General FAQ

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 a coronavirus.

    A novel coronavirus is a new coronavirus that has not been previously identified.

    SARS-CoV-2 is the virus that causes COVID-19. “SARS” stands for severe acute respiratory syndrome, “CoV” stands for coronavirus. This virus is similar to the SARS virus that emerged in China in 2002, hence the 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 December 2019.

    Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed COVID-19 cases. The following symptoms of COVID-19 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 a bit 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.  For additional information, see Children and COVID-19.

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

    Symptoms typically appear 2-14 days after exposure.

    COVID-19 is spread primarily through respiratory droplets (meaning moisture that comes from coughing, sneezing, singing, or talking). These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. 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. 

    The virus may also spread by airborne transmission in certain circumstances. The infection may be transmitted by exposure to the virus in small droplets and particles that can linger in the air for minutes to hours. These viruses may be able to infect people who are farther than 6 feet away from the person who is infected or after that person has left the space, and occur within enclosed spaces that have inadequate ventilation. On some occasions, the infected person may be breathing heavily, such as when singing or exercising.

    Although most spread involves sick people passing infectious droplets, some people don't ever have symptoms (asymptomatic people). The virus that causes COVID-19 can spread from infected people who do not have any symptoms. Because this type of spread is possible, it is very important for everyone to follow recommendations for physical distancing, hand washing and mask wearing, even if they do not feel sick.

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

    COVID-19 is primarily transmitted from person-to-person through respiratory droplets. These droplets (larger particles) and aerosols (smaller particles) are released when someone with COVID-19 sneezes, coughs, or talks. Current data supports the spread of SARS-CoV-2 (the virus that causes COVID-19) via airborne transmission under special circumstances. 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 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. Transmission may occur when a person touches surfaces contaminated with virus from an infected person and then touches their mouth, nose, or eyes. Frequent hand washing and cleaning and disinfection of high-touch surfaces (such as door knobs) can help prevent viral transmission.

    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 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 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, 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 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.

    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 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 spread of disease, including the importance of 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.

    Masks do not impact VDH contact tracing efforts. 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.

    For those with access to the internet, the best sources of up-to-date information 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.

    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 common COVID-19 myths can be found here.

    There is no evidence that staying at home more during the COVID-19 outbreak can weaken the immune system (the part of your body that fights off germs). Our immune system is built up over many years and won’t suddenly stop working after a few months. Staying at home whenever possible is an important step you can take to protect yourself from COVID-19. However, staying at home and being isolated from others can negatively impact our health in other ways. Stress, depression, bad sleep patterns, lack of exercise, and eating unhealthy foods can all hurt the immune system. Work on healthy habits such as getting enough rest, managing stress, staying connected to friends and family, and eating a healthy diet. More information on food and COVID-19 can be found on CDC’s website. Exercising is also important. Getting out into the fresh air can be good for both our bodies and our minds.

    Anyone, regardless of race or ethnicity 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.

    Yes, healthcare facilities, including hospitals and emergency rooms, are still safe to visit. You should get immediate medical attention if you have any medical emergency. Hospitals and healthcare facilities continue to sanitize regularly and are prepared to treat patients for all medical conditions and emergencies. While there, wear a mask, stay at least 6 feet away from others, and practice hand hygiene as much as possible.

    Mutations occur in SARS-CoV-2, just like with most viruses, and new variants of the virus are expected to occur over time.  Multiple variants of the virus that cause COVID-19 have been documented in the United States and globally during this pandemic. Scientists are continually monitoring for genetic changes in the virus. This helps us better understand how the virus is changing and if these changes might affect how the virus spreads and what happens to people who are infected with it. 

    A new variant strain of the virus that causes COVID-19 has been identified in the United Kingdom and has been associated with a rapid increase in cases of COVID-19 in southern England. Initial studies suggest that the new variant, known as the “SARS-CoV-2 VOC 202012/01” or “B.1.1.7",  may spread more easily from person to person. This could increase the overall spread of SARS-CoV-2.

    This variant has been identified through genetic sequencing efforts in multiple states in the U.S., including Virginia. A report from health experts indicates there is a "realistic possibility" that the variant was associated with an increased risk of death compared to non-variants.

    The South African government announced that it had also seen the emergence of a new variant, referred to as “B.1.351”. This variant emerged independent of the B.1.1.7 variant. The B.1.351 variant has been detected in multiple countries including the U.S. The first case of this variant strain was recently detected in Virginia.

    CDC and state and local health departments are continually monitoring and studying the SARS-CoV-2 variants spreading in the United States to quickly detect any changes of significance.  Public health recommendations for slowing the spread—wearing masks, staying at least 6 feet apart from others, avoiding crowds, ventilating indoor spaces, washing hands often, and getting vaccinated when it is your turn — will also prevent the spread of these variants.

    More information on the emerging variant strains can be found on New Variant of Virus that Causes COVID-19 Detected, Emerging SARS-CoV-2 Variants  and Implications of the Emerging SARS-CoV-2 Variant. 

    Viruses normally enter into a cell and “hijack” some of the cell’s machinery to make more virus particles. This process is called replication. Sometimes, this process does not make an exact copy of the virus and a change occurs when the virus is making a genetic copy. This change is called a mutation. Most mutations don’t really cause the virus to change very much. Occasionally, mutations can lead to changes that alter a virus’ ability to infect a host, survive in the environment, or affect its ability to cause a range of symptoms associated with the virus.

    Vaccines work by exposing your body to something foreign, which causes your immune system to react and remember it. That way, the next time your immune system is exposed, it will be able to fight off that foreign body. If a vaccine uses a part of the virus that mutates or changes, your immune system may not recognize the invader, reducing the vaccine’s ability to provide protection. If a vaccine can be developed that targets more stable parts of the virus that do not mutate or change as often, it may provide our body with a better chance at longer lasting immunity and protection.

    By looking at mutations, we can also troubleshoot when a vaccine may stop working, and potentially make updates so that the vaccine will work better in the future. This is the process that happens every year with the flu vaccination. The vaccines currently available for COVID-19 appear to still work to prevent the variants of the virus that have been identified.

    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 recent 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. 

    There are certain situations were it may be especially important to have a mask that has a better fit and provides additional protection:

    The new variants seem to spread more easily, which can ultimately lead to more cases of COVID-19. Virginia is working to get everyone vaccinated as soon as possible.  Meanwhile, it is important that everyone continues with the recommended prevention measures

    This means wearing masks correctly, staying at least six feet from others, avoiding crowds, washing hands often, getting vaccinated for COVID-19 when it is your turn, and staying home if you are infected with COVID-19 or if you have had close contact with someone with COVID-19. Continuing with these prevention strategies will help to limit the spread of the virus that causes COVID-19, including the variant strains. 

    CDC is collaborating with EPA to confirm that disinfectants on EPA’s List N: Disinfectants for Coronavirus (COVID-19) inactivate these variant viruses. 

    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.

    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.

    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 and monitored closely for symptoms of infection.

    VDH is actively encouraging people with close contact with a known infected person, to stay home, monitor for symptoms and follow all recommendations (e.g., wear a mask, watch their distance, and wash hands frequently) for 14 days after their last exposure.

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

    • Counting your date of last exposure as Day 0, after Day 10 without testing; OR

    • After Day 7 with a negative PCR for antigen test performed on or after Day 5.

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

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

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

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

    Information on COVIDWISE can be found here

    FAQs regarding COVIDWISE can be found here. 

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

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

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

    Information on Sara Alert can be found here.

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

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

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

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

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

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

    Information regarding these outbreaks can be found here.

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

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

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

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

    Disease Prevention

    We recommend that everyone follow these prevention practices:

    • Get vaccinated against COVID-19 when it becomes available to you 
    • Practice physical distancing
    • Wear a mask over your mouth and nose in indoor and some outdoor public settings (see noted exceptions)
    • Avoid contact with sick people
    • Avoid touching your eyes, nose, or mouth with unwashed hands
    • Clean your hands often by washing them with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer that contains 60%–95% alcohol, when soap and water are not readily available. Soap and water should be used if hands are visibly dirty
    • It is especially important to clean hands after going to the bathroom; before eating; after coughing, sneezing or blowing your nose; after leaving a public place; or after handling your mask
    • If you are sick, stay home and rest, even if illness is mild
    • Avoid in-person gatherings of more than 10 people, under certain circumstances
    • Those 65 years of age and older are encouraged to self-quarantine

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

    For more information read VDH’s prevention tips.

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

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

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

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

    • Two symptomatically ill hairstylists who were later proven to have COVID-19 interacted for prolonged periods with dozens of customers over an eight day period. Stylists and customers all wore masks as was required locally. None (0%) of 67 customers later consenting to an interview and SARS-CoV-2 test developed infection.
    • In a study of 124 Chinese households with at least one laboratory-proven COVID-19 infection, those households in which the index (first) case was using a mask before she/he developed symptoms had a 79% lower COVID-19 transmission rate to other people in their household. 
    • In a Thailand study of >1000 contact persons interviewed as part of COVID-19 contact tracing investigations, those contacts who reported always wearing a mask during high-risk exposures had a 70% lower COVID-19 infection rate than contact persons who did not always wear masks in those situations.
    • In a very large COVID-10 outbreak on a U.S. Navy aircraft carrier, use of face coverings led to a 70% lower infection rate among those using the face coverings.
    • In investigations among passengers on long international flights in which some passengers were later found to have been COVID-19-infected before boarding the flights, rigid masking policies on some flights were associated with many fewer COVID-19 infections transmitted on those flights.
    • At least eight community-level analyses have found that having organizational and/or political leaders issue and promote masking directives was followed by significant decreases in new COVID-19 infections in the population(s) at risk.
    • Several of these and other studies that also examined community mortality found lower COVID-19 death rates in those populations. 

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

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

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

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

    Even if you always wear a mask, however, it’s important to remember that following other public health guidelines about physical distancing, minimizing time in indoor spaces, handwashing, etc. can reduce your COVID-19 infection risk even farther. 

    More information on protection from COVID-19 by masks or other face coverings can be found on the VDH website and on the CDC website

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

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

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

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

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

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

    In addition, although a face shield or goggles could provide a slight extra bit of protection from COVID-19, neither one is a substitute for a mask under the Governor’s Executive Order 63.

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

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

    For more information on this topic, please see here.

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

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

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

    Executive Order 72 requires that all individuals in the Commonwealth aged five and over must cover their mouth and nose with a mask, as described and recommended by the CDC, if they are in an indoor setting shared by others. This requirement applies to state and local government settings, train stations, bus stations, and intrastate public transportation, including buses, rideshares, trains, taxis, and cars for hire, as well as any waiting or congregating areas associated with boarding public transportation.

    Additionally, CDC has issued an order that requires masks to be worn by all travelers while on public transportation, such as airplanes, ships, buses, trains (which includes all passengers and all personnel operating conveyances), as well as on transportation hubs, which began on February 1.

    Masks must also be worn outdoors when unable to maintain at least six feet of physical distance from other individuals who you do not live with. Masks should be washed after each use, if they are the washable, non-disposable type. Masks should not be placed on children younger than 2 years of age, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the cover without assistance.  

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

    Considerations for Wearing Masks

    Using Masks to Slow the Spread of COVID-19 

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

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

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

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

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

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

    VDH Living with Someone with COVID-19

    CDC Living in Close Quarters

    CDC Caring for Someone Sick

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

    There is still a lot that is unknown about the newly emerged COVID-19 and how it spreads. Coronaviruses are generally thought to be spread most often by respiratory droplets. Even though the coronavirus can survive for a short period on some surfaces, it is unlikely to be spread from domestic or international mail, products or packaging. However, it may be possible that people can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads

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

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

    Exposure to COVID-19

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

    Close contact is defined as being within 6 feet of a person with COVID-19 for a total of 15 minutes or more over a 24-hour period or having exposure to the person’s respiratory secretions (for example, coughed or sneezed on; shared a drinking glass or utensils; kissing) while they were contagious. A person with COVID-19 is considered to be contagious starting from 2 days before they became sick, or 2 days before they tested positive if they never had symptoms. 

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

    • Quarantine. VDH recommends that you self-quarantine (stay home) for 14 days after the last time you saw that person and practice physical distancing. Physical distancing means staying at least 6 feet away from others. Do not go to work or school during this time period. Avoid all public spaces, public activities, and group gatherings and do not take public transportation such as buses, trains taxis, or ride-shares during this time. If necessary, your local health department can ensure that your basic needs (for example, food and medication) are being met while you have to be in quarantine.
      • Certain people are not required to stay home (quarantine) after exposure. This includes people who:
        • Have had COVID-19 within the past 3 months as long as they do not develop new symptoms. 
        • Have been fully vaccinated for COVID-19 within the past 3 months as long as they have no symptoms and are not inpatients or residents in a healthcare setting. 
          • Fully vaccinated means 2 weeks or more have passed since getting the second dose in a 2-dose series, or 2 weeks or more have passed since getting one dose of a single-dose vaccine.
          • Healthcare settings include hospitals and long-term care facilities (e.g., nursing homes, assisted living facilities).
        • 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.
    • 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. If you have only mild illness, it is important to stay home and rest to prevent spreading infection to others. If you do have symptoms and want to get tested for COVID-19, please reach out to your healthcare provider. Your provider may collect samples to test you or help you to find sampling sites in your area. If you have a medical emergency, call 9-1-1 and let them know that you have had exposure to a person with COVID-19.
    • Answer the call.  Your local health department will reach out to you with more recommendations if you are identified as a close contact during contact tracing. However, if a health department is seeing a large number of COVID-19 cases, they may not have the resources to do timely contact tracing and case investigation for all reported cases of COVID-19 and will need to prioritize certain contact tracing and case investigation efforts. If you know you were a close contact to someone with COVID-19 while they were contagious, stay home and monitor your health, even if the health department does not call you.
    • Respond to notifications. If you use the COVIDWISE app and receive a notice that you have been exposed, stay home and monitor your health after the potential exposure. 
    • Get tested. VDH recommends testing on or after day 5 from exposure. Contact your healthcare provider to ask about getting tested because of your exposure. There are many test sampling sites available throughout the state to get yourself tested. Call ahead and wear a mask when you leave home.
    • How long do I need to stay home (quarantine)? It can take up to 14 days after an exposure for you to develop COVID-19. It is safest to stay home (quarantine) for 14 days. If you are not able to stay home for 14 days after your last exposure and you do not have symptoms, you have 2 options*:
      • Counting your date of last exposure as Day 0, you may leave home after Day 10; or
      • If PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. If you receive a negative test result before Day 7, you should not leave home yet. 

