COVID-19

COVID-19

Have a question about COVID-19? We will ask the experts.

Send questions to tribdem@tribdem.com.

Note: Due to the volume of questions submitted, we will not be able to answer them all. Any questions of an urgent nature should be directed immediately to your primary care physician.

Readers of The Tribune-Democrat asked the following questions:

“Can I still get the vaccine if I am on an antibiotic?”

The answer:

I can understand your concern. Antibiotics are taken for bacterial infections. The vaccine is for a virus. You can receive the vaccine if you are on antibiotics. You shouldn’t get the vaccine if you are having symptoms of an infection.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

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“Will getting the mRNA vaccine prevent me from finding out if I presently have Memory B-Cells for COVID-19? I’m presently trying to get a diagnosis for post viral symptoms from a respiratory illness from Feb. 20 and would like to know what exactly caused this before I get the vaccine. Otherwise I may never know what’s wrong with me.”

The answer:

In general, a positive blood SARS-CoV-2 IgG test result is presumed to mean a person has been infected with SARS-CoV-2, the virus that causes COVID-19, at some point in the past. SARS-CoV-2 IgG detection occurs a median 14 days after infection with a range of 10-21 days.

In my opinion, vaccination will not interfere with a blood SARS-CoV-2 (COVID-19) IgG antibody determination.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

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“I initially got a negative COVID test result 3-4 days after symptoms first appeared. I took another test 4 days after that first test and received a positive result. I suspect my first test result was a false negative because I was in the early infection stage. 

“I took another test 17 days after my positive test date (24 days since initial symptoms) which came out negative. It has been 28 days since my initial symptoms, but symptoms have not improved. (I am specifically concerned about my breathing difficulty, though X-ray came out normal.) Is it safe to stop isolating, or is it likely I got a false negative result on my recent test and so should continue isolation?

“My doctor has reassured me that I am clear to end isolation, but I am very hesitant especially considering the similarity of my current condition to my initial condition (with symptoms but negative result). All my tests were nasal swab RT-PCR tests.”

The answer:

I agree with your physician that it is OK to end isolation. A study found that in patients who had recovered from COVID-19, almost 90% reported persistence of at one symptom, particularly fatigue and shortness of breath.

I recommend you follow-up with your physician. 

If your breathing difficulty persists, you may need further testing including possibly a CT scan of your chest, pulmonary function studies, and/or cardiac evaluation.

Also, due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, you should be vaccinated regardless of whether you already had COVID-19 infection. If you were treated for COVID-19 symptoms with either monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

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“I tested positive, and a week later my wife showed symptoms and now tested positive, but I am now negative. Can she pass it back to me again?”

The answer:

Current evidence indicates reinfection is uncommon within 90 days following initial infection, although reinfection is possible.

Therefore, COVID-19 vaccination should be offered regardless of whether you already had COVID-19 infection.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

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“My husband and I have both had our vaccines. He has an underlying heart condition. If I fly to Florida to see grandchildren without him, would I need quarantine after returning home? Is it safe to travel after our vaccines or should I wait until more is known about the variants? There seems to be a lot of conflicting information and I certainly don’t want to bring anything home to him.”

The answer:

I understand the desire to return to normal activities. The question of vaccinated individuals being able to transmit virus is still being determined. Studies done in Rhesus Macaques showed that vaccinated monkeys had very low levels of virus in their nasal passage upon full vaccination (14 days after the second dose). This means that transmission after vaccination is unlikely.

It is possible, from the data mentioned above, that you can have virus in your nose for and give it to someone else in the 1-3 days it takes your immune system to clear it. If you are both vaccinated, you will likely not develop clinical disease.

For now, the recommendation is to wear masks when in public and practice physical distance for all. We all must determine what level of risk we are comfortable with.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

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“I just got my second Moderna shot today. Right before the shot, I took ibuprofen to help with any side effects. About 3 hours later, I started getting a little headache so I took some Tylenol thinking I could alternate between the two. I’ve drank a lot of water throughout the day to stay hydrated, but I just read that the CDC does not recommend taking pain medication before the shot as it may lessen the immune response. 

“Did I ruin my shot at protection? Do I need to get another shot? Is there a way to get my antibodies tested in a few weeks once I am supposed to be fully (95%) immune? I also made the stupid mistake of having margaritas after the first shot. I found out afterwards I was supposed to avoid alcohol for best results. Please help! Has my failure to research ahead of time ruined chance at protection? If so, is there anything I can do now?”

The answer:

Antipyretic or analgesic medications (e.g., acetaminophen or non-steroidal anti-inflammatory drugs) may be taken for the treatment of post-vaccination local or systemic symptoms if medically appropriate. However, routine prophylactic administration of these medications for the purpose of preventing post vaccination symptoms is not currently recommended. The impact on antibody response is unknown.

In my opinion, you did not ruin your chance at protection, and I do not advise another COVID-19 vaccination at this time. I also do not recommend antibody testing.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

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“I am finishing up a quarantine from testing positive last week (symptoms very mild) for both myself and daughter. My symptoms have all subsided this day 7 of my quarantine. My girlfriend (separate household) just received her first dosage of the Moderna vaccine today. We have planned a weekend getaway for the following weekend. She is concerned about the close proximity of my recovery and our time together and is unsure if the vaccine will give her a ‘boost’ to protect her.”

The answer:

According to documents the company submitted to the FDA, the Moderna vaccine can provide 80% protection 14 days after the first dose, compared to 95% two weeks after the second dose (in people age 18 to 65, and 86% in those over 65).

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“Years ago, I went through fertility treatment and it was discovered I had a high level of NK cells in my blood. Today, I tested positive for COVID. Does this put me at risk for a cytokine storm once my body has gotten control of the virus?”

The answer:

Many COVID-19 complications may be caused by a condition known as cytokine release syndrome or a cytokine storm. This is when an infection triggers your immune system to release inflammatory proteins called cytokines into the bloodstream. These cytokines may begin to attack normal body tissues and damage organs, rather than just fighting off the virus. Cytokine storms are known to occur in other autoimmune diseases.

I cannot predict whether your previous history of high level of natural killer (NK) cells will put you at a higher risk of cytokine storm. Uterine NK cells are different from other peripheral NK cells.

I recommend that you are closely followed up by your physician and consider referral to an immunology specialist.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“I tested positive for COVID-19 on Jan. 5. I am a 73-year-old woman with hypertension as an underlying condition. I retested on Feb. 10 because my dentist requires a negative test before she will replace the filling I lost in my tooth. I called an emergency dental office and they told me the same thing. Do I have any options? I don’t know how long I will continue to test positive.”

The answer:

Sometimes the SARS-CoV-2 (COVID-19) virus is persistent in detectable levels up to 12 weeks or longer after infection, but likely isn’t infectious. The cause of this persistence of detectable virus has yet to be determined.

Your self-isolation should have ended based on the date of your positive viral test, which was Jan. 5.

I suggest you contact your local health department for current local information for dental requirements in your area.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“A close friend received the Regeneron antibody cocktail after developing symptoms from COVID-19 and testing positive. He has had bouts of pneumonia, and his doctor believed he was an ideal candidate, but he had the infusion 12 days after his positive test due to scheduling problems. Was it too late for the infusion to be effective? He had it on Feb. 9 and still has symptoms.”

The answer:

I cannot speculate or comment on your friend’s illness or treatment, and I advise that your friend follow up with his physician.

I will discuss the Regeneron cocktail, which includes two investigational SARS-CoV-2 specific monoclonal antibodies, casirivimab and imdevimab. These monoclonal antibodies received Emergency Use Authorization (EUA) from the FDA for non-hospitalized mild to moderate COVID-19-positive patients. Casirivimab and imdevimab are administered together as a single intravenous infusion to outpatients who are at high risk for progressing to severe COVID-19 and/or hospitalization. The proposed mechanism of action is that these monoclonal antibodies bind to specific viral sites on the spike protein of the SARS-CoV-2 virus and acts as neutralizing antibodies, preventing viral attachment, entry and replication.

The monoclonal antibodies should be administered as soon as possible after a positive SARS-CoV-2 test result and within 10 days of COVID-19 symptom onset. Administration of the antibodies to high-risk outpatients with recently diagnosed mild to moderate COVID-19 reduced viral load and decreased the risk of hospitalization and emergency department visits.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“I am a teacher who received my first vaccine on Jan. 21. I flew to a family funeral and flew home the next day. I found a substitute to teach my classes and I received my second COVID vaccine.

“My question is, should I get a COVID test to return to teach if I wait eight days from my flight, which is five days after receiving my second vaccine?”

The answer:

If your state and/or school district requires testing after travel, it is OK to get a viral test eight days after travel (which is five days after receiving your second COVID-19 vaccine injection).

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“How soon after recovering from shingles can you have a COVID-19 vaccination?”

The answer:

When your shingles rash has no blisters, wait two weeks before you get a COVID-19 vaccine.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“I had no side effects from the second vaccine as most people have had. Does this mean it may possibly have not work and I still could get COVID? Really nervous about this.”

The answer:

Thank you for choosing vaccination. The VAERS, Vaccine Adverse Event Reporting System, states that most, 91%, of all people experience mild side effects. That is tiredness, headache and dizziness.

Our immune systems respond to infections by mounting an adaptive response. 

This specific adaptive response is dependent on how severe our symptoms are, how old we are and if we have any underlying medical conditions. After the response occurs, our immune system generates four types of memory cells: helper T-cells (that help the other white blood cells), killer T-cells (that kill cells of our body that are infected), memory B-cells (that make antibodies) and then antibodies (found in the serum of our blood).

Rest assure that your immune system mounted a response and that you are protected.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

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“I received my second dose of Pfizer 14 days ago. My wife has not yet been vaccinated. I am anxious to resume weight work at my gym, which maintains strict protocols. Am I putting my wife at risk if I go to the gym?”

The answer:

Thank you for choosing vaccination. You are doing your part to protect not only yourself but your community.

I understand the desire to return to normal activities. The question of vaccinated individuals being able to transmit virus is still being determined. Studies done in Rhesus Macaques showed that vaccinated monkeys had very low levels of virus in their nasal passage upon full vaccination (14 days after the second dose). This means that transmission after vaccination is unlikely. ref: N Engl J Med 2020; 383:1544-1555DOI: 10.1056/NEJMoa2024671.

For now, the recommendation is to wear masks when in public and practice physical distance for all. We all must determine what level of risk we are comfortable with. I suggest that you speak with your spouse and talk about how you will mitigate the risk at the gym. Discuss the protocols and determine as a couple what you are comfortable with.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

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“My parents, ages 83 and 85, will get their second vaccines soon. I’m worried about side effects. My question is twofold: Can you tell me the percentage of people who have side effects from the second dose (praying they only have a sore arm like they did after first shot), and, secondly, do you think my parents should be vaccinated on different days?”

The answer:

Thank you for choosing vaccination for your family.

The CDC has a Vaccine Adverse Event Reporting System; this system collects data on all vaccinations and any issues are reported by health-care workers. As of last week, the report showed low rates of serious side effects, something that corroborates data from the clinical trials.

Most, 91%, of the side effects are dizziness, tiredness and headache. Few saw anaphylaxes, for a rate of 4.5 people per million doses. This has prompted an advisory for those allergic to PEG, polyethylene glycol or polysorbate, to not be vaccinated with the currently approved vaccines.

Approximately 14 million doses have been given and 113 deaths were reported. 

Please keep in mind that these deaths have not been attributed to the vaccine yet. I know it is difficult to think about, but we do have deaths every day. These deaths may have been from other causes and simply occurred within the week of their vaccination.

Please know that these vaccines have had significant, comprehensive, safety evaluations like no other vaccine in infectious disease history. I trust the science and worked to get my mother, father, aunt and uncle vaccinated (they reported fatigue from the second shot).

As for your question about getting vaccinated on separate days, that is a family choice. Most individuals are very tired after the second dose.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If I have been tested for 1gG antibodies after COVID, can I be around someone who does not live with me who also had COVID and has been tested for 1gG antibodies and not wear my mask?”

The answer:

In general, a positive IgG antibody test is presumed to mean a person has been infected with SARS-CoV-2, the virus that causes COVID-19, at some point in the past.

It is unclear at this time if a positive IgG infers immunity against future COVID-19 infection.

Therefore, yes — you should wear a mask and practice social distancing when with someone who does not live with you.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Both my husband and I tested positive for COVID-19 on Feb. 6. My symptoms were mild to nonexistent. I had received my first vaccination and was scheduled for second vaccine on the 10th. My husband, not vaccinated, has experienced mild to moderate symptoms, primarily dry cough, up and down temperature and persistent nausea. However, he has experienced dizziness and the sensation of fainting when he gets up. It seems to accompany the periods of nausea. Is this worrisome? 

“He is eating and keeping hydrated. He is resting most of the time. His pulse and blood pressure are normal for a healthy 65-year-old. He takes no other medication. He has no heart or lung issues.”

The answer:

Nausea and dizziness are not uncommon with COVID-19 illness. A sudden drop in blood pressure, dehydration and getting up too quickly can all cause dizziness. An early study from China found dizziness to be the most common neurological manifestation of COVID-19. While it’s clear that COVID-19 can cause dizziness, it’s not entirely clear why. It’s possible that an autoimmune problem is triggered by the COVID-19 infection.

It’s important for your husband to be evaluated by his primary care physician or a neurologist to make sure the dizziness is not caused by another health problem.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“I am in a health care facility. I have had both vaccinations and I tested positive and then I got the rapid test and it was negative. Do I still have to be isolated because previously I been tested about 50 times and this is the first time positive then the rapid was negative?”

The answer:

I’m assuming you tested positive with a molecular Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). SARS antigen (rapid) tests are known to be less sensitive than molecular PCR tests that detect viral nucleic acids. A negative rapid antigen test result does not rule out COVID-19 infection.

The Pfizer and Moderna COVID-19 vaccines are both excellent and are 94 to 95% effective, but there is a 5% risk of infection.

Considering all of the above and the fact that you are in a health care facility, I do recommend you self-isolate for 10 days if you are not immunocompromised, and 20 days if you are immunocompromised.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“I have signed up to get my COVID-19 vaccine in three days. I just had a tooth pulled using laughing gas and a few shots. 

“I will not take any Advil on the day I receive the shot or after that. Is it OK to have the vaccine?”

The answer:

Yes.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I already had COVID-19 and received the vaccine as well, can I be an asymptomatic carrier of the virus and transmit to another human being?”

The answer:

Thank you for your question. I realize that the science around whether someone who is vaccinated can transmit the virus to others unknowingly can be confusing. The mRNA vaccine is called a genomic vaccine. It uses the mRNA to make a protein. Like using a blueprint to build a building.

The mRNA used in both approved vaccines was recovered from the SARS-CoV-2 virus that was circulating at the beginning of the pandemic. mRNA viruses have a specific, mathematical, rate of mutation. Variants were always expected. This is known.

So, when the mRNA in the Pfizer or Moderna vaccines is injected into someone, it will stimulate the body to make the viral spike protein from the beginning of the pandemic. Again, normal. Our bodies take that protein, and our immune system will generate antibodies to that protein. Each section of that protein will have an antibody that can bind to it.

The mutations that have occurred in the UK, South African and Brazilian variants all occurred in the spike proteins. Some of the protein is the same, some is different in the variants. Think of it like you having long, curly hair one day and then cutting it the next. Some of your hair is the same in both cases.

Antibodies generated from the vaccine will provide some protection for the variants.

The goal of vaccination is always stop clinical infection. In some cases, stopping clinical infection stops transmission (such as with bacterial vaccines). With viruses, it is sometimes not possible to stop all cells from being infected (because they are so small 80nm or less and individuals may be exposed to varying amounts of the virus during exposure). Think of it like you trying to find Waldo in a sea of red and white shirts. It becomes hard to find just Waldo. That is what your immune system does every time you are exposed to something, try to find Waldo.

The goal of these mRNA vaccines was never to stop transmission, that is why we all still have to wear masks; it was simply to keep people from getting clinical symptoms that put them in the hospital.

To that end, choosing vaccination will reduce your likelihood of being hospitalized if you are infected with one of the variants. This was the goal, and it was accomplished.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

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“My husband and I tested positive for COVID in August. We both ran fevers, a little nausea and we didn’t go out for two weeks. We notified all of our neighbors, family and we stayed in for 14 days. Do we still need to take the vaccine?”

The answer:

Yes, you and your husband should both be vaccinated regardless of whether you already had COVID-19. That’s because experts do not yet know how long you are protected from getting infected again after recovering from COVID-19.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I have not had COVID-19, no symptoms, and I’m careful about where my family and I go and always wear a mask. Do I need a vaccine shot?”

The answer:

Yes, is the short answer.

This virus is continually changing (all of the variants you may be hearing about) and a vaccine will prevent you from having severe disease. That means it will keep you out of the hospital. In addition, vaccination will increase the immunity of our community (herd immunity).

When you choose vaccination, you are helping those in our community who cannot get vaccinated due to cancer or other illness.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If you do not have a reaction after the second dose of Moderna, does that mean that if you had caught the virus earlier you would have been an asymptomatic carrier?”

The answer:

What a great question. Every person will respond a bit differently to the vaccine. The vaccine is designed to display the SARS-CoV-2 virus to your immune system before you get exposed from someone.

After vaccination, our immune system generates four types of memory cells: helper T-cells (that help the other white blood cells), killer T-cells (that kill cells of our body that are infected), memory B-cells (that make antibodies), and then antibodies (found in the serum of our blood).

For some of us, we will have swollen lymph nodes in our arm pit region and be very tired; others will experience no symptoms at all. In all cases, the immune system is responding.

Even though you did not have a particularly discomforting experience, you can rest assured that your immune system is working to protect you from SARS-CoV-2.

Science still isn’t sure about how much virus a vaccinated person may have in their noses. 

The vaccine will protect against clinical infection (symptoms); however, it may not protect against what we call viral shedding. This is when a vaccinated person has a small amount of viral replication going on in their noses. This means you may be able to spread it to others. That is why I urge you to continue to wear your mask, even after vaccination.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My mother is 83 years old and had COVID the week between Christmas and New Year’s. She has now tested positive for the antibodies. Can she go ahead and get the vaccine or should she wait, and if so, how long? We can’t seem to get any clarification on this and she has an appointment to get the shot but we don’t know if she should.”

The answer:

It is unclear at this time if positive IgG antibodies infers immunity against future COVID-19 infection.

If your mother was treated for COVID-19 symptoms with monoclonal antibodies or convalescent plasma, she should wait 90 days before getting a COVID-19 vaccine.

If she was not treated with monoclonal antibodies or convalescent plasma, she can be vaccinated now in my opinion.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

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“I had my first Moderna vaccine on Jan. 28. I just found out I was exposed on Feb. 14. I’m to receive my second vaccine on Feb. 28. Getting tested for COVID. If I test positive, am I able to get vaccine?”

The answer:

Thank you for choosing vaccination.

Vaccination recommendations for those who have been exposed to SARS-CoV-2 but not symptomatic are able to continue with vaccination. If you become symptomatic, you will need to delay your vaccination until you are no longer symptomatic.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband has coronavirus and pneumonia now. He’s in the hospital, 15 days on a ventilator, and nurses say they’re giving him all kind of antibiotics for treatment. What will cure him of this terrible sickness? I want him to live.”

The answer:

I don’t know the details of your husband’s current treatments. I’m assuming his physicians are doing everything possible, however there is no known cure at this time.

You didn’t mention if your husband is being treated at a university medical center. If not, I suggest you discuss with his physicians transferring him to a university medical center.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“I took my husband to the ER because he was feeling weak and he has a low red blood cell count. He was having trouble breathing and a COVID-19 test came back positive, and he was admitted to the hospital. He was two weeks out from his second Pfizer vaccination. He was put on Remdesivir and IV steroids. I have no symptoms and my COVID test results are not back yet. I am scheduled for my second Moderna vaccine. Is it safe for me to go ahead with my vaccine?”

The answer:

I hope your husband is doing well and I thank you for choosing vaccination.

Vaccination recommendations for those who have been exposed to SARS-CoV-2 but not symptomatic are able to continue with vaccination. If you become symptomatic, you will need to delay your vaccination until you are no longer symptomatic.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband and I have both been fully vaccinated. I have no underlying conditions and he has heart disease with previous heart attack, triple bypass, pacemaker/defibrillator. It was 23 years ago. His condition is very stable and he’s a very active 68-year-old. We live in a community with very low spread, but always practice good hygiene. I will be flying to Florida to visit family next month, a two-hour nonstop flight. I have an N95 mask that I will wear on the flight, covered with a cloth mask. My sister will be there, who is also fully vaccinated. Her grown daughter, son-in-law, and three grandchildren – ages 12, 9 and 1 – will also be there. I’d like to know if I should mask in their home? I will not be going to any stores, bars or restaurants. We will be traveling to stay two nights in a hotel on the beach. 

