Prevention

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

• Between people who are in close contact with one another (within about 6 feet).
• Through respiratory droplets produced when an infected person coughs, sneezes, or talks.
• These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
• COVID-19 may be spread by people who are not showing symptoms.

The virus that causes COVID-19 is spreading very easily and sustainably between people. 

Prevent the spread of germs. Avoid close contact with people who are sick, cover your cough/sneeze, avoid touching your face, clean “high touch” surfaces, stay home when sick, wash your hands often, cover your mouth and nose with a cloth face cover when around others. Here are tips:

• How to protect yourself when you go out for essential errands
• How to clean your car and ride with others

Wear a Mask/Face Covering 

CDC recommends wearing cloth face coverings in public settings (such as grocery stores and pharmacies). These can help slow the spread of the virus. Cloth face coverings can be made from a scarf, bandana, or you can make one using one of these patterns online. Sew and No-Sew Instructions

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

The cloth face coverings recommended are not surgical masks or N-95 respirators.  Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders.

Symptoms

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness.

Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

This list is not all possible symptoms. Other less common symptoms have been reported, including gastrointestinal symptoms like nausea, vomiting, or diarrhea.

If you develop emergency warning signs* for COVID-19 get emergency medical attention immediately. Emergency warning signs include:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Bluish lips or face

*This list is not all possible symptoms. Please call your medical provider for any other symptoms that are severe or concerning to you. Call 911 or call ahead to your local emergency facility: Notify the operator that you are seeking care for someone who has or may have COVID-19.

People at Higher Risk for Serious Illness from COVID-19

People of any age with certain underlying medical conditions are at increased risk for severe illness from COVID-19:

People of any age with the following conditions are at increased risk of severe illness from COVID-19:

• Chronic kidney disease
• COPD (chronic obstructive pulmonary disease)
• Immunocompromised state (weakened immune system) from solid organ transplant
• Obesity (body mass index [BMI] of 30 or higher)
• Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• Sickle cell disease
• Type 2 diabetes mellitus

• Children who are medically complex, who have neurologic, genetic, metabolic conditions, or who have congenital heart disease are at higher risk for severe illness from COVID-19 than other children.

COVID-19 is a new disease. Currently there are limited data and information about the impact of underlying medical conditions and whether they increase the risk for severe illness from COVID-19. Based on what we know at this time, people with the following conditions might be at an increased risk for severe illness from COVID-19:

• Asthma (moderate-to-severe)
• Cerebrovascular disease (affects blood vessels and blood supply to the brain)
• Cystic fibrosis
• Hypertension or high blood pressure
• Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
• Neurologic conditions, such as dementia
• Liver disease
• Pregnancy
• Pulmonary fibrosis (having damaged or scarred lung tissues)
• Smoking
• Thalassemia (a type of blood disorder)
• Type 1 diabetes mellitus

Information for other populations like pregnant people, people experiencing homelessness, and people with disabilities.

Those Who Need Extra Precautions

• Racial & Ethnic Minority Groups
• People with Disabilities
• People with Developmental & Behavioral Disorders
• Pregnant People
• People Experiencing Homelessness

Extra steps people in higher risk groups or their caretakers can take:

• CDC People of Any Age with Underlying Medical Conditions
• Sign up for Senior Call Check - A daily call for people 65+ who live alone. Call 1-866-50-CHECK or register online
• Frequently Asked Questions: Coronavirus Disease 2019 (COVID-19) and Older Adults
• 3/10/2020 Press Release: Preparedness for People at Higher Risk for COVID-19
  

If You’ve Just Tested Positive - ISOLATE

Follow your healthcare provider’s guidance. Most people can recover at home. It is important that you stay home and take care of yourself. Stay away, or isolate, from others as much as you can. Read the CDC guidance on What to Do if You are Sick. Do not have visitors, unless they are caring for you.

You should also answer the call from contact tracers who will check in on your health and ask you some questions to help slow the spread of COVID-19. Answer and/or return any calls from “MD COVID.” If you do not have caller ID on your phone, look for the phone number (240) 466-4488. Please follow the guidelines they provide on the call.

