COVID-19 Frequently Asked Questions

• Video: Comprehensive Guidance on COVID-19
• COVID-19 Treatment info
• Long COVID info
• NYS Affirmation forms: for isolation, for quarantine

Questions

How it spreads

• What is a novel coronavirus?
• How does the virus spread?
• Community spread: What is community spread?
• Who is more at risk?
• What about new variants or strains?

Protect yourself and your community

• How can I help protect myself?
• Hand Washing
• When with others outside your household
• Travel guidance

Coronavirus Variants

• What is a virus variant?
• Delta variant
• Omicron variant
• Omicron BA.2 subvariant

Symptoms

• What are the symptoms of COVID-19?
• What are the risk factors for severe illness?

Long COVID

• What is long COVID? 

Testing

• Who should be tested for COVID-19?
• Where is testing conducted?:
• Insurance: What if I do not have health insurance?

Confirmed Cases and Close Contacts

• Confirmed case
• Case investigation
• Contact tracing
• Close contact

Isolation and Exposure

• Isolation: What is isolation?
• Exposure: What should I do if I've been exposed to COVID-19?
• PreK-12 guidance
• References

Vaccine Information

• COVID-19 Vaccine, Vaccination clinics, FAQ

Treatments for COVID-19

• Treatments proven effective against COVID-19 are available by prescription

Tompkins County response

• The Health Department
• State of Emergency: What does it mean in Tompkins County?
• Emergency Operations Center: What is an EOC?
• Timeline: COVID-19 Tompkins County EOC Response: Review the response history timeline from January forward (updated approx bi-weekly).
• Virtual Q&A Updates: Recordings of live stream “Town Hall” updates with County officials

Resources & Reference Links

• NYSDOH and NY-Forward web pages
• Local resources
   

What is a novel coronavirus?

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases. A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans. COVID-19 is the infectious disease caused by the most recently discovered coronavirus, which is know as SARS-CoV-2.

How It Spreads

How does the virus spread?

COVID-19 is thought to spread mainly from person-to-person through respiratory aerosols that go into the air when an infected person coughs or sneezes, speaks, sings, or otherwise exhales with force. Aerosols are particles smaller than 5 micrometers. The virus lingers in the air for many hours when ventilation is poor.

What is community spread?

Community spread means people have been infected with the virus in an area, including people who are not sure how or when they became infected. COVID-19 seems to be spreading easily and continually in the community (“community spread”).

Who is more at risk?

Older adults and anyone with an underlying chronic medical condition may be at greater risk. This includes older adults, those who are immune-compromised, or have a chronic medical condition, especially heart or lung disease, and diabetes. For more information about additional steps that should be taken by those at higher risk for complications, visit the CDC COVID-19 web page, People with Certain Medical Conditions. 

Will the virus mutate to form new variants or strains?

Viruses constantly change through mutation, and new variants of a virus are expected to occur over time. Scientists monitor changes in the virus, including changes to the spikes on the surface of the virus. These studies are helping to understand how changes to the virus might affect how it spreads and what happens to people who are infected with it. The Variants section below provides much more information.

How can I help protect myself and my community?

The best way to prevent illness is to avoid being exposed to this virus. Use everyday hygiene actions to help stop the spread of respiratory diseases, including:

• Avoid any contact with people who are sick.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash. If a tissue is not available, cover your cough or sneeze into your elbow.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• Avoid handshakes and hugs, use an elbow bump instead
• 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 with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
  • For more information about hand-washing., see the CDC Hand-washing website.

All About Washing Your Hands

Watch this great 3 minute video from the CDC to get a close look at why and how to wash your hands often.
(May not display in all browsers.)

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When in public or with others outside of your household

In an ongoing effort to slow the spread of Coronavirus and COVID-19, residents should be familiar with and follow all guidance from the Tompkins County Health Department and NYS Department of Health. the following measures are important steps to slow the spread of COVID-19.

Wear a face mask

Face masks help to protect those who may be indoors with someone who is infected but doesn't know it. The virus is carried by aerosols that are exhaled during normal breathing. Talking, shouting, and singing project the aerosols a greater distance, and wearing a mask helps to reduce that distance and therefore how far the virus can spread. Face masks work best when everyone wears one. Click here for more about face masks. 

