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Emergency Supplies Pregnant Women and Families with Infants 

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Emergency Supplies Pregnant Women and Families with Infants 

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8.Emergency Supplies Pregnant Women And Families WithInfants

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Fillable Medical conditions/ prescriptions form 

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Fillable Medical conditions/ prescriptions form 

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1.Family Communication Plan Fillable Card

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Dr. Hotez answers questions about the vaccines

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Dr. Hotez answers questions about the vaccines

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How to help children prepare

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Welcome

Welcome to Ready Harris Kids, your home for family preparedness education in Harris County. Scroll through the sections on this page to find information for Kids, Adults and Educators.

Ready Harris Kids presents Olivia the Preparedness Opossum! She is here to teach you all about preparedness in Harris County. Her fun activity book, along with all of the content on this page, is available in English, Spanish, Chinese, Vietnamese and Arabic.

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Welcome Welcome to Ready Harris Kids, your home for family preparedness education in Harris County. Scroll through the sections on this page to find information for Kids, Adults and Educators. Ready Harris Kids presents Olivia the Preparedness Opossum! She is here to teach you all about preparedness in Harris County.

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Supporting your child's mental health as they return to school during COVID

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Supporting your child's mental health as they return to school during COVID

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The coronavirus outbreak has caused major disruptions to daily life and children are feeling these changes deeply. While the return to school will be not only welcome but exciting for many students, others will be feeling anxious or frightened. Here are tips to help your children navigate some of the complicated emotions they may be facing with going back to school.

My child is scared to go back to school. How can I help him feel at ease?

Starting school or starting a new school year can be stressful at the best of times, let alone during a global pandemic. You can make him feel at ease by having an open conversation about what it is that's worrying him and letting him know that it's natural to feel anxious.

Children may feel nervous or reluctant to return to school, especially if they have been learning at home for months. Be honest - for example you could go through some of the changes they may expect at school, such as needing to wear forms of protective clothing like masks. Children may also find it difficult being physically distanced from friends and teachers while at school - you could encourage them to think about other ways to bond and stay connected.

Reassure children about safety measures in place to help keep students and teachers healthy and remind children that they can also help prevent germs spreading by washing their hands with soap and coughing or sneezing into their elbow.

Remind children about the positives - that they will be able to see their friends and teachers (if they are physically returning to the classroom) and continue learning new things.

My child's school is recommending the wearing of protective clothing, which is making my child feel more nervous. What should I say to her?

Approach this conversation with empathy, saying that you know she is feeling anxious about coronavirus, but that it's healthy to talk about our worries and emotions. Children may also get upset or frustrated if they are finding it hard to wear masks, especially when running or playing. You can reassure your children that lots of adults are working hard to help keep your family safe, but emphasize that it's important we all follow the recommended measures to take care of more vulnerable members of our community.

How can I encourage my child to follow precautions (such as frequent handwashing, physical distancing, etc.) at school without alarming her?

One of the best ways to keep children safe from COVID-19 and other diseases is to simply encourage regular handwashing. It doesn't need to be a scary conversation. Sing along with their favourite song or do a dance together to make learning fun. Make sure to teach them about how even though germs are invisible, they could still be there. When children understand why they need to wash their hands, they're likely to continue doing so.

You can also show children how to cover a cough or a sneeze with their elbow, and ask them to tell you if they start to feel like they have a fever, cough or are having difficulty breathing.

>> Read everything you need to know about washing your hands

My child is not part of the same group as his close friends returning to school and is feeling even more isolated. How can he feel more connected to the classroom and his friends?

If your child's school starts to return gradually, your child may be anxious about being separated from his friends. When the official reopening of schools is announced, help him get ready to return to school by sharing information on when and how this will happen.

Letting your kids know ahead of time that schools may need to close again will help them to be prepared for the period of adjustment ahead. It's also important to continue to remind them that learning can happen anywhere - at school and at home.

For those with access to the Internet, safe and monitored use of online games, social media and video chat programmes can provide great opportunities for children to connect with, learn and play with their friends, parents and relatives while at home. You could also encourage your children to use their voices online to share their views and support those in need during this crisis.

You can encourage your children to take advantage of digital tools that get them up and moving, like online exercise videos for kids and video games that require physical movement. Remember to balance online recreation with offline activities, including time outside, if possible.

>> Learn 5 ways to help keep children learning during the COVID-19 pandemic

How can I gently check in to see how my child is coping?

It's important to be calm and proactive in your conversations with children - check in with them to see how they are doing. Their emotions will change regularly and you need to show them that's okay.

Whether at school or at home, caregivers can engage children in creative activities, such as playing and drawing, to help them express and communicate any negative feelings they may be experiencing in a safe and supportive environment. This helps children find positive ways to express difficult feelings such as anger, fear or sadness.

As children often take their emotional cues from the key adults in their lives - including parents and teachers - it is important that adults manage their own emotions well and remain calm, listen to children's concerns, speak kindly and reassure them.

>> Read more on how to protect your family's mental health in the face of COVID-19

Is there anything I should look out for as my child starts back at school?

In addition to checking in on your child's physical health and learning when she goes back to school, you should also keep an eye out for signs of stress and anxiety. COVID-19 may be impacting your child's mental health, and it's important to demonstrate that it's normal and OK to feel overwhelmed at times. When in doubt, empathy and support are the way to go.

There have also been concerns that incidents of stigmatization and bullying may increase when children return to school, due to some of the misinformation around COVID-19. You should explain that the virus has nothing to do with what someone looks like, where they are from or what language they speak. If they have been called names or bullied at school, they should be encouraged to tell a trusted adult. Remind your children that everyone deserves to be safe at school and online. Bullying is always wrong and we should each do our part to spread kindness and support each other.

My child is worried about bullying at school and online, how can I talk to them about it?

If your child is worried about bullying either in person or online, it's important to let them know that they are not alone and they can always talk to you or another trusted adult. The more you talk to your children about bullying, the more comfortable they will be telling you if they see or experience it. Check in with your children daily and ask about their time at school and their activities online, and also about their feelings. Some children may not express their emotions verbally, so you should also look out for any anxious or aggressive behaviour that may indicate something is wrong.

You should also engage your children in open and honest conversations about how to stay safe online. Have an honest dialogue with your children about who they communicate with and how. Make sure they understand the value of kind and supportive interactions and that mean, discriminatory or inappropriate contact is never acceptable. If your children experience any of these, encourage them to tell you or a trusted adult immediately. Be alert if you notice your child becoming withdrawn or upset, or using their device more or less than usual, it could be a sign that they are being bullied online.

