Your Liver & COVID-19

Ever seen someone cough or sneeze who doesn’t cover their mouth? You’ve likely seen a spray of fluids come out of their mouth. Gross, we know. If that person is infected with something like COVID-19, all those little drops can contain infection or viruses; thankfully, this spray only travels a short distance before settling. That is why social distancing and handwashing frequently and thoroughly is so important! Recently published data shows:

• Respiratory drops can remain in the air and infect someone for up to 30 minutes
• Surfaces may remain contaminated for up to 3 days

Last Updated on May 4, 2022

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Right now, we believe that people are most contagious when they are experiencing symptoms and at their sickest. Some spread may be possible when someone doesn’t have any symptoms. There are some reports of this happening, but this does not seem to be the main way the virus spreads.

Last Updated on May 4, 2022

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Social distancing can reduce and slow the spread of this virus. By keeping 6 feet between people, you reduce your risk of becoming sick yourself. If you avoid getting sick, you can also protect others, like family members who may be at a higher risk than you. Juan Delcan, a visual artist, created the animation, below, to show how social distancing can help slow and stop the spread of COVID-19 and save lives. As you can see, without proper social distance the virus can spread rapidly.

Last Updated on May 4, 2022

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The CDC is currently listing the following people as being at high-risk for severe illness from COVID-19:

• People aged 65 years and older
• People who live in a nursing home or long-term care facility
• People of any age with the following:
  • Chronic Lung Disease: moderate to severe asthma, emphysema, COPD
  • Diabetes Mellitus: Type 1, Type 2, and Gestational (related to pregnancy)
  • Cardiovascular (or heart) Disease
  • Chronic Renal (or kidney) Disease, particularly if not well-controlled
  • Chronic Liver Disease, particularly if not well-controlled
  • Immunocompromised Condition including but not limited to:
    • Cancer Treatment
    • Bone Marrow or Organ Transplant
    • Immune Deficiencies
    • Poorly controlled HIV or AIDS
    • Prolonged use of corticosteroids (like prednisone) or other immune weakening medications
  • Severe obesity
  • Pregnancy (people who are pregnant are known to be at risk with severe viral illness)
  • Current or Former Smoker

Last Updated on May 4, 2022

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Be careful and be smart. If you can, wipe down and disinfect your shopping cart. Use hand sanitizer while in the store and be sure to avoid touching your face. When you return home, wash your hands. If you’re very worried or at risk, you may want to disinfect products as you unpack them before putting them away. Everyone should dispose of one time use bags immediately or wipe down reusable bags. Wash your hands immediately after you finish putting away your groceries.

Here is a helpful resource from Harvard Public Health

Last Updated on May 4, 2022

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For many people, it might feel like you just started hearing about this virus and disease. Here’s a helpful timeline to understand the when this started and how it spread:

Last Updated on May 4, 2022

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• Stay Home, Call a Doctor. If you have mild symptoms, stay home. Do not go to work, school, public places, use public transportation, or be close to people. If you have very bad symptoms and feel you need to be seen by a doctor, call before you go. Describe what your symptoms are and listen to the instructions. Call your doctor before you go anywhere. If it is a medical emergency, call 911 and tell them your symptoms and possible risks (like recent travel history or contact with someone who has the virus).
• Know your risks. Have you had close contact with someone diagnosed with COVID-19? What are your symptoms (fever, cough, difficulty breathing)? Do you have a chronic disease that might make you at risk of becoming more sick? It’s important you share this information, to the best of your ability, with the medical professional you consult.
• Listen to your doctor. Based on the information you tell your doctor, you will be told what to do next. Next steps may include:
  • Keeping track of your symptoms and informing your doctor’s office if you have new or worsening symptoms.
  • Being seen by a doctor to be evaluated in person. If you can, go alone to your appointment to avoid exposing anyone else.
  • Going to a clinic or hospital.
• Protect Others.
  • If you need to leave your home to be seen by a doctor, wear a mask to avoid infecting other people. Healthy people should not wear masks but if you are sick you want to reduce exposure to other people.
  • Sneeze or cough into the bend of your elbow or use a tissue and throw it away immediately.
  • Distance yourself from others and following instructions for isolation or quarantine.
• Stay Calm. It can be really scary to think you are sick with a contagious illness or to be sick with a new illness. Every day, throughout our country and world, we are learning more about COVID-19. We are all in this together.

Last Updated on May 4, 2022

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Yes, it is possible a person can get COVID-19 if they touch a surface with the virus on it and then tough their face, mouth, nose, or eyes. New data suggests the virus may be able to live on contaminated surface for up to 3 days. That’s why washing your hands thoroughly and frequently, especially after touching something, is so important. Here is a helpful video that explains how this can happen

Last Updated on May 4, 2022

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Most people who become sick with COVID-19 feel similar symptoms to the flu: fever, cough, and shortness of breath. Most people will recover from these symptoms with rest and proper care at home (drinking lots of fluids, taking over-the-counter medicine as instructed by your doctor, etc.); recovery may take several days, or even a week or two. Be sure to call your doctor if you feel sick and follow their specific instruction. Remember, everybody’s health is different!