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

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

    If you have had close contact with a person with COVID-19, VDH recommends that you get tested for COVID-19 on or after day 5 since your last exposure. The day of the exposure is considered day 0.  

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

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

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

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

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

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

    If you had or continue to have close contact with a contact of someone with COVID-19, you should be very sure to follow all the recommendations, like wearing a mask when you are around people, staying at least 6 feet away from others,  washing your hands with soap and water, covering your coughs and sneezes, and cleaning surfaces frequently. Stay alert for symptoms of COVID-19. You do not need to be tested or stay home (quarantine) just because you are a contact of a contact.

     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:

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

     

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

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

    If you have had close contact with someone with COVID-19, even if you don’t have symptoms, it is important to stay at home for 14 days since your last exposure. It can take up to 14 days after exposure to the virus for a person to develop COVID-19 symptoms. By self-quarantining for 14 days, you lower the chance of passing COVID-19 to others in case you do get sick.

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

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

     

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

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

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

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

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

    VDH Exposure to COVID-19 Website

    Illness from COVID-19

    People with COVID-19 can have a wide range of symptoms  ranging from mild to severe respiratory illness with symptoms of fever, cough, shortness of breath. Some people have other symptoms, including chills, muscle pain, headache, sore throat, or new loss of taste or smell, congestion or runny nose, nausea or vomiting, diarrhea. Not everyone with COVID-19 will have all symptoms and fever might not be present. These symptoms may appear 2-14 days after exposure. This list does not include all possible symptoms and will be updated as we learn more about COVID-19.

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

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

    Both influenza (flu) and COVID-19 are contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by the SARS-COV-2 virus and flu is caused by  influenza viruses. Symptoms of flu and COVID-19 can be similar, so testing may be needed 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 911 and get emergency care.  Here are more details:

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

    Tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours (or 2 days) before the person has any symptoms or tests positive. By letting your close contacts know they may have been exposed to COVID-19, you are helping to protect everyone.

    Call 911 if you have a medical emergency: If you have a medical emergency and need to call 911, notify the dispatch personnel that you 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 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
      • Stay home: People who are mildly ill with COVID-19 are able to isolate at home during their illness. Try not to leave home except to get medical care.
      • Take over-the-counter medicines, such as acetaminophen, to help you feel better.
      • Stay in touch with your doctor. Call before you get medical care. Be sure to get care if you feel worse or you think it is an emergency.
      • Avoid public areas: Do not go to work, school, or public areas.
      • Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.
    • Separate yourself from other people and animals in your home. This is known as home isolation
      • Stay away from others: As much as possible, you should stay in a specific “sick room” and away from other people in your home. Also, you should use a separate bathroom, if available.
      • When possible, have another member of your household care for your animals while you are sick. If you are sick with COVID-19, avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a mask. See COVID-19 and Animals for more information.
    • Call ahead before visiting your doctor
      • Call ahead: Call the healthcare provider and tell them that you have respiratory illness and it is possible you might have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.
      • If you do not have a doctor, your local health department may be able to help connect you with a healthcare provider or free clinic in your area.
    • Wear a mask 
      • If you are sick: You should wear a mask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office.
      • If you are caring for others: If the person who is sick is not able to wear a mask (for example, because it causes trouble breathing), then people who live with the person who is sick should not stay in the same room with them, they should wear a mask when they enter a room with the person who is sick. Visitors, other than caregivers, are not recommended.
      • Make sure to remove your mask correctly, wash or store your mask properly  and wash your hands after touching a used mask.
    • Cover your coughs and sneezes
      • Cover: Cover your mouth and nose with a tissue when you cough or sneeze.
      • Dispose: Throw used tissues in a lined trash can.
      • Wash hands: Immediately wash your hands with soap and water for at least 20 seconds or, if soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.
    • Clean your hands often
      • Wash hands: Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
      • Hand sanitizer: If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
      • Soap and water: Soap and water are the best option if hands are visibly dirty.
      • Avoid touching: Avoid touching your eyes, nose, and mouth with unwashed hands.
    • Avoid sharing personal household items
      • Do not share: You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home.
      • Wash thoroughly after use: After using these items, they should be washed thoroughly with soap and water.
    • Clean all “high-touch” surfaces every day
    • Clean and disinfect: Practice routine cleaning of high touch surfaces and your “sick room.” Let someone else clean and disinfect common areas but not your bedroom and bathroom.
    • High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables.
    • If a caregiver or other person needs to clean and disinfect a sick person’s bedroom or bathroom, they should do so on an as-needed basis. The caregiver should wear a mask and wait as long as possible after the person has used the bathroom.
    • Clean and disinfect  any surfaces that may have blood, stool, or body fluids on them.
    • Household cleaners and disinfectants: Clean the area or item with soap and water or another detergent if it is dirty. Then use a household disinfectant. 
    • Be sure to follow the instructions on the label to ensure safe and effective use of the product. Many products recommend keeping the surface wet for several minutes to ensure germs are killed. Many also recommend precautions such as wearing gloves and making sure you have good ventilation during use of the product.
    • Most EPA-registered household disinfectants should be effective.
    • Monitor your symptoms
    • If you develop emergency warning signs for COVID-19, get medical attention immediately. Emergency warning signs include*:
      • Difficulty breathing or shortness of breath
      • Persistent pain or pressure in the chest
      • New confusion or inability to arouse
      • Bluish lips or face

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

    • Call 911 if you have a medical emergency: If you have a medical emergency and need to call 911, notify the dispatch personnel that you have, or are being evaluated for COVID-19. If possible, put on a mask before emergency medical services arrive.

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

         VDH Resources and Support 

         What to do if you are Sick 

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

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

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

    • At least 10 days have passed since your symptoms first appeared AND
    • At least 24 hours with no fever without fever-reducing medication AND
    • Other symptoms have improved

    For more information, see:

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

    CDC Interim Guidance on Home Isolation

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

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

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

    The FDA provides information here.

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

     

    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 quarantine themselves for 14 days 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 will get in touch with you.

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

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

    For more information on reinfection, click here.

    Testing for COVID-19

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

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

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

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

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

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

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

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

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

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

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

    Similar to other antigen tests, a small percentage of false positive and false negative results from this test may occur. Positive results should be presumed to be correct but confirmed by another test as soon as possible.

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

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

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

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

    These tests tell you if you had a past infection by looking for antibodies in the blood.  Antibodies are proteins made by the immune system when a germ enters a person’s body. It usually takes 1-3 weeks for the body to make antibodies in response to an infection. We do not know how much protection the antibodies might provide or how long this protection might last. 

    Antibody tests have limited ability to diagnose COVID-19 and should not be used alone to diagnose COVID-19. Results from these tests should also not be used to make decisions about returning to work or school, traveling, using  personal protective equipment (PPE), or following disease prevention recommendations.

    Viral tests check samples from your respiratory system to see if you are currently infected with SARS-CoV-2, the virus that causes COVID-19. How the sample is collected will depend on the 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 tests check your blood for antibodies, which may show if you had a past infection.  An antibody test may not be able to show if you have a current infection, because it can take 1-3 weeks after infection to make antibodies. Antibody tests have limited ability to diagnose COVID-19 and should not be used alone to diagnose COVID-19.

    Some health departments are setting up community testing events.  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. Please reach out to the specific site for more information.

    If testing at a private lab is not available, your healthcare provider may request testing for patients who meet the high priority and priority testing criteria through Virginia’s state public health lab, the Division of Consolidated Laboratory Services (DCLS) by contacting the local health department.

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

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

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

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

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

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

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

    Ct is a very technical term used by laboratory scientists that stands for “Cycle Threshold.” Ct is a number generated during some PCR tests. The Ct number 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 earlier the test detected the virus, which usually is associated with more genetic material being present.

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

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

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

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

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

    Certain counties do send someone out to test you at your home, but most do not. 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 samples in their office or lab or provide you with information about where you can go locally for testing.

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

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

    As of March 18, 2020, many insurance plans cover the cost of 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, call your insurance company. You can usually find their phone number on your insurance card. Most insurance covers testing costs without a co-pay. You will also find information about insurance and COVID-19 testing costs here. Some testing sites might have additional fees that aren’t covered by insurance so it is a good practice to ask about all costs before getting tested.

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

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

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

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

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

    PCR and antigen tests are two types of diagnostic tests for COVID-19. PCR tests are considered the “gold standard” for diagnosing COVID-19. PCR tests are highly accurate and usually do not have to be repeated. Antigen tests are also usually highly 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 health care provider may order a PCR test if your antigen test shows a negative result but you have symptoms of COVID-19.

    VDH provides a chart comparing different types of coronavirus tests.

    Check out the following websites:

    CDC COVID-19 Testing Website

    CDC COVID-19 FAQs

    VDH COVID-19 Website

    VDH COVID-19 Testing

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

    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.

    FDA has issued an emergency use authorization for the monoclonal antibody called bamlanivimab, as well as for the monoclonal antibody combinations of casirivimab plus imdevimab and bamlanivimab plus etesevimab, for individuals with mild to moderate symptoms of COVID-19 who are at higher risk of severe illness. This includes individuals over the age of 65 years and others with chronic medical conditions. Individuals must be 12 years of age or older and weigh at least 40 kilograms (about 88 pounds.)

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

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

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

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

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

    Stress and Coping with COVID-19

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.

    Contact tracing involves finding people who may have been exposed to an illness and providing guidance to prevent them from spreading it. Contact tracing is not a new tool - public health uses it every day for other contagious diseases like measles and tuberculosis (TB). It is an important part of how Virginia can stop the spread of COVID-19. To learn how contact tracing works, click here.

    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.  

    It depends on where you traveled and other individual circumstances. 

    For more information, visit the VDH Travelers page here.

    If you have traveled to an area where COVID-19 is spreading in the community or if you have been in close contact with a person with COVID-19, you should take your temperature twice daily and remain alert for signs of illness, including fever, cough, 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. 

    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 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. 

    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. 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.

    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. 
    • Have been fully vaccinated for COVID-19 within the past 3 months as long as they have no symptoms and are not inpatients or residents in a healthcare setting.
      • Fully vaccinated means 2 weeks or more have passed since getting the second dose in a 2-dose series, or 2 weeks or more have passed since getting one dose of a single-dose vaccine.
      • Healthcare settings include hospitals and long-term care facilities (e.g., nursing homes, assisted living facilities).
    • 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. 
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.

    VDH has a number of data dashboards to help your organization make decisions. It is important to note that there is no one number or metric to make a decision.

    In addition to the VDH COVID-19 Daily Dashboard, VDH also presents data on Virginia's COVID-19 Key Measures web page.

    The Key Measures page presents the main measures that government and community leaders use to make decisions on how to keep Virginians healthy and safe. The data on this page are monitored to help inform Forward Virginia guidelines.

    The Pandemic Metrics dashboard, which is in the Virginia’s COVID-19 Key Measures web page, presents metrics that describe the current spread of COVID-19 in Virginia and how the COVID-19 spread has changed over time. This dashboard can be used to help guide prevention measures to reduce the impact of COVID-19.

    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 daily and posted on the VDH Daily Dashboard, which can be found here.

    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 three  dashboards to see data on COVID-19 vaccines: Summary, Vaccines Received, and Demographics

    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. 

     

    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. 

    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 close by 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.
    • The vaccine is distributed in large quantities and should then be administered in clinics over the next 7-10 days. Additionally, 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. Healthcare personnel have been 100% focused on getting shots in arms, so it takes time for reporting to catch up and for different computer systems to feed seamlessly into VIIS.
Vaccination
Schools, Workplaces & Community Locations
  • Virginia’s Plan for Reopening – Safer at Home (Mask Order Still in Effect)

    Temporary restrictions are in place in Virginia. 

    Restrictions include:

    • Universal mask requirement
    • Social gathering size of 10 people indoors and 25 people outdoors
    • Continued restrictions on dining establishments
    • Recommendation to telework

     

    Third Amended Executive Order Seventy-Two and Order of Public Health Emergency Nine describe these restrictions and are available here. Supplemental Guidelines for All Business Sectors is available here.

     

    Public and private in-person gatherings of more than 10 people indoors or 25 people outdoors who do not live in the same household are not allowed. Social gatherings include but are not limited to parties, celebrations, or other social events. 

    This requirement does not apply to people performing duties of their employment or people in an educational instructional setting. Additionally, more than 10 people inside and 25 people outside are allowed to assemble for religious services and for educational instruction as long as they follow the requirements listed in EO 72 for Public and Private In-Person Gatherings.

    Yes, masks, also known as cloth face coverings, are required in phase three. As of December 14, Executive Order 72 requires that all Virginians aged 5 and older wear masks in indoor settings shared with others and when outdoors within 6 feet of another person who is not a family member. 

    Exceptions are provided in the following situations:

    • While exercising.
    • While eating or drinking.
    • If a person has trouble breathing or is unable to remove their mask without help.
    • While playing a musical instrument, when wearing a mask would inhibit a person’s ability to play the instrument (e.g., wind instruments) and 10 feet of distance is maintained from others, for both indoor and outdoor settings.
    • A person seeking to communicate with a hearing-impaired person, for which the mouth needs to be visible.
    • Very young children - Adults accompanying minors should use the adult’s best judgment with respect to placing a mask on a minor between the ages of two through four.
    • When temporary removal of the mask is necessary to secure government or medical services.
    • While participating in a religious ritual.
    • Persons with health conditions or disabilities that prohibit wearing a mask. Adaptations and alternatives should be considered to make it easier to wear a mask, if possible, or to reduce the risk of spreading the virus if it is not possible to wear a mask.

