You Asked, We Answered

There are currently several coronaviruses that infect people around the globe every year, and 4 of these are responsible for about 20% of “common colds.” While all coronaviruses are covered in spike proteins, which appear as a “crown” around the outside of this type of virus and give them their name (corona means crown in Latin), not all coronaviruses are the same.

The coronaviruses that caused the SARS outbreak in 2003 and the MERS outbreak in 2012 were, like the current coronavirus, much more serious than the common cold. The current coronavirus pandemic is caused by the virus SARS-CoV-2. Once a person becomes infected with SARS-CoV-2, they can develop the symptoms of COVID-19, the disease caused by SARS-CoV-2.

Below are the responses to the most common questions that Door County Medical Center has received about the coronavirus, SARS-CoV-2, and COVID-19.

I got the vaccine and have symptoms, should I be tested?

Yes. The CDC continues to recommend testing for all symptomatic individuals regardless of vaccination status or prior COVID infection. If you develop any signs or symptoms of illness, including but not limited to loss of taste or smell, cough, runny nose, nasal congestion, headache, body aches, fever or chills, sore throat, shortness of breath or difficulty breathing, nausea, vomiting, or diarrhea you should be tested and quarantine, at a minimum, until you know the results of your COVID test.

How long should I wait to test if I am exposed and have no symptoms?

If you have been in close contact (within 6 feet for a total of 15 minutes or more over a 24-hour period) to someone with COVID-19, even if you are fully vaccinated (at least two weeks out from final dose of COVID vaccination), you should get tested 3-5 days after exposure and monitor for symptoms. If you are fully vaccinated, you should wear a mask in public indoor settings for 14 days or until you receive a negative test result.  If you are not fully vaccinated, you will also need to quarantine to protect yourself, your family, and your community.

What is the typical wait time for results?

The wait time for results is dependent on multiple factors, the most common being the demand for testing. Results from DCMC can be found on the patient portal.

Are we testing for the variant?

The DCMC COVID PCR test detects all currently known variants but does not differentiate between them. We send a selection of positive COVID specimens to the State weekly for sequencing. DCMC does not receive results of the variant testing, but the State uses the data to understand which strains are spreading in our state and how common the new strains are in our communities.

What are the most common symptoms of COVID-19?

According to the Centers for Disease Control and Prevention (CDC) the most common symptoms of COVID-19 include:

• Fever or Chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

Symptoms may appear between 2 to 14 days after exposure. Not all people will have the same combination of symptoms, and indeed some people will be asymptomatic—that is, they will be infected with the coronavirus but have no symptoms and will not develop COVID-19.

Which warning signs or symptoms should I look out for, or call my doctor about, if I have an underlying condition?

Perhaps one of the biggest risk factors for developing COVID-19 is age. While young children rarely show any symptoms of infection, people ages 65 and older are at a high-risk of developing severe illness from COVID-19.

An increased risk of developing severe illness from COVID-19 is also associated with people of all ages who have certain underlying medical conditions, which include, per the CDC:

• Chronic lung disease or moderate to severe asthma
• Serious heart conditions
• Compromised immune systems
• Severe obesity (a body mass index of 40 or higher)
• Diabetes
• Chronic kidney disease (especially that which requires dialysis)
• Liver disease

The most important warning signs to look out for regarding the development of severe COVID-19 are:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Bluish lips or face

While those who are 65 or older, or have an underlying medical condition, should be particularly vigilant when looking for the abovementioned warning signs, in reality, these symptoms of severe illness can strike anyone of any age that has developed COVID-19. If you know someone that has contracted SARS-CoV-2 and is displaying any of these symptoms—even if they are a 25-year-old marathon runner—call your doctor or hospital right away.

Are there any long-term effects of COVID-19 that we know about?

The first cases of SARS-CoV-2 that we know of first appeared in December of 2019, so we can’t yet be sure how long “long-term” is. The World Health Organization (WHO) estimates that it takes 3 to 6 weeks for most people to recover from COVID-19. However, there are some people who contract this coronavirus and develop COVID-19 symptoms that last for months, or even sustain organ damage.

• Blood clots: One complication from COVID-19 that has primarily emerged in younger people with the disease is blood clotting, which can lead to strokes, pulmonary embolisms (in the lungs) and renal (kidney) failure.
• Olfactory nerve damage: Another longer-term complication seen in those who have recovered from COVID-19 is neurological—the lost of taste and smell. While many have reported the loss of taste and smell as a symptom of COVID-19, a small number of those with that particular side effect are reporting that the loss of these senses, thus far, seems permanent.
• Lung damage: Many will be familiar with the affect SARS-Cov-2 has on the lungs. Indeed, this organ seems to be one of the primary targets of this virus. People that have had COVID-19 often cough, and/or complain of shortness of breath, weeks after recovering. Additionally, doctors preforming CT scans have found evidence of scarring—the so-called “ground-glass opacities”—on the lungs of COVID-19 patients. This type of damage can be permanent
• Heart damage: Like the lungs, the heart seems to be one of the organs most likely to be targeted by the coronavirus. Physicians have reported inflammation and damage to the heart muscle in patients with COVID-19. Some are warning that, “COVID-19 survivors may experience long-lasting cardiac damage and cardiovascular problems, which could increase their risk of heart attack and stroke.”

What does “community-spread” mean?

