General FAQ

Note: This information is based on currently available evidence, resources, information, emergency use authorization, and expert opinion, and is subject to change.

COVID-19 Basics
  • General Questions

    Coronaviruses are a group of viruses that can cause illness in people and animals.The common cold is an example of an illness that can be caused by one of four milder types of coronaviruses.

    SARS-CoV-2 is the name of the specific type of coronavirus that causes COVID-19. “SARS” stands for Severe Acute Respiratory Syndrome, the name of the group of symptoms that is seen in the most severe COVID-19 cases. “CoV” stands for coronavirus. This SARS-CoV-2 virus is related to the original SARS virus that emerged in China in 2002, hence the current number “2.”

    COVID-19 (“Coronavirus Disease 2019”) is an infectious respiratory disease caused by a new (novel) coronavirus that initially emerged in Wuhan Provence, China in late 2019.

    Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed COVID-19 cases. The following are some of the COVID-19 symptoms that may appear 2-14 days after exposure to the virus:

    • Fever or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea

    The symptoms of COVID-19 can vary from person to person. Some people with COVID-19 infection have no symptoms (also known as asymptomatic). Children generally experience similar signs and symptoms of illness as adults. 

    Visit VDH’s web page for more information on what to do if you feel sick.

    For more information on symptoms of COVID-19, visit the CDC’s webpage: Symptoms of Coronavirus.For easy to read material on how COVID-19 can make you feel sick, click here.

    For easy to read material on how COVID-19 can make you feel sick, click here.

    Symptoms of COVID-19 typically appear 2-14 days after exposure to someone infected with the virus.

     COVID-19 is spread primarily through three ways: 

    1. The first is by breathing in air when close to an infected person who is exhaling (e.g., quiet breathing, speaking, singing, exercise) aerosol particles and small respiratory droplets that contain the virus. The small droplets and aerosol particles (which are formed when the droplets rapidly dry) are small enough that they can remain suspended in relatively still air for minutes to hours.
    2. Secondly, having these small droplets and particles that contain the virus land on or in the eyes, nose, or mouth, especially through splashes and sprays like when coughing or sneezing.
    3. COVID-19 can also spread by touching the eyes, nose, or mouth with hands that have the virus on them. 

    Spread is more likely when people are in close contact with one another. Close contact includes: being within 6 feet of someone who has COVID-19 for a total of 15 minutes or more over a 24-hour period; providing care at home to someone who is sick with COVID-19; having direct physical contact with someone who has COVID-19 (touched, hugged, or kissed them); sharing eating or drinking utensils with someone that has COVID-19; being sneezed or coughed on, or somehow got respiratory droplets on you from someone who has COVID-19. In K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students are wearing masks the entire time and the school has other prevention strategies in place. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor. This exception does not apply to teachers, staff, or other adults in indoor K-12 settings.

    Although most spread involves sick people passing infectious droplets, some infected people don't ever have symptoms (asymptomatic people) but can still spread the virus. Because this type of asymptomatic spread is possible, it is very important for everyone to follow recommendations for physical distancing, mask wearing, avoidance of poorly unventilated spaces, and hand washing, even if they do not feel sick. It is also critically important to get fully vaccinated as soon as eligible.

    For more information about how COVID-19 spreads, click here. For easy to read material on how COVID-19 spreads, click here

    COVID-19 is primarily transmitted from person-to-person through respiratory droplets and aerosols. These droplets (larger particles) and aerosols (smaller particles) are released when someone with COVID-19 sneezes, coughs, sings, or talks. Current data supports the idea of spread of SARS-CoV-2 (the virus that causes COVID-19) via airborne transmission, another name for aerosol spread. Short-range inhalation of aerosols is a possibility for COVID-19, as with many respiratory pathogens. The virus, in small droplets and particles, can spread from an infected person to others who are more than 6 feet away and even after the infected person has left the space. Airborne transmission is a possibility, particularly in crowded and inadequately ventilated spaces, and when the infected person is breathing heavily, such as when singing or exercising. Certain medical procedures performed in healthcare facilities can also generate fine aerosols. 

    For more information about how COVID-19 spreads, click here.

    The primary and most important mode of transmission for COVID-19 is through close contact from person-to-person. Respiratory secretions or droplets expelled by infected individuals can contaminate surfaces and objects, which can be a source of infection transmission when a person touches surfaces contaminated with virus from an infected person and then touches their mouth, nose, or eyes. However, current epidemiological data and studies show that the risk of getting COVID-19 via this route is considered to be low. Frequent hand washing and cleaning of high-touch surfaces (such as door knobs) with soap or detergent is usually enough to reduce the risk of transmission via contaminated surfaces, as this removes microbes from the surfaces.

    You should, however, disinfect surfaces in the home if someone with a suspected or confirmed case of COVID-19 infection has been indoors within the last 24 hours.

    The virus that causes COVID-19 has been found in semen and in feces of people who are infected with the virus. Transmission through respiratory droplets is more likely when people are in close unmasked contact with one another (within about 6 feet)

    The virus that causes COVID-19 has not been detected in drinking water. Conventional water treatment methods that use filtration and disinfection, such as those in most municipal drinking water systems, should remove or inactivate the virus that causes COVID-19.

    There is no evidence that the virus that causes COVID-19 can be spread to people through the water in pools, hot tubs, spas, or water play areas. Proper operation and maintenance (including disinfection with chlorine and bromine) should inactivate the virus in the water. The virus that causes COVID-19 is transmitted primarily through close contact with other people. It is important that people take steps to protect themselves from exposure to COVID-19, especially while there is on-going community transmission of the virus.

    There is no evidence that either ticks or mosquitoes can transmit the virus that causes COVID-19.

    Everyone is at risk if they are exposed to COVID-19. However, older adults and people with underlying medical conditions are at increased risk for severe COVID-19 illness.

    It is especially important for people at increased risk of severe illness from COVID-19, and those who live with them, to protect themselves from getting COVID-19.

    When assessing a person’s risk of exposure to COVID-19, the formal definition of close contact means being within 6 feet of a person with COVID-19 for a cumulative total of 15 minutes or more over a 24-hour period or having exposure to the person’s respiratory secretions (for example, being coughed or sneezed on; sharing a drinking glass or utensils; kissing) while they were contagious. For example, briefly walking by someone with COVID-19 in a store is not considered close contact. In K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students are wearing masks the entire time and the school has other prevention strategies in place. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor. This 3-6 foot exception does not apply to teachers, staff, or other adults in indoor K-12 settings.

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

    Contact tracing is a method often used by public health authorities to prevent the spread of disease. For COVID-19, contact tracing means ensuring that everyone who has been in close contact with a person diagnosed with COVID-19 is aware that they might have been exposed. The health department will check-in on the health status of people potentially exposed to the virus and provide them with information about how to prevent the further spread of disease, including the importance of self-quarantine (which means staying at home and maintaining distance from others) and what to do if symptoms develop.  

    More information about contact tracing can be found here

    If you have been in close contact with someone who tested positive for COVID-19, even while one or both of you were wearing a mask, you may still be contacted by VDH. In K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students are wearing masks the entire time and the school has other prevention strategies in place. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor.  This exception does not apply to teachers, staff, or other adults in indoor K-12 settings.

    For those with access to the internet, the best sources of up-to-date information on COVID-19 are the Virginia Department of Health website and the Centers for Disease Control and Prevention website. You can also call 877-ASK-VDH3 for additional information or look at the Frequently Asked Questions (FAQs) on the VDH website.

    No.

    UV light or lamps should not be used to disinfect your skin. UV radiation can irritate or harm your skin and eyes. If you need to clean up, wash your hands with soap and water, use a hand sanitizer with at least 60% alcohol or take a shower and put on clean clothes. 

    Additional information about COVID-19 facts can be found here.

     

    Anyone, regardless of race, ethnicity, or social class can get COVID-19. People can fight stigma and help, not hurt, others by providing social support. Counter stigma by learning and sharing facts. Communicate the facts that viruses do not target specific racial or ethnic groups. Share the facts on how COVID-19 actually spreads to help stop stigma.

    The CDC is constantly monitoring for emerging diseases and responding to disease outbreaks across the globe. For a list of current outbreaks CDC is responding to, you can visit the CDC’s outbreak website.

    Ensure that masks have two or more layers of washable, breathable fabric, completely cover your nose and mouth, and fit snugly against the sides of your face without gaps. 

    CDC has suggested a number of ways to improve fit of masks to provide extra protection. Wearing two masks (double-mask) is one way to achieve this; that is a disposable mask underneath and a cloth mask on top. You may also wear a cloth mask with a fitter or a brace for a better fit. A CDC report showed that wearing a cloth mask over a medical procedure mask provided more protection to the person wearing the masks as well as more protection to others (source control).

    Another suggestion for a better fit includes knotting and tucking ear loops of a 3-ply mask where they join the edge of the mask. A YouTube tutorial showing how to do this can be found here. 

    If you choose to wear a gaiter, make sure it has two layers or fold it to make two layers, for better protection.

    You will still be required to wear a mask in certain situations, even if you are vaccinated. You should wear a mask in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. 

    Respirators and surgical masks must meet FDA standards to confirm their performance. To help the public make informed decisions about other types of masks they might purchase, ASTM International developed a new Barrier Face Covering standard (number F3502-21). ASTM International worked with CDC's National Institute for Occupational Safety and Health on this standard. Masks that meet the standard passed certain design and performance requirements. Masks are tested for how well they fit, how well they filter large and small air particles and how breathable they are. CDC provides a list of ASTM F3502 compliant products here. If you have questions about a particular mask, contact the manufacturer directly for test reports and other inquiries.

    At the top of all VDH web pages, there is a Google Translate button that says 'Select Language.' Clicking on this button translates web page content into 100+ different languages immediately. From there, you can go to the main COVID-19 page at: https://www.vdh.virginia.gov/coronavirus/ where you can learn more about COVID-19. 

    The vdh.virginia.gov website is providing the “Google Translate” option to assist you in reading the vdh.virginia.gov website in languages other than English. Google Translate cannot translate all types of documents, and may not provide an exact translation.

    En la parte superior de todas las páginas web del VDH, hay un botón del Traductor de Google que dice "Seleccionar idioma". Al hacer clic en este botón, el contenido de la página web se traduce a más de 100 idiomas diferentes inmediatamente. Desde allí, puede ir a la página principal de COVID-19: https://www.vdh.virginia.gov/coronavirus/ donde puede obtener más información sobre el COVID-19.

    El sitio web vdh.virginia.gov ofrece la opción "Traductor de Google" para ayudarlo a leer el sitio web de vdh.virginia.gov en otros idiomas además de inglés. Google Translate no puede traducir todos los tipos de documentos y es posible que no proporcione una traducción exacta.

    Virginia Questions

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

     

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

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

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

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

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

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

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

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

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

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

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

    • You should get tested 3-5 days after exposure, and wear a mask in public indoor settings for 14 days or until they receive a negative test result.
    • You should also monitor for any symptoms of COVID-19 for 14 days following exposure
    • If you experience any symptoms during this period then you should isolate, get tested if indicated, and inform your healthcare provider of your vaccination status at the time of presentation to care.

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

    • If you do have COVID-19 then, you should inform your provider about your vaccination status at the time of presentation to care.

    More information on isolation, quarantine and public health monitoring is available here.

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

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

    Information on COVIDWISE can be found here.
    FAQs regarding COVIDWISE can be found here.

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

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

    If you are exposed to someone with COVID-19, your local health department may ask you to check in with Sara Alert™. Sara Alert™ is a tool developed by the national non-profit MITRE, in collaboration with state and national public health organizations. If you are identified as being exposed to COVID-19 by your local health department, you will get a message from Sara Alert™ each day and answer a few questions about how you’re feeling. The message will come from 844-957-2721 or an email from notifications@saraalert.org. By checking in with Sara Alert™, you can let the health department know how you’re feeling and help to slow the spread of COVID-19 in your community. Learn more about How Sara Alert™ Works.

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

    Information on Sara Alert can be found here.

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

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

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

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

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

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

    Information regarding these outbreaks can be found here.

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

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

    Disease Prevention

    If you are fully vaccinated, you should wear a mask in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. You do not have to wear masks or practice physical distancing in most outdoor settings. 

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

    FAQs on the public transportation order are available here.On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. In Virginia’s 2021 legislative session, Senate Bill 1303 passed requires schools to provide in-school instruction in accordance, to the maximum extent practicable, with the mitigation strategies provided by the CDC. These mitigation strategies include mask wearing indoors for all students, staff, and visitors regardless of vaccination status. Additional FAQs on the Public Health order can be found here

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

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

    You should also take the following prevention steps:

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

    For more information read VDH’s prevention tips.

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

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

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

    If you are fully vaccinated, you should however wear a mask in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. Check here to see if you are in one of those areas.

     If you are fully vaccinated, you should however wear a mask in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. Fully vaccinated individuals do not have to wear masks or practice physical distancing in most outdoor settings except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.

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

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

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

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

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

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

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

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

    If you are fully vaccinated you should wear a mask in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often.

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

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

    For more information on this topic, please see here.

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

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

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

    If you have been fully vaccinated, you should wear a mask in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. Check here to see if you are in one of those areas. You do not have to wear a mask or practice physical distancing in most outdoor settings except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.

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

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

    In Virginia, an issued Public Health Emergency Order requires universal masking in all indoor settings in public and private K-12 schools for all individuals aged two years and older, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention

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

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

    Visit Considerations for Wearing Masks for additional information from the CDC. 

    See here for more information from VDH.

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

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

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

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

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

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

    Caring for Someone with COVID-19

    CDC Living in Close Quarters

    CDC Caring for Someone Sick

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

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

     

    The following tools identify ways to improve ventilation:

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

    More detailed information can be found here.

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

    Exposure to COVID-19

    A person is said to have a “case” of COVID-19 if their SARS-CoV-2 infection has been confirmed by a laboratory test.

    Close contact is defined as being within 6 feet of a person with COVID-19 for a total of 15 minutes or more over a 24-hour period OR having exposure of any duration 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. Exception: In K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students are wearing well-fitting masks the entire time. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor. This exception does not apply to teachers, staff, or other adults.

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

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

    Exception: In K-12 settings, a student who is within 3-6 feet from an infected student is not considered a close contact as long as both students are wearing well-fitted masks the entire time. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor. NOTE: This exception does not apply to teachers, staff, or other adults.  

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

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

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

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

    • People who have had COVID-19 within the past 3 months as long as they do not develop new symptoms*.
    • People who have been fully vaccinated for COVID-19 as long as they have no symptoms. However, fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3-5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. They should isolate if they test positive.
    • Healthcare personnel (HCP) who are fully vaccinated for COVID-19 do not need to stay home (quarantine) after a workplace or community-associated exposure or be restricted from work as long as they do not have any symptoms and do not have any conditions that weaken the immune system (e.g., organ transplantation, cancer treatment). HCP should continue to follow quarantine recommendations after close contact and follow all travel recommendations. For additional details, see here.
    • People who have been fully vaccinated for COVID-19 and who have either traveled in the United States or arrived back in the United States after traveling internationally. Visit VDH’s Travelers website for information about testing requirements and recommendations for travelers.
    • People who have had close contact with a person who was a close contact to someone with COVID-19 (“contact of a contact”). If your contact person tests positive for COVID-19, then you should stay home (quarantine).

    *It is very important that people who are not fully vaccinated, but who are not required to stay home (quarantine) because they have had COVID-19 in the past 3 months, monitor their health for 14 days after their last exposure and continue following all recommendations (e.g., wear a mask, stay at least 6 feet away from others, avoid crowds and poorly ventilated areas, and wash hands often). Even if you are fully vaccinated, to maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.

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

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

    • Counting your date of last exposure as Day 0, you may leave home after Day 10; or
    • If viral 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. Even 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 are identified as a close contact of a person with COVID-19 and are unvaccinated, VDH recommends being tested immediately and then tested again in 5-7 days after last exposure if the initial test is negative or immediately if symptoms develop during quarantine.

    Fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3-5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. They should self-isolate if they test positive. Fully vaccinated people with ongoing COVID-19 exposure (i.e. household contact) should get tested 3-5 days after their first exposure and again get tested 3-5 days after the end of isolation for the person with COVID-19. They should wear a mask when in contact with the person with COVID-19 throughout the infected person’s isolation period and also wear a mask indoors in public until 14 days after the infected person’s isolation period ends or until the fully vaccinated close contact receives their final test result.

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

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

    • Counting your date of last exposure as Day 0, you may leave home after Day 10; or
    • If PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. If you receive a negative test result before Day 7, you should not leave home yet

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

    Additionally, for unvaccinated individuals CDC recommends being tested immediately after being identified as a close contact and tested again in 5-7 days after last exposure if the initial test is negative or tested immediately if symptoms develop during quarantine. Fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3-5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. They should isolate if they test positive. If you have tested positive for COVID-19 in the past 3 months, you may not need to be tested.

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

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

    Yes. You can lower your risk by having the person with COVID-19 wear a mask, staying at least 6 feet away, wearing a mask yourself, and limiting the amount of time you spend in the room. Having good ventilation in the room, such as by opening windows, can help, too. 

    Fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3-5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. More information can be found on the VDH COVID-19 Testing website here.  

    If you have been identified as a close contact and are not fully vaccinated,you should be tested immediately. If you test negative, you should be tested again 5-7 days after your last exposure or immediately if symptoms develop. If you have tested positive for COVID-19 in the past 3 months, you may not need to be tested. 

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

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

    • Counting your date of last exposure as Day 0, you may leave home after Day 10; or
    • If PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. If you receive a negative test result before Day 7, you should not leave home yet

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

     If you have been in close contact with a person with COVID-19, you should take your temperature twice daily* and remain alert for signs of illness, including fever, cough, chills, muscle or body aches, headache, sore throat, new loss of taste or smell, shortness of breath or difficulty breathing, congestion or runny nose, nausea or vomiting and diarrhea. 

    *NOTE: It is important to not eat, drink, or exercise for at least 30 minutes before taking your temperature.

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

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

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

    VDH Exposure to COVID-19 Website

    Illness from COVID-19

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

    Because the symptoms of COVID-19 can look different in different people, it is important to get tested and/or speak to your healthcare provider if you have any concern.

    You can use the Coronavirus Self-Checker to help determine when to seek testing or medical care.

    Yes. It is possible to test positive for the flu (as well as other respiratory infections) and COVID-19 at the same time. It is important to get vaccinated against both COVID-19 and influenza this year.

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

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

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

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

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

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

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

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

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

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

    You can use the Coronavirus Self-Checker to help determine when to seek testing or medical care.

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

    • Stay home except to get medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-shares, or taxis. Stay in touch with your doctor. Be sure to get care if you feel worse or think it is a medical emergency. 
    • Separate yourself from other people and animals in your home as much as possible and avoid contact with other household members, including pets. This is known as home isolation.
    • Call ahead before visiting your healthcare provider if you think you might have COVID-19, so the healthcare provider’s office can take steps to keep other people from getting infected or exposed.
    • Get tested if you have symptoms, even if you are fully vaccinated. 
    • Wear a mask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. Make sure to remove your mask correctly, wash or store your mask properly and wash your hands after touching a used mask.
    • Cover your coughs and sneezes and dispose of any tissues in a lined trash can. If you are able, wash your hands with soap or use an alcohol-based hand sanitizer that contains at least 60% alcohol right away.
    • Clean your hands often. Avoid touching your eyes, nose, and mouth. Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
    • Avoid sharing personal household items (e.g., dishes, drinking glasses, towels, etc.)
    • Clean all “high-touch” surfaces every day and your “sick room.” Let someone else clean and disinfect common areas but not your bedroom and bathroom. Clean and disinfect any surfaces that may have blood, stool, or body fluids on them. Follow the instructions on the label to ensure safe and effective use of the product. 
      • Tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours (or 2 days) before the person has any symptoms or tests positive. Visit Exposure to COVID-19 to learn more about how to monitor your health and protect your community if you’ve been exposed to a person with COVID-19.  
    • Call 9-1-1 if you have a medical emergency. Emergency warning signs include (but are not limited to): trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse a person, or pale, gray or blue-colored skin, lips or nail beds, depending on skin tone. Please consult your healthcare provider for any symptoms that are severe or concerning.

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

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

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

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

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

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

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

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

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

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

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

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

    For more information, see: 

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

    CDC Interim Guidance on Home Isolation 

     

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

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

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

    The FDA provides information here.

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

     

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

     

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

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

    A CDC MMWR highlighted the fact that being unvaccinated was associated with 2.34 times the odds of reinfection compared with being fully vaccinated.

    For more information on reinfection, click here.

    A breakthrough infection is an infection with the virus that causes COVID-19 even after you have been vaccinated. This is an expected occurrence for a small percentage of those receiving any vaccine, since no vaccine for any disease is 100% effective in preventing infection in every person who receives it. If breakthrough infections occur, they appear to be mild. The COVID-19 vaccines continue to be highly protective against severe illness.

     

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

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

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

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

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

    More information on long-term effects of COVID-19 illness can be found here.

    Body System Conditions noted (subject to change & not mutually exclusive)
    Cardiovascular Myocarditis, heart failure, pericarditis, orthostatic intolerance (e.g., postural orthostatic tachycardia syndrome (POTS))
    Pulmonary Interstitial lung disease, reactive airway disease
    Renal Chronic kidney disease
    Dermatologic Alopecia
    Rheumatologic Reactive arthritis, fibromyalgia, connective tissue disease
    Endocrine Diabetes mellitus, hypothyroidism
    Neurologic Transient ischemic attack/stroke, olfactory and gustatory dysfunction, sleep dysregulation, altered cognition, memory impairment, headache, weakness, and neuropathy
    Psychiatric Depression, anxiety, and post-traumatic stress disorder (PTSD), psychosis
    Hematologic Pulmonary embolism, arterial thrombosis, venous thromboembolism, or other hypercoagulability
    Urologic Incontinence, sexual dysfunction
    Other Weight loss, dysautonomia, vitamin D deficiency, allergies and mast cell activation syndrome, reactivation of other viruses, pain syndromes, and progression of comorbid conditions

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

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

     

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

    UVA Post COVID clinic (Charlottesville, VA)

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

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

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

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

    Treatment for COVID-19

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

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

     

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

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

    Monoclonal antibodies can be used in two different ways: 1) to prevent COVID-19 in someone who has been exposed to the virus, and 2) to treat someone who has COVID-19. 

    The FDA has authorized two combinations of monoclonal antibodies for emergency use as post-exposure prophylaxis (prevention) for COVID-19 in certain adults and pediatric individuals (12 years of age and older weighing at least 40 kg) who are at high risk for progression to severe COVID-19, including hospitalization or death. More information can be found here and here.

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

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

    There are clinical trials underway to see if other 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 and the VDH website here.

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

    The FDA 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. Animal products containing ivermectin SHOULD NOT be used in people. These

    products can cause serious health effects, including death. While there are approved uses for ivermectin in people and animals, it has not been shown to be a safe or effective way to prevent or treat COVID-19

    Please help us protect public health by reporting any animal drug advertising/animal ivermectin products with claims about preventing or curing COVID-19 by emailing FDA-COVID-19-Fraudulent-Products@fda.hhs.gov or calling 1-888-InfoFDA (1-888-463-6332). 

    Ivermectin tablets are approved by the FDA to treat people with intestinal strongyloidiasis and onchocerciasis, two conditions caused by parasitic worms. In addition, some topical forms of ivermectin are approved to treat external parasites like head lice and for skin conditions such as rosacea. If your health care provider writes you an ivermectin prescription, fill it through a legitimate source such as a pharmacy, and take it exactly as prescribed.

    Seek immediate medical attention or call the poison control center hotline (1-800-222-1222) for advice if you have taken ivermectin or a product that contains ivermectin and are having symptoms. Signs and symptoms include gastrointestinal effects (nausea, vomiting, abdominal pain, and diarrhea), headache, blurred vision, dizziness, fast heart rate, and low blood pressure. Other severe nervous system effects have been reported, including tremors, seizures, hallucinations, confusion, loss of coordination and balance, decreased alertness, and coma.

    For more information, please see FDA FAQ: COVID-19 and Ivermectin Intended for Animals and FDA: Why You Should Not Use Ivermectin to Treat or Prevent COVID-19

    COVID-19 Variants

    When the virus that causes COVID-19 infects a human host, it uses the host cells to make copies of itself. As part of this process, called replication, copying errors can occur and the resulting copy is then not an exact genetic match of the “parent” virus. Any changes to the viral genome like this are called mutations. It is normal and expected for many types of virus to constantly change through mutation and some mutations can affect how easily a virus can be spread or can affect the kind of symptoms that develop in infected people. Accumulations of these kinds of mutations can lead to the emergence of new viral variants or strains. 

    Sometimes these new COVID-19 variants emerge for a short time and then disappear – either because the mutations provide no real functional benefit to the virus or because they might negatively impact the way the virus functions. Other times, new variants can emerge that make it easier for the virus to be spread from one person to another, or change the spectrum of disease that we see, or affect the immune system’s ability to protect us from that virus. Another good example of this mutation process is the flu, where we know that the influenza virus changes over time and we all need to get an updated flu vaccine every year to keep us protected from the newest circulating strains (or variants) of the flu. 

    The best way to stop COVID-19 variants from developing in the first place is to stop the spread of the SARS-CoV-2 virus that causes COVID-19.

    Click here for a brief video on “What causes a virus to change?”. 

    The World Health Organization provides information on the effects of virus variants on COVID-19 vaccines.

    Scientists are continually monitoring for genetic changes in the SARS-CoV-2 virus that causes COVID-19. Several variants of the virus have been documented in the United States and globally during this pandemic. (The most recently arrived variant in the United States is the Delta variant.) Information about the characteristics of these variants is rapidly emerging. This information helps us better understand how much the virus is changing and if these changes might affect how the virus spreads and what happens to people who are infected with it.

    For the most up to date information on the variants, including information on where it was first detected and other attributes (including increase in transmission and severity), please see the VDH site: https://www.vdh.virginia.gov/coronavirus/variants/ or the CDC site: SARS-CoV-2 Variant Classifications and Definitions

    See here, for additional information about the Delta Variant. 

    This VDH dashboard lists the number of COVID-19 infections, hospitalizations, and deaths caused by a variant of concern reported in Virginia.

    Public health recommendations to slow the spread of the virus that causes COVID-19 will also work to protect us from these variants. Until you are fully vaccinated, you should keep yourself and others safer by: 

    • Wearing a mask that covers your nose and mouth when you are around people not in your own household, both indoors and in crowded outdoor settings
    • Staying at least 6 feet apart from other people when possible 
    • Keeping away from large crowds and poorly ventilated spaces
    • Washing your hands often

    The World Health Organization (WHO) also classifies variant viruses as Variants of Concern and Variants of Interest. U.S. classifications may differ slightly from those of the WHO because the importance of variants may differ by location.

    More information on the variant viruses can be found on About Variants of Virus that Causes COVID-19 Detected, Emerging SARS-CoV-2 Variants  and Genomic Surveillance for SARS-CoV-2 Variants. 

    First, the Delta variant is now the predominant COVID-19 variant in the United States and in Virginia, having essentially replaced all earlier strains. (Since the week of August 30-September 3, Delta has beens the cause of more than 99% of all new U.S. COVID-19 infections.) This rapid shift has probably occurred because Delta is more contagious than all the other COVID-19 variants that circulated earlier in the pandemic. Being more contagious means that the Delta variant can spread faster from  person-to-person and thus cause many more infections than earlier variants, even in vaccinated individuals. In addition, some early data suggest that the Delta variant is causing more severe illness when it infects unvaccinated people.

    Despite this, the current COVID-19 vaccines remain highly effective at preventing severe COVID-19 disease and death, including from the Delta variant, meaning that unvaccinated people remain the greatest public health and medical concern.

    COVID-19 infections with the Delta can also occur in vaccinated people and people with these symptomatic breakthrough infections apparently can transmit the SARS-CoV-2 virus that causes COVID-19. However, such transmission to other people happens much less frequently from vaccinated people than from unvaccinated people, because (1) vaccinated people get Delta infections much less frequently than unvaccinated people and (2) because fully vaccinated people who do get Delta infections seem to be infectious for a shorter time than unvaccinated people who get Delta infections.

    Because of the ongoing rapid spread and high transmissibility of Delta, and because vaccines are not perfect, masks and other layered COVID-19 prevention strategies are increasingly important for supplementing the societal benefits of COVID-19 vaccines.

    The most recent data and other information on the Delta variant can be found here

    A US government interagency group has recently updated developed a Variant Classification scheme that defines four classes of SARS-CoV-2 variants:

    The World Health Organization (WHO) also classifies variant viruses as Variants of Concern and Variants of Interest. U.S. classifications may differ from those of the WHO because the importance of variants may differ by location.

    More information on this topic can be found here and here.

    A US government interagency group developed a Variant Classification scheme that defines three classes of SARS-CoV-2 variants:

    The World Health Organization (WHO) also classifies variant viruses as Variants of Concern and Variants of Interest. U.S. classifications may differ from those of the WHO because the importance of variants may differ by location.

    More information on this topic can be found here and here. 

Testing for COVID-19
  • Testing for COVID-19

    COVID-19 viral tests check samples from your respiratory system (e.g., nose, throat) 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 specific test that is used. The test might be based on a nasal swab, throat swab, or saliva sample. This VDH infographic is a resource for patients about what to expect when they have a specimen taken with a nasopharyngeal (NP) swab as part of a COVID-19 test. The sample may need to be collected by a healthcare provider or could be done by self-collection. 

    Antibody (serology) tests check your blood for antibodies to SARS-CoV-2 that would show whether you had a past infection.  An antibody test will 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 should not be used to identify active (current) COVID-19 illness or to make decisions about returning to work or school, traveling, using personal protective equipment (PPE), or the need to stop following disease prevention measures like wearing a mask, physical distancing, or avoiding crowded or poorly ventilated places.

    1. A viral (diagnostic) test tells if you have a current or recent infection. Two types of viral tests can detect the virus that causes COVID-19: (1) molecular tests (e.g., RT-PCR tests) look for the virus’s genetic material, and (2) antigen tests look for a specific protein that is part of the virus. Antigen tests can be easy to run and affordable, but are not always as accurate as molecular tests.

    2. An antibody (serology) test might tell you if you had a past infection. An antibody test would probably not show if you have a current infection because it can take 1–3 weeks after an infection starts for your body to make antibodies. Having antibodies to the virus that causes COVID-19 might provide some protection from getting infected with the virus again but, 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 the different types of tests, please visit VDH’s Testing Webpage.

    You can also use CDC’s COVID-19 Viral Testing Tool to help you understand COVID-19 testing options. The tool helps individuals determine what type of test they should seek. After test results are in, the tool can help interpret test results and guide next steps.

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

    COVID-19 testing is widely available and 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. If you cannot get to a testing location, you and your healthcare provider might also consider either an at-home collection kit or an at-home test. More information about currently available self-collection kits and self-tests can be seen on this VDH table. Contact your healthcare provider to see if one of these is right for you and available in your area.

    VDH strongly recommends COVID-19 viral testing for the following people:

    • People with symptoms or signs of COVID-19 regardless of vaccination status
    • Most people who have had close contact with someone known or suspected to have COVID-19
      • Fully vaccinated people should be tested 3-5 days following a known exposure to someone with suspected or confirmed COVID-19, even if you don’t have symptoms. Following a high risk exposure, fully vaccinated asymptomatic HCP should have a series of two viral tests for SARS-CoV-2 infection. In these situations, testing is recommended immediately (but not earlier than 2 days after the exposure) and, if negative, again 5–7 days after the exposure.
      • People who are not fully vaccinated should be tested immediately after a known exposure, again at 5-7 days following exposure if the first test is negative, and immediately if symptoms develop during quarantine.
      • NOTE: People who tested positive for COVID-19 within the past 3 months and recovered do not need to get tested after exposure as long as they do not have symptoms.
    • People who participate in activities that are higher risk for COVID-19 exposure (e.g. travel, attending large events, or being in crowded indoor settings)
    • People who have been referred for COVID-19 testing by their healthcare provider or state/local health department   
    • People who plan to travel or who have recently returned from travel with some exceptions for fully vaccinated people traveling only in the United States
    • People who are not fully vaccinated and who plan to visit people at high risk of developing severe COVID-19
    • People without symptoms of COVID-19 who have no known exposures to COVID-19 but wish to help public health officials understand how many people are infected (known as surveillance testing) may be considered. 

    You can use the Coronavirus Self-Checker to help determine when to seek viral testing or medical care. 

    Your healthcare provider may collect samples to test you or help you find testing sites in your area. For additional information on testing sites in your area, visit VDH COVID-19 Testing Sites. If you cannot get to a testing location, you and your healthcare provider might also consider having you use either an at-home collection kit or an at-home test. More information about currently available self-collection kits and self-tests can be seen on this VDH table. Contact your healthcare provider to see if one of these is right for you and available in your area.

    Even if you test negative during your quarantine period after a known exposure, VDH recommends that you complete a full 14-days of quarantine before being around other people. Count your date of last exposure as Day 0. 

    NOTE: A slightly riskier approach to COVID-19 prevention is that 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 if you have a negative PCR or antigen test performed on or after Day 5. 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 who are not fully vaccinated.

    No. 

    You should not be testing out of isolation if you have been infected with SARS-CoV-2 and have tested positive for COVID-19. 

    If you never develop symptoms, you are able to end isolation 10 days after the date of your first positive COVID-19 test. 

    If you have had a mild to moderate COVID-19 infection, you are able to end isolation 10 days after your symptoms began as long as your other symptoms have improved and it has been at least 24 hours since you last had a fever without using fever-reducing medicines.

