Editor’s Note: Information about the novel coronavirus is rapidly changing. As a result, some of the information or advice in this article may be out-of-date. You can find The Atlantic’s most current COVID-19 coverage here.
Updated at 9:38 a.m. ET on March 17, 2020.
The coronavirus is now testing the global population in ways no microbe has for a century. Much is unknown about exactly how this particular virus causes the disease known as COVID-19, but much is known about how best to stop it. The basic principles of disease mitigation that have worked reliably for millennia—hygiene and social distancing—are no less applicable today.
While the world waits for vaccines and medications, slowing the spread of the new virus is crucial. The more people who are infected at once in a given area, the greater the strain on local health-care systems. When those systems are overrun, people will die who could have been saved in less demanding circumstances. Minimizing that impact requires every single person to take part. Individual behaviors matter in an immediate sense. They matter especially among the demographic most likely to survive an infection—the young and healthy—who may need to pay the closest attention to preventive measures. These are the people who may spread the disease while believing that they have only a bad cold. They can infect the elderly, or people who have chronic diseases or immune conditions, who are less likely to survive.
A lot of prevention advice is going around, both good and bad. I hope it’s helpful to compile some of the former in one place. Much of what follows is not original—generally don’t trust health advice that no one else is giving—and please bear in mind that any guidance can and should change as the situation develops. Local health departments and personal physicians should tailor recommendations for specific populations and scenarios.
That said, here are preventive measures that people are considering at the moment, and some notes that are worth your time and attention. The things most of us take for granted as common knowledge must now be acted upon. We all know how to do these things; now we just need to actually do them.
Using hand sanitizer
It works, if you can find it. Use it often. Make sure it’s alcohol-based (at least 60 percent alcohol). There are some “natural” products that contain less, or none, designed to be less drying to your hands. These can’t be counted on. You can also make your own with isopropyl alcohol, if you can find it.
This is always important, but especially now. Wash your hands for 20 seconds, regularly. Note that soap works ideally in combination with scrubbing and heat, but cold water works far better than nothing. You do not need antibacterial soap; the coronavirus is a virus, not a bacterium.
Cleaning hand towels
Wash them often, too.
It’s not a clearly threatening practice, and physical touch has its own value to consider, as do gestures of respect. But I’ve been an advocate of alternative forms of greetings such as fist bumps for years, and this outbreak doesn’t change that.
Touching your face
The person most likely to give you this virus is you. It will happen when you touch something coated in viral particles, getting them onto your fingertips, and then touch your face. Avoiding touching your face would be very effective, but no one is going to stop, at least not entirely. That said, if everyone did even a little less face touching, it might make a dent collectively. (If every person on Earth touched their face one fewer time each day, that would mean 230 billion fewer face touches a month.)* The other option is to touch only your face and nothing else.
Here’s an unproven suggestion from me that transcends this particular outbreak: All business and public spaces should turn their bathrooms’ doors around, so you push on the way out rather than the way in. If building codes or other safety codes prohibit this, install a foot pull. Or, as long as privacy is moderately protected, remove the door altogether. If none of this is possible, at least put the trash can for paper towels outside the door so everyone can use a paper towel to touch the handle.
Disinfecting common surfaces
The crux of all the focus on hand-washing is that you’re unlikely to get the virus from someone coughing or sneezing directly into your face. You are much more likely to catch the virus by touching something that someone else touched after coughing into their hand. This can partly be prevented by disinfecting surfaces.
The most commonly touched surfaces in homes and offices, especially shared spaces, are priority. Countertops, remote controls, and refrigerator handles should be disinfected regularly. That said, it’s very possible to become compulsive about this in ways that have their own risks. Any given surface is very unlikely to harbor a dangerous virus, so it’s possible to overdo this and waste a lot of time, resources, and concern. But if you’re the sort to typically only clean things that look visibly dirty, do consider the invisible.
