Coronavirus Q+A with Doctor Dan Ketterer Originally posted on the IDCGA website.(Version 4.0, updated 4/6/20)

My name is Dr. Daniel Ketterer, and I am an Infectious Disease physician practicing in Atlanta, Georgia. My purpose in writing this guide is to address some of the most pertinent questions regarding SARS-CoV-2 / COVID-19, and to provide guidance for what you can do to help your family and society.

This guide is for educational purposes, and is designed to be a primer on SARS-CoV-2/COVID-19 for the layperson. It is not intended to provide individualized medical advice or replace the advice of your physician. This guide features Level 1 and Level 2 learning. Each question will have a concise and correct Level 1 answer. On some questions, there will be a link to the Level 2 explanation after the Level 1 response. Level 2 responses will be longer and more detailed, but no less essential. If you have time, try to read the Level 2 explanations. By breaking the guide up in this way, I can get the most important points for a variety of topics quickly, and the rationale behind my statements and opportunities to learn will also be available to those interested.

This guide is as current as of the revision date above. Science changes with new information, and I recommend regularly reviewing WHO, NIH, and CDC and your local health department websites.

https://www.who.int/health-topics/coronavirus

https://www.nih.gov/coronavirus

https://www.cdc.gov/coronavirus/2019-ncov/index.html

Please share this guide on Facebook by hitting the “Share” button below this post. As I update the guide in the future, the shared posts will also automatically update so you are sharing the most current version at all times. If you have friends with large social-media footprints, or friends with access to celebrities, encourage them to read and share this guide.

I am also OK with re-posting this guide on other social media platforms or websites with a few caveats. Please copy the entire guide and make sure to update it as new versions come out. Also, please do not monetize it in any way. Everyone involved in this project is a volunteer that cares about saving lives through education, and this message is too important to have motivations questioned.

With education and a rational, evidence-based approach, we will save lives together.

Daniel Ketterer M.D.

— 𝗪𝗵𝗮𝘁 𝗶𝘀 𝗖𝗼𝗿𝗼𝗻𝗮𝘃𝗶𝗿𝘂𝘀/𝗦𝗔𝗥𝗦-𝗖𝗼𝗩-𝟮/𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

Coronaviruses are a large family of viruses primarily found in animals, but some can also infect humans. There are 7 known coronavirus strains that infect humans: 4 cause a cold-like illness, and 3 have caused more serious illnesses.

The 3 known to cause serious illness are:

• SARS-CoV-1, the virus that caused the 2003-2004 Severe Acute Respiratory Syndrome (SARS) outbreak
• SARS-CoV-2, the virus that causes Coronavirus Disease of 2019, also known as COVID-19
• MERS-CoV, the virus that causes Middle Eastern Respiratory Syndrome

Using HIV as an analogy:

HIV is the virus that can cause the clinical syndrome known as AIDS; likewise, SARS-CoV-2 is the virus that can cause the clinical syndrome known as COVID-19.

— 𝗛𝗼𝘄 𝗶𝘀 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝘁 𝗳𝗿𝗼𝗺 𝘀𝗲𝗮𝘀𝗼𝗻𝗮𝗹 𝗶𝗻𝗳𝗹𝘂𝗲𝗻𝘇𝗮?

COVID-19 is 𝘃𝗲𝗿𝘆 different and much more serious than seasonal influenza.

Unlike seasonal influenza:

• There are no approved treatments for COVID-19.
• There is no protective vaccine for SARS-CoV-2 available yet.
• There is no herd immunity to help limit the virus from being spread broadly.
• The probability of developing severe lung disease (called Acute Respiratory Distress Syndrome or ARDS), multi-organ failure, heart attacks, and dying is 𝗺𝘂𝗰𝗵 higher with SARS-CoV-2.

— 𝗪𝗵𝗮𝘁 𝗶𝗻𝗶𝘁𝗶𝗮𝗹 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀 𝘀𝗵𝗼𝘂𝗹𝗱 𝗜 𝗯𝗲 𝗮𝘄𝗮𝗿𝗲 𝗼𝗳 𝘁𝗵𝗮𝘁 𝘀𝘂𝗴𝗴𝗲𝘀𝘁 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

The two most common initial symptoms are fever and cough. Less common initial symptoms include: diarrhea, fatigue, abdominal pain, loss of smell, muscle or joint aches, and headaches.

— 𝗛𝗼𝘄 𝗹𝗼𝗻𝗴 𝗮𝗳𝘁𝗲𝗿 𝗲𝘅𝗽𝗼𝘀𝘂𝗿𝗲 𝗱𝗼𝗲𝘀 𝗶𝘁 𝘁𝗮𝗸𝗲 𝘂𝗻𝘁𝗶𝗹 𝘀𝗼𝗺𝗲𝗼𝗻𝗲 𝗱𝗲𝘃𝗲𝗹𝗼𝗽𝘀 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀?

The average has been 5-6 days with a range of 2-14 days. This is why those potentially exposed are being asked to self-quarantine for 14 days.

— 𝗛𝗼𝘄 𝗰𝗮𝗻 𝗜 𝘁𝗲𝗹𝗹 𝗶𝗳 𝗺𝘆 𝘀𝗲𝗮𝘀𝗼𝗻𝗮𝗹 𝗮𝗹𝗹𝗲𝗿𝗴𝗶𝗲𝘀 𝗮𝗿𝗲 𝗮𝗰𝘁𝗶𝗻𝗴 𝘂𝗽 𝗼𝗿 𝗶𝗳 𝗜 𝗵𝗮𝘃𝗲 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

Unfortunately, some of the symptoms of seasonal allergies can mimic COVID-19. However, there are some useful (but not 100% conclusive) aspects to consider:

1. Have you had prolonged close contact exposure (i.e. a family member in the same household) with an individual with known COVID-19? If so, this increases the likelihood one’s symptoms are due to COVID-19.
2. Fever over 100.4 ℉/38℃ is a very common symptom of COVID-19, but an infrequent symptom of seasonal allergies.
3. If antihistamines relieve your symptoms, this is more suggestive that your symptoms are due to allergies.

Ultimately, none of the three above tips are entirely foolproof, and social distancing and testing are still advised.

— 𝗔𝗿𝗲 𝘁𝗵𝗲𝗿𝗲 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀 𝘁𝗵𝗮𝘁 𝗮𝗿𝗲 𝗰𝗼𝗺𝗺𝗼𝗻 𝘄𝗶𝘁𝗵 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵 𝘁𝗵𝗮𝘁 𝗮𝗿𝗲 𝗻𝗼𝘁 𝘀𝗲𝗲𝗻 𝘄𝗶𝘁𝗵 𝗶𝗻𝗳𝗹𝘂𝗲𝗻𝘇𝗮 𝗼𝗿 𝗼𝘁𝗵𝗲𝗿 𝗳𝗹𝘂-𝗹𝗶𝗸𝗲 𝗶𝗹𝗹𝗻𝗲𝘀𝘀𝗲𝘀?

