The number of virus cases is exploding nationwide. Medical and health officials have been begging people for weeks to refrain from their usual holiday gatherings and to continue to practice the guidelines given to them by the Centers for Disease Control and Prevention.

Still, misinformation and confusion about symptoms, quarantine periods, and more pervade.

Dr. Timothy Friel, an infectious specialist and chair of the Department of Medicine at Lehigh Valley Health Network, said he knows there are people who still question the severity of the virus.

“I can tell you the reality is that I have faced and my colleagues have faced each and every day, whether they are working critical care, hospital medicine, emergency medicine, my infectious disease counterparts, the nurses who are there each and every day, we have never worked harder and we are fully committed to taking care of each and every individual. It is a very, very real problem,” he said.

COVID-19 is not the flu

One of the misconceptions is that the coronavirus is the same as the influenza virus.

Friel explained the differences.

There are two types of influenza virus: influenza A and B, plus several different subtypes. COVID-19 is a coronavirus, originally called SARS-CoV-2.

The new name is an abbreviation for coronavirus disease and 19 is for 2019, the year in which it first began.

“COVID-19 is a different virus, and the manifestations of this disease are in general more significant than that which we see within influenza,” Friel said.

Part of the confusion lies in how the disease manifests in people. One neighbor could have the sniffles and be in bed for 24 hours, while his neighbor ends up intubated in the hospital for five weeks.

“It is the same virus that causes these very different manifestations in individuals,” he said.

This is possible because our bodies are all different.

“Our biologies, our genetics are all different, and we don’t have a great way of predicting who will and who will not have the most severe disease. That’s what makes this such a significant foe,” he said. “In my lifetime as an infectious disease doctor, we have never seen this volume of patients in our hospitals.”

Is it a cold or COVID-19?

Another challenge is knowing when it is a cold, and when it is COVID.

Friel said that some people experience a sudden onset of the disease: cough, shortness of breath, fever and aches. When that happens, it’s obvious that the person should get tested for COVID-19 and isolate in order to keep from spreading the virus. The problem is that many people have less obvious symptoms. A runny nose is a really common one.

“If you have any concerns that this is out of the normal, try to isolate yourself. Put yourself in a position that if this is COVID-19, you are not going to expose others,” he said. “If the symptoms are significant, reach out to your health care team. Call for a video visit. Whenever in doubt ask someone.”

If a person knows he has been exposed to the virus and has symptoms, go get tested. The test will confirm the diagnosis.

Friel said most people should quarantine for 10 days from the date they began showing symptoms, as long as there has been at least one day without fever.

Using medications like acetaminophen or ibuprofen to reduce a fever doesn’t count as being a day without a fever.

Some people will continue to test positive and have symptoms past 10 days.

“Even though people have continued to test positive, we have been unable to culture the virus. We don’t think they are contagious to others,” he said.

There are exceptions to this rule.

People who have had a severe manifestation of the disease, or have been in the hospital or the intensive care unit should continue to be in isolation for 20 days, because they might carry a higher viral load, and could shed the virus for a longer period of time, Friel said.

Another exception would be if a person has had a fever for 12 days, then isolation is for those 12 days plus one extra day.

“The golden rule is always 10 days from the time of symptoms with at least 24 hours without having a fever,” he said. “For people who are asymptomatic, they never develop symptoms, it’s 10 days from the positive test.”

Managing symptoms

The majority of people can manage their symptoms at home, and should get plenty of rest and plenty of fluids. But if a person feels shortness of breath, chest discomfort, lightheaded, dizzy or dehydrated, then he should contact his doctor.

If the symptoms are severe, Friel recommends going to the emergency room or calling for an ambulance.

“Getting to a higher level of care is incredibly important, and it should be done in a timely fashion,” he said.

Once a person has had COVID and recovered, he cannot pass on the virus.

“You really only infect others if you have active infection,” Friel said.

For three months after recovery, a person’s body is able to control viral replication and prevents them from spreading the virus to others.

“How long that prevention lasts is still one of the big unknowns,” he said.