First published: March 23, 2020 | Last updated: July 14, 2020
This guide is also available in Spanish

This guide, developed by physician experts in Medicine and Infectious Diseases, offers step-by-step instructions for some of the most common situations you might encounter, focusing on how you can protect yourself and your community:

  1. In Public Places (including where you work)
    a)
    What to avoid
    b)
    Keeping your hands clean
    c)
    Transportation
    d)
    Other advice for preventing the spread of coronavirus
    e)
    When to wear a mask or cloth face cover

IN PUBLIC — INCLUDING WHERE YOU WORK

PART A: What to avoid

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

It is OK to leave your home to walk, jog, bike, and walk your dog.

In fact, this is encouraged to help you maintain your mental and physical health, but maintain 6 feet of space between you and others and follow the hand-hygiene guide below.

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

Avoid touching any surfaces others might touch

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

Additional objects to try to avoid touching include:
hand railings
elevator buttons
payment terminals at shops
tabletops
chair armrests
workout equipment at gyms

PART B: Keeping your hands clean

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

❏ Carry hand sanitizer that has at least 60% alcohol in its list of “active ingredients” with you at all times. DIY hand sanitizer

❏ Use hand sanitizer:
before touching any surface (to protect others).
after (to protect yourself).

❏ Sanitize your hands before touching your cell phone, every time.

❏ Avoid touching your head, face, eyes, or neck.
→ If you NEED to touch your face, sanitize your hands before and after.

❏ Do not touch other people, especially their faces, hands and arms.
→ If you NEED to touch other people, sanitize your hands before and after.

The CDC does not recommend wearing gloves in public. We agree. You can still pick up the virus on the gloves and you are less likely to clean your hands while wearing gloves.

PART C: Transportation

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

It is safest to walk, bike (your own personal bike), or drive a personal car to your destination.

If you can, try to avoid all public transportation, including bus, subway, train, taxicab, ride-share, bike-share, plane, and ferry.

If you must use public transportation, please follow the instructions in Part B.

If you drive a personal car:

  1. Sanitize your hands before touching the vehicle and your keys.

PART D: Other advice for preventing the spread of coronavirus

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.
Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

PART E: Masks

SECTION 1: MEDICAL MASKS

Photo by National Cancer Institute on Unsplash

In general, wearing a mask meant for a healthcare worker is NOT RECOMMENDED unless advised by your doctor. These masks are often called “surgical masks.”

Update: On April 3, 2020, the CDC recommended that everyone wear a cloth face cover when in public. Please see Section 2, below, for guidance.

If your doctor advises you to wear a medical mask, the World Health Organization (WHO) has a great site explaining when and how to wear a mask.

A few examples of when you might be advised to wear a medical mask:

❖ If you have symptoms, live with others, and you must be in the same room.
❖ If you are taking care of someone with symptoms who is unable to wear a mask.
❖ If you develop symptoms and are instructed to go to a hospital or healthcare center.

Otherwise:
➢ Do not wear a medical mask unless you have symptoms and must leave your home.
➢ Do not buy N95 respirator masks for public or home use.
**Health workers desperately need these masks to provide patient care and supplies are running short across the country and the world.

Most importantly, though:
If you have more than 10 medical masks at home:
**Please donate them to your local hospital today.

If you have any N95 respirator masks at home:
**Please donate them to your local hospital today.

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

SECTION 2: CLOTH FACE COVERS

Photo credit: visuals on Unsplash

On April 3, 2020, the U.S. Centers for Disease Control (CDC) recommended that everyone wear a cloth face cover when in public, particularly in places where physical distancing will be hard to maintain, like at grocery stores, at pharmacies, and while riding public transit. The World Health Organization (WHO) has made a similar recommendation.

The decision to wear a cloth face cover remains an individual choice in most locales, but here’s what we think you should know:

  • Wearing a cloth face cover MAY help reduce spread of coronavirus to those around you if you are infected and don’t know it.

If you choose to wear a cloth face cover (recommended):

  • Continue to treat all surfaces in public like they have coronavirus on them.
Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

Here are four options for sanitizing your cloth face cover:

  1. Wash in hot water and detergent in the washing machine. Dry completely.

*If your cloth face cover is visibly soiled, use only option #1 or #2.

How often should I sanitize my cloth face cover?

  • The CDC and WHO simply say “often” or “frequently.”

How do I make a cloth face cover?

How many cloth face covers should I make or buy?

  • Consider having at least a few, so that you can rotate them and allow more time between the use of each one.

