Basing Decisions on Science & Research
By MedExpert Science & Research | Mar 15, 2020
If I go to the grocery store and stop to speak with a person who is standing about 6 feet away, then what is my risk of becoming infected with COVID-19?
Bottom line, no one really knows the numbers at this time but there are clues that may help us live our lives with more confidence.
According to the CDC, the COVID-19 virus is thought to spread mainly from person-to-person through respiratory droplets produced when an infected person coughs or sneezes.[i] The logic behind keeping people six feet apart is that droplets of a sneezing person do not travel more than about 6 feet. Primary infection is believed to occur when a droplet lands in the mouths or noses of people who are nearby or when droplets are inhaled into the lungs.
According to CDC, it may also be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads. It is important to apply any known means to protect yourself from the virus.
Vigilant adherence to personal hygiene may have some statistical support to reduce your risk of infection. Following are results recently published in NIH’s MMWR (Morbidity Mortality Weekly Report) of the first 10 people in the United States with confirmed COVID-19.[iii]
These first 10 people confirmed with COVID-19 had “close” contact with 445 persons. Of the 445 people in close contact with the 10 infected people:
- 19 were members of patient’s household;
- 104 were community members who spent at least 10 minutes within 6 feet of the patient;
- 100 were community members in a health care setting; and
- 222 were health care personnel.
Each local health jurisdiction conducted active symptom monitoring of the 445 close contacts by daily telephone calls, text, or in-person inquiries about fever or other symptoms for 14 days following the last known exposure to a person with confirmed COVID-19.
During the 14 days of active symptom monitoring, 54 (12%) close contacts developed new or worsening symptoms (note symptoms only) deemed by local public health authorities to be concerning for COVID-19 and were thus considered persons under investigation (PUIs) and subsequently were tested for SARS-CoV-2.
Two (2) people of the 445 tested positive (0.45%) and here is the breakdown by association to patient.
- Of the 19 members of patient’s household, 2 tested positive;
- Of the 104 community members who spent at least 10 minutes within 6 feet of the patient; 0 tested positive;
- Of the 100 community members in a health care setting; 0 tested positive; and
- Of the 222 health care personnel; 0 tested positive.
Here are points when interpreting these results.
- Only 54 of the 445 people were tested which means that others in the 445 group could have had such mild symptoms as not to warrant testing. This would have increased the number of secondary infections.
- A monitoring time period of only 14 days was used; there is data indicating that the virus may be contagious longer than 14 days. This would increase the number of secondary infections.
- Given all 445 individuals were being monitored and contacted on a daily basis, most exposed individuals were prompted to maintain high personal hygiene habits (frequent hand washing; wiping surfaces with alcohol wipes; avoidance of touching face, eyes, mouth or “picking” noses.) This may be a promising point to explain why the number of secondary infections was low.
The current CDC policy to protect yourself from exposure includes:
- If possible, maintain a distance of at least 6 feet.
- Practice proper hand hygiene. Wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available and illicit drugs are NOT suspected to be present, use an alcohol-based hand sanitizer with at least 60% alcohol.
- Do not touch your face with unwashed hands.
- Have a trained Emergency Medical Service/ Emergency Medical Technician (EMS/EMT) assess and transport anyone you think might have COVID-19 to a healthcare facility.
- Ensure only trained personnel wearing appropriate personal protective equipment (PPE) have contact with individuals who have or may have COVID-19.
- Learn your employer’s plan for exposure control and participate in all-hands training on the use of personal protective equipment, “PPE” for respiratory protection, if available.[ii]
[iii] Active Monitoring of Persons Exposed to Patients with Confirmed COVID-19 — United States, January–February 2020 Weekly / March 6, 2020 / 69(9);245–246 On March 3, 2020, this report was posted online as an MMWR Early Release. Authors: Rachel M. Burke, PhD1; Claire M. Midgley, PhD1; Alissa Dratch, MPH2; Marty Fenstersheib, MD; Thomas Haupt, MS4; Michelle Holshue, MPH5,6; Isaac Ghinai, MBBS6,7; M. Claire Jarashow, PhD8; Jennifer Lo, MD9; Tristan D. McPherson, MD6,10; Sara Rudman, MD; Sarah Scott, MD6,12; Aron J. Hall, DVM1; Alicia M. Fry, MD1; Melissa A. Rolfes, PhD1