Coronavirus refers to a family of viruses that cause a spectrum of diseases ranging from the common cold to severe life-threatening pneumonia. They’re named for the spike proteins on the surface of the virus that make the virus look like a crown or star.

The 2019 novel coronavirus was identified as the cause of an outbreak of respiratory illness first detected in Wuhan City, Hubei Province, China, in December 2019. The virus has been named SARS-CoV-2, and the disease it causes has been named coronavirus disease 2019, abbreviated as COVID-19. On March 11, 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization.

Updated April 14, 2020

The virus that causes COVID-19 spreads from person to person. Someone who has COVID-19 can spread the illness to others, even if they don’t show any symptoms. The principle mode of transmission is thought to occur mainly via respiratory droplets that travel up to six feet in the air after an infected person coughs or sneezes. This is similar to how influenza and other viruses spread. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

There is also some evidence that virus particles can remain on contaminated surfaces for several days, but the CDC does not believe that this is the main way that the virus spreads.

Updated May 1, 2020

Viral shedding occurs when a virus is detected in body fluids such as nasal secretions and saliva. Evidence suggests that the novel coronavirus is most contagious when symptoms are worse and viral shedding is high. However, it appears that some people can be contagious prior to developing symptoms, suggesting that viral shedding is occurring even early in the infection.

There is limited research about how long the virus stays in the air. The virus is mostly transmitted when people are in close contact with one another, spread by droplets produced when an infected person sneezes or coughs.

Research suggests that COVID-19 lives for up to 72 hours on hard, shiny surfaces and up to 24 hours on cardboard, paper and fabric. It is not known if the virus present on surfaces remains infectious, surfaces suspected of contamination should be disinfected.

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 mouth, nose or eyes. This is why hand-washing is always a good practice.

Updated April 22, 2020

The symptoms of COVID-19 infections can range from very mild to severe respiratory illness and may include fever, cough and shortness of breath. These symptoms can be very similar to those for influenza, so it may be difficult to distinguish without clinical testing. Patients with this virus have had mild to severe respiratory illness with symptoms that can include:

• Fever, cough, shortness of breath (most common)
• Headache, unexplained muscle aches, changes in taste and smell, sore throat, eye conjunctivitis, confusion, fatigue, stomach upset (nausea, vomiting, diarrhea) (less common)

The CDC recommends seeking immediate medical attention if you develop any of the following emergency signs:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion or inability to awaken or stay awake
• Bluish colored lips or face

Symptoms of the coronavirus may appear in as few as two days or up to 14 days after exposure, according to the U.S. Centers for Disease Control and Prevention (CDC).

Use our online symptom checker in MyChart or the CDC's coronavirus self-checker to get a better idea of what your next steps should be if you are feeling ill. 

No, there is no evidence that children are more susceptible. Although infections in children have been reported, including very young children, most confirmed cases of COVID-19 have occurred in adults.

For more information, please visit our FAQ on Coronavirus and Pediatric Patients.

It is not known if infection with COVID-19 results in long-lasting immunity. This is still under active  investigation.

Updated April 22, 2020

If you think you have been exposed to COVID-19 and develop a fever and symptoms such as cough or difficulty breathing, call your health care provider or our patient hotline at 415-514-7328. Please use the UCSF MyChart “Coronavirus & Flu Symptom Checker” before you call the hotline. If you are a patient of the UCSF Cancer Center, please contact that clinic for specific instructions prior to calling the UCSF coronavirus line.

If you are a UCSF Health patient and have symptoms of COVID-19, we are committed to helping you get tested within 48 hours.

In the meantime, if you feel sick, take the following precautions:

• Avoid public areas, and stay away from others in your home. If you can use a separate bedroom and bathroom, do so.
• Cover your mouth and nose when coughing or sneezing.
• Wear a mask to cover your nose and mouth if you have cough and are around other people in your home or in public. Please do not wear a mask with a valve, as these masks allow droplet release and do not protect others who may be nearby.
• Wash your hands after touching your face, before eating, after using the bathroom. If soap and water is not available, use hand sanitizer with >60% alcohol.
• Avoid sharing personal household items.
• Clean all high touch services every day such as counters, tabletops, doorknobs, phones, keyboards. Use a household cleaning spray or wipe according to label instructions.
• Monitor your symptoms. If you feel your symptoms are worsening, contact your health care provider.

Watch a video that explains more.

If you have a medical emergency, call 911 and notify the dispatch personnel that you have or are being evaluated for COVID-19.

If you are sick, please contact your physician or call our patient hotline at 415-514-7328 so that we can best triage your situation.

