General FAQ

Spread of the Omicron variant 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. To find your COVID-19 Community Level, visit the CDC website. 

VDH continues to collect and monitor the data on COVID-19 cases, hospitalizations, and deaths. 

VDH continues to work with our laboratory partners at the Division of Consolidated Laboratory Services. Genomic surveillance of positive samples to identify how the SARS-CoV-2 virus can be genetically different, helps us monitor for specific variants and to detect other genetic changes in the virus that are present in positive cases in Virginia.

VDH epidemiologists might identify situations of concern, for example, COVID-19 infection in people who had recent international travel to an area where new variants are coming up, outbreaks that seem to spread very quickly, or cases of illness that are more severe than expected. In these situations, whole genome sequencing of samples can be requested to help our public health investigation and response efforts.

The VDH wastewater surveillance program can provide an early signal for a rise in COVID-19 cases, including cases with and without symptoms, and samples can also be tested for variants. Wastewater surveillance can also provide data on the prevalence (proportion of the population that have an infection) of the virus in the community when patient testing data is limited. 

We are closely watching the effect of variants on several dynamics of the pandemic including the effect on how easily they spread, disease severity, on immunity after vaccination or natural infection, on the ability of tests to detect the virus, on the effectiveness of monoclonal antibody treatments, and on vaccine effectiveness. 

COVID-19 Community Levels can help communities and individuals make decisions based on the level of COVID-19 transmission in their specific county,and their unique needs.

Use the VDH Geography Locator Tool to help you identify your health district and health region.

VDH is changing from trying to investigate every case of COVID-19 and trace all contacts to focusing on follow-up of outbreaks and cases in high risk settings. Public health staff will prioritize responding to COVID-19 clusters and outbreaks in long-term care facilities and other congregate settings, healthcare settings, and other high-risk settings, and will focus on follow-up with individuals most at risk for negative health effects from COVID-19. More information on contact tracing is available on the VDH website.

COVIDWISE is the official Virginia Exposure Notification System (ENS) app. This free smartphone app is available to all Virginians on Google Play and in the App Store. Your phone can be used to notify you quickly if you’ve been exposed. Using the app is voluntary and your privacy is protected. Location is never used and the app has a feature that can take symptom onset date into consideration. 

Information on COVIDWISE can be found on VDH’s COVIDWISE webpage 

FAQs regarding COVIDWISE can be found on VDH's COVIDWISE FAQ page.

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 or 855-922-2644 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 COVIDWISE Verification Code Portal. This portal will allow individuals who have tested positive for COVID-19 to get 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, if you are not up to date on COVID-19 vaccines or you have not tested positive with a viral test for COVID-19 in the last 6 months, you stay at home and away from others, especially from those at a higher risk of severe illness, as much as possible. Wear a mask for at least 10 days, 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 an online tool developed by the national non-profit MITRE, in collaboration with state and national public health organizations  to use daily health checks to monitor people who are sick with COVID-19 or who may have been exposed. If you are identified as being exposed to COVID-19 by your local health department, you will get a daily message from Sara Alert™ asking 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 via text, email, or phone how you’re feeling and help to slow the spread of COVID-19 in your community. Learn more about How Sara Alert™ Works.

Information on Sara Alert can be found on the Sara Alert webpage.

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

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

Mask guidance: 

• People with symptoms, a positive test, or who were exposed to someone with COVID-19 (and either not up to date on COVID-19 vaccines or have not tested positive for COVID-19 in the last 6 months) should wear a mask.
• People should also wear a mask based on the COVID-19 Community Level (low, medium or high) in areas where they live. 
• People with weakened immune systems or who are at increased risk for severe illness :
  • should talk to their healthcare provider about what extra precautions, like masking, that they may need.
  • should wear a mask or respirator that gives them more protection when their COVID-19 Community Level is high.
  • should avoid non-essential indoor activities when COVID-19 Community Level is high.
• People may choose to mask at any time.
• Please note, the COVID-19 Community Level mask guidance does not apply to healthcare settings; in these settings please follow CDC’s infection prevention and control recommendations for healthcare settings.

Testing guidance: 

• At all COVID-19 Community Levels, get tested if you have COVID-19 symptoms.
• You should get tested five days after you are exposed to someone with COVID-19, if you have not recovered from COVID-19 (with a positive viral test) in the past 6 months or you are not up to date on your COVID-19 vaccines.
• People with weakened immune systems or who are at increased risk for severe illness should talk to their healthcare provider about testing recommendations, regardless of the COVID-19 Community Level. 
• Medium or High COVID-19 Community Level: If you have household or social contact with someone at high risk for severe disease, you should consider self-testing to detect infection before contact. 
• Treatments work best when started early, so rapid access to testing is critical for people at increased risk, in addition to other layers of prevention. 

