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What You Need to Know About the Coronavirus

Cases climb among the unvaccinated as delta variant spreads

Latest Updates

  • FDA grants approval to Pfizer’s COVID-19 vaccine. The Food and Drug Administration (FDA) on Aug. 23 granted official approval to Pfizer-BioNTech’s mRNA vaccine for people 16 and older, making it the first approved vaccine in the fight against COVID-19. Previously, the vaccine was being administered under emergency use authorization and will continue to be available under this designation for people ages 12 to 15 and for certain immunocompromised individuals seeking a third shot. “The FDA’s approval of this vaccine is a milestone as we continue to battle the COVID-19 pandemic. While this and other vaccines have met the FDA’s rigorous, scientific standards for emergency use authorization, as the first FDA-approved COVID-19 vaccine, the public can be very confident that this vaccine meets the high standards for safety, effectiveness, and manufacturing quality the FDA requires of an approved product,” Acting FDA Commissioner Janet Woodcock, M.D., said in a statement. Pfizer’s vaccine will now be marketed as Comirnaty. 

  • COVID cases and hospitalizations continue to climb in U.S. The seven-day moving average of daily new cases is nearly 94 percent higher compared to the peak observed last summer on July 20, 2020, according to data from the Centers for Disease Control and Prevention (CDC). And hospitals in six states are reporting their highest levels of new COVID-19 admissions since the start of the pandemic, the agency reported on Aug. 20. Black Americans are bearing the biggest burden when it comes to hospitalizations in the U.S.: The rate of hospitalizations for non-Hispanic Black people has increased faster and risen higher than other groups, the CDC reports. The delta variant is largely behind the latest surge in disease; it is responsible for about 99 percent of new COVID-19 cases. 

  • Long-term care workers must get vaccinated. Nursing homes that get funding from either the Medicare or Medicaid programs will have to require all of their workers to get a COVID-19 vaccine or they will not be able to participate in those programs, the president announced on Aug. 18. Virtually all nursing homes participate in these programs, which help pay for long-term care for Medicare beneficiaries who need rehabilitation after a hospital stay and Medicaid recipients whose incomes qualify them for government financial assistance. The new regulations will apply to the more than 15,000 nursing home facilities that the White House says employ about 1.3 million workers who take care of 1.6 million nursing home residents. These are among the most vulnerable populations when it comes to becoming infected with the coronavirus. The CDC and the Centers for Medicare and Medicaid Services both say that since the spread of the delta variant, COVID-19 cases have risen and the agencies have confirmed a “strong relationship” between the increase in cases among nursing home residents and the rate of vaccination among those who are taking care of them.

  • Vaccine boosters for all could begin Sept. 20. Americans who have received both doses of the Pfizer-BioNTech or Moderna COVID-19 vaccines should plan to get a third dose eight months after their second shot, Biden administration officials said at an Aug. 18 briefing. Based on the late December 2020 start of the vaccinations, that means people would start becoming eligible for these extra shots about Sept. 20 — beginning with the health care workers, residents of nursing homes and other long-term care facilities and older Americans who got the first COVID-19 vaccinations. And because people did not start getting the one-dose Johnson & Johnson vaccine until March 2021, the data isn’t yet available to determine whether a booster is warranted for that product, officials said, although they anticipate one will be recommended. The administration’s plan requires sign-off by the U.S. Food and Drug Administration (FDA) and the CDC, but leaders of both those agencies signed a statement supporting this plan. Officials stressed that even people in those early groups should not get a booster shot before Sept. 20. Only people with compromised immune systems should get a third shot now, the two agencies say. Administration officials said there will be an ample supply of both vaccines for the third shots and that they will be administered free of charge. 

  • Third COVID vaccine dose gets green light for some immunocompromised individuals. People whose immune systems are moderately or severely compromised are now allowed to get a third dose of the Pfizer-BioNTech or Moderna coronavirus vaccine, after the FDA expanded the emergency use authorizations for the two vaccines and a CDC advisory panel unanimously voted in favor of the decision. There isn’t yet enough data to evaluate whether an additional dose of the one-shot Johnson & Johnson vaccine is warranted for this limited population, the advisory panel said when it met on Aug. 13. The news impacts the less than 3 percent of American adults whose immune systems are weakened from such conditions as a solid organ transplant or other maladies that have an equally crippling effect on the immune system. These individuals may not have had an adequate immune response from two vaccine doses, and additional doses could help boost protection. Anthony Fauci, the president’s chief medical adviser, said at a White House briefing earlier in the week that apart from the people with compromised immune systems “we do not believe that others — elderly or nonelderly — who are not immunocompromised need a vaccine [booster] at this time.” At the same time, Jeff Zients, President Joe Biden’s COVID-19 response coordinator, said that if and when a booster shot is recommended, “We have the supply and people will be able to get a booster in a fast and efficient way.”

