Pradaan

Financial FAQs

Refer to this list of frequently asked questions that provide you with everything you need to know regarding the finance world. Please don’t hesitate to contact us for any other queries.

  1. Create a death certificate.
  2. Locate the will.
  3. Locate all financial documents.
  4. Make a list of dues and liabilities.
  5. Notify financial institutions.
  6. Close and transfer accounts.
  7. Get reimbursed for claims and manage assets.
  8. Check income and investments.
  9. File tax returns.
  10. Erase online presence.

If the parent passes away at the hospital, you will have to fill a form with details like the deceased’s name, age, mother/father’s name, and address. The details are forwarded to the local municipal body’s zonal office/ registration centre, where the death certificate is issued at the specified time. You can download from the municipal website for multiple copies.

Ensure the details provided are the same as those on any official documents or records like PAN card or Aadhaar card. Any mistake, even the use of initials instead of the full name, can cause problems.

If one dies without a Will then the assets are distributed equally among the legal heirs. The line of legal heirs is clearly defined under Succession law.

Locating all financial documents and organise them. Divide them into four categories- assets, liabilities, expenses and income.These will include bank-related papers (savings accounts/deposits, ATM cards, credit cards), insurance (life, health, motor vehicle), investments (insurance, stocks and mutual funds, savings schemes like Senior Citizen Savings Scheme or NSCs, and fixed deposits), utility bills and account numbers (electricity, water, gas, phone, Internet), taxation, property papers, loan and EMI documents, clubs and other memberships, among others.

The list of typical expenses include utility bills (electricity, water, gas, phone, Internet), credit card dues, insurance premiums, mutual fund SIPs, advance and other tax dues, loan EMIs, subscriptions and membership fees, among others. This is where joint bank accounts and nominations are useful since you can keep using the account to make immediate and crucial payments.

These will include banks, insurers, companies where investments have been made, tax department, and utility bodies. You will also need to contact creditors and home loan/personal loan companies.

In case of a joint account or one with a nominee, you will have to close it and open a new account for the surviving parent. The money will be given to the joint account holder or the nominee.In case of a single account in the name of a parent, you will have to close it and have the proceeds transferred to the nominee as above. If there is no nominee, the amount will pass on to legal heirs for which you will have to procure a will, or in its absence, a succession certificate.

For loans, if the borrower had a cosigner, or joint debtor, the latter is responsible for repaying the loan, and if he is unable to do so, the lender can file a lawsuit to procure the payment. In case of a single borrower, the executor of the will is responsible for settling debts.

For transferring investments other than property, you will have to fill up the specified forms and produce a death certificate as well as identity/residence proofs if you are a nominee or a legal heir. Otherwise, you will have to get a succession certificate.

Submit your bills with prescriptions, reports, x-rays etc. with the prescribed reimbursement form, to the insurance company. Some insurance companies may insist to get the signature from the hospital in the reimbursement form.

If it is a pre-hospitalisation claim, then submit the documents in the same manner.

If it is a post hospitalisation, then wait for your treatment completion & submit. In either case, mention the type of claim in the form

If the gas, telephone, etc, were in the deceased parent’s name, you will have to get the name changed by producing the death certificate, identity proofs, declaration by legal heirs and NOC by other heirs, as well as other specified forms. It’s best to go to the service provider’s website and check all the forms needed before approaching them.NOC by other heirs, as well as other specified forms. It’s best to go to the service provider’s website and check all the forms needed before approaching them.

You will have to transfer the ownership of the vehicle by making an application to the original registered authority by the legal heirs or the person succeeding to the possession of the vehicle, along with the required documents. These can be checked at the website of the transport department of the respective state.

The death of a parent means that the surviving spouse’s financial plan will change due to the alteration in the holding pattern of investments. Since the joint accounts will change to single accounts, the permissible limit of investment will fall, affecting the inflow.

The sudden termination of active employment of the spouse can also result in a drastic fall of income. But even if the spouse was not employed, the conversion of joint accounts to single accounts means that the investment amount will exceed the permissible limit.

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You will have to transfer the ownership of the vehicle by making an application to the original registered authority by the legal heirs or the person succeeding to the possession of the vehicle, along with the required documents. These can be checked at the website of the transport department of the respective state.

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Medical FAQs

Wondering what other people are asking us? Find answers to questions about COVID-19 symptoms, vaccines, recovery, and more. Contact us for more queries.

Coronaviruses are a family of viruses that typically cause mild respiratory infections like the common cold, but also more severe (and potentially deadly) infections. They are zoonotic diseases, meaning they are transmitted from animals to people.

A coronavirus that originated in China led to the Severe Acute Respiratory Syndrome outbreak in 2003. Another coronavirus emerged in 2012 in Saudia Arabia causing Middle East Respiratory Syndrome. And now, we have COVID-19, caused by a novel coronavirus named SARS-CoV-2 that emerged in late 2019.

Coronaviruses are named after the Latin word corona, meaning “crown” or “halo,” because they have “crown-like spikes on their surface,” according to the U.S. Centers for Disease Control and Prevention.

The novel coronavirus responsible for this outbreak is known as SARS-CoV-2. The illness caused by the virus is called COVID-19

We don’t know yet when the virus first came to the United States. We don’t have any evidence yet that it was here in December but we also don’t have evidence that it wasn’t here.

