18 Big Questions About Beating COVID-19 You Might Be Too Embarrassed to Ask
There’s no such thing as a stupid question.
Editor's Note: This article was updated on April 8, to reflect the latest statements about the AstraZeneca vaccine in relation to reports of blood clots, and on April 13, to highlight the similar reports related to the Johnson & Johnson vaccine.
It doesn’t quite feel real, but it’s been more than a year since the world’s first lockdown in Wuhan, China, to help stop the spread of the COVID-19 pandemic.
An awful lot has happened since then: 106 million cases, 2.3 million deaths worldwide, and a whole heap of questions from people looking for the best, most reliable answers.
Like, when will this all end? Are some vaccines better than others? Is it dangerous to use public toilets now?
There’s no such thing as a stupid question. We don’t all have as many degrees as Chris Whitty — the UK’s acronym-happy chief medical officer — and we all want answers. But with so much information flowing, it might sometimes feel embarrassing to ask a question it feels like everyone but you knows the answer to.
So from the absolute basics to some of the more complicated stuff, we’ve collated a bunch of the key questions people are asking about the pandemic, COVID-19 vaccines, and more — and answered as many as we could with the most trusted sources from around the world.
From ways to prevent yourself catching the virus, to how the world is making moves to eliminate it, here’s the latest on what the science has to say on the questions we're all asking.
1. Should I wash my shopping with soap and water?
Although the virus can reportedly survive for up to 24 hours on cardboard and 72 hours on plastics, according to the New England Journal of Medicine, the risk of infection from virus particles on those surfaces decreases over time.
That’s why the US Centers for Disease Control (CDC) has advised that shoppers do not need to clean and disinfect their food packaging. Instead, it recommends washing your hands after handling products you suspect have been touched by others.
"There is currently no confirmed case of COVID-19 transmitted through food or food packaging,” said the World Health Organization (WHO).
Did you know COVID-19 can live on cardboard for 24 hours? The lifespan of COVID-19 depends on the surface it’s on. Here are some common surfaces and the lifespan for each. pic.twitter.com/7qJ5xqClyJ— University Health System (@UnivHealthSys) March 23, 2020
2. How much time does this virus stay alive on surfaces?
Beyond cardboard and plastics, that same study said that the virus was still detectable in the air after 3 hours, on copper after 4 hours, and after 72 hours on steel.
Here’s how you might catch the virus via surfaces: you’re out in public, you touch a surface that’s been touched by loads of other people before you, and then you touch your face. So avoid “high-touch” surfaces, like supermarket shelves and door handles, as much as possible — and wash your hands thoroughly and regularly.
One expert from the University of Florida added that many household cleaning products wouldn’t do too well against coronavirus anyway. You’re better off just practicing good personal hygiene, he told the New Scientist.Here’s a list from the CDC of products that would do the job.
3. Does a reusable face mask work better than a single-use mask?
The easy answer is: from a health perspective, it doesn’t really matter.
However, there are other advantages to wearing masks you can simply wash clean. It will save you money from having to repeatedly purchase more single-use masks, it’s much better for the environment, and you could even make them yourself.
Whatever you do, make sure you follow the WHO guidelines on how to use them — like how to take them on and off again without touching your face — and, once again, wash your hands before and after.
The most important thing? Keep those masks on whenever you have to enter public places like supermarkets, and it's a good idea to wear your mask whenever you leave the house.
4. Could someone get infected by sitting on a public toilet like in a store?
Well first you’ve got to find an open public toilet. In London, they’re like unicorns.
Public toilets are a risky business for a few reasons — though not necessarily just from all the squatting. Although not specific to coronaviruses, researchers at the University of Connecticut and Quinnipiac University in 2018 found that hand dryers massively multiplied bacteria in the air. It’s not entirely clear if this applies to the virus — but it doesn’t hurt to look instead for touchless paper dispensers to dry your hands instead.
Similarly, with all their confined spaces and side-by-side sinks and urinals, public toilets make social distancing difficult. Indeed, some experts in Australia have called for changes in the way public bathrooms are designed in the future to avoid physical contact entirely — for example, with self-cleaning cubicles, sensor-activated taps, and automatic doors at entrance and exits.
