This post will answer these questions:
- How is this the coronavirus that causes COVID-19 transferred?
- How do I get infected with COVID-19?
- Can I go to the grocery store?
- What’s the most important steps I can take to protect myself and my family from this coronavirus?
- Should I tell people I’m sick If I have COVID-19? What will they think?
So the test was positive but no need to panic. Last night was not the greatest. I’m not so sick, but a pleasant night’s sleep it was not. I had some chills and body aches and a dry hacking cough that kept me up most of the night, but I made it through. It feels like I have a mild case of the flu. Today, the acetaminophen (1000mg every 6 hours) made a big difference and I was functional. At least I was as functional as a man can be while a prisoner in his own basement.
So how did I get this little bugger? It’s quite remarkable that something that is so small that it makes other microorganisms look like mountains has brought the entire world to its knees. What is this thing anyways and how does it spread so fast.
Viruses are simply packages of genetic material wrapped in a protein shell and packed in a lipid bag. The virus cannot propagate on its own the way bacteria can. It needs your cells for that. It injects its DNA or RNA into your cells and hijacks the machinery of your cells to reproduce itself. This virus is technically called SARS-CoV2 and the disease it causes is COVID-19. SARS CoV-1 caused the SARS epidemic in 2003. I’m going to use the term COVID19 for both.
The real issue is, how does it get in you? How does one get infected? The answer primarily is via the fomite to face pathway. The word of the day will have to be fomite. A fomite is any inanimate object that, when contaminated with or exposed to an infectious agent, can transfer the organism to someone else.
With COVID-19, the virus lives in large droplets. Large droplets are what you spew with a cough or sneeze. The good news is that they only travel 6 feet. The bad news is that my basement prison is coated in them for sure. What happens is as follows:
- Because of the size of the droplets, they fall to the ground before travelling 6 feet.
- Someone with coronavirus coughs, emitting large droplets containing the virus. Droplets settle on surfaces in the room, creating a thin film of coronavirus. The virus may be shed in nasal secretions as well, which could be transmitted to the environment.
- The virus persists on fomites in the environment. Depending on the type of surface, it may persist for roughly four days
- Someone else touches the contaminated surface hours or days later, transferring the virus to their hands.
- If the hands touch a mucous membrane (eyes, nose, or mouth), this may transmit the infection.
This is all good news because it tells us how to prevent the spread:
- Wash your hands a lot. 20 seconds with soap and water or 60% or higher alcohol hand sanitizer (Whisky is not a high enough alcohol concentration so save it, you may need it for other reasons). Don’t forget to get your wrists as well.
- Clean surfaces frequently. If you touch it, clean it. Any household cleaner will work.
- Try not to touch your face. If you have an itch that must be scratched sanitize your hands before and after.
- Even if you come into contact with the virus if you wash your hands before touching your face you won’t get infected.
- If you stay 6 feet away from an infected person they can’t cough or sneeze it on you.
What does this mean?
- If you want to go to the grocery store you can (as long as you haven’t been knowingly exposed). Just be sure to wash the cart handle with lysol wipes or with alcohol solution. Bring hand sanitizer.
- You don’t need to wear a mask. Since the virus is transmitted more from your hands by touching your face and not by directly inhaling, masks don’t help. It may be a problem if someone who is infected directly coughs or sneezes in your face which is why healthcare workers need to wear masks.
- You can go out and jog or walk. Try to stay more than 6 feet away from people. Even if you don’t stay that far away there is not much to worry about unless a jogger passes by and coughs directly on you which seems unlikely. You probably will need these outdoor treks to help you with your cabin fever. You should definitely avoid gyms and places with close contact, though.
- From the onset of symptoms do your best to think of anyone you came into close contact with in the prior 7 days and let them know you’re not feeling well.
THE MOST IMPORTANT THING:
If you feel sick, assume you have COVID-19 and isolate yourself. Think of all the people you have come into contact with and immediately let them know, so that they can take appropriate precautions. You might save a life.
My COVID Journey 
Thank you so much!! Refuah Shelamah!!! HaShem should protect you, you family and all the front line worlds (and everyone else but especially the people helping to fight this)! We have been taking it very seriously and staying in as much as possible. Be well!!’
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Hi Dr. Grove,
Thank you for sharing your knowledge and experience.
