COVID-19: What it is and how it spreads.
What is coronavirus disease 2019 (COVID-19)?
COVID-19 is caused by a new respiratory virus. In December 2019, the virus began circulating in humans. Health experts are concerned because little is known about this new virus and it has the potential to cause severe illness and pneumonia.
What are the symptoms of COVID-19?
Symptoms may appear in as few as two days or as long as 14 days after exposure to the virus. They include:
- Shortness of breath
Reported illnesses have ranged from mild symptoms to severe illness and death.
How does COVID-19 spread?
Health experts are still learning about how this new coronavirus spreads. The virus is thought to spread mainly from person-to-person:
- Between people who are in close contact (within about six feet) of an ill person.
- Through respiratory droplets produced when an infected person coughs or sneezes.
- It also may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it, then touching their mouth, nose or eyes.
Can someone spread the virus without being sick?
People are thought to be most contagious when they are most symptomatic (the sickest). Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
Can I infect someone else before I show symptoms of the virus?
People are thought to be most contagious when they are most symptomatic (the sickest). Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.
Should I be concerned about getting COVID-19 from products or packages shipping from China or other parts of the world?
In general, coronaviruses are unable to survive on surfaces such as shipping packages for long periods of time. There is likely a very low risk of spread from products or packages shipping over a period of days or weeks at ambient temperatures. Currently, there is no evidence to support transmission associated with imported goods.
How can I protect myself from getting COVID-19?
If you are traveling overseas follow the CDC’s guidance at CDC.gov/Travel. There are steps you can take to prevent the spread of flu and the common cold that will also help prevent COVID-19, including:
- Wash your hands with soap and water.
- Avoid touching your eyes, nose or mouth with unwashed hands.
- Cover your mouth and nose with a tissue or upper sleeve when coughing or sneezing.
- Avoid contact with people who are sick.
- Stay home if you are sick and contact your healthcare provider.
- Keep at least six feet away from one another to the maximum extent possible.
It is important to remember that stigma and discrimination occur when people associate an infectious disease, such as COVID-19, with a population or nationality. COVID-19 does not target people from specific populations, ethnicities, or racial backgrounds.
Should I wear a mask to protect myself from getting COVID-19?
No. Facemasks are not recommended for healthy people. Facemasks should be used by:
If you are sick with respiratory illness and visit a healthcare provider, you may be asked to wear facemask during your visit.
Can I sew a facemask to use for myself or to donate to healthcare workers?
There have been many news reports about using a CDC approved pattern to make facemasks.
- Homemade facemasks are not appropriate for use by healthcare workers. Healthcare workers wear highly specialized equipment including surgical masks, face shields, or respirators called N95 masks. These masks require training and fit testing.
- Surgical facemasks are recommended for use on people who are sick with respiratory illness to prevent the spread of germs (coughing, sneezing). It is important to know that facemasks are not effective if used improperly or without frequent handwashing.
- In settings where facemasks are not available, healthcare providers might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.
Should I be concerned about my pets or other animals and COVID-19?
To date, CDC has not received any reports of pets or other animals becoming sick with COVID- 19. There is no evidence that companion animals including pets can spread COVID-19. However, since animals can spread other diseases to people, it’s always a good idea to wash your hands with soap after being around animals.
Monitoring, isolation and quarantine measures
How many people in Michigan have been diagnosed with COVID-19?
Updated results are available at Michigan.gov/Coronavirus.
Why doesn’t the state provide more details about the location and hospital of patients who test positive or are being treated?
The HIPAA Privacy Rule protects the privacy of patients’ health information but also allows for some disclosures of information when necessary to protect the state’s public health from immediate threats.
In an emergency situation, reasonable safeguards must remain in place to protect certain patient information against intentional or unintentional prohibited use. In most cases, reasonable efforts must be made to limit the information disclosed to that which is the minimum necessary to prevent the spread of a disease like COVID-19.
That often includes providing general information on patient’s county or age, while not disclosing their exact location. Providing the minimum necessary information is also important for the overall safety and security of the patient, while protecting others’ health.