For that reason, avoid touching things as much as possible. But most importantly, remember to follow the WHO guidelines when you wash your hands: once you’re done, use a paper towel to turn off the tap.
And when it comes to the toilet itself: although some early research from China suggested that the virus might be able to be transmitted from fecal matter, the CDC has said there’s no evidence that anybody has actually contracted the virus this way, and based off similar viruses like SARS, assume that the risk is “low”.
However, you should still beware "aerosolized feces" — particles which, according to 2013 research from the Association for Professionals in Infection Control and Epidemiology, lift into the air from the toilet as you flush. But it’s easy to avoid most of that ickiness by closing the lid before flushing to stop about 80% of the particles.
In your own home, take a more attentive approach to sanitizing your surfaces. In general, try to avoid public toilets. Pee at home if you can!
5. Will cold (refrigerator or freezer) kill the virus?
To put it simply: we don’t really know. But probably not.
The WHO has clarified that there is no data that suggests the virus can be killed by cold or heat. Although freezing can slow the spread of bacteria, there is zero evidence right now that it stops the transmission of COVID-19. Basically, we need more research.
But if you’re worried about COVID-19 on your food, there’s two things you can do. Although your fridge and freezer might not kill the virus, cooking food thoroughly will — and it’s always good practice to wash your food before eating.
And without wanting to sound like a broken record: wash your hands after handling food too.
6. Is a closed air-conditioned office more prone to contamination even while maintaining social distance?
The real question here is: do aerosols — the tiny droplets that come out when we cough or breathe that can carry virus particles — get further spread by air conditioning?
Again, there isn’t enough data to draw complete conclusions one way or another. But although it’s very unlikely that air conditioning moves those droplets over long distances, like across an entire supermarket, it might allow virus particles to carry over shorter distances, surviving for longer than might have happened without it.
For example, one study of a restaurant in China between January and February found that three separate families contracted the virus on one night, reportedly because one asymptomatic, COVID-19 positive diner was sitting in front of an air conditioning unit that could carry larger droplets further than one meter.
But although an expert confirmed the validity of this theory to HuffPost, he was quick to emphasize that this “does not, in any way, imply [COVID-19] is spread by air conditioning”. However, the statement that a closed air-conditioned office is more prone to contamination is invariably true if droplets do indeed travel slightly further through the air that way — even though that difference might be tiny.
7. How does testing actually help prevent the virus?
Before vaccines started rolling out, comprehensive COVID-19 testing was one of the best weapons we had against the virus. And as evident in countries like South Korea, aggressive testing can lead to a plummeting death rate: despite hundreds of daily cases in March 2020, South Korea managed to report zero new infections by April 30.
It’s not just about the individual, it’s about the community: if an entire population can access testing, it helps health services adapt to demand and informs government guidelines. If you test widely, you can find the virus before symptoms develop, immediately self-isolate, and prevent it from infecting others.
That’s why Imperial College London — the university that influenced the UK government’s shift in strategy from herd immunity to lockdown in March 2020 with its virus modelling — has insisted that all health care workers have access to test results, irrespective of symptoms, while the London School of Hygiene & Tropical Medicine has suggested trialing a universal testing process.
“We cannot stop this pandemic if we do not know who is infected,” said the WHO’s director general Dr. Tedros Adhanom Ghebreyesus.
8. Are all tests the same? What actually happens when you get tested?
It’s pretty simple in the UK right now, for example: you get a swab up your nose and in the back of your throat — either with a home testing kit, or via a mobile testing unit, an NHS facility, or a drive-through. These “viral tests” are the most popular globally, but they only tell you if you have the virus at the moment you take the test. A version of this is the “lateral flow” test: a rapid response that can get you an answer within 30 minutes.
There’s another type of test you might have heard about: the antibody test. It’s a blood test that looks for the proteins used by your immune system to fight off the virus, meaning it can reveal whether you’ve had it in the past. But the CDC says it can take 1-3 weeks after infection to release those antibodies — and on May 27, updated its guidance to reveal that those tests can be wrong up to half of the time.
