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Introduction Coronaviruses are a family of viruses that can cause illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In 2019, a new coronavirus was identified as the cause of a disease outbreak that originated in China. The virus is known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic. So far there have been 770,875,433 confirmed cases and 6,959,316 deaths globally associated with Covid-19. The United States of America has 103,436,8299 confirmed cases and 1,127,152 deaths as of September 28, 2023. Influenza, respiratory syncytial virus (RSV), and COVID-19 are all part of the seasonal respiratory virus lineup. According to the Centers for Disease Control and Prevention (CDC), the upcoming fall and winter are expected to have a similar number of hospitalizations for respiratory diseases as last year. ​ Symptoms: Symptoms of coronavirus disease 2019 (COVID-19) may appear 2 to 14 days after exposure. Common symptoms include fever, cough, tiredness. Early symptoms of COVID-19 may include a loss of taste or smell. Other symptoms may include: · Shortness of breath or difficulty breathing. · Muscle aches. · Chills. · Sore throat. · Runny nose. · Headache. · Chest pain. · Pink eye (conjunctivitis). · Nausea. · Vomiting. · Diarrhea. · Rash. The severity of COVID-19 symptoms can range from very mild to severe. Some people may have only a few symptoms. Some people may have no symptoms at all but can still spread it. This is called asymptomatic transmission. Some people may experience worsened symptoms, such as worsened shortness of breath and pneumonia, about a week after symptoms start. Some people experience COVID-19 symptoms for more than four weeks after they're diagnosed. These health issues are sometimes called post-COVID-19 conditions. Some children experience multisystem inflammatory syndrome, a syndrome that can affect some organs and tissues, several weeks after having COVID-19. Rarely, some adults experience the syndrome too. Transmission: The virus that causes COVID-19 spreads easily among people. Data has shown that the COVID-19 virus spreads mainly from person to person among those in close contact. The virus spreads by respiratory droplets released when someone with the virus coughs, sneezes, breathes, sings or talks. These droplets can be inhaled or land in the mouth, nose or eyes of a person nearby. Sometimes the COVID-19 virus can spread when a person is exposed to very small droplets or aerosols that stay in the air for several minutes or hours — called airborne transmission. The virus also can spread if you touch a surface with the virus on it and then touch your mouth, nose or eyes. But the risk is low. Complications: Although most people with COVID-19 have mild to moderate symptoms, the disease can cause severe medical complications and lead to death in some people. Older adults or people with existing medical conditions are at greater risk of becoming seriously ill with COVID-19. When to see a doctor? If you have COVID-19 symptoms or you've been in contact with someone diagnosed with COVID-19, contact your health care team right away for medical advice. Your health care professional will likely recommend that you get tested for COVID-19. If you have emergency COVID-19 symptoms, seek care immediately. Emergency symptoms can include: - Trouble breathing. - Constant chest pain or pressure. - Trouble staying awake. - New confusion. - Pale, gray or blue-colored skin, lips or nail beds — depending on skin tone. Let your health care team know if you are an older adult or have chronic medical conditions, such as heart disease or lung disease, as you may have a greater risk of becoming seriously ill with COVID-19. ​ Reinfection Reinfection with the virus that causes COVID-19 occurs when you are infected, recover, and then get infected again. You can be reinfected multiple times. Reinfections are most often mild, but severe illness can occur. Staying up to date with COVID-19 vaccine and treating COVID-19 illness within a few days of when symptoms start decreases your risk of experiencing severe illness. Once you have had COVID-19, your immune system responds in several ways. This immune response can protect you against reinfection for several months, but this protection decreases over time. People with weakened immune systems who get an infection may have a limited immune response or none. Protection against severe COVID-19 illness generally lasts longer than protection against infection. This means even if you get infected again, your immune response should help protect you from severe illness and hospitalization. As the virus evolves, new variants with the ability to evade your existing immunity can appear. This can increase your risk of reinfection. Reinfection can occur as early as several weeks after a previous infection, although this is rare. What are