What does it mean if someone is being monitored for COVID-19?
Public health monitors the health of people who could have been exposed to the virus.
MDHHS is receiving daily referrals about travelers from the CDC airport quarantine stations. Once MDHHS receives the referral, the information is provided to the local health department in the jurisdiction where the traveler resides. Local health department staff contact the individual, assess their risk and supervise daily for health monitoring (temperature, cough, difficulty breathing) for 14 days after their last day of exposure.
Has anyone been quarantined?
To date, no one has been placed in a quarantine facility in Michigan because the screening process has not identified any individuals as being at “high risk” of infection. Some individuals have been asked to self-quarantine in their own homes based on their risk of exposure.
Where is or are the quarantine facilities?
At this time, we are not releasing the locations of quarantine facilities due to individual privacy.
Why is it important to have quarantine and isolation measures for the COVID-19 outbreak?
- The COVID-19 outbreak has caused very severe illness in some individuals.
- There is no approved vaccine or medication to treat COVID-19 patients.
- Isolation and quarantine efforts seem to have reduced new COVID-19 transmission in other countries.
I think I was exposed, but I do not have symptoms.
What is the definition of close contact?
Close contact is defined as:
a. Being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a health care waiting area or room with a COVID-19 case
– or –
b. Having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).
I have been around someone who is sick. Do I need to self-quarantine?
- If you were around them while they were showing symptoms: If you have been around someone who is sick with respiratory illness (cough, fever, shortness of breath) you should try to self-quarantine to the best of your ability (try to stay home and away from others).
- If you were around them and they were not yet showing symptoms: If you have been around someone who is currently sick with respiratory illness, but was not showing symptoms of illness while you were with them, it is not likely that you were exposed to the illness through them. You should monitor yourself for symptoms of respiratory illness (cough, fever, shortness of breath) and remember to practice good social distance.
I’ve been around someone who has been diagnosed with COVID-19. Do I need to self- quarantine?
- If you were not considered a close contact: In general, it is encouraged that people stay home right now, as much as possible. Of course, if you develop symptoms (cough, fever, shortness of breath), and are concerned about your health, contact your healthcare provider to discuss your symptoms.
- If you are a close contact: You should self-quarantine away from others for 14 days since the last day you had contact with that person. It is possible that your local health department will call you to discuss your risk, you can also reach out to your local health department. If you develop symptoms of respiratory illness (fever, cough, shortness of breath), and are concerned about your health, please call your healthcare provider.
Someone I was in close contact with was in contact with someone who tested positive (3rd party exposure).
For example, a close friend of my spouse has been diagnosed, and they recently spent time together.
Unless the person you were in contact with was showing symptoms of respiratory illness (cough, fever, shortness of breath) it is unlikely you were exposed through them.
If the person was not showing symptoms: You should monitor yourself for symptoms of respiratory illness (cough, fever, shortness of breath) and remember to practice good social distance, but quarantine is not required. If you develop any symptoms (fever, cough, shortness of breath), you should self-isolate at home and contact a healthcare provider if you are concerned about your health. This is true even if the person later becomes symptomatic.
Someone in my household was exposed (as a close contact) to someone who tested positive for COVID-19. What should I do?
Have that person in the household self-quarantine for 14 days while monitoring for symptoms. Follow appropriate precautions for cleaning, hand hygiene, respiratory etiquette.
You should monitor yourself for symptoms of respiratory illness (cough, fever, shortness of breath) and remember to practice good social distance, but quarantine is not required. If you develop any symptoms (fever, cough, shortness of breath), you should self-isolate at home and contact a healthcare provider if you are concerned about your health.
A co-worker tested positive for COVID-19, should I be concerned?
In general, workplaces are not environments that would cause you to be in close contact. Being in close contact requires prolonged proximity or care provided (like keeping someone company while they are sick or assisting with bathing) or directly being exposed to the illness (like being coughed on).
