COVID-19 spreads when an infected person breathes out droplets and very small particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouth. In some circumstances, they may contaminate surfaces they touch. People who are closer than 6 feet from the infected person are most likely to get infected.

COVID-19 is spread in three main ways:

• Breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus.
• Having these small droplets and particles that contain virus land on the eyes, nose, or mouth, especially through splashes and sprays like a cough or sneeze.
• Touching eyes, nose, or mouth with hands that have the virus on them.
• Protect yourself by:
  • Staying at least 6 feet (about 2 arm lengths) from other people.
  • Keeping distance from others is especially important for people who are at higher risk of getting very sick.

People with certain medical conditions like diabetes, heart disease and respiratory illness have an increased risk of severe illness from COVID-19. When an individual with any of these underlying conditions contracts COVID-19, their preexisting condition, or “comorbidity,” increases the chances of severe symptoms and even death.

In Shelby County, 94% of deaths related to COVID-19 have had a preexisting condition — or comorbidity. People of any age with the following conditions are at increased risk of severe illness from COVID-19:

• Heart Conditions
• Diabetes
• Respiratory illness like COPD
• Obesity
• Cancer
• Chronic kidney disease
• Sickle  Cell disease
• Immunocompromised patients (weakened immune system)

Learn more at cdc.gov

An effective early treatment is now available for persons who test positive and have the following risk factors:

• Anyone over age 12 with obesity, chronic kidney disease, diabetes, or whose immunity is compromised by disease or prescription treatments.
• Anyone age 12-17 with sickle cell disease; neuromuscular disorder; dependence on medical intervention, such as a breathing or feeding tube; or a lung disorder such as asthma that requires daily medication.
• Anyone over age 55 with cardiovascular disease, hypertension, COPD or other chronic respiratory disease.
• Anyone over age 65.

If you test positive, and have any of these risk factors, ask your health care provider about early COVID-19 treatments.

The Omicron variant is the latest strain of the COVID-19 virus.  The variant was identified in November 2021 and has now been detected in many nations, including the United States.

Right now, it is not yet clear whether Omicron is more transmissible (e.g., more easily spread from person to person) than the other variants, including the Delta variant, that is currently the dominant variant in the United States.

The Delta variant is highly contagious, more than 2x as contagious as previous variants.

The greatest risk of transmission is among unvaccinated people who are much more likely to contract, transmit, become seriously ill and die from the virus. It is not yet clear how protective the COVID-19 vaccines are against the Omicron variant.

According to the CDC, a breakthrough infection is the detection of SARS-CoV-2 RNA or antigen in a respiratory specimen collected from a person ≥14 days after they have completed all recommended doses of a U.S. Food and Drug Administration (FDA)-authorized COVID-19 vaccine, meaning they are “fully vaccinated.” Breakthrough infections happen much less frequently than infections in unvaccinated people and they also much less likely to cause serious illness, hospitalization or death.

Yes, the Omicron variant has now been detected in Shelby County.

Fully vaccinated people with Delta variant breakthrough infections can spread the virus to others. However, vaccinated people appear to be infectious for a shorter period than unvaccinated people.

Yes. A revised booster vaccine became available in September 2022. It is called a “bivalent” vaccine because it protects against the original strain of COVID-19 and the newer Omicron variant. The new booster is now available to anyone 5 or older who has, at a minimum, completed the initial two-dose series of either Pfizer or Moderna COVID-19 vaccine at least two months ago. More information about the bivalent boosters.

Find a vaccination site near you by going to https://www.vaccines.gov/ and entering your zip code.

The CDC recommends that you and your family continue to take preventative measures such as wearing a mask in public indoor settings with areas of substantial or high community transmission, washing your hands frequently, and physically distancing yourself from others by at least 6 feet, when possible. Everyone 5 years and older can protect themselves from COVID-19  by being vaccinated. Travelers should continue to follow CDC recommendations regarding travel, including wearing masks on all forms of mass transit.

According to the CDC, COVID-19 Vaccine booster shots are available for all adults 18 and older for Moderna and Johnson & Johnson vaccine recipients who completed their initial series at least 6 months ago.

COVID-19 Vaccine booster shots are available for all adults 18 and older and adolescents ages 12 and older for Pfizer-BioNTech vaccine recipients who completed their initial series at least 5 months ago.

Pfizer-BioNTech COVID-19 booster vaccinations are also available to moderately or severely immunocompromised 5–11-year-olds 28 days after their second shot.

