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Medical experts answer common questions about COVID-19

Written By: Wendi Hawthorne, UTHealth | Updated: April 5, 2020
sewing medical masks

As new data on COVID-19 continues to roll out on a daily basis, questions are asked about who’s at risk, how it’s being transmitted, and what additional precautions people need to take. Experts at The University of Texas Health Science Center at Houston (UTHealth) help break it down.

How the virus spreads

According to the World Health Organization (WHO), transmission of COVID-19 occurs through respiratory droplets – which means being in direct contact with someone who has respiratory symptoms (coughing or sneezing). It can also occur indirectly by touching a surface or sharing an object touched by an infected person. WHO says airborne transmission is possible, but only in specific settings where respiratory droplets become airborne – for example, being in the room where an infected person is receiving a nebulizer treatment, or during an intubation procedure.

So, what do the experts say? Handwashing and social distancing are still your best measures of protection against COVID-19. “Social distancing works for viruses like COVID-19 that are transmitted through respiratory droplets,” said Michael Chang, MD, an infectious disease specialist with McGovern Medical School at UTHealth.

Can asymptomatic people transmit the virus?

According to the U.S. Centers for Disease Control and Prevention (CDC), new data suggests that people may be able to spread the virus before they develop symptoms. However, this does not appear to be the main mode of transmission. Essentially, those who are the most contagious are people that are displaying symptoms such as cough, fever, and shortness of breath. Other less common symptoms include a sore throat, muscle pain, headache, and nasal congestion.

Steps to avoid contamination at home

People are perhaps more aware than ever before of their hand hygiene and the need to properly sanitize frequently touched surfaces and objects. But, what about medical devices that may be used on a daily basis, such as CPAP machines and nebulizers?

According to Chang, following the recommended, normal cleaning processes should be adequate in preventing contamination. “I’m not sure that you would need additional cleaning on top of what is already recommended,” he said.

Chang said if you think you have COVID-19 symptoms, be sure to check with your doctor to see if it is safe to continue using devices such as a CPAP, BiPAP, or nebulizer. The use of these devices is not recommended if you have COVID-19 because you could infect others around you through airborne transmission.

In a recent study published in The New England Journal of Medicine, scientists discovered the virus that causes COVID-19 can survive on plastic and stainless steel as long as two to three days, on copper for up to four hours, and on cardboard for as long as 24 hours. During the study, the virus was also detected in aerosols for up to three hours.

The CDC recommends cleaning hard, nonporous surfaces with any common household disinfectant. If the item is dirty, it should be cleaned with soap and water before disinfecting, since dirt can prevent disinfectants from penetrating the germs. The CDC recommends following the manufacturer’s instructions for all cleaning and disinfection products.

Another disinfectant option recommended by the CDC is a solution of diluted household bleach. The bleach product should be at least 1,000 parts per million sodium hypochlorite. Follow the manufacturer’s instructions for application, and ensure a contact time of at least one minute. Be sure to allow proper ventilation during and after application. Do not mix household bleach with ammonia or any other cleaner.

Prepare a bleach solution by mixing:
5 tablespoons (1/3 cup) bleach per gallon of water
or
4 teaspoons bleach per quart of water

Should you wear a mask or gloves out in public?

Guidelines concerning masks are in flux right now. CDC guidelines state that only healthcare and front line professionals need to wear PPE while treating patients who may have COVID-19. That includes N95 masks, a face shield, gloves, and disposable gowns.

When it comes to wearing surgical or cotton masks for your own protection or others while running errands, the CDC may be issuing new guidelines soon. Since droplets are the main route of contagion, a surgical or cotton mask could decrease the droplets you breathe out and cut down on what you are breathing in, according to Hilary Fairbrother, MD, MPH, an emergency medicine physician at UTHealth. So, homemade cotton masks could be helpful while running essential errands. Leave the surgical masks for health care workers.

Luis Ostrosky, MD, an infectious disease expert at UTHealth, noted that that masks are not a substitute for continuing social distancing and thorough hand hygiene, and that if not used properly, they can be more detrimental than helpful since they can easily be contaminated. The same goes for wearing latex gloves. “Most people do not use them properly and still touch their face,” Ostrosky said.

Make a household plan

If a family or household member is an essential employee, especially those who are first responders or health care workers, it is important that everyone in the home practice rigorous social distancing measures, in addition to good hand hygiene. Ostrosky recommends social distancing at home as much as possible, as well as continuous self-monitoring for symptoms of COVID-19. If a family member has been exposed to the virus or is symptomatic, they should segregate from the rest of the household.

The CDC recommends choosing a room in your home that will be used for a household member who is sick to keep them separated from those who are healthy. Items such as towels and bedding should not be shared and should be cleaned appropriately. If possible, sick family members should also use a separate bathroom. For more tips to keep your home clean and family healthy, visit CDC.gov.

Experts say you should not congregate with anyone outside your home, including family and close friends, even if everyone is practicing social distancing. According to Susan Wootton, MD, an infectious disease pediatrician at UTHealth, now is not the time to visit other family members, especially older adults. “Social distancing is still very much encouraged. If you live with your grandparents, continue routine handwashing at home, cleaning high-touch surfaces and monitoring for symptoms,” Wootton said.

Wootton also recommends that only one family member run necessary errands when needed. “I would suggest that families minimize the number of people going to grocery store if at all possible. However, in some cases, it may be necessary to bring your baby or toddler. If so, be sure to maintain distance from others, and keep your child in their stroller to minimize touching of surfaces. Wash hands thoroughly when you return home.”

Ultimately, keep practicing social distancing, continue washing hands properly and often, clean high-touch surfaces in your home frequently, and stay home and away from others, especially if you are sick. All of these measures will help slow the spread of COVID-19.

As the clinical practice of McGovern Medical School at UTHealth Houston, UT Physicians has locations across the Greater Houston area to serve the community. To schedule an appointment, call 888-4UT-DOCS.