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

Yes. 

While all masks and respirators provide some level of protection, properly fitted respirators provide the highest level of protection. Wearing a highly protective mask or respirator may be most important for certain higher risk situations (e.g., taking care of someone who has COVID-19), or by some people at higher risk for severe illness. 

Masks can also help protect others in the surrounding area by reducing the amount of virus that any infected person, even someone who does not know yet that they are infected, can spread to others. This added protection is particularly important since many people infected with the Omicron, BA.2 and BA.2.12.1 variants can be infected but “asymptomatic”. Wearing a well-fitting mask can help reduce the amount of virus that an infected person, even an asymptomatic one, breathes out into her or his surroundings. Anyone around an infected person with no symptoms can still be protected in part if that infected person is wearing a mask and is thus breathing out smaller amounts of virus. 

Some masks and respirators may be harder to tolerate or wear consistently than others. Therefore, it’s important that you always choose a well-fitting and comfortable mask or respirator and wear it properly (covering your nose and mouth). A mask or respirator will be less effective if it is not worn properly or taken off frequently.

The latest VDH guidance on masks, and when to wear one, can be found on the mask webpage. Masking guidance varies depending on the community level of COVID-19 transmission and the updated guidance does not apply to congregate or healthcare settings.

The CDC has a new webpage to help you Find Free Masks. Information on how to use your N95 respirator is available on the CDC website.

High-quality non-surgical N95 masks are being made available to all Americans for free. Masks are available at community health centers and retail pharmacies across the U.S. Up to three masks will be available to each person for free.

You can visit CDC’s Find Free Masks (N95 Respirators) webpage where you can enter your zip code to find free respirators at participating locations.

You can also visit:

• Vaccines.gov to find pharmacies near you that are distributing free masks.
• HRSA Health Center COVID-19 N95 Mask Program to find community health centers distributing free masks.

If you are up to date with your vaccines, 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 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.

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. This requirement to wear a mask on airplanes, rail travel, and public transportation has been extended through March 18, 2022. 

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

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 and respirators are effective at reducing the spread of the virus that causes COVID-19, when worn consistently and correctly.Some masks and respirators give more protection than others, and some may be harder to tolerate or wear frequently than others. It is most important to wear a well-fitted mask or respirator correctly that is comfortable for you and that provides good protection.

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 Your Guide to Masks for additional information from the CDC. 

Visit the Mask webpage for more information from VDH.

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. CDC also provides easy to read material.

Portable air cleaners (also known as air sanitizers or purifiers) can help get clean air delivered by using a high-efficiency particulate air (HEPA) filter. A HEPA filter is a type of mechanical air filter that can likely remove at least 99.7% of dust, pollen, mold, bacteria, and small airborne particles. 

When used properly, portable air cleaners and HEPA filters can help reduce airborne contaminants. Portable HEPA filters may be especially helpful when you cannot let in  outdoor air 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 stay up to date on COVID-19 vaccines and use other prevention measures.

The VDH fact sheet has information on how to improve ventilation, to reduce the risk of COVID-19 spread indoors.

You can view the CDC Interactive Ventilation Tool to see how particle levels change indoors, as you adjust ventilation settings. 

Additional household precautions and other best practices recommended are available:

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 easily indoors than outdoors. Ask experienced heating, ventilation, and air conditioning (HVAC) professionals when considering changes to HVAC systems and equipment.

Ways to improve ventilation indoors are available on the CDC website.

More detailed information about improving ventilation can be found on CDC’s Ventilation in Buildings page. The Environmental Protection Agency (EPA) also issued guidance in March 2022 (Clean Air in Buildings Challenge: Guidance to Help Building Owners and Operators Improve Indoor Air Quality and Protect Public Health).

The VDH fact sheet has information on how to improve ventilation, to reduce the risk of COVID-19 spread indoors.

You can also view the CDC Interactive Ventilation Tool where you can create different scenarios by selecting options, to see how particle levels change indoors, as you adjust ventilation settings.

To be considered exposed to COVID-19, you have to have had close contact with someone who is suspected or confirmed to have COVID-19 while they are contagious (can spread the infection). 

Close contact means:

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

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

Using the COVIDWISE app on your phone 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. 

For more information visit VDH’s what to do if you've been exposed to COVID-19. CDC has a fact sheet with Recommendations for COVID-19 Close Contacts.             

Visit VDH’s what to do if you've been exposed to COVID-19 for complete guidance. 

