COVID-19: Prevention

by Sean Elliott, MD

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    00:08 COVID-19 Prevention.

    00:11 So, what does one do, in the middle of an outbreak, with an illness like COVID-19.

    00:15 Well, there are many interventions that are possible and especially are important, when, many individuals in a local region are infected.

    00:23 So, mitigation strategies for an outbreak setting, are most successful if one can control public gatherings.

    00:31 I mean, this is all about social distancing, if most people are infected, don't go to an area, where you might be exposed to all those respiratory secretions.

    00:41 Physical distancing, minimum of three feet, more like six feet, perhaps even longer, in the setting of COVID-19, where some transmission has been through aerosols, those small droplets which travel far further, than one to two meters out from the human being.

    00:57 And for those situations where one can not socially distance and even for those cases in a crowd setting, requiring face masks is critical.

    01:07 In fact, if one looks at the pandemic to date, one of the most successful intervention strategies has been, mandatory face masks to prevent transmission of droplets with a secondary smaller benefit of preventing being exposed to the droplets from other individuals.

    01:25 What about, where there's a limited number of infected people.

    01:28 So, that this would typically be, an intervention in the early stages, either pre-epidemic or the very first stages of introduction to a small community, where there's a limited number of infected people.

    01:41 In that situation one can isolate the suspect case, test them and then do contact tracing, to see whom they are exposed to and whom they might have exposed and then provide a quarantine sort of using the ring system to limit the spread.

    01:58 The ring system means taking the index patient, quarantining all their first or primary contacts and then quarantining the contacts of the contacts.

    02:08 It’s a two-ring system, which has been used very successfully in other epidemics and the global history of the world.

    02:15 There were several general mitigation measures in place during the first year of the pandemic.

    02:20 Some of these directives included facial masking in public, avoiding large crowds or sick individuals, and maintaining social distancing of two meters or six and a half feet to help prevent local spread As the second year of the pandemic began, the CDC recommended masks be worn by both vaccinated and unvaccinated individuals at high risk settings.

    02:39 In the time since, mask mandates have been generally lifted, but their use is still recommended for at risk individuals.

    02:47 Other steps to take, not touching face or eyes with hands.

    02:51 This has to do with proven transmission, by the hands, to mucosal surfaces of active virus, within respiratory droplets.

    03:00 So, potentially an infected person coughs or sneezes onto a horizontal surface, let's say the desk and then your hand rests on the desk, acquires the respiratory droplets with active virus in and then you, touch your eye you rub your nose, I don't know, pick your teeth, so, there’s absolutely the potential for transmission that way, so, avoiding that contact.

    03:24 And then along with that washing the hands frequently.

    03:28 Soap and water scrubbing for at least 20 seconds, followed by a strong rinse.

    03:32 You can sing the alphabet song twice if that helps or using an alcohol-based hand sanitizer, where there is at least 60 percent ethanol or our isopropyl alcohol, in the hand sanitizer itself, rub till dry.

    03:48 Using good respiratory hygiene, if the person is unmasked, now, that this may be, maybe we had a mask rupture, because that happens that the strings come unattached or we forgot the mask and it's in our car or something.

    04:02 So, coughing into the crook of the elbow, using a tissue to cover the mouth, anything one can do to cover nose and mouth, when coughing or sneezing is going to be appropriate.

    04:13 Other general infection control practices include things like improving ventilation in indoor spaces by opening windows, using HEPA filters and routinely cleaning surfaces, especially in high traffic areas.

    04:27 Quarantine protocols after close contact exposure have also shifted since the beginning of the pandemic.

    04:33 Current guidelines state that if an individual is up to date on their vaccinations or has recently had COVID, no quarantine is needed.

    04:41 But they must wear a mask around others for ten days unvaccinated or those not up to date on their boosters are still asked to self-quarantine for at least five days and wear a mask for ten days after a close contact exposure.

    04:56 If a person has a confirmed or suspected case of COVID with mild symptoms or positive viral test, they should self-quarantine for at least five days and wear a mask for ten days regardless of vaccination status.

    05:08 Recovered patients can have detectable COVID RNA for three months in their upper respiratory tract, but they are unlikely to be infectious at this point.

    05:18 The number of positive flu cases recorded by the CDC between September 2020 and January 2021 dropped 99% from that same period the year prior.

    05:29 So if these mitigation measures have been used in 2018 to 2019, we can extrapolate that nearly 290,000 cases of the flu could have been prevented.

    About the Lecture

    The lecture COVID-19: Prevention by Sean Elliott, MD is from the course Coronavirus.

    Included Quiz Questions

    1. To protect others from the spread of respiratory droplets from an infected person that contain the virus
    2. To block the air that asymptomatic people exhale, which contains airborne virus particles
    3. To decrease the forced expiratory volume (FEV1) in patients with the virus
    4. To identify oneself as a person with COVID-19
    5. Mostly to protect yourself from inhaling the virus in the ambient air
    1. 60% alcohol
    2. 70% alcohol
    3. 50% alcohol
    4. 80% alcohol
    5. 90% alcohol
    1. Decreased 99%
    2. Increased 10%
    3. Decreased 50%
    4. Was unchanged
    1. On public transportation
    2. In all indoor events
    3. At all times outside the home
    4. In health care settings
    5. By all persons who have suspected or documented COVID-19 or exposure to SARS-CoV-2

    Author of lecture COVID-19: Prevention

     Sean Elliott, MD

    Sean Elliott, MD

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