This one warrants its own special note because phone screens may be the surface we touch the most. Other, similar coronaviruses are known to live on glass for up to four days. If you’ve been touching your phone with viral hands, then you do a beautiful job washing those hands, and then you touch your phone again, you may have just recontaminated yourself. I’m not suggesting constantly cleaning your phone. The Centers for Disease Control and Prevention currently recommends once a day, though I don’t see how—if it’s worth doing at all—that would be often enough. That said, I have never once cleaned my phone. (Editor’s note: Since publication, the author has begun to clean his phone nightly.)
Masks seem logical as preventive measures because the disease is spread by respiratory droplets, which can travel simply by breathing but mostly distribute in plumes from coughs or sneezes. If you were sick and had to leave home for some reason, ideally you would wear a surgical mask. But even this precaution is far from perfect—the wearable equivalent of sneezing into your elbow instead of right in someone’s face. You’re still infectious and should behave accordingly. The World Health Organization has published recommendations for when civilians should use masks. But stockpiling also deprives other people who might have needed to follow those guidelines.
The U.S. surgeon general, Jerome Adams, has urged Americans to stop buying face masks. This is a matter of short supply, should worst-case scenarios play out. In an ideal world, people who live with other people would have masks on hand when someone in the house gets sick, and they could help prevent close-quarters spread. But this is not an ideal world, and masks are needed for the people who are at the highest risk. When doctors, nurses, and first responders cannot work, new crises present themselves.
This mainly applies to people in remote areas where the town’s one grocery store could close down. Closing the store would be preferable to having sick employees report to work. In these areas, it’s always advisable to have a short-term supply of food (for any natural disaster), and this would be fair to treat similarly. Elsewhere, supply chains could be threatened, requiring certain shippers or grocers to close temporarily and certain foods to become scarce in certain areas, but none of this is cause for stockpiling.
Stockpiling prescription medications
Most U.S. prescription medications are made in China, whose own outbreak has raised concerns about medication supply chains. As of now, supplies have not been disrupted, and China is reporting declines in the spread of the virus. As with food, though, anyone who has a vital prescription and lives in a place where access would be affected by the single shutdown of a local pharmacy or a public-transit system, for example, should always have a small supply for emergencies. Health-care providers should help ensure this.
It’s always advisable to avoid travel if you’re sick, and especially now. Until the world has a better handle on how far this virus has spread and what to do about it, travel of all sorts should ideally be kept to a minimum. But no stay home directive is sustainable for long periods, and urgent life events will overlap with this outbreak. So guidance about this will be targeted, and ideally informed by easy screening and testing that can advise people with the sniffles whether they are fine to get on a plane or should urgently self-quarantine.
This is an extremely imperfect directive, as so many people’s jobs and other obligations make it impossible. But no single recommendation is perfect or universally applicable. And Americans have proved, flu season after flu season, that many workplaces are not accommodating enough of staying home. If workplaces are not accommodating, business may suffer even more in the long run, if more shutdown measures are taken.
Seeking medical care
This may be the most crucial question: When do mild symptoms warrant attention? Most people are not accustomed to seeking care or testing when they have a mild cough or runny nose. My hope is that, in the coming days and weeks, local and federal officials share clear guidelines for exactly how and when to seek medical attention early in the disease’s course. China’s containment measures depended on early detection that isolated people at the beginning of their infectious stage. Then again, we can’t have everyone with a cough and sniffles rushing to doctors’ offices.
South Korea pioneered drive-through screening clinics. The idea seems smart: There are no doorknobs to touch, no crowded waiting rooms with magazines that have been coughed on for months. Maybe most important, there is no paperwork to fill out and no cost. If an outbreak hits a major city, clinics and hospitals will likely be overrun with people who have cold and flu symptoms. Some of those people will need reassurance that they can go home and will be fine; others will need admission to a hospital; others may need an intermediate level of care, monitoring, and quarantine.
No matter your position, there are people who stand to lose much more than you do if they get sick. No matter how worried you are, there are people who are more worried. Look out for them, and help make sure everyone takes these basic measures and doesn’t panic. Societies break down when people fear one another as simply bipedal distributors of infectious agents. See people as allies in this unique moment of uncertainty.
*This article previously misstated the number of face touches that could be avoided if the entire global population touched their face one fewer time per day.
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