    Documentation to verify the medical condition is not required. More information can be found here.

    Any child over the age of 2 years old is encouraged to wear a mask, but it's only required for children aged 5 and over.  Adults should use good judgment to decide whether to place a mask on a minor between the ages of two through four.

    Masks help reduce the spread of the virus. Masks protect the person wearing the mask and also help protect other people around them. Wear a mask, maintain six feet of physical distancing, increase cleaning, and wash hands regularly to keep yourself and others safe. Get vaccinated against COVID-19 when it becomes available to you.

    Per Executive Order 72, the Virginia Department of Health shall have authority to enforce mask requirements. Any willful violation or refusal, failure, or neglect to comply with the Orders, issued pursuant to § 32.1-13 of the Code of Virginia, is punishable as a Class 1 misdemeanor pursuant to § 32.1-27 of the Code of Virginia. The State Health Commissioner may also seek injunctive relief in circuit court for violations, pursuant to § 32.1-27 of the Code of Virginia. Violations of requirement to wear masks in indoor settings with others shall be a Class 1 misdemeanor pursuant to § 44-146.17 of the Code of Virginia and enforceable by the Virginia Alcoholic Beverage Control Authority. No minor shall be subject to criminal penalty for failure to wear a mask.

    Lead through example by following mask guidelines.  You can’t control other people’s choices. The thing you can do is control yourself and do everything you can to protect yourself.

    If you have questions or concerns about Executive Order 72, call 877-ASK-VDH3, then choose selection #2. Do NOT call your local health department.  Do NOT contact law enforcement to address alleged violations.  If you have observed violations of Executive Order 72 and wish to file a complaint, fill out the report form located here. Please file only one complaint per incident.

    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.

    Yes, you should wear a mask indoors even with physical distancing. Covid-19 spreads primarily through respiratory droplets, which have the potential to travel farther than six feet, especially when talking loudly, singing, or exercising.

    Executive Order 72 does not provide an exemption for indoor spaces even with physical distancing. This includes schools and workplace settings, among others.

    There is no scientific proof or evidence that wearing a mask can hurt your immune system. Masks help limit the amount of respiratory droplets that go into the air to help stop the spread of COVID-19. Doctors, nurses, and other medical staff have been wearing masks for decades. Disposable masks should be thrown away if they become wet or dirty, and only used one time. Cloth face coverings should be washed. See Using Masks to Slow the Spread of COVID-19 for more information.

    There is no scientific proof or evidence that wearing a mask can hurt your oxygen levels or make you breathe in dangerous levels of carbon dioxide. Disposable masks and cloth face coverings fit loosely and air can pass through. They help us by cutting down on the droplets that come out when we speak, cough or sneeze. If you are having a hard time breathing, your mask covering might be too thick. See Using Masks to Slow the Spread of COVID-19 for more information.

    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.

    Considerations for wearing masks 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:

      • Avoid contact with sick people.
      • Avoid touching your eyes, nose, or mouth with unwashed hands.
      • Clean your hands often by washing them with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer that contains 60%–95% alcohol. Soap and water should be used if hands are visibly dirty.  Do not use any hand sanitizer that is methanol based.  More information about methanol based hand sanitizers can be found here.
      • It is especially important to clean hands after going to the bathroom; before eating; and after coughing, sneezing or blowing your nose.
      • If you are sick, stay home and rest, even if illness is mild.
      • Practice physical distancing, staying at least 6 feet from others if you have to go out.
      • Avoid in-person gatherings. Both small gatherings, such as dinner parties and birthday parties, and large gatherings, such as weddings and funerals, pose a risk of spreading COVID-19 among communities. This is especially true if there is a high level of community transmission.  
      • Social gatherings in Phase Three are limited to 25 people, and physical distancing and mask use should be maintained. 
      • Older adults and those with other risk factors are recommended to stay home if possible
      • Wear a mask when you are in public
      • Get vaccinated when it is your turn

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

    Social distancing, also called “physical distancing,” means keeping a safe space between yourself and other people who are not from your household. It is one one of the measures 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. If you are cheering, singing, exercising, or participating in an activity that increases respiration, increase this distance to 10 feet.

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

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

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

    • Stay informed about local COVID-19 spread and be aware of school, work, and local closures.
    • Get vaccinated against COVID-19 when it becomes available to you.
    • Put distance between yourself and others. 
    • Avoid contact with sick people.
    • Stay in touch with others by phone, social media, or email.
    • Take care of the emotional health of your household members and yourself. 
    • Stay home if you are sick or if you are caring for a member of your household that is sick.
    • Follow your household plan of action. 
    • Avoid taking public transportation such as buses, trains, taxis, or ride-shares, when possible.
    • Limit your child’s interactions with additional children and adults outside of childcare or school to decrease risk.
    • Limit your contact with others and avoid public spaces, public activities, and group gatherings.
    • Wear a mask when out in public, or are with others who do not live in your household.

     

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

    Household Plan 

    Managing Anxiety and Stress

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

    This is unknown at this time.  Vaccines are now available and vaccination efforts are underway for specific priority groups (e.g., healthcare personnel, persons age 65 and older).  Also, it’s not clear if previous infection with the virus that causes COVID-19 leads to long-lasting immunity.

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

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

    It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

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

    Schools (K-12)

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

    Each school division is deciding how to safely teach children by applying everyday prevention measures in the school setting.  Many decisions involve ways to minimize interactions and maximize distance between people within the school.  Some solutions being considered include:  creating one-way hallways, marking them with tape on the floor; keeping students in the classroom and rotating teachers instead; staggering class periods to limit the number of students in the hallway when changing classrooms; and  assigning lockers by defined groups of students or eliminating lockers altogether. Please contact your local school division for more information regarding reopening of schools. Frequently asked questions are  available at  Virginia Department of Education FAQs 

    Many parents, caregivers, and guardians face new and difficult choices, such as deciding between in-person and virtual learning. The Centers for Disease Control and Prevention (CDC) has designed a tool to help parents, caregivers, and guardians weigh the risks and benefits of each option and make this decision making process easier. It is organized to provide parents and caregivers with general information on COVID-19, and options to consider for virtual, in person and hybrid options, if offered. The CDC has also developed checklists that are intended to help parents, guardians, and caregivers, plan and prepare for the upcoming school year.  Please discuss any concern you may have with your local school division.

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

    For more information, please see here.

    To help school districts make these decisions, VDH and the Department of Education have updated Interim Guidance for K-12 School Reopening.  VDH recommends schools use the CDC Operational Strategy for k-12 Schools jointly with the Interim Guidance for K-12 School Reopening document to inform decisions about school operations with regard to COVID-19.

    For more information about K-12 best practices, please visit the Department of Education’s   Recover, Redesign, Restart 2020 website.

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

    As feasible, schools should have students and staff eat meals in classrooms, while maintaining physical distancing as much as possible, instead of in a communal dining hall or cafeteria. If communal dining halls or cafeterias are used, schools should encourage physical distancing in food service lines and at tables while eating. Students and staff should wash their hands with soap and water for 20 seconds or use a hand sanitizer that contains at least 60% alcohol before and after eating. Schools should clean and disinfect food line areas, tables, and chairs between uses.  CDC guidance and CDC 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.

    The Virginia Department of Health is encouraging students and their families to prepare for the upcoming school year.  Many students will need updated immunizations, physicals for enrollment, medication administration, documentation for health conditions and emergency action plans for chronic conditions (asthma, allergy, diabetes and seizures). Please contact your health care provider to discuss your child’s medical needs for the upcoming school year.

    Yes.  Please continue to focus on your child’s immunization just as you would for in-person learning.  Immunization requirements have not been waived for the 2020-21 school year. The Superintendent’s memo 132-20 (5/29/20) regarding health requirements for enrollment is included for your review and below is the link: 

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

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

    Children need to continue to get the recommended vaccines on schedule. Vaccines provide individual and community immunity, no matter where you are. The Virginia Department of Education is requiring all public school students to have required immunizations to be enrolled in school. Please continue to focus on your child’s immunization just as you would for in- person learning

    Children will be assigned to small groups that will spend time together, including during time on the playground.  This is called  cohorting students and limits the amount of interaction each child has with others to reduce the risk of COVID-19.  The risk of disease is lower when your child is outdoors compared to  indoors, where there is less fresh air. Masks should be used indoors and also outdoors when physical distancing may be difficult.

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

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

    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.

    And Social Emotional Learning Resources for Parents

    Governor Ralph S. Northam announced statewide measures to contain the spread of COVID-19 in November 2020. 

    The measures require children age 5 and older to wear a mask in indoor public settings. Children age 5 and older must wear masks when they are in schools and child care settings. Children are not required to wear masks when exercising, at recess for example. The Executive Order, available on the Governor’s website, does not provide relief to the mask wearing mandate even when 6 feet or more away from other people. 

    Mask wearing has been shown to prevent the spread of COVID-19.  Almost all school staff and students should be able to wear masks safely and consistently and should be encouraged to do so. Children under 2 years and anyone who has trouble breathing or is unconscious, incapacitated, or otherwise unable to remove a mask without assistance should not wear masks. 

    The Governor’s Executive Order does not require use of masks by students or staff with medical conditions or disabilities for whom wearing a mask would negatively affect their health or safety. Also, persons needing to have their mouth visible in order to communicate with the hearing impaired do not need to wear a mask while doing that. In situations like these, when masks cannot be worn, following other COVID-19 prevention measures, such as physical distancing and hand washing, is particularly important.  

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

    The American Academy of Pediatrics reminds parents that staying home and physical distancing are the most effective ways to prevent  the spread of the virus, but it supports mask use, says mask are safe for the vast majority of children, and offers advice about helping children get accustomed to masks. The A.A.P.’s suggestions include putting a mask on a child’s favorite stuffed animal, decorating masks so they’re more personalized and drawing a mask on your child’s favorite book character.

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

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

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

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

    Per the Phase Guidance for Virginia’s preK-12 schools, the state recommends that schools follow CDC guidance 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.  VDH recommends schools use the CDC Operational Strategy for k-12 Schools jointly with the Interim Guidance for K-12 School Reopening document to inform decisions about school operations with regard to COVID-19. The VDOE also advises local school divisions to work with local health officials and school board counsel on appropriate health and safety practices. In addition, the Virginia Association of School Nurses (VASN) developed a Health Services Recovery Plan resource for school nurses and administrators to plan and prepare for a safe school environment and the delivery of school health services.

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

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

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

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

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

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

    Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. Parents of children who are medically fragile or have one or more chronic conditions should check with their health care provider about school attendance. In addition, employees that meet the criteria listed for ‘higher risk’ populations should check with their healthcare provider before returning to work. The Governor’s phase guidance for public schools recommends remote learning and teleworking options be made available to students and staff that fall into this category.  Please discuss any concern you may have with your local school division.

    Anyone who has had close contact (within 6 feet for a total of 15 minutes or more in a day) with someone with COVID-19 needs to stay home and distanced from others (quarantine) for 14 days from date of last exposure and monitor their health status closely.  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.

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

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

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

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

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

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

    CDC recommends that anyone who has had international travel get tested for COVID-19 with a PCR or antigen test 3-5 days after returning from international travel and stay home for 7 days after travel, even if you test negative. If you don’t get tested, it’s safest to stay home for 10 days after travel.  Additional information can be found on the CDC Guidance for Travelers website.

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

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

    As always, keeping at least 6 feet away from others, wearing a mask, washing hands often, avoiding crowds and contact with persons at risk for severe COVID-19, and monitoring for symptoms are recommended as best practices.

    The safest thing to do is to reduce non-essential activities in the time after travel. 

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

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

    VDH recommends that communities experiencing a low rate of COVID-19 transmission should maintain Forward Virginia Phase 3 mitigation strategies as a baseline as described in the Phase Guidance for Virginia Schools . VDH and the Department of Education have updated Interim Guidance for K-12 School Reopening. VDH recommends schools use the CDC Operational Strategy for k-12 Schools jointly with the Interim Guidance for K-12 School Reopening document to inform decisions about school operations with regard to COVID-19.

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

    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.

    Students should check with their colleges or universities. Many colleges and universities have return protocols that include quarantining and testing before returning to campus after an extended break. For more information, see VDH’s guidance for college students on extended breaks here

    VDH guidance for students on college campuses is available here

    Sports and Recreational Activities

    The total number of spectators in indoor venues cannot exceed 30% of the occupancy load of the certificate of occupancy for the venue or 25 spectators per field, whichever is less. For outdoor venues the total number of spectators cannot exceed 30 percent of occupancy for the venue or 250 spectators per field, whichever is less. Races and marathons may have up to 1000 participants as long they are grouped into staggered start times with no more than 25 people per group. Spectators must wear masks at all times.

    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 COVID-19 activity in a community, 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.

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

    Best practices include the following:

    • All participants and spectators should maintain at least 6 feet of physical distance to the greatest extent possible.
    • During times of substantial COVID-19 activity, VDH strongly advises athletes to wear masks at all times during group training, competition, and on the sidelines. If wearing a mask makes participation in sports difficult, it is advisable not to participate in sports at this time.
    • Limit contact among participants, coaches, and spectators off the field, including in locker rooms, social events, and carpooling to competitions or practices.

    A detailed list of VDH recommended best practices can be found here.

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

    See Considerations for Recreational Sports for more information on the risk associated with playing certain sports.

    A person may play a wind instrument without a mask as long as 10 feet of physical distancing can be maintained from other people. This rule applies to both indoor and outdoor rehearsal and performance settings. Please refer to Executive Order 72 for more details.

    Child Care Programs

    For child care programs and centers that remain open during this time in Phase III, it is encouraged that they adapt their service settings as much as possible to align with public health recommendations. Additionally, as per the  Executive Order 72, everyone age 5 and over must wear a mask in an indoor setting shared by others and outdoor settings where a distance of 6 feet cannot be maintained between a person and others who are not from the same home. Specific Phase III Department of Social Services guidelines for child care can be found here. Please also visit the Department of Social Services COVID-19 child care website to learn more information. 