Updated April 14, 2020

If you are experiencing high levels of anxiety, fear and/or stress in response to the COVID-19 pandemic, you are not alone. Below is a list of evidence-based resources and strategies to help you cope with this challenging time.

What can I do for exercise?

Continue to move while practicing physical distancing. More than ever before, we know that our physical health affects our mental health. Exercise can reduce stress reactivity and even improve symptoms of depression and anxiety. You can find a variety of online resources with guided exercise routines that offer an opportunity to move even if you do not currently have access to a safe place to exercise outside.

How can I stay connected to friends and family during social distancing?

“Social distancing” is a misnomer. What we actually need to do now is physical distancing, while we work hard to stay socially connected. Take time to stay in touch with friends and family by phone, video, text or email. In addition to sharing social support about the current crisis, it is a good idea to talk about other topics you would normally discuss. Consider hosting a dinner using FaceTime or Zoom, so you can talk while you eat (and talk about some positive things, not just this crisis).

How can I stay updated on news and world events?

Reading or watching an excess of news about a traumatic event can create symptoms of post-traumatic stress disorder. Try to limit COVID-19 media exposure to no more than twice a day (for example, check for updates in the morning and before dinner), and try to avoid reading about COVID-19 right before bedtime. Before sending alarming headlines to friends and family, pause to consider whether the information will be truly helpful or hurtful.

What other techniques can I use to reduce stress?

There are many other techniques and resources available to help you reduce stress, whether it’s related to the pandemic or not. Here is just a sampling.

Guided Imagery

Guided imagery is a tool that encourages you to create images in your mind that can bring about a desired physical response, such as feeling more relaxed. Studies show that it can be helpful for coping with stress, anxiety and sleep difficulty. The UCSF Osher Center for Integrative Medicine provides free guided imagery recordings here: https://osher.ucsf.edu/guided-imagery-meditation-resources.

Mindfulness and Meditation Apps Are Available for All Levels of Experience

Developing a regular meditation practice (ideally about 20 minutes per day) is a powerful way to reduce stress, calm anxiety, improve your physical and emotional health, and sleep better. Find the one that is right for you, or try the UCLA Mindful App. It’s free and has meditations led by Diana Winston, Director of Mindfulness Education at UCLA's Mindful Awareness Research Center.

Breathing Exercises

If you are learning a breathing exercise for the first time, the most important thing is to choose one that you can easily learn. This one is simple for beginners and helps to activate the part of the nervous system required to feel relaxed. It is called “4-5-6” because those are the numbers of seconds spent in each phase of the breath cycle. Here are the instructions:

1. After breathing all of the air out of your lungs, inhale through your nose to the count of four.
2. Then, pause the breath with full lungs before exhaling to the count of five.
3. Follow the pause with a very full exhalation through your nose to the count of six. The last couple of counts will be an active exhalation, pushing out as much air as is comfortable.
4. Do this for eight breaths in a row.

While practicing this exercise, be aware of how you are breathing. The exercises should be done with diaphragmatic breathing, moving your abdomen in and out with each breath. Many of us breathe more with our chests than our abdomens, but the opposite is more effective for these breathing exercises.

Further Resources:

The UCSF Department of Psychiatry has compiled information to help you cope with stress and anxiety during this pandemic.

You can also reference UCSF Campus Life Services' Tips to Stay Social and Well.

At this time, we recommend video visits for routine, non-urgent medical visits. UCSF Health is able to offer telehealth visits, in which you can interact with your provider via video and receive management recommendations without coming into the clinic.

• The first step to setting this up is to activate your MyChart account, and call your provider’s clinic to set up the visit.
• If you are unable to do a video visit, we recommend postponing non-urgent visits.
• Your clinical team is also available to respond to your questions via MyChart and telephone.
• We can also see you in a face-to-face visit for urgent issues that cannot be resolved via telehealth, telephone or MyChart.

If possible we recommend keeping at least a one-month supply of medications for chronic conditions. Your insurance company may limit the amount you can keep on hand (consider a mail order pharmacy). Keep over the counter home remedies available, if you need to treat fever at home. We recommend keeping acetaminophen at home, as this is safe for most older adults.

If you are caring for an older adult with dementia, the Alzheimer’s Association provides useful tips and information.

Updated May 1, 2020

Remdesivir is an investigational antiviral compound undergoing clinical trials in China, the United States, and the United Kingdom as a potential treatment for COVID-19, including at UCSF Health. It is not yet licensed or approved anywhere globally.

