Frequently Asked Questions about COVID-19

  “Shared expectations lead to predictability.”

 06      Q: Why is the 6-foot social distance rule so hard to apply?

A:       We are creatures of habit.  Our environment is organized allowing us to habitually be close to others.  Unless you constantly think about it, this environment will make it difficult to walk and stand among others at a distance.  Some examples include:

• Most sidewalks are narrow encouraging people to walk side-by side.
• Store aisles do not allow people to pass with distance between.
• Floors at checkout counters have restricted space.
• People standing in line 6 feet apart to enter a building will have others cutting in front of them.

The only answer is to constantly assess each situation and manage risk by standing aside, waiting, or finding other routes to prevent crowding.  Governor Lamont recently stated guidelines for all retail stores to address some of these usual problems of spacing.  Even then, you may discover new problems when shopping.  Thinking about them early will prepare you to react appropriately instead of habitually.  By creating one-way traffic up and down store aisles, passing carts coming the other way can be eliminated.  But we all have found someone ahead blocking the aisle while carefully selecting an item – and we quickly and closely pass by.  Are we now willing to pause and wait?  If we ourselves want to stop to find the right product and people are behind us, are we willing to walk ahead to come back up the aisle so others won’t have to pass us?  If lines are painted on the floor 6 feet apart, how will you react when you find several people ahead of you standing in the one space between lines?  Will you just ignore them and line up behind them anyway?  Or, in case they were unaware of this spacing requirement, would you speak pleasantly to them as a reminder?  Another new recommendation is for stores to limit the number of shoppers to 50% of a store’s total capacity.  Many stores have elected to limit the number to much less – say 30% of even 20% of the usual traffic.  Once inside, if you feel really crowded, would you leave and shop elsewhere?  If you waited outside to get in, would it be harder for you to leave immediately to find a less crowded store?

There is no “right answer.”  But thinking it through, we all can make safer judgements to stop acting out old habits.

07      Q: We hear there are different Covid-19 tests available (or not available!).  Why is this?

A: To effectively manage this pandemic, two different sets of information are required.  These are the presence of live virus in a person, and a later determination that the person has recovered from the disease.

Diagnostic: the “COVID-19 RT-PCR” was the first test we were told about.  This determines if the patient is infected and contagious. A mucous sample is swabbed and taken to a laboratory.  In a series of steps, this sample is tested for the presence of the genetic template that causes the virus to replicate itself inside cells of the infected person.  A genetic map is created of any ribonuclear molecules present.  This map is then compared to the genetic map of a known coronavirus-19 sample.  A positive result shows the person was infected and had live virus cells at the time the sample was taken.  If negative, it does not indicate their future status if they later become infected.  This test in the laboratory takes several hours.  A large batch of samples can be combined, but even then, there’s a long delay to learn of a positive result.

On March 27, 2020, the Food and Drug administration issued an “Emergency Use Authorization” to Abbott Laboratories for trial use limited to hospitals and laboratories of its rapid testing kit, “ID NOW.”.  This test also amplifies the nucleic acid in samples taken, and analyzes if it is specific to the coronavirus-9 pathogen.  But this is done in a small portable unit located at the testing site.  A full laboratory is not required.  Positive results are available in 5 minutes; negative results take longer, up to 13 minutes.  This test is not yet approved, and requires FDA evaluation before it can have widespread public application.

Diagnostic testing is most useful to identify anyone with COVI-19 requiring isolation from those not infected with coronavirus-19.  (Note: the term COVID-19 names the disease caused by the coronavirus-19 virus.)  When tests are not available, all admissions have to be considered highly infectious.  This results in stockpiles of personal protective equipment (PPE) being rapidly depleted.

Diagnostic testing is also required for wide-spread public testing to identify those not showing symptoms but may be shedding virus leading to their being quarantined.

Testing for antigens: The other test is to take a blood sample and test the serum for the antibodies that show the person had previously been infected with coronavirus-19.  This is not used as a diagnostic tool as many tested positive would already have recovered.  This test helps to more accurately identify the population of previously infected patients.  Public health officials can than more accurately map the geographic locations of the epidemic to predict future outbreaks of the disease.  Because of the apparent immunity in those who have recovered from (or “resolved”) their disease, this test would be necessary to identify individuals who might be able to return to work early.