Good ventilation

Aerosols can linger in the air for hours, so good ventilation is important for indoor spaces. Opening windows will help, as will use of a portable HEPA air filter. A CDC study demonstrates that Portable HEPA air cleaners can reduce exposure to aerosols carrying virus in indoor environments, especially when combined with universal masking. The EPA states that, "when used along with other best practices recommended by CDC and others, filtration can be part of a plan to protect people indoors."

Social distancing

Social distancing can help keep the coronavirus from spreading from one person to another, especially for those at higher risk for severe illness or hospitalization. Stay at least 6-feet away from anyone who is not part of your immediate household. 6-feet is about 2 adult arm lengths. Your household are the people you live with and around everyday. For indoor spaces where people are gathering for an extended period of time (more than 10-15 minutes), good ventilation and universal masking is also important.

Take extra precautions at large public events

Avoid gathering in groups with others who are not members of your household. If you are at a gathering or in a group with people from outside your household, wear a mask, encourage others to wear a mask, and seek out areas that with adequate ventilation.

Travel

New York State's Travel Advisory has been lifted, and traveler health forms are no longer required when entering the state. However, it is a good idea to familiarize yourself with ongoing guidance from the CDC. This includes the following:

• Delay travel until you are up to date with your vaccinations. 
• Know the COVID transmission rate at your destination, and know the local guidance and regulations related to COVID-19.  
• Wearing a mask over your nose and mouth is required in indoor areas of public transportation (including airplanes) traveling into, within, or out of the United States and indoors in U.S. transportation hubs (including airports). 
• Do not travel if you have been exposed to COVID-19, you are sick, or if you test positive for COVID-19.
• If you must travel within the U.S. and are not fully vaccinated, get tested before and after your trip.
• International travelers, know the country's entry and exit requirements, including vaccination and /or testing mandates. When you travel to the United States by air, you are required to show a negative COVID-19 test result or documentation of recovery from COVID-19 before you board your flight. The timing of this test depends on your vaccination status and age.

Coronavirus Variants

What is a virus variant?

Variants are expected as viruses constantly change and become more diverse through mutation. Sometimes, due to their nature or mutation, new variants disappear, and other times, they persist. Many variants of the virus that causes COVID-19 have been studied and identified since the beginning of the pandemic. Some changes allow the virus to spread more easily, and those variants must be carefully monitored.

The Delta variant

Delta is a COVID-19 “Variant of Concern.” New data shows that people infected with Delta have higher viral loads—meaning more virus in their body—than with previous variants. Delta spreads about twice as easily from one person to another, compared with earlier strains. In May 2021, less than 1% of U.S. cases were the Delta variant. In July 2021, 80% of cases were of the Delta variant.

Data has shown that fully vaccinated people who are infected with the Delta are contagious and can potentially spread the virus to others, though maybe for a shorter time period than someone who is unvaccinated. Vaccinated individuals represent less of the transmission occurring around the country.

According to data published August 10, Delta was the dominant strain of the SARS-CoV-2 virus in Tompkins County. Samples from positive cases were taken by Cornell University’s Virology Lab during the months of June and July 2021. Of the 87 samples that were sequenced, 80 were the Delta variant. Six of the samples were other variants of the virus. All samples of fully vaccinated individuals sequenced in this batch resulted from infection by the Delta variant.

Omicron Variant

On 11/26/21, the CDC released a statement about the new Variant of Concern named Omicron, emphasizing the ongoing importance of familiar prevention measures. The Tompkins County Health Department recommends the following: get vaccinated, wear a mask in indoor public places, maintain social distance and avoid crowded areas when in public, wash hands frequently, monitor your symptoms, and get tested if symptoms develop.

Omicron BA.2 subvariant

The World Health Organization (WHO) considers Omicron sublineage BA.2 to be a variant of concern that should be monitored as a distinct variant relative to Omicron BA.1. At a global level, the proportion of reported sequences designated BA.2 has been increasing relative to BA.1 in recent weeks, according to a 2/22/2022 statement from WHO.

