Coronavirus: how long does it take to get sick? How infectious is it? Will you always have a fever? COVID-19 basics explained

Coronavirus: how long does it take to get sick? How infectious is it? Will you always have a fever? COVID-19 basics explained


Sanjaya Senanayake, Australian National University

You’re probably inundated with news and messages about coronavirus at the moment. But how do you know if you’re consuming evidence-based information or just speculation and myth?

There’s still a lot we don’t know but here’s what the evidence tells us so far about the coronavirus, called SARS-CoV-2, and the disease it causes, COVID-19.

How does it spread?

COVID-19 is transmitted through droplets generated via coughing and sneezing.

This means it can spread during close contact between an infected and uninfected person, when it’s inhaled, or enters the body via the eyes, mouth or nose.

Infection can also occur when an uninfected person touches a contaminated surface.

What are the symptoms?

COVID-19 causes similar symptoms to the flu. Fever is the most common symptom, occurring in almost 88% of cases, while a dry cough is the next most common, affecting almost 68% of those with the virus.

Data from 55,000 cases in China also show other symptoms can include:

  • fatigue, in 38% of cases
  • producing sputum or phlegm, 33%
  • shortness of breath, 19%
  • sore throat, 14%
  • headache, 14%.

Unlike other coronaviruses that cause the common cold, COVID-19 is hardly ever associated with a stuffy nose. This is seen in just 5% of cases.

Diarrhoea is also uncommon, affecting only 4% with the virus.

The Conversation, CC BY-ND

Can I be infected if I don’t have a fever?

Yes, you can still have coronavirus if you don’t have a fever. This occurs in about 12% of cases.

How long does it take to get sick?

The incubation is the period from when you’re infected to when you become sick. For COVID-19, the range is 1-14 days, with an average incubation period of 5-6 days.

How sick do people usually get?

Most people who get sick (80%) have a mild illness which rarely involves needing to go to hospital. They recover after about two weeks.

But just over 20% of people sick with COVID-19 will need to be hospitalised for severe difficulties with breathing.

Of the 20% who need to be hospitalised, 6% become critically ill with either respiratory failure (where you can’t get enough oxygen from your lungs into your blood), septic shock, and/or multiple organ failure. These people are likely to require admission to an intensive care unit.

It appears to take about one week to become severely ill after getting symptoms.

How often do people die of it?

The case fatality rate refers to the number of deaths among those who have tested positive for coronavirus. Globally, the case fatality rate today stands at 4%.

But this rate varies country to country and even within countries. These variations may partially be explained by whether hospitals has been overwhelmed or not.

Read more:
How does coronavirus kill?

The case fatality rate in Wuhan was 5.8% (although one model says it may be lower at 1.4%). In the rest of China, it was at 0.7%.

Similarly in Europe, Italy’s case fatality rate is (8.3%), greatly surpassing that of Germany (0.2%).

However the case fatality rate only includes people who are tested and confirmed as having the virus.

Some modelling estimates suggest that if you calculated the number of deaths from the total number of cases (those confirmed with tests and those that went undetected) the proportion of people who die from coronavirus might be more like 1%.

Read more:
The coronavirus looks less deadly than first reported, but it’s definitely not ‘just a flu’

Who is most at risk of dying?

People aged over 60 years with underlying health problems are at highest risk of severe disease and death.

For people aged 60-69, 3.6% of those who are infected will die from COVID-19. This rises to 8% for for 70-79 year olds and 14.8% for those over 80.

Among people under 50 years, just 0.2-0.4% will die from the disease and this rises to 1.3% for 50-59 year olds.

Read more:
Why are older people more at risk of coronavirus?

How infectious is it, and how does that compare with the flu?

COVID-19 and influenza are probably fairly similarly infections.

A single ill person with COVID-19 can infect more people than a single ill person with influenza. COVID-19 has a higher “reproduction number” of 2.0-2.5. This means one person will infect, on average, 2 to 2.5 people.

Seasonal influenza has a reproduction number of about 1.28, meaning one person will infect, on average, between one and two people.

But this is balanced by influenza’s ability to infect more quickly. It takes, on average, 3 days to become sick with the flu, but you can still transmit it before symptoms emerge.

It takes 5-6 days to become sick with COVID-19. We still don’t know if you can be infectious before getting coronavirus symptoms, but it doesn’t seem to be a major driver of transmission.

