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 and monitored closely for symptoms of infection.

VDH is actively encouraging people with close contact with a known infected person, to 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 for 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.

If you want to be tested, please contact your healthcare provider. Your provider may collect samples to test you or help you to find sampling sites in your area. Learn more about what to do if you feel sick. 

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 now 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.

Information on COVIDWISE can be found here. 

FAQs regarding COVIDWISE can be found here.

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.

For the most up to date information, check the VDH website, which is updated daily with COVID-19 case information reported by, county, independent city and zip code.

The Virginia Department of Health encourages everyone in Virginia to take extra precautions to prevent the spread of infectious respiratory disease, regardless of whether or not COVID-19 has been reported in your location. 

For more information about precautions, you can take to help protect against COVID-19 and other infectious respiratory illnesses, check out our Coronavirus Prevention Tips and CDC’s webpage on how to protect yourself and others. 

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.

The Virginia Serology Project was conducted in the summer of 2020. The study showed that an estimated 2.4% of adult Virginians have antibody test evidence of a prior COVID-19 infection. The presence of COVID-19 antibodies was highest in Hispanic individuals (10.2%), residents of the Northern region (4.4%), and among those uninsured or insured through Medicaid (3.8%). Statewide, Hispanic ethnicity, residence in an apartment building or other multi-family housing unit, and reported contact with a COVID-19 case significantly increased the risk of having a positive antibody test. The project’s findings will help Virginia address the COVID-19 pandemic by understanding risk factors and giving the public health system and hospitals information to plan for future health care needs.

VDH partnered with a health system in each of Virginia’s five health planning regions to estimate the total number of people that have been infected with the COVID-19 virus in Virginia at any time in the past. From June 1 to August 14, 2020, 4,675 adult outpatients presenting for non-COVID related health care agreed to complete a questionnaire and provide a blood sample for COVID-19 antibody testing. Enrollment was stratified to meet the age, race, and ethnic population distribution of each region. Participating health care systems across Virginia include: Inova Health System (Northern), Virginia Commonwealth University (Central), Sentara Healthcare (Eastern), Carilion Clinic (Southwest), and University of Virginia (Northwest).

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.

You can find more information about testing sites in Virginia, including community testing events, at this website. Each facility has different policies and procedures for testing; please reach out to the individual facility for information about testing availability and procedures. VDH testing guidance can be found here.

Virginians can now use COVIDCheck, an online risk-assessment tool to check their symptoms and connect with the appropriate health care resources, including COVID-19 testing.

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.

We recommend that everyone follow these prevention practices:

• • Practice physical distancing
  • Wear a mask over your mouth and nose in indoor and some outdoor public settings (see noted exceptions)
  • 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, when soap and water are not readily available. Soap and water should be used if hands are visibly dirty
  • It is especially important to clean hands after going to the bathroom; before eating; after coughing, sneezing or blowing your nose; after leaving a public place; or after handling your mask
  • If you are sick, stay home and rest, even if illness is mild
  • Avoid in-person gatherings of more than 10  people, under certain circumstances
  • Those 65 years of age and older are encouraged to self-quarantine

With two COVID-19 vaccines now approved in the U.S., it is important to get vaccinated when  vaccines are readily available for your priority group.

It is very important that people with even mild signs of illness (fever, cough, chills, shaking with chills, muscle pain, headache, sore throat) stay home to prevent spreading illness to others! 

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 droplet spread, masks reduce 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 recently highlighted by CDC provide convincing data adding to the evidence for the prevention effectiveness of masking for individuals with high risk exposures:

• 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.
• In a very large COVID-10 outbreak on a U.S. Navy aircraft carrier, use of face coverings led to a 70% lower infection rate among those using the face coverings.
• In investigations among passengers on long international flights in which some passengers were later found to have been COVID-19-infected before boarding the flights, rigid masking policies on some flights were associated with many fewer COVID-19 infections transmitted on those flights.
• At least eight community-level analyses have found that having organizational and/or political leaders issue and promote masking directives was followed by significant decreases in new COVID-19 infections in the population(s) at risk.
• Several of these and other studies that also examined community mortality found lower COVID-19 death rates in those populations. 

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. 

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.

Even if you always wear a mask, however, 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. 

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. 

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 Governor’s Executive Order 63.

The more an 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?

Executive Order 72 requires that all individuals in the Commonwealth aged five and over must cover their mouth and nose with a mask, as described and recommended by the CDC, if they are in an indoor setting shared by others. This requirement applies to state and local government settings, train stations, bus stations, and intrastate public transportation, including buses, rideshares, trains, taxis, and cars for hire, as well as any waiting or congregating areas associated with boarding public transportation. Masks must also be worn outdoors when unable to maintain at least six feet of physical distance from other individuals who you do not live with. Masks should be washed after each use. Masks should be washed after each use. 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. A video about how to make one at home can be found here. 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

Using Masks to Slow the Spread of COVID-19

Yes. CDC recommends that people practice routine cleaning of frequently used surfaces with household cleaners and EPA registered disinfectants that are appropriate for the surface. Please see CDC’s guidance on cleaning and disinfecting your home 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.

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

There is still a lot that is unknown about the newly emerged COVID-19 and how it spreads. Coronaviruses are generally thought to be spread most often by respiratory droplets. 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

Check out the VDH Prevention Tips web page for more information.

If you or someone you take care of are taking prescription drugs, talk to your doctor, pharmacist, and insurance provider about keeping an emergency supply of medications at home. Virginia Medicaid is allowing members to obtain a 90-day supply of many routine prescriptions.

A case is an identified COVID-19 infection that has been confirmed with a positive laboratory result. If you have been diagnosed with COVID-19, you must isolate, which means separate yourself from people who are not sick to avoid spreading illness. For details see FAQ Section Isolation / Quarantine / Movement Restrictions / Public Health Monitoring.

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. Contacts of COVID-19 must quarantine, which means stay at home to limit community exposure to illness and to see if symptoms develop. For details see FAQ Section Isolation / Quarantine / Movement Restrictions / Public Health Monitoring.

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. 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. 

VDH recommends that you self quarantine (stay home) for 14 days after the last time you saw that person and practice physical distancing. Physical distancing means keeping a distance of at least 6 feet from others. 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 such as buses, trains taxis, or ride-shares during this time. If necessary, your local health department can ensure that your basic needs (for example, food and medication) are being met.

