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Frequently Asked Questions

It can be difficult to understand all the facts about COVID-19. There can be lots of misinformation, and we are learning more about the virus as we go. Below are frequently asked questions that can help you better understand the risks of the virus and how to best protect yourself and your community.

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FAQs about COVID-19

What is COVID-19?

COVID-19 (Coronavirus Disease 2019) is a disease caused by a respiratory virus first identified in Wuhan, Hubei Province, China in December 2019. COVID-19 a new virus that hasn’t caused illness in humans before. Worldwide, COVID-19 has resulted in thousands of human infections, causing illness and in some cases death. Cases have spread throughout the world, with more cases reported daily.

What is the current COVID-19 situation in Maryland?

Up-to-date information about testing and case counts in Maryland is available at coronavirus.maryland.gov​. The page is updated daily.

On May 13, Governor Larry Hogan announced the ‘​Maryland Strong: Roadmap to Recovery​,’ which lays out a path to the gradual and responsible reopening of Maryland’s economy while protecting public health. The recovery process will be implemented in multiple phases with a flexible, community-based approach that empowers individual jurisdictions to make decisions regarding the timing of reopenings. For the reopening status of Maryland’s jurisdictions, please​ visit here​.

Marylanders are advised to heed all state and local public health guidance:

  • All Marylanders who are older and have underlying health conditions that put them at greater risk for COVID-19 are advised to avoid crowds
  • Employers should continue to encourage telework for their employees whenever possible
  • Everyone should continue wearing masks or face coverings in public areas, businesses, and public transportation
  • Marylanders should continue practicing physical distancing, staying six feet apart when possible

On Dec. 17, Governor Hogan issued an emergency order requiring Marylanders to limit all travel to essential purposes only. All Marylanders who do travel outside of Maryland or any individuals who do travel to Maryland must either obtain a negative COVID-19 test result or self-quarantine for 10 days. This applies to all states, with the exception of Delaware, Pennsylvania, Virginia, and Washington, DC.  Read the governor’s order and the companion health directives.

MDH issued a public health advisory warning Marylanders against all non-essential activities and holiday gatherings with people outside one’s immediate household. Under this advisory, all Marylanders should refrain from attending public and private gatherings of more than 10 people in one location and should practice physical distancing to the maximum extent possible.

Information about the Hogan administration’s ongoing response to COVID-19 is available here​.

What are risk factors for serious illness from COVID-19?

Everyone is at risk for COVID-19. However, symptoms can range from mild to severe and may have different complications for each person. Older people, age 60 and above, and those with pre-existing medical conditions have a higher risk for serious illness from COVID-19. Examples of pre-existing medical conditions include cancer, diabetes, heart disease or other conditions impacting the immune system’s ability to fight germs.

While older people and those with pre-existing conditions are at a higher risk, current ​MDH data shows that the majority of infections are in adults under 60​ years of age. People of all ages need to practice social distancing to prevent the spread of COVID-19.

How does COVID-19 spread?

COVID-19 is thought to spread mainly through close contact from person to person. People who are infected but do not show symptoms can also spread the virus to others.

Close contact is described by the Centers for Disease Control and Prevention (CDC) as being within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated. Cumulative total can be determined by adding individual exposures over a 24-hour period (e.g., three 5-minute exposures for a total of 15 minutes).

  • COVID-19 most commonly spreads during close contact
    • People who are physically near (within 6 feet) a person with COVID-19 or have direct contact with that person are at greatest risk of infection.
    • When people with COVID-19 cough, sneeze, sing, talk, or breathe they produce respiratory droplets.
    • Infections occur mainly through exposure to respiratory droplets when a person is in close contact with someone who has COVID-19.
    • Respiratory droplets cause infection when they are inhaled or deposited on mucous membranes, such as those that line the inside of the nose and mouth.
  • COVID-19 can sometimes be spread by airborne transmission
    • There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away within enclosed spaces that had inadequate ventilation.
    • The amount of infectious smaller droplet and particles produced by the people with COVID-19 became concentrated enough to spread the virus to other people. The people who were infected were in the same space during the same time or shortly after the person with COVID-19 had left.
    • Available data indicate that it is much more common for the virus that causes COVID-19 to spread through close contact with a person who has COVID-19 than through airborne transmission.

What are the symptoms of COVID-19?

Symptoms, or combinations of symptoms, that may appear 2-14 days after exposure include:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

What is the difference between the flu and COVID-19?

Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, and testing may be needed to help confirm a diagnosis. Flu and COVID-19 share many characteristics, but there are some key differences between the two.

  • Signs and Symptoms: Both COVID-19 and the flu have common symptoms including chills, fever, cough, headache, muscle aches, sore throat, runny nose and fatigue. COVID-19 seems to cause more serious illnesses in some people. Other signs and symptoms of COVID-19, different from flu, may include change in or loss of taste or smell.
  • When Symptoms Appear After Exposure: If a person has COVID-19, it could take them longer to develop symptoms than if they had flu. Typically, a person with the flu develops symptoms anywhere from 1 to 4 days after infection.  A person with COVID-19 may typically develop symptoms 5 days after being infected, but symptoms can appear between 2 and 14 days after infection.
  • For more information, see the CDC ​Similarities and Differences between Flu and COVID-19​.

What do I need to know about the flu season during the COVID-19 pandemic?

Getting a flu vaccine during the 2020-2021 influenza season is more important than ever because of the ongoing COVID-19 pandemic. Flu vaccination is especially important for adults 65 years and older, who account for most hospitalizations and deaths from flu and from COVID-19.

Flu information and resources in Maryland:

https://health.maryland.gov/flu

Read more from the CDC:

Protect Your Health This Flu Season​

Adults 65 & over are at higher risk for flu complications​

What should I do if I think I am sick with COVID-19?

If you become sick with fever, cough or have difficulty breathing, contact your health care provider, especially if you are over 60 years of age or have pre-existing medical conditions. If you do not have a health care provider, contact your local health department. Follow these steps:

  • Call your health care provider, local health department or emergency room before you go
  • Tell them about your symptoms, any recent travel and close contacts (such as people in your household)
  • Wear a mask

If someone has COVID-19, what will happen to them?

The vast majority of people recover from this infection. Most people will have mild or moderate symptoms. Most people may be advised to recover at home and isolate themselves from others. These individuals should call their physicians or health care practitioners if their symptoms get worse.

Some COVID-19 infections can lead to serious illness, and in some cases death. If someone has a more serious illness from COVID-19, they may be admitted to the hospital.

Should I wear a face mask?

On September 1, Gov. Hogan announced further amendments to the statewide masking order that has been in effect since April 18. All Marylanders over age 5 should continue wearing face coverings in indoor public areas, retail stores, outdoors when unable to maintain social distancing, and on public transportation. Face coverings are also required in offices of physicians and dentists, hospitals, pharmacies, and laboratories; and at work in any area where interaction with others is likely such as shared areas of commercial offices. Face coverings should cover both your nose and your chin to properly protect against infection. Read the order here.

Masks and face coverings can be made from household items and include wearing a scarf or bandanna that covers the nose and mouth. The CDC has detailed guidance and instructions regarding homemade masks and face coverings available here.

Masks and face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance. People with disabilities who are unable to wear a mask are provided reasonable accommodations per the Americans with Disabilities Act.

The masks and face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance. The CDC has also advised that face coverings with ventilators should be avoided.

Should I cancel plans to travel?

On Dec. 17, Gov. Larry Hogan issued an emergency order requiring Marylanders to limit all travel to essential purposes only. All Marylanders who do travel outside of Maryland or any individuals who do travel to Maryland must either obtain a negative COVID-19 test result or self-quarantine for 10 days. This applies to all states, with the exception of Delaware, Pennsylvania, Virginia, and Washington, DC.  Read the governor’s order and the MDH health directives.

At this time, the CDC warns that travel increases your chance of getting and spreading COVID-19. Staying home is the best way to protect yourself and others from COVID-19.

The CDC warns: You can get COVID-19 during your travels. You may feel well and not have any symptoms, but you can still spread COVID-19 to others. You and your travel companions (including children) may spread COVID-19 to other people including your family, friends, and community for 14 days after you were exposed to the virus.

Don’t travel if you are sick or if you have been around someone with COVID-19 in the past 14 days. Don’t travel with someone who is sick.

If you must travel:

  • Avoid contact with sick people.
  • Wear a cloth face covering in public.
  • Avoid touching your eyes, nose, or mouth.
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not readily available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
  • It is especially important to clean hands after going to the bathroom; before eating; and after coughing, sneezing or blowing your nose.
  • Avoid close contact with others.
  • Avoid traveling if you are sick.

People who are at increased risk for serious illness are also advised to avoid nonessential air travel.

CDC recommends travelers defer all cruise ship travel worldwide.

Visit the CDC travel advisory site and Testing and International Air Travel page to check on current travel warnings and orders if you are planning a trip abroad.

What can I do to protect myself and others?

Take everyday preventive steps to slow the spread of COVID-19:

  • Wash your hands often with soap and warm water for at least 20 seconds
  • Use an alcohol-based hand sanitizer with at least 60 percent alcohol if soap and water are not available
  • Cover your coughs and sneezes with a tissue, your sleeve or your elbow
  • Avoid touching your eyes, nose and mouth
  • Clean and disinfect​ ​frequently touched objects and surfaces using standard cleaning practices
  • Practice social distancing — keep distance between yourself and others and avoid crowds
  • Cover your mouth and nose with a cloth face cover when around others
  • Avoid close contact with people who are sick
  • If you are sick, stay home, except when seeking medical care

What is social distancing?

The best way to slow the spread of COVID-19 is through “social distancing,” which means avoiding close contact with others. Social distancing can take many forms, depending on your lifestyle and your family or living situation. Social distancing can include the following habits and steps:

  • Avoid handshaking, hugging and other intimate types of greeting
  • Stay at least six feet away from others whenever possible, and wear a mask
  • Avoid non-essential travel (your health care provider may have specific guidance for your situation)
  • Avoid crowds, especially in poorly ventilated spaces
  • Work from home if possible, for your work situation
  • Avoid unnecessary errands — consider ways to have essential items, like food and other household supplies, brought to you through delivery services or through family or social networks

It is recommended that those at a high risk of becoming seriously ill from COVID-19 stay home as much as possible and contact their health care provider.

While social distancing and self-quarantine are needed to limit and control the spread of the disease, social connectedness is important. Virtual resources can and should be used during this time. Talk to your friends and family on the phone or over video to stay connected.

Is there a vaccine or medicine I can get for COVID-19?

There are now authorized and recommended vaccines to prevent COVID-19 in the United States. To learn more about the Maryland COVID-19 vaccination plan and COVID-19 vaccination, please read Frequently Asked Questions. For information about COVID-19 vaccines, please visit MDH’s informational webpage.

How can I be more prepared for COVID-19?

  • Have an adequate supply of non-prescriptive drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines
  • Check your regular prescription drugs to make sure you have an adequate supply; refill your prescriptions if needed
  • Have a thermometer, tissues and hand sanitizer in case you become ill and must stay at home to recover
  • Talk with family members and loved ones about how they would be cared for if they got sick and what will be needed to care for them at home
  • Have a two-week supply of water and food available at home

Can I get tested for COVID-19?

State officials encourage anyone who wants to be tested for COVID-19 to get tested, including people who do not have symptoms​.

For more information about COVID-19 testing and a list of testing sites in Maryland, please visit covidtest.maryland.gov​​.

Will the Maryland Department of Health test animals for coronavirus?

In accordance with current federal guidelines, the Maryland Department of Health will not be testing the general companion animal population. Based on the limited information available to date, the risk of animals spreading COVID-19 to people is considered to be low. Since the situation is ever-evolving, public and animal health officials may decide to test certain animals out of an abundance of caution. The decision to test will be made collaboratively between local, state and/or federal public and animal health officials.

For more information, please visit the AVMA COVID-19 website and CDC COVID-19 and Animals FAQs.