Sometimes a person that has become infected with a virus, like SARS-CoV-2, can trace how they became infected. Maybe they contracted it from a friend. Perhaps the infection was transmitted while that person was traveling abroad. Either way, public health officials can identify a source. This is where the term “contact tracing” comes from, and it is what public health officials always hope to be able to do—trace the source of an infection. When a person becomes sick and does not know how they contracted the disease, this is referred to as community spread. In a case like this, there is no way to pinpoint the origin of the person’s infection—in other words, the disease is spreading unchecked within the community.

Is wearing a mask an effective way to prevent the spread of SARS-CoV-2? How should I wear mine? 

The simple answer: Yes, you should wear a mask! Try to keep the edges tight against your face (even if you have a beard) and make sure the mask goes over your nose and under your chin. If you wear glasses, make or purchase a mask that can go almost to the bridge of your nose, then place your glasses over the mask. This will prevent fogging when you breathe.

As previously mentioned, people who have been infected with SARS-CoV-2 can go up to two weeks without showing symptoms (presymptomatic), and may never even develop symptoms (asymptomatic). In fact, in asymptomatic cases, the infected person may be unaware they have the disease until they have been tested for antibodies. However, this doesn’t mean that the presymptomatic or asymptomatic person can’t spread the coronavirus to others. In fact, the CDC estimates that 20% to 50% of SARS-CoV-2 infections are asymptomatic and a recent study published in the Annals of Internal Medicine found that presymptomatic and asymptomatic people were responsible for up 45% of all coronavirus transmission. The reason for wearing a mask is that you are, in effect, protecting people from you. The mask will not necessarily protect you from contracting SARS-CoV-2 (there are specific masks, like N95 respirators, that can prevent the wearer from becoming infected), but it will help reduce the risk that you will transmit it if you have the coronavirus and are presymptomatic or asymptomatic.

One last statistic: A recent study, supported by the WHO, found that wearing masks could reduce the spread of the coronavirus by up to 85%.

How effective is it to stay 6ft apart?

The same WHO funded study that was mentioned above (regarding masks) also found that standing at least 3 feet apart could reduce transmission of SARS-CoV-2 by up to 82% and that standing 6 feet apart would reduce transmissibility even further. The important takeaway is that it is important to reduce prolonged close contact (more than a few minutes) with other individuals—especially when indoors where there is less air circulation.

Should I be wearing gloves when I go out in public?

No, wearing gloves is not necessary and, according to the CDC, it can even increase transmissibility. 

The coronavirus cannot enter your body through your skin, but rather, through the nose, mouth and eyes. One of the ways SARS-CoV-2 can be transmitted is by touching a surface (like the top of a table) that is covered with the coronavirus, getting it on your hand or fingers, then touching your nose, mouth or eyes. Wearing a mask and washing your hands frequently with soap and water will help to prevent this kind of transmission, but unfortunately you can still touch your face with a glove on your hand, and “if not properly removed, gloves can be a source of contamination”—that is, the removed glove could come in contact with your hands or face.

How and where can I get tested for antibodies?

When a person becomes infected with a virus, their body’s immune system will produce a large, Y-shaped protein that can bind to the virus and neutralize it. Once a person has been sick and beaten back an illness like COVID-19, their immune system will continue to produce antibodies to prevent a repeat infection (this is the point of vaccines, to “trick” your body into producing antibodies before you get sick). Antibody tests cannot tell you if you have SARS-CoV-2, but rather, if you have had it in the past. Currently, DCMC is not allowing people to self-order an antibody test. In order to obtain an antibody test for SARS-CoV-2, DCMC recommends that you contact your primary care clinician and ask about obtaining a test.

Where can I get resources for my business regarding COVID-19 guidelines? 

There are several excellent websites that provide a wealth of information for businesses trying to navigate the coronavirus pandemic.

• The Door County government website can be accessed at: https://www.co.door.wi.gov/909/Coronavirus-Disease-COVID-19. Among the range of topics covered, this site provides information for what to do if you think an employee has been exposed to, or is infected with SARS-CoV-2.
• The Wisconsin Economic Development Corporation (WEDC), which can be accessed here: https://wedc.org/reopen-guidelines/, and the Door County Economic Development Corporation (DCEDC), which can be accessed here: https://livedoorcounty.org/2020/03/covid19/, are designed specifically for businesses in Wisconsin and Door County. These websites provide guidance for safely reopening your business, provide information on unemployment benefits and financial assistance, and answer questions like, “What is an essential business?” 
• Destination Door County, the county’s tourism website also provides information for Door County businesses, which can be accessed here: https://www.doorcounty.com/open/.
• Town Hall Meetings: DCMC and Door County Public Health have hosting a series of virtual town hall meetings so local business owners can ask questions and get the latest recommendations for reopening. The next town hall meeting will be held on June 17th, 2020, at 4PM central time. To join this Zoom meeting click here:
  https://us02web.zoom.us/j/84886473407?pwd=eWR5cnhyR0xZSVN5T3hZTmQxRHRQZz09. The meeting ID is: 848 8647 3407, the password is: 378673.
• DCMC and Door County Public Health have also created a quick-to-read flyer for local businesses that covers many of the most important guidelines for safely reopening in a single page. To download the flyer, click here: https://www.doorcounty.com/media/18006/dcmc-public-health-commitment-to-safety-flyer.pdf

Thank you to everyone for your questions! If you need more information, please visit either Door County Medical Center’s website at: https://www.dcmedical.org/, or Door County’s government website at: https://www.co.door.wi.gov/909/Coronavirus-Disease-COVID-19.