Frequently Asked Questions
Our own Chief Medical Officer Dr. Rizzo answers frequently asked questions about COVID-19 from individuals living with chronic lung disease.
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COVID-19 is a respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), a type of virus that is novel, or new, to humans. Spread person-to-person when people sneeze, cough, sing, talk or even breathe, it carries the potential for mild to severe illness, which may include pneumonia and lung damage in some people who become infected.
Everyone is at risk for getting COVID-19 if they are exposed to the virus. People with serious underlying health conditions, including COPD, lung cancer or lung transplant recipients, are more likely to have worse outcomes if they become sick with COVID-19.
Risk of severe illness from COVID-19 increases with age. According to the CDC, more than 80% of COVID-19 deaths occur in people over age 65.
People from many racial and ethnic minority groups are at increased risk of getting sick and dying from COVID-19, often at younger ages than listed above.
Individuals of any age who have serious underlying medical conditions, particularly if not well controlled, such as chronic lung diseases (COPD, moderate-to-severe asthma, interstitial lung disease, cystic fibrosis and pulmonary hypertension) serious heart conditions, cancer, diabetes, kidney disease, pregnancy, sickle cell, overweight with a body mass index (BMI) over 25, individuals who smoke, and those who have weakened immune systems from solid organ transplant can make you more likely for severe illness.
Individuals who are asymptomatic have been exposed to the coronavirus but they do not have symptoms of COVID-19 so they don’t know they are infected. This is particularly troubling because if you are sick you will stay home, but if you don’t know you are sick, you could be spreading the disease to others without realizing it. Staying home as much as possible, maintaining at least six feet distance from others when in public and wearing a cloth face covering help protect others in case you are an asymptomatic carrier.
SARS-Cov-2, the virus that causes COVID-19, is a type of coronavirus. Like all viruses, coronaviruses change constantly through mutation, resulting in new variants or strains. There are several new variants health officials are monitoring especially close, the United Kingdom strain called B.1.1.7, the South African strain called B.1.351., the Brazil strain called P.1 and others under scrutiny. These viruses appear to be better at spreading than past versions of SARS-CoV-2, and research is ongoing to determine if any of them cause worse illness or higher death rates. The CDC regularly posts updates when new information becomes available and has created a map to see where the variant strains have been identified within the United States.
The ways to protect yourself from coronavirus infection haven’t changed. Keep washing your hands, wearing a mask in public, maintaining social distancing and when it is available to you, talk to your doctor about getting a COVID-19 vaccine.
Across the country, medical offices are opening back up for non-urgent appointments. If you have a previously scheduled appointment coming up or a new, non-urgent concern, I recommend you contact your healthcare provider to discuss if a virtual or in-person appointment is preferred.
If you are experiencing any symptoms that could be COVID-19 (shortness of breath, chest tightness, dry cough) be sure to communicate that by phone with the healthcare provider. Do not take public transportation to the appointment, wear a cloth face covering and follow any other advice your doctor provides.
There are two kinds of tests available for COVID-19. The one you are asking about tests for current infection – a viral test that is usually obtained by way of a nasal swab. The two main reasons to get tested are if you’re having symptoms that could be COVID-19 or have been exposed to a person confirmed to have COVID-19. These results may help your doctor determine how you should be treated and also become important in tracking contacts to decrease the spread of COVID-19. In most instances you will need a prescription or order from your physician. Contact your healthcare provider if you feel you should be tested to discuss your concerns.
The CDC recommends individuals wear a cloth face mask when out in public and unable to maintain at least a six-foot distance from others, such as in a grocery store, to further reduce the transmission of the virus. This safeguards against individuals who may have few to no symptoms and still unknowingly spread the disease when they talk, cough or sneeze. Check out our steps to help yourself get used to wearing a cloth face covering in public.
Building on the prior recommendation of wearing a face mask to protect others from your respiratory droplets, we now know that it also provides some protection for you from breathing in other people’s respiratory droplets as well as discourages you from touching your face in public. Commercial masks, such as N95 masks, are not recommended as they are urgently needed by healthcare providers caring for sick individuals. Read more about masks in our latest blog.
Facemasks are recommended over face shields. Facemasks fit snugly against the face and provide better protection to prevent respiratory droplets from leaving your mouth and nose and potentially infecting another person nearby. You can learn more in our latest blog.
There is enough evidence to support a widespread recommendation for double masking. Since last April when Americans were first advised to wear a face mask, the following directions were included: have two or more layers of washable, breathable fabric; cover both your mouth and nose and fit snugly against the sides of your face without gaps. The multiple layers of cloth with a snug fit help prevent the back and forth exchange of particles that could transmit SARS-CoV-2, the virus that causes COVID-19. If wearing two masks helps you achieve these objectives, provides you additional peace of mind and doesn’t impair your breathing, then wearing two masks may be a good option for you to consider. Regardless of if you wear one mask or two, it is also important to stay six feet apart from those not living in your home, wash your hands, and avoid crowds and poorly ventilated places to help reduce the spread of COVID-19.