3^rd doses are not required, but are recommended for all adults 18 and older, adolescents ages 12 and older, and moderately or severely immunocompromised 5–11-year-olds.

The CDC recommends 3^rd doses of either the Pfizer or Moderna COVID-19 vaccine and 2nd doses of the Johnson & Johnson COVID-19 vaccine.

Individuals who got the Johnson & Johnson COVID-19 vaccine, booster shots are also recommended for those who are 18 and older and who were vaccinated two or more months ago.

You can now mix and match the doses of the COVID-19 vaccine. For example, if you received 1^st and 2^nd doses of the Pfizer vaccine, you can receive the Moderna vaccine as your 3^rd dose and vice versa.

The CDC recommends getting a third dose of the COVID-19 vaccine at least 5 months after the second dose of either the Pfizer vaccine and at least 6 months after the second dose of either the Pfizer or vaccine.

Visit https://www.vaccines.gov/ and enter your zip code to find the closest vaccination site near you.

Yes, the Centers for Disease Control and Prevention now recommends children as young as 6 months old may receive the initial two-dose series of COVID-19 vaccine. Children aged 5 and older may also receive the Omicron-specific booster dose, as long as they have completed the initial two-dose series at least two months ago.

Both Pfizer and Moderna COVID-19 initial series vaccines have been approved for children age 6 months or older. The decision about which vaccine your child receives should be made in consultation with your vaccine provider.

Adolescents ages 12 years and older will receive the same dosage of the Pfizer COVID-19 vaccine as adults. Even though the pediatric Pfizer vaccine has the same active ingredients as the vaccine given to adults and adolescents, children ages 5-11 cannot get the same vaccine that is given to adults and adolescents. They will receive an age-appropriate dose that is one-third of the adult dose. Smaller needles will also be used.

Yes, if your child received the Pfizer vaccine, they will need a second dose of the three weeks after their first vaccination. If they received the Moderna vaccine, they will need a second dose four weeks after the first vaccination.

The drive-thru public sites are not vaccinating children age 5-11 for practical safety reasons. To find a vaccination site that is vaccinating children in that age range, go to Vaccines.gov, select “Pfizer-BioNTech (age 5-11)” under vaccine options, and enter your zip code. Some vaccination sites may require an appointment.

Extensive clinical trials were conducted to study the effects of vaccine in children age 5 to 11. Some of those trials were conducted right here in Memphis by St. Jude Children’s Research Hospital. The studies found the vaccine to be both safe and effective in preventing serious illness from COVID-19 among children in the 5 to 11-year-old age range. The Food and Drug Administration and the Centers for Disease Control and Prevention then reviewed the findings of those clinical trials and approved the vaccine for children.

Even though severe illness with COVID-19 is rare, unvaccinated children can:

• Become infected with the virus that causes COVID-19
• Get very sick from COVID-19
• Have both short and long-term health complications from COVID-19
• Spread COVID-19 to others

For all those reasons, the vaccine is recommended for both healthy children and those who have medical conditions that put them at high risk of complications from COVID-19 infection.

No. Children ages 5 years and older and adults who are eligible should get vaccinated regardless of whether they already had COVID-19. Evidence is emerging that people get better protection by being fully vaccinated compared with previously having a COVID-19 infection. One study showed that unvaccinated people who already had COVID-19 are more than two times as likely than fully vaccinated people to get COVID-19 again.

Yes, your child can get both the COVID-19 vaccine and other vaccines, including the flu vaccine at the same time.

Myocarditis is an inflammation of the heart muscle that can cause chest pain, shortness of breath and other symptoms. It is a rare side effect that has been reported after vaccination with mRNA vaccines like the COVID-19 vaccine. Infection with viruses like COVID-19 can also cause myocarditis.

No. There is no evidence that COVID-19 vaccines cause fertility problems or affect the onset of puberty in either males or females.

Many studies have looked at vaccines and autism, and all studies to date show there is no relationship between vaccines and autism spectrum disorder.

Your child may experience some mild side effects, which are normal signs that their body is building immunity against the COVID-19 virus. Your child may experience pain, redness, or swelling at the injection site. Placing a cool, damp cloth on the injection site can ease discomfort. Other symptoms may include:

• Tiredness
• Headache
• Chills
• Fever
• Nausea

These mild side effects may affect your child’s ability to do daily activities, but should go away in a few days.

Aspirin is not recommended for children and adolescents under 18 years of age. We recommend that you ask your healthcare provider for advice on  using a non-aspirin pain reliever.

