregnant, you should continue to receive your recommended vaccines. Talk with your healthcare provider about visits for vaccines during pregnancy.

During the COVID-19 pandemic, parents of infants may experience increased stress and fatigue that could affect their infants’ sleep practices. Safe sleep is an important part of keeping infants healthy, including during the COVID-19 pandemic. If you have an infant, you can help reduce your baby’s risk of sudden infant death syndrome (SIDS) and other sleep-related deaths by doing the following:

• Place your baby on his or her back for all sleep times – naps and at night.
• Use a firm, flat sleep surface, such as a mattress in a crib, covered by a fitted sheet.
• Have the baby share your room but not your bed. Your baby should not sleep on an adult bed, cot, air mattress, or couch, or on a chair alone, with you, or with anyone else.
• Keep soft bedding such as blankets, pillows, bumper pads, and soft toys out of your baby’s sleep area.
• Do not cover your baby’s head or allow your baby to get too hot. Signs your baby may be getting too hot include if he or she is sweating or if his or her chest feels hot.
• Do not smoke or allow anyone to smoke around your baby.

Ideally, newborn visits should be done in person so that your pediatric healthcare provider can check your baby’s growth and feeding, check your baby for jaundice, make sure your baby’s newborn screening tests were done, and get any repeat or follow-up testing, if necessary. Ask your healthcare provider how they are taking steps to separate healthy patients from those who may be sick. Some health care providers may choose to delay visits like well-child checks and routine vaccine visits. These decisions will be based on circumstances in your community and your child’s individual care plan. Call your provider’s office to ask about any upcoming appointments or about when your child’s vaccinations are due.

Vaccines are also an important part of keeping your child healthy, especially if your child is under 2 years old. Vaccines help provide immunity before being exposed to potentially life-threatening diseases. Vaccines for illnesses such as measles, influenza (flu), whooping cough (pertussis), and other infectious diseases are important for your child’s health. This will help to prevent outbreaks of vaccine-preventable diseases among young children during the COVID-19 pandemic.

No. A mask or face shield could increase the risk of sudden infant death syndrome (SIDS) or accidental suffocation and strangulation. Babies move frequently and their movement may cause the plastic face shield to block their nose and mouth, or cause the strap to strangle them.

There are also no data supporting the use of face shields among babies for protection against COVID-19 or other respiratory illnesses.

CDC does not recommend use of face shields as a substitute for masks for the general public, including pregnant or breastfeeding parents.

For current information and additional reading, you can check out the CDC’s website: 

CDC COVID-19 Pregnancy, Breastfeeding, and Caring for Newborns  and Pregnant People

Children and adolescents can be infected with SARS-CoV-2, can get sick with COVID-19, and can spread the virus to others. The rates of infection and COVID-19 symptomatic illness in children were comparable to infection and symptomatic illness rates in adults ages 18-49 and higher than rates in adults ages 50 and older. Systematically tested children and adolescents, regardless of symptoms, for acute SARS-CoV-2 infection (using antigen or RT-PCR assays) or prior infection (through antibody testing) had rates of infection comparable or higher than in adults. 

Children and adolescents who are infected with SARS-CoV-2 are more commonly asymptomatic (never develop symptoms) or have mild, non-specific symptoms (e.g. headache, sore throat). It is important to note that they can spread SARS-CoV-2 to others when they do not have symptoms or have mild, non-specific symptoms and may not know that they are infected and infectious.

Young children (less than age 12 years) comprise a greater proportion of the population who are unvaccinated and therefore at risk. While the rates of severe outcomes (e.g. hospitalization, mortality) from COVID-19 among children and adolescents are low, youth who belong to some racial and ethnic minority groups are disproportionately affected.  For example, a higher proportion of COVID-19 cases in school-aged children who are Hispanic or Latino or are Black or African American were hospitalized or required intensive care unit (ICU) admission than reported among White school-aged children. 

For more information on this topic, please click here.

You can encourage your child to help stop the spread of COVID-19 by teaching them to do the same things everyone should do to stay healthy. 

• Family members over the age of 12 should get the COVID-19 vaccine.  Children ages 12-17 have been approved for use with the Pfizer-BioNTech vaccine. 
• Avoid close contact with people who are sick.
• Stay home when you are sick, except to get medical care.
• Cover your coughs and sneezes with a tissue and throw the tissue in the trash.
• Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty. Do not allow children to lick or eat the hand sanitizer. 
• Clean and disinfect frequently touched surfaces and objects (e.g., tables, countertops, light switches, doorknobs, and cabinet handles).
• Launder items, including washable plush toys, as appropriate and in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from an ill person can be washed with other people’s items.
• It is recommended children over the age of 2 years wear masks when in public settings with unvaccinated people.