•  Quarantine. Counting the last time you had contact with that person as Day 0, you should quarantine (stay home) for 5 days afterwards (i.e. Day 0-5).
• Wear a well-fitting mask around other people, inside your home or in public for 10 days. Do not go to places where you are unable to wear a mask. Avoid travel for 10 days.
• Monitor your health for 10 days after your last contact. Look for common symptoms of COVID-19. 
• Get tested on Day 5 or soon after, if possible. Get tested immediately if you develop symptoms. If your test is positive, follow the isolation guidance.
• Respond to notifications. If you use the COVIDWISE app and receive a notice that you have been exposed, stay home (quarantine), and monitor your health after the possible exposure. 

These people are not required to stay home (quarantine) after exposure: 

• People who are up to date with your COVID-19 vaccines.
• People who had COVID-19 within the last 6 months (you tested positive using a viral test) if they have fully recovered and remain asymptomatic. 
• People who had COVID-19 within the last 90 days (you tested positive using a viral test) if they have fully recovered and remain asymptomatic in the following settings: healthcare workers/facilities or staff and residents of long term care facilities,  correctional facilities, or homeless shelters.

Other people might not have to stay home (quarantine) after exposure.

• Students ages 5-11 years who completed their COVID-19 primary vaccine series but have not yet received a booster can forgo quarantine at this time. However, starting with the beginning of the 2022-2023 academic school year, all students should follow general CDC Quarantine Guidance, and should quarantine if they are not up to date on COVID-19 vaccines (including booster doses, when eligible).
• Healthcare personnel (HCP) who are up to date on their vaccinations for COVID-19 should be tested immediately (but generally not earlier than 24 hours after the exposure) and 5–7 days after exposure, even if they don’t have symptoms. However, they do not need to stay home (self-quarantine) after a workplace or community-associated exposure or be restricted from work as long as they are not immunocompromised (e.g., organ transplant, cancer treatment) or do not have any symptoms. HCP who have recovered from SARS-CoV-2 infection in the prior 90 days and do not have any new symptoms do not require work restriction following a higher-risk exposure. HCP should continue to follow quarantine recommendations after close contact and follow all travel recommendations. For additional details, visit CDC’s Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the COVID-19 Pandemic.
• People who traveled in the United States or arrived back in the United States after traveling internationally should visit VDH’s Travelers website for information about testing requirements and recommendations for travelers.

People who are not required to stay home (quarantine) after exposure should still watch for symptoms of COVID-19 for 10 days and continue to wear a mask, stay at least 6 feet away from others, avoid crowds and poorly ventilated indoor spaces, and wash hands often.

  It depends on the situation.

• If you develop COVID-19 symptoms, you should get tested immediately. 
• If you do not develop COVID-19 symptoms and are not up to date on COVID-19 vaccines, you should consider getting tested 5 days (or soon after) following your last close contact with the person with COVID-19. If you have ongoing exposure (e.g.,as a household contact or caregiver), even if you are up to date on COVID-19 vaccines, you should consider getting tested twice.The first time is 5–7 days after the first exposure. The second time is 5–7 days after the end of isolation for the person with COVID-19. 
• If you tested positive for COVID-19 with a viral test within the previous 6 months and recovered afterwards, and remain without COVID-19 symptoms, you do not need to get tested after close contact. 

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

People who are not up to date with their COVID-19 vaccinations should quarantine for 5 days following their last exposure, even if they have a negative test during this period: If you do not develop symptoms, counting your date of last exposure as Day 0, you should get tested on or soon after Day 5, if possible. If you test negative on or after Day 5, you can end quarantine (leave your home) after Day 5 if you do not have COVID-19 symptoms. You should continue to wear a mask when around others and in public for Days 6–10. If you cannot wear a mask around others, quarantine at home until Day 10 after your last exposure.
It can take up to 10 days after an exposure for you to develop symptoms of COVID-19. 

People who are up to date with their COVID-19 vaccinations and those who had COVID-19 in the last 3 months (90 days) do not need to quarantine if they do not have COVID-19 symptoms.

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

You do not need to be tested or stay home (quarantine) if you are a contact of a contact. But you should stay in touch with that contact person. If your contact person tests positive for COVID-19, then you become a true close contact and may have to be tested and stay home (quarantine), depending on your vaccination, booster or recent COVID-19 recovery status.

If you have been in close contact with a person with COVID-19, you should take your temperature twice daily and remain alert for COVID-19 symptoms. It is important to not eat, drink, or exercise for at least 30 minutes before taking your temperature. These symptoms include 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 or and diarrhea.      

It may take up to 10 days after an exposure for you to develop COVID-19. 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, visit VDH’s If you are sick or Infected website. 

For more information on what you should do if you have been exposed to COVID-19, visit the VDH Exposure to COVID-19 Website.