    Once COVID-19 has been detected in the community and the childcare center remains open, childcare centers should:

    • Educate parents and staff on the signs and symptoms of COVID-19. Encourage employees at greater risk to stay at home. 
    • Communicate with parents to keep children who are sick at home.  
    • Implement physical distancing strategies such as classroom spacing, including the same group each day in the same classroom with the same teachers, with no more than 10 people in a room, (including teachers). Also consider altering or halting group activities, staggering playground time and keeping groups separate for art, music and exercising. Provide adequate supplies for good hygiene.  
    • Practice frequent hand washing and sanitize surfaces frequently. Refer to CDC guidance on cleaning and disinfecting procedures for child care centers that remain open. Consider placing hand hygiene stations at the entrance of the facility, so that children and staff can clean their hands before they enter. If a sink with soap and water is not available, provide hand sanitizer with at least 60% alcohol next to parent sign-in sheets. 
    • Consider screening children and staff before entering the building. Persons who have a fever of 100.40 (38.00C) or above or other signs of illness should not be admitted to the facility. 
    • Restrict outside visitors and volunteers.
    • Ensure children's naptime mats or cribs are spaced out as much as possible, ideally 6 feet apart. Consider placing children head to toe when napping.
    • Modify drop off and pick up procedures. Consider staggering arrival and drop off times and/or have child care providers come outside the facility to pick up the children as they arrive or deliver to parents at pick-up.
    • Staff members and children as old as 5 must wear masks within the facility. Masks should NOT be put on babies and children under age two.

     

    Childcare centers should review the  Phase III guidance  provided by the Department of Social Services on their website to prepare and respond to COVID-19 situations.   Review CDC's guidance for Schools and Child Care Programs and Supplemental Guidance for Child Care Programs That Remain Open (updated July 23, 2020).

    • 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.
    • 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.  
    • Childcare centers should review the child care guidance provided by the Department of Social Services on their website to prepare and respond to COVID-19 situations. Basic preparation includes, but is not limited to: Review, update, and implement emergency operations plans (EOPs)
    • Develop information-sharing systems with partners.
    • Establish procedures for students and staff who are sick at school or school-related events.
    • Perform routine environmental cleaning.
    • Create communications plans for use with the school community.
    • Review CDC's Schools and Child Care Programs (updated December 3, 2020) and Supplemental Guidance for Child Care Programs That Remain Open (updated July 23, 2020)
    • Share resources with students, their families and staff.
    • Promote messages that encourage staff and students who are sick to stay home.
    • Provide additional hand hygiene supplies, as well as, tissues throughout school buildings.
    • Maintain masks onsite in case someone becomes ill.
    • Identify a space that can be used to isolate staff or students who become ill.

    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.

    The Department of Social Services has issued recommendations including encouraging families to remain at home to care for their children if possible and limiting capacity to 10 individuals per room to include staff. Guidance for childcare workers can be found at DSS FAQ For Child Care Services.

    Business and Workplaces: General

    During Phase 3 of Virginia’s Plan for Reopening (Safer at Home), many businesses may operate with extra precautions in place to protect people from COVID-19 transmission. Please review Phase 3 Guidelines for All Business Sectors to review requirements and recommendations for businesses. Additional information about business operations during Phase 3 can be found here. Phase Three Guidelines in Spanish can be found here.

    Essential retail businesses may remain open during their normal business hours. Such businesses are: 

    • Grocery stores, pharmacies, and other retailers that sell food and beverage products or pharmacy products, including dollar stores, and department stores with grocery or pharmacy operations; 
    • Medical, laboratory, and vision supply retailers; 
    • Electronic retailers that sell or service cell phones, computers, tablets, and other communications technology; 
    • Automotive parts, accessories, and tire retailers as well as automotive repair facilities; 
    • Home improvement, hardware, building material, and building supply retailers;  
    • Lawn and garden equipment retailers; 
    • Beer, wine, and liquor stores; 
    • Retail functions of gas stations and convenience stores; 
    • Retail located within healthcare facilities; 
    • Banks and other financial institutions with retail functions; 
    • Pet and feed stores; 
    • Printing and office supply stores; and  
    • Laundromats and dry cleaners.

    Questions about essential services can be directed to commerce.trade@governor.virginia.gov.

    On February 17, 2021, Governor Northam signed Second Amended Executive Order 72. This order states, “All employees of all businesses listed in section II, subsections A and C shall wear a face covering while working at their place of employment.” This order also states, “all individuals in the Commonwealth aged five and older must cover their mouth and nose with a face covering, as described and recommended by the CDC, if they are in an indoor setting shared by others.” This order provides exceptions for persons eating or drinking, persons exercising or using exercise equipment, any person who has trouble breathing or is unconscious, incapacitated, or otherwise unable to remove the mask without assistance, any person seeking to communicate with the hearing impaired and for which the mouth needs to be visible, when temporary removal of the mask is necessary to secure government or medical services, and persons with health conditions or disabilities that prohibit wearing a mask.  Adaptations and alternatives for individuals with health conditions or disabilities should be considered whenever possible to increase the feasibility of wearing a mask or to reduce the risk of COVID-19 spreading if it is not possible to wear one. An exception also exists for any person who is playing a musical instrument, when wearing a mask would inhibit the playing of the instrument (e.g. wind instrument), if at least 10 feet of physical distancing can be maintained from other persons, whether the rehearsal or performance is indoors or outdoors. The restrictions in Second Amended Executive Order 72  are effective immediately  and shall remain in force until 11:59 PM, Sunday, February 28, 2021. Amended restrictions for recreational sports shall be effective at 12:00 a.m. on February 22, 2021, and shall remain in full force and effect until 11:59 p.m., February 28, 2021.

    Furthermore, on January 13, 2021, the Safety and Health Codes Board  adopted the  Final Permanent Standard for workplaces across the Commonwealth to prevent workplace exposure to COVID-19, including standards related to personal protective equipment, sanitation, physical distancing, infectious disease preparedness and response plans, record keeping, training, and hazard communications. A web page devoted to the Final Permanent Standard containing Outreach, Education and Training materials has been set up and is being populated with documents. 

    On November 13, 2020, Governor Northam signed Sixth Amended Executive Order 67, which outlines business restrictions during Phase 3. The amended order is effective immediately and shall remain in force until amended or rescinded.  

    On July 20, 2020, CDC updated guidance for ending isolation for persons with COVID-19 not in healthcare settings. The updated guidance is available here. Information on COVID-19 testing strategies in high-density critical infrastructure workplaces after a COVID-19 case is identified can be found here. Further information can be found on the VDH Businesses website and in CDC guidance to prevent COVID-19 in the workplace

    A guide evaluating non-critical infrastructure workers with COVID-19 symptoms or exposures can be found here.

    Guidance on identifying critical infrastructure workers can be found here. The Cybersecurity & Infrastructure Security Agency identifies 16 critical infrastructure sectors: Chemical; Commercial Facilities; Communications; Critical Manufacturing; Dams; Defense Industrial Base; Emergency Services; Energy; Financial Services; Food and Agriculture; Government Facilities; Healthcare and Public Health; Information Technology; Nuclear Reactors Materials and Waste; Transportation Systems; Water and Wastewater Systems. On December 16, 2020 CISA updated their guidance document for “Ensuring Essential Critical Infrastructure Workers’ Ability to Work” which can be found here. This document identifies and lists critical infrastructure workers within the 16 critical infrastructure sectors.

    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 because masks are not worn.  Consider closing break rooms or placing chairs and tables at least 6 feet apart to reinforce appropriate physical distancing and prevent outbreaks.

    Per Sixth Amended Executive Order 67, restaurants and beverage services may operate with extra precautions in place to protect people from COVID-19 transmission. A full list of requirements and recommendations for restaurant and beverage services can be found in the Phase 3 Guidelines for All Business Sectors (p. 8-11). FAQs for restaurants and beverage services can be found here. A guide for evaluating non-critical infrastructure workers with COVID-19 symptoms or exposures can be found here.

    Of note, there is no evidence that COVID-19 is spread through food or food shipped from affected regions.

    Forward Virginia Phase Three Guidelines state that karaoke must remain closed. If live musicians are performing at an establishment, they must remain at least ten feet from patrons and staff. Phase Three Guidelines in Spanish can be found here.

    Modified dining areas using a tent or other artificial enclosure where the tent flaps are down or where air is recirculated through an HVAC system are considered indoor spaces. In these areas, Amended Executive Order 63 applies and patrons must wear a mask while not eating or drinking. The best rule of thumb is to wear a mask, indoors or outdoors, whenever you cannot maintain at least 6 feet of distance from others who are not members of your household and when you are not actively eating or drinking.

    Second Amended Executive Order 72 states “All individuals in the Commonwealth aged five and older must cover their mouth and nose with a face covering, as described and recommended by the CDC, when outdoors and unable to maintain at least six feet of physical distance from other individuals who are not Family members.” This order is effective immediately and shall remain in full force and effect until 11:59 p.m., February 28, 2021.

    Not at this time.  Feel free to check the VDH website, which is updated daily, or call 877-ASK-VDH3 if you have additional questions.

    We have posted available print resources and highlights on the VDH website.

    The Virginia Department of Health offers a playlist of 22 short videos on a number of topics on its homepage

    Our resources page includes information on additional topics of interest to individuals.  Encourage employees to familiarize themselves with our symptom checker called CovidCheck.

    Finally, 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.

    A guide for evaluating non-critical infrastructure workers with COVID-19 symptoms or exposures can be found here.

    Business and Workplaces: Final Permanent Standard

    On January 13, 2021, the Virginia Safety and Health Codes Board adopted the Final Permanent Standard(FPS) addressing occupational exposure to the SARS-CoV-2 Virus That Causes COVID-19. The FPS took effect on January 27th, 2021. 

    Final Permanent Standard for controlling COVID-19 can be found here

    Training material for the FPS 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 FPS can be found here. 

     

    The Final Permanent Standard adopted by the Virginia Department of Labor and Industry requires all employers to establish a system for collecting information about employees (including contract and temporary employees as well as full-time) who have symptoms consistent with COVID-19. Employees need to follow the procedures established by the employer. Illness information is needed during the pandemic so measures can be put in place to prevent the spread of the disease. Employers must keep employee illness information confidential.

    The Occupational Safety and Health Laws of Virginia give employees the right to file complaints about workplace safety and health hazards. Further, the Occupational Safety and Health Laws give complainants the right to request that their names not be revealed to their employers. Complaints from employees and their representatives are taken very seriously by the Virginia Occupational Safety and Health program (VOSH). Information on how to file complaints about violations of the FPS can be found here. 

    Effective January 27, 2021 , Employers shall 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 SARS-CoV-2 virus during that 14-day time period.

    After the initial report of outbreak (two or more cases), employers shall continue to report all cases to VDH until the local health department notifies the business that the outbreak has been closed.

    After the outbreak is closed, subsequent identification of two or more cases of COVID-19 during a declared emergency shall be reported. 

    The  Final Permanent Standard provides that “The employer shall notify the Virginia Department of Labor and Industry within 24 hours of the discovery of three (3) or more employees present at the place of employment within a 14-day period testing positive for SARS-CoV-2 virus during that 14-day time period.”

    The requirements to report outbreaks to VDH and DOLI are fulfilled by employers entering COVID-19 case reports  into the Virginia Department of Health’s (VDH) online reporting portal.  Employers can submit up to 10 COVID-19 positive cases into the portal.

    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. 

    The symptom-based strategy means waiting until 10 days after symptom onset, having  no fever for at least 24 hours without fever-reducing medications, and having other symptoms improve. Of note, loss of taste or smell can persist for weeks and should not delay ending isolation. 

    The time-based strategy means waiting until 10 days after specimen collection and not having any other symptoms develop.

    People who have had close contact with someone with COVID-19 should monitor for symptoms and follow all disease control recommendations (e.g., wear a mask, avoid crowds, follow social distancing, and wash hands frequently) for 14 days after the last exposure. VDH and CDC still recommend that close contacts quarantine (stay home) for 14 days after their last exposure. This is the safest option. If people choose to end quarantine early, there are 2 options:

    • Quarantine can end after Day 10 without testing and if no symptoms have developed; OR Quarantine can end after Day 7 if a viral test (e.g., PCR or antigen test) performed on or after Day 5 is negative and if no symptoms have developed.

     

    Persons with COVID-19 symptoms may discontinue isolation under the following conditions:

    • At least 10 days have passed since symptom onset and
    • At least 24 hours have passed with no fever without the use of fever-reducing medications and
    • Other symptoms have improved (loss of taste or smell may persist for weeks or months after recovery and need not delay the end of isolation).

     

    Certain people do not need to quarantine after exposure to COVID-19. This includes people who: 

    • Have had COVID-19 within the past 3 months as long as they do not develop new symptoms.
    • Have been fully vaccinated for COVID-19 within the past 3 months as long as they have no symptoms and are not inpatients or residents in a healthcare setting.
      • Fully vaccinated means 2 weeks or more have passed since receipt of the second dose in a 2- dose series, or 2 weeks or more have passed since receipt of one dose of a single-dose vaccine.
      • Healthcare settings include hospitals and long-term care facilities (e.g., nursing homes, assisted living facilities).
    • People who are not required to 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.

     

    For more information, see Virginia Department of Health Interim Guidance on Screening, Monitoring and Testing Employees Returning to Work: Critical Infrastructure Employees (Non-Healthcare)

    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 recommends in their Guidance for Business Response that employers should not require a positive COVID-19 test result or a healthcare provider’s note for employees who are sick to validate their illness, qualify for sick leave, or 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.

    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

    Please review your local government’s website and all of Governor Northam’s current Executive Orders to determine what restrictions are in place in your region/locality. Event planners are encouraged to confer with local government and public health leadership about any planned events.

    Example signage is available in the VDH Business Toolkit. Further guidelines for social gatherings can be found in the Guidelines for All Business Sectors (p. 5-7) and the VDH Social Gatherings and Public Indoor Spaces webpage here and VDH Public Outdoor Spaces here. Guidance from the CDC for Events and Gatherings can be found here. Additional considerations for events and gatherings can be found here.