Compared with adults, children and adolescents with COVID-19 are more commonly asymptomatic (never develop symptoms) or have mild, non-specific symptoms (e.g. headache, sore throat). Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. Children are less likely to develop severe illness or die from COVID-19. The extent to which children suffer long-term consequences of COVID-19 is still unknown. Underlying medical conditions are also more commonly reported among children who are hospitalized or admitted to an ICU than those not.

CDC recommends that unvaccinated individuals 2 years and older wear a mask that covers their nose and mouth when they are out in the community. Masks should NOT be put on babies or children younger than 2 because of the danger of suffocation. Information on children and masks from the American Academy of Pediatrics can be found here.

School divisions have the ability to implement local mask policies based on community level conditions and public health recommendations. Virginia guidance strongly recommends divisions adopt the following for the 2021-2022 school year: 

• Elementary schools should implement a requirement that students, teachers, and staff wear masks indoors, regardless of vaccination status, until vaccination is available for children under 12 years old and there has been sufficient time to allow for children younger than 12 years old to be fully vaccinated. 
• At a minimum, middle and high schools should implement a requirement that students, teachers and staff who are not fully vaccinated wear masks indoors. 
• All schools may want to consider universal masking for specific reasons as outlined in certain circumstances by the CDC.

All schools should be prepared to adjust local mask policies as local public health conditions evolve throughout the year.

Helping children understand and follow recommendations, like physical distancing and wearing a mask , can be challenging if your child has intellectual disabilities, sensory issues, or other special healthcare needs. Keeping children at home and sheltering in place can lower stress created by physical distancing and mask recommendations. Reach out to others for help in running essential errands. 

Behavioral techniques can be used to address behavioral challenges and to develop new routines. These include social stories, video modeling, picture schedules, and visual cues. Try rewarding your child in small ways with his or her favorite non-food treat or activities to help switch routines and to follow recommendations.

Many of the organizations you turn to for information and support around your child’s complex, chronic medical condition may have information on their websites to help families address issues related to COVID-19. Your child’s therapist(s) and/or teachers may also have resources to help successfully introduce new routines to your child.

Additional information on caring for children and on child development specific conditions are available.

CDC Guidance Documents to Support People with Disabilities. CDC released guidance documents to support the needs of people with disabilities. These documents provide guidance for direct service providers (DSPs), group home administrators, caregivers, families, and people with developmental and behavioral disorders to help prevent infection and mitigate negative effects of COVID-19.

• • Direct Service Providers
  • Group Homes for Individuals with Disabilities
  • Direct Service Providers, Caregivers, Parents, and People with Developmental and Behavioral Disorders
  • People with Developmental and Behavioral Disorders  

MIS-C stands for multisystem inflammatory syndrome in children (MIS-C), which is associated with COVID-19. Patients with MIS-C have presented with a persistent fever and a variety of other signs and symptoms including multiorgan (e.g., cardiac, gastrointestinal, renal, hematologic, dermatologic, neurologic) involvement and elevated inflammatory markers. Additional symptoms may include abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes and feeling extra tired. MIS-C may begin concurrently with a COVID-19 infection or weeks after a child is infected with COVID-19. The child may have been asymptomatically infected with COVID-19 and, in some cases, the child and their caregivers may not even know they had been infected with COVID-19. Children with a history of MIS-C should consider delaying COVID-19 vaccination until they have recovered from illness and for 90 days after the date of diagnosis of MIS-C. This should be a discussion with the healthcare team.

The American Academy of Pediatrics has developed interim guidance for the evaluation and management of MIS-C, which is very comprehensive and may be found here. CDC’s case definition and basic information may be found here.

Highlights include the following: 

• Providers in the outpatient or emergency department setting should evaluate any child with persistent fever (≥3 days) who is moderately to severely ill with clinical signs of organ dysfunction (e.g. gastrointestinal, respiratory, cardiac, skin, or neurologic). Early consultation with the nearest pediatric infectious disease and rheumatology specialist and pediatric referral center should be considered. Laboratory screening for systemic inflammation may be considered.
• Severely ill-appearing patients and those in shock should be evaluated and treated in the emergency department/critical care setting. Transfer to a referral center should be arranged.
• Any child sick enough to warrant admission for fever, abdominal pain, diarrhea, and/or organ dysfunction in whom MIS-C is suspected should be cared for in a hospital with tertiary pediatric/cardiac intensive care units.