Is there anything else I should know?

Do not stigmatize people of any specific ethnicities or racial background. ​ ​Viruses do not target people from specific populations, ethnicities or racial backgrounds.

Stay informed and seek information from reliable, official sources. Be wary of myths, rumors and misinformation circulating online and elsewhere. ​ ​Health information shared through social media is frequently inaccurate, unless coming from an official, reliable source such as the CDC, MDH or local health departments.

Are there additional resources available for specific groups, such as businesses?

The CDC provides current information about COVID-19 at ​cdc.gov​.

Businesses

Pregnant Women, those who are breastfeeding, and children

Travelers

To receive weekly emails about COVID-19, register here.

FAQs about Monoclonal Antibody Treatment for COVID-19

What are monoclonal antibodies?

Monoclonal antibodies are laboratory-made proteins that mimic natural antibodies’ ability to fight viruses such as COVID-19.

Is monoclonal antibody treatment available in Maryland?

Monoclonal antibody treatment for COVID-19 is available in Maryland under an emergency use authorization (EUA). The two products available in Maryland are Bamlanibimab and Casirivimab and Imdevimab.

Does monoclonal antibody treatment work?

Clinical trials have shown fewer COVID-19-related hospitalizations or emergency room visits and a decrease in the amount of virus in an infected person’s blood in patients at high risk for developing severe COVID-19 symptoms.

How do I know if I’m eligible for monoclonal antibody treatment?

Currently, monoclonal antibody treatment may only be used in adults and adolescents (12-17 years old) with mild to moderate COVID-19 symptoms who:

  • Recently had a positive COVID-19 test
  • Are within 10 days of first experiencing symptoms
  • Do not need to be hospitalized for COVID-19 treatment
  • Weigh at least 88 pounds
  • Are in one of the following high risk categories:
    • Are age 65 and older or have chronic kidney disease, BMI of 35 or greater, diabetes, or an immunosuppressive disease
    • Are age 55 to 64 AND have cardiovascular disease, hypertension, chronic respiratory diseases, or COPD
    • For adolescents: high BMI, sickle cell disease, heart disease, neurodevelopmental disorders, a medical-related technological dependence, asthma or other chronic respiratory disease

If I test positive for COVID-19, how can I get this treatment?

Talk to your health care provider as soon as you test positive for COVID-19 so they can determine if monoclonal antibodies are the right treatment for you.

How are monoclonal antibodies administered to COVID-19 patients?

Patients receive monoclonal antibody treatment through a single, one-hour IV infusion, followed by at least one hour of observation.

What are the side effects of monoclonal antibody treatment?

The most common reported side effects are nausea and vomiting. Other side effects with bamlanivimab include diarrhea, dizziness, headache, and itchiness. Additional side effects with casirivimab/imdevimab include hyperglycemia and pneumonia. Receiving any medicine by IV may cause brief pain, bleeding, bruising, soreness, swelling and infection where you get the needle.

Will my insurance cover monoclonal antibody treatment?

Monoclonal antibodies are provided at no cost to patients. However, there may be other associated costs related to the process of infusing the antibodies that may be covered by insurance.

Can I get a COVID-19 vaccine if I have monoclonal antibody treatment?

Those who have had monoclonal antibody treatment should wait 90 days before getting vaccinated.

FAQs about COVID-19 and Older Adults

Do older adults have a higher risk of becoming more seriously ill from COVID-19?

Older adults (age 60+) and those with pre-existing medical conditions have a greater risk for serious illness, and in some cases death, if they become infected with COVID-19. Examples of pre-existing medical conditions include cancer, diabetes, heart disease or other conditions that impact the immune system’s ability to fight germs.

If you are an older adult or you have one or more chronic health conditions, you can take action to reduce your risk of exposure to COVID-19:

  • Take everyday precautions to keep space between yourself and others
  • Keep away from others who are sick, limit close contact and wash your hands often with soap and water or hand sanitizer with at least 60 percent alcohol content
  • Avoid crowds as much as possible

What can older adults do to be prepared for COVID-19?

Older adults are advised to prepare in the following ways:

  • Check your regular prescription drugs to make sure you have an adequate supply; refill your prescriptions if needed
  • Have an adequate supply of non-prescriptive drugs and other health supplies, including pain relievers, stomach remedies, cough and cold medicines
  • Have enough household items, groceries, and water on hand so that you will be prepared to stay at home
  • Consider ways of getting food brought to your house through family, social or commercial networks if you are forced to stay home for longer than your supplies allow
  • Stay in touch with others by phone or email; you may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick
  • Determine who can provide you with care if your caregiver gets sick
  • Practice social distancing — keep distance between yourself and others

Wash your hands after putting away groceries, touching money or handling anything that comes from outside the home. Clean your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place. Ask anyone entering your home to wash their hands upon entering.

Use commercial cleaning products to wipe high-touch points often, including:

  • Canes, walker grips, wheelchair arms, push handles and brake handles
  • Handrails and commode chair handrails, faucets, doorknobs, and refrigerator handles
  • Reacher/grabber handles and pill boxes
  • Telephones, remotes and light switches

Why is social distancing especially important for older adults?

The best way to slow the spread of COVID-19 is through “social distancing,” which means avoiding close contact with others. Social distancing can take many forms, depending on your lifestyle and your family or living situation. Social distancing can include the following habits and steps:

  • Avoid handshaking, hugging and other intimate types of greeting
  • Stay at least six feet away from others whenever possible, and wear a mask
  • Avoid non-essential travel (your health care provider may have specific guidance for your situation)
  • Avoid crowds, especially in poorly ventilated spaces
  • Work from home if possible, for your work situation
  • Avoid unnecessary errands — consider ways to have essential items, like food and other household supplies, brought to you through delivery services or through family or social networks

For older adults, social distancing is especially important because they are a high-risk group. It is recommended that those at a high risk of becoming seriously ill from COVID-19 stay home as much as possible.

While social distancing and self-quarantine are needed to limit and control the spread of the disease, social connectedness is important. Virtual resources can and should be used during this time. Talk to your friends and family on the phone or over video to stay connected.

What can I do to support older adults?

  • Know what medications your older loved one is taking and contact them to ask if they need refills or an extended supply of medication
  • Check in with any older friends or family members regularly by email or phone to see if they need assistance, food, water or other supplies. Always wash your hands and keep a safe distance when visiting.
  • If a loved one is living in a care facility, monitor the situation — ask the facility about its protocol if there is an outbreak and about the health of other residents

How is MDH helping care facilities?

MDH is working with Maryland care facilities to ensure they are prepared for COVID-19. For up to date information, see the FAQs about Nursing Homes, Assisted Living, and Congregate Living Facility Orders and Support Efforts.

FAQs about Testing

Who should get tested?

The Maryland Department of Health encourages the following individuals to get tested:

  • Symptomatic​ ​individuals
  • All who suspect exposure, including those who are asymptomatic
  • Individuals who are at risk of exposure, including workers in frequent contact with the public in health care, emergency services, food and grocery, retail or manufacturing, public transportation, educational, and other congregate settings
  • Individuals who have been in large gatherings
  • Individuals who have traveled recently, including those who have traveled to a state with a COVID-19 test positivity rate above ten percent or a case rate over 20 per 100,000.

Where am I able to be tested? Whom do I contact?

There are more than 240 testing sites available throughout Maryland. Location, contact, and scheduling information for many of the COVD-19 test sites in Maryland can be found at covidtest.maryland.gov. If in doubt, patients are encouraged to contact the site where they plan to be tested to verify that site’s appointment procedures and other testing requirements.

What does the test consist of? What is the process?

Generally, the test involves a swab (“q-tip”) inserted into the back of the patient’s nostrils or the lower portion of the nose (both methods are accurate and effective). Most patients report minor, temporary discomfort at most.

Where can I learn more about the different types of tests available in Maryland?

A table comparing common types of COVID-19 tests is now available at COVIDtest.maryland.gov.

How long does it take to receive results? How do people who are tested get their results?

Generally, the results will be available within approximately two to five days, depending on laboratory testing demands and resources. In most cases, you will have the option to be contacted with your results via text message or phone call or to retrieve your results through an online patient portal.

​Note (12/10/20): ​ Many labs are currently returning test results within 2-3 business days. However, due to the high volume of tests being processed across the country, it ​may​ take longer than expected to receive your results. Labs across the state are working as quickly and carefully as possible.

Will I have to pay for the COVID-19 test?

In many circumstances, tests are provided at no out-of-pocket cost to individuals. However, individuals should contact their health plan prior to receiving a COVID-19 test to determine whether testing is covered by the plan in their circumstance. Out-of-pocket expenses may apply if the test is not covered by the health plan. Maryland Medicaid will cover the costs of COVID-19 testing for its beneficiaries.

Will my insurance cover treatment if I test positive for COVID-19?

Health insurance plans cover medically necessary treatment for disease, but the treatment may be subject to deductibles, copayments, and/or coinsurance. You will need to pay those amounts, even if the care is covered. If you have a limited-benefits plan, there may be additional restrictions on what is covered.

If I do have COVID-19, what happens?

The vast majority of people recover from this disease in one to two weeks. Most people will have mild to moderate symptoms and will be advised to recover at home and isolate themselves from others. Any individual whose symptoms get worse should call a health care provider.

After The Test

What do I do while waiting for my results?

Stay at home and self-isolate. Frequently wash your hands with soap and water for at least 20 seconds. Limit contact with pets and animals; wear a face covering when you are around others; clean and disinfect frequently touched objects and surfaces. Monitor your symptoms. If your symptoms get worse, please call your health care provider’s office. If you are having a medical emergency, such as difficulty breathing, call 911. Tell the 911 operator that you were tested for COVID-19 and are waiting for results.

What do I do if my test results are positive for COVID-19?

If you test positive, you should self-isolate at home. You can be with others after:

  • At least 10 days since symptoms first appeared; and
  • At least 24 hours with no fever without fever-reducing medication; and
  • Other symptoms of COVID-19 are improving.

Continue to practice good hygiene, including frequent and thorough hand washing, disinfecting “high-touch” surfaces, and frequently washing clothing and bedding. Avoid contact with other members of the household and pets. Practice physical distancing within the home and wear a mask around other people.

Will my positive COVID-19 test results be reported to public health entities?

Yes. Positive COVID-19 test results will be reported to the appropriate public health agency in accordance with applicable Maryland laws and regulations.

When can I be around others after having COVID-19?

Talk to your health care provider especially if you have a ​high-risk underlying health condition​ or if you are 65 years and older. You may need to stay away from other people longer.

Most people can follow the CDC’s three conditions before being around others:

  1. It has been at least 10 days since symptoms first appears, ​AND
  2. It has been at least 24 hours with no fever without the use of fever-reducing medications, AND
  3. Other symptoms of COVID-19 are improving (loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation) ​.

When around others, remember to maintain six feet of distance and wear a face covering.

Please visit ​covidtest.maryland.gov​ for additional information about testing and to find a testing site near you.

FAQs about Contact Tracing

What is contact tracing?

Contact tracing is the process of identifying people who may have come into contact with an individual with an infectious disease. The process involves identifying infected people, determining who they have been in close contact with while infectious and asking people who are potentially infected to stay home until it is clear they are not sick.

For the coronavirus pandemic, contact tracing begins with a phone interview of the positive COVID-19 patient and obtaining details regarding the patient’s contacts, who they have interacted with and where they have gone recently. The next step involves locating people with whom the infected person has interacted during their infectious period.

I tested positive, why haven't I gotten a call?

While the goal of contact tracing is to talk to all cases and all of their named close contacts, when case counts get too high, it might not be possible. The key things to know if you test positive but don’t get a call are to isolate (please see the FAQs about Isolation and Quarantine) and to tell your close contacts of their exposure. Call your local health department if you need access to resources or have questions. And please answer our call the first time we call – the caller ID will read “MD COVID”. If you do not have caller ID, look for the phone number (240) 466-4488.

