Why coronavirus guidance keeps changing — and what you really need to know

Doctors admit the guidance has been confusing, but as protests continue and businesses reopen, here's what they want Americans to keep in mind.
An employee at Northwestern Memorial Hospital in Chicago puts on personal protective equipment before working with coronavirus patients.
An employee at Northwestern Memorial Hospital in Chicago puts on personal protective equipment before working with coronavirus patients.Laura Brown / Northwestern Medicine

If it seems like guidance from the medical community surrounding COVID-19 keeps changing, that's because it has been — and doctors know that can be confusing.

From who should be wearing masks to whether children are getting sick, it's true that as research develops and doctors continue to learn more about the new coronavirus, some of the guidance has shifted.

"This is a new scenario for all of us," said Dr. James Town, a UW Medicine critical care physician and director of the Medical Intensive Care Unit at Harborview Hospital in Seattle, who was on the front lines early in the pandemic. "People were hit with an onslaught of information that was hard to parse. Being frustrated is completely understandable."

This is a new scenario for all of us. Being frustrated is completely understandable.

Dr. James Town

Doctors admit the health care community could have been better about communicating what they knew, and more importantly, what they didn't know.

"One of the things we in medicine didn't do a good enough job of is explaining where there was uncertainty and how this was always going to be an evolving situation," Town said. "That doesn't always make people feel reassured. We know more now than we did a month ago, two months ago, but we have to acknowledge that some things we are still learning."

The good news? Doctors are starting to feel like they have a better handle on the virus, although most still fear a second wave this fall. And they stress that much of the guidance they provided to the public early on is still incredibly important. As protests continue and businesses reopen across the country, here's what doctors want people to keep in mind.

How the virus is transmitted hasn't changed

In the beginning, doctors flip-flopped a little on whether the virus could live on objects, such as doorknobs, or whether person-to-person contact was more likely to lead to infection (it is), but how the virus is transmitted remains the same.

"This is a respiratory virus," Dr. Eric Cioe-Pena, an emergency room physician at Northwell Health in New York City, told TODAY. "It is transmitted through droplets that reside in our nose, our mouth, our respiratory track. Is it a very contagious virus. Those things haven't really changed."

That's why wearing a mask is still important, especially since doctors have also learned that people can be infected with the virus, and thus become contagious, long before they're showing symptoms.

"In fact, they're probably the most infectious in the three days before they develop symptoms," Cioe-Pena said. "In March and April, that wasn't thought to be true. We didn't think they were infectious until they had developed fever and symptoms. Our understanding of COVID has changed dramatically since then. Because of that change, we want everyone to wear masks."

The country is reopening, but that doesn't mean the virus is gone

As people across the country gather in large crowds to protest the murder of George Floyd, or flock to restaurants and other businesses in states that have reopened, it can be easy to assume the threat of COVID-19 is over. Even the director of the Centers for Disease Control and Prevention has expressed concern that people aren't getting the message.

But doctors say it is still important — perhaps even more so, especially if you're out and about — to be vigilant when it comes to taking precautions.

"The virus does not discriminate against who it hits, whether you went to a protest or went to get your hair cut," said Dr. Michelle Prickett, a pulmonary and critical care specialist at Northwestern Memorial Hospital in Chicago. "Everyone still has to practice the same hand hygiene, social distancing, masking and ways of retaining the virus to themselves so that we can reopen the country. We all have the same goal."

Of course, this is all happening with summer right around the corner, and many people wonder what kind of effect the warmer weather will have on the virus. Typically, respiratory viruses do decrease during summer, Prickett said. And there's some benefit to being outside and getting fresh air, but that doesn't mean summer will kill the virus.

"Viruses don't like UV light, high heat, humidity," Town said. "But how that actually translates into real-world practice, we don't know. That's one of the things that's been frustrating. You'll learn something in isolated conditions, in a lab experiment or a highly controlled clinical trial, and then maybe you find that in a real-world setting, it's a lot messier. I think we'll see the virus linger a bit longer at a lower level, and then when fall rolls around, we'll see another surge."

We're all still learning about the virus

It's also important to acknowledge that the science will continue to evolve.

"No one is a COVID expert," Prickett said. "We are learning as we go. We do not have every answer, but we are looking for those answers."

On the bright side, she thinks the health care industry has learned a lot during this pandemic.

"There's a lot more direct communication, as opposed to policies or procedures," she said. "We're taking a more multidisciplinary approach, which has been very nice to see. Everyone is collaborating and sharing information."