    Results from point-of-care tests may be available at the testing site in less than an hour. Other viral diagnostic tests must be sent to an offsite laboratory for analysis, a process that can take up to a few days. In addition, if some areas are experiencing a high demand for testing, it may cause a delay in processing tests and providing results

    Self-testing, also called at-home testing, allows a person to collect a specimen and perform either a molecular or antigen test at home according to directions provided with the kit. Likewise, an adult can test a child by collecting a specimen and running the test. Test results are typically available in 10-30 minutes, depending on the test.  If you perform a self-test, be sure to contact your physician or other healthcare provider with the test result, especially if it’s positive. More information about currently available self-collection kits and self-tests can be seen on this VDH table

    A different product is also available -- a home specimen collection kit. With these kits, a specimen, typically a nasal swab, is obtained at home by the person to be tested, placed inside protective packaging, and mailed to a lab for testing. With home collection kits, no testing is done at home. Results come back from a lab in days. Currently, there are at least 40 kinds of self-collection kits available. Be sure to note the type of test (a self-collection kit vs. self-testing kit) so you get the correct product.

    The Centers for Disease Control and Prevention (CDC) provide more information about at-home tests, including information about how to collect your own specimen on their webpage for Self-Testing

    As of March 31, 2021, FDA authorized multiple tests for over-the-counter (OTC) use without a prescription when used for serial screening. Serial screening or serial testing is testing that is repeated at different points in time and may be more likely to detect infection compared to COVID-19 testing that’s done at a single point in time.  

    Currently, there are five at-home tests which have a specific FDA Emergency Use Authorization (EUA) for serial testing. Serial testing includes testing people with or without COVID-19 symptoms OR with or without an epidemiologic reason to suspect they have COVID-19.  A common epidemiologic reason, for example, would be testing someone who is a frequent close contact to a known COVID-19 case.  

    Currently, all at-home serial tests are antigen tests.  They are: 

     COVID-19 viral testing is widely available. Please contact your local health department to see if they offer testing. Testing may also be available at a healthcare provider’s office, urgent care center, pharmacy, or other healthcare clinic. Contact your healthcare provider to discuss testing or, to find testing sites in your area, visit the website Virginia COVID-19 Testing Sites. Each testing site has different policies and procedures for testing and billing so please reach out to the specific site for more information.

    Testing at Virginia’s public health laboratory (Division of Consolidated Laboratory Services or ‘DCLS’) or partnering laboratories is usually limited to certain less common situations, such as to confirm the presence of an outbreak, or testing by whole genome sequencing. In addition, only your healthcare provider may request state public health laboratory testing for these scenarios by contacting their local health department.

     If you test positive for COVID-19 by a viral test (e.g., PCR or antigen test), you should isolate yourself and stay home and away from others regardless of COVID-19 vaccination status and follow your healthcare provider’s 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 diagnostic test, you may not have been 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 an active COVID-19 infection at the time of testing, and you should continue to monitor yourself for the full 14 quarantine days after your last exposure. You might have tested negative if the sample was collected very early in your incubation period but you could still test positive later during your illness. CDC recommends being tested immediately after being identified as a close contact and tested again in 5-7 days after last exposure if the initial test is negative or immediately if symptoms develop during the quarantine period. It is important to note that viral antigen tests are not as accurate as viral molecular tests, and to discuss the implications of this difference with your healthcare provider.

    Serology (antibody) tests can sometimes tell if you had a past COVID-19 infection by looking for antibodies in your blood. Antibodies are proteins made by the normal immune system after an infectious germ enters a person’s body. It usually takes 1-3 weeks for the body to make antibodies in response to an infection and, equally important, we do not know how much protection against COVID-19 these antibodies might provide or how long this protection might last. 

    Because antibodies are not made immediately after a COVID-19 infection starts, antibody (serology) tests should NOT be used to diagnose current or recent COVID-19 disease. Results from these tests should also NOT be used to make decisions about returning to work or school, traveling, using personal protective equipment (PPE), or the need to stop following disease prevention measures like wearing a mask or physical distancing. Antibody tests should NOT be used to determine whether a person should receive a COVID-19 vaccine. 

    Finally, antibody tests should NOT be used to evaluate a person’s level of immunity or protection from COVID-19 at any time, and especially after the person received a COVID-19 vaccination. CDC and VDH also recommend that people NOT get antibody (serology) testing done after vaccination.

    A positive antibody test result shows you may have antibodies from a past infection with the SARS-CoV-2 virus that causes COVID-19 or from receiving a COVID-19 vaccine. However, there is also a small chance that a positive result means that you have antibodies from an infection with a different virus from the same family of 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 that virus again. If it does, we do not know how much protection the antibodies may provide or how long this protection may last. 

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

    NOTE: Antibody tests should not be used to evaluate a person’s level of immunity or protection from COVID-19 at any time. In particular, it is not recommended for people to get antibody (serology) testing done after vaccination. 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.

    If you were exposed to COVID-19 but test negative for antibodies (blood test), that could mean that you may not have had COVID-19. However, because it typically takes 1–3 weeks after infection for your body to make antibodies, the test may also be negative because it was taken too early. In that case, it’s possible you could still get sick from that recent COVID-19 exposure and could still spread the virus if you do get sick.

    If you do get COVID-19 symptoms after an exposure and a negative antibody test, you would then need another COVID-19 test called a viral diagnostic test​.

    If you are still unclear about the meaning of your test results, you should definitely talk with your healthcare provider about it. Until we know more and until you have been fully vaccinated, you should continue to wear a mask and to take other steps to protect yourself and others.

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

    Ct is a technical term used by laboratory scientists that stands for “Cycle Threshold.” Ct is a number generated during some PCR tests that refers to the number of cycles the test had to go through before it could detect genetic material of the virus in the sample. Generally, the lower the Ct value, the easier it was for the test to detect the virus, which usually means that more of the virus’s genetic material was present.

    Many factors can affect Ct values, such as how and when the sample was collected, so the information has to be interpreted carefully by specially trained persons. In addition, Ct values and cutoffs can differ by each type or brand of test and they cannot be compared from one test type to another. Finally, some PCR tests do not use Ct values, but use a different value instead to report the test being positive or negative.

    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’.

    Please contact your healthcare provider to determine if you need to be tested. If the healthcare provider determines that you should be tested, they might either collect your test samples in their office or lab or provide you with information about where you can go locally for testing. There are also options for prescription and non-prescription self-administered at-home testing kits that can be mailed to a person’s home and for self-collection kits that allow specimens to be mailed to a laboratory for testing. 

    More information about at-home tests, including information about how to collect your own specimen, can be found on the CDC webpage for Self-Testing. More information about currently available self-administered at-home tests can also be found on this VDH table

    Many health insurance plans cover the cost of COVID-19 testing and other related health care costs. Testing costs depend on what type of test is ordered (PCR/molecular or antigen test) and who is providing the test. For specific information about your health insurance coverage, contact your insurance company. Most insurance covers at least some testing costs. However, some testing sites might have additional processing or other fees that aren’t covered by your health insurance so it is a good practice to ask about all costs before getting tested.

    To find free testing, visit VDH’s COVID-19 Testing Sites to find a testing location in Virginia, enter in your zip code, and select the option for “Free Testing Available.” You might also 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.

    You will get your test results from the healthcare provider or facility that collected your specimens. Ask your provider or facility, when they collect your specimen, about the best way to get your results. Most clinics and health care providers will provide results by telephone.

    For self-administered at home and over-the-counter COVID-19 tests, how you get results will vary by the test. However, some test results can be provided in as little as 20 minutes. You may also need to have access to a “smart” device such as a smartphone and to download the Mobile App for that test. 

    While VDH receives both positive and negative COVID-19 test results from private labs, the best way to know how you will get your results is to talk with your healthcare provider or other person collecting your test specimen.

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

    VDH provides a chart comparing different types of coronavirus tests. 

    Ethylene oxide has been used for decades to sterilize medical equipment that can’t be exposed to heat or moisture. The gas does not linger on the items sterilized. Ethylene oxide can be cancerous with chronic and large amounts of exposure (like if inhaled for prolonged periods). However, this level of exposure does not occur with a COVID-19 test. Any exposure from a COVID-19 test swab would be a trace amount, and nowhere near concentrations known to cause harm or be hazardous. Individuals should not avoid COVID-19 testing for this reason.

    Check out the following websites: 

    CDC COVID-19 Testing Website

    CDC COVID-19 FAQs

    VDH COVID-19 Testing

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

Public Health Actions
  • Isolation / Quarantine / Movement Restrictions / Public Health Monitoring

    Isolation is the separation of sick people with a contagious disease from people who are not sick. People in isolation need to stay home and separate themselves from others in the home as much as possible.

    Quarantine is the separation of people who were exposed to a contagious disease to see if they become sick. People in quarantine should restrict movement by staying home and monitoring their health closely in case they become ill.

    Everyone is being asked to limit their interactions with other people during the pandemic to lower the risk of spreading COVID-19. Anyone who might have COVID-19 or might have been exposed to someone with COVID-19 needs to be extra careful to stay away from others, especially those who have a higher risk for serious illness from COVID-19. This is to help prevent the spread of disease and protect people’s health.  

    If you have a condition or are taking medications that weaken your immune system, you may NOT be fully protected even if you are fully vaccinated. Talk to your healthcare provider. Even after vaccination, you may need to continue taking all precautions. However, if you live or work in a healthcare facility (e.g., hospital or long-term care facility or nursing home), you do not have to stay away from others (even after close contact) as long as you don’t have symptoms or immunocompromising conditions (e.g., organ transplantation, cancer treatment), but you should still get tested. Even if you are fully vaccinated, to maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission. If you are fully vaccinated, and had close contact with someone who has COVID-19, you should get tested 3-5 days after your exposure, even if you don’t have symptoms. You should also wear a mask indoors in public for 14 days following exposure or until your test result is negative. You should isolate for 10 days if your test result is positive.

    Following a high risk exposure, fully vaccinated asymptomatic HCP should have a series of two viral tests for SARS-CoV-2 infection. In these situations, testing is recommended immediately (but not earlier than 2 days after the exposure) and, if negative, again 5–7 days after the exposure.

    It depends on your travel destination and other individual circumstances, such as if you are fully vaccinated for COVID-19. 

    For more information, visit the VDH Travelers page here.

    If you have traveled to an area where COVID-19 is spreading in the community, traveled internationally, 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, difficulty breathing, chills, muscle pains, headache, sore throat, and a new loss or taste or smell. 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 any signs or symptoms of COVID-19 stay home to prevent spreading illness to others. 

    You can use the Coronavirus Self-Checker to help determine when to seek testing or medical care.

    Call 9-1-1 if you have a medical emergency: If you have a medical emergency and need to call 9-1-1, notify the dispatch personnel that you might have COVID-19. If possible, put on a mask before emergency medical services arrive. Emergency warning signs include (but are not limited to): trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse a person, or bluish lips or face.

    If you become sick with fever, cough, or difficulty breathing, and are in need of medical care, call your healthcare provider to let them know you need care. Please call ahead to the healthcare provider. The healthcare provider can evaluate your illness, give advice, and determine if you need to be tested for the virus that causes COVID-19.

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

    If a person does not comply with voluntary quarantine, the VDH may issue a quarantine order that legally requires the person to comply with quarantine restrictions. Law enforcement can become involved, if needed, to ensure compliance.

    Persons with COVID-19 who have symptoms regardless of vaccination status need to isolate until:

    • At least 10 days* have passed since symptoms started and
    • At least 24 hours have passed since fever went away without the use of fever-reducing medications and
    • Other symptoms have improved.

    *Healthcare providers might advise some people with serious problems with their immune system to stay in isolation for up to 20 days after symptoms started.

    Persons with COVID-19 who never develop  symptoms may end their isolation when at least 10 days have passed since the date of their first positive COVID-19 PCR or antigen test but should continue monitoring their health and for symptoms for the full 14 days.

    For more information, see Discontinuation of Isolation for Persons with COVID-19 Not in Healthcare Settings and the VDH Infographic When Is It Safe To Be Around Others: Ending Isolation in Non-Healthcare Settings.

    It is safest to stay home for 14 days after last exposure (or contact). If people are not able to stay home for the full 14 days after exposure and do not have symptoms, there are 2 options for when you may leave home: 

    1. After Day 10 without testing or 
    2. After Day 7 if a PCR or antigen test performed on or after Day 5 is negative. 

    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. 

    Certain people are not required to quarantine after exposure to COVID-19. These include people who: 

    • Have had COVID-19 within the past 3 months as long as they do not develop new symptoms*. 
    • People who have been fully vaccinated for COVID-19 as long as they have no symptoms*.
      • Fully vaccinated people who live with someone with a weakened immune system, at increased risk of severe disease, or unvaccinated (including children under age 12 years) could also wear a mask at home for 14 days after close contact with someone with COVID-19 or until they receive a negative test result. People with weakened immune systems (immunocompromised) who have been fully vaccinated should talk with their healthcare provider about whether staying home (quarantining) after close contact exposure is recommended.
    • Healthcare personnel (HCP) who are fully vaccinated for COVID-19 do not need to stay home (quarantine) after a workplace or community-associated exposure or be restricted from work as long as they do not have any symptoms and do not have any conditions that weaken the immune system (e.g., organ transplantation, cancer treatment). HCP should continue to follow quarantine recommendations after close contact and all travel recommendations. For additional details, see here.
    • People who have been fully vaccinated for COVID-19 and have traveled domestically or who have arrived back in the United States from traveling internationally.  Visit VDH’s Travelers website for information about testing requirements and recommendations for travelers.

    People who have had close contact with a person who was a close contact to someone with COVID-19 (“contact of a contact”). If your contact tests positive for COVID-19, then you should stay home (quarantine). 

    *It is very important that people who are not fully vaccinated, but who are not required to stay home (quarantine) because they have had COVID-19 in the past 3 months, monitor their health for 14 days after their last exposure and continue following all recommendations (e.g., wear a mask, stay at least 6 feet away from others, avoid crowds and poorly ventilated areas, and wash hands often). Even if you are fully vaccinated, to maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.

    People who are not required to stay home (quarantine) after exposure must still watch for symptoms of COVID-19 for 14 days and continue to wear a mask, stay at least 6 feet away from others, avoid crowds, and wash hands often. Fully vaccinated individuals with an ongoing COVID-19 exposure (i.e. a household contact) should wear a mask when in contact with the person with COVID-19 throughout the infected person’s isolation period. They should also wear a mask indoors in public until 14 days after the infected person’s isolation period ends or until the fully vaccinated close contact receives their final test result.

Data and Surveillance
  • Data and Surveillance

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

    COVID-19 surveillance data are collected from a variety of sources by the Virginia Department of Health according to the Regulations for Disease Reporting and Control. These sources include laboratory reports of COVID-19 test results, case investigation interviews conducted by the health department, monitoring of close contacts, and syndromic surveillance for coronavirus-like illness. Case-based data are reported into the Virginia Electronic Disease Surveillance System (VEDSS), which is a system used to receive surveillance data from these various sources and report that data to CDC.

    The death data that VDH is reporting are not official or final counts. In an effort to report deaths as quickly as possible, VDH is counting any death that occurs in a person who was reported to the health department as having COVID-19 and any death that mentions COVID-19 as a  cause of death on a death certificate for a person who was not previously reported to the health department. Some deaths in a person with COVID-19 will not be included in the COVID-19 death count, such as, if the person died as a result of an injury or accident. This method is not standardized nationally, so Virginia death data should not be compared to data from other states or for the United States at this time.

    Eventually, all death records will be processed in a standardized manner and become available in a final form. At this time, the final, official death data for deaths that occurred in 2020, are not expected until the end of 2021. You might see delays in reporting deaths or a backlog of death data because of how death certificates are processed and how mortality, due to COVID-19, is assigned in the surveillance data system.

    Hospitals do not inform the Virginia Department of Health (VDH) of patients’ underlying health conditions. In addition, VDH does not consistently gather information on underlying health conditions for Virginia residents who test positive or are reported with COVID-19.

    This information and more is updated on Monday - Friday and posted on the VDH Cases and Locality Dashboards, which can be found here. Any deaths that are reported over the weekend (Saturday or Sunday) can be viewed when the statistics are updated on Monday morning.

    To learn more about how VDH counts COVID-19 associated deaths, please view the COVID-19 Data Insights blog post here.

    There may be a couple of reasons why cases can change up or down over a few days. These reasons apply for all of our geographic-specific data.

    This can be due to:

    • Additional cases are reported to VDH. Sometimes there can be a slight delay in reporting, or
    • Cases may be reassigned to another city or county if we get updated address information on a COVID-19 case. We may get initial reports that will put a case in one county, but upon investigation of the case, the residential address will be in a different location outside of that county. Cases are assigned to the city or county of their home address.

    It is important to note that data are preliminary and may be subject to change.

    VDH reports all cases of COVID-19 by where the person lives. However, this can sometimes be more complex for reporting cases of COVID-19 in college students.

    If a student is living at their college address for 5 days or more: A student becomes ill with COVID-19 symptoms or is tested and found to be positive for SARS-CoV-2, the virus that causes COVID-19, the student will be counted in the city or county of their college address.

    If a student lived somewhere prior to returning to campus AND it is less than 5 days since their return to campus: The student will be counted at the city or county of their previous address.

    It is important to consider that if a student is tested off-campus and gives their home address and not their campus address, the case will be recorded at their home address.

    If a student is part of an outbreak, regardless of where a student was tested or which address was given, the student will be counted at the location where the outbreak occurred.

