As the number of confirmed cases of COVID-19 in New York and the rest of the country continues to rise, questions are swirling about what the disease is and how afraid New Yorkers need to be. Given that the virus is new and the news is fast-moving, the answers are not always clear or definitive. Since the beginning of the epidemic in China, Gothamist and WNYC have been speaking to a variety of health experts and government officials to get a handle on the spread and the risks of infection. Here is what we know to date.

If you have questions we don't answer, feel free to ask us—email us at [email protected] or call and leave a message at 646-470-7736—and we'll keep adding updates here. [This post has been most recently updated on April 21, 2020]

What is coronavirus? Or am I supposed to call is COVID-19?

Actually there are many kinds of coronaviruses. The World Health Organization explains, "Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV)."

The one that's been in the news is a novel (new) coronavirus that hadn't been identified in humans before. Named COVID-19, it was first reported in Wuhan, China at the end of 2019, and, at this point, has affected thousands of people worldwide.

The United States now leads all countries in confirmed coronavirus cases. There are almost 790,000 cases in the U.S., with over 43,000 deaths. In New York—which reported its first case on March 1—there are over 250,000 positive cases, with nearly 140,000 in New York City. NYC is also counting over 14,00 COVID-19-related deaths.

See more at our COVID-19 statistics page for New York and NYC.

How is it spread?

It's believed that COVID-19 is spread through "person-to-person contact" (when people are within six feet of each other; "through respiratory droplets produced when an infected person coughs and sneezes") and "spread from contact with infected surfaces or objects," according to the CDC. For instance, "It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads."

What is community spread?

It's a term describing the "spread of an illness for which the source of infection is unknown," according to the CDC. It indicates an escalation of a virus to a new level of contagion. NY state and NYC officials say that the Westchester County resident who has coronavirus contracted it through community spread, because he did not travel to any of the countries where there have been known cases.

What are symptoms of COVID-19?

Symptoms resemble those of a cold or flu; the CDC says the symptoms may appear "2-14 days after exposure," and include fever, cough, and shortness of breath.

Who is most at risk?

Most people who get COVID-19 will recover, but, as NY Governor Andrew Cuomo pointed out, 20% will get seriously ill. The groups of people who are believed to be at most risk are elderly, immune-compromised, and those with underlying respiratory issues. The U.S. deaths so far have been clustered in Seattle, at a nursing home.

During an episode of The Daily, Donald McNeil, a health and science reporter for the NY Times, made two observations: 1) Children don't seem to get as sick (maybe because they are exposed to many coronaviruses at school); and 2) one prominent coronavirus fatality, doctor and whistleblower Li Wenliang who brought attention to the illness last year, was only 34; he may have been exposed to a lot of the virus by being in contact with many sick people.

Based on initial studies, the cases have tilted towards males, and some doctors have noted that although China has hundreds of millions of smokers, only 2% of Chinese women smoke.

So children are not as susceptible?

This is something that puzzles doctors, too. A New England Journal of Medicine article from earlier this year noted that of 425 cases in China, no one under 15 years old was afflicted. Dr. Frank Esper, a pediatric infectious diseases specialist at Cleveland Clinic Children's Hospital, told NBC News, "This is one of the unusual findings and curveballs that this virus keeps throwing at us. Normal coronaviruses seem to affect children and adults equally, but this one, for whatever reason, certainly skews more to the adult population."

Dr. Vanessa Raabe, an assistant professor in pediatric and adult infectious diseases at NYU Langone, suggested that it could be due to the fact that immune systems weaken as people age. "We've seen similar patterns for other diseases—chickenpox, for example," Raabe said. "Adults who get it tend to get much more severe cases than children."

Or it's possible that kids have it, but their mild symptoms of coughing and sneezing resemble a regular cold.

How bad is coronavirus? Is it as bad as SARS or MERS?

