COVID-19 FAQs for police: Part 2

We answer some commonly asked questions about COVID-19 transmission and testing


By Marianne Meyers, BS

A quick disclaimer: There is still much we don’t know about COVID-19 and unfortunately that means some answers may be our best guess based on current information and data available.

These FAQs were developed based on our current understanding of the virus, which may change over time.

Medical personnel wearing protective equipment screen people referred by doctors for COVID-19 testing in a parking lot of FedEx Field, Monday, March 30, 2020, in Landover, Md. (AP Photo/Andrew Harnik)
Medical personnel wearing protective equipment screen people referred by doctors for COVID-19 testing in a parking lot of FedEx Field, Monday, March 30, 2020, in Landover, Md. (AP Photo/Andrew Harnik)

COVID-19 Testing

At what point during the incubation period will testing show positive?

A recent study showed that the average incubation period is about 5 days, while about 97% of patients will show symptoms within 12 days. This is why the Centers for Disease Control (CDC) recommends self-isolation for 14 days following exposure.

Regarding testing positive, it really depends on the individual. Some will test positive with little or no symptoms, but the majority will be symptomatic when they test positive.

What is the turnaround time for a COVID-19 test sample to come back either positive or negative?

It depends on your hospital or the group performing the testing. Tests can take anywhere from 48 hours to a week for the results to return. More rapid tests are currently being developed.

Can you show symptoms and test negative but then test positive a few days later?

If you are showing symptoms that means that the virus has replicated enough to be detected by the test. Therefore, if you have symptoms but test negative, your symptoms are most likely not due to COVID-19, although no test is 100% perfect. It’s possible that when you are asymptomatic you may test negative early in an infection and then positive later once the virus has had the opportunity to replicate and grow.

If someone had the exact symptoms 6 weeks ago and recovered 4 weeks ago, would they have a positive result if tested now if it was COVID-19 then?

If they have fully recovered, then they should test negative since the virus is no longer present or replicating in their body because the current tests look for virus particles. There are some reports of individuals getting re-infected, but this seems to be rare. Blood tests are being developed to test if you were once infected and now immune, but are not available yet.

PERSONAL PROTECTIVE EQUIPMENT (PPE)

We are hearing conflicting reports. Some say that masks don't help you from getting the virus, but then we see medical personal with masks. Do they help or diminish a person’s chances of contracting the coronavirus?

Per CDC guidelines, facemasks should be worn by:

  • Those who are sick
  • Those caring for sick individuals
  • Those interacting with people who are sick.

Facemasks may be in short supply, therefore priority should be given to caregivers. In general, individuals should only wear masks when they are in close prolonged contact with COVID-19 or potential COVID-19 patients.

Facemasks do protect you from respiratory droplets that transmit the disease.

We are being told by our medical professionals that surgical masks are acceptable if an N95 mask is not available. Can that be confirmed?

COVID-19 is mainly spread by coughing, sneezing and other fluids (droplets), which a surgical mask will protect against. There are some cases when an N95 mask should be used, such as airway management because there is a potential for virus aerosolization. For those who are not performing airway management, surgical masks and proper handwashing are sufficient for their protection based on the types of tasks they will be performing.

Can N95 masks be reused multiple times to conserve resources?

The World Health Organization (WHO) and CDC are currently not recommending reusing masks. However, in hospitals where supplies are in critically short supply, attempts at “cleaning” the mask and reusing may occur against standard advice. The CDC currently has a “burn rate” calculator that can help you determine how quickly you are using your PPE.

There is constant talk about proper fit testing for N95 masks. Many large departments are trying to catch up to the spread of the disease but there is a concern about giving out equipment without the proper fit. How necessary is it to be fit-tested for an N95 mask and will the mask still be operable without a fit test?

It is important to ensure that the N95 masks are fitted correctly to the wearer. If they are not fitted correctly, the user is at risk for exposure despite wearing the mask. Training is important to ensure that masks are being used correctly otherwise they may not be providing adequate protection. In addition, facial hair may impair proper sealing.