People with COVID-19 might not have any symptoms. If they do have symptoms, these can range from mild to severe.

Symptoms can include:

This list does not include all possible symptoms and will be updated as we learn more about COVID-19. See the list of symptoms on the CDC website.

Because COVID-19 symptoms can look different in different people, it is important to get tested and/or speak to your healthcare provider if you have any concerns about your symptoms. You can use the Coronavirus Self-Checker to help you decide when to seek testing or medical care.

Yes. It is possible to be infected by the flu and COVID-19 at the same time. The best way to prevent this from happening is to get vaccinated against both COVID-19 and the flu. One vaccine is not a substitute or a replacement for the other.

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 be needed during flu season to know which disease you have.

If you have flu or COVID-19 symptoms, you should stay home and contact your Healthcare Provider for evaluation, treatment, and testing. 

More information regarding similarities and differences between flu and COVID-19 is available on the CDC website.

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

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

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

• Contact your healthcare provider right away and call ahead before visiting your healthcare provider if you think you might have COVID-19, to determine if you need treatment. 

• Stay home (isolate) for at least 5 days, except to get medical care. Visit VDH’s Isolation Calculator. Do not go to work, school, or public areas and avoid using public or group transportation. Stay in touch with your doctor. Be sure to get care or find treatment options if you feel worse or think it is a medical emergency. Your first day of symptoms should be counted as Day 0. If you have a positive test and no symptoms, Day 0 is the day you tested. You can leave isolation on Day 6 if you are fever-free for 24 hours without fever-reducing medication, your other symptoms have improved, and you can wear a mask around other people through Day 10.

• • • Separate yourself from other people and animals in your home as much as possible and avoid contact with other household members, including pets.
    • If you are immunocompromised, consult your healthcare provider for the duration of your isolation and visit CDC’s Ending Isolation web page.

• Get tested if you have symptoms, regardless of vaccination status. If you cannot find a test, continue to follow steps for isolation until you can get tested. 

• Wear a well-fitting mask or respirator for 10 days when you are around other people (e.g., sharing a room or vehicle) or pets. 

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

• Wash or clean your hands often with soap and water for at least 20 seconds. Avoid touching your eyes, nose, and mouth. If you can’t wash your hands with soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and wrists 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.”
• Tell your recent 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. 

• 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. CDC has fact sheets with recommendations for people with COVID-19 and CDC Interim Guidance on Home Isolation

This VDH guidance applies to general community settings, including K-12 schools, colleges and universities, and workplaces. It does not apply to healthcare facilities or high-risk congregate settings (e.g., correctional and detention facilities, homeless shelters, or cruise ships). Visit VDH’s Schools, Workplaces, & Community Locations webpage for additional details for how to isolate in your particular setting. 

These groups, or people that fit into more than one of these groups, are at higher risk for developing severe illness:

• Older people 
• People living in a nursing home or long-term care facility 
• People with weakened immune systems 
• People of any age with certain medical conditions and disabilities
• People from racial and ethnic minority groups 

”Breakthrough infection” is a term describing a SARS-CoV-2 virus infection that causes a usually mild COVID-19 illness even after you have been fully vaccinated or are up-to-date with your COVID-19 vaccinations. In public health terms, breakthrough infections should not be considered vaccine failures because they are expected to occur in some people who receive any vaccine, since no vaccine is 100% effective.  Breakthrough infections are nearly always mild although they can sometimes be more severe in people whose immunity is weakened because of an underlying illness or because they are elderly. In nearly everyone else, being up to date with COVID-19 vaccination is highly protective against severe illness and hospitalization. 

Yes, there can be.

Although most people with COVID-19 get better within weeks to months of illness, some do not. Scientists 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.

The best way to prevent long-term effects of COVID-19 is by getting vaccinated against COVID-19 as soon as you can.

More information on long-term effects of SARS-CoV-2 infection and COVID-19 illness can be found on CDC’s Post-COVID Conditions website.

Check out the following website(s):

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

CDC COVID-19 Symptoms Website

CDC also provides easy to read materials: 

Things to Know about COVID-19

10 Things to Know When You Have COVID-19

Staying Away from People When You Have COVID-19

Long COVID is also known as post-COVID conditions. People suffering from Long COVID are sometimes called “Long Haulers”. Long COVID is a range of symptoms that can last weeks or months after first being infected with the SARS-CoV-2 virus that causes COVID-19. Long COVID symptoms  can appear weeks after initial infection. Long COVID can happen to anyone who has had COVID-19, even if the illness was mild, or even if 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

Some of these symptoms can get worse after physical or mental activities.

More information on long-term effects of COVID-19 illness can be found on CDC’s  Post-COVID Conditions website.