    The case will be assigned to the city or county where they are under quarantine, regardless of where their home address may be.

    You can view COVID-19 vaccine data here. There are four dashboards to see data on COVID-19 vaccines: Summary, Vaccines Received, Demographics, and Federal Doses

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

    The Vaccines Received dashboard shows data on vaccine doses received by healthcare providers. 

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

    The Federal Doses dashboard shows data about people who have gotten the vaccine from a federal agency, including Bureau of Prisons, Department of Defense, Indian Health Service, and Veterans Affairs.

    Although not at the locality level, the best metric to see how receipt of the vaccine vs. administration of the vaccine is going at the state level is by the metrics on the VDH COVID-19 Vaccines Received dashboard. You can also see the number of vaccine doses received by healthcare providers that partner with VDH at the provider level on the Vaccines Received dashboard here. This list is updated weekly. 

    Comparing vaccine doses received to vaccine doses administered is complex. A large difference between the number of COVID-19 vaccine doses received and the number of doses administered is expected due to several factors.  Here are a few reasons why vaccines received cannot be compared to doses administered at the local level. 

    • Vaccine doses received and vaccine doses administered use two different data systems, and vaccine doses received are based on where the doses were sent to healthcare providers, whereas vaccine doses administered are based on where the person lives at the time they were given the vaccine. For example, Virginia Beach residents can go outside of their city to get a vaccine, or people who do not live in Virginia Beach but may live in another locality nearby can come to Virginia Beach to get a vaccine. In this case, Virginia Beach residents would be counted in Virginia Beach, even if they did not get the vaccine in Virginia Beach. The same also applies for people who got the vaccine in Virginia Beach but live in a neighboring locality. They would be noted as their locality of residence, not Virginia Beach. 
    • In some cases, a bulk shipment to a large hospital will then be redistributed to other vaccine administration sites in those health systems.  For example, if 100 doses of the vaccine were sent to Virginia Beach for administration, but Virginia Beach sent 50 doses to Norfolk, we currently have data that says that 100 doses were received in Virginia Beach. VDH is working to better understand the redistribution of vaccines to other vaccine administration clinics in communities.
    • Healthcare providers report doses to the Virginia Immunization Information System (VIIS) up to 72 hours after administration. It takes time for data to be entered after a person receives their vaccine. It takes time for reporting to catch up and for different computer systems to feed seamlessly into VIIS.

    VDH has a Variants of Concern dashboard that is updated weekly on Fridays. This dashboard presents the number of COVID-19 infections, hospitalizations, and deaths at the health region and health district level due to variants of concern, also known as mutations or changes, of the virus that causes COVID-19. The dashboard also shows state totals of infections, hospitalizations, and deaths due to variants of concern by age group, sex, and race/ethnicity. To learn more about variants, please see the Variants web page here.

Vaccination
Schools, Workplaces & Community Locations
  • Virginia’s Plan for Reopening

    You should wear masks and practice physical distancing in all indoor public settings and in crowded outdoor settings based on CDC recommendations.

    This recommendation is for people aged 2 years and older. Masks should not be worn by children under the age of 2. Adults should use their best judgment in putting masks on children aged 2-4 while inside public areas. They should also use their best judgment for these children when they are outdoors in crowded settings or within 6 feet of others who are not fully vaccinated. Find a mask made for children, if possible.

    You should wear a mask in healthcare settings, like a hospital or doctor’s office.

    You should wear a mask if you live, work, or visit a correctional facility or homeless shelter. 

    You must wear a mask when using public transportation (airplanes, ships, ferries, trains, subways, buses, taxis, and rideshares, as well as in indoor transportation hubs, such as airports and stations), per a federal order.

    On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. Frequently asked questions about the Order are available here.

    A mask is NOT a substitute for physical distancing. Masks should still be worn in addition to staying at least 6 feet apart, especially when indoors around people who don’t live in your household.

    You should wear a mask in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. Check here to see if you are in one of those areas.

    You do not have to wear masks or practice physical distancing in most outdoor settings.

    There are some settings where there are still mask requirements, including some federal, state, local, tribal, or territorial laws, rules, and regulations and local business and workplace guidance.

    You should wear a mask in healthcare settings, like a hospital or doctor’s office.

    You should wear a mask if you live, work, or visit a correctional facility or homeless shelter.

    You must  wear a mask in indoor child care settings and at K-12 schools, per the Virginia State Health Commissioner’s Public Health Order. Frequently asked questions about the Order are available here.

    You should wear a mask if you take medication or have a condition that weakens the immune system, unless your healthcare provider advises otherwise.

    You might also choose to wear a mask regardless of the level of transmission, particularly if you or someone in your household has a weakened immune system or is at increased risk for severe disease, or if you live with someone who is not fully vaccinated.

    You must wear masks when using public transportation (airplanes, ships, ferries, trains, subways, buses, taxis, and rideshares, as well as in indoor transportation hubs, such as airports and stations), per a federal order.

    Private businesses or organizations may choose to continue to require masks for all patrons. Additionally, fully vaccinated individuals may choose to continue to wear masks in public if they would prefer to.

    Masks are still recommended by CDC and VDH for all people, regardless of vaccination status,  in specific congregate settings such as homeless shelters and correctional facilities. Additionally, CDC recommends that masks are worn in healthcare settings.

    The CDC defines healthcare settings in the following manner: Healthcare settings refers to places where healthcare is delivered and includes, but is not limited to, acute care facilities, long term acute care facilities, inpatient rehabilitation facilities, nursing homes and assisted living facilities, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities, such as dialysis centers, physician offices, and others.

    Any child aged two or older is strongly encouraged to wear a mask. Adults should use good judgment to decide whether to place a mask on a minor between the ages of two through four.

    As of August 12, 2021, a Public Health Order requires all individuals aged two and older to wear masks when indoors at public and private K-12 schools, regardless of vaccination status. The Order also applies to PreK if the program is at a K-12 school.

    No. A face shield should not be used as a substitute for a mask. Face shields are primarily used to protect the eyes of the person wearing them and may be used in addition to wearing a mask.

    Talk with your healthcare provider for advice on how to wear masks. It may be helpful to practice wearing a mask at home for short time periods to help you adjust to wearing a mask in public settings.

    A mask should fit snugly but comfortably against the side of your face and cover your nose and mouth. It should be secured with ties or ear loops and be able to be washed and machine dried without damage or change to shape.

    Additional VDH guidance for masks can be found here.

    CDC's mask recommendations can be found here.

    Community Questions and Concerns

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

    • Get vaccinated
    • Wear a mask when you are in public
    • 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 your hands after going to the bathroom; before eating; and after coughing, sneezing or blowing your nose.
    • If you are sick, stay home and rest, even if the illness is mild.
    • Practice physical distancing, staying at least 6 feet from others.

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

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

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

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

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

    Schools (K-12)

    Virginia law requires that school boards provide in-person instruction in the 2021-2022 school year in adherence, to the maximum extent practicable, with applicable CDC mitigation strategies.

    Virginia schools should select appropriate, layered prevention strategies to decrease the transmission of COVID-19 in schools. School officials, together with public health officials, need to consider multiple factors when making decisions about layered prevention strategies. In addition to important context about local communities, vulnerable populations, and equity concerns, the primary factors to consider are the level of community transmission, vaccination coverage, trends in school-related outbreaks or increasing cases, data from school screening testing programs, and the ages of the children served in a given school. Key prevention strategies include: promoting vaccination; consistent and correct use of masks; physical distancing; screening testing; ventilation; handwashing and respiratory etiquette; cleaning and maintaining healthy facilities; staying home when sick and getting tested; and contact tracing in combination with isolation and quarantine.

    As of August 12, 2021, a Public Health Order requires all individuals aged two and older to wear masks when indoors at public and private K-12 schools, regardless of vaccination status. The Order also applies to Pre-K if the program is at a K-12 school. The Order does not apply to outdoor school settings. VDH recommends those who are not fully vaccinated wear masks in crowded outdoor settings or during outdoor K-12 settings or during outdoor activities that involve close contact with other people, but it is not a requirement.

    For additional details, please see VDH Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools

    Yes. On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. Senate Bill 1303 requires schools to provide in-school instruction in accordance, to the maximum extent practicable, with the mitigation strategies provided by the CDC. These mitigation strategies include mask wearing indoors for all students, staff, and visitors regardless of vaccination status.

     

    In Virginia’s 2021 legislative session, Senate Bill 1303 passed which requires:

    Each school board shall offer in-person instruction to each student enrolled in the local school division in a public elementary and secondary school for at least the minimum number of required instructional hours and to each student enrolled in the local school division in a public school-based early childhood care and education program for the entirety of the instructional time provided pursuant to such program. For the purposes of this act, each school board shall (i) adopt, implement, and, when appropriate, update specific parameters for the provision of in-person instruction and (ii) provide such in-person instruction in a manner in which it adheres, to the maximum extent practicable, to any currently applicable mitigation strategies for early childhood care and education programs and elementary and secondary schools to reduce the transmission of COVID-19 that have been provided by the federal Centers for Disease Control and Prevention.

    • Key reasons for the issuance of the Order include:
    • Keeping students in school for in-person learning remains a priority of the

    Commonwealth. Consistent masking in schools will help reduce the chances of

    students becoming exposed to COVID-19 while at school, and will reduce the

     overall number of students having to remain at home for quarantine.

    • CDC recommends universal indoor masking for all teachers, staff, students, and

    visitors to schools, regardless of vaccination status.

    • Vaccination of those who are eligible remains the most important strategy to

    combat COVID-19.

    • While cases in Virginia have increased rapidly since mid-June 2021,

    masks are a proven tool to reduce in-school transmission, even in communities

    with low vaccination rates and high levels of spread.

    • Delta is more contagious than earlier forms of the virus and likely causes more

    infections. Preliminary evidence suggests some fully vaccinated people who

    become infected with this variant can spread the virus to others.

    • Children younger than 12 years old are not yet eligible to receive the COVID-19 vaccine.
    • A large proportion of older students remain unvaccinated. 
    • Outbreaks can and have occurred in K-12 schools in Virginia. While fewer children have been sick with COVID-19 compared with adults, children can be infected with the virus that causes COVID-19, can get sick, can spread the virus to others, and can have severe outcomes. Masks are a proven tool to reduce in-school transmission.
    • The Order does not apply to outdoor school settings. VDH recommends those who are not fully vaccinated wear masks in crowded outdoor settings or during outdoor activities that involve sustained close contact with other people, but it is not a requirement.

    For additional information, see VDH Information on Mask Webpage and Interim Guidance for the 2021-2022 school year. 

    Additional FAQs on the Public Health order can be found here

    Please see the Department of Education FAQs for additional information. 

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

    Keeping students in school for in-person learning remains a priority of the Commonwealth. While cases in Virginia have increased rapidly since mid-June 2021, masks are a proven tool to reduce in-school transmission, even in communities with low vaccination rates and high levels of spread. In many cases, wearing a mask in school can help prevent a child from having to quarantine when classmates test positive for COVID-19. Delta is more contagious than earlier forms of the virus and causes more infections. Children younger than 12 years old are not yet eligible to receive the COVID-19 vaccine. A large proportion of older students remain unvaccinated.

    Outbreaks can and have occurred in K-12 schools in Virginia. While fewer children have been sick with COVID-19 compared with adults, children can be infected with the virus that causes COVID-19, can get sick, can spread the virus to others, and can have severe outcomes. Virginia’s hospitalization and fatality data by age group and locality can be found here.

    COVID-19 related hospitalizations have been increasing since July 2021. CDC provides a tool to view weekly case trends by age group here. The default setting depicts data for the entire United States, but state data can be selected and viewed individually. The VDH outbreak dashboard provides information about reported outbreaks across the state and can be sorted by locality and exposure setting. VDH uses the national outbreak definition which can be found here. There is concern that these numbers may continue to increase as school-aged children return to classroom settings if prevention measures are not implemented. Furthermore, although many young children may not have severe symptoms of illness from the virus that causes COVID-19, they may pass it to immunocompromised people or people who cannot get vaccinated in their household or community.

    Additional FAQs on the Public Health order can be found here.

    The Order states that This Order shall be effective August 12, 2021, and shall remain in full force and effect until the CDC guidelines for K-12 schools change, unless this Order is sooner amended or rescinded. Several factors may also be considered, including the level of community transmission, health system capacity, and vaccine eligibility. The Order is a temporary but necessary measure, and until CDC guidelines change or trends are more favorable, the Order will remain in place.

    If you would like to report a violation of the Public Health Order, contact your local health department. Contact information for your local health department can be found here: https://www.vdh.virginia.gov/local-health-districts/.

    VDH fully expects all individuals to comply with this Public Health Order. Orders of the Commissioner or the Board of Health may be enforced pursuant to Virginia Code §32.1-27 which provides, in part, that any person not obeying an order of the Commissioner may be compelled in a proceeding instituted in an appropriate court by the Board or Commissioner to obey such order. Any parent or guardian of a student aggrieved by a school board action should consult with an attorney as to how to proceed.

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

    CDC provides additional FAQs here: Parents and Caregivers – What Is Your School Doing to Protect Your Child from COVID-19?

    If your child is identified as a close contact of someone with COVID-19, your child needs to follow testing and quarantine guidance from your school. A representative from the local health department may also call parents of close contacts to provide quarantine guidance.

    People who have had close contact with someone who has COVID-19 need to stay home and away from others. This is called quarantine. CDC and VDH recommend a 14-day quarantine for unvaccinated close contacts before returning to normal activities, including in-person school and school activities. A 14-day quarantine is the safest option. This is because your child can become infected with COVID-19 but may not develop the infection for up to 14 days. In fact, some data show that a person may spread COVID-19 before they show symptoms or even without symptoms.

    However, VDH and CDC recognize that the 14-day quarantine duration can cause substantial personal burden and might lead to low compliance. Therefore, VDH allows for shorter quarantine durations as acceptable alternatives, including for teachers, staff, and students of K12 schools.

    If your child develops symptoms at any point during quarantine (even if they are fully vaccinated), they need to get tested and isolate immediately. Be sure to notify your school if this happens and reach out to your healthcare provider.

    If your child is fully vaccinated, CDC and VDH recommend that they get tested 3-5 days after being exposed and monitor for any symptoms for 14 days. Your fully vaccinated child does not need to quarantine as long as they do not have symptoms.

    There are options for a shorter quarantine. A full 14-day quarantine period might be required by your school, daycare, or workplace. Contact your school, daycare, or workplace to learn more and follow its quarantine recommendations.

    Information for schools and parents about contact tracing and quarantine is available on the VDH K-12 page. VDH’s Exposed to COVID-19 webpage also provides the most updated information: vdh.virginia.gov/coronavirus/local-exposure/. Your local health department continues to be the best resource and point of contact for guidance regarding your specific potential exposure. Large exposure events require extensive resources from local health departments, so response times may be slower as they follow up with people identified as close contacts.

    VDH has a data dashboard called COVID-19 Outbreaks by Selected Exposure Settings that is available here. VDH posts information about reported COVID-19 outbreaks, including those in K-12 public and private schools with 30 or more students and staff members, on this dashboard. This dashboard is updated weekly. You can look at all the outbreaks reported to VDH across all exposure settings or you can use the filter to look at only the outbreaks in the K-12 settings (select “K-12” in the Facility Type drop-down menu). There will be no identifiable information in the data presented.

    CDC and VDH do not recommend requiring a negative COVID-19 test in order for students or staff to return to school, instead only those who have met the CDC criteria for return to school should do so. 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.  However, some school divisions may require a note from a provider to return to school or work. Please check with your local school division for guidance.

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

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

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

    Make sure that you provide the school with health care provider documentation (HCP) of the child’s food allergy and treatment protocols. This includes HCP authorization and parental consent to administer medication to students in the event of anaphylaxis or illness due to exposure. Meet with school staff, including teachers, school nurses and administrators, to discuss safety measures and establish/update a Section 504 plan.  Please discuss any concern you may have with your local school division.

    Make sure that you provide the school with health care provider documentation (HCP) of the child’s healthcare needs and treatment protocols. This includes HCP authorization and parental consent to administer medication or administer treatments to students. The CDC offers guidance for families of children needing extra precautions during COVID. Families are encouraged to meet with school staff, including teachers, school nurses and administrators, to discuss safety measures and establish/update a Section 504 plan.  Please discuss any concern you may have with your local school division.

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

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

    The Code of Virginia requires that children be adequately immunized (§ 22.1-271.2) and receive a school entrance physical (22.1-270) within the 12 months prior to entering public kindergarten or elementary school. Other required immunizations include Human Papillomavirus (HPV) for girls and boys entering the seventh grade   Diphtheria, Tetanus, and Pertussis (Tdap) booster for entry into seventh grade and Meningococcal  Conjugate Vaccine (MenACWY) for entry into seventh and 12th grade. 

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

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

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

    For those that are eligible (12 years and older) to receive the COVID-19 vaccine and other vaccines may now be administered without regard to timing. This includes simultaneous administration of COVID-19 and other vaccines on the same day, as well as co-administration within 14 days. Testing for TB infection with one of the immune-based methods, either the tuberculin skin test (TST) or an interferon release assay (IGRA), can be done before, after, or during the same encounter as COVID-19 vaccination. Information for parents is available on the VDH Back to School Website.