Some people are risk of having more severe, or worse, symptoms with this infection. Those people at a higher-risk will need to monitor themselves closely and, if they start to experience any sort of flu-like symptoms, should call their doctor’s office immediately, even if symptoms are mild.

Last Updated on May 4, 2022

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It’s important to follow CDC guidelines, and listen to your doctor and local health department to decide when to stop home isolation. According to the CDC, you have recovered if it has been at least 7 days since your symptoms started, if you have not had a fever for 3 days and haven’t been taking fever-reducing medicine, and if symptoms like cough and shortness of breath have improved. But again, even the CDC says you should listen to your doctor and local health officials as every community is experiencing COVID-19 differently.

Last Updated on May 4, 2022

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On March 11, 2020, the World Health Organization declared COVID-19, the disease caused by the coronavirus, a pandemic. Prior, the disease was designated an epidemic. What is the difference?

• Outbreak: a sudden increase in the number of people sick with a disease. Outbreaks last for different lengths of time and can impact a community or a much larger geographic area. For example, every year we anticipate an outbreak of the flu. We can protect ourselves from becoming infected with the flu by using a vaccine. Vaccines reduce the number of people who get sick and result in a smaller, shorter outbreak.
• Epidemic: an outbreak of disease that spreads quickly and affects many individuals at the same time.
• Pandemic: an epidemic which spreads over a greater geographic area, often worldwide, and impacts an exceptionally high amount of the population. Pandemics often involve a new virus or a strain of a virus that is not commonly seen. When there is a new virus or a new strain, humans have little to no immunity and the virus can spread easily. Pandemics have social and economic impact in addition to the impact on human health.
• Has this ever happened before? There have been many pandemics and epidemics throughout history with varying death tolls. The Bubonic or Black Plague, Spanish Flu, HIV/AIDS, and, now, COVID-19. Here is a helpful Infographic to learn more about the history of pandemics and provide some context to this rapidly evolving situation.

Last Updated on May 4, 2022

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• Coronavirus: coronaviruses are a group of viruses named for the crown like spikes on their surface. There are several types of coronaviruses that can infect people. People around the world are regularly infected by the four known human coronaviruses (229E, NL63, OC43, and HKU1). These viruses cause mild illness, like the common cold. Coronaviruses can infect animals, evolve to infect humans, and become new, or novel, coronaviruses. Three recent examples are:
  • MERS-CoV: a coronavirus that causes Middle East Respiratory Syndrome or MERS)
  • SARS-CoV: a coronavirus that causes severe acute respiratory syndrome or SARS
  • SARS-CoV-2: the new, novel, coronavirus that causes coronavirus disease 2019 or COVID-19

• COVID-19: the newly identified (or novel) coronavirus causes the disease COVID-19 (COronaVIrus Disease 2019). It is suspected that this virus began infecting animals, changed, then started to infect humans. COVID-19 was initially linked to a live animal market in China but is now spreading from person-to-person throughout the world.

Last Updated on May 4, 2022

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During an outbreak, public health specialists work to identify who is sick, their symptoms, when they got sick, and where they might have gotten sick. Every virus spreads, or transmits, differently. By gathering this data and doing a process called contact tracing, public health officials are better able to control the disease. Some viruses are highly contagious, meaning they spread very quickly and easily from one person to another. Measles are an example of a highly contagious virus. Another important difference between viruses is if the virus spreads continually without stopping, which is called a sustained spread.

Last Updated on May 4, 2022

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Contact tracing work done by the World Health Organization and local officials in China resulted in the current belief that COVID-19 originated in a live market in China. If you look at reports of COVID-19 cases on the website of your local Department of Public Health or Health and Human Services (we have created a map so you can find your state’s COVID-19 information center) you may see information about transmission or how the virus was acquired.

Public health officials rely on contact tracing to control an outbreak. By knowing where someone has been and who they have been around, public health officials can identify individuals that may have been exposed to the virus by that person and prevent additional people from becoming infected. In the early days of an outbreak, this is much easier because fewer people are infected. As more and more people become infected, contact tracing becomes much more difficult as the numbers rise exponentially.

This information is important for contact tracing. Here is an infographic which describes what contact tracing is and why it is so important. Click to view enlarged version.

Last Updated on May 4, 2022

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• Person to Person: the virus is spreading from one person to another. COVID-19 is thought to spread mainly between individuals who are in close contact with one another (within 6 feet) through the respiratory droplets from someone who is infected when they cough or sneeze. If you are standing close enough, you could inhale those droplets into your lungs and become infected as well. You may also see this as close contact. This sort of a case means we have clearly traced an infection to another individual source.
  • Close contact: being within 6 feet of someone for an extended period of time or when they sneeze or cough.
• Travel: COVID-19 is now in every single state and most countries. However, there are some states with more cases than others. Travel from a location with many cases results in wider spread of the virus. Travel is an important part of contact tracing. Doctors ask patients about recent travel history if they present with symptoms of COVID-19. This can help them decide if the person is at risk for COVID-19. Also, doctors will need to know where that person has traveled in case they were infectious and spread the virus further. For example, in Massachusetts there were no cases on Martha’s Vineyard, a small island off the coast. However, someone from the mainland traveled to the island and now there are confirmed cases on the island. It is really important to limit travel right now because we will also limit the travel of the virus.
• Community Spread: many states are experiencing community spread. Community spread means that many people in an area are infected and some do not know how or where they were infected. As of this writing, more than half of the states in the US are reporting community spread. This elevates the risk for everyone in the area and makes the spread of the virus much harder to contain. If you are living somewhere there is community spread, you need to be extra cautious. Check out our FAQs to help you navigate!