The World Health Organization (WHO) developed a clinical case definition of post COVID-19 condition in October 2021, stating that the condition is “usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis.”

Yes. However, being up to date with COVID-19 vaccination reduces the risk of getting Long COVID.

The extent of protection from Long COVID with vaccination is uncertain. Among people who do get COVID-19 disease, recent information from a large British study suggests that, compared to vaccinated people who get breakthrough COVID-19 infections, about twice as many unvaccinated people who get COVID-19 have symptoms lasting more than 28 days. Another large study suggests that vaccines offer less protection against long term symptoms than previously expected. This is an evolving area of research. Additional studies will be needed to clarify the ultimate burden of “Long COVID” in vaccine breakthrough cases. 

Yes. According to a recent large review (that is not yet peer reviewed), 1 in 4 children  with COVID-19 symptoms develop "Long COVID”. The most common reported symptoms were mood symptoms, fatigue, and sleep disorders.

As more is learned about the natural history of SARS-CoV-2 infection, the symptoms and conditions will likely change over time.

A UK study, published in the journal called Nature, shows that even mild COVID-19 illness can lead to changes in the brain, with less gray matter in the parts related to smell and memory.

A study published in  the medical journal Radiology shows that small airway disease and air trapping occurs and persists in some individuals, regardless of the severity of their prior COVID-19 illness. 

A study published in Nature, showed that individuals with COVID-19 , even those who were not hospitalized, are at increased long term risk of cardiovascular disease (including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease.) 

A CDC MMWR shows that approximately 1 in 5 adults 18+ have a health condition that might be related to their previous COVID-19 illness. 

See how CDC is using science to learn more about long COVID

Most post-COVID conditions can be diagnosed and managed by primary care providers. If needed, specialty care providers and support services (e.g., occupational therapy, physical therapy, social work) can work with people with this condition to help them rehabilitate and regain their strength and abilities. Healthcare professionals may also consider referral to post-COVID care centers for additional care. 

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)

The RECOVER (Researching COVID to Enhance Recovery) initiative is working on a nationwide study population to support research on the long-term effects of COVID-19. This program is a research initiative from the National Institutes of Health (NIH). Interested volunteers can visit the website for more information.

Because people with Long COVID have such a large range of possible symptoms, the evaluation and treatment of each Long COVID patient is individualized to the specific symptoms of that patient.

Because the Omicron and its sub-variants have been causing COVID-19 disease for only a short period and because disease caused by them is milder than COVID-19 disease caused by earlier variants, it is not yet clear whether the risk of Long COVID after Omicron or BA.2 infections is any different from the Long COVID risk after earlier COVID-19 variants.

As of July 2021, Long COVID can be considered a disability under the Americans with Disabilities Act (ADA). Learn more: Guidance on “Long COVID” as a Disability Under the ADA, Section | HHS.gov.

People with known or suspected COVID-19 should contact their healthcare provider for specific medical advice.  In general, people with mild illness should stay home, rest, drink plenty of fluids, and take over-the-counter (OTC) medication(s) to help relieve symptoms they are having. Be sure to follow the instructions on the package of the OTC medication, and do not give OTC cough or cold medicine to children under 6 years old. A table of types of OTC medication(s) you can take for each symptom is available on VDH’s web page What to do if you have confirmed or suspected coronavirus disease (COVID-19). Continue to monitor your symptoms and call your healthcare provider if they get worse or you are concerned. Be sure to stay away from others (isolate) in the home to prevent the spread of disease.

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

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

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

Please consult a physician or other healthcare provider for additional recommendations about disease treatment. Further information can be found on CDC’s Treatments Your Healthcare Provider Might Recommend if You Are Sick webpage and on VDH’s Treatments are available for COVID-19 and COVID-19 Therapeutics websites. 

Remdesivir (brand name = Veklury) is an antiviral drug that is used to treat patients with COVID-19. The drug can be used to treat patients who are hospitalized or those who don’t need to be in the hospital.  The FDA has approved remdesivir to treat hospitalized adults and children aged 28 days or older weighing at least 3 kg and who 1) are hospitalized, or 2) are not hospitalized and have mild-to-moderate COVID-19, and are at high risk for progression to severe COVID-19, including hospitalization or death. Remdesivir is given by a healthcare provider who injects the drug into a person’s vein.  

Yes. 

Paxlovid (nirmatrelvir and ritonavir) is a prescription antiviral pill that can be taken at home. On December 22, 2021, FDA granted the drug an Emergency Use Authorization (EUA) to treat COVID-19 patients 12 years or older who are at high-risk of developing severe COVID-19. A large study indicated that if the drug was used within the first five days of illness onset, it was nearly 90% effective in preventing the development of severe COVID-19. Effectiveness in those 65 years or older was about 94%.