variants of Covid- 19? Viruses are constantly changing, including the virus that causes COVID-19. These changes occur over time and can lead to new strains of the virus or variants of COVID-19. Some changes and mutations allow the virus to spread more easily or make it resistant to treatments or vaccines. As the virus spreads, it may change and become harder to stop. Slowing the spread of the virus, by protecting yourself and others, can help slow new variants from developing. ​ Testing Interpreting test results in the first 90 days after a previous infection (that is, reinfection) can be challenging. CDC has developed testing guidance explaining which type of test you should take under different circumstances. If you have tested positive for COVID-19 within the past 90 days and are testing for a possible new infection: - Use an antigen test. - Consult a healthcare provider if you have any questions or concerns. Protecting Yourself and Others – What You Can Do If you were exposed to the virus that causes COVID-19, you should follow exposure guidance, regardless of your vaccination status or if you have had a previous infection. For those who have previously been infected, vaccination offers added protection, especially against reinfection leading to hospitalization. CDC recommends that people ages 6 months and older, including those with previous infections, stay up to date with COVID-19 vaccines. Regardless of your vaccination status or if you have had a previous infection: COVID-19 treatments are available for those eligible. ​ Prevention: You can take many steps to lower your risk of infection from the COVID-19 virus and lower the risk of spreading it to others. - Avoid close contact with anyone who is sick or has symptoms - Avoid crowds and indoor places that have poor airflow - Wash hands often with soap and water for at least 20 seconds - Wear a face mask in indoor public spaces if you're in an area with a high number of people with COVID-19 in the hospital. - Clean and disinfect high- touch surfaces - Stay home from work, school and public areas, and stay home in isolation if you're sick, unless you're going to get medical care. The CDC recommends a COVID-19 vaccine for everyone age 6 months and older. The COVID-19 vaccine can lower the risk of death or serious illness caused by COVID-19. It lowers your risk and lowers the risk that you may spread it to people around you. Getting a COVID-19 vaccine also is important because the flu and COVID-19 may be spreading at the same time and cause similar symptoms. Getting a COVID-19 vaccine and a flu vaccine is the best way to protect against both. The COVID-19 vaccination schedule in the U.S. depends on a person's age, immune system and previous vaccinations. In general, - people age 6 months through 11 years can get either the Moderna or Pfizer-BioNTech COVID-19 vaccines. - People aged 12 and older can choose the Moderna, Pfizer-BioNTech or Novavax COVID-19 vaccines. Kids aged 6 months to age 5 - Kids age 6 months up to age 4 are up to date if they had three doses of the Pfizer-BioNTech COVID-19 vaccine and at least one dose included the omicron variant. - At age 5, kids who got the Pfizer-BioNTech COVID-19 vaccine are caught up if they had at least one dose that included the omicron variant. - Kids age 6 months through age 5 who got the Moderna COVID-19 vaccine are up to date after two doses, as long as at least one included the omicron variant. People age 6 and older The CDC recommends that everyone age 6 and older should have one vaccine dose that includes the omicron strain. This vaccine needs to be in addition to any other COVID-19 vaccines received in the past. - People older than age 6 with typical immune systems are up to date with their COVID-19 vaccines after one shot with either the Pfizer-BioNTech or Moderna COVID-19 vaccines that include the original and omicron strains. - People age 12 and older who chose the Novavax vaccine are up to date after two shots. But the CDC recommends people get one shot of either the updated Pfizer-BioNTech or Moderna COVID-19 vaccines at least two months after the last Novavax shot. - If you originally got the Janssen/Johnson & Johnson shot, get an updated Moderna or Pfizer-BioNTech COVID-19 vaccine in order to get up to date with your COVID-19 vaccines. Reference: 1. Coronavirus disease 2019 (COVID-2019). Centers for Disease Control and Prevention. Accessed June 19, 2023. 2. Coronavirus disease (COVID-19) outbreak. World Health Organization. Accessed Oct. 22, 2021. 3. AskMayoExpert. COVID-19: Inpatient management (adult). Mayo Clinic; 2021. 4. Coronavirus (COVID-19) update: FDA authorizes first standalone at-home sample collection kit that can be used with certain authorized tests. U.S. Food & Drug Administration. Accessed May 20, 2020. 5. WHO Coronavirus (COVID -19) Dashboard

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