As New York City adjusts to the post-COVID-19 world, more people are going back to the office. If you are one of them, you may be wondering how to do so safely; after all, while New York has done comparatively well at controlling the spread of the virus, the pandemic is far from over.

The first thing to remember, says Dana S. Mazo, MD, MSc, Assistant Professor of Medicine (Infectious Disease) at the Icahn School of Medicine at Mount Sinai and physician lead for Infection Prevention at Mount Sinai Queens, is that the skills we need to safely go back to the office are the same ones we’ve been practicing since New York was the pandemic’s epicenter in March.

In this Q & A, Dr. Mazo provides salient advice for those returning to the office in addition to the basic tools of social distancing, wearing a face covering, avoiding face touching, and hand washing.

I commute using a cab/car service. How can I ride safely?

First, everyone in the vehicle should wear a mask for the entire ride. To improve the air flow, keep the windows open if possible and, if you need to turn on the air conditioning, don’t recirculate the air as that will only spread germs.

The virus can also be spread by touching a contaminated surface and then touching your face—especially the mouth, nose or eyes. To prevent this from happening, you should sanitize your hands and/or use antiseptic wipes on frequently touched surfaces especially before handling your own belongings or face.

If you are the passenger, be sure to use hand sanitizer soon after you first get in the car when you will have just touched the door handles, seat belt and possibly window controls. Then, try not to touch anything during the trip—especially your face—and use hand sanitizer, if you do. If possible, use a contactless payment option. When you leave, and again have to touch seat belts and door handles, don’t forget to again use hand sanitizer as soon as possible and definitely before touching your belongings or face.

If you are the driver, or you share your car, be sure to sanitize the steering wheel, dashboard, gear shift, and any other frequently touched surfaces. As an extra step to help keep passengers and our city safe, use a wipe to clean between passengers, pay special attention to highly touched surfaces such as interior door handles and seat belts. Make sure to sanitize your hands after touching anything the passenger may have touched. And, if you use valet parking, remember to sanitize everything the valet may have touched before you start for home.

Finally, if you are sharing a car with someone outside your household “bubble,” you will need to be especially cautious since you will have to sit close to that person in an enclosed space for presumably more than 10-15 minutes. Even if you are both wearing face coverings, there is still some risk; although much less than if one of you were not masked. Are you willing to be at risk from everyone that person has had contact with? Remember, it’s not just the car mate, it’s also everyone they interact with. If you don’t want to take on that risk, sharing a car becomes more complicated.

Should I take special precautions when using public transportation?

While you may be nervous about public transportation, just keep using the same public health tools you have been practicing. The most important step is to wear a face covering and to walk away from someone who is not wearing one.

These days, subways and trains are less crowded than they used to be, so social distancing is less difficult than it would have been at the start of the year. Stand apart from others on the subway or train platform or at the bus stop.

Try to avoid touching the handrails on stairs or escalators, the turnstiles, the gate—or anything else, for that matter. Opt for contactless payment whenever possible. While onboard, don’t touch anything if you don’t have to—sanitize your hands immediately if you need to push a button, pull a cord, or touch a pole—and try to keep at least six feet of space between you and anyone else. When you are settled in your seat, you can sanitize your hands just in case. Remember to hit the hand sanitizer again once you’re back on the sidewalk, and, when you get to your building, sanitize again if you must push or pull a door open.

How do I deal with my anxiety about going back to the office?

Anxiety is normal. We are in the middle of an international crisis; this is not business as usual. Remember, you have been practicing social distancing, mask wearing, and hand sanitizing for months now. These skills will now be applied to a new situation: commuting and the office environment. The key is to plan ahead and stay vigilant. To protect yourself and your loved ones from COVID-19, you must assume everyone around you may be an asymptomatic carrier of the virus.

And, if you feel sick, stay home. If you start to feel sick on your way to work, go back home. If you start to feel sick when you’re at the office, pack up your stuff and go home. Given the dangerousness and high communicability of COVID-19, this is not the time to tough it out.

Several months into the COVID-19 crisis, most people in the New York metropolitan area are intimately familiar with the first line of defense against the virus—social distancing, face coverings, and impeccable hand hygiene.

But, as reopening expands and more New Yorkers feel comfortable travelling, the risk of encountering someone who may have the virus increases. To combat a rise in cases due to this surge in movement, local leaders have implemented quarantine guidelines.

In this Q & A, Krystina Woods, MD, Hospital Epidemiologist and Medical Director of Infection Prevention at Mount Sinai West, answers questions about quarantine and explains why it is an essential tactic in preventing the spread of COVID-19. 

Who needs to quarantine? Why does it last 14 days?

Quarantine is recommended for someone who has had close contact with an individual who tested positive for COVID-19 as well as anyone who returns from international travel. Quarantine is required by law if someone has returned to New York State from one of the states listed on the quarantine list, as ordered by Governor Andrew M. Cuomo. This list also applies to residents of and visitors to New Jersey and Connecticut, where governors have put the same order in place. The list of states changes rapidly, so make sure you keep up to date. 

While we are still learning more about COVID-19, we know that patients typically develop symptoms between 2 and 14 days after being exposed to the virus. Quarantine guidelines are in line with this 14-day exposure window.

I just returned from a COVID-19 hot spot and need to quarantine. Does that mean I cannot leave my apartment for the entire two weeks?

If you are on quarantine you should not leave your apartment. In fact, it is against the law to do so if you are returning from a “hot spot” state.

Thankfully, we can get just about anything delivered. So, those who are under quarantine should plan on having groceries and other necessary items delivered. Also, you should not socialize with anyone outside of your household. Do not invite people over until your quarantine is complete.