Published studies to date have not demonstrated the benefit of using remdesivir for the treatment of COVID-19.  However, a recent press release from the National Institutes of Allergy and Infectious Diseases reported improved clinical outcomes in an interim analysis of a large randomized control trial in patients taking remdesivir compared to those taking placebo.  Publication of this study through a process of peer review is pending as are several other studies using remdesivir.

UCSF is currently leading clinical trials of remdesivir, as well as of hydroxychloroquine and the antibiotic azithromycin.

Updated May 1, 2020

Hydroxychloroquine is in a class of drugs that are primarily used to treat malaria, but also are used to treat discoid or systemic lupus erythematosus and rheumatoid arthritis in patients whose symptoms have not improved with other treatments.

We currently don’t know whether hydroxychloroquine is effective in treating patients with COVID-19. There have been a few small studies that have not answered key questions and have shown evidence of harm by using chloroquine and hydroxychloroquine in patients with COVID-19. This demonstrates the importance of not using these drugs off-label and instead testing them in clinical trial settings where we can monitor patients.

UCSF is currently leading clinical trials of hydroxychloroquine and the antibiotic azithromycin, and of remdesivir.

Updated May 1, 2020

There are two main types of tests for COVID-19. Reverse transcriptase polymerase chain reaction (RT-PCR) directly detects active viral infection. Serology tests detect immune response (antibodies) to infection, which typically takes at least two to three weeks to develop.

UCSF Health is doing testing at various locations including drive-through sites, Respiratory Symptom Clinics and our emergency room. We perform these tests using a polymerase chain reaction (PCR) technique similar to that used in testing for COVID-19 by the Centers for Disease Control and Prevention (CDC).

PCR allows scientists to detect very small amounts of virus in a sample obtained with a swab from a patient’s nose and throat.

Test results can be expected typically between 24-72 hours. Test results are published in MyChart, and we will telephone you if the results are positive. You will receive a robotic call if it is negative.

Updated May 1, 2020

In addition to providing COVID-19 diagnostic and serologic testing services, UCSF has initiated a number of new research studies. Teams are assessing the performance of commercially available serologic tests, as well as the performance and quality of available diagnostic PCR tests so that health systems and governments are aware which are the most effective testing platforms. 

Updated May 1, 2020

Serology blood tests are designed to identify who has previously been infected with COVID-19.  They look for an immune response to the coronavirus in the form of a specific protein material, or antibodies, in your blood. It takes time for the body to produce antibodies, so antibodies may not be detected early on after infection. Not all patients may develop detectable antibodies, particularly patients who have weakened immune systems due to underlying diseases or certain medications.

Serology tests for COVID-19 are mainly used for diagnostic testing of patients whose symptoms indicate a high suspicion of COVID-19, but who are seeking care more than a week after symptoms began and who do not test positive for COVID-19 RT-PCR test. The tests also are useful for people who want to donate convalescent serum and, once they are more reliable, can be used to determine how broadly the virus has spread in the community in the past.

There continues to be significant variability in commercial serologic tests, but we hope to see more accurate tests come online soon. In the meantime, testing of asymptomatic individuals with low suspicion for prior infection should be approached with caution until we understand more about the potential for false positive and false negative results.

Updated March 1, 2020

SARS-CoV-2 serology tests are now available for UCSF patients with a provider order. Recommended uses for this test are described above. Results should be back within 24 hours from the time blood is drawn for the test.

Updated May 1, 2020

Convalescent serum is the cell-free part of blood containing antibodies that is taken from patients who have recovered from a certain illness and then delivered to patients with the same illness to help their immune response. It is a treatment that has been used for many infections over the years, but its effectiveness still needs to be studied for patients with COVID-19.

Updated May 1, 2020

A positive test shows that you have antibodies that may have resulted from COVID-19 infection. It could also be a false positive test from a cross reaction with antibodies from a related coronavirus or other virus (there are multiple other common coronaviruses that cause mild upper respiratory infections).

Antibodies can appear approximately one week after infection and typically peak four to six weeks after symptom begin.  Most people will develop antibodies within two to three weeks after infection. Some patients, particularly those with immunocompromising conditions, may not produce a detectible antibody response. The length of time that antibodies remain in the body after infection is not well known for SARS-CoV-2.  For most viruses, antibodies remain detectable for months or sometimes even years after infection.

We currently don’t know whether antibodies to the SARS-CoV-2 virus offer immunity against future infections and if so, for how long. Several other coronaviruses have limited or short-term immunity after an infection, but it is too early in this epidemic to understand whether or how antibodies will protect people who have had COVID-19.