• 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. If you develop signs of illness, take appropriate actions. If you have only mild illness, it is important to stay home and rest to prevent spreading infection to others. Not everyone with COVID-19 will have all symptoms and fever might not be present. If you do have symptoms and want to get tested for COVID-19, please reach out to your healthcare provider. Your provider may collect samples to test you or help you to find sampling sites in your area. If you have a medical emergency, call 911 and let them know that you have had exposure to a person with COVID-19.
• 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. However, if a health department is seeing a large number  of COVID-19 cases, they may not have the resources to do timely contact tracing and case investigation for all reported cases of COVID-19 and will need to prioritize certain contact tracing and case investigation efforts. 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 an exposure notification, stay home and monitor your health after the potential exposure. 
• Get tested. VDH recommends testing on or after day 5 from exposure. Contact your healthcare provider to ask about getting tested because of your exposure. There are many test sampling sites available throughout the state to get yourself tested. Call ahead and wear a mask when you leave home. 
• How long do I need to stay home (quarantine)? It can take up to 14 days after an exposure for you to develop COVID-19. 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. 

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 that you get tested for COVID-19 on or after day 5 since your last exposure. The day of the exposure is considered day 0.  

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. 

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.

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.

If you had or continue to have close contact with a contact you must take preventative actions, by washing your hands with soap and water, covering your coughs and sneezes, and cleaning surfaces frequently. You must be alert for symptoms of COVID-19.

If you had or continue to have close contact with a contact you must take preventative actions, by washing your hands with soap and water, covering your coughs and sneezes, and cleaning surfaces frequently. You must be alert for symptoms of COVID-19.

VDH does not recommend testing for contacts of a contact. Quarantine is also not recommended. 

For example, person A has been in close contact with person B. Person B has been in close contact with person C, who has tested positive for COVID-19. Person B should quarantine for 14 days and contact a healthcare provider for a clinical evaluation and testing. Person A does not need testing or quarantine, unless they develop symptoms concerning for COVID-19. If Person B were to test positive for COVID-19, and Person A had close contact with Person B within 48 hours before diagnosis or 10 days after diagnosis, Person A would now become a contact of a case. 

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. Available data indicate that persons with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset. To continue safe contact with others, they should also be fever free for 24 hours with improvement of symptoms. 

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

• Living with a person who has COVID-19
• Providing care for a person who has COVID-19
• 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)

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.

Being indoors, such as a classroom or hospital waiting room, with a sick person with COVID-19 and remaining more than 6 feet away, does not put you at a higher risk of getting sick. Additionally, briefly walking by or being briefly in the same room as a sick person with COVID-19 does not put you at a higher risk of getting sick. However, there is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. Airborne transmissions occur within enclosed spaces that have inadequate ventilation.

Even if you don’t have symptoms, it is important to stay at home for 14 days since your last exposure. It can take up to 14 days after exposure to the virus for a person to develop COVID-19 symptoms. By self-quarantining for 14 days, you lower the chance of possibly exposing others to COVID-19.

 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 traveled to an area where COVID-19 is spreading in the community or 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 is very important that people with even mild signs of illness (fever, cough, chills, shaking with chills, muscle pain, headache, sore throat) stay home to prevent spreading illness to others! 

See Illness from 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 have a wide range of symptoms reported ranging from mild to severe respiratory illness with symptoms of fever, cough, shortness of breath. Some people have other symptoms, including chills, muscle pain, headache, sore throat, or new loss of taste or smell, congestion or runny nose, nausea or vomiting, 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 (fever, cough, chills, shaking with chills, muscle pain, headache, sore throat) 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 infection with influenza viruses.  Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, and testing may be needed to help confirm a diagnosis.

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.

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.

It depends on the severity of your symptoms. If you have mild illness, it is important to stay home and rest. Even those with mild illness could pass the infection to others.

Virginians can use COVIDCheck, a new online risk-assessment tool to check their symptoms and connect with the appropriate health care resources, including COVID-19 testing.

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

Call 911 if you have a medical emergency: If you have a medical emergency and 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.  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 bluish lips or face.

If you are sick with COVID-19, or suspect you are infected with the virus that causes 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

• • • Stay home: People who are mildly ill with COVID-19 are able to isolate at home during their illness. You should restrict activities outside your home, except for getting medical care.
    • Take over- the counter medicines, such as acetaminophen, to make you feel better.
    • Stay in touch with your doctor. Call before you get medical care. Be sure to get care if you feel worse or you think it is an emergency.
    • Avoid public areas: Do not go to work, school, or public areas.
    • Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.

• Separate yourself from other people and animals in your home. This is known as home isolation

• • • Stay away from others: As much as possible, you should stay in a specific “sick room” and away from other people in your home. Also, you should use a separate bathroom, if available.
    • Limit contact with pets & animals: You should restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. It is recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus.
    • When possible, have another member of your household care for your animals while you are sick. If you are sick with COVID-19, avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a mask. See COVID-19 and Animals for more information.

• Call ahead before visiting your doctor

• • • Call ahead: If you have a medical appointment, call the healthcare provider and tell them that you have respiratory illness and it is possible you might have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.
    • If you do not have a doctor, your local health department may be able to help connect you with a healthcare provider or free clinic in your area.

• Wear a mask 

• • • If you are sick: You should 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.
    • If you are caring for others: If the person who is sick is not able to wear a mask (for example, because it causes trouble breathing), then people who live with the person who is sick should not stay in the same room with them, they should wear a mask when they enter a room with the person who is sick. Visitors, other than caregivers, are not recommended.
    • 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

• • • Cover: Cover your mouth and nose with a tissue when you cough or sneeze.
    • Dispose: Throw used tissues in a lined trash can.
    • Wash hands: Immediately wash your hands with soap and water for at least 20 seconds or, if soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.

• Clean your hands often

• • • Wash hands: 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.
    • Hand sanitizer: 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.
    • Soap and water: Soap and water are the best option if hands are visibly dirty.
    • Avoid touching: Avoid touching your eyes, nose, and mouth with unwashed hands.

• Avoid sharing personal household items

• • • Do not share: You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home.
    • Wash thoroughly after use: After using these items, they should be washed thoroughly with soap and water.

• Clean all “high-touch” surfaces every day

• • Clean and disinfect: 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.
  • 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.

• • • Clean and disinfect areas with bodily fluids: Also, clean any surfaces that may have blood, stool, or body fluids on them.
    • Household cleaners and disinfectants: Clean the area or item with soap and water or another detergent if it is dirty. Then use a household disinfectant. 
      • 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.

• Monitor your symptoms

• • Call your doctor: Before going to your doctor’s office or emergency room, call ahead and tell them your symptoms. 
  • Wear a mask: If possible, put on a mask before you enter the building. If you cannot put on a mask, try to keep a safe distance from other people (at least 6 feet away). This will protect the people in the office or the waiting room.
  • Alert health department: Ask your healthcare provider to call the local health department. Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate.
  • If you develop emergency warning signs for COVID-19, get medical attention immediately. Emergency warning signs include*:
    • Difficulty breathing or shortness of breath
    • Persistent pain or pressure in the chest
    • New confusion or inability to arouse
    • Bluish lips or face

* This list is not all-inclusive. Please consult your healthcare provider for any symptoms that are severe or concerning.