The key issue is access. According to the Africa Centres for Disease Control and Prevention (Africa CDC), just 1.3 million tests had been carried out across the entire continent by the middle of May 2020 — less than in the UK on its own — because, like we’re seeing with vaccines now, richer countries were reportedly pushing to be first in the queue.
So although cases on the continent have been relatively low, there are fears that many cases are going undetected. And while there have been more deaths in the UK than across the whole of Africa, a report from Boston University School of Public Health published Dec. 24, 2020, has suggested that a lack of death registrations means the real number of deaths on the continent could be higher.
That’s why organizations like the Foundation for Innovative New Diagnostics (FIND) have been working with the WHO and others to ramp up testing in the world’s poorest countries.
➡️This week our CEO @BoehmeCatharina spoke at @EU_Commission's Coronavirus Global Response pledging event, calling on key stakeholders to support this landmark collaboration & provide the necessary resources for #COVID19 diagnostics & testing. #UnitedAgainstCoronavirus 🇪🇺 https://t.co/NKifIps20S— FIND (Foundation for Innovative New Diagnostics) (@FINDdx) May 7, 2020
9. Can you catch COVID-19 twice?
A recent report from Public Health England (PHE) has suggested that if you get the virus, you should be immune for at least five months afterwards.
To be specific: if you were previously infected, you have an 83% lower risk of getting the virus — a higher number than some approved vaccines.
That doesn’t mean you can move through the world any differently though. You should still stay home and follow local guidelines. The PHE report found that those previously infected can still carry the virus in their nose and throat. So there’s still a good chance that you could transmit the virus to others without developing COVID-19 symptoms yourself.
You might be able to catch the virus again. But the chances of that are seemingly slim.
10. Will we ever be able to eradicate the virus?
Now there’s a vaccine, anything is possible.
But according to the BMJ, a medical journal, there is a difference between possible and achievable. Even with a vaccine, new strains from different countries would mean that anything close to eradication might mean permanently restricted borders.
It could also mean a vaccine strategy similar to the flu, where every year new vaccines are created to replicate the evolution of the virus.
However, even if it isn’t completely eradicated, we could get life back on track with a combination of herd immunity from an effective vaccination rollout and treatments that reduce the number deaths from people with COVID-19. What that does mean, though, is that we need the whole world to be able to access vaccines and treatments.
That's not an easy task when, as of February 2021, just one of the 29 poorest countries in the world has received any vaccines. That was Guinea, which had 55 donated by Russia.
However, there are organizations working on plans to distribute the vaccine fairly. Donor countries including the UK have been funding COVAX — a scheme that aims to deliver 2 billion vaccine doses to low-income countries in 2021. It’s one part of the ACT-Accelerator, a collaboration of international organizations set up to ensure that the tools to end the pandemic are equitably distributed.
Meanwhile, Gavi, the Vaccine Alliance, has spent the last 20 years building supply chains to distribute and stockpile vaccines to reach the world’s poorest communities, while driving down its price to make them affordable to all.
And the Coalition for Epidemic Preparedness Innovations (CEPI), a partnership between public, private, philanthropic, and civil organizations that’s funding vaccine development projects across the world, has written in agreements to all its partners that include equitable access provisions. Any successful vaccine on a CEPI-funded project will also be manufactured across multiple countries too, so global distribution in that instance is assured.
11. Are the Oxford-AstraZeneca and Pfizer-BioNTech vaccines safe?
In the UK, for example, both had to go through stringent safety checks before they were approved by independent regulators. That meant testing animals to start, then clinical trials with a few human volunteers, before tens of thousands are studied after receiving the vaccine, often from different parts of the world.
The Pfizer-BioNTech vaccine was actually tested on 40,000 people before it became the UK’s first approved vaccine, according to the BBC. That doesn't mean minor side-effects aren't possible. Some people report soreness in the injection site, similar to many other vaccines, while those with serious allergic reactions to ingredients in the vaccine are being advised to discuss it with a medical professional first.