“When I return home, again double-masking, do I need to quarantine from my husband, since he is fully vaccinated as well? I’m trying to be safe for all involved and wondering if you could give me some advice.”

The answer:

The CDC recommends that you do not travel at this time. All travel deemed unnecessary is strongly discouraged.

If you must travel, wear a mask, stay at least 6 feet apart, avoids crowds and wash your hands often.

Concerning whether to quarantine from your husband upon your return, my opinion is yes considering his significant cardiac history. Although the Pfizer and Moderna vaccines are 94% to 95% effective, there is a 5% risk of infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My aunt, diagnosed with COVID-19, and her husband have been around me and my children. Not sure how close he got to the children, but he did not come within 10 feet of me. Should I worry about contact exposure?”

The answer:

There is the possibility of exposure.

Out of an abundance of caution, I recommend you and your children quarantine. Ideally, people should quarantine separately.

Quarantine can end after Day 10 without testing and if no symptoms were reported during daily monitoring. Another option is quarantine may end after Day 7, if viral testing done on Day 7 is negative for you and all the children and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My 86-year-old mother lives in a nursing home. She has tested positive at Thanksgiving, again at Christmas and again Feb. 11, while in the hospital. I never heard of anyone testing positive for that length of time. Is this normal?

“Is she still contagious? Could she just be carrying the antibodies? She’s had no symptoms at all this whole entire time that she’s tested positive.”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks or longer after infection, but likely isn’t infectious. The cause of this persistence of detectable virus has yet to be determined.

When viral isolation in tissue culture has been attempted in such persons, live virus has not been isolated. There is no evidence to date that clinically recovered persons with persistent or recurrent detection of viral RNA have transmitted SARS-CoV-2 (COVID-19) to others. Despite these observations, it’s not possible to conclude that all persons with persistent or recurrent detection of SARS-CoV-2 (COVID-19) RNA are no longer infectious.

In general, a positive IgG antibody test is presumed to mean a person has been infected with SARS-CoV-2, the virus that causes COVID-19, at some point in the past.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My brother had COVID-19 in December and is in acute care, still recovering. My question is, he has his own bathroom at home. Is it still contaminated if no one has gone in since then? Also, do germs last in the refrigerator?”

The answer:

SARS-CoV-2, the virus that causes COVID-19, can survive on surfaces, but not for this long. The bathroom is likely safe to enter.

Your questions about germs is more complicated. There are many types of pathogens: bacteria, viruses, helminths, fungus, protists and prions. Most pathogens are unable to survive in cold temperatures, but the refrigerator does not make it cold enough to kill them. So, the answer is, yes, they can survive in the refrigerator.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Thank you for such a wonderful service. 

“I am currently in India and traveling to the UK to join the health service. I want to take the first dose of Covishield as it would protect me against catching infection while traveling. I also have to produce a negative COVID test to board the flight to reach UK. 

“My question is, if I take Covishield vaccine and then take a swab test, will it be positive? After taking the Covishield first dose here, can I take Pfizer (both doses) after reaching the UK? As a common practice, health workers are given Pfizer vaccine there.”

The answer:

Covishield is made from a weakened version of the adenovirus that causes the common cold. 

This type of vaccine is called viral vector vaccine. It uses the adenovirus as the delivery system (the way for the genomic material of SARS-CoV-2 to get into our cells) and it removes the parts of the virus that will make you ill. Instead, it adds the mRNA of SARS-CoV-2 to the adenovirus. 

Think of it like the SARS-CoV-2 genome living in a different housing. That will allow the immune system to see a weakened version of COVID-19 and begin to mount a response to it.

You will not test positive for COVID-19 with a genome test after getting the Covishield vaccine. A swab test occurs by sampling your nose. The vaccine is injected into your arm. There will not be virus in your respiratory tract to detect.

I am not aware of any scientific data regarding vaccination with both Covidshield and any of the mRNA vaccines.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I’m due for my second dose of Moderna on March 4 and scheduled to leave the country on March 7, and I have to get a negative result on a test at least carried out on March 5. I am keeping very safe without any social gatherings and never had any symptoms of COVID or flu. If I’m not infected in the meantime, can my result show positive due to the vaccination?”

The answer:

Thank you for your question. I know this is difficult. 

The Moderna vaccine is given in the arm and is the mRNA or blueprint for the spike protein of SARS-CoV-2 the virus that causes COVID-19. The tests that are given for COVID-19 use a nasal swab. 

Since there is no virus in the vaccine, there will be no ability for the mRNA given in the vaccine to copy itself. Instead, our bodies will make proteins out of the mRNA.

Your test will not be positive if it is a genome test after vaccination.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I received one dose of the Moderna vaccine a month ago. I just tested my antibodies and I am negative. Why? Shouldn’t I have some antibodies after one dose?”

The answer:

I can understand how these results can be confusing. 

Our immune systems respond to infections by mounting an adaptive response. This specific adaptive response is dependent on how severe our symptoms are, how old we are and if we have any underlying medical conditions. After the response occurs, our immune system generates four types of memory cells: helper T-cells that help the other white blood cells, killer T-cells that kill cells of our body that are infected, memory B-cells that make antibodies, and then antibodies, which are found in the serum of our blood.

Some individuals will have high levels of antibodies, while some will have high levels of other cells, and still some will have those cells go into a hibernation state. They will remain in the blood, but don’t activate until you see the pathogen again.

I would not be concerned about the low level of antibodies. This is normal. You have the other levels of protection, and those memory B cells will come out of hibernation when/if you are exposed again.

If you were vaccinated and had a natural infection with SARS-CoV-2, you certainly have made memory cells. They are just waiting until they are needed to activate again.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I don’t drive. My ride scheduled her vaccine for Feb. 17 and mine is Feb. 18. Can I ride with her on Feb. 17?”

The answer:

You may have to check with your vaccine provider and see if they have enough doses for you. It isn’t a problem to change the vaccine to a later time, but it is not recommended to receive the second dose early.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife and myself just got over COVID last Wednesday. My question is: When can we get the vaccination? People I know who just got over it are getting a shot soon, and my wife said we have to wait 90 days.”

The answer:

This is a confusing time and so much information is circulating. 

Your question is a good one.

The 90 days is an ask. If you had COVID-19, officials are recommending (because of vaccine supply) that those who had COVID-19 in the past 90 days wait to get vaccinated. However, there is no scientific reason why you need to wait. As long as you are not symptomatic with COVID-19, you can receive the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I had both Pfizer shots and so did my next-door neighbor. It has been two weeks since we both had our second shots. I live alone, and so does she. Can we now visit each other without worry of bringing the virus to each other?”

The answer:

Thank you for your question. 

Since you are both fully vaccinated at this time, you can visit with each other. I recommend that you continue to wear your masks when visiting anyone.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My husband and I had COVID in August. We were both tested at different doctor offices. We isolated ourselves for 14 days and notified everyone we had been around. Do we still need to take the vaccine?”

The answer:

Thank you for your question. I know it can be difficult to know what to do. It is recommended that anyone who is eligible receive the vaccine. Our bodies have two ways of developing an immune response: by getting infected naturally or by receiving a vaccine. 

When this happens, we make antibodies to provide protection for the next time we are exposed to that pathogen.

In the case of SARS-CoV-2, the virus that causes COVID-19, we are not sure how long natural immunity will last. 

Some studies say up to eight months, some are reporting less. By choosing vaccination, you are boosting your immune response and providing your body with greater protection. I urge you to get vaccinated even though you had a natural infection.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I had my first Moderna vaccine on Jan. 18. On Jan. 30, my husband had a possible COVID exposure. He took a test and we are awaiting the results. If the test comes back positive, can I still get my second Moderna shot?

“Neither my husband nor I have any symptoms at all.”

The answer:

As long as you are not symptomatic, you can continue with your scheduled vaccine. Persons who are symptomatic should not get vaccinated.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I received the antibody infusion Dec. 2. I went online and got my first vaccine scheduled for this week. Is this OK?”

The answer:

Was the antibody infusion for COVID-19? If so, it could make the vaccine less effective. If the infusion was for something else, then there is no issue with getting the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have a pacemaker. Can I get a COVID-19 vaccine?”

The answer:

Yes.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I tested positive using the SARS Cov-2 RNA, QL, RT, PCR COVID on Jan. 11. My symptoms were chills, sore throat and major head pressure. On Jan. 26, I had the antibodies test and it came back negative. So, did I have COVID? Did I take the antibody test to soon? When is it best to get the antibody test. 

“One article says trust the PCR, another says trust antibody test. The the next says you need both positive. Thank you for any answers or advice you may have.”

The answer:

The reverse transcriptase-polymerase chain reaction (RT—PCR) remains the “gold standard” for clinical diagnostic detection of SARS-CoV-2 (COVID-19). In my opinion, you had COVID-19.

Regarding the negative antibody test, was the blood test for SARS-CoV-2 IgG? If yes, the possibilities include the test was a false negative, or the test was done too early. IgG median detection is

14 days with a range of 10-21 days.

I recommend a repeat blood test for SARS-CoV-2 IgG antibodies at a hospital lab. If the repeat IgG antibody test is negative, perhaps your immune system quickly neutralized the virus and the antibodies didn’t stay long in your body.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had the first Moderna vaccine on Jan. 4. That means I should get the second shot of Moderna soon. However, I will be in Florida. I have been trying to arrange the second shot with several pharmacies in that area of Florida. I’m not having much luck. Most are saying they don’t have it and have no idea when they will. The others are two to three hours away. I am 68, and a caregiver.”

The answer:

Thank you for your question. In the coming days and weeks I am sure others will be experiencing similar issues.

If you are unable to get the Moderna vaccine exactly 28 days after the first dose, you can delay the second shot. The vaccine will still provide protection to you. The 28 days is the earliest you can get the vaccine based on clinical trials. Receiving the second shot a bit later is acceptable.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I got my first COVID shot Friday. No sooner do I get home than my work called and said I came in contact with someone. What should I do?”

The answer:

Vaccination is not likely to be effective for preventing the disease from that exposure. Regarding your history of exposure, I recommend you self-quarantine separately. Your quarantine can end after day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

After your quarantine period has ended, I advise getting the second vaccine injection if you had no symptoms and your viral testing results are negative. Otherwise, contact your physician for further instructions.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had a bad reaction to first dose of Pfizer vaccine 36 hours after my shot. My throat closed up.

“I am indeed a long-time allergy patient (including shell fish and latex). I did seek medical attention and was given steroids to take down swelling. I was told not to get second Pfizer dose.

“Will I be able to get a different vaccine, and is there any guidance around that? Of the potential vaccine options, such as Johnson & Johnson or Oxford, is there an option that would be best for those who had problems with first dose of vaccine?”

The answer:

I truly wish I had an answer for you. The other vaccine candidates you mentioned are still in clinical trials. The data on allergic reactions and the Johnson and Johnson COVID-19 as published in the New England Journal of Medicine in January 2021, said that there were five allergic reactions among all the participants (805).

I urge you to speak with your primary care physician about this issue and wait to seek COVID-19 vaccination.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If I’m vaccinated against COVID and I’m around someone who isn’t, can I take the virus to a third party?”

The answer:

An excellent and clinically relevant question, but unfortunately the answer isn’t known at this time. That’s why it’s very important to continue preventative actions (masking, good hand-washing hygiene, social distancing and avoiding gatherings or crowds) after vaccination.

It’s not known if a vaccinated person who is exposed to SARS-CoV-2 (COVID-19) but not infected can transmit or spread the virus to someone who is not vaccinated. This is also important because of the highly contagious mutations (or variants) that remain a serious threat.

Therefore, it is imperative to continue masking and other preventative actions after being vaccinated.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I took the first dose of the vaccine at work before I went on leave for Christmas, on Dec. 16. Arm was sore but no big deal. That Friday, I started getting chills fever and bad head aches. A week later, I lost taste so I went got tested on Dec. 26 and tested positive. My question is, after taking first dose and getting COVID, could the first dose be less effective? I did take the second shot in the right time after recovering fine.”

The answer:

There are two ways our bodies can develop immunity to an infection. 1. by getting vaccinated and 2. by becoming infected naturally (via exposure). It takes our bodies about 10-14 days to develop the necessary antibodies to provide protection from infection, regardless of how we were exposed.

It is possible to be were exposed and pre-symptomatic when you received the vaccine due to the long incubation period of SARS-CoV-2 (it is 14 days). You should suffer not negative side effects from having the vaccine during your pre-symptomatic phase of infection.

It is important to remember that the first dose of the vaccines are 50% effective at preventing infection and the second doses increase that to 95% or more.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“Received my first COVID vaccination shot today. My son visited last weekend and just informed me he has tested positive. What does that mean for me?”

The answer:

Vaccination following exposure is not likely to be effective for preventing the disease from that exposure.

I advise you to self-quarantine separately. Quarantine can end after day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I am wondering which arm to have the injection given. My left shoulder was replaced two years ago and I have a titanium rod in my arm. Although I am able to use my arm, I do not have 100% use of it – still somewhat stiff and sometimes aches. Sixteen months ago, I was diagnosed with breast cancer in my right breast and had a lumpectomy and also removal of some lymph nodes for testing. I have no pain or residual effects in the right arm.”

The answer:

Often during breast cancer treatment, some or all of the lymph nodes under the arm are removed. When many lymph nodes under the arm have been removed, a woman is at higher risk of lymphedema. Lymphedema may occur after surgery or radiation to the lymph nodes.

Protecting the arm on the side of the surgery is very important after breast surgery. Poor drainage of the lymphatic system can cause that arm to be more at risk for infection. To protect your right arm (side of breast surgery) from infection, ask for injections and blood draws to be done on the left arm. Therefore, my opinion is to get both vaccine injections in your left arm. Your previous left shoulder replacement and titanium rod shouldn’t be a problem for the vaccine injections.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My husband works at a skilled nursing facility and gets tested twice a week using PCR nasal swabs. He also has had both doses of the Pfizer vaccine, with the second dose administered on

Jan. 14. On Jan. 28, he tested positive for the virus, but was and is still showing no symptoms. He tested again on Jan. 31 and the test results came back negative. I also got tested on Jan. 31 and my test was also negative, also with no symptoms.

“We have been isolating away from each other in the house since his positive result, but now that we both have negative tests and no symptoms, should we still isolate separately for the full 10 days? We do not plan to go into public until his quarantine period is over, so it’s more a question of how long we should stay away from each other.

“Thank you for posting so many great questions and answers! There are so many different unique situations, it’s hard to know how to apply CDC guidelines in all cases.”

The answer:

Either your husband’s first PCR test result on Jan. 28 was a false positive, or his second test result on Jan. 31 was a false negative.

Out of an abundance of caution and since he works at a skilled nursing facility, your husband should self-isolate 10 days since the date of his positive PCR test result on Jan. 28.

Your self-quarantine can end either after day 7 if a repeat diagnostic specimen (done on day 7) tests negative and if no symptoms were reported during daily monitoring, or your self-quarantine can end after day 10 without testing and if no symptoms have been reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Do the clear face shields, especially the small ones that go from the chin up to just above the nose meet the mask mandate? I have seen mostly servers in restaurants and cashiers using them.”

The answer:

CDC does not recommend using face shields as a substitute for masks.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I didn’t realize you were suppose to wait

14 days in between vaccines. It was only 8 days from my pneumonia shot to when I received my first COVID shot. What does it mean now?”

The answer:

You should still complete the COVID-19 vaccine series on schedule.

If you received the Pfizer COVID-19 vaccine, the second injection should be given 21 days after the first dose. If you received the Moderna COVID-19 vaccine, the second injection should be given 28 days after the first dose.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My husband’s mother lives in an assisted-living facility that also takes care of dementia patients. The facility is split in half between the two sides. The entire population of dementia patients has tested positive for COVID-19, and approximately one half of the staff have also tested positive. This facility is still allowing visitors to the assisted-living side, as none of them have contracted it. I am afraid for my husband to visit a building that has so many patients who are positive. Would it be wise for him to wait to visit until they finish vaccination? And can he bring this virus home to me? Of the two of us, I have a much weaker immune system because of a disease I have.”

The answer:

I agree that it is best for everyone, including your husband’s mother, to wait until all are fully vaccinated. It is also important to continue masking and other preventative actions including good hand-washing hygiene and social distancing after vaccination.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I got my second Pfizer vaccine on Jan. 29.

My husband’s office was exposed the next week, Feb. 1-5. We put him in the basement as soon

as we found out on the 5th. My kids and I are upstairs. 

“None of us have symptoms but I am a dental hygienist and I am supposed to work. Is that

OK? 

“Do you think the vaccine had enough time to work? We all are getting tested Monday.”

The answer:

The Pfizer vaccine is 95% effective two weeks after the second injection. Out of an abundance of caution, I advise you and the children to self-quarantine. Ideally, people should quarantine separately.

Quarantine for you and the children can end after day 7 if a diagnostic specimen (done on day 7, February 12) tests negative and if no symptoms were reported during daily monitoring. Obviously, I advise you not to work while in quarantine.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“I had symptom onset Dec. 28 and recovered after a mild case. I’m now on Day 40. Yesterday, I helped a friend with diabetes complications and she had to go to hospital for these issues. Upon arrival, they tested her and she received a positive test. Should I be concerned of reinfection or at least carrying the virus to others again?”

The answer:

I hope you were wearing a mask.

Reinfection is uncommon within 90 days following initial infection. Out of an abundance of caution, I recommend you self-quarantine separately. 

Your quarantine can end after day 10 without testing and if no symptoms have been reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Today I received my first COVID vaccine, but when the pharmacist injected it he squeezed my arm. Now I’m worried that I won’t be covered. Is this true?”

The answer:

If the COVID-19 vaccine was properly injected, I don’t believe squeezing the arm will have any adverse effects.

I advise getting the second injection as recommended, in 21 days for Pfizer vaccine or 28 days for Moderna vaccine.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have my COVID-19 test result and came out positive? I have my first Moderna vaccine Jan. 15. I don’t understand why I get positive as of Feb. 9 but I don’t have any symptoms. Feb. 4, I went to the hospital to visit a friend thats the day I suspected I have been exposed. Should I get another COVID test? Can I get my second vaccine?”

The answer:

If you are not immunocompromised, I recommend you self-isolate at least 10 days since the date of your positive COVID-19 test (Feb. 9). If you are immunocompromised, then at least 20 days of self-isolation is advised.

Recommendations for persons with current COVID-19 or asymptomatic SARS-CoV-2 infection are to defer vaccination in persons with known current COVID-19 infection until the person has recovered from acute illness and no longer requires isolation. It is OK if you have to wait a little longer than the recommended time between the two vaccine doses, and you don’t have to start over again.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I got my first COVID shot on Jan. 11. My second shot is upcoming. I just found out Feb. 7 that I have to quarantine because someone who has no symptoms tested positive. I have no symptoms. Can I still get my second shot? Do I have to start all over?”

The answer:

If your quarantine started Feb. 7, quarantine can end after day 7 if a diagnostic specimen tests negative on day 7 and if no symptoms were reported during daily monitoring.

It is OK if you have to wait a little longer

than the recommended time between the two

vaccine doses, and you don’t have to start over again.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I tested positive for COVID-19 last week but didn’t have any symptoms. What is the earliest that I can get the vaccine?”

The answer:

For persons with current COVID-19 or asymptomatic SARS-CoV-2 infection: Defer vaccination in persons with known current COVID-19 infection until the person has recovered from the acute illness and no longer requires isolation.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“What would happen if one takes the vaccine, not knowing he/she was positive for the virus at the time of the vaccine? Several of my friends who have tested positive had no symptoms when they were tested or in the days and weeks after. They were tested only because family members were ill with the virus. What would happen if someone who was positive for the virus but didn’t know it took the vaccine?”

The answer:

What a good question. There are no risks associated with receiving the vaccination after exposure or infection with SARS-CoV-2.

If someone is symptomatic for any infection, they should not receive any vaccine. However, if they were exposed but not symptomatic, then it is acceptable for those individuals to receive the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am wondering which arm to have the injection given in. My left shoulder was replaced two years ago and I have a titanium rod in my arm. 

“Although I am able to use my arm, I do not have 100% use of it – it is still somewhat stiff and sometimes aches. Sixteen months ago, I was diagnosed with breast cancer in my right breast and had a lumpectomy and also removal of some lymph nodes for testing. I have no pain or residual effects in the right arm.”

The answer:

Often during breast cancer treatment, some or all of the lymph nodes under the arm are removed. When many lymph nodes under the arm have been removed, a woman is at higher risk of lymphedema. Lymphedema may occur after surgery or radiation to the lymph nodes.