• • Call 911 if you have a medical emergency: If you have a medical emergency and 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.

More great information about what to do if you are sick can be found at:

VDH Resources and Support 

What to do if you are Sick 

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 the following conditions are at increased risk of severe illness from COVID-19. A list of specific medical conditions can be found here.

See Testing for 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

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.

A person who does not have symptoms of COVID-19 and does not have a positive laboratory test for the virus has no responsibility to share information about this virus with others.  It should be shared only at the discretion of the individual and with healthcare providers who need the information to provide necessary medical care services. A person suspected or confirmed to be ill with COVID-19, or confirmed by laboratory test to be infected with the virus should notify contacts who have been exposed so that the contacts can quarantine themselves for 14 days.

COVID-19 is a reportable condition. If you have a confirmed positive lab result, both the lab and your healthcare provider are required to report your status to the local health department and someone from the health department will 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:

• Wear a mask in public places.
• Stay at least 6 feet away from other people.
• Wash your hands with soap and water.
• Avoid crowds and confined spaces.

For more information on reinfection, click here.

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

Contact your doctor if you have symptoms, had an exposure, or have taken part in activities that put you at higher risk for COVID-19 and want to be tested for COVID-19.

Testing may be available at your doctor’s office, urgent care center, pharmacy, or other healthcare clinic. Some testing sites in Virginia are offering community testing events, such as drive-thru testing.

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

Testing capacity at commercial, private, and hospital laboratories performing SARS-CoV-2 testing continues to increase in Virginia.

There are two different types of tests available: viral tests (diagnostic) and antibody tests.

1. A viral (diagnostic) test tells you if you have a current infection. There are currently two types of viral tests that detect the virus that causes COVID-19: molecular tests (e.g., RT-PCR tests) that look for the virus’s genetic material and antigen tests that look for a specific protein on the surface of the virus. Antigen tests can be easy to run and affordable but are not always as accurate as molecular tests.
2. An antibody test might tell you if you had a past infection. An antibody test might not show if you have a current infection because it can take 1–3 weeks after infection for your body to make antibodies. Having antibodies to the virus that causes COVID-19 might provide protection from getting infected with the virus again. If it does, we do not know how much protection the antibodies might provide or how long this protection might last.

For more information about differences between the different types of tests, please visit VDH’s Testing Webpage.

If you have symptoms, plan to travel, or had an exposure and want to get tested for COVID-19, please contact your healthcare provider. Testing should also be considered if you have taken part in activities that put you at higher risk for COVID-19 because you could not physically distance as needed, such as attending large social or mass gatherings, or being in crowded indoor settings. Your provider may collect samples to test you or help you to find sampling sites in your area. For additional information on testing sites in your area, visit VDH COVID-19 Testing Sites.

Even if you test negative during your quarantine period from an exposure, VDH still recommends that you complete a full 14-day quarantine before going back to work or being around others. Count your date of last exposure as Day 0. If you are not able to stay home for 14 days after your exposure and you do not have symptoms, you may leave home after Day 7 with a negative PCR or antigen test performed on or after Day 5.

Results from point-of-care tests may be available at the testing site in less than an hour. Other viral tests must be sent to a laboratory for analysis, a process that can take a few days. Some jurisdictions are experiencing a high demand for testing, which may cause a delay in processing tests and providing results.

FDA recently provided emergency use authorization for the first over-the-counter fully at-home diagnostic antigen test for COVID-19. The Ellume COVID-19 Home Test detects fragments of proteins of the SARS-CoV-2 virus from a nasal swab sample. This test can be used in persons 2 years of age or older. Results can be provided in as little as 20 minutes. 

Similar to other antigen tests, a small percentage of false positive and negative results from this test may occur. Therefore, for people without symptoms, positive results should be treated as presumptively positive until confirmed by another test as soon as possible.

Individuals with positive results should isolate and seek additional care from their health care provider. Individuals who test negative and experience COVID-like symptoms should follow up with their health care provider as negative results do not rule out COVID-19. 

The Ellume COVID-19 Home Test uses a mid-turbinate nasal swab (sample is collected further back than the usual nasal swab), but not as far back as nasopharyngeal swabs. 

The Ellume COVID-19 Home Test correctly identified 96% of positive samples and 100% of negative samples in individuals with symptoms. In people without symptoms, the test correctly identified 91% of positive samples and 96% of negative samples.

Information on at home testing is available from the CDC here.

PCR testing for COVID-19 is very sensitive. CDC and other scientists have found that PCR tests can remain persistently positive for many weeks after infection. Despite these persistently positive test results, scientists have not been able to culture live virus from these samples. So, it appears that the PCR tests that are performed within 90 days of infection and that are positive are really picking up dead viral fragments. In addition, there have been very few cases of documented COVID-19 reinfection. The data so far indicate that reinfection within 90 days does not occur. For these reasons, retesting of asymptomatic people within 90 days of their initial infection is not generally advised.

VDH recommends the following:

For persons previously diagnosed with COVID-19 who remain asymptomatic after recovery, retesting is not recommended within 90 days after the date of symptom onset for the initial COVID-19 infection, even if the person had close contact with an infected person. Quarantine is not recommended even if the person had close contact with an infected person as long as the person has recovered, already met requirements for release from isolation, and has remained asymptomatic since the new exposure; the person should continue to take all recommended measures to prevent SARS-CoV-2 transmission (i.e., wear a mask, stay 6 feet away from others, avoid crowded settings, and wash hands often).

For persons who develop new symptoms consistent with COVID-19 within 90 days after the date of initial symptom onset and there is no alternative etiology (e.g., influenza) to explain the symptoms, the person may warrant COVID-19 retesting. Consultation with infectious disease or infection control experts is recommended, especially if the symptomatic person had close contact with an infected individual in the past 14 days. Persons being evaluated for reinfection should isolate under recommended precautions while being evaluated. If SARS-CoV-2 reinfection is confirmed or suspected, individuals should remain in isolation until they meet the criteria to discontinue isolation. For most people, discontinuation of isolation can be determined with a time-based strategy (i.e., 10 days after symptom onset or first positive test for asymptomatic individuals and at least 24 hours without a fever, without using fever-reducing medication and improvement of symptoms).

These tests tell you if you had a previous infection by looking for antibodies in the blood.  Antibodies are proteins made by the immune system when a germ enters a person’s body. Our immune system helps us fight off germs and diseases. The test uses a blood sample to look for antibodies made in response to SARS-CoV-2 rather than looking for the virus itself. It usually takes 1-3 weeks for the body to make antibodies in response to an infection. We do not know how much protection the antibodies might provide or how long this protection might last.