Government and health officials alike have emphasized that the majority of people who come down with coronavirus will self-recover, and compared getting coronavirus to having the flu. The CDC's lethality rate for coronavirus is 1.4% (the rate for the flu is 0.6%). Yesterday the WHO cited a 3.4% mortality rate, but experts believe the death rate will become lower when more is known about the disease (for instance, the WHO mortality rate does not factor in mild cases from people who didn't seek medical attention, according to the NY Times).

Carl Goldman, a man who contracted COVID-19 on the Diamond Princess cruise ship, wrote about his experience in the Washington Post, "I have the coronavirus. And it hasn’t been that bad. I am in my late 60s, and the sickest I’ve ever been was when I had bronchitis several years ago. That laid me out on my back for a few days. This has been much easier: no chills, no body aches. I breathe easily, and I don’t have a stuffy nose. My chest feels tight, and I have coughing spells. If I were at home with similar symptoms, I probably would have gone to work as usual."

On the other hand, health care workers in New York and New Jersey are seeing young patients being intubated—some dread their next shift as they describe their hospitals as "war zones." David Lat, an ex-marathoner and healthy 44-year-old, was conscious for six days while on a ventilator before recovering.

The virus is also causing unexpected damage to other organs; there's currently a shortage of dialysis machines, as some coronavirus patients' kidneys have been failing.

Severe acute respiratory syndrome, or SARS, was first an outbreak in Asia in 2003; at the time, there were 8,098 cases and 774 people died, which is a 9.5% mortality rate. Middle East Respiratory Syndrome (MERS) emerged in the Arabian Peninsula; according to the CDC, "about 3 or 4 out of every 10 patients reported with MERS have died."

What's the best thing I can do?

As the United States' hotspot for cases, New York is under a stay-at-home order, New York on PAUSE, that lasts through at least May 15h. This means that anyone who is not an essential worker—such as someone who works in health care, for the police, postal service, or fire department, at a pharmacy or supermarket—must remain at home.

New Yorkers—and those in other states with similar measures—are also asked to socially distance and remain at least six feet away from people you don't live with (families in the same apartment, for instance, can be closer together), and they must wear masks or face-coverings in public, on mass transit or if they cannot socially distance.

Epidemiologist Dr. Stephen Morse tells us, "The best thing is to stay home as much as possible, and strictly observe those precautions"—like hand-washing (see below) and covering our mouths and noses when we cough or sneeze—"we can probably all recite in our sleep now."

There is also no vaccine, so public health officials have repeatedly emphasized that people should practice common sense tactics that you'd use to avoid getting the cold or flu—the foremost one being wash your hands for at least 20 seconds.

Also:

  • Use a hand sanitizer with at least 60% alcohol if you aren't able to wash your hands.
  • Avoid contact—6 feet—with people who are sick.
  • Really try not to touch your eyes, nose, and mouth.
  • Cough or sneeze into a tissue—and then throw your tissue away.
  • Clean and disinfect objects and surfaces with a household cleaning spray or wipe.
  • Stay home if you're sick.

Plus, doesn't hurt to say it again:

  • Wash your hands for at least 20 seconds with soap after you've coughed or sneezed; using public transportation; opened common doors; gone to the bathroom; etc.

What if I think I'm sick ... with coronavirus? Can I get tested?

If you feel like you're sick and you think you might have been exposed to coronavirus, call your medical provider or 311. They will ask you questions and determine whether you should be tested. At this moment, only those who are seriously ill and need hospitalization or are frontline workers (like medical staff or other essential workers) are being tested.

One of the complications is that there are dozens of private companies designing tests and testing equipment, which then labs purchase... and those labs need specific chemicals or must follow certain protocols for that test. There are also challenges along the supply chain to get materials for tests to the points of testing.

President Trump keeps talking about a vaccine coming in a few months. Will there be a vaccine soon?

A vaccine is not expected for another 12-18 months, according to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institute of Health.

Will this go away when it's warmer?

