American doctor shares 7 things he examines when he decides when and where to go out


As we regain some degree of normalcy after weeks of social distancing, we all need a plan. As an immunologist, I have thought about it a lot personally and professionally.

When I venture out, I will first check the number of new COVID-19 infections in my community. In Virginia, for example, as of May 16, some health districts had 200 new cases per day and others less than 10. I will be less risk averse when new cases drop to near zero.

Second, I will assess my risk of serious infection and the risk of serious infection for those I visit.

The CDC defines these risk factors as being over the age of 65 or having serious underlying health conditions, which include chronic lung disease, moderate to severe asthma, severe heart disease, immunodeficiency, l severe obesity (body mass index greater than 40), diabetes, kidney disease requiring dialysis, liver disease or living in a nursing home or long-term care facility.

If I have one of these risk factors, or I visit someone with one of these risk factors, I will be extremely careful.

Third, I will learn about how COVID-19 is transmitted. Airborne transmission and fomites, or contaminated surfaces such as doorknobs, are both means of infection.

The SARS-CoV-2 virus that causes COVID-19 is stable in airborne droplets, or aerosols, for hours and on the surface of cardboard for one day and plastics for two days.

A study New England Journal of Medicine, for example, showed that half of the nursing home patients who had COVID-19 were symptom-free at the time of diagnosis, by a nasal swab PCR test for the virus, and yet contagious for the others.

Normal speech generates droplets of oral fluid that are potentially infectious but are captured by a cloth facial mask, preventing transmission to others.

I will wear a mask to avoid spreading the infection to others, avoid touching surfaces such as handrails, try not to touch my eyes or nose or mouth with my hands, and wash my hands frequently.

I will try to stay outside, where the risk of aerosol infection is lower, and if inside, I stay six feet from others and limit my time there.

I will assess my risk of infecting others. If I have a fever, cough, or other flu-like symptoms, such as muscle pain or fatigue, I will not venture out and risk exposing others to COVID-19.

Even if I am in good health, I will wear a mask when I am outside so that I can protect others if I am infected without knowing it but pre-symptomatic.

While it is tempting to resume normal activities, I must remember – and I hope you will be too – that my individual behavior affects not only my health, but also yours. The conversation

William Petri, Professor of Medicine, University of Virginia.

This article is republished from The Conversation under a Creative Commons license. Read the original article.


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