There has been one case in France that may have occurred in December, but that’s really the only evidence so far that the virus may have been outside of China prior to January.

Common signs of coronavirus infection include runny nose, cough, fever, sore throat, and shortness of breath.

COVID-19 can cause a wide range of signs and symptoms at varying levels of severity. The most common are fever, dry cough, and tiredness. Other symptoms include shortness of breath or difficulty breathing, muscle aches, chills, sore throat, headache or chest pain.

Other symptoms that aren’t as common include: gastrointestinal symptoms, new loss of smell or taste, skin changes (like lesions), confusion, and eye problems.

Some patients can temporarily lose their sense of smell. This is because the “hook” of cells used by SARS-CoV-2 to latch onto and infect cells is up to 700 times more prevalent in the olfactory-supporting cells lining the inside of the upper part of the nose than in the cells lining the rest of the nose and windpipe that leads to the lungs. The supporting cells are necessary for the function/development of odor-sensing cells.

COVID-19 can cause damage to the lungs that impedes their ability to remove oxygen from the air. A lot of patients develop what’s known as severe acute respiratory distress syndrome.

One of the mechanisms that the SARS-CoV-2 virus uses to enter the lungs, called the ACE2 receptors, lives in the heart as well. When the virus enters the heart, it can cause clots, pulmonary embolism, or clots within the arteries of the heart causing a heart attack.

If you develop any of the following emergency warning signs for COVID-19, get medical attention immediately by calling your doctor’s office. Emergency warning signs include (but are not limited to):

  1. Trouble breathing
  2. Persistent pain or pressure in the chest
  3. New confusion or inability to arouse
  4. Bluish lips or face
  5. Please call your medical provider for any other symptoms that are severe or concerning to you.

Coronaviruses are typically transmitted from person to person through exhalation of respiratory droplets (from the nose and mouth) and close contact. People can contract COVID-19 if they breathe in droplets from an infected person who coughs or exhales droplets. Those droplets can also land on objects and surfaces, and people can then catch the virus from touching those surfaces and then touching their eyes, nose, or mouth. Coronaviruses are typically transmitted from person to person through exhalation of respiratory droplets (from the nose and mouth) and close contact. People can contract COVID-19 if they breathe in droplets from an infected person who coughs or exhales droplets. Those droplets can also land on objects and surfaces, and people can then catch the virus from touching those surfaces and then touching their eyes, nose, or mouth.

Small particles that contain infectious amounts of virus can also remain suspended in the air for a period of time and travel farther distances than larger droplets usually produced when people sneeze or cough.

Wearing a mask, staying at least six feet away from others, and avoiding prolonged contact (more than fifteen minutes) indoors with others are all helpful mitigation factors.

Yes. A lab study suggests that as many as 50% of people who have the disease show no symptoms and are still able to spread the disease.

Most people with COVID-19 can discontinue isolation 10 days after symptom onset. For people with no symptoms of COVID-19, isolation can be discontinued 10 days after the date of their first positive test.

We’re still trying to understand how asymptomatic transmission happens and the extent to which it happens.

A few ways that we think that the virus spreads: if people are talking to each other from relatively short distances, it’s possible for someone who is infected and doesn’t yet have symptoms to put some virus out there that someone who is standing close by could be exposed to. We also know that some outbreaks have occurred in settings where people are singing. The more you force air out of your mouth, the greater possibility of carrying virus with it.

Transmission has also occurred in very close quarters, like between husbands and wives or roommates. We don’t know exactly how that transmission occurred, but you can imagine any number of ways: if people are touching their mouths and then touching surfaces or something along those lines.

There’s a lot of work that still needs to be done to understand the extent to which asymptomatic transmission happens and how exactly it does.

New evidence points towards likelihood that the virus may be spread through aerosols that linger, not just droplets that fall.

Droplets caused by coughing and sneezing are still the main source of infection. Remaining six feet away from others means you are less likely to be exposed to droplets.

There can also be fomites, which is infectious material from droplets or aerosols that land on surfaces you might touch. Handwashing is very effective in this circumstance.

Young children can be infected and transmit to others.

It continues to be the case that children often do not have any symptoms at all. If they do have symptoms, they're quite mild. This makes it hard to understand what transmission looks like in children.

When we look only at symptomatic illness, there's very little evidence of transmission. But when we look at serosurveys, which look at evidence of prior infection, we see that children are infected at rates similar to adults. That suggests that there's more happening underneath the surface than we are able to see.

There is a rare and dangerous condition in sick children called multi-system inflammatory syndrome in children (MIS-C) which is thought to be caused by an immune reaction to SARS-CoV-2.

Hospitalization rates vary by age group and increase with age. Approximately 90% of hospitalized patients have one or more underlying conditions, the most common being obesity, hypertension, chronic lung disease, diabetes, and cardiovascular disease.

Yes. COVID-19 is much deadlier than the flu. COVID-19 has a higher severe disease and mortality rate than influenza in all age groups, except perhaps children under the age of 12.

You can be around others after:

  1. 10 days since symptoms first appeared AND
  2. 24 hours with no fever without the use of fever-reducing medications AND
  3. Other symptoms of COVID-19 are improving*
  4. *Loss of taste and smell may persist for weeks or months after recover and need not delay the end of isolation.

It's difficult to confirm a case of reinfection. You need to have samples of sequencing from the first infection and again from the second infection to actually be able to tell if it's a different variant of the virus and not just the same persistent infection that's coming back.