The genetic differences in BA.2 compared to its sister BA.1 include some amino acid differences in the spike protein and other proteins. Studies show that BA.2 has a growth advantage over BA.1, with initial data suggesting that BA.2 appears inherently more transmissible than BA.1.  This difference in transmissibility appears to be much smaller than, for example, the difference between BA.1 and Delta.

People who tested positive for COVID-19 during the Omicron surge from November may have protection against reinfection with BA.2, at least for a limited time. Vaccination with three doses of an mRNA vaccine (initial 2-dose series, plus a either a third dose or a booster dose) is still the best protection against severe disease, hospitalization, and death.

References

• WHO Statement on Omicron sublineage BA.2, World Health Organization, 2/22/2022.
• CDC Omicron Variant page
• CDC Delta Variant page
• CDC What You Need to Know About Variants
• NYSDOH COVID-19 Variant Data

Symptoms

What are the symptoms?

Current symptoms reported for patients with COVID-19 have included mild to severe respiratory illness with fever, cough, and difficulty breathing.

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.

The following symptoms may appear 2-14 days after exposure, and may be early warning signs:

• Fever or chills
• Cough
• Trouble breathing
• Pain or pressure on the chest that doesn't go away
• Muscle or body aches
• Loss of taste or smell
• Experience confusion or trouble waking up
• Nausea, vomiting, diarrhea
• Bluish lips or face

This list is not all inclusive, so consult your health care provider about other symptoms that are severe or concerning. Read about COVID-19 Symptoms on the NYSDOH website, or on the CDC website.

Severe illness

Under certain conditions, individuals of any age can be more likely to get severely ill from COVID-19.

• Older adults. More than 80% of COVID-19 deaths occur in people over age 65, and more than 95% of COVID-19 deaths occur in people older than 45.
• Minorities, people with disabilities, and underserved populations who have less access to regular health care.
• Medical conditions, including (not listed in order of risk)
  • Cancer
  • Liver or kidney disease or conditions
  • Chronic lung disease
  • Diabetes (Type 1 or 2)
  • Heart conditions or cerebrovascular disease
  • HIV infection
  • Immunocompromised (weakened immune system)
  • Solid organ or blood stem cell transplant
  • Overweight and obesity
  • Pregnancy
  • Smoking (current or former)
  • Substance use disorders
  • Dementia or other neurological conditions
  • Down syndrome
  • Sickle cell disease or thalassemia
  • Children with certain underlying conditions (more CDC info)
  • Complete CDC list with links to more information

Long COVID

Long COVID (also called post-COVID conditions or long-haul COVID) is a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19. Long-COVID symptoms can show as different types of new or recurring health problems, occur in different combinations, and last for different lengths of time. Some types of post-COVID conditions tend to be limited to people who have had severe illness, however long-COVD symptoms can happen to anyone who has had COVID-19, even if the illness was mild, or if they had no initial symptoms.

People commonly report experiencing different combinations of the following symptoms:

• Difficulty breathing or shortness of breath
• Tiredness or fatigue
• Symptoms that get worse after physical or mental activities (also known as post-exertional malaise)
• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Cough
• Chest or stomach pain
• Headache
• Fast-beating or pounding heart (also known as heart palpitations)
• Joint or muscle pain
• Pins-and-needles feeling
• Diarrhea
• Sleep problems
• Fever
• Dizziness on standing (lightheadedness)
• Rash
• Mood changes
• Change in smell or taste
• Changes in menstrual period cycles

Estimates of the proportion of COVID-19 cases who develop long COVID varies widely. A person of any age who has had COVID-19 can later develop a post-COVID condition, although they appear to be less common in children and adolescents than in adults.

As of July 2021, long COVID can be considered a disability under the Americans with Disabilities Act (ADA). An individualized assessment is necessary to determine whether a person’s long COVID condition or any of its symptoms substantially limits a major life activity.  Visit Guidance on Long COVID as a Disability on HHS.gov for more information.