If someone in your household did not travel to the COVID-19 hotspot and does not require quarantine, you should quarantine yourself from those household members.

What should I do if I begin exhibiting COVID-like symptoms during quarantine?

If you begin to exhibit symptoms of COVID-19 while quarantining, step back and consider how you are feeling. If you are well enough to treat yourself at home with rest, fluids, and medication for fever, then you should do so.

If you are not well enough to stay home, if your symptoms suddenly worsen, or if you are experiencing trouble breathing, difficulty maintaining consciousness, confusion, chest pain/pressure, or have blue lips, you should seek medical help immediately. If you need an ambulance to bring you to the emergency room, let the dispatcher know that you are having COVID-like symptoms. This will allow emergency medical personnel to take the proper precautions when taking care of you.

If I remain asymptomatic throughout the 14-day quarantine, should I still get tested for COVID-19?

No. If you have completed your 14-day quarantine and have not experienced symptoms throughout, you do not need to get tested for the virus.

Do you have any more advice for those who will need to self-quarantine?

If you are sharing your home with someone who does not need to quarantine, make sure you have ample cleaning supplies—particularly if you don’t have a separate bathroom—so you can clean high-touch surfaces like faucets, the toilet flusher, door knobs, and shower door handles. If possible, sleep in a separate bedroom–with the window open to allow for fresh air to circulate–and remain in that bedroom/separate space for as much of the day as possible. If you need to leave your separate room, make sure to wear a face covering and try not to touch anything more than is necessary.

Also, make sure you have a COVID-19 emergency care kit, stocked with a working thermometer and non-expired fever-reducing medications. And keep your doctor’s phone number handy, just in case you develop symptoms that require medical attention.

Remember, the purpose of the quarantine is to prevent spreading COVID-19 throughout our community. Currently, the New York metropolitan area has a very low COVID rate, and we want to keep it that way. Although you may feel well, those without symptoms have the potential to spread the virus. So it is important to take all precautions.

If you are one of the many New Yorkers who have missed the bench press, the elliptical, and the free weights at your local fitness center, you are in luck. Governor Andrew M. Cuomo officially gave the green light for gyms throughout New York State to open on Monday, August 24, with Mayor Bill de Blasio authorizing indoor workouts throughout the five boroughs starting in September.

Establishments will need to operate with a limited capacity and follow a slew of safety protocols. However, there are still a few things New Yorkers should keep in mind before heading back. Waleed Javaid, MD, Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai, explains what every fitness enthusiast needs to know before heading back to the gym.

What precautions should you take when heading back to the gym?

There are three critical elements that we all need to consider:

Wear a face covering during all social interactions—this includes your gym workouts. Be sure to have on a surgical mask or a cloth face covering that shields your nose and mouth.

Hand hygiene is extremely important. When you enter and leave the gym, you should wash your hands with an alcohol-based sanitizer. Also, sanitize your hands when switching between machines or using new equipment.  

Maintain social distance as much as possible. Make sure you are keeping six feet away from everyone all the time. There will be exceptions to this rule when we might have to walk past somebody. That is fine, but should be limited.

Last, remember that we are still in the midst of a pandemic. So, if you are ill, you should not be going to a gym or be out in any public setting.

Are there health practices that gym goers should look for at their fitness center?

The Centers for Disease Control and Prevention (CDC) has come out with recommendations for gyms that include social distancing, masking requirements, making sure that hand sanitization is available, and limiting the amount of people who will be in the gym at any given time. In addition to the CDC’s guidelines, the New York State Health Department has issued air filtration guidance for establishments. Those planning to head to their gym should check that it regularly follows these guidelines.

I plan to hit the gym. Are there activities that are high risk for spreading COVID-19 that I should avoid?

Higher risk activities include anything that requires you to be close to another person—for example, bench presses. If your workouts involve close contact with another person, it might be helpful to have a regular gym buddy or maybe even a small group of people that you work out with regularly. But, you will need to make sure that everybody you work with or work closely with is extremely careful with their activities outside of the gym. Also, any activity that will require you to take your mask off should be avoided. For example, if you typically run on the treadmill for an hour, may not be able to wear a mask.  

Everyone should prepare to adopt these key practices for next six to eight months while we work on an effective treatment or vaccine for COVID-19.

Is the virus spread through sweat?

There is no clear evidence that COVID-19 is spread through sweat. We do know that the virus is spread through contact with respiratory droplets emitted from the nose and mouth. So, if a person with COVID-19 touches their face, they can contaminate their hands and other surfaces with the virus.

Studies have shown that people touch their face, on average, five times an hour. So, in terms of COVID-19 prevention, I would not worry about sweat in the gym. I would be more concerned about wiping down equipment with a disinfectant before use.

How risky is it to head back to the gym?

I’m not sure if I can put a number on the risk. It’s important to remember that any activity that increases our social interaction is going to increase our risk. Going to the grocery store, going out on the street with many people—that is risky. Heading to an indoor gym where people might be breathing heavily and where there might be close contact with others is certainly a higher risk.

One thing that New York City has recommended is that gyms install enhanced filters to increase air circulation. In addition to wearing a face covering, practicing social distance, and having excellent hand hygiene—I believe increased air circulation in these enclosed spaces might decrease the risk.

Do you have any additional advice for those thinking about hitting the gym?

I think following COVID-19 prevention guidance is going to be important. Social distance, wear a face covering, wash your hands extensively, and stay away from those who are obviously ill.

In the case of gyms, it will be especially important to make sure that machines and any fitness equipment that you use are disinfected properly. This should enhance your ability to stay away from this illness while working out at the gym.