Molnupiravir (brand name is Lagevrio) was authorized by FDA on December 23, 2021 to treat infected adults aged 18 years and older who are felt to be at high-risk of severe outcomes from COVID-19. Molnupiravir is a prescription antiviral capsule that can be taken at home. Because testing of molnupiravir in animals suggested a risk of fetal harm, it should not be used in women who are pregnant, at risk of becoming pregnant, or who are breastfeeding.

Paxlovid and Molnupiravir are NOT to be considered as a substitute for COVID-19 vaccination. 

For more information about therapies for COVID-19,  please visit CDC’s Treatments Your Healthcare Provider Might Recommend if You Are Sick webpage and VDH’s Treatments are available for COVID-19 and COVID-19 Therapeutics websites.

Patients can use the COVID-19 Treatment Locator to find a pharmacy near them that carries the medication. Both oral antiviral medications require a prescription from a healthcare provider.  

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 against the SARS-CoV-2 virus (the virus that causes COVID-19) are versions of the antibodies your body naturally makes against the virus, but are made in a laboratory. 

Monoclonal antibodies can be used in three different ways: 1) to prevent COVID-19 in someone before they are exposed to the virus (pre-exposure prophylaxis), 2) to prevent COVID-19 in someone who has already been exposed to the virus (post-exposure prophylaxis), and 3) to treat someone who has COVID-19 (treatment). 

Pre-Exposure Prophylaxis

The FDA has authorized Evusheld, a combination of two different monoclonal antibodies (tixagevimab and cilgavimab), for emergency use for pre-exposure prophylaxis (prevention before exposure) against COVID-19 in adults and pediatric patients (12 years of age and older weighing at least 40 kg) who are not currently infected with SARS-CoV-2 and who have not had a known recent exposure to an individual infected with SARS-CoV-2 AND:

• Who have moderate to severe immune compromise and may not mount an adequate immune response to COVID-19 vaccination, OR
• For whom vaccination with any available COVID-19 vaccine, according to the approved or authorized schedule, is not recommended due to a history of a severe adverse reaction.

Post-Exposure Prophylaxis 

The FDA had previously authorized two combinations of monoclonal antibodies for emergency use as post-exposure prophylaxis (prevention after exposure) for COVID-19 in certain adults and children who were at high risk for progression to severe COVID-19. These were:  

• REGEN-COV
• Bamlanivimab and etesevimab

Both of these monoclonal products, however, are not currently authorized because they are not effective against the Omicron variant that is dominant in the U.S. There are currently no FDA authorized or approved medications for post-exposure prophylaxis against COVID-19.

Treatment

Use of the monoclonal antibody bebtelovimab has been authorized by FDA to treat non-hospitalized patients 12 years and older who are confirmed to have COVID-19 and are at high-risk of progression to severe COVID-19. Current data shows that bebtelovimab has activity against the Omicron BA.2 subvariant.

Information on other specific therapies can be found on VDH’s COVID-19 Therapeutics webpage and NIH’s COVID-19 Treatment Guidelines website.

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 and the VDH COVID-19 Therapeutics website.

Patients can use the COVID-19 Treatment Locator to find a monoclonal antibody administration site near them. Most monoclonal antibody administration sites require a prescription and an appointment for treatment.

Yes. Most monoclonal antibody administration sites require a referral or prescription from a healthcare provider and an appointment to receive treatment. Most sites do not take walk-in patients.

Side-effects vary by the type of treatment. Please consult the package insert for the specific product to see reported side effects. Package inserts can be found on the FDA website for COVID-19 therapies. Reported side effects (not an all-inclusive list) across products may include nausea, diarrhea, skin rash and allergic reactions.  

IV infusions and injections also may cause brief pain, bleeding, skin bruising, soreness, swelling, and infection at the location where the IV was placed. Talk to your healthcare provider if you experience any side effect that bothers you or does not go away quickly. 

The following medications have been purchased by the U.S. Government and are free to all patients:

• Paxlovid
• Molnupiravir (Lagevrio)
• Bebtelovimab
• Evusheld

Pharmacies that dispense Paxlovid and molnupiravir are not allowed to charge for the medications. Facilities that administer bebtelovimab and Evusheld may not charge for the medication itself, however, they are allowed to charge an administration fee for giving the medication intravenously or by intramuscular injection.  Patients must have a prescription from their physician to receive these medications.

