You have an essential role to play in slowing the spread of the new coronavirus. The good news is that small changes in personal behavior can buy time — slowing 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.
Slow the outbreak by keeping yourself and others from getting sick.
Stock up on food responsibly and create a household plan.
Stay at home to protect others, and use these strategies to keep life as normal as possible.
What to do if you or a family member gets sick.
You Can Prevent Infection
Slow the outbreak by keeping yourself and others from getting sick.
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.
Wash your hands (the right way)
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 towel 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.”
Use hand sanitizer
If you are away from a sink, use alcohol-based hand sanitizer with at least 60 percent 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.)
Wash your hands often
As a general practice, think about washing your hands before you leave the house (protect others from your germs) and after you arrive at your destination (to remove germs you picked up from door knobs, elevator buttons, public transportation, etc.) You should also wash your hands before, during and after you prepare food. Wash hands before and after you eat, clean your house and change a diaper (you’re touching a baby!) Wash hands after you touch a shopping cart, use the bathroom, blow your nose, cough or sneeze, care for a pet and touch the garbage.
Break the face-touching habit
We know you want to touch your face. Studies suggest that humans touch their faces as a form of self-soothing. For those moments when you must touch your face, keep tissues in your pocket to rub itchy eyes and noses (and then throw them away). Wearing glasses, makeup and gloves can also help.
Clean your home
Infectious disease specialists know where germs lurk, so we asked them how to clean. Their advice? In between regular cleaning, focus daily on high-touch areas — door knobs, light switches, television remotes, refrigerator and microwave handles, cabinet and drawer pulls, faucet handles and toilet flushers. If you’ve got a popular favorite spot for mail or a popular family closet, give that area an extra wipe. “I try not to be neurotic about it,” says Dr. Kryssie Woods, a hospital epidemiologist and the medical director of infection prevention at Mount Sinai West in New York. “But wash your hands when you get home and try to clean some of those high-touch areas. That’s good advice even without the coronavirus.”
Use the right cleaning products
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 percent 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.
Clean your phone
The germs on your hands, your desk and your face are now probably on your phone. Some of those germs are harmless, and some are gross. (A 2011 British study found fecal matter on 1 out of 6 smartphones.) Nobody has documented coronavirus transmission from a smartphone, and if you’re washing your hands frequently, it’s not a big worry. Apple says to wipe your iPhone with a 70 percent isopropyl alcohol wipe or Clorox Disinfecting Wipes. Don’t use bleach or other agents. Avoid sharing your phone with others if you can — touching someone else’s phone is like holding their hand. And try to use a headset or the speaker phone function so your phone doesn’t touch your face.
Cover your sneeze or cough
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, chances are that hand will contaminate a TV remote, a door knob 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.
Keep your distance
The main 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 10 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. Here’s a running list. More states and cities may follow their lead.
While some people are practicing “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 over looking well can transmit the virus.”
What does it mean to shelter in place? Can I leave the house?
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.
Reconsider your travel plans
Travel advisories are changing by the day. Borders are closing, airlines are canceling flights — and don’t even think about going on a cruise. You can still travel by plane, train and automobile, but the risk is that the outbreak is moving fast and conditions can change quickly. People over 65 and those with health issues should stay home. You can check for new travel restrictions here.
You Can Prepare Yourself and Your Family
You can stock up on food and supplies without contributing to shortages. And every family should have a plan for coping with an emergency.
Stop hoarding!
Panic-buying has prompted some people to fight over toilet paper, pilfer from each other’s shopping carts and even steal sanitizer and masks from hospitals. Make a commitment to your community and yourself that you will not take more than what you need for a few weeks at a time. Be reassured that while there may sometimes be empty shelves and delays, food makers are confident in the supply chain. If you can’t find an item, talk to your grocery or pharmacy manager to find out when new shipments are expected. Remember, if you stockpile supplies, that means someone else — probably more vulnerable than you — won’t have what they need.
Stock up on food the right way
Stocking your kitchen to prepare for the unexpected can be daunting. How much food do you need for a two-week emergency supply? How much more food do you need now that everyone is working and studying at home? Whatever your food preferences, it’s important that you eat the recommended amounts of healthy foods to keep your immune system running strong.
Now is not the time to seek comfort in processed foods, junk food snacks and high-sugar packaged foods. Your immune system is powered by a nutrient-dense diet of protein, fruits and vegetables to function at its best. While it can take years of bad eating to develop diabetes or heart disease, the effect of a poor diet has an almost immediate impact on your immune system, said Dr. Mark Hyman, a Cleveland Clinic physician and author of the book “Food Fix.”
Have an emergency supply. Two weeks is best, but many of us don’t have the space or the funds for that much food. You don’t need to buy it all at once. When you shop, just pick up a few extra frozen foods, boxed or canned pantry items and long-lasting refrigerated foods. Buy fresh produce when you can for daily life, and save frozen and canned produce for unexpected events, like a two-week home quarantine.
Plan for daily nutrition. For optimal health, you need a mix of protein, vegetables, fruits, whole grains and some fats.
