Coronavirus Q&A: What you need to know

Published February 24, 2020

Published

Since Nebraska Medicine and the University of Nebraska Medical Center (UNMC) handled the treatment of three patients with Ebola in 2014, we have led the world in treatment, training and quarantine methods for highly infectious diseases.

In the video above, Nebraska Medicine/UNMC officials discuss the 13 Americans who arrived in Nebraska from the Diamond Princess cruise ship docked off the coast of Japan after COVID-19 exposure. 

Below, our infectious disease experts have answered common questions about the virus, including advice about how to protect yourself and your loved ones. 

What quarantine efforts are underway?

View our daily coronavirus update for the most up-to-date information.  

What is the latest on the Americans who were monitored at Camp Ashland? 

The 57 people who arrived in Nebraska on Friday, Feb. 7, for COVID-19 (novel coronavirus) monitoring and quarantine left the Nebraska National Guard’s Camp Ashland location as their quarantine period came to an end on Thursday, Feb. 20. The 14-day quarantine period, mandated by the CDC, officially ended at 9 a.m.

By all accounts, their stay in Ashland, Nebraska, was uneventful. One person developed minor respiratory symptoms on Friday, Feb. 14, and was transported to the National Quarantine Unit on the UNMC/Nebraska Medical Center campus. After two negative coronavirus tests, this person returned to Camp Ashland for the remainder of the quarantine period.

These 57 people were flown to Omaha after being in the Wuhan area of China, where the current COVID-19 outbreak is believed to have originated. All 57 left Omaha via Eppley Airfield.

Why were the Americans in China and on cruise ships brought to Nebraska?

Nebraska Medicine/UNMC have answered the global health emergency call before. In the last five years, we have been busy teaching other health care professionals around the world, developing new approaches to care, conducting research, and putting what we learned into practice. Along with our federal partners, we have the right people for this job. There is no better place for our fellow Americans to be.

Is there risk to the community from team members working with quarantined evacuees?

Those who are monitoring and providing care for the individuals under quarantine and in the Nebraska Biocontainment Unit wear personal protective equipment (PPE). Addtionally, all team members working in the National Quarantine Unit and Nebraska Biocontainment Unit undergo monitoring twice daily in addition to wearing PPE. There is no elevated risk for the community or for anyone receiving care, visiting, working or studying at a Nebraska Medicine or UNMC facility.  

Will those being quarantined or isolated interact with each other and have access to common areas?

The individuals who are under quarantine in the National Quarantine Unit are each in a separate airborne isolation room, and do not have access to common areas and are currently unable to interact face-to-face. Technology was provided to each guest to ensure they can continue to communicate with their friends and family. 

What is COVID-19 (formerly known as the novel coronavirus)?

There are numerous coronaviruses. Many infect animals such as bats, camels, cats, etc. Coronaviruses can also cause infections in humans and, in most instances, result in a mild upper respiratory infection (common cold). Prior to COVID-19, two other coronaviruses (SARS, MERS) were known to cause more serious lower respiratory infection (pneumonia). COVID-19 is a new virus strain that is believed to have originated around the city of Wuhan, China, and started spreading among people in late 2019. 

What is the main concern with this virus?

Health experts are concerned because we still don’t have complete information on how the virus behaves and the full spectrum of disease. This information will become clearer over time as scientists investigate further.  

What do experts know so far about the severity of the illness caused by COVID-19?

Most reported cases have been mild (similar to a cold). However, some cases have resulted in severe pneumonia that requires patients to spend time in a hospital, and a small proportion of victims have died. We currently do not know enough about the illness to predict who will develop more severe disease, but current data indicate that older age and underlying disease (COPD, diabetes, immunosuppression, etc.) may be risk factors. 

What are the symptoms and complications?

Symptoms can range from quite mild to severe illness. Fever, cough, and shortness of breath are characteristic symptoms of infection. Symptoms have shown up as soon as two days to as long as 14 days after exposure to the virus. In more severe cases, pneumonia develops, which may make it difficult to breathe. 

What’s the risk to Nebraskans?

Currently, we estimate a low risk to people living in this region. Nebraska Medicine Health Centers, Immediate Care Clinics, emergency rooms, and the UNL and UNO campus health clinics are screening patients to promptly identify and evaluate any suspected cases. Travelers to certain parts of the world, particularly China, may have a higher risk. 

How can I avoid getting COVID-19?

