Dr. Nicholas D. Harrel is a General Surgeon at Summit Healthcare. He has taken time to breakdown some of the frequently asked questions related to COVID-19. Over the next few weeks, Dr. Harrel will post answers to some of these questions to ensure our communities are educated on what you can do to stay healthy.
“I have been answering COVID-19 questions for patients, friends and family for several weeks. While I am not an infectious disease expert or an epidemiologist, I am a concerned physician and can weed through a lot of the hearsay and speculation.”
Q:
Everyone says don’t touch your face.
What ways can we spread the virus?
A: Covid-19 is currently classified as a respiratory droplet virus. It can be spread through direct contact with infected surfaces or droplets and mucous membranes (eyes, nose and mouth). Droplet transmission occurs when a person is in in close contact (within 1 m) with someone who has respiratory symptoms (e.g., coughing or sneezing) and is therefore at risk of having mucous membranes exposed to potentially infective respiratory droplets. Transmission may also occur through fomites (surfaces) in the immediate environment around the infected person. Therefore, transmission of the COVID-19 virus can occur by direct contact with infected people and indirect contact with surfaces in the immediate environment or with objects used by the infected person.
Airborne transmission is different from droplet transmission as it refers to the presence of microbes within droplet nuclei, which are generally considered to be particles <5μm in diameter, can remain in the air for long periods of time and be transmitted to others over distances greater than 1 m. This is most common during medical procedures and healthcare providers wear PPE and specialized masks (N95) to help prevent transmission.
There has been only one reported case to the WHO of Covid-19 virus appearing in fecal material and none in the blood. Antibodies have been found in both, but that is not considered a guarantee of a route of viral transmission.
Q: Should I wear a mask or gloves when going out into the community?
A: Gloves stop the direct transmission from a surface to the person, but they do not stop the spread from passing the virus to other surfaces. Frequent hand washing with soap and warm water for at least 30 seconds or 60% alcohol-based hand sanitizers (that completely dry) are best. Masks can serve two functions. Certain masks like n95 will stop smaller aerosolized viral particles that healthcare workers might encounter. Regular surgical and cloth masks will stop larger particles. Masks can protect you from other infected people. If you have symptoms you should wear a mask, and even if you don’t have symptoms, you should wear a mask. Covid-19 has been shown to be spread by people who show no symptoms, but are infected. But more importantly, they will act as a constant reminder to not touch our faces. Studies have shown people commonly touch their faces 16 times an hour, that’s almost 400 times a day.
Q: Do I need to wipe down every package or groceries that I come into contact with?
A: Yes, it’s what we refer to as a best practice. Meaning it has not been scientifically proven, but it makes a lot of sense and the downside is minimal when compared to the possible benefit. The virus can live on different surfaces for different amounts of time. Things that can be left outside for 72 hours will greatly decrease the chance of transmission. Other items like produce can be washed and scrubbed with soap and water for 20-30 seconds. Other packaged items can be wiped down with rubbing (isopropyl) alcohol solutions of greater than 60% or diluted bleach solutions. The CDC recommends 5 tablespoons (1/3rd cup) bleach per gallon of water or 4 teaspoons bleach per quart of water.
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