Let’s Talk About COVID-19 Prevention
With treatments still experimental and hospital beds limited, protecting yourself against the novel coronavirus is imperative. You can’t control everything—but here’s what you can.by Erin L. Boyle Health Writer
The proliferation of information about the novel coronavirus is mind-boggling, and the rapidity with which new discoveries are happening makes it hard to stay up to date, minus those who have virology degrees. There are still worrisome unknowns: If you’ve had it, are you immune? What’s the current best treatment? How do we move forward without widespread testing? With those looming Qs still unanswered, and so much of it out of our hands, it’s anxiety-provoking. Like always, your best course of action is focusing on what you can control—and these prevention techniques will help keep you, and others, as safe as possible.
Our Pro Panel
We went to some of the nation’s top experts in infectious disease to bring you the most up-to-date information possible.
Amesh A. Adalja, M.D.
Internist specializing in infectious diseases and critical care
University of Pittsburgh Medical Center
Jeanne D. Breen, M.D.
Infectious disease specialist, Assistant Clinical Professor, Laboratory Medicine
Yale School of Medicine
New Haven, CT
John Swartzberg, M.D.
Clinical Professor, Emeritus
UC Berkeley - UCSF Joint Medical Program, Infectious Diseases & Vaccinology Division, UC Berkeley School of Public Health
Experts believe COVID-19 is mainly spread through person-to-person transmission—someone sneezes, coughs, or talks within 6 feet of you, you inhale the droplets they expel doing so, and voila. Other less common ways it may spread include through the air, on contaminated surfaces, and through contact with the feces of someone who is sick. The main take-home message here is wash your hands and stay 6 feet away from people you don't live with.
Yes, they can, especially properly fitted N95 masks, which filter out at least 95% of airborne particles—but Centers for Disease Control and Prevention (CDC) officials have asked the general public to avoid using these masks, leaving the limited supply to healthcare workers. Instead, the CDC has advised people to wear cloth masks when they must be in public to help prevent asymptomatic transmission of the disease.
Here’s what we know so far: A recent New England Journal of Medicine article found that COVID-19 stays on stuff for varied amounts of time, with various levels of contamination, including copper (4 hours), plastic (3 days), stainless steel (3 days). Other studies have looked at the larger class of coronaviruses and found they lived on paper for 4 to 5 days and fabric up to 4 days. This is likely true of the novel coronavirus as well.
Spray away. Use alcohol solutions with at least 70% alcohol and common EPA-registered household disinfectants to clean surfaces. If you can't find ready-made disinfectant sprays, make your own diluted household disinfectant wipes: mix 1/3 cup bleach per gallon of water and spray this mixture on paper towels. Wipe down kitchen and bathroom counters, door handles, remote controls, light switches, devices, and cell phones.
What Is COVID-19, Exactly?
First appearing on the scene in the city of Wuhan, China, in December 2019, the novel coronavirus belongs to a family of viruses called “coronaviruses,” which were discovered in the late 1960s. The new disease strain is technically known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the illness that the SARS-CoV-2 virus causes is COVID-19.
The virus, which has now infected more than 4 million people around the world, can cause mild or severe respiratory symptoms, the most common being fever, dry cough, and shortness of breath, but many people are asymptomatic or experience other issues. These include signs that often replicate the common cold or the flu, ranging from nausea to headaches to diarrhea and runny noses.
If you think you may have COVID-19, call your doctor ASAP to determine if you’re eligible for a test or if you should self-quarantine. If you’re wondering how you got it, here’s the deal.
How Is the Novel Coronavirus Transmitted?
There’s a ton we’re still learning about the ways this virus gets into your system, but the most likely source is another person. If you are near an infected person who coughs or sneezes, you may inhale droplets of their virus-carrying mucus or saliva and can become infected yourself. Similarly, if someone with the virus coughs into their hand, and you touch that hand and then touch your own mouth, nose, or eyes, the virus can find its way into your system.
You may also get it by touching infected surfaces or objects. Studies are ongoing, but several have shown the coronavirus to live on materials like plastic, steel, paper, and cloth for up to four—maybe even five—days. (Tips on how to safely kill the virus on surfaces are below, don’t worry!)
It’s also possible, though less likely, that the virus can be transmitted through the air itself—meaning a sick person walking down the street breathes out, and a few seconds later, you walk by the same spot and breathe in, and the droplets in the air enter your system. And COVID-19 may live in feces and could be transmitted if you’re caring for a sick person and come in contact with their stool.