It's also important to familiarize yourself with your child's school's safeguarding and bullying policies, as well as the appropriate referral mechanisms and helplines available.

>> Read more about how to keep your child safe online while stuck at home during the COVID-19 outbreak

>> Cyberbullying: What is it and how to stop it

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Supporting your child's mental health during COVID-19 school returns

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The coronavirus outbreak has caused major disruptions to daily life and children are feeling these changes deeply. While the return to school will be not only welcome but exciting for many students, others will be feeling anxious or frightened. Here are tips to help your children navigate some of the complicated emotions they may be facing with going back to school.

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Article: We thought is was just a respiratory virus

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Article: We thought is was just a respiratory virus

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We Thought It Was Just a Respiratory Virus | UCSF Magazine

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We were wrong.

By Ariel Bleicher and Katherine Conrad UCSF Magazine Summer 2020 Illustration: Anna & Elena Balbusso

In late January, when hospitals in the United States confirmed the presence of the novel coronavirus, health workers knew to watch for precisely three symptoms: fever, cough, and shortness of breath. But as the number of infections climbed, the symptom list began to grow. Some patients lost their sense of smell and taste. Some had nausea or diarrhea. Some had arrhythmias or even heart attacks. Some had damaged kidneys or livers. Some had headaches, blood clots, rashes, swelling, or strokes. Many had no symptoms at all.

By June, clinicians were swapping journal papers, news stories, and tweets describing more than three dozen ways that COVID-19, the disease the coronavirus causes, appears to manifest itself. Now researchers at UC San Francisco and around the world have begun taking a closer look at this dizzying array of symptoms to get at the disease's root causes. They are learning from people inside the hospital and out; people on the brink of death and only mildly sick; people newly exposed and recovered; people young and old, Black, brown, and white. And they are beginning to piece together the story of a virus unlike any known before.

How infection sets in

Viruses lead a curious purgatorial existence of being neither fully alive nor dead. Enveloped in a protein cloak, a virus consists almost entirely of genetic material - DNA or RNA, the blueprints for all of life. But it can't reproduce on its own. To survive, it must break into a cell and co-opt the cell's gene-copying machinery.

The novel coronavirus, an RNA virus named SARS-CoV-2, has become notorious for its skill at breaking and entering human cells. Its tools of choice are the protein spikes protruding from its surface - a feature that distinguishes all coronaviruses. The spikes of SARS-CoV-2 are the crème de la crème: By the luck of the evolutionary draw, they are able to easily grab hold of protein gates on human cells known as ACE2 receptors and, like jackknives, pry these gates open.

"You can think of an ACE2 receptor like a docking site," says Faranak Fattahi, PhD, a UCSF Sandler Fellow. When the coronavirus pandemic hit San Francisco, Fattahi repurposed her laboratory to study this key receptor, which normally plays a role in regulating blood pressure. "When the virus lands on it," she says, "it initiates a molecular process that brings the virus inside the cell."

If you're exposed to SARS-CoV-2 - say, from a cough or sneeze - the virus will likely first encounter ACE2 receptors on cells in your nose or throat. But these receptors also populate your heart, gut, and other organs. Fattahi's team has found evidence suggesting that male sex hormones such as testosterone may increase the number of ACE2 receptors that cells produce, which could help explain why SARS-CoV-2 seems to wreak greater havoc on men than on women and why kids rarely get sick. "The fewer ACE2 receptors, the less risk of infection - that's the idea," she says, adding that this hypothesis for the disease's gender gap is only one of several.

Once inside a few initial host cells, the virus sets them to work churning out copies of itself. Within hours, thousands of new virus particles begin bursting forth, ready to infect more cells. Although SARS-CoV-2 is less deadly than the original SARS virus, which emerged in 2002, it replicates more rapidly. Also unlike SARS, which primarily infects the lungs, SARS-CoV-2 replicates throughout the airway, including in the nose and throat, making it highly contagious - like the common cold.

However, infection with SARS-CoV-2 usually doesn't feel like a cold. Fewer than 20% of infected people who eventually show up at a hospital report having had a sore throat or runny nose. During the first few days of being infected, you're more likely to have a fever, dry cough or, peculiarly, lose your sense of smell or taste.

Most likely, though, you won't feel sick at all. When UCSF researchers tested people for SARS-CoV-2 in San Francisco's Mission District, 53% of those infected never had any symptoms. "That's much higher than expected," says Monica Gandhi, MD, MPH, a UCSF professor of medicine with expertise in HIV. Surveys of outbreaks in nursing homes and prisons show similar or even higher numbers. "If we did a mass testing campaign on 300 million Americans right now, I think the rate of asymptomatic infection would be somewhere between 50% and 80% of cases," Gandhi says. Millions of people may be spreading the virus without knowing it, she points out, making asymptomatic transmission the Achilles' heel of efforts to control the pandemic - and highlighting the importance of universal masking.

"The majority of people who have COVID-19 are out in the community, and they are either asymptomatic or only mildly ill," says Sulggi Lee, MD, PhD, a UCSF assistant professor of medicine. When the coronavirus pandemic hit San Francisco in early March, Lee conceived a study to investigate why. She scrambled to assemble a team and procure funding and equipment. She borrowed a colleague's mobile clinic - a van outfitted with an exam table and a phlebotomy chair - so that her team could drive around the city, collecting samples from infected people. Lee hopes data from the study, called CHIRP (COVID-19 Host Immune Response Pathogenesis), will show how people's immune systems respond as SARS-CoV-2 starts to gain a foothold in their bodies.

"A lot is riding on that initial response," she says. If Lee and her collaborators can figure out the biological processes that allow some infected people to stay relatively well, they can perhaps use that knowledge to prevent others from falling severely ill.

Battling in the lungs

True to its name, SARS-CoV-2 (which stands for severe acute respiratory syndrome coronavirus 2) is first and foremost a bad respiratory virus. If your immune system doesn't defeat it at its landing site in your nose or throat, it will advance down your windpipe, infiltrating the cells lining your lungs' branching air tubes. At the tubes' ends, tiny air sacs called alveoli pass oxygen to your blood. As the virus multiplies, the alveoli may fill with fluid, shutting down this critical gas exchange. Your blood-oxygen level may drop and, typically about six days into an infection, you may start feeling short of breath.

What causes this mayhem? "Some of it is definitely caused by the virus itself," says Michael Matthay, MD, a UCSF professor of medicine who has studied acute respiratory diseases for more than 30 years. Inevitably, a fast-replicating virus will kill or injure many of the lung cells it infects; the more cells it infects, the more ruin it will leave in its wake.

