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107-490: On April 20, 2020, RMTD reduced its daily routes after six employees, including five drivers, tested positive for COVID-19 . The district later received a $ 9.3 million grant from the U.S. Department of Transportation as part of the CARES Act . In August 2020, the pre-COVID-19 route system resumed and RMTD launched Token Transit, a mobile fare app that allows passengers to purchase bus passes on their cell phones. The app displays

214-567: A Skagit County, Washington , choral practice resulted in 32 to 52 of the 61 attendees infected. An existing model of airborne transmission (the Wells-Riley model ) was adapted to help understand why crowded and poorly ventilated spaces promote transmission, with findings supported by aerodynamic analysis of droplet transfer in air-conditioned hospital rooms. Airborne transmission also occurs in healthcare settings; long-distance dispersal of virus particles has been detected in ventilation systems of

321-408: A contaminated surface or object before touching their own mouth, nose, or eyes, though strong evidence suggests this does not contribute substantially to new infections. Transmission from human to animal is possible, as in the first case, but the probability of a human contracting the disease from an animal is considered very low. Although it is considered possible, there is no direct evidence of

428-627: A preprint indicated Omicron subvariants BA.4 and BA.5 could cause a large share of COVID-19 reinfections , beyond the increase of reinfections caused by the Omicron lineage, even for people who were infected by Omicron BA.1 due to increases in immune evasion, especially for the unvaccinated. However, the observed escape of BA.4 and BA.5 from immunity by a BA.1 infection is more moderate than of BA.1 against studied prior cases of immunity (such as immunity from specific vaccines). Immunity from an Omicron infection for unvaccinated and previously uninfected

535-494: A strain of coronavirus known as "severe acute respiratory syndrome coronavirus 2" ( SARS-CoV-2 ). COVID-19 is mainly transmitted when people breathe in air contaminated by droplets / aerosols and small airborne particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the closer people are. However, infection can occur over longer distances, particularly indoors. The transmission of

642-507: A systemic inflammatory response syndrome . Among healthy adults not exposed to SARS-CoV-2, about 35% have CD4 T cells that recognise the SARS-CoV-2 S protein (particularly the S2 subunit) and about 50% react to other proteins of the virus, suggesting cross-reactivity from previous common colds caused by other coronaviruses. Transmission of COVID-19 The transmission of COVID-19

749-454: A blunting rather than a complete loss [of immunity] is the most likely outcome. The virus can't possibly lose every single epitope on its surface, because if it did that spike protein couldn't work any more. So, while some of the antibodies and T cell clones made against earlier versions of the virus, or against the vaccines may not be effective, there will be others, which will remain effective. (...) If half, or two-thirds, or whatever it is, of

856-419: A certain critical size, generally thought to be <100μm diameter, evaporate faster than they settle; due to that fact, they form respiratory aerosol particles that remain airborne for a long period of time over extensive distances. Infectivity can begin four to five days before the onset of symptoms. Infected people can spread the disease even if they are pre-symptomatic or asymptomatic . Most commonly,

963-419: A certain critical size, generally thought to be <100μm diameter, evaporate faster than they settle; due to that fact, they form respiratory aerosol particles that remain airborne for a long period of time over extensive distances. Infectivity can begin four to five days before the onset of symptoms. Infected people can spread the disease even if they are pre-symptomatic or asymptomatic . Most commonly,

1070-428: A digital bus pass or ticket on the phone's screen, eliminating the need for a paper pass or cash. On June 15, 2023, RMTD unveiled six new battery-electric buses , the first electric buses in the fleet. The buses will replace diesel buses from 2007, reducing carbon emissions by 4,500 metric tons annually. RMTD plans to have a fully electric fleet by 2036. The Downtown Transfer Center , located at 501 West State Street,

1177-632: A fourth dose is only partially effective against Omicron. Many cases of infection broke through, albeit "a bit less than in the control group", even though trial participants had higher antibody levels after the fourth dose. On 23 December 2021, Nature indicates that, though Omicron likely weakens vaccine protection, reasonable effectiveness against Omicron may be maintained with currently available vaccination and boosting approaches. In December, studies, some of which using large nationwide datasets from either Israel and Denmark, found that vaccine effectiveness of multiple common two-dosed COVID-19 vaccines

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1284-683: A health condition that increases the risk of severe COVID-19, and people who live with someone from one of these groups from engaging in kissing, casual sex , or other activities, and recommended wearing face mask during sex. The risk of transmission from all size droplets and aerosols is lower in indoor spaces with good ventilation. The risk of outdoor transmission is low. Transmission events occur in workplaces, schools, conferences, sporting venues, dormitories, prisons, shopping facilities, and ships, as well as restaurants, passenger vehicles, religious buildings and choir practices, and hospitals and other healthcare settings. A superspreading event in

1391-422: A higher risk of developing severe symptoms. Some complications result in death. Some people continue to experience a range of effects ( long COVID ) for months or years after infection, and damage to organs has been observed. Multi-year studies are underway to further investigate the long-term effects of the disease. COVID‑19 transmission occurs when infectious particles are breathed in or come into contact with