Protecting the arm on the side of the surgery is very important after breast surgery. 

Poor drainage of the lymphatic system can cause that arm to be more at risk for infection. To protect your right arm (side of breast surgery) from infection, ask for injections and blood draws to be done on the left arm.

Therefore, my opinion is to get both vaccine injections in your left arm. Your previous left shoulder replacement and titanium rod shouldn’t be a problem for the vaccine injections.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My husband took a job in a New York hospital to help with the COVID-19 outbreak. He will be there for a few weeks and many of his patients are COVID-positive. He will have a test prior to leaving, but will continue home if negative. He is only temporary in this environment, but others deal with this daily. I’m wondering what we need to do when he comes home. We have school-aged children, and have instruction face to face. Do we all need to quarantine?”

The answer:

I’d like to thank your husband for stepping up to help with this global health crisis. 

Those that are helping on the front lines deserve all our respect.

When your spouse is working, he will be wearing personal protective equipment and that will greatly reduce his exposure risk. If he tests negative for the virus, there is no need for you and your family to quarantine.

If it is possible for you to quarantine and you are concerned about the timing of his test relative to exposure on his last day in the hospital, you could have your husband test on the fourth or fifth day he is home. This timeframe will allow for detection of the virus on the last day he worked on the COVID floor, as it may take five to seven days for symptoms to show.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I have a vaccine appointment coming up. I just found out that I had contact with someone who tested positive on Jan. 28. Can I still keep my vaccine appointment?”

The answer:

Yes, and thank you for choosing vaccination. As long as you are not symptomatic at the time of vaccination, you are cleared to received the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My wife and I are both in our 70s. My wife was not feeling well in December. She went to the doctor and he prescribed some medication for pneumonia. She tested positive for COVID-19. 

“She recovered very well within a week. We tried to schedule a vaccine for both of us and they told us we had to wait until March (90-day wait time) for her to take the vaccine. My question is: Can I (husband) schedule my vaccine or do I have to wait 90 days also? What happens if I take the vaccine? I was not tested for COVID-19 since I felt fine. I do not know if I had the virus.”

The answer:

You (husband) can receive your COVID-19 vaccine now. Viral testing for acute or prior infection for the purpose of vaccine decision making is not recommended.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I’m vaccinated for COVID-19 and I’m around someone who isn’t, can I carry the virus to a third party?”

The answer:

An excellent and clinically relevant question, but unfortunately the answer isn’t known at this time. That’s why it’s very important to continue preventative actions (masking, good hand-washing hygiene, social distancing and avoiding gatherings or crowds) after vaccination. 

It’s not known if a vaccinated person who is exposed to SARS-CoV-2 (COVID-19) but not infected can transmit or spread the virus to someone who is not vaccinated. This is also important because of the highly contagious mutations (or variants) that remain a serious threat. 

Therefore, it is imperative to continue masking and other preventative actions after being vaccinated. 

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“My adult son, who does not live with me, was just diagnosed with COVID-19. He is married and has a child. They pulled their child out of school and are quarantining. My question is: My daughter-in-law and granddaughter were at my house two days ago. Should my husband and I be tested? Should we quarantine?”

The answer:

Yes, you and your husband should self-quarantine separately. Your quarantines can end after Day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“Should the second COVID-19 shot go into the arm where the first dose was given? Will giving it in another arm reduce side effects and/or affect the immune response since it will involve a different route and set of lymph nodes?”

The answer:

There is no evidence that giving the second injection in the opposite arm will reduce side effects, affect the immune response or is of any medical benefit.

It’s a personal decision of the person being vaccinated.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • •

“My husband tested positive (antibody test) after coming back from an international trip (with no symptoms). I tested negative and we quarantined 12 days. Do my two daughters, ages 21 and 7, need testing? (No symptoms.)

"Also, I work as a health aide and that family is requiring my whole family to be tested before I can return to work. Is this necessary?”

The answer:

I’m assuming your two daughters live with you and that your daughters also quarantined for 12 days. If that is true, your daughters don’t need testing. Regarding your second question, does the whole family need tested before returning to work – in my opinion, no.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My husband has had non-muscle invasive bladder cancer three times, and is currently undergoing BCG (Bacillus Calmette-Guerin) treatment as a preventative measure. He’s on his second round of BCG treatment and just had his first of three treatments in this round. He’s been offered the Moderna COVID-19 vaccine. 

"Should he take the vaccine now or wait until after he completes the BCG treatments which will be in 2 weeks. If he should wait until after the BCG treatments, how long do you recommend he wait?”

The answer:

Currently, I’m not aware of any information on the co-administration of the COVID-19 Moderna vaccine with BCG (immunotherapy).

In updated guidance citing an increased risk for severe illness among adults with certain medical conditions, CDC says such individuals may receive mRNA COVID-19 vaccine (Pfizer and Moderna) as long as they haven’t had a severe allergic reaction to any of its ingredients. Some experts may advise waiting 14 days after completing the BCG treatments before getting the COVID-19 vaccine.

I’m in favor of receiving the vaccine sooner rather than waiting, although I recommend you also discuss this with your husband’s treating medical oncologist and urologist, who know his medical history best.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’m getting my second dose of the Moderna vaccine this week and in two weeks I’ll be ‘fully covered.’ I work with children (as a therapist) and my daughter has twin babies. 

"We’ve been very careful up until this point, and each time I’ve seen the babies, I’ve had to quarantine and then get a negative test. 

"Once my 44-day period is up and I’m officially covered by the vaccine, should I be able to see the babies? Does it make sense to take a rapid test before going to see them to be sure I’m not spreading COVID even if I’m not sick. Do I still need to quarantine and cancel clients before seeing them?”

The answer:

Thank you for choosing vaccination.

Since we are not yet sure if those that are vaccinated are able to transmit SARS-CoV-2 to others. It would be in your best interest to wear a mask when with other individuals, practice social distancing when with those not in your pod, and wash your hands regularly.

In my opinion, you do not need to quarantine before a visit once fully vaccinated, but you should have that discussion with your family and determine how everyone feels about your visiting. 

Keep in mind that each person has their own level of comfort with the risk of exposure.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“There are four of us living in the same household and all have been very careful, following COVID precautions outside of the home, but we are a close family and always kiss hello and goodbye, good morning and goodnight.

“On Jan. 29, our 27-year-old daughter, who works with the public in retail, began with symptoms. She was tested, and we are waiting for results, but I’m 98% sure she is positive. She also has moderately controlled asthma.

“1. I am a RN in an ambulatory care setting and have received my second Pfizer COVID vaccines. My second one was on

Jan. 8. Do I need to quarantine from work and if so, for how long?

“2. My husband also works in health care, in administration. He is due to receive his second Moderna vaccine on Feb. 2. Does he need to quarantine from work and if so, for how long?

“3. We have a house cleaner who came on Jan. 29 to clean. She wore a mask and gloves the whole time in our house. Do we need to notify our cleaning person, and what should we advise her?

“4. We also have another adult daughter who is disabled. She dog-sits Monday through Friday, taking Access, a government-sponsored transportation for those unable to drive or use public transport. Does our disabled daughter need to quarantine at home, and if so, for how long? Also, do we need to notify the dog owner and the transport company that she has been exposed, or only if she becomes either symptomatic or positive?

“5. Our family dog sleeps with our 27-year-old daughter.”

The answer:

1. The Pfizer vaccine is 95% effective which is excellent, but there is a 5% chance you can get infected. Out of an abundance of caution, I recommend you self-quarantine separately pending your daughter’s test results. If she tests positive, your quarantine can end after Day 7 if your diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

2. Your husband is a household contact, and he should also self-quarantine separately pending the daughter’s results. If the daughter tests positive, his quarantine can end after Day 7 if his diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

3. In my opinion, yes you should notify her and that would be good stewardship. If the house cleaner was not a close contact of your daughter, then she does not need to self-quarantine. 

A close contact is defined as being within 6 feet for 15 minutes or more, or being directly exposed to respiratory secretions (cough or sneeze).

4. If your disabled daughter was a close contact, then she should also self-quarantine separately pending the other daughter’s test result. If the 27-year-old daughter tests positive, the disabled daughter’s quarantine can end after Day 7 if her diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

I would notify them if the disabled daughter tests positive.

5. According to the CDC, a small number of pet cats and dogs have been reported to be infected with SARS-CoV-2 (COVID-19). Most of these pets became sick after contact with people with COVID-19. Isolate the dog from the daughter. 

Contact a veterinarian if the dog develops signs of SARS-CoV-2 (COVID-19) infection – which may include fever, coughing, difficulty breathing, lethargy, sneezing, nasal discharge, ocular discharge, vomiting or diarrhea.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If a patient had passed away two weeks ago and they do a nasal swab, will it still be detected in the body, or won’t it show up anymore?”

The answer:

For suspected COVID-19 cases, CDC recommends collecting and testing postmortem nasopharyngeal (NP) swab specimen. Reverse transcription-polymerase chain reaction (RT-PCR) remains the “gold standard“ for clinical diagnostic detection of SARS-CoV-2 (COVID-19).

I’m not aware of any autopsy studies that performed NP swab tests two weeks postmortem. 

However, clinical studies involving patients infected with SARS-CoV-2 (COVID-19) have shown negative NP swab (RT-PCR) in the late or recovery stages of infection, but sometimes the virus is persistent in detectable levels up to 12 weeks after infection.

So, getting back to your question, it’s a 50-50 chance.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have four married children and five grandchildren. If all adults get vaccinated, is it safe to vacation together this August?”

The answer:

Planning something to look forward to in times like these keep us going. I can understand your desire to be together after being apart for so long.

Two weeks after the second dose of either the Pfizer or Moderna mRNA vaccine will make vaccinated individuals 95% protected. Hopefully, many will choose vaccination and we will have about 80% of individuals in the United States protected by the vaccine by the fall.

Children who have reached puberty (10-plus) are likely to have high viral loads but not be symptomatic or have mild symptoms. You didn’t mention how old your grandchildren are. However, if the adults are vaccinated, they will be protected, but the kids may still infect each other.

Risk is involved in all our choices. I suggest you discuss the idea with each family and decide if you are all comfortable with the risk-level. If you are vaccinated and wear a mask in public, your risk is low.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“We are scheduled to receive our second dose of the Pfizer vaccine in 31 days, rather than the recommended 21 days. Should we be concerned that the expected efficacy might be diminished?”

The answer:

What a great question. I can understand why one would be worried about timing of the vaccines.

The 21 days for Pfizer and the 28 days for Moderna are the earliest that you can get the vaccine. 

These timelines came about because of the clinical trials. 

Individuals cannot receive the second dose of the vaccine earlier because it does not provide a sufficient level of protection against infection. Delaying the vaccine, either one for a second dose is acceptable. A few weeks will not affect the efficacy.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I am 58 and received my second shot on Jan. 29. On Saturday, I had lunch with my son and grandson, who both had sniffles. My grandson spent the night. He’s 4, and we snuggled a lot. On Sunday, my son called to say he couldn’t taste or smell. He went to be tested and will likely be positive. My question: I went to work Monday, but am I a potential risk to my co-workers, assuming my grandson is also likely positive?”

The answer:

Thank you for choosing vaccination.

It takes our immune systems about two weeks after the second dose of the mRNA vaccines to provide 95% protection against infection. This means that 5% of individuals who are fully vaccinated may still become sick after exposure to SARS-CoV-2.

If your grandson tests positive, you were exposed. If you do not develop symptoms, then you are not a risk to your co-workers.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If your husband and yourself have the shots for the vaccine, would it be safe to go to a large wedding in two months?”

The answer:

Vaccination will provide protection to you, but it will not provide protection to others you may meet. Having a large gathering now is not a good idea.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“If my wife, an elementary teacher, gets vaccinated for COVID-19 and I don’t, can she bring the virus home with her if she is exposed to it at school.”

The answer:

It is unlikely that your spouse will bring infectious virus home to you after vaccination. Current recommendations are for vaccinated individuals to continue to wear their mask, practice social distancing and wash their hands regularly. With these precautions in place, there is minimal risk to you from her exposure at work.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“My husband had his first vaccine shot through the VA. He is waiting to get his second shot. I have not had any vaccine yet. My husband was in a vehicle with an unmasked person for two hours yesterday. This person is anti-mask and is out and about every where. Should I stay away from my husband for a period of time?”

The answer:

If the COVID status of the person that was with your husband is unknown, it’s an even chance that the person is contagious.

If your husband received his first COVID vaccine injection two weeks ago, then the vaccine is approximately 50% effective.

Out of an abundance of caution, I advise your husband to self-quarantine separately. His quarantine can end after day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“We are hoping to go to Ireland in July. If I receive the first vaccine in February and the second dose on schedule, will I still be protected from COVID-19 in July and be able to travel outside the U.S.? How long of a duration of time is a person considered protected once vaccinated? Will we all have to be revaccinated every 3 to 6 months?”

The answer:

What a great question!

I wish I had more information to share with you on this topic. We don’t know for certain if people are immune to reinfection after vaccination simply because not enough studies have been done yet.

To learn the answer to that question would require tracking the re-exposure of a significant number of people and determining if they get sick. 

These studies have not been done because the vaccine has only been available since January.

What we do know comes from a study published in the journal Science. This study looked at the cells involved in immune memory. Researcher examined the four cells used in immunologic memory and found that they persisted for 8 months following infection with SARS-CoV-2. It is important to note that the study stopped at 8 months and that immunity may last longer.

If we look at other vaccines, it is possible that immunity may last for years. However, the variant strains must be considered when talking vaccination. Pfizer, Moderna, and the yet approved Johnson and Johnson vaccine all provide some level of protection against the variants seen at present. 

What that means is that vaccinated individuals may get sick, but they will have a milder case of COVID-19 than those that are not vaccinated.

It may be too soon to say whether a trip to Ireland is a good idea. Many in the infectious disease/public health/epidemiology arena are watching for a spring surge.

For now, keep wearing your masks, social distancing and washing your hands.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“I am 83 years old and have known allergies to penicillin, rocephin, sulfa, amoxicillin, vancomycin, erythromycin and drugs ending in -mycin. Also to shell fish and blue cheese. Am I able to get either of the vaccines. I have put my name and request for each of the vaccines. No response as of yet.”

The answer:

Hypersensitivity reactions have been reported with COVID-19 mRNA vaccine, and caution is advised with use of the vaccine in persons with a history of severe allergic reaction (anaphylaxis).

A history of mild allergic reaction to food or oral medications is not a contradiction to using the vaccine.

I recommend you discuss vaccination with your physician, who knows your allergy history best. 

Immediate treatment (including epinephrine) for severe hypersensitivity reactions should be available during vaccine use.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

 

• • • • •

 

“There are a few articles on the internet stating that an ‘NSAID’ should not be taken before receiving the COVID vaccine. I checked the CDC website and this is not mentioned. Also, my wife received the vaccine and this is not mentioned on the fact sheet she received that lists the things to be reported before getting the shot. Do you have any information on this?”

The answer:

NSAIDS, or non-steroidal anti-inflammatory drugs, are designed to suppress the innate immune response. Our bodies have two basic types of immune responses, the innate response (which we are born with) and the adaptive response (that happens after exposure via natural infection or vaccine). For the adaptive response to work best, it needs to have a strong innate response.

Think of it like this, you need to lift lighter weights when starting to train for heavy lifting. 

You work your way up to lifting heavy weights with time and training. The innate response is like those light weights, it helps prepare the adaptive response to do the heavy lifting.

If we take drugs such as NSAIDS, acetaminophen or ibuprofen, they can hinder the innate response. This won’t stop the adaptive response, but it can slow the process of the adaptive response.

If you can handle the minor side effects associated with the vaccine, don’t take any anti-inflammatory drugs.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“I received the first shingles shot. My second shot is due soon. I was also fortunate enough to receive the Moderna vaccine. My second COVID vaccine is scheduled for Feb. 23. Should I get the second shingles shot when it is scheduled, or should I wait to complete the COVID-19 vaccine protocol?”

The answer:

I’m assuming you already received the second shingles (Shingrix) injection. If you had no adverse reaction to either the Shingrix vaccine or the first Moderna COVID injection, I recommend you obtain the second Moderna COVID vaccine injection 28 days after the first Moderna shot.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

 

• • • • •

 

“Can I get a COVID-19 vaccine if I have metal parts inside my body?”

The answer:

Yes.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My wife and I tested positive for COVID in the middle of December and have since recovered. 

“I am a firefighter and have received the first dose of Pfizer vaccine. My second is coming up. 

“If someone in our household would test positive for COVID, would I be able to still get the second dose? I do know that the wife and I are technically immune for up to 90 days as well.”

The answer:

This is a great question and one that I am sure many others have. Current recommendations do not require a negative COVID-19 test to receive the Pfizer or Moderna vaccines. 

However, if you are symptomatic for COVID-19, it is advised that

you wait until your symptoms resolve before you receive the

vaccination.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“My mom, who is 73, has had both shots. My brother wants her to go to his house and babysit his kids. My dad has not been vaccinated yet but he will get his first soon. Three adult people had COVID-19 at my brother’s house in the last month. Can she go as long as she wears a mask and social distance from the kids?”

The answer:

If your mom’s second vaccine injection was two weeks ago or longer, then the vaccine is 94-95% effective. That means there is a 5% chance of infection.

Yes, I recommend your mom continue preventative actions, including masking, social distancing, avoiding gatherings and good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My husband tested positive on Jan. 21. I tested negative. He quarantined to a different house. I tested positive on Jan. 26. Should we continue to live apart or can he come home since we are both positive?”

The answer:

As of Feb. 2, your husband’s self-isolation should have ended if he is not immunocompromised. If he is immunocompromised, then 20 days of self-isolation is recommended from Jan. 21.

Since you tested positive on Jan. 26, your isolation period is 10 days from Jan. 26 if not immunocompromised, and 20 days if you are immunocompromised.

There’s no problem in having multiple people isolate together, as long as, they’re all positive.

Also, reinfection is uncommon within 90 days following initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband is due for bypass surgery on Thursday. He needs to get a virus test two days prior to surgery. Can he get the COVID vaccine before that or should he wait a few weeks after he recovers?”

The answer:

In my opinion, he should get the COVID vaccine as soon as possible.

I also advise your husband to inform his cardiac surgeon.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“I received the Moderna vaccination on Dec. 31. Twelve days later, I took a blood test and tested positive for IgG antibodies. However, I was negative for IgM antibodies. Is it likely that the Moderna created those IgG antibodies, or is it more likely that I had COVID-19 and recovered? I am curious because I had symptoms for two months (September through November) but tested negative for COVID-19 twice during that time period. My doctors could never figure out what was wrong with me and suspected two false negative tests.”

The answer:

The immune response is an elegant one. When we encounter any pathogen for the first time, our bodies mount a specific response to that pathogen by generating IgM antibodies. When we see that same pathogen again, it’s called a sequela (a sequel to the original infection). This time around, the immune response makes IgG antibodies. IgG antibodies are more versatile; they can go into many places in the body (IgM is bigger and can’t fit everywhere.

Since you had IgG antibodies 12 days after the first shot, it is highly likely that your immune system saw the virus before.

It takes seven to 10 days to mount the IgM response the first time, but it only takes two to three days to mount the IgG response for any sequela.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My 83-year-old uncle received a vaccine a week ago and is now in hospital with COVID and pneumonia. Now I am a little concerned about getting vaccinated.”

The answer:

I am sorry to hear about your uncle. I can absolutely guarantee that he did not get the virus from the vaccine.

Both the Pfizer and Moderna vaccines are mRNA vaccines. This means that they use our cell’s own process to make the spike protein of SARS-CoV-2, the virus that causes COVID-19. This spike protein is then broken down by the cell and shown to the cells of the immune system in a process called antigen presentation (think of it like an introduction to the body). The immune system will then mount a response to that spike protein causing the individual to have injection site pain, tiredness and after about a week, a swollen lymph node in the arm pit closest to the injection site.

Since there is no virus in the vaccine, there is no way he could have gotten the virus from the vaccine. What is more likely is he was exposed and pre-symptomatic when he received the vaccine, and due to the long incubation period of SARS-CoV-2 (14 days), he did not show symptoms when he was vaccinated. He was in the pre-symptomatic phase of infection.

Please don’t let this experience cause you to refuse vaccination. Right now, we all need to get vaccinated as soon as possible to stop this pandemic.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

“I received the vaccine on Jan. 26 and then had a test for COVID-19 on Jan. 27 with a positive result on Jan. 28. Will the vaccine still be effective?”

The answer:

Yes, your vaccine will still be effective. It takes our immune system about 14 days after the second dose to provide full protection.

