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COVID-19 and Why We Need All The Rules MARCH 20, 2020 by HARVEY HAHN, MD, FACC


As COVID-19 spreads throughout the world, you may be asking why social distancing? Why the 6 foot rule? Why the directive to not expose or share food in public when the CDC is telling us that this is a droplet transmission disease? It’s not a gastrointestinal bug. Why?

In medicine the most important question is always WHY. Instead of following rules you don’t understand and running into situations you don’t understand learn the WHY so you can figure out what to do in any situation.

First, let’s start by defining what a fomite is. Fomites are any objects or materials that are capable of harboring infectious diseases and transferring them to another host. Like counter-tops, handrails, phones, and menus, for example.

Here are the why’s:

The no food rule is to avoid accidentally touching someone else’s oral secretions and getting infected. Think double dipping in salsa except the salsa is a COVID-19 stew!

The 6 foot rule is to keep you outside the typical cough/sneeze blast zone so you don’t get an infected persons mouth/nose (oropharyngeal) secretions on you. The radius is actually tighter. People who talk loud, laugh a lot, spit a little while talking-they are still a risk WITHIN the 6 foot zone.

But what if healthy people get together? Surely young adult people don’t need “social distancing” do they? They’re healthy and probably won’t even by symptomatic. Social distancing accomplishes what?

Remember, it’s not just about you.

The elderly man who lives with his daughter who you just hung out with because, well, you’re both young and healthy, he’s the one we’re concerned about. Although the death rate is about 1-3% overall, the average in the over 80 age group is 10%. So he’s staying isolated, staying away from danger, but his daughter can bring the disease home. Here’s  how.

You’re both hanging out. Maybe helping a church with a live-stream during this crisis. Supposed I touch my lips while thinking. Then I grab my phone and put it on the table. The table now has a low viral load on it. The virus can survive for some time (if it’s plastic or steel, apparently 3 days without a host) now making that table a possible source of infection for everyone else who sits there after me. It’s not just hugging and shaking hands. Truth is, shaking hands is low risk as long as you wash your hands immediately after shaking, before you touch anything else. Now think about surfaces that have not been disinfected-chairs, tables, hand rails, movie theaters, gym equipment. Now you know why they are shutting these all down.

This isn’t to scare you but to help you understand the WHY of these recommendations so that we can operationalize some tactics to reduce becoming a vector.

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