More Information:

• CDC: Steps to help prevent the spread of COVID-19 if you are sick
• Cleaning And Disinfecting Your Home: Everyday Steps and Extra Steps When Someone Is Sick

If You Need a Provider

If you need a provider, go to www.frederickhealth.org/Find-a-Doctor.aspx

If you do not have Medicaid, Frederick Health Hospital is also providing Virtual Visits for $25: frederickhealth.zipnosis.com

As part of the state's overall response to the coronavirus, and in an effort to prioritize health and safety, Maryland Health Connection opened a new special enrollment period for uninsured Marylanders. If you need a provider, call 301-600-3124 to make a Medicaid enrollment appointment by phone or visit Maryland Health Connection: www.marylandhealthconnection.gov There is a special enrollment period until December 15. 

After You’ve Recovered

If you have recovered from a confirmed case of COVID-19, visit COVIDConnect for Marylanders. This secure portal is open to all Maryland residents who were confirmed to have tested positive for COVID-19 and who are now recovered from their disease. It will be a place for you to share information, promote action and find support.

You are isolating because you've tested positive for COVID-19. You can end your isolation and be around others after: 

• 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*

*Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation

Most people do not require testing to decide when they can be around others; however, if your healthcare provider recommends testing, they will let you know when you can resume being around others based on your test results.

For more details, see the CDC page for When You Can Be Around Others After You Had COVID-19.

My Employer Wants a Letter 

If you need a letter to give your employer to prove that you're clear to return to work, check with your Contact Tracer. They can give you a link to a personalized letter to give to your employer.

People who have been in close contact with someone who has COVID-19—excluding people who have had COVID-19 within the past 3 months.

People who have tested positive for COVID-19 do not need to quarantine or get tested again for up to 3 months as long as they do not develop symptoms again. People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if there is no other cause identified for their symptoms.

What counts as close contact?

• You were within 6 feet of someone who has COVID-19 for a total of 15 minutes or more
• You provided care at home to someone who is sick with COVID-19
• You had direct physical contact with the person (hugged or kissed them)
• You shared eating or drinking utensils
• They sneezed, coughed, or somehow got respiratory droplets on you

Stay home and monitor your health

• Stay home for 14 days after your last contact with a person who has COVID-19.
• Watch for fever (100.4◦F), cough, shortness of breath, or other symptoms of COVID-19
• If possible, stay away from others, especially people who are at higher risk for getting very sick from COVID-19

Options to reduce quarantine

Reducing the length of quarantine may make it easier for people to quarantine by reducing the time they cannot work. A shorter quarantine period also can lessen stress on the public health system, especially when new infections are rapidly rising.

Your local public health authorities make the final decisions about how long quarantine should last, based on local conditions and needs. Follow the recommendations of your local public health department if you need to quarantine. Options they will consider include stopping quarantine

• After day 10 without testing
• After day 7 after receiving a negative test result (test must occur on day 5 or later)

After stopping quarantine, you should:

• Watch for symptoms until 14 days after exposure.
• If you have symptoms, immediately self-isolate and contact your local public health authority or healthcare provider.
• Wear a mask, stay at least 6 feet from others, wash your hands, avoid crowds, and take other steps to prevent the spread of COVID-19.

Contact Tracing

The purpose of contact tracing is to limit the number of people who will get infected by COVID-19. 

If you are confirmed positive for COVID-19, you will be contacted by a public health worker to get more information about where you have been and who you have been with. 

The contact tracer will help you recall everyone you have had close contact with during the timeframe while you were infectious.

The contact tracer will contact these exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible.

To protect patient privacy, contacts are only informed that they may have been exposed to a patient with the infection. They are not told the identity of the patient who may have exposed them.

Contacts are provided with education, information, and support to understand their risk, what they should do to separate themselves from others who are not exposed, monitor themselves for illness, and the possibility that they could spread the infection to others even if they themselves do not feel ill.

Contacts are encouraged to stay home and maintain social distance from others (at least 6 feet) until 14 days after their last exposure, in case they also become ill. They should monitor themselves by checking their temperature twice daily and watching for cough or shortness of breath. To the extent possible, public health staff should check in with contacts to make sure they are self-monitoring and have not developed symptoms. Contacts who develop symptoms should promptly isolate themselves and notify public health staff. They should be promptly evaluated for infection and for the need for medical care.

For more information about contact tracing:

• Maryland Department of Health Contact Tracing FAQs
• CDC’s Contact Tracing : Part of a Multipronged Approach to Fight the COVID-19 Pandemic

Feeling anxious about the COVID-19 situation?

Call 211 or 866-411-6803 to reach the local 211 center in Frederick, MD for mental health and health resources and general questions about COVID-19.

