BY DEBORAH LEE, MD JUNE 24, 2020
Our long, hot summer has now arrived. And COVID-19 or not, we all need to get outside. Here’s the problem: after the tedious incarceration of lockdown, going outside suddenly seems scary, with coronavirus outbreaks in 26 states. Is it safe to go outside? How do you know you won’t get the virus? How do you become infected with COVID-19 outside? What can you do to stay safe? As a doctor, I’m asked these questions all the time. Here are the top ways to avoid catching coronavirus.1
Remember: You’re Safest at Home. But You’re Safer Outdoors Than in an Enclosed Space That’s Not Your Home
You’re safest when in your own home—there is always risk outside—so stay in unless it’s absolutely essential to leave. As for other people’s spaces: Don’t go inside another person’s house, or any buildings other than your own home, unless you’re willing to take the risk. Being outside is, in fact, safer. You are very unlikely to get infected with COVID-19 outside in the fresh air. The risk of transmission increases significantly when you go indoors.
We know that the virus spreads itself from person to person inside droplets of respiratory mucus. These are exhaled when an infected person speaks, coughs or sneezes. The larger respiratory droplets only travel a short distance and are quickly dispersed by wind and air currents, before they fall to the ground. The virus is also sensitive to temperature, and humidity, so it cannot exist for long periods suspended in the air, or outside the body. Smaller droplets, known as aerosols can linger for up to 3 hours.
However, if you go indoors, you have lost this protection.
Be aware that air conditioning units and ventilation systems may increase the risk of transmission, especially in shopping malls, restaurants, and offices, for example. The key message is to practice social distancing at all times—the CDC recommendation is that you stay 6 feet, (about 2 arms lengths) away from any person who is not in your household.2
When to Wear a Mask
The CDC recommends everyone wears a mask if they are out of their own home, and unable to practice safe social distancing—for example, inside a supermarket, a pharmacy or a doctor’s office. This is especially important any time you are inside.
Outside, if you are in a built-up area, where the sidewalks are crowded, you should also wear a mask, and of course, whenever you use public transport.
However, if you are walking, when you get into a less busy spot, where you can keep your 6 feet distance with ease, you can remove your mask. When you are out in the open, such as a park, woodland or a non-crowded beach (or in the water), there is no need to wear a mask.
Wearing a mask is helpful to reduce viral spreading, however, it does not prevent viral spread altogether. Don’t think that by wearing a mask, none of the other protective measures matter. You still need to be hand washing frequently and staying 6 feet away from other people.
Scientists believe you must be in close proximity to another person for at least 15 minutes to stand a good chance of acquiring the virus. They also feel it’s important to keep moving. You are less likely to transmit the virus if you walk and talk 6 feet apart, than if you sit still, for example, sharing a park bench, or a beach towel, even when you still maintain the 6-foot distance.
Remember, you do need to breathe in a significant amount of virus to become infected. You won’t get infected from breathing in just a few virus particles. However, no-one knows how much virus is required to result in a person becoming infected with COVID-19. To stay safe‚ stay outside in the fresh air, stay 6 feet away from other people, and keep moving when possible.4
The days of popping to the corner shop without a second thought have now disappeared. The virus is still there, and no-one wants a second peak, so don’t take chances. When you go anywhere, plan ahead.
It’s still important to limit going out, and even though businesses are reopening, and life seems to be resuming some sort of normality, it’s going out, and mixing with other people which increases the risk of becoming infected.
Here’s some advice:
- If you want to go with friends and/or family to any outdoor venue, such as a woodland park, look it up first online. Choose somewhere close to home. Check the car parking, and the facilities. Take adequate food and water supplies with you. Try to avoid peak times to avoid the crowds. Take your mask, and hand sanitizer.
- You should only meet up with a small group, and limit the number of other households. Risk is increased when you mix with larger numbers of people and people you don’t know, and from new households.
- Wear your mask anywhere where social distancing is not possible.
- Check the map of states with reported COVID-19 infections, and the updates from your local health department, plus any specific stay at home requests from your state.
- Wash your hands frequently before, during, and after the trip.
- Follow local instructions when you get to the venue. Touch as little as possible. Disposable barbecues are not advisable as they can cause wildfires. Keep to footpaths. Take all your litter home with you.
- When you get home, why not leave your shoes outside the house. COVID-19 has been found frequently on the shoes of healthcare workers and those working in a pharmacy.