There are 26 known cases of reinfection which illustrate that we don't know exactly how long immunity may last for COVID-19.

The CDC recommends that all people, whether or not they have had COVID-19, take steps to prevent getting and spreading COVID-19. Wash hands regularly, stay at least six feet away from others whenever possible, and wear masks.

Pregnant people might be at an increased risk for severe illness. There may be an increased risk of adverse pregnancy outcomes, such as preterm birth, among pregnant people with COVID-19. Limited evidence suggests that it is not likely for mothers with COVID-19 to spread the virus to babies in their breast milk, but there are precautions mothers with COVID-19 should take if they are breastfeeding. Please visit the CDC resource for precautions pregnant and breastfeeding people can take to reduce these risks.

There are two key differences: First, it’s causing severe disease for individuals which causes big strains on the healthcare system.

Second, we just don’t know much about it compared to other RNA viruses that cause upper respiratory infections every day.

There is some strong data from the UK that suggest the [variant of the] virus is more transmissible. To be sure it's the virus sequence changes that are causing this, we need to see if this variant spreads as easily in other countries.

There are currently two theories about what, specifically, makes this strain more transmissible. One is that this variant virus is “stickier,” meaning it requires a smaller amount of virus to cause infection because it’s better at adhering to your cells. Another theory is that this variant causes people to harbor more virus particles in their noses and throats, which means more virus is expelled when people talk, cough, or sneeze.

Behavioral and situational factors could help a more transmissible variant spread even further, but wearing a mask, ensuring physical distance, and hand washing will still help.

Transmission is often used when we talk about populations, while contagious is more often used when we are talking about an individual. They are interchangeable to some degree.

Masks, social distancing, and hand washing should work against the variants just as well. But higher transmission could mean more cases, which can increase risk for individuals and overwhelm hospital systems again, so it may be necessary to re-implement closures and restrictions to flatten the curve if it starts to rise.

All viruses mutate, and SARS-CoV-2 has been mutating at a pretty consistent rate since it entered the human population.

This new variant has accumulated an extremely large number of mutations compared to other lineages. Usually we can follow the evolution of a virus because we find related viruses with fewer mutations. But with this virus, it seems to have just appeared with a lot of mutations. It will be important to determine how this virus got so many mutations without being identified sooner.

If the new variant is more transmissible than other SARS-CoV-2 lineages, it eventually could be the most commonly found lineage of SARS-CoV-2. However, while we still have so many people with no immunity to the virus, we should still see different lineages spreading in different parts of the world.

Available information suggests that the following are at a higher risk for severe illness from the virus:

People of any age with the following conditions:

  1. Cancer
  2. Chronic kidney disease
  3. COPD
  4. Immunocompromised state from solid organ transplant
  5. Obesity (BMI of 30 or higher)
  6. Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
  7. Sickle cell disease
  8. Type 2 diabetes mellitus

As you get older, your risk for severe illness increases. For example, people in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, at higher risk for severe illness than people in their 50s. The greatest risk for severe illness is among those aged 85 or older.

Other people who may need extra precautions include: racial and ethnic minority groups, people in rural communities, people with disabilities, pregnant and breastfeeding people, people experiencing homelessness, and people with developmental and behavioral disorders. For a full list and recommended precautions, please visit the CDC resource.

They do. Certainly, people of advanced age and people with underlying conditions statistically are among those mostly likely to be hospitalized and die, but that’s not always the case. People in both of those categories also may have mild infection or may become sick and survive their illness.

Most research suggests that individuals on chronic immunosuppressive medicines have a similar likelihood of severe COVID disease, if they get infected, as those who are not on such medications. Individuals concerned about the potential risks of these medicines should talk with their healthcare provider, as well as use evidence-based approaches to reduce the risk of COVID infection such as social distancing and mask wearing.

There is not specific data around this. In general, we think of people who do not have a spleen or whose spleen is not functioning well as being immunosuppressed. I would be more cautious with those individuals and more aggressive in their care. Those individuals would want to have more social distancing than the average person.

There is an elevated risk of clotting from oral contraceptives. COVID will synergize with whatever other propensity you have to get clots so someone on birth control may be more likely to clot than the average person.

Testing for COVID can be divided into two main groups: testing for active SARS-CoV-2 infection or testing for past SARS-CoV-2 infection. Active infection indicates that a person has virus that is replicating and that they could infect others. Past infection indicates that an individual has recovered from COVID-19 and has no actively replicating virus.

To test for active infection, diagnostic antigen or molecular tests are used.

To test for past infection, serology tests are used.

Learn more about the specific types of antigen, molecular, and serology tests, how they are collected, and when each should be used here.

The Center for Health Security has created a flowchart to help you determine what COVID-19 test type you may need.

In general, if you may have a current COVID-19 infection and you are experiencing symptoms, you should seek an antigen or molecular diagnostic test. These tests may be referred to with terms like: PCR, qPCR, rRT-PCR, antigen, rapid antigen test, RPA, RT-LAMP, and CRISPR.

Because of the diversity and breadth of tests currently available, most diagnostic tests can still be reliably used to diagnose the variant strains.

Public health officials rely on testing results to track the state of the pandemic and policymakers use this information to guide decisions on reopening schools and businesses.