  • Vccinated people can spread the delta variant to others. A study released July 30 by the CDC shows that vaccinated people who get COVID-19 from the highly contagious delta variant have similar viral loads as unvaccinated individuals, meaning that while they may not get severely ill from an infection, it is possible for them to transmit the virus to others. This finding was “a pivotal discovery” that led to the CDC’s updated guidelines that encourage vaccinated people to wear a mask in indoor settings in areas where COVID-19 transmission rates are high, CDC Director Rochelle Walensky explained in a statement. “The masking recommendation was updated to ensure the vaccinated public would not unknowingly transmit virus to others, including their unvaccinated or immunocompromised loved ones,” she said. Masks are also strongly encouraged in schools, based on this new data. And fully vaccinated individuals who live with young children or people who are immunocompromised or otherwise vulnerable may also want to consider masking up in public indoor settings, the new guidance states. You can check the status of the virus in your community on the CDC’s website.  
  • Breakthrough infections that cause serious illness are still rare. Even though vaccinated people can transmit the virus to others, breakthrough infections that result in serious illness and death are extremely rare, data show. As of Aug. 2, more than 164 million people in the U.S. have been fully vaccinated against COVID-19; 7,525 with COVID-19 vaccine breakthrough infections have been hospitalized or have died — about 0.004 percent, the CDC reports. However, about 75 percent of these serious breakthrough infections have occurred in adults 65 and older. 
  • Vaccine rules announced for federal employees as COVID cases climb. President Joe Biden announced on July 29 that federal employees and onsite contractors will have to attest to their vaccination status. Unvaccinated workers will be required to wear a mask, physically distance from others, and comply with weekly or twice-weekly testing. The federal government employs more than 4 million Americans. The president also introduced new incentives to help encourage more Americans to get vaccinated, including reimbursements to small- and medium-sized businesses who give their employees time off to get their family members vaccinated. And he called on states, territories, and local governments to offer $100 to anyone who gets fully vaccinated using money from the American Rescue Plan. “If incentives help us beat this virus, I believe we should use them. We all benefit if we can get more people vaccinated,” Biden said in a press conference.
  • COVID-19 drives drop in life expectancy in U.S. A new federal report shows that life expectancy in the U.S. fell by 1.5 years in 2020 compared to 2019, mostly due to the coronavirus pandemic. For Black and Hispanic Americans, two groups disproportionately impacted by illness and death from COVID-19, the decrease was even more drastic — about 3 years. The drop in life expectancy in 2020 “was the largest one-year decline since World War II, when life expectancy declined 2.9 years between 1942 and 1943,” health officials said in a news release. COVID-19 deaths contributed to 74 percent of the decline, overall. Unintentional injuries, homicides, diabetes and chronic liver disease and cirrhosis also contributed. 

Answers to the most frequently asked questions about COVID-19.

Are older adults at higher risk of illness? 

Older adults and people with chronic underlying health conditions are more likely than younger, healthier people to experience serious illness from COVID-19, the disease caused by the coronavirus. The risk increases for people in their 50s and continues to rise with age, the Centers for Disease Control and Prevention (CDC) reports, with individuals 85 and older at the greatest risk for severe illness. Ninety-five percent of COVID-19 deaths in the U.S. have occurred among people who were 50 or older.

Part of the reason risk increases with age is that people are more likely to have other health issues later in life, and underlying health conditions are a huge driver of complications that arise from COVID-19. A June 2020 report from the CDC found that hospitalizations for people with COVID-19 were six times as high for patients with chronic health conditions, compared to otherwise healthy individuals; deaths among this population were 12 times as high.

