Yes, the six-feet rule applies to your own home sometimes, too.

By Leah Groth
March 26, 2020
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As the number of COVID-19 cases continue to climb, most people are practicing the preventive methods recommended by the Centers for Disease Control and Prevention, the World Health Organization, and other agencies—social distancing, self-quarantining, and self-isolating (in addition to other hygienic practices)—to avoid coming into contact with or spreading the coronavirus. But what happens when you or someone you live with is diagnosed with COVID-19?

While much about the novel coronavirus is still unknown, researchers seem to know one thing for sure: The infectiousness of COVID-19 seems to make it a family affair. "While we in the US are still learning a lot about the disease, data from China suggests that intrafamily spread is common and responsible for clusters of outbreaks within communities,” Jaimie Meyer, MD, a Yale Medicine infectious disease specialist, tells Health

This is mostly due to the fact that SARS-CoV-2—the novel coronavirus that causes COVID-19 disease—is spread primarily from person to person through droplets that become aerosolized and propelled when someone coughs or sneezes, says Dr. Meyer. Because the virus can also survive on various surfaces for certain periods of time, it is also thought to spread from person to person through direct contact with those surfaces. Both of those things make the home of someone living with COVID-19 a hotspot for others to pick up the disease. 

That's why—while it's entirely possible for those who are asymptomatic to spread the disease—it's crucial for those showing symptoms to self-isolate. "If you are feeling ill with symptoms of COVID-19 or have been diagnosed with COVID-19, it is important to stay home to prevent transmitting the virus to people in your community and to stay isolated within your home to prevent transmitting the virus to other people in your household,” says Dr. Meyer.

Of course, that's easier said than done. “Isolating can be really hard, especially when you live with other people or in smaller spaces,” she adds. While she doesn’t think people are intentionally disregarding isolation procedures, she points out that it can be logistically challenging and potentially confusing as guidelines are changing so often. “Isolation can also be psychologically challenging and distressing, especially if you don’t feel well.” 

So, how do you self-isolate in a shared home?

Dr. Meyer points to the Centers for Disease Control’s very clear guidelines on how to care for and cohabitate with someone who is sick with novel coronavirus. One of the first, is basically locking down the home by not allowing visitors in unless they have an "essential need" to be there. 

The CDC explains that while a caregiver can help the patient with their basic needs in the home—grocery getting, prescription filling, and other personal needs as well as monitoring their symptoms and communicating with their healthcare provider if they are getting sicker—they should be making very little, if any, physical contact with them. In that case, sharing a room with someone who is sick is not a good idea. "If possible, designate a bedroom and bathroom for their use only,” Dr. Meyer instructs, adding that good air flow is also key. “Close the door but open a window to improve the ventilation of the space.”

If you are a caregiver and do have to come into contact with a person showing symptoms of and diagnosed with COVID-19, make sure the individual has their mouth and nose covered, preferably with a surgical mask. "If you can’t get your hands on one (they are hard to find these days), a scarf or shirt can work just fine as make-shift masks," says Dr. Meyer. 

It should go without saying that you should also avoid using the same household items as the infected person. “You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items,” instructs the CDC. “After the patient uses these items, you should wash them thoroughly.” And, if you must clean the patient's room or bathroom, extra care should be taken to sanitize potentially contaminated surfaces, per the CDC. The same goes for washing the clothes or bedding of the infected person, which should be immediately removed and washed if they're contaminated with any bodily fluids (blood, stool, saliva, mucus, etc.). All of this should be done while wearing gloves, per the CDC, which should be disposed of after use, so you can wash your hands immediately.

Also important: If you are the individual isolating, make sure you take care of your health. "Drink plenty of fluids, rest, and take acetaminophen or ibuprofen as needed for fevers or body aches," says Dr. Meyer. “Pay attention to your symptoms, and call your doctor if you have difficulty breathing.”

These precautions are (luckily) only temporary for as long as you or the person in your household is ill. "[People] can come out of isolation when at least seven days have passed since symptoms first appeared, it's been at least three days without a fever (without use of medications), and respiratory symptoms are improving," says Dr. Meyer.

This is important, she says, since many people feel that they can come out of isolation as soon as they start feeling better. "It can be tempting to end isolation too early,” she explains. This is especially problematic in COVID19 because people can continue to “shed” the virus in droplets for weeks after the acute illness. “You can protect your household and other people in your community from becoming ill if you see the isolation period through completely.”

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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