Hospitals in Wuhan have become full and are sending patients home, telling them to quarantine themselves. If the virus spreads and this ends up happening to you or someone in your family, don’t panic. A friend who studied contagious diseases at Harvard told me “sending people home and telling them to quarantine themselves isn’t necessarily a bad solution as long as they don’t have pre-existing conditions and do effectively quarantine.”
So how do you “effectively” quarantine yourself or a family member? This short guide is intended to serve as a basic process that you can follow if you find yourself in this scary situation. It is partially adapted from CDC recommendations for airline and cruise ship staff, which I will link below in case you wish to read more.
What you will need / 您将需要些什么
- Soap, or if no soap is available, a hand sanitizer that is alcohol-based and contains at least 60% alcohol
- A way of covering the sick person’s coughing and sneezing (ideally face mask, but tissues are fine too if masks are sold out)
- Plastic bags for throwing away bodily waste and other contaminated materials (if no bags are available, use a washable trash can temporarily until you are able to buy them)
Ideal if you can get them:
- Fever-reducing medicines: (1) ibuprofen, brand name Advil, or (2) paracetamol, also known as acetaminophen, brand name Tylenol
- A disinfectant to clean bathrooms and other surfaces touched by the sick person, containing: (1) formaldehyde, (2) hydrogen peroxide, or (3) alcohol
- Disposable, impermeable gloves
- Respirator or face mask for caregiver
- Eye goggles or some other form of eye protection (glasses or sunglasses are better than nothing if goggles are not available)
- Disposable cleaning cloth or towels
Setting up the area / 设置隔离区
The goal is to give the sick person basic survival items (water, food, fever-reducing medicine) without becoming infected. If possible, give the sick person their own room, and assign only one person in the family to interact with the sick person as the caregiver. If your apartment is too small to give them their own room, mark a distance of 2 meters on the floor with an object and instruct your family that no one is to go closer without taking precautions.
Place a small stool, table, or other object near the sick person so they can reach water and other necessities without getting up, since severe pneumonia symptoms may make it extremely difficult for them to move.
Process for sick person / 患者注意事项
If a face mask is available, the sick person should wear it at all times. The purpose of the face mask is to stop water droplets from dispersing throughout the room when the person coughs or sneezes. For this to work, the absorbent fabric of the face mask should completely cover the mouth and nose (see image). If a face mask is not available or if it is uncomfortable for the sick person, tissues will serve the same function.
Image source: Hong Kong Centre for Health Protection / 图片来源：香港卫生防护中心
This is extremely important because flu droplets can survive in the air for several hours, and can survive on hard surfaces for 24 hours. However, they only survive approximately 15 minutes on the specialized absorbent fabric of face masks and tissues.
The sick person should dispose of all tissues and other items they have touched or left bodily waste on very carefully so the caregiver can collect the trash without being exposed to additional chance of contamination.
Additionally, the sick person should touch as few surfaces as possible if they need to move around the apartment or use the bathroom. They should inform the caregiver of any hard surfaces they touched in the bathroom and other places.
Process for caregiver / 护理人员注意事项
Before going into the sick person’s room, the caregiver should put on adequate protection. Ideally, this means a respirator, goggles, disposable gloves, and clothes that cover all or most exposed skin.
Respirators differ from face masks because instead of just being a cloth covering the face, they additionally have a filter that can keep out flu particles. For this to work, the respirator must create a tight seal around the face of the wearer. This can be uncomfortable, so the CDC recommends face masks for extended use, and respirators only when direct interaction with patients is necessary. If you are able to get a respirator, it should be at least N95 (US standard) or FFP3 (EU standard).
If you do not have a respirator or face mask, do not worry, the caregiver will just need to be more careful and try to reduce the time spent interacting with the sick person. The sick person should be extremely careful not to cough, sneeze, or even talk in the direction of the caregiver if they do not have a respirator. Additionally, while this probably has limited effectiveness, if nothing else is available the caregiver can try putting something over their face to cover it (ex. wrap it with a scarf, cover it with a bag).
The Wuhan virus has been confirmed to transmit through the eyes. This does not just mean that the eyes were touched with contaminated hands, but rather that the eyes became exposed to flu particles in the air. If you can buy goggles that create a seal against the face, they would be ideal. If not, at least have the caregiver use glasses or sunglasses to protect against the largest particles which may be spread by coughing, sneezing, or speaking. In the case that you do not have any eye protection, also ask the sick person to be extremely careful not to cough, sneeze, or even talk in the caregiver’s direction.
If available, disposable gloves should be used in all interactions with the sick person. Be extremely careful that the caregiver not touch the outside part of the gloves when removing them (see image). They should throw away gloves after removing them: do not reuse gloves. Even though they were wearing gloves, the caregiver must still wash their hands with soap after removing them.
如果可能的话，在与患者的所有接触中都应使用一次性手套。护理人员在脱掉手套时，应特别小心，避免接触到手套的外部（见图）。取下手套后，应立即扔掉手套。请勿重复使用手套。此外，尽管 接触 患者时戴着手套，护理人员在脱掉手套后仍必须用肥皂洗手。
Image source: CDC / 图片来源：美国疾病控制中心
Both the sick person and care giver must wash their hands properly. The CDC recommends washing for at least 20 seconds. Make sure to wash between the fingers and up to your wrists. Do not turn off the water after washing your hands: use a disposable towel if available, or a small towel or other cloth that you exclusively use to turn off the water if not. Make sure the caregiver does not use the same towel as the sick person to dry their hands.
Finally, if possible the caregiver should have clothing that they put on immediately before interacting with the sick person and take off immediately afterward. Ideally this clothing would be impermeable or at least thick and cover as much exposed skin as possible.
The caregiver must be aware at all times of what constitutes a contaminated surface and what is safe to touch. Anything the caretaker touches with gloves still on is contaminated. Anything the sick person comes into physical contact or even close proximity with is contaminated. This includes the caretaker’s clothing, gloves, and even the external portion of their respirator or face mask, if they have one. Have the caretaker wash their hands after touching anything that is contaminated. If items or clothing that are contaminated must be reused at a later time, put them in a safe place where no one will touch them until the caretaker uses them again with disposable gloves on.
Best of luck to everyone in Wuhan, and in the rest of China. Stay safe, and 加油.
Special thanks to Joseph Chen from the Peking University School of Transnational Law for translating into Chinese.
Additional resources / 其他资源:
- CDC – Interim Recommendations for Airline Crew: Novel Coronavirus in China
- CDC – Guidance for Cruise Ships on Influenza-like Illness (ILI) Management
- CDC – Preventing Spread of Disease on Commercial Aircraft: Guidance for Cabin Crew
- CDC – Interim Guidance for Ebola Virus Cleaning, Disinfection, and Waste Disposal in Commercial Passenger Aircraft
- NHS – How long do bacteria and viruses live outside the body?