    Due to the impact of COVID-19 in Virginia, many events are canceled and many venues are temporarily closed. Please contact the event organizers to determine whether the event is cancelled. If you have been exposed to COVID-19 or are at increased risk for severe illness, you should not attend in-person gatherings. More information on who should avoid in-person celebrations can be found on the CDC webpage here.

    Due to the impact of COVID-19 in Virginia, many events have been modified or cancelled. Please contact the event organizers to determine whether the event is cancelled. In Virginia, parades follow Phase Three Guidelines for Entertainment and Public Amusement here (pages 30-33). However, your region/locality may have stricter restrictions in place.

    Those planning celebrations at home should consider virtual celebrations. If virtual celebrations cannot be held, organizers should keep the gathering as low-risk as possible by holding the event outside, ensuring attendees who do not live in the same household remain 6 feet apart, discouraging sharing of food or drinks, ensuring attendees wear masks, and inviting only local friends and families to attend.

    The more people an individual interacts with and the longer the interaction lasts, the higher the risk for infection. VDH provides more information on the risk of spreading COVID-19 at social events on the Social Gatherings and Public Indoor Spaces webpage here and relative risk levels for events on the Public Outdoor webpage here. CDC also provides general considerations for before, during, and after these celebrations.

     

    Travel may increase your chance of spreading and getting COVID-19. CDC continues to recommend postponing travel and staying home, as this is the best way to protect yourself and others. The safest thing to do is to stay home, but If you do decide to travel, be sure to take steps during your trip to protect yourself and others from COVID-19. If you have been exposed to COVID-19 or are at increased risk for severe illness, you should not travel.

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

    VDH does not recommend carpooling at this time. If it is necessary 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

    Many communities of faith have provided guidance on how to practice faith in times when public gatherings would put the community at risk. Additionally, virtual/online services are being held for many communities of faith to allow people to worship without having to gather in-person.

    When deciding whether to attend worship services in person, consider factors that impact the risk of COVID-19 transmission. These considerations can be found on the VDH webpage for Faith-based Organizations here.

     

    In Phase Three of Forward Virginia, religious services are encouraged to follow the best practices described in the Phase Three Guidelines for Social Gatherings (page 5).  Phase Three Guidelines in Spanish can be found here.

     

    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 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. See VDH's Guidance for Performing Arts for more information 

    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) and the Department of Social Services (DSS) 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.

     

    Religious services include but are not limited to daily or weekly worship, ordination, baptism, wedding and funeral ceremonies, and observations associated with certain holidays.

    There is not a limit to the number of participants who can attend a religious service. However, if the religious service has more individuals than permitted by the applicable gathering ban, (10 people indoors or 25 people outdoors under Third Amended Executive Order 72) the service is subject to the requirements found in Section II, Paragraph B(1) in EO 72, found here. 

    A social gathering associated with a religious service, such as a funeral or wedding reception, should follow the guidance for social gatherings in the appropriate Phase guidance for businesses and may not exceed 10 individuals. More information on social gatherings can be found on the VDH webpage for social gatherings and public indoor spaces

    Additional information and guidance for faith-based organizations and other community gatherings can be found on the VDH Faith-based Organizations webpage here and CDC Community Organizations and Gatherings webpage here, including Considerations for Communities of Faith here and 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 visitors and nonessential personnel, as well as restrict group activities, including communal dining, inside nursing homes. While visitor restrictions may be difficult for residents and families, it is an important temporary measure for their protection.

    Additionally:

    1- Most people will not be able to visit loved ones at this time. Some visitation may be allowed on a case-by-case basis by the facility. If you are allowed to visit your loved one in a nursing home, make sure you are not sick. If you are sick, delay your visit until you can see your doctor and get checked out.

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

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

    4- Visitors should not visit more than one resident. Visits should be in the resident’s room, and not in common areas. 

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

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

    • Set up the following restrictions now:
      • Require residents and staff to wear a mask
        • Limit points of entry to the facility. Visitors, volunteers, and non-essential healthcare staff must be restricted from the facility, except for end-of-life situations.  
      • Restrict all residents to their room and require physical distancing. Cancel all group activities and communal dining.
      • Residents should be allowed to leave only for medically necessary purposes (e.g., hemodialysis), and should wear a mask (if tolerated) when they leave.
      • Designate a location to isolate residents with suspected or confirmed COVID-19.
    • Identify cases as early as possible by actively screening all residents daily for fever and respiratory symptoms (pulse oximetry). 
      • Long-term care (LTC) residents with COVID-19 may show atypical symptoms including new or worsening malaise, new dizziness, diarrhea, or sore throat.  Identification of these symptoms should prompt isolation and further evaluation.
    • Institute staffing recommendations at the facility:
      • Screen healthcare staff for fever, respiratory symptoms, and possible exposures at the beginning of their shift. If they are ill, have them put on a mask (if they do not wear one already) and leave the workplace.
      • Implement universal use of masks for healthcare staff while in the facility, as supply allows. 
      • Designate healthcare staff who will be responsible for caring for COVID-19 patients. 
      • To mitigate staffing shortages, exposed healthcare staff may continue to work while wearing a mask as long as they remain asymptomatic. Testing exposed, asymptomatic healthcare staff is advised.
    • Follow environmental cleaning and disinfection procedures consistently and correctly.
      • Management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures.

    Routine testing of long-term care facility staff who do not have COVID-19 symptoms is required. How often this staff testing happens is based on community-level COVID-19 activity, which is classified as either low, medium, or high. Low community activity (a test positivity rate of less than 5%) means that staff will be tested at least once a month, medium community activity (a test positivity rate from 5 - 10%) means that staff will be tested at least once a week, and high community activity (a test positivity rate greater than 10%) means that staff will be tested at least twice a week. More information about community test positivity rates is available on the Virginia PCR test positivity dashboard.

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

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

    Yes, under certain circumstances, restricting residents to their rooms is recommended (not mandated). According to the CDC guidance document (dated March 21, 2020) “Preparing for COVID-19: Long-term Care Facilities, Nursing Homes,” this type of restriction would apply to care of residents with an undiagnosed respiratory illness, or care of symptomatic residents who are awaiting transport to a facility that can provide a higher level of care which the patient needs. Residents diagnosed with, or suspected to have, COVID-19 are recommended to be isolated in their room(s) with the door closed, to the extent possible. If there are cases of COVID-19 in the facility OR if there is widespread transmission (greater than 10% positivity rate) of the virus in the community, residents who have not been diagnosed with COVID-19 are encouraged to be restricted to their rooms to the extent possible. If residents leave their rooms, they should wear a mask, practice social distancing and wash their hands. Residents who leave their rooms can be redirected back to their rooms. It may be helpful to engage the resident in light exercise in the facility – this may reduce restlessness, agitation and wandering.

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

    CDC has guidance for preparing for COVID-19 in LTCFs.

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

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

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

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

    The contact number for complaints is:

    Toll Free: 1-800-955-1819

    Metro Richmond area: (804) 367-2106

    More detailed information may be found here.

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

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

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

    To File a Written Complaint:

    1. Select from the 2 types of complaint forms:
      Nursing Facility Complaint 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 a skilled nursing facility / nursing home.”

    Funerals and COVID-19

    There is currently no known risk associated with being in the same room at a funeral or visitation service with the body of someone who died of COVID-19.

    In some situations, many people have become sick with COVID-19 after attending a funeral service. To help prevent the spread of COVID-19 in communities, changes need to be made to the way funerals, visitations, and memorials to the deceased are held. People attending the funeral and/or visitation service should remain at least 6 feet apart from one another and wear masks. Regardless of the number of people attending, everyone should also practice good hand, cough and sneeze hygiene. Because we do not know all the ways the SARS-CoV-2 virus can be spread, older adults and people with high risk conditions are recommended not to attend. These groups of people are at higher risk of developing severe illness if they become infected with the virus that causes COVID-19. Consideration can be given to livestreaming the funeral or visitation service so that others may participate remotely, or video recording the events. Additional guidance for individuals and families, including the risk of different types of services and gatherings, can be found here.

    Please see Executive Order 72 for current Virginia restrictions affecting religious services (beginning on page 12.)

    COVID-19 is a new disease and we are still learning how it spreads.  People should consider not touching the body of someone who has died of COVID-19.

    Yes.  People who died of COVID-19 can be buried or cremated, but check for any additional state and local requirements that may dictate the handling and disposition of the remains of individuals who have died of certain infectious diseases.

    A funeral or visitation service can be held for a person who has died of COVID-19. Funeral home workers should follow their routine infection prevention and control precautions when handling a decedent who died of COVID-19. If it is necessary to transfer a body to a bag, follow Standard Precautions, including additional personal protective equipment (PPE) if splashing of fluids is expected. For transporting a body after the body has been bagged, disinfect the outside of the bag with a product with EPA-approved emerging viral pathogens claims expected to be effective against COVID-19 based on data for harder to kill viruses. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.). Wear disposable nitrile gloves when handling the body bag.

    Embalming can be conducted. During embalming, follow Standard Precautions including the use of additional PPE if splashing is expected (e.g. disposable gown, face shield or goggles and N95 respirator). Wear appropriate respiratory protection if any procedures will generate aerosols or if required for chemicals used in accordance with the manufacturer’s label. Wear heavy-duty gloves over nitrile disposable gloves if there is a risk of cuts, puncture wounds, or other injuries that break the skin. Additional information on how to safely conduct aerosol-generating procedures is in the CDC’s Postmortem Guidance. Cleaning should be conducted in accordance with manufacturer’s instructions. Products with EPA-approved emerging viral pathogens claims are expected to be effective against COVID-19 based on data for harder to kill viruses. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time).

    After cleaning and removal of PPE, perform hand hygiene by washing hands with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water is not available. Soap and water should be used if the hands are visibly soiled.

    Decedents with COVID-19 can be buried or cremated, but check for any additional state and local requirements that may dictate the handling and disposition of the remains of individuals who have died of certain infectious diseases.

    After an autopsy of a decedent with confirmed or suspected COVID-19, follow the cleaning and waste disposal guidance in the CDC’s Postmortem Guidance.

    More information can be found at the following links:

    Funeral Home Workers

    COVID-19 Guidance Postmortem Specimens

Special Populations
  • Special Populations: Immunocompromised or Underlying Health Conditions

    People with weakened immune systems or underlying health conditions should continue to follow their treatment plans, including continue medications, obtain at least a 2-week supply of prescription and non-prescription medications, and ensure vaccinations are up-to-date. Keep your regularly scheduled medical appointments. If a medical emergency happens, do not delay going to the Emergency Room or calling 911 because of concern about COVID-19.

    Additionally, these individuals should take the following precautions to reduce the risk of exposure to COVID-19:

    • Avoid leaving home as much as possible. If you must leave home, try to maintain a distance of at least six feet between you and people outside you do not live with.       
    • Avoid large gatherings or places where people congregate.
    • Wash your hands often with soap and water for at least 20 seconds.
    • Keep these items on hand and use them when venturing out: a mask and hand sanitizer with at least 60% alcohol, if possible.
    • Wear a mask.
    • Limit contact with frequently touched services. Clean and disinfect these surfaces when possible. 
    • Avoid all cruise travel and non-essential air travel.
    • Have supplies, food, and medicine delivered to your home.

    Call your healthcare professional if you have concerns about COVID-19 and your underlying condition or if you are sick. 

    For information and resources for people with underlying health conditions, please visit  CDC's guidance for People of Any Age with Underlying Medical Conditions. This resource 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  experienced 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

    Correctional Facilities and COVID-19

    Local health departments respond to single cases of COVID-19 identified in corrections settings, as resources allow, to recommend implementation of actions to prevent outbreaks.  Recommendations include putting infection prevention strategies in place, testing and monitoring of quarantined contacts or all incarcerated persons and staff if indicated. Additional actions at the facility may be recommended. CDC recommends that close contacts of someone infected with COVID-19, whether the exposed person is a staff member or a resident of the correctional facility, should be placed under quarantine for 14 days, and not one of the shorter duration options.

    Health department staff provide onsite and/or remote consultation with the correctional facility on infection prevention and control practices. Health department staff coordinate and facilitate testing to confirm outbreaks as indicated. Additional testing at the facility may be recommended, especially of close contacts to an identified case.

    The key measures to protect incarcerated persons, staff and the community are to take all steps possible to prevent the introduction of SARS-CoV-2 into facilities, to identify early and isolate COVID-19 cases, to vaccinate residents and staff at correctional facilities when vaccine is available, and to implement appropriate infection prevention recommendations to prevent further spread in the facility and the community.  

    The Virginia Department of Corrections and Virginia’s local and regional jails have taken proactive steps to reduce opportunities for introduction of SARS-CoV-2 into facilities, including limiting and adapting in-person visitation, reducing transfers and intakes if at all possible, applying physical distancing measures in all possible parts of facilities, providing hand hygiene supplies, and educating and preparing staff and incarcerated persons for COVID-19 response. These facilities continue to actively work with state and local health department partners as they now make plans to provide vaccines for residents and staff when it is available. Frontline essential workers, including people who work in correctional facilities, and people living in correctional facilities, are eligible to receive COVID-19 vaccine as part of Phase 1b in Virginia. 

    Pregnancy and Infants

    Based on what we know at this time, pregnant people are at an increased risk for severe illness from COVID-19 compared to non-pregnant people. A study found that pregnant women are more likely to be admitted to the intensive care unit (ICU), receive invasive ventilation and extracorporeal membrane oxygenation, and are at increased risk of death compared to nonpregnant women. But much remains unknown and the CDC is working with state, local, and territorial health departments and external partners to learn more about COVID-19 during pregnancy. Additionally, there may be an increased risk of adverse pregnancy outcomes, such as preterm birth, among pregnant people with COVID-19. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick.