You likely got vaccinated in the presymptomatic phase, when you were contagious but not symptomatic. Your infection status will not change how the vaccine works.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I was unblinded from COVID-19 clinical trial and found I received vaccine and not placebo three months ago. I went for a COVID-19 antibody test just the other day and the test was negative! I am wondering if I can get a T-cell test to see if I am protected by T vs. B cells.

“In January 2020, I had all symptoms of COVID-19 after returning from international travel. I recovered and had a antibody test in May 2020 – also was negative, different test lab different test. Are there people who respond differently to this virus that would account for my still having no measurable B cell-based immune response? The vaccine was successful in early trials at producing titers of high level.”

The answer:

Thank you for volunteering and choosing vaccination.

I can understand how these results can be confusing. Our immune systems respond to infections by mounting an adaptive response. This specific adaptive response is dependent on how severe our symptoms are, how old we are, and if we have any underlying medical conditions. After the response occurs, our immune system generates four types of memory cells: Helper T-cells (that help the other white blood cells), Killer T-cells (that kill cells of our body that are infected), memory B-cells (that make antibodies) and then antibodies (found in the serum of our blood).

Some individuals will have high levels of antibodies, while some will have high levels of other cells, and still some will have those cells go into a hibernation state. 

They will remain in the blood, but don’t activate until you see the pathogen again.

I would not be concerned about the low level of antibodies, this is normal. You have the other levels of protection and those memory B cells will come out of hibernation when/if you are exposed again.

If you were vaccinated and had a natural infection with SARS-CoV-2, you certainly have made memory cells. They are just waiting until they are needed to activate again.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband just tested positive for COVID-19 and is having mild symptoms. I am an ICU COVID nurse, not having any symptoms, and am fully vaccinated (two doses of Pfizer and two weeks out from second dose). I have a few questions: 1. Could I spread the virus to others? 2. Is my potency to spread the virus different from before I was vaccinated when I would be exposed at work without PPE? 3. I guess the big question is, if I’m not symptomatic and am fully vaccinated, is it OK for me to go to the grocery store and to work without risking passing it on to someone (wearing a mask and performing lots of hand washing of course)?

The answer:

The Pfizer vaccine is 95% effective which is excellent, but you have a 5% chance of infection, and you are a close contact of your husband who tested positive. Therefore, I recommend you self-quarantine separately. Your quarantine can end after day 7 if a diagnostic specimen tests negative and if no symptoms have been reported during daily monitoring.

1. The answer is not known at this time. That is why it is important to continue preventative measures, including masking, good hand-washing hygiene, physical distancing as much as possible, and avoiding gatherings.

2. Exposure risk is reduced by adhering to personal protective equipment (PPE) mandates.

3. Yes, but after you completed your quarantine as I discussed above.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My husband was exposed to COVID at work and tested positive. I developed symptoms a few days later and also tested positive. Does my husband have to quarantine 14 days from his test date or start from the onset of my symptoms?”

The answer:

I assume your husband has no symptoms. If that is true and he is not immunocompromised, his self-isolation may end when at least 10 days have passed since the date of his positive test result. If he is immunocompromised, then at least 20 days of self-isolation is recommended since the date of his positive test result.

If you are not immunocompromised, your self-isolation can end when at least 10 days have passed since your symptoms first appeared and at least 24 hours have passed since last fever without the use of fever reducing medications, and your symptoms have improved. If you are immunocompromised, then at least 20 days of self-isolation is recommended.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I just recently went back to work this week after being sick with COVID. My adult son lives with me and he was having some symptoms, so he got tested and got the results on the 20th showing he’s positive. My question is even though I have immunity for a few months hopefully, can I be infecting others at my work since my son now has it?”

The answer:

Regarding yourself:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. However, it is important that you continue preventative actions, including masking, good hand-washing hygiene and social distancing. 

I also recommend the COVID-19 vaccine. Based on clinical trials, vaccination is safe and likely effective in persons with evidence of prior COVID-19 infection.

Regarding your son who now has COVID-19, he should self-isolate for 10 days if he is not immunocompromised, and 20 days if he is immunocompromised.

I advise defer COVID-19 vaccination for him until he has recovered from acute illness and no longer requires isolation. Based on current evidence that reinfection is uncommon within 90 days following initial infection, vaccination may be delayed until near the end of the 90 day period.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“On Jan. 19, I received the first dose of the vaccine, and two days after I took the swab test because we needed it for work. One day later I got the result and tested positive, but I don’t feel anything, so I wanted to make sure. I got tested again at a different hospital, and while waiting for the result, I isolated myself just to make sure I wouldn’t spread the virus if I really have it. After a day, I got the result, and it was negative. I wanted to know, how is this possible? Should I continue to isolate myself? And to make it clear, I don’t feel anything and I got the first dose of the vaccine already.”

The answer:

You didn’t mention the type(s) of tests that were done, e.g., PCR or antigen? There are multiple possibilities and scenarios, and I don’t have enough information to give a definitive answer.

My recommendations include:

• Obtain a swab PCR (molecular Polymerase Chain Reaction) COVID-19 test and continue to self-isolate pending the result.

• Also, obtain blood tests for SARS-CoV-2 IgM and IgG antibodies.

• I advise you to discuss your lab results with your physician and ask for further instructions.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“Thank you for making yourselves available for these questions. They are incredibly helpful and I have learned a lot from them.

“1. I have read up on mixed information about the latent period of the virus. I know that you can be infectious 2-3 days before you even exhibit symptoms, but when someone is first exposed to the virus, does it take time for the virus to replicate and so are you not considered infectious immediately after the exposure? I know that the incubation period is 2-14 days, but how long is the latency period where you are not yet contagious? I assume that it is a very small window.

“2. Although the virus can persist in the body for up to 12 weeks, can we generally assume that you are no longer contagious after 30 days? But I am curious to know, how long is the virus infectious in a hospitalized patient on a ventilator after a full month?

“3. After weeks of getting the first dose of the vaccine (few days before being due for the second dose), I understand that you can still get infected with COVID. Do symptoms typically show quicker in these folks since the body has already seen the mRNA with the vaccine or is the incubation period the same?”

The answer:

Your questions are both interesting and thoughtful.

1. The latency period of COVID-19 infection is the period of time in which newly infected individuals are asymptomatic and non-infectious. Based on mathematical models and projections that I have reviewed, the reported estimated latency period is 6-12 hours.

2. Persons with more severe to critical illness or severely immunocompromised likely remain infectious no longer than 20 days after symptom onset.

Regarding your question how long is the virus infectious in a hospitalized patient on a ventilator after a full month, I don’t have an exact answer. 

Infection is a known risk associated with being on a ventilator. The breathing tube in the airway can allow bacteria and virus to enter the lungs which can lead to pneumonia.

I’ve previously discussed this topic with university medical center specialists who have treated COVID-19 patients with prolonged ventilator support. They have reported variant COVID reinfection based on viral genomic sequencing and cultures (unpublished data).

3. Because the median incubation period of SARS-CoV-2 is 4-5 days, it is unlikely that the first dose of COVID-19 mRNA vaccine would provide an adequate immune response within the incubation period for effective post-exposure prophylaxis.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“Is there any danger having eye surgery on Wednesday and a COVID vaccination on Thursday?”

The answer:

In my opinion, no.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I am an 80-year-old female. I just tested positive for COVID-19. I am quarantining until Feb. 5. 

“I am due to get the first shot of Moderna on Feb. 11 and the second shot on March 11. Does having a positive diagnosis have any effect on me getting the vaccine?”

The answer:

In my opinion, no.

However, based on current evidence that reinfection is uncommon within 90 days following initial infection, vaccination may be delayed until near the end of the 90-day period.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I have lupus, Sjögren’s syndrome, Raynauds, lichen sclerosis, mixed connective tissue disease, hypothyroidism, high blood pressure and am pre-diabetic. I had COVID in November and I had to get two CT scans because they think I may have also had pneumonia at the same time and they are seeing ground glass opacity and some interstitial changes which they are monitoring and want me to return for another CT scan in three months. 

“I just got a flu shot and they have me on an inhaler medication once a day for two weeks to help with cough and breathlessness. When should I get the vaccine? Is there a waiting period after having COVID until you are able to receive the vaccine? Is there a waiting period since I just had the flu shot? They say you can’t get COVID again for three months. Is that actually true? I’m scared to get it again before the vaccine with my current lung issues and auto immune diseases.”

The answer:

Considering your medical history, my opinion is you should get the COVID-19 vaccine now. There is no waiting period with the flu vaccine.

Based on current evidence that reinfection is uncommon within 90 days following initial infection, vaccination may be delayed until near the end of the 90-day period. However, you’re already close to 90 days out, and I personally would not wait any longer.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

  

• • • • •

 

“I just received the first dose of the Pfizer vaccine today (Monday), and I want to see my girlfriend this Friday. The only issue is that she tested positive for COVID last Wednesday. I didn’t see her between the time she was exposed and developed symptoms, and I took several tests to make sure I was negative prior to receiving my first dosage. 

“Will it be safe to see her on Friday, which will be her 10th day of isolation? Or do I need to wait longer? If so, how much longer?”

The answer:

The first dose of both vaccines will provide about 50% protection against acquiring SARS-CoV-2, the virus that causes COVID-19. However, this protection takes about 14 days to develop, that means that few (5% of those vaccinated) may still get sick after exposure.

It takes our bodies about 14 days after the second dose to build up the response to the virus. If you are exposed in that time or even later, it is possible that you could be infected.

You should wait until her quarantine is complete at Day 14.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If three close adult family members in their mid-70s and older are living in one household with no COVID symptoms (other age related difficulties such as asthma, heart disease and RA), is it advisable for all three to get the vaccine on the same day at the same clinic and potentially from the same manufactured batch of vaccine?”

The answer:

Thank you for choosing vaccination. Households do not need to get the vaccine at the same time.

Both the Pfizer and Moderna vaccines are mRNA vaccines. 

This means that they use our cell’s own process to make the spike protein of SARS-CoV-2, the virus that causes COVID-19. This spike protein is then broken down by the cell and shown to the cells of the immune system in a process called antigen presentation (think of it like an introduction to the body). The immune system will then mount a response to that spike protein causing the individual to have injection site pain, tiredness and after about a week, a swollen lymph node in the arm pit closest to the injection site.

Since there is no virus in the vaccine, there will be no natural infection and no possibility of contagiousness. However, it may be easier to schedule the group at the same time. Vaccinated individuals will still need to wear a mask in public and continue to maintain social distance and hand washing. Science does not yet know if a vaccinated individual will be capable of being a carrier for the virus.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My U.S. veteran husband (55 years old) has a valve issue: 30% of his oxygenated blood never leaves his heart. He is awaiting surgery when things are safer. Meanwhile, to protect him, we have been isolated and fully quarantined in our home since March. Weirdly, I have been offered an appointment to get the vaccine next week, whereas he has not (through the VA nor any other).

“My concern is in the 15-minute, indoor waiting period after receiving the vaccine. I have not been indoors anywhere since March in order to prevent airborne exposure. The last thing we want is for me, the healthy partner, to get vaccinated relatively early and be exposed to people and their aerosols, then potentially expose my unfortunate husband. For that reason, I think I will cancel my vaccination appointment until after he has secured his own vaccine. What is your guidance?

“We live in New Mexico where we don’t have access to primary care doctors. After four years of living here, I am still unable to find one due to dearth of resources. So I can’t ‘contact my medical professional’ locally and truly appreciate your help.”

The answer:

Thank you for choosing vaccination.

I would urge you to not cancel your appointment. When you are indoors at the clinic, you will be with others wearing masks and socially distant. Individuals who are symptomatic will not be getting vaccinated. It is possible that someone is in the presymptomatic period, but it you are wearing your mask and they are wearing theirs and you are 6 feet apart, your exposure risk is low. If you want to be abundantly cautious, you can wear a face shield along with your mask to reduce your exposure risk even more.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“I had a positive test on Dec. 27 with a nasal swab. I am now at

Day 22 of recovery with mild symptoms. On Jan. 6, I tested negative at the same place as my positive test. My wife started to feel ill on Jan. 10, and on Jan. 11 she tested negative. Her symptoms continued to get worse, and on Jan. 13 she tested positive. She is recovering with mild symptoms. 

“My question is, can I get the virus again? I am sure that I have antibodies, but I am still really nervous. I don’t want to go through all of this again. We have been in lockdown the whole time. We haven’t seen or gone anywhere since I tested positive.”

The answer:

Based on current evidence, reinfection is uncommon within 90 days following initial infection, but not impossible.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I received my first Pfizer vaccine on Dec. 30 and just got my second dose on Jan. 20. My menstrual cycle is now eight days late as of Jan. 22. Has this been looked into yet? I’m slightly concerned. I’m also experiencing right kidney pain. In the past, I’ve passed one kidney stone in my right kidney, but haven’t had any issues in several years.”

The answer:

There has been an alarming amount of misinformation surrounding the mRNA vaccines for COVID-19 and infertility issues with women. This information began on Twitter with a post that took a section of the document that was used enroll participants in the Pfizer clinical trials. To enroll in clinical trials certain things need to be understood. Women were asked not to get pregnant. This is standard in some clinical trials as they do not know if the treatment will be dangerous to a developing fetus.

Some took this information and created a myth that if women received the mRNA vaccines, they would be infertile. This is not true. If the spike protein caused infertility in women, then we would already see a decrease in the birth rate because the spike protein is a part of the virus. 

Therefore, women of childbearing age who were infected with SARS-CoV-2 would have been affected in the same way this myth is claiming. There has not been a decrease in the birth rate.

As for menstrual cycles, I am not aware of any scientific data that suggests the vaccine will interfere with a female’s menstrual cycle. I urge you to reach out to your gynecologist.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My 90-year-old mother (who is also high risk, aortic valve replacement in January 2020) has had the first round of Moderna vaccine, and may have been exposed to the virus recently. She’s scheduled to receive the second shot in the next 10 to 12 days. She has no symptoms (most likely too soon to have symptoms). Should she be tested prior to receiving the second round vaccine? Also, what side effects should we expect with the second round at her age? We’ve heard they are much worse than the first round.”

The answer:

If your mother has no symptoms, I do not recommend viral testing. 

Considering your mother’s age and medical history, I advise getting the second vaccine injection, but you also should discuss this with your mother’s physician, who knows her medical condition best.

Side-effects after the second vaccine injection may include pain at the injection site, chills, headache, muscle aching and fever.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I work in health care and I am pretty sure I was exposed or had COVID-19. If I find out I do have IGg antibodies, do I still need to get the vaccine? I know that antibodies may only last a few months.”

The answer:

Yes.

Vaccination is safe and likely effective in persons with evidence of prior COVID-19 infection.

Vaccination should be offered to persons regardless of history of symptomatic or asymptomatic infection. 

Viral testing for acute or prior infection for the purpose of vaccine decision making is not recommended.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My parents got their first vaccine and all is well; just sore around the area. Their second shot is due 28 days later. Expecting they would feel flu-like symptoms as reported after the second shot, are they contagious? Not of COVID-19, but the side effects itself. Will I catch their flu/illness?”

The answer:

Thank you for choosing vaccination!

You will not be at risk of becoming sick from individuals experiencing side effects from the vaccine. Those side effects are the individual’s own response to the infection.

There are two ways our bodies can develop immunity to an infection: 1. By getting vaccinated, and 2. By becoming infected naturally (via exposure). 

It takes our bodies about 10-14 days to develop the necessary antibodies to provide protection from infection, regardless of how we were exposed.

If you develop immunity from a vaccine that contains no virus, such as mRNA vaccines, you have no chance of being contagious. You are correct in that vaccinated individuals may experience cold- or flu-like symptoms upon the second dose. This is normal, healthy and good. It means the body is making ready to protect the individual from SARS-CoV-2.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“As a child, I was given the DPT (diphtheria, pertussis and tetanus) vaccine and went into a coma and almost died. Doctors determined that I was allergic to the tetanus shot. Does that have any correlation to the COVID-19 vaccine? I work at a school and I am being urged to get the vaccine.”

The answer:

Serious reactions have been reported after Tdap (tetanus, diphtheria and acellular pertussis) vaccination, including hypersensitivity reaction, anaphylaxis, encephalopathy and seizures. Warnings, precautions and concerns related to COVID-19 vaccine (mRNA) include anaphylaxis and hypersensitivity reactions. 

Instructions include: use the COVID-19 vaccine with caution in persons with history of severe allergic reaction to any other vaccine. I recommend a referral and consultation with either a neurologist, allergist or infectious disease specialist before receiving the COVID-19 vaccine in this individual.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I am a health care provider and receive COVID-19 testing twice a week. The tests are PCR nasal swabs. I was negative Dec. 28, Dec. 30, positive Jan. 5 and negative Jan. 7. No real symptoms – some fatigue beginning of January and some gastro

effects Jan. 10-12. No fever. Received Pfizer vaccine Dec. 27. Scheduled for booster. My question is, was Jan. 5 a false positive

PCR?”

The answer:

Molecular Polymerase Chain Reaction (PCR) tests detect viral nucleic acids (genetic material) from the SARS-CoV-2 (COVID-19) virus, and are very sensitive.

The negative PCR test on Jan. 7 may be a false-negative, or be in the early stage of infection. I would consider blood tests for SARS-CoV-2 IgM and IgG antibodies.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I tested positive for COVID (qPCR test), having congestion and a fever, as well as body aches. Eleven days after my positive test, (which was two days after symptoms), I tested negative (qPCR). Is it possible I had a false positive, as in a cold or flu of some sort was incorrectly identified as COVID? Or did my body clean up the virus quickly?”

The answer:

PCR test results may be negative in the late or recovery stages of COVID-19 infection, or the second PCR test result was a false negative.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“If I am taking an antibiotic for a sinus infection, should I get the COVID vaccine?”

The answer:

Yes.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

 

“My fiance, who lives with me, found out this morning that her boss tested positive for COVID-19. He and she are the only ones in the two-room office, but they are certainly in each other’s face all the time. After she became aware, she took a rapid test and it came back negative. Common sense tells me she should quarantine, but that’s basically impossible here. Should she be taking a rapid test every single day? What are the chances she could become positive in the next couple days even though she tested negative today?”

The answer:

It’s an even chance.

I recommend you and your fiancé self-quarantine separately.

Quarantine can end after day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I want to visit and hold my new granddaughter. She is almost 2 months old. She was born with a minor lung issue and will need surgery in a few weeks. I took a test and the results said not detected. I have been self-isolating for five days now. I will take another test in a week. If I take another test in a week with the same result, am I OK to visit? What is the difference between not detected and negative? If I test not detected or negative, does this mean I could still be a carrier? In other words, does testing detect if you are a carrier but have no symptoms?”

The answer:

I understand your desire to hold your new granddaughter, but the safest action is not visiting now and risk infecting her before lung surgery.

Not detected and negative are interchangeable and mean the same. Different labs may use either term.

Yes, you could test positive, not have symptoms, and be contagious. Also, a negative rapid antigen test result does not rule out COVID-19 infection. 

A negative molecular Polymerase Chain Reaction (PCR) test result is sensitive, but only a snapshot in time. In other words, a negative PCR result today may be positive on another day.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“Hello, I have a question I was unable to find an answer to and I would really appreciate your help. Thank you so much. My boyfriend and I tested positive for COVID-19 on Nov. 26. We recovered completely after a two-week isolation. If we get in contact with someone who has COVID, would we be able to safely go home to family or would we possibly be putting them at risk?”

The answer:

Based on current evidence, reinfection is uncommon within 90 days following initial infection.

However, if you are in close contact with a person in the active phase of COVID-19 infection, you may increase the risk of transmission.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I have a small dental office and my entire staff has been vaccinated. We have been wearing full PPE throughout the day and separating during breaks and lunch. People are having lunches in their own cars. Now that we are all vaccinated, can we resume having lunch together in the break room with the door closed?

“This question extends further – can people begin to socialize more normally if both parties have been fully vaccinated? We realize that masking and social distancing in public will still be needed for quite some time until the number of new COVID cases drops significantly. But private gatherings of people who are fully vaccinated, is that still a problem?”

The answer:

The Pfizer and Moderna vaccines are 94% to 95% effective, but there is a 5% risk of infection. Also, it’s not known at this time if vaccinated people can spread COVID-19 to those who are not vaccinated. Therefore, preventative actions including masking, good hand-washing hygiene and social-distancing are still recommended.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My daughter and her husband have been invited to dinner at the house of a couple who had COVID-19 at the end of October. The couple have recovered with no lingering symptoms. Is it safe to go over and not wear masks? (Only four people total) My daughter and husband have not had COVID.”

The answer:

Based on current evidence, reinfection is uncommon within 90 days following initial infection. However, I recommend preventative actions including masking, good hand-washing and social-distancing.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My mom is 87 and lives in an assisted living facility in Montgomery County. She had COVID-19 and her caretaker had the virus. If I take her out for an indoor gathering with fewer than 10 people to be with her family, upon her return to the assisted living facility, does she have to quarantine in her room for 14 days and set her back into isolation again which brings depression?”