It's unclear if coronavirus COVID-19 will be seasonal, but Elizabeth McGraw, of Center for Infectious Disease Dynamics at Pennsylvania State University, told NPR, "What we know is that they're [the droplets] are better at staying afloat when the air is cold and dry. When the air is humid and warm, [the droplets] fall to the ground more quickly, and it makes transmission harder."

Another point of reference: The Spanish flu pandemic of 1918 came in three waves, spring of 1918, fall of 1918, and spring of 1919.

Healthy people should wear face masks.

Initially, the CDC, as well as state and local health officials, did not recommend wearing a face mask for those who are not infected or sick. Officials had only said healthcare professionals to wear masks, or those who have COVID-19 and are showing symptoms, to protect others from the risk of getting infected. The type of mask that is considered to protect the most from this coronavirus is the N-95 style respirator mask, which was used during the much deadlier SARS epidemic, so flimsy surgical masks won't help you. The N-95 masks are also difficult to wear and require users to be fit-tested.

But by April 2nd, when cases in New York were peaking, Mayor Bill de Blasio recommended residents wear face coverings outside. The CDC reversed its position and also said masks should be worn, and, on April 17th, New York's mask/face covering order went into effect.

Also, back in February, renowned virologist Dr. James Webb sent a letter to friends and family with his tips to prepare—and the letter went viral. One of his tips was "Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you—it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth."

Officials caution against people stockpiling medical or N95 type masks, because that will seriously limit supply to frontline workers. Regular members of the public can wear cloth masks or face-coverings.

What is self-quarantining? Should everyone do it?

The federal government initially only recommended that anyone who traveled from China be self-monitoring their symptoms, but things had been more vague about those who have traveled to the other countries on the watchlist, Iran, Italy, Japan, and South Korea.

"After returning from their mid-February trip to Europe, all of the travelers from a private Rhode Island high school resumed normal activities, except a chaperone who was ill and stayed home," the Wall Street Journal reported. "State health officials advised all the travelers to self-quarantine for 14 days under public-health supervision after the man tested positive for the coronavirus." A health official in Ohio told the WSJ, "The federal partners always have been on the slow side to respond. Just like any bureaucracy, the higher up you go, the more people to answer to and the more complex even simple decisions become."

Now, self-monitoring has expanded to include the other countries. New York City's Health Department explained, "Home self-monitoring means you check yourself for fever and remain alert for cough or shortness of breath. Everyone on home self-monitoring has been provided a plan for whom to contact during the self-monitoring period to determine whether medical evaluation is needed if they develop fever, cough or shortness of breath. People on home self-monitoring are also asked to stay at home and avoid going outside for the entire self-monitoring period. You should not attend work, school, public events or group gatherings. You can get a doctor’s note online at nyc.gov/health/coronavirus if you need to provide documentation of your absence to your school or employer."

A woman who was evacuated from Wuhan, China shared her diary of quarantine on a U.S. military base with the Times, offering a glimpse into some of the exhaustion, stress, and small moments of joy she felt.

Fashion editors who returned to New York from Milan Fashion Week in February are all reportedly self-monitoring/self-quarantining themselves.

Now that many states are under stay-at-home orders, everyone is essentially self-isolating and trying to preserve their own health.

Why is the city telling us a lot of details about the second New York case of coronavirus, the attorney from New Rochelle, like where he worked and where his kids go to school, but not as much about the first case, the health care professional in Manhattan who had been in Iran?

The health care worker had been to a watchlist country and had also been self-monitoring, according to officials, who felt they had enough information about who she contacted between the flight back to New York and her home. In the case of the New Rochelle man, he contracted COVID-19 through community spread, which requires government agencies to trace his steps, as well as those of people in his sphere who also now test positive, including his wife, daughter, son, and the neighbor who drove him to the hospital.