Antibody tests have limited ability to diagnose COVID-19 and should not be used alone to diagnose COVID-19. Results from these tests should also not be used to make decisions about staffing or the ability of an employee to return to work, the need for available personal protective equipment (PPE), or the need to discontinue preventive measures, like social distancing.

Viral tests check samples from your respiratory system to see if you are currently infected with SARS-CoV-2, the virus that causes COVID-19. How the sample is collected will depend on the test type and testing location. Methods of collection include a nasal swab, throat swab, or saliva sample. The sample may need to be done by a healthcare provider or could be done by self collection. 

Antibody tests check your blood for antibodies, which may show if you had a previous infection.  An antibody test may not be able to show if you have a current infection, because it can take 1-3 weeks after infection to make antibodies. Antibody tests have limited ability to diagnose COVID-19 and should not be used alone to diagnose COVID-19.

At this time, most local health departments are not doing testing for COVID-19. Your healthcare provider will determine if you need to be tested for COVID-19 and might consult with your local health department if needed. If you do not have a healthcare provider, your local health department may be able to help connect you with a healthcare provider or free clinic in your area. Your healthcare provider does NOT need VDH approval for testing through a private lab.

If testing in the private sector is not available, clinicians may request testing for patients at DCLS by contacting the local health department.

Testing is available through Virginia’s state public health lab, the Division of Consolidated Laboratory Services (DCLS), for people who meet the high priority and priority testing criteria, found here (Updated December 14, 2020).

VDH Recommendations for prioritizing SARS-CoV-2 testing

* Description of symptoms associated with COVID-19.

† A close contact is any person who was within 6 feet of an infected person for a total of 15 minutes or more over a 24-hour period or who had exposure to respiratory secretions from an infected person (e.g., being coughed or sneezed on, sharing a drinking glass or utensils; kissing), starting from 2 days before the person became sick (or 2 days before specimen collection if asymptomatic) until the person was isolated. If testing is not readily available, prioritize testing of symptomatic close contacts or those at increased risk for severe COVID-19. If there is a known exposure date, it is reasonable to test asymptomatic close contacts 5 days or more after the date of last exposure. If the close contact is tested too early, the test might not be able to detect COVID-19 infection. Close contacts who do not have symptoms and test negative for COVID-19 should still complete the full 14-day quarantine. VDH and CDC continue to recommend a 14-day quarantine period as the safest option. If the person cannot stay home for the full 14 days after exposure and does not have symptoms, the person may end quarantine earlier. Counting the date of last exposure as Day 0, the person may leave home after Day 10 without testing or after Day 7 with a negative PCR or antigen test performed on or after Day 5. If the person does not stay home for the recommended 14 days, the person should continue monitoring for symptoms and follow all other recommendations (e.g., wear a mask, watch their distance, and wash hands often) for the full 14-day period after the last exposure.

Critical infrastructure workers are defined by the Cybersecurity & Infrastructure Security Agency (CISA) in their Guidance on the Essential Critical Infrastructure Workforce: Ensuring Community and National Resilience in COVID-19 Response. Of note, workers in the education sector or those who support the education sector were recently added as critical infrastructure workers.

¶ Vulnerable populations include low-income individuals and families; people of color (i.e. Black or African American, Hispanic or Latino); individuals defined by CDC as having increased risk of severe COVID-19 because of older age or medical condition (e.g., hypertension, diabetes, asthma, chronic obstructive pulmonary disease [COPD]) or requiring extra precautions (e.g., individuals living in rural communities, people experiencing homelessness, women who are pregnant or breastfeeding, people with developmental and behavioral disorders); individuals living in multi-generational households; individuals who are uninsured or underinsured; and individuals living with disabilities, access, or functional needs.

** Testing for outbreak investigations means confirming the presence of an outbreak (i.e., two or more laboratory-confirmed cases within a 14-day period). Typically, this involves testing specimens from 2–5 persons. If an outbreak is confirmed, VDH might recommend additional testing at a private/commercial or a public health laboratory, depending on the affected setting.

†† Community testing events are often designed to reach vulnerable populations.

§ A point prevalence survey (PPS) involves testing all people in a facility at a specific point in time, regardless of symptoms. There are different types of PPS. A baseline PPS can be performed, regardless of whether sporadic COVID-19 infections have been previously identified. A PPS can also be performed after an outbreak has been confirmed as part of the overall outbreak response. Examples of when public health is likely to recommend testing at a private/commercial laboratory include facility-wide testing in child care facilities, K-12 schools, institutes of higher education, and workplaces. For additional information on how public health prioritizes PPS, see here. For assistance with point prevalence surveys, please contact your local health department.

If you test positive for COVID-19 by a viral test, you should isolate and follow your healthcare providers guidance on steps to take if you are sick. If you are a healthcare or critical infrastructure worker, notify your work of your test result.  Please see this link for additional information on what to do if you are sick: What to Do If You Are Sick

If you test negative for COVID-19 by a viral test, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. The test result only means that you did not have COVID-19 at the time of testing. You might test negative if the sample was collected early in your infection and test positive later during your illness. You could also be exposed to COVID-19 after the test and get infected then.​ It is important to note that viral antigen tests are not as accurate as viral molecular tests, and to discuss the implications of this with your healthcare provider.

Except in instances in which viral testing is delayed, antibody tests should not be used to    diagnose a current COVID-19 infection. An antibody test may not show if you have a current COVID-19 infection because it can take 1–3 weeks after infection for your body to make antibodies.

A positive test result shows you may have antibodies from an infection with the virus that causes COVID-19. However, there is a chance a positive result means that you have antibodies from an infection with a virus from the same family of viruses (called coronaviruses), such as the one that causes the common cold.  Having antibodies to the virus that causes COVID-19 may provide protection from getting infected with the virus again. If it does, we do not know how much protection the antibodies may provide or how long this protection may last. Talk with your healthcare provider about your test result and the type of test you took to understand what your result means. Your provider may suggest you take a second type of antibody test to see if the first test was accurate. You should continue to protect yourself and others since you could get infected with the virus again. If you work in a job where you wear personal protective equipment (PPE), continue wearing PPE. You may test positive for antibodies even if you have never had symptoms of COVID-19. This can happen if you had an infection without symptoms, which is called an asymptomatic infection.

Regardless of whether you test positive or negative, the results do not confirm whether or not you are able to spread the virus that causes COVID-19. Until we know more, continue to take steps to protect yourself and others.

You can find more information about serology tests on VDH’s COVID-19 Testing Site.