1498-459: A hospital. Some scientists criticized public health authorities, including the WHO , in 2020 for being too slow to recognize airborne (aerosol) transmission of COVID-19 and to update their public health guidance accordingly. By mid-2020, some public health authorities had updated their guidance to reflect the importance of airborne transmission. The WHO updated it only by 23 December 2021. There

1605-699: A person with COVID-19 has been in an indoor space is minor after 3 days (72 hours), regardless of when it was last cleaned." Although the COVID-19 virus likely originated in bats , the pandemic is sustained through human-to-human spread, and the risk of animal-to-human spread of COVID-19 is low. COVID-19 infections in non-human animals have included companion animals (e.g., domestic cats, dogs, and ferrets ); zoo and animal sanctuary residents (e.g., big cats , otters , and non-human primates); mink in mink farms in multiple countries; and wild white-tailed deer in numerous U.S. states . Most animal infections came after

1712-423: A range of effects, such as fatigue , for prolonged periods after an initial COVID-19 infection. This is the result of a condition called long COVID , which can be described as a range of persistent symptoms that continue for months or years. Long-term damage to organs has been observed after the onset of COVID-19. Multi-year studies are underway to further investigate the protracted effects of long COVID. Reducing

1819-486: A room. There is evidence that infectious SARS-CoV-2 survives in aerosols for a few hours. There is substantial evidence for transmission events across a room (i.e., over distances larger than a metre or two) that is associated with being indoors, particularly in poorly ventilated spaces, although even indoor air drafts driven by air conditioning systems may contribute to the spread of respiratory sections. This has led to statements that transmission occurs most easily in

1926-414: A surface or object that has the virus on it (called a fomite ), and then touching their own mouth, nose, or eyes, but it is not the main mode of transmission, and the risk of surface transmission is low. As of July 2020, "no specific reports which have directly demonstrated fomite transmission" although "People who come into contact with potentially infectious surfaces often also have close contact with

2033-411: A two-layered face mask and a face shield effectively restricts the leakage in the forward direction. The face shield enables particles to escape from below it, and thus it is not recommended for protecting the spreading of the virus . An N95 respirator completely restricts the forward leakage of particles, but in a badly fitting respirator, a significant amount of particles escape through the gap between

2140-734: Is a novel severe acute respiratory syndrome coronavirus. It was first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan. All structural features of the novel SARS-CoV-2 virus particle occur in related coronaviruses in nature, particularly in Rhinolophus sinicus (Chinese horseshoe bats). Outside the human body, the virus is destroyed by household soap which bursts its protective bubble . Hospital disinfectants, alcohols, heat, povidone-iodine , and ultraviolet -C (UV-C) irradiation are also effective disinfection methods for surfaces. SARS-CoV-2

2247-571: Is associated with COVID-19 and is reported in as many as 88% of symptomatic cases. Published data on the neuropathological changes related with COVID-19 have been limited and contentious, with neuropathological descriptions ranging from moderate to severe hemorrhagic and hypoxia phenotypes , thrombotic consequences, changes in acute disseminated encephalomyelitis (ADEM-type), encephalitis and meningitis . Many COVID-19 patients with co-morbidities have hypoxia and have been in intensive care for varying lengths of time, confounding interpretation of

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2354-600: Is associated with transmission of COVID-19. The COVID-19 virus had poor survivability on surfaces; less than 1 in 10,000 contacts with contaminated surfaces, including non-food-related surfaces, lead to infection. As a result, the risk of spread from food products or packaging is very low. Public health authorities recommend that people follow practice good hygiene by washing hands with soap and water before preparing and consuming food. The COVID-19 virus has not been detected in drinking water . Conventional water treatment (filtration and disinfection) inactivates or removes

2461-433: Is available, guidelines and recommendations for hypertensive patients remain. The effect of the virus on ACE2 cell surfaces leads to leukocytic infiltration, increased blood vessel permeability, alveolar wall permeability, as well as decreased secretion of lung surfactants. These effects cause the majority of the respiratory symptoms. However, the aggravation of local inflammation causes a cytokine storm eventually leading to

2568-402: Is because pregnant women with COVID‑19 appear to be more likely to develop respiratory and obstetric complications that can lead to miscarriage , premature delivery and intrauterine growth restriction . Fungal infections such as aspergillosis , candidiasis , cryptococcosis and mucormycosis have been recorded in patients recovering from COVID‑19. COVID‑19 is caused by infection with

2675-522: Is closely related to the original SARS-CoV . It is thought to have an animal ( zoonotic ) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus , in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples (BatCov RaTG13 ). The structural proteins of SARS-CoV-2 include membrane glycoprotein (M), envelope protein (E), nucleocapsid protein (N), and

2782-494: Is concern that some medical procedures that affect the mouth and lungs can also generate aerosols, and that this may increase the infection risk. Some medical procedures have been designated as aerosol-generating procedures (AGPs), but this been done without measuring the aerosols these procedures produce. The aerosols generated by some AGPs have been measured and found to be less than the aerosols produced by breathing. Less virus (strictly speaking, viral RNA) has been found in

2889-425: Is harder due to the weak ventilation system and the high density of people. Emergency departments are also great sites for transmission of COVID-19 . The dispersion of respiratory droplets can be influenced by various factors, including the ventilation system , the number of infected patients , and their movements, which highlights the importance of proper ventilation and air filtration systems in reducing