Percent positive is the percentage of all coronavirus tests performed that are actually positive, or: (positive tests)/(total tests) x 100%. The percent positive (sometimes called the percent positive rate or positivity rate) helps public officials understand the current level of SARS-CoV-2 transmission in the community and whether or not a community is doing enough testing for the number of people who are getting infected.

Earlier in the pandemic, the issues were collection devices—not enough swabs or viral transport media (the fluid that the swab goes in).

Now, the issues are a bit different. The testing process is a very complex system. There are point- of-care tests, which are rapid. And then high-throughput diagnostic tests, which are PCR tests— the ones traditionally done in hospitals, clinical labs, commercial labs, and public health labs. Both those tests are in short supply. Pipette tips—plastic components for test cartridges—are also in short supply.

There’s huge demand from hotspot states and people who want to get tested—so they can go see their relatives or travel, for example. This has been a challenge because we want to make sure we’re using testing for the right reasons and right purposes.

How do we get out of this? One really good answer is we all need to wear masks, distance, and follow the general rules of hygiene. If we do that, we can bring the curve back down. The curve we speak of is about ICU beds and hospitalizations, but it’s actually also about test capacity. We will be able to test as many people as we need to test if we don’t have so much transmission. We are not going to be able to massively ramp up production.

Yes. Someone exposed to a person with COVID-19 needs a 10-day quarantine regardless of test results.

A negative test result from a sample that is truly positive. For example, if a person was truly sick with COVID-19 but received a negative test result, that would be a false negative.

If a person has had a known exposure to COVID-19 (the CDC defines “exposure” as close contact with someone who has COVID-19), but a negative COVID-19 test, that person should still quarantine and self-monitor for symptoms for 10 days after exposure.

If a person has not had any known exposure to COVID-19 and is not experiencing symptoms, there is no need to quarantine if a test is negative.

If symptoms are present but a person has a negative COVID-19 test, that person should still follow home isolation recommendations. In a clinical setting, doctors and nurses may proceed with precautions as though it is a positive diagnosis.

A positive test result from a sample that is not truly positive. For example, if a person was truly uninfected but got a positive test result that would be a false positive.

This has not happened with PCR tests. Antigen tests, or those that look for antibodies, could potentially read positive falsely if they are not processed in a certain period of time.

The CDC recommends the following:

  1. Regularly and thoroughly wash your hands with soap and water for at least 20 seconds or clean them with a 60% alcohol-based hand sanitizer. Avoid touching your eyes, nose, and mouth with unwashed hands.
  2. Maintain at least six feet of distance between yourself and anyone who doesn’t live in your household. If someone in your home is sick, maintain six feet of distance from the sick person if possible.
  3. Cover your mouth and nose with a mask when around others.
  4. Cover your mouth and nose with your bent elbow or a tissue when you cough or sneeze, then dispose of the used tissue immediately.
  5. Clean and disinfect frequently touched surfaces daily, including doorknobs, tables, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
  6. Stay home if you feel unwell. If you have a cough, fever, and difficulty breathing, call your health provider.

 

There is growing evidence that wearing masks protects the wearer as well as others.

There is growing evidence that wearing masks protects the wearer as well as others.

Masks—no matter what kind of mask—filter out the majority of viral particles.

Gloves are important in a clinical setting but not needed out and about in everyday life. The most important thing you can do to prevent infection is to wash your hands when you touch surfaces.

If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.

The best thing you can do is to follow prevention guidelines like wearing a mask, practicing social distancing, and avoiding close contact with others not in your household.

But there are other things you can do to be prepared in the event of illness such as knowing where and how to access testing, having a plan for quarantine and isolation, and understanding your employer's sick leave policy. Read more about how to prepare for COVID here.

If you have a confirmed COVID diagnosis via a positive test, it's important to isolate yourself immediately, answer your phone in case a contact tracer is trying to reach you, and call your doctor or health care provider if you have one.

Read more information on what to do if you have COVID here.

The coronavirus may remain detectable for hours to days on surfaces made from a variety of materials, including clothing.

Here is general guidance on fruits and vegetables: (via CDC). There is not specific guidance for coronavirus. In general, the risk of transmission is low, but will be reduced further with cooking.

In general, takeout food is low risk—particularly if the food is cooked. You should wash your hands after touching the packages, but the risk of contracting coronavirus from food delivery, takeout, groceries, or mail, is low.

There is no evidence of transmission through the public water supply.

If multiple people in a household have confirmed COVID-19, it’s fine for them to isolate together.

If a household member has COVID-19, that person should be isolated from others in the home, and the entire household should quarantine for 14 days.

If someone in your household is sick, that person should be isolated as much as possible from other household members and all members of the household should follow guidance for quarantining.

The CDC recommends that people wear masks in public to reduce the risk of asymptomatic spread. Masks should be worn indoors at all times, and outdoors when it is not possible to remain at least six feet away from others.

Surgical masks and homemade cloth masks can help reduce the spread of droplets.

If you do not have access to an N95 mask, one way to boost the protection of a cloth mask is by wearing a surgical mask underneath it.

Important note: This guidance is not intended for a health care workers. That guidance can be found here.

It’s still not recommended. It’s believed that after you recover, you are protected from reinfection, but we are again in a particularly bad place in the pandemic, and it is not the time to be taking risks or to rely on things that we hope are true. It’s best to just stay home.