    The state does not require COVID-19 vaccines for students or staff; but local divisions may choose to require the vaccine of school staff as a matter of employment. Additionally, Virginia school division staff may be covered under forthcoming federal vaccination requirements. This requirement is not yet in place and additional information is forthcoming.

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

    For more about the COVID-19 vaccine, and where to find a free one near you, please visit https://www.vdh.virginia.gov/covid-19-vaccine/

    School divisions are subject to the Standard for Infectious Disease Prevention of the SARS-CoV-2 Virus That Causes COVID-19, issued by the Virginia Safety and Health Codes Board. The most recent version became effective September 8, 2021.

    The amended Department of Labor and Industry (DOLI) Standard includes requirements for all employers as well as specific requirements for higher-risk workplaces (16VAC25-220-60, page 37), which includes school divisions. The Standard also requires employers with higher-risk workplaces to create a written Infectious Disease Preparedness and Response Plan (16VAC25-220-70, page 44) and requires training (16VAC25-220-80, page 47) of certain employees as well.

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

    The Virginia Department of Health has issued guidance related to recreational and school-based athletics, available online here. With regard to masks, they recommend the following:

    Indoors: If tolerable, wear a mask while playing indoor sports, especially any sport that involves close contact. At K-12 schools, masks are not required when exercising, but should still be worn if possible when engaging in active sports play. Anyone (age 2 and up) should wear a mask on the sideline, in the locker room, or in the stands when in a school or when transmission levels are substantial or high

    Outdoors: Playing outdoor sports is generally safer than indoors. Unvaccinated athletes, coaches, officials, and spectators should strongly consider wearing masks, especially if close contact is likely to occur. Fully vaccinated people might also consider wearing a mask in crowded outdoor spaces if they or someone in their household is immunocompromised.

    However, the Virginia High School League governs athletic competitions and local school divisions may have their own policies in place (such as vaccine requirements for athletes or mask mandates for outdoor spectators).

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

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

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

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

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

    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. 

    Masks are protective in both directions. First, they reduce the amount of COVID-19 virus that infected people – even those who are infected but still without symptoms – shed into their environment. Second, when masks are properly designed and worn, they 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. An individual's benefit increases with increasing community mask use.

    The CDC has also released several reports that highlight the importance of mask wearing specifically in schools. A summary of those findings can be found here. To mention a few:

    • Schools without a mask requirement were 3.5 times more likely to have COVID-19 outbreaks compared to schools that started the year with a mask requirement. (Link)
    • Increases in pediatric COVID-19 case rates during the start of the 2021–22 school year were smaller in U.S. counties with school mask requirements than in those without school mask requirements. (Link

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

    However, it’s important to remember that the COVID-19 protection provided by masks is not absolute. Schools should follow the Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools. This guidance emphasizes several key prevention strategies, including vaccination, masking, physical distancing, screening testing, ventilation, hand hygiene, cleaning, staying home when sick, and prompt contact tracing once any cases are identified. Of all available prevention strategies, vaccination, masking, and physical distancing should be prioritized.

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

    Masks are a key public health measure to decrease viral spread. There is no evidence to show that masks made for public use lower oxygen levels. Cloth and medical (or surgical) masks have breathable layers that will not cause your child to retain carbon dioxide or block the oxygen they need.

    Most children, including children with most medical conditions, aged 2 or older can safely wear face masks for extended periods of time- including an entire school day.

    Mask wearing for children at risk of COVID-19 exposure is also recommended as a safe practice by the American Academy of Pediatrics and by the American Lung Association.

    There is no evidence that mask wearing weakens the immune system. Also, mask wearing does not interfere with lung development. Wearing a mask in class does not keep children from breathing properly or make their heart work harder, and also does not affect their emotional state or make it harder for them to remember class material. Teachers can learn from what doctors and nurses have done to help them communicate with children while wearing a mask, and use more gestures while speaking, like pointing to help focus children’s attention and waving hello. Posting pictures of the teacher without a mask in the classroom can also help students connect with their teacher.

    N-95 masks provide a higher level of protection, but are typically reserved for medical professionals. There is some evidence that prolonged use of an N-95 mask can lead to some build-up of carbon dioxide levels in the body. However, these levels are still below short term acceptable levels. Children with lung conditions who may require higher levels of protection from their mask, should speak with their healthcare provider regarding these concerns.

    Children with mental health issues that are exacerbated by mask wearing, should speak with their healthcare provider about alternatives and accommodations if needed.

    To address parents and caregivers' concerns on the emotional toll the pandemic continues to have on children’s well-being and development, the AAP provides answers to some common questions about young children’s speech and language development with mask use and the physical impact of mask wearing on children. CDC has a resource toolkit designed to support parents in supporting their child’s mental health

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

    On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. For additional information, see VDH Information on Mask Webpage.  

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

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

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

    On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status.The Order does allow for exemptions when students are exercising or using exercise equipment, but masks are still strongly encouraged. For additional information, see VDH Information on Mask Webpage

    A person may play a wind or brass instrument without a mask as long as 6 feet of physical distance can be maintained from other people. Maintain at least 6 feet of distance during activities when increased exhalation occurs such as when singing, shouting, or playing wind/brass instruments. Consider increasing distance even more (10 feet apart) during these activities if the room size allows for it. Covers may also be used on wind and brass instruments to reduce droplet spread while playing. Limit activities that require close contact between performers (e.g., lifting a dancer, scenes in a play that require very close contact between actors), especially when indoors.  

    For additional information, see VDH Information on Mask Webpage and VDH Guidance for Performing Arts.

    On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. The order applies to all individuals aged two and older. 

    • This is based on the observation that COVID-19 infection rates are rapidly increasing across the Commonwealth, the Delta variant is more contagious than previous strains of the virus and can be spread by even those that are vaccinated, and face masks have been scientifically proven to be effective, well-tolerated and safe. For additional information, see Interim Guidance for the 2021-2022 school year. Masks must be worn on school buses, per a federal order.
    • For additional information, see VDH Information on Mask Webpage

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

    Camps may follow CDC Guidance for Operating Youth Camps

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

    On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This order applies to all activities on the grounds of private and public schools grounds during instruction, extra curriculars, social gatherings, etc.

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

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

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

    • Parents or caregivers are strongly encouraged to monitor their children for signs of infectious illness every day. Students who are sick should not attend school in-person.
    • CDC does not currently recommend universal symptom screenings (screening all students grades K-12) be conducted by schools.
      For more information, the VDH has developed guidance for parents and school staff When Should a Child Stay Home From School and/or Child Care? 

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

     

     If there is a confirmed case of COVID 19 in school, the local health department will work closely with school administrators to determine a course of action for their schools. Temporary school closures should only be necessary in the context of controlling spread associated with increased impact to school such as increased cases or outbreaks. The Virginia Department of Health (VDH) recommends that schools start by reviewing the Centers for Disease Control and Prevention (CDC) Guidance for COVID-19 Prevention in K-12 Schools. The CDC Guidance is best used together with Virginia’s Interim Guidance for COVID-19 Prevention in PreK-12 Schools and COVID-19 Resources provided by the U.S. Department of Education. 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 healthcare provider about school attendance. In addition, employees that meet the criteria listed for ‘higher risk’ populations should check with their healthcare provider before returning to work. Schools should provide remote learning exceptions and teleworking options for students and staff who are at high risk of severe illness (as defined by the CDC). People who have a condition or are taking medications that weaken their immune system may not be fully protected even if they are fully vaccinated. Please discuss any concern you may have with your local school division.

    People who are not fully vaccinated who have had close contact with someone with COVID-19 need to stay home and distanced from others (quarantine) for 14 days from the date of last exposure and monitor their health status closely. Close contact means being within about 6 feet for a total of 15 minutes or more over a 24-hour period. In indoor K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students wore well-fitting masks the entire time. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor. This exception does not apply to teachers, staff, or other adults in indoor K-12 settings. The VDH document Clarification of VDH K-12 Close Contact Definitions and Quarantine Periods provides clarification on how close contacts are assessed in K-12 schools. These unvaccinated individuals who are close contacts of persons with COVID-19 should be tested immediately after being identified, and if negative, tested again in 5–7 days after last exposure or immediately if symptoms develop during quarantine. They can leave quarantine after 10 days if no symptoms develop or after 7 days, if a COVID-19 test conducted on or after Day 5 is negative. VDH recommends a 14 day quarantine, as it is the safest option. 

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

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

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

     An individual diagnosed with COVID-19 should not return to work or school until they meet all criteria to end isolation:

    • At least 10 days have passed since symptoms first appeared and
    • At least 24 hours have passed with no fever without the use of fever-reducing medication, and
    • Other symptoms have improved.

     VDH has developed algorithms to help guide schools When Should a Child Stay Home From School and/or Child Care?

    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 

    The CDC has developed a toolkit to help schools respond to COVID cases.

    During the COVID-19 pandemic, asthma treatments using inhalers with spacers (with or without a face mask, according to each student’s individualized treatment plan) are preferred over nebulizer treatments whenever possible in the school setting. The use of asthma inhalers (with or without spacers or face masks) is not considered an aerosol-generating procedure.

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

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

    Being within 6 feet of a person who has COVID-19 for a total of 15 minutes or more over a 24-hour period, or having direct exposure to respiratory secretions (e.g., being coughed or sneezed on, sharing a drinking glass or utensils, kissing), or caring for a person who has COVID-19, or living with a person who has COVID-19. Exception: In indoor and outdoor K-12 settings, a student who was within 3 to 6 feet of an infected student is not considered a close contact as long as both students wore well-fitting masks the entire time. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor..  Students who were less than 3 feet apart for a total of 15 minutes or more are considered close contacts, even if both students wore masks. The K-12 exception does not apply to teachers, staff, or other adults. This means that the standard close contact definition is applied when assessing exposure in a K-12 setting that involves a student with an infected adult or an exposed adult. The VDH document Clarification of VDH K-12 Close Contact Definitions and Quarantine Periods provides clarification on how close contacts are assessed in K-12 schools.  The CDC has developed a toolkit to help schools respond to COVID cases. 

    Diagnostic tests are used to identify current COVID-19 infection and should be used if your child has any symptoms. Screening tests are used regularly to identify unknown cases or cases without symptoms so that actions can be taken to quickly prevent further spread of COVID-19.The CDC provides FAQS for Parents and for additional information from VDH, see Interim Guidance for the 2021-2022 school year and K-12 Testing in schools. Contact your local school division for additional information.

    Screening testing can help promptly identify and isolate cases, quarantine those who may have been exposed to COVID-19 and are not fully vaccinated, and identify clusters. This can help reduce the risk to students, teachers and staff, and controlling outbreaks before they expand can help limit any disruption to in-person education. Any screening test performed in the school setting is voluntary and requires parental consent prior to testing. Contact your local school division for additional information. The CDC provides FAQS for Parents and for additional information from VDH, see Interim Guidance for the 2021-2022 school year and  K-12 Testing in schools.

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

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

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

    Diagnostic testing is intended to identify current infection in individuals and should be performed on anyone that has signs and symptoms consistent with COVID-19.

    Additional information about antigen testing is available.

    While generic messaging may be shared with the school community regarding a positive test in the school, neither the student’s name or any other information that could potentially identify the ill person can be shared. The local health department will work with the student and their family to determine which individuals meet the close contact definition. The local health department will notify those individuals and provide information about disease prevention steps they should take, without disclosing personal identities.

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

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

    Schools (K-12): Testing

    The Virginia School Screening Testing for Assurance program,  or ViSSTA, is a free COVID-19 screening testing program for Virginia public and private K-12 students, teachers, and staff for the 2021-22 school year.

    No.  Although the Virginia Department of Health (VDH) strongly encourages schools to participate, the ViSSTA program is optional. In combination with other mitigation strategies, screening testing is an important layer of prevention against the transmission of COVID-19.

    Screening testing is routine testing of individuals who do not have COVID-19 symptoms and/or do not have a known close contact to a person with COVID-19.  Many COVID-19 infections come from contact with a person who does not have symptoms; screening testing can help identify infected people who may be contagious as early as possible so measures can be taken to keep the virus from spreading.

    Public and private schools can be matched with vendors who will conduct pooled screening testing in schools.  Public schools can also receive funding for needed supplies and/or to hire local school staff to support the program, such as school division testing coordinators,  school nurses or mitigation specialists.  There is no cost to schools to conduct screening testing in schools.  Schools may have to assign certain duties to existing staff to help support the program and liaise with the vendor and school community to help make the program successful. 

    The school testing program is open to all students, teachers, and staff. Although screening testing programs are primarily intended for people who are not fully vaccinated, vaccinated individuals may also participate. Testing is completely free to participants.

    The program is open to Pre-K or early education programs if the students/faculty are co-located with K-12 students/faculty.

    Yes. The ViSSTA program is open to both public and private schools. Participating public and private schools can be matched with screening testing vendors and can receive eMed BinaxNOW Antigen At-Home Test Kits for diagnostic testing or testing of persons who have had close contact with a case.  Public schools can also receive additional funding to hire support staff.

    At this time, VDH is supporting schools by contracting with vendors to conduct pooled screening testing (and follow-up testing) in schools. Schools that elect to conduct their own testing program outside of the ViSSTA program cannot be reimbursed for costs at this time. Participating schools can also continue to receive eMed BinaxNOW Antigen At-Home Test Kits as resources allow.

    Weekly screening of employees, such as unvaccinated teachers/staff can be supported through the ViSSTA program using the weekly PCR testing.  At this time, the method being used is pooled PCR screening testing with follow-up testing as needed.  It is unclear at this time what the pending OSHA rule will entail; the ViSSTA program will consider that information at the time of publication and will consider program adjustments as necessary and within available resources. We would encourage school divisions to initiate screening testing on students and supervising adults (e.g. teachers and staff) as soon as feasible, with a focus on those who are not yet fully vaccinated.  Although screening testing is a helpful layer of prevention, vaccination remains the most powerful tool to prevent transmission of COVID-19.  The eMed BinaxNOW kits should not be used for weekly employee screening at this time.

    The turnaround time for pooled tests is approximately 24-48 hours from the time specimens are received by the lab to results being reported. Most labs return results within 24 hours. 

    The samples are processed at partner labs that VDH has contracted with for the ViSSTA program. VDH has executed emergency contracts with the following vendors: 

    • Aegis Labs
    • Inalab

    Contracts previously existed for the following vendors:

    • Mako Diagnostics
    • Next Molecular

    Individuals who have previously tested positive (on an individual, not pooled, test) in the past 90 days should be excluded.  After 90 days, they may be included again in the pools.

    If a pool tests positive, the individuals in that pool may need to be re-tested.  Some laboratories conduct the individual follow-up testing at the lab, without a second sample collection.  Some vendors will need to return the following day for a second sample collection on those individuals.  Individuals in a positive pool can remain in school if they have been re-tested and are awaiting test results unless this conflicts with individual school policy.  Individuals who refuse the confirmatory test (if needed) will need to be presumed positive and be isolated from school for the remainder of the 10 day isolation period.  Individuals consenting to participating in pooled screening testing should be informed that there may be an instance where a repeat sample is necessary to collect to avoid this situation of potentially unnecessary isolation. 

    When the individual who has COVID-19 is identified on confirmatory testing,  those individual test results will be reported to the individual, designated school officials, and the Virginia Department of Health for appropriate follow up actions.

    These at-home test kits are intended for diagnostic testing on K-12 students, teachers, and staff who have signs/symptoms of COVID-19 or for testing of K-12 students, teachers, and staff who have been identified as close contacts to a case.  The kits may be distributed to members of the school community for use at home or can be self administered at school per school policy.  These at-home test kits complement other mitigation strategies in K-12 schools, including in-school pooled PCR screening testing (ViSSTA), mask policies, and case investigation/contact tracing.

    School divisions/schools that are participating in the ViSSTA Covid-19 Screening Testing Program will be prioritized for future diagnostic test shipments.  For school divisions that choose not to participate in the screening program, VDH will not be able to guarantee continued supply of these products that are intended for diagnostic use. 

    School divisions/private schools may request additional supplies through the kit distribution reporting survey that is due every Tuesday at 5pm. VDH will review all orders submitted by this deadline and may reach out with questions to substantiate the request. Orders will ship weekly.

    If a school/district chooses to utilize eMed test kits, after the supplies are received at the school, it is the responsibility of the school to further distribute the eMed test kits to the individual and adhere to required data reporting to VDH so that VDH can monitor inventory and needs

    The eMed Certified Guide, who receives a rigorous training and testing certification in the testing process, the terminology, testing administration, and the flow of the Abbott BinaxNOW COVID-19 Ag Home Test.

    Results are available approximately 15 minutes after completion of the test.

    The document Antigen Test Results and Next Steps Handouts has helpful information to guide persons through next steps following antigen test results depending on whether you have symptoms and/or whether you have had known contact to a person with COVID-19. 

    A symptomatic person who receives a positive test result on the virtually-guided at-home antigen test is considered a COVID-19 case and should immediately isolate (stay away from others).