I got a text message from the Maryland Department of Health. Is it legitimate?

The Maryland Department of Health (MDH) might text people who test positive or their named contacts for a couple of reasons. The text message may remind people to answer our call when a contact tracer calls to get more people to answer on the first call. Another reason MDH might send a text is to provide the verification code that an infected person needs to share their COVID-19 diagnosis through MD COVID Alert, without having to wait for a contact tracer to call.

What happens after the list of contacts is established?

Following the interview with the infected patient, other individuals who came into close contact with the infected person will be contacted by phone and guidance will be provided regarding how to quarantine and monitor themselves for symptoms.

During quarantine individuals will be monitored by text, secure web survey or telephone and actively referred for testing should they develop symptoms. This process was developed to help prevent further person-to-person spread of the infection.

Why is contact tracing necessary?

Contact tracing is an essential tool used to decrease the spread of infectious disease and has been effectively employed during other health emergencies, such as the H1N1 pandemic in America and Ebola outbreaks in Africa.

Effective use of contact tracing is a critical step in decreasing the number of COVID-19 cases. In fact, contact tracing was one of the “four building blocks” of public health response described by Governor Larry Hogan as critical in reopening Maryland — along with securing adequate supplies of PPE, expanding testing and ensuring Maryland had ample hospital surge capacity for infections.

Who conducts contact tracing?

Local health departments across the state are conducting contact tracing. Maryland has also contracted with NORC at the University of Chicago, one of the largest independent social research organizations in the United States, to assist in contact tracing efforts.

How many contact tracers are actively tracking movements and locations of positive COVID-19 patients?

Maryland currently has more than 1,500 contact tracers working through the Maryland Health Department and the 24 local health departments to conduct interviews with individuals who tested positive for COVID-19. With the recent increase in case counts, Maryland is hiring additional contact tracers to meet the demand.

Does contact tracing damage my privacy and violate HIPAA laws?

No. Contact tracers take extreme measures to protect the privacy of infected patients and maintain strict adherence to HIPAA regulations. During a trace investigation, a person will be notified that they may have come into contact with an infected individual, but the infected person’s name is not disclosed.

What kinds of questions might a contact tracer ask me?

If a contact tracer calls you, they will ask about your health, any potential symptoms you may have, and the duration of those symptoms. They may ask about your whereabouts for a specific period of time. If you had close contact with others during that time, they will ask for names and contact information for those individuals.

The investigator will ask you to be as specific as possible about the nature and location of your interactions with others, as a way of understanding who might be potentially infected.

What kind of questions will a contact tracer never ask?

A contact investigator will never ask you for your social security number, financial or bank account information, or personal details unrelated to COVID-19. They will not ask for photographs or videos of any kind. They will not ask for your passwords. They will not ask for money or payment. They will ask for verification of your date of birth, address, and any other phone numbers you may have.

What if I’m called, told to isolate or quarantine and need assistance?

Call your local health department for help connecting with county resources that are available to you during your isolation or quarantine period. Please see the MDH FAQs about Isolation and Quarantine for more information.

How do I know that a call from a contact tracer is not a scam? Is there a way to verify who is calling?

With the prevalence of telephone scams and other fraud, we understand people’s reluctance to answer detailed questions from someone who calls to ask about their movements and contact with friends and loved ones. Maryland’s contact tracing efforts have several methods by which you can verify the identity of the caller.

When your phone rings, the caller ID will read “MD COVID” on your screen. If you do not have caller ID on your phone, look for the phone number (240) 466-4488 or 1-800-559-6410. Depending on whether your contact investigator is calling directly from NORC or your local health department, there will also be a list of phone numbers you will be given to verify the caller’s identity.

MDH and county health departments use the state-of-the-art contact tracing platform internally called ‘COVID Link,’ which assists in collecting information about people who test positive for COVID-19 and any individuals they have come into close contact with. COVID Link was operational on June 1, 2020.

What is MD COVID Alert?

MD COVID Alert is the official COVID-19 Exposure Notifications Express system for Maryland. This system was developed to assist, but not replace Maryland’s contact tracing efforts. MD COVID Alert uses Bluetooth Low Energy technology to quickly notify users who might have been exposed to someone who tested positive. This  technology can help Maryland residents stop the spread of COVID-19. To learn more about MD Covid Alert, please read these Frequently Asked Questions.

How does MD COVID Alert protect my privacy?

The service is opt-in only. You have full control to opt in to receive Exposure Notifications and can turn them off at any time. The service will never track your location — it uses Bluetooth rather than GPS. Your identity will never be revealed to anyone. The service will never collect, transmit or store any of your personal information.  Learn more about MD COVID Alert’s Privacy Policy.

I have been vaccinated for COVID-19. Do I still need to isolate or quarantine if I am contacted?

Yes. At this time, if you have been vaccinated for COVID-19, CDC recommends following their existing guidance for quarantine and isolation. CDC is closely monitoring the evolving science for information that would change their recommendations. CDC’s current guidance for quarantine and isolation can be found here.

It is important to continue to follow CDC’s current isolation and quarantine guidance because while research has shown the COVID vaccines prevent symptomatic cases of COVID-19 we do not yet know if they prevent people from getting the virus and passing it to others.

Do I have to quarantine if I have already had COVID-19?

People who have tested positive for COVID-19 within the past 3 months and recovered do not have to quarantine or get tested again as long as they do not develop new symptoms. People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if there is no other cause identified for their symptoms.

FAQs about MD COVID Alert

What is MD COVID Alert?

MD COVID Alert is the official COVID-19 Exposure Notifications Express system of Maryland. This system was developed to assist, but not replace Maryland’s contact tracing efforts.

MD COVID Alert uses Bluetooth Low Energy technology to quickly notify users who might have been exposed to someone who tested positive. This will reduce the risk of infection and help Maryland stop the spread of COVID-19.

How can MD COVID Alert help with contact tracing efforts?

Traditional methods of contact tracing are critical to containing the spread of infection. Technology can support and augment these efforts by allowing public health authorities to quickly notify people who might have been exposed to a person with COVID-19, including those the person might not know directly. This starts with MD COVID Alert on your smartphone.

If you have an iPhone, opt-in to Exposure Notifications in your device settings. On Android, you can download the MD COVID Alert app on the Play Store.

Where can I download MD COVID Alert?

MD COVID Alert is available at no cost to you. For Apple users, you do not need to download an app – simply go to your phone’s Settings, enable Exposure Notifications, and select Maryland as your region.

To enable MD COVID Alert, you must have one of the follow iOS versions:

  • iPhone 6s or newer: iOS 13.7 or lateriPhone 5s, 6, or 6 Plus: iOS 12.5
  • All older devices: Currently not supported.
  • Apple is working on solutions. We will share updates as more information is available.

iPhones that support iOS 13.7 or later are: iPhone 12, 12 Mini, 12 Pro, 12 Pro Max, 11, 11 Pro, 11 Pro Max, XR, XS, XS Max, X, SE (2nd generation), 8, 8 Plus, 7, 7 Plus, 6s, 6s Plus, SE (1st generation).

For Android users, download MD COVID Alert app through the Play Store. Android users can use MD COVID Alert if their phone supports Bluetooth Low Energy, Android Version 6 (API 23) or above, and can access the Google Play Store.

Do I have to use MD COVID Alert?

No. Using MD COVID Alert is voluntary, and you may choose to uninstall or disable it at any time. MD COVID Alert is intended for use by individuals 18 years of age or older.

Can minors use MD COVID Alert?

MD COVID Alert is for persons 18 years old and older. If a minor enables MD COVID Alert and receives an exposure notification, they should show the alert to a parent or legal guardian. Questions can be sent to mdh.mdcovidalert@maryland.gov.

How does MD COVID Alert work?

MD COVID Alert works by assigning you a random number called a ‘random ID’. To ensure these random IDs cannot be used to identify users or their whereabouts, they change every 10-20 minutes. As the user goes about their day, their devices and other devices around them exchange the random IDs via Bluetooth Low Energy technology.

On a daily basis, your phone downloads a list of all the random IDs associated with verified positive COVID-19 cases and checks them against the random IDs users have encountered in the two days prior to their positive test or symptom onset. If there’s a match, the system will notify users of the date of exposure. No other information about the exposure will be shared.

Will MD COVID Alert protect my privacy?

Your privacy is important to the Maryland Department of Health, Apple, and Google. You are in charge of how much information is shared. You must opt into the system in order for it to work and you can turn exposure notifications off any time.

MD COVID Alert does not track your location. It does not collect or use the location from your device. It uses Bluetooth, which can be used to detect if two devices are near each other – without revealing where the devices are or who they belong to. All the Exposure Notification matching happens on your smartphone. The system does not share your identity with other users, Apple, or Google. Learn more about MD COVID Alert’s Privacy Policy.

What counts as close contact?

Close contact is described by the Centers for Disease Control and Prevention (CDC) as being within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the person is isolated. Cumulative total can be determined by adding individual exposures to the same person over a 24-hour period (e.g., three 5-minute exposures for a total of 15 minutes). This is approximated using Bluetooth technology.

Specifics on Exposure Notifications

What should I do if I get an alert from MD COVID Alert?

I received an exposure notification. How can I find my date of exposure?

On an iPhone, go to Settings and open Exposure Notifications. The exposure date is found under “You might have been exposed to COVID-19… “

On an Android phone, the date of exposure is conveyed in the alert message under “possible exposure date”.

Why does the exposure date reflect a day I didn’t leave the house?

In order to preserve anonymity, the date of exposure is approximately within 24 hours of contact. Therefore, the contact could have occurred the previous day. In addition, because MD COVID Alert uses your phone’s Bluetooth technology to determine proximity, if another person used your phone somewhat distant to you (e.g., borrowed your phone and took it elsewhere), it is possible you could be notified of an exposure even if you did not leave the house.

Is MD COVID Alert compatible with other exposure notification apps?

MD COVID Alert is completely interoperable with Exposure Notifications apps in states that are using the Association of Public Health Laboratories (APHL) National Key Server. More information and a full list of participating jurisdictions are available here.  Users that travel between these regions will receive Exposure Notifications if they come in close contact with another user that has verified a positive test result regardless of the State experience they are using.

Does MD COVID Alert work outside of Maryland?

Yes, MD COVID Alert’s exposure notifications will work outside of Maryland if the area that you are traveling to also has an exposure notifications mobile app interoperable through the Association of Public Health Laboratories (APHL).

Currently, MD COVID Alert works with the neighboring jurisdictions of DC, Delaware, Pennsylvania, and Virginia. Users who work or travel between these regions will receive Exposure Notifications if they come in close contact with another user that has verified a positive test result.

More information about APHL and a full list of participating jurisdictions is available here.

I already downloaded an Exposure Notifications system from another state. Do I need to download MD COVID Alert, too?

Yes. If you live in Maryland, it is important for you to enable Exposure Notifications based on the State where you currently live and where you expect to be tested and access services if needed.

You can switch regions by:

  • (On iPhone) Going to Settings > Exposure Notifications > Region > Add Another Region Select Region (United States > Maryland);
  • (On Android) Open the MD COVID Alert app > Click Settings > Click Exposure Notifications > Click ‘Switch App’

Do I always need to leave MD COVID Alert open for the system to work?

No. MD COVID Alert will run in the background, without draining your battery or data, when it is not open. You will need to make sure the system is installed, and Exposure Notifications service has been enabled for MD COVID Alert to work.

Do I always need to keep Bluetooth turned on for MD COVID Alert to work?

Yes. Bluetooth must always be turned on for the Exposure Notifications System to detect how close you are to other users.

I tested positive, how do I get my verification code?

To enter your positive test result into MD COVID Alert you will need a verification code from the Maryland Department of Health. Someone from the State or local health department contact tracing program will reach out to you within 24-48 hours of your positive test to guide you through the process. Please answer the call when you get a phone call from MD COVID or (240) 466-4488.