It’s not necessarily linked to older age or underlying health conditions. People who are young and previously healthy can experience lingering sequelae, or long-term lingering symptoms, of COVID-19 infection. It’s not really clear what the biological mechanism of that is, but it’s clear that it is a problem and it’s going to be something we’re going to have to be grappling with collectively as we figure out how best to support and care for those people.

If they are ill from coronavirus, you can drop off food or other supplies for them, call them, and make sure they’re coping well. If they are getting sicker, you can help them notify their doctor or local public health agency to arrange for medical care.

Keep your pets—just keep your distance if you have COVID-19.

While few pet animals have been shown to carry SARS-CoV-2, and even fewer have gotten sick, it is possible for owners to transmit the COVID-19 virus to their pets. Cats and ferrets may be more likely than other kinds of pets to contract the virus. Some dogs have tested positive too.

The recommendation right now is to keep your distance from pets if you are diagnosed with COVID-19 or have been exposed to someone who tested positive. If you have COVID-19 and your pet is sick, please contact your veterinarian.

The most important thing when going grocery shopping is for you to take precautions to not be within six feet of someone else for more than 15 minutes, to wear a mask, and to wash your hands after you’ve touched any surfaces. It matters less whether you were there for 15 minutes versus an hour. It’s more about the actions and the physical distancing that you take when you're at the store. It’s also better to go when there are fewer people around.

If someone is smoking a cigarette and coughing at the same time, maybe, but there’s not a biological mechanism for how the virus would be in the smoke.

There are reports that this can be helpful and there are more proning studies going on. The challenge with proning is that it is staffing intensive. You need a lot of staff to put people in the proning position and keep them that way—and a lot of PPE to do this safely.

Wet markets have come up in a number of contexts—certainly with COVID-19, and the 2003 SARS epidemic was linked to a wet market. The challenge with COVID-19 is that we don’t actually know much about the wet market that was involved. We know that the initial cluster of patients seen by clinicians had an occupational connection there. But we don’t fully know if and how they became infected at the wet market. It’s possible that the virus was circulating in the population and somebody who had it spread it at the wet market. We don’t know that it came from the animals there.

Wet markets have been identified as places of risk for the potential of animal viruses to spill over into human viruses, and there’s an active conversation around what to do about that. Some want to shut them down but worry it will just drive the practice underground in a way that authorities are unable to regulate. Others advocate for more regulatory approaches, so that when they occur, they occur as cleanly as possible.

There is growing evidence that infection can confer some level of immunity. If SARS-CoV-2 is like other coronaviruses that currently infect humans, we can expect that people who get infected will be immune for months to years, but probably not their entire lives.

What we know from virology and from animal models is that the less virus you take in—what’s called the inoculum, or the dose—the less likely you are to get sick. We have done this in hamster models. The more SARS-CoV-2 that you give to hamsters, the more sick they get. If you give them less, they get less sick.

In the last month, there is data that even asymptomatic infection does seem to trigger immunity. There are two arms in the immune response: antibodies and T-cells. Antibody response can wane over time, but T-cells are what gives you lasting immunity. Asymptomatic—or mild—infection can give you strong T-cell immunity, which can last for a very long time.

The New York Times Coronavirus Drug and Treatment Tracker is following 21 treatments for effectiveness and safety. This resource is updated frequently.

The Novel Coronavirus Research Compendium (NCRC) is a literature curation effort by over 50 faculty members with collaborating institutions that review thousands of papers about COVID-19 research, including treatment, each week.

Yes, you should still wear a mask, practice social distancing, and frequently wash your hands even if you receive the vaccine. That’s because protection from the vaccine is not perfect, and because it’s still not known if you can still spread the virus to other people once you have been vaccinated.

Restrictions like mask wearing and social distancing will be eased over time as the level of virus in the community drops.

There is no evidence that an MMR booster will provide any protection from SARS-CoV-2. But, it is still important for people, and kids in particular, to get the MMR vaccine to prevent those diseases.

Early questions about whether hydroxychloroquine might be of help to patients with COVID-19 have been addressed by high-quality research, and the results do not support the medication’s use. In June, the U.S. Food and Drug Administration found “no benefit for decreasing the likelihood of death or speeding recovery,” and revoked the medication’s authorization for use in COVID-19.

We’re expecting to have an increase in COVID cases this fall and winter at the same time that influenza occurs annually. It will be important to increase the proportion of the population vaccinated against flu as a means to protect ourselves and our communities, but also to save hospital capacity to treat those with COVID-19.

Regarding flu vaccine effectiveness: There are many different influenza viruses. The vaccines we get in the United States tend to protect us against three or four different kinds, but there isn’t always a perfect match between the vaccine and the viruses circulating in the community. The good news is that even if you got sick after getting the flu vaccine, odds are that you got less sick and had a shorter duration of illness because you got that flu vaccine. Flu vaccines are very good at reducing the chances of having a very severe illness and having a bad outcome requiring hospitalization or potentially leading to death. (Public Health On Call podcast, July 28, 2020)

Regarding COVID-19 vaccine effectiveness: The short answer is that we don’t yet know. The very first people who got the very first vaccine were immunized in March and it’s only July. So we don’t know very much about the durability of the immune response in people. Our hope would be [that protection would last] at least a year or more, and then people might need boosters.

All vaccines deliver a viral protein that causes the person being vaccinated to make an immune response. There are different ways to do this: one is to give the whole, inactivated virus so that is doesn't make the person sick.

