Stop the spread of germs

Preventing coronavirus at home

Basic protective measures against the new Coronavirus

You have an essential role to play in slowing the spread of the new coronavirus. The good news is that small changes in personal behaviour can buy time — curbing the outbreak, preventing hospitals from becoming overwhelmed and reducing cases until scientists develop treatments and, eventually, a vaccine. Here's some practical advice from doctors and public health experts to protect yourself and your community.

The respiratory illness coronavirus has spread across the world, including the U.S., and the WHO has officially declared the disease a pandemic. As the threat becomes more widespread, new precautions must be taken: The federal government has implemented various protective measures, as have individual state, county and city governments. You, too, should take steps to protect yourself from COVID-19 and limit the spread of the novel coronavirus to others. In this article, learn how. 

 Many of us probably will contract the new coronavirus at some point and experience only mild illness. So why not just get sick and get it over with? Because people at higher risk — older people and those with existing health problems — depend on the actions of everybody else to stay safe.

The impact just one person can have on spreading the virus — or tamping it down — is exponential. In the space of a month, one infected person leads to about 400 additional cases, according to Adam Kucharski, a mathematician who specializes in disease outbreaks.

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Even though you spend most of your day indoors while quarantined at home, chances are you still leave the house to run errands and get fresh air, setting you on a collision course with other people outside your household -- and potentially their germs. The people around you in grocery stores and on strolls through the neighbourhood are in the same position as you, appropriately cautious about the spread of the highly contagious new strain of coronavirus that can be passed along on by those who appear asymptomatic.

As a result, the Centers for Disease Control and Prevention, the leading U.S. institute that sets guidelines for health and infectious disease, issued a new recommendation for people to voluntarily wear face coverings, including homemade face masks, when you venture out to places where social distancing is a challenge, or in areas that are hotspots for the disease's transmission, like cities with a high number of confirmed positive cases.

The American Red Cross continues to monitor the coronavirus disease 2019 (COVID-19) pandemic closely and follow the latest guidance from the Centers for Disease Control and Prevention.

We understand this is a stressful time and people want to know what they can do now to protect themselves and their families. Below are some everyday steps that people in the U.S. can take now. Besides, stay informed about what's happening in your community and always follow the directions of state and local authorities.

Stay home for Health Safety

How likely are you to get the coronavirus? 

Anyone can contract COVID-19, although certain groups of people have a higher risk of developing severe complications from the virus and requiring hospitalization. Many people who get coronavirus will experience cold- or flu-like symptoms, and some people who understand the virus will be completely asymptomatic. But no matter which group you fall into, everyone has a responsibility to limit the spread to other people, especially to those who may develop deadly complications, Dr. Tom Moorcroft, an osteopathic doctor who specializes in infectious disease, 

Human coronaviruses cause infections of the nose, throat and lungs. They are most commonly spread from an infected person through respiratory droplets generated when you cough or sneeze, close, prolonged personal contact, such as touching or shaking hands touching something with the virus on it, then touching your mouth, nose or eyes before washing your hands. Current evidence suggests person-to-person spread is efficient when there is close contact.

Keep track of the coronavirus pandemic.

People at high risk of developing severe complications from COVID-19 include older adults, pregnant women, people with asthma and H.I.V., and people with underlying diseases, including heart disease, lung disease and diabetes. 

"Over 80% of people will have only mild symptoms from COVID-19. Adults who are healthy and active generally do the best," Dr Moorcroft says, but part of the problem is that young, healthy people can spread the virus to people who will not tolerate it as well as healthy populations. 

"Physical distancing is a key component to decrease asymptomatic spread," Dr Moorcroft explains. "This works by minimizing your risk of being exposed to the virus and, if you are an asymptomatic carrier, you minimize the potential that you infect someone else."  While this may sound very simple, Dr Moorcroft emphasizes that it is useful and "imperative at the current time."

As the U.S. surpasses 277,000 confirmed cases of COVID-19, and over 1 million reported cases worldwide, social distancing and thoroughly washing your hands are considered the most effective safeguards, an essential even if you do wear a cloth mask (save the surgical masks and N95 respirators for the front line health responders). 

Here are smart, sound tips to follow when you do need to leave the house to run essential errands. And here's the current understanding of coronavirus when it comes to food delivery and mail, such as Amazon packages.

Necessary protective measures against the new coronavirus

Stay aware of the latest information on the COVID-19 outbreak, available on the WHO website and through your national and local public health authority. Most people who become infected experience mild illness and recover, but it can be more severe for others.

Wash your hands frequently

Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water. Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands. 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 with at least 60% alcohol.

