I’ve been keeping close track of the novel coronavirus that exploded in China, has now swept around the globe, and is now officially known as COVID-19 since December. The World Health Organization declared a the coronavirus outbreak a public health emergency of international concern on January 30th, and given how COVID-19 has continued to spread, it is now inevitable that we will be dealing with a pandemic. The potential public health threat posed by COVID-19 is high, both globally and to the United States. But individual risk is dependent on exposure. For the general American public, who are unlikely to be exposed to this virus at this time, the immediate health risk from COVID-19 is considered low. But under current circumstances, certain people will have an increased risk of infection, like healthcare workers caring for patients with COVID-19 and other close contacts of persons with COVID-19.
The truth is, based on what we know right now, fear is the most dangerous contagion here. The coronavirus is a serious threat that could be very disruptive to our society, especially the global supply chains and economy and our place in it, but the virus itself appears to be something we can survive if we take the appropriate preventive measures. I’ve been answering individual questions about this outbreak for a while, but at this point I think it would just be easier to drop all my thoughts in one place. So like my good friend, author, and fellow pandemic hawk Steven Konkoly laid out with his COVID-19 Primer, here is my take on the way forward regarding the coronavirus.
How COVID-19 Spreads
Current understanding about how the virus that causes coronavirus disease 2019 (COVID-19) spreads is largely based on what is known about similar coronaviruses.
The virus is thought to spread mainly from person-to-person.
- Between people who are in close contact with one another (within about 6 feet)
- Via respiratory droplets produced when an infected person coughs or sneezes.
- These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
Spread from contact with infected surfaces or objects
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
When does spread happen?
- People are thought to be most contagious when they are most symptomatic (the sickest).
- Some spread might be possible before people show symptoms; there have been reports of this with this new coronavirus, but this is not thought to be the main way the virus spreads.
How efficiently does the virus spread?
How easily a virus spreads from person-to-person can vary. Some viruses are highly contagious (like measles), while other viruses are less so. Another factor is whether the spread continues over multiple generations of people (if spread is sustained). The virus that causes COVID-19 seems to be spreading easily and sustainably in Hubei province and other parts of China. In the United States, spread from person-to-person has occurred only among a few close contacts and has not spread any further to date.
FORTIFY YOUR CASTLE
Preparing for a “significant event” is pretty much the same whatever the threat. The standard advice is based on the “72 on you” principle which refers to maintaining 72 hours or three days worth of provisions on hand. This is a good start that carries the bonus benefit of taking yourself off the board so others less fortunate can get the help they need. This concept is a great start, but I always suggest that you build out your supplies equivalent to your family’s needs for at least two weeks. These preps should cover food (store what you eat and eat what you store), water (at least 1 gallon per person per day), specialized medications, OTC meds and prescriptions, medical / first aid supplies, diapers, baby needs, and have some cash on hand.
STARE DOWN THE MONSTER
Face up the fact that COVID-19 is out there and it could be coming to a neighborhood or school near you soon, so stay informed. My personal favorite one-stop-shop for the latest information on this novel coronavirus is this COVID-19 Dashboard by Johns Hopkins CSSE. Also be sure to sign up for alerts with your local government.
In the pandemic that might hit, social distancing / isolation is the proactive measure, so avoid crowds and public gatherings and just stay home. If you must leave the house, there are some proven, basic things you can do to keep you and your family safe and navigate this epidemic.
Talk to your kids now rather than later. They are likely already hearing about it. Put it in perspective and that there may be some disruptions. You are the adult, so set the example.
Speaking of setting the example, make sure the kids are fully vaccinated and that you all have flu shots (which I hope you’ve already done). Why on the last? A more resilient society in terms of overall public health will be more resilient to other public health threats. Planning/preparedness for disruption is what government should be doing. But it’s also what we should be doing, especially parents.
From the Center for Disease Control (CDC):
There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to prevent illness is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory diseases, including:
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose, and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Follow CDC’s recommendations for using a facemask.
- CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
- Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
Community Mitigation Guidance for COVID-19 Response in the United States: Nonpharmaceutical Interventions for Community Preparedness and Outbreak Response
Non-pharmaceutical interventions (NPIs) are public health actions that can slow the spread of emerging respiratory diseases like COVID-19 for which vaccines and drug treatments are not yet available.1 They include personal protective measures implemented by individuals and community measures implemented by affected communities.1 NPIs are used to build community preparedness in communities without known COVID-19 disease and to support outbreak responses in communities where local cases or cluster of diseases have occurred.NPIS for Community Preparedness
CDC recommends individuals and families follow everyday preventive measures:
- Voluntary Home Isolation: Stay home when you are sick with respiratory disease symptoms. At the present time, these symptoms are more likely due to influenza or other respiratory viruses than to COVID-19-related virus.
- Respiratory Etiquette: Cover coughs and sneezes with a tissue, then throw it in the trash can.
- Hand Hygiene: Wash hands often with soap and water for at least 20 seconds; especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with 60%-95% alcohol.
- Environmental Health Action: Routinely clean frequently touched surfaces and objects
Routine use of these measures by individuals and their families will increase community resilience and readiness for responding to an outbreak.NPIs for COVID-19 Outbreaks in Communities
- Personal Protective Measures. During an outbreak in your community, CDC recommends the everyday preventive measures listed above—especially staying home when sick—and taking these additional measures:
- Keeping away from others who are sick.
- Limiting face-to-face contact with others as much as possible
- Consulting with your healthcare provider if you or your household members are at high risk for COVID-19 complications
- Wearing a facemask if advised to do so by your healthcare provider or by a public health official
- Staying home when a household member is sick with respiratory disease symptoms, if instructed to do so by public health officials or a health care provider (Voluntary Home Quarantine)
- Community Measures. If COVID-19 disease is occurring in your community, state and local public health authorities may decide to implement:
- Temporary closures or dismissals of childcare facilities and schools
- Other social distancing measures that increase the physical space between people, including:
- Workplace social distancing measures, such as replacing in-person meetings with teleworking
- Modifying, postponing, or cancelling mass gatherings.
Decisions about the implementation of community measures will be made by local and state officials, in consultation with federal officials as appropriate, and based on the scope of the outbreak and the severity of illness. Implementation will require extensive community engagement and ongoing and transparent public health communications.
If you’re planning on upcoming travel, keep these things in mind. The CDC does not recommend canceling or postponing travel to destinations with level 1 travel notices because the risk of COVID-19 is thought to be low. If you travel, take the following routine precautions.
Because of how air circulates and is filtered on airplanes, most viruses and other germs do not spread easily on airplanes. Although the risk of infection on an airplane is low, travelers should try to avoid contact with sick passengers and wash their hands often with soap and water for at least 20 seconds or use hand sanitizer that contain 60%–95% alcohol.
The CDC does not recommend travelers wear facemasks to protect themselves from COVID-19. You may choose to wear a mask, but it is more important that everyone follow everyday prevention practices.
EXTRA STEPS AND CONSIDERATIONS
Here’s some advice from Laurie Garrett, Former Sr Fellow at CFR.org, recipient of the Pulitzer Prize, Polk (2Xs) and Peabody Awards, Author of I Heard the Sirens Scream, The Coming Plague, Ebola & Betrayal of Trust, and a survivor of 30 various outbreaks:
- When you leave your home, wear gloves—winter mittens or outdoor gloves—and keep them on in subways, buses, and public spaces.
- If you are in a social situation where you should remove your gloves, perhaps to shake hands or dine, do not touch your face or eyes, no matter how much something itches. Keep your hands away from contact with your face. And before you put your gloves back on, wash your hands thoroughly with soap and warm water, scrubbing the fingers. Put your gloves on.
- Change gloves daily, washing them thoroughly, and avoid wearing damp gloves.