If you test negative for antibodies (blood test), that means you may not have ever had COVID-19. Talk with your healthcare provider about your test result and the type of test you took to understand what your result means. You could still have a current infection. The test may be negative because it typically takes 1–3 weeks after infection for your body to make antibodies. It’s possible you could still get sick if you have been exposed to the virus recently. This means you could still spread the virus. Some people may take even longer to develop antibodies, and some people who are infected may not ever develop antibodies.

If you get symptoms after the antibody test, you might need another test called a viral test​.

Regardless of whether you test positive or negative, the results do not confirm whether or not you are able to spread the virus that causes COVID-19. Until we know more, continue to take steps to protect yourself and others.

You can find more information about serology tests on VDH’s COVID-19 Testing Site.

Ct stands for “Cycle Threshold.” Ct is a number generated during a PCR test. The Ct number refers to the number of cycles needed for a sample to grow and cross a cutoff point (threshold) where it changes from negative (not detectable) to positive (detectable).

Ct values and cutoffs differ by test and cannot be compared from one test to another. Some PCR tests also do not use Ct values but use a different value instead to report the test being positive or negative.

PCR positive results and the Ct values cannot determine infectiousness. More research is needed to determine the amount of virus necessary to infect someone else. Viral load changes drastically over the course of infection. 

For more information on Ct values, refer to the CDC Lab FAQs for Interpreting Results of Diagnostic Tests and the Association of Public Health Laboratories (APHL) resource: ‘Ct Values: What They Are and How They Can be Used.’

Healthcare workers or frontline responders who are ill with symptoms of COVID-19 (fever, cough, shortness of breath, chills, muscle pain, sore throat, new loss of taste/smell), or are well and want to discuss testing, should contact their healthcare provider. Some employers may provide testing through their occupational health program.

Some local areas are offering drive-through testing for people with symptoms of COVID-19. You can find more information about testing sites in Virginia at this website. Each facility has different policies and procedures for testing; please reach out to the individual facility for information about testing availability and procedures.

Having additional access to COVID-19 testing is helpful to residents but VDH does not endorse any one type of testing over others. Please contact your healthcare provider if you are sick.

Certain counties do send someone out to test you at your home, however the majority do not. Please contact your healthcare provider to determine if testing is needed. If the healthcare provider determines that testing is indicated, they might either collect samples to test you or provide you with information about where you can go locally for testing.

Your healthcare provider will determine if you need to be tested for COVID-19 and might consult with your local health department if needed. If your healthcare provider has determined that you do not need to be tested for COVID-19, you should follow your healthcare provider’s guidance regarding any necessary treatment or self-care.

Yes, this is possible. If you test negative for COVID-19, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. It is possible that you were very early in your infection when your sample was collected and that you could test positive later. Or you could be exposed later and then develop illness. In other words, a negative test result does not mean you won’t get sick later. This means you could still spread the virus.

As of March 18, many insurance plans cover the cost of testing and other related health care costs. Testing costs are variable depending on what type of test is ordered (PCR/molecular or antigen test) and the source of provider for such tests. For specific information about your health insurance coverage, call your insurance company. You can usually find their phone number on your insurance card. Most insurance covers testing costs without a co-pay. You will also find information about insurance and COVID-19 testing costs here. Some testing sites might have additional fees that aren’t covered by insurance so it is a good practice to ask about all costs before getting tested.

Uninsured or under-insured people in Virginia with COVID-19 symptoms can get tested through the state public health lab for free. Please contact a free clinic, federally qualified health center (FQHC), or emergency department to have the specimen collected, or visit www.coverVA.org to see if you qualify for Medicaid. Your local health department might also be able to connect you with free clinics or FQHCs in your area.

Most insurance plans cover the cost of testing and related health care costs.  For specific information about your health insurance coverage, call your insurance company.  You can usually find their phone number on your insurance card. Most insurance covers testing costs without a co-pay.  You will also find information about insurance and coronavirus costs here.

Uninsured or underinsured people in Virginia can obtain testing from the state public health lab or a commercial laboratory if they meet the testing criteria. People without insurance are encouraged to contact a free clinic, federally qualified health center (FQHC), or urgent care center to have the specimen collected. Visit https://coverva.org/ to see if you qualify for Medicaid. Your local health department might also be able to connect you with free clinics or FQHCs in your area.

You will get your test results from the healthcare professional or facility that collected your specimens. Ask your healthcare provider, when they collect your specimen, what the best way to get your results is. Most clinics and health care professionals are providing results by telephone.

While VDH does receive COVID-19 test results from private labs, including both positive and negative results, the best way to know how you will get your results is to talk with your healthcare provider.

PCR and rapid antigen tests are both two types of diagnostic tests for COVID-19. PCR tests are considered the “gold standard” for diagnosing COVID-19. PCR tests are highly accurate and usually do not have to be repeated. Rapid antigen tests are usually highly accurate, but false positives can occur. Rapid antigen tests are more likely to miss an active COVID-19 infection compared to molecular tests. Your health care provider may order a PCR test if your antigen test shows a negative result but you have symptoms of COVID-19.

VDH provides a chart comparing different types of coronavirus tests.

Check out the following websites:

CDC COVID-19 Testing Website

CDC COVID-19 FAQs

VDH COVID-19 Website

VDH COVID-19 Testing

VDH COVID-19 Testing Sites (Information on One-Day Testing Events is located in the table below the map)

For mild illness, treatment consists of supportive care, relief of symptoms, drinking plenty of fluids, staying home to rest, and practicing home isolation and physical distancing within the household to avoid spreading infection to others. Over-the-counter (OTC) medication can help with symptoms (see the table here). Children under the age of 6 years should not be given OTC cough or cold medications; they offer little benefit and may have serious side effects. All OTC medication should be used according to the package instructions. For most persons with mild illness, these measures may be all that is needed. If a person is considered high risk, their healthcare provider may recommend treatment with a monoclonal antibody, such as bamlanivimab or casirivimab plus imdevimab, for mild illness. These individuals should contact their healthcare provider as soon as symptoms start.

For people with more serious illness, you should call your healthcare provider and follow their recommendations for treatment and self-care.

For 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, immediate medical attention is needed 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, for use in adults and children aged 12 years or older for the treatment of COVID-19 requiring hospitalization. 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 being studied as a treatment for COVID-19. Gilead Sciences Inc., the pharmaceutical company that makes remdesivir, received approval from the U.S. Food and Drug Administration on October 22, 2020 to allow the medication to be utilized by hospitalized COVID-19 patients who are adults and children aged 12 years or older. Children younger than 12 years of age may receive remdesivir through an Emergency Use Authorization (EUA).

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.