Yes. Masks are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air and onto other people when the person wearing the mask coughs, sneezes, talks, or raises their voice. This is called source control. This recommendation is based on what we know about the role respiratory droplets play in the spread of the virus that causes COVID-19, paired with emerging evidence from clinical and laboratory studies that shows masks reduce the spray of droplets when worn over the nose and mouth. Masks are recommended for people who have not been vaccinated against COVID-19, especially in crowded and poorly ventilated indoor locations. The CDC now says people who are fully vaccinated need not wear masks when around other people either indoors or outdoors, because their risk of spreading COVID-19 virus to others is very low.

Masks must be worn in Shelby County in the following circumstances(unless a valid CDC exemption applies as set forth below):

• You are awaiting, boarding, disembarking, or traveling on public airplanes, ships, ferries, trains, subways, buses, taxis, and ride-shares. This includes hubs, airports, terminals, stations, and ports of entry. Please note that the CDC plans to amend its guidance on mask-wearing in outdoor areas of conveyances.
• Requirement for Face Masks on Public Transportation Conveyances and at Transportation Hubs – www.cdc.gov/coronavirus/2019-ncov/travelers/face-masks-public-transportation.html
•  You are in an indoor, public setting in Shelby County unless:
  • You are a child under the age of 2 years.
  • You are seated in a restaurant or bar for the purpose of eating and drinking.
  • You are engaged in other activities that require removal of a mask, such as cardio activities inside a gym, grooming activities, or theatre performances.
  • You are in a place of worship and the place of worship does not require you to wear a mask.
  • You are in an indoor setting that is not open to the public.
  • You are a person with a disability who cannot wear a mask, or cannot safely wear a mask, for reasons related to the disability.
  • You are a person for whom wearing a mask would create a risk to workplace health, safety, or job duty as determined by a workplace risk assessment.
  • You are a K -12 grade school student and your parent has submitted a written notification that you are opting out of wearing a mask according to Governor Lee’s Executive Order No 84.

Because the CDC currently considers Shelby County to be an area of substantial or high transmission, masks are highly recommended if you are in an outdoor setting that involves close contact with others who may not be fully vaccinated. Please also consult with your health care provider about wearing a mask due to any health conditions you may have.

Face coverings are strongly encouraged at all voting locations for anyone voting or administering an election.

The notice should be provided to tenant(s) along with the service of process of the eviction notice or at least two weeks before execution of a writ of possession, whichever is shorter.  An example of proof of notice that can be used: Notice of Emergency Assistance.

Yes.

Several nationally-recognized organizations issued a joint statement in January 2022 recommending states begin to transition away from universal contact tracing for individual cases of COVID-19.

Based on these recommendations, beginning on February 14^th, the Tennessee Department of Health and the Shelby County Health Department will no longer investigate and contact trace every case of COVID-19, but will continue to investigate outbreaks and clusters, particularly in high-risk settings.  Individuals who are COVID positive or think they have been exposed should still follow the recommended guidelines to prevent the spread of the virus.

https://www.tn.gov/content/dam/tn/health/documents/cedep/novel-coronavirus/Employer_Letter.pdf.

Additionally, in alignment with the Tennessee Department of Health, on February 14^th, Shelby County Health Department will no longer provide clearance letters for recovered cases to return to work.

Both the CDC and TDH discourage employers and schools from requiring a medical note for clearance to return to work or school after an individual has COVID-19. The link above details information about that, which is also the information that the SCHD call center will provide to people who are seeking Return To Work letters.

Those who test positive for COVID-19 may provide documentation of their positive test result (such as a photo, print out of lab results, or note from a provider that administered the test) to indicate their need for exclusion from in-person activities during their period of isolation.

Employers and schools are encouraged to provide access to sick leave, telework, and other accommodations without individual documentation from a doctor or nurse regarding an individual’s need to stay home.

The new CDC recommendations provide that cases should isolate for a minimum of 5 days after onset and may be released after they are without fever for 24 hours (without fever-reducing medication) and show improvement in symptoms. Cases without symptoms should isolate through 5 days after their specimen collection date.

Regardless of symptoms, CDC recommends wearing a well-fitting mask when around others for 10 days following onset/specimen collection.

Further Notes:

• Some severely ill patients may need to isolate for a longer time period.
• Lingering cough or loss of taste or smell should not prevent a case from being released from isolation.
• If a follow-up PCR test is positive, cases do not need to re-enter isolation as long as they have completed the 5-day isolation and had symptom improvement for a minimum of 24 hours.