No. This is why testing for COVID-19 often also involves influenza and other viral illness testing.

— 𝗛𝗼𝘄 𝗶𝘀 𝘁𝗵𝗲 𝘃𝗶𝗿𝘂𝘀 𝘀𝗽𝗿𝗲𝗮𝗱?

The majority of cases are spread 2 ways:

𝗗𝗿𝗼𝗽𝗹𝗲𝘁 𝗿𝗲𝘀𝗽𝗶𝗿𝗮𝘁𝗼𝗿𝘆 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻:

This is the primary method the virus is spread. This means the infectious virus particles found in the respiratory secretions of those infected with SARS-CoV-2 are being transmitted when in close contact with an uninfected person. If these secretions get in the mouth, nose, or eyes of an uninfected person, they can be infected. Specific activities responsible for droplet transmission include:

• Sneezing
• Coughing
• Kissing
• Talking to or breathing on someone (if within very close range)

𝗙𝗼𝗺𝗶𝘁𝗲 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻:

Fomite transmission means an environmental surface gets contaminated with virus from an infected person’s respiratory droplets, an uninfected person touches that surface, then touches their mouth, nose, or eyes. An example of fomite transmission would be an uninfected person touching a tissue someone with COVID-19 recently sneezed into, and then that uninfected person touching their mouth, nose, or eyes.

Of note, this is thought to be a possibility of infectious spread, but likely much less so than droplet respiratory transmission.

For Level 2 information on close contacts and fomite transmission, click this link:

bit.ly/L2CCFomite

— 𝗖𝗮𝗻 𝗜 𝘀𝗽𝗿𝗲𝗮𝗱 𝘁𝗵𝗲 𝘃𝗶𝗿𝘂𝘀 𝗯𝗲𝗳𝗼𝗿𝗲 𝗜 𝗵𝗮𝘃𝗲 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀, 𝗮𝗻𝗱 𝗵𝗼𝘄 𝘀𝗼𝗼𝗻 𝘄𝗼𝘂𝗹𝗱 𝗜 𝗳𝗲𝗲𝗹 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀 𝗮𝗳𝘁𝗲𝗿 𝗲𝘅𝗽𝗼𝘀𝘂𝗿𝗲?

𝗬𝗲𝘀. Infectious viral shedding of SARS-CoV-2 has been detected 24-48 hours before symptom onset. On average, symptoms start 5-6 days after exposure, but can range from 2-14 days. This is why it is important to undergo a 2-week self-quarantine after a high-risk exposure and also why many states are now imposing shelter-in-place orders. It helps limit the spread of infection that can occur before someone shows symptoms.

— 𝗪𝗵𝗮𝘁 𝗶𝘀 𝗽𝗿𝗲-𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝗮𝘁𝗶𝗰 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻 𝗮𝗻𝗱 𝗮𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝗮𝘁𝗶𝗰 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻?

The CDC estimates that somewhere between 5-13% of new COVID-19 infections occurred from 𝗽𝗿𝗲-𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝗮𝘁𝗶𝗰 individuals. Pre-symptomatic transmission means an individual is infected with the virus and infecting others, but has not yet had any symptoms of COVID-19. This typically occurs in the first week after being exposed.

𝗔𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝗮𝘁𝗶𝗰 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻:

Asymptomatic Transmission implies a person is infected with SARS-CoV-2 and does not develop any symptoms of COVID-19 at any point, but is still spreading the virus. This is uncommon, and is thought to account for 1-3% of cases of COVID-19.

— 𝗜 𝗵𝗲𝗮𝗿𝗱 𝗼𝗻 𝘁𝗵𝗲 𝗻𝗲𝘄𝘀 𝘁𝗵𝗮𝘁 𝘁𝗵𝗲 𝘃𝗶𝗿𝘂𝘀 𝗰𝗮𝗻 𝗹𝗶𝘃𝗲 𝗶𝗻 𝘁𝗵𝗲 𝗮𝗶𝗿 𝗳𝗼𝗿 𝟯 𝗵𝗼𝘂𝗿𝘀. 𝗗𝗼𝗲𝘀 𝘁𝗵𝗮𝘁 𝗺𝗲𝗮𝗻 𝗦𝗔𝗥𝗦-𝗖𝗼𝗩-𝟮 𝗶𝘀 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘁𝘁𝗲𝗱 𝗯𝘆 𝗮𝗶𝗿𝗯𝗼𝗿𝗻𝗲 𝗺𝗲𝗮𝗻𝘀?

There is no evidence at this time to suggest any cases have been due to airborne transmission.

A very detailed Level 2 explanation on airborne transmission and infectious dose, and why it is critical to understand how this virus is transmitted, can be found here:

bit.ly/Level2Airborne

— 𝗦𝗵𝗼𝘂𝗹𝗱 𝗜 𝘄𝗲𝗮𝗿 𝗮 𝗺𝗮𝘀𝗸 𝗶𝗳 𝗜 𝗱𝗼𝗻’𝘁 𝗵𝗮𝘃𝗲 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀?

Check your state and local guidance to see if mask wearing is encouraged.

Those working in healthcare facilities should wear masks while at work.

Social distancing of a minimum of 6 feet while in the community should be your primary method to prevent transmission, and reduce pre-symptomatic and asymptomatic spread of the virus.

Level 2 discussion on mask use can be found here: bit.ly/Level2Masks

— 𝗔𝗿𝗲 𝘁𝗵𝗲𝗿𝗲 𝗮𝗻𝘆 𝘀𝗶𝘁𝘂𝗮𝘁𝗶𝗼𝗻𝘀 𝘁𝗵𝗲 𝗽𝘂𝗯𝗹𝗶𝗰 𝘀𝗵𝗼𝘂𝗹𝗱 𝘂𝘁𝗶𝗹𝗶𝘇𝗲 𝗮𝗻 𝗡𝟵𝟱 𝗺𝗮𝘀𝗸?

No. See bit.ly/Level2Airborne

— 𝗦𝗵𝗼𝘂𝗹𝗱 𝗜 𝘄𝗲𝗮𝗿 𝗮 𝗺𝗮𝘀𝗸 𝘄𝗵𝗲𝗻 𝗼𝘂𝘁𝘀𝗶𝗱𝗲?

The probability of infection is extremely low outside due to the larger volume of air and wind. Regardless, employ social distancing at all times in the community.

