How COVID-19  Spreads

Person-to-person spread

The virus is thought to spread mainly from person-to-person.

  • Between people who are in close contact with one another (within about 6 feet).
  • Through respiratory droplets produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

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.

Spread from contact with contaminated surfaces or objects

It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

How easily the virus spreads

How easily a virus spreads from person-to-person can vary. Some viruses are highly contagious (spread easily), like measles, while other viruses do not spread as easily. Another factor is whether the spread is sustained, spreading continually without stopping.

The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas.

Know How it Spreads

  • There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).
  • The best way to prevent illness is to avoid being exposed to this virus.
  • The virus is thought to spread mainly from person-to-person.
    • Between people who are in close contact with one another (within about 6 feet).
    • Through respiratory droplets produced when an infected person coughs or sneezes.
  • These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Take steps to protect yourself

Clean your hands often

  • Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
  • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid close contact

Take steps to protect others

Stay home if you’re sick

Cover coughs and sneezes

  • Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
  • Throw used tissues in the trash.
  • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.

Wear a facemask if you are sick

  • If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. Learn what to do if you are sick.
  • If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.

Clean and disinfect

  • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
  • If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.

Stress and Coping

The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. Coping with stress will make you, the people you care about, and your community stronger.

Everyone reacts differently to stressful situations.  How you respond to the outbreak can depend on your background, the things that make you different from other people, and  the community you live in.

People who may respond more strongly to the stress of a crisis include

  • Older people and people with chronic diseases who are at higher risk for COVID-19
  • Children and teens
  • People who are helping with the response to COVID-19, like doctors and other health care providers, or first responders
  • People who have mental health conditions including problems with substance use

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others call

  • 911
  • Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)

Stress during an infectious disease outbreak can include

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs

People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Additional information can be found at the Substance Abuse and Mental Health Services Administration (SAMHSAexternal icon) website.

Taking care of yourself, your friends, and your family can help you cope with stress. Helping others cope with their stress can also make your community stronger.

Things you can do to support yourself

  • Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.

Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

Reduce stress in yourself and others

Sharing the facts about COVID-19 and understanding the actual risk to yourself and people you care about can make an outbreak less stressful..

When you share accurate information about COVID-19 you can help make people feel less stressed and allow you to connect with them.

Learn more about taking care of your emotional health.

For parents

Children and teens react, in part, on what they see from the adults around them. When parents and caregivers deal with the COVID-19 calmly and confidently, they can provide the best support for their children. Parents can be more reassuring to others around them, especially children, if they are better prepared.

Not all children and teens respond to stress in the same way. Some common changes to watch for include

  • Excessive crying or irritation in younger children
  • Returning to behaviors they have outgrown (for example, toileting accidents or bedwetting)
  • Excessive worry or sadness
  • Unhealthy eating or sleeping habits
  • Irritability and “acting out” behaviors in teens
  • Poor school performance or avoiding school
  • Difficulty with attention and concentration
  • Avoidance of activities enjoyed in the past
  • Unexplained headaches or body pain
  • Use of alcohol, tobacco, or other drugs

There are many things you can do to support your child

  • Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions and share facts about COVID-19 in a way that your child or teen can understand.
  • Reassure your child or teen that they are safe. Let them know it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
  • Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
  • Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
  • Be a role model.  Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.

Learn more about helping children cope.

For responders

Responding to COVID-19 can take an emotional toll on you. There are things you can do to reduce secondary traumatic stress (STS) reactions:

  • Acknowledge that STS can impact anyone helping families after a traumatic event.
  • Learn the symptoms including physical (fatigue, illness) and mental (fear, withdrawal, guilt).
  • Allow time for you and your family to recover from responding to the pandemic.
  • Create a menu of personal self-care activities that you enjoy, such as spending time with friends and family, exercising, or reading a book.
  • Take a break from media coverage of COVID-19.
  • Ask for help if you feel overwhelmed or concerned that COVID-19 is affecting your ability to care for your family and patients as you did before the outbreak.

Learn more tips for taking care of yourself during emergency response.