But SARS-CoV-2 doesn't appear to be a savage destroyer of cells. Although it's too early to know for sure, the virus's fatality rate seems to be roughly 10 times that of the flu. "You would think that's because it's just a killing machine," says Max Krummel, PhD, UCSF's Smith Professor of Experimental Pathology and chair of the Bakar ImmunoX initiative. So far, however, the science suggests otherwise.

"One of the weirder things about this new coronavirus is it doesn't seem to be incredibly cytopathic, by which we mean cell-killing," Krummel says. "Flu is really cytopathic; if you add it to human cells in a petri dish, the cells burst within 18 hours." But when UCSF researchers subjected human cells to SARS-CoV-2, many of the infected cells never perished. "It's pretty compelling data that maybe we're not dealing with a hugely aggressive virus," Krummel says.

The bigger provocation, he suspects, may be your own immune system. Like any pathogen, SARS-CoV-2 will trigger an immune attack within minutes of entering your body. This counterstrike is extraordinarily complex, involving many tactics, cells, and molecules. In a UCSF study called COMET (COVID-19 Multi-Phenotyping for Effective Therapies), Krummel and other scientists have been observing this immune warfare in more than 30 people admitted to UCSF hospitals with COVID-19 and other respiratory infections. "What we're doing is looking at patients' blood, their genes, and the secretions from their noses and lungs, and we're asking, 'What's your army? What's your response strategy?'"

It's pretty compelling data that maybe we're not dealing with a hugely aggressive virus."

Max Krummel, PhD

An early analysis of COMET data, Krummel says, suggests that the immune systems of many hospitalized patients mobilize differently - and more aggressively - against SARS-CoV-2 than against influenza viruses, which cause the flu. Their lungs are ravaged, these data suggest, not by the virus alone but by the detritus of an immunological battle gone awry. This rogue immune response could explain why, around day 11 of a COVID-19 infection, patients often develop a severe pneumonia known as acute respiratory distress syndrome, or ARDS.

Ultimately, COMET seeks to find COVID-19 therapies that can rein in an overeager immune system in order to prevent or treat ARDS. But that feat won't be easy, says Carolyn Calfee, MD, MAS '09, an ARDS expert, UCSF professor of medicine, and co-leader of the study. Too much or the wrong kind of intervention, she explains, could cripple a person's immune system to the point where it can't clear an infection. "It's a fine line between therapeutic and deleterious," Calfee says. "We're trying to find that balance."

Typically, people who die from COVID-19 ARDS die around day 19. Reported rates of mortality have varied widely, with the highest rates being where the pandemic has hit hardest, overwhelming hospital resources and staff. At UCSF hospitals - likely due to the city's early shelter-in-place orders, which prevented an initial surge of COVID-19 cases - so far only 10 of 85 critically ill patients have died.

"The good news is that we've been doing clinical trials of best-care practices for ARDS since 1998," Matthay says. Thanks to research by him and others, for example, clinicians have long known which ventilator settings result in the fewest deaths and how to flip patients onto their stomachs - a technique known as proning - to best help them breathe. If public health measures can keep hospital admissions low so that frontline providers can make good use of the skills and knowledge they already have, we may find that we have less to fear from SARS-CoV-2 than we thought.

On the other hand, the virus behaves in ways that are still mysterious.

Heart failure

In April, Susan Parson, MD, a Bay Area medical examiner, made a startling discovery. For nearly two months, officials had believed that the first people in the U.S. to die from COVID-19 had died of respiratory failure in Washington state in late February. At the time, the U.S. Centers for Disease Control and Prevention limited testing to people who had respiratory symptoms and had recently traveled to China or otherwise been exposed to the virus. Those restrictions, however, turned out to be misguided.

As a medical examiner for California's Santa Clara County, Parson had done a routine autopsy on a 57-year-old woman named Patricia Dowd, who had died suddenly at home on February 6. In Dowd's tissues, Parson found the cause of her death: SARS-CoV-2. But the virus hadn't wrecked Dowd's lungs. In fact, she had only mild pneumonia. Instead, SARS-CoV-2 had ruptured her heart.

Meanwhile, epidemiologists began learning that preexisting heart disease and related conditions put people at greater risk of suffering and dying from COVID-19. "We're finding that many patients who have more severe forms of the illness are obese, they are diabetic, they are hypertensive," says cardiologist Nisha Parikh, MD, a UCSF associate professor who specializes in population health research. Such risk factors, she says, are unusual. "They're not ones that really stood out in prior epidemics."

Clinicians, too, were seeing surprising numbers of COVID-19 patients develop heart problems - muscle weakness, inflammation, arrhythmias, even heart attacks. "We're not used to respiratory viruses having such dire consequences on the heart in such apparently high numbers," says cardiologist Gregory Marcus, MD, MAS '08, UCSF's Endowed Professor of Atrial Fibrillation Research. Many patients whose hearts acted up also had failing lungs. But others had no other symptoms or, like Dowd, only mild ones.

Since March, Marcus has co-led one of the largest community surveys to better understand the spread of SARS-CoV-2 and its myriad effects. The study, dubbed COVID-19 Citizen Science, has so far enrolled more than 27,000 people; anyone with a smartphone can participate. Marcus plans to also start collecting data from wearable devices, including Fitbits and Zio patches, which wirelessly monitor heart rhythms. "There may be large numbers of people who are suffering from cardiovascular effects of COVID-19 in the absence of other symptoms," Marcus says. "I'm worried we're missing those cases."

It stands to reason that SARS-CoV-2 affects the heart. After all, heart cells are flush with ACE2 receptors, the virus's vital port of entry. And, indeed, laboratory experiments suggest that the virus can enter and replicate in cultured human heart cells, says Bruce Conklin, MD, a professor of medicine and an expert in heart-disease genetics at UCSF and the Gladstone Institutes.

But Conklin doesn't think SARS-CoV-2 necessarily kills heart cells outright. Rather, in the process of copying itself, the virus steals pieces of the genetic instructions that tell the heart cells how to do their job. "It's hauling away and hijacking stuff that's necessary for the heart to beat," he says. He is currently testing this hypothesis using human heart cells grown in cup-sized vessels in the lab of Todd McDevitt, PhD, a bioengineer at UCSF and the Gladstone Institutes.

It's also possible, however, that an infected person's own immune system may do the majority of the damage in the heart, as it appears to do in the lungs. "The heart probably gets infected by a lot of other viruses, and they don't have a lethal effect," Conklin says. "What makes this one different?"