AT HOME

Your home should be your safe space. You should be able to relax at home and act normally without fear of the virus. The coronavirus can spread through the air as droplets and aerosols. It can also survive on some surfaces for over 3 days.

→ In order to make your home a safe space, first you’ll need to thoroughly clean your home.
→ After that, the #1 goal is: don’t bring the virus home with you.

PART A: Cleaning your home for the FIRST TIME

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

Disinfect any other frequently touched surfaces, including:
counter tops
utensils
plates
glassware
any other surfaces that the virus can live on for long periods such as plastic objects (e.g. pens, video game controllers) and stainless steel objects (e.g. silverware) that anyone has touched in the past week

For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective.

Photo credit: Kelly Sikkema on Unsplash

These are just a few common household cleaners you could use, from the EPA’s very long list:

● Clorox Multi Surface Cleaner + Bleach
● Clorox Disinfecting Wipes
● Lysol Brand Clean & Fresh Multi-surface Cleaner

PART B: EVERY TIME you return to your home

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

Sanitize:
Clean the outer surfaces of all items you’ve brought home with an approved virus-killing cleaning solution.
*This CDC guide has excellent detailed cleaning instructions.

Quarantine:
Allow them to sit untouched for an appropriate amount of time to allow any virus on them to die (could be up to several days for plastics).
*See the WHO FAQ for up-to-date information on how long the coronavirus is thought to survive on surfaces.

PART C: Receiving Deliveries

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

Treat anything you bring into the home as potentially having coronavirus on it.

There are 2 options to dealing with the package itself: quarantine or clean.

Quarantine the package:

  1. For cardboard packages: leave package in an out-of-the-way area for at least 24 hours.
    For plastic packages: leave package in an out-of-the-way area for at least 3 days.

-or-

Clean the package:

  1. Disinfect outer surface of package.
Photo credits: Wynand van Poortvliet, Liam Kevan, Rhodi Lopez, Joshua Earle on Unsplash

IF YOU DEVELOP SYMPTOMS

Graphic by: @FutureMDvsCOVID. A downloadable/printable PDF of this graphic is available here.

If you have any new symptoms of a viral infection, like fever, chills, cough, excessive tiredness, muscle aches, mild shortness of breath, sore throat, headache, runny nose, nausea, vomiting, diarrhea, or loss of your sense of smell, then act like you DO have coronavirus.

If you have mild or moderate symptoms and can manage at home:

  1. Call your doctor to let them know that you have symptoms. They will let you know if they think you should be tested and give you further instructions.
    *If you do not have a doctor, look for local resources or telemedicine options.

If you develop severe symptoms, call 911 to be transported to the hospital for evaluation.
Let dispatchers know that you might have coronavirus so the first responders can prepare adequately.

Photo credit: camilo jimenez

We plan to update this guide as we learn more about the coronavirus and how to combat it. Please see below for additional resources we think you will find helpful.

_______________________________

Authors and Peer Reviewers:
Andrew Junkin, MD
Julia Cooperman, MD MS.Ed
Sigall K. Bell, MD
Dan Schwarz, MD MPH

Elisabeth Merchant, MD
Lachlan Forrow, MD
Christina Yen, MD
Ahmed Abdul Azim, MD
Adam Strauss, MD
David Kopelman, MD
Joshua Allen-Dicker, MD MPH SFHM
Shree Lata Radhakrishnan, MD MSCI
Ashley E. D. Kane, MD MSCR
Polly van den Berg, MD
Monica Mahoney, PharmD
Jennifer Hu, MD
Peter F. Weller, MD (Chief, Divisions of Infectious Disease; Allergy & Inflammation)
Eileen Reynolds, MD (Chief, Division of General Medicine & Primary Care)
Mark L. Zeidel, MD (Chairman, Department of Medicine)

The above is a collaborative of faculty and post-graduate fellows in the Department of Medicine at Beth Israel Deaconess Medical Center in Boston, Massachusetts, a teaching hospital of Harvard Medical School. The info-graphics from this guide were created by a team of Harvard Medical School students.

Since the novel coronavirus (COVID-19) is a new infection, there are a lot of questions that no one in the world knows the answers to right now! Our advice may change as we learn more.

This guide does not take the place of instructions you receive from your doctor or other healthcare professional. If you have medical concerns, please contact your doctor, healthcare professional, or local public health authority.

To learn more about the novel coronavirus that causes the disease COVID-19, please see the CDC guide. It is a great place to start and has answers to many basic questions.

Complementary resources:

  1. How to prepare for and navigate a telehealth appointment.

References:

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

Physician & Educator

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