For people who have been released from quarantine

Being separated from others if a healthcare provider thinks you may have been exposed to COVID-19 can be stressful, even if you do not get sick. Everyone feels differently after coming out of quarantine. Some feelings include :

  • Mixed emotions, including relief after quarantine
  • Fear and worry about your own health and the health of your loved ones
  • Stress from the experience of monitoring yourself or being monitored by others for signs and symptoms of COVID-19
  • Sadness, anger, or frustration because friends or loved ones have unfounded fears of contracting the disease from contact with you, even though you have been determined not to be contagious
  • Guilt about not being able to perform normal work or parenting duties during quarantine
  • Other emotional or mental health changes

Children may also feel upset or have other strong emotions if they, or someone they know, has been released from quarantine. You can help your child cope.

Watch for symptoms

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases.

The following symptoms may appear 2-14 days after exposure.*

  • Fever
  • Cough
  • Shortness of breath

*This is based on what has been seen previously as the incubation period of MERS-CoV viruses.

Who is at higher risk?
Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:
  • Older adults
  • People who have serious chronic medical conditions like:
    • Heart disease
    • Diabetes
    • Lung disease

Take actions to reduce your risk of getting sick

If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease.

  • Stock up on supplies.
  • Take everyday precautions to keep space between yourself and others.
  • When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
  • Avoid crowds as much as possible.
  • Avoid cruise travel and non-essential air travel.
  • During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.

Have supplies on hand

  • Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.
  • If you cannot get extra medications, consider using mail-order for medications.
  • Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.

Take everyday precautions

Avoid close contact with people who are sick.

Take everyday preventive actions:

  • Clean your hands often
  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
  • If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
  • To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
  • Wash your hands after touching surfaces in public places.
  • Avoid touching your face, nose, eyes, etc.
  • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
  • Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
  • Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

If COVID-19 is spreading in your community

Take extra measures to put distance between yourself and other people to further reduce your risk of being exposed to this new virus.

  • Stay home as much as possible.
  • Consider ways of getting food brought to your house through family, social, or commercial networks

If a COVID-19 outbreak happens in your community, it could last for a long time. (An outbreak is when a large number of people suddenly get sick.) Depending on how severe the outbreak is, public health officials may recommend community actions to reduce people’s risk of being exposed to COVID-19. These actions can slow the spread and reduce the impact of disease.

Have a plan for if you get sick

  • Consult with your health care provider for more information about monitoring your health for symptoms suggestive of COVID-19.
  • Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick.
  • Determine who can care for you if your caregiver gets sick.
Watch for symptoms and emergency warning signs
  • Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor.
  • If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs*:
    • Difficulty breathing or shortness of breath
    • Persistent pain or pressure in the chest
    • New confusion or inability to arouse
    • Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

What to do if you get sick

  • Stay home and call your doctor.
  • Call your healthcare provider and let them know about your symptoms. Tell them that you have or may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed.
  • If you are not sick enough to be hospitalized, you can recover at home. Follow CDC instructions for how to take care of yourself at home.
  • Know when to get emergency help.
  • Get medical attention immediately if you have any of the emergency warning signs listed above.

What others can do to support older adults

Community support for older adults

  • Community preparedness planning for COVID-19 should include older adults and people with disabilities, and the organizations that support them in their communities, to ensure their needs are taken into consideration.
    • Many of these individuals live in the community, and many depend on services and supports provided in their homes or in the community to maintain their health and independence.
  • Long-term care facilities should be vigilant to prevent the introduction and spread of COVID-19. Information for long-term care facilities can be found here.

Family and caregiver support

  • Know what medications your loved one is taking and see if you can help them have extra on hand.
  • Monitor food and other medical supplies (oxygen, incontinence, dialysis, wound care) needed and create a back-up plan.
  • Stock up on non-perishable food to have on hand in your home to minimize trips to stores.
  • If you care for a loved one living in a care facility, monitor the situation, ask about the health of the other residents frequently and know the protocol if there is an outbreak.

Above data are from CDC website, more details please visit https://www.cdc.gov/