Monoclonal antibodies are antibodies (proteins) made in a laboratory. They come from patients who have successfully recovered from an infection by mounting an immune response. Antibodies are proteins made by a person's immune system to fight an infection. Antibodies bind to the virus (or other type of germ) to prevent entry into a person’s cells.

FDA has issued an emergency use authorization for the monoclonal antibody called bamlanivimab, as well as for the combined monoclonal antibodies casirivimab and imdevimab, 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.)

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 provided one way for 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.

No, it is not.  Drinking or injecting bleach is VERY dangerous and can cause serious illness or death. Please consult a licensed physician or other healthcare provider for treatment recommendations.

Please see the Vaccination section for more information.

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:

• • 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 illness is mild.
  • Practice physical distancing, staying at least 6 feet from others if you have to go out.
  • Avoid in-person gatherings. Both small gatherings, such as dinner parties and birthday parties, and large gatherings, such as weddings and funerals, pose a risk of spreading COVID-19 among communities. This is especially true if there is a high level of community transmission.  
  • Social gatherings in Phase Three are limited to 25 people, and physical distancing and mask use should be maintained. 
  • Older adults and those with other risk factors are recommended to stay home if possible
  • Wear a mask when you are in public
  • Get vaccinated when it is your turn

It is very important that people with even mild signs of illness (fever, cough, chills, muscle pain, sore throat, or new loss of taste or smell) stay home to prevent spreading illness to others!

Social distancing, also called “physical distancing,” means keeping a safe space between yourself and other people who are not from your household.

Social distancing should be practiced in combination with other everyday preventive actions to reduce the spread of COVID-19, including wearing masks, avoiding touching your face with unwashed hands, and frequently washing your hands with soap and water for at least 20 seconds.

To practice social or physical distancing, stay at least 6 feet (about 2 arms’ length) from other people who are not from your household in both indoor and outdoor spaces.

Even when staying six feet apart, try to limit the amount of time you are in contact with people you do not live with. A quick trip to the grocery store for a few essential items is less risky than spending several hours at a party, even if you stay six feet away from others at the party. Outdoor gatherings are safer than those held indoors.

“The curve” refers to a graph of the number of new cases of COVID-19 per day.  Flattening the curve means we want to push the number of new cases reported each day down as much as we can.  The current aim of the global response is to slow, or stop, the transmission of coronavirus. This way, fewer people become infected at the same time. If many people become infected with the virus at the same time, this could overwhelm the medical care system – this is what we are actively trying to avoid.  

Current infection prevention and control measures such as physical distancing, wearing masks, closing or modifying schools, bar seating, and restricting capacity at fitness centers, restaurants, etc. are all ways to reduce places where people can congregate.  This is done to help reduce the number of new infections. By following these practices, we can all help slow the spread of COVID-19 and prevent the healthcare system from becoming overwhelmed with patients.

If COVID-19 is spreading in your community, you should take the following steps:

• Stay informed about local COVID-19 activity and be aware of school, work, and local closures.
• Put distance between yourself and others.
• Avoid contact with sick people.
• Stay in touch with others by phone or email.
• Take care of the emotional health of your household members and yourself.
• Stay home if you are sick or if you are caring for a member of your household that is sick.
• Follow your household plan of action.
• Avoid taking public transportation such as buses, trains, taxis, or ride-shares, when possible.
• Limit your child’s interactions with additional children and adults outside of childcare or school to decrease risk.
• Limit your contact with others and avoid public spaces, public activities, and group gatherings.
• Wear a mask when out in public.
• Get vaccinated when it is your turn

Please visit the following websites for more information about creating a household plan and managing stress and anxiety:

Household Plan

Managing Anxiety and Stress

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. Vaccine has just become available in the U.S. as of December 14, 2020 and vaccination efforts have started for priority groups (e.g., healthcare personnel).. Also, it’s not clear if previous infection with the virus that causes COVID-19 leads to long-lasting immunity.

Please visit the VDH website to view the most accurate information about cases and the region of the state where they are located. Additional information is available at Virginia.gov.

Coronaviruses appear to spread from person-to-person through respiratory droplets. Currently there is no evidence that you can get COVID-19 from food. Before preparing or eating food it is important always 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.

It may be possible that a person 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.

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.

Check out the following website(s):

CDC COVID-19 FAQs

VDH Prevention Tips

CDC How to Prevent Getting Sick from COVID-19

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. Remember to supervise young children when they use hand sanitizer to prevent swallowing alcohol.

It is up to individual school divisions to consider how this will occur.  Schools will consider creating one-way hallways to reduce close contact and place physical guides, such as tape, on floors or sidewalks to create one-way routes. Where feasible, keep students in the classroom and rotate teachers instead. Guidance suggests staggering class periods by cohorts for movement between classrooms if students must move between classrooms to limit the number of students in the hallway when changing classrooms, and assign lockers by cohort or eliminate lockers altogether.  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 about how their child will return to school in the fall, such as deciding between in-person and virtual learning. The Center for Disease Control (CDC) has designed a tool to help parents, caregivers, and guardians weigh the risks and benefits for consideration in order to make this decision making process easier. It is organized to provide parents and caregivers with general information on COVID-19, and options to consider for virtual, in person and hybrid options, if offered. For many families, back to school planning will look different this year than it has in previous years. Your school will have new policies in place to prevent the spread of COVID-19. You may also be starting the school year with virtual learning components. The CDC has developed checklists that are intended to help parents, guardians, and caregivers, plan and prepare for the upcoming school year.  Please discuss any concern you may have with your local school division.

A close contact who develops symptoms is considered to be a suspected case of COVID-19. The person moves from quarantine to isolation at that point. Isolation can end after 10 days from symptom onset, as long as the person is at least 24 hours fever-free and other symptoms have improved.

For more information, please see here.

VDH recommends that communities and school divisions use the CDC Indicators for Dynamic School Decision-Making framework together with VDH Guidance for Mitigation Measures in K-12 Settings (Pandemic Metrics dashboard) when considering actions related to school decision making.

To review  K-12 activities that are allowed and guidance for Phases II & III, please visit the Department of Education’s Recover, Redesign, Restart 2020 website.

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 have students and staff eat meals in classrooms, while maintaining physical distancing as much as possible, instead of in a communal dining hall or cafeteria. If communal dining halls or cafeterias are used, 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 establishing/updating 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 the upcoming school year.  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). Please contact your health care provider to discuss your child’s medical needs for the upcoming school year.

Yes.  Please continue to focus on your child’s immunization  just as you would for in person learning.  Immunization requirements have not been waived for the 20-21 school year . The Superintendent’s memo 132-20 (5/29/20) regarding health requirements for enrollment is included for your review and below is the link: 

http://www.doe.virginia.gov/administrators/index.shtml

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 entering sixth grade; and a Diphtheria, Tetanus, and Pertussis (Tdap) booster for entry into seventh grade.