Another way is to deliver the nucleic acid that encodes the protein and let the [vaccinated person's] cells actually make the protein. RNA is the nucleic acid that codes for proteins that cells make. It has all the information needed to be able to synthesize the protein. [mRNA vaccines] deliver the RNA that encodes the viral protein you're interested in and lets the cell actually make that protein to then stimulate the immune system.

People have been working on these kinds of vaccines for the last 10 years.

There are two versions: the [Pfizer and Moderna COVID-19 vaccines] we're dealing with just use the messenger RNA.

There's also a version [that uses] a self-replicating RNA, where it also has the information needed to copy that RNA so you can make more copies of it. They've been worked on mostly for cancer vaccines.

Both self-replicating and non-self-replicating RNA have been explored for quite a period of time for immunization purposes as well.

[mRNA vaccines] have several advantages. Because the cell itself is going to make the protein, it's much more likely to be the native protein or have the right properties that the virus would also have.

Another big advantage is that they're fast to make. If you have the basic platform that [allow you] to insert the sequence for your particular protein of interest, you can just take [that] out and put another one in. It's very fast to substitute in a new, different coding sequence for a protein.

They have had prototypes for influenza, for rabies, for a number of other [viruses], but they’ve never gotten to phase 3 testing. I think maybe the need was not so emergent and so critical as it has been here.

[COVID-19] has really motivated [researchers] to move the technology forward fast. But as you say, there’s really been a lot of work that’s been ongoing for the last five to 10 years with this platform.

We're very likely to see other vaccines [using this platform]. [SARS-CoV-2] came along as a brand-new virus, so it opened the way to apply these newer methods.

There are still questions about how durable this immunity is but it’s likely to get applied to more emerging infectious. Where we have other new viruses coming on the scene, it may embolden people somewhat to try it.

Efforts are underway to develop a "universal" flu vaccine to train the immune system to fight diverse strains of seasonal or pandemic flu.

There's a lot of different ways that people calculate efficacy. Think about it as if you were vaccinated and your friend was not vaccinated, and you were both exposed to the same amount of virus. Your risk of coming down with COVID is 95% reduced compared to your unvaccinated friend.

Some other vaccines offer 50% efficacy. When you think of it in those terms—if you have a 50% reduced risk of coming down with disease [compared to] an unvaccinated person exposed to the same amount of virus—it's still a pretty good risk calculation for yourself.

95% efficacy is amazing. That's more like the efficacy that we see for childhood vaccines—diphtheria, MMR, tetanus, or measles.

In the United States, the FDA has required the same large clinical trial that it would otherwise require for a vaccine. We didn’t do what some other countries did and approve it just based on some blood test results; we actually looked at tens of thousands of people to see whether or not it prevented the disease.

One of the ways the process was sped up is that the taxpayers put a lot of money into this program—that was run out of the White House—to allow companies to basically start each part of the process right from the beginning.

Typically, what would happen is a company might do one study and see whether it works. If it doesn’t work, then they’re done. If it does work, then they start planning the next phase. And if that phase works, then they start planning the next. Everything is A, then B, then C. But with the money that the taxpayers put forward, the companies were able to do A, B, and C all at once. So, they started that first phase and if that worked, they were ready to get going on that second phase. If it wasn’t going to work, they would have lost all the money [spent] preparing for the second phase.

But what they gained was time. They were able to move from A, to B, to C so much quicker because they didn’t have that period in between where they were assessing and figuring out what kind of investment [would be needed] for the next round.

COVID vaccines are new, but these kinds of concerns about vaccines go back for a long time. These are often intentionally a misconstruction of information by people who are anti-vaccine.

Do they include animal blood? Do they include formaldehyde? No, they don't. Some [vaccines] do have preservatives, but all of them have been tested many times and have a good safety record, particularly in the quantities that are in the vaccine. A lot of times, people forget that we ourselves are made up of chemicals, and some of these things in the vaccine, there are sometimes more of them in your own body naturally.

It's important to be aware of your sources of information about the vaccine and also to recognize that there are groups that are intentionally poisoning the information atmosphere with things that are not true about the vaccine. Some don't really care about vaccines and are not really “anti-vaccine.” They're just really trying to sow discord.

A good hint of whether the information comes from a source that's intending to sow discord is if it makes you angry, if it inspires a powerful emotion. Just take the next step and look at your source. See if [the information] is coming from a place where there are people who are experts in that topic, who can address the concerns but without trying to manipulate you.

I've even heard [the claim] that there was some sort of chip in the vaccine—that is not possible and not something that is in these vaccines

So far, it looks like the mutations that are in the spike protein in these different variants are not going to let the virus escape the vaccine. This could change—particularly as SARS-CoV-2 continues to spread throughout the world, with each new host creating opportunities for mutation. If these mutations notably alter the protein’s structure, new variants could elude the antibodies elicited by vaccines for other variants.

Fortunately, mRNA vaccines are well-suited for keeping up with sudden changes in the viral landscape. The mRNA itself is manufactured via a standardized process in which the core ingredient is a DNA sequence encoding a specific viral protein. This means vaccine makers can update the vaccine to fend off new strains by simply tweaking the “recipe” to encode a new protein.

If this virus becomes endemic, it might be that new vaccine variants will need to be rolled out to match the variants that take root.

A randomized control trial is a study design where a patient is randomized to either option one or option two, sometimes multiple options, and sometimes one of those options is a placebo. That study design allows us to control for factors that may influence our ability to see the benefits and the risks associated with something like a treatment.

