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Here's a question from Twitter:

Why is it that the super quick test kits that we've read about being used in South Korea aren't available everywhere? And can people catch it twice?

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Different countries have decided to develop their own tests. The reasons why will likely be the subject of many long articles in the future. There are a lot of unknowns about why testing has proved to be such a fiasco - why countries decided to make their own; why some have had shortages; what happens when materials run low. Hopefully we'll have some answers -- and more importantly solutions -- soon.

It's really early to say, but it looks like all of the research so far is pretty clear: people are not catching it twice. Researchers are thinking that once you get it, you may have immunity for 1-3 years.

It seemed as though people were catching it twice because they would test negative one day and test positive the next. (Or negative one week, and positive the next.) The reason seems to be that the virus sometimes isn't detected on the tests; that's why the current advice is that everyone should be tested 24 hours after a negative test to ensure it's still negative.

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I'm trying to make a mental plan for what to do if I develop a cough and fever. Given that I'm in a low-risk group, is it reasonable to plan to stay home as long as the cough and fever stay pretty mild? I'm fearful of transmitting it to more vulnerable populations if I go out and about, and it doesn't sound like I'd be able to get tested for coronavirus anyway.

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I got a cold during this (still have it). I didn't want to go in and spread it, so I called the doctor. In DC, anyway, their guidance is NOT to come into the doctor's office, but to schedule a video appointment if you have any flu or cold-like symptoms. I did and they said I was low risk for COVID-19. To stay home and not go out/interact with people until 24 hours after my symptoms stopped (coughing/sneezing). I always get hit hard when I get sick, so a week later I'm still coughing some. I've just stayed away from people. Keep in contact with your doctor and let them make the calls. Don't go in, but call first.

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Yes this is a very good point! Always call before you go - first of all, to make sure you're not going to be adding pressure to the hospital system, and secondly, so they have time to put on personal protective gear and put you in an isolation room if it is COVID-19.

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I love that you're thinking about this, and this is a fantastic plan. If you get sick, you should still call your doctor if only to check in. Depending on where you live, you may be able to get a test - but in most places, that's not currently an option unless you meet the testing criteria (sick with all symptoms AND recent travel/contact with a confirmed case).

In the meantime, the doctor may tell you to stay home and monitor your symptoms. Most (80%) cases are mild and just go away on their own. If your symptoms get worse (high fever, chest pain/tightness, shortness of breath), call the doctor or hospital right away to be seen. When the disease does get bad, it does so very quickly.

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Could use some suggestions about managing anxiety, in particular in front of small children. Also, this is more on the medical side: do we know much (anything?) about children with pre-existing conditions who get it? Thinking about my daughter who has asthma. I trust her pulmonologist who has said not to worry too much and that she can go to school as long as schools are open, but...I know the data from China says kids generally didn't get it or did well with it, and that must include some number of kids with pre-existing conditions. But I can't seem to find numbers that deal with that subset of kids directly.

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Excellent questions. I've also been looking into research on kids with preexisting conditions. There's not much research on how kids have done in China, because very few kids qualified for the research. That's a really good thing -- it means kids weren't getting very sick or sick at all, even when they had the virus, so there weren't many study subjects.

Here's research on infants, including newborns: https://jamanetwork.com/journals/jama/fullarticle/2761659

There's also data on older patients with preexisting conditions, but I wouldn't weigh that too heavily in this case, because age truly seems to matter to this virus.

Managing anxiety is so important, especially around kids. They're noticing that things are different, and they will need more reassurance. It's hard to give assurances when we don't know what's going to happen. But staying informed and taking precautions is the best thing you can do right now -- and you're doing it! That will go a long way.

When you're with kids, try to engage as actively as you can. When you need to cry or rage or scroll Twitter, try to do it in another room. But when kids are there, try to focus on playing more and talking with them. You can even ask what your kids are hearing, depending on their ages, and answer questions they have.

Treasure these moments. Try to stay fully in them. We may be full of worry for our kids -- but these moments are what keep us fighting to protect them.