If you have been in close contact with your co-worker: You should self-quarantine away from others for 14 days since the last day you had contact with that person. It is possible that your local health department will call you to discuss your risk, you can also reach out to your local health department. If you develop symptoms of respiratory illness (fever, cough, shortness of breath), and are concerned about your health, please call your healthcare provider.
If you have not been in close contact with your co-worker: You should monitor yourself for symptoms of respiratory illness (cough, fever, shortness of breath) and remember to practice good social distance, but quarantine is not required. If you develop any symptoms (fever, cough, shortness of breath), you should self-isolate at home and contact a healthcare provider if you are concerned about your health. Remember to follow appropriate precautions for cleaning your work area, hand hygiene, and respiratory etiquette.
I’m getting sick, but I don’t have all 3 symptoms – should I self-quarantine/what should I do?
If you are sick, please stay home until 72 hours after symptoms have resolved. Follow appropriate precautions for cleaning, hand hygiene, respiratory etiquette. If you are concerned about your health, or develop severe symptoms, contact your healthcare provider.
I have symptoms or respiratory illness, but my primary care doctor will not test me for COVID-19. My job requires an official test result to return to work.
If you are sick, please stay home until 72 hours after symptoms have resolved. Follow appropriate precautions for cleaning, hand hygiene, respiratory etiquette.
Michigan Department of Health and Human Services encourages employers to not require a doctor’s note or negative test result to return to work, although it is not mandated. Employment related concerns can be reported to or discussed with the Department of Labor and Economic Opportunity.
Who determines if someone should self-quarantine or self-isolate?
The local health department has legal authority to mandate quarantine and isolation measures. Anyone who has symptoms of respiratory illness should stay home (self-isolate) to protect others and everyone should remember to practice good social distance.
Testing for COVID-19
What determines if someone is tested for COVID-19?
Testing is dependent on the current status of COVID-19 in local communities, as well as the course of illness. Clinicians should work with the local health department to determine if testing is warranted. Criteria may change as we understand more about COVID-19.
How can I get tested for COVID-19.
Individuals who are concerned about their health and experiencing respiratory illness or other concerning symptoms, should contact their healthcare provider to discuss their symptoms.
Healthcare providers make decisions about testing based on signs and symptoms of respiratory illness and potential exposure. They also try to rule out other causes for respiratory illness.
- If your healthcare provider decides it is necessary to test for COVID-19, they will take the sample and order testing. You will receive your results from your healthcare provider.
- If your healthcare provider decides it is not necessary to test for COVID-19, and you do not agree, you could consider getting a second opinion.
- If your healthcare provider does not offer COVID-19 testing, and you are concerned about your health, you should contact a different healthcare provider.
Testing at the Michigan Department of Health and Human Services Bureau of Laboratories (BOL) is prioritized for high-risk individuals and those that may pose a risk to the public. Commercial laboratories can also perform COVID-19 testing.
Do health workers know how to take samples correctly from patients?
Sample collection for COVID-19 is similar to procedures that hospitals and healthcare workers follow for respiratory viruses. MDHHS Bureau of Laboratories (BOL) have developed kits and guidance to ensure proper collection and shipping of samples.
How long does it take to get test results?
Bureau of Laboratories (BOL) prioritizes specimens for testing based on risk to the person and the community. For information about testing from commercial or hospital laboratories, contact your healthcare provider. BOL can not provide test results to patients.
Preventing the spread of COVID-19 in Michigan.
What is the Stay Home, Stay Safe shelter in place order?
Gov. Gretchen Whitmer signed the “Stay Home, Stay Safe” Executive Order (EO 2020-21) on Mar. 23, 2020. The executive order directs all Michigan businesses and operations to temporarily suspend in-person operations if they are not necessary to sustain or protect life.
It also directs Michiganders to stay in their homes unless they’re a part of critical infrastructure workforce, engaged in an outdoor activity, or performing tasks necessary to the health and safety of themselves or their family, like going to the hospital or grocery store.
If someone must go out for one of these essential services, everyone is strongly encouraged to continue to practice steps to prevent spread of flu and the common cold.
