Crystal Watson, senior scholar at Johns Hopkins Center for Health Security, shares best practices and tips for responding to coronavirus outbreak
As the novel coronavirus outbreak has intensified worldwide, public health officials, including the Centers for Disease Control and Prevention, have urged the public to practice social distancing to limit the virus’s spread. As the number of cases has grown, certain groups have been asked to also self-quarantine and self-isolate. But when is it appropriate to enact self-quarantine or self-isolation, and what steps should be taken to minimize the risk of transmission between household members?
For answers to these and other questions, the Hub turned to Crystal Watson, an assistant professor at the Johns Hopkins Bloomberg School of Public Health and senior scholar at the Johns Hopkins Center for Health Security. The conversation has been edited for length and clarity.
What is the difference between self-quarantine, self-isolation, and social distancing?
Self-quarantine is staying in place, either at home or elsewhere, for fourteen days because you have been exposed to someone who has tested positive for COVID-19. Self-isolation would be isolating within the house after you start showing symptoms of COVID-19. Social distancing is a response in which people remain home and distant from others (such as by refraining from shaking hands or hugging or going to the store at off hours), without any known exposure to the virus, to limit possible transmission to or from others.
What are the signs or symptoms that someone should self-isolate? When can the self-isolation end?
If you do develop symptoms, like a fever, cough, or shortness of breath, that is when you would need to self-isolate at home, away from other household members. If you develop these symptoms, contact your medical provider but stay home as long as those symptoms are manageable (like you would for a normal cold or flu). If you have severe shortness of breath or if symptoms suddenly get worse, that is when you should seek out medical care.
Coverage of how the COVID-19 pandemic is affecting operations at JHU and how Hopkins experts and scientists are responding to the outbreak
According to CDC guidelines, individuals with COVID-19 symptoms should self-isolate until their symptoms have resolved and it has been at least seven additional days since symptoms first appeared to ensure they are no longer contagious.
What is the safest way to self-isolate one person within a larger household?
If you can have a separate space for the sick person—a space where they can access the restroom without traveling through commons spaces—that would be best. Those who are caring for loved ones who are sick at home should wash their hands frequently, avoid close contact as much as possible, and have the sick individual wear a surgical or procedure mask to prevent droplets spreading through the air. It is also important to clean frequent- or high-touch surfaces, as well to clean clothes in very hot water. Caregivers should also wear a mask, if possible.
In households that are not able to accommodate these suggestions, what else can be done to limit transmission at home?
If you’re not a caregiver, maintaining six feet of distance and washing your hands frequently are the main steps, along with cleaning surfaces often. If you are a caregiver, it’s certainly tougher. You should wear a mask if possible and follow the other guidelines of handwashing and cleaning clothes and surfaces frequently.
How can parents and other caregivers help children and dependents who are unable to follow the recommended advice (like washing hands and not touching your face), particularly if they need to be self-isolated?
I think that’s a tougher situation. It’s very hard to stay away from kids, especially when they’re ill and need care and comfort. If possible, main caregivers should be those who are not at high risk from COVID-19, meaning those not over age sixty or with underlying health issues. Other than that, it’s important to take the normal precautions in terms of handwashing and cleaning, but it is much more difficult with children.
How much can caregivers rely on childcare alternatives (relatives, neighbors, babysitters) in this moment?
In general, it’s important to keep the circle smaller. At the moment, not exposing yourself to many additional people is best. Healthcare workers, people with critical jobs, and hourly employees who have to work will need to rely on childcare providers. In those situations, you may ask someone you know and trust, and who is reliable in taking the social distancing rules seriously. If possible, childcare providers should not be in a group that’s at high-risk for COVID.
What supplies should be on hand, for both self-quarantine and self-isolation?
For self-quarantine you should have your basic supplies like food and thirty days of any medications being taken. If you should become sick, and in anticipation of becoming sick, you should have supplies like Gatorade—something to rehydrate—as well as cough medicine to manage symptoms, and Tylenol to assist with the fever.
The reality of isolating and quarantining in South Africa
The reality is that none of these measures are easy or even possible for many in South Africa. Nuclear shared living spaces and poor access to sanitation to wash hands and no masks means that these are high-risk hotspots for transmission.
Based on a 2011 census, there are roughly 61 households for each toilet and nearly 400 households share a tap in Imizamo Yethu, a Cape Town township that dates back to the 1990s and the apartheid-era.
“We are seeing townships become virus hotspots because we haven’t dismantled the apartheid city.”Edward Molopi, a researcher with housing and human rights charity the Socio-Economic Research Institute in Johannesburg.
The city of Cape Town has partnered with the Department of Water and Sanitation to distribute 41 million liters of water into informal settlements to aid handwashing to stem the virus spread.
“We remain committed to doing all we can to find solutions to challenges in serving our vulnerable residents,” said Alderman Limberg, a member of the city’s Mayoral Committee for Water and Waste in a press release.
WHAT CAN WE DO?
- Be a hero, and mask up
- Support your staff and those around you to mask up
- Support your staff’s family to mask up
- Help us mask up 18.5 million people
We are committed to providing mask packs – with three masks to Wash 1, Wear 1, Spare 1, and a multi-lingual infographic – to South Africa’s most high-density at-risk hotspots. But we can’t do it alone.