But this is extremely rare. Overwhelmingly, you’ll be safe.
12. Does the AstraZeneca vaccine cause blood clots?
While the AstraZeneca vaccine has been deemed “safe and effective” by regulators around the world, blood clots have become a concern because of a small number of cases that have developed in people who have taken it, which has been further investigated over the past few weeks.
As a result, the European Medicines Agency (EMA), the European Union’s medicines regulator, said on April 7 that unusual blood clots should be listed as a very rare side effect of the AstraZeneca vaccine.
It decided to add this after studying 86 cases, the BBC reported, however the agency still recommends that people still take the vaccine as protection against COVID-19.
Emer Cooke, the director of the EMA said: “Our safety committee... has confirmed that the benefits of the AstraZeneca vaccine in preventing COVID-19 overall outweigh the risks of side effects."
Cooke added: "This vaccine has proven to be highly effective, it prevents severe disease and hospitalisation, and it is saving lives."
Meanwhile, the UK government has said that as a precaution people under the age of 30 will be offered a different COVID-19 vaccine, such as the Moderna or Pfizer vaccine instead.
The UK’s regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), said that there was “no proof the vaccine had caused the clots but the link was getting firmer."
The World Health Organization (WHO) has also released a statement on the study, saying: “Based on current information, a causal relationship between the vaccine and the occurrence of blood clots with low platelets is considered plausible but is not confirmed.”
The statement added that the events, while concerning, were “very rare” given the low numbers reported among the “almost 200 million individuals who have received the vaccine” globally.
Matt Hancock, the UK’s health secretary, said that the safety system around the vaccine roll-out meant that very rare incidents like this could be spotted. "The safety system that we have around this vaccine is so sensitive that it can pick up events that are four in a million," he added.
Some news reports have put the risk into context, highlighting for example that the risk from the AstraZeneca vaccine is lower than that of taking the contraceptive pill or taking a long-haul flight.
13. What about the risk of blood clots with the Johnson & Johnson vaccine?
Similarly, there have been some extremely rare reports of blood clots in the Johnson & Johnson vaccine.
It led health authorities in the US on Tuesday to pause the rollout of that specific jab. It’s only expected to last a few days, until more information comes to light.
Although only six cases have been reported from 6.8 million doses (0.00009%), the Food and Drug Administration (FDA), a federal US health department, said it was acting "out of an abundance of caution", according to the BBC.
The Biden admin says the U.S. has enough doses of the Pfizer and Moderna COVID vaccines for 300 million Americans, so the Johnson & Johnson pause will not have a "significant effect" on vaccine distribution plans.— Kyle Griffin (@kylegriffin1) April 13, 2021
The numbers are relatively similar to the AstraZeneca vaccine, which recorded 222 blood clots across 34 million people (0.0007%). Both vaccines work in a very similar way too, using the same adenoviral vector technology — so they make a useful comparison.
It’s important to note that while the blood clots are very rare, health regulators often slow down rollouts of drugs as they study for further side effects. So none of this would have come as a surprise.
Johnson & Johnson responded by saying safety was its "number one priority." It has also decided to delay the rollout of the vaccine in Europe until it could review the cases with European health authorities.
14. Are some vaccines better than others?
It depends what you mean by “better.”
Certain vaccines have better “efficacy” than others, which essentially means the reduction of risk in you getting the virus. For example, Pfizer/BioNTech has said its vaccine is 95% effective after two doses, roughly the same number as Moderna. But while the Oxford-AstraZeneca jab is somewhere between 62-90%, no volunteers went to hospital after contracting the virus.
There’s also some differences in how much protection you get depending on how many jabs you have. Most of the vaccines need two doses, but the Johnson & Johnson vaccine has a 66% efficacy rate from just one injection.
Finally, there are differences in how the vaccines need to be stored. The Pfizer-BioNTech vaccine needs to be stored in extreme cold (-70 degrees Celsius), while the Moderna jab needs to be at freezer temperature (-20 degrees Celsius). However, the Oxford-AstraZeneca, the Novavax, and the Johnson & Johnson vaccines can all be kept at fridge temperature, meaning they're far easier to be transported, essential in less developed countries.