2996-785: Is highly underestimated for sneezing. Researchers strongly recommend using the elbow or hands to prevent droplet leakage even when wearing face masks during sneezing and coughing . Wearing masks in indoor spaces reduces the risk of transmission, but it is recommended to immediately evacuate any space where sneezing has occurred. The Pfizer-BioNTech , Moderna , AstraZeneca and Janssen COVID-19 vaccines provide effective protection against COVID-19, including against severe disease, hospitalisation, and death, and "a growing body of evidence suggests that COVID-19 vaccines also reduce asymptomatic infection and transmission" as chains of transmission are interrupted by vaccines. While fully vaccinated people can still become infected and potentially transmit

3103-433: Is no evidence of COVID-19 transmission through feces or urine. COVID-19 is not an insect-borne disease ; there is also no evidence that mosquito are a vector for COVID-19. COVID-19 is not a sexually transmitted infection ; while the virus has been found in the semen of people who have COVID-19, there is no evidence that the virus spreads through semen or vaginal fluid , however transmission during sexual activities

3210-755: Is pretty clear and was anticipated from the mutational changes we have pinpointed in its protein structure. These make it more difficult for antibodies to neutralise the virus ." A 2024 study published in JAMA Network Open found that vaccinated individuals infected with the Omicron or Delta variants of COVID-19 did not have a higher overall risk of developing new autoimmune diseases compared to those who were not infected. Researchers noted that these results differ significantly from many earlier studies, which reported an increased long-term risk of various autoimmune conditions following infection with earlier COVID-19 variants. Those studies, however, did not consider

3317-585: Is still possible due to proximity during intimate activities which enable transmission through other paths. Many people do not transmit the virus, but some transmit to many people, and the virus is considered to be "over dispersed" – the transmission rate has high heterogeneity. " Super-spreading events " occur from this minority of infected people, generally indoors and usually in high-risk venues where people remain in close proximity and poor ventilation for an extended period, such as restaurants, nightclubs, and places of worship. Such crowded conditions enable

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3424-507: Is substantially lower against the Omicron variant than for other common variants including the Delta variant , and that a new (often a third) dose – a booster dose – is needed and effective, as it substantially reduces deaths from the disease compared to cohorts who received no booster but two doses. Vaccines continue to be recommended for Omicron and its subvariants. Professor Paul Morgan, immunologist at Cardiff University said, " I think

3531-457: Is the passing of coronavirus disease 2019 from person to person. COVID-19 is mainly transmitted when people breathe in air contaminated by droplets / aerosols and small airborne particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the closer people are. However, infection can occur over longer distances, particularly indoors. The transmission of

3638-595: Is the cause of the bud release and the formation of the viral envelope. The N and E protein are accessory proteins that interfere with the host's immune response. Human angiotensin converting enzyme 2 (hACE2) is the host factor that SARS-CoV-2 virus targets causing COVID‑19. Theoretically, the usage of angiotensin receptor blockers (ARB) and ACE inhibitors upregulating ACE2 expression might increase morbidity with COVID‑19, though animal data suggest some potential protective effect of ARB; however no clinical studies have proven susceptibility or outcomes. Until further data

3745-437: Is the least effective means of preventing particle leakage since the leaked particles due to a sneeze travelling a distance of 2.5 ft. The combination of a surgical mask with a face shield restricts the forward motion of particles notably. A two-layered face mask has noticeable leakage in the forward direction, but with the addition of a cotton stitch there is significantly less leakage of particles. The combination of

3852-450: Is the primary hub for the RMTD, serving 14 routes. The center opened February 11, 2019, replacing an earlier transfer facility at the same location. The transfer center provides riders with restrooms, vending machines, an indoor waiting area and a location to purchase tickets and passes. The East Side Transfer Center , located at 725 North Lyford Road, opened in 2012, serving buses and riders on

3959-465: Is the viral component that attaches to the host receptor via the ACE2 receptors. It includes two subunits: S1 and S2. Studies have shown that S1 domain induced IgG and IgA antibody levels at a much higher capacity. It is the focus spike proteins expression that are involved in many effective COVID‑19 vaccines. The M protein is the viral protein responsible for the transmembrane transport of nutrients. It

4066-524: Is used to find and alert people who have been in contact with an infected individual in the 48 to 72 hours before they develop symptoms, or before that individual's test date if asymptomatic. Initial reports suggested that this early transmission was restricted to the two-to-three day time window, but an author correction later acknowledged that transmission could begin four to five days before symptom onset. People are most infectious shortly before and after their symptoms begin —even if mild or non-specific—as

4173-849: The Alpha variant (B.1.1.7, formerly called the UK variant), first found in London and Kent, the Beta variant (B.1.351, formerly called the South Africa variant), the Gamma variant (P.1, formerly called the Brazil variant), the Delta variant (B.1.617.2, formerly called the India variant), and the Omicron variant (B.1.1.529), which had spread to 57 countries as of 7 December. On December 19, 2023,