The best advice is to practice good hygiene and common sense measures like you would with the seasonal flu. Those things include:

  1. Wash your hands often with soap and warm water for at least 20 seconds – hand sanitizer is a second option.
  2. Don’t touch your mouth, nose or eyes, especially with unwashed hands.
  3. Avoid contact with people who are sick.
  4. If you are sick, stay at home.
  5. Cover your mouth and nose with a tissue or sleeve when coughing or sneezing – DON’T cough or sneeze into your hands.
  6. Frequently clean and disinfect frequently touched objects in your home, car and workplace.
  7. If you are traveling overseas, make sure to follow CDC guidelines at wwwnc.cdc.gov/travel. Right now in the U.S., there are very few cases and they are all linked to travel or close contact with an ill person.

What is the treatment for the virus?

A vaccine isn’t available yet. Most people have recovered by drinking lots of fluids, resting and taking pain and fever medication. If symptoms worsen, medical care might be needed.

What is the source of the outbreak?

We know that the closest coronavirus relatives of this current virus are all harbored in Asian bats. Although it is most likely that the virus was recently introduced into the human population from an animal source in China. Initial cases appear to be linked to a live food market in Wuhan, China. Investigations are ongoing to determine the virus' source and mode of transmission.

How does the virus spread?

This virus probably originally emerged from an animal source, but can now spread from person-to-person. At this time, it’s unclear how easily or sustainably this virus is spreading between people. Coronaviruses generally spread by respiratory droplets generated when a sick person coughs or sneezes. Coronaviruses may survive on surfaces that have been contaminated with respiratory secretions. (For example, a sick person coughs on their hand and then touches a doorknob.) Thus, contaminated surfaces may be another, less common, route of transmission. It should be noted that common disinfectants kill coronaviruses on surfaces.

Are some people more susceptible to getting the novel coronavirus?

We do not know enough about the virus to determine this. However, older people with chronic medical problems may be more susceptible to severe disease and death based on preliminary reports.

How do you test a person for the novel coronavirus?

Currently, testing for COVID-19 is only available at the CDC. However, this may change as the outbreak progresses.

What should I do if I had close contact with someone who has COVID-19?

If you are not ill but had contact with a person confirmed to have COVID-19, notify your doctor, who will work with public health staff to determine whether you can be cared for at home. If it is determined that you can be isolated at home, you will be monitored by staff from your local or state health department.

While being monitored:

  • Restrict your activities outside the home
  • Separate yourself from other people in the home as much as possible
  • Call ahead before visiting your doctor
  • Wear a face mask
  • Cover your coughs and sneezes
  • Wash your hands
  • Avoid sharing household items
  • Monitor your symptoms

Is it safe to travel to China or other countries where COVID-19 cases have occurred? 

The situation is evolving. Stay up-to-date with the CDC’s travel health notices related to this outbreak. At the present time, only essential travel to China is recommended.

What if I recently traveled to China and got sick? 

If you were in China and feel sick with fever, cough, or difficulty breathing within 14 days after you left, you should: 

  • Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms
  • Avoid contact with others
  • Do not travel while sick
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing
  • Wash your hands frequently with soap and water for at least 20 seconds to avoid spreading the virus to others. (Use an alcohol-based hand sanitizer containing at least 60% alcohol if soap and water are not available)

Can I get COVID-19 from packages or products shipped from China?

In general, because of poor survivability of coronaviruses on surfaces, there is a very low risk of spread from products or packaging that are shipped over a period of days or weeks at ambient temperatures. Currently, there is no evidence to support transmission of COVID-19 associated with imported goods, and there have not been any cases of novel coronavirus in the United States associated with imported goods.  

What about animals or animal products imported from China?

The CDC does not have any evidence to suggest that animals or animal products imported from China pose a risk for spreading COVID-19 in the United States. This is an evolving situation; information will be updated as it becomes available. 

When did the first case of novel coronavirus occur in the United States?

The first U.S. case was announced Jan. 21, 2020, in Washington state.

How is Nebraska tracking the novel coronavirus?

State and local health departments are monitoring and tracking the situation in Nebraska.

Am I at increased risk now that Americans are returning to the United States from the epicenter?  

The risk remains low. Americans returning from high-risk areas will be screened and monitored for a period of time to ensure that they do not exhibit symptoms of the virus. 

What happens if a case is reported in Nebraska, or someone being monitored in Nebraska shows signs of the virus? 

State and local health authorities would determine if the patient can be monitored at home (for mild disease,) or if they need to go to a hospital for evaluation and medical treatment.

What is public health doing to protect Nebraskans?

Public health services are closely monitoring the situation and are active in the evaluation and tracking of potential cases. They are working to establish diagnostic testing at the state level. Contingency plans are in place in the event cases occur in Nebraska.   

COVID-19 is dominating news cycles and social media. How worried should I be?

This situation is evolving and all persons are encouraged to keep track of events via reliable news sources – the CDC or World Health Organization, for example. Unfortunately, a lot of misinformation can be spread, causing unneeded anxiety. All persons should be taking steps to prevent the spread of common respiratory viruses – such as the flu – which will also help to prevent the spread of COVID-19.