— 𝗜𝗳 𝗜’𝗺 𝗶𝗻𝗳𝗲𝗰𝘁𝗲𝗱 𝘄𝗶𝘁𝗵 𝘁𝗵𝗲 𝘃𝗶𝗿𝘂𝘀, 𝘄𝗵𝗮𝘁 𝗶𝘀 𝘁𝗵𝗲 𝗲𝘅𝗽𝗲𝗰𝘁𝗲𝗱 𝗼𝘂𝘁𝗰𝗼𝗺𝗲?

The outcome depends on multiple factors, namely if you are at high risk for severe disease, i.e. those with advanced age (over 60), congestive heart failure, structural lung diseases like COPD or asthma, hypertension, immunocompromised or requiring immunosuppressive medications, diabetes, or pregnant. For the cases from China, 80% of those with the virus had mild illness and recovered, 14% developed severe disease (pneumonia, breathing issues) requiring hospitalization, and 5-6% developed critical disease like ARDS, organ failure, or heart attacks, requiring ventilators and other critical support interventions in the ICU.

The biggest predictive value for severe disease and death is age over 60. Young to middle-aged adults without the above health problems are more likely to only have mild disease and more likely to recover from pneumonia or ARDS. Children also tend to get milder disease (see below).

Most individuals that get infected can spread the disease for up to 7-12 days after the onset of symptoms, but the highest likelihood of infecting others is in the first few days after symptoms start.

On average, people with mild illnesses, such as those with isolated fever and cough, can expect to take 2 weeks to fully recover. Those with more severe illness, such as pneumonia, breathing difficulties, ARDS or heart involvement, can take 3-6 weeks to fully recover if they do not worsen to the point of critical illness or death.

— 𝗪𝗵𝗼 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝘁𝗲𝘀𝘁𝗲𝗱 𝗳𝗼𝗿 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

It is recommended that until we have large scale testing kit availability 𝗮𝗻𝗱 a way to test people without putting uninfected persons at risk, those with mild symptoms (fever, cough), and who do not have the high-risk factors mentioned in the previous question should stay at home and self-quarantine.

Testing ability has increased in many major cities, but some areas are still struggling with demand. If you are concerned that you or a loved one may have COVID-19, and have risk factors for severe disease, I recommend contacting your physician’s office to set up a telemedicine appointment to see if you should be screened for COVID-19.

Individuals in high risk fields for both acquisition and transmission (such as health care workers), should also consider testing if they become symptomatic. Finally,those with worsening shortness of breath symptoms or high risk of developing severe disease should seek testing.

— 𝗛𝗼𝘄 𝗶𝘀 𝘁𝗲𝘀𝘁𝗶𝗻𝗴 𝗽𝗲𝗿𝗳𝗼𝗿𝗺𝗲𝗱?

There are now 2 methods being utilized for testing:

The first involves testing for the genetic material of the virus from swabs of the nose and throat.

The second is a blood test to see if you have been exposed.

Level 2 discussion on the two methods of testing can be found here: bit.ly/level2testing

— 𝗪𝗵𝗮𝘁 𝗮𝗿𝗲 𝘁𝗵𝗲 𝗹𝗶𝗺𝗶𝘁𝗮𝘁𝗶𝗼𝗻𝘀 𝗼𝗳 𝘁𝗵𝗲 𝘁𝗲𝘀𝘁𝘀?

The swab and blood test, if positive, confirms that a person has been infected with the virus.

However, both tests can be falsely-negative early in the disease, usually before symptoms start.

See Level 2 discussion on limitations of tests here: bit.ly/level2limitations

— 𝗪𝗵𝗮𝘁 𝗱𝗼𝗲𝘀 “𝗳𝗹𝗮𝘁𝘁𝗲𝗻𝗶𝗻𝗴 𝘁𝗵𝗲 𝗰𝘂𝗿𝘃𝗲” 𝗺𝗲𝗮𝗻, 𝗮𝗻𝗱 𝘄𝗵𝗮𝘁 𝗶𝘀 “𝗰𝗼𝗻𝘁𝗮𝗰𝘁 𝘁𝗿𝗮𝗰𝗶𝗻𝗴”?

𝗖𝗼𝗻𝘁𝗮𝗰𝘁 𝘁𝗿𝗮𝗰𝗶𝗻𝗴

Contact tracing is typically performed by your local health department to identify people that may be spreading the virus and those they may have infected. Those potentially infected by a known COVID-19 patient are contacted and told to monitor for symptoms and self-quarantine.

However, if the number of COVID-19 cases overwhelms the resources of the health department, they will not be able to utilize their limited resources for contact tracing. This is where “flattening the curve” comes in. 𝗙𝗹𝗮𝘁𝘁𝗲𝗻𝗶𝗻𝗴 𝘁𝗵𝗲 𝗰𝘂𝗿𝘃𝗲 means using measures like social distancing and shelter-in-place and work from home to limit the number of COVID-19 cases at any given time. This has two major benefits:

1. Health departments effectively contact trace cases and reduce further spread.
2. The hospital system is less likely to be overwhelmed by a large number of COVID-19 patients presenting at the same time. Since the number of health care workers and tools we need to effectively take care of COVID-19 patients is limited, by spreading out the infections over time, we can reduce the likelihood of running out of essential supplies and treatments.

— 𝗪𝗵𝗮𝘁 𝗺𝗲𝗱𝗶𝗰𝗶𝗻𝗲𝘀 𝗮𝗿𝗲 𝗮𝘃𝗮𝗶𝗹𝗮𝗯𝗹𝗲 𝗳𝗼𝗿 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

There are 𝗻𝗼 recommended medications right now for SARS-CoV-2/COVID-19. All medications currently being used are being used on an experimental and compassionate-use basis and do not have robust clinical trial data to show efficacy against COVID-19.

This includes treatments that have been touted in the media to be effective against SARS-CoV-2 such as chloroquine/hydroxychloroquine, remdesivir, and IL-6 blockers like tocilizumab.

Many medications have shown potential to stop the virus in laboratory settings, but this does not always reflect how well a drug will do at stopping an infection in the body.

Additionally, hoarding of these medications has occurred, limiting the ability to use them on severe COVID-19 patients for clinical trials. Some people using these medications without physician guidance have developed toxicities or died.

As treatment guidelines are developed, I will update the guide with their recommendations.

— 𝗪𝗵𝗲𝗻 𝘄𝗶𝗹𝗹 𝗮 𝘃𝗮𝗰𝗰𝗶𝗻𝗲 𝗯𝗲 𝗮𝘃𝗮𝗶𝗹𝗮𝗯𝗹𝗲?

The first vaccine against SARS-CoV-2 went into human testing on 3/16.