Protein Eat about 7 to 8 ounces daily (spread across two or three meals) in any combination of meat, chicken, fish, pork eggs, tempeh, tofu, beans and veggie burgers. A serving of protein should be about the size of your palm, said Dr. Hyman. (For a child, it should be the size of a child’s palm.)
Produce Eat at least 2.5 cups of vegetables and 1 to 2 cups of fruit a day. (We really should eat twice that much, but we don’t.) Root vegetables (carrots, squash, yams) along with apples and oranges can all last for several weeks in the refrigerator without spoiling. Frozen vegetables taste better and have less sodium than canned vegetables. Pickled foods (kimchi, pickles, sauerkraut) are great for an emergency food stash.
Grains Avoid processed grains when you can, but for quick lunches and easy dinners you can stock up on 3 to 4 daily servings of whole grains per person, said Lisa R. Young, adjunct professor of nutrition at New York University. Look for quinoa, oatmeal and brown rice, freeze whole wheat tortillas (they take up less space than bread) and try to find whole-wheat pasta or pastas made with lentils or black beans.
Keep healthy snacks on hand. Nuts, seeds, fruits and nut butters are best. If you run out of fresh fruit, a smoothie made with frozen fruit, yogurt or almond milk with nuts and seeds is a treat. A little dried fruit (don’t overdo it) and microwave popcorn is O.K.
Dairy and non-dairy products. Non-dairy milks made from almonds, soy and coconut (choose those with no added sugar) tend to last longer in the fridge than regular milk. Regular yogurt can also be frozen.
Don’t forget your pets
It’s a good idea to have a two-week supply of pet food, cat litter and pet medications on hand in case of a quarantine, official restrictions of movement or supply issues.
And have more than one emergency pet plan in place. A close friend and I have agreed to take care of each other’s pets in the case of an emergency. But I’ve also got backup plans with my neighbor and the dog walker, just in case.
Try for a 90-day supply of prescription medications
To plan for quarantines or store closings, have an extra supply of prescription drugs. Whether you can do that depends on your prescription drug plan. Some plans allow you to get a 90-day supply by signing up for mail order. Other plans may allow you to request a “vacation override” to get an extra month of medication if you plan to leave town. Talk to your pharmacist and your doctor about how you might stock up on medication and whether any of the drugs you take are at risk for shortages.
Make sure you have a thermometer
Given that fever is a common symptom of coronavirus, it’s a good idea to take your temperature with a reliable thermometer. Many stores have sold out of thermometers, but keep trying. Drug stores restock supplies daily, so ask when the next shipment is expected. Or ask a friend if they have one to spare. Just make sure you clean it with alcohol.
Know your hospital
In any emergency, would you know how to get to your closest hospital? Is the closest hospital an in-network or out-of-network hospital on your insurance plan? Knowing the answers to these questions now will help you move quickly in any emergency. And it makes sense to rehearse a little — drive by your hospital so you know where the emergency room entrance is.
Get to know your neighbors
Only one in four adults knows most of their neighbors, according to a Pew Research Center study. Reach out to neighbors (from a safe distance) about how they are coping with virus worries. Exchange phone numbers so you can help each other out with mail or deliveries or pet sitting if one of you becomes ill or needs to be away for an extended period of time.
Keep an emergency bag
Your household plan should include a list of essentials to pack should you need to make a quick exit for any emergency. If possible, you’ll want to bring items like a toothbrush, a bottle of water and a snack (expect long waits) and phone chargers. (An E.R. doctor told me phone chargers are the most-requested item in an emergency room.) While you should not be collecting masks, if you have a mask at home already, the time to use it is on the way to the hospital to protect those around you, including the hospital admission staff.
Keep important documents handy
In case of emergency, is there someone who can retrieve needed documents? And would they be able to find them? Keep a digital file or a lock box with essential documents. This includes things like passport, birth certificate and social security card, but also important health documents, like copies of health insurance and prescription drug cards, a list of any allergies or health worries, a list of prescriptions, family contact information and health care proxies and directives.
Make sure your end-of-life documents are up to date
It’s not a pleasant topic, but dealing with end-of-life issues when you are well will take an enormous burden off your loved ones should an emergency arise. The A.A.R.P. has a page dedicated to advanced directives with links to the correct document for the state where you live. You’ll find information about health care proxies, a form to designate someone to make health decisions for you if needed, and living wills, which allow you to decide what kind of care you want at the end of life. Many hospitals now keep health care proxies and advanced directives in a patient’s medical records if you ask. But you should also share copies with friends and family members and keep a copy in your digital or home files.
If you have elderly parents, friends or family members, help them get their end-of-life documents in order now. If you haven’t completed a will, check with a lawyer. A will typically needs to be notarized in person, which can’t happen if notary offices are closed. Some states will recognize a will that hasn’t been notarized as long as it’s signed by witnesses.
Stay Home
Based on the pattern of the virus in other countries, many of us are going to be working from home and sheltering in place for weeks or possibly months at a time. Here are some strategies to keep life as normal as possible.