Last Updated on May 4, 2022

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• Presumptive versus Confirmed Cases: testing right now is being done at the state level. When COVID-19 began spreading in the United States, state labs could test someone but were then required to submit the test to the CDC for confirmation. If someone tested positive at a state run lab they were a “presumptive case” and, if the CDC lab confirmed the positive result, that person would then be considered a “confirmed case.” As of March 14, 2020, CDC confirmatory testing was no longer required to consider a positive test done at a state lab confirmed. You may still see presumptive cases listed if a lab that is not run by the state conducted the test; this sample does need to be sent to a state or federal lab for confirmation.
• Suspect Cases: you may have been heard or read about suspect cases of COVID-19. If someone is showing symptoms of a COVID-19 infection they will be tested for other illness that may cause similar symptoms, like the flu. If they have no other illness that could cause the symptoms and they have had close contact with someone who does have COVID-19 or they live in a country/area where there is community spread happening, they will be considered a suspect case of COVID-19.

Last Updated on May 4, 2022

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Some groups have been told they are at a heightened risk for developing complications if they become infected with this virus. It’s hard to know who falls into this category. We have included, below, the CDC’s current listing of underlying health conditions that may put you at a higher risk. If you are unsure or if you are living with chronic disease not listed below, please be sure to contact your doctor with your concerns. The CDC is currently listing the following people as being at high-risk for severe illness from COVID-19:

• People aged 65 years and older
• People who live in a nursing home or long-term care facility
• People of any age with the following:
  • Chronic Lung Disease: moderate to severe asthma, emphysema, COPD
  • Diabetes Mellitus: Type 1, Type 2, and Gestational (related to pregnancy)
  • Cardiovascular (or heart) Disease
  • Chronic Renal (or kidney) Disease, particularly if not well-controlled
  • Chronic Liver Disease
  • Immunocompromised Condition including but not limited to:
    • Cancer Treatment
    • Bone Marrow or Organ Transplant
    • Immune Deficiencies
    • Poorly controlled HIV or AIDS
    • Prolonged use of corticosteroids (like prednisone) or other immune weakening medications
  • Severe obesity (a BMI of 41 or higher)
  • Pregnancy (people who are pregnant are known to be at risk with severe viral illness)
  • Current or Former Smoker

Last Updated on May 4, 2022

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Social Distancing for an Individual: making sure there is distance between you and other people to avoid spreading illness. Staying at least 6 feet away from other people reduces your chances of becoming ill with COVID-19.

Social Distancing for a Community: steps taken to reduce large crowds or gatherings; it is hard to maintain distance at a social gathering or in a crowded space. This might include the following:

• Cancelling or postponing religious/cultural ceremonies like weddings, baptisms, bat/bar mitzvahs, etc.
• Working from home/remote instead of going to an office
• Closing schools or switching to online classes
• Cancelling or postponing large conferences
• Limiting the number of people allowed to gather in an area
• Using tele-medicine for doctors’ appointments instead of in-person appointments

Last Updated on May 4, 2022

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Self-Quarantine: someone who has been exposed or who may be sick with COVID-19 might be asked to self-quarantine. This lasts 14 days because two weeks is enough time to know if you will become sick and contagious to other people. After a self-quarantine period has ended, if you don’t have symptoms, follow your doctor’s advice on returning to normal life. If you recently traveled somewhere with a lot of COVID-19 cases or if you have been exposed to an infected person you might be asked to self-quarantine. This involves:

• Frequent hand washing and standard hygiene
• Not sharing towels and utensils with others in your household
• Staying at home
• No visitors
• Social distancing from people in your household

Isolation: making sure people who are confirmed to have COVID-10 stay away from those who do not have it. Isolation may happen at home or at a hospital or similar health care setting.

Last Updated on May 4, 2022

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A lot of people have been talking about Flattening the Curve and Exponential Spread. But what does all of this really mean for COVID-19? This virus spreads quickly and easily in communities. The number of people sick could become very large, very quickly. Using protective measures, like social distancing, self-quarantine, and isolation, are attempts to keep this from happening, or flattening the curve. The curve (line on the graph) shows the number of people getting sick and needing doctors’ assistance or hospitalization. If too many people get really sick, all at once, in a matter of days, hospitals could become overloaded and the health care system would be overwhelmed. This would also mean more people could die because they may not be able to get the help they need. By flattening the curve, the same number of people may get sick but instead of happening all at once, it happens over time, to make sure people can be taken care of as best as possible.

Here is a great video that describes exponential spread, flattening the curve of COVID-19 infections, and what you can do to help your community.

Last Updated on May 4, 2022

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