However, this vaccine has to be tested extensively for safety and manufactured on a large scale. The earliest a vaccine is expected is in the first half of 2021.

— 𝗠𝘆 𝗳𝗮𝗺𝗶𝗹𝘆 𝗺𝗲𝗺𝗯𝗲𝗿 𝘁𝗲𝘀𝘁𝗲𝗱 𝗽𝗼𝘀𝗶𝘁𝗶𝘃𝗲, 𝗮𝗻𝗱 𝗜 𝘄𝗮𝘀 𝗶𝗻 𝗰𝗹𝗼𝘀𝗲 𝗰𝗼𝗻𝘁𝗮𝗰𝘁 𝘄𝗶𝘁𝗵 𝘁𝗵𝗲𝗺. 𝗕𝗲𝘀𝗶𝗱𝗲𝘀 𝘀𝗲𝗹𝗳-𝗾𝘂𝗮𝗿𝗮𝗻𝘁𝗶𝗻𝗲 𝗮𝘁 𝗵𝗼𝗺𝗲, 𝗶𝘀 𝘁𝗵𝗲𝗿𝗲 𝗮𝗻𝘆𝘁𝗵𝗶𝗻𝗴 𝗜 𝗰𝗮𝗻 𝗱𝗼?

— 𝗜 𝘁𝗲𝘀𝘁𝗲𝗱 𝗽𝗼𝘀𝗶𝘁𝗶𝘃𝗲 𝗳𝗼𝗿 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵 𝗹𝗲𝘀𝘀 𝘁𝗵𝗮𝗻 𝟰 𝗱𝗮𝘆𝘀 𝗮𝗳𝘁𝗲𝗿 𝘁𝗵𝗲 𝘀𝘁𝗮𝗿𝘁 𝗼𝗳 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀, 𝗶𝘀 𝘁𝗵𝗲𝗿𝗲 𝗮𝗻𝘆𝘁𝗵𝗶𝗻𝗴 𝗜 𝗰𝗮𝗻 𝗱𝗼?

If you were either:

1. Exposed in the last 4 days to a COVID-19 positive individual
2. Tested positive for COVID-19 and have had symptoms for less than or equal to 4 days

You may be eligible to enroll in a medication study conducted by the University of Minnesota in which you are sent hydroxychloroquine or placebo.

For details and to sign up for this clinical trial, please visit https://covidpep.umn.edu

Medication trials like this one are how researchers will determine which treatments are effective for COVID-19.

— 𝗜𝗳 𝗜 𝗵𝗮𝘃𝗲 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵, 𝗵𝗼𝘄 𝗹𝗶𝗸𝗲𝗹𝘆 𝗶𝘀 𝗶𝘁 𝗺𝘆 𝗳𝗮𝗺𝗶𝗹𝘆 𝘄𝗶𝗹𝗹 𝗮𝗹𝘀𝗼 𝗴𝗲𝘁 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

Early in the pandemic, the risk of family members getting COVID-19 was about 10%. However, by utilizing social distancing, mask wearing for the sick, and cleaning surfaces, the risk of a family member getting COVID-19 drops to about 3%.

This is why it is absolutely critical to have a plan ready based on guidance from the CDC, WHO, and NIH on how to care for sick individuals in case a family member gets COVID-19.

https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID19_FAQ_HouseholdReady-H.pdf

https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/index.html

— 𝗜 𝘁𝗲𝘀𝘁𝗲𝗱 𝗽𝗼𝘀𝗶𝘁𝗶𝘃𝗲 𝗳𝗼𝗿 𝗦𝗔𝗥𝗦-𝗖𝗼𝗩-𝟮. 𝗪𝗵𝗲𝗻 𝗰𝗮𝗻 𝗜 𝗹𝗲𝗮𝘃𝗲 𝗾𝘂𝗮𝗿𝗮𝗻𝘁𝗶𝗻𝗲 𝗮𝗻𝗱 𝗿𝗲𝘁𝘂𝗿𝗻 𝘁𝗼 𝘄𝗼𝗿𝗸?

This result may depend on your employers guidelines and advice from your physician.

Guidance on criteria for returning to work will update based on testing availability, particularly if the rapid blood test is widely available.

The CDC does provide some guidance on this, but please note, the link below is intended for healthcare providers as the intended audience.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html

— 𝗠𝘆 𝘀𝘁𝗼𝗿𝗲 𝗶𝘀 𝗼𝘂𝘁 𝗼𝗳 𝗮𝗹𝗰𝗼𝗵𝗼𝗹 𝗴𝗲𝗹 𝗮𝗻𝗱 𝗱𝗶𝘀𝗶𝗻𝗳𝗲𝗰𝘁𝗮𝗻𝘁 𝘄𝗶𝗽𝗲𝘀. 𝗛𝗼𝘄 𝗰𝗮𝗻 𝗜 𝗰𝗹𝗲𝗮𝗻 𝗺𝘆 𝗵𝗮𝗻𝗱𝘀 𝗮𝗻𝗱 𝗼𝘁𝗵𝗲𝗿 𝘀𝘂𝗿𝗳𝗮𝗰𝗲𝘀?

Soap and water is very effective against the virus and can be used for hand hygiene and for cleaning surfaces.

Additionally, you can make your own bleach wipes at home using the following recipe:

Mix 1/3 cup of bleach per gallon of water. You can then use paper towels soaked in the solution to make your own disinfectant wipes. Always remember to use gloves and wear eye protection for splashes, and to only use in well-ventilated spaces.

— 𝗖𝗮𝗻 𝘁𝗵𝗲 𝘃𝗶𝗿𝘂𝘀 𝗿𝗲𝗮𝗰𝘁𝗶𝘃𝗮𝘁𝗲 𝗮𝗳𝘁𝗲𝗿 𝗜 𝗿𝗲𝗰𝗼𝘃𝗲𝗿 𝗮𝗻𝗱 𝗺𝗮𝗸𝗲 𝗺𝗲 𝘀𝗶𝗰𝗸 𝗮𝗴𝗮𝗶𝗻?

There is no evidence at this time to suggest that this virus reactivates after one recovers from infection.

— 𝗖𝗮𝗻 𝗜 𝗴𝗲𝘁 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵 𝗳𝗿𝗼𝗺 𝗺𝘆 𝗽𝗲𝘁𝘀 𝗼𝗿 𝘃𝗶𝗰𝗲-𝘃𝗲𝗿𝘀𝗮?