Yes. The evidence is now clear that COVID-19 can be spread both by droplet and airborne aerosol transmission. Large droplets can be seen, for example when you exhale in cold weather, and they quickly fall out of the air. The smaller droplets that contribute to airborne aerosol transmission are lighter, can remain suspended for hours, and may travel across a room.
This means that indoor, poorly ventilated buildings have the potential to spread disease if individuals from different households gather – even if they are wearing masks and at least six feet apart. You can reduce your risk of airborne transmission by being outdoors and in uncrowded indoor spaces with good ventilation.
While secondhand smoke and secondhand e-cigarette (vaping) emissions are proven causes of a variety of lung health and other diseases, in the case of coronavirus the real danger is from the smoker. Secondhand smoke is of two types—side-stream and mainstream.
Sidestream smoke comes off the lighted end of the cigarettes themselves and carries the toxins and carcinogens into the air to cause exacerbations of asthma and COPD and are known causes of lung cancer. Mainstream secondhand smoke is what is exhaled by the smoker after they puff. This smoke not only contains the toxins and carcinogens as above but it also contains respiratory droplets from the smoker that may carry the COVID-19 virus. Therefore, not only are individuals potentially spreading virus by not wearing a mask, they are blowing these droplets to the people around them who may potentially get infected. I recommend maintaining social distance of at least six feet from individuals to reduce the risk of spreading COVID-19, including from individuals who are smoking or vaping.
People who have been exposed to the new coronavirus and who are at risk for coming down with COVID-19 should practice self-quarantine. Health experts recommend that self-quarantine lasts 14 days. Two weeks should provide enough time to know if they will become ill and be contagious to other people. Self-quarantine involves using standard hygiene and washing hands frequently, not sharing things like towels or utensils, staying home, not having visitors and staying at least six feet away from other people in your household, preferably in a separate room with a separate bathroom. Once your quarantine period has ended, if you do not have symptoms, follow your doctor’s instructions on how to return to your normal routine.
New guidance from CDC provides options to reduce quarantine, if in alignment with local public health officials. In some cases and if you have not experienced any symptoms, you can end quarantine on day 10 if you have not been viral tested or on day 7 if you have been viral tested and you receive a negative test result that took place on day 5 or later.
It’s a good idea to wipe down surfaces and objects that enter your home using an alcohol (at least 70%) or bleach-based solution to remove germs. If the newspaper arrives in a plastic bag, carefully remove the bag and throw it away. Then, after you touch the paper, thoroughly wash your hands. The CDC has guidance on how to clean and disinfect your home should you have a suspected or confirmed case of coronavirus in your home.
Even though we have vaccines that protect against COVID-19 and businesses are reopening, COVID-19 is not gone. I continue to recommend staying home as much as possible, especially if you or a family member are at higher risk for severe illness from COVID-19 and have not yet had a turn to be vaccinated. If you are still weighing travel options, please consult the CDC recommendations for travel within the United States or internationally. You can also read our latest blog dedicated to travel during the pandemic.
Anybody who is sick should be kept away from others, especially a high-risk individual. In fact, the high-risk individual should additionally contact his/her healthcare provider for advice. The high-risk individual should talk to their doctor about what is happening, monitor themselves for symptoms and share any concerns that might warrant getting tested. It is important to distinguish between the flu and COVID-19 because there are potential and different treatments for each.
High Risk Groups
Anyone with a compromised immune system, which includes people with autoimmune disease, on chemotherapy or living with an organ transplant, should be more stringent on staying home and other preventive measures such as hand washing, social distancing and disinfecting. Additionally, you should contact your healthcare provider to determine an individual action plan based on your specific situation.
First, check out our steps to help yourself get used to wearing a cloth face covering in public. There are many different types of face coverings with a variety of fabrics, designs, straps and fits may make one mask more comfortable than another.
Individuals living with chronic lung diseases may be asymptomatic (no symptoms) carriers of COVID-19 who can go on to infect others and should wear cloth face masks when in public areas. When my patients ask about not wearing a face covering, I review options with them and reiterate why wearing a mask is important to stop the spread of COVID-19. And I tell them if their lung disease is so severe that it makes breathing with a cloth face covering difficult then they are certainly at increased risk of severe illness from COVID-19 and really need to remain home and distanced from others.
Being a current or former smoker increases your risk for severe illness from COVID-19. Generally speaking, both cigarette smoking and vaping are linked to lung inflammation, as well as reduced lung and immune function. Therefore, long-terms smokers and e-cigarette users will have a higher risk of developing chronic lung conditions and serious respiratory infections.
Air pollution can make the COVID-19 pandemic worse for some communities. Since it is a disease affecting the lungs, people who live in places with more pollution could be more vulnerable to severe illness.
A tough question indeed. COPD, for example, is a high-risk disease for readmission to the hospital. So, the best things to do is stay home and on your maintenance medications. If you absolutely must be out of your home, maintain social distance, avoid sick people, wear a cloth face covering, watch the air quality and keep your hands clean. Stay in contact with your healthcare provider about any change in symptoms. There’s no good answer other than following your treatment plan as prescribed.
