Shanghai/China-Jan.2020: New type coronavirus 2019-nCoV pneumonia in Wuhan has been spreading into many cities in China. People wearing surgical mask sitting in subway in Shanghai. (Shutterstock)
By Kelsey Piper, VOX
The novel coronavirus is continuing its spread in the United States. Over the weekend, the number of people affected in the US jumped from 60 to 86, with cases in New York, Florida, and Rhode Island and 13 confirmed cases in Washington state (including the first two US fatalities). That’s despite serious limitations on testing, which means many US cases may be undiscovered.
Meanwhile, the World Health Organization raised its risk assessment worldwide to the highest level, as more countries — now nearly 50 — reported cases.
The recent developments in the US suggest that what the Centers for Disease Control and Prevention (CDC) warned us about is already happening: that we are now seeing community spread, meaning novel coronavirus cases that have no links to overseas travel or to other known cases.
These developments have many Americans wondering — wait, are survival preparations now necessary? Is stockpiling food a sensible idea or a massive overreaction? Is it selfish or paranoid to be planning for the worst?
“The most important recommendation is don’t panic, but prepare,” Dr. Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University, told me. “We’re not going into a crazy movie situation where the world is on fire, but we may be going into a situation where there are people walking around who are sick.”
If the coronavirus spreads more widely in the US, having prepared for its arrival will benefit not just you but also your loved ones, your neighbors, and people in your community. You don’t need to take major steps to survive without electricity or water (both should keep working just fine), but changing your habits and shopping patterns and planning ahead can protect you and others.
“Preparing for the almost inevitable global spread of this virus, now dubbed COVID-19, is one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind,” Zeynep Tufekci argued in Scientific American.
So, yeah, you should be taking some steps to get ready. Here’s the reasonable person’s guide to coronavirus preparation, where we (with help from public health experts) try to help you not panic, but prepare.
1) Seriously, wash your hands
Some of the most impactful steps to stop a coronavirus outbreak are ones we are all aware of but often find it hard to put into practice.
“Wash your hands much more than you think you need to wash your hands and try not to touch your face,” Katz told me. “It’s not satisfactory because people feel they should be doing much more, but at this point, it’s the best advice we can be giving.”
According to the CDC, you should “wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.” If soap and water aren’t readily available and your hands are not visibly dirty, you can also use hand sanitizer.
You should also avoid shaking hands, use a tissue when you blow your nose and put the tissue in the trash, and avoid touching your eyes, nose, and mouth. “General health maintenance is important,” Harvard epidemiology professor Marc Lipsitch told me. “Quit smoking, if you smoke — that’s a good recommendation at all times, but maybe some people will use this as extra motivation.” Taking care of yourself will put you in a better position to weather the coronavirus and pays dividends even if you never get sick.
2) You don’t need to wear a face mask if you’re well, but you should if you are sick
In pictures from cities in China, South Korea, Singapore, and Japan, all of which have experienced significant coronavirus outbreaks, almost everyone is wearing face masks.
That prompted many Americans to wonder — should we be doing that too? The answer is that unless you are sick, it’s not a particularly good idea.
The CDC “does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19 [the disease caused by the novel coronavirus]. You should only wear a mask if a healthcare professional recommends it.”
“The most important thing in the conversation about masks is that there is a shortage,” Katz told me. “We need to make sure that we have enough for our front-line health care workers.” That said, there’s an important use case for masks: If you are sick, they can protect the people around you. The CDC does recommend that people who show symptoms of Covid-19 wear a mask “to help prevent the spread of the disease to others.”
“If you are somebody who is sick and is coughing or sneezing, those surgical masks will capture most of your sneeze from possibly infecting somebody else,” Katz told me, so they’re worth it in that case. But for prevention, masks are hard to use properly and don’t do all that much, so your preparatory efforts are better focused elsewhere.
3) If you get sick, you might be out of commission for a few days or weeks. Get the things you’d need to manage that.
The majority of cases of Covid-19 don’t require hospitalization. You might have a fever, feel very sick, and recover slowly over the course of a few weeks. You can take steps in advance to make sure this isn’t too disruptive, and taking those steps now is a good idea.