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Thank you, Melody!

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Of course! I wish I had more definitive answers!

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I found this piece today, which validated my fears and also gave good information--mostly experts speculating about the same info we already have, but it was interesting to note that generally speaking corona viruses are not as likely to cause asthma attacks as rhinoviruses:

https://parenting.nytimes.com/parent-life/coronavirus-asthma-kids?module=latest-filters-feed&action=click&rank=3&position=5

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That is VERY good to know!

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Our preschool is shutting down on Monday. Is it safe to go to a park/play structure and how many kids makes a space a bad idea? And is it okay to meet up with friends for a play date? I worry about the cabin fever driving kiddo up the wall. I'm in Silicon Valley which is a bit of a hot spot.

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In places where there's community spread, I would avoid going to places like a playground where lots of kids touch the equipment. The virus may last up to 2-3 days on surfaces, and sanitizing everything, even if you're the only people there, is really hard.

However, if you can take walks in the park, do it! Research on SARS showed that fresh air can help. Just try to stay 6 feet away from other people.

Interacting with friends is a call you'll have to make. If any of them have been sick, it's an obvious no, but sometimes people carry the virus and have no idea. (This certainly seems to be the case for kids.) If you do need social interaction, could you all go on a walk outside? You could forego the hugs and keep a little distance while still not feeling cooped up and alone.

It might be time to get creative about indoor activities - painting, coloring, games, new toys, and TV/iPad for reward times. Anything that works!!

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Thank you. Fingers freaking crossed.

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Follow-up question: what about chlorinated public pools? Is it time to cancel swim class for kiddo?

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Ooh this is a very good one! I haven't seen any research on this, so this is my guess: If the pool is definitely using the right mixture of chlorine (EPA has info on the concentrations of disinfectants that work on this virus), it could kill the virus in the water. But you'd still have contact with railings, etc, and potentially with other people. In places where there's community transmission, I'd err on the side of canceling public events and classes.

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One more question! What about the library? I understand not hanging out there for significant periods of time, but is it safe to go in, take 10-15 minutes, and grab a few books?

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It's a judgment call, but I probably wouldn't - since the virus may be able to last for 2-3 days on surfaces. Libraries often have fantastic digital collections as well - not nearly the same, but could help?

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Got it. Ahhhhh I'm gonna miss the library.

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SAME. And bookstores!

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Question for you -- I think it's a big deal, but my boss/company is not on board with us working from home for a period of weeks/months, even though we have the capacity to do so. I live in MD, where the first case of community transmission was just reported (not in my county). At what point do I put my foot down and demand to work from home? I am not too concerned for my own health but do not want to be a vector.

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First of all, I am so sorry that your company is not thinking about your health and the health of others, and I hate that you have to fight to do the right thing. Making this decision is tough - you don't want to jeopardize your job, but you have to think of the people you come into contact with (and yourself, too, even if you're not worried).

Maryland declared a state of emergency and closed all schools. That's a major move. They haven't closed businesses yet, but it's likely we'll start to see non-essential stores closing or moving to limited hours. Here's the state's guidance: "We ask that all employers consider employee safety at all times and review their teleworking, leave, and continuity of operations plans and policies." https://mema.maryland.gov/Pages/state-of-emergency-coronavirus.aspx

If you haven't already, I would go to your employer with this information and urge them to allow all employees to begin working from home. I would also ask them what their policies are on workers' comp if you or another coworker is exposed in the workplace.

I would absolutely put my foot down when 1) someone at work starts displaying symptoms or 2) you feel off (tired, a little sick, etc) at all.

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I feel like I'm simultaneously overreacting and underreacting. HELP!

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I feel that way every day! Am I doing enough? Do I need to relax, and just accept our eventual viral overlords? Is this all going to blow over in a week or two, and I'm being paranoid?

The thing is, this is brand-new territory for all of us. It has been a LONG time since we've seen a global pandemic like this. So none of us really know how to react! The only thing we can do is follow our instinct and practical advice. Being careful goes such a long way!

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