How does MD COVID Alert determine who is a COVID-19 positive case?

When a person tests positive for COVID-19, a contact tracer reaches out to that individual. During that conversation, the contact tracer will ask if the person has MD COVID Alert or provide instructions on how to access the system. If the individual has MD COVID Alert enabled, the representative will offer them a unique verification code to report their diagnosis through MD COVID Alert. This will trigger exposure alerts to go out to users that they were in close contact with.

Will using MD COVID Alert drain my battery?

MD COVID Alert uses Bluetooth Low Energy, which is designed to have minimal impact on battery life. You should not see a significant change in phone battery consumption.

Will MD COVID Alert use a lot of data?

No. Every day, MD COVID Alert downloads new anonymous keys for detecting possible exposures. You can expect this to consume a few megabytes of your data each day.

Will MD COVID Alert work on iPads or Tablets?

No, MD COVID Alert does not work on iPads or Tablets.

Will this work with a smartwatch that is Bluetooth enabled?

No, the MD COVID Alert technology was designed specifically for smartphones and is not supported on smartwatches.

What does Matched Key Count mean?

For users that dive deeper into their phone’s Exposure Notifications features, they may find the Matched Key Count.

Every 4-6 hours, your phone runs checks against the ‘keys’ of phones that have a confirmed positive test. If you met the criteria to receive an exposure notification, you would receive a notification directly on your phone’s home screen (like a text message or weather alert).  Users do not need to review their Matched Key Count. During these regular checks, your phone is recording any possible matches in the “Matched Key Count” field. If you see a number larger than 0, this means your phone was in “contact” with a positive phone but did not meet the criteria MDH selected to receive an exposure notification.

The criteria to receive an exposure notification is based on the CDC’s definition of a close contact, which means that your phone must be in close contact with another phone for at least 15 minutes or more, within 6 feet, and recorded over the course of 24 hours.

If you have a “Matched Key Count” of 1 or more but did NOT receive an exposure notification message directly on your phone, this means you did not meet the exposure criteria.  For instance, you may have been within 10ft or you could have been in contact for only 5 minutes.

Technical

What phones can support MD COVID Alert?

To enable MD COVID Alert on an iPhone, you must have one of the follow iOS versions:

  • iPhone 6s or newer: iOS 13.7 or later
  • iPhone 5s, 6, or 6 Plus: iOS 12.5
  • All older devices: Currently not supported. Apple is working on solutions. We will share updates as more information is available.

iPhones that support MD COVID Alert are:iPhone 12, 12 Mini, 12 Pro, 12 Pro Max, 11, 11 Pro, 11 Pro Max, XR, XS, XS Max, X, SE (2nd generation), 8, 8 Plus, 7, 7 Plus, 6s, 6s Plus, SE (1st generation), 6, 6 Plus, and 5s.

Android users can use MD COVID Alert if their phone supports Bluetooth Low Energy, Android Version 6 (API 23) or above, and can access the Google Play Store.

For more information about Exposure Notifications, please visit www.google.com/covid19/exposurenotifications.

How do I disable Exposure Notifications on an iPhone?

You can disable all Exposure Notifications by going to Settings > Exposure Notifications and tapping Turn Off Exposure Notifications. This will also delete the Bluetooth Identifiers recorded from other devices, associated metadata, your Random Device Keys, and your Exposure Notifications regions.

You can also delete the Bluetooth Identifiers, associated metadata, and Random Device Keys by going to Settings > Exposure Notifications > Exposure Logging and tapping Delete Exposure Log.

If you turn off Bluetooth on your device by going to Settings > Bluetooth, that will disable the sharing and collection of random Bluetooth Identifiers with other devices. This means that the Public Health Authority for your active region won’t be able to notify you about exposures to someone with COVID-19 that occur while Bluetooth is off.

The remaining features of Exposure Notifications will continue to operate while you have Bluetooth turned off. Turning Bluetooth back on will re-enable the sharing and collection of random Bluetooth Identifiers with other devices.

Apple will disable the Exposure Notifications system on a regional basis when it is no longer needed.

Within Settings I can see several Exposure Checks, many at the same time. Do these mean I was exposed?

Within your device’s Settings menu, you can see an Exposure Notifications or Exposure Logging section (the path to these is slightly different on some devices, but is typically as stated here):

iOS: Settings > Privacy > Health > COVID-19 Exposure Logging or Settings > Exposure Notifications

Android: Settings > Google > COVID-19 Exposure Notifications. Within those menus, you can find an “Exposure checks” field with a timestamped list.

These items are not exposures, but rather when your device made the checks against the tokens from positive users that your device has downloaded from the server to look if you have had an exposure. You may see several entries with the same date, as the keys of positive users are separated into a few files, and your device will download and check for matches within each of those files.

If two people are in different rooms with a wall between them, does the wall block the Bluetooth signal or could the person in another room be identified as a close contact?

A wall would be expected to diminish the signal strength between devices, but the extent of that would be determined by the materials and structure of the wall. It is possible, but unlikely, that two devices close to a shared wall would still have sufficient signal strength to trigger a notification.

Once a person uploads their positive tests results, how long does it take MD COVID Alert to send out information that they tested positive?

If a user submits a positive test result in MD COVID Alert to notify others, users that they were near can expect to receive an exposure notification within the next day from the time the report was submitted. This time is needed to make the positive user’s tokens available on the server and for other users’ devices to download those tokens and check for potential matches.

What if people submit false test reports in MD COVID Alert?

To prevent users from submitting false test results, MD COVID Alert requires users to verify their test result using a verification code. A contact tracer will call you on the phone and provide the code via SMS text.

Click the link in the SMS text to enter the code into MD COVID Alert to report your positive test. MD COVID Alert will upload the list of anonymous keys it has been in contact with only after a test result has been verified.

Do I need to be connected to Wifi or a cellular data connection for MD COVID Alert to work?

The exchange of anonymous tokens between users is done using Bluetooth and does not require Wifi or a cellular data connection. If Bluetooth is turned on, your phone will exchange tokens with others. However, other functionality, including verification code submission and positive key downloads to receive notifications do require a Wifi or cellular data connection to work.

Why does Location need to be enabled on Android devices?

Location does not need to be enabled on Android devices with Android 11. Older versions of Android do require location to be enabled for Bluetooth to work, even though location data is not collected or used by MD COVID Alert.

In 2015, in an effort to improve user privacy, Google built into Android a requirement that Location be turned on to enable Bluetooth. They did not anticipate the current need for MD COVID Alert to use Bluetooth technology without Location. MD COVID Alert does not collect any user location data. For additional information on location access on your Android phone, please visit Google’s Help page on Exposure Notifications and Android location settings.

On an Android device, I get an “Internal error” when attempting to enable MD COVID Alert. How can I fix this?

This can be an issue for Android devices where Google Play services have not been updated. To resolve this, follow these steps:

  • On your Android phone or tablet, open Settings.
  • Tap “Apps” or “Apps & notifications” then “See all apps.”
  • Scroll down and tap “Google Play services”
  • Scroll down and tap “App Details” or “App details in store”
  • Tap “Update” or “Install”

This should resolve your issue. If it does not, please visit: www.google.com/covid19/exposurenotifications.

I turn my phone off periodically, usually a few hours per day to charge and/or reboot it. Does that affect MD COVID Alert?

Yes, this does affect MD COVID Alert slightly. Turning off your phone will prevent receipt of anonymous key updates that allow for the exposure notifications to work effectively. If your phone is off while you are at home alone, then there will be no effect. You would not want your phone to be off when you might encounter other people outside your household.

What can I do if my smartphone doesn’t support MD COVID Alert?

MDH appreciates your interest in MD COVID Alert. Unfortunately, if your phone does not meet the version requirements, it is not possible to use MD COVID Alert. We understand that this may prevent some people from being able to use MD COVID Alert. We will keep the community updated on any changes in these requirements.

Does it matter who my cell phone carrier is?

No.  MD COVID Alert is supported by all phone carriers.  Users from all carriers with mobile devices with Android 6+ and iOS 13.7+ are able to use MD COVID Alert.

If you have questions about MD COVID Alert that are not answered here, please submit questions to mdh.mdcovidalert@maryland.gov or call the Maryland Department of Health Call Center at 877-319-1525. The Call Center is open Monday – Friday, 8:30 a.m. – 5:00 p.m. and is closed on the weekends.

FAQs about the Maryland COVID-19 Vaccination Plan and COVID-19 Vaccination

What is the Maryland COVID-19 Vaccination Plan?

Under Governor Larry Hogan’s direction, state agencies continually develop and update Maryland’s comprehensive and coordinated prevention and response plans for COVID-19.

The Maryland Department of Health (MDH) will communicate directly with the public, providing accurate information about how to protect yourself and your family from COVID-19 and updates as this situation develops.

The draft statewide COVID-19 vaccination plan focuses on three major phases of vaccine availability and distribution. Phase 1 targets those at highest risk of exposure to or developing complications from COVID-19. Phase 2 targets essential non-healthcare and transportation workers, and people at moderately higher risk of severe COVID-19 illness. Phase 3 focuses on vaccinations for the general public. The initial draft of the state plan is available here.

What is a COVID-19 vaccine?

A COVID-vaccine is one way to prevent serious illness due to COVID-19. Vaccination causes your body to create antibodies without getting sick with the COVID-19 disease. The Advisory Committee on Immunization Practices (ACIP) and other experts will provide recommendations on priority groups and when groups should be vaccinated. Guidance on determining and providing the vaccine to priority groups will be based on the principles included in the Center for Disease Control’s (CDC) Interim Updated Planning Guidance on Allocating and Targeting Pandemic Influenza Vaccine During an Influenza Pandemic.

What is Operation Warp Speed?

Operation Warp Speed is a partnership among components of the U.S. Department of Health and Human Services and the U.S. Department of Defense to help develop, make and distribute millions of vaccine doses for COVID-19 as quickly as possible while ensuring that the vaccines are safe and effective. Operation Warp Speed has been working since the pandemic started to develop COVID-19 vaccine candidates.

How do we know the COVID-19 vaccine is safe?

The U.S. vaccine safety system ensures that all vaccines are as safe as possible. Safety is a top priority while federal partners work to make a COVID-19 vaccine(s) available. Vaccines undergo a series of rigorous clinical trials using thousands of study participants to generate data and other information for the Food and Drug Administration (FDA) to determine their safety and effectiveness to approve or authorize for emergency use. Following approval or authorization, many vaccine safety monitoring systems watch for adverse events or possible side effects. Visit the CDC’s website for more information about ensuring the safety of COVID-19 vaccines in the U.S. — including information about specific vaccine monitoring systems.

Is a COVID-19 vaccine necessary?

COVID-19 infections can be a minor hindrance or lead to severe disease or even death. There are many reasons to get vaccinated.

  • Based on what we know about vaccines for other diseases, experts believe that getting a COVID-19 vaccine may help keep you from getting seriously ill even if you do get COVID-19.
  • Getting vaccinated yourself may also protect people around you, particularly people at increased risk for severe illness from COVID-19.
  • Getting COVID-19 may offer some natural protection, known as immunity. But experts don’t know how long this protection lasts, and the risk of severe illness and death from COVID-19 far outweighs any benefits of natural immunity. COVID-19 vaccination will help protect you by creating an antibody response without having to experience sickness.
  • Wearing masks and social distancing help reduce your chance of being exposed to the virus or spreading it to others, but these measures are not enough. Vaccines will work with your immune system so it will be ready to fight the virus if you are exposed.

Why would I need a vaccine if I can do other things — like social distancing, washing my hands and wearing a mask — to prevent the virus that causes COVID-19 from spreading?

Stopping a pandemic requires using all the tools available. Vaccines work with your immune system so your body will be ready to fight the virus if you are exposed. Other steps, like covering your mouth and nose with a mask and staying at least 6 feet away from others, help reduce your chance of being exposed to the virus or spreading it to others. Together, COVID-19 vaccination and following CDC’s recommendations to protect yourself and otherswill offer the best protection from COVID-19.