Graph with three bars. Bar at left has 80% at top and Non-Severe at bottom. Bar in middle has 15% at top and Severe at bottom Bar at right has 5% at top and Critical at bottom. Text below graph reads: Most symptomatic cases of COVID-19 are mild. To left of graph, small circle with the letter "i" in the middle opens to text reading: Graph Data: Wu et al., JAMA 2020. Livingston et al., JAMA 2020. Garg et al, MMWR 2020. Stoke et al., MMWR 2020. Left of graph: illustration of a coronavirus.

Most symptomatic cases of COVID-19 are mild.

Stranger things

Toward the end of March, as San Francisco began to warm up, Sonia got cold feet. She put on wool socks and turned up her heater. Still, her feet felt frozen. Three days later, her soles turned splotchy purple. Red dots appeared on her toes. At night, her cold feet itched and burned. Walking hurt. And she was exhausted, napping through afternoon Zoom meetings. "It was so bizarre," says Sonia, a San Francisco resident. A week later, her symptoms were gone.

"Yes, COVID," wrote Lindy Fox, MD, a UCSF professor of dermatology, replying to an email describing Sonia's case. Sonia wasn't surprised. Anyone, like her, who's been following news of the pandemic has probably heard about "COVID toes," a painful or itchy skin rash that sometimes pops up in young adults with otherwise mild or asymptomatic cases of COVID-19. "It looks like what we call pernio, or chilblains," Fox says, "which is a pretty common phenomenon when somebody goes out in cold weather - they start to get purple or pink bumps on their fingers or toes."

Many people with rashes like Sonia's don't test positive for COVID-19, Fox says, which has made some clinicians skeptical of the connection; when patients have both, it's just a coincidence, they believe. But Fox doesn't think so. For one thing, "the time of year is wrong," she says. "Pernio usually shows up in the dead of winter." Even more compelling, dermatologists around the world are "getting crazy numbers of calls about it," Fox says. "In the last three weeks, I've had somewhere between 10 and 12 patients.
Normally, I have four a year."

And it's not just dermatologists who are adding their observations to COVID-19's ever-expanding symptom list. Gut specialists are finding that 20% to 40% of people with the disease experience diarrhea, nausea, or vomiting before other symptoms, says gastroenterologist Michael Kattah, MD, PhD, a UCSF assistant professor. If you swallow virus particles, he says, there's a good chance they will infect cells lining your stomach, small intestine, or colon. As in the lungs and heart, these cells are studded with vulnerable ACE2 portals.

Especially disconcerting, Kattah says, is how long the virus seems to persist in the gut. About 50% of patients with COVID-19 have virus particles in their stools, often for weeks after their nose swabs test negative, he points out. Laboratory studies show that these particles are often still alive and can infect cells in a petri dish. Whether fecal transmission occurs between people, however, is an open question. If the answer is yes, people recovering from COVID-19 may need to stay quarantined even after they feel well, and the rest of us will need to be as meticulous about bathroom hygiene as we've become about handwashing and mask-wearing.

Other specialists are also raising flags. Neurologists worry about reports of COVID-19 patients with headaches, "brain fog," loss of the sense of smell, dizziness, delirium, and, in rare cases, stroke. Nephrologists worry about kidney stress and failure. Hepatologists worry about liver injuries. Ophthalmologists worry about pink eye. Pediatricians, meanwhile, worry about a peculiar COVID-related inflammatory syndrome that's showing up in kids and young adults.

There's a lot of smoke. We need to figure out where the fire is coming from."

Michael Wilson, MD

Researchers are still sorting out the causes for this constellation of effects. If you come down with a particular symptom, is it because the virus is attacking your cells? Because your immune system is overreacting? Or just because you're very sick? In any severe illness, for example, the kidneys must work extra hard to filter waste and control nutrients and fluid; if overtaxed, they may begin to fail. Similarly, cognitive problems can result from increased blood toxins due to stressed kidneys or from low oxygen due to respiratory distress. "There's a lot of smoke," says Michael Wilson, MD '07, MAS '16, the Rachleff Distinguished Professor at UCSF's Weill Institute for Neurosciences. "We need to figure out where the fire is coming from."

Recently, there's been speculation that some of COVID-19's seemingly disparate symptoms may stem from trouble in the blood. Blood clots, for example, are showing up in cases of COVID-19 frequently enough for clinicians to take notice. "There's something unique about the coagulation system in these patients," says nephrologist Kathleen Liu, MD '99, PhD '97, MAS '07, a UCSF professor of medicine. In caring for COVID-19 patients on dialysis machines, she's been surprised to see blood clots block dialysis tubes more than usual. Clotted tubes are common, she says, "but this is extreme."

That may be because, as growing evidence suggests, SARS-CoV-2 can infect cells in the walls of blood vessels that help regulate blood flow and coagulation, or clotting. If true, this behavior could explain some of the virus's weirder (and rarer) manifestations, such as heart attacks, strokes, and even "COVID toes."

"Our vasculature is a contiguous system," says cardiologist Parikh. "Thus injury in one area, such as blood vessels in the lungs, can set off clotting cascades that affect multiple organs." Some of that trouble likely results from inflammation triggered by the immune system, she points out, although another culprit may be the body's RAAS, or renin-angiotensin-aldosterone system, a hormone system that controls blood pressure and fluid balance. Because RAAS involves ACE2 receptors, Parikh suspects it may become disrupted when the virus infects cells through these receptors, thus triggering coagulation and other downstream effects. Her lab is now studying this system in COVID-19 patients to better understand how SARS-CoV-2 infection affects it.

Inevitably, some ailments may turn out to be red herrings. During a pandemic, when people are flocking to hospitals with infections, clinicians will also see a rise in other health problems, simply by the rules of statistics, points out S. Andrew Josephson, MD, the Francheschi-Mitchell Professor, chair of UCSF's neurology department, and a member of the Weill Institute for Neurosciences. "If the prevalence of infection is high, then almost any condition - a broken leg, if you will - you might conclude is associated with COVID-19."

"As clinicians, we want to get information to our medical community and to the public as quickly as possible," Josephson says, "but we have to be cautious about not making too big a deal of a little blip."

The long tail

As with any infection, how long a bout of COVID-19 lasts varies from person to person. If you're ill enough to need critical care, you can expect the disease to take at least a few weeks to run its course. In some cases, symptoms persist for months. For a typical milder case, though, you should feel better within a couple weeks.