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.

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Hand washing is the cornerstone of infection control, but we've all been doing it wrong. Wet your hands (the water temperature doesn't matter), soap up vigorously and start counting to 20 as you scrub everywhere, including wrists and fingernails. One big mistake is that people shake their hands to air dry them. Dry with a paper towel instead to remove any lingering germs, and when you're done, use the cloth to turn the faucet handle, so you don't re-contaminate your hands.

"Your hands carry almost all your germs to your respiratory tract. Keeping them as clean as possible is really helpful," said Dr Adit Ginde, a professor of emergency medicine at the University of Colorado School of Medicine. "It would dramatically reduce transmission if people did it well."Yes, this is still the no. 1 way to prevent coronavirus, Dr Moorcroft says. "The things you should do to protect yourself from the coronavirus are things you should do every day," he points out. "The no. 1 thing you can do to prevent any respiratory illness is to practice good personal hygiene."

Washing your hands correctly -- using soap and water and washing for at least 20 seconds -- or using hand sanitizer when soap and water aren't available, still stands as the best way to prevent the spread of infectious diseases, according to the C.D.C.  

Along with social distancing, washing your hands thoroughly is one of your best defences against acquiring coronavirus. Give your hands a thorough scrub each time you get back. Twenty seconds is the going recommendation, which may seem like ages, but if you wash slowly, it's easy to do. 

I count five long seconds (one-one-thousand) of soaping each hand, in between the fingers and up to the wrists, then count another five seconds for washing each hand thoroughly to get the soap (and any dead germs) off. I often wash the soap dispenser pump, and faucet handles, too.

That helps me feel safe enough to adjust my contacts, blow my nose and pick that nagging something or other out of my teeth in the comfort of my own space.

If you are away from a sink, use alcohol-based hand sanitizer with at least 60 per cent alcohol, and scrub your hands with the sanitizer the same way you would with soap and water. If you can't find hand sanitizer, don't worry. Washing your hands with soap and water is better anyway. (If you see the recipe circulating on social media for homemade sanitizer using aloe vera gel and alcohol, it doesn't really work. Don't waste your money and just wash your hands.)

how to prevent COVID-19 while at home

Maintain social distancing

When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain the virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.

Avoid close contact with people who are sick. Remember that some people without symptoms may be able to spread the virus. Keeping distance from others is especially important for people who are at higher risk of getting very sick. Stay home from work, school, and away from other public places. If you must go out, avoid using any kind of public transportation, ridesharing, or taxis.

The primary way communities are trying to slow the virus is to practice social distancing. Try to keep six feet of personal space in public areas to avoid flying droplets from a sneeze or cough (droplets that carry the virus can travel about that distance). Avoid cramped workspace and standing shoulder to shoulder with people in bars or subways. The C.D.C. recommends no gatherings larger than ten people in places with minimal to moderate spread and no gatherings of any size in harder-hit areas. Hundreds of millions of people in more than a dozen states have been ordered to stay home except for essential trips like getting groceries or walking the dog. 

While some people are practising "social monogamy" — socializing with only one set of trusted friends — public health experts are now discouraging even that much contact. "Even if you choose only one friend to have over, you are creating new links and possibilities for the type of transmission that all of our school/work/public event closures are trying to prevent," said Dr Asaf Bitton, the executive director of Ariadne Labs at Brigham and Women's Hospital. "The symptoms of coronavirus take four to five days to manifest themselves. Someone who comes overlooking well can transmit the virus."

Yes. Even in communities where the authorities have imposed strict rules about leaving the house, you can still go out for essentials. In most cases, it's also still O.K. to take walks or exercise outside. Families should spend time in backyards and open spaces (avoid playground equipment) while maintaining six feet of distance from people they don't live with.

The C.D.C., the WHO, governments and healthcare workers are all urging people to stay home if they can. Obviously, some people don't have the luxury of working from home, and people still need to venture out to grocery stores and gas stations. But when you can stay home, do so to flatten the curve. 

Did we mention distance? Social distancing can mean anything from hunkering down at home and refraining from seeing outside friends and family in person to keeping a boundary between you and others when you do go out. 

The practice of keeping 6 feet away from those outside your homegroup extends to waiting in line at the grocery store, going on walks (you can momentarily walk in the bike lane if you're careful about looking out for street traffic) and picking up food to go.

Some states are enforcing social distancing in grocery stores, and some businesses are doing that themselves. But if you need to keep more distance between you and someone else while on a walk or when reaching for an item at the store, take a step back and wait or politely ask the person to give you more clearance ("Oh, I'm trying to keep my distance from everyone.")