So influenza can spread faster than COVID-19.

The case fatality rate of COVID-19 is higher than that of seasonal influenza (4% versus 0.1%), although as noted above, the true fatality of COVID-19 is still not clear.

Read more:
The ‘dreaded duo’: Australia will likely hit a peak in coronavirus cases around flu season

Can you be reinfected?

It’s too early to know if someone infected with COVID-19 can get it again.

On the basis of what we understand about other coronaviruses, it is likely that infection will give you long-term immunity. But it’s unclear whether that will mean one year, two years or lifelong immunity. The Conversation

Still have more questions? We might have you covered in this video.

Sanjaya Senanayake, Associate Professor of Medicine, Infectious Diseases Physician, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

CROI 2020 Report Back

CROI (Conference on Retroviruses and Opportunistic Infections) was scheduled in Boston from 8-11 March 2020. However, with the growing COVID-19 outbreak in the USA, the conference program was transferred to a virtual/digital format. This report back has been provided by NAPWHA Senior Research Manager, Dr John Rule, who has selected some snippets of information, which he has curated our NAPWHA member organisations and NAPWHA Treatment Officer Network.

Prof. Sharon Lewin of the University of Melbourne was one of the first speakers at CROI 2020 and here is her take home slide from her presentation titled ‘HIV Cure from Bench to Bedside’. It is forward looking with a few question marks. Access the presentation webcast recording via the

The ‘London’ Patient

Ravindra Gupta first presenting the case at CROI 2019 in Seattle. Photo by Liz Highleyman.

A London man continues to have no detectable HIV 30 months after stopping antiretroviral therapy, according to a report by Professor Ravindra Gupta of University College London at the Conference on Retroviruses and Opportunistic Infections (CROI 2020). When his case was first presented at CROI 2019, he was known simply as the ‘London patient’, but on Monday he, Adam Castillejo, went public with an interview in The New York Times. The latest findings strongly suggest that Castillejo has joined Timothy Ray Brown, formerly known as the ‘Berlin patient’, as the second person to have been cured of HIV.

Weight Gain on ARV Treatment

Weight gain after starting antiretroviral treatment is likely to raise the risk of diabetes but does not push up cardiovascular disease risk, two large analyses presented to CROI 2020 show.

Several randomised clinical trials carried out in sub-Saharan Africa and cohort studies in North America and Europe have shown substantial weight gain occurs after starting antiretroviral treatment, particularly in black women and people exposed to both dolutegravir and tenofovir alafenamide (TAF).


Long Acting Injectables

Long-acting injectables might be administered every two months

A combination of two long-acting injectable drugs administered every two months suppresses HIV viral load as well as monthly injections, according to a report at CROI 2020.

Treatment that can be taken every other month would improve convenience and possibly adherence. However, in this study, those who received the every-other-month regimen were more likely to develop resistance if they did not maintain viral suppression.

Other interesting CROI 2020 links


Events marking the National Day of Women Living with HIV 2020

NAPWHA and the National Network of Women Living with HIV known as Femfatales had the honour of hosting a dinner and one-day forum in Sydney to mark the 5th National day of Women living with HIV (#NDWLHIV). It was a valuable opportunity for women to join together and hear from other leaders in the sector and plot a course forward to better engage with and deliver for all women living with HIV in Australia.

Access some of the presentations from the event:

For this year’s National Day of Women Living with HIV 2020, read more about the Femfatales who made a call to action for #EachforEqual increased awareness and equitable access to HIV testing.

About Femfatales

Femfatales (the National Network of Women living with HIV) is an advisory group, constituted to provide NAPWHA with an ongoing consultative forum for the discussion of issues for women living with HIV in Australia.

Corona Virus (COVID-19) Information Update

Coronavirus (COVID-19) is raising valid concerns among our communities and one such concern is around the possibility of interrupted supply chains for medications for people living with HIV and PrEP users.

Following extensive consultation with pharmaceutical companies, the Therapeutic Goods Administration (TGA), and the Pharmaceutical Benefits Advisory Committee (PBAC) the key message is that COVID-19 poses no threat to the availability of HIV medications for Australian consumers.

To help you learn more about COVID-19 NAPWHA has co-produced with Australian Federation of AIDS Organisations (AFAO) and Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine an updated fact sheet released on 9 March 2020 (this is an updated version of the Factsheet published on 5 February 2020).