People with the following conditions are at increased risk for severe illness from COVID-19, the CDC says:

  • Cancer
  • Chronic kidney disease
  • Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate to severe), interstitial lung disease, cystic fibrosis and pulmonary hypertension
  • Dementia or other neurological conditions
  • Diabetes (type 1 or type 2)
  • Down syndrome
  • Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)
  • HIV infection
  • Immunocompromised state (weakened immune system)
  • Liver disease
  • Overweight and obesity (defined as a body mass index of 25 or greater)
  • Pregnancy
  • Sickle cell disease or thalassemia
  • Smoking, current or former
  • Solid organ or blood stem cell transplant (includes bone marrow transplants)
  • Stroke or cerebrovascular disease, which affects blood flow to the brain
  • Substance use disorders (such as alcohol, opioid or cocaine use disorder)

What can older adults do to reduce their risk? 

Get vaccinated

The FDA has officially approved one vaccine from Pfizer-BioNTech and has issued emergency use authorizations (EUA) for two other COVID-19 vaccines developed by Moderna and Johnson & Johnson (J&J). All three vaccines are safe and effective at preventing hospitalization and death from COVID-19. In fact, less than 1 percent of vaccinated individuals have been hospitalized or have died from COVID-19, according to the CDC. 

People who have been fully vaccinated — which is two weeks after the single dose J&J shot, or two weeks after the second shot of the two-dose vaccines — can start to ease up on some precautions practiced throughout the pandemic. For example, fully vaccinated individuals don’t need to get tested before or after travel or self-quarantine after travel. Vaccinated individuals can also ease up on mask-wearing in some situations, although health officials do recommend wearing one in indoor public spaces in areas where coronavirus cases are surging. Masks are also still required on planes, buses, and other forms of public transportation. 

Otherwise, keep up mitigation efforts

If you haven’t been vaccinated, the best way to dodge a coronavirus infection is to avoid being exposed to the virus. Limit interactions with people outside your household as much as possible, keep a distance of at least 6 feet from others and wash your hands often with soap and water (or use an alcohol-based hand sanitizer if soap and water are not an option). Also, avoid crowds and poorly ventilated spaces.

Masks are advised for unvaccinated individuals in public settings. Face masks help protect the wearer from coronavirus infection, in addition to helping protect others from being infected by the wearer.

Wearing a surgical mask under a cloth mask significantly improves protection from the coronavirus by creating a tighter fit around the face, a CDC study published Feb. 10 found. The study showed that when a cloth mask was worn over a surgical mask, 92.5 percent of cough particles were blocked, compared to only about 42 percent from a cloth or surgical mask alone. 

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What about travel? 

Before you make travel plans, be sure to double-check any rules pertaining to your destination and mode of transportation. Many countries and states have travel restrictions or guidelines in place that could affect your trip — the same goes for airlines. AARP has a list of coronavirus restrictions in every state. Plus, the CDC has country-specific travel recommendations based on COVID-19 risk levels. 

The CDC says both vaccinated and unvaccinated travelers should still follow these recommendations for traveling safely.

  • Wear a mask over your nose and mouth. Masks are required on planes, buses, trains and other forms of public transportation and in U.S. transportation hubs such as airports and stations.
  • Keep a safe distance from others and avoid crowds.
  • Wash your hands often or use hand sanitizer.

Travel guidance for fully vaccinated people. Fully vaccinated travelers are “less likely to get and spread COVID-19,” health officials say, but they should still be on alert and wear masks, avoid crowds, socially distance and wash their hands frequently. They can leave the country without getting a COVID-19 test unless their destination requires it, and they do not need to self-quarantine after returning to the U.S. unless it’s required by a local jurisdiction.

However, vaccinated people are still required to have a negative COVID-19 test result before they board an international flight in order to return to the U.S., the CDC says, and they should take a COVID-19 test three to five days after returning. People are fully vaccinated two weeks after they receive their second dose of the two-dose COVID-19 vaccines or the single-dose Johnson & Johnson vaccine. 

Travel guidance for unvaccinated people.
 The CDC recommends delaying travel until you are fully vaccinated because travel increases your chance of getting and spreading COVID-19.

Testing can help you travel more safely, the CDC says. The CDC recommends getting tested with a viral test one to three days before your trip. Keep a copy of your test results with you during travel; you may be asked for them.

International travel is strongly discouraged for unvaccinated individuals. Those who must travel should have a negative COVID-19 viral test result no more than three days before leaving the country and they are required to have a negative COVID-19 viral test result no more than three days before returning to the U.S.