How and when to stay home
The rules change by the day, and there’s always a chance local, state or federal authorities will impose more restrictions on movement. Here’s a guide:
Social distancing Social distancing is ultimately about creating physical distance between people who don’t live together. At the community level, it means closing schools and workplaces and canceling events like concerts and sporting events. For individuals, it means keeping six feet of distance between you and others while in public (indoors and outdoors) and avoiding physical contact with people who do not share your home. For children, this means no playdates or group sports — other than with siblings who live together. “This is not a snow day!” says Dr. Bitton of Brigham and Women’s Hospital.
Shelter in place In a nutshell, this means don’t leave the house unless you absolutely have to. Don’t socialize with people outside your family. Don’t go to a friend’s house for dinner or invite someone over. Go outside only for essential needs: groceries, prescriptions or to walk the dog. Outdoor exercise is permitted, as long as you keep six feet between you and non-family members.
Self-monitoring Self-monitoring is for people who learn they might have been exposed to the virus but had only distant contact with the infected person. This means regularly checking your temperature and watching for signs of coronavirus infection, including fever, shortness of breath and coughing. A person who is self-monitoring should already be following community rules for staying home and limiting interactions with others.
Self-quarantine This term is used to separate and restrict the movement of someone who is well but who recently had close contact with a person who later was diagnosed with the virus. A person in self-quarantine should stay home, and avoid going to the grocery store or interacting with the public even on a limited basis for a 14-day period. A person in self-quarantine should sleep in a separate space from family members.
Self-isolation Anyone who has a diagnosed case or a suspected case based on their symptoms should self-isolate. A person in isolation should stay in a separate room with no or minimal contact with the rest of the household (including pets) and use a separate bathroom if possible.
Consider wearing a homemade mask when you leave the house
Guidance on whether to wear a mask has been confusing and continues to shift. Everyone agrees that medical masks are in short supply and should be reserved for healthcare workers in hospitals, first responders, home caregivers and people who are sick (who should wear them to protect a caregiver). If you have a stash of masks, you can check with your hospital or medical school to see if they will accept donated masks to be used by healthcare workers. You may want to keep a few to use if someone in your home becomes ill.
Recent research suggests masks might be protective in crowded spaces.
Now the Centers for Disease Control and Prevention recommends that everyone wear nonmedical face coverings in public settings. President Trump said the guidelines were voluntary, leaving the decision about wearing masks up to individuals.
If you wear a mask, don’t let it give you a false sense of security. You still need to limit trips outside, and be mindful about handwashing and touching your face. And from what I’ve seen, most people are wearing masks incorrectly. People often fidget with the mask, pulling it down off their face and pushing it back up. I saw one couple grocery shopping while wearing masks over their mouths but not their noses (both mouth and nose should be covered).
Linsey Marr, a Virginia Tech scientist and an expert in the transmission of viruses in the air, emphasized that most people do not need the high level of protection offered by a medical mask. “The potential for exposure is so much lower in a grocery store compared to working in a hospital close to patients,” she said.
Don’t neglect fitness
You’re not commuting to work anymore, so consider using that time to build a fitness habit. Exercise is good for your immune system.
Health club and fitness classes Most gyms are closed. If you live in a part of the country where gyms are still open, talk to your gym or fitness instructor about plans for live streaming fitness classes if public health officials impose more restrictions on movement. If you are still going to the gym, keep your distance, wipe down equipment, wash or sanitize your hands often. Avoid peak times so you come into contact with fewer people. Bring your own yoga mats and towels and make sure you have six feet of space on all sides.
Exercise at home You can invest in home exercise equipment or smart-home exercise systems like Peloton or the Mirror, but that can get expensive. You can find a number of workouts to do at home for free. Beginners can try the Well Six-Minute Workout video series. We’ve got a guide to How to Start Working Out, the 9-Minute Strength Workout and Yoga for Everyone. Taking walks and jogging or running are safe ways to exercise outside, maintain your distance from others and keep you from going stir-crazy at home. Learn more about setting up a space in your home for exercise.
Create structure
As someone who has worked primarily from home for 20 years, I know how important it is to maintain a routine similar to how you work at the office. This isn’t just about being more productive (although it helps). A schedule will help you take breaks, preserve family time and avoid letting home-based work take over your weekends. Your children should also have a routine that matches, as much as possible, their school day. Here are some tips:
Wake up at the same time each day, shower and get dressed in comfortable clothes (not pajamas).
Create a task list and establish working hours. Do the same for your children.
Take a lunch break. If your children are at home, schedule lunch and a brief recess for all of you outside, if community rules allow it.
Take coffee and stretch breaks. It’s much easier to stay sedentary for hours of working at home than in the office because you don’t have meetings and chats with colleagues to break up the monotony.
Plan check-ins with work colleagues to stay connected.
Stop work at the end of the work day at the same time you would normally leave the office. Don’t forget to take weekends off!
Use your normal commuting time for self-care. You’ve just gained a significant amount of free time that in the past you used for commuting. Be mindful of the time bonus and use it for self-care, time with family or pleasure, like reading a book or listening to a podcast.
Make space. Read Wirecutter’s guide to creating a dedicated home work space.
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