4280-750: The COVID-19 pandemic . The symptoms of COVID‑19 are variable but often include fever, fatigue, cough, breathing difficulties , loss of smell , and loss of taste . Symptoms may begin one to fourteen days after exposure to the virus. At least a third of people who are infected do not develop noticeable symptoms . Of those who develop symptoms noticeable enough to be classified as patients, most (81%) develop mild to moderate symptoms (up to mild pneumonia ), while 14% develop severe symptoms ( dyspnea , hypoxia , or more than 50% lung involvement on imaging), and 5% develop critical symptoms ( respiratory failure , shock , or multiorgan dysfunction ). Older people are at

4387-515: The Delta variant , which became the dominant variant of COVID-19 in 2021, is substantially higher. Among five studies catalogued in October 2021, Delta's mean estimate R 0 was 5.08. Temperature is also a factor that affects the transmissibility of the virus . At elevated temperatures and low virus concentration rates the virus is in its weak state and the spreading of it is strenuously. At low temperatures and excessive virus concentration rates

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4494-724: The Imperial College COVID-19 Response Team reported an about 41% (95% CI , 37 – 45% ) lower risk of a hospitalization requiring a stay of at least 1 night compared to the Delta variant, and that the data suggested that recipients of 2 doses of the Pfizer–BioNTech , the Moderna or the Oxford–AstraZeneca vaccine were substantially protected from hospitalization. In January 2022, results from Israel suggested that

4601-572: The Spanish flu , Middle East respiratory syndrome , and Zika virus . In January 2020, the World Health Organization (WHO) recommended 2019-nCoV and 2019-nCoV acute respiratory disease as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations or groups of people in disease and virus names to prevent social stigma . The official names COVID‑19 and SARS-CoV-2 were issued by

4708-482: The small intestine . The virus can cause acute myocardial injury and chronic damage to the cardiovascular system . An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China, and is more frequent in severe disease. Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in

4815-705: The spike protein (S). The M protein of SARS-CoV-2 is about 98% similar to the M protein of bat SARS-CoV, maintains around 98% homology with pangolin SARS-CoV, and has 90% homology with the M protein of SARS-CoV; whereas, the similarity is only around 38% with the M protein of MERS-CoV . The many thousands of SARS-CoV-2 variants are grouped into either clades or lineages . The WHO, in collaboration with partners, expert networks, national authorities, institutions and researchers, have established nomenclature systems for naming and tracking SARS-CoV-2 genetic lineages by GISAID , Nextstrain and Pango . The expert group convened by

4922-531: The viral load peaks at this time. Based on current evidence, adults with mild to moderate COVID-19 remain infectious (i.e., shed replication-competent SARS-CoV-2) for up to ten days after symptoms begin, although there are few transmission events are observed after five days. Adults with severe to critical COVID-19, or severe immune suppression (immunocompromised persons), may remain infectious (i.e., shed replication-competent SARS-CoV-2) for up to 20 days after symptoms begin. Patients who are tested positive to

5029-426: The "three C's": crowded places, close contact settings, and confined and enclosed spaces. This mode of transmission occurs via an infected person breathing out the virus, which is then carried by the air to a person nearby, or to someone across a room, who then breathes the virus in. Attempts to reduce airborne transmission act on one or more of these steps in transmission. Masks or face coverings are worn to reduce

5136-538: The B.1 lineage. Several notable variants of SARS-CoV-2 emerged throughout 2020. Cluster 5 emerged among minks and mink farmers in Denmark . After strict quarantines and the slaughter of all the country's mink , the cluster was assessed to no longer be circulating among humans in Denmark as of 1 February 2021. As of December 2021 , there are five dominant variants of SARS-CoV-2 spreading among global populations:

5243-539: The CNS, possibly within an infected white blood cell. Research conducted when Alpha was the dominant variant has suggested COVID-19 may cause brain damage. Later research showed that all variants studied (including Omicron) killed brain cells, but the exact cells killed varied by variant. It is unknown if such damage is temporary or permanent. Observed individuals infected with COVID-19 (most with mild cases) experienced an additional 0.2% to 2% of brain tissue lost in regions of

5350-506: The COVID-19 infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: a respiratory symptom cluster with cough, sputum , shortness of breath , and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea. In people without prior ear, nose, or throat disorders, loss of taste combined with loss of smell

5457-400: The COVID-19 virus is exposure to respiratory droplets (small liquid particles) carrying infectious virus (i.e., airborne or aerosol transmission ). Spread occurs when the particles are emitted from the mouth or nose of an infected person when they breathe, cough, sneeze, talk, or sing. Human breath forms a roughly cone-shaped plume of air; in an infected person, the breath carries out

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5564-465: The SARS-CoV-2 virus entered into human populations through natural zoonosis , similar to the SARS-CoV-1 and MERS-CoV outbreaks, and consistent with other pandemics in human history. Social and environmental factors including climate change , natural ecosystem destruction and wildlife trade increased the likelihood of such zoonotic spillover . The disease quickly spread worldwide, resulting in

5671-509: The U.S. CDC and the European Centre for Disease Prevention and Control recommend these controls in all situations related to COVID-19 patient treatment (other than during crisis shortages). There is a research that suggests that variation in airway resistance , as measured by CFD (Computational Fluid Dynamics) , may be a useful tool for predicting the forecast of critically ill COVID-19 patients. A person can get COVID-19 by touching