08      Q: It’s so confusing!  First, they tell us not wear facemasks in public unless we are sick.  Now we hear that if we do wear facemasks, it might be helpful?  Why is this?

A: We have all learned that surgical face masks, and the specialized N95 masks protect the wearer from having virus particles reach their nose and mouth. Early on, fearing hoarding by the public, CDC recommended that medical facemasks not be worn by healthy people.

Evidence has increased that infected people “shed” infectious virus particles before they show symptoms.  If these asymptomatic people were wearing a cloth covering over their mouths and noses, the resulting aerosol of infectious spray will be disbursed over shorter distances.  Considerations include:

• Face coverings do not need to be sterile. Do not use medical facemasks designed for use by healthcare workers!  These are in critical shortage.  You can make your own fabric face covering.
• Use of face coverings do not substitute for social distancing and washing hands. They only provide the same protection as when among infected people with symptoms who are wearing a face cloth.
• One advantage is that reaching up to touch the face as a habitual action will touch the cloth, reminding them of this habit without actually touching their mouth or nose.
• Another advantage is that others may initially assume you are infected and move away making it easier to maintain the 6-foot separation.
• What do you do if you see someone not wearing a cloth face covering? If they don’t understand its purpose, would you pleasantly remind them they should wear one for your (not their) protection?  Would you speak to someone else nearby wearing one stating your appreciation for protecting others?  This new guideline is hard to reinforce when some of our political leaders have openly stated this is only a recommendation – that they will not personally use a face cloth.  Group reinforcement may help this recommendation become universal.

09      Q: Why do some grocery stores open early and limit shoppers to only those over age 60?

A:  This idea was originated by grocery stores as an idea to encourage older people to feel safe shopping for food.  Many (but not all) stores offer access to stores after the areas have been disinfected overnight.  Also, these early shoppers would avoid being surrounded by a larger group of shoppers of all ages – including children.

There are several issues emerging indicating this might not be such a good idea.

First is the notion that not all stores are following the same procedures.  Most stores may disinfect their shopping cart handles, but some may not.  Other options not universally followed by grocers would be spray disinfecting the aisles, and wiping all counters, open shelving and checkout areas.  Fewer stores will actually disinfect the separate cans, jars and packaged goods on the shelves.

Another concern is the assumption that none of the older shoppers are not infected and shedding virus without showing any symptoms.   This might not be true!  The greater the numbers of older individuals coming in to shop, the denser that group will become.  This places the greater number of people who are at risk of complications in one confined place.

Perhaps the better advice would be simply to let others do the shopping for you.

10      Q: Family members are used to closely sharing space as a group.  How and when should social distancing and continuous hand washing be carried out at home?

A: When living as a family unit, people are used to sharing space, hugging each other, and doing many other activities that place each comfortably in close contact.  It is important to understand that the coronavirus-19 particles do not act differently among families than in the population.  Whenever a member of a family goes out of the house to shop, to work, or do any other activity, the virus will behave the same as if they were a total stranger out there.

For the family member going outside, be rigid in following the standard guidelines.  Keep at least 6 feet away from others.  Whenever possible, wash your hands and use hand sanitizer.  You are not just protecting yourself, but your whole family.  Consider using a cloth face covering and encourage others to do the same to avoid infection from anyone without symptoms.  In an office or other locations where possible, disinfect surfaces (door handles, tables, chairs, computer keyboards, phones, etc.) before touching them.  After leaving, wash your hands and use hand sanitizer.  On returning home, leave outside any packages or shopping bags containing items purchased.  These can be sanitized before being separately brought in.  Once inside, again wash hands or use hand sanitizer, then disinfect all door knobs and surfaces you touched coming in.  Consider washing clothes if you were unable to follow the social-distancing guidelines.

For all family members at home: be patient!  Encourage and support each other to follow the coronavirus-19 guidelines.  Consider the person who is returning from outside as possibly infected.  Washing hands, using hand sanitizer and disinfecting surfaces should not be ignored.  “Old habits are hard to break!”