These are the most likely methods of transmission, but scientists continue to learn more every week (and we’ll keep you up-to-date with any major changes). In the meantime, defense is your best offense: The most effective way to stop the spread of this disease is to minimize your odds of coming in contact with it in the first place. And with that…
Top 10 Precautions to Protect Yourself From COVID-19
Employ these strategies to keep yourself as safe as possible during this global pandemic:
1. Social distance. The phrase has become as famous as Jay and Bey, and for crucial reason: Staying home with as few people as possible is the best way to help contain the virus. The more people you’re around, the higher your chances of being exposed. Only leave the house for necessary reasons: grocery shopping, picking up prescriptions, essential doctor’s appointments, and solitary exercise. This means no playdates or sleepovers for the kids, no playgrounds or basketball courts for your workouts, and no congregating on street corners.
2. Wash your hands. Often. Any bar or liquid/gel soap is fine. The most important thing is to be thorough. We'll give you more detailed advice on handwashing, below.
3. Use hand sanitizer. When you don’t have access to soap and water, use a nickel-size squirt of hand sanitizer with at least 60% alcohol, and rub it all over your hands until they’re dry (for at least 15 seconds). It’s not as effective as washing with soap—it kills bad agents with its high alcohol content but doesn’t slough it off your hands the way soap and water does—but if you’re in a pinch, or, say, riding on public transportation and can’t wash your hands right away, this is the stuff you want.
4. Avoid touching your face. Really, really try hard not to touch your eyes, nose, or mouth with unwashed hands, as this gives the virus easy access into your body. This area is called the “T” zone and studies show that we touch our T zones between 16 and 23 times an hour. Do whatever it takes: Wearing gloves may be a helpful reminder, but know that gloves themselves don’t stop the spread, so you’ll still need to wash your hands, ideally first with your digit-covers on, and then again after you remove them.
5. Wear a cloth mask when you can. In early April 2020, the Centers for Disease Control and Prevention (CDC) recommended that Americans wear cloth masks to help slow the spread of COVID-19. The announcement came after studies showed that people with the virus—but no symptoms—can still spread the disease. The CDC asked that people leave surgical masks and N-95 respirators to medical professionals because of shortages in these critical supplies, and instead purchase cloth masks or make face coverings at home.
6. Stay home when you’re sick. Best case: You’re already working from home with a job considered “non-essential.” But if you have to go to work or are an employee in an “essential” business (like healthcare, drug stores, and grocery stores), it’s important to stay home when you’re sick, as a weakened immune system could make you more vulnerable to the virus. Talk with your employer about taking sick days and ask a friend or family member to purchase necessities that can’t be delivered.
7. Cover yourself. If someone near you coughs, let’s hope they cough into a tissue (and you should, too). No tissue? Try an elbow. Either way, if you’ve been around someone who is sneezing or hacking, be sure to wash whatever you’re wearing after since COVID-19 can live on fabric.
8. Skip the handshake (and the hug). Because they can put you at risk of those nasty infected droplets, let people know ahead of time that you’re currently not shaking hands. Go for a head nod, elbow bump, or the universally accepted air high-five.
9. Avoid touching surfaces with bare skin. To ring a doorbell, open a door, or push an elevator door button, get creative. Carry a paper towel (then toss it after) or punch the button with your knuckle (you’re less apt to knuckle your face, after all, but still wash thoroughly with soap and water after.) Use a lipstick tube to ring doorbells, bottle opener to turn sink knobs, and whatever else you think of. Just be sure to wash the items thoroughly later.
10. Use supplements with caution. You may have heard about Chinese doctors using high levels of vitamin C to combat COVID-19 in hospitalized patients—more research is needed, but it’s not recommended to try this at home. In fact, it’s best not to take any supplements for virus prevention, as there is little research on possible negative effects. If you do get COVID-19, zinc lozenges might (we stress “might”) help, as zinc has been shown to help shorten the duration of common cold symptoms. Don’t use zinc spray in your nose, however, because it can damage your sense of smell.
So How Do You Wash Your Hands Properly?
Seems like a “how do you cut your steak properly” kind of Q, but there really is a science to proper handwashing.
First: Any bar or liquid/gel soap is fine. You don’t need an antibacterial soap, because this is a virus, not bacteria. And, actually, antibac soaps put us at risk for “superbugs”—bacteria that’s harder to fight off—so it might be better to avoid using them anyway.