“If you get sick, the last thing you want to do is have to go to the store,” Katz told me. “What do you want to have on hand?” Purchasing a couple of weeks’ supply of foods you’d want while home sick with the flu is a good idea, as well as other essentials: toilet paper, cleaning supplies, laundry detergent.
We should be “getting ready for the possibility that people will want to stay at home or be asked to stay at home,” Lipsitch told me. That means thinking about what you might need to buy in the next month and trying to buy as much as possible of it now.
“If you are somebody who takes daily medication, you want to have more than a week’s supply, and really, you want to have as much of that on hand as your insurance will allow you to have,” Katz said.
“People might want to slowly start to stock up on enough nonperishable food to last their households through several weeks of social distancing at home during an intense wave of transmission in their community,” risk communications experts Jody Lanard and Peter Sandman wrote last week. (Social distancing refers to any measures to reduce human contact, like canceling events, working from home, or ordering food rather than going to the grocery store.)
None of these recommendations are specific to the coronavirus. They would also be good advice if your town were about to experience a blizzard, a hurricane, or a flood. Katz thinks that’s a good way to think about the situation. In any disaster, it’s a good idea to plan to have what you need during a period where you might get stuck in your home. The coronavirus doesn’t need to be wildly exceptional to warrant such preparations.
“If there’s a situation where people in your community are sick,” Katz asked me, “do you want to potentially expose yourself for a toilet paper run?”
Of course, not everyone can afford to stock up on a month of supplies, and not everyone has space to store them. But anything you can arrange ahead of time means one less inconvenience or one less trip while you’re sick.
4) Consider what you’d do if schools and daycares are closed
In Japan, schools are closed through late March, while in South Korea the start of the school year has been postponed to March 9. As the coronavirus worsens in the US, we will see school closures, too. So far, a few schools in Washington State have closed, though they hope to reopen in a few days.
The closure of schools would be enormously disruptive to the lives of many families, and planning for that possibility might be one of the most important forms of coronavirus preparation you can do now. It’s “important to be at the family level doing some contingency planning for if schools are closed for a period of time or if your day care is closed,” Katz said.
“I think it’s reasonably likely” that schools will close, Lipsitch told me, though he noted that we do not have much evidence about whether children — who are disproportionately unaffected by the virus — play many roles in spreading it, and that we should, therefore, think carefully before doing something as disruptive as closing schools.
The effect of coronavirus on children is one of the many critical research questions we don’t fully understand yet. While most influenzas hit children and elderly people hardest, that’s not the pattern that has been observed with the coronavirus so far. If that’s because they get infected but tend to have mild cases, then schools will be a major avenue for virus transmission and might need to close. But if they don’t generally get infected at all, then hopefully some of the most disruptive measures on the table — like widespread school closures — can be avoided.
5) Psychological preparation is important too
Pandemics are scary. The spread of the coronavirus within the US could be a significant disruption to many people’s lives, a health crisis for some smaller number of people, and a deadly tragedy for a still-smaller number.
“It helps to be a little psychologically prepared for the possibility that life will be very different for a period of time,” Lipsitch told me. Processing that possibility now can help us “get over the surprise of that, to some extent, before it happens.” So coronavirus paranoia, if you’re experiencing some, isn’t silly or unreasonable — it’s part of the totally normal process of coming to grips with a significant problem.
“The ‘adjustment reaction’” — that is, the stress, hypervigilance, obsessive reading about a crisis, imagining its effects on your family, and worrying — “is a step that is hard to skip on the way to the new normal,” Lanard and Sandman write. “Going through it before a crisis is full-blown is more conducive to resilience, coping, and rational response than going through it mid-crisis.”
So be forgiving of yourself if you’re having an “adjustment reaction” or if your friends and loved ones are. The spread of the coronavirus will be genuinely disruptive, difficult, and for some people dangerous. Taking real steps to mitigate the effects it will have on you or your family isn’t a silly thing to do — it’s a responsible one.
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