5778-564: The United States is a stub . You can help Misplaced Pages by expanding it . This article about transportation in Illinois is a stub . You can help Misplaced Pages by expanding it . COVID-19 Coronavirus disease 2019 ( COVID-19 ) is a contagious disease caused by the coronavirus SARS-CoV-2 . The first known case was identified in Wuhan , China, in December 2019. Most scientists believe

5885-426: The WHO declared that another distinctive variant, JN.1, had emerged as a "variant of interest". Though the WHO expected an increase in cases globally, particularly for countries entering winter, the overall global health risk was considered low. The SARS-CoV-2 virus can infect a wide range of cells and systems of the body. COVID‑19 is most known for affecting the upper respiratory tract (sinuses, nose, and throat) and

5992-759: The WHO on 11 February 2020 with COVID-19 being shorthand for "coronavirus disease 2019". The WHO additionally uses "the COVID‑19 virus" and "the virus responsible for COVID‑19" in public communications. The symptoms of COVID-19 are variable depending on the type of variant contracted, ranging from mild symptoms to a potentially fatal illness. Common symptoms include coughing , fever , loss of smell (anosmia) and taste (ageusia), with less common ones including headaches , nasal congestion and runny nose , muscle pain , sore throat , diarrhea , eye irritation , and toes swelling or turning purple, and in moderate to severe cases, breathing difficulties . People with

6099-547: The WHO recommended the labelling of variants using letters of the Greek alphabet , for example, Alpha , Beta , Delta , and Gamma , giving the justification that they "will be easier and more practical to discussed by non-scientific audiences". Nextstrain divides the variants into five clades (19A, 19B, 20A, 20B, and 20C), while GISAID divides them into seven (L, O, V, S, G, GH, and GR). The Pango tool groups variants into lineages , with many circulating lineages being classed under

6206-699: The air for long periods of time to larger droplets that remain airborne briefly or fall to the ground. Additionally, COVID-19 research has redefined the traditional understanding of how respiratory viruses are transmitted. The largest droplets of respiratory fluid do not travel far, but can be inhaled or land on mucous membranes on the eyes, nose, or mouth to infect. Aerosols are highest in concentration when people are in close proximity, which leads to easier viral transmission when people are physically close, but airborne transmission can occur at longer distances, mainly in locations that are poorly ventilated; in those conditions small particles can remain suspended in

6313-470: The air for minutes to hours. The number of people generally infected by one infected person varies, but it is estimated that the R 0 ("R nought" or "R zero") number is around 2.5. The disease often spreads in clusters , where infections can be traced back to an index case or geographical location. Often in these instances, superspreading events occur, where many people are infected by one person. A person can get COVID-19 indirectly by touching

6420-561: The air near intensive care unit (ICUs) with COVID-19 patients than near rooms with COVID-19 patients that are not ICUs. Patients in ICUs are more likely to be subject to mechanically ventilation, an AGP. This suggests that in hospitals, areas near ICUs may actually pose less risk of infection via aerosols. This has led to calls to reconsider AGPs. The WHO recommends the use of filtering facepiece respirators such as N95 or FFP2 masks in settings where aerosol-generating procedures are performed, while

6527-428: The animals were in close contact with a human with COVID-19, such as an owner or caretaker. Experimental research in laboratory settings also shows that other types of mammals (e.g., voles, rabbits, hamsters, pigs, macaques , baboons ) can become infected. By contrast, chickens and ducks do not seem to become infected with, or spread, the virus. There is no evidence that the COVID-19 virus can spread to humans from

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6634-515: The brain connected to the sense of smell compared with uninfected individuals, and the overall effect on the brain was equivalent on average to at least one extra year of normal ageing; infected individuals also scored lower on several cognitive tests. All effects were more pronounced among older ages. The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the glandular cells of gastric , duodenal and rectal epithelium as well as endothelial cells and enterocytes of

6741-591: The brain found as complications leading to death in people infected with COVID‑19. Infection may initiate a chain of vasoconstrictive responses within the body, including pulmonary vasoconstriction – a possible mechanism in which oxygenation decreases during pneumonia. Furthermore, damage of arterioles and capillaries was found in brain tissue samples of people who died from COVID‑19. COVID‑19 may also cause substantial structural changes to blood cells , sometimes persisting for months after hospital discharge. A low level of blood lymphocytess may result from

6848-428: The brains of those who have died from COVID‑19, but these results need to be confirmed. While virus has been detected in cerebrospinal fluid of autopsies, the exact mechanism by which it invades the CNS remains unclear and may first involve invasion of peripheral nerves given the low levels of ACE2 in the brain. The virus may also enter the bloodstream from the lungs and cross the blood–brain barrier to gain access to

6955-409: The clear jelly liquid found in lung autopsies of people who died of COVID-19. One possibility addressed in medical research is that hyuralonic acid (HA) could be the leading factor for this observation of the clear jelly liquid found in the lungs, in what could be hyuralonic storm, in conjunction with cytokine storm . One common symptom, loss of smell, results from infection of the support cells of

7062-406: The data. Of people who show symptoms, 81% develop only mild to moderate symptoms (up to mild pneumonia ), while 14% develop severe symptoms ( dyspnea , hypoxia , or more than 50% lung involvement on imaging) that require hospitalization, and 5% of patients develop critical symptoms ( respiratory failure , septic shock , or multiorgan dysfunction ) requiring ICU admission. At least a third of