The challenges of COVID-19 have brought out the best and worst in people’s behavior. Some people seem to think there is one rule for the rest of the country and a different rule for them. (For an example, see what’s happening in Texas.) Others, absorbed in chatting to friends or looking after children, tend to forget they should be keeping their distance. So quite often you can look around you and see people cheek-by-jowl, and seemingly completely unconcerned.
Now is the time to be assertive. Don’t be afraid if someone is encroaching on your space to ask them politely “Please can I have a bit more space here.” Be polite, and try to be friendly, and non-accusing. You don’t want to provoke a violent reaction.
Set a good example. Be proactive about handwashing and using a sanitizing gel. Cross the road if necessary, to give people a wide berth. Move a seat away on public transport if needed.6
Keep a Safe Distance Behind the Person in Front of You When Walking
There’s a lot more to becoming infected than just inhaling a few virus particles—there has to be a sufficient number of virus particles, and these have to be capable of surviving and reproducing in order to infect you. The closer you are to someone else, the greater the risk. At 6 feet away, the risk is minimal, especially outdoors, whatever the other person is doing. However, keep a safe distance and use your common sense. If you can, dodge the slipstream and walk to one side.7
Don’t Greet Other People With a Hug or a Kiss
It’s instinctive to run up and hug and kiss friends and family. But this is now a big “no-no” for anyone not living under your roof. The virus is transmitted in saliva, so do not kiss anyone, share a drink, or eat any food someone else has been eating, who is not living in your household. So for now, there are plenty of other greetings—from a Vulcan salute to an air-hug!8
Try to Avoid Using a Public Toilet
If you must use a toilet while you are out, take extreme care as this is where transmission could occur. COVID-19 was isolated from 60% of toilet sites (toilet seat, sink and door handle) from an infected patient’s hospital room.
Although COVID-19 is largely spread through respiratory droplets, it may be spread from feces. After having your bowels open, when you flush the toilet, viral particles in the feces can spread upwards as an aerosol in the plume of water, some suggest as high as 3 feet.
Evidence suggests the virus can survive for up to 3 hours as an aerosol, and 3 days, if splashed onto a plastic surface, such as a toilet seat. If you go into someone’s home, they could be shedding virus. Or indeed, if you visit a public toilet, you have no idea who has just been in there before you. Visiting the toilet has to be one of the riskiest moments for viral transmission. Make sure before you leave your house, you have your mask, disposable gloves, sanitizing wipes and alcohol gel in your bag. 9
Chlorine and bromine both effectively destroy COVID-19. The CDC states that swimming in swimming pools is safe. However, it’s the proximity to other people that’s the problem and you still need to stay 6 feet away in the water. You will probably be safer in a friend’s swimming pool in their backyard than in a public swimming pool.
Take care in crowded locker rooms, and when using the shower and bathroom facilities, washing your hands as usual and keeping your distance.
Freshwater, such as outdoor rivers and lakes, have the potential to be contaminated with COVID-19 from untreated sewage. Get advice from the State-Based Healthy Swimming Information.
If you visit a beach, make sure you maintain social distancing, swim, and enjoy your recreation, then move on. It may not be advisable to set up camp on the beach for long periods. 10
What About Take Out Food?
The good news is that having take out does not appear particularly risky. However, for the lowest risk on a day out you are probably best to prepare and take your own food. You may want to purchase hot food or drinks while you are out, and the principles are the same.
Most evidence suggests there is little risk from COVID transmission through food or the packaging of food. If you swallow the virus into your stomach it’s likely to be killed by stomach acids anyway.
However, here are a few tips:
- Make it a contactless purchase.
- The vendor should put the food down on the counter and step back before you step forward to pick it up.
- Wash your hands before eating.
One Last Note From the Doctor
Remember: People infected with COVID-19 excrete virus when they have no symptoms. Asymptomatic people, infected with COVID-19, who don’t know they have the infection, are just as infectious, and transmit just as much virus, as those who have tested positive, and do have symptoms. If someone feels well, you can’t tell if they have COVID-19, unless they have a test. Even someone who appears completely well may have the virus in their body and can pass it on to you. This is everyone you pass on the street, in the park, and at the corner shop. Stay alert and be on a constant lookout. COVID-19 is a hidden enemy. And stay indoors unless it’s absolutely essential not to.
Dr. Deborah Lee is a medical writer for Dr Fox Online Pharmacy.
At Forster Physical Therapy we meet and exceed all CDC COVID prevention protocols. If you are not sure if you have Coronavirus or you would prefer to stay at home for your physical therapy, please let us know and we will proceed with telemedicine appointments. Call 310-656-8600 today.