We will need more studies to determine if the presence of antibodies means a person won’t get re-infected. Until those studies are done, decisions about returning individuals to work or school should not be based on antibody test results.

Updated May 1, 2020

Not necessarily. Antibodies may become detectable before infectious virus is cleared by the body, so a positive antibody test does not mean you cannot spread the virus to other people.

Updated May 1, 2020

A negative test means you probably have not had a previous infection with COVID-19 that has since resolved. However, you could still have a current infection if antibodies have not formed yet (it takes 1 to 3 weeks to develop antibodies), or you could have had a previous infection but not developed an antibody response (particularly if you have a weak immune system from underlying medical conditions or medications).

Updated June 17, 2020

Governor Gavin Newsom issued a directive requiring health insurance companies to waive member cost-sharing amounts for screening and testing for the COVID-19 disease. The federal government passed the Families First Coronavirus Response Act, which also offers waiving of patient co-pays, co-insurance & deductibles for COVID-19 screening and testing.  This FFCRA only applies to COVID-19 screening and testing and not other services rendered.

Updated April 22, 2020

Currently, there is no vaccine to prevent COVID-19 infection. The best way to prevent infection is to avoid being exposed to this virus. The U.S. Centers for Disease Control and Prevention (CDC) recommends everyday preventive actions to help prevent the spread of respiratory viruses.

• Wash your hands often with soap and warm water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60 percent alcohol if soap and water are not available.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home and do not travel or go to work or school when you are sick.
• Cover your mouth and nose with a tissue when you cough or sneeze then throw the tissue in the trash. Then wash your hands with soap and water.
• Clean and disinfect frequently touched objects and surfaces.
• Wear a cloth face covering while you are outside and in public settings. Masks with valves are not recommended, as these masks allow droplet release and do not protect others who may be nearby. 
• Practice physical distancing by staying at least 6 feet away from other people, especially if COVID-19 is currently spreading in your community.

Many states, including California, have implemented shelter in place policies that encourage all residents to remain home except for trips for essential services. In order to limit the spread of this virus, it is highly recommended that you follow policies implemented by your local government. You can find more information about the shelter in place policy here.

Updated April 22, 2020

The CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain, such as grocery stores and pharmacies.

The CDC also recommends that those who are ill should wear a facemask when around other people and before you enter a healthcare provider’s office. Employees and visitors to UCSF Health hospitals and clinics are now wearing masks at all times to further reduce the risk of spread of COVID-19 among our workforce and patients.

At UCSF Health, we support the use of face masks or face coverings. Please note that physical distancing, i.e. maintaining at least 6 feet away from others, is still required, even when wearing a mask.

Reasons we support the use of face masks:

• The highly contagious nature of the virus
• The potential for asymptomatic and pre-symptomatic transmission
• Empiric evidence from Asia, where masks are routinely used
• Supplies of hospital-grade masks for health care workers must continue to be a priority, but extra surgical masks or homemade masks of multilayered cotton will likely provide more protection compared to wearing nothing during this epidemic.

Of note, avoid wearing a mask that contains a valve (typically a raised plastic cylinder about the size of a quarter on the front or side of the mask) that is designed to facilitate easy exhaling. The latest Order of the Public Health Officer in San Francisco (C19-12 “Requiring Face Covering”) specifically prohibits masks of this type. Valves permit droplet release from the mask, putting others nearby at risk.

An increasing number of cities in the U.S. are embracing this recommendation: "Stay in place, keep your space, and cover your face."

Updated April 20, 2020

There is much information being shared on social media and other forums, not all of which are scientifically based. Medical professional societies are reacting in real time to developments and sharing consensus recommendations. Our physicians at UCSF are meeting daily to make consensus decisions on what is best for our patients based on available data and experience of our colleagues. The best available data indicate that it is safe to continue your regular medications, including heart / blood pressure medicines such as the ACE inhibitor and ARB classes of drugs that some patients may have been prescribed.

Currently, most patients with COVID-19 do not require treatment. For the minority of patients that become more ill, therapy is supportive. At this time, there is no specific treatment for COVID-19. Studies are underway to test antiviral medications and work is in progress to develop a vaccine. We do not currently recommend the use of hydroxychloroquine for the treatment or prevention of COVID-19 in the outpatient setting, but studies are being performed to see if this might be beneficial.

Updated April 20, 2020

Researchers are currently investigating whether convalescent sera (blood plasma from recovered patients that contains COVID-19 antibodies) may be beneficial to patients who are critically ill from COVID-19.  Whether this approach is truly beneficial requires rigorous study.  Recovered patients interested in donating can contact the Red Cross or Vitalant.