Here’s how to wash your hands:
Rinse your hands with water
Turn the water off without touching the faucet (use a paper towel or your elbow if you can—if you can’t, leave the water running)
Lather soap all over your hands and between your fingers and under your nails
Do so for at least 20 seconds. Need some help counting those seconds? Sing the alphabet song to Z (you know the one… A, B, C, D, E, F, G…), or happy birthday twice, or parts of pop songs (think the chorus in Dolly Parton’s “Jolene” or Lizzo’s “Truth Hurts”)
Rinse soap off with water
Dry your hands with a clean towel, air dryer, or the air (in a public bathroom, don’t use a shared drying method, like a towel—though one in your home is just fine!)
Here’s why washing your hands works:
It turns out, COVID-19 has an Achilles heel.
Viruses either have an envelope around them made of lipids (fats), or they don’t. COVID-19 happens to be an envelope virus. It depends on that envelope for its survival. Things like soap, and disinfectant like hand sanitizer with 60% and higher alcohol content, disrupt that envelope, rendering the virus no longer viable.
More on that: The soap molecule has a hydrophobic end and a hydrophilic end. The hydrophilic end binds with water, and the hydrophobic end repels water, binding with fat. So soap accomplishes two good things at once—pulling the virus’s fats off your hands, literally removing it, as well as destroying its all-important envelope, thus killing it.
Here’s when to wash your hands:
Before, during, and after handling food
After using the bathroom
After blowing your nose, coughing, or sneezing
After touching high-touch surfaces like door handles, public transportation surfaces, tables, and desks. This isn’t always practical given how many surfaces we touch each day, so if you can’t do this, avoid touching your eyes, nose and mouth, and wash your hands when you get home.
When you return from being in the public
When you handle anything that others have handled
3 Ways to Kill the Coronavirus
Now that you’ve successfully wiped any possibility of COVID-19 right off your hands, let’s move on to protecting the rest of your world.
To keep kitchen and bathroom countertops and your floor (especially in high-traffic entrance areas like front foyers and mudrooms) COVID-free, first clean or mop hard surfaces with soap and water. Then, apply disinfectant. According to the CDC, alcohol solutions with at least 70% alcohol and most common EPA-registered household disinfectants (find those here) should be effective.
The CDC also approves of using homemade diluted bleach solutions, following the manufacturer’s instructions for application and proper ventilation. (Don’t use expired bleach—it isn’t as effective.) Here’s how to DIY:
Mix 1/3 cup bleach per gallon of water or 4 teaspoons bleach per quart of water.
Pour diluted bleach solution into a spray bottle (an empty bottle or mason jar works too, if you don’t have a spray bottle).
Hold bottle 10 inches from surface and spray, then gently rub solution in with a clean paper towel.
You can also spray the solution directly onto paper towels then use them to wipe objects as you would with impossible-to-find store-bought disinfectant wipes.
For soft surfaces like rugs and drapes, clean with the manufacturer-suggested cleaning products and then, if possible, put them in the washing machine using the hottest setting. This, plus laundry detergent, should kill the virus.
Clean Household Items
Think doorknobs, your remote control, light switches, mousepad, bottom of your backpack or handbag, and so on need to be cleaned. This includes any and all electronics—your tablet, laptop keyboard, and cellphone (especially that cellphone) can be harbingers of nasty. Use a microfiber cloth and disinfectant to sanitize non-electronics. For electronic devices, unplug and turn off, then check the manufacturer instructions first to make sure a disinfectant-dampened cloth won’t damage anything.
Wash Reusable Grocery Bags
Although it’s unlikely that COVID-19 will spread via your tote bag, if you regularly use these bags to bring home food and other items, it’s theoretically possible. To remove germs, use water and soap, or throw them in the washing machine if the bags allow. Note: Some stores are requiring that you bag your own items if you bring your own bags. Even if they don’t require it, the fewer hands touching your food at this point, the better, so don’t be afraid to volunteer!
3 Ways to Shop Safely
It used to be almost everyone’s favorite pastime, but these days, the less in-person shopping you do, the better. Still, we’ve all got to eat somehow! These strategies will help you get your essentials safely during the COVID-19 crisis.
Get Creative for Sourcing Essentials
Is your supermarket still low on toilet paper? Use social media and small business websites to see what’s available in your community: Office supply shops might have disinfectant spray, some distilleries are making hand sanitizer, and local restaurants may have paper towels and toilet paper they can’t use while closed. Buying locally can help keep local businesses, and your neighbors who own them, afloat. Just be sure to choose delivery, curbside pickup, or take-out to lower your odds of virus infection.