    Pregnant women should engage in preventive actions to avoid infection like limiting interactions with people that might have been exposed to or infected with COVIID-19,washing hands often, covering your mouth and nose with a mask, staying at least 6 feet away from others outside your household, covering coughs and sneezes and frequent cleaning and disinfecting frequently touched surfaces.

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

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

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

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

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

    Some newborns have tested positive for the virus that causes COVID-19 shortly after birth. It is unknown if these newborns get the virus before, during, or after birth from close contact with an infected person. Most newborns who have tested positive for COVID-19 had mild or no symptoms and have recovered fully. However, there are a few reports of newborns with severe illness.

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

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

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

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

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

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

    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 mother is low if precautions are taken. After discussing, make an informed decision of whether your newborn is staying in the same room with you while in the hospital.

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

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

    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.

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

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

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

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

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

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

    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. If you are pregnant, you should continue to receive your recommended vaccines. Talk with your healthcare provider about visits for vaccines during pregnancy.

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

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

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

    Vaccines are also an important part of keeping your child healthy, especially if your child is under 2 years old. Vaccines help provide immunity before being exposed to potentially life-threatening diseases. Although there is not yet a vaccine to help protect against COVID-19, vaccines for illnesses such as measles, influenza (flu), whooping cough (pertussis), and other infectious diseases are important for your child’s health. This will help to prevent outbreaks of vaccine-preventable diseases among young children during the COVID-19 pandemic.

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

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

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

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

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

    Children and COVID-19

    While some children and infants have been sick with COVID-19, adults make up most of the known cases to date. Some reports suggest that infants under 1 year old and children with underlying medical conditions, particularly sickle cell disease and chronic kidney disease, might be at higher risk of serious illness from COVID-19 than other children.

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

    • Avoid close contact with people who are sick.
    • Stay home when you are sick, except to get medical care.
    • Cover your coughs and sneezes with a tissue and throw the tissue in the trash.
    • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
    • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty. 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.
    • Children over the age of 2 years are encouraged to wear masks when in outdoor and indoor public settings. 
    • Family members should get the COVID-19 vaccine when it is available to them

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

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

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

    Executive Order 63  requires all Virginians aged 5 years and older to wear masks in indoor public settings and business establishments.

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

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

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

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

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

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

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

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

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

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

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

    Currently there are no specific drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment or prevention of COVID-19 or MIS-C. Treatment remains mainly supportive and includes prevention and management of complications.

    Currently we do not know a lot about MIS-C. Any child suspected to have MIS-C should be placed in a private room (if available) on transmission-based precautions. Healthcare facilities should ensure that infection prevention and control policies, including universal source control, are in place to minimize the chance of exposure to SARS-CoV-2 among providers, patients, and families.

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

    Additional precautions may include virtual learning or the use of child care.

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

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

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

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

    For more information, see: COVID-19 and Children

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

    Homeless Population

    Homeless shelters have not been required to close under any of Governor Ralph Northam’s executive orders. Shelters are encouraged to maintain operations and provide essential services to those in need. Individual shelters may have made the decision to close or change operations. 

    The capacity restrictions included in Executive Order 72 do not apply to homeless shelters. Homeless shelters should take steps to stop the spread of COVID-19 infections, such as ensuring physical distancing and helping individuals experiencing homelessness and shelter staff access vaccines when they are eligible. 

    No, the hotel cannot require that the person experiencing homelessness disclose their status.  A person suspected or confirmed to be ill with COVID-19 by laboratory test should notify contacts who have been exposed. Contacts should follow quarantine recommendations and monitor their health for 14 days after their exposure. The community service organization who placed the ill or infected person will assist with communication of information, the initiation of isolation for that person, and quarantine of suspected contacts.

    A person who does not have symptoms of COVID-19 and does not have a positive laboratory test for the virus has no responsibility to share information about this virus with others.  Information about health conditions can remain confidential and should be protected.  It should be shared only at the discretion of the individual and to healthcare providers who need the information to provide necessary medical care services.

    VDH and the Department of Housing and Community Development (DHCD) guidance for homeless shelters is available here.

    Some of these recommendations include: 

    • Increasing distance or adding a barrier between staff and guests for registration and entry.
    • Having shifts for meals or staggering access to services. 
    • Increasing distance or physical barriers between beds, arranging beds head-to-toe.

    VDH encourages shelter staff to screen people for symptoms consistent with COVID-19 infection. Guests who have tested positive or have symptoms should have a separate space from all other guests. Those who are at increased risk for severe illness from COVID-19 should also have a separate area, if possible.

    Additional VDH resources for homeless service providers are available here

    CDC’s Toolkit for People Experiencing Homelessness is also available here.

    Individuals experiencing homelessness can obtain help by calling 2-1-1 or the Crisis Assistance Contact number in the area of the state where they are. The list of Crisis Assistance Contacts can be found here. A map of Crisis Assistance Contacts is located here.

    If possible, separate spaces and bathrooms should be provided to each guest who is experiencing symptoms of COVID-19. Physical distancing and other barriers should be in place if sick guests must be isolated together in the same area. If symptoms are severe, and a guest has difficulty breathing, a medical provider should be consulted. VDH provides guidance on testing for COVID-19, which includes consideration for those who work or live in a congregate setting.

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. COVID-19 risk in most countries is high, and travelers should avoid nonessential travel to high-risk destinations. Travelers at increased risk for severe illness should consider postponing all travel, including essential 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, is awaiting COVID-19 test results, or had close contact with someone with COVID-19 within the past 14 days should delay 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 defer all cruise ship travel worldwide.

    Yes. If you have to stop in a country with a Level 3 travel notice, even if it is just for a layover at the airport, that is included in CDC’s recommendation to avoid nonessential travel to that area. 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.

    Many 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 that your travel plans may be disrupted. 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.

    U.S. citizens, lawful permanent residents, and their families arriving from international destinations are still allowed to enter the U.S. 

    Foreign nationals who have visited China, Iran, the European Schengen area (includes 26 European countries), the United Kingdom, Brazil, the Republic of Ireland, and South Africa 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.

    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”.

    People arriving from other countries are not being quarantined unless they have been in close contact with someone with COVID-19; however, pre-flight testing requirements and the testing and precautionary recommendations (practicing physical distancing, wearing a mask within households and when making essential trips outside of the household, avoiding close contact with persons at high risk of severe COVID-19, and washing hands frequently) apply to people entering the US from other countries.

    The testing requirement before flying to the US and testing and disease prevention precautions like practicing physical distancing, wearing a mask within households and when making essential trips outside of the household, avoiding close contact with persons at high risk of severe COVID-19, and washing hands frequently apply to anyone entering the US from another country.

    Some types of travel and activities increase the risk for exposure to COVID-19.  If your family member participated in higher risk activities, such as those listed below, or may have been exposed before or during their trip, they should be extra sure to follow all the recommended precautions (e.g., distance, mask, etc.) to protect others for 14 days after arrival.

    Here are examples of activities and situations that can increase travel related risk of exposure to COVID-19:

    • Being in an area that is experiencing high levels of COVID-19 spread. You can check the levels for places traveled, including countries, S. states and territories, counties, and cities.
    • Going to a large social gathering like a wedding, funeral, or party.
    • Attending a mass gathering like a sporting event, concert, or parade.
    • Being in crowds – for example, in restaurants, bars, airports, bus and train stations, or movie theaters.
    • Traveling on a cruise ship or river boat.

    All international travelers will be required to have a negative COVID-19 test before flying to the US and are encouraged to follow the testing and disease prevention precautions such as practicing physical distancing, wearing a mask within households and when making essential trips outside of the household,avoiding close contact with persons at high risk of severe COVID-19, and washing hands frequently after they return.

    When deciding whether to return to work after arriving back in the US, a person who traveled should think about whether they engaged in high risk activities (discussed in the question above), whether they have any potential symptoms of COVID-19, and whether they can maintain at least 6 feet of distance from others and wear a mask in the workplace.

    Anyone who engaged in high risk activities during travel should stay home and limit contact with others for 14 days after travel.

    Anyone with any symptoms of disease should isolate immediately and seek testing services and medical care as necessary.

    Those who cannot maintain distance and masking at work are advised to stay home for 7 days after travel if a COVID-19 test performed 3-5 days after return is negative.  It is safest to stay home for 10 days.

    See CDC’s After You Travel Internationally webpage to learn what precautions you should take.

    See VDH’s Travelers site for more information.

    It is very important that people with ANY signs of illness (fever, cough, chills, shaking with chills, muscle pain, headache, sore throat, loss of taste or smell) stay home to prevent spreading illness to others.

    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 travelers avoid all cruise travel, including river cruises, worldwide. The risk of COVID-19 spreading on cruise ships is high. People with an increased risk of serious illness should especially avoid travel on cruise ships, including river cruises. CDC has issued a Level 4 Travel Health Notice for cruise ship travel. 

    People who do  travel on a cruise should get tested 3-5 days after returning from the trip AND stay home for 7 days after travel, even if they test negative.  It's safest to stay home for 10 days after travel, especially for those who do not get tested. 

    For additional information, see COVID-19 and Cruise Ship Travel, Travelers Returning from Cruise Ship and River Cruise Voyages.

    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.

    Yes. CDC recommends that people wear a mask to cover their nose and mouth while in a community setting, including during any public transportation. Effective February 2, 2021 all travelers aged 2 years 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, taxis, rideshares) and in 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.

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

    The masking recommendation is in addition to the other usual COVID-19 prevention measures, including maintaining at least 6 feet of distance from others as much as possible, avoiding crowds and ill persons, practicing good hand hygiene, etc. You should get the COVID-19 vaccine when it becomes available to you.

    VDH Recommendations Regarding Masks

    U.S. Travelers

    The situation in the U.S. is rapidly evolving.  Many communities in the US are experiencing high levels of COVID-19. Be aware that 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 or here for U.S. 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 Coronavirus and Travel in the United States page. 

    Those who need to travel within the U.S. should carefully follow all COVID-19  precautions (wearing a mask, staying at least 6 feet away from others, washing hands, etc.). Anyone ill with any symptoms of COVID-19 or who has recently tested positive or had close contact with someone with COVID-19 should not travel.

    Here are examples of activities and situations that can increase your risk of exposure to COVID-19:

    • Being in an area that is experiencing high levels of COVID-19 spread. You can check the levels for places you traveled, including countries as well as U.S. states, territories, counties, and cities.
    • Going to a large social gathering like a wedding, funeral, or party.
    • Attending a mass gathering like a sporting event, concert, or parade.
    • Being in crowds — for example, in restaurants, bars, airports, bus and train stations, or movie theaters.
    • Traveling on a cruise ship or river boat.

    If you participated in higher risk activities or think that you may have been exposed before or during your trip, be extra sure to follow all the COVID-19 precautions (e.g., wearing a mask, keeping at least 6 feet away from others, avoiding close contact with persons at high risk of severe illness, etc.) to protect others for 14 days after arrival or return.

    Tests and quarantine for returning travelers is not generally required in Virginia, but some recommendations are in place.  Anyone who has had close contact with someone with COVID-19 should be quarantined for up to 14 days from the date of last exposure.  Anyone with any symptoms of COVID-19 should isolate and stay away from others for at least 10 days.

    Some types of travel and activities increase the risk for exposure to COVID-19.  If your family member participated in higher risk activities or may have been exposed before or during their trip, they should be extra sure to follow all COVID-19 precautions to protect others for 14 days after arrival. In addition, they may consider the following:

    • Consider getting tested with a viral test 3–5 days after returning and reduce non-essential activities for a full 7 days after travel, even if the test is negative. People who don’t get tested should consider reducing non-essential activities for 10 days.
    • Anyone who tests positive should isolate  to protect others from getting infected.
    • Stay home as much as possible.

    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 the most precautions possible.

    • Get a flu shot before travel. Get a COVID-19 vaccine if it is available to you. Wait for 2 weeks after getting your second vaccine dose to travel because it takes time for your body to build protection after any vaccination.
    • Get tested 1-3 days before travel with a viral test. Make sure you get your test results before you travel. If you are waiting for results, delay your travel. Do not travel if your test result is positive; immediately isolate yourself. You may have been exposed to COVID-19 on your travels. You and your travel companions (including children) may pose a risk to your family, friends, and community.
    • Practice physical distancing.
    • Wear a mask.
    • Wash your hands frequently.
    • Avoid large groups of people.
    • Follow all precautions when you return from travel for 14 days.
    • Get tested with a viral test 3-5 days after travel AND reduce all non-essential activities for 7 days after travel. Even if you test negative, stay home for the full 7 days. If your test is positive, isolate yourself to protect others from getting infected. If you don’t get tested, it’s safest to stay home for 10 days after travel.. Avoid being around people who are at increased risk for severe illness for 14 days, whether you get tested or not.
    • If you are planning to travel for an upcoming holiday, see CDC’s information about Holiday Celebrations.

    Yes. Since COVID-19 activity is widespread in multiple states, it is recommended and required in some states that travelers wear a mask during travel regardless of the travel destination. Effective February 2, 2021 all travelers aged 2 years 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, taxis, rideshares) and in 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. Other important infection prevention and control measures include:

    • Get vaccinated against COVID-19 when it is available to you. Wait for 2 weeks after getting your second vaccine dose to travel because it takes time for your body to build protection after any vaccination.
    • Avoid all non-essential travel and stay at home as much as possible.
    • Avoid close contact with sick people.
    • Avoid touching your eyes, nose, and mouth with unwashed hands.
    • Stay home when you are sick.
    • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
    • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning product.
    • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
    • If soap and water are not readily available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
    • Those with underlying medical conditions or disabilities that increase their risk for serious illness should consult with their healthcare provider before travel.

    See CDC Recommendation Regarding the Use of Masks here.

    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.

    Walking a dog is important for both animal and human health and well-being. Walk dogs on a leash, maintaining at least 6 feet (2 meters) of distance from other people and animals, do not gather in groups, stay out of crowded places and avoid mass gatherings. Avoid going to dog parks or public places where a large number of people and dogs gather. To help maintain physical distancing, do not let other people pet your dog when you are out for a walk.