Testing and quarantining are also advised upon return. AARP has information about specific travel advisories, and airline change fees, as well as tips on how to stay safe when you travel.

How is the coronavirus spreading?

We’ve learned a lot about how the coronavirus spreads since the beginning of the pandemic. Health experts are now less focused on surface transmission: “Current evidence strongly suggests transmission from contaminated surfaces does not contribute substantially to new infections,” the CDC says. Cleaning surfaces with soap or detergent is enough to prevent the spread of coronavirus in most situations.

Instead, updated CDC guidance says COVID-19 spreads “when an infected person breathes out droplets and very small particles that contain the virus” and another person inhales them, which is why experts warn against congregating in poorly ventilated spaces. These droplets and particles can also land on a person’s eyes, nose or mouth and “in some circumstances, they may contaminate surfaces they touch.”

Finally, it’s important to note that COVID-19 can be spread by people before they start showing symptoms or even if they never develop symptoms (asymptomatic). A study published Jan. 7 in JAMA Network Open found that people without symptoms account for about 59 percent of all COVID-19 transmission. The study underscores why it’s important for unvaccinated individuals to wear a mask, practice social distancing, avoid crowds and take other precautions, whether you have symptoms or not.

What are the symptoms?

People with COVID-19 have reported a wide range of symptoms that typically appear two to 14 days after exposure to the virus. Here is the latest list of symptoms, according to the CDC:

  • 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

The CDC acknowledges this list is not exhaustive; skin rashes or lesions may also be a sign of the virus.

Anyone who experiences symptoms should call their health care provider and get tested. Those who are feeling sick and are unsure of their symptoms can also check the CDC’s interactive guide for advice on appropriate medical care.  

However, if you develop emergency warning signs — pain or pressure in the chest; new disorientation or confusion; pale, gray, or blue-colored skin, lips, or nail beds; difficulty breathing; or an inability to wake or stay awake — get medical attention immediately, health officials warn. 

The CDC also has tips for what to do if you are diagnosed with COVID-19.

How is COVID-19 treated?

Researchers are continuing to study potential treatments for COVID-19, and several promising developments have taken place. Here are some of the treatment options:

Remdesivir: Remdesivir is the first — and so far, only — treatment for COVID-19 to receive approval from the U.S. Food and Drug Administration (FDA). Research shows it can help hospitalized COVID-19 patients recover faster.

Dexamethasone and other corticosteroids: The World Health Organization (WHO) in 2020 issued new guidelines that strongly recommend the use of dexamethasone (along with other inexpensive and common corticosteroids such as hydrocortisone) for the treatment of patients “with severe and critical COVID-19.” Clinical trials found that corticosteroids cut the risk of death in patients hospitalized with the disease.

Bamlanivimab and etesevimab: This therapy, from drug manufacturer Eli Lilly, combines two monoclonal antibody drugs. The combination received an emergency use authorization (EUA) from the FDA on Feb. 9 to treat mild to moderate cases of COVID-19 in patients at high risk of severe disease, including people 65 and older and those with chronic medical conditions. Bamlanivimab is no longer authorized as a treatment when used on its own. The drugs are not approved to treat hospitalized patients or those who require oxygen.

Casirivimab and imdevimab: Another antibody treatment, Regeneron's COVID-19 monoclonal antibody cocktail received an EUA for the treatment of mild to moderate COVID-19 in non-hospitalized patients who are at high risk of progressing to more severe illness, including people 65 and older and those with chronic medical conditions.

Convalescent plasma: Blood plasma donated by individuals who have recovered from coronavirus infection contains antibodies that may speed recovery when administered to patients hospitalized with COVID-19. The FDA granted an EUA for convalescent plasma on Aug. 23, 2020. A study published Jan. 6 in the New England Journal of Medicine found that giving plasma infusions to patients 65 and older experiencing mild COVID-19 symptoms within a few days of symptom onset significantly reduced the need for oxygen support. However, a federally funded study concluded the treatment did not prevent the progression of disease when given to a high-risk group of outpatients in the first week of their symptoms.

What should I know about the vaccines?

The FDA on Aug. 23, 2021 approved the first COVID-19 vaccine for Americans 16 and older from Pfizer-BioNTech. Two other vaccines are available under emergency use authorization, including one from Moderna and another from Johnson & Johnson (J&J). Moderna has already filed for FDA approval and J&J is expected to do so soon.