More Helpful Tips

• Even though normal routines have been disrupted, it can be helpful to have a schedule with regular sleep, wake, and meal times.
• Make time for socializing via phone or video.
• Get some fresh air or exercise, following social distancing orders.
• Help not hurt. COVID-19 affects all types of people. Be kind to those who are affected, they have not done anything wrong.
• Limit your media exposure. Just get enough information from reputable sources, once or twice a day, so you can take practical steps to make your plans and protect yourself and loved ones.
• Be supportive. Using precautions, safely supporting others in their time of need is good for the person receiving support as well as the helper.
• Find ways to share hopeful and positive stories and images of local people coming together or who have recovered.
• Honor caregivers and healthcare workers supporting people affected with COVID-19 in your community. Thank them for the role they play to save lives and keep your loved ones safe.

Additional Resources:

SAMHSA Tips For Social Distancing, Quarantine, And Isolation During An Infectious Disease Outbreak

Children’s Mental Health Matters

Plan & Prepare

Creating a household plan can help protect your health and the health of those you care about in the event of an outbreak of COVID-19 in your community. You should base the details of your household plan on the needs and daily routine of your household members. Get Your Household Ready for Coronavirus

For older adults, people at higher risk and their caregivers, click here for additional planning and preparedness tips.

Make sure your all-emergencies preparedness kit also contains these things:

• Pain relievers, fever reducers, decongestants, and cough drops
• Alcohol–based hand sanitizer
• Thermometer
• Facial tissues, paper products
• Extended supply of prescription medications
• Diapers or pet supplies if needed

Travel

There is widespread, ongoing transmission of novel coronavirus worldwide. CDC recommends that travelers avoid all nonessential international travel. All international travelers should stay home for 14 days after returning from travel, monitor their health, and practice physical distancing. 

Stay home for 14 days from the time you returned home from international travel.

During this 14-day period, take these steps to monitor your health and practice social distancing:

1. Take your temperature with a thermometer two times a day and monitor for fever. Also watch for cough or trouble breathing. Use this temperature log to monitor your temperature.
2. Stay home and avoid contact with others. Do not go to work or school.
3. Do not take public transportation, taxis, or ride-shares.
4. Keep your distance from others (about 6 feet or 2 meters).

For more information:

• CDC travel guidelines
• Global COVID-19 Pandemic Notice

Interested in becoming a Maryland Responder?

Membership is open to anyone over 18 years of age who is interested in promoting public health and assisting in the event of an emergency. Whether you are an actively licensed health care professional, student, retired health professional or someone with an interest in volunteering during emergencies, you are encouraged to register. Because many health personnel will already be committed to a role during an emergency, there is a need to recruit non-medical personnel who can assist health professionals during emergency responses.

Register today at https://mdresponds.health.maryland.gov/

Our Actions

FCHD is closely monitoring the current situation and taking the following actions:

• We have been planning and coordinating since the end of January with all of our local partners to include Frederick Health Hospital, Fire and Rescue Services (including EMS & 911), Frederick County Emergency Management, Frederick County Public Schools, and all of our Frederick County healthcare providers. We collectively stood up a Joint Information Center (JIC) to coordinate messaging and send out regular updates to keep our community informed.
• We’re regularly monitoring WHO, HHS, CDC, and MDH for updates and pushing that information out to our first responders, healthcare providers, health systems, local businesses, and area schools.
• We have posted signs in all FCHD receptionist areas and our receptionists have been trained what to do in case someone says they’re sick or have recently been to an affected area.
• We are conducting county-wide regular calls with healthcare providers, sharing the most up-to-date information about symptoms, screening and testing guidelines.
• We are pushing out to local healthcare systems the CDC guidance on infection control, hospital preparedness assessments, Personal Protective Equipment (PPE) supply planning, and clinical evaluation and management.
• We’re providing guidance to Frederick County Government and municipal officials to help plan and prepare for COVID-19 and respond if there is a local outbreak.
• We are sharing CDC business guidance to help public and private sectors ensure they can able to operate with adaptations like telework and flexible sick leave policies, as well as how to respond if an employee gets sick. We are enforcing the Governor’s orders for retail establishments and employers.
• We’re receiving PPE from state and national sources, and distributing PPE to healthcare providers according to Maryland Department of Health priority groups and our FCHD Ethics Committee guidelines.
• Health Department staff are assigned to long term care and assisted living facilities to provide individual guidance and support. 
• The Health Department’s Local Behavioral Health Authority staff are assigned to behavioral health residential treatment and housing programs to provide individual guidance and support.