    Until we know more about how this virus affects animals, CDC encourages pet owners to treat pets as you would other human family members to protect them from possible infection. This means limiting contact between pets and people or animals outside the household as much as possible and avoiding places where large numbers of animals and people gather.

    If you must take your pet to a groomer, daycare, or boarding facility, follow any protocols put into place at the facility, such as wearing a mask and maintaining at least 6 feet of space between yourself and others if possible.

    Limit pet items brought from home to the facility and thoroughly clean any objects that are taken into a facility and returned home (such as leashes, bowls, and toys). Such items can be cleaned with warm, soapy water and allowed to dry. If you use a chemical disinfectant on your pet’s items, use an EPA-registered disinfectant and make sure that product is safe for use around animals. Disinfected items should be thoroughly rinsed with clean water and allowed to dry before reuse. 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.

    Do not put masks on pets, and do not take a sick pet to a groomer, daycare, or boarding facility. If you think your pet is sick, call your veterinarian. Your veterinarian can evaluate your pet and determine the next steps for your pet’s treatment and care.

    Dog parks provide socialization and exercise for dogs, which is an important part of their wellbeing. Because there is a small risk that people with COVID-19 could spread it to animals, CDC recommends that you do not let pets interact with people outside of your household, especially in places with community spread of COVID-19. Therefore, you should consider avoiding dog parks or other places where large numbers of people and dogs gather.

    Some areas are allowing dog parks to open. If you choose to go to a dog park, follow local guidelines. There are ways to reduce the risk of you or your dog getting infected with COVID-19 if you go to a dog park.

    • Do not take your dog to a dog park if you are sick or if you have recently been in close contact with a person with COVID-19.
    • Do not take your dog to a dog park if your dog is sick. Signs of sickness in dogs may include fever, coughing, difficulty breathing or shortness of breath, lethargy, sneezing, discharge from the nose or eyes, vomiting, or diarrhea.
    • If your dog has tested positive for the virus that causes COVID-19, talk to your veterinarian about when it is appropriate for your pet to go back to normal activities.
    • Try to limit your dog’s interaction with other people outside of your household while at the dog park.
    • As much as possible, avoid touching common items in the dog park like water bowls. Wash your hands or use hand sanitizer after touching items from the park. To make sure your dog has fresh water, consider bringing your own portable water bowl.
    • Limit other pet items brought to the dog park, such as toys. Clean and disinfect anything taken to the park and returned home (leashes, toys, water bowls).
    • Do not wipe or bathe your dog with chemical disinfectants, alcohol, hydrogen peroxide, or any other products not approved for animal use.

    You should restrict contact with pets and other animals while you are sick with 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 sick with COVID-19 limit contact with mammalian animals until more is known about the virus.

    When possible, people should shelter in place with their pets and have a healthy member of the household provide care for the animals. Those who are sick should avoid contact with pets, including petting, snuggling, being kissed or licked, and sharing food while you are sick.

    Whenever possible, people should shelter in place with their companion animals. If you must care for your pet or be around animals while you are sick, 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 who are sick should avoid petting, snuggling, being kissed or licked, and sharing food with their animals while sick.

    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 person-to-person 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 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 symptoms or signs of 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 sick people avoid contact with animals whenever possible. In some situations, it might be necessary for a patient to be in contact with these animals. For people who are sick and need to be around animals, they should wash their hands before and after interacting with animals and wear a mask during animal contact. Those who are sick should avoid petting, snuggling, being kissed or licked, and sharing food with their animals while sick.

    There are no restrictions on healthy people (those without symptoms or signs of 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, follow the advice for those who are sick and have animals. Specifically, you should restrict contact with pets and other animals while you are sick with 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 sick with COVID-19 limit contact with mammalian animals until more is known about the virus. When possible, people should shelter in place with their pets and have a healthy member of the household provide care for the animals. Those who are sick should avoid contact with pets, including petting, snuggling, being kissed or licked, and sharing food while you are sick.  If you must care for your pet or be around animals while you are sick, 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 cats, dogs, ferrets, fruit bats, hamsters, and tree shrews can become infected with the virus. Cats, ferrets, fruit bats, and hamsters 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. Laboratory mice, pigs, chickens, and ducks did not become infected or spread the infection based on results from these studies. Some non-human primates can become infected SARS-CoV-2 and become sick. SARS-CoV-2 has also been reported in mink (which are closely related to ferrets) on multiple farms in Europe and the United States.

    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: COVID-19 and Animals

    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, typically through respiratory droplets from coughing, sneezing, or talking.

    People with COVID-19 should isolate themselves from other people and animals, including pets, during their illness until we know more about how this virus affects animals. If you must care for your pet or be around animals while you are sick, 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 while sick.

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

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

    The USDA National Veterinary Services Laboratories 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. Based on information available to date, it appears that the virus can spread from people to animals in some situations. People with COVID-19 should isolate themselves from other people and animals, including pets, during their illness until we know more about how this virus affects animals. If you must care for your pet or be around animals while you are sick, 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 while sick.

    The USDA and CDC do not recommend routine testing of animals for this virus. Because the situation is ever-evolving, public and animal health officials may decide 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 to suggest the virus that causes COVID-19 is circulating in free-living wildlife in the United States, or 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 the virus that causes COVID-19 is present in any free-living wildlife in the United States, including bats. 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.

    You should follow state and local jurisdictional guidance regarding continuing operations at your facility. Horse and other livestock shows must implement the Forward Virginia Phase 3 mandatory requirements or not take place.

    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.

    • Encourage employees and other visitors, including boarders, owners, farriers, veterinarians, and those taking lessons, not to enter the facility if they are sick.
      • 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 of 100.4℉ (38.0℃) or above, 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.
    • Limit the number of people entering the facility. Consider staggering lessons and visiting times to limit the number of people in the facility 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 use of common areas like grooming or wash stalls and tack rooms.
    • Increase distance and limit duration of contact between employees and visitors in the facility. Whenever possible, people should maintain at least 6 feet of distance between each other at the facility, including instructors teaching lessons. Allow for physical distancing and avoid large numbers of people within the facility, including in employee-only areas.
    • Visitors and employees should wear masks to protect 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.
    • Encourage employees and other visitors to get vaccinated for COVID-19 when a vaccine is available to them. For more information about the COVID-19 vaccination response in Virginia, please visit: https://www.vdh.virginia.gov/covid-19-vaccine/. For specific questions related to vaccine access in your area, please check your local health department
    • Follow local guidance on shelter in place and travel recommendations when traveling for showing, training, or trail riding.
    • If traveling to a new facility, limit contact between people, horses, tack, equipment, and other supplies from different facilities, and maintain a distance of at least 6 feet between horses and riders.
      • Follow state and local guidance on travel. People who are sick should not travel to other facilities.
      • People visiting other facilities should follow the same precautions as they would normally, including maintaining at least 6 feet of distance between each other, wearing a mask to protect others, and washing hands frequently with soap and water.
    • 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:

    Forward Virginia Guidelines

    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)

     

    Horse and other livestock shows must either implement the Forward Virginia Phase 3 mandatory requirements or they must not take place. These requirements apply to both indoor and outdoor shows. See the Forward Virginia Guidelines and associated FAQs for more information about the mandatory requirements and other best practices to prevent COVID-19.

    Information for Veterinarians

    Given community transmission of COVID-19 in the U.S., many people, including clients and staff may become ill. Veterinary clinics should consider the following:

    General Concepts to Prevent COVID-19:

    • 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 rescheduling non-urgent appointments and 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.

    • Wear a mask: People can spread COVID-19 to others even if they do not feel sick. All people aged 5 years and older must cover both their mouth and nose with a mask in indoor settings and when outdoors and unable to maintain at least 6 feet of physical distance with others who live outside of their household. Masks should fit snugly, but comfortably against the sides of the face, completely cover the nose and mouth, be secured with ties or ear loops, be made of multiple layers of fabric and allow for breathing without restriction. Reusable cloth masks should be able to be laundered and machine dried at the end of each day without damage or change to their shape. Encourage employees, clients and other persons who enter the veterinary clinic to wear masks both while at work and in public.
    • Wash your hands: Encourage everyone in your clinic to wash their hands Signs reminding people to wash their hands can help with this.

    Wash hands often with soap and water for at least 20 seconds, especially after using the restroom, before eating, after blowing your nose, coughing, or sneezing, and between client/patient visits. If soap and water are not readily available, use an alcohol-based hand sanitizer with 60%-95% alcohol. Place hand sanitizer, sanitizing wipes, and tissues in all exam rooms, meeting rooms, restrooms, break rooms, lobbies, and other common areas. Avoid touching your eyes, nose, and mouth with unwashed hands.

    • 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, (fever, cough, shortness of breath, difficulty breathing, sore throat, runny or stuffy nose, body aches, headache, chills or fatigue, new loss of taste or smell, nausea, vomiting, diarrhea), 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.

    • Get vaccinated: Vaccinations are now available that greatly reduce a person’s risk of getting seriously ill from the virus that causes COVID-19. Veterinarians and frontline staff are prioritized for vaccination in Phase 1b of Virginia’s COVID-19 vaccination plan. Encourage employees to get vaccinated when a vaccine is available to them. For specific questions related to vaccine access in your area, please check your local health department.

    Phase 1b includes a large number of people and it will take several weeks to vaccinate all people eligible for vaccination in Phase 1b while vaccine supply is limited. To pre-register for COVID-19 vaccination, visit Virginia’s statewide vaccination pre-registration system at vaccinate.virginia.gov. Individuals who have previously filled out a survey or form or signed up for a waitlist to be vaccinated through their local health district have been automatically imported into the new statewide system and do not need to pre-register again.

    For general COVID-19 vaccination questions, you can call 877-VAX-IN-VA (877-829-4682) to talk with our knowledgeable Vaccinate Virginia representatives seven days a week, from 8 a.m. to 8 p.m. For specific questions related to vaccine access in your area, please check your local health department website.

    Additional Infection Prevention and Control Strategies:

    Employee Return to Work After Illness:

    • For those with suspected or confirmed COVID-19, home isolation can be discontinued after at least 10 days have passed since symptoms first appeared and the person has not had a fever for at least 24 hours without the use of fever-reducing medications and other symptoms have improved.
    • For those with non-COVID illness, return to work criteria should be guided by the alternate diagnosis, when available. In the absence of an alternate diagnosis, people should remain at home until at least 24 hours after fever subsides and others symptoms of illness have improved without the use of medication.

    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/

    VDH FAQs for Businesses and Workplaces.

    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.

    • Educate your clients on the differences between the enteric coronaviruses that circulate in domestic animals and this novel coronavirus, which, though it shares the same common name (“coronavirus”), is actually quite different.
    • There is no evidence that animals play a significant role in the transmission of SAR-CoV-2, the virus that causes COVID-19.
    • Do not wipe or bathe your pet with chemical disinfectants, alcohol, hydrogen peroxide, or any other products not approved for animal use.
    • Routine testing of animals for COVID-19 is not recommended by the CDC, USDA, or AVMA at this time.
    • People diagnosed with COVID-19 should have a different member of the household care for any mammalian pets in the home, if possible. The ill owner/household member should avoid contact with pets as they would avoid contact with other household members, including avoiding petting, snuggling, being kissed or licked and sharing food. If the ill individual must care for the pet, they should wash their hands before and after interacting with the pet and wear a mask if one is available when interacting with their animals.
    • If an animal needs veterinary care and a person in that pet’s household has been ill with COVID-19, encourage clients to inform the veterinary team of the COVID-19 exposure.
    • 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.
    • Every effort should be made to allow companion animals to continue to shelter in place at home with their families during the COVID-19 outbreak.

    By far, the greatest risk of COVID-19 exposure to staff, volunteers, and the public comes from person-to-person contact. 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. However, because we are still learning about this virus and because all animals can carry germs that can make people sick, it is always a good idea to practice healthy habits around pets and other animals.

    If asked to provide care for an animal exposed to a person with COVID-19, veterinarians and veterinary staff can take the following precautions:

    • Whenever possible, have a healthy household member or friend bring the animal to your clinic to limit contact with sick people.
      • Entry into the home where a person with COVID-19 lived should be avoided in order to prevent person-to-person 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 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

    For additional information, see AVMA: Interim recommendations for intake of companion animals from households where humans with COVID-19 are present

    Companion animals presenting with illness or injury should receive veterinary care. By far, the greatest risk of COVID-19 exposure to staff, volunteers, and the public comes from person-to-person contact. 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. However, because we are still learning about this virus and because all animals can carry germs that can make people sick, it is always a good idea to practice healthy habits around pets and other animals.

    If asked to provide care for an animal exposed to a person with COVID-19, veterinarians and veterinary staff can take the following precautions:

    • Whenever possible, have a healthy household member or friend bring the animal to your clinic to limit contact with sick people.
      • Entry into the home where a person with COVID-19 lived should be avoided in order to prevent person-to-person 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 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

    Where appropriate, testing for infectious diseases that commonly cause companion animal illness should be conducted. If staff observe a new, concerning illness and the companion animal has had close contact with a person with confirmed or suspected COVID-19 infection, or an animal diagnosed with SARS-CoV-2, the supervising veterinarian should contact the state public health veterinarian or designated animal health official to discuss whether or not there is a need to test that animal for SARS-CoV-2, the virus that causes COVID-19 in people. Neither the CDC, USDA, nor AVMA recommends that companion animals be routinely tested for SARS-CoV-2 at this time.

    For more information, see:

    VDH Health Professionals: Veterinarians

    Clean frequently touched, non-porous surfaces and objects with cleansers and water prior to applying an EPA-registered, hospital-grade disinfectant that is effective against SARS-CoV-2. Refer to the product label for the appropriate contact time and make sure that the product is safe for use around animals.

    VDH recommends that veterinarians consider prioritizing appointments for:

    • Dogs and cats that have never been previously vaccinated for rabies,
    • Older and/or immunosuppressed animals, and
    • Any animal that requires a rabies booster vaccine due to an exposure.

    The reason for this recommendation is that, in most cases, the public health response to a healthy, immunocompetent dog or cat exposed to rabies for which there is a record of previous vaccination (even if the vaccination is several months expired) is a booster and 45 days confinement (i.e., the same as a currently vaccinated animal).