The Women’s Network make a call to action for #EachforEqual increased awareness and equitable access to HIV testing

Monday 9 March 2020 is the 5th National day of Women living with HIV (#NDWLHIV) in Australia — founded by the National Network of Women Living with HIV known as Femfatales. Our awareness raising network highlights issues relevant to women, and also celebrates the lives of all women living with HIV.

To help raise awareness of HIV, Femfatales invites all organisations and agencies concerned about women’s health to hold a morning or afternoon tea, or similar event, in support of women living with and affected by HIV.

In Australia, one in every ten people living with HIV is a woman. This National Day brings into focus approximately 3,000 women living with HIV.

On this day Femfatales makes a call to action for:

  • Equitable and timely access to HIV testing for all women, regardless of perceived risk
  • Ending the avoidable rates of late HIV diagnosis among women
  • Greater public awareness of HIV testing, treatments, and prevention

Katherine Leane, Femfatale’s Chair, explains further:

“There is a general misconception that sexually active women are not at risk for HIV. Consequently, many women believe they don’t need to be tested.”

“Our healthcare providers often share this mistaken belief. Even when a woman presents multiple times to their doctor with unexplained illnesses, fever or weight loss, the question ‘Could it be HIV?’ is never asked.”

“By the time a woman is diagnosed, she has usually lived with HIV for many years without treatment. This late diagnosis often means she has developed a compromised immune system and sometimes, progressed to an AIDS-defining illness.”

“Assumptions about who is ‘at-risk’ in public health narratives have restricted women’s access to HIV testing on an equal basis to men.”

This National Day of Women Living with HIV shares the theme adopted by International Women’s Day 2020 — “I am Generation Equal, Realising Women’s Rights” or #EachforEqual — which draws from the notion of collective individualism and shared responsibility, where everyone can play a collective role in accelerating gender equality.

In appreciation of this theme, Ms Leane reminds us:

“Collectively, we can make change happen by starting conversations about HIV with our doctors, nurses, dentists and other professionals in health care settings.”

The National Association of People with HIV Australia (NAPWHA) is Australia’s peak non-government organisation representing community-based groups of people with HIV. They provide advocacy, policy, representation, health promotion and outreach at a national level.

NAPWHA Vice President, Ms Sarah Feagan, states:

“As a national women’s network, we know the importance of keeping women on the agenda. This 5th National Day gives us an opportunity to celebrate the strength and diversity of the HIV community of women, and to recognise the unique challenges they face. We hope that all women living with or affected by HIV feel strengthened by our visibility.”

“NAPWHA aligns itself with the MIWA (Meaningful Involvement of Women Living with HIV) principles and knows the value and importance of keeping women firmly on the agenda. On this National Day we hope that all women living with or affected by HIV feel strengthened by our visibility and strive for equality and pleasure in their lives.”

Femfatales declares that it is time for all women who are sexually active, to be offered comprehensive and culturally appropriate sexual health screening, including HIV testing.

Celebrate. Advocate. Inspire. Empower.

Media Contact

For media enquiries, or to arrange an interview with:

Katherine Leane — Femfatales Chair
Sarah Feagan — NAPWHA Vice-President; Femfatales Member

Contact Saysana Sirimanotham – NAPWHA Communications Officer on 0424 898 698 or

About Femfatales

Femfatales (the National Network of Women living with HIV) is an advisory group, constituted to provide NAPWHA with an ongoing consultative forum for the discussion of issues for women living with HIV in Australia.

Download a printable version

‘Every Journey Counts’ — NAPWHA launches video campaign for World AIDS Day

‘Every Journey Counts’ — NAPWHA launches video campaign for World AIDS Day

At the NAPWHA and Australian Federation of AIDS Organisations (AFAO) joint Annual General Meeting 2019, we posed several questions to community advocates and leaders to craft a series of videos for World AIDS Day 2019 and to put people living with HIV at the heart of a campaign.

The Australian theme for this year’s World AIDS Day is ‘Every Journey Counts’, and in our video series we ask our advocates and leaders what that theme means to them. Their powerful responses illustrate how diverse, different and vital all people’s individual journeys with HIV are.

With the 1 December on approach, you can also find out how to engage and show your support by attending events held in all Australian States and Territories. Find out more at 

With thanks to in-kind Creative Production by Habane Rupert of