    After the test taker completes their test with the online proctor, eMed will report the results to the Virginia Department of Health. Individuals taking tests should report any positive results to their respective school leadership so that follow up actions can be initiated promptly.

    The ELC Reopening Schools grant requires grant recipients to conduct K-12 screening testing in K-12 settings and states are required to substantially support this required activity across the jurisdiction.  All schools that request virtually-guided eMed antigen test kits for purposes of testing symptomatic persons or persons who have had close contact with a case have received an initial allotment.  Future supplies will be prioritized to those schools that have enrolled in the ViSSTA screening testing component of the program.

    Institutions of Higher Education

    VDH has a dedicated webpage  that addresses the needs of IHEs. This webpage provides resources for students, health services, administrators, and facilities managers. CDC provides Guidance for Institutions of Higher Education. Additionally, CDC has compiled a vaccine toolkit which is intended to be used by institutions of higher education.

    Sports and Recreational Activities

    Consider the extent of community transmission in a region/locality when deciding whether and how to participate in recreational sports activities. During times of substantial or high levels of community transmission of COVID-19, participating in recreational sports that involve close contact with others may increase risk of COVID-19 transmission and is not advisable. This is especially true with large events. 

    Visit VDH's COVID-19 Level of Community Transmission to find out the level of community transmission in your area.

    VDH’s Considerations for Recreational Sports can be found here.

    Sports competition involving close, sustained contact with others, and sports played indoors, are at higher risk of spreading COVID-19.  Examples include: Wrestling, Football, Competitive cheerleading, Rugby, Martial arts competition, Indoor basketball, and Ice hockey. 

    See CDC’s science brief and VDH’s Considerations for Recreational Sports for more information on the risk associated with playing certain sports.

    Child Care Programs

    Child care programs and centers are encouraged to adapt their service settings as much as possible to align with public health recommendations and encourage vaccination among staff and families. Please visit the Department of  Education COVID-19 child care website for more information.

    CDC Guidance for Child Care Settings remains in place, and the Virginia Department of Health along with the Centers for Disease Control and Prevention continue to recommend that masks be used indoors for children over age two and for all staff in child care settings, regardless of vaccination status. 

    • Staff should help children learn simple practices they can use to decrease their risk of spreading COVID-19, such as:
      1. Use visual tools, demonstrations, stories, and play
      2. Encourage children to cover cough and sneezes with their arms or a tissue
      3. Teach and reinforce handwashing with soap and water for at least 20 seconds and increase monitoring to ensure adherence among all children. Staff should assist young children with hand washing if necessary.
    • The CDC advises staff and children was their hands continuously at the following key times:
      1. When arriving at the facility
      2. Before and after preparing food or drink
      3. Before and after handling food or eating
      4. Before and after helping a child adjust their mask
      5. Before and after diapering a child
      6. After using the bathroom or helping a child use the bathroom
      7. After having contact with bodily fluids
      8. After handling trash
    • Practicing enhanced cleaning measures can help reduce the risk of spreading COVID-19 in a childcare facility. The CDC recommends developing a schedule for increased frequency of routine cleaning of high-touch surfaces
    • When selecting cleaning products, consult the EPA’s list of Disinfectants for Coronavirus (COVID-19).
    • The CDC recommends discouraging the use of shared objects among children, especially those that are difficult to clean between uses.
    • Plan to have an isolation room or an area for children or staff who begin to show symptoms of COVID-19 while in the facility. Ideally this room should have access to a separate restroom. Ensure that isolated children are still under adult supervision. Arrange safe transportation home or to a healthcare facility (if severe symptoms) for the child or staff member if showing symptoms of COVID-19.
    • Close off any areas used by children or staff who have begun to exhibit symptoms of COVID-19 until these areas can be disinfected. 
    • Preferably wait at least 24 hours before cleaning and disinfecting closed off areas.
    • Your childcare center should consult with the local health department as soon as possible. Your childcare center should communicate next steps to you based on local health department recommendations.
    • You should monitor yourself and your child for symptoms of illness.These symptoms include: fever greater than 100.4 F, cough, and/or shortness of breath. If your child develops the symptoms, please keep them home, contact your healthcare provider and inform your childcare center.
    • Continue to practice good hygiene (handwashing), physical distancing and keeping a distance of at least 6 feet from others, avoiding crowded settings, and continuously monitor your and your child’s health.   
    • Develop policies that encourage sick employees to stay at home without fear of negative consequences. Ensure policies are clearly communicated to your staff.
    • Your childcare center may need to close based on the local health department's recommendations and contact investigation. Closure and duration will be dependent on a number of factors including staffing levels, outbreak levels in the community, and the number of people affected within the facility. Assessing these and other factors will help the local health department determine the severity of the situation, which will help inform recommendations.
    • In the case the facility does close, symptom-free children and staff should not attend or work at another facility, which would potentially expose others.  

    The CDC encourages all childcare facilities to have an emergency operations plan in place in case a student or staff member contracts COVID-19. Please consult the Early Childhood National Center’s emergency preparedness guide for further guidance. Review CDC's Schools and Child Care Programs. Childcare centers should also review the Guidelines for Child Care provided by the Virginia Department of Education to prepare and respond to COVID-19 situations.

    If you have any signs of illness, even very mild illness, such as a dry cough, slight fever, chills, shaking chills, muscle pain, headache, sore throat or new loss of taste or smell, it is very important that you stay home and rest. Even those with mild illness could pass the infection to others. If you need a letter for work/school, please consult with your healthcare provider.

    If a staff member has previously exhibited symptoms of COVID-19, or has been exposed to someone who has tested positive with COVID-19, consult the CDC’s criteria to develop a plan to allow those staff to return to work 

    Business and Workplaces: General

    Familiarize yourself with the  Virginia Standard for workplaces across the Commonwealth to prevent workplace exposure to COVID-19. A web page devoted to the Virginia Standard containing Outreach, Education and Training materials has been set up and is being populated with documents. Additional FAQs regarding the Virginia Standard can be found here

    Encourage employees to get vaccinated. See VDH General Recommendations for Businesses and other Establishments for additional guidance. 

    Guidance for ending isolation for persons with COVID-19 in non healthcare settings is available here. Further information can be found on the VDH Businesses website.

    When employees socialize they tend to stand closer together than is recommended to mitigate the spread of COVID-19. This is higher risk when employees are eating and drinking because masks are not worn, especially if employees are not fully vaccinated. Consider placing chairs and tables at least 6 feet apart to reinforce appropriate physical distancing and prevent outbreaks. Encourage employees to take breaks outside if they need to remove their mask.

    Refer to the DOLI resources, which provide an infectious disease plan template and information about training and COVID-19 compliance.

    Yes, employees are required to mask depending on several factors. In accordance with the Virginia Standard, employers shall provide and require employees that are not fully vaccinated wear a mask. Fully vaccinated employees in areas of substantial or high community transmission must wear a mask. Otherwise at-risk employees (because of a prior transplant or other medical condition) must wear face coverings or surgical masks while indoors, unless their work task requires a respirator or other PPE.

    Businesses may choose to require masks for customers in their establishment.

    In areas with substantial or high transmission, CDC and VDH recommend everyone aged 2 and older wear a mask in public indoor settings. When transmission levels are low or moderate, individuals who are unvaccinated and aged 2 or older should wear masks in all indoor public settings and in crowded outdoor settings. See VDH General Recommendations for Businesses for more guidance.

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

    There is a section dedicated to Schools, Workplaces and Community Locations with specific resources and information depending on the type of situation. Under the Businesses section, the resources available include information on relative risk levels in business settings, setting-specific resources and signage toolkits

    The Virginia Department of Labor and Industry also provides information and training for businesses. Information may be found here.

    Business and Workplaces: Virginia Standard

    The Virginia Standard addresses occupational exposure to the SARS-CoV-2 Virus That Causes COVID-19. The revised Standard for controlling COVID-19 became effective September 8, 2021 and can be found here. Training material for the Standard can be found here. Workers who feel unsafe in their workplace can file a formal complaint with the federal Occupational Safety and Health Administration here. Information on how to file complaints about violations of the Standard can be found here. FAQs regarding the Standard can be found here.

    Yes, the Standard requires employers to report to VDH within 24 hours of the discovery of two or more of its own employees present at the place of employment within a 14-day period testing positive for COVID-19. Please visit the DOLI FAQ for information about reporting cases.

    Business and Workplaces: Return to Work

    No. CDC and VDH do not recommend using COVID-19 testing to make this decision. Instead, we recommend a symptom-based strategy for those with symptomatic infections and a time-based strategy for those with asymptomatic infections. These two strategies are summarized in the infographic entitled "VDH When to End Isolation or Quarantine" that is available here.

    CDC recommends that employers should not require a healthcare provider’s note for employees to return to work. Healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely manner. Please follow VDH guidance for travelers.

    CDC recommends that employers should not require a healthcare provider’s note for employees who are sick to validate their illness or qualify for sick leave. Healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely manner.

    You can speak with your supervisor or human resources department about your concerns and related workplace policies. Information about travel can be found here

    Considerations for Religious and Social Events

    Example signage is available in the VDH Business Toolkit. Further guidelines for social gatherings can be found in the VDH Social Gatherings webpage here. Guidance from the CDC for Events and Gatherings can be found here. Additional considerations for events and gatherings can be found here.

    For more information on travel please visit the VDH travel page. Additional information can also be found on the CDC Travel page here.

    Carpooling is safest between vaccinated individuals. VDH does not recommend carpooling for those who are not vaccinated. If it is necessary for unvaccinated individuals to carpool, the CDC recommends the following ways you can help prevent the spread of COVID-19 when carpooling:

    • Wear masks in a shared vehicle
    • Cover coughs and sneezes
    • Limit the number of people
    • Ride with the same people to work or to other events and gatherings
    • Use fresh air through vents or windows
    • Clean and disinfect surfaces often
    • Use proper hand hygiene
    • Stay at least six feet apart while waiting

    Singing is considered to be a high risk activity due to the increased amount of respiratory droplets and aerosols that may contain the COVID-19 virus if a person is infected. For this reason, singing is not recommended for unvaccinated individuals as part of religious services at this time. Increasing distance between individuals, wearing masks, and increasing ventilation in an area (or singing outside) can help reduce this risk.

    The Virginia Department of Health has worked closely with the Virginia Department of Housing and Community Development (DHCD) to create guidance for homeless shelters.  More information can be found on our webpage, including links to the specific guidance documents and resources from the Centers for Disease Control and Prevention (CDC). CDC also has a toolkit for community and faith-based organizations here

    VDH has worked with the Department of Education (DOE) to create guidance for child care and K-12 schools. The relevant Phase guidance and other resources can be found on our webpage for Child Care and Camps or our webpage for K-12 education.

    Community service activities occurring at religious organization facilities should follow the relevant physical distancing, occupancy, and cleaning & disinfection phase guidance for businesses. More information can be found on the VDH webpage for businesses and CDC toolkit for community and faith-based organizations here.

     

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

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

    Additionally:

    1- If you are allowed to visit your loved one in a nursing home, make sure you are not sick. If you are sick, delay your visit until you can see your doctor and get checked out.

    2- If you are not sick and visiting your relative in a nursing home, make sure to wash your hands and wear a mask during your visit. The CDC recommends that all people entering a health facility wear a mask to stop the spread of COVID-19. Maintain at least six feet of physical distance from staff and other residents in the facility. Look for posted signs in the facility with any special instructions.

    3- If your loved one is sick, especially with a cough, fever, or difficulty breathing, inform the doctor or staff at the nursing home for further guidance.

    4- Visitors should not visit more than one resident at a time. Visits should ideally be in the resident’s room. If the resident is in a shared room and the roommate is unvaccinated, the roommate should not be present during the visit if possible. If neither resident is able to leave the room for the visit, all present should maintain physical distance and wear a mask. If the resident and visitor are fully vaccinated, they may choose to have close contact and not wear masks while alone in the visitation space. However, in areas of substantial or high transmission, all people regardless of vaccination status should wear a mask while indoors. If either the resident or their visitor is not fully vaccinated, they may choose to have close contact while wearing masks, though maintaining social distance is the safest option. More information on visitation is available in the updated recommendations from CDC.

    5- When caring for fully vaccinated residents with immunocompromising conditions, long-term care facilities should follow infection prevention and control recommendations for unvaccinated individuals. More information is available here.

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

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

    • Maintain these restrictions:
      • Residents, staff, and visitors should wear a well-fitted cloth mask or face mask, even if they are fully vaccinated. If all residents are fully vaccinated, they may have close contact and not wear a mask in a group setting. In areas of substantial or high transmission, all people regardless of vaccination status should wear a mask while indoors.
      • When indoor visitation occurs for a fully vaccinated resident, ensure that the visitor is aware of the risks associated with visitation, maintains six feet of distance from other residents and staff, and performs hand hygiene before contact with the resident.
      • Develop a plan that manages visitation and visitor flow to make sure that physical distancing can be maintained at all times. This may include limiting the number of visitors per resident allowed at one time and total number of visitors allowed in the facility at one time.
      • Cancel group activities and communal dining when COVID-19 county positivity rate is more than 10% and less than 70% of residents are fully vaccinated.
      • In areas of substantial or high community transmission, group activities and communal dining can be allowed and if there are unvaccinated residents present, all residents should wear a mask and the unvaccinated residents should maintain physical distance. If all residents are fully vaccinated however, they may choose to have close contact and not wear a mask. In areas of low or moderate community transmission, fully vaccinated residents who do not have other indications for source control (e.g., close contact with someone with SARS-CoV2 infection) may choose not to wear a mask.
      • Fully vaccinated residents should be allowed to leave the facility and are not required to quarantine when they return, as long as they have not had close contact with anyone who had COVID-19 in the past 14 days. Fully vaccinated residents who had close contact with someone with SARS-CoV-2 infection for 15 minutes or more should wear source control and do not need to quarantine unless they develop symptoms or test positive. Unvaccinated residents who had close contact with someone with SARS-CoV-2 infection should quarantine for 14 days, even if they receive a negative viral test.
      • Fully vaccinated residents who are newly admitted do not need quarantine upon admission as long as they do not have symptoms or test positive for SARS-CoV-2.
      • Designate a location to isolate residents with suspected or confirmed COVID-19.
    • Identify cases as early as possible by actively screening all residents daily for fever and respiratory symptoms (pulse oximetry).
      • Long-term care residents with COVID-19 may show atypical symptoms including new or worsening malaise, new dizziness, diarrhea, or sore throat. Identification of these symptoms should prompt isolation and further evaluation.
    • Institute staffing recommendations at the facility:
      • Screen healthcare staff for fever, respiratory symptoms, and possible exposures at the beginning of their shift. If they are ill, have them put on a mask (if they do not wear one already) and leave the workplace.
      • Implement universal use of masks for healthcare staff while in the facility, as supply allows. In areas of low or moderate community transmission, some fully vaccinated staff may choose not to use source control when they are in well-defined areas that are restricted from patient access (e.g., staff meeting rooms, kitchen). However, all staff wearing source control is the safest practice in healthcare facilities.
      • Designate healthcare staff who will be responsible for caring for COVID-19 patients.
      • Asymptomatic healthcare personnel with high-risk exposures may continue to work if they are fully vaccinated. To mitigate staffing shortages, exposed healthcare staff who are not fully vaccinated may continue to work while wearing a mask as long as they remain asymptomatic. More information on work restrictions for staff is available here, under “Work restriction for asymptomatic healthcare personnel and quarantine for asymptomatic patients and residents.”
    • Follow environmental cleaning and disinfection procedures consistently and correctly.
      • Management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures.
    • Continue to regularly vaccinate any new admissions and staff who are not already fully vaccinated.

    Routine testing of residents is not recommended when the facility is not experiencing an outbreak. Routine testing of unvaccinated staff is based on the level of community transmission level of COVID-19 infection. Facilities in communities with moderate, substantial, or high community transmission should routinely test unvaccianted staff. In areas with moderate transmission, unvaccinated staff should be tested once per week. In areas with substantial or high transmission, unvaccinated staff should be tested twice per week. If a symptomatic individual is identified in the facility, residents and staff with signs or symptoms should be tested, regardless of vaccination status. If there is a newly identified case of COVID-19 in the facility and close contacts can be determined, then all residents and staff with close contact to that individual should be tested regardless of vaccination status. If there is a newly identified case of COVID-19 in the facility and close contacts cannot be determined, then residents and staff who shared a location with the case (i.e., unit, wing, floor, etc.) should be tested regardless of vaccination status. More information on testing is available here.

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

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

    Yes, under certain circumstances, restricting residents to their rooms is recommended (not mandated). This type of restriction would apply to care of residents with an undiagnosed respiratory illness, or care of symptomatic residents who are awaiting transport to a facility that can provide a higher level of care which the patient needs. Residents diagnosed with, or suspected to have, COVID-19 are recommended to be isolated in their room(s) with the door closed, regardless of vaccination status. Unvaccinated residents with close contact to an individual who tests positive for SARS-CoV-2 should be quarantined for 14 days. Symptomatic residents, regardless of vaccination status, should be restricted to their rooms. If residents leave their rooms, they should wear a mask, practice social distancing and wash their hands. Residents who leave their rooms can be redirected back to their rooms. It may be helpful to engage the resident in light exercise in the facility – this may reduce restlessness, agitation and wandering. Residents with dementia might require additional assistance and supervision when they leave their rooms.