- Masks are useless when worn outdoors and may not be very helpful even indoors. Most masks deteriorate after one or two wearings. Using the same mask day after day is worse than useless—it’s disgusting, as the contents of your mouth and nose eventually coat the inside of the mask with a smelly veneer that is attractive to bacteria. I rarely wear a face mask in an epidemic, and I have been in more than 30 outbreaks. Instead, I stay away from crowds, and I keep my distance from individual people—a half meter, about 1.5 feet, is a good standard. If someone is coughing or sneezing, I ask them to put on a mask—to protect me from their potentially contaminated fluids. If they decline, I step a meter (about 3 feet) away from them, or I leave. Don’t shake hands or hug people—politely beg off, saying it’s better for both of you not to come in close contact during an epidemic.
- Inside your household, remove all of the towels from your bathrooms and kitchen immediately, and replace them with clean towels that have the names of each family member on them. Instruct everybody in your home to only use their own towels and never touch another family member’s. Wash all towels twice a week. Damp towels provide terrific homes for viruses, like common colds, flus, and, yes, coronaviruses.
- Be careful with doorknobs. If it’s possible to open and close doors using your elbows or shoulders, do so. Wear gloves to turn a doorknob—or wash your hands after touching it. If anybody in your home takes sick, wash doorknobs regularly. Similarly, be cautious with stairway banisters, desktops, cell phones, toys, laptops—any objects that are hand-held. As long as you handle only your own personal objects, you will be ok—but if you need to pick up someone else’s cell phone or cooking tools or use someone else’s computer keyboard, be mindful of not touching your face and wash your hands immediately after touching the object.
- If you share meals, do not use your personal chopsticks and utensils to remove food from a serving bowl or plate and, of course, tell your children to never drink out of anybody else’s cups or from a container of shared fluid. It is customary in China to prepare several dishes for a meal and then allow everybody at the table to use their personal chopsticks to pull food from the common dishes: Don’t do this until the epidemic is over. Place serving spoons in each dish and instruct everybody at the table to scoop what they want from the serving dishes onto their personal plates or bowls, return the serving spoon to the main dish, and then use their personal chopsticks only to pick food from their personal plate or bowl into their mouth. Wash all food and kitchenware thoroughly between meals and avoid restaurants that have poor hygiene practices.
- When the weather allows, open your windows at home or work, letting your space air out. The virus cannot linger in a well-ventilated space. But of course, if it is cold or the weather is inclement, keep warm and close those windows.
- Finally, if you are caring for a friend or family member who is running a fever, always wear a tight-fitting mask when you are near them, and place one on the ailing person (unless they are nauseated). When you replace an old, dirty mask from the face of your friend or loved one be very, very careful—assume, for the sake of your protection, that it is covered in viruses, and handle it while wearing latex gloves, place it inside of a disposable container, seal it, and then put it in the trash. While wearing those latex gloves, gently wash the patient’s face with warm soap and water, using a disposable paper towel or cotton swab, and seal it after use in a container or plastic bag before placing it in your household trash. Wear long-sleeved shirts and clothing that covers your body when you are caring for your ailing friend or relative. Clean everything your patient wears or touches very thoroughly in hot soapy water, including sheets, towels, and utensils. If you have space, isolate the sick person in your household in a room, or a corner of a room, where they are comfortable, but separated from the rest of the household. If the weather is tolerable, open a window that is on the opposite side of the room, so that air gently blows past the patient’s face and then outdoors. Of course, don’t do this if it is very cold, as your friend or loved one will be made sicker if uncomfortably cold.
So coronavirus is real, it’s here, and you can navigate this crisis. Keep things simple and straight forward and odds are everything will be fine. Wash hands often with soap and water for at least 20 seconds, avoid touching your face with unwashed hands, avoid close contact with people who are sick, cough or sneeze into your elbow or use a tissue to cover it, and throw the tissue away. Clean and disinfect frequently touched objects and surfaces. Be safe. Do not panic. Take commonsense precautions. As frightening as this time is, you will get through it. It’s all good. You’ve got time, so use it.