Treatment and Medication
Do not use disinfectants on or in your body. The use of disinfectants should be applied as directed for cleaning surfaces, not people. The Environmental Protection Agency has a list of over 400 cleaning products that have been tested to disinfect surfaces against the virus that causes COVID-19.
No, mouthwash is not intended to prevent or treat COVID-19. Mouthwash is an antiseptic that protects against germs that cause bad breath and plague build-up and is a healthy part of your daily oral hygiene routine.
The best protection from the spread of COVID-19 is to stay home, wash your hands, maintain social distance and wear a mask.
Pulse oximeters are not recommended for otherwise healthy individuals. They are indicated for individuals with lung or heart disease who receive supplemental oxygen as a way to monitor and adjust their prescribed oxygen therapy. You can read more about this in our latest blog.
Many individuals use a nebulizer to take inhaled medications at home and it is safe to continue doing so.
However, if you have suspected or diagnosed COVID-19, you should speak with your healthcare provider about additional precautions to take when using your nebulizer. Learn more about controlling chronic lung diseases during the pandemic.
It’s generally advised to continue taking your current medications to maintain optimal health. Having a poorly controlled chronic condition may put you at increased risk of severe illness. If you have any concerns about the medications you are currently taking they should be directed to your healthcare provider.
Contact tracing is a decades old public health strategy to reduce diseases from spreading. If someone you have been in close contact with tests positive for COVID- 19, you will be contacted by public health workers with next steps. You will be asked to stay home and maintain social distance from others until 14 days since the date of exposure. You will need to monitory yourself for symptoms of COVID-19 and report any changes of health status immediately. You will remain in constant communication with your healthcare provider and the public worker throughout as they support you during this time and will help determine when home isolation may end. Read more about contact tracing in our latest blog.
This is a good question. There is a lot of talk in the news about antibody testing, a blood test that checks for proteins (antibodies) specific to this disease that helped fight off the illness. This tells us if you have previously been infected with the novel coronavirus. We do not know if these antibodies provide protection, and for how long, from getting infected again. We will have to wait and see if the antibodies make individuals immune to the virus moving forward.
The lungs are a major target of COVID-19. When the virus is inhaled into the lungs, it invades the tissues, causing inflammation and breathing problems. If the infection gets worse it can develop into pneumonia. In a small number of severe cases, patients can develop acute respiratory distress syndrome (ARDS) that will require them to be placed on a ventilator for oxygen. If too much of the lung is damaged and not enough oxygen is supplied to the rest of the body, respiratory failure could lead to organ failure and death. The recovery rate and complications from severe illness caused by COVID-19 will vary person to person but there may be some long-term damage to the lungs. Long lasting lung health consequences are still being studied.
Millions of Americans have recovered from COVID-19. Many of these individuals are experiencing symptoms long after the few weeks it takes most people to recover. Termed ‘long-haulers’ or experiencing post-COVID long term symptoms, even people who were not hospitalized and who had mild illness may be experiencing longer-term symptoms. Learn more about Long-Haulers at Lung.org.
Yes, I encourage you to consider doing this. When your body fought the infection it created COVID-19 antibodies in your plasma, the disease fighting part of your blood. Now your blood contains a tool that might help others also fight off the disease. You can learn more and find donation sites at on the FDA’s website.
Most children with COVID-19 are asymptomatic or have mild symptoms, though there have been reports of youth hospitalized with severe illness and sadly, some deaths have been reported. There is a new body of evidence looking at a small sub-set of children who are experiencing symptoms of Multisystem Inflammatory Syndrome in Children (MIS-C) that is associated with COVID-19. This is a troubling new development that the medical community is researching. COVID-19 is a disease that has never been seen in humans before and we are constantly learning and adapting recommendations based on new information. For now, the best advice I can give you is to continue staying home, wearing a mask, maintaining social distancing, washing hands and distancing yourself from individuals who are ill. And I encourage you to be in contact with your healthcare provider regarding any new symptoms you or your children may develop.
Opening Up Guidelines
It depends. Healthcare providers are following national and local guidance of when to open facilities based on a number of factors. As facilities slowly open up, prioritization is made for individuals who would most benefit from services considering that individual’s physical and emotional wellbeing. I recommend speaking with your doctor about when it makes sense for you to resume appointments.
The recommendation to stay home and limit the spread of the virus hasn’t changed in spite of recent openings. Re-opening doesn’t mean the virus is gone from your community. I encourage you to utilize takeout or delivery options to support local diners and restaurants. Many stores are offering no-contact curbside pickup or delivery options. Consult your local and state agencies for the latest public health guidance for your area, especially if you are considered among those at high risk for complications if you get infected.
If you decide to venture out, it is important to maintain social distancing of at least six feet from others, wear a cloth face covering for the protection of others, and wash your hands often. Do NOT go out if you are experiencing symptoms that might be COVID-19 (short-of-breath, chest tightness, cough, fever).
Reviewed and approved by the American Lung Association Scientific and Medical Editorial Review Panel.
Page last updated: April 13, 2021