Shop, Don’t Hoard
If every time you go to the store or shop online, you put one or two extras in your cart, we get it. It’s good to be prepared. Stuff on sale? Take advantage and buy a few more. But please, for the love of all things good and kind, do not buy every can of baby formula, box of diapers, and toilet paper rolls in sight. That behavior has a domino effect—both on people’s psyches and the actual supply chain. The end result is that next time you need things, they’ll likely be out of stock. Take one and leave one, and trust that the store will restock by the time you’re running low again.
COVID-19 can live on cardboard for up to 24 hours, a study found, so it’s possible that it’s on the paper bills in your pocket, too. Other countries hard-hit by the novel coronavirus have taken this threat seriously.
South Korea’s central bank quarantined cash from local banks in a safe for two weeks, until any possibility of the virus living on the surfaces was eliminated. In China, lenders were required to both disinfect cash and keep it in safes for 14 days (depending on the region in which the money originated). The U.S. hasn’t issued such rules, but still, now might be the time to bust out your credit card (wiped down with disinfectant, of course) or sign up for Apple Pay if you have an iPhone.
7 Ways to Stay Safe if You’re at High Risk
If you’re over 60 or in one of the other at-risk groups for a severe reaction to the disease (meaning, if you have one or more risk factors like high blood pressure, diabetes, are immunocompromised, or have a chronic lung condition), you might already know about prevention techniques—like wearing a mask and avoiding close social contact—because flu season poses a real risk to you already.
You’re also probably tired of hearing that “most people will have mild symptoms”—you’re not most people, but your health and well-being matter just as much as the 80% who won’t get seriously sick from COVID-19. For you, avoiding this disease is of paramount importance. Here’s what the CDC recommends doing:
1. Take everyday precautions. Keep at least 6-feet of space between yourself and others.
2. Avoid public contact. If you have to be in a shared space, wear a mask, keep away from anyone who is sick, limit close contact, and wash your hands often.
3. Stick with the smallest group possible. If you live with someone, live with them and only them. Avoid crowds of 10 or more, or even small gatherings (think, a dinner party with extended family), because flattening that curve means keeping your exposure to others as minimal as possible.
4. Avoid non-essential travel. Obvious, no? Now is not the time for a road trip to Vegas.
5. Stay home. If there’s a COVID-19 outbreak in your community, do everything you can to avoid going out.
6. Talk with your doctor. Knowing your risks can help you minimize them. Is there anything else you should, or can, be doing to stay safe?
7. Practice telemedicine. The U.S. Food and Drug Administration issued guidance during the pandemic to allow at-home monitoring of health measurements including blood pressure, body weight, and electrocardiography. Take advantage of this. Stay healthy, stay in communication with your doctor via the internet, and stay safe.
The bottom line, whether you’re at high risk or just regular risk, is that this disease can be serious, and one of the disturbing parts is how much we still don’t know about who it attacks, why, and what any long-term side effects will be of getting COVID-19.
The advice here will help keep you safe and may prevent you from getting the virus. But no plan is foolproof. If you start feeling ill, call your doc and request a test. If it’s positive, at least you know you’re not alone: You’ll be joining the ranks of well over 4 million people afflicted as COVID-19 marches on.
About COVID-19: The New England Journal of Medicine. (2020). “A Novel Coronavirus from Patients with Pneumonia in China, 2019.” nejm.org/doi/full/10.1056/NEJMoa2001017
How Do I Get the New Coronavirus: World Health Organization. (2020) “How Does COVID-19 Spread?” who.int/news-room/q-a-detail/q-a-coronaviruses
Social Distancing: Science. (2020). “Substantial Undocumented Infection Facilitates the Rapid Dissemination of novel coronavirus (SARS-CoV2).” science.sciencemag.org/content/early/2020/03/24/science.abb3221.long
How Long Contaminants Stay on Items: The New England Journal of Medicine. (2020). “Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1.” nejm.org/doi/10.1056/NEJMc2004973
Use of Zinc: The Journal of Family Practice. (2011). “Zinc for the Common Cold—Not If, But When.” ncbi.nlm.nih.gov/pmc/articles/PMC3273967/
Cleaning/Sanitizing: Centers for Disease Control and Prevention. (2020). “How to Clean and Disinfect.” cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/disinfecting-your-home.html
How to Protect Yourself if High-Risk: Centers for Disease Control and Prevention. (2020). “Protect Yourself.” cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html
Prevention Tips: Centers for Disease Control and Prevention. (2020). “Know the Facts About Coronavirus Disease 2019 (COVID-19) and Help Stop the Spread of Rumors.” cdc.gov/coronavirus/2019-ncov/about/share-facts.html
Chronic Diseases and COVID-19: JAMA. (2020). “Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China.” jamanetwork.com/journals/jama/fullarticle/2762130