Would you recommend that Healthcare professionals wear shoe covers when caring for confirmed or PUI COVID-19 patients?
I wonder, if a HCP unknowingly steps in COVID-19 droplets and then moves onto the next non-infected patient, could that potentially spread the virus to that non-infected patient if the non-infected patient were to drop an item (fomite if you will) onto those droplets, pick-up said item, and then touch their face?
Thank you,
Arielle
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Hi Arielle,
I don’t believe the CDC is recommending this. The reason is, the places where shoes go are usually not in places where people touch their face. I suppose that a virus could get on the bottom of a fomite, but it is highly unlikely.
Dan
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Dr Grove,
Would these masks help in a mask shortage?
Please delete my comment so nobody hoards it. It is the only one of 5 like that’s not sold out.
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They would but would be more protection than is necessary
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I don’t understand how it’s possible to safely grocery shop. If someone shopping has the virus, they touch various vegetable while trying to pick what’s ripe, you do the same…
The checkout person touches the vegetables, Now you bring those vegetables home….
It would seem to me that the grocery store is probably one of the single largest points of transmission. Instead, control who shops and have them all tested and protective gear.
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May you have a full Refreah Shlemah.
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Dr Grove,
I’m concerned that significant virus transmission is occurring beyond 6 feet from those infected with COVID-19 who are symptomatic with coughing and sneezing. Yes, perhaps the virus survives best, lives longest, in large droplets which may not transmit easily beyond 6 feet, but small droplets will likely sustain virus for minutes to hours. Small droplets are coughed and sneezed Great Diatances, as you know. It only takes a .moment for this highly contagious agent to be inhaled. Small droplets inhaled even further into the airways. Also, apparently, it doesn’t take a large inoculation to transmit infection.
The New Rochelle, NY outbreak began its acceleration with an infected person returning from Asia who attended a 700 person social event. Half were infected. I have no doubt coughing over distances spread the virus at the event, way beyond 6 feet.
Therefore, it is easy, reasonable, rational and sensible to recommend that symptomatic people isolate themselves, as you selflessly did, but then go further to block respiratory secretions from going airborne in such a way as to be inhaled by others. This may mean a surgical mask on symptomatic people in the presence of others, or isolation (no mask necessary) when separated in another room (door closed) or on another floor away from others. Care givers for the infected person should wear N95 mask protection as well as other appropriate personal protective barriers.
You know how contagious and chicken pox virus is. It seems to jump even room to room! Other respiratory virus is much less contagious. COVID-19 seems to be on the higher end of this spectrum.
Had we stressed from the early days, in addition to 6 feet of social distancing and frequent hand washing, measures designed to protect from incubating and asymptomatic cases, the isolating of those with respiratory symptoms of cough and/or sneezing, I believe we would have significantly flattened the curve way more than we did. To take effective personal responsibility, people must know and understand what to do and why. “Social distancing” must include: if you don’t feel well, 6 feet may be not enough. Coughing and sneezing spreads virus, isolate yourself, ”
During this acceleration phase, I believe this is still an important public health measure. The Mayor of our city actually announced on the radio last week, If you keep 6 feet apart, and someone coughs or sneezes, you will be safe. I do NOT think this is good advice, given the explosive growth and transfer rate of COVID-19 cases.
Thank you for your honest and heartfelt personal story. You will save lives!
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Firstly, I wish you a Refuah Shleima mehera. Thank you for your very informative blog.
My question is about clothes. The droplets surely fall on or touch our clothes. What spreadability is there from our clothes and what is the lifespan on our clothes?
Thank you and Good Shabbes.
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Recent studies have reported that the virus can stay airborne for a long time ( I’ve read between 30min &3hrs) So why are experts telling people it’s only spread through touching or close contact? That doesn’t sound consistent with evidence, nor is it consistent with the Chinese recommendations. I understand that the CDC and other organizations are concerned about laypersons hoarding PPE, but I am not comfortable with misleading people. What are your thoughts? https://www.medscape.com/viewarticle/926929
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The experiments were all done in a lab under strictly controlled conditions. In reality any aerosol produced by coughing will quickly sediment, dry out etc. Recovered virus particles were given ideal conditions to grow in order to check viability. In reality conditions won’t necessarily be ideal nor surviving numbers large enough to infect. It also mimicked an aerosolizing procedure more than regular interaction. It also has yet to be replicated.
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