7169-430: The east side of Rockford with 4 routes. The transfer center provides riders with restrooms, vending machines, an indoor waiting area and a location to purchase tickets and passes. In addition to serving RMTD buses, Greyhound Lines intercity buses also stop here. The ridership statistics shown here are of fixed route services only and do not include demand response. This article related to bus transportation in

7276-716: The expression of ACE-2, thereby facilitating the SARS-Cov2 virus to enter cells and to replicate. A competition of negative feedback loops (via protective effects of interferon alpha) and positive feedback loops (via upregulation of ACE-2) is assumed to determine the fate of patients suffering from COVID-19. Additionally, people with COVID‑19 and acute respiratory distress syndrome (ARDS) have classical serum biomarkers of CRS, including elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer , and ferritin . Systemic inflammation results in vasodilation , allowing inflammatory lymphocytic and monocytic infiltration of

7383-428: The eyes, nose, or mouth. The risk is highest when people are in close proximity, but small airborne particles containing the virus can remain suspended in the air and travel over longer distances, particularly indoors. Transmission can also occur when people touch their eyes, nose or mouth after touching surfaces or objects that have been contaminated by the virus. People remain contagious for up to 20 days and can spread

7490-521: The face. While drugs have been developed to inhibit the virus, the primary treatment is still symptomatic , managing the disease through supportive care , isolation , and experimental measures . During the initial outbreak in Wuhan , the virus and disease were commonly referred to as "coronavirus" and "Wuhan coronavirus", with the disease sometimes called "Wuhan pneumonia". In the past, many diseases have been named after geographical locations, such as

7597-523: The heart. ACE2 receptors are highly expressed in the heart and are involved in heart function. A high incidence of thrombosis and venous thromboembolism occurs in people transferred to intensive care units with COVID‑19 infections, and may be related to poor prognosis. Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels caused by blood clots) may have a significant role in mortality, incidents of clots leading to pulmonary embolisms , and ischaemic events (strokes) within

7704-500: The host cell. Following viral entry, COVID‑19 infects the ciliated epithelium of the nasopharynx and upper airways. Autopsies of people who died of COVID‑19 have found diffuse alveolar damage , and lymphocyte-containing inflammatory infiltrates within the lung. From the CT scans of COVID-19 infected lungs, white patches were observed containing fluid known as ground-glass opacity (GGO) or simply ground glass. This tended to correlate with

7811-525: The immune response is not going to be effective, and you're left with the residual half, then the more boosted that is the better ." Professor Francois Balloux of the Genetics Institute at University College London said, " From what we have learned so far, we can be fairly confident that – compared with other variants – Omicron tends to be better able to reinfect people who have been previously infected and received some protection against COVID-19. That

7918-522: The infection, children may develop paediatric multisystem inflammatory syndrome , which has symptoms similar to Kawasaki disease , which can be fatal. In very rare cases, acute encephalopathy can occur, and it can be considered in those who have been diagnosed with COVID‑19 and have an altered mental status. According to the US Centers for Disease Control and Prevention , pregnant women are at increased risk of becoming seriously ill from COVID‑19. This

8025-539: The infectious person, making the distinction between respiratory droplet and fomite transmission difficult to discern." Each contact with a surface contaminated with SARS-CoV-2 has less than a 1 in 10,000 chance of causing an infection. Various surface survival studies have found no detectable viable virus on porous surfaces within minutes to hours, but have found viable virus persisting on non-porous surfaces for days to weeks. However, surface-survival studies do not reflect real-world conditions, which are less favorable to

8132-450: The lower respiratory tract (windpipe and lungs). The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the receptor for the enzyme angiotensin-converting enzyme 2 (ACE2), which is most abundant on the surface of type II alveolar cells of the lungs. The virus uses a special surface glycoprotein called a " spike " to connect to the ACE2 receptor and enter

8239-409: The lung and the heart. In particular, pathogenic GM-CSF-secreting T cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in people with COVID‑19. Lymphocytic infiltrates have also been reported at autopsy. Multiple viral and host factors affect the pathogenesis of the virus. The S-protein , otherwise known as the spike protein,

8346-447: The moment a person first becomes infected and the appearance of the first symptoms. The median delay for COVID-19 is four to five days possibly being infectious on 1–4 of those days. Most symptomatic people experience symptoms within two to seven days after exposure, and almost all will experience at least one symptom within 12 days. Most people recover from the acute phase of the disease. However, some people continue to experience

8453-512: The mucous membranes (mouth, nose, and eye). The initial amount of virus on the surface (i.e., the viral load in respiratory droplets) also affects fomite transmission risk. Hand washing and periodic surface cleaning impede indirect contact transmission through fomites. Fomite transmission can be easily prevented with use of regular household cleaners or disinfection . When surface survival data and factors affecting real-world transmission are considered, "the risk of fomite transmission after

8560-418: The nose and the mask. None of the protective face masks and face shields completely block the escape of particles projected by a sneeze , but they all effectively reduce the leakage and reach of the sneeze within 1–3 ft. The N95 respirator is the best face coverage for mitigating the spread because it completely impedes the forward leakage of the particles. The widely accepted safe distance of 6 ft