Additional Isolation and Quarantine information is available here: https://www.tn.gov/content/dam/tn/health/documents/cedep/novel-coronavirus/IsolationQuarantineRelease.pdf

Further information: https://www.tn.gov/content/tn/health/cedep/ncov/cases-and-contacts.html

The Shelby County Health Department uses standard criteria to define a case, which was developed from national guidance put out by the Centers for Disease Control and Prevention. Only individuals who test positive for SARS-CoV-2, the virus that causes COVID, or who meet specific symptom and exposure criteria are considered COVID-19 cases.

Anyone who has a positive confirmatory test result for the virus that causes COVID-19. The only confirmatory test for SARS-CoV-2 is a polymerase chain reaction (PCR) test, which detects the genetic material of the virus. Individuals must have a positive PCR test to be counted as a confirmed case.

The vast majority of all COVID-19 cases in Tennessee were classified as confirmed cases, meaning they had a positive PCR test.

Anyone who has not had a positive confirmatory test, but 1) has a positive antigen test or 2) meets the clinical criteria of COVID-19 infection and is at high risk for having been infected with COVID-19 by another person, such as being a close contact.

The majority of probable cases have a positive antigen test. As antigen tests become more widely available, there will be an increase in probable cases in Tennessee and nationwide.

Including probable cases in case counts provides a better understanding of COVID-19 illness in the community. Not every person who has COVID-19 will get tested with a confirmatory test, so including those who are tested with an antigen test or who have COVID-19 symptoms after exposure to the virus helps the Shelby County Health Department (SCHD) better understand how many people in Tennessee have COVID-19. SCHD reports probable cases as recommended and follows national criteria to ensure the infection is reported uniformly across the country.

Shelby County Health Department investigates confirmed and probable cases in the same way, by interviewing the case and identifying contacts.

Isolation:

A person who tests positive for COVID-19 is placed in isolation for at least 10 days. That means you must stay at home without any visitors and avoid other household members as much as possible. After 10 days, if you have not experienced symptoms or fever for at least 24 hours, you are considered recovered and can be released to resume daily activities, including work. A negative test result is not required to return to work, once the isolation period is completed. However, if you are experiencing symptoms, the period of isolation may be extended to up to 21 days, or until you have been without symptoms for at least 24 hours. Recovered persons do not need to be retested if they are re-exposed within 90 days nor are placed in quarantine again within 90 days.

Contact Tracing:

Individuals who test positive for COVID-19 must notify those who are known to have been in contact with them and also comply with the Health Department on case investigations.  If you test positive, you will be asked to list everyone you have been in close contact with for 2 days before you developed symptoms or 2 days before you were tested, if you have no symptoms. Anyone who has been within 6 feet of you for 15 minutes or longer during that time period will be placed into quarantine.

Quarantine:

Quarantine is a public health strategy used to separate someone who may have been exposed to an illness and who is still in a period of time when they can develop illness. Quarantine is used to prevent transmission in the event the exposed person develops the illness. The Centers for Disease Control and Prevention (CDC) originally set a 14-day quarantine period for COVID-19 based on estimates of the upper bounds of the virus’ incubation period. Since that time, research indicates that more than 90% of exposed persons who go on to develop COVID-19 illness develop symptoms within 10 days of exposure. For that reason the CDC has revised its guidance to allow for a shorter quarantine period under the following conditions:

• Quarantine can end after Day 10 of of exposure without testing and if no symptoms have been reported during daily monitoring.
• In some cases, quarantine can end after Day 7 of exposure, if a diagnostic specimen tests negative for the SARS-CoV-2 virus and if no symptoms were reported during daily monitoring, but quarantine cannot be discontinued earlier than after Day 7.

In both cases, the quarantined person must continue to 1. Monitor for signs and symptoms of illness, 2. Wear a mask when around others, and 3. Observe social distancing through Day 14 of exposure.

The best way to know is to get tested for COVID-19. Testing is free and widely available. We recommend anyone who develops new symptoms should be tested. The symptoms of COVID-19 may be mild or vague. If you feel ill or think you may have been exposed, you owe it to yourself and the people around you to get tested.

They are not at higher risk; however, if they also suffer from asthma, common among people with respiratory allergies, they are at greater risk of developing serious illness from COVID-19.

Yes, and that is another good reason to be tested for COVID-19.