COVID-19: Frequently Asked Questions

With COVID-19 information constantly evolving, it can be challenging to keep up with the latest recommendations. We hope the following FAQ with WellcomeMD’s Dr. Neal Carl and Dr. John Woodward will provide clarity to some of the most pressing questions we hear from patients.

It’s important to remember that for now, and for some months to come, we all need to continue to wear masks, practice social distancing, wash our hands frequently, and avoid crowds and large groups.

Click on each question to expand the answer.

+ When is the best time to test for COVID-19 following an exposure?

Three to five days following an exposure is recommended based on the average incubation period. For exposed individuals who have a negative result, a 14-day quarantine is still suggested.

+ When should asymptomatic individuals be tested for COVID-19?

Anyone who has had close contact with an individual with COVID-19 should be tested. Additionally, COVID-19 screening is common in congregate settings (e.g. long-term care facilities), among hospitalized patients, and prior to surgical procedures, aerosol-generating procedures, and immunosuppression therapy. At WellcomeMD, we are also testing asymptomatic patients who need to travel or visit at-risk family members.

+ Is there a way to distinguish COVID-19 clinically from other respiratory illnesses, particularly influenza?

No, the clinical features of COVID-19 overlap substantially with flu and other respiratory viral illnesses. There is no way to distinguish them besides testing.

+ When should patients with confirmed or suspected COVID-19 be advised to stay at home? When should they go to the hospital?

Home management is appropriate for most patients with mild symptoms (e.g. fever, cough, fatigue, muscle soreness) provided they can be adequately isolated, monitored, and supported in the outpatient setting. However, patients with risk factors for more severe illness (e.g. morbid obesity, cardiovascular disease, COPD/asthma, diabetes, cancer, immunocompromised patients, etc.) should be evaluated by their physician, even if they only have mild symptoms.

If the patient being monitored at home develops symptoms of more serious disease, including persistent chest pain or shortness of breath, they should be promptly evaluated by a physician and may require hospitalization.

If possible, we recommend monitoring the patient’s blood oxygen levels with home oximetry. If levels fall below 94% when walking, then the patient should be promptly evaluated by a physician.

+ What advice should be given to patients with known or presumed COVID-19 who are managing at home?

We recommend the following while managing COVID-19 at home:

• Prevent or treat symptoms using supportive care; take acetaminophen (Tylenol) and hydrate
• Maintain close contact with your healthcare provider
• Monitor your condition for worsening symptoms including shortness of breath, which should prompt clinical evaluation and possible hospitalization
• Separate from your household members (e.g. stay in a separate room and wear masks while in the same room)
• Wash your hands frequently
• Disinfect commonly touched surfaces frequently

+ When managing at home, how long should patients remain isolated?

Patients managing care at home should remain isolated until at least 14 days after the first onset of symptoms AND at least 24 hours after the resolution of fever without the use of fever-reduction AND there is improvement in symptoms (e.g. cough, shortness of breath, etc.)

For patients with a confirmed COVID-19 test but no symptoms, home isolation should follow a time-based strategy. Asymptomatic patients should remain isolated until at least 14 days after their positive COVID-19 test AND there is no evidence of subsequent illness.

If patients need to be retested to return to work, that test will be administered on day 14.

+ Will WellcomeMD offer the COVID-19 vaccine and do you recommend it?

WellcomeMD has applied to receive a supply of vaccines, but we do not know when the vaccine will be available to us.

For Virginia residents: Governor Northam shared Virginia’s three-phased COVID-19 distribution plan last week. Health care workers and residents of long-term care facilities are top priority for receiving the vaccine. Next come critical infrastructure staff, adults with high-risk medical conditions, and adults ages 65 and over. After these groups comes the general public.

For North Carolina residents: Dr. Mandy Cohen, secretary for North Carolina's Department of Health and Human Services, shared insight into the state's multi-phased COVID-19 distribution plan last week. Health care workers dealing directly with COVID-19 patients and long-term care facility residents and staff are top priority for receiving the vaccine. Next come individuals with two or more medical conditions that could result in severe COVID-19 cases. The state is still determining how best to distribute the vaccine beyond these initial groups.

The U.S. Department of Health and Human Services and the Department of Defense have worked together to ensure the development of a safe and effective vaccine. Not only is the vaccine being reviewed by the FDA, but an independent advisory board is also conducting a review of the vaccine data to ensure safety and efficacy. With the rigorous review required to receive FDA emergency use authorization, we have every reason to support COVID-19 vaccination.

We will continue to review the vaccine process for safety and effectiveness and update our recommendations accordingly.