A CITIZEN’S GUIDELINE TO COVID-19 SELF-PROTECTION

12 Common Sense Practices that are Easy to Do, Low-Risk and Might Yield Benefits

Not endorsed or censored by any governmental agency.

1.      Only you can protect yourself and your community from a microscopic airborne coronavirus that can remain infectious on surfaces for hours to days. In a pandemic, public health is everyone’s responsibility.

Nobody can see, smell or taste the novel SARS-CoV-2 virus. Many positive tests are in asymptomatic persons. Therefore, all persons with whom you come in contact are potential sources of contagion. Those persons simply might have occupied the same space and touched the doorknobs, bathroom fixtures or other surfaces hours or possibly even days before you were there. You can take simple measures to protect yourself and others. The following recommendations are all in the “cannot hurt and might help” category.

2.      If you are not feeling sick and you must go out in public, it is totally okay to wear a cloth mask or a scarf, re-usable mask or even a bandana to cover your nose and mouth. Completely acceptable in Asia, the rest of the world can adopt this pragmatic and harmless practice.

The medical-grade N95 masks and other disposable personal protective equipment (PPE) must be preserved for the frontline medical and public health workers treating, testing and tracing cases for isolation or quarantine. That said, covering your mouth and nose might limit your exposure to airborne droplets but likely will diminish other people’s exposure to you, if you happen to be an asymptomatic carrier (i.e. a “spreader”). Make a fashion statement that reinforces public health. It is bad enough to be coughing and sneezing on other people, but you could just be breathing on them transmitting the novel coronavirus, and vice versa. This is mitigation, not a guarantee of protection.

3.      Cover your eyes all the time. The whites of your eyes are covered with a mucous membrane (the conjunctiva) that have epithelial cells, practically identical to the respiratory tract. Through the tear ducts, the nasal passages are anatomically connected to the lacrimal system. While goggles and wraparound safety glasses are better than regular prescription glasses, even regular sunglasses can provide some protection from droplets and other particulate matter. The naked eye is exquisitely vulnerable to certain viral particles and touching it should be with freshly washed hands only. Coronavirus has been reported to present with “pink eye” in 1 in 200 cases.

4.      When outdoors, wear cloth gloves or work gloves (not “surgical” Latex or nitrile gloves.) Disposable gloves have their place in the medical community, commercial food preparation and disinfecting contaminated spaces. The rest of the time you can wear cloth gloves when outside of the home. Like the cloth mask, this reminds you not to touch your eyes, nose and mouth. These would be removed of course for eating, hygiene or toileting. You can use multiple pairs and wash them frequently. Wearing gloves can protect your bare hands from inadvertently touching contaminated surfaces, and you probably will not put your gloves in your nose, mouth or eyes.

5.      Wash your hands twice after using a public restroom. Try to touch the fixtures with your bare hands as little as possible. Leave the restroom with nothing but soap and water on your hands. Use your paper towel to open the door, since you have no way of guaranteeing that all the previous users were scrupulously hygienic.

6.      Cover your hair, wear a hat or even a hoodie. Everyone sheds hair and skin cells. Keep yours to yourself. Whether this is a mode of transmission or not is impossible to know, but your hair is a potential reservoir for particulate matter or droplets that get on it when you are outdoors or in public spaces.

7.      Keep outdoor clothing separate from clothing for your indoor space. Change out of your outdoor clothing and shoes immediately upon your return home. Just as you would take off your wet rainwear, leave the outside (“viral rain”) away from your living space.

8.      Carry your own ink pen for signing receipts, and if possible, a capacitive pen for touch screens (smartphones and merchant terminals). This is an easy way to prevent inadvertent hand-to-hand transmission, especially in highly travelled areas. You can carry two pens, one for your gloved hand and one for your bare hand. Do not lend your pen(s) or smartphone to anyone.

9.      Practice washing your hands before every meal. Use wiped-down silverware or chopsticks as much as possible so you do not introduce germs on your hands directly into your mouth.

10.  Eat a diet rich in beta-carotene (a Vitamin A precursor) or take a multivitamin to bolster your immune system.

Dietary sources include most dark green, leafy vegetables like broccoli and spinach, as well as orange and yellow colored vegetables and fruits like mango, papaya, peaches, apricots and goji berries, plus eggs, fortified milk (including non-dairy) and fortified breakfast cereals, or if you prefer, cod liver oil.

While too early to know for the novel coronavirus, Vitamin A supplementation, for example, in the 0-5-year-old age group, in malnourished populations, causes a reduction in all-cause mortality, predominantly from respiratory and diarrheal diseases, as well as vision loss from night blindness, xerophthalmia and keratomalacia. The attack rate of other respiratory viridae (e.g. respiratory syncytial virus, RSV) can be lessened with prophylactic Vitamin A supplementation in hyporetinolemic persons. It might help with the coronavirus, and beta-carotene has a good safety profile.

As a novel virus, uninfected persons of any age are immunologically na?ve to SARS-CoV-2. While the data might not be available in this time of crisis, any reduction in total infections, attack rate, number of severe cases requiring hospitalization, acuity of symptoms, length of hospital stay, or fatality rate would be beneficial from a public health point of view. Increasing your dietary vitamin A levels with beta-carotene is an “oldie, but a goodie,” and generally considered “safe.”

11.  If you must eat with your hands, consider the Indian tradition of eating with your right hand only. If you have trouble remembering to do this, as the saying goes, “sit on your left hand, which is where it belongs anyway.” Some asymptomatic carriers have digestive symptoms, so while the fecal-oral route is uncertain for the novel coronavirus, there is good reason to prevent this form of contamination for any disease.

12.  Doom ought to be averted, but only will be if humanity collectively decides to do it. Everyone in the world better open their eyes and take the coronavirus pandemic dead seriously by protecting yourself, your loved ones and every other soul walking the planet. In combination with staying home and social distancing, these simple practices might help, won’t hurt, and certainly will be a crowd-pleaser, if we ever have a crowd again to please.

Stop mucking around. It is time to matter!

Copyright 2020 by Daniel Schainholz, MD, MPH

Permission unconditionally granted for translation and reproduction for special needs.