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

    CDC has guidance for infection prevention and control across a variety of healthcare settings and in nursing homes.

    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 COVID-19 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 FormOther 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 an Assisted Living Facility.”

Special Populations
  • Special Populations: Immunocompromised or Underlying Health Conditions

    Most people who have conditions or who are taking a medication that weakens their immune system can and should be fully vaccinated against COVID-19 unless they have one of the rare contraindications to COVID-19 vaccine.

    If you have a weakened immune system or an underlying health condition but are not yet fully vaccinated, you should talk to your healthcare provider(s) ASAP about getting fully vaccinated with COVID-19 vaccine as well as getting the additional (third) vaccine dose now being recommended for those with weakened immune systems. You should also continue to follow the rest of your treatment plan. 

    However, even after you are fully vaccinated and have received the additional (third) vaccine dose recommended for those with weakened immune systems, your weakened immune system still may not have responded completely to the vaccine. In that case, you may still NOT be fully protected against COVID-19 and you should continue taking all routine COVID-19 precautions to protect yourself and others, until your healthcare provider says you no longer need to do so. 

    At home, those of you with a compromised immune system should closely monitor your own health and should avoid close contact with any household members who are sick. In addition, in order to provide you with an extra layer of protection, you should ask your other household members, friends, care providers, and co-workers who are vaccine eligible to become fully vaccinated against COVID-19.

    Please see our vaccination FAQs for additional information for immunocompromised people. 

    Additionally, when outside your home, you should continue taking standard out-of-home COVID-19 precautions to further reduce your risk of exposure to COVID-19:

    • Wear a mask to protect yourself and others
    • Stay at least six feet from others that you don’t live with..       
    • Avoid crowds and poorly ventilated indoor spaces.
    • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer with at least 60% alcohol.
    • Avoid non-essential travel.
    • Consider having food, medicine and other supplies delivered or mailed to your home.

    In terms of your routine healthcare, call your healthcare provider if you have other concerns about COVID-19 and your underlying condition or if you become sick. 

    And remember, in case of any medical emergency, do NOT delay going to an Emergency Room or calling 911.

    For other information and resources for people with underlying health conditions, please visit  CDC's guidance for People of Any Age with Underlying Medical Conditions. This guidance contains more in-depth information about preventing COVID-19 illness and also categorizes activities by risk level for individuals with underlying health conditions. 

    Please call the Virginia Medication Assistance Program toll free hotline and they can assist you directly.  The phone number is 855-362-0658.

    Patients with COVID-19 who have compromised immune systems should work with their healthcare provider to determine when to end self-isolation. In some cases, severely ill patients with compromised immune systems experience prolonged viral shedding after recovery. As such, severely ill patients should consider isolating for 10-20 days. 

    For more information, please see Discontinuation of Isolation for Persons with COVID -19 Not in Healthcare Settings

    Pregnancy and Infants

    Yes.

    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 non-pregnant women. Additionally, there may be an increased risk of adverse pregnancy outcomes, such as preterm birth (delivering the baby earlier than 37 weeks), among pregnant people with COVID-19. Having certain underlying medical conditions can further increase a pregnant person’s risk for developing severe illness as well. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick.

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

    Yes.

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

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

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

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

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

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

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

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

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

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

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

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

     

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

     

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    Ensure your own social, emotional and mental health

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

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

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

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

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

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

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

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

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

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

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

    Children and COVID-19

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

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

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

    A MMWR article, looking at hospitalizations associated with COVID-19 among children and adolescents, shows that the proportions of hospitalized children and adolescents with severe disease were similar before and during the period of Delta predominance.

    For more information on this topic, please click here. 

    To help pediatricians manage COVID-19 surges while also meeting the needs of non-COVID-19 patients, the AAP has released interim guidance on monoclonal antibody treatment/post-exposure prophylaxis, managing care of patients in inpatient/outpatient settings during episodes of surge, and providing acute care in ambulatory settings.

    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.

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

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

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

    CDC recommends that unvaccinated individuals 2 years and older wear a mask that covers their nose and mouth when they are out in the community and in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. Check here to see if you are in one of those areas.

    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.

    As of August 12, 2021, a Public Health Order requires all individuals aged two and older to wear masks when indoors at public and private K-12 schools., regardless of vaccination status. The Order also applies to PreK if the program is at a K-12 school.

    The Order does not apply to outdoor school settings. VDH recommends those who are not fully vaccinated wear masks in crowded outdoor settings or during outdoor activities that involve close contact with other people, but it is not a requirement. 

    This Order reinforces the current state law (Senate Bill 1303) that requires Virginia schools, to the maximum extent possible, to use prevention strategies outlined by CDC. CDC’s recommended strategies currently include masking of all teachers, staff, students, and visitors while indoors.

    Masks must be worn on school buses, per a federal order.

    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.

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

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

     

    Highlights include the following: 

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

     

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

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

     

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

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

     

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

    It is recommended to take everyday actions to prevent children from getting COVID-19. These actions include getting vaccinated (for children 12 and older), washing hands often with soap and water, avoiding people who are sick, practicing physical distancing between your child and other people, having children 2 years and older wear masks when in public outdoor settings and/or in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. Check here to see if you are in one of those areas. Covering coughs and sneezes, frequent cleaning of surfaces that are touched often, and close monitoring of your child’s health. 

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

    1. Help Children Learn at Home: ask your school district about available school services; create a schedule and routine for learning at home; consider your child's learning needs (needs help or special education services); consider additional homeschooling/learning options; and ongoing communication with your child's school and your child’s teacher. 
    2.  Guidance for Child Care Programs that Remain Open - the site provides a range of options for screening children upon arrival to ensure that children who have a fever or other signs of illness are not admitted to the facility. The additional options may be useful when personal protective equipment (PPE) is in short supply.

    Guidance for Operating Youth Camps During COVID-19- Camp administrators, in collaboration with state, local, territorial, and tribal health officials, can adapt the recommendations in the CDC guidance to meet the unique needs and circumstances of the children served. The guidance is intended to help camp administrators operate camps while preventing the spread of COVID-19 and protecting campers, their families, staff, and communities. Overnight summer camps may begin operation on May 1, 2021. Employ the use of cohorts for the first 14 days of any camp session. Cohort size may not exceed 25 campers, not including camp personnel

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

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

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

    For more information, see: 

    COVID-19 and Children

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

Travelers
  • International Travelers

    The risk of COVID-19 is high in much of the world. The situation varies by country and is subject to change. For the most up-to-date information on travel advisories, please visit CDC’s travel advisory website and review the U.S. Department of State’s Travel Advisories and  country specific COVID-19 recommendations.

    Travel increases your chance of getting and spreading COVID-19. Fully vaccinated travelers are less likely to get and spread COVID-19. However, fully vaccinated international travelers may still face additional risks and should follow guidance provided here. CDC and VDH recommend delaying travel until you are fully vaccinated. COVID-19 risk in many countries is high, and all travelers should avoid nonessential travel to high-risk destinations. To check a destination’s COVID-19 risk level see CDC's COVID-19 Travel Recommendations by Destination.

    Anyone with any symptoms of COVID-19, who has recently tested positive for COVID-19, or is awaiting COVID-19 test results should delay travel. Travelers who are not fully vaccinated and had close contact with someone with COVID-19 within the past 14 days should not travel. 

    When deciding whether to travel, consider not only the potential risk of COVID-19 but also potential travel restrictions, quarantine, testing requirements, and medical care availability in the areas you plan to visit. CDC also recommends all travelers who are not fully vaccinated avoid all cruise ship travel worldwide.

    Yes. CDC has Travel Health Notices for countries and territories with specific advice for fully vaccinated and unvaccinated travelers. If CDC recommends avoiding nonessential travel to a country or territory based on your vaccination status, layovers at the airport should also be avoided.  If a layover is unavoidable, CDC recommends that travelers not leave the airport. Travelers whose only exposure to a higher risk country was in a layover may still be subject to screening and monitoring when entering the United States.

    Some countries have implemented travel restrictions and mandatory quarantines, closed borders, and prohibited non-citizens from entry with little advance notice. If you choose to travel internationally, be aware of the requirements and restrictions for travelers at your destination. If you get sick or are exposed to a person with COVID-19 during your trip, you may be isolated or quarantined and your return to the United States may be delayed.

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

    Foreign nationals who have visited China, Iran, the European Schengen area (includes 26 European countries), the United Kingdom, Brazil, the Republic of Ireland, South Africa, or India in the past 14 days may not enter the United States. Citizens and lawful permanent residents of the United States, certain family members, and other individuals who meet specified exceptions, who have been in one of the countries listed above in the past 14 days will be allowed to enter the United States. For more detail, see CDC’s website on Travelers Prohibited from Entry into the US.

    Effective January 26, the United States requires all air passengers arriving from a foreign country to have proof of a negative COVID-19 test (PCR or antigen test) conducted within the 3 days before departure. Anyone with a positive pre-flight test result should isolate and delay travel until they meet criteria for discontinuing isolation.

    This testing requirement applies to all air passengers, 2 years of age or older, traveling into the United States, including U.S. citizens and legal permanent residents. It also applies to people who have been vaccinated against COVID-19. People who have had a positive viral test in the past 3 months (but not within the past 3 days) and have met the criteria to end isolation may travel with documentation of the positive viral test result and a letter from a healthcare provider or a public health official that states they have been cleared for travel. The positive test result and letter together are referred to as “documentation of recovery”.

    Virginia currently does not have any quarantine requirements for people arriving in Virginia from other countries. VDH recommends (but does not require) that unvaccinated travelers get tested 3-5 days after travel and stay home (quarantine) for 7 days. Unvaccinated travelers who do not get tested should stay home for 10 days.

    Additional information on pre-flight testing requirements and testing, quarantine, and other precautions after travel are available at CDC’s International Travel during COVID-19.

    The family member who recently traveled should follow all testing, quarantine, and other recommendations provided on CDC’s After International Travel website. These recommendations will differ based on whether they are fully vaccinated, not fully vaccinated, or recently recovered (within the past 3 months) from COVID-19.

    Please review the VDH guidance for travelers to learn what to do when you return from a domestic or international trip. Additionally, consult your workplace to learn about their return to work policies. Any traveler who has symptoms or tests positive for COVID-19 should isolate immediately and seek medical care as necessary. Travelers with suspected COVID-19 should get tested. They should not go to work until it is safe to end isolation

     

    Travelers who do not have symptoms or a recent positive COVID-19 viral test should consider whether they are fully vaccinated, not fully vaccinated, or recently recovered from COVID-19. Recommendations for testing, staying home (quarantining), and additional precautions will differ between these groups. See CDC’s After You Travel Internationally webpage to learn what precautions you should take.  

     

    Additionally, some activities may increase the risk of getting or spreading COVID-19, particularly for travelers who are not fully vaccinated. These activities may include cruise travel or travel to countries experiencing high levels of COVID-19 spread. These activities may also be considered when deciding when to return to work.

    CDC recommends in their Guidance for Business Response that employers should not require either a COVID-19 test result or a healthcare provider’s note for employees to return to work. Healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely manner.

    CDC currently recommends that all travelers who are not fully vaccinated avoid cruise travel, including river cruises, worldwide. The risk of COVID-19 spreading on cruise ships is high. CDC also recommends that travelers who are at increased risk of serious illness avoid cruise ship travel, regardless of vaccination status. CDC has issued a Level 3 Travel Health Notice for cruise ship travel.

    If you do decide to travel on a cruise, visit CDC’s COVID-19 and Cruise Ship Travel and Travelers Returning from Cruise Ship and River Cruise Voyages. These pages provide information for travelers who are fully vaccinated, not fully vaccinated, or recently recovered from COVID-19.

    Because of how air circulates and is filtered on airplanes, most viruses and other germs do not spread easily on airplanes. Although the risk of infection on an airplane is low, travelers should wear a mask, maintain as much distance from others as possible, try to avoid contact with sick passengers, and wash their hands often with soap and water for at least 20 seconds or use hand sanitizer that contains at least 60% alcohol.

    Pilots are required by federal regulation to report to CDC all illnesses and deaths that occur on the plane before arriving in the United States. If a sick traveler is considered to be a public health risk, CDC works with local and state health departments and international public health agencies to contact passengers and crew exposed to that sick traveler—according to CDC disease protocols. Be sure to give the airline your current contact information when booking your ticket.

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

    All travelers aged 2 years and older are required to wear face masks while on public transportation into, within, or out of the United States including Virginia (e.g., planes, ships, ferries, trains, subways, buses (including school buses), taxis, rideshares) and while indoors at U.S. transportation hubs, such as airports and stations. This requirement applies to passengers, conveyance operators (e.g., crew, drivers, conductors, and other workers involved in the operation of conveyances), and operators of transportation hubs. Travelers are not required to wear masks in outdoor areas of a transportation conveyance or transportation hub, but masks are still recommended in these areas for travelers who are not fully vaccinated. 

    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.

    FAQs on the public transportation order are available here.

    U.S. Travelers

    COVID-19 is still spreading within Virginia and across the United States (U.S.). It is safe to travel in the U.S. if you are fully vaccinated. If you are not fully vaccinated, travel can increase your risk of getting or spreading COVID-19 and staying at home is the safest option.

     

    If you decide to travel and want to determine if COVID-19 is spreading at or near your destination, check here for U.S. states, cities, and counties. Check here for international locations. Get important information as you consider traveling to different cities and states across the United States here. All travelers should check with the state or local health department where you are, along your route, and where you will be visiting to get the most up-to-date information, in case there are travel restrictions, stay-at-home orders or quarantine requirements upon arrival, state border closures, or other requirements. Plan to keep checking for updates as you travel.

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

    Tests and quarantine for returning travelers are not generally required in Virginia but are recommended for those who are not fully vaccinated with an FDA-authorized or fully approved vaccine or a vaccine authorized for emergency use by the World Health Organization. Visit CDC’s Domestic Travel during COVID-19 to see which precautions you should take after travel. 

    Individuals who are not fully vaccinated and have close contact with someone with COVID-19 should get tested and quarantine for up to 14 days from the date of last exposure. Anyone with any symptoms of COVID-19 should isolate, get tested, and stay away from others for at least 10 days.

    If you have traveled or if you are thinking of traveling within the U.S., check the appropriate state recommendations and mandates before travel and understand how to travel safely and take appropriate precautions. Visit CDC’s Travel Planner to get information about U.S. locations. 

     

    Recommendations and requirements for both fully vaccinated and unvaccinated travelers in the United States are available at CDC’s Domestic Travel during COVID-19 page

    If you are planning to travel for an upcoming holiday, see CDC’s information about Holiday Celebrations.

    All travelers in the United States ages 2 and older are required to wear face masks while on public transportation in the United States including Virginia (e.g., planes, ships, ferries, trains, subways, buses (including school buses), taxis, rideshares) and in indoor U.S. transportation hubs, such as airports and stations. This requirement applies to passengers, conveyance operators (e.g., crew, drivers, conductors, and other workers involved in the operation of conveyances), and operators of transportation hubs. Travelers are not required to wear a mask in outdoor areas of a conveyance (like on a ferry or the top deck of a bus), but masks are still recommended in these areas for travelers who are not fully vaccinated.

    FAQs on the public transportation order are available here.

    Additionally, fully vaccinated people should follow state and local mask recommendations and requirements at their destination. Fully vaccinated people should wear a mask in public indoor settings in areas of substantial and high transmission. This means you are in a place where the spread of COVID-19 is happening more often. Check here to see if you are traveling to or in one of those areas.

    Travelers aged 2 years and older who are not fully vaccinated should continue to wear masks in indoor and outdoor settings, as recommended by CDC. Adults should use their best judgment in putting face masks on children ages 2-4 while inside public areas or when outdoors and within 6 feet of others who do not live with them.

     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.

    Consistent with CDC guidance, Virginia currently does not have any quarantine requirements for people arriving in the Commonwealth from other U.S. locations.

Animals & Veterinarians
  • Animals and COVID-19

    At this time, there is no evidence that animals play a significant role in spreading the virus that causes COVID-19. Based on the limited information available to date, the risk of animals spreading COVID-19 to people is considered to be low. A small number of pets have been reported to be infected with the virus that causes COVID-19, mostly after contact with people with COVID-19. 

    Pets have other types of coronaviruses that can make them sick, like canine and feline coronaviruses. These other coronaviruses cannot infect people and are not related to the current COVID-19 outbreak. 

    Since animals can spread other diseases to people, it’s always a good idea to practice healthy habits around pets and other animals, such as washing your hands and maintaining good hygiene. For more information on the many benefits of pet ownership, as well as staying safe and healthy around animals including pets, livestock, and wildlife, visit CDC’s Healthy Pets, Healthy People website.

