As the novel coronavirus known as COVID-19 spreads around the United States, guidance for prevention and containment are being issued by the Centers for Disease Control and Prevention (CDC). People who have fever or respiratory symptoms, such as coughing and difficulty breathing, are being advised to stay at home except to get medical care. Krystina Woods, MD, Hospital Epidemiologist and Medical Director of Infection Prevention at Mount Sinai West, helps us understand the “dos and don’ts” of self-quarantining, and what that may mean for New Yorkers.
The CDC recommends staying home except to get medical care. How and why is this different from other respiratory diseases?
Many of the CDC guidelines for quarantine might be used by someone who has a severe case of the flu. But because we are just starting to understand how COVID-19 is being spread, and how long the incubation period is, the guidelines are going to be necessarily conservative.
The CDC recommends that the patient stay in a separate bedroom. And if possible, use a separate bathroom.
Yes, and that might pose a challenge to New Yorkers. Certainly, if there’s a separate bedroom and bathroom for the patient that would be best. Another strategy for roommates and spouses to consider: Is there a friend or family member the roommates or spouse can stay with? But even in small apartments, there are things you can do to protect each other. In studio apartments, separating the beds as much as possible is advisable. And because of the close proximity, the patient, roommates, and others in the household should wear masks.
If you share a bathroom, make sure you don’t share towels. The patient might bring their towel back to their own room if they have a separate bedroom. Always wipe down surfaces such as the sink, toilet handle, light switches, and door knobs with a household cleaner with disinfectant. Don’t share personal items such as toothbrushes or drinking glasses.
If the patient has their own room, they should wear a mask when they come out. And even though it’s winter, cracking a window for some ventilation is a good idea.
What precautions should people take concerning meals?
If the spouse or roommate can prepare meals for the patient, that would be best. Meals can be left outside the patient’s door, so the patient doesn’t need the kitchen. You can even text when the meal is on the way, or to communicate back and forth. Disposable plates and utensils might be an option, but not totally necessary. Washing the patient’s dishes immediately after use, and then washing your hands, should be enough.
What additional precautions should family, spouses, or roommates take?
Others in the household should wash their hands as much as possible. We touch so many things that could be contaminated without thinking: phones, microwaves, remote controls. Wash your hands before you leave home and when you get home. Wash them after touching anything the patient could have touched or used: bedding, dishes, the bathroom doorknob. Try not to touch your face, especially your eyes, nose and mouth.
If the patient has a medical appointment, it’s hard to get there without public transportation. What advice would you give?
People should avoid using subways, buses, taxis, or ride-sharing services if they’re sick. You should only go to medical appointments that are absolutely necessary, not routine appointments. Maybe a friend can give you a ride for appointments that are essential. If so, you might want to sit in the back seat instead of the passenger seat, and open the window.
How long will the self-quarantine last?
It’s hard to provide a time frame for any self-quarantine because it depends on the severity of the disease. Some people may have a very mild case, and some may have severe symptoms. The duration of symptoms varies from person to person. But certainly, a person should be quarantined while they have a fever or respiratory symptoms such as coughing or difficulty breathing. The New York Department of Health will be monitoring each case of COVID-19 very carefully, and they will provide guidance.