8667-480: The olfactory epithelium , with subsequent damage to the olfactory neurons . The involvement of both the central and peripheral nervous system in COVID‑19 has been reported in many medical publications. It is clear that many people with COVID-19 exhibit neurological or mental health issues . The virus is not detected in the central nervous system (CNS) of the majority of COVID-19 patients with neurological issues . However, SARS-CoV-2 has been detected at low levels in

8774-454: The outside. Alternatively, the air may passed through filters to remove the virus-containing particles. A combination of shielding (protection from large droplet ejection) and air filtering, eliminating aerosols, ("Shield and sink" strategy) is particularly effective in reducing transfer of respiratory materials in indoor settings. The sneeze resembles a free turbulent jet . The turbulent multiphase cloud contributes critically to increasing

8881-496: The peak viral load in upper respiratory tract samples occurs close to the time of symptom onset and declines after the first week after symptoms begin. Current evidence suggests a duration of viral shedding and the period of infectiousness of up to ten days following symptom onset for people with mild to moderate COVID-19, and up to 20 days for persons with severe COVID-19, including immunocompromised people. Infectious particles range in size from aerosols that remain suspended in

8988-488: The peak viral load in upper respiratory tract samples occurs close to the time of symptom onset and declines after the first week after symptoms begin. Current evidence suggests a duration of viral shedding and the period of infectiousness of up to ten days following symptom onset for people with mild to moderate COVID-19, and up to 20 days for persons with severe COVID-19, including immunocompromised people. Severe acute respiratory syndrome coronavirus   2 (SARS-CoV-2)

9095-411: The people who are infected with the virus do not develop noticeable symptoms at any point in time. These asymptomatic carriers tend not to get tested and can still spread the disease. Other infected people will develop symptoms later (called "pre-symptomatic") or have very mild symptoms and can also spread the virus. As is common with infections, there is a delay, or incubation period , between

9202-541: The potential protective effects of COVID-19 vaccination, including booster doses. A January 2022 study by the UK Health Security Agency found that vaccines afforded similar levels of protection against symptomatic disease by BA.1 and BA.2, and in both it was considerably higher after two doses and a booster than two doses without booster, though because of the gradually waning effect of vaccines, further booster vaccination may later be necessary. In May 2022,

9309-471: The range of the pathogen -bearing drops originating in human coughs and sneezes .  The jet's reach is nearly 22 ft in 18.5 seconds and 25 ft in 22 seconds. The shape of the expelled particles is conical, with a spreading angle of 23 degrees. The trajectory of the turbulent jet is inclined due to the inclination angle of the nose. Smaller droplets travel a considerable distance as freely suspended tracers and may still get reflected and follow

9416-416: The respiratory tract, people with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL‑2 , IL‑6 , IL‑7 , as well as the following suggest an underlying immunopathology: Interferon alpha plays a complex, Janus-faced role in the pathogenesis of COVID-19. Although it promotes the elimination of virus-infected cells, it also upregulates

9523-859: The risk of long COVID includes staying up to date on the most recent COVID-19 vaccine, practicing good hygiene, maintaining clean indoor air, and physical distancing from people infected with a respiratory virus. Complications may include pneumonia , acute respiratory distress syndrome (ARDS), multi-organ failure , septic shock , and death. Cardiovascular complications may include heart failure, arrhythmias (including atrial fibrillation ), heart inflammation , thrombosis , particularly venous thromboembolism , and endothelial cell injury and dysfunction. Approximately 20–30% of people who present with COVID‑19 have elevated liver enzymes , reflecting liver injury. Neurologic manifestations include seizure , stroke, encephalitis , and Guillain–Barré syndrome (which includes loss of motor functions ). Following

9630-604: The same manner that people sick with COVID-19 should avoid contact with people. The is no evidence for intrauterine transmission of COVID-19 from pregnant women to their fetuses. Studies have not found any viable virus in breast milk. Breast milk is unlikely to spread the COVID-19 virus to babies. Noting the benefits of breastfeeding , the WHO recommends that mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue to breastfeed, while taking proper infection prevention and control measures. No evidence suggests that handling food or consuming food

9737-622: The skin, fur, or hair of pets. The U.S. CDC recommended that pet owners limit their pet's interactions with unvaccinated people outside their household; advises pet owners not to put face coverings on pets, as it could harm them; and states that pets should not be disinfected with cleaning products not approved for animal use. If a pet becomes sick with COVID-19, the CDC recommends that owners "follow similar recommended precautions as for people caring for an infected person at home." People sick with COVID-19 should avoid contact with pets and other animals, in

9844-424: The spread of COVID-19 within an emergency department setting. COVID-19 is more infectious than influenza , but less so than measles . Estimates of the number of people infected by one person with COVID-19—the basic reproduction number ( R 0 )—have varied. In November 2020, a systematic review estimated R 0 of the original Wuhan strain to be approximately 2.87 (95% CI , 2.39 – 3.44 ). The R 0 of

9951-460: The turbulent cloud. Droplets with a diameter less than 50 μm remain suspended in the cloud for an extended period of time, which allows the cloud to reach heights of 4 to 6 meters, where ventilation systems can be contaminated. Because physical intimacy and sex involve close contact, in October 2021, New York City Department of Health discouraged unvaccinated persons, immunocompromised people, people over 65, persons with COVID-19, people with

