A. Person-to-person spread

The virus is thought to spread mainly from person-to-person.

• Between people who are in close contact with one another (within about 6 feet).

• Through respiratory droplets produced when an infected person coughs or sneezes.

B. Can someone spread the virus without being sick?

• People are thought to be most contagious when they are sick.

• Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.

C. Spread from contact with contaminated surfaces or objects

It may 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.

How easily the virus spreads

Some viruses are highly contagious (spread easily), like measles, while other viruses do not spread as easily. Another factor is whether the spread is sustained, spreading continually without stopping.

The virus that causes COVID-19 seems to be spreading easily and sustainably in the community – “community spread”.

Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.?

Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:

• Older adults

• People who have serious chronic medical conditions like:

• Heart disease

• Diabetes

• Lung disease

How to prevent the spread of COVID-19 if you are sick

i. Watch for symptoms

The following symptoms may appear 2-14 days after exposure.

• Fever

• Cough

• Shortness of breath

If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include:

• Difficulty breathing or shortness of breath

• Persistent pain or pressure in the chest

• New confusion or inability to arouse

• Bluish lips or face

ii. Stay home except to get medical care

• Stay home: People who are mildly ill with COVID-19 are able to recover at home. Do not leave, except to get medical care. Do not visit public areas.

• Stay in touch with your doctor. Call before you get medical care. Be sure to get care if you feel worse or you think it is an emergency.

• Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.

iii. Separate yourself from other people in your home

• Stay away from others: As much as possible, you should stay in a specific “sick room” and away from other people in your home. Use a separate bathroom, if available.

• Limit contact with pets & animals: You should restrict contact with pets and other animals, just like you would around other people.

• Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people with the virus limit contact with animals until more information is known.

• When possible, have another member of your household care for your animals while you are sick with COVID-19. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with them. See COVID-19 and Animals for more information.

iv. Wear a face mask if you are sick

• If you are sick: You should wear a face mask when you are around other people and before you enter a healthcare provider’s office.

• If you are caring for others: If the person who is sick is not able to wear a facemask (for example, because it causes trouble breathing), then people who live in the home should stay in a different room. When caregivers enter the room of the sick person, they should wear a face mask. Visitors, other than caregivers, are not recommended.

v. Cover your coughs and sneezes

• Cover: Cover your mouth and nose with a tissue when you cough or sneeze.

• Dispose: Throw used tissues in a lined trash can.

• Wash hands: Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.

vi. Clean your hands often

• Wash hands: Wash your hands often with soap and water for at least 20 seconds. This is especially important after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.

• Hand sanitizer: If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.

• Soap and water: Soap and water are the best option, especially if hands are visibly dirty.

• Avoid touching: Avoid touching your eyes, nose, and mouth with unwashed hands.

vii. Avoid sharing personal household items

• Do not share: Do not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people in your home.

• Wash thoroughly after use: After using these items, wash them thoroughly with soap and water or put in the dishwasher.

viii. Clean all “high-touch” surfaces everyday

Clean high-touch surfaces in your isolation area (“sick room” and bathroom) every day; let a caregiver clean and disinfect high-touch surfaces in other areas of the home.

• Clean and disinfect: Routinely clean high-touch surfaces in your “sick room” and bathroom. Let someone else clean and disinfect surfaces in common areas, but not your bedroom and bathroom.

• If a caregiver or other person needs to clean and disinfect a sick person’s bedroom or bathroom, they should do so on an as-needed basis. The caregiver/other person should wear a mask and wait as long as possible after the sick person has used the bathroom.

High-touch surfaces include phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets, and bedside tables.

• Clean and disinfect areas that may have blood, stool, or body fluids on them.

• Household cleaners and disinfectants: Clean the area or item with soap and water or another detergent if it is dirty. Then, use a household disinfectant.

• Be sure to follow the instructions on the label to ensure safe and effective use of the product. Many products recommend keeping the surface wet for several minutes to ensure germs are killed. Many also recommend precautions such as wearing gloves and making sure you have good ventilation during use of the product.

• Know what medications your loved one is taking and see if you can help them have extra on hand.

• Monitor food and other medical supplies (oxygen, incontinence, dialysis, wound care) needed and create a back-up plan.

• Stock up on non-perishable food to have on hand in your home to minimize trips to stores.

• If you care for a loved one living in a care facility, monitor the situation, ask about the health of the other residents frequently and know the protocol if there is an outbreak.

• If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease.

  • Stock up on supplies.

  • Take everyday precautions to keep space between yourself and others.

  • When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.

  • Avoid crowds as much as possible.

  • Avoid cruise travel and non-essential air travel.

  • During a COVID-19 outbreak in your community, stay home as much as possible to further reduce your risk of being exposed.

  Have supplies on hand

  • Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.

  • If you cannot get extra medications, consider using mail-order for medications.

  • Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.

  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.

  Take everyday preventive actions:

  • Avoid close contact with people who are sick

  • Clean your hands often

  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.

  • If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.

  • To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.

  • Wash your hands after touching surfaces in public places.

  • Avoid touching your face, nose, eyes, etc.

  • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)

  • Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.

  • Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships

• • Stay home and call your doctor.

  • Call your healthcare provider and let them know about your symptoms. Tell them that you have or may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed.

  • Stay in touch with others by phone or email. You may need to ask for help from friends, family, neighbors, community health workers, etc. if you become sick.

  • If you are not sick enough to be hospitalized, you can recover at home.

  • Know when to get emergency help.

  • Get medical attention immediately if you have any of the emergency warning signs listed above.