The answer:

Based on Pfizer clinical trials, vaccination is safe and likely effective in persons with evidence of prior COVID-19 infection.

The safest option for your mom is to not attend the indoor gathering.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I was diagnosed with a UTI and started Macrobid that night. The next day, I started having nausea, body aches and slight cough. I also work in health care, so I need to know if I should take a COVID test. I had COVID-19 in the middle of November.”

The answer:

Perhaps your symptoms are side-effects from Macrobid (nitrofurantoin).

Based on current evidence, reinfection is uncommon within 90 days following initial infection. However, I recommend a molecular Polymerase Chain Reaction (PCR) swab COVID-19 test and that you self-quarantine pending the PCR result.

I also advise you to contact your physician as soon as possible for further instructions.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My mom has COVID-19 and she’s a diabetic. 

“Right now, she can’t taste or smell anything and she has no appetite, so has little to no energy. 

“What can I do to help her?”

The answer:

About 25% of recovered COVID-19 patients regain their senses of taste and smell within two weeks of other symptoms resolving.

My recommendations include:

• Contact her physician as soon as possible and ask if she qualifies for COVID-19 monoclonal antibody infusion.

• Request from her physician a dietary consult, home health referral, home physical therapy and home occupational therapy.

• Notify her physician if she is loosing weight, getting worse or appears depressed.

Best wishes for a quick recovery.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I am 73 and my husband is 74 and on chemo for prostate cancer. In late December, I went on a three-day trip with my daughter and son-in-law. 

“We stayed in same hotel and hung around all day and ate and drank together. We did wear masks and gloves when we were outdoors. We came home and after a week, they revisited us again, (having isolated while we were home.) We had dinner and spent several hours watching TV, talking and having cocktails. The next day, my daughter said she and her husband woke up not feeling well, had cold-like symptoms. Son-in-law went to work Monday and Tuesday but on Tuesday his employer sent him to be tested for COVID. He tested positive. My daughter’s symptoms were worse. Her doctor told her she was positive, too, since her husband was positive. My husband and I remained symptom-free, but got tested. I had antigen test and tested negative. My husband had the PCR test and his results were also negative. We never got ill or had symptoms. My doctor finds this hard to believe and other family members do not believe that my daughter and son-in-law really had COVID. The biggest question is why my husband and I didn’t get it after being with them so many times. Can you please offer some kind of explanation?”

The answer:

I don’t have an exact answer.

One possibility is your immune systems neutralized the virus. Another explanation is that not all close contacts get infected.

I know of many couples where one individual was infected, but not the other despite living together and not isolating.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My family (myself, my wife and our 6-year-old son) went home for the holidays. In preparation for our return travel, we went for PCR tests on Jan. 13, but my wife’s result was positive while my own and that of my son were negative. Since the results came out, she has been in isolation in a separate room and she has been without any symptoms for four days now and she is perfectly OK. Is there any explanation why my and son results came back negative? When do you think we should end isolation and go for a repeat test because we must present negative COVID-19 negative results to be able to travel back to our base?”

The answer:

One possible explanation is your and your son’s immune systems neutralized the virus. Another possibility is you and your son tested too early. The incubation period for the SARS-CoV-2 (COVID-2) virus is 2-14 days.

Regarding your wife:

If your wife is not immunocompromised, her isolation may be discontinued when at least 10 days have passed since the date of her positive PCR test. A repeat test for her is not recommended.

Regarding you and your son:

Both of you are close contacts of a person (your wife and your son’s mother) diagnosed with COVID-19. You and your son should quarantine. Ideally, people should quarantine separately. 

You and your son’s quarantine can end after day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I had the first Moderna vaccine on Jan. 4. That means I should get the second shot of Moderna on Feb. 1. However, I will be in Florida at that time. I have been trying to arrange the second shot with several pharmacies in that area of Florida. I’m not having much luck. 

“Most are saying they don’t have it and have no idea when they will. The others are two to three hours away. I am 68, and a caregiver. What can I do?”

The answer:

Thank you for your question. In the coming days and weeks, I am sure others will be experiencing similar issues.

If you are unable to get the Moderna vaccine exactly 28 days after the first dose, you can delay the second shot. The vaccine will still provide protection to you. The 28 days is the earliest you can get the vaccine based on clinical trials. 

Receiving the second shot a bit later is acceptable.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“On Sept. 9, I experienced mild flu-like symptoms which lasted less than 24 hours. I have now tested positive nine times (at Week 1, 2, 3, 4, 6, 8, 13 and 17 following onset of symptoms). 

“No medical professional has been able to give me a reason why I continue to test positive (PCR and rapid tests) and remain symptomatic. During this time, my spouse continues to be asymptomatic and testing negative (PCR). Can your experts offer an explanation?”

The answer:

I appreciate your question and concerns.

It’s known that the SARS-CoV-2 (COVID-19) virus is sometimes persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. However, I’ve not heard or read of persistent positive tests lasting 17 weeks. Are you immunocompromised?

I recommend a referral as soon as possible to an infectious disease specialist at a university medical center. You may need viral cultures, genetic testing and an evaluation of your immune system.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“We are going to visit my daughter at college. She tested positive and was done with her 10-day quarantine seven days ago. 

“She has no symptoms. Now her roommate tested positive. Is there any way that my daughter would be able to spread the virus to us? 

“They have separate rooms and separate bathrooms.”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

I do recommend everyone wear a mask and practice everyday preventative actions including good hand-washing hygiene and distancing.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“I work as an in-home caregiver for a 95-year-old elderly man who contracted the COVID-19 virus from one of his sons who lives in the house with him. I immediately went and got tested on the day they found out they were positive, and I tested negative. I did not go back around the man for 12 days while he was in quarantine. They both quarantined for 12 days. They both were retested a second time. 

“The son got retested 12 days later and was negative. I also retested 12 days later and tested negative again. But the 95-year-old father got retested three weeks later and still tested positive. My question is me being the 95-year-old’s caregiver am I still open to contract the COVID-19 virus from him even though he has been in quarantine for almost a month and it still testing positive? Can I still catch it from him after he’s complted his 14-day quarantine but still has the virus?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

I recommend you get the COVID vaccine. I also advise mask-wearing and good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I played tennis in 44 degrees on Sunday. Tuesday, one of the opponents tested positive. What does that mean for me?”

The answer:

A close contact is defined as being within 6 feet for 15 minutes or more, or being directly exposed to respiratory secretions (cough or sneeze).

If you were a close contact, then I recommend you self-quarantine separately. Quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. The other option is quarantine can end after Day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I get the first vaccine this week, is there any certainty of getting the second one within three weeks, and by the same manufacturer?”

The answer:

What a great question. I can understand why one would be worried about timing of the vaccines.

The 21 days for Pfizer and the 28 days Moderna are the earliest that you can get the vaccine. 

These timelines came about because of the clinical trials. 

Individuals cannot receive the second dose of the vaccine earlier because it does not provide a sufficient level of protection against infection. Delaying the vaccine, either one for a second dose, is acceptable.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My niece has COVID-19, as does her boyfriend. Can they see each other? I’m a concerned auntie.”

The answer:

As a general rule, people should self-isolate to their own home, and also in a private room.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I have a question about the COVID vaccine. After taking it my dad got sick and his symptoms are just like the virus itself. Could we get infected in the house?”

The answer:

Vaccinated individuals can still become infected with SARS-CoV-2, the virus that causes COVID-19. The reason is that the vaccines after both doses are 95% effective at preventing COVID-19 (after one dose they are 50% effective at prevention), that means that few (5% of those vaccinated) may still get sick after exposure.

It takes our bodies about 14 days for the Moderna vaccine and seven days for the Pfizer vaccine after the second dose to build up the response to the virus. If you are exposed in that time or even later, it is possible that you could be infected.

For now, the recommendations are to not assume complete immunity after vaccination. To be abundantly cautious, you should quarantine for at least seven days. Even those who are vaccinated should wear a mask when in public, practice social distancing, and wash their hands regularly.

It is also possible that your father was in the presymptomatic phase of his infection, where he was contagious but not showing symptoms yet before he received the vaccine. Given the incubation period of two to 14 days, he could have been exposed to the virus, and only started to show symptoms after vaccination.

To be abundantly cautious, I’d have him self-isolate until a diagnosis can be provided.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“When can my husband on dialysis get the vaccine? He is 60 years old and has been on dialysis for 12 years. He is in poor health.”

The answer:

Individuals with preexisting conditions such as chronic kidney disease are able to get a COVID vaccine in Phase 1A, now. I urge you to reach out to your doctor or local hospital and find out how they are proceeding with scheduling vaccines.

If you are local to Cambria County, this link will allow you to fill out a questionnaire and Conemaugh Memorial Medical Center will evaluate your application and contact you about receiving your vaccine.(https://www.conemaugh.org/health-information/covid-19-information/covid-19-vaccine-information)

“COVID-19 Vaccine Information – conemaugh.org: We are in the process of distributing COVID-19 vaccines in accordance with prioritization guidance from the Centers for Disease Control and Prevention, the federal government and our state.”

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“If someone turns COVID-positive after he gets the first dose of vaccine, when can he safely get his second dose?”

The answer:

This is a great question and one that I am sure many others have. 

Current recommendations do not require a negative COVID-19 test to receive the Pfizer or Moderna vaccines. However, if you are symptomatic for COVID-19, it is advised that you wait until your symptoms resolve before you receive the vaccination.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My active 78-year-old mother is high risk with multiple health issues. The most recent is that she had autoimmune encephalitis on Oct. 23. She was treated with IV steroids and IVIG. She is still taking 5mg of Prednisone daily. 

“She also had seizures and is on Keppra daily. Additionally, she has CVID and regularly infuses subcutaneously with IGG medication. She has rheumatoid arthritis, kidney disease, diabetes, pulmonary issues, is on blood thinners and two weeks ago started on procrit due to low hemoglobin. She has recovered phenomenally from the encephalitis and now has only minimal short-term memory loss and is active within her household.

“I have checked individually with eight of her doctors who have given her clearance to receive the Moderna vaccine next Tuesday. You answered the question posed about Guillain-Barre and the recommendation was that the person not receive a COVID-19 vaccine. Now that leads me to wonder should my mom receive the vaccine next week? They are both about the immune system attacking the body; in my mom’s case causing brain inflammation.”

The answer:

In updated guidance, CDC recommends that patients who received COVID-19 targeted monoclonal antibodies or convalescent plasma defer vaccination for 90 days, as a precaution in the absence of data. 

However, the agency says COVID-19 vaccines may be given to patients who receive other types of passive antibody treatment not specific to COVID-19.

Also, citing an increased risk for severe illness among adults with certain medical conditions, the CDC says such individuals may receive an mRNA COVID-19 vaccine as long as they haven’t had a severe allergic reaction to any of its ingredients. The guidance covers immunocompromised, autoimmune conditions, Guillain-Barre syndrome and Bell’s palsy.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was vaccinated two weeks ago with Moderna vaccine. The county now states they have no vaccines left. If they don’t get in a supply in two weeks or it goes to vaccinate new people, can I get a Pfizer vaccine as my second dose elsewhere?”

The answer:

Good question. The vaccines are not interchangeable. You will need to get the Moderna vaccine for your second dose. It is OK if you must delay the second dose past the 28 days for the Moderna vaccine. There is no maximum time frame between the first and second doses for either vaccine. So, if the second dose is administered greater than one month after the first Moderna vaccine dose, there is no need to restart the series.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“My daughter was due to have second Moderna vaccine Jan. 19. I had a positive COVID test today, but was negative two days ago by a different clinic. When can she take the second vaccine?”

The answer:

You didn’t mention if your daughter has symptoms now, or if she was previously infected with COVID-19.

I don’t have enough information to make a specific recommendation. Therefore, I advise your daughter to contact her physician as soon as possible for instructions.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“If my husband is 76 and in Phase 1B, can he wait and take the vaccine the same time as me since I am 72 in Phase 1C? Or does he lose his chance.”

The answer:

If you are in a group that is permitted to get the vaccine earlier than someone in your household, you will not lose your place if you choose to get the vaccine at a later time.

I strongly urge individuals to follow the phases set forth by public health officials. These groups were prioritized because of the greater risk to their health based on scientific data. The more people we get vaccinated, the safer we all will be.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • • 

 

“I had a nasal RT-PCR test on Jan. 5, which came back positive on Jan 6. I am asymptomatic. My husband and two grown children (whom we have been eating dinner with every day) had tests on Jan. 7 which came back negative. They also have had no symptoms. My husband and I have been isolating at home in separate rooms since my diagnosis. Should he move out to my daughter’s apartment? I am 62 and he is 82 so we are most concerned about him.

“Also, he is scheduled to receive the vaccine. 

Should he go ahead with the vaccine or reschedule?”

The answer:

Your husband and two grown children should quarantine separately, but your husband does not need to move to your daughter’s apartment.

Vaccination following exposure is not likely to be effective for preventing the disease from that exposure. Persons with known exposure should wait to seek vaccination until after their quarantine period has ended and if no symptoms have been reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • • 

 

“I am a nasopharyngeal cancer patient and was recovered more than six years ago. Can I be administered/receive COVID-19 Pfizer vaccine? Are there any complications?”

The answer:

The side effects associated with the Pfizer vaccine are similar to that of other vaccines, injection site pain, regional lymph node swelling and mild body aches.

I would suggest that you reach out to your physician for questions specific to your health. While I hold a Ph.D. in Infectious Disease Microbiology, each individual speciality within the medical field will have a group of people working to answer questions specific to that discipline.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“My 94-year-old dad was in the hospital for an issue unrelated to COVID-19. His roommate tested positive and days later my dad also tested positive. They released my dad the day after he tested positive since he was showing no symptoms. We were in the car together for 30 minutes. He was in the back seat, me in the front driving – both wearing masks. He lives alone. However, I have to go over there to bring him some meds, some food, but trying not to go often. When I do go, I leave the items right inside the door with no direct contact with him.

“As long as I am not showing any symptoms, I don’t plan on getting tested, since it wouldn’t shorten my quarantine time anyway. I am self-quarantined since the car ride home from the hospital. He will be off quarantine a week before I will. After he is off, is it safe for me to actually spend time with him or do I have to wait until my quarantine is over?”

The answer:

Reinfection is uncommon within 90 days following initial infection. However, since your Dad is 94, I recommend you wait until your quarantine is over.

COVID-19 vaccination may be delayed until your dad no longer requires isolation or until near the end of the 90-day period.

I recommend you and your dad continue preventative measures, including mask-wearing and good hand-washing hygiene.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I received my first Pfizer vaccine. I am scheduled to receive my second vaccine next week. However, I am now in quarantine and will be unable to get my second vaccine as prescribed

21 days after the first. Does this matter if I can’t get it for another 10 days?”

The answer:

Thank you for your question. In the coming days and weeks, I am sure others will be experiencing similar issues.

If you are unable to get the Pfizer vaccine exactly 21 days after the first dose, you can delay the second shot. The vaccine will still provide protection to you. The 21 days is the earliest you can get the vaccine based on clinical trials. Receiving the second shot a bit later is acceptable.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“My wife and I both tested positive for COVID-19 a week ago. According to the CDC guidelines, I can officially end my quarantine period. (10 days since symptoms first appeared and 24 hours with no fever without the use of fever-reducing medications and other symptoms of COVID-19 are improving). However, my wife and I took COVID-19 tests (wife’s work protocol) and she is still positive; I am negative. If her symptoms have greatly improved and I am completely symptom-free, do I have to extend my quarantine period because she is still positive?”

The answer:

No.

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with COVID-19 who are improved after recovery shouldn’t undergo virus testing within

3 months after the date of symptom onset for the initial infection.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“Do I have to have a negative COVID-19 test to receive the vaccine?”

The answer:

This is a great question and one that I am sure many others have. Current recommendations do not require a negative COVID-19 test to receive the Pfizer or Moderna vaccines. However, if you are symptomatic for COVID-19, it is advised that you wait until your symptoms resolve before you receive the vaccination.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“A friend of mine said that when she went to a drive through to get COVID-tested her windshield was marked by one of the attendants. And hers was the only car they did that to. Why did they do that?”

The answer:

Perhaps the attendant was counting, but I don’t know for certain, and I haven’t heard that previously.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My wife is older (78) and in the next tier to get the shot. Can I get the shot when she does? I am younger then my wife. We live in San Jose.”

The answer:

Thank you and yours for choosing vaccination. It is so very important to the health of the public.

I understand the desire to be vaccinated at the same time as someone in your household.

Distribution of the vaccines are being coordinated by the health departments of each state. 

If you are not in a high-risk group, you may not be able to get the vaccine when your wife does. I suggest you reach out to your family physician to learn about vaccine distribution in your area.

The good news is that once we reach about 80% vaccination in the population, the virus will have a harder time spreading in the population as it won’t have any susceptible hosts. Take comfort in knowing our most vulnerable populations are being prioritized.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“I am 64 with rheumatoid arthritis and recently diagnosed also with Felty Syndrome. My husband is 68 with early COPD and recently quit smoking following an emergency laparoscopic cholecystectomy a month and a half ago. Prior to surgery he was tested for COVID-19 and negative. We only go out for medical, hair and dental appointments and wear masks at all times. We use sanitizer and hand-washing protocols. We order food online and it is loaded into the car trunk by store employees with no contact. We sleep in separate rooms because of individual sleeping habits, but are together at various times of the day in close contact.

“Neither of us have had any symptoms. Are we safe to have close contact with each other or should we distance in case we are asymptomatic carriers? Can we be asymptomatic, but one pass it to the other even with precautions we’re taking?”

The answer:

In my opinion, you are safe to have close contact with each other, although anything is possible. I recommend the COVID-19 vaccine for both of you when it is available.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“My husband cannot get the vaccine because he had Gillians-Barre Syndrome. If I get the vaccine will I infect him with COVID-19? Does he need to quarantine from me after I get the shot?”

The answer:

No. Both the Pfizer and Moderna vaccines are mRNA vaccines. This means that they use our cell’s own process to make the spike protein of SARS-CoV-2, the virus that causes COVID-19. This spike protein is then broken down by the cell and shown to the cells of the immune system in a process called antigen presentation (think of it like an introduction to the body). The immune system will then mount a response to that spike protein causing the individual to possibly have injection site pain, tiredness and after about a week a swollen lymph node in the arm pit closest to the injection site.

Since there is no virus in the vaccine, there will be no natural infection and no possibility of contagiousness. When you get the vaccine, you will only be making the protein, not the virus, and that will make it impossible to infect your spouse.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“I am extremely lonely for my granddaughter and her toddler daughter. We are extremely close. I was her labor coach, she has lived with us a couple times in the past. Until the lockdown (California), we have had some visits when our county dropped tiers.

“She is a home health-care worker with one client. If she stays isolated other than work and within her family group, can we visit with each other? We have not spent time with grandchildren. We are missing milestones. I’m 65, my husband is 57. He’s healthy, still working outside house. I’m retired with fibromyalgia.”

The answer:

There is possible exposure risk with your granddaughter’s occupation and your husband’s travel.

I recommend the COVID-19 vaccine when it is available for you, your husband and granddaughter.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I have had the first round of the COVID-19 vaccine. My wife has not. Do I need to wear a mask around her, socially distance from her, and avoid intimacy with her? I am reading that there may be quarantine time associated with getting the vaccine. If so how long? Help.”

The answer:

I can understand the confusion based on all the misinformation circulating. What may be confusing is that info that you will still need to wear a mask after being vaccinated. This is because science doesn’t know if an individual who is vaccinated will be able to be a carrier of the virus. This means we don’t know if they will be able to spread the virus to others without being symptomatic themselves.

More directly to your question, no, since the vaccine is mRNA, a biological molecule that is nucleic acid, and not the SARS-CoV-2 virus there is no way a person with the vaccine can be infectious. The vaccine provides instructions to make a part of the virus, think of it like a blueprint for a building, the instructions are there but no actual virus.

Family units or individuals living together do not need to be vaccinated at the same time. Each state is working on plans for vaccine deployment. I urge you to look at your state health department website for more information on when a vaccine will be available for you.

I know it is difficult to think that you may not get vaccinated and family members will. At this point, it is paramount that we protect those that are working for the common good and those that run the highest risk of complications.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“My doctor gave azithromycin 250 mg tablet for five days and dexaMETHasone 4 mg tablet once a day for seven days for mild symptoms of COVID. 

“I am on day 13 since the positive test results. 

“I was reading on dexamethasone and it said with mild like symptoms it could have a negative result and effect my immune system and results in poor recovery. Is this correct? How do I know if I am out of the woods with COVID? When will I know if I am recovered?”

