© 2020 PRIVATE HEALTH MANAGEMENT

Coronavirus (COVID-19) Pandemic

CIRCLE OF SAFETY

HOW TO REDUCE COVID-19 INFECTION RISK AT HOME

MARCH 27, 2020

 

Although a global pandemic of COVID-19 is beyond any one person’s control, we all have an opportunity and an obligation to adapt our behavior to mitigate the spread of this contagion for the safety of our communities, our healthcare workers and ourselves. 

 

In order to insure to the maximum extent possible that you are not exposed to the virus, you can create a CIRCLE OF SAFETYaround your home. The core principal is physical distance— but not social distance-- from people who might be infected and from surfaces that might contain virus particles for many hours or days. Although some of these steps may feel awkward and cumbersome, they must be implemented now to reduce the spread of this highly contagious disease and help ensure your safety and the safety of your loved ones. If you live with others, everyone in your home should follow these guidelines. This is especially important for the most vulnerable populations described below.

 

These guidelines draw upon the scientific literature, practices used by clinicians in other viral outbreaks and the experiences of our infectious disease physicians and former military advisors. All have been adapted for home and individual use.

 

HOUSEHOLD

  • Those who live in your house form your CIRCLE OF SAFETY

  • Do not let anyone into your home who does not have an essential reason to be there

  • If someone needs to enter your home:

    • Do not permit them to enter if they have any symptoms or have reason to believe they have been infected

    • Have them leave their shoes and outer garment outside, sanitize their hands, and if available, put on gloves and a mask (which they should take with them). 

    • After they leave, sanitize any surfaces they have touched and wash your hands

 

At Home

  • Before entering your home, take your shoes off and leave them outside or spray them with a disinfectant. If possible, take your clothes off, especially the outer layer, if you have been to a highly trafficked area like the supermarket or pharmacy or come into close proximity to anyone outside your CIRCLE OF SAFETY. Remove your gloves and use disinfectant wipes on your cell phone, keys, credit cards, wallet, etc. that you used during your trip. 

  • Immediately upon entry, wash hands with soap and warm water for at least 20 seconds, and do so regularly and before preparing and eating meals

  • Wash clothes frequently and bedding and towels at least once a week

 

Provisioning

  • Make a list of products you use regularly, including any prescription medications, and order a two-month supply now for home delivery if possible 

  • Procure supplies that would be helpful if you become sick, such as fever reducers, cold medications, electrolyte replacements, etc.

  • Anticipate shortages and delays both in stores and via e-commerce

 

Accepting Deliveries

  • Prevent the introduction of virus into your home as follows: 

    • Have all deliveries of food, drugs, supplies, etc. dropped off outside your door, without any contact with the delivery person. Postmates and other services now offer this option. 

    • Do not bring any exterior packaging into your home 

    • Before you begin to open the exterior package outside your home, put on gloves and disinfect the package

    • If the contents of the package are likely to have been touched by others, use disinfectant spray or wipes to disinfect the contents

    • For fresh fruit and vegetables, wash them immediately in hot soapy water. For prepared hot foods that are ready to be eaten, put them in a microwave or oven to increase the heat.

    • After processing your delivery, remove your gloves and wash hands thoroughly with soap and water for at least 20 seconds

    • Use disinfectant spray or wipes on doorknob, doorbell, etc., after delivery 

    • Cancel dry cleaning as there is a risk of contamination

 

Cleaning

  • Clean and disinfect your home regularly, especially shared hand-touch surfaces such as doorknobs, light switches, countertops, faucets, etc.

  • A recent study published in the New England Journal of Medicine found that the virus is detectable for up to 3 hours in droplets in the air, up to 4 hours on copper, and up to 2-3 days on plastic and stainless steel. Recent data suggest that the virus may remain infectious even longer, so these precautions are even more important.

  • You can easily make an effective disinfectant by mixing household liquid bleach and water at a ratio of 1 part bleach to 10 parts water. Put it in a dedicated spray bottle, MARK IT CAREFULLY and KEEP IT AWAY FROM CHILDREN. Do not use the bottle for anything else. The mixture can be used for up to 24 hours. Spray on shoes, outer packages, hand touch surfaces, etc.