What is Maryland doing to help make sure people can get vaccinated against COVID-19?

Maryland is working with partners at the federal, state, local and community level to work through the logistics of delivering, storing and administering the COVID-19 vaccine. Maryland is also making sure that people have the information they need to be confident in deciding to get vaccinated. Key priorities include:

  • Developing and regularly sharing clear and accurate information with people to make sure they understand the risks and benefits of getting vaccinated and can make informed decisions.
  • Helping healthcare providers answer their patients’ questions about the vaccine.
  • Engaging communities and individuals in an equitable and inclusive way to ensure that people have opportunities to ask questions and get clear, accurate information about the COVID-19 vaccine.

Easy access to COVID-19 vaccines is equally critical. Maryland is working with public health professionals, healthcare providers, and other partners to make sure people can easily get a COVID-19 vaccine and that cost is not a barrier.

Where can I get information about COVID-19 vaccines and the current vaccination status in Maryland?

Additional information about COVID-19 vaccines and vaccination is available at covidlink.maryland.gov/content/vaccine.

Are the COVID-19 vaccines safe for pregnant women?

People who are pregnant and part of a group recommended to receive the COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated. A conversation between pregnant patients and their clinicians may help them decide whether to get vaccinated with a vaccine that has been authorized for use under Emergency Use Authorization (EUA). While a conversation with a clinician may be helpful, it is not required prior to vaccination.

Key considerations pregnant patients can discuss with their healthcare provider include:

  • The likelihood of exposure to COVID-19
  • Risks of COVID-19 to them and potential risks to their fetuses
  • What is known about the vaccine and how well it works to develop protection in the body, known side effects of the vaccine, and the lack of vaccine research done during pregnancy

Should women who are breastfeeding get the COVID-19 vaccine?

There is currently no data on the safety of COVID-19 vaccines in lactating women or on the effects of mRNA vaccines on the breastfed infant or on milk production/excretion. mRNA vaccines, like Pfizer and Moderna, are not thought to be a risk to the breastfeeding infant. People who are breastfeeding and are part of a group recommended to receive a COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated.

Should people with severe allergies get the COVID-19 vaccine?

The CDC says that people who have experienced severe reactions to prior vaccines or injectable drugs can still get the Pfizer-BioNTech vaccine for COVID-19, but should discuss the risks with their doctors ahead of time.

Can children get the COVID-19 vaccine?

Children under the age of 16 will not be able to get vaccinated at this time. This is because very few children have been part of the clinical trials to date. More research is needed to make sure any COVID-19 vaccine is safe and effective for infants and children.

Do the COVID-19 vaccines have any side effects?

After the COVID-19 vaccination, you may have some side effects. This is a normal sign that may indicate your body is building immunities to protect you from the virus. The side effects of the COVID-19 vaccination may feel like flu and might even affect your ability to do daily activities, but they should go away in a few days.

Learn more about what side effects to expect and get helpful tips on how to reduce pain and discomfort after your vaccination.

What are the common misconceptions about the COVID-19 vaccine?

Now that there are authorized and recommended COVID-19 vaccines in the U.S., accurate vaccine information is critical. Here are the facts behind some of the most common vaccine myths:

MYTH: COVID-19 vaccines are used to microchip people.
FACT: There is no vaccine microchip, and the vaccine will not track people or gather personal information into a database.

MYTH: You can get COVID-19 from the vaccine.
FACT: None of the COVID-19 vaccines currently in development in the United States use the live virus that causes COVID-19. There are several different types of vaccines in development. However, the goal for each of them is to teach our immune systems how to recognize and fight the virus that causes COVID-19. Sometimes this process can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity. Learn more about how COVID-19 vaccines work.

MYTH: COVID-19 vaccines will alter my DNA.
FACT: According to the CDC, the first COVID-19 vaccines to reach the market are messenger RNA, or mRNA, vaccines. Messenger RNA vaccines work by instructing cells in the body how to make a protein that triggers an immune response. Injecting messenger RNA into your body will not interact or do anything to the DNA of your cells. Human cells break down and get rid of the messenger RNA soon after they have finished using the instructions.

Does Maryland have a campaign to address any concerns people may have about getting the vaccine?

MDH is working with trusted community partners, priority group representatives and representatives of vulnerable populations to launch a public health campaign that focuses on the safety and efficacy of a vaccine. Materials under development will be thoroughly researched, easy to understand, transparent and available to all Marylanders, especially those who are disproportionately impacted by COVID-19. MDH’s campaign messaging will represent all regions and demographic groups and will complement communications from CDC, pharma and national, regional and community-based health organizations.

What is an emergency use authorization and how is it used to respond to COVID-19?

In certain types of emergencies, the FDA can issue an EUA to provide more timely access to critical medical products that may help during the emergency when there are no adequate, approved, and available alternative options. The EUA process is different from full FDA approval, clearance or licensing because the EUA standard requires significantly less data than otherwise would be required for approval, clearance or licensing by the FDA. This enables the FDA to authorize the emergency use of medical products that meet the criteria for issuance within weeks rather than months to years. It must be determined that the vaccines are safe and effective in diminishing the severity of COVID-19 symptoms to gain an FDA emergency use authorization or full licensing.

What percentage of the community needs to get vaccinated to have herd immunity to COVID-19?

Experts do not know what percentage of people would need to get vaccinated to achieve herd immunity to COVID-19. Herd immunity is a term used to describe when enough people have protection—either from previous infection or vaccination—that it is unlikely a virus or bacteria can spread and cause disease. As a result, everyone within the community is protected even if some people don’t have any protection themselves. The percentage of people who need to have protection in order to achieve herd immunity varies by disease.

How many doses of a COVID-19 vaccine will be needed? Will a booster dose be needed?

The number of doses of a COVID-19 vaccine that will be needed will depend on the type of vaccine that is administered. The coronavirus vaccines that have been approved so far require two doses. When giving two doses, they are usually given approximately one month apart. Since several vaccines are likely to become available over time, it is possible that some vaccines will require one dose while others may require two doses. It is also possible that over time, additional doses of vaccine may be needed to provide continued protection. It will take ongoing evaluation over several months and years to understand how our immune systems respond to this virus and how vaccines that become available assist in that response.

Will a COVID-19 vaccine need to be given annually?

At this time, we only have information about the length of immunity for as long as people were vaccinated during the trials. For example, if the first people in the study were vaccinated in July 2020 and the vaccine is licensed in December 2020, we will only have information about the immune response up to 5 months after vaccination. The vaccine manufacturer will continue to monitor vaccine recipients for several months or more, so that over time, we will continue to get a better picture of the durability of immunity. With this information, we will be better able to understand whether vaccines against COVID-19 will require annual dosing like influenza.

How long will it take before a COVID-19 vaccine is able to prevent serious illness for the recipient?

Generally, it takes a week or two for immunity to develop following vaccination, but the specific timeline for any coronavirus vaccine will depend to some extent on which type of vaccine is licensed. For example, a live, weakened vaccine requires time to reproduce in the body, whereas an inactivated vaccine is given at a dose that will generate immunity. On the other hand, because the live, weakened vaccine reproduces to generate immunity, it might provide a more robust immune response than an inactivated vaccine.

Will there be enough vaccines for everyone?

Due to the limited supply of COVID-19 vaccines currently available in the United States, not everyone will be able to be vaccinated right away. It is understandable how concerning this would be for people, especially for those who are at increased risk for serious illness from this virus and for their loved ones

That is why, early in the response, the federal government began investing in select vaccine manufacturers to help them increase their ability to quickly make and distribute a large amount of COVID-19 vaccine. This will allow the United States to start with as much vaccine as possible and continually increase the supply in the weeks and months to follow.

The goal is for everyone to be able to easily get a COVID-19 vaccine as soon as large quantities are available. Several thousand vaccination providers will be available, including doctors’ offices, retail pharmacies, hospitals, and federally qualified health centers.

How will vaccinations be distributed as part of Maryland’s phased vaccination plan?

MDH will focus this plan on three major phases of vaccine availability and distribution.

Phase 1 will begin when there is limited vaccine availability and will focus on target priority groups to receive vaccination. These groups will include those at highest risk of exposure to or developing complications from COVID-19, including:

  • Healthcare workers, residents and staff of long-term care facilities, first responders
  • People at significantly higher risk of severe COVID-19 illness

Phase 2 will include people in critical infrastructure roles, including essential non-healthcare and transportation workers, and people at moderately higher risk of severe COVID-19 illness.

Phase 3 will be a wide-scale distribution of the vaccine associated with broad availability to the general population of the state.

The move to advanced phases will be based on the availability of COVID vaccine, achievement of targeted metrics for vaccination of higher priority groups or notification by CDC and state authorities that the general public phase can begin.

Will I have to pay for COVID-19 vaccination?

According to the CDC, vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. However, vaccination providers will be able to charge an administration fee for giving the shot to someone. Vaccine providers can get this fee reimbursed by the patient’s public or private insurance company or, for uninsured patients, by the Health Resources and Services Administration’s Provider Relief Fund.

If you had the virus and recovered will you still be able or need to get the vaccine?

We do not know how long antibodies last after infection or whether they will protect against reinfection. So, while vaccine trials are being completed, it will be important for scientists to continue learning about COVID-19, particularly whether people who got sick with COVID-19 can be re-infected.

The current vaccine trials will include immunizing people who have never been infected with COVID-19 as well as those who have been previously infected. We will soon know whether vaccination of those who have been previously infected affords more complete or longer lasting protection than those who were previously infected but haven’t been vaccinated.

Does immunity after getting COVID-19 last longer than protection from COVID-19 vaccines?

The protection someone gains from having an infection (called natural immunity) varies depending on the disease, and it varies from person to person. Since this virus is new, we don’t know how long natural immunity might last. Some early evidence—based on some people— seems to suggest that natural immunity may not last very long. Regarding vaccination, we won’t know how long immunity lasts until we have a vaccine and more data on how well it works. Both natural immunity and vaccine-induced immunity are important aspects of COVID-19 that experts are trying to learn more about, and the CDC will keep the public informed as new evidence becomes available.

If I get the vaccine, do I still have to wear a mask and practice social distancing?

Yes. While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to us to help stop this pandemic, like covering your mouth and nose with a mask, washing hands often and staying at least 6 feet away from others. Together, COVID-19 vaccination and following the CDC’s recommendations for how to protect yourself and others will offer the best protection from getting and spreading COVID-19.

Experts need to understand more about the protection that COVID-19 vaccines provide before deciding to change recommendations on steps everyone should take to slow the spread of the virus that causes COVID-19. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision.

Once I get vaccinated, will I receive any sort of documentation to show that I have received the COVID-19 vaccine?

Since both of the COVID-19 vaccines approved so far require two doses, you will receive a COVID-19 Vaccination Record Card once you receive your first dose. It will also remind you of when you will need to return to receive your second dose. You will need to bring the card with you when you return for the second dose so that it can be documented on the card.

You can also get a copy of your immunization record by going to Md.MyIR.net.

I was already vaccinated; do I still need to isolate or quarantine?

Yes. At this time, if you have been vaccinated for COVID-19, CDC recommends following their existing guidance for quarantine and isolation. CDC is closely monitoring the evolving science for information that would change their recommendations. CDC’s current guidance for quarantine and isolation can be found here.

What is a COVID-19 variant, and will the vaccine protect me from it?

Viruses constantly change through mutation, and new variants of a virus are expected to occur over time. Multiple variants of the virus that causes COVID-19 have been documented in the United States and globally during this pandemic. Information about the characteristics of these variants is rapidly emerging. At this time, there is no evidence that these variants can evade the recently developed vaccines or cause more severe illness or increased risk of death.

For more information, see the CDC ​Emerging SARS-CoV-2 Variants​.

