Additional reporting by Josefa Velasquez
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While the number of COVID-19 deaths in the city is staggering, it’s worth remembering that many thousands more New Yorkers have been infected and recovered.
We’re likely nowhere near the end of the outbreak. And for the increasing number of people on the mend, knowing how to move forward is not easy.
THE CITY has heard from readers with questions ranging from how to live safely after having symptoms, to what is antibody testing to how — and why — to donate plasma. Here are the most up-to-date answers we could gather from experts and some folks who’ve lived through it:
I had the virus and now I’m feeling better. When can I leave isolation?
According to the latest guidance from the Centers for Disease Control and Prevention and current discharge instructions from the Columbia University Medical Center, you can end isolation when you reach all three of these milestones:
• You’ve had no fever for at least three full days (72 hours) without taking fever-reducing medication.
• Your other symptoms have improved, particularly if you had shortness of breath or a cough.
• At least seven days have passed since your symptoms began.
But public health experts who spoke to THE CITY stressed that an absence of symptoms does not necessarily mean you can’t get others sick — or that you should stop caring about social distancing.
There are many things about the new coronavirus that the science community does not yet fully understand, noted Dr. Danielle Ompad, associate professor of epidemiology at the School of Global Public Health at New York University.
One of those unknowns is how long an ill person will be “shedding virus” — that is, remain infectious, she said.
Ompad’s advice: Be conservative as you calculate how long you’ll wait to leave isolation and keep up with all of the safety protocols “everybody’s being asked to follow” — including social distancing, frequent hand washing and wearing a mask in public.
“We’re really glad that you no longer have symptoms and that you’ve recovered, but that doesn’t mean you can swagger out of your house unprotected,” she said. “You could still be shedding virus and just not know it.”
For Gowanus resident Willamae Boling, 26, and their partner, it was difficult to determine when it was safe to leave the house. In late March, they both developed COVID-19 symptoms — high fever, coughing, fatigue and shortness of breath — but did not get tested.
They both saw the CDC’s guidance on ending isolation, but also read different sources that said to wait 14 days after your fever breaks.
“Within probably, I don’t know, eight days after the fever went away, we needed to go to the grocery store,” Boling said. “And then we wore masks and gloves — just trying to do the best we can.”
I’m still tired all the time. Should I be concerned?
Be patient with yourself, especially if you’ve had severe symptoms.
Dr. Stephen S. Morse, professor of epidemiology at the Mailman School of Public Health at Columbia University, said some people who recover will continue to feel respiratory symptoms “as a result of tissue damage during the disease,” or may feel fatigued for quite a while.
“Don’t be afraid to go slowly and give yourself some time,” he said.
Karen Gershenhorn has needed a lot of patience as she recovers from COVID-19. Her symptoms ran the gamut from “the classic sore throat” to fatigue, fever and chills to joint pain and loss of taste, smell and appetite, she said in an email.
Two weeks after first feeling sick, the 62-year-old believed she was well enough to go out to garden a bit in a green space near her home on the Upper West Side. She got her doctor’s approval. But the jaunt proved to be too much.
“That night I was knocked out again,” she said.
Throughout the ordeal, she said, “symptoms just randomly appear and disappear.” After three weeks of illness, she has “not yet come out the other side.”
Her advice for others?
“Ask for and accept help from your neighbors,” she said, and remember “you are not alone.”
Am I immune to the novel coronavirus after beating COVID-19?
If you’ve recovered from COVID-19, you might have some immunity — but you should act like you don’t, experts said.
That’s because we simply don’t have enough information about how the virus behaves, Morse said.
“It’s one of the many things we’re still learning,” he said. “Although we assume that it probably lasts for at least several months, immunity may also vary from individual to individual.”
Bruce Y. Lee, professor of health policy at the CUNY Graduate School of Public Health, said he would “not assume immunity,” particularly with reports coming out about former COVID-19 patients in South Korea testing positive for the virus again after recovering.
“If you recover from measles or something like that, you tend to be immune,” Lee said. “But here … you don’t want to run the risk of getting reinfected again. Until it’s proven that you are actually immune, you really need to be careful.”
Patients testing positive again does not necessarily mean they have been reinfected, Lee noted: It could be because of testing flukes. But without gathering more data, it’s impossible to tell.
“Unless we have more information through scientific studies and do a lot more testing, we’re flying blind,” he said.