Can the virus spread before symptoms present? 

There is some concern that COVID-19 can be spread prior to the development of symptoms, but this has not been confirmed. Other viruses, like influenza, can sometimes be transmitted for 24 to 48 hours before symptoms develop. However, in general, symptomatic persons are a much more important source of transmission. 

If I have cold or flu-like symptoms, when do I worry that it might be more than the cold or flu?

At the present time, unless you have traveled to China or have been in close contact with someone who has traveled to China, your risk is low. You should take care of yourself by getting plenty of rest, drink fluids, take acetaminophen or ibuprofen for aches, pains or fever, and avoid going out in public. (Stay home from work or school.) If you develop signs of more serious illness – difficulty breathing, for example – you should promptly seek medical attention.

Why is there so much attention on COVID-19 when influenza kills thousands every year?

New diseases, because of some degree of ambiguity, always generate more concern. We don’t pay as much attention to illnesses such as influenza – even though it results in 25,000 to 50,000 deaths per year in the U.S – because we know what to expect and have become used to the yearly influenza epidemics.

Could we see cases in this region unrelated to the arrival of rescued Americans? 

It is possible that COVID-19 will spread within the United States. However, actions are being taken to screen for cases, develop more readily accessible tests, isolate and quarantine sick persons, and to develop new medications and vaccines. There is reason to be optimistic.

For University of Nebraska students, faculty and staff:

What steps are the UNL and UNO Health Centers taking to screen for COVID-19?  

All patients who check in for any medical appointment are asked a series of questions about their recent travel. If it is determined that a patient has been potentially exposed to 2019-nCOV, staff will follow current CDC guidelines for risk assessment and management

If students, faculty or staff have arrived here from China recently, should they be monitored by Nebraska Medicine/UNMC? Should family members of those who recently arrived still come to work or class?   

If you have traveled to China and returned on Friday, Jan. 24, or later, you are expected to self-quarantine in your home for 14 days beginning the day of your arrival, and should not report to work or class.

If this applies to you, here are the steps you should take:

  1. Register with your local county health department and follow instructions for symptom monitoring:
  2. Notify us:
    • Employees: Contact your manager
    • Faculty members and providers: Contact your department administrator or chair 
    • Students: Contact your campus student health center:
      • UNL: 402.472.5000
      • UNO: 402.554.2374
      • UNMC: 402.559.5158
  3. During self-quarantine, if you experience a fever or respiratory symptoms, contact your county health department for further instruction
  4. Receive authorization to return to work or class if you do not develop symptoms during your 14-day quarantine:
    • Employees, faculty members or providers: Contact Nebraska Medicine Employee Health at 402.552.3563
    • Students: Contact your campus student health center
      • UNL: 402.472.5000
      • UNO: 402.554.2374
      • UNMC: 402.559.5158
  5. At the conclusion of the 14 day self-quarantine period, if you are symptom free and have checked in with Employee Health or Student Health, you will be welcomed back to your usual position and accustomed duties.  

If there is an outbreak in Nebraska, what would the health system do? Do they have enough masks and hospital beds for patients?  

We plan and prepare for these types of events. We have been reviewing our organizational pandemic plan and meeting to address preparedness issues. Supplies and additional space for patients are at the top of our list of things we prepare for. 

Could you evaluate the risk in Nebraska compared with other states in the United States?   

At the present time, there are very few cases of the novel coronavirus in the U.S. The risk in the U.S. is low and the risk in Nebraska is even lower, as there are fewer travelers from China. Although the risk is low at this time, the situation is being monitored closely, and contingency plans have been formulated. The Nebraska Biocontainment Unit could serve as a referral site to care for patients who contract this virus. We expect that more cases will arise in the U.S., however, we do not yet know enough about the virus to predict how widely it will spread outside of China.  

Compared with SARS, is this a bigger threat to the U.S.? And compared with flu, is COVID-19 more serious? 

Based on current information, we think that this virus causes milder disease on average compared with SARS. However, the new coronavirus seems to be more readily spread from person-to-person than SARS. We anticipate more information from scientists and public health officials over the next few weeks that will help us understand the level of risk to the U.S. and other countries. However, we know that influenza is a danger every year, causing 35,000 deaths in an average season in the U.S. We’re currently experiencing a very active flu season, so it’s important to get your flu shot, stay home from work or school if you’re sick, avoid close contact with those who are sick, cover your cough or sneeze with a tissue and wash your hands frequently. 

Are there additional resources for international students who may have a language or cultural barrier? 

All health care facilities have interpreter services available if needed. The WHO website has information on the 2019 novel coronavirus available in Chinese.