10058-507: The virus acting through ACE2-related entry into lymphocytes. Another common cause of death is complications related to the kidneys . Early reports show that up to 30% of hospitalised patients both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems. Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of

10165-463: The virus again after recovery, in case they weren't being reinfected, is found to be not transmitting the virus to others. Nearly a third of people with COVID-19 remain contagious five days after the onset of symptoms or a positive test. This is reduced to 7% for those who test negative twice with rapid tests on days 5 and 6. Without testing, 5% are contagious on day 10. People who are asymptomatic do not show symptoms but still are able to transmit

10272-551: The virus being transmitted by skin to skin contact. Transmission through feces and wastewater have also been identified as possible. The virus is not known to spread through urine , breast milk , food , or drinking water . It very rarely transmits from mother to baby during pregnancy. After people are infected with COVID-19, they are able to transmit the disease to other people beginning as early as four to five days before developing symptoms, known as presymptomatic transmission. To reduce such transmission, contact tracing

10379-418: The virus breathed out by an infected person (who may not know they are infected), as well as the virus breathed in by a susceptible person. Social distancing keeps people apart. To prevent virus building up in the air of a room occupied by one or more infected people, ventilation is used to vent virus-laden air to the outside (where it will be diluted in the atmosphere) and replace it with virus-free air from

10486-752: The virus even if they do not develop symptoms. Testing methods for COVID-19 to detect the virus's nucleic acid include real-time reverse transcription polymerase chain reaction (RT‑PCR), transcription-mediated amplification , and reverse transcription loop-mediated isothermal amplification (RT‑LAMP) from a nasopharyngeal swab . Several COVID-19 vaccines have been approved and distributed in various countries, many of which have initiated mass vaccination campaigns . Other preventive measures include physical or social distancing , quarantining , ventilation of indoor spaces, use of face masks or coverings in public, covering coughs and sneezes, hand washing , and keeping unwashed hands away from

10593-509: The virus is carried out through virus-laden fluid particles, or droplets, which are created in the respiratory tract, and they are expelled by the mouth and the nose. There are three types of transmission: "droplet" and "contact", which are associated with large droplets, and "airborne", which is associated with small droplets. If the droplets are above a certain critical size, they settle faster than they evaporate , and therefore they contaminate surfaces surrounding them. Droplets that are below

10700-509: The virus is carried out through virus-laden fluid particles, or droplets, which are created in the respiratory tract, and they are expelled by the mouth and the nose. There are three types of transmission: "droplet" and "contact", which are associated with large droplets, and "airborne", which is associated with small droplets. If the droplets are above a certain critical size, they settle faster than they evaporate , and therefore they contaminate surfaces surrounding them. Droplets that are below

10807-504: The virus is in its robust state and the spreading of it is unchallenged. In January 2022, William Schaffner , professor of infectious diseases at Vanderbilt University Medical Center, compared the contagiousness of the Omicron variant to that of the measles . Source control is the principal mode of protection of COVID-19 after receiving the vaccine . There are many types of face masks, including surgical mask , two-layered face mask, face shield , and N95 respirator . A surgical mask

10914-428: The virus to others (particularly in areas of widespread community transmission ), they do so at a much lower rate than unvaccinated people. The primary cause of continued spread of COVID-19 is transmission between unvaccinated people. Pfizer-BioNTech (BNT162b2) and Moderna (mRNA-1273) mRNA vaccines provide reduced protection against asymptomatic disease but do reduce the risk of serious illness. On 22 December 2021,

11021-404: The virus to spread easily via aerosols, they can create clusters of cases, where infections can be traced back to an index case or geographical location. Another important site for transmission is between members of the same household, as well as hospitals due to the abundance of pathogens present. Traffic vehicles are also a site for transmission, since the control of the pathogen there

11128-417: The virus-containing droplets. So we expect the highest concentration of virus-containing droplets to be directly in front of an infected person, which suggests that the risk of transmission is greatest within three to six feet of the source of the infection. But breath contains many droplets that smaller than 100 micrometres in size, and these can stay suspended in the air for at least minutes and move across

11235-491: The virus. At least a third of the people who are infected with the virus do not develop noticeable symptoms at any point in time. Asymptomatic carriers tend not to get tested. Persons with asymptomatic COVID-19 infection can have the same viral load as symptomatic and presymptomatic cases, and are able to transmit the virus. However, the infectious period of asymptomatic cases has been observed to be shorter with faster viral clearance. The dominant mode of transmission of

11342-419: The virus. COVID-19 virus RNA is found in untreated wastewater, but there is no evidence of COVID-19 transmission through exposure to untreated wastewater or sewerage systems. There is also no evidence that COVID-19 transmission to humans occurs through water in swimming pools , hot tubs , or spas. While SARS-CoV-2 RNA has been detected in the urine and feces of some persons infected with COVID-19, there

11449-401: The virus. Ventilation and changes in environmental conditions can kill or degrade the virus. For example, temperature , humidity , and ultraviolet radiation ( sunlight ) all influence reductions in viral viability and infectiousness on surfaces. Fomite transmission risk is also reduced because the virus does not transfer efficiently from the surface to the hands, and then from the hands to

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