The answer:

Dexamethasone (corticosteroid) and azithromycin (antibiotic) are for investigational use in COVID-19.

In my opinion, dexamethasone is for hospitalized patients with suspected or confirmed severe COVID-19 requiring supplemental oxygen or mechanical ventilation.

COVID-19 is a virus, and antibiotics do not work against viruses as they only work on bacterial infections. However, some patients may develop a bacterial infection such as pneumonia. In that case, a health-care professional may treat the bacterial infection with an antibiotic.

I recommend you follow up with your physician, who knows more about your medical history, clinical condition, and treatment.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“I am a physician and received both doses of the Pfizer vaccine. Second shot received Jan. 6. 

“My nanny became positive on Jan. 7 and exposed my 2-year-old son. I was never in contact with her without a mask. We have been self-isolating since then. My son had a syncopal event on Jan. 6 and went to the ER. He is supposed to have a neuro appointment on Jan. 12, so I had him tested on Jan. 10. He is otherwise asymptomatic. 

“Unfortunately, he is positive. I tested myself and was negative.

“My question: After the second dose of the vaccine, how long does one need to self-isolate/quarantine in my situation (2-year-old COVID-positive child in the household). Are there new guidelines?”

The answer:

The Pfizer vaccine provides 95% protection

1-2 weeks after the second injection. That’s excellent protection, but not 100%.

Therefore, I recommend you quarantine 10 days if no symptoms have been reported during daily monitoring. Your quarantine can end after day 7 if a repeat diagnostic specimen tests negative and if no symptoms have been reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 

• • • • •

 

“If my husband can get the vaccine and I can’t get mine the same day, am I at risk from him?”

The answer:

No. Since the vaccine is mRNA, a biological molecule that is nucleic acid, and not the SARS-CoV-2 virus, there is no way a person with the vaccine can be infectious. The vaccine provides instructions to make a part of the virus, think of it like a blueprint for a building the instructions are there but no actual virus.

Family units or individuals living together do not need to be vaccinated at the same time. Each state is working on plans for vaccine deployment. I urge you to look at your state health department website for more information on when a vaccine will be available for you.

I know it is difficult to think that you may not get vaccinated and family members will. At this point, it is paramount that we protect those who are working for the common good and those who run the highest risk of complications.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 

• • • • •

 

“Just received my virus test results, which were presumptive positive. What does that mean? Experienced exposure at a post-Christmas family gathering. All adults present (seven) have tested COVID-19 positive and have varying degrees of symptoms. I, too, have had mild symptoms. 

“Can I assume I am positive? Information on my test results directed me to be re tested ASAP. Is that necessary?”

The answer:

In my opinion, a presumptive positive result is when a patient has tested positive by a public health laboratory, but results are pending confirmation at the Centers for Disease Control and Prevention (CDC). For public health purposes, a presumptive positive result using the CDC test is treated as a positive. CDC confirmation of local and state tests for COVID-19 is no longer required.

If you are not immunocompromised, I recommend you self-isolate at least 10 days since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms have improved.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Where is the COVID-19 vaccine in Cambria County? When can we expect the administration of the vaccine into the arms of people 75 and older who are not in nursing homes? What is the delay?”

The answer:

The Pennsylvania Department of Health is working on ways to increase access to the vaccine, including at pharmacies. The state has not yet revealed its strategy for meeting the new guidance for seniors. At this time, I honestly don’t know the exact date when the vaccination of people 75 years and older will begin.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My best friend in Nashville has cancer. I will be going up the third week in February after I quarantine for two weeks. Which would be better for me? 

“The vaccine or quarantining?”

The answer:

Both quarantining for two weeks and receiving the COVID-19 vaccine are advisable.

You should receive both doses of either the Pfizer or Moderna vaccine and wait one to two weeks after the second injection to obtain full protection. However, getting the vaccine may not prevent you from spreading the coronavirus. Therefore mask-wearing, social distancing and good hand-washing hygiene are still recommended for those who are vaccinated against coronavirus.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“If I had vaccined (both doses), but was exposed to COVID, do I still need to quarantine?”

The answer:

Vaccinated individuals can still become infected with SARS-CoV-2, the virus that causes COVID-19. 

The reason is that the vaccines are 95% effective at preventing COVID-19, that means that few (5% of those vaccinated) may still get sick after exposure.

It takes our bodies about 14 days for the Moderna vaccine and seven days for the Pfizer vaccine after the second dose to build up the response to the virus. If you are exposed in that time or even later, it is possible that you could be infected.

For now, the recommendations are to not assume complete immunity after vaccination. To be abundantly cautious, you should quarantine for at least seven days. Even those who are vaccinated should wear a mask when in public, practice social distancing and wash their hands regularly.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“After receiving my second vaccine and a family member gets the virus, do I still have to quarantined since I am vaccinated?”

The answer:

Vaccinated individuals can still become infected with SARS-CoV-2, the virus that causes COVID-19. The reason is that the vaccines are 95% effective at preventing COVID-19, that means that few (5% of those vaccinated) may still get sick after exposure.

It takes our bodies about 14 days for the Moderna vaccine and seven days for the Pfizer vaccine after the second dose to build up the response to the virus. If you are exposed in that time or even later, it is possible that you could be infected.

For now, the recommendations are to not assume complete immunity after vaccination. To be abundantly cautious, you should quarantine for at least seven days. Even those who are vaccinated should wear a mask when in public, practice social distancing and wash their hands regularly.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Can spouses of veterans get their COVID-19 shots at the same time as they do?”

The answer:

The VA is now offering COVID-19 vaccine to these two groups:

• Veterans living in long-term care facilities.

• VA healthcare personnel.

After these two groups, the VA will begin to offer COVID-19 vaccines to more veterans who are at high risk of severe illness from COVID-19.

I recommend you contact the Department of Veterans Affairs regional office in your county, or contact your VA healthcare team.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My husband and I tested positive on Dec. 5. We had mild symptoms. We tested positive again on Dec. 13 (but we’re feeling fine), then on Dec. 19 tested negative. 

“Is it alright to get the vaccine on Jan. 14?”

The answer:

Thank you for your question and choosing to get vaccinated.

Yes, you can receive the vaccine after being infected with SARS-CoV-2 as long as you are not experiencing acute symptoms of the infection.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I work in health care and tested positive for COVID-19. The first dose of vaccines have started and anyone who has tested positive are the last to be vaccinated. 

“Is this right? Is there scientific evidence to back this up? I have heard that you can get the virus twice?”

The answer:

What a great question. The reason individuals who have recovered from COVID-19 are asked to wait to get vaccinated is because your body has mounted an immune response to the virus naturally. There is scientific evidence that this immune response can last for up six months or more. In fact, one recent paper suggest that immunity can last for a few years!

The delay of 90 days is to allow those that have not been infected to mount the same response that you did naturally.

Thank you for your question.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My sons and I hunted outdoors with my brother on Dec. 20. My brother stood by our open truck window and spoke across me to my daughter. On Dec. 22, my brother tested positive for COVID, my son and I both participated in a National Guard Testing on Dec. 23 and both received negative results. On Dec. 28, my son and I both spiked symptoms and subsequently tested positive on Dec. 29. Is it possible that my brother was our direct contact and it took eight days to develop symptoms?”

The answer:

Yes. Symptoms of coronavirus disease (COVID-19) may appear two to 14 days after exposure. This time after exposure and before having symptoms is called the incubation period.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My daughter has had the first Moderna vaccine and is due to get second vaccine dose on Jan. 19. She tested negative for COVID virus two days ago and positive today. Can she receive the immunity injection?”

The answer:

What a great question and one that may also be on the mind of others. It is recommended that individuals who are infected with SARS-CoV-2 in between doses (after the first does of the vaccine but before the second) should wait until their acute symptoms resolve before getting the second dose. This goes for both the Moderna and the Pfizer vaccines.

The first dose of both vaccines will provide about 50% protection against acquiring SARS-CoV-2, the virus that causes COVID-19. So, your question may be relevant for others in the same situation.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My husband rode for 10 minutes in a vehicle with a co-worker on Dec. 29. 

“On Dec. 31, this person tested positive for COVID. Not sure when symptoms appeared. They both had surgical masks on, they had a window cracked. My husband is diligent about hand-washing. 

“He was not made aware of the positive co-worker until Jan. 2, so we (myself and three kids – 13, 10 and 3 months) were around him for those four and a half days. 

“My parents visited twice, he rode in vehicle with my dad, he went to stores and work one day. Once he found out of his exposure on Jan. 2, his work put him off 15 days and he began mask-wearing in our home, slept separate and won’t hold our baby, cleaning extra, etc. He’s getting a test (which seems to me like equal risk for exposure to what he had at work). 

“How cautious should we be in our home since we have already been exposed for days? How worried should my parents be since they visited? If his test is negative, can we be a little less cautious and sleep in the same bed again (our baby sleeps with us)?”

The answer:

If your husband tests negative seven days after his exposure and he reported no symptoms during daily monitoring, then his quarantine can end.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“If one received the first shot of the Pfizer vaccination on Jan. 4, learned he was positive on Jan. 9 after having a PCR test on the 7th as a preventive weekly regimen at work, should there be any issue to prevent taking the second Pfizer vaccination shot around the 25th of January? Does the positive diagnosis pose an issue? Do one’s symptoms affect whether the second shot can be taken? Also, after testing positive, is one still considered contagious after the 14-day quarantine period?”

The answer:

It is recommended that individuals who are infected with SARS-CoV-2 in between doses (after the first does of the vaccine but before the second) should wait until their acute symptoms resolve before getting the second dose. This goes for both the Moderna and the Pfizer vaccines.

The first dose of both vaccines will provide about 50% protection against acquiring SARS-CoV-2, the virus that causes COVID-19. So, your question may be relevant for others in the same

Vaccinated individuals can still become infected with SARS-CoV-2, the virus that causes COVID-19. The reason is that the vaccines are 95% effective at preventing COVID-19, that means that few (5% of those vaccinated) may still get sick after exposure.

It takes our bodies about 14 days for the Moderna vaccine and seven days for the Pfizer vaccine after the second dose to build up the response to the virus. If you are exposed in that time or even later, it is possible that you could be infected.

For now, the recommendations are to not assume complete immunity after vaccination. To be abundantly cautious, you should quarantine for at least seven days. 

Even those who are vaccinated should wear a mask when in public, practice social distancing and wash their hands regularly.

If you quarantine for 14 days and do not develop symptoms, then you are free to end quarantine and safe in the knowledge that your exposure did not cause an infection. If you were isolating, as a result of symptoms or a positive test for COVID-19, and you did so for 14 days, are fever-free for at least 24 hours without medication and your symptoms have improved, then you are safe in the knowledge that you are not contagious.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“My husband received test results that he was COVID positive Nov. 26. He had minimal symptoms, such as a regular cold. I started to feel sick that same day, I tested Nov. 29 with a negative result. My symptoms included chills, fever, sweating and body aches. I continued to have fever and was not getting better and retested Dec. 5, with another negative result. 

“The doctor had checked the X-ray ordered, and it was determined I had pneumonia, and received prescription for an antibiotic. I continued to feel ill for a total of two weeks, first day of feeling better was Dec. 10.

“Fast forward to Dec. 25 and I have been in contact with COVID again. My youngest son tested positive Dec. 31. 

“I, too, tested same day and came back negative again. Is it possible that I didn’t test ‘in time’ the first time or is there a possibility that certain people will just test negative every time? Looking forward to your answer as family and friends are baffled by this.”

The answer:

You didn’t mention the type of tests that were done. There are several possible explanations.

First is false negative results. Negative rapid antigen test results do not rule out COVID-19 infection.

Second, a negative molecular Polymerase Chain Reaction (PCR) result can occur in the early or late stages of COVID-19 infection.

You could consider a blood test for SARS-CoV-2 IgG antibodies. If that blood test is positive, it indicates you were previously infected with COVID-19 in the past, but it doesn’t give an exact date.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I hate to take up your time but I find this question of the utmost importance. 

“I was sick last Thursday, I am a first responder and my agency had me go to the area hospital immediately to get tested. I had the SARS-COV-2 PCR test and it was positive. I have all of the symptoms listed for COVID. My wife has been by my side and is also sick with all of the same symptoms except that she can taste and smell, which I still can not. She just came back from being tested at the local community college that is offering tests. This was the first available date after the holiday that the site was open and she could get tested. They gave her a antigen test which came back negative. How can this be? I am afraid that they may have given her the wrong test and she has asthma. 

“I am very worried about her and this will ease my mind. “

The answer:

You and your wife had different tests. 

Your test was a molecular Polymerase Chain Reaction (PCR), and your wife’s test was a rapid antigen. Negative rapid antigen test results do not rule out COVID-19 infection.

I recommend your wife retest with a swab PCR. I also advise her to quarantine separately pending the results of her PCR test.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“My mom lives with me on a temporary basis. She went to her permanent home (I drove her) where she is the only occupant, several months ago with plans to return to live with me in a few short months. 

“Although we have been practicing the safety protocols as outlined by the CDC or neither of us has had or has COVID-19, with the numbers rising in the state coupled with the new strain that is making its way across the country, is it safe for her to return to live with me right now? I would be driving to get her.”

The answer:

I do not advise travel at this time.

I do recommend COVID-19 vaccination as soon as the vaccine is available.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I’m in Phase 2 with chronic illnesses – three at least – HIV, hepatitis C and liver damage. What do I need to do in order to get the vaccine?”

The answer:

Each state has different COVID-19 vaccine distribution guidelines.

I suggest you contact your local health department for assistance and instructions.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I saw on your website in which questions were being asked regarding to COVID and how certain situations should be handled. I wanted to pose a question from an employer perspective. We had an employee test positive for COVID-19 (via nasal swab) at the end of September. The employee was asymptomatic at the time and never showed any symptoms, but we had this employee

work from home for a period of two weeks.

“This same employee got tested again with a nasal swab in the middle of November because this person was given a reward of some sort for getting tested with a local organization. The test results came back as detected. Does this mean this person is positive for the coronavirus again or is this the same occurrence from two months ago? Also, is this person considered contagious and should we have the employee work from home again? Again, the employee is asymptomatic.”

The answer:

In your question you did not mention the type of test that was done. 

Both the rapid test and the genome test use nasal swabs.

The rapid test is good for detecting positive individuals who are symptomatic. It is less so for those individuals who are asymptomatic. The genome test can detect positive individuals from about three days after exposure and infection until the virus is cleared. The clearance in some individuals can last for a few weeks to months after the infection has resolved.

Think of it this way: If you have a large group of people, 800,000, in a field, it could take a few days to weeks to clean up after them. 

The same thing happens with your immune system. One cell can produce up to 10,000 viruses and many cells become infected in an infection. The clean-up can take time.

Several factors come into play when determining how long the clean-up will take. It is difficult to determine, from your question, if the individual is in the clean-up phase or if they were reinfected.

Data shows that a small percentage, less than 1%, of individuals are reinfected with SARS-CoV-2.

That number may change as new data is collected and more testing is done.

I cannot say for certain what the reason is for a positive test a second time, but the above options are two possibilities.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 • • • • •

“If I get both of my Moderna vaccine injections, and three weeks go by after my second injection, can I safely travel to the Caribbean (Turks and Caicos) and not have to quarantine upon my return? I live in Washington, D.C.”

The answer:

The Moderna vaccine is highly effective at preventing you from getting a symptomatic infection with SARS-CoV-2.

However, science is not yet certain about your ability to transmit the virus to others after vaccination. What I mean is that you will not get sick, but you may make others sick.

You will need to continue to wear masks, maintain social distance and observe quarantine even after vaccination, until such time as science can determine if vaccinated individuals are able to be asymptomatic carriers of the virus or not.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“My husband works in a school and was in the building until Nov. 23. I work from home and have worked from home since March. All of my children are attending school virtually. 

“My husband and I have left home rarely and try to order groceries for curbside pickup, etc. 

“When we do go somewhere public, we wear masks and socially distance. Three weeks ago, my daughter’s best friend spent the night (she and her mom have been isolating together) and my son spent the night at my sister’s house (she and her family had the virus a few months ago.)

“Last weekend all of my kids were sick with what I assumed was strep throat. Shortly after, I began to show symptoms. I was tested on Nov. 25 and my test came back positive on Nov. 27. On Nov. 28, my three kids and my husband were tested. My kids no longer feel sick but one has a lingering sore throat. We received their results last night and all four of them have tested negative.

“Until now, my only explanation was that my husband is an asymptomatic carrier and infected the rest of us, as he is our primary connection to the outside world right now. How likely is it that he was asymptomatic and my kids were symptomatic and they are already testing negative after infection?

“Or is it more likely that they just haven’t tested positive yet? We are all isolating at home together but were operating under the assumption that we were all positive.”

The answer:

In your question you didn’t mention the type of test that everyone had. If you all had the rapid test, a negative result only means that you were negative at the time of the test. If you all had a genome test, it is more sensitive, and you can trust the negative results.

The rapid test is better at detecting positive patients when they are symptomatic. A negative result in an asymptomatic person only says that at the time of testing you were negative.

As for how you got SARS-CoV-2, I cannot say. There is a hypothesis that says approximately 15% of individuals with SARS-CoV-2 are asymptomatic and never develop symptoms, but that is just a hypothesis. We are not doing enough testing in the U.S. to determine if that hypothesis is true.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My husband had a kidney transplant. When the vaccine is available he will receive the vaccine shot. I am 63 and do not qualify for the vaccine shot. My question is: would I be able to receive the vaccine shot, since we live in the same house? I was the kidney donor to my husband. He received my left kidney.”

The answer:

Distribution of the vaccines are being coordinated by the health departments of each state. Given that you are not in a high-risk group, you may not be able to get the vaccine when your husband does. I suggest you reach out to your family physician to learn about vaccine distribution in your area.

The good news is that once we reach about 80% vaccination in the population, the virus will have a harder time spreading in the population as more it won’t have any susceptible hosts. Take comfort in knowing our most vulnerable populations are being prioritized.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown. 

• • • • •

“I work with people with autism. We try and keep their masks on as much as possible, but because they are people with disabilities, they are exempt from the mandate. On Monday, I worked with an elementary-aged patient with autism at their school. The patient did not have his mask on and I was within 6 feet for an hour and a half.

“Tuesday, I was around the patient, but was able to socially distance. Again, the patient did not have his mask on for most of the time.

“On Wednesday, at around lunchtime, the patient developed a fever. The fever stuck around with a sore throat for less than 24 hours. So, the patient was essentially sick for less than 24 hours.

“The patient’s exposure was from six days prior. On Friday, the patient tested positive via a rapid test. Patient has been asymptomatic since Thursday afternoon. 

“Patient’s mother and twin sibling both tested negative. I took a rapid test on Thursday as well as Sunday. Both of which returned as negative. I also took a PCR on Sunday. Do I need to still self-quarantine? This is day five with a negative COVID test and from what I understand most symptoms show up within five to six days.”

The answer:

Yes, you should self-quarantine separately for 14 days. You are a close contact of a person diagnosed with COVID-19. Negative rapid antigen test results do not rule out COVID-19 infection. Also, the mean incubation period for the SARS-CoV-2 (COVID-19) virus is estimated to be five days with a range of two to 14 days.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“I received the COVID Moderna vaccine on Dec. 29. The next day, my husband developed symptoms and tested positive. I then became symptomatic and tested positive Dec. 31. My question is: will having the vaccine around the time of my diagnosis increase my symptoms and increase my risks?”

The answer:

I understand your concern and am sure you are not alone in this situation.

There are two ways our bodies can develop immunity to an infection:

1. By getting vaccinated and

2. By becoming infected naturally (via exposure). It takes our bodies about 10-14 days to develop the necessary antibodies to provide protection from infection, regardless of how we were exposed.

It is very possible that you were exposed and pre-symptomatic when you received the vaccine due to the long incubation period of SARS-CoV-2. You should suffer not negative side effects from having the vaccine during your pre-symptomatic phase of infection.

It is important to remember that the first dose of the vaccines are approximately 50% effective at preventing infection and the second doses increase that to 95% or more.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Can a person with a severe urinary-tract infection with e-coli in his/her culture throw a false positive for a test?”

The answer:

No.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I participated in AstraZeneca’s Phase 3 trials and received my second shot 10 days ago. They are still not unblinding the studies and I would like to help them in the studies, but at the same time, I really would like to know if I got the placebo or the real thing. If I went myself to get a blood test for antibodies, would that show up that I have the vaccine? 

“Also, can I keep those results from AstraZeneca so this way they could still use me for testing?”

The answer:

When individuals sign up for and agree to terms in a clinical trial such as the one you describe, there are certain things you agree to abstain from. I do not know the terms of your agreement with AstraZeneca, but I would expect that in that document you agreed to remain blinded as to which you were receiving, placebo or vaccination.