  • Here is a list of EPA-approved products for use against emerging viral pathogens

 

 

Make a Plan in Case Someone Gets Sick

  • Most people infected with COVID-19 will experience mild symptoms similar to a common cold that do not require care from a physician

  • If someone were to become sick, determine where they can self-isolate within your home to minimize risk of infection for others

  • Determine who will care for the sick person and consult the CDC guidelines for caring for a loved one with suspected COVID-19

  • Contact the sick person’s healthcare provider by calling before they get care and avoid public transportation if visiting the provider

  • If the sick person has trouble breathing, persistent pain or pressure in the chest, becomes confused, is not arousable or has bluish lips or face, seek medical attention immediately 

 

Keep in Touch with Friends and Family

  • Physical distancing does NOT require social distancing 

  • By connecting with each other, we can support everyone’s mental and physical health 

  • We strongly encourage staying in close touch with your loved ones, friends and colleagues via technology-- call, text, email, FaceTime, Zoom, etc.

  • Write a letter – yes, it’s been a long time since we regularly did this; why not bring it back?

 

 

LEAVING HOME

  • Only leave your home for essential needs (work, necessary doctor appointments obtaining food and prescription drugs and supplies) and exercise (running, biking, hiking in a remote area) 

  • Avoid public transportation, if possible

  • When you need to go outside, wear disposable gloves, a face mask, hat, long sleeves and pants

  • Maintain distance from others in public areas (at least six feet)

  • Keep antiviral hand sanitizer with you and use it often

  • Do not touch shared hand-touch surfaces

  • If you must go to the supermarket, pharmacy, or other retail establishment, wear gloves and a mask. Bring antiviral hand sanitizer and wipes with you. Wipe down the cart and wear gloves. Do not touch items at the store besides those you purchase. Ask the sales clerk to sanitizer their hands before double-bagging your items and exchanging payment. Avoid cash transactions if possible.

  • Use credit cards/Apple Pay instead of cash whenever possible

 

 

MOST VULNERABLE POPULATIONS

People who are more likely to become seriously ill if infected should take all possible precautions.

 

There is evidence to show that the following factors increase the risk of a more serious presentation if infected:  

  • Increased Age / Male

  • COPD/Smoking

  • Cardiovascular disease

  • Diabetes

  • Hypertension

 

The following factors likely increase the risk:

  • Autoimmune conditions, particularly those on biological treatments, including:

    • Rheumatoid arthritis

    • Inflammatory Bowel Disease (Ulcerative Colitis and Crohn’s disease)

    • Lupus and scleroderma

  • On immune-suppressive medication routines most frequently related to:

    • Organ transplantation

    • Cancer

  • Diabetes

  • Chronic kidney disease

PRECAUTIONS & SYMPTOMS

MARCH 12, 2020

 

As you can imagine, we are receiving an enormous number of inquiries related to COVID-19. We have assembled a consortium of experts in pandemic management, infectious disease, and other specialties to assist us in addressing these inquiries. 

 

Clients, please contact the Private Health COVID-19 Task Force at COVID19@privatehealth.com. We will do our best to address your issue in a timely fashion. Thank you for understanding.

 

You can also sign up for our periodic newsletter here.

 

Below is some overall guidance. 

 

 

Private Health Management is providing this COVID-19 report based on the information available and the judgment of experts as of the date of the report. Knowledge about this unprecedented outbreak is evolving rapidly and chaotically and many things once believed to be true have been shown by subsequent developments to be erroneous. While the content herein is based on our current understanding and the current guidance of experts, Private Health expects that there will be rapid, unpredictable and ongoing changes in the course of this epidemic and the measures that are being used or advocated to address it. Accordingly,  we encourage everyone to (i) consult many other sources of information (ii) make decisions based on all of the information they can obtain and (iii) be prepared to make rapid changes in their plans. Private Health Management does not accept any liability or responsibility whatsoever for any decisions or actions based in part or whole on this or other information or guidance we provide.   

In addition, this report and all other information and guidance provided by Private Health Management are not to be used or relied on for any diagnostic or treatment purposes. This report and all other information and guidance are not intended to substitute for individualized medical advice, diagnosis or treatment by a physician who is aware of an individual’s medical history and has had an opportunity to conduct an examination. Do not rely on this report in place of seeking professional medical advice.