This is very unlikely to occur. See the link for more information: bit.ly/level2pets

— 𝗜 𝗵𝗲𝗮𝗿𝗱 𝗰𝗵𝗶𝗹𝗱𝗿𝗲𝗻 𝗱𝗼𝗻’𝘁 𝗴𝗲𝘁 𝘃𝗲𝗿𝘆 𝘀𝗶𝗰𝗸 𝘄𝗶𝘁𝗵 𝘁𝗵𝗶𝘀. 𝗜𝘀 𝘁𝗵𝗮𝘁 𝘁𝗿𝘂𝗲?

Yes. Those under 20 years old typically only develop a mild flu-like illness, and are much less likely to progress to severe disease or die. This may be due to how their immune system responds to infections.

The most important thing to remember if you are in a household with anyone under the age of 20 is that they are just as likely as adults to get infected with the virus. They can then spread the virus to people that have a higher likelihood of getting severe disease. It is important 𝗲𝘃𝗲𝗿𝘆𝗼𝗻𝗲 learns proper hand hygiene and social distancing.

— 𝗜𝘀 𝘁𝗵𝗲𝗿𝗲 𝗲𝘃𝗶𝗱𝗲𝗻𝗰𝗲 𝘁𝗵𝗮𝘁 𝗦𝗔𝗥𝗦-𝗖𝗼𝗩-𝟮 𝗰𝗮𝗻 𝗯𝗲 𝗽𝗮𝘀𝘀𝗲𝗱 𝗶𝗻 𝘂𝘁𝗲𝗿𝗼 𝗮𝗻𝗱 𝗶𝗻𝗳𝗲𝗰𝘁 𝗺𝘆 𝗱𝗲𝘃𝗲𝗹𝗼𝗽𝗶𝗻𝗴 𝗯𝗮𝗯𝘆?

There have not been cases of babies being delivered that have been sick with this virus.

A few cases have raised questions for in-utero transmission, although this is not conclusive at this time.

You can read more here: bit.ly/level2preg

— 𝗜𝘀 𝗦𝗔𝗥𝗦-𝗖𝗼𝗩-𝟮 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘁𝘁𝗲𝗱 𝘃𝗶𝗮 𝗳𝗲𝗰𝗲𝘀/𝘀𝘁𝗼𝗼𝗹?

There is no evidence of this occurring at this time.

While the virus has been detected in the stool rarely in severe disease, it has not been shown to be a method of transmission at this point.

However, there are certain practices you should be doing anyway to reduce the possibility of spreading 𝗮𝗻𝘆 fecal-oral diseases:

1. Close the toilet seat lid when you flush. This reduces the probability of toilet bowel contents being expelled into the environment.
2. Wash your hands with soap and water after using the bathroom.

— 𝗖𝗮𝗻 𝗜 𝗴𝗲𝘁 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵 𝗶𝗳 𝗮𝗻 𝗶𝗻𝗳𝗲𝗰𝘁𝗲𝗱 𝗿𝗲𝘀𝘁𝗮𝘂𝗿𝗮𝗻𝘁 𝘄𝗼𝗿𝗸𝗲𝗿 𝗰𝗼𝘂𝗴𝗵𝘀 𝗼𝗻 𝗺𝘆 𝗳𝗼𝗼𝗱?

It is unlikely that one can get COVID-19 from food. The FDA and other international food safety organizations have stated that food is NOT thought to be a method of transmission of SARS-CoV-2. However, until fomite transmission is better understood, it may still be theoretically possible.

To reduce this possibility, order foods served hot or reheat them after you receive in an oven or microwave. Also, consider supporting restaurants that are asking employees about symptoms, checking for fever, and providing paid sick leave for those who get the virus.

— 𝗜 𝗿𝗲𝗮𝗱 𝘁𝗵𝗮𝘁 𝘁𝗵𝗲 𝘃𝗶𝗿𝘂𝘀 𝗰𝗮𝗻 𝗹𝗶𝘃𝗲 𝗼𝗻 𝗰𝗮𝗿𝗱𝗯𝗼𝗮𝗿𝗱 𝗮𝗻𝗱 𝘀𝘂𝗿𝗳𝗮𝗰𝗲𝘀 𝗳𝗼𝗿 𝗵𝗼𝘂𝗿𝘀. 𝗛𝗼𝘄 𝘀𝗵𝗼𝘂𝗹𝗱 𝗜 𝗰𝗹𝗲𝗮𝗻 𝗺𝘆 𝗺𝗮𝗶𝗹, 𝗽𝗮𝗰𝗸𝗮𝗴𝗲𝘀, 𝗮𝗻𝗱 𝗴𝗿𝗼𝗰𝗲𝗿𝗶𝗲𝘀?

Fomite transmission, as I mentioned above, is thought to be a distant secondary form of transmission to droplet transmission. That being said, one can never completely eliminate all risk of acquisition and if measures being taken are causing wasting of limited resources and mental strain, it may not be worthwhile to do these things.

The lab studies of how long a virus remains viable on surfaces need to be interpreted with caution as these scenarios may not be applicable to real-life and do not reveal if the virus can still cause infections in people if they touch these surfaces and their face hours or days later.

Focus your disinfection of surfaces to those most likely to be contaminated with high amounts of virus. There would be surfaces that someone with COVID-19 might have gotten respiratory secretions on or touched with their hands. Cleaning repeatedly-touched surfaces like elevator buttons and hand-rails are the highest priority.

If you are concerned about surfaces you have contacted potentially being contaminated, remember, the simplest and most effective tool in your arsenal is to wash your hands for 20 seconds and abstain from touching your face.

— 𝗔𝗿𝗲 𝘁𝗵𝗲𝗿𝗲 𝗮𝗻𝘆 𝗻𝗮𝘁𝘂𝗿𝗮𝗹 𝗼𝗿 𝗰𝗼𝗺𝗽𝗹𝗲𝗺𝗲𝗻𝘁𝗮𝗿𝘆 𝗿𝗲𝗺𝗲𝗱𝗶𝗲𝘀 𝗜 𝗰𝗮𝗻 𝘂𝘀𝗲 𝗳𝗼𝗿 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

No.

From the NIH: “There is no scientific evidence that any of these alternative remedies can prevent or cure the illness caused by this virus (SARS-CoV-2).”

— 𝗖𝗮𝗻 𝗜 𝗴𝗲𝘁 𝗶𝗻𝗳𝗲𝗰𝘁𝗲𝗱 𝗮𝗴𝗮𝗶𝗻 𝗮𝗳𝘁𝗲𝗿 𝗵𝗮𝘃𝗶𝗻𝗴 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

This is unknown at this time. We do form antibodies against the virus as I mentioned before in the testing section. We still don’t know how effective they are for fighting the disease and how long they stay in the body.

Early data in monkeys re-challenged with the virus show that monkeys didn’t get sick on a second exposure if they had antibodies.