It’s really important in this setting because we don’t know much about COVID-19. The design is how we identify medical countermeasures, vaccines, medications.

There is no basis for believing that they impact fertility. Of course, all things will be evaluated eventually, but this is a vaccine that has been described as a Snapchat message to the immune system. It is basically some mRNA that gets into the cells, triggers this immune response, and then it degrades, and then it’s gone. It’s a very temporary thing that gets into the body to help the immune system be able to recognize the coronavirus. It would certainly not be anticipated to have any kind of long-term effect like infertility.

Side effects may vary with the type of COVID-19 vaccine. We know the most about side effects following vaccination with the Pfizer and Moderna messenger RNA—or mRNA—vaccines.

The most common side effect is soreness at the site of injection. Other side effects include fatigue, headache, muscle aches, chills, joint pain, and possibly some fever.

Usually 24 to 48 hours, and no more than a few days.

Side effects were more frequent after the second dose in the vaccine trials.

Side effects are similar after the Pfizer and Moderna mRNA vaccines but could differ with other types of vaccines.

No—in fact, vaccine side effects have been less frequent and severe in adults older than 55 years in the vaccine trials.

You will be told about the side effects of the vaccine and when you should consult a health care worker at the time you are vaccinated.

The Centers for Disease Control and Prevention advises that you should contact your doctor or health care provider if the redness or tenderness where you got the shot increases after 24 hours, or if your side effects are worrying you or do not seem to be going away after a few days.

There are no known safety issues with taking acetaminophen or ibuprofen with vaccination. Some experts have expressed concern that taking these medications might interfere with the immune response to the vaccine, but there is not data available to address this question directly.

As a result, it is generally recommended to take these medications only if necessary. The CDC says, "If you have pain or discomfort, talk to your doctor about taking an over-the-counter medicine, such as ibuprofen or acetaminophen." People who suffer specific medical complications of fevers should discuss a plan for using fever-reducing medications with their physicians before vaccination.

Yes—and this is why it is important to continue to wear a mask, practice social distancing, and wash your hands.

The first dose will not provide complete protection, and it will take about seven days after your second dose before you will achieve a full protective level of immunity that develops in about 95% of vaccine recipients. If you are exposed to SARS-CoV-2 before this time, it is possible that you could develop COVID-19.

Even once you have received both doses of the COVID-19 vaccine, it will still be important to continue practicing public health mitigation strategies like masks and distancing until the pandemic is under control and we know more about how the vaccines prevent transmission.

The side effects of the vaccine typically start within 12 to 24 hours of vaccination, but it may be difficult to tell the two apart if you become infected between vaccine doses.

If you experience side effects that last beyond 48 hours, you should contact your doctor or medical provider for advice.

The second dose boosts the immune response so that people can fight off infection of the actual coronavirus. There is clearly some protection from the first shot; how much there is, though, isn’t known. There will be more research done to see whether one shot might be enough, but for now, the evidence is really about two shots.

Yes. We’re going to learn a lot more about the effectiveness of the vaccine for different groups of people, including people who had been exposed before. It’s possible that there might be variations in that recommendation, but for right now, the safer thing to do, and what wound up being recommended, is for people to get the vaccine.

It is quite possible that the vaccination is going to provoke a stronger immune response, more protection for the individual, than getting sick, at least for people who had mild illness, but we don’t know that for sure yet.

Yes—If there is still a lot of virus out there being passed around, then people probably are going to be asked to wear masks and keep socially distant in order to reduce the spread and prevent the chance that the virus comes into contact with someone who is vulnerable and could get quite sick.

Over time, as more people get vaccinated and as more people take other precautions, the amount of virus is going to go down a lot. When those rates go way down, I think that the restrictions on our behavior might change.

What we don’t understand fully about the vaccine yet is whether it protects against infection. We know for sure that they do a good job protecting against moderate and severe illness, but it’s not really clear yet if people who get vaccinated are still able to transmit the virus to others.

One reason is that this virus is more easily transmitted than SARS (SARS caused an epidemic in 2003.). People with SARS were most likely to transmit the virus when they were quite ill, so a lot of transmission occurred in health care environments. Once we were able to improve infection control in health care environments, we were able to bring the epidemic under control. The 2009 pandemic caused by the new flu strain H1N1 was similar to COVID-19 in the sense that people transmitted their infections quite easily. But it was a milder virus; it didn’t produce the same level of severe illness or death that we so far have seen with this novel coronavirus.

COVID-19 is not as deadly as SARS was. On average, SARS killed about 10% of the known cases, and the estimates for this virus are much lower. But the fact that it’s so easily transmissible— much more like a flu than SARS—has made response to this pandemic quite difficult.

What’s going on at your local level can change over time, from week to week, or month to month.

Local or state health department websites can tell you what’s going on in your community. First, look at the number of COVID-19 cases. This number includes those who test positive—and, remember that not everyone who is infected or feels sick will access a test, so that number is just the tip of the iceberg. You want to see what that number of cases is doing over time, note if it is going up or down. Another thing to be aware of if there is major change is the amount of testing that’s going on in your community.

The second number to look at is the number of deaths in the community. There’s been a lot of debate about how to measure COVID-19 deaths, but you’re going to be looking at that trend over time. Not just how many people died today, but over the last week. Hopefully, it is decreasing, signaling lower risk.