At that point, the question foremost on your mind will be: Am I immune? There are now more than a dozen antibody tests on the market, but most are unreliable, according to UCSF research. And even the best tests can't tell you whether you have enough of the right kinds of antibodies to protect you against reinfection. "There is a lot of hope and belief that we'll have an antibody test that actually informs us of immunity, but we're not quite there yet," says Chaz Langelier, MD, PhD, a UCSF assistant professor of medicine who is working to improve diagnostic tools for COVID-19.

What we have in the meantime are a lot of unknowns: If you do become immune to SARS-CoV-2, when and how does that occur? Will you gain immunity from a mild or asymptomatic case, as well as a severe one? How long will that immunity last?

"The answers will have huge implications for social distancing and masking and for getting the economy back up and running," says Michael Peluso, MD, a clinical fellow who came to UCSF three years ago to help fight HIV. Now he's co-leading a new study called LIINC (Long-term Impact of Infection with Novel Coronavirus), which is enrolling people who have been infected with SARS-CoV-2 and will follow them for two years. Besides illuminating changes in immunity over time, LIINC is investigating chronic effects of infection on the immune system, lungs, heart, brain, blood, and other parts of the body.

"I hope people will recover and immunity will be protective and long-lasting, and that will be that," Peluso says.

It's what we all hope. We hope we will beat an infection swiftly - or, better yet, avoid the virus until there is a vaccine. We hope that if we do fall gravely ill, we will be cared for by the best providers and tended to by people we love. The reality, as we already know, is more complicated. And even if COVID-19 doesn't batter our bodies, the pandemic will surely leave scars - on our psyches, our livelihoods, our institutions, and our health - that we are only beginning to fathom. In truth, we don't know how our cards will fall, as individuals or as a people. Only time - and data - will tell.

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We Thought It Was Just a Respiratory Virus

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We were wrong. By Ariel Bleicher and Katherine Conrad UCSF Magazine Summer 2020 Illustration: Anna & Elena Balbusso In late January, when hospitals in the United States confirmed the presence of the novel coronavirus, health workers knew to watch for precisely three symptoms: fever, cough, and shortness of breath.

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5 Actions We Each Need to Take to Fight COVID

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5 Actions We Each Need to Take to Fight COVID

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5 Actions We Each Need to Take to Fight COVID-19

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Texas Medical Association

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COVID Decision Tree 072020 Texas Medical Assoc

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The National Child Traumatic Stress Network

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Knowing what to do right before and during a hurricane can help families feel more in control and take steps to increase their safety.

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Hurricane and Flood Recovery for Children video

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Hurricane and Flood Recovery for Children video

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Hurricane and Flood Recovery for Children

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Ready Rosie - Helping children prepare for storms

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Ready Rosie - Helping children prepare for storms

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ReadyRosie is an early education tool that helps families, schools, and communities across the nation deepen and scale their family engagement efforts. Our tools leverage the power of video modeling, family workshops, professional development opportunities, and mobile technology to build powerful partnerships between families and educators, resulting in Ready Families, Ready Educators, Ready Children .

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You Tube channel

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The Texas Division of Emergency Management (TDEM) serves the State of Texas by managing the all-hazards emergency management plan for the state. TDEM works c...

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fema federal emergency management agency disaster recovery "federal emergency management agency" dhs "department of homeland security" "disaster response" "d...

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For emergencies, call your local fire/EMS/police or 9-1-1. FEMA reviews all comments for appropriate content. Comments that are off-topic or include abusive ...

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Communicating with an individual with a disability or access or functional needs during an active shooter situation tips

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Communicating with an individual with a disability or access or functional needs during an active shooter situation tips

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Find 30 pages of information from different sources

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Toll free support line

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Toll Free COVID-19 24/7 Support Line: 833-986-1919

The Harris Center is operating the 24/7 statewide COVID-19 mental health support line launched by Texas Health and Human Services. The support line offers trauma-informed support and psychological first aid to those experiencing stress and anxiety related to COVID-19.

You're not alone. You or someone you know may get help by accessing the Harris County's COVID-19 Mental Health Support Line at 833-986-1919.

No Cost Virtual Support Groups for Healthcare Workers in Harris County

Healthcare workers are experiencing an unprecedented amount of stress amidst the COVID-19 epidemic. The Harris Center for Mental Health and IDD wants to be here for you during this challenging time.

Please reach out to our COVID-19 Mental Health Support Line to speak to a caring responder 24/7.

If you identify yourself as a healthcare worker, you can be referred to SHARE*, a virtual support group designed specifically for healthcare workers to connect with others who are experiencing similar stressors and building new ways to cope. SHARE is facilitated by experienced mental health professionals from The Harris Center for Mental Health and IDD. *Support for Healthcare workers to Assist with Relief Electronically

Help share the word using this flyer.

CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Harris County Public Health: http://publichealth.harriscountytx.gov/Resources/2019-Novel-Coronavirus

Ready Harris Self-Assestment Tool: https://checkforcorona.com/harris-county#/welcome

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Toll Free COVID-19 24/7 Support Line: 833-986-1919 The Harris Center is operating the 24/7 statewide COVID-19 mental health support line launched by Texas Health and Human Services. The support line offers trauma-informed support and psychological first aid to those experiencing stress and anxiety related to COVID-19. You're not alone.

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Fort Bend County Health and Human Services 

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Fort Bend County Health and Human Services 

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Fort Bend County, TX - Health & Human Services

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Fort Bend County Website PINNACLE Senior Center

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For help with resources in your area.

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211 connects you to expert, caring help. Every call is completely confidential.

What are you looking for today?

This phone call has given me more hope than I ever thought possible. I have been beaten down for so long and told that I could never be anything. Just talking with you meant even more than all the resources you gave me.

United Way of Central Maryland 211 Client

Referrals to help and resources were made by the 211 network in 2022.

If it were not for your help, I don't know what I would have done without food. It's been too dangerous to go out and I can't afford to be at risk.

211 Miami Client

Average increase in 211 call volume throughout 2020 due to COVID-19 pandemic.

211 saved my life. It was below freezing, and I had nowhere to sleep. They helped me find a place to stay and create a plan to get my life back.

Cleveland 211 Client

People call 211 for assistance with housing, homelessness, and utility bills every year.

Partner with Us

Whether you provide local services, operate a national non-profit, or represent a company that wants to help more people, 211 can help. Across the country, 211s are vital partners to hundreds of organizations, businesses, and government agencies.

Learn more about our work with partners like the Ad Council, IBM, Lyft, SingleCare, and join us today.