Will an influenza (flu) vaccine protect me from COVID-19?

Getting a flu vaccine will not protect against COVID-19. However, flu vaccination has many other important benefits. Flu vaccines have been shown to reduce the risk of flu illness, hospitalization and death. Getting a flu vaccine this fall will be more important than ever, not only to reduce your risk from flu but also to help conserve potentially scarce health care resources.

Why is it important to get the flu vaccine during the COVID-19 pandemic?

Efforts to reduce the spread of COVID-19, such as stay-at-home and shelter-in-place orders, have led to decreased use of routine preventive medical services, including immunization services. Ensuring that you continue or start getting routine vaccinations during the COVID-19 pandemic is essential for protecting yourself and others from vaccine-preventable diseases and outbreaks, including flu. Routine vaccination prevents illnesses that lead to unnecessary medical visits and hospitalizations, which further strain the healthcare system.

For the upcoming flu season, flu vaccination will be very important to reduce flu because it can help reduce the overall impact of respiratory illnesses on the population and lessen the resulting burden on the healthcare system during the COVID-19 pandemic. A flu vaccine may also provide several individual health benefits, including keeping you from getting sick with flu, reducing the severity of your illness if you do get the flu and reducing your risk of a flu-associated hospitalization. For more information about seasonal influenza in Maryland, visit here.

What can I do to help protect myself from getting COVID-19 until I can receive a vaccine?

You should cover your mouth and nose with a mask when around others, avoid close contact with people who are sick, stay 6 feet away from others, avoid crowds and wash your hands often. Get more information about these and other steps you can take to protect yourself and others from COVID-19. Marylanders are encouraged to visit covidlink.maryland.gov to learn more.

FAQs about Nursing Homes, Assisted Living, and Congregate Living Facility Orders and Support Efforts

Background Information

In March, the Maryland Department of Health (MDH) issued Recommendations for Infection Control and Prevention of COVID-19 in Facilities Serving Older Adults and guidance for Preparing for and Responding to COVID-19 in Long-term Care and Assisted Living Facilities.

In response to increasing cases of COVID-19 in Maryland’s nursing facilities, Governor Larry Hogan issued his first executive order specific to nursing homes and other health care facilities on April 5. The order authorized MDH to take any action necessary to protect Maryland’s most vulnerable population from the virus.

This order was amended and superseded by the April 29 order.  These orders created a framework of support for nursing homes and other health care facilities, along with new requirements, aimed at protecting residents and staff.

Currently,  the following directives and orders from the Maryland Department of Health are in effect:

What action has the state taken to help nursing home residents treated for COVID-19 in the hospital when discharged?

Since April 5th, previously ill residents are guaranteed the right to return to their “home” facility if the facility can follow the CDC recommendations for transmission-based precautions.

The nursing home matters order directs the Office of Health Care Quality (OHCQ) to assist hospitals and nursing homes in placing patients. OHCQ can be reached at mdh.dischargeassist@maryland.gov.

What is the testing policy for Maryland nursing home facilities?

As of November 17, all nursing home staff, volunteers, and vendors who are regularly in a facility must be tested at least twice a week using one mandatory PCR Assay and one rapid POC COVID-19 test on separate days.

The  MDH strongly recommends that all nursing homes test all staff to the maximum degree possible including testing twice a week using a POC system.

Individuals who have previously tested positive for COVID-19 within the timeframe established by CDC and whose positive test results have been documented are exempted.

What is the testing policy for Maryland assisted living facilities?

All assisted living facilities with 50 or more licensed beds must test all staff, volunteers, and vendors who are in the facility regularly based on the local jurisdiction’s positivity rate as identified by CMS in the past week:

  • Testing at least once a month where the local jurisdiction’s positivity rate is below or equal to 5%;
  • Testing at least once a week where the local jurisdiction’s positivity rate is 5%-10%; and
  • Testing at least twice as week where the local jurisdiction’s positivity rate is over 10%.

MDH strongly recommends that all staff, volunteers, and regular vendors who are in a facility with 50 or more beds, be tested on a weekly basis for COVID-19 using a PCR Assay test or an approved rapid POC COVID-19 test. Individuals who have previously tested positive for COVID19 within the timeframe established by CDC and whose positive test results have been documented are exempted.

When a resident or staff member tests COVID-19 positive, all residents who have not previously tested positive for COVID-19 in the previous 90 days must be tested using a PCR assay test. Testing of all negative residents must be repeated weekly until there are no PCR assay confirmed positive results among residents and staff for at least 14 days since the most recent positive result.

Assisted living facilities with less than 50 licensed beds must test weekly until no new resident infections are confirmed in a 14-day period since the most recent positive result.  Individuals who have previously tested positive for COVID-19 within the timeframe established by the CDC and whose positive test results have been documented are exempted.

Do visitors have to be tested?

Currently, nursing homes and assisted living facilities have different requirements.

Effective November 17, all nursing home visitors must have proof of a negative COVID-19 test result within 72 hours prior to their indoor visit.

Under MDH’s current assisted living directives and orders, visitors are not required to have a COVID-19 test prior to visiting an assisted living facility.  However, individual facilities may have facility specific guidance in place regarding visitor testing.

MDH recommends that visitors take all precautions to protect their loved ones including staying home if sick and getting tested before they visit.

Facilities screen all visitors for signs and symptoms of COVID-19, including temperature checks. Facilities will refuse entrance to anyone screening positive for symptoms of COVID-19.

All visitors, regardless of type of facility, must wear the appropriate face covering (e.g., surgical mask, cloth face covering) at all times when they are inside the facility.

What are the criteria for opening facilities to indoor visitors?

If a nursing home is currently in outbreak status or the local jurisdiction is at 10% positivity or greater, then indoor visitation is suspended except for compassionate care visits. Each facility individually determines requests for compassionate care visits.

Additionally, if the local jurisdiction is within 5-10% positivity, each nursing home must restrict the number of indoor visitors to no more than 5% of the total residents at the facility at any one time. And, if a local jurisdiction is below 5% positivity, nursing homes must continue to implement Centers for Medicare & Medicaid Services (CMS) guidance on visitation (QSO-20-39-NH).

Either MDH or a local health department may direct a facility to a more restrictive set of conditions at any point.

Assisted living programs are reminded that indoor visitation is not permitted if the facility is currently conducting outbreak testing,in accordance with federal guidance on this subject.

Any facility may implement additional visitation restrictions, to include the number of individuals allowed in the facility at any given time or visitor testing, on a facility-specific basis given each facility’s circumstances and infection control guidelines.

What are the criteria for outdoor visitation?

For outdoor visitation, all facilities must  follow the CMS guidance on nursing home visitation (QSO-20-39-NH) and any additional MDH guidance. Either MDH or a local health department may direct a facility to a more restrictive set of conditions at any point

Who is responsible for testing staff, volunteers, and vendors?

Each facility is responsible for making appropriate contractual and financial arrangements for the testing of staff, volunteers, and vendors.

Each facility must  establish and maintain COVID-19 testing arrangements with laboratories for PCR Assay-based testing.

How is Maryland helping nursing homes with the new testing regulations?

Beginning the week of November 16, the State will provide all nursing homes with Abbott BinaxNow POC tests to conduct twice a week testing of staff through the end of the 2020. The State will provide quantities of Becton, Dickinson & Co. Veritor test supplies for purchase for nursing homes that have those POC systems.

On October 1, Governor Larry Hogan announced that the state would allocate an additional $6 million to help nursing home facilities cover the cost of testing staff as a result of new federal and state testing guidelines and reopening facilities to indoor visitation.

Nursing homes can register and schedule a testing date with CIAN Diagnostics of Frederick for  two free rounds of diagnostic testing services. Staff testing will be offered on a first-come first-serve basis during  November 9 through December 18.

How is Maryland helping congregate facilities face the challenges associated with COVID-19 and required compliance?

In July, Governor Hogan appointed Dr. Jeffrey S. Woolford Director of Community and Facility Initiatives. In this role, Dr. Woolford leads all non-regulatory COVID-19 matters involving nursing homes, assisted living facilities, group homes, and other congregate living settings.

Additionally, the state has implemented and deployed Technical Assistance Teams (TATs) in an effort to support facilities with meeting the many and various directives from the Centers for Disease Control (CDC), the Centers for Medicare and Medicaid (CMS), Governor Larry Hogan, MDH, and local health departments related to COVID-19.

What are Rapid Response Teams (RRT)?

A Rapid Response Team is the initial team sent to evaluate a facility when assistance is requested by the facility, or at the request of the MDH or local health department.

Depending on the reason for the RRT’s deployment, the team may consist of a Technical Assistance Team (TAT), a Certified Infection Control Nurse, and a local health department representative.

What are Technical Assistance Teams (TATs)?

These non-regulatory teams provide support to facilities by reviewing operational practices. If necessary they can help a facility to improve those practices or put preventive measures in place that may ultimately mitigate the spread of COVID-19.  TATs prioritize facility visits based on a risk matrix that looks at 10 factors to determine the likelihood of a COVID-19 outbreak. In addition to making recommendations, TAT members provide guidance on a range of topics such as proper usage of personal protective equipment and infection control best practices.  TAT services are at no cost to the facility.

What if a facility needs more assistance than a TAT can provide?

If a facility may benefit from additional assistance, the TAT may recommend a follow up visit from the team along with a Certified Infection Control (CIC) professional who is typically a RN specializing in elder care.  Facilities that may still require additional assistance are referred to the Maryland Department of Health Epidemiology team.

What does it mean that a TAT is non-regulatory?

The role of a TAT is one of support and education whereas  MDH’s regulatory  Office of Health Care Quality (OHCQ) licences, certifies, and  monitors the quality of care in Maryland’s health care facilities. OHCQ is responsible for surveying facilities to determine compliance with State and federal regulations. When problems or deficiencies are noted, the OHCQ initiates administrative action against facilities. If a facility fails to correct problems and is unable or unwilling to do so, the OHCQ may impose sanctions such as license revocation, fines, bans on admission, or other restrictions on the operating license. TATs have no regulatory authority or affiliation with OHCQ.

Do TATs work for OHCQ?

A TAT does not work for OHCQ. The goal of a TAT is to help a facility prevent or correct problems or deficiencies related to COVID-19 prior to an OHCQ survey.  TATs and OHCQ do not coordinate site visits as OHCQ is prohibited from sharing that information.  If at any time OHCQ and a TAT find themselves at the same site at the same time, the TAT will leave the premises and reschedule the visit.

Do TATs get tested following the Maryland testing policy for facilities?

TAT members are tested twice a week regardless of the facility’s jurisdiction and positivity rate.

How can nursing homes prepare for potential staffing shortages?

Effective November 17, nursing homes must coordinate with hospital(s) in their region to ensure that the facility has adequate clinical and infection control staffing support should an outbreak occur. All nursing homes are also required to establish at least one mutual aid arrangement with another nursing home facility.

Nursing homes should take the following actions to prepare for potential staffing shortages:

  1. Utilize the Chesapeake Registry.
  2. Contact your local health department for potential staffing support.

Nursing homes are strongly encouraged to enter into, confirm, or supplement any existing staffing agreements through private staffing agencies.

What is the status of “bridge teams” that support nursing home facilities?

Bridge teams, now called Facility Bridge Teams, can be activated as needed. These teams were created at the end of April to provide continuity of care for residents when nursing home staffing falls below required levels due to COVID-19.

A Facility Bridge team can include between two to six members per 12 hour shift per day up to four days giving the nursing home time to hire temporary staff to cover for COVID-19 positive staff during the 14-day isolation period.

A team will be available to nursing home facilities through June of 2021 most likely on a fee for service basis similar to services contracted through the Chesapeake Registry.

How do nursing homes register with the Chesapeake Registry and how will it benefit the facilities?

Nursing facilities must now register with the Chesapeake Registry. Any facility previously registered does not need to register again. The Registry, affiliated with the Maryland Hospital Association (MHA), is a staffing resource that can quickly connect available quality supplemental staffing with employers.