These requirements have NOT been waived and families are encouraged to make appointments with their pediatrician or primary care provider now to avoid the "back to school rush".

Children need to continue to get the recommended vaccines on schedule. Vaccines provide individual and community immunity, no matter where you are. 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 just as you would for in person learning.

Emphasis should be placed on cohorting students and limiting the size of groups participating in playground time. Outdoor transmission of virus is known to be much lower than indoor transmission. Masks should be used outdoors, when physical distancing may be difficult.

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.

The key to slowing the spread of COVID-19 and decreasing risk to others is to practice physical distancing. When  school is out, children should consider socially distant ways to play with children from other households. To help children maintain social connections while physical distancing, help your children have supervised phone calls or video chats with their friends.  If children are playing outside their own homes, they should stay 6 feet from anyone who is not in their own household. Make sure children practice everyday preventive behaviors, such as washing their hands often with soap and water and wearing a mask, as developmentally appropriate.

Schools should anticipate and be prepared to address a wide range of mental health needs of children and staff when schools reopen. Preparation for infection control is vital and admittedly complex during an evolving pandemic. But the emotional impact of the pandemic, financial/employment concerns, social isolation, and growing concerns about systemic racial inequity — coupled with prolonged limited access to critical school-based mental health services and the support and assistance of school professionals — demands careful attention and planning as well. Schools should be prepared to adopt an approach for mental health support.

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 and Social Emotional Learning Resources for Parents.

Governor Ralph S. Northam announced new statewide measures to contain the spread of COVID-19.

The measures include the expansion of the existing mask mandate to require children age 5 and older to wear a mask in indoor public settings. Children age 5 and older must wear masks when they are in schools and child care settings. Children are not required to wear masks when exercising , at recess for example. The EO, available on the Governor’s website,.does not provide relief to the mask wearing mandate even when 6 feet of physical distancing is accomplished.

Evidence continues to mount on the importance of universal masking in interrupting the spread of SARS-CoV-2. School staff and students should be able to wear masks safely and consistently and should be encouraged to do so. Children under 2 years and anyone who has trouble breathing or is unconscious, incapacitated, or otherwise unable to remove a mask without assistance should not wear masks.

Exceptions are made for students with medical conditions or disabilities, for whom wearing a mask would pose a threat to their health or safety. Exceptions are also made for those communicating with the hearing impaired.

Additionally, the EO provides that students may remove masks when playing a musical instrument if 10 feet of distance is maintained; or when eating, drinking or exercising.

The American Academy of Pediatrics reminds parents that staying home and physical distancing are still most effective in preventing the spread of the virus, but it offers advice about helping children get accustomed to masks. They are not recommended for those under 2, and there may be some children who can’t wear them — the A.A.P. mentions those with “severe cognitive or respiratory impairments.” On the other hand, immunocompromised children might need more protection than cloth face coverings offer, and N95 masks are recommended.

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.

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, and the individual.

The American Academy of Pediatrics recommends that “when non vigorous exercise is being performed and physical distancing is not possible, a cloth face mask should be worn.” The CDC recommends that “people who are engaged in high intensity activities, like running, may not be able to wear a mask if it causes difficulty breathing.  If unable to wear a mask, consider conducting the activity in a location with greater ventilation and air exchange (for instance, outdoors versus indoors) and where it is possible to maintain physical distance from others.”

The purpose of the public wearing facemasks is to keep exhaled respiratory droplets from reaching others. Masks with one-way valves or vents allow air to be exhaled through a hole in the material, which can result in expelled respiratory droplets entering the environment and  does not prevent the person wearing the mask from transmitting COVID-19 to others. Therefore, CDC does not recommend using facemasks if they have an exhalation valve or vent.

Per the Phase Guidance for Virginia’s preK-12 schools, the state recommends that schools follow CDC guidance to promote behaviors that reduce spread, maintain healthy environments and operations, as well as prepare for when someone gets sick. Virginia’s guidance includes health, safety and physical distancing recommendations aligned with CDC guidance for each phase. 

The CDC school indicators should serve as the starting point to make determinations on what to do in a school, but should not dictate the decisions that school districts make to best serve their individual communities.

Local school divisions should continue to refer to CDC resources for the most up-to-date guidance on best practices for preventing the spread of COVID-19. The Virginia Department of Health (VDH) provides K-12 Guidance in alignment with the phases outlined in the Forward Virginia blueprint. The VDOE also advises local school divisions to work with local health officials and school board counsel on appropriate health and safety practices. In addition, the Virginia Association of School Nurses (VASN) developed a Health Services Recovery Plan resource for school nurses and administrators to plan and prepare for a safe school environment and the delivery of school health services.

The CDC does not currently recommend universal symptom screening for K-12 schools. Parents or caregivers should be 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 should be 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 for quarantine before returning to school. If symptoms persist or worsen they should contact their healthcare provider. 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 Interim Guidance for K-12 for schools and use the School Decision Tree to determine school closing in collaboration with the local health department. Schools should follow 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. The Governor’s phase guidance for public schools recommends remote learning and teleworking options be made available to students and staff that fall into this category.  Please discuss any concern you may have with your local school division.

Many people diagnosed with COVID-19 do not have any symptoms of illness. Public health recommendations have been updated to accommodate new scientific evidence, evolving epidemiology, and the need to simplify risk assessment. The CDC provides guidance based on community exposure, for people exposed to people with known or suspected COVID-19 or possible 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 does 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 to determine when those exposed to or diagnosed with COVID-19 can return to work or school.

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.

For information on the difference, see VDH: Isolation, Quarantine, Movement Restrictions and Public Health Monitoring. VDH and the CDC continue to recommend a 14 day quarantine period but options are available.

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

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

CDC recommends after international travel, get tested with PCR or antigen test 3-5 days after international travel and stay home for 7 days after travel, even if you test negative. If you don’t get tested, it’s safest to stay home for 10 days after travel.

Those who have traveled internationally should not be at school in the time after travel (7 days with negative test, or 10 days with no test).

The recommendation for domestic travel is to consider getting tested 3-5 days after travel and reducing non-essential activities for 7 days after travel, even if you test negative. If you don’t get tested, it’s safest to stay home for 10 days after travel.

The safest thing to do is to reduce non-essential activities (defined here: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/essential-goods-services.html) in the time after travel.

While generic messaging may be shared with the school community regarding a positive   test in the school, neither the student’s name nor other identifying information should 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.

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 mitigation 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

VDH recommends that communities experiencing a low transmission should maintain Forward Virginia Phase 3 mitigation strategies as a baseline as described in the Phase Guidance for Virginia Schools .