Yes. There is currently no scientific evidence to show that taking ibuprofen while sick with COVID-19 will lead to worsening illness. Either ibuprofen or acetaminophen is commonly used to reduce fever. However, both acetaminophen and ibuprofen, like any medication, can have serious side effects. If you use ibuprofen and/or acetaminophen, be sure to use it according to the instructions that came with the product.  If you are unsure what the best or appropriate medication is for you, be sure to consult with your healthcare provider.

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, ivermectin has not been shown to be a safe or effective way to prevent or treat COVID-19. According to a study in JAMA Internal Medicine from February 2022, early treatment with ivermectin in adults with mild to moderate COVID-19 and other medical conditions did not lower the risk of severe disease compared to similar study participants who did not receive ivermectin.  Additionally, a research team that looked at patients in Brazil, found no meaningful difference in outcomes for patients taking ivermectin vs. placebo, and the drug did not reduce hospital admissions.

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

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

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

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

If an individual is experiencing COVID rebound, they should contact a healthcare provider if their COVID-19 rebound symptoms persist or worsen. The CDC encourages individuals to report a possible case of COVID-19 rebound after PAXLOVID treatment to Pfizer using the following online tool: Pfizer Safety Reporting.   

Check out the following websites:

VDH: Treatments are available for COVID-19

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

CDC: What to Do If You Are Sick

CDC: Caring for Someone Sick at Home

CDC: Treatments Your Healthcare Provider Might Recommend for Severe Illness

Virginia law requires that school boards provide in-person instruction in the 2021–2022 school year. 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.

The state recommends that school divisions 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 has the following resources:

• Interim Guidance for COVID-19 Prevention in Virginia Pre-K-12 Schools
• K-12 COVID-19 Parent Flowchart

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

Ventilation is one component of maintaining healthy environments, and is an important COVID-19 prevention strategy for schools and childcare programs. Ventilation systems clean and disperse air, decreasing the likelihood that students will inhale particles suspended in the air that are contaminated with the virus that causes COVID-19. Please refer to CDC’s information on Ventilation in Schools and Child Care Programs,   VDH Ventilation Best Practices, VDH Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools, and EPA’s Clean Air in Buildings Challenge: Guidance to Help Building Owners and Operators Improve Indoor Air Quality and Protect Public Health.

• Per Executive Order Two, schools should marshal available resources to improve inspection, testing, maintenance, repair, replacement and upgrades of equipment to improve the indoor air quality in school facilities, including mechanical and nonmechanical heating, ventilation, and air conditioning systems, filtering, purification, fans, control systems and window and door repair.
• Have an HVAC expert ensure the school building’s HVAC system is operating properly. The damper should be adjusted to increase the amount of exterior air that is brought in, and filters should be changed frequently and upgraded when possible to better remove respiratory particles from the air. Exhaust fans should be run to further improve air exchange. Consider additional ways to improve ventilation, such as opening doors and windows, using window fans to direct air out of windows, or using portable room air cleaners using a HEPA filter. If doors and windows are opened, eliminate any safety hazards (e.g., do not open windows if a child could fall out).
• Reduce the risk of exposure of children and school bus drivers to the virus that causes COVID-19 by opening bus windows when possible. Consider upgrading school bus filters to a highest efficiency (MERV) possible. Filters up to  MERV-13 are available. Make sure that the filters chosen are compatible with your bus’s ventilation system. 

Executive Order 2 and law SB739 allows parents to decide if their child will wear a mask at school. While parents and families can decide whether their child wears a mask at school, VDH recommends that: 

• All persons aged two years and older consider masking based on the COVID-19 community level and refer to the updated VDH masking guidance. 
  • At low COVID-19 community levels: wear a mask based on your personal preference and your level of risk of developing severe illness. 
  • At medium COVID-19 community levels: talk to your healthcare provider about wearing a mask indoors in K-12 schools if you have a weakened immune system or at high risk for severe illness. 
  • At high COVID-19 community levels: CDC recommends wearing a well-fitting mask indoors in public regardless of vaccination status or individual risk. At high levels, people at high risk for severe illness should wear a mask that provides greater protection like an N95 or KN95. 
  • People wear a mask when they return to school on Days 6–10 following a 5-day isolation or quarantine period* 
  • Schools review the Virginia Department of Labor and Industry (DOLI) has guidance for minimizing the risks of COVID-19 in workplaces.

*Following a 5-day isolation or quarantine period, parents have a choice to either send their child back to school wearing a mask on Days 6–10 or to keep their child home for the entire 10 days. 

If your child is identified as a close contact of someone with COVID-19 or tests positive for COVID-19, your child needs to follow quarantine or isolation guidance from your school. A representative from the local health department may also call parents of close contacts to provide quarantine guidance. Please refer to VDH updated Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools and the VDH K-12 COVID-19 Parent Flowchart for isolation and quarantine recommendations. School districts may choose to continue more stringent isolation and quarantine requirements or may implement the CDC guidance on quarantine and isolation. Please contact your school or school district for details on their isolation and quarantine policies.   

