Coronavirus cases continue to surge throughout the United States and experts say some portions of the country are beyond containment.
The wide-spread virus has a high person-to-person transmission rate and is beginning to seriously affect younger adults, not just older generations.
According to a report by the Centers for Disease Control and Prevention that tracked the first 2,500 cases in the U.S., nearly 40% of COVID-19 patients who were hospitalized were between the ages of 20 and 54.
Those who are infected and don’t require hospitalization are instructed to stay home, but that still leaves families and roommates vulnerable.
So, what can one do to keep loved ones safe while recovering at home from COVID-19? And what can caregivers do to stay healthy?
Designate personal space for COVID-19 patient
Dr. Raphael Viscidi, an infectious disease specialist at Johns Hopkins Medicine, said respiratory viruses are commonly transmitted between people with the closest and prolonged contact.
“Reports that are coming out of China suggest that many, if not most, of (coronavirus) transmissions are coming from family units,” he said.
The goal is to reduce social contact, the duration of contact and the environmental space shared with a sick person on a day-to-day basis.
That starts in the bedroom.
“It’s a very small shared environment with a high probability the virus is present,” Viscidi said. The bed itself is a surface where a sick person is depositing the coronavirus with just a cough or sneeze.
Harvard Medical School recommends caregivers use a separate bedroom while the infected person is sick. Viscidi said the recommended self-quarantine time is at least 14 days.
In addition to their own bedroom, Harvard is also recommending the sick person have their own designated bathroom so no one else in the house is exposed to contaminated surfaces.
“You spend time in the bathroom,” Viscidi said. “They’re trying to identify places where someone who’s sick is more likely to be spreading the virus.”
Bathrooms have surfaces touched on a daily basis, such as faucets, doorknobs, toilets and sink counters. They’re also relatively small, increasing the risk of exposure.
Home ventilation & good airflow
When a person is sick with coronavirus, they release the virus into the environment through coughing or just breathing.
The virus may remain infectious in the air for hours. A study published Tuesday in the New England Journal of Medicine found viable virus could be detected in the air for up to three hours.
“We’re not by any way saying there is aerosolized transmission of the virus” but this work shows the virus stays viable for long periods in certain conditions, so it’s theoretically possible, study leader Neeltje van Doremalen at the National Institute of Allergy and Infectious Diseases told the Associated Press.
The virus is transmitted through droplets that fall quickly and can exist on surfaces as well, perhaps for as long as three days depending on conditions. Although, Viscidi noted that transmitting the virus through a surface is very low unless an individual is constantly touching the surface for a long time.
In order to minimize that risk, the CDC recommends having good airflow or ventilation in the form of air conditioning or a simple open window.
How to serve food & keep social distancing
Dr. Joseph Khabbaza, a pulmonary and critical care physician at the Cleveland Clinic, said all standard rules apply when it comes to food preparation.
Washing hands and disinfecting kitchen surfaces are common practices in the kitchen, even if no one is sick in the house.
“The frequent cleaning of surfaces is really the key in those settings,” he said.
Khabbaza also said it’s important to maintain the recommended distance of six feet away from a person in all rooms but especially in the kitchen.
There are a number of ways to serve an infected person food, Khabbaza said. It can be left by the door to be retrieved or left in the kitchen for the sick person to come out and eat.
Caregivers can enter the room as long as the patient is wearing a mask. The caregiver also could wear a mask if more are available.
Although there is no specific diet for coronavirus patients, Khabbaza said they may not have an appetite and may only want soup or crackers.
Harvard Medical School advises family members not to share household items such as dishes, drinking glasses, cups or eating utensils with the sick. After use, they should be washed thoroughly.
Keep the door closed & limit circulation
Keeping the sick person's bedroom and bathroom door closed can provide an extra layer of precaution.
“It’s an extra physical barrier that no droplets are leaving that space,” Khabbaza.
However, he points out it’s not likely a particle is able to travel far, survive outside the body and infect a healthy person.
Wiping surfaces, frequent hand-washing and avoiding the face are more crucial to minimize transmission of the virus even in settings that aren’t contained.
Communicating with your loved ones without contact
Limiting contact is the name of the game, and in our modern world, it’s become much easier with the use of technology.
Family members can limit contact by using computers, cellphones and tablets to message and call loved ones while they are sealed safely inside their designated bedrooms.
Khabbaza stresses the importance of comforting sick people in their time of need.
“It’s almost impossible not to feel that anxiety just with this climate and environment,” he said. “There’s a big benefit of minimizing that anxiety, making sure that you’re relaxed around your loved one is important.”
He suggested using FaceTime or Skype to communicate with people who are sick instead of just messages and calls.
“That’s one way you can have lots of conversation and laugh together and see each other smile while still being at very low risk of transmission,” Khabbaza said.
Dealing with trash can waste
The CDC and Harvard Medical School advise caretakers to place all used disposable gloves, facemasks and other contaminated items in a lined container before disposing of them with other household waste.
While Viscidi said it’s not necessary to double-bag garbage, Khabbaza said extra bags couldn’t hurt and it’s never a bad idea to use gloves while handling waste.
Tissues shouldn’t be harmful after they’ve already made it to the bottom of a wastebasket.
"Particles and droplets shouldn’t just be aerosolized as a tissue in the wastebasket," he said. "Once it's in there, it won't go anywhere."
However, he said it could be helpful if the sick person ties up the garbage bag before the caregiver comes in and takes it out. This could minimize anxiety when entering the room.
"You won't be able to take care of your loved one as well if your nerves are taking over," he said.
Pet interaction
Although there haven’t been reports of pets or other animals becoming sick, the CDC recommends restricting contact with them while sick with COVID-19 until more is known about the virus. This includes petting, snuggling, being kissed or licked and sharing food.
If possible, have another person in the house who’s not sick to care for the animals. If that’s not possible, make sure the sick person washes their hands before and after interacting with pets and wear a face mask.
Viscidi said limiting pet interaction benefits people in the house more than the pet itself.
“If you’re having severe symptoms … and you’re petting them constantly, there’s going to be some virus on the dog,” he said. “And then somebody else comes by and pets the dog.”
The dog isn’t going to get infected, but it can act like a contaminated surface for other people to get sick.
How to properly clean the house
As many public health experts have reiterated, the key to keeping people healthy is hygiene.
The CDC defines cleaning as the removal of germs, dirt and impurities of surfaces, and defines disinfecting as using chemicals to kill germs on surfaces. The agency recommends disinfecting surfaces after cleaning to further lower the risk of spreading infection.
The CDC recommends taking the following precautions when disinfecting the house while a family member is sick with COVID-19:
So what do you do with the waste?
Be aware that there can be contaminated residue on used tissues, masks and gloves from someone sick with the coronavirus that can be dangerous to others that live in the home. Here are some ways to correctly dispose of the contaminated items.
SOURCE USA TODAY reporting; Stanford University; World Health Organization; Centers for Disease Control and Prevention