— 𝗜𝗳 𝗜 𝗴𝗲𝘁 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵 𝗮𝗻𝗱 𝗿𝗲𝗰𝗼𝘃𝗲𝗿 𝗳𝗿𝗼𝗺 𝘁𝗵𝗲 𝗱𝗶𝘀𝗲𝗮𝘀𝗲, 𝗰𝗼𝘂𝗹𝗱 𝗺𝘆 𝗯𝗹𝗼𝗼𝗱 𝗯𝗲 𝘂𝘀𝗲𝗱 𝘁𝗼 𝗵𝗲𝗹𝗽 𝘀𝗼𝗺𝗲𝗼𝗻𝗲 𝘄𝗵𝗼 𝗶𝘀 𝘀𝗶𝗰𝗸?

Possibly. Studies are being conducted right now transfusing antibodies from plasma donations of those who have recovered from COVID-19 into the sickest patients in the hospital. There is not enough data to suggest this is an effective treatment at this time.

— 𝗔𝗿𝗲 𝘁𝗵𝗲𝗿𝗲 𝗰𝗲𝗿𝘁𝗮𝗶𝗻 𝗺𝗲𝗱𝗶𝗰𝗮𝘁𝗶𝗼𝗻𝘀 𝗜 𝘀𝗵𝗼𝘂𝗹𝗱 𝗼𝗿 𝘀𝗵𝗼𝘂𝗹𝗱 𝗻𝗼𝘁 𝘁𝗮𝗸𝗲 𝗶𝗳 𝗜 𝗵𝗮𝘃𝗲 𝗖𝗢𝗩𝗜𝗗-𝟭𝟵?

This area is rapidly changing and the best advice is to speak with your physician as each person’s medical need for a medication can vary.

___________________________________________________________________________

*** 𝙃𝙚𝙧𝙚 𝙖𝙧𝙚 𝙨𝙤𝙢𝙚 𝙥𝙧𝙖𝙜𝙢𝙖𝙩𝙞𝙘 𝙩𝙝𝙞𝙣𝙜𝙨 𝙮𝙤𝙪 𝙘𝙖𝙣 𝙙𝙤 𝙩𝙝𝙖𝙩 𝙘𝙖𝙣 𝙠𝙚𝙚𝙥 𝙮𝙤𝙪𝙧𝙨𝙚𝙡𝙛 𝙛𝙧𝙤𝙢 𝙗𝙚𝙘𝙤𝙢𝙞𝙣𝙜 𝙨𝙞𝙘𝙠, 𝙠𝙚𝙚𝙥 𝙮𝙤𝙪𝙧 𝙢𝙚𝙣𝙩𝙖𝙡 𝙝𝙚𝙖𝙡𝙩𝙝 𝙞𝙣 𝙜𝙤𝙤𝙙 𝙘𝙤𝙣𝙙𝙞𝙩𝙞𝙤𝙣, 𝙖𝙣𝙙 𝙨𝙖𝙫𝙚 𝙡𝙞𝙫𝙚𝙨. ***

— 𝗗𝗢 𝗡𝗢𝗧 𝗣𝗔𝗬 𝗔𝗧𝗧𝗘𝗡𝗧𝗜𝗢𝗡 𝗧𝗢 𝗧𝗛𝗘 𝗖𝗔𝗦𝗘 𝗡𝗨𝗠𝗕𝗘𝗥𝗦 𝗔𝗡𝗗 𝗗𝗘𝗔𝗧𝗛 𝗥𝗔𝗧𝗘.

These numbers mean absolutely nothing to your overall safety and do not need to be repeated on social media. Why do the numbers not matter?

1. The number of cases WILL increase due to increased availability of testing detecting those with milder symptoms.
2. The number of cases will increase with disease spread.
3. The death rate will appear to be higher than it actually is in the beginnings of a pandemic since available testing is being used on the sickest individuals who end up in the hospital.

Knowing these numbers on a moment-to-moment basis will do nothing to help you if you or a loved one are exposed to SARS-CoV-2, they will simply increase existential dread and panic.

Assume the virus it is in your community even if you have no reported cases, and use social distancing at all times. The lack of reported cases in your specific community may be due to a lack of testing availability or those with mild symptoms not presenting for testing.

— 𝗞𝗲𝗲𝗽 𝘆𝗼𝘂𝗿 𝗺𝗲𝗻𝘁𝗮𝗹 𝗵𝗲𝗮𝗹𝘁𝗵 𝗶𝗻 𝗰𝗵𝗲𝗰𝗸.

Consider abstaining from coronavirus news outside of international reputable medical sources including the NIH, WHO, CDC, or your local health department.

Think about this question for a moment: In all of the time you spent watching or reading news coverage about coronavirus, and checking social media for updates, how much have you actually learned what you should be doing in the pandemic?

This is the purpose of this guide—education, not alarm, is the key to reducing cases of COVID-19 and saving lives.

Understanding this disease and developing a plan on how you can help yourself and your community reduces anxiety of the unknown.

Some news organizations continue to focus on cases and deaths for good reason: you will keep watching and returning to them if you feel uninformed, scared, confused, or filled with vitriol. This generates views, clicks and advertising revenue. These incentives do not align with the public good of reducing harm from this disease.

If you feel disconnected by not reading the news, limit yourself to your local city paper, which will likely focus on how coronavirus is affecting the community around you and point to ways you can help your community. Alternatively, if anyone reading this guide has a suggestion for a news source that is providing pragmatic information, and not focusing on political failures and cases/deaths, please let me know in the comments.

— 𝗜𝗳 𝘆𝗼𝘂 𝗰𝗮𝗻, 𝗽𝗹𝗲𝗮𝘀𝗲 𝗱𝗼𝗻𝗮𝘁𝗲 𝗯𝗹𝗼𝗼𝗱 𝗮𝗻𝗱/𝗼𝗿 𝗽𝗹𝗮𝘀𝗺𝗮 𝗼𝗿 𝗵𝗲𝗹𝗽 𝗼𝗿𝗴𝗮𝗻𝗶𝘇𝗲 𝗮 𝗯𝗹𝗼𝗼𝗱 𝗱𝗿𝗶𝘃𝗲 𝗶𝗳 𝘆𝗼𝘂 𝗰𝗮𝗻’𝘁.

Due to the coronavirus pandemic, many hospitals are facing severe blood shortages. Blood donation facilities are taking special precautions to keep you safe from coronavirus exposure. There have been 𝗻𝗼 cases of giving or receiving a blood transfusion causing COVID-19. Please consider donating blood so others do not die from conditions requiring transfusions.

Currently, less than half of those living in the US can donate blood. However, it is worth checking for changes in the FDA guidelines for blood donations regularly if you are restricted from donating.