Not sure where to start? We can help. Call 211

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Get help paying bills, finding food, and locating other resources near you. Call 211 now for confidential help from a caring expert.

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A way forward to opening up social circles

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We are starting to enter into a new normal. Restrictions are being lifted and we are beginning to decrease social distance, yet we must continue to work together to reduce the risk of viral transmission. Until accurate testing is available and herd immunity is achieved, this can be achieved through self-awareness and communication.
Covid CARE calls in four specific elements to consider and discuss with others as you start broadening your social circles:
Covid CARE is a model to build trust through communication to co-create a healthier social expansiveness.
What will be our "new normal"?
There are people who are taking physical distancing very seriously, and others who feel anger and frustration at being told what to do by our Government. Our current political climate is fragmenting us further. We are impacted by the economic damages brought on by the closing of the economy, isolation from friends and family, and fear of sickness and death.

These stories and feelings can either tear us apart or bring us together. It will be our choice to make: Will our new normal be one based on scarcity and fear or on an abundance of hope and love? Finding that point where the freedom of the individual is balanced with care for others is key. It is here that we can create a new normal where we can all be seen and cared for equally, regardless of privilege; an opportunity to integrate ourselves back into society as supportive rather than oppressive.

COVID CARE provides us a model in which to move forward together.
A Word about Shame and Judgement
Shame is a powerful tool used to maintain conformity to a social standard. It works. It also causes death, depression, isolation, and deep suffering far greater than any virus ever could. Being judgmental about others' choices shuts people down from being honest. Not knowing what someone is doing during the age of coronavirus is potentially deadly. It is far better to know if someone is not following measures to reduce viral transmission, so that you can protect yourself, than to shame and judge them to where they don't disclose that to anyone else (while not changing their behavior). Listening to their reasons and having an open discussion is far more effective to have them care about their choices.

The Container includes the people who are in your household/domicile, living space, work space, or whom you might interact with without social distancing or precautions. Some other terms used are circle, cohort, contact circle, COVID pod, COVID-bonded, germacule, droplet bonded,and primary community. You could have a primary container - those that you share space with - and a secondary container, such as work spaces or visitors who have their own primary residences or containers. Those with bigger containers have bigger risks of infections associated with them.

Your container can have people at different social distances and include people who are in multiple containers. It should include the people who you directly intersect with: anyone who comes within 6 feet of you for more than 10 minutes. As time goes on, these containers may change, with people moving away or closer. While it may seem like a hassle, drawing out your contacts can be a visual way to show others. This way, others can better make a decision knowing who is who and what they are willing to enter.

Many people know who is in their container, and feel safe within those choices, but many people do not have that privilege. Essential/front line workers, incarcerated, houseless and people in detention, have no say or ability to protect themselves from viral transmission. We have a social responsibility to them to understand our ability to make choices and continue to account for this when we begin to open up our container to others.

You can create your own Container diagram here to share with others.

We often take people that we live with for granted. Maybe we have not clearly sat down and spoken our boundaries and risk reduction etiquette out loud, but have a common understanding of each other while we are in the place of "stay at home" measures. As we move towards broadening our containers, we need to create agreements with each other to help navigate these changes.

Agreements may have allowances for those not at the same level. For example, if one person in the container socializes with others at less than 6 feet, the other members of the container may wish to stay more than 6 feet from them, and ask for extra cleaning of shared spaces or wearing of masks when near each other. The highest risk person or the person with the lowest risk tolerance would ideally set the standards of acceptable behavior for the container.

In some containers, it is difficult to have perfect risk reduction behaviors, such as maintaining 6 foot distance from strangers, wearing masks, or staying at home. In these situations, disclosure about the additional risks to others must be made as one broadens the social network. This is not about getting an infection that can easily be treated with an antibiotic, but something that can kill someone even with two degrees of separation.

This is the most controversial and difficult place to navigate as we reduce social distancing and open society back up. Forsaking joy, love, pleasure and others for the period of time until herd immunity is reached will cause inordinate suffering. We each have our own personal tolerance for illness, disease and death. It is imperative that we understand this in order to take into account everyone else in our container and community at large. Risk Tolerance does not supersede public health policies and government regulations.
Why consider risk tolerance and not just risks themselves?
Risk tolerance is subjective and can dictate the behaviors we impart unconsciously to others. We each form our risk tolerance based on personal history and societal risks. Understanding risk tolerance and being responsible for your choices is critical to our ability to open up our society as safely as possible. Low or high risk tolerance does not make one better or worse, but with COVID-19, the need to be clear and conscious with one's choices is critical to the health of society.

The more someone is at risk of disease and death due to where they live, their health, pre-existing conditions, economic status, race, or age, the lower their risk tolerance. Others feel that they have less to lose if they get sick, and are willing to take on more risks. One cannot know everyone's level of vulnerability who we come in contact with. Essential workers and those they care for have died due to others' inadvertent exposure.

I use a backpack as a metaphor to explain the concept of risk tolerance:

The more you carry in your backpack (personal risks, precautions you are using), the slower you move (lower tolerance), but the more likely you are to survive. The less you carry, the faster you move (high tolerance) but the less likely you will survive by putting yourself and others at higher risk.
As risk tolerance increases, so does the potential harm to others. You are responsible for protecting others from yourself, otherwise that is a consent and boundary violation.
Higher risk frontline and essential workers, people of color, migrant workers and those residing in nursing homes are at especially high risk and may not have the ability to protect themselves with this conversation, so it is up to those of us who can, to help everyone stay healthy.

The following scale is not inclusive of all situations and is just a guide. This is not prescriptive . The intent here is to create a common vocabulary so we can communicate where we each stand.

0: Very Strict - Have been in very strict isolation alone or with others in a container, which may include the following:

Stays exclusively within the container/household.

6 feet apart with others within the household/container.

Strict etiquette including hand washing, masks and social distancing are used 100% of the time within the container.

Groceries delivered and wiped down.

No one outside is allowed in.

Infection control protocols outside of the bedroom. Bleach or sanitizing all surfaces touched by more than one person, no shared bathroom spaces.

People in this category are more likely to be at a higher risk of death from contracting the disease or be in a container with someone who is. They may value social responsibility towards others, and/or want to flatten the curve. Areas with a high density of people, such as a city, may be at this level for the foreseeable future, until adequate testing and contact tracing is readily available. Getting through this pandemic without illness to self or others is a strong priority.

1: Strict - Have been in strict isolation alone or with others in a container, which may include the following:

Does not optionally leave the house/container except to get groceries and go to work.

