Source: The Conversation (Au and NZ) – By Sunanda Creagh, Head of Digital Storytelling
A suite of new measures aimed at slowing the spread of the coronavirus COVID-19 have been announced by federal and state governments in the last 24 hours.
We’ve collated the regulations in an infographic below – but it’s important to remember the situation is rapidly changing.
The regulations clearly proscribe some activities but are silent on others. So we asked two infectious disease researchers to reflect on some common scenarios.
They stressed the basics apply in any situation – wash your hands regularly with soap and water, practice good cough and sneeze etiquette, stay away from others if you’re unwell and try to reduce contact with others. Where contact is required, we should stay at least 1.5 metres apart from other people (one researcher, Ian M. Mackay said 2 metres would be better).However, there’s often no single correct answer. All we can do is make the best decision we can in line with the medical evidence, the directions from government, and our own abilities and priorities. Difficult choices lie ahead for all of us.
Can I walk the dog?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: Walking the dog should be fine. If you were to walk past someone who was actually sick, you’d be classed as a “casual contact” just by going past them. If you had a face-to-face conversation within 2 metres of them, you’d be classed as a “close contact” just because you have had that face-to-face conversation. So really, the advice is: just keep walking, don’t stop or chat.
Sanjaya Senanayake, infectious diseases physician: Yes, that wouldn’t be a problem. Just try to avoid very crowded areas and keep your distance from other people by staying at least 1.5 metres apart. I think, in this climate, to have some physical outdoor exercise, if you can, is a good idea. If it’s a dog park with lots of dogs running around while their owners stand around and chat, just be careful to stay at least 1.5 metres apart from the other owners.
Can I have a friend over?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: It’s better not to. When we are sharing the same room for two hours or more you can increase your risk, even if you are 2 metres apart. Prolonged time in the same room is a real risk so it’s better not to be spending a long time together.
If you decide to do it, you need to be 2 metres apart, your house needs to be really clean, don’t share any utensils, wash your hands a lot.
It’s better, though, if you can put that off and have the conversation by phone or Zoom, FaceTime or Skype.
Sanjaya Senanayake, infectious diseases physician: If you’re aiming for true social isolation, there’s a risk with every encounter you have. But if it’s just one friend and you are both well and you practice good hand hygiene and stay at least 1.5 metres apart when chatting, it could be okay. There’s a risk but you can reduce the risk.
You could possibly avoid food that has been touched by other people. Maybe bring your own food and drink.
Should I have my child’s tutor over?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: It would be better not to have that happen. Even if they are more than 2 metres, it’s prolonged exposure in an enclosed room and that tutor may have visited many other houses or travelled by public transport. The tutor and the child are both at risk – as well as anyone they subsequently encounter. Remember, people can be infected but still look well.
It would be better if that could be done remotely.
Sanjaya Senanayake, infectious diseases physician: I think it’s probably OK, as long as the tutor is well and the child and tutor can work together without sitting too close. The same principles apply – good hand hygiene and stay at least 1.5 metres apart if anyone is unwell.
Should my child have a playdate?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: For now, at least until we know more, that should stop as well.
Not even if both the kids and their families have been mostly staying home. Social distancing means keeping away. Kids have close contact relationships – they don’t keep their distance from each other – and they are random and, in this context, unreliable. It would be better to stop playdates and look for other ways our kids can interact with their friends. But watch the type and amount of social media use.
We have to be serious about this stuff and that means doing as much as we can to break any chains of transmission.
Sanjaya Senanayake, infectious diseases physician: With kids, it depends greatly on the age of the kids.
For very young kids, I would say no. Younger kids are more likely to have close contact and may not be so good with hand hygiene. You just can’t trust young kids to follow the rules of good hygiene and distancing. It’s mostly about minimising the contact and trying to use other options as much as possible, such as FaceTime, Skype and Zoom. For older kids, they are likely to rely on their social media networks and that’s probably for the best.
Can my kid play at the park with a friend?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: There’s risk. It’s better to be out in the open air than in a room, because you have lot of air, often moving air, to dilute any droplets that may come from coughing or spitting when you talk and shout. But when you start doing stuff together – especially in areas with shared shiny surfaces like a public barbecue or play equipment – it gets risky. Steer clear of play equipment and water fountains, for example.
It’s better if you are keeping apart at a distance outside. But the risk isn’t zero.
Sanjaya Senanayake, infectious diseases physician: If they are young kids, they are still likely to have close contact with each other so I’d approach with caution.
Can I have in-home visit by a service provider, for example a health worker who assists a person with a disability?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: That is a tough one. The health care worker should probably wear a mask as they are at higher risk of acquiring an infection because they are visiting so many people. A health care worker would be more aware of infection control than most people but they would need to be able to keep themselves and the people they visit safe.