While I understand your desire to know if you were immunized or not, I urge you to read over the agreement you made with AstraZeneca before scheduling any antibody testing.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I am being treated for CLL with prednisone (10 milligrams) and Rituxan intravenously every three months. Will I be able to take the vaccine when it becomes available?”

The answer:

The coronavirus vaccine immunization guidelines have not yet been approved and released. When the vaccine becomes available, I recommend you discuss vaccination with your treating medical oncologist.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My husband was exposed directly between Nov. 4 and 7. When we found out, we both got tested on Nov. 9 and received negative results back on the 10th. On Nov. 13, he started to show symptoms, so I scheduled him another test for Nov. 15 and he was positive this time. I decided to get retested so I would have a quarantine time line and got retested on Nov. 19 and just received negative results again. All of our tests were the PCR test. How is this possible, we have taken zero precautions at home between us? Also, how long do I have to quarantine if I have been exposed for over 16 days now?”

The answer:

Regarding your husband, if he is not immunocompromised, he can stop isolation after at least 10 days have passed since his symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms have improved. If your husband is immunocompromised, then at least 20 days of isolation is recommended since symptoms first appeared.

You are a household contact and should self-quarantine separately for 14 days. This will be 14 days from the date your husband with COVID-19 is released from isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was dating a guy before the pandemic who works in retail. When the pandemic hit, we stopped dating because he was still interacting with customers on a daily basis. In May or June, he got COVID. I’m wondering if that means I could start dating him again or would I be at risk of him passing on germs from his customers even though he has already had the virus? I really liked the guy and it would be great to be able to see him again, but I definitely don’t want to put myself at risk and I also have roommates who I can’t in good conscience put at risk.”

The answer:

An interesting question, who’s safer?

Regarding the guy you previously dated, reported COVID-19 reinfection rates have been low to date. It is not known for certain how long antibodies stay in the body after infection, or how long protective immunity may last. And you may be at higher risk from your roommates.

Hopefully, the vaccine and broad immunization will soon be available.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • •

“I have a close friend who is a 30-year-old male. He was diagnosed with COVID-19 while taking a flight. They sent him directly to ICU and then he started coughing up blood. That was almost two months ago. 

“He has edema in his lower extremities. He has tested again positive for the COVID-19. What is his chances of full recovery? Will he be a carrier all his life? Can he give it to someone that is 73 years old? Will he always have a disability?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious.

His prognosis for full recovery depends upon his immune status, if he has any preexisting medical conditions, and whether he develops lung or heart problems from the COVID-19 infection. His young age is a good prognostic factor. I’m certainly hoping for a full recovery, and time will tell.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Do you have to have a negative COVID-19 test to receive vaccine?”

The answer:

This is a great question and one that I am sure many others have.

Current recommendations do not require a negative COVID-19 test to receive the Pfizer or Moderna vaccines.

However, if you are symptomatic for COVID-19, it is advised that you wait until your symptoms resolve before you receive the vaccination.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“On Dec. 21, I went to a local testing site for a rapid test in Hauppauge, New York. The person administering my nasal swab test had a mask on, but it looked like a typical surgical one and not a tight-fitting N95. She had no additional protective equipment such as a visor on while administering the test. Because she may have seen a lot of patients so far, am I at risk of potentially being exposed to COVID-19 from her? Are all test administrators required to take a test themselves (or at this point, be vaccinated?).”

The answer:

In my opinion, your risk is probably low.

At our medical center, test administrators are not required to be routinely tested. COVID-19 vaccination is strongly encouraged, but not mandatory at our medical center.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • • 

“I had the Pfizer COVID vaccine this morning and get COVID tested tomorrow for surgery in a week. Will this be a problem?”

The answer:

No.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“If I obtained the vaccine, do I need to quarantine away from my 70-year-old husband and wear a mask around him?”

The answer:

Thank you for your questions. I appreciate your concern for your family members.

The Pfizer and Moderna vaccines for COVID-19 do not contain any virus. 

Instead, they contain a biological molecule called messenger RNA. This molecule will be made into the viral spike protein and your body will mount an immune response to it.

The lack of virus in the vaccine means that you are not contagious. It is safe to interact with members of your household without a mask after the vaccine.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“What happens if your spouse gets the COVID-19 vaccine and you don’t? Can you get sick from your spouse?”

The answer:

The vaccine for COVID-19, whether it is from Pfizer or Moderna, contains no virus. 

Instead, what these vaccines contain is RNA. RNA is a biological molecule that is nucleic acid. Most of us are familiar with DNA, the biological molecule that holds all our genetic material and is a nucleic acid. 

DNA is used to make RNA in a process called transcription. Think of it like this, if you wanted to write “Hello” in Spanish, you’d write “Hola.” They are the same word with the same meaning, just using a different set of letters. That is what happens with DNA and RNA, same message different make-up.

That RNA is then translated into proteins, another type of biological molecule that does the work.

If you wanted to turn “Hola” into a gesture, you’d wave. That is like what occurs in translation of RNA into proteins. You turn a word into an action.

The COVID-19 vaccines have a bit of SARS-CoV-2 RNA in them, the bit that makes the spike protein. The spike protein is what the virus uses to get into our cells.

Our bodies will take the RNA and translate it into this spike protein. Then our immune system will recognize that spike protein as something to be destroyed and mount a response to it. This response will generate antibodies that will protect us, with 95% certainty, from infection with SARS-CoV-2.

Some vaccines have what is called live virus contained in them and can result in someone who receives that vaccine being contagious with the pathogen. Since the COVID-19 vaccine is only RNA, it cannot be transmitted. There is no risk of acquiring the infection from someone who has been vaccinated.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Could these new vaccines help those already infected? Someone should be trying it on some of those seriously infected? Would help hospital immensely.”

The answer:

CDC 2020 recommendation is that defer vaccination in persons with known current COVID-19 infection until the person has recovered from acute illness and no longer requires isolation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • •

“My husband became symptomatic on Dec. 25 and tested positive on Dec. 27. My youngest son, 12, started with GI symptoms on Dec. 27. They have both been isolating in separate bedrooms since symptom onset. I have been quarantined downstairs bringing supplies up masked and distanced. I am an optometrist and have had Type 1 diabetes for 33 years. I have been extremely diligent in my precautions to avoid this virus. However, Tennessee is currently a global hot zone. I could get my vaccine this week by our health department. Is that advisable or should I wait until quarantine period is over?”

The answer:

I am very happy to hear that you are following isolation protocols for your sick family members.

Since you are in the medical profession, you can get the vaccine in accordance with the Tier One roll-out. Guidance from the CDC suggests that your possible exposure does not preclude you from getting the vaccine. However, if you become symptomatic, it is advised that you wait to get the vaccine until your symptoms resolve.

You will need to contact your local hospital to arrange vaccination. The roll-out for healthcare workers is being coordinated by each state’s health department.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My girlfriend is a 39-year-old nurse. She contracted COVID-19 at work. She is almost over it now. But now, she keeps falling asleep very randomly. I mean literally in the middle of a sentence.

“She has no history of narcolepsy either. She’s mostly laying down when it happens though. But when she’s up and walking around, she’s fine. My question is: is that a normal side effect?”

The answer:

Narcolepsy is a sleep disorder which often includes periods of excessive daytime sleepiness.

According to researchers, evidence suggests that narcolepsy arises from the interaction of genetic, environmental and triggering that then lead to an immune-mediated loss or dysfunction of neurons in the brain.

In other words, COVID-19 infection may trigger an immune system reaction that can attack brain neurons leading to narcolepsy.

I recommend your girlfriend consult either a sleep specialist or neurologist for further evaluation and treatment.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • •

“After receiving the COVID-19 inoculation, is there a delay of 10 to 30 minutes before departure?

“This would cover a shot reaction to the recipient.”

The answer:

Vaccine side-effects are generally minor, including mild soreness at the injection site. However as a precaution, the person should be observed 15 to 30 minutes after vaccination for a remote chance of a severe allergic reaction.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I do not live with my parents. My dad tested positive for coronavirus/COVID-19. He and my mom quarantined at home. 

“My mom had three tests (the full test with nasal swab, not the rapid) during a 14-day timeframe when my dad was ill and tested negative each time. My dad’s symptoms fully subsided and he then had a follow-up, full nasal swab test and tested positive again – his PCP let him know that people can still test positive for some time after infection and recommended he not get another test. After 20 days, on his physician’s guidance, he ended his period of isolation at home.

“My parents would like myself and my boyfriend to spend some time with them in their home, masks off. We did frequently see them pre-COVID-19 diagnosis given we have parallel, strict approaches to living in the pandemic. Is my dad still infectious from his previous bout with COVID-19? What is the level of risk in being in their home? I am unsure of whether and for how long the home/air in the home can hold the virus.”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. However, households are, and will continue to be, important venues for transmission of SARS-CoV-2 (COVID-19). Therefore, studies have recommended preventative actions such as increased mask-wearing at home.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

 • • • • • 

“My mom began having COVID symptoms on Nov. 23. Her boyfriend in the same household had symptoms before her but wasn’t tested initially. After my mom became sick, they both got tested and both came back positive. My sister then started having symptoms on Nov. 26. She also tested positive and tested positive for the flu as well. They have all done their 10-plus day quarantine. They have gotten tested since and still have tested positive. I want to visit my family. Is there any way they could still be contagious? My sister went to the ER twice for her symptoms. I do not live in my parents’ home. Should I wear a mask at all times if I do? Is there anything specifically I should avoid in my house?”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. If none of them are immunocompromised, they may stop isolation after 10 days and resume normal activities. If any are immunocompromised, then 20 days of isolation is recommended.

I also recommend wearing a mask and other preventative actions including social distancing (which is difficult with family) and good hand-washing hygiene.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Both my wife and I tested positive for COVID this past Sunday. We are taking vitamin D3, zinc hydrochlorine and vitamin C. My question is: Can we cross infect each other if one recovers sooner than the other one?”

The answer:

Since both of you are infected with the same pathogen, SARS-CoV-2, you need not worry about infecting each other if one recovers first.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

 “My husband received the Pfizer vaccine. 

“I’m assuming because this isn’t a live virus vaccine, there would be no shedding? I realize following distancing and masking is still mandatory, but, would that help give me any potential benefit/immunity to COVID-19 since we live in the same house?”

The answer:

What a great question. I am sure others in your situation are wondering the same thing.

Both the Pfizer and Moderna vaccines are mRNA vaccines. This means that they use our cell’s own process to make the spike protein of SARS-CoV-2, the virus that causes COVID-19. 

This spike protein is then broken down by the cell and shown to the cells of the immune system in a process called antigen presentation (think of it like an introduction to the body). The immune system will then mount a response to that spike protein causing the individual to possibly have injection site pain, tiredness, and after about a week a swollen lymph node in the armpit closest to the injection site.

Since there is no virus in the vaccine, there will be no natural infection and no possibility of contagiousness. However, you are correct in your assertion that your husband will still need to wear a mask in public and continue to maintain social distance and hand-washing. Science does not yet know if a vaccinated individual will be capable of being a carrier for the virus.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

 “Thank you for your feature where experts answer questions related to COVID-19. (These questions provide valuable understanding for how COVID-19 works and how we should think about COVID-19 scenarios that are more specific than you can find in a general article on the internet. I have enjoyed reading through many of them.)

“I have read through most or all of the questions and have not seen one that addresses my question so I would like to see if an expert can weigh in on it.

“My question is regarding transmission from outdoors to indoors. Virtually all articles out there are for outdoor-outdoor transmission or indoor-indoor transmission. Let’s say that you are having a landscape company do some improvement to your yard which would require several workers to be in your back or front yard for many hours and possibly multiple days. Due to the aerobic nature of the work and being outside none of the workers wear masks. Is there any risk of an ‘outdoor-to-indoor transmission’ if one of the workers is actively shedding the live virus and the house is directly downwind? How much would open windows versus closed windows play a role in the answer? Would the risk be classified as virtually zero, extremely low, low, medium? 

“Does the risk change with factors such as distance to the house, time, HVAC parameters, etc.? This hypothetical scenario would also have application to so-called ‘window visits’ that many people are doing at nursing homes to see older friends and family, where they visit for potentially multiple hours and possibly without masks on for both the inside and outside people. I have tried to find information that may help provide input to this question but have not found anything of value or substance. Any information you can provide on this scenario would be great.”

The answer:

Your question is a good one. There have been many studies looking at how transmission of SARS-CoV-2 and its variants, are occurring. 

These studies show that less than 10% of transmission of the virus is occurring in outdoor settings where mitigation efforts are in place (mask-wearing).

There have been studies that look at ventilation systems and how the virus is spread due to airflow inside. Airflow direction certainly plays a role in airborne transmission inside. If we consider the physics of the situation you describe, there are many factors that must be considered (windspeed, amount of humidity, respiration rate of the contagious person, distance from the house, amount of sunlight and the intake of air into the house).

Airborne transmission means that the virus is surrounded in small lightweight mucus debris. That particle has mass and will eventually be pulled to the ground due to gravity. 

In windless conditions inside, the particle can travel about 6 feet. When you factor wind outside into that, it can increase the distance the particle can travel before it reaches the ground. However, outside, you must consider all the other factors that would affect the virus. Humidity comes into play, more humid, the virus will be viable longer. Sunlight also comes into play, the UV light from the sun can decrease the viability of the viral genome. 

Plus, consideration must be given to the other factors I mentioned.

Taken together, I would hypothesize that the risk is very low for outside-to-inside transmission.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“If one has had a past single occurrence of Guillain Barre Syndrome – obviously excluding recurrent/chronic forms – is there any one of the upcoming COVID vaccines that may be better to take? It is understood that a conversation with your medical provider would be warranted, but it does not seem at this point that such a provider would have enough legacy data to help guide this decision, and it also seems that contracting COVID could present greater risk.”

The answer:

A large epidemiological study in the United Kingdom found no association between COVID-19 and Guillain-Barre Syndrome.

Dr. Anthony Fauci recently said people who’ve had Guillain-Barre Syndrome, should not get the COVID-19 vaccine “because you might trigger a similar, serious response.” Dr. Fauci’s recommendation was made out of an abundance of caution.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband became infected with COVID earlier this week. We isolated him to the upstairs master bedroom and I moved downstairs/slept on the couch. Unfortunately, a few days later I tested positive for the virus. 

“My symptoms are less severe than his, but we both definitely have COVID. Since we both are positive with the virus, can we sleep in the same room again? Or is it possible he has a more severe version of COVID than me and I should continue to isolate from him?”

The answer:

You and your husband can isolate together, as long as, we’re sure you’re both positive.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I was exposed to COVID-19 about 31/2 weeks ago and was under quarantine for 14 days with no symptoms. Yesterday, I woke up with symptoms. Is it possible to get symptoms after 31/2 weeks? I’m concerned I was unknowingly exposed after quarantine and now have exposed others. I have a call into my PCP and will probably be tested.”

The answer:

I agree you were probably exposed a second time after your quarantine.

If you are not immunocompromised, I recommend you self-isolate for 10 days after symptom onset and follow-up with your primary care physician.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I tested positive for the COVID-19 virus. I have had fever, nausea and no appetite. I am scheduled for a total knee replacement on Jan. 15. Is it safe to have that surgery after recently having the COVID-19 virus?”

The answer:

If you are not immunocompromised, I recommend at least 10 days of isolation since symptoms first appeared. If you are immunocompromised, at least 20 days of isolation is recommended since symptoms first appeared.

I advise you to contact your primary care physician and orthopedic surgeon as soon as possible for further instructions and discuss whether to cancel your elective total knee replacement surgery. You also need to get checked for possible COVID-19 pneumonia.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I recently got out of quarantine. Do I have to wait to get the shot? I’m a health-care worker.”

The answer:

An important question.

SARS-CoV-2 (COVID-19) infection or exposure (CDC 2020):

• Persons with current COVID-19 or asymptomatic SARS-CoV-2 infection: Defer vaccination in persons with known current COVID-19 infection until the person has recovered from the acute illness and no longer requires isolation. Based on current evidence, that reinfection is uncommon within 90 days following initial infection, vaccination may be delayed until near the end of the 90-day period.

• Persons with history of COVID-19 or asymptomatic SARS-CoV-2 infection: Based on Pfizer clinical trials, vaccination is safe and likely effective in persons with evidence of prior COVID-19 infection. Vaccination should be offered to persons regardless of history of symptomatic or asymptomatic infection. 

Viral testing for acute or prior infection for the purpose of vaccine decision making is not recommended.

• Persons with known SARS-CoV-2 exposure: Vaccination following exposure is not likely to be effective for preventing the disease from the exposure. Persons with known exposure should wait to seek vaccination until after their quarantine period has ended. For persons in congregate settings (long-term facilities, correctional facilities), residents with known exposure may be vaccinated; however, if COVID-19 is strongly suspected and viral testing results are pending, consider deferring vaccination.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“I was wondering how long after a COVID-19 vaccine would antibodies show in an IgG test?”

The answer:

If your body develops an immune response, which is the goal of vaccination, there is the possibility you may test positive on some antibody tests. Antibody tests indicate you had a previous infection and that you may have some level of protection against the virus. Experts are currently looking how COVID-19 vaccination may affect antibody testing results.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Our 26-year-old son moved into his own apartment on Dec. 17. He and his best friend were exposed to the virus on Dec. 19. His friend has not had any symptoms but tested positive on Dec. 24. My son had nausea and vomiting on Dec. 23 and body aches and chills beginning that night. He also tested positive on Dec. 24. He had a fever for three days. He never lost his sense of smell or taste. He has been symptom free now for 30-plus hours. Can we see him on New Year’s Eve and/or New Year’s Day or is that too early?”

The answer:

I understand the desire to see family at this time of year. We have traditions and are all craving a sense of normalcy. However, since it has not been 10 days since symptoms have begun, it is risky to visit with your son. He is very likely still shedding the virus and may spread it to you.

I wish I had better news for you.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I keep hearing people say that they/their friend/family member never left the house and yet contracted COVID-19. Are these likely just not true statements or are there documented cases like this? I suspect that maybe they never left the house but had visitors or perhaps got too close to a delivery person. 

“What I’m trying to understand is the actual prevalence of this happening or the actual prevalence of the virus transferring from food packaging or other delivered items. Everything science-based that I have read says that this risk is low and yet I also read anecdotes from a lot of people saying that they are sheltering in place and still caught it.”

The answer:

Experts believe the SARS-CoV-2 (COVID-19) virus spreads mainly from person to person. I agree that visitors may be the source. Masks are more important than originally thought.

Another way to catch the new coronavirus is when you touch surfaces that someone who has the virus has coughed or sneezed on. You may touch a counter top or doorknob that’s contaminated and then touch your nose, mouth or eyes.

The virus can live on surfaces such as plastic and stainless steel for two or three days. To stop it, clean and disinfect all counters, knobs, and other surfaces you and your family touch several times a day.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband and I disagree about spending time with our grandchildren and extended family. The grandkids’ parents are in regular contact with at least five other households. 

“My grandson is 3 months old and had open heart surgery when he was 3 weeks old to have a narrow part of his aorta removed. He has other heart issues that will need further surgery when he is older. He is not on immunosuppressant medication. My husband thinks it is perfectly OK to go hang out with the grandkids. The parents have 10-minute COVID tests that they received from the hospital and he is of the opinion that if the test is negative, he can spend time there without a mask.

“I disagree and refuse to go over there. My husband says he is going without me. They only live about a mile away, so he plans on going over at least once a week (and is not happy about my decision to not go for Christmas).

“My concern is if I need to isolate and stay away from him if he is spending time at another household?”

The answer:

Negative rapid antigen COVID test results does not rule out infection. There is risk associated with outside home visitors and considering the number of your grandkids parents’ exposures.

Social distancing is very difficult with family members. I do recommend wearing a mask and good hand-washing hygiene when visiting.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“At the grocery store, or any store, which is safer to use – the regular register checkout line, or the self-checkout?”

The answer:

When you are out in public, it is best to keep your distance from others and to wear a mask. If there is a self-checkout available, that will reduce your contact with others. Remember to wash your hands often.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I was exposed to COVID-19 on Nov. 26, became symptomatic on the 29th, and tested positive on the 30th. I luckily had only a mild case and am feeling better. I have isolated from my family since my symptoms began. They have tested negative three times and are symptom-free. I tested again on Dec. 8 and unfortunately, my results are still positive. Does this mean I am still contagious? I am hoping to end isolation, but don’t want to infect my family. I read that sometimes patients who were symptomatic will test positive for three months after getting better. Help!”