As of 4/2/2020, the restriction on men who have sex with men (MSM) and women who have sex with MSM has been reduced by the FDA from a 12-month restriction since last sexual act to 3-months for blood donation.

For more information on if you are eligible to donate blood please see the link below. At the time of writing, this link has not been updated to reflect the recent change in FDA policy on MSM.

https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements/eligibility-criteria-alphabetical.html

— 𝗜𝗱𝗲𝗻𝘁𝗶𝗳𝘆 𝗽𝗲𝗼𝗽𝗹𝗲 𝗶𝗻 𝘆𝗼𝘂𝗿 𝗹𝗶𝗳𝗲 𝘁𝗵𝗮𝘁 𝗵𝗮𝘃𝗲 𝗮 𝗵𝗶𝘀𝘁𝗼𝗿𝘆 𝗼𝗳 𝗱𝗲𝗽𝗿𝗲𝘀𝘀𝗶𝗼𝗻 𝗼𝗿 𝗺𝗮𝘆 𝗯𝗲 𝗮𝘁 𝗿𝗶𝘀𝗸 𝗮𝗻𝗱 𝗰𝗼𝗻𝘁𝗮𝗰𝘁 𝘁𝗵𝗲𝗺.

With people being told to shelter-in-place or self-quarantine, anxiety about the unknown is now common. We need to be proactive about early identification of signs of worsening mental illness and help each other.

I have provided a large list of resources at the end of this guide for mental health assistance.

— 𝗖𝗼𝗻𝘁𝗮𝗰𝘁 𝘆𝗼𝘂𝗿 𝗽𝗵𝘆𝘀𝗶𝗰𝗶𝗮𝗻(𝘀) 𝗮𝗻𝗱 𝗮𝘀𝗸 𝗶𝗳 𝘁𝗵𝗲𝘆 𝗵𝗮𝘃𝗲 𝗮 𝘁𝗲𝗹𝗲𝗺𝗲𝗱𝗶𝗰𝗶𝗻𝗲 𝗼𝗽𝘁𝗶𝗼𝗻 𝗳𝗼𝗿 𝗮𝗽𝗽𝗼𝗶𝗻𝘁𝗺𝗲𝗻𝘁𝘀.

— 𝗤𝘂𝗶𝘁 𝘀𝗺𝗼𝗸𝗶𝗻𝗴, 𝗶𝗺𝗽𝗿𝗼𝘃𝗲 𝘆𝗼𝘂𝗿 𝗯𝗹𝗼𝗼𝗱 𝗽𝗿𝗲𝘀𝘀𝘂𝗿𝗲 𝗮𝗻𝗱 𝗯𝗹𝗼𝗼𝗱 𝘀𝘂𝗴𝗮𝗿𝘀.

There has never been a more critical time to quit smoking than now. Poorer outcomes and death have been seen in those with lung disease, uncontrolled hypertension, and poorly-controlled diabetes.

— 𝗖𝗼𝗻𝘁𝗮𝗰𝘁 𝗲𝗹𝗱𝗲𝗿𝗹𝘆 𝗶𝗻𝗱𝗶𝘃𝗶𝗱𝘂𝗮𝗹𝘀 𝗶𝗻 𝘆𝗼𝘂𝗿 𝗹𝗶𝗳𝗲 𝘃𝗶𝗮 𝗽𝗵𝗼𝗻𝗲 𝗼𝗿 𝗼𝘁𝗵𝗲𝗿 𝗿𝗲𝗺𝗼𝘁𝗲 𝗰𝗼𝗺𝗺𝘂𝗻𝗶𝗰𝗮𝘁𝗶𝗼𝗻 𝗺𝗲𝘁𝗵𝗼𝗱𝘀 𝘁𝗼 𝗺𝗮𝗸𝗲 𝘀𝘂𝗿𝗲 𝘁𝗵𝗲𝘆 𝗮𝗿𝗲 𝗵𝗲𝗮𝗹𝘁𝗵𝘆 𝗮𝗻𝗱 𝗵𝗮𝘃𝗲 𝗽𝗹𝗲𝗻𝘁𝘆 𝗼𝗳 𝗳𝗼𝗼𝗱 𝗮𝗻𝗱 𝗿𝗲𝘀𝗼𝘂𝗿𝗰𝗲𝘀. 𝗧𝗮𝗹𝗸 𝘄𝗶𝘁𝗵 𝘁𝗵𝗲𝗺 𝗮𝗯𝗼𝘂𝘁 𝘁𝗵𝗲 𝗶𝗺𝗽𝗼𝗿𝘁𝗮𝗻𝗰𝗲 𝗼𝗳 𝘀𝗼𝗰𝗶𝗮𝗹 𝗱𝗶𝘀𝘁𝗮𝗻𝗰𝗶𝗻𝗴.

— 𝗣𝗿𝗮𝗰𝘁𝗶𝗰𝗲 𝘀𝗼𝗰𝗶𝗮𝗹 𝗱𝗶𝘀𝘁𝗮𝗻𝗰𝗶𝗻𝗴.

When around groups of people in an enclosed environment, try to keep a 6-foot distance from others.

— 𝗜𝗳 𝘆𝗼𝘂 𝗮𝗿𝗲 𝘀𝗶𝗰𝗸 𝗮𝗻𝗱 𝗻𝗼𝘁 𝘄𝗲𝗮𝗿𝗶𝗻𝗴 𝗮 𝗺𝗮𝘀𝗸, 𝗰𝗼𝘂𝗴𝗵 𝗶𝗻 𝘁𝗵𝗲 𝗶𝗻𝘀𝗶𝗱𝗲 𝗼𝗳 𝘆𝗼𝘂𝗿 𝘀𝗵𝗶𝗿𝘁, 𝗶𝗻𝘀𝗶𝗱𝗲 𝗼𝗳 𝘆𝗼𝘂𝗿 𝗲𝗹𝗯𝗼𝘄, 𝗼𝗿 𝗼𝗻 𝗮 𝘁𝗶𝘀𝘀𝘂𝗲 𝘁𝗵𝗮𝘁 𝗶𝘀 𝗶𝗺𝗺𝗲𝗱𝗶𝗮𝘁𝗲𝗹𝘆 𝗱𝗶𝘀𝗰𝗮𝗿𝗱𝗲𝗱 𝗶𝗻𝘁𝗼 𝗮 𝘁𝗿𝗮𝘀𝗵 𝗯𝗶𝗻. 𝗙𝗼𝗹𝗹𝗼𝘄 𝘁𝗵𝗶𝘀 𝘄𝗶𝘁𝗵 𝗶𝗺𝗺𝗲𝗱𝗶𝗮𝘁𝗲 𝗵𝗮𝗻𝗱 𝘀𝗮𝗻𝗶𝘁𝗮𝘁𝗶𝗼𝗻.