No social distancing with members of one's container.

Strict etiquette including hand washing, masks and social distancing are used 100% of the time when outside of the container.

Groceries delivered and/or wiped down before being allowed into the container.

No visitors are brought inside the container.

Person to person connection is done virtually or across a wide berth >6 ft + masks.

Exercise alone or with others, distance strictly maintained.

For some, while they may want to be at this level, they cannot due to their societal, economic, and/or personal situation. Essential workers may be strict when they are able to make those decisions but their work puts them at higher risk, so their risk tolerance is higher than their desire.

2: Fairly Strict - Have been in fairly strict isolation alone or with others in a container, which may include the following:

Leaves the house to go to work, where etiquette to reduce transmission is not strictly available.

Fairly strict etiquette including hand washing, masks, and social distancing are used 80-100% of the time when outside of the container.

Minimizes grocery and other shopping (once a week or less).

Exercise with others where distance may not always be strictly maintained for brief moments.

May socialize with others outside of the container, at 6 ft apart or less than 6 ft with masks.

No sexual activity with anyone outside of the container. (Sexual activity is any behavior where sexual touch is exchanged.)

No one in the container has prolonged (more than 10 minutes) exposure with those outside the container.

People in this category may need more social exchange with others but still want to reduce the risks of infection as much as possible. Other circumstances, such as needing to continue work or take care of someone outside of the primary container, may require this level of risk tolerance.

3: Somewhat Open - Have chosen to be somewhat open with their container alone or with others, which may include the following:

Leaves the container to exercise, go to the store, work and other activities several times a week.

Etiquette including hand washing, masks and social distancing are used about 80% of the time when outside of the container.

Sometimes socializes with others who are not in one's container

Maintains social distance

Less than 10 people

No more than twice a week.

Sometimes socializes with others at less than a 6 foot distance if they have been following fairly strict or somewhat open protocols as well.

May engage in sexual activity with others only if they have also have similar risk tolerance, with consent. Sexual activity is limited to no exchange of bodily fluids including open mouth kissing and oral sex.

People in this category may be found in places with lower Covid infections. Those who have lower risk of death and disease to themselves, and do not share space with others at high risk, may be in this category.

4: Moderately Open - Have chosen to be moderately open with their container alone or with others, which may include the following:

Leaves the container to exercise, go to the store, work, and other activities multiple times a week.

Etiquette including hand washing, masks and social distancing are used around 40-60% of the time when outside of the container.

Regularly socializes others who are not in one's container

May not maintain social distance

More than 10 people

No regard to how often one socializes.

May engage in sexual activity with others only if they have also have similar risk tolerance, with consent. Sexual activity can include exchange of bodily fluids including open mouth kissing and oral sex.

People here may believe they have no risk factors, or do not believe they know anyone who is at risk if they get the infection, or may be wanting to get infected.

They may have already been infected, tested positive for antibodies, and feel sure that they are no longer a vector for infecting others. Please note, that at the time of this writing, we do not know whether having antibodies to SARS-CoV-2 imparts immunity.

5: Very Open

Leave the container to exercise, go to the store, work and other activities multiple times a week with no precautions that have been shown to reduce viral transmission.

Etiquette including hand washing, masks and social distancing are used about 0-40% of the time when outside of the container.

Regularly socializes with others who are not in one's container

Does not maintain social distance

More than 10 people

No regard to how often one socializes.

Engages in sexual activity with others only if they have also have similar risk tolerance, with consent. Sexual activity can include exchange of bodily fluids including open mouth kissing and oral sex.

Some people desire infection, have tested positive for antibodies, or do not want to be told what to do.
Anyone with this risk tolerance has the social responsibility to take strong precautions from possibly infecting others who may be vulnerable, including essential workers.
As members of a greater community, the choices we make will help support one another. Some of these choices are based on hard science, such as hand washing protocols. Others we are still figuring out, such as the benefits of wearing masks.

Clean hand protocol - Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.

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

Avoid touching your eyes, nose, and mouth with unwashed hands.

Secure Shared Space - Determined by those within a container. This may be a place where you do not feel the need to have strict measures such as wiping down surfaces after touch, wearing gloves, or covering your face.

Physical (social) distance - 6 feet is an old determination that has been the set standard for shared air space. Previous studies, using aircrafts as a model, have determined that this is the distance needed to avoid sharing small droplets. However, a sneeze or cough can carry viral particles much further.

Covering your coughs and sneezes - All coughs and sneezes, even if they are due to environmental allergies, need to be covered. The ideal is a clean paper tissue that is immediately thrown away into a closed container. Hands need to be washed or use of hand sanitizer immediately afterwards.

Masks - Are worn to protect others from you, not the other way around. Wearing a mask in public can have an overall impact of slowing down the transmission of the virus. The CDC does recommend the use of a mask, even a plain cloth mask, whenever you are out in public. If everyone was to wear a mask in public, it reduces the inadvertent transmission of people who may be asymptomatic as well. Please remember to wash your cloth masks regularly.

See this good NYTimes article for further information: A User's Guide to Face Masks

Gloves - Are not well recommended since some people use the wearing of gloves to touch anything. Gloves can give a false sense of protection. If you are going to wear gloves, they must be put on after a 20 second hand wash or use of alcohol sanitizer. Do not touch your face with your gloved hand or you will self contaminate.Take off the gloves as soon as they are no longer needed. Pull one off first, then use the clean hand to go under the glove to pull the other one off. Do not reuse them and dispose of them in a closed container.

Sex - The virus lives in saliva, any exchange of bodily fluids carries a risk of transmission. The virus has been found in stool, so any anal play can transmit the virus to your respiratory passages (mouth) and should be avoided unless you are in a mutually monogamous container with them. Sexual activity is not limited to exchange of bodily fluids and this might be a chance to discover the array of sensual and intimate activities that are available to us.

We are in a time of great uncertainty. We do know, for those that believe in data and science, that social distancing, adequate hand washing, and stay at home measures have reduced the transmission of SARS-CoV-2 virus. Until accurate testing is widely available and contact tracing set up, these are the best measures we have to decrease morbidity and mortality due to COVID-19. Unfortunately, there isn't a clear end in sight.

Rather than despair, we need to find a way to proceed forward with grace and compassion. Communication with those in your day to day life, having clear agreements to meet everyone's needs, and understanding your conscious and unconscious behavior will be critical as we begin to open up our society. Until we have what we need to safely relax social restrictions, talking with those in your container/circle is one small tool that can go a long way as we prepare to ride out this storm together. Shame has no role in helping us stay together. Rather than using shame as a tool to encourage conformity, I recommend using accountability and communication. Using COVID CARE as a model for communication, each can work towards creating a new "normal" where we learn to be self aware, responsible and care for one another.

