Over the last few weeks, many of us in the UK have been careful to socially distance ourselves from others in order to slow down the spread of the SARS-CoV-2 (COVID-19) viral outbreak. The requirements are as follows:
Stay at home
- Only go outside for food, health reasons or work (but only if you cannot work from home)
- If you go out, stay 2 metres (6ft) away from other people at all times
- Wash your hands as soon as you get home
Do not meet others, even friends or family.
You can spread the virus even if you don’t have symptoms.
These precautions are effective and appropriate for almost everyone, however, there are a few people who are more vulnerable due to age or a specific health condition and may need to take further precautions. Some, but certainly not all patients with aspergillosis will fall into that category, and in some cases will have to be individually considered by your doctor.
If you fall into the extremely vulnerable category you will be informed by a letter from UKgov, your GP, you local hospital doctor or for some (those with CPA) from the National Aspergillosis Centre. This is known as the shielding letter.
If you are extremely vulnerable
The UK government have severe asthma and severe COPD as conditions that put people at high risk from the coronavirus COVID-19 outbreak. The full document published by Public Health England(March 24th) which also contains links to a large number of other relevant documents can be accessed here. Aspergillosis refers to a range of diseases and individual cases, some of which may fall into the high-risk category but some will not.
The main points (in addition to maintaining good handwashing, cough into tissues) are:
- Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough.
- Do not leave your house.
- Do not attend any gatherings. This includes gatherings of friends and families in private spaces for example family homes, weddings and religious services.
- Do not go out for shopping, leisure or travel and, when arranging food or medication deliveries, these should be left at the door to minimise contact.
- Keep in touch using remote technology such as phone, internet, and social media.
All people at high risk are being informed of this by text/email/letter over the next week so that they are fully aware of what they must do to protect themselves.
In our discussions with aspergillosis patients, a few more points relating to social isolating that are not fully covered by the above document have been raised, so we will try to answer them here – if you have more questions please join our Facebook group and discuss it there.
Can I use my garden?
If you have a private garden and can maintain social distancing from neighbours and other people living in your home the answer is yes.
Deliveries: can I catch the virus?
There is a specific research paper that answers some of these questions. COVID-19 survival on a variety of surfaces was measured under one set of conditions:
SARS-CoV-2 is the current virus (2020 outbreak) which appears as red markers in each graph. We can see that the length of time it takes for the virus to lose half of its infectious particles (ie the half-life) is shortest for cardboard(3-4hrs) and copper (1 hr), so any virus on cardboard packaging should last the least amount of time, whereas the half-life was 6-7 hours for plastic, or roughly twice as long.
Given that someone who is infected by SARS-CoV-2 (COVID-19) can produce over a million viruses in their throat, we can see that a single cough could contain hundreds of thousands. If that number landed in cardboard it would take over 2 days for the virus to ‘die-off’, twice as long as that for plastic. Clearly it is sensible to take precautions with deliveries depending on what they are wrapped in and wipe them down with sanitiser containing more than 60% alcohol or bleach, or this US EPA document is very useful describing a large choice of disinfectants.
How easy is it to be infected if someone is coughing?
The paper above shows that the half-life of the virus under standard conditions as an aerosol ie after a cough or sneeze is similar to copper and can stay in the air for at least an hour, though the majority are thought to sink to the floor within 2-metre area in minutes. It will take 12-24 hours to die-off in air, perhaps longer under non-standard conditions (e.g. warmer temperature or higher humidity) but perhaps longer when it lands depending on the surface it lands on. This is why thorough hand washing is vital to prevent the settled virus from being passed on, and 2-metre spacing keeps us away from direct aerosols in the event of someone coughing.
Should I be cleaning my phone?
The figures given above for the survival of the virus on plastic are helpful when you realise that we all carry around a plastic screen, hold it in our hands, put it up against our faces. If any viruses land on our phones they can remain viable for over 4 days. For that reason, we should be cleaning our phones regularly, at least daily. Use alcohol-based wipes – this article gives more detail.
Disinfecting surfaces: What should I use?
Confusingly different disinfectants need to be used in different ways, and different surfaces may need different disinfectants. The best disinfectants for your hands & skin are preferably soap & running water as the soap unsticks & disables the virus and the water washed it off and dilutes the virus in your skin very efficiently – hot water with soap best of all. If you cannot access running water then hand sanitisers containing at least 60% alcohol (NOT just soap & surfactants) are effective until you can wash your hands properly.
NOTE that most wet wipes/baby wipes are designed to clean and NOT kill coronavirus.
For other surfaces, there are a range of useful disinfectants but some are no good for disinfecting surfaces covered in virus and many need to be left on the surface for longer than you think! Thankfully this document from the US Environmental Protection Agency is very informative.
Cleaning an area that has been exposed to SARS-CoV-2 eg after someone in a house has been diagnosed as Coronavirus positive and has left
Myths to ignore
BBC part 1
- Drink water
- Ice cream
- Drinkable silver (colloidal silver)
and part 2
- Holding your breath
- Home-made hand sanitizer
- The virus can survive on surfaces for a month
- Cow urine
I haven’t received a shielding letter, what do I do?
Letters are still being sent out, you may yet receive one and until then the general advice is to socially distance yourself from everyone (see above) rather than shield yourself. For people with asthma who have not received a letter Asthma UK have released some guidelines suggesting further action
For people with chronic lung disease, the British Lung Foundation have released some helpful guidelines.