Why did Gov. Whitmer issue a shelter in place order?
The shelter in place order is an important to protect the health of the public and to save lives based on data and recommendations from medical experts.
- Michigan is among the top five states in the nation in number of confirmed COVID-19 cases.
- Taking aggressive action to protect our communities is the most important way we can mitigate further spread of COVID-19.
- People of all ages can develop symptoms and become a carrier, even if they do not feel very sick.
Other states that have issued stay at home orders include Ohio, New York, Pennsylvania, California, Louisiana, New Jersey and Connecticut.
What types of jobs or workplaces are considered essential during the shelter in place order?
Most Michigan businesses will be required to temporarily suspend in-person operations effective Tuesday, March 24 at 12:01 a.m.
- Businesses and operations are prohibited from requiring workers to leave their homes, unless those workers are necessary to sustain or protect life or to conduct minimum basic operations.
- Businesses and operations are to designate the workers who meet those criteria and notify them.
- Businesses that remain open must adopt social distancing practices and other mitigation measures to protect workers and patrons in the performance of that necessary in-person work.
Examples of jobs or workplaces allowed to remain open include:
- grocery stores
- hospitals and mobile emergency units
- doctor’s offices, when performing non-elective services
- utility companies
- law enforcement
- banks and credit unions
- gas stations
For a full list of businesses and services still open, visit Michigan.gov/coronavirus.
How do I know if I am essential? Will my employer tell me?
Businesses and operations are to designate the workers who meet those criteria and notify them.
How does the State of Michigan determine which jobs or workplaces are essential?
Essential jobs help sustain or protect life and safety. Examples of essential services include jobs that:
- Keep the electricity on and water running.
- Ensure communities and roadways are safe and clean.
- Allow residents continued access to food and basic supplies to follow precautions that prevent the spread of an illness.
- Continue to fill prescriptions that keep people healthy or prevent life-threatening conditions.
What activities still permitted outside of the home during a shelter in place order?
- All public and private gatherings of any number of people occurring among persons outside a single household are temporarily prohibited.
- Residents may still be asked to go to work if they are healthy and perform an essential job.
- People may leave the house for limited and necessary purposes, such as grocery shopping, picking up prescriptions or to receive medical care.
- Outdoor activities are permitted, including walking, hiking, running, cycling, or any other recreational activity. Outdoor activities must not conflict with an executive order and individuals must remain at least six feet from other people.
- Anyone who is sick with symptoms of respiratory illness should still stay home and isolate.
- Remember to continue to take steps to prevent the spread of COVID-19.
What are the penalties for failing to comply with a shelter in place order?
The shelter in place order is mandatory and enforceable through fines and jail time.
Is there a ban on people entering Michigan or leaving Michigan?
There is no ban on people entering or leaving Michigan.
When will the shelter in place order end? Could it be extended?
The Stay Home, Stay Safe shelter in place order will last for three weeks. This is subject to change, depending on data available on the virus, its spread and health experts’ recommendations to keep people safe.
Is the school closure order going to be extended to match?
More information on school closures and questions regarding any possible extension of the current closures will be available soon. State education officials and health experts are closely monitoring this crisis and will continue to act in the best interests of Michigan students and school employees. At this time, the governor is considering extending the closure until at least April 13.
Can kids and families still pick up food from distribution sites?
Yes. The State of Michigan is working to ensure that children who rely on the food provided by schools will have the resources they need. The Michigan Department of Education (MDE) has developed an online map for families to find meals. Families can access the map at www.mcgi.state.mi.us/schoolnutrition.
What has Michigan done to prevent the spread of COVID-19 in Michigan?
MDHHS began working with local health departments, healthcare coalitions, hospital and healthcare partners when the novel coronavirus outbreak began in Wuhan, China. Initial focus was working with federal partners to ensure that Michigan’s public health system could support traveler screening and monitoring to limit the entry of cases into the U.S.