If you do have an in-home visit you need to clean the house as much as possible, wash hands and do whatever you can to reduce the risk.
Sanjaya Senanayake, infectious diseases physician: That is a difficult one. That will need to be looked at by health authorities.
A health care worker should not come to your house if they are unwell. If they are coming, they should call ahead and make sure the person they are visiting is also well before they arrive to provide care.
There will have to be exceptions, of course, because otherwise people who need to have dressings changed and so on they will need to come to hospital and that’s not ideal.
Health care workers are being heavily educated about when they should be tested, because they are at risk of COVID-19. If there’s a lot of COVID-19 transmission in that particular community, the health care worker should wear appropriate PPE (personal protective equipment) even if the person they are visiting is not obviously sick.
Can the cleaners come over?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: No. Clean your own house. They may be professional cleaners but they are not professionals at infection control.
And cleaning may need to be more frequent than usual. You may need to be cleaning your house more than once a week so just get used to that idea.
Sanjaya Senanayake, infectious diseases physician: Yes, I think the cleaners can come over. But if you have cleaners in your house, you should try to go out while the cleaners are there and let them do their work. Go for a walk outside, while staying at least 1.5 metres away from others.
What about sending kids to school?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: Many states are doing slightly different things with regards to schools.
I am very conscious we don’t want to drain essential workforces because some would need to stay home. So I think what NSW is doing – where parents are advised to keep kids home if they can and only send kids to school if they have no other option – is probably the best option for now.
We’ve heard there’s no reason to believe children are transmitting the virus – but there’s also no reason to believe they won’t be. If we are serious about flattening the curve, schools need to be in the picture, and we need to reduce the number of kids at school.
The risks are then to the teachers who are going to be repeatedly exposed to children who may more become infected in greater numbers as time goes on. That’s a real concern for them and for the fact they may then inadvertently be spreading virus in the community. There is no easy answer on schools which is why the issue is being constantly reassessed as we learn more.
Sanjaya Senanayake, infectious diseases physician: I still don’t think we really understand the epidemiology of infection of kids. The downside of broadscale school closures is people will have to stay home with their kids, especially for health workers. And if that’s unnecessary then it’s not ideal. I don’t know the right thing to do. It’s a tough one.
Can I go for a walk with a friend or friends?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: I would advise against that. We know asymptomatic transmission happens. It may happen from spitting while talking. If you are walking alongside someone and having a chat, then there is risk. If you are out in the open moving air, that reduces your risk but it’s really better to pick up the phone. You can even be on the phone and going for a walk together in separate places, or on other sides of the road and wave to each other. It is really hard but we need to get creative right now. It’s time to get very serious about doing everything you can to reduce transmission.
Testing has been limited so we may in fact have a lot more community spread than we realise right now.
Sanjaya Senanayake, infectious diseases physician: If you are outside, you have a lot of air currents to make things more safe for you. I stood at least 1.5 metres from someone and walked with them and I think that’s feasible. Just try to stay at least 1.5 metres apart.
Or go to a neighbour’s house and knock on the door but then stay at least 1.5 metres apart from them while you chat.
Should I get takeaway?
Ian M. Mackay, researcher on rare viral threats to public and environmental health: Takeaway is a good idea because it supports small business, is a treat in tough times and it takes the stress off having to cook and find food. The issue, of course, is the risk of contaminated surfaces.
The best idea is once you have got the food in the house, put the bag down and open it up. Then go away and wash your hands properly before you handle the food. Then come back and take out the food with clean hands, and then get rid of the bag. Then wash your hands again. Then away you go.
That’s not 100% foolproof because there’s still some risk, but you reduce the risk with each step.
And the social distancing rules apply all the time, whatever you are doing – whether its waiting for food or walking the dog – stay 2 metres away from other people.
Sanjaya Senanayake, infectious diseases physician: It’s a hard one. I have been wondering this, too. It’s not just getting the takeaway, its about congregating while you wait for the food to be ready. Try to maintain at least 1.5 metres distance from anyone else. If you are less than 1.5 metre from anyone but you’re there for less than 15 minutes it doesn’t count as a “close contact”.
You have to wonder: is the food contaminated with virus particles? You have to hope the staff at the restaurant aren’t working while sick and they are practising good hygiene. You and I can’t police that.
Whatever choices you make on these issues, remember it’s about risk mitigation. Hardly anything is ever zero risk. And sometimes these choices are hard.
– ref. State-by-state: how Australia’s new coronavirus rules will affect you – https://theconversation.com/state-by-state-how-australias-new-coronavirus-rules-will-affect-you-134379