There is still a lot we don't know about and the tests are still not accurate enough to be reliable.

At this time we have two tests that are available:

Viral test - to check if you have a current Covid infection. There is up to a 30% false negative rate in some of the tests.

Antibody test - to check if you have antibodies to the virus. This tells us that you have some immunity to the virus. We don't yet know that just because someone has developed antibodies, that they are fully protected from reinfection, or how long any immunity lasts.

I see many tests being offered that have not yet been FDA approved and there is no available data on their accuracy.

FDA Test Validation.
FDA Emergency Approved Tests
"The top Covid-19 comorbidities listed by New York, in order, are hypertension, diabetes, high cholesterol, coronary artery disease, dementia, and atrial fibrillation, a heart condition. Chronic obstructive pulmonary disease, another respiratory ailment, but one with an older demographic than asthma, ranks seventh. Renal disease, cancer and congestive heart failure round out the list." NY Times
NYC Health Tracker, Comorbidities
For those who choose to wear a mask, watch this demonstrated in a WHO video, the key is to not to touch the outside of the mask - and to wash your hands if you do.
Facts on use of Face Masks DIY Face Masks, NYTimes CDC Mask Recommendations The History of Social Distancing, NYTimes Social Distancing, NYTimes CDC Prevention Recommendations Evelin Dacker MD is an Integrative Family Physician in Salem, Oregon. Evelin was the Executive Director of Portland. She created the safer sex communication model STARS to help facilitate open and honest sex conversations. She is a sexual health activist, consent educator and TEDx Speaker.

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We are starting to enter into a new normal. Restrictions are being lifted and we are beginning to decrease social distance, yet we must continue to work together to reduce the risk of viral transmission. Until accurate testing is available and herd immunity is achieved, this can be achieved through self-awareness and communication.

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Centers for Disease Control and Prevention

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Venturing Out? Be Prepared and Stay Safe

Updated June 12, 2020

As communities and businesses are opening, you may be looking for ways to resume some daily activities as safely as possible. While there is no way to ensure zero risk of infection, it is important to understand potential risks and how to adopt different types of prevention measures to protect yourself and to help reduce the spread of COVID-19. As a reminder, if you have COVID-19, have symptoms consistent with COVID-19, or have been in close contact with someone who has COVID-19, it is important to stay home and away from other people. When you can leave home and be around others depends on different factors for different situations. Follow CDC's recommendations for your circumstances.

In general, the more closely you interact with others and the longer that interaction, the higher the risk of COVID-19 spread. So, think about:

How many people will you interact with?

Interacting with more people raises your risk.

Being in a group with people who aren't social distancing or wearing cloth face coverings increases your risk.

Engaging with new people (e.g., those who don't live with you) also raises your risk.

Some people have the virus and don't have any symptoms, and it is not yet known how often people without symptoms can transmit the virus to others.

Can you keep 6 feet of space between you and others? Will you be outdoors or indoors?

The closer you are to other people who may be infected, the greater your risk of getting sick.

Keeping distance from other people is especially important for people who are at higher risk for severe illness, such as older adults and those with underlying medical conditions.

Indoor spaces are more risky than outdoor spaces where it might be harder to keep people apart and there's less ventilation.

What's the length of time that you will be interacting with people?

Spending more time with people who may be infected increases your risk of becoming infected.

Spending more time with people increases their risk of becoming infected if there is any chance that you may already be infected.

What to Consider Before You Go:

Asking these questions can help determine your level of risk:

Is COVID-19 spreading in my community?

What are the local orders in my community?

Review updates from your local health department to better understand the situation in your community and what local orders are in place in your community. Also find out about school closures, business re-openings, and stay-at-home orders in your state.

Will my activity put me in close contact with others?

Practice social distancing because COVID-19 spreads mainly among people who are in close contact with others.

It's important that you and the people around you wear a cloth face covering when in public and particularly when it's difficult to stay 6 feet away from others consistently.

Choose outdoor activities and places where it's easy to stay 6 feet apart, like parks and open-air facilities.

Look for physical barriers, like plexiglass screens or modified layouts, that help you keep your distance from others.

Use visual reminders-like signs, chair arrangements, markings on the floor, or arrows-to help remind you to keep your distance from others.

Do I practice everyday preventive actions?

If I get sick with COVID-19, will I have to miss work or school?

If you are sick with COVID-19, stay home. Also find out about your work or school's telework or sick leave policy.

If you decide to engage in public activities, continue to protect yourself by practicing everyday preventive actions. If you will be running an errand, follow CDC's running errands considerations.
Items to have on hand

A cloth face covering

Tissues

Hand sanitizer with at least 60% alcohol, if possible

Frequently Asked Questions

Is it safe to do activities?

The risk of an activity depends on many factors, such as:

Is COVID-19 is spreading in your community?

Will you have a potential close contact with someone who is sick or anyone who is not wearing a face covering (and may be asymptomatic)?

Are you at increased risk of severe illness?

Do you take everyday actions to protect yourself from COVID-19?

CDC cannot provide the specific risk level for every activity in every community. That's why it's important for you to consider your own personal situation and the risk for you, your family, and your community before venturing out.

What activities are safer?

Activities are safer if you can maintain at least 6 feet of space between you and others, because COVID-19 spreads easier between people who are within 6 feet of each other. Indoor spaces with less ventilation where it might be harder to keep people apart are more risky than outdoor spaces. Interacting without wearing cloth face coverings also increases your risk.

Venturing Out? Be Prepared and Stay Safe

Consider these tips to keep you and others safe when you venture out.

Click the links below for more information about CDC's considerations tips for reducing your risk during the COVID-19 pandemic:

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Venturing Out? Be Prepared and Stay Safe Updated June 12, 2020 As communities and businesses are opening, you may be looking for ways to resume some daily activities as safely as possible.

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Before, During, After Tornado Preparedness

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Surviving and active shooter video

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RUN. HIDE. FIGHT.® Surviving an Active Shooter Event - English

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Last Resort Active Shooter Survival Measures

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Last Resort Active Shooter Survival Measures

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LAST RESORT ACTIVE SHOOTER SURVIVAL MEASURES from ACT Cert (Run, Hide, FIGHT/ Avoid, Deny, DEFEND)

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Attack Poverty