Hospitals and healthcare partners were also engaged to establish screening procedures for any patients presenting for care with a travel history and symptoms that could be indicative of a possible COVID-19 case. These activities have mirrored much of the public health response to recent Ebola outbreaks.
While MDHHS was implementing those activities, there has been considerable effort put into planning for the next phase of this outbreak which would include community mitigation.
- On Feb. 3, MDHHS activated the Community Health Emergency Coordination Center to coordinate with local health departments.
- On Feb. 28, Gov. Gretchen Whitmer activated the State Emergency Operations Center to help coordinate the state’s response.
- On March 3, Governor Gretchen Whitmer announced the creation of four task forces to combat the spread of coronavirus and assess the impact it may have on Michiganders’ day-to-day lives. These task forces include: State Operations, Health and Human Services, Education, and Economy/Workforce.
- On March 10, the State Emergency Operations Center Joint Information Center was activated to assist with the public information effort
- On March 10, Governor Gretchen Whitmer declared a state of emergency to slow the spread of COVID-19.
What is a state of emergency? Does it indicate the severity of a situation?
A state of emergency declaration is simply a way to free up resources. It is a temporary order that allows the governor to assist communities in need better and faster by making resources immediately available. It also makes it easier for the state to seek federal assistance during and after a natural disaster, pandemic and more.
What is community mitigation?
Community mitigation activities are routinely utilized on a small scale by public health when responding to outbreaks. This may be a public health response to a chicken pox outbreak in a school or school district, or visitor restrictions in hospitals during flu season. Community mitigation uses a variety of non-pharmaceutical interventions (NPIs) to limit the spread of the virus.
- Personal NPIs are everyday preventive actions, such as staying home when you’re sick, covering coughs and sneezes and washing your hands. These actions can help keep yourself and others from getting and spreading respiratory illnesses like the flu.
- Community NPIs are policies and strategies such as school closures and dismissals, postponing social gatherings and social distancing (telecommuting). Organizations and communities can put these strategies into place to help slow the spread of illness during an infectious disease outbreak.
- Environmental NPIs include routine surface cleaning that helps to eliminate the virus from frequently touched surfaces and objects, such as toys, refrigerator handles, desks, and doorknobs in homes, childcare facilities, schools, workplaces, and other settings where people regularly gather.
In weekly, routine calls with local health departments and healthcare partners, MDHHS has been working to transition our preparedness and response toward community mitigation. MDHHS staff and administration will continue to work with our state partners to implement community mitigation strategies in response to the COVID-19 outbreak as needed. This is a similar approach as was taken in 2009 in response to the Pandemic Influenza H1N1.
For events and event planners
I am planning or attending a conference or event, do I have to cancel it?
The Stay Home, Stay Safe Executive Order does not permit people to leave their homes for conferences or events. Planners working on future events should prepare for the possibility that these restrictions may still be in place.
For schools and students
Should I be concerned about my student returning to college after spring break?
Students who traveled during spring break should contact their university’s travel office. Many universities have restricted travel to certain parts of the world. This means your student might be asked to remain off campus until 14 days after they returned to the U.S. and are symptom free.
Are schools preparing for community spread in Michigan?
MDHHS and Michigan Department of Education (MDE) issued recommendations for public and nonpublic schools and libraries. School districts were asked to review considerations including:
- Reporting influenza-like activity, absenteeism, and potential school dismissals.
- Educating students, staff, and the community about COVID-19 and how to prevent spread.
- Reviewing current dismissal policies, including employment stipulations for staff.
- Planning for impact to meal programs if school day, sport, or gathering cancelations are necessary.
- Coordinating with local health departments on decisions to exclude a student or staff member, or to close schools altogether.
- As of March 16, 2020, all elementary school buildings and secondary school buildings in Michigan are closed.
For businesses and consumers
If schools are closed and large events are prohibited, why are so many businesses open?
The Stay Home, Stay Safe permits continued work for essential functions to business and infrastructure. If you plan to visit a business or office, consider the following:
- Many businesses are taking extra precautions, such as providing hand sanitizer at entryways or cleaning more frequently, to protect their customers. If you are concerned, you could call the business ahead of time and ask what precautions are in place before deciding if you should go.