Clinicians who suspect MIS-C in a child should use a multidisciplinary approach involving many pediatric specialists, which may include but is not limited to cardiology, infectious disease, immunology, hematology, rheumatology, pediatric hospital medicine, and critical care, to guide individual patient treatment. There are 3-4 sub-types of MIS-C that may require slightly different management based on evolution of symptoms and laboratory values. Optimal treatment for a patient with MIS-C is not known; however, is best determined by the multidisciplinary clinical team. Interventions that have been used may be found here.

Currently there are no specific drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment or prevention of COVID-19 or MIS-C. Treatment remains mainly supportive and includes prevention and management of complications.  The American College of Rheumatology (ACR) has developed clinical guidance for the management of MIS-C here. 

Clinicians who suspect MIS-C in a child should use a multidisciplinary approach involving many pediatric specialists, which may include but is not limited to cardiology, infectious disease, immunology, hematology, rheumatology, pediatric hospital medicine, and critical care, to guide individual patient treatment. There are 3-4 sub-types of MIS-C that may require slightly different management based on evolution of symptoms and laboratory values. Optimal treatment for a patient with MIS-C is not known; however, is best determined by the multidisciplinary clinical team. Interventions that have been used may be found here, in addition to the ACR guidelines.

Children who are hospitalized with suspected MIS-C should be considered patients under investigation for COVID-19. RT-PCR and antibody testing for COVID-19 (if available) should be performed. Local infection control policies should be followed. Healthcare facilities should ensure that infection prevention and control policies, including universal source control, are in place to minimize the chance of exposure to SARS-CoV-2 among providers, patients, and families.

Patients in whom MIS-C is diagnosed should be reported to the local or state public health department. Clinicians in Virginia may report cases here.

VDH recommends taking everyday actions to prevent children from getting COVID-19. These actions include getting vaccinated (for children 12 and older), washing hands often with soap and water, avoiding people who are sick, practicing physical distancing between your child and other people, having children 2 years and older wear masks when in public settings, covering coughs and sneezes, frequent cleaning of surfaces that are touched often, and close monitoring of your child’s health.

Additional precautions may include virtual learning, child care and summer camp programs.

1. Help Children Learn at Home: ask your school district about available school services; create a schedule and routine for learning at home; consider your child's learning needs (needs help or special education services); consider additional homeschooling/learning options; and ongoing communication with your child's school and your child’s teacher.
2.  Guidance for Child Care Programs that Remain Open - the site provides a range of options for screening children upon arrival to ensure that children who have a fever or other signs of illness are not admitted to the facility. The additional options may be useful when personal protective equipment (PPE) is in short supply.
3. Guidance for Operating Youth and Summer Camps During COVID-19- Camp administrators, in collaboration with state, local, territorial, and tribal health officials, can adapt the recommendations in the CDC guidance to meet the unique needs and circumstances of the children served. The guidance is intended to help camp administrators operate camps while preventing the spread of COVID-19 and protecting campers, their families, staff, and communities. Overnight summer camps may begin operation on May 1, 2021. Employ the use of cohorts for the first 14 days of any camp session. Cohort size may not exceed 25 campers, not including camp personnel.

MIS-C is currently reportable in VA and healthcare providers should immediately report patients with suspected MIS-C to the local health department. VDH will review these reports and count reports as MIS-C cases if certain criteria are met.

Specific tests for MIS-C are not available. To test for COVID-19, there are molecular, antigen, and serology tests available in Virginia. More laboratory and radiological testing might be needed to assess the child’s condition and those tests may be conducted based on the doctor’s recommendations.

MIS-C may begin weeks after a child is infected with COVID-19. The child may have been asymptomatically infected with COVID-19 and, in some cases, the child and their caregivers may not even know they had been infected. Close monitoring of other household members for any COVID-19 like symptoms should be ongoing. Testing might be considered in some situations.

For more information, see: COVID-19 and Children

You should contact your healthcare provider or pediatrician right away if your child has fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. Seek emergency care immediately if your child is showing any emergency warning signs of MIS-C or other concerning signs: trouble breathing, pain or pressure in the chest that does not go away, new confusion, inability to wake or stay awake, bluish lips or face, or severe abdominal pain.

For Parents: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 

Information for Pediatric Healthcare Providers