What are the treatment options for COVID-19?

There are several, and which one is best depends on how sick someone is.

For example, steroids such as dexamethasone can lower the risk of dying for severely ill patients. But they may do the opposite for those who are only mildly ill.

In the United States, no treatments are specifically approved for COVID-19, but a few have been authorized for emergency use and several more are being considered. A panel of experts convened by the National Institutes of Health updates guidelines as new studies come out.

Here’s what’s advised for various patients:

— Not hospitalized or hospitalized but not needing extra oxygen: No specific drugs recommended, and a warning against using steroids.

— Hospitalized and needing extra oxygen but not a breathing machine: The antiviral drug remdesivir, given through an IV, and in some cases also a steroid.

— Hospitalized and on a breathing machine: Remdesivir and a steroid.

What about convalescent plasma, an infusion of blood from a COVID-19 survivor that contains antibodies that fight the virus? Not enough is known to recommend for or against it, the guidelines say.

However, enough is known to advise against hydroxychloroquine and certain drugs that affect the immune system — multiple studies have found them ineffective against the coronavirus.

Aside from drugs, doctors have learned more about ways to treat hospitalized patients, such as putting them on their bellies and other measures that may prevent the need for breathing machines.

Can the coronavirus travel more than 6 feet in the air?

Research indicates it can, but it’s not clear how much of the pandemic is caused by such cases.

People spray liquid droplets of various sizes when they cough, sneeze, talk, sing, shout and even just breathe. The coronavirus can hitchhike on these particles.

The advice about staying at least 6 feet apart is based on the idea that the larger particles drop to the ground before getting very far.

But some scientists have also focused on tinier particles called aerosols. These can linger in the air for minutes to hours, and spread through a room and build up in concentration if ventilation is poor, posing a potential risk of infection if inhaled.

For aerosols, “6 feet is not a magic distance” and keeping even farther apart is better, says Linsey Marr, who researches airborne transmission of infectious diseases at Virginia Tech.

Some scientists say there’s enough evidence about aerosols and the virus to take protective measures. In addition to the usual advice, they stress the need for ventilation and air-purifying systems when indoors. Even better, they say, is to stay outdoors when interacting with others.

How can I tell the difference between the flu and COVID-19?

It’s impossible to tell without a test. Influenza and COVID-19 have such similar symptoms, you may need to get tested to know what’s making you miserable.

Body aches, sore throat, fever, cough, shortness of breath, fatigue and headaches are symptoms shared by the two.

One difference? People with the flu typically feel sickest during the first week of illness. With COVID-19, people may feel the worst during the second or third week, and they may be sicker for a longer period.

Another difference: COVID-19 is more likely than the flu to cause a loss of taste or smell. But not everyone experiences that symptom, so it’s not a reliable way to tell the viruses apart.

That leaves testing, which will become more important as flu season ramps up this fall in the Northern Hemisphere. Doctors will need to know test results to determine the best treatment.

It’s also possible to be infected with both viruses at the same time, said Dr. Daniel Solomon, an infectious diseases expert at Brigham and Women’s Hospital and Harvard Medical School in Boston.

Whether you get tested for one or both viruses may depend on how available tests are and which viruses are circulating where you live, he said.

“Right now we are not seeing community transmission of influenza, so widespread testing for the flu is not yet recommended,” Solomon said.

Both the flu and coronavirus spread through droplets from the nose and mouth. Both can spread before people know they are sick. The flu has a shorter incubation period — meaning after infection it can take one to four days to feel sick — compared to the coronavirus, which can take two to 14 days from infection to symptoms.

On average, COVID-19 is more contagious than flu. But many people with COVID-19 don’t spread the virus to anyone, while a few people spread it to many others. These “superspreader events” are more common with COVID-19 than flu, Solomon said.

Preventing the flu starts with an annual flu shot tailored to the strains of the flu virus that are circulating. Health officials would like to see record numbers of people get flu shots this year so hospitals aren’t overwhelmed with two epidemics at once.

There’s no vaccine yet for COVID-19, although several candidates are in the final testing stages.

Precautions against COVID-19 — masks, social distancing, hand-washing — also slow the spread of the flu, so health officials hope continued vigilance could lessen the severity of this year’s flu season.

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