Wearing masks

Medical masks, including surgical, medical procedure face masks and respirators (like N95 masks), must be kept for healthcare workers and others providing direct care to COVID-19 patients. Wearing a non-medical mask (for example a homemade cloth mask) in the community has not been proven to protect the person wearing it. Strict hygiene and public health measures, including frequent hand washing and physical (social) distancing, will reduce your chance of being exposed to the virus.

Wearing a non-medical mask is an additional measure you can take to protect others around you. Wearing a non-medical mask is another way to cover your mouth and nose to prevent your respiratory droplets from contaminating others or landing on surfaces. Just like our recommendation not to cough into your hands (instead, cover your cough with tissues or your sleeve) a mask can reduce the chance that others are coming into contact with your respiratory droplets. 

If wearing a non-medical mask makes you feel safer and stops you from touching your nose and mouth, that is also good. But remember not to touch or rub your eyes.

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It is important to understand that non-medical masks have limitations and need to be used safely.

If you choose to use a non-medical face mask:

  • you must wash your hands immediately before putting it on and immediately after taking it off (in addition to practising good hand hygiene while wearing it)
  • it should fit well (non-gaping)
  • you should not share it with others
  • Face masks can become contaminated on the outside, or when touched by your hands. When wearing a mask, take the following precautions to protect yourself:
  • avoid touching your face mask while using it
  • change a cloth mask as soon as it gets damp or soiled
  • put it directly into the washing machine or a bag that can be emptied into the washing machine and then disposed of
  • cloth masks can be laundered with other items using a hot cycle, and then dried thoroughly.
  • non-medical masks that cannot be washed should be discarded and replaced as soon as they get damp, stained or crumpled
  • dispose of masks properly in a lined garbage bin
  • don't leave discarded masks in shopping carts, on the ground, etc.
  • Non-medical masks alone will not prevent the spread of COVID-19. You must consistently and strictly adhere to good hygiene and public health measures, including frequent hand washing and physical (social) distancing.
  • Use a tissue to cover your nose and mouth, and throw used tissues in a lined trash can if a tissue isn't available, cough or sneeze into your elbow — not your hands. Wash your hands immediately.

You could spread COVID-19 to others even if you do not feel sick. Everyone should wear a cloth face cover when they have to go out in public, for example to the grocery store or to pick up other necessities. Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, damaged or otherwise unable to remove the mask without assistance.

If you are in a private setting and do not have on your cloth face covering, remember always to cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.

Learn to practice "respiratory etiquette," says Dr William P. Sawyer, a physician in Sharonville, Ohio, and creator of HenrytheHand.com, a website dedicated to handwashing and hygiene practices. Respiratory etiquette means being aware of where you cough or sneeze. No matter where you are (even at home) don't sneeze into your bare hand. If you do, the chances are that hand will contaminate a T.V. remote, a doorknob or a faucet handle. Always grab a tissue when you sneeze or cough (no cloth handkerchiefs!), and then throw it away and wash or sanitize your hands immediately. If you don't have a tissue, sneeze into your elbow. Yes, you've contaminated your sleeve, but we don't usually touch that part of our arms, and germs die more quickly on fabrics than on hard surfaces.

Clean and disinfect

Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks. If surfaces are dirty, clean them: Use detergent or soap and water before disinfection. Clean all surfaces that are touched often, like counters, tabletops, and doorknobs. Use household cleaning sprays or wipes according to the label instructions.

You don't need hospital-grade cleaners. Most experts believe that regular household cleaning supplies (which often contain the same ingredients as hospital cleaners) will kill the virus. If your store has run out of disinfectant cleaners and bleach that promise to kill 99.9 per cent of germs, don't panic. Although soap and water won't kill all germs, scientists say scrubbing with soapy water should get rid of coronavirus on surfaces. You can check the C.D.C.'s page on cleaning recommendations.

While we've got the go-ahead to use disinfecting wipes on phones, another smart idea is to avoid placing your device on iffy surfaces, to begin with. Do you really need to put your phone down, or can you just stash it in a coat pocket or purse? The less you can expose your phone to shared surfaces, the less you need to worry about them in the first place.

If you do put your phone down on a shared surface, lay down a napkin and set your phone on that. It'll save you having to disinfect your device quite so often.

Try to stay calm

In addition to your physical health, you should take care of your mental health. High-stress levels can take a toll on your immune system, which is the opposite of what you want in this situation. If you're feeling overly anxious about COVID-19, follow these tips from a psychotherapist to keep your nerves calm.

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