This is a live public health moment. Things are changing all the time and no data is perfect, but a lot of data can be really helpful.

The Johns Hopkins Coronavirus map is a good resource to examine the spread in other states and countries around the world. The map is updated in real time as additional information is made available from a variety of sources.

The Center for Health Security has an Operational Toolkit for Businesses Considering Reopening or Expanding Operations in COVID-19. The toolkit includes an instruction manual, business risk worksheet, and an assessment calculator.

Taking temperatures is a very insensitive and imprecise tool. People can have elevated temperatures for all sorts of reasons that don’t correlate with illness, such as exercise. People can also suppress their fevers by taking Tylenol or other over-the-counter medications.

Having ubiquitous temperature monitors is not likely to be a great benefit and may result in a huge number of false positives and false negatives.

Contact tracing is critical to managing transmission, but it’s resource intensive and requires a lot of data gathering. This can strain public health departments and areas that can’t recruit or train tracers.

Digital tools can facilitate quick and effective communication and give access to real-time information. Contact tracing tools and apps can follow up with patients, notify individuals of potential exposure, and refer them to testing facilities and care if they develop symptoms. There are also apps that collect user-generated data where users report symptoms or fill out surveys that can help officials map outbreaks.

But these tools may be costly, and there are questions of usability of the platforms. There are also privacy considerations, as some apps require the use of Bluetooth and location sharing.

I don’t think things will be completely back to normal until we have a vaccine, especially for things like mass gatherings. There is a cost to keeping everything closed down—and not just an economic cost, but peoples’ health. There is a psychological impact of being locked up and not being able to live your life that really has to be measured.

Everybody wants to get back to normal, but it’s going to take a little bit of time and it has to be done in a really measured and mindful way.Everybody wants to get back to normal, but it’s going to take a little bit of time and it has to be done in a really measured and mindful way.

The biggest factor determining risk in schools is what the virus is doing outside of them. In places where you have a very high test positivity, like well into the double digits, that suggests that the outbreak is very widespread and that testing isn't keeping up.

Regardless of whether schools open online, in person, or with a hybrid approach, there will be learning disruptions to consider. COVID-19 is exacerbating growing inequities around achievement, development, and graduation rates.

Schools can also expect a year of uncertainty and should think about plans for positive cases among students, faculty, and staff, or spikes in community transmission. Teachers and parents will need to help children manage distress caused by uncertainty, distance learning, and fear, and school leaders and educators will need to plan for different scenarios.

Designing an effective testing strategy will require careful consideration of your group’s goals, resources, and structure. A testing strategy is a tailored plan that not only includes identifying the actual tests used but also describes the steps and factors to address to ensure that testing is rolled out in an effective way. In this section, we identify important factors you that can help you design your own testing strategy.

While a testing strategy will be unique to each organization, group, or individual, a few common factors should be considered when creating any testing plan:

  1. Are you trying to determine a current or past infection?
  2. Would you prefer to have samples collected at home or by a trained professional?
  3. How many people will be tested?
  4. What age groups will be tested?

We’ve largely built testing off our health care system, with all the inequities built into it. That’s one of the reasons we’re suggesting a call center that’s available to everyone. Even though this virus started in the United States with people returning from cruises or international travel, the populations at greatest risk are low-income minority communities with high rates of chronic illness and insecure housing and food. The initial attention to people who got coronavirus on cruises and international trips has distracted us from the urgency of providing not just testing, but also follow-up services—food, housing, and other supports—for vulnerable populations. It’s the right thing to do as a matter of justice, but it’s also absolutely critical for control of the disease.

The coronavirus disease 2019 (COVID-19) pandemic has had tragic and disproportionate adverse effects on Black, Indigenous, and People of Color (BIPOC) communities across the United States.

As the COVID-19 vaccination campaign begins, it is critical that vaccines be delivered fairly and equitably—so that everyone has the same level of access to this lifesaving technology. Just as pressing is the need to address longstanding disparities that have created the unequal situation that BIPOC communities are now in.

The Center for Health Security has released a plan for elected and appointed officials that contains the tools to create, implement, and support a vaccination campaign that works with BIPOC communities to remedy COVID-19 impacts, prevent even more health burdens, lay the foundation for unbiased healthcare delivery, and enable broader social change and durable community-level opportunities.

It’s critically important that we have racial and ethnic diversity.

We know that COVID causes increased rates of severe disease in Latinx and Black populations and in Native American populations. We will certainly want to be able to offer these COVID vaccines to these high-risk populations and encourage their use. But we need to know how well these vaccines work in these populations—if different vaccines work differently—so that we can offer the most effective vaccines.

Keeping an eye on the data is an important priority: knowing who is impacted and where they’re impacted.

Communication is also really important—making sure that the public understands why we might be seeing these patterns, and that it’s more about our society and the way our resources and opportunities are allocated than it is about individual behaviors. We need to do what we can to better understand the challenges of those communities, engage with trusted leaders, listen with respect, and show empathy and concern. We need to recognize the remarkable contributions of African American communities and follow our words up with real actions that bring about positive change.

We also need to focus on frontline workers and low-wage workers, and understand their needs—providing protective equipment, safe spaces to work, paid sick leave, hazard pay, or health insurance and access to testing and care. And, we need to provide for people’s basic needs: stable housing, food security, and digital access to education and health care.