School administration and the local health department will work together to discuss the potential impact on in-person and hybrid learning in the school setting. Schools may need to make necessary changes to their individual school district educational plan depending on the level of transmission and the ability of a school to implement mitigation measures. VDH has developed Outbreaks in School Settings – Coronavirus dashboard for schools to help inform local communities about the impact of COVID-19 in K-12 schools and to aid in making decisions that support the health and safety of students and school staff in Virginia. This dashboard lists public and private K-12 schools that are currently experiencing or have experienced a COVID-19 outbreak. Only distinct outbreaks investigated by the local health department and associated cases and deaths related to the school are included. Transmission must occur within the school facility or at a school-sponsored event among students, faculty, staff, or visitors to be classified as a school-associated outbreak.   The presence of an outbreak at a school does not reflect a school's ability to educate its students or to protect the health and safety of its school community. Schools and local health departments work together to identify best practices to prevent and control COVID-19 in schools and to promote a healthy learning environment for students and staff.

The U.S. Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) have created important new 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 visitors and nonessential personnel, as well as restrict group activities, including communal dining, inside nursing homes. While visitor restrictions may be difficult for residents and families, it is an important temporary measure for their protection.

Additionally:

1- Most people will not be able to visit loved ones at this time. Some visitation may be allowed on a case-by-case basis by the facility. 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. 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. Visits should be in the resident’s room, and not in common areas. 

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.

• Set up the following restrictions now:
  • Require residents and staff to wear a mask
    • Limit points of entry to the facility. Visitors, volunteers, and non-essential healthcare staff must be restricted from the facility, except for end-of-life situations.  
  • Restrict all residents to their room and require physical distancing. Cancel all group activities and communal dining.
  • Residents should be allowed to leave only for medically necessary purposes (e.g., hemodialysis), and should wear a mask (if tolerated) when they leave.

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 (LTC) 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. 
  • To mitigate staffing shortages, exposed healthcare staff may continue to work while wearing a mask as long as they remain asymptomatic. Testing exposed, asymptomatic healthcare staff is advised.
• 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.

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.

The residents of long-term care facilities are often older adults with underlying conditions and are considered to be at high-risk for COVID-19. Traveling for holidays to visit family increases their chances of getting COVID-19. Traveling for holidays to visit family increases their chances of getting COVID-19. VDH published Holiday Considerations for Long-Term Care Facility Residents and their Families. This document lists things to consider when making decisions about how to celebrate holidays this year. VDH recommends that residents of long-term care facilities avoid leaving the facility to join family gatherings during holidays this year. A safer alternative is a family visit in the facility. If a resident does choose to leave the facility to celebrate a holiday, they should consider ways to lower their chance of getting COVID-19, such as wearing a mask, washing hands frequently, and quarantining for 14 days after visiting family.

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). According to the CDC guidance document (dated March 21, 2020) “Preparing for COVID-19: Long-term Care Facilities, Nursing Homes,” 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.

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.”

Based on what we know at this time, 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, among pregnant people with COVID-19. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick.

Pregnant women should engage in preventive actions to avoid infection like limiting interactions with people that might have been exposed to or infected with COVIID-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 and disinfecting frequently touched surfaces.

Much is still unknown about the risks of COVID-19 of newborns born to mothers with COVID-19. Preterm (early) birth and other problems with pregnancy and birth, have been reported in babies born to mothers who tested positive for COVID-19. We do not know if these problems were related to the virus. 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.

Current evidence suggests that the risk of a newborn getting COVID-19 from its mother is low, especially when she uses 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 mothers with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggest this is not likely.

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 completed 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 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 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.

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 mother 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.

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.

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

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.

Although there is no vaccine available to protect against the virus that causes COVID-19, 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. 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. Although there is not yet a vaccine to help protect against COVID-19, 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 moms.

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

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

Based on available evidence, children do not appear to be at a higher risk for COVID-19 than adults. While some children and infants have been sick with COVID-19, adults make up most of the known cases to date. Some reports suggest that infants under 1 year old and children with underlying medical conditions, particularly sickle cell disease and chronic kidney disease, might be at higher risk of serious illness from COVID-19 than other children

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.

• 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.
• 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.
• Children over the age of 2 years are encourage to wear masks when in outdoor and indoor public settings.

No. The symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally presented with mild symptoms. Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. It’s not known yet whether some children may be at higher risk for severe illness, for example, children with underlying medical conditions and special healthcare needs. There is much more to be learned about how the disease impacts children.

CDC recommends that everyone 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.

Wearing a mask is a public health measure people should take to reduce the spread of COVID-19 in addition to (not instead of) physical distancing, frequent hand cleaning ,and other everyday preventive actions.

As of November 15, Governor Northam expanded the mask mandate established by Executive Order 63 to require all Virginians aged 5 years and older to wear masks in indoor public settings and business establishments.

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.

Early studies report children of all ages are at risk for COVID-19; however, complications of COVID-19 appear to be less common among children compared with adults based on limited reports from China and the United States. Based on limited data on children with suspected or confirmed COVID-19, infants (<12 months of age) may be at higher risk of severe or critical disease compared with older children, with hospitalization being most common among children aged <1 year and those with underlying conditions, such as chronic lung disease (including asthma), cardiovascular disease, and immunosuppression.

CDC is still working to understand MIS-C and its effects on children.  We do not yet know which children are at risk for developing MIS-C.

At this point it is not clear. In the United States, 2% of confirmed COVID-19 cases occurred in children aged <18 years. However, that figure might change as more information becomes available. Providers who have cared or are caring for patients younger than 21 years of age meeting MIS-C criteria should report suspected cases to their local health department.

Providers should send any child with any combination of severe inflammatory symptoms to the hospital for further evaluation. These symptoms may include (but are not limited to) persistent fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extreme fatigue; However, not all children will have the same symptoms, and some children may have symptoms not listed here. More information is available on the CDC website.

At the hospital, further assessment will be conducted based on the child’s clinical condition, laboratory results, and X-rays or other imaging studies. Treatment will be provided to try to relieve the child’s symptoms and inflammation.

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.

Currently we do not know a lot about MIS-C. Any child suspected to have MIS-C should be placed in a private room (if available) on transmission-based precautions. 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.

Based on what we know now, VDH recommends taking everyday actions to prevent children from getting COVID-19. These actions including 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 or the use of child care.

1. 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.

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.

CDC: Multisystem Inflammatory Syndrome in Children (MIS-C)
CDC: Considerations for Inpatient Obstetric Healthcare Settings
CDC: Evaluation and Management Considerations for Neonates At Risk for COVID-19
CDC: Health Advisory for Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19)

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