We have perhaps never wondered why the distance between two hospital beds, or two first-class flight seats is always three feet. It is a standard distance for public health safety to prevent spread of droplet infection by coughing or sneezing. As the global Covid-19 pandemic spreads with over 2,00,000 affected and 8,200 succumbing to the illness worldwide, India has seen the number of cases increasing each day with multiple states affected. Various states are initiating a shutdown as the next two weeks are crucial for preventing community transmission of the virus.
Chaos, panic and anxiety are rampant as people stock up on food and other daily supplies, fearing isolation. Hand sanitisers and face masks have been declared as ‘essential commodities’ by the government, though they are unavailable almost everywhere. Our own hospital is facing a shortage of these essentials for surgeries and other procedures, as patients keep demanding free supplies. Busy roads and airports stay deserted most of the time, with people avoiding crowds and public gatherings. Further fear has arisen due to the suspicion that a few suspected cases have defied quarantine and travelled to other places.
Each day, the helplines and laboratories are flooded with calls and requests for Covid-19 diagnostic testing. The sales of antibiotics and cough syrups have spiked over the counter and certain stocks are likely to get depleted soon. Though the situation in China’s Wuhan has relatively stabilised with new cases touching single digits for the first time since the outbreak began, the rest of the world is currently in the ‘viral’ grip. Amidst all this panic, there is a plethora of information about ‘Do’s and ‘Don’ts’ related to Covid-19 that keep circulating each moment on various social and digital platforms. A lot of them are genuine, some speculative and some myths, though at times of crisis, people tend to follow all of them alike. Considering the repeated doubts and questions that I have faced from my friends, relatives and patients since India reported its first Covid-19 case, I chose to put down the main precautions of safety. The two main strategies to prevent and contain Covid-19 infection are fairly simple:
1. Social distancing: Worldwide, WHO and CDC have been recommending this for the last two months, though the world has started to pay heed to this warning only of late. This has been the first precaution mentioned by any epidemiologist and infectious-disease expert that I have come across. Symptomatic (coughing, sneezing, sore throat, fever) or not, it’s better to maintain some distance (at least 2-3 feet) between individuals during any communication or interaction. As mentioned before, the hospital beds, flight seats or ideal public sitting arrangements are designed based on this ‘social distancing’, so that the infection does not spread. Physical contact is better avoided. The Indian greeting of namaste comes handy in such situations. The other arm of this precaution is to refrain from any unnecessary travel, public gatherings or crowded places. Be it malls, theatres, airports, cafes, pubs, etc., all these sites can lead to overcrowding with the potential ‘droplet spread’ of the virus. The states are closing down these places, mainly due to this reason.
2. Hand and respiratory hygiene: There has been a lot of hue and cry over alcohol-based hand sanitisers. They are convenient to carry and use. However simple soaps that generate more lather are perhaps the most effective. The ‘fat’ in the lather dissolves the viral coat, killing it. It’s important that hands are sanitised on both sides for some time (at least 30 seconds), with a liberal amount of sanitiser or soap. Dettol and Savlon are ineffective. Hands need to be cleaned before having food, after touching any exposed external surface and especially after returning from outside.
Hand hygiene also includes not touching any part of the face (eyes, nose, mouth, ears), especially when hands are not cleansed. Covering the face fully while coughing or sneezing is vital to prevent the virus from spreading in air. Though I see literal agitation over face masks, especially N95 respirator masks, the CDC guidelines clearly mention that it is not necessary, unless you are working in a hospital set-up or caring for an infected/suspected case of Covid-19. The virus is smaller than the face mask pores. However, it might prevent unwanted touching of our faces. If at all needed, they can be used in public gatherings, like airports and in the vicinity of hospitals.
Most importantly, there is no need to panic. Covid-19 is not fatal! More than 82,000 people around the world have recovered. Extremes of age, pre-existing ill-health and immune-compromised conditions increase the risk. Also, having a cold is not the same as Covid-19. The administration is doing its best to contain the outbreak. Unwarranted discussion and anxiety will only add to the existing public chaos. Besides public health, Covid-19 has also hijacked ‘social media’, continuing its top spot in all forwards, memes and messages. Please stay away from misinformation and senseless forwards.
The WHO and CDC websites are fairly simple and lucid to follow for authentic information. If you have breathing trouble, sore dry throat, fever and cough for more than 7-10 days, please seek medical help.
Further, if isolation is advised, please cooperate and follow the same. It is of prime importance to control the spread. Testing for Covid-19 has standard protocols and the physicians will inform you, if needed. Let us make others aware of these simple precautionary measures and follow them for the greater good.
Dr Debanjan Banerjee
MD, Geriatric Psychiatrist, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru Email: dr.djan88@gmail.com