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

The student or staff member would be considered a close contact of the household member with COVID-19.  While someone is isolating at home, try to minimize close contact with others in the household as much as possible. This includes having the person with COVID-19 in a separate bedroom and using a separate bathroom if possible, staying at least 6 feet apart, minimizing time spent with each other, wearing well-fitted masks, and improving air flow by opening a window. If a household member has close contact with the person isolating at home during their 5-day isolation, then the household member needs to take steps to protect themselves and might need to quarantine. Those who test positive or develop COVID-19 symptoms should follow recommendations for isolation. See VDH isolation and quarantine guidance and CDC Guidance for K-12 Schools. 

People with COVID-19 should continue to wear a well-fitting mask around others at home and in public for 5 additional days (Day 6 through Day 10) after the end of their 5-day isolation period. People that are exposed to someone with COVID-19 after they complete isolation are not considered close contacts.

CDC provides FAQs for individuals with ongoing COVID-19 exposures. 

Be sure to notify your school if this happens and reach out to your healthcare provider.

CDC and VDH do NOT recommend requiring a negative COVID-19 test in order for students or staff to return to school. Please see VDH updated Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools and the K-12 COVID-19 Parent Flowchart. However, some school divisions may require a note from a healthcare provider to return to school or work. Please check with your local school division for guidance. 

Children who are in the 6–10 Day period after isolation or quarantine should ideally be at least 6 feet away from others during meals and snacks, or other unmasked periods. 

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

Schools and families should be aware that participating in team sports or other extracurricular activities, especially indoor activities involving shouting or singing, increase the risk of SARS-CoV2 transmission. Additional guidance and consideration can be found in the American Academy of Pediatrics Sports and Physical Activities Guidance, VDH Considerations for Recreational Sports, and VDH Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools. 

The Virginia High School League governs athletic competitions; local school divisions may also 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 required school immunizations. Please consult with your healthcare provider for school required vaccine guidance. 

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.

The CDC does not currently recommend universal symptom screening for K-12 schools. Screening procedures are available at school for students and staff who arrive with or develop symptoms during the course of the day. VDH updated Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools. Additionally, VDH provides a K-12 COVID-19 Parent Flowchart.VDH has adopted new CDC isolation and quarantine guidance for K-12 schools. See isolation and quarantine guidance provided by CDC Guidance for K-12 Schools.  Please discuss any concern you may have with your local school division.

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 an N-95 or surgical mask, goggles, and gloves before entering into the room to evaluate the individual. Call the student’s parent or the employee’s family member 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. 

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, especially if the student is unvaccinated and if masking is no longer practiced at the school. Make sure that you provide the school with healthcare provider documentation (HCP) of the child’s healthcare needs and treatment protocols. This includes HCP authorization and parental consent to administer medication or administer treatments to students. The CDC offers guidance for families of children needing extra precautions during COVID-19. Families are encouraged to meet with school staff, including teachers, school nurses and administrators, to discuss safety measures and establish/update a Section 504 plan. Please discuss any concern you may have with your local school division.

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 health care provider and local school division.

VDH has updated Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools. Additionally, VDH provides a K-12 COVID-19 Parent Flowchart.

Recommendations for people who have been exposed are available at VDH's What to do if you were potentially exposed to COVID-19 and VDH When Is It Safe to Be Around Others Guidance.

The CDC and VDH recommend people stay home (quarantine) for at least 5 days, and get tested on or as soon after Day 5 if possible. A person can end quarantine after Day 5 if they have no symptoms and can wear a mask when around others through Day 10 after their last contact with someone with COVID-19. VDH recommends a 10-day isolation or quarantine period for students who are not willing to wear a mask in school on Days 6–10 after quarantine or isolation. See isolation and quarantine guidance provided by CDC Guidance for K-12 Schools. Please discuss any concern you may have with your local school division.

No.

Those who have tested positive using a viral test in the past 90 days do not need to quarantine or get tested after exposure as long as they have recovered from their previous illness and have no new symptoms.  Please see Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools. Additionally, VDH provides a K-12 COVID-19 Parent Flowchart. See isolation and quarantine guidance provided by CDC Guidance for K-12 Schools. 

 An individual diagnosed with COVID-19 should not return to work or school until they meet all criteria to end isolation. Please refer to the following resources:

• VDH When Is It Safe to Be Around Others Guidance
• VDH Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools
• VDH K-12 COVID-19 Parent Flowchart 
• CDC Guidance for K-12 Schools

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. 

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