COVID-19 Transmission

How do you define an exposure?

You need to be in close contact with an infected individual in order to get sick. This includes:

  • Living in the same household
  • Caring for a patient with COVID-19
  • Being in direct contact with secretions from a sick person (coughing, sneezing, etc.)
  • Being within 6 feet of a sick person for more than 10 minutes.

These situations do not count as an exposure if you are wearing the proper PPE!

How is COVID-19 spread?

Currently, we believe that COVID-19 is being spread predominately by respiratory droplets (coughing, sneezing, etc.) and by direct contact (touching others or objects that infected individuals have also touched).

If you contract COVID-19 and get over it, is it safe to assume you are now immune? If not, are you at risk of re-infecting yourself by handling household goods that you touched while infected?

Right now, we believe that once you have been infected and recovered fully that you are now immune to the virus. There are some reports of re-infection, but it is unlikely that you would get sick again by handling items you had previously handled while sick.

If someone is confirmed to have COVID-19, what is the typical length of time before they are no longer contagious?

We are still unsure how long patients are contagious but current belief is that they are most contagious while they are displaying symptoms and can transmit the disease a few days before and after they have symptoms. Data from China suggests asymptomatic people should be isolated for 14 days to ensure they do not develop symptoms.

If someone is not showing symptoms and you are in contact with them, but later within the 2-14 days exhibits symptoms and tests positive, is it possible that you could be infected with the virus as well?

Yes, it is possible that you are infected. Therefore, you should self-isolate for 14 days to ensure you don’t develop symptoms.

If COVID-19 is causing pneumonia, can people take a preventive measure such as getting a pneumonia vaccine to help reduce or mitigate the impact on a patient? Is this something we should consider for first responders?

The pneumonia vaccine is designed to protect against bacteria that commonly cause pneumonia. It won’t prevent COVID-19 from causing pneumonia but it may prevent a secondary bacterial infection from occurring. First responders should be up to date on all their vaccinations.

When washing hands, should we use antibacterial soap?

Regular soap is sufficient. The key is to cover all surfaces and wash for at least 20 seconds. If you are unable to use soap and water, hand sanitizer containing at least 60% alcohol will kill most pathogens.

Are the symptoms different for mild illness?

The most common symptoms of COVID-19 are fever, tiredness and a dry cough. That being said, some patients may have aches, nasal congestion, runny nose, sore throat or diarrhea. More severe symptoms include difficulty breathing or respiratory distress.

Do symptoms always include fever?

A recent study from China found that about 90% of COVID-19 patients had a fever. We can assume that the majority will have a fever, but there is still a possibility that some infected patients will not.

Have there been any updates to the guidelines regarding pregnant women?

Pregnant women are susceptible as well but do not appear to be at an increased risk. They should practice social distancing and wear appropriate PPE. Currently, we don’t believe the virus can cross the placenta to the baby because of cases we have seen in China.

References

World Health Organization. Advice on the use of masks in the community, during home care and in healthcare settings in the context of the novel coronavirus (COVID-19) outbreak

Centers for Disease Control and Prevention. Coronavirus (COVID-19).

Laboratory Corporation of America. Labcorp’s testing for COVID-19 Q&A.

Guan W, Ni Z, Yu Hu, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. The New England Journal of Medicine. March 26, 2020.

Wang LS, Wang YR, Ye DW, Liu QQ. A review of the 2019 Novel Coronavirus (COVID-19) based on current evidence. International Journal of Antimicrobial Agents. March 2020.

Washington State Department of Health. What to do if you were potentially exposed to someone with confirmed coronavirus disease (COVID-19). 


About the author

Marianne Meyers, BS, is a third-year medical student at the University of Washington School of Medicine interested in pursuing emergency medicine. Previously, she was a member of the Santa Clara University collegiate EMS squad where she received her B.S. in Public Health Science. Additionally, she has worked with the King County Public Health Department in Seattle, Washington studying EMT naloxone administration.

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