- Medical offices, like dentist offices, have infection control procedures to protect their patients. If you are concerned, you could call the office ahead of time and ask about their procedures. If you are still concerned, you could reschedule or reach out to another provider.
Does the virus live on currency notes and coins? Should businesses stop accepting them?
We know that COVID-19 can live on surfaces. The length of time the virus lives on a surface depends on the type of surface (e.g., hard, porous). It is not known how long, or even if, the virus lives on currency, but everyone should always practice good hygiene when handling money. Money handlers should be sure to wash their hands frequently and avoid touching their eyes, nose, and mouth.
What actions should businesses take to prepare for community spread of COVID-19?
Employers should consider strategies to prevent spread of illness in the workplace including:
- Encouraging sick employees to stay home and ensuring that policies are consistent with public health guidance.
- Separating employees with acute respiratory illness.
- Routinely clean frequently touched surfaces.
- Provide information to employees before traveling.
I have an employee who was diagnosed with COVID-19? What should I do next?
You could let your employees know that they may have been exposed to COVID-19. Do not identify the person with COVID-19. Make sure your employees are advised of the signs and symptoms of COVID-19. Please advise your employees to call or contact a medical provider first to have their symptoms screened. At this time, not everyone’s symptoms or medical history qualifies them for testing. Do not show up to a medical facility without first contacting a medical provider.
Do I need to close my business if a positive case of COVID-19 has been identified?
It is not necessary to close your business, however, perform a thorough cleaning.
- Clean all frequently touched surfaces including workstations, countertops, doorknobs, and elevator buttons.
- Use cleaning agents that are usually used per your industry standards and follow the directions on the label.
Will the local health department reach out to my business if we have a positive case of COVID-19?
The local health department oversees investigations into COVID-19 cases. They follow up with all individuals who may have been in contact with the patient and may release any locations a patient visited, if they cannot fully account for all potential contacts.
COVID-19 healthcare preparedness
Does Michigan have a system in place to warn of a potential outbreak early on?
Michigan has a surveillance system to detect cases and clusters associated with an infectious disease outbreak as reported by healthcare providers, emergency departments and local health departments. Also, emergency medical service (EMS) agencies are working closely with MDHHS to report and investigate clusters of respiratory illness requiring EMS transfers to hospitals. These systems are reviewed daily to warn of potential outbreaks of illness, including COVID-19.
Is Michigan’s healthcare system ready to treat patients with severe or critical disease?
Currently, there are no therapeutics to treat COVID-19, only supportive care. Healthcare providers are prepared to provide supportive care to COVID-19 patients. MDHHS provides updates to healthcare providers to ensure they are equipped with the most current guidance. MDHHS maintains a cache of vital medical equipment that can be deployed to healthcare organizations if necessary.
MDHHS is taking necessary steps to order and distribute emergency materiel, including PPE to frontline health care workers through regional health care coalition networks.
PPE is being acquired through:
- Strategic National Stockpile Allocation
- Leveraging emergency procurement with PPE manufacturers
- Collection of donated material
Do healthcare workers have the necessary training and equipment to keep them safe?
MDHHS provided guidelines and recommendations for safety measures, including the proper use of Personal Protective Equipment (PPE), to healthcare providers, facilities, and EMS agencies. MDHHS is working to obtain additional supplies, including PPE for healthcare workers, to support an outbreak response and healthcare operations in Michigan.
How can I help?
Is there something I can do to help? Are volunteers needed?
For healthcare workers: Michigan Volunteer Registry is the system used to pre-identify and pre-register credentialed healthcare workers. If you are not currently registered and want to be prepared to serve, register MIVolunteerRegistry.org.
Local communities may have needs for food distribution and other support services. If you are not sure how to get connected to local volunteer projects, you can call 2-1-1 to find out.
To ask about donating material, email the Michigan Community Service Commission at COVID19Donations@Michigan.gov.
Source: Michigan Department of Health and Human Services