To register and to obtain assistance with temporary staffing, or for any questions, email covidstaffing@mhaonline.org. Registration may take up to two days to validate.  While all facilities must register, facilities are not required to use Registry staffing.  Facilities that elect to do so will be required to complete a short-term contract.

How will the Chesapeake Regional Information System for Our Patients (CRISP) reporting requirements help?

CRISP, Maryland’s secure health information exchange, allows nursing facilities to share data with a variety of healthcare stakeholders. Effective in April, nursing facilities must update CRISP daily to include their bed census and COVID-19 specific data. The daily sharing of this self-reported data will help to identify trends early and monitor the spread, or mitigation, of COVID-19 in nursing homes.

What is the purpose of the Nursing Home Task Force and what is its current status?

In April, Governor Larry Hogan convened the Nursing Home Task Force, a multi-agency team, led by the then Special Safety and Compliance Officer, Col. Eric Allely. The task force was assembled to support nursing home facilities and ensure their compliance with the ever increasing and changing COVID-19 regulations and improve communications with MDH and the public. By integrating the efforts of various state partners and MDH staff, the team supported nursing facilities to achieve universal testing, access to personal protective equipment (PPE), and meet staffing needs.

Beginning in July, congregate facilities support transitioned to the Community and Facility Initiatives Director Dr. Jeffrey S. Woolford, his team, and TATs. This non-regulatory group focuses on the prevention and control of COVID-19 in these facilities.

How is the state supporting facilities that need personal protective equipment (PPE)?

Nursing homes and assisted living facilities can request PPE from the state by submitting a PPE Request Form.

All nursing homes are required to follow the CDC’s Strategies to Optimize the Supply of PPE and Equipment.

How will vaccinations be distributed as part of Maryland’s phased vaccination plan?

MDH has drafted a statewide COVID-19 vaccination plan that focuses on three major phases of vaccine availability and distribution in Maryland. To learn more about the Maryland COVID-19 vaccination plan and COVID-19 vaccination, please read these Frequently Asked Questions.

FAQs about Mental Health, Stress and Anxiety

What should I do if I have an existing mental health condition?

People with pre-existing mental health conditions should continue with their treatment plans during an emergency and monitor for any new symptoms.

Additional information may be found at the Substance Abuse and Mental Health Services Administration (SAMHSA) website, ​https://www.samhsa.gov/disaster-preparedness​.

What if I am feeling anxious or stressed related to COVID-19?

Everyone reacts differently to stressful situations. The emotional impact of an emergency on a person can depend on the person’s characteristics and experiences, the social and economic circumstances of the person and their community and the availability of local resources. People can become more distressed if they see repeated images or hear repeated reports about the COVID-19 outbreak in the media.

Reactions during an infectious disease outbreak can include:

  • Fear and worry about your own health status and that of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco or other drugs

Feelings of fear, anxiety, sadness and uncertainty are normal during a pandemic. Fortunately, being proactive about your mental health can help to keep both your mind and body stronger.

What can I do to support myself?

Avoid excessive exposure to media coverage of COVID-19. Take breaks from watching, reading, or listening to news stories. It can be upsetting to hear about the crisis and see images repeatedly. Try to do some other activities you enjoy to return to your normal life. When you do read news, avoid media outlets that build hype or dwell on things that can’t be controlled. Instead, turn to information sources that provide reliable information about how to protect yourself.

Recognize the things you can control. Take care of your body. Take deep breaths, stretch, meditate, and exercise. Keep yourself grounded. Try to get regular sleep and maintain a healthy diet. It is not unusual for individuals to experience disruptions in both eating and sleeping during a crisis, and it is very important to try to maintain healthy habits, and to avoid strategies such as using drugs or alcohol to handle stress.

Make time to unwind and remind yourself that strong feelings will fade. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships. Maintain a sense of hope and positive thinking.

Stay connected. Staying at home and distancing from others should not mean you are completely isolated. Reaching out to people you trust is one of the best ways to reduce anxiety, depression, loneliness, and boredom during social distancing, quarantine, and isolation. You can use the phone, email, text messaging, and social media to connect with friends, family, and others. Talk “face to face” with friends and loved ones using Skype or FaceTime.

Maintain proper infection control techniques such as hand-washing and social distancing.

Check how realistically you are viewing the situation. Avoid dramatic media and stick to credible sources of information, such as the CDC. Social media is not a great source of information.

What are some of the things you can’t control?

All you can do is pay attention to those things above that you can control. Worrying will merely aggravate the situation.

There is some benefit to planning. But after you have a plan, move on and focus on living your life rather than worrying about the virus. Don’t try to control other people’s reactions. Listen and help people work through the facts concerning the virus but understand that hyping or denying the existence of a threat is not helpful.

Call your health care provider if stress reactions interfere with your daily activities for several days in a row.

Where can I find additional resources?

American Foundation for Suicide Prevention

Taking Care of Your Mental Health in the Face of Uncertainty


Black Mental Health Alliance

https://blackmentalhealth.com

Call 410-338-2642 or email ​info@blackmentalhealth.com


CDC

Mental Health and Coping with COVID-19

Strategies to Help Children Cope With a Disaster

Taking Care of Your Emotional Health


Gender Spectrum

Resources for Challenging Times


Maryland’s Crisis Helpline

Call 211 and press 1, text 898-211, or visit​ ​pressone.211md.org​ ​for information or to ​chat confidentially​ about local services and programs.


Maryland Family Tree

24/7 Parenting HelpLine: 1-800-243-7337


MDH’s Operation Roll Call

Maryland veterans can also enroll in Operation Roll Call (1-877-770-4801) — a program that offers regular check-in calls and a chance to talk to someone who can offer support.


MD Mind Health

Text “MDMindHealth” to 898-211 to sign up to receive encouragement, reminders, and resources for staying connected.


National Association of School Psychologists

Helping Children Cope With Changes Resulting From COVID-19


SAMHSA

SAMHSA’s Disaster Distress Helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters. This toll-free, multilingual, and confidential crisis support service is available to all residents in the United States and its territories: 1-800-985-5990

FACT SHEET: Coping With Stress During Infectious Disease Outbreaks:

FACT SHEET: Taking Care of Your Behavioral Health: Tips for Social Distancing, Quarantine, and Isolation During an Infectious Disease Outbreak

FACT SHEET: Talking with Children: Tips for Caregivers, Parents, and Teachers during Infectious Disease Outbreaks

Tips for Social Distancing, Quarantine and Isolation

Warning Signs and Risk Factors for Emotional Distress


The Center for the Study of Traumatic Stress

​Coronavirus and Emerging Infectious Disease Outbreaks Response


WHO

Healthy Parenting in the time of COVID-19

For Parents of Young Children

How can I help my children?

Children react, in part, to what they see from the adults around them. When parents and caregivers deal with the COVID-19 calmly and confidently, they can provide the best support for their children. Parents can be more reassuring to others around them, especially children, if they are better prepared.

Not all children respond to stress in the same way. Some common stress-related behavior to watch for in children include:

  • Excessive crying and irritation
  • Returning to behaviors they have outgrown, like toileting accidents or bedwetting
  • Excessive worry or sadness
  • Unhealthy eating or sleeping habits
  • Irritability and “acting out” behaviors
  • Poor school performance or avoiding assignments
  • Difficulty with attention and concentration
  • Avoidance of activities enjoyed in the past
  • Unexplained headaches or body pain
  • Use of alcohol, tobacco, or other drugs

There are many things you can do to support your child:

Take time to talk with your child about the COVID-19 outbreak. Answer questions and share facts about COVID-19 in a way that your child can understand:​ ​Stop the Spread of Rumors​. ​Limit your child’s exposure to media coverage of COVID-19. Children may misinterpret what they hear and can become frightened about something they do not understand.

Reassure your child that they are safe. Let them know it is okay if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.

Help children find positive ways to express disturbing feelings such as fear and sadness. Every child has his/her own way to express emotions. Sometimes engaging in a creative activity, such as playing and drawing, can facilitate this process. Children feel relieved if they can express and communicate their disturbing feelings in a safe and supportive environment.

Help your child to have a sense of structure. When it is safe to return to school or childcare, help them return to their regular activity. Be a role model; take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members and rely on your social support system.

The American Academy of Child and Adolescent Psychiatry has more resources and information about children and anxiety.

The American Academy of Child and Adolescent Psychiatry has more information about talking to children about coronavirus (COVID-19).

How should I talk to my child about the 2020/21 school year?

This school year looks very different from previous years due to the pandemic and the specific measures in place to curb its spread. Talk to your child and explain the planned safety measures. Have open and honest conversations, being sure to address their fears and concerns.

The Centers for Disease Control (CDC) has more detailed resources and information on back to school planning, including mental health and social-emotional wellbeing considerations.

I’m feeling stress and anxiety about the choices in front of us. Will my children pick up on that?

Yes. ​Children are “sponges” and take emotional cues from their parents and caregivers. However, it is perfectly normal to feel stress and anxiety during this time of uncertainty. If you feel immobilized by these feelings, please seek professional help through a licensed behavioral health/medical provider. It is important that parents, caregivers and teachers manage their own emotions by remaining calm, being mindful of tone, listening to the child(ren)’s concerns, and reassuring them of their safety and well-being.

For Adolescents and Young Adults

Everyone is worrying about the coronavirus pandemic, but everyone I know is healthy. Should I worry?

Everyone reacts differently to stressful situations. Adolescents and young adults often feel like nothing can go wrong. While this is normal, and can help reduce your worries, make sure you take steps to stay healthy. Recognize others may be hiding their worries in many ways. Some people become very irritable, angry and even start fights with others. Sleep and eating may become disrupted. Especially if other frightening things have happened, some youth may develop nightmares or have panic attacks. Still others may increase their use of alcohol, tobacco and drugs to escape from what is going on.

What can I do to help cope?

Limit your screen time. Limit your time watching, reading or listening to news stories. Avoid scrolling through your friends’ Instagram or Snap posts about illness and COVID-19.

Keep yourself grounded. Exercise, meditate. Draw, write in a journal or use music to express your thoughts and feelings. Do things that make you feel good and are also good for you.

Plan the things you ​can​ do: wear your mask, wash your hands, carry wet wipes or other items when you are out in public. Recognize the things you can control, like having good hygiene.

Reach out to your friends and family. If you can, talk about how you are feeling. Talk about anything positive — laugh, joke. Make sure you get enough sleep and stick to your pre-COVID-19 routine as much as you can. Let someone know if you are not able to do your usual activities because of your worrying.

Stay connected. Staying at home and distancing from others should not mean you are completely isolated. Reaching out to people you trust is one of the best ways to reduce anxiety, depression, loneliness, and boredom during social distancing, quarantine, and isolation. You can use the phone, email, text messaging, and social media to connect with friends, family, and others. Talk “face to face” with friends and loved ones using Skype or FaceTime.

Find more resources in the MDH Behavioral Health Administration’s student and young adult resource guide, Coping in the 2020/21 School Year.

For more information about coping, check out the CDC’s Support for Teens and Young Adults.

For Healthcare Workers

What should I know?

As a health professional, you may feel overwhelmed. As a person working with individuals who are potentially ill, you also likely have concerns about the risk of becoming infected yourself. You may also be concerned about your own financial security and family in the event of a quarantine or infection.

It is important to look after yourself and maintain a balanced view of the situation. There are some things you can control, and other things that you can do nothing about. The challenge is to separate these things so that you can take reasonable steps to protect yourself, but also let go of worries and anxieties that simply get in your way. It will be important to help your clients make the same distinctions.

It is important to recognize that health care workers can suffer secondary trauma as a result of their emotional involvement with distressing situations. Check in with yourself, noting if you have any symptoms of anxiety or depression. These could include sleeplessness, fatigue, irritability, depression, anger, illness, guilt and withdrawal. There are resources available online to help you cope. Please use them if you need them.