 

 

GENERAL PRECAUTIONS

  1. Maintain social distancing. Do not shake hands, hug, kiss or exchange business cards. Avoid contact with people who are sick. Maintain an eight foot distance if you are near someone with symptoms to avoid air droplets from coughing and sneezing. 

  2. Clean your hands. Use antiviral hand sanitizer containing at least 60% alcohol on dry hands once an hour, after handwashing and drying, and after touching any shared surfaces. Wash your hands frequently with liquid soap and water for at least 30 seconds. 

  3. Avoid hand touch surfaces such as handrails, doorknobs, elevator buttons and bathroom fixtures as they have been proven to transmit infections.

  4. Avoid “hand to head” contact to prevent hands from infecting your eyes, nose and mouth. 

  5. Get the flu vaccine. The flu is co-circulating and several flu patients have caught the coronavirus in the hospital because of the compromised immune system.

  6. Practice respiratory hygiene by covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Immediately dispose of the used tissue and wash your hands.

  7. Stay home when sick. If you have a fever, cough and difficulty breathing, call your primary care physician. 

 

SYMPTOMS

COVID-19 typically causes mild to moderate upper-respiratory tract illnesses with symptoms that resemble the flu or a bad cold. Approximately 70% of cases report an initial fever presentation that comes on slowly and a dry, barking cough after the first day. The time from exposure to the onset of symptoms is thought to be about two to 14 days. Approximately 90% of the cases present clinical symptoms by nine days post-infection. There is a chance that asymptomatic patients may be infectious in the 24 hours before they have symptoms. 

Symptoms may include:

  • Fever

  • Cough

  • Runny nose

  • Headache

  • Sore throat

  • General feeling of being unwell

  • Difficulty breathing 

  • More serious: pneumonia, bronchitis, lung lesions

 

If you develop any of these symptoms, don a face mask, go home and call (do not visit in person) your primary care physician.

 

WHAT TO DO IF YOU ARE SYMPTOMATIC

If an individual is at higher risk for serious presentation and is symptomatic:    

  • They should call, not visit, their primary care physician and their relevant specialists and inform them of their symptoms, travel history during the prior 14 days and if they have reason to believe they have been exposed to COVID-19. Those physicians will determine if the individual should be tested and how they should be treated.

 

If an individual is at not at higher risk for serious presentation and is symptomatic:    

  • If this individual does not have any of those factors, they should call, not visit, their primary care physician, who will determine if they should be tested and how they should be treated.

If serious symptoms present:    

  • In the event that people either with or without the risk factors develop serious symptoms, which fortunately happens in only a small portion of cases, they will likely need to be hospitalized. 

 

RISK FACTORS FOR SERIOUS PRESENTATION

The following factors increase the risk of a more serious presentation if infected:    

People with the following conditions:

  • Autoimmune conditions, particularly those on biological treatments, including:

    • Rheumatoid arthritis

    • Inflammatory Bowel Disease (Ulcerative Colitis and Crohn’s disease)

    • Lupus

    • Scleroderma

  • Pulmonary compromise, including COPD and smokers

  • On immune-suppressive medication routines most frequently related to

    • Organ transplantation

    • Cancer

  • Diabetes

  • Chronic kidney disease

  • HIV/AIDS

 

People older than 55 years old

 

 

 

Clients may contact the Private Health COVID-19 Task Force at COVID19@privatehealth.com.

We will do our best to address your issue in a timely fashion. Thank you for understanding.

COVID-19 Disclaimer

Private Health Management is providing this COVID-19 report based on the information available and the judgment of experts as of the date of the report. Knowledge about this unprecedented outbreak is evolving rapidly and chaotically and many things once believed to be true have been shown by subsequent developments to be erroneous. While the content herein is based on our current understanding and the current guidance of experts, Private Health expects that there will be rapid, unpredictable and ongoing changes in the course of this epidemic and the measures that are being used or advocated to address it. Accordingly,  we encourage everyone to (i) consult many other sources of information (ii) make decisions based on all of the information they can obtain and (iii) be prepared to make rapid changes in their plans. Private Health Management does not accept any liability or responsibility whatsoever for any decisions or actions based in part or whole on this or other information or guidance we provide.