    For questions concerning animal licensing requirements in your locality, you can contact your local treasurer's office and/or animal control agency, as these would be the local government entities that oversee licensing and enforce rabies vaccination laws.

    Globally, a small number of animals have become infected with SARS-CoV-2 after exposure to people with COVID-19. Initial animal infections were detected in two dogs in Hong Kong, neither of which showed signs of illness associated with SARS-CoV-2. 

    Since then, there have been a few reports of natural infection detected in cats, dogs, mink, tigers and lions, and other animals after exposure to people with COVID-19. The USDA website lists cases of SARS-CoV-2 in animals that have been confirmed by USDA’s National Veterinary Services Laboratories. The first description of animal illness associated with natural SARS-CoV-2 was published in a MMWR Report: First Reported Cases of SARS-CoV-2 Infection in Companion Animals — New York, March–April 2020. Illness associated with SARS-CoV-2 in animals, based on limited information to date, tends to be mild and self-limiting.  

    At this time, there is no evidence that animals play a significant role in spreading the virus that causes COVID-19 and the risk of animals spreading COVID-19 to people is considered to be low. However, because we are still learning about this virus and because all animals can carry germs that can make people sick, it is always a good idea to practice healthy habits around pets and other animals. This includes washing hands before and after interacting with animals or handling their food, waste, or supplies. According to the World Organization for Animal Health (OIE), there is no justification in taking measures against companion animals that may compromise their welfare, such as harming them or abandoning them based on unfounded fears over COVID-19.

    Veterinarians should contact their State Public Health Veterinarian, State Veterinarian, or designated animal health official if they are seeing a new, concerning illness in a patient that has had close contact with a person with COVID-19 and other, more common causes of illness have been ruled out.

    Some commercial animal health labs have developed testing to detect SARS-CoV-2 (the virus that causes COVID-19 in people). Neither the CDC, USDA, nor AVMA recommend that companion animals be routinely tested for SARS-CoV-2. Given that reports of SARS-CoV-2 infections in animals are uncommon, veterinarians are encouraged to perform a thorough medical evaluation of sick animals, including diagnostic testing for more common causes of illness suitable for the animal’s species and clinical presentation. Any veterinarian seeing a new, concerning illness in a patient that had close contact with a person with COVID-19, should contact their State Public Health Veterinarian or State Veterinarian.

    More information about situations in which animal testing might be indicated and points to consider when contemplating animal testing is available in the CDC’s Interim Infection Prevention and Control Guidance for Veterinary Clinics Treating Companion Animals During the COVID-19 Response and VDH’s Testing and Management of an Animal Positive for SARS-CoV-2 in Virginia page.

     

    The clinical spectrum of illness for the SARS-CoV-2 virus remains largely undefined in animals. Companion animals may present with respiratory or gastrointestinal clinical signs based on the presentation of other coronaviruses more commonly found in animals as well as other emerging coronaviruses, including SARS-CoV-1 infection.

    Clinical signs more likely to be compatible with SARS-CoV-2 infection in mammalian animals may include a combination of the following: fever, coughing, difficulty breathing or shortness of breath, lethargy, sneezing, nasal discharge, ocular discharge, vomiting, and/or diarrhea. The first description of animal illness associated with natural SARS-CoV-2 was published in a MMWR Report: First Reported Cases of SARS-CoV-2 Infection in Companion Animals — New York, March–April 2020

    These clinical signs may mirror many other more common animal diseases. Given that reports  of SARS-CoV-2 infections in animals are uncommon, veterinarians are encouraged to perform a thorough medical evaluation of sick animals, including diagnostic testing for more common causes of illness suitable for the animal’s species and clinical presentation.

    Decisions to test should be based on a number of factors including a link to a known human or animal infected with SARS-CoV-2, detection of atypical patterns of animal illness (particularly in a congregate or shelter-type setting) and/or in association with an academic research institution.  

    Veterinarians are encouraged to take a thorough history to assess for likely SARS-CoV-2 exposure or risk factors in the 2 weeks prior to symptom onset (such as whether the animal has been in close contact with a person or animal suspected or confirmed to be infected with SARS-CoV-2, a person with COVID-19 compatible symptoms, or had recent exposure to a known high-risk environment, such as a nursing home) and consider other, more common causes of illness. Veterinarians with additional questions about testing for SARS-CoV-2 are encouraged to contact either their State Public Health Veterinarian or their State Veterinarian

    More information about situations in which animal testing might be indicated and points to consider when contemplating animal testing is available in the CDC’s Interim Infection Prevention and Control Guidance for Veterinary Clinics Treating Companion Animals During the COVID-19 Response and VDH’s Testing and Management of an Animal Positive for SARS-CoV-2 in Virginia page.

     

    After the decision has been made to test an animal for SARS-CoV-2, a licensed veterinarian may collect samples using appropriate personal protective equipment (PPE) and sample collection methods. Any positive samples need to be confirmed through additional testing by USDA’s National Veterinary Services Laboratory.

    Additional information about testing animals for SARS-CoV-2, including recommendations on appropriate PPE, is available at:

    CDC: Interim Infection Prevention and Control Guidance for Veterinary Clinics Treating Companion Animals During the COVID-19 Response

    VDH: Testing and Management of an Animal Positive for SARS-CoV-2 in VA

    There is currently no evidence that animals, including common domestic livestock and poultry species, play a significant role in the transmission of COVID-19. Globally, there have not been any reports of natural SARS-CoV-2 infections in common livestock and poultry species. SARS-CoV-2 has been reported in farmed mink (which are closely related to ferrets) on multiple farms in Europe and the United States. For more information, see CDC COVID-19 and Animals.

    The FDA’s Center for Veterinary Medicine has recently become aware of increased public visibility of the antiparasitic drug ivermectin after the announcement of a research article that described the effect of ivermectin on SARS-CoV-2 in a laboratory setting. The Antiviral Research pre-publication paper, “The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro,” documents how SARS-CoV-2 (the virus that causes COVID-19) responded to ivermectin when exposed in a petri dish. This type of study is commonly used in the early stages of drug development. Ivermectin was not given to people or animals in this study.

    Additional testing is needed to determine whether ivermectin might be safe or effective to prevent or treat coronavirus or COVID-19. While there are approved uses for ivermectin in people and animals, it is not approved for the prevention or treatment of COVID-19. You should not take any medicine to treat or prevent COVID-19 unless it has been prescribed to you by your healthcare provider and acquired from a legitimate source.

    For additional information, please see:

    FDA Letter to Stakeholders: Do Not Use Ivermectin Intended for Animals as Treatment for COVID-19 in Humans

    FDA FAQs: COVID-19 and Ivermectin Intended for Animals

    NIH: COVID-19 Treatment Guidelines - Ivermectin

Healthcare Providers
  • Healthcare Providers: General Questions

    Older adults and people of any age with certain underlying medical conditions are at greater risk for serious illness. In addition, there are factors related to each individual’s situation (e.g. breastfeeding or pregnant) and where they live (e.g. rural communities or homeless) which may mean they need to take extra precautions. A full list of people at increased risk of severe illness and other people who need to take extra precautions, can be found on CDC’s website here.

    Older Adults:

    Among adults, the risk for severe illness from COVID-19 increases with age, with older adults at highest risk. As you get older, your risk of being hospitalized for COVID-19 increases and 8 out of 10 COVID-19-related deaths reported in the United States have been among adults aged 65 years and older.

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

    Infections occur mainly through exposure to respiratory droplets when a person is in close contact with someone who has COVID-19. Close contact is defined as being within 6 feet for a total of 15 minutes or more over a 24-hour period or having direct exposure to respiratory secretions. People who are infected can spread the virus to others, whether the infected person is symptomatic, pre-symptomatic, or asymptomatic.

    Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours. These viruses may be able to infect people who are farther than 6 feet away from the person who is infected or after that person has left the space. This airborne transmission is less of a factor with COVID--19 compared to infections like tuberculosis and measles.

    Respiratory droplets can also land on surfaces and objects. It is possible that a person could get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or eyes. Direct contact (Inhalation of droplets) is a much more likely mode of transmission for COVID-19 compared to indirect contact (spread from touching surfaces).

    Please see CDC’s website on How COVID-19 Spreads for more information.

     

    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.

    Available data indicate that adults with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset. Most adults who have had more severe illness or are severely immunocompromised likely remain infectious no longer than 20 days after symptom onset. Some severely immunocompromised people have been shown to shed replication-competent virus beyond 20 days. Recovered adults can continue to shed low levels of detectable but non-infectious SARS-CoV-2 RNA in upper respiratory specimens for up to 3 months after illness onset. They have not been shown to have transmitted SARS-CoV-2 to others.

    More detail from CDC can be found here.

    Yes. 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.

    All patients with COVID-19 should be provided with correct self-isolation guidance. See:

    What to do if you are Sick

    Interim Guidance for Implementing Home Care

    Caring for Someone Sick at Home

    Persistent symptoms are being reported among COVID-19 survivors, including individuals who initially experience a mild acute illness. While older patients may have an increased risk for severe disease, young survivors, including those physically-fit prior to SARS-CoV-2 infection, have also reported symptoms months after acute illness.

    The most commonly reported symptoms include fatigue, dyspnea, cough, arthralgia, and chest pain. Other reported symptoms include cognitive impairment, depression, myalgia, headache, fever, and palpitations.  More serious complications appear to be less common but have been reported. These complications include:

    Cardiovascular: myocardial inflammation, ventricular dysfunction

    Respiratory: pulmonary function abnormalities

    Renal: acute kidney injury

    Dermatologic: rash, alopecia

    Neurological: olfactory and gustatory dysfunction, sleep dysregulation, altered cognition, memory impairment

    Psychiatric: depression, anxiety, changes in mood

    Post-COVID-19 care centers are opening at academic medical centers in the United States, bringing together multidisciplinary teams to provide a comprehensive and coordinated treatment approach to COVID-19 aftercare. The National Institutes of Health have published interim guidelines for the medical management of COVID-19, including a section on persistent symptoms or illnesses after recovery from acute COVID-19. These guidelines will be updated as new information emerges. Survivor support groups are connecting individuals, providing support, and sharing resources with survivors and others affected by COVID-19. Multi-year studies will be crucial in elucidating longer-term sequelae. CDC continues active investigation into the full spectrum of COVID-19 to establish a more complete understanding of the natural history of SARS-CoV-2 infection and COVID-19 related illnesses, which can inform care strategies as well as the public health response to this virus.

    For more information, please see CDC’s Late Sequelae of COVID-19.

    Cases of reinfection with COVID-19 have been reported, but remain rare​. ​

    Most people who have had a COVID-19 infection have mounted an antibody response. It is not certain how long the antibody response lasts after infection, but it appears to last for some months. The protection wanes over time and is not expected to be life-long. Research continues to determine how likely reinfection is, how often it happens, how severe illness associated with reinfection is, and how soon reinfection occurs.

    If a healthcare provider suspects reinfection may have occurred in a patient and respiratory specimens are available from each infection, contact your local health department to discuss possible laboratory confirmation and investigation of the reinfection.  The patient suspected to have a new infection should follow isolation and other COVID-19 prevention recommendations.

    Please see the CDC Clinical FAQs section “Testing, Isolation, and Quarantine for Persons Who Have Recovered from Previous SARS-CoV-2 Infection” for more information.

    If the patient cannot be evaluated using CDC’s recommended infection prevention and control precautions, the outpatient practice will need to arrange referral and transport of the masked patient to a setting where this can be done. Inform the receiving facility about any patients who might have COVID-19 before the patient is sent to another facility.

    Facilities experiencing PPE shortages should report supply chain issues to their Regional Healthcare Coalition. The coalition may have resources available to help meet your PPE needs.

    Please report supply chain issues to your Regional Healthcare Coalition. They might have resources to help meet your needs. Additionally, CDC has strategies to optimize the existing supply of PPE in times of shortages.

    Emotional reactions to stressful situations, such as this emerging health crisis, are expected. Remind patients that feeling sad, anxious, overwhelmed or having trouble sleeping or other symptoms of distress is normal. If symptoms become worse, last longer than a month, or if someone struggles to participate in their usual daily activities, encourage them to reach out for support and help.

    Patients experiencing distress or other mental health concerns related to the COVID-19 outbreak can call the national Disaster Distress Helpline at 800-986-5990 or text “TalkWithUs” to 66746 for 24/7 emotional support and crisis counseling. Calls and texts are answered by trained counselors who will listen to the caller’s concerns, explore coping and other available supports, and offer referrals to community resources for follow-up care and support. More information about the Disaster Distress Helpline can be found here

    The Department of Behavioral Health and Development Services (DBHDS) in Virginia offers a crisis counseling program and warm line to help citizens with trauma, grief and overall distress due to COVID-19.

    Please call (877) 349-6428 Toll Free

    9:00 AM - 9:00 PM Monday - Friday

    5:00 PM - 9:00 PM Saturday and Sunday

    Responding to COVID-19 can take an emotional toll on both first responders and healthcare providers. There are things you can do to reduce secondary traumatic stress (STS) reactions:

    • Acknowledge that STS can impact anyone helping families after a traumatic event.
    • Learn the symptoms including physical (fatigue, illness) and mental (fear, withdrawal, guilt).
    • Allow time for you and your family to recover from responding to the pandemic.
    • Create a menu of personal self-care activities that you enjoy, such as spending time with friends and family, exercising, or reading a book.
    • Take a break from media coverage of COVID-19.
    • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
    • Connect with others. Talk with people you trust about your concerns and how you are feeling.
    • Ask for help if you feel overwhelmed or concerned that COVID-19 is affecting your ability to care for your family and patients as you did before the outbreak.

    For more information, please see:

    Sustaining the Well-Being of Healthcare Personnel During Coronavirus and Other Infectious Disease Outbreaks

    Healthcare Personnel and First Responders: How to Cope With Stress and Build Resilience

    The Virginia Department of Health regularly updates its website with th