The worldwide COVID-19 pandemic involves information that is continually evolving and being updated as public health officials and scientists collect more data and develop an understanding of the virus. Health professionals should check this page and other respected websites for the latest information.

What do we know about how COVID-19 is spread?

The most current evidence shows the virus transmits easily between people, most often through droplets generated by coughs and sneezes. Part of the idea of social distancing is that droplets can generally carry for only 5 to 6 feet. If you’re farther than that, your chances of getting the virus are generally lower.

COVID-19 may also be spread by people who are not showing symptoms (i.e., “asymptomatic”). According to the CDC, 35% of all people with COVID-19 are asymptomatic. However, those individuals are still as infectious as people with symptoms. 

The disease might be transmitted when people touch a contaminated surface or object and then touch their face, nose or mouth or eyes. However, this is not thought to be the main way the virus spreads. Current data and information also suggest that the risk of COVID-19 spreading from pets to people is low as well.

No matter the risk of transmission, rigorous hand hygiene and optimal cleaning practices at home and in public settings helps guard against the transmission of COVID-19.

Can COVID-19 be spread by asymptomatic exposure?

Based on the evidence from China, asymptomatic transmission may occur and has contributed to a limited amount of transmission of COVID-19 infections. People can shed the virus before they have symptoms, but this is generally less than individuals with symptoms. According to the Centers for Disease Control and Prevention (CDC), “the potential for pre-symptomatic transmission underscores the importance of social distancing, including the avoidance of congregate settings, to reduce COVID-19 spread.”

What are the signs of a COVID-19 patient surge that we should be watching for?

We continue to watch daily the rate of new infections, and the number of patients in the hospital (at UC Davis Medical Center and other regional medical centers), for signs of increase that could be an early warning for a potential patient surge. The state and county health departments are also keeping track of COVID-19 cases and watching for signs of a potential surge in COVID-19 patients. Working with other hospitals and our local public health departments, and with our own in-house testing capabilities, we should be able to quickly recognize the kind of increasing trend lines that would be early indicators of a possible surge in COVID-19 patients requiring hospitalization.

How worried should healthy people be about becoming infected with COVID-19?

Most healthy people who become infected with COVID-19 have no symptoms or have mild symptoms. However, there have been healthy people who have progressed to severe disease. We must be vigilant regardless of age and underlying illness. People who have underlying illness and who are older are at higher risk for getting severe disease, but they’re not the only ones at risk.

What health care protocols are appropriate to help prevent the spread of COVID-19?

Contact droplet is the predominant route of COVID-19 transmission. Using appropriate contact droplet precautions, and in the circumstance where the patient can be masked, you increase the potential protection. If aerosolization is expected, then you should upgrade to N95 or PAPR-level protection. Since surfaces are lower risk but not zero risk of virus transmission, good hand hygiene, as well as keeping hands away from your face and appropriate housekeeping within the health care facility are still the best ways to protect against COVID-19 transmission.

Should I wear a mask and maintain 6 feet of distance to help protect against COVID-19?

In every location, all employees need to either maintain at least 6 feet of distance from other people at all times, or wear a mask. In clinical areas where 6 feet of space between people cannot be maintained, clinical masks (ear loop/procedure masks) need to be worn. In non-clinical areas, employees should stay 6 feet apart at all times, or there should be a barrier in place (example: cubicle walls), or a face covering needs to be worn. In non-clinical areas, these masks can be cloth or homemade (with no logos).

This is in alignment with the Governor’s direction on April 14 to ensure our actions are aligned to achieve the following:

  • Ensure our ability to care for the sick within our hospitals;
  • Prevent infection in people who are at high risk for severe disease;
  • Build the capacity to protect the health and well-being of the public; and
  • Reduce social, emotional and economic disruptions

Which procedures are at highest risk for releasing airborne particulates of COVID-19?

Procedures that release upper and lower respiratory tract specimens into the air are at higher risk for releasing airborne particulates by aerosolization. These procedures include intubation, BiPAP, high-flow nasal cannula, nebulizing medications, CPR and resuscitation and bronchoscopy. During these aerosol-generating procedures, providers should wear PAPR or an N95 mask as well as eye protection, a gown, and gloves. If available, it is preferred that the procedure be conducted in an airborne isolation room or private room, and personnel should be limited.

What are the isolation and PPE recommendations when no aerosol-generating procedures are being performed?

For patients where no aerosol-generating procedures are expected, use contact and droplet precautions. Providers should use a surgical mask, eye protection (e.g. face shield), gown, and gloves.

If I've tested positive for COVID-19, what's the process for returning to work?

Based on updated guidance from the CDC (April 30), the Calif. Dept. of Public Health (May 7), and Sacramento County’s Dept. of Public Health (May 9), there is now updated criteria for healthcare providers (HCP) returning to work.

Data no longer supports a test-based strategy to determine when staff can return to work. Instead, the criteria have shifted to a symptom-based strategy for those who test positive and are symptomatic, and a time-based strategy for those who test positive but are asymptomatic. In addition, the time-based strategy for returning to work has been expanded from 7 days to 10 days, which is supported by the latest scientific information.

For the symptomatic HCP with suspected or confirmed COVID-19, use the symptom-based strategy and do not return to work until:

  • At least 3 days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and…
  • At least 10 days have passed since symptoms first appeared

For the HCP who is asymptomatic with laboratory-confirmed COVID-19, and who has not had any symptoms, use the time-based strategy and do not return to work until:

  • 10 days have passed since the date of the first positive COVID-19 diagnostic test, assuming HCP has not subsequently developed symptoms since their positive test. If they develop symptoms, then the symptom-based or test-based strategy should be used.

Visit the CDC website for additional return-to-work information.

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