All three vaccines are safe and effective at preventing severe disease, studies show, and adverse reactions have been extremely rare.

The Moderna and Pfizer-BioNTech vaccines call for two doses, spaced 21 days (Pfizer) or 28 days (Moderna) apart. However, if that is not feasible, the CDC has said the doses may be spaced up to six weeks apart. Health officials have given the OK for some immunocompromised individuals to get a third dose of the Pfizer and Moderna vaccines to enhance their protection from COVID-19. Additional doses are not recommended for others at this time but could be made available as soon as mid-September.

The J&J vaccine requires only one shot. On April 23, health officials added a warning to this vaccine’s fact sheet following reports of a rare but serious type of blood clot experienced by a small number of people who had received the J&J vaccine. The FDA and CDC reviewed 15 reported cases of the blood clotting disorder, all in women ages 18 to 59 who had received the J&J vaccine and determined the vaccine’s benefits outweigh any known risks.

The new warning advises individuals to seek medical attention right away if they experience any of these symptoms after receiving the J&J vaccine: chest pain; leg swelling; persistent abdominal pain; severe or persistent headaches or blurred vision; or easy bruising or tiny blood spots under the skin beyond the site of the injection. Among the known cases, these symptoms occurred six to 15 days after vaccination, setting them apart from the expected vaccine side effects. It also warns health care providers that heparin — a drug commonly used to break up clots — may be harmful in patients with this rare type of clot. 

Another rare but possible side effect linked to the J&J vaccine: Guillain-Barré syndrome, a neurological disorder in which the immune system attacks and damages nerve cells. In most of the cases the syndrome occurred within 42 days of someone getting the J&J vaccine. The FDA has not modified its EUA for the J&J vaccine and says the chances of this syndrome emerging are “very low.”

Mild cases of inflammation of the heart muscle and surrounding tissue (called myocarditis and pericarditis) have also been reported among younger people following COVID-19 vaccination. Health officials determined this is an “extremely rare side effect” and are still encouraging anyone eligible for a vaccine to get one.

It’s common to experience temporary side effects after getting the vaccine, such as soreness in the arm, headache, fatigue, muscle and joint pain, nausea, fever or chills.

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The latest on how to get the vaccine.

What should I know about coronavirus variants?

Public health officials have identified several new strains of the coronavirus, some of which are more contagious and could potentially be more lethal. Another concern experts have is that the vaccines won’t protect against a new variant that emerges.

The most common variant, known as B.1.617.2 (or delta), was first discovered in India but is now circulating in a number of countries, including the U.S., where it is the dominant variant. The strain is highly contagious, but experts say the federally authorized vaccines so far seem to provide a high level of protection against severe illness caused by delta.

Other variants of concern include one first discovered in the United Kingdom (B.1.1.7., or alpha), another first identified in South Africa (B.1.351, or beta), and a third first found in Brazil (P.1, or gamma). The vaccines have also proven effective against these strains.

Do some people have lingering symptoms?

Many COVID-19 survivors battle lingering symptoms for weeks or months after infection, even if the initial infection was mild or asymptomatic. Sometimes called “long-haulers,” they suffer from dizziness, insomnia, confusion, a racing heart or a host of other lasting effects that keep them from getting back to their normal lives.

Experts encourage COVID-19 patients experiencing continuing symptoms to seek care from a medical provider. Many U.S. hospitals have set up special clinics for survivors and have already learned a lot about the best ways to help.

What should I know about testing?

The CDC says you should consider getting a COVID-19 test if:

  • You have symptoms of COVID-19 — this applies to both vaccinated and unvaccinated individuals. 
  • You have had close contact with someone with confirmed COVID-19. 
  • You have been asked to get tested by a healthcare provider or state or local health department.

The most accurate COVID-19 tests use a method called polymerase chain reaction, or PCR. PCR tests require your sample to be sent to a lab, so it can take a few days to get results. 

The FDA has also given EUAs to rapid tests that use what’s called antigen technology. Antigen tests are faster because samples don’t have to be sent out to a lab, but studies show they are less accurate, especially if you are asymptomatic. 

What’s more, five at-home COVID-19 tests have the FDA’s OK. These tests deliver results in real time at home and are sold over the counter without a doctor's prescription. Some are already available.

This story will be updated periodically with new developments. Check back regularly.

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