15. With so much misinformation out there, how can I know what to believe?
The WHO has described the sheer volume of fake news out there as an “infodemic”, undermining the health services fighting the pandemic on the front lines and frustrating coordinated global efforts to communicate the right information to people.
Whether that misinformation is social media posts that perpetuate untrue vaccine myths or false accusations that hospitals are empty of COVID-19 patients, the WHO has one clear message: “misinformation costs lives”. This is especially true among ethnic minority communities, as is emerging in countries around the world.
It comes down to this: if you see a post online that does not come from a trusted source, or does not have verifiable information, do not share it. Information that comes from international organizations that are staffed by world-leading experts such as the WHO, the US Centers for Disease Control and Prevention, and the London School of Hygiene and Tropical Medicine are reliable.
Be careful with first-person accounts that are put forward as evidence of a wider pattern. Head here to find a larger list of sources you can trust.
16. Should I be worried about new strains of the virus?
There’s no need to panic. It was entirely expected that mutations of the virus would form, right from the start of the pandemic.
But even with the more challenging variants, such as the more transmissible versions from the UK and South Africa, the issue is not the mutations themselves. What matters, regardless of the form of the virus, is keeping infections down more generally.
That’s because when COVID-19 is passed from person to another, it makes copies of itself. Mutations happen when it makes mistakes as it duplicates. So the more we clamp down on transmission, the less likely it is that new variants will emerge. You can learn more about this process, and further information about COVID-19 variants, here.
Right now, it looks like the vaccines we have still work against the new variants. However, there’s a chance that variants might make them less effective. At any rate, pharmaceutical companies are able to tweak vaccines in order to meet the challenge of mutations. All they need is time, bought by adherence to government guidelines like social distancing and mask-wearing.
17. So that’s the vaccine. But what is being done to find treatments?
In a word, lots!
A good example to bear in mind when it comes to the importance of treatments beyond vaccines is the HIV/AIDS crisis. After 40 years, a vaccine is still yet to be found. But HIV/AIDS has been brought under control in many parts of the world precisely because testing and treatment has become more widely available.
Likewise for COVID-19, if we can find effective treatments, in addition to a vaccine, we’ll be able to make progress with far greater speed. It’s something international organizations have been working towards since the start of the pandemic.
Take, for instance, the COVID-19 Therapeutics Accelerator: a collaborative effort to research, develop, and produce effective treatments for the virus as quickly as possible with the Bill & Melinda Gates Foundation, the Wellcome Trust, and the UK’s Foreign, Commonwealth, and Development Office (FCDO).
The Accelerator will also work to ensure that as the right medicines are discovered — like antiviral drugs that help people fight off the flu — those treatments are made accessible to all countries equally.
“The only way to treat a viral infection, such as COVID-19, is with antiviral drugs,” wrote Mark Suzman, CEO of the Bill & Melinda Gates Foundation. “Right now, we can only treat the symptoms since there simply aren’t antiviral medications that can treat a range of conditions in the same way that antibiotics do for bacterial infections.”
18. What is long COVID?
For many people, the symptoms of the virus can last weeks. For others, it can stretch on for months.
This is what’s known as “long COVID”, officially defined as problems, such as exhaustion, that persist for at least 12 weeks after infection. Other known symptoms include shortness of breath, coughing, and aches and pains. There are lots of theories on why this happens, but nothing concrete just yet.
It is certain, however, that it’s real: an article published in the Journal of the American Medical Association found that 87% of 143 people needing hospital treatment due to the virus in Rome still reported symptoms two months after being discharged. Meanwhile a study in Dublin found half of those surveyed had fatigue 10 weeks after infection.
If you have more questions, there are lots of sources out there for answers — but, as we highlighted above, it's important that you're getting your information from trusted sources. You can find a list here of lots of places — from the NHS to the CDC — to find answers to your questions, that are supplied by medical professionals and experts.