This is important even if you are alone to reduce the chance of surfaces in your environment being contaminated with the virus.

If you are at home sick, put on a mask anytime a caregiver is within 6 feet of you.

— 𝗠𝗮𝗸𝗲 𝘆𝗼𝘂𝗿 𝘃𝗼𝗶𝗰𝗲 𝗵𝗲𝗮𝗿𝗱!

Encourage locations that cause people to congregate close for prolonged periods of time (churches, concert venues, bars, etc.) to suspend activities or use webcasts. We as individuals need to be responsible for reducing the spread of SARS-CoV-2. Do more than not show up: help stop the spread in the community through direct activism.

— 𝗕𝗲 𝗮 𝗰𝗮𝗹𝗺, 𝗿𝗮𝘁𝗶𝗼𝗻𝗮𝗹 𝗹𝗲𝗮𝗱𝗲𝗿 𝘄𝗶𝘁𝗵 𝘆𝗼𝘂𝗿 𝘀𝗼𝗰𝗶𝗮𝗹 𝗺𝗲𝗱𝗶𝗮 𝗽𝗼𝘀𝘁𝘀.

Do not spread photos of empty store shelves on social media. What starts as someone posting a photo of an empty toilet paper shelf, prompts others to simultaneously go out and wipe store shelves clean out of fear of shortages. Posting the photos creates a self-fulfilling prophecy. The grocery supply chain has not been disrupted, and shortages are simply due to unnecessary overbuying exceeding expected demand.

Additionally, do not post news stories about new and unproven medications against COVID-19 or new routes of transmission.

— 𝗣𝗮𝘆 𝗮𝘁𝘁𝗲𝗻𝘁𝗶𝗼𝗻 𝘁𝗼 𝗰𝗼𝗻𝘁𝗮𝗰𝘁/𝗸𝗶𝗹𝗹 𝘁𝗶𝗺𝗲𝘀 𝗳𝗼𝗿 𝗱𝗶𝘀𝗶𝗻𝗳𝗲𝗰𝘁𝗮𝗻𝘁𝘀 𝘁𝗼 𝗽𝗿𝗲𝘃𝗲𝗻𝘁 𝗳𝗼𝗺𝗶𝘁𝗲 𝘁𝗿𝗮𝗻𝘀𝗺𝗶𝘀𝘀𝗶𝗼𝗻.

When you are cleaning surfaces that may be contaminated, pay attention to the chemical contact/kill time of the product you are using against SARS-CoV-2. This means that once you use the disinfectant, be it a wipe or a spray, you must leave it on the surface and visibly wet without wiping, rinsing, or touching the surface for the duration of the contact time before it is safe to use.

If the information is not on the product label, there is an easy short-cut to determine the contact time:

Simply bookmark the following link on your phone:

https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

Now look at the label of the product in question and find the “EPA Registration Number” which is on the back of all disinfectants. Type that number (including the hyphen) into the search box and you will see the contact time as well as recommended surfaces to use it on.

For example, if you are wiping down a grocery cart handle with a Lysol wipe, punching the EPA number (777-114) into their database shows a contact time of 10 minutes for SARS-CoV-2. This would mean you would have to wipe your grocery handle and wait 10 minutes before touching it to ensure the surface is clean for SARS-CoV-2. Waiting 10 minutes for your shopping cart is probably something you don’t want to do, so check your products before you buy them in this database.

When in doubt about if you contacted a contaminated surface, wash your hands as soon as possible, and don’t touch your mouth, nose, or eyes.

— 𝗖𝗹𝗲𝗮𝗻 𝘆𝗼𝘂𝗿 𝗽𝗵𝗼𝗻𝗲 𝘀𝗰𝗿𝗲𝗲𝗻.

Use 70% isopropyl alcohol either as a pre-packaged wipe or with a microfiber cloth. Do not use this on any “holes” on your phone (charging ports, speakers, etc). If your phone screen is cracked and you are worried about liquid damage, I recommend putting a glass screen protector over your cracked screen, and then cleaning that surface.

— 𝗗𝗼𝗻’𝘁 𝗽𝗮𝗻𝗶𝗰 𝗮𝗯𝗼𝘂𝘁 𝘁𝗵𝗲 𝗹𝗮𝗰𝗸 𝗼𝗳 𝗵𝗮𝗻𝗱 𝘀𝗮𝗻𝗶𝘁𝗶𝘇𝗲𝗿. 𝗨𝘀𝗲 𝘀𝗼𝗮𝗽 𝗮𝗻𝗱 𝘄𝗮𝘁𝗲𝗿 𝗶𝗻𝘀𝘁𝗲𝗮𝗱!

Don’t worry about stores not having hand sanitizer or bother making your own. Soap works as well or better. You should also wash your hands for 20 seconds using the method I link below.

https://www.who.int/gpsc/clean_hands_protection/en/

— 𝗗𝗶𝗱 𝘆𝗼𝘂 𝘀𝘁𝗼𝗰𝗸𝗽𝗶𝗹𝗲 𝗡𝟵𝟱 𝗺𝗮𝘀𝗸𝘀?

If the boxes haven’t been opened, see if your local hospital will accept them. We are experiencing severe shortages and your donation can absolutely save lives.

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This guide was written in the memory of Li Wenliang, Marcello Natali, and the countless medical heroes who have given their lives to save their communities from this disease.

Special thanks to the following: bit.ly/covidcredits

𝗠𝗲𝗻𝘁𝗮𝗹 𝗛𝗲𝗮𝗹𝘁𝗵 𝗥𝗲𝘀𝗼𝘂𝗿𝗰𝗲 𝗟𝗶𝘀𝘁

UCSF has compiled a very good website/guide with pragmatic and proactive steps for addressing the mental health implications of this pandemic:

https://psychiatry.ucsf.edu/coronavirus

If you have health insurance, call the member-services number on the back of your card and ask for a list of in-network mental health providers providing telehealth services.

For a better idea what changes to allow you to access mental health services have taken place with your insurance carrier or your state, please see this website

https://www.psychiatry.org/psychiatrists/covid-19-coronavirus/practice-guidance-for-covid-19

𝗘𝗺𝗲𝗿𝗴𝗲𝗻𝗰𝘆 𝗛𝗼𝘁𝗹𝗶𝗻𝗲𝘀:

National Suicide Prevention Lifeline 1-800-273-8255

LGBT National Hotline 1-888-843-4564

GLBT National Youth Talkline (youth helping youth through age 25) 1-800-246-7743