The answer:

Sometimes, the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

If you are not immunocompromised, you may stop isolation and resume normal activities after at least 10 days have passed since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms have improved.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“I had a PCR COVID-19 test on Oct. 26 that came back negative, then a PCR test on Oct. 29 that came back positive and a PCR test on Nov. 1 that came back negative. Was my positive a false positive or just low viral load that didn’t amount to anything? I have several autoimmune diseases and have been extremely careful, but I work in senior living where we have positive cases (I’m not a caregiver though). I’m just trying to figure out if it was a true positive or if the PCR can still throw out false positives?”

The answer:

A positive PCR (molecular Polymerase Chain Reaction) test result is highly accurate, and I believe you were infected with the SARS-CoV-2 (COVID-19) virus. The negative PCR test on Nov. 1 was probably in the late or recovery stages of infection, or that PCR was a false negative. You could consider a blood test for SARS-CoV-2 IgG antibodies. If that blood test is positive, it indicates you were previously infected with COVID-19, but it doesn’t give the exact date.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband tested positive on Dec. 11 and 12. He had both a rapid test and regular test. I had a regular test on Dec. 11 that was negative. I had another regular test that I am awaiting results from. He developed mild cold symptoms a few days ago, but has had no fever. How long should we both quarantine? I have been in the same room with him and using the same bathroom as him. We have been disinfecting everything that is touched after each contact with the surface. When he is cleared to return to work, do I need to spray the entire house with disinfecting air spray or how long will the germs be able to infect us in our home?

“I know he should be isolated to one room but I know he will not agree to that and he will get upset if I suggest it. I will continue to disinfect all surfaces, keep distance within the same room and wash hands frequently. We have been sleeping in separate rooms since Dec. 11. When will we be OK to resume sleeping together and normal activities?”

The answer:

If your husband is not immunocompromised, his isolation can end 10 days after symptoms first appeared, and he can then resume normal activities. Ideally, you should quarantine separately. Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Or your quarantine can end after Day 7 if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if

no symptoms were reported during daily monitoring.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband was exposed to COVID on Dec. 7, and started showing symptoms about four to five days ago. He tested positive, and I tested negative. We have been sleeping in the same bed every night (except tonight), and been around each other without masks. For how long should I self-isolate/quarantine? And same with him? We have two very little boys so logistics are challenging. I already had to stop work since we now don’t have childcare while we’re in isolation. Just trying to figure it all out. Because I tested negative, do you think that means I have the antibodies or that I wasn’t exposed long enough?”

The answer:

If your husband is not immunocompromised, his isolation can end 10 days after symptoms first appeared, and he can then resume normal activities. If you are immunocompromised, then 20 days of isolation is recommended since symptoms first appeared. Ideally, you should quarantine separately. Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring.

Or your quarantine can end after Day 7 if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if no symptoms have been reported during daily monitoring. Regarding your negative test results, there are several possibilities. First, you may have had a robust neutralizing antibody response to the virus. Secondly, your test was a false negative. Lastly, you may have tested too early. The incubation period for the SARS-CoV-2 (COVID-19) virus can be two to 14 days, with an estimated mean of five days.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Our daughter and son-in-law had COVID-19 with symptoms beginning the Sunday prior to Thanksgiving. They both fully recovered and they and the children are now symptom-free except that the kids all have perpetual allergies and frequently do not cover sneezes. They are not tidy nor clean people, and their house is always dirty. They are offended we don’t want to come and visit. They would not want to wear masks if we visit, either. 

My husband and I are older than 60 and we will be visiting my mom-in-law, who is 83, in a few weeks. Are we being overly cautious or should we just try to get over our concerns that we could still catch the virus from them?”

The answer:

I recommend continuing preventative actions, including wearing a mask. At this time, I do not advise visiting your elderly mother-in-law who is 83 because of increasing COVID-19 cases and related deaths.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“An employee had been off work with COVID and has just been given the green light to return to work. However, her husband just tested positive. Can she still carry the virus and expose other employees at work if she returns? Just trying to keep everyone safe.”

The answer:

The employee was released back to work. All employees should continue preventative actions, including masking and good hand-washing hygiene.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband became infected with COVID earlier this week. We isolated him to the upstairs master bedroom and I moved downstairs and slept on the couch. Unfortunately, a few days later, I tested positive for the virus. My symptoms are less severe than his, but we definitely have COVID. Since we both are positive with the virus, can we sleep in the same room again? Or is it possible he has a more severe version of COVID than me and I should continue to isolate from him?”

The answer:

You and your husband can isolate together, as long as you’re sure you’re both positive.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter is having a group of friends for Christmas Eve. My daughter husband and three grandkids want to come visit us Christmas Day. My husband has cancer and I am on dialysis, 72 years old. 

“Is this risky?”

The answer:

Oh my yes! It is risky. The majority of cases of COVID-19 are coming from small group gatherings in individual homes.

I know it can be hard to talk to family about these issues, I suggest that you offer for them to visit outside and distant while wearing masks.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Hello, I was reading your answers to questions about COVID and I was wondering if I can ask a couple of my own as I can’t find this info anywhere and would like to more accurately judge our risks.

“1. How much of a risk is grocery or other shopping or similar activities – being indoors with other people in fairly large buildings with masks mandated for everyone and generally keeping 6 feet apart and not touching face etc? Can you still catch it through the eyes or by passing too close to someone or is the risk minimal if both are in masks? Does there need to be some time limit, such as 10-15 minutes to get infected or would walking through a potential ‘cloud’ of virus be enough?

“2. I keep hearing people say they have no idea how they got infected, even those who followed all precautions, wore masks and goggles, stayed home and had everything delivered and sanitized with gloves etc. It’s really scaring me. How do you believe these cases can happen?

“3. How much of a risk are children’s activities outdoors such as soccer or just playing, where they are wearing masks but not necessarily distancing far enough due to age? How much can the virus spread between two masked individuals outdoors?”

The answer:

These are very relevant and important questions. I understand your concern and realize how the barrage of information and ever-changing situation can cause anxiety.

This global pandemic has showed the power of science and has allowed the general public to see behind the laboratory doors (so to speak). In many other situations, science has the answer and provides it. This time the public is learning right along with the scientists. It isn’t like they show on TV, right?

I see a common theme in your questions, what risks should I be taking? We all have a risk bank, just as a coin bank, we can choose where to spend that risk based on situation analysis.

Grocery stores and other areas where people gather masked and distant present a level of risk depending on the level of community spread of SARS-CoV-2, the virus that causes COVID-19, in your area. 

Carnegie Mellon University has an excellent tool to help determine the level of community spread in your area. You can find it by Googling CMU Covidcast. I cannot say for certain what the risk is in your particular area. That tool will help. 

Higher levels of community spread will mean greater risk in public.

SARS-CoV-2 has a long incubation period coupled with a period before symptoms start of a few days where individuals appear healthy and are spreading virus like wildfire. This is how people get sick with COVID-19 and can’t place where they got it. Think of it like this, do you remember every item of good you consumed last week? Thinking about all your contacts in the past four days can be difficult.

As for children’s activities, research shows that children have as high or higher viral loads as adults, but with milder symptoms. The main symptoms I children involve gastrointestinal issues and a mild fever.

If community spread is high in your area, children are at risk, too.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“My family of three traveled to a private condo for Thanksgiving week at the beach on Nov. 21. We brought our own groceries, we drove straight through for 14 hours only stopping for gas and restrooms. We were vigilant with mask-wearing, hand-washing and using hand sanitizer consistently. 

“We did not gather and did not have any contact with anyone other than buying coffee/takeout twice while masked and distanced. The condo had been empty the week prior to our arrival and when we entered, I immediately Lysol-sprayed every room and Lysol-wiped all hard surfaces. We all tested on Nov. 25 to prepare to return home and all tested negative. It was a thorough nasal swab, but we noted it was not as deep or pointy as the tests we have had prior – were not sure if this was a PCR test, our results came back one to two days later (all negative). We returned home on Nov. 28 and all tested again Nov. 29 with PCR swab test and on Nov. 30, two of the three of us were positive and our teenage daughter was negative. We have isolated in part of the house for 10 days, our daughter has been quarantining upstairs for 14 days from Dec. 1. We were fortunately all asymptomatic the entire time. 

“Now that our isolation and her quarantine are over, can we stop wearing masks in our home and can we all sit together again at the dinner table and on the couch or do we need to continue to mask at home? We are fully following measures inside and outside of the home, and practicing good handwashing and sanitizing at home but want to move about the house without masks if possible.”

The answer:

In my opinion, your family of three does not need to mask at home. Outside of your home, everyone should mask. If you have visitors or outside family members in your home, everyone should mask and socially distance.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My boyfriend visited his family on Thanksgiving and tested positive (PCR) shortly after. He did not have a fever but he did experience mild symptoms (cough, chest tightness/difficulty breathing, stuffy nose) and only very recently stopped coughing Dec. 13. I’m wary about seeing my boyfriend even though his isolation period has ended. However, I miss him and it is likely that I won’t be able to see him until the new year if I go home to my family without visiting him this week. Is it wrong/dangerous if we hang out?”

The answer:

Your boyfriend’s isolation has ended, and he can resume normal activities. I do advise him to wear a mask and practice other preventative actions.

Gatherings with family members who do not live with you can increase the chances of getting or spreading COVID-19 or the flu. 

As cases and deaths continue to increase rapidly across the United States, the safest way to celebrate holidays, is to celebrate at home with the people you live with.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My daughter and I both became ill with sore throat, fever, chills, headache – just like the flu. 

“On Day 5, my daughter lost her sense of taste and we had her and my son tested via nasal swab for COVID (he had no symptoms; I was too sick to leave the house and test). She was positive – so it is an assumption I was positive as well since we had the same symptoms, although I was much sicker and still recovering almost three weeks later. Per the health department, we remained in quarantine for 10 days after the first symptom date and my son remained in self-isolation for an additional two weeks. My son tested negative on the first test – and has consistently been negative through several additional tests. My daughter is required to test negative before she can return to certain activities – she has tested inconclusive twice in the past eight days. We are now almost three weeks out from the initial symptom/illness. Is she considered contagious? I have read that inconclusive should still be interpreted as positive and she should not be around others, but other articles indicate she is no longer contagious.”

The answer:

Sometimes the virus is persistent in detectable levels up to 12 weeks after infection, but likely isn’t infectious. For this reason, people previously diagnosed with symptomatic COVID-19 who are asymptomatic after recovery shouldn’t undergo virus testing within three months after the date of symptom onset for the initial infection.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“Thank you for this forum. My husband and I have followed every guidance since the beginning of the pandemic. He is 64 and in excellent shape (triathlete) and the only medical issue he has is asthma. He goes to work every day, where he has a private office and his own lounge area and restroom. And because he is out in the world, he also shops for the items we cannot get delivered.

“Everything we get is wiped down with Clorox wipes before entering our home. I am 56 and retired. I’m fairly healthy having had to retire because I had a viral attack five years ago that made me very sick with inflamed lymph nodes. Otherwise, I take no medications and keep active by walk/running my dog in middle of day when no one is outside. We don’t socialize, we don’t go to bars or restaurants, and celebrated Thanksgiving by ourselves as recommended.

“On Dec. 8, my husband had to use his rescue inhaler in the middle of night (first time in a few years) and was having restless sleep. 

“On Dec. 9, he came home midday feeling sick with flu-like symptoms. I sent him straight upstairs to isolate and began to disinfect all the surfaces, change bedding, etc.

“On the morning of Dec. 10, he was still symptomatic (night sweats, body aches, fever) so we got us both rapid tested for flu and COVID. We were both flu negative, but he was COVID positive. I tested negative for both. 

“In the afternoon of Dec. 10, I began to have a cough, severe headache. Then on Dec. 11, I had a virtual visit with Teledoc because I developed shortness of breath, low-grade fever (100.3) and muscle aches. She said my test was most likely false negative. I will have PCR test and antibodies checked.

“If I test positive, can my husband and I begin to share a space again? Or do we stay separate, because we were infected at different times with potentially different viral loads? I’m very confused about what to do inside our house when both are sick.”

The answer:

There is no problem isolating together, as long as we’re sure you’re both positive. 

Duration of isolation is at least 10 days since symptoms first appeared and at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms have improved. Therefore, your husband’s isolation can end on Dec. 19, and your isolation can end on Dec. 20, if no fever and symptoms are improved.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • • 

“My husband and I took a trip to Disney World with our two daughters and their respective husbands and children. Upon our return, four of the six adults and two of the children tested positive for COVID-19, and the other two adults who had no symptoms whatsoever did not get tested immediately.

“My question is, if my husband and son-in-law’s tests come back positive, do I need to extend my quarantine until he is finished with his? And if they are negative, could they still get sick from the rest of us? Is it common for family members who have not been isolated from sick ones, do not get the virus? I’d like to add that my husband had an antibody test done which came back negative.”

The answer:

Since your husband and son-in-law were exposed to positive individuals, they will need to quarantine for at least a week, even with a negative test result. If they test positive, they will need to self-isolate for at least 10 days from the time symptoms start.

I gather from your question that you are positive. If your husband and son-in-law are self-quarantining away from positive individuals, they are reducing their exposure and along with that, their risk. You will need to maintain your isolation until it has been at least 10 days since your symptoms have begun, you have been fever free for at least 24 hours without medication, and your symptoms have improved.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

 • • • • •

“Is there anything you can take for COVID-19 besides the vitamin C DB zinc to help with the healing?

The answer:

I assume you are referring to oral meds and not intravenous remdesivir or monoclonal antibodies.

Dexamethasone (a potent oral or intravenous steroid) is for investigational use, potential clinical benefit for hospitalized patients with suspected or confirmed severe COVID-19 requiring supplemental oxygen or mechanical ventilation.

Olumiant (baricitinib) received emergency use authorization (EUA) by the FDA for use with remdesivir in hospitalized patients with suspected or confirmed COVID-19 patients requiring supplemental oxygen or mechanical ventilation.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My husband started showing symptoms of COVID-19 on the Saturday after Thanksgiving and got tested. I was not really experiencing symptoms, but my employer told me to get tested. Both of our tests were negative. 

“I returned to work. My husband found out he was in direct contact with a positive case, tested again, and came back positive. I then came home to quarantine. My employer told me there was ‘no need’ to get tested due to the fact I live with my husband. She said I was a ‘probable’ case. They started my quarantine on the day I got tested. Ten days later, I returned from work and saw my family immediately. Now I am wondering if there was any chance I did not catch the virus from my husband until the last day of his quarantine (two days before my quarantine ended). Could I be walking around positive? I never developed any symptoms. It feels like an impossible question to answer. I just want to know if I put my family at risk by visiting them the day my quarantine ended.”

The answer:

I can understand your concern for your family. This pandemic has created much worry and anxiety about our loved ones. It is difficult to discern your timeline from what you wrote, but from what you have stated, the risk to your family from the visit is low. The incubation period for SARS-CoV-2 is 14 days, if it has been that long since you have seen your family and you are not sick, then all is well.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“Monoclonal antibody treatment seems to be an actual cure for those treated early. It stops the progression of the disease and would certainly stop all deaths and hospitalizations if it was available to everyone. It has been reported that celebrities, the well-connected and very rich people have been privileged to receive this and recover quickly. Why isn’t this available to everyone and why hasn’t this been manufactured so that it is available. People don’t have to die every single day. I have rarely seen this mentioned in the news and am terribly disturbed that we have a way to stop people from dying and nobody is talking about it.”

The answer:

The investigational intravenous monoclonal antibodies have been granted an Emergency Use Authorization (EUA) by the FDA. These monoclonal antibodies will be allocated to state health departments by the U.S. Department of Health and Human Services (HHS) based on case counts and severity of outbreaks. These state health departments will be responsible for allocating the antibody to local health facilities.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

• • • • •

“My dad presumably got COVID-19 from his brother on Nov. 21. 

“The day after Thanksgiving, my mom was the first person in the household to begin exhibiting symptoms, then my brother, then my dad. Everyone started getting better and my dad’s symptoms peaked on Dec. 9 – since then everyone in the house has been on the up. I want to go home to spend Christmas with them but my dad just took a COVID test on Dec. 17 that came back positive – is it safe for me to visit? I’m also concerned that there might be a living virus lingering in the house on surfaces and such. Is it safe for me to visit so soon after they’ve all just recently started recovering? If my dad did get it from his brother on Nov. 21 – it will have been a month since the initial infection happened. Can I go home on the 24th and not get sick?”

The answer:

I understand how much you want to see your family. The situation that occurred with your family members as a result of the Thanksgiving get together is what Public Health officials are hoping to prevent by asking people to forgo visits over the winter holidays.

Most transmission is occurring when families get together in small groups and don’t practice social distance, wear their masks or wash their hands on the regular. It is easy to feel safe and secure in your familial home.

SARS-CoV-2 thrives in that exact environment. It is a virus that is transmitted via airborne droplets and aerosols. It has a long incubation period before symptoms start and individuals who are infected are contagious days before symptoms start.

Most individuals will be non-infectious after about 10 days of symptoms. There are individuals who are infectious longer, but that is rare.

Your father is likely shedding the virus but is not infectious. The virus causes a significant amount of damage to the body. That takes time to clean up. One infected cell can release between 8,000 and 10,000 viruses. That clean up, done by the body’s immune system, can take weeks. Think of it like this, if you held a party with 20,000 people in your house, it would take some time to clean

up. The party is over, but the garbage remains.

– Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • •

“I had the virus in March. I was tested for antibodies in June and again in September. I had more than 2,500 antibodies. My husband was just diagnosed positive for the virus. Questions: Can I carry the virus even if I have antibodies? Can I get the virus again? 

“Do I have to be quarantined from him and others?”

The answers:

Excellent questions!

There is not enough information currently available to say if or how long after infection someone is protected from getting COVID-19 again. This is called natural immunity. Early evidence suggests natural immunity from COVID-19 may not last very long, but more studies are needed to better understand this.

It is also not known at this time if you have natural immunity or if after receiving the COVID-19 vaccine, can you transmit the virus to someone who has not been vaccinated or who has no natural immunity. This is why it’s still important to wear a mask, socially distance and practice good hand-washing hygiene after being vaccinated. I’m hopeful that these questions will be soon answered after more people are vaccinated.

Since your husband was diagnosed positive for COVID-19, I recommend you self-quarantine separately. Your quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring. Quarantine can end after Day 7 if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if no symptoms have been reported during daily monitoring.

– Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber. 

• • • • •

“My husband is 74 with heart disease. He has a pacemaker. He had back surgery seven weeks ago because he could barely walk. I take care of him and the household. I am a fairly healthy 60-year-old woman. 

“He will probably be able to get the vaccine early on in the distribution cycle because of his high risk health issues. Will I be able to get vaccinated at the same time he does, because I am his primary source of help? I am basically his caregiver.”

The answer:

I commend you for all you are doing for your family.

Each state has regulations and a distribution plan for the COVID-19 vaccine. I cannot say what the distribution plan is for your state. Given your age, you may have to wait on the vaccine. I suggest you contact your primary care physician for more information regarding your state’s plan.

If you are unable to get the vaccine but your husband is, he will be protected and you can protect yourself (until you can get vaccinated) by wearing a mask, washing your hands regularly and practicing social distance.

Jill D. Henning, associate professor of biology, University of Pittsburgh at Johnstown.

• • • • • 

“Our 11-year-old grandson flew to Pennsylvania from Miami, Florida, to be with his father for Thanksgiving. He flew there with his other grandmother. In that family gathering, there were two other children (ages 1 and 8) who had been having fever off and on, but nobody knew this. Our grandson started with some symptoms two to three days later as well as the others.

“Our grandson is now positive and also the grandmother and the stepmother. His father is the only negative so far (I suspect it’s false negative). They will stay there and quarantine and wait to retest.

“I have a couple of questions. Should the father (negative and no symptoms yet) isolate and quarantine? Does the family have to isolate separately, from each other if they are all coronavirus positive? After 10 days or a negative test, can he fly back to Miami and does he have to isolate and quarantine again in Florida?”

The answer:

The father is a close contact, and he should self-quarantine separately according to the latest CDC guidelines below.

• Quarantine can end after 10 days without testing and if no symptoms have been reported during daily monitoring.

• When diagnostic testing resources are sufficient and available, then quarantine can end after day seven if a diagnostic specimen (swab molecular Polymerase Chain Reaction – PCR) tests negative and if no symptoms have been reported during daily monitoring.

Other family members who have tested positive for COVID-19 can isolate together, as long as, we’re sure they’re all positive.

In my opinion, your grandson may fly back to Florida after his 10 days of isolation, but he must wear a mask. I don’t recommend that he self-isolate again in Florida; however Florida may have specific requirements for returning residents.

Dr. David Csikos, chief medical officer, Chan Soon-Shiong Medical Center at Windber.

Have a question about coronavirus, also known as COVID-19? Send questions to tribdem@tribdem.com.

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