Think about what you need to help yourself and those you are helping to handle the stress involved in this situation — what are some of the things you can control?

Make sure you understand how your employer will address the outbreak. Remember that your reaction to the situation may not be the same as those of your colleagues or your clients. Everybody reacts differently to stressors, including those brought on by this outbreak. Respect other people’s feelings.

Maintain proper infection control techniques such as wearing your mask, hand-washing and social distancing.

Check how realistically you are viewing the situation. The Centers for Disease Control and Prevention (CDC) has continually pointed out that the vast majority of individuals, even if they do get sick, will not become terribly ill. Avoid dramatic media and stick to credible sources of information, such as the CDC. Social media is not a great source of information.

Keep yourself grounded. Exercise, meditate. Talk to your friends on the phone. Try to get regular sleep and a healthy diet. It is not unusual for individuals to experience disruptions in both eating and sleeping during a crisis, and it is very important to try to maintain healthy habits, and to avoid strategies such as using drugs or alcohol to handle stress.

What are some of the things you can’t control? Worrying will merely aggravate the situation.

All you can do is pay attention to those things above that you can control.

The infection is likely to spread through the population in unpredictable ways. There is nothing you can do about this. If you follow precautions you are less likely to get sick, but there are no guarantees.

There is some benefit to planning. But after you have a plan, move on and focus on living your life rather than worrying about the virus. Don’t try to control other people’s reactions. Listen and help people work through the facts concerning the virus but understand that hyping or denying the existence of a threat is not helpful.

Visit the Center for the Study of Traumatic Stress page on Sustaining the Well-Being of Healthcare Personnel during Coronavirus and other Infectious Disease Outbreaks.

For COVID-19 guidance specific to behavioral health, visit bha.health.maryland.gov/Pages/bha-covid-19.

For Older Adults and Adults with Disabilities

What are warning signs and risk factors that older adults and adults with disabilities may be experiencing emotional stress or anxiety?

Older adults and adults with disabilities who are impacted by an infectious disease outbreak are faced with difficult challenges. Many older adults already struggle to maintain social connections and meaningful activities because they may not have many friends and family members nearby, they may not drive, children are grown, and they are likely retired. When asked to further limit contact with the public to reduce exposure to COVID-19, they may experience increased loneliness and isolation.

Additionally, many older adults and adults with disabilities are reliant on help from family, friends or paid caregivers. Fear of not having access to this care if the caregiver becomes sick can cause stress and anxiety.

Warnings signs of stress may include:

  • Difficulty concentrating on daily activities
  • Loss of interest in daily activities
  • Crying spells, irritability or bursts of anger
  • Difficulty eating
  • Sleep problems, like difficulty falling asleep, staying asleep or sleeping too much
  • Increasing physical distress symptoms such as headaches, stomach pains or restlessness
  • Increased fatigue
  • Feeling guilty, helpless or hopeless

Older adults and adults with disabilities most at risk of experiencing severe emotional stress or anxiety include those with a history of:

  • Exposure to other traumas, including severe accidents, abuse, assault, combat or rescue work
  • Chronic medical illness or psychological disorders
  • Chronic poverty, homelessness, or discrimination
  • Those who lost a loved one or friend involved in an infectious disease outbreak
  • Those who lack economic stability and/or knowledge of the English language
  • Older adults who may lack mobility or independence
  • Older adults who rely upon others for daily assistance

What can older adults and adults with disabilities do to reduce emotional stress and anxiety?

  • Avoid excessive exposure to media coverage of COVID-19
  • Only consult legitimate sources, like the Centers for Disease Control and Prevention, for information about COVID-19
  • Engage in activities that bring comfort or joy
  • Take deep breaths, stretch or meditate
  • Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep and avoid alcohol and drugs
  • Make time to unwind and remember that strong feelings will fade
  • Share your concerns and how you are feeling with a friend or family member
  • Call your health care provider if stress reactions interfere with your daily activities for several days in a row
  • Avoid making major life decisions

Be especially aware of scams related to COVID-19. The Federal Trade Commission has identified several of them and is offering tips to protect yourself and others: ​Coronavirus Advice for Consumers​.

FAQs about Isolation and Quarantine

What is the difference between quarantine and isolation?

Isolation​ is the separation of people with COVID-19 from others. People in isolation need to stay home and separate themselves from others as much as possible. Sharing food, utensils, bathroom facilities and sleeping quarters, as well as contact with pets, should be avoided.

Quarantine​ is for people who may have been exposed to COVID-19 because they were in close contact with someone with COVID-19. These people may or may not get sick. People in quarantine should stay home as much as possible for 14 days, limit their contact with other people, and monitor themselves closely for symptoms of COVID-19. Most people who are going to get sick will get sick within 2-14 days of exposure.

While 14 days is the recommended length of quarantine, there are options to reduce the length of quarantine. In most instances, people without symptoms can end quarantine after day 10 without testing or after day 7 after receiving a negative test result. If quarantine is ended before the full 14 days, people should continue to monitor for symptoms and practice other preventive behaviors (e.g., mask use) through day 14.

Who needs to quarantine?

People who have been in close contact with someone who has COVID-19—excluding people who have had COVID-19 within the past 3 months.

People who have tested positive for COVID-19 do not need to quarantine or get tested again for up to 3 months as long as they do not develop symptoms again. People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if there is no other cause identified for their symptoms.

What counts as close contact?

Close contact is described by the Centers for Disease Control and Prevention (CDC) as being within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated. Cumulative total can be determined by adding individual exposures over a 24-hour period (e.g., three 5-minute exposures for a total of 15 minutes).

I just tested positive for COVID-19. What do I do?

Follow your healthcare provider’s guidance. Most people can recover at home. It is important that you stay home and take care of yourself. Stay away, or isolate, from others as much as you can. Read the CDC guidance on ​What to Do if You are Sick​. Do not have visitors, unless they are caring for you.

You should also answer the call from contact tracers who will check in on your health and ask you some questions to help slow the spread of COVID-19. Answer and/or return any calls from “MD COVID.” If you do not have caller ID on your phone, look for the phone number (240) 466-4488. Please follow the guidelines they provide on the call.

When is it safe to resume normal activities after I have been in isolation?

Most people with symptoms of COVID can follow the CDC’s three conditions before being around others:

  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.*

*Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation.

If you tested positive but have no symptoms and you continue to be well, you can be with others after 10 days after testing positive.

When around others, remember to stay six feet apart and wear a face covering.

This guidance is subject to change. Talk to your health care provider especially if you have a high-risk underlying health condition or if you are 65 years and older. You may need to stay away from other people longer.

When is it safe to resume normal activities after I have been in quarantine?

While 14 days is the recommended length of quarantine, there are options to reduce the length of quarantine. In most instances, people without symptoms can end quarantine after day 10 without testing or after day 7 after receiving a negative test result. If quarantine is ended before the full 14 days, people should continue to monitor for symptoms and practice other preventive behaviors (e.g., mask use) through day 14.

If you remain symptom-free, it is usually safe to resume normal activities when 14 days have passed since your last contact with someone with COVID-19.

Will my positive COVID-19 test results be reported to anyone?

Yes. Under Maryland law, positive COVID-19 test results will be reported to the Maryland Department of Health and local Health Department. However, your information will not be shared with the public, or in contact tracing investigations with people who may have had close contact with you. See ​covidLINK​.

What symptoms require medical attention right away?

Call 911 or go to the nearest emergency care provider if you have:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face

Let 911 or the provider know you have COVID-19. This will help them know how to care for you and keep other people from getting infected.

How can I protect my family or caregivers while recovering from COVID-19 at home?

Try to stay away from others as much as possible. Try to stay in one room and, if you can, don’t use the same bathroom as them. When around others, wear a face covering and have them wear one too. Everyone should wash their hands often. Avoid sharing anything like dishes, towels, or bedding. Make sure all high touch areas are disinfected every day. See ​Caring for Someone Sick at Home.

Caregiver Tips:

  • Wash hands often.
  • Avoid touching your eyes, nose, and mouth.
  • Shared spaces in the home should have good air flow. If you can, open a window or use a fan. This will help remove COVID-19 respiratory droplets from the air.
  • Wear a disposable facemask and gloves when you touch or have contact with the patient, especially when you have contact with their blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, urine.
  • Wash clothes or bedding that have blood, stool, or body fluids on them. Keep soiled items away from your body. Wash laundry thoroughly.
  • When removing gloves and mask, first remove and dispose of gloves. Then, wash your hands right away. Next, remove and dispose of facemask, and wash your hands again.
  • Throw out disposable face masks and gloves after using them. Do not reuse.
  • Place all used disposable gloves, facemasks, and other contaminated items in a lined trash can. Wash your hands at once after handling these items.
  • Clean all “high-touch” surfaces, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, stool, or body fluids on them.
  • Household members should care for any pets in the home. Do not handle pets or other animals while sick. For more information, see COVID-19 and Animals.

I was already vaccinated; do I still need to isolate or quarantine?

Yes. At this time, if you have been vaccinated for COVID-19, CDC recommends following their existing guidance for quarantine and isolation. CDC is closely monitoring the evolving science for information that would change their recommendations. CDC’s current guidance for quarantine and isolation can be found here.

It is important to continue to follow CDC’s current isolation and quarantine guidance because while research has shown the COVID vaccines prevent symptomatic cases of COVID-19 we do not yet know if they prevent people from getting the virus and passing it to others.

Do I have to quarantine if I have already had COVID-19?

People who have tested positive for COVID-19 within the past 3 months and recovered do not have to quarantine or get tested again as long as they do not develop new symptoms. People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if there is no other cause identified for their symptoms.

FAQs about Telehealth

How does telehealth work?

Telehealth uses technology to allow patients and providers in separate locations to have a real time virtual office visit. The technology can include audio-video conferencing services, video chat using FaceTime, Facebook Messenger video chat, Google Hangouts video, Zoom or Skype, or a telephone-only call.

What are the changes to telehealth to address COVID-19?

Temporary changes to telehealth regulations include allowing a patient to receive telehealth services in their own home or any other private location as agreed upon by you and your health care provider. Another is to allow telephone-only telehealth “visits.”

How do I get a telehealth appointment?

You can contact your health care provider to schedule a telehealth visit like you would an office visit. You may also check with your insurer.

What should I do to get ready for a telehealth visit?

  • Write down your questions
  • Make a list of your symptoms
  • Note when your symptoms started and if they have changed
  • Be ready to verify your identity
  • Be ready to talk to your provider from a quiet, private place
  • Consider trying a “visit” with someone else using the same device and location for your telehealth visit to assure everything works
  • Be ready and able to answer when your provider calls for your scheduled telehealth visit

Your provider may call from a number other than their office. Caller ID may show “Unknown Caller,” “Private,” “Blocked” or “No Caller ID.” Be sure to answer the call at your appointment time.

Is telehealth secure?

Privacy and security depend on the service or video chat that you and your provider use. Your provider must explain the telehealth service to you and any privacy or security limitations.

Are there any apps that providers should not use for a telehealth visit?

You should not use an app that is public facing like Facebook Live, Twitch or TikTok. These apps do not protect your privacy.

Do telehealth services have any consent requirements?

Your provider must get your consent for telehealth services and note it in your medical record. You may give verbal consent. A parent or guardian may give consent.

Are all telehealth services available by telephone only?

A provider can evaluate medical devices, refer you to health care services, provide treatment and issue most prescriptions. However, some services are not eligible for telephone-only telehealth. Some examples of services that are not eligible for telephone only visits include physical therapy services, occupational therapy services and speech language services. Ask your insurer or provider what services are available.

Where can I find information on my insurer’s telehealth options?

You can use the links below to visit each insurers website for more information about telehealth during the COVID-19 outbreak. Or, call the number on your member ID card.

For Medicaid HealthChoice, use the links below to visit each insurer’s website.

Maryland behavioral health providers can contact the Behavioral Health Administrative Services Organization.