"It’s a recognition that virtually all of this information will surface on its own through bulletins to employees and building tenants, and City medical personnel appearing on the ground," Wiley Norvell, communications director for Mayor Bill de Blasio, explained to us. " We can let it come out by drips and drabs, and risk rumor and misinformation folding into it, confusing the public. Or we can put it out ourselves in succinct fashion, appropriately convey the risk factors people involved are facing, and make sure people know where to turn for correct information."

It's also possible that the city wanted to give more information so people and businesses who may have had different kinds of contact with the attorney's office, say, a food delivery or courier company, could be informed. Still, The city has not offered anywhere near this level of information for other people with coronavirus. They were offering some biographical details—age, gender, borough of residence—but nothing else. And then there were too many cases.

Do I need to stockpile food and supplies?

It couldn't hurt. Dr. Ali Khan, the CDC's former director of the Office of Public Health Preparedness and Response, suggested stockpiling 10-14 days of basic necessities, including non-perishable food. Some New Yorkers have been busy doing this, leading to some empty shelves in supermarkets. Hand sanitizer and Clorex disinfecting wipes are in particularly high demand.

Here are some suggestions for what to stock up on when it comes to food. Some experts recommend ordering deliveries of food or groceries to limit your exposure outside.

Should I go to work? Should I send my kids to school?

While NYC and NY state officials tried to encourage people to maintain as normal a routine as possible even into mid-March, as cases of coronavirus increased, schools were shut down and the state went into a stay-at-home mode for all non-essential workers.

Students have now switched to remote learning. It is unclear when schools will reopen; Mayor de Blasio says that the 2019-2020 academic year will continue remotely while Governor Cuomo says only he can make that decision (and the governor has not made one yet).

While essential workers are helping the city run and treating the ill, non-essential workers fall into two groups: Those who are able to work from home and those were jobs have disappeared because of the stay-at-home order and pandemic.

Should I cancel my trip?

Gothamist has a primer for travelers that gives some tips on what to think about. Those with pending travel plans should consult the CDC's coronavirus website for the latest travel advisories. The agency is currently recommending that Americans avoid all nonessential travel to China, Iran, South Korea and Italy. The CDC has also advised older adults and those with chronic medical conditions to consider postponing nonessential travel to Japan. Given the evolving nature of the epidemic, people should anticipate that more countries could be added to the agency's watchlist.

Dr. Irwin Redlener, the director of Columbia University's National Center for Disaster Preparedness, has advised people to stay current on the news and to consult official health authorities' websites.

"It's a very fluid and dynamic situation," he said, adding, "Your doctor is not in all that much better a position to advise you."

Should I cancel my gym membership?

Since mid-March, gyms, along with movie theaters, nail salons, and other non-essential businesses, have been shut down. You should see if you gym can freeze your membership if you wish to visit them again when they, hopefully, reopen or you can try to cancel your membership. New York Sports Club, whose membership cancellation policies were considered onerous before the pandemic, were even more challenging with people wishing to end their membership, prompting the NY Attorney General to get involved.

Should I take the subway and other mass transit?

Only essential workers should be on mass transit these days. Also, any commuters should be wearing masks or face-coverings.

The MTA has increased its deep-cleaning and disinfection of subway cars, buses, commuter rail trains, and stations (including "customer touch-points" at Grand Central Terminal). NJ Transit has also upgraded their cleaning plans.

What else should I worry about?

Dr. W. Ian Lipkin, a virologist who consulted on the film Contagion and is known as the "Master Virus Hunter," told us, "I’m increasingly concerned about rumors, misinformation, sexism, racism and other forms of xenophobia that circulate like viruses in social media. Let’s tackle those threats to peace and democracy."

Another issue are the racial disparities in the coronavirus patients and fatalities themselves. The virus has hit some communities much harder—specifically, Hispanic and black populations in poorer parts of the city. City and state officials have pointed to generations of institutional racism that have led Hispanics and black to have poorer health and more limited access to quality healthcare.