    At this time, there is no evidence that the virus that causes COVID-19 can spread to people from the skin or fur of pets. Since animals can spread other diseases to people, it’s always a good idea to practice healthy habits around pets and other animals, such as washing your hands and maintaining good hygiene. Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide, or any other products not approved for animal use. These substances may poison your pet and lead to serious illness or death.

    You should restrict contact with pets and other animals while you have COVID-19, just like you would around other people, until it is safe for you to end isolation and be around others. Although reports of animals becoming sick with COVID-19 are uncommon, it is still recommended that people with suspected or confirmed COVID-19 should avoid contact with animals, including pets, livestock, and wildlife.

    When possible, people should shelter in place with their pets and have a healthy member of the household provide care for the animals. 

    Every effort should be made to allow companion animals to continue to cohabitate with their family when possible. If there is not a healthy family member or friend who can care for the pet while someone is hospitalized, temporary sheltering of the animal might be necessary. Such animals can be boarded at a pet boarding facility (e.g., veterinary clinic, animal shelter, or other boarding facility). 

    While the risks of COVID-19 from contact with such animals are considered very low, it is nonetheless prudent that caregivers use the best available information on general infection prevention for contagious diseases, including coronaviruses.

    • Whenever possible, entry into the home where a person with COVID-19 lived should be avoided in order to prevent transmission. Companion animals should be collected with minimal contact with people living in the home. This includes remaining a minimum of 6 feet away from other people, wearing a mask when around people in the home, and limiting contact with the home environment.
      • If collection of the animal means interacting with people from COVID-19 infected households or being exposed to home environments that might be contaminated with the virus, public health officials may recommend personal protective equipment (PPE) and provide training in the proper use of such equipment. Consult with your local health department.
    • Wash hands with soap and water or use a hand sanitizer that contains at least 60% alcohol before and after handling a companion animal.
    • If an animal needs to be housed in an animal shelter, veterinary clinic, or boarding facility, gloves and gowns or coveralls should be worn while performing routine intake exams and treatments in order to reduce contagious disease risks.
      • Gloves and gowns or coveralls are a good infection prevention control practice generally, and continue to be important during the COVID-19 pandemic. Gowns or coveralls should be laundered before reuse if going to be reused.
      • Hands should always be washed with soap and water including after gloves are removed and discarded.
      • The animal intake area as well as materials in animal areas such as food and water bowls and bedding should be routinely cleaned and sanitized.
      • There is no need to bathe an animal because of COVID-19 concerns; at this time, there is no evidence that the virus that causes COVID-19 can spread to people from the skin or fur of pets.
      • Animals that were in contact with COVID-19 should be separated from the general animal population during the animal’s stay due to the unknown risks associated with this rapidly evolving emerging infectious disease.  
        • Every effort should be made to promptly reunite sheltered companion animals with their owners.
        • Animals that need to be adopted or sent to a foster home should be held for 14 days out of an abundance of caution.
      • Dogs should be walked outside for elimination and exercise but direct contact with other companion animals should be avoided as a best practice to protect animal health.
      • Routine cleaning and disinfection is important in animal areas. Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure. Normal cleaning and disinfection protocols for both animal housing and common areas used in shelters are sufficient. Increased sanitation of surfaces frequently touched by people (e.g., light switches and door knobs) is recommended to reduce exposure to/from humans.

    There are no restrictions on healthy people (those without suspected or confirmed COVID-19) interacting with service or therapy animals. As animals can spread other diseases to people, it’s always a good idea to wash your hands after being around animals.

    VDH recommends that people with COVID-19 avoid contact with animals whenever possible. In some situations, it might be necessary for a person with COVID-19 to be in contact with these animals. If you must care for your pet or be around animals while you have COVID-19, you should wash your hands before and after you interact with your pets and wear a mask when you must interact with your animals (e.g., during feeding or walking). Those with COVID-19 should avoid petting, snuggling, being kissed or licked, and sharing food with their animals until it is safe to end isolation

    There are no restrictions on healthy people (those without suspected or confirmed COVID-19) interacting with animals. As animals can spread other diseases to people, it’s always a good idea to wash your hands after being around animals.

     

    Make sure that you have adequate supplies of food, medications and any other items necessary for both you and your pet for the length of quarantine recommended (i.e., up to 14 days) for those exposed to COVID-19

     

    If you become sick during your quarantine period, or test positive for the virus that causes COVID-19, follow the advice for those who are sick and have animals. Specifically, you should restrict contact with pets and other animals while you have COVID-19, just like you would around other people. Although reports of animals becoming sick with COVID-19 are uncommon, it is still recommended that people with suspected or confirmed COVID-19 should avoid contact with animals, including pets, livestock, and wildlife.. When possible, people should shelter in place with their pets and have a healthy member of the household provide care for the animals. Those with COVID-19 should avoid contact with pets, including petting, snuggling, being kissed or licked, and sharing food until it is safe to end isolation. If you must care for your pet or be around animals while you have COVID-19, wear a mask and wash your hands before and after you interact with pets. 

    Based on the limited information available to date, the risk of animals spreading COVID-19 to people is considered to be low. There is no reason to think that any animals, including shelter pets, play a significant role in spreading the virus that causes COVID-19.

    We know that cats, dogs, and a few other types of animals can be infected with SARS-CoV-2, the virus that causes COVID-19, but we don’t yet know all of the animals that can get infected. Of the small number of animals confirmed to have SARS-CoV-2 in the U.S., it is believed that most of the animals became sick after contact with infected people. 

    Recent experimental research shows that many mammals, including cats, dogs, bank voles, ferrets, fruit bats, hamsters, mink, pigs, rabbits, raccoon dogs, tree shrews, and white-tailed deer can be infected with the virus. Cats, ferrets, fruit bats, hamsters, racoon dogs, and white-tailed deer can also spread the infection to other animals of the same species in laboratory settings. Data from studies suggest that dogs can get infected but might not spread the virus to other dogs as easily as cats and ferrets can. There is some evidence suggesting that laboratory mice, which could not be infected with original strains of SARS-CoV-2, can be infected with new virus variants. 

    Some non-human primates can become infected with SARS-CoV-2 and become sick. SARS-CoV-2 has also been reported in mink (which are closely related to ferrets) on mink farms in multiple countries. 

    Chickens and ducks do not seem to become infected or spread the infection based on results from studies. 

    At this time, there is no evidence that animals play a significant role in spreading the virus that causes COVID-19. Based on the limited information available to date, the risk of animals spreading COVID-19 to people is considered to be low. Further studies are needed to understand if and how different animals may be affected by the virus that causes COVID-19.

    For additional information, see: CDC: Animals and COVID-19

    We are still learning about this virus and how it spreads, but it appears it can spread from humans to animals in some situations. The CDC is aware of a small number of pets reported to be infected with the virus that causes COVID-19 after close contact with people with COVID-19, however, there is no evidence that pets, including cats and dogs, play a significant role in spreading COVID-19 to people. The virus that causes COVID-19 spreads mainly from person to person.

    People with suspected or confirmed COVID-19 should avoid contact with animals, including pets, livestock, and wildlife until it is safe to end isolation. If you must care for your pet or be around animals while you have COVID-19, wear a mask and wash your hands before and after you interact with pets. Those who are sick should avoid petting, snuggling, being kissed or licked, and sharing food with their animals until it is safe to end isolation.

    Keep pets indoors when possible to prevent them from interacting with other animals or people.

    For additional information, see: CDC: Animals and COVID-19.

    The USDA National Veterinary Services Laboratories (NVSL) confirmed on December 31, 2020 that a Virginia cat tested positive for SARS-CoV-2. This is the first animal in Virginia that has tested positive. It is believed that the cat became ill after being in close contact with people sick with COVID-19. On April 20, 2021, NVSL confirmed that three tigers at a Virginia zoo also tested positive for SARS-CoV-2. 

    Based on information available to date, it appears that the virus can spread from people to animals in some situations. People with suspected or confirmed COVID-19 should avoid contact with animals, including pets, livestock, and wildlife. If you must care for your pet or be around animals while you have COVID-19, wear a mask and wash your hands before and after you interact with pets. Those who are sick should avoid petting, snuggling, being kissed or licked, and sharing food with their animals until it is safe to end isolation

    The United States Department of Agriculture (USDA) and the Centers for Disease Control and Prevention (CDC) do not recommend routine testing of animals for this virus. In some situations, the decision might be made to test animals in certain unique circumstances. The decision to test should be made collaboratively between the animal’s clinical veterinarian and public and animal health officials.

    Call your veterinary clinic with any questions about your animal’s health. In order to ensure the veterinary clinic is prepared for the animal, the owner should call ahead and arrange the hospital or clinic visit. Make sure to tell your veterinarian if your animal was exposed to a person with COVID-19, and if your animal is showing any signs of illness. Veterinarians with questions about testing can contact state animal and public health officials who help decide whether samples should be collected and tested.

    Currently, there is no evidence that wildlife might be a source of infection for people in the United States. The first case of a wild animal testing positive for the virus in the United States was a tiger with respiratory illness at a zoo in New York City. However, this tiger was in a captive zoo environment, and public health officials believe the tiger became sick after being exposed to a zoo employee who was infected and spreading the virus.

    We are still learning about this virus, but it appears that it can spread from people to susceptible animal species in some situations, especially after close contact with a person with COVID-19. For this reason, the virus may threaten the health and welfare of wildlife and could negatively impact conservation efforts. Anyone who comes into close proximity or contact with wildlife is encouraged to take caution to minimize the spread of SARS-CoV-2 between people and wildlife. ​

    If a wild animal were to become infected with the virus, we don’t know whether the infection could then spread among wildlife or if it could spread to other animals, including pets. Further studies are needed to understand if and how different animals, including wildlife, could be affected by COVID-19. Because wildlife can carry other diseases, even without looking sick, it is always important to enjoy wildlife from a distance.

    Take steps to prevent getting sick from wildlife in the United States:

    Other coronaviruses have been found in North American bats in the past, but there is currently no evidence that wildlife might be a source of infection for people in the United States.. In general, coronaviruses do not cause illness or death in bats, but we don’t yet know if this new coronavirus would make North American species of bats sick. Bats are an important part of natural ecosystems, and their populations are already declining in the United States. Bat populations could be further threatened by the disease itself or by harm inflicted on bats resulting from a misconception that bats are spreading COVID-19. However, there is no evidence that bats in the United States are a source of the virus that causes COVID-19 for people. Further studies are needed to understand if and how bats could be affected by the virus that causes COVID-19.

    For more information, visit: CDC Reducing the Risk of SARS-CoV-2 Spreading between People and Wildlife.

    There have not been any reports of horses testing positive for the virus that causes COVID-19. Based on the limited information available to date, the risk of animals spreading the virus that causes COVID-19 to people is considered to be low. COVID-19 is primarily spread from person to person, so steps should be taken to reduce the risks for people visiting your facility.

    • Vaccinations are now available that greatly reduce a person’s risk of getting seriously ill from the virus that causes COVID-19. Fully vaccinated people can resume many activities that they engaged in prior to the pandemic. Encourage employees and other visitors to get vaccinated. To find a COVID-19 vaccination appointment, visit vaccinate.virginia.gov or call 877-VAX-IN-VA (877-829-4682).
      • Unvaccinated employees should be encouraged and supported to make arrangements to get a vaccination. It is a critical step toward protecting an individual’s health and the health of those around them, including family, friends and coworkers.
    • Encourage employees and other visitors, including boarders, owners, farriers, veterinarians, and those taking lessons, not to enter the facility if they are sick or have recently tested positive for the virus that causes COVID-19.
      • People who have been sick should not enter the facility until the criteria to discontinue home isolation are met. 
      • Implement sick leave policies for employees that are flexible, nonpunitive, and consistent with public health guidance, allowing employees to stay home if they have symptoms of respiratory infection.
    • Consider conducting daily health checks (e.g., symptom and/or temperature screening) of employees and others visiting the facility before they enter the premises. People with a fever or other signs of illness should not be admitted to the premises. If implementing health checks, conduct them safely and respectfully. See our General Business page for more information.
      • Employees or visitors who appear to have symptoms upon arrival or who become sick during their visit should immediately be separated from other employees and visitors and sent home.
    • Consider staggering lessons and visiting times to limit the number of people in the facility at one time and the potential for person-to-person contact. You can also take steps to decrease high-traffic areas by limiting areas open to visitors/owners and staggering the use of common areas like grooming or wash stalls and tack rooms.
    • Allow for physical distancing and avoid large numbers of people within the facility, including in employee-only areas.
    • Visitors and employees who are not yet fully vaccinated should wear masks to protect themselves and others, especially where physical distancing measures are difficult to maintain. Wearing a mask does NOT replace the need to practice physical distancing.
    • Set up hand hygiene stations at the entrance and within the facility, so that employees and people entering can clean their hands before they enter. Employees should wash hands regularly with soap and water for at least 20 seconds. 
      • An alcohol-based hand sanitizer containing at least 60% alcohol can be used, but if hands are visibly dirty, they should be washed with soap and water before using an alcohol-based hand sanitizer. 
      • Examples of hand hygiene stations may be a hose and soap located at entrances to allow for handwashing before entry.
    • Clean and disinfect frequently touched surfaces such as grooming tools, halters, lead ropes, shared tack and equipment, and door handles/gates (including those to stall doors and pasture/turn out areas) on a routine basis. To disinfect, use products that meet EPA’s criteria for use against the virus that causes COVID-19 and are appropriate for the surface, diluted household bleach solutions prepared according to the manufacturer’s label for disinfection, or alcohol solutions with at least 70% alcohol. Follow manufacturer’s directions for use, especially regarding product contact time and protections from chemical hazards posed by cleaners and disinfectants.
    • Follow state and local guidance on travel, mask use and other COVID-19 precautions when traveling for showing, training, or trail riding.
    • If other animals, such as barn cats, are present at the facility, be aware that a small number of pets have been reported to be infected with the virus that causes COVID-19, mostly after contact with people with COVID-19.

    For more information, see:

    VDH: Businesses and COVID-19

    CDC: Guidance on Preparing Workplaces for COVID-19 and Interim Guidance for Businesses

    CDC: Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19)

    Information for Veterinarians

    Given community transmission of COVID-19 in Virginia and nationally, veterinary clinics should consider the following:

    General Concepts to Prevent COVID-19:

    • Get vaccinated: Vaccinations are now available that greatly reduce a person’s risk of getting seriously ill from the virus that causes COVID-19. Fully vaccinated people can resume many activities that they engaged in prior to the pandemic. Encourage employees to get vaccinated. To find a COVID-19 vaccination appointment, visit vaccinate.virginia.gov or call 877-VAX-IN-VA (877-829-4682).
    • Wear a mask: Unvaccinated people can spread COVID-19 to others even if they do not feel sick. Encourage employees, clients and other persons who enter the veterinary clinic to wear masks, regardless of vaccination status. 
    • Watch your distance: The greatest risk of exposure to COVID-19 comes from contact with other people. Businesses offering professional services, such as veterinary practices, should ensure patrons can adhere to physical distancing recommendations and practice enhanced sanitizing practices, particularly on high-touch surfaces (such as workstations, countertops, and doorknobs). Veterinary practices can utilize various strategies to increase physical distancing, such as offering "curbside" service. The main goal is to limit the number of people you come into contact with on any given day. 

    Consider making arrangements to have clients call you from their car upon arrival, and have someone from your practice pick up the animal outside so the client does not have to come inside the practice. Discuss care measures via phone when possible.

    Limit the number of people coming into the clinic. Recommend restriction of employee visitors (family, friends, and pets) to business purposes only and request that clients limit the number of people who accompany an animal to the clinic for an appointment.

    Veterinary clinics should follow similar guidance to prepare and respond to the threat of COVID-19 as any other business in the Commonwealth. 

    • Wash your hands: Encourage everyone in your clinic to wash their hands often. Signs reminding people to wash their hands can help with this.
    • Stay home when sick: Veterinary hospital management should actively encourage sick employees to stay home by ensuring that the practice’s sick leave policies are flexible and consistent with public health guidance. Telework options should be explored, where possible. 

    If you or a member of your staff are ill with symptoms COVID-19, or have recently tested positive for the virus that causes COVID-19, stay at home. If you or a member of staff become ill during a shift, go home immediately. 

    Encourage clients who are sick to reschedule non-urgent pet appointments. If the appointment is urgent, have a healthy person bring the animal for care.

    • Follow public health guidance for those exposed to a person with COVID-19: If you or a member of your staff have potentially been exposed to a person with COVID-19, follow current public health recommendations for quarantine, testing, health monitoring and other precautions to prevent further transmission.

    Additional Infection Prevention and Control Strategies:

    Employee Return to Work After Illness: For information about when an employee can return to work after a suspected or confirmed diagnosis of COVID-19, visit VDH’s If You Are Sick page and When It Is Safe To Be Around Others infographic .

    All employers can find additional guidance to prevent COVID-19 in the workplace at the following sites: https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html and https://www.vdh.virginia.gov/coronavirus/schools-workplaces-community-locations/

    Great information is also available on the AVMA website at: https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19

    More detailed guidance for veterinarians is also available at the CDC: Interim Infection Prevention and Control Guidance for Veterinary Clinics Treating Companion Animals During the COVID-19 Response.