References

• CDC: Post COVID Conditions web page
• CDC: Caring for People with Post COVID Conditions
• NIHR (UK): New definitions for long COVID

Testing

Who should be tested for COVID-19?

Testing is available at no cost to all Tompkins County residents, regardless of circumstances or reason, at the Cayuga Health Sampling Site, beginning 9/1/20. Appointment required. Click here for details.

Tompkins County residents are encouraged to get tested based on the following guidelines:
ANYONE WHO

1. Has had a recent onset of symptoms listed above, such as fever, cough, shortness of breath, or body aches
2. Individual has been exposed to someone with COVID-19 in the last 14 days, by their own observation, or as informed through a contact investigation or potential public exposure
3. Individual’s employer, school, or other organization has a testing program through a contract with Cayuga Health
4. Individual is an essential worker
5. Individual is a Tompkins County resident 
6. Individual has an upcoming medical or surgical procedure

Additional information about testing is on the NYS Department of Health website.

Where is testing conducted?

Cayuga Health System operates a drive-through testing site located in the back parking lot at The Shops at Ithaca Mall. Click here for complete information about the CHS Sampling Site.

• There is no cost for Tompkins County residents who get tested for medical or surveillance reasons. 
• Testing at the Cayuga Health Sampling Sites for non-residents who do not meet the medical criteria is $99.
• Appointments are required for all testing. Register here. Or call Cayuga Health Registration Line at 607-319-5708. 

Free testing is available at any NYS-run sampling sites. Call the NYS COVID Hotline for other locations and to register: (888) 364-3065

You can also call your primary health care provider if you have symptoms or have been in a room with a person who tested positive. If you do not have a primary care provider, call 2-1-1. Always call before going to the office for medical evaluation.

Additional testing sites are available in the greater Tompkins County area. To find sites, go to the NYS "Find a Test Site" page, and enter your ZIP code. Before you get tested, be sure you know whether or not there is a fee for the service.

The NYS website page about testing is coronavirus.health.ny.gov/covid-19-testing.

What if I do not have health insurance?

NYS has a directive requiring New York Insurers to waive the cost of COVID-19 testing.

Testing is free at all NYS-run sampling sites. An appointment is required. To find the closest site and preregister, call the NYS COVID Hotline, (888) 364-3065.

Confirmed Cases and Close Contacts

Confirmed case

An individual who has tested positive for the Coronavirus is a "confirmed case." The person may or may not have symptoms, but is presumed to be contagious.

Case Investigation

When a confirmed case is identified, they are interviewed by a Case Investigator and asked where they have been, and to list people who they may have been in close contact with during the time they were infectious, usually 2 days before they had symptoms or were tested.

Contact Tracing

Contact tracing is the process of connecting with all close contacts who were identified by the positive case during the case investigation.

• During a surge in cases, such as the Omicron surge that began in December 2021, case investigations and contact tracing are known to be less effective epidemiological tools to reduce the spread of disease.
• New York State has given local health departments the ability to suspend contact tracing. This means if you test positive for COVID-19 or are a close contact of someone who has tested positive for COVID-19, you may not get a call from a county or state COVID-19 case investigator.

Who is a Close Contact?

A close contact is someone who is identified by the positive case during the case investigation. Those individuals are then notified that they were exposed to the virus.

• A close contact is defined by the CDC as someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period.
  • Note that someone is considered a close contact based on the total exposures added together. An infected person (positive case) may identify you as a close contact if they were with you a few times over the course of one day, for a few minutes each time, altogether adding up to 15 minutes or more.
  • It does not make any difference whether or not the infected person was wearing a mask.
• The infectious period starts from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the positive case is isolated.
• Exception for PreK-12 students in an indoor classroom setting:
  • The close contact definition excludes students who were within 3 to 6 feet of an infected student (positive PCR test) if both the infected student and the exposed student(s) correctly and consistently wore well-fitting masks the entire time.
  • This exception does not apply to teachers, staff, or other adults in the indoor classroom setting.
• Source and more details on the CDC website.

Isolation and Quarantine 

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Virtual Updates 

Recordings of live streamed Q&A “Town Hall” sessions with County officials

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