Meanwhile, health experts across the world have warned of the possibility of multiple waves of the virus. In China, President Xi Jinping April 8 cited the risk of a second wave of the virus rising in that country.
The following day at his daily news conference, Gov. Andrew Cuomo reminded New Yorkers of that possibility.
“Remember, the 1918 Spanish flu came in three waves. We’re on the first wave,” he said. “Everybody is assuming, ‘Well, once we get through this, we’re done.’ I wouldn’t be so quick to assume that.”
What is antibody testing and can it sort out who has immunity?
Antibodies are part of your immune system’s reaction to a virus, to help “get it out of there,” said Ompad of NYU. When presented with a virus, your system first produces generalized antibodies, then antibodies that directly match the virus.
“It gets more specific. Your body gets clever,” said Ompad.
An antibody test for COVID-19 would consist of checking for the presence of the specific antibody created in reaction to the virus.
Lee stressed, however, that “the presence of antibodies does not necessarily mean immunity.” But testing is still needed because “at least it’s better to know who has been exposed,” he said.
Cuomo has called for widespread antibody testing as the best option for allowing life to start getting back to normal in New York. The thinking goes: If you can sort out who has been exposed and who hasn’t, then at least the people with presumed immunity could get back to work.
Right now, the capacity for antibody testing — usually conducted by private companies or academic institutions — doesn’t exist for a large enough segment of the population, the governor has said. The state’s health department developed an antibody test and is awaiting approval for the U.S. Food and Drug Administration.
On April 10, Cuomo said the state has begun producing hundreds of antibody tests and will be able to make 1,000 tests a day by April 17. He predicted the capacity would reach 2,000 tests daily by April 24.
“That sounds like a lot, but that’s a drop in the bucket,” he said.
To make testing more widely available, Cuomo has implored President Donald Trump to invoke the Defense Production Act to increase testing production.
I was out sick with virus symptoms, but now I really need to go back to work. Should I?
As of March 22, New York banned all in-office functions of non-essential businesses in the state. So, if your non-essential workplace is asking you to come into work, it may be in violation of the state order.
If you are an essential worker, follow all of the above recommendations on when to stop self-isolation. Here is the link again to the CDC’s guidance on that.
For essential workers who have been exposed to COVID-19 or someone with symptoms, the CDC issued guidance on April 8 about how to get back to work safely. The advice includes:
• Pre-screening workers to measure their temperature and symptoms before starting work or entering the workplace
• Wearing a mask at all times for 14 days after the last exposure
• Practicing social distancing of six feet “as work duties permit in the workplace”
• Cleaning and disinfecting all work spaces routinely, including offices, bathrooms, common areas and shared electronic equipment
I’ve recovered from COVID-19 and I want to donate blood plasma to help others. How can I do that?
You may have heard recently about calls from medical facilities for blood plasma donations to help current COVID-19 patients recover.
The idea behind the experimental treatment is to “help people who are sick to get better a bit faster,” said Dr. Bruce Sachais, chief medical officer of New York Blood Center, which is conducting plasma donations at four NYBC locations in the five boroughs.
But he stressed that the blood treatment is not a magic bullet.
“I don’t expect that it’s going to be a miracle where you give them the plasma and then they walk out the door the next day,” he said. “But we do expect that it will be helping them to improve more quickly than they might otherwise.”
The New York Blood Center is currently looking only for donors who’ve had an official positive test for COVID-19. The application can be completed online and the center will get in touch with potential donors by phone soon after.
Those looking to donate should also make sure they meet the general criteria to give blood before applying, Sachais said.
The process to donate will feel pretty similar to blood donation, Sachais said, though an anticoagulant used for the plasma process may give some donors a tingling sensation.
During the donation, you will be hooked up to a special machine for about 45 minutes that sorts out different parts of the blood. The whole visit will take about an hour, he said.
“In this case, we’ll keep the donated plasma, which is the liquid part of the blood, and then all of the cells — the white cells, the red cells, the platelets — will go back to the donor,” he said. “That allows us to collect more of a volume of the plasma.”
How much will an individual donation help coronavirus patients? Sachais says it depends on the donor’s size and antibody levels, but on average “the typical donor will help three people.”
Donors can give plasma at New York Blood Center, Mount Sinai Hospital, Montefiore Medical Center or through the Red Cross. For an updated list of locations, visit the National COVID-19 Convalescent Plasma Project’s donation information page.
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