Health

No singing and 38 other steps to protect yourself against coronavirus as 2m rule slashed to 1m


 WITH coronavirus cases plummeting, lockdown measures are set to ease next week – and pubs, restaurants and hotels will be allowed to reopen.

And while it might feel like life is slowly returning to something like normal, experts warn the relaxed rules doesn’t mean the pandemic is over.

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Experts warn that singing could spread coronavirus – so save it for when you’re at home doing the dishes

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Experts warn that singing could spread coronavirus – so save it for when you’re at home doing the dishesCredit: Getty Images – Getty

Instead, it’s even more important that even that people know how to protect themselves while out in public, the Government says.

Boris Johnson announced earlier this week that the social distancing rule could be slashed from two metres to a “one-metre plus” system from July 4.

But this is only the case if certain “mitigation measures” are being followed, according to the country’s top experts.

This includes actions such as wearing a mask, regularly washing hands, sitting side-by-side rather than face-to-face – and is what is meant by “plus” in the new “one-metre plus” rule.

Prof Chris Whitty, England’s chief medical officer, said earlier this week that if these aren’t followed Britain could see an “uptick” in Covid cases.

To help the nation get to grips with the next stage of lockdown, Sage has published 39 mitigation steps that could help reduce the risk of spreading the virus…

Elimination

1. Quarantine infectious person

Removing infectious people eliminates the source of the virus and therefore reduces the risk of others becoming exposed and infected.

There is strong evidence that a disease cannot be passed on if an infectious person is effectively isolated.

This would be done through an effective test, trace and isolate approach and relies on being able to detect and quickly react.

2. Close high risk environments

Close some high risk environments which enable more intimate social contact such as bars, restaurants and places of worship.

Experts say that closure can be very effective but needs full cooperation of the organisation and may require financial incentives to support the action.

 

 

Substitution

3. Reduce time spent in one place

Shorter times in roles where face-to-face contact could happen can reduce the amount of exposure to infectious people and therefore reduce the likelihood of spreading the bug.

As yet, there’s not enough data on the infectious dose of Covid-19 to be able to specify a safe duration of contact.

4. Work in bubbles

Grouping together the same people limits the size of the network where the virus can spread, experts say.

If there is a case of infection, it is less likely that it will be spread widely within a workforce.

5. Work outdoors

There’s very few reports of transmission of coronavirus in outdoor environments, the experts say.

Some modelling studies suggest the wind can carry particles further, while laboratory evidence shows bright sunlight could reduce the virus’ survival time.

Working outdoors is also likely to reduce the amount of surface contamination.

There are practical considerations, of course, such as the weather and accessibility issues.

6. Restrict ‘loud activities’

Experts say that people should reduce their talking time and avoid singing.

Studies measuring droplet production found high rates of transmission reported in several choirs and religious groups.

Scientists say there’s no conclusive evidence, but warn that louder activities can produce higher numbers of droplets which could leader to higher viral emission rates.

They warn that activities which increase breathing rate could increase exposure and advise against musical activities especially using wind and brass instruments or singing.

7. ‘Click and collect’ ordering

Use mobile phone based readily-available systems such as remote ordering or “click and collect” services in hospitality, retail and food sectors.

This can substantially reduce face-to-face exposure – and in some cases eliminate it entirely.

Experts warn that touch screen surfaces can harbour germs, which can be transferred between users, so advises regular cleaning so they don’t become a “hot spot”.

Engineering

8. Anti-microbial surfaces

Replace surfaces with ones that have an anti-microbial finish – it could enhance the decay rate of the virus, experts say.

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It is effective for bacteria and there are studies emerging to show that it can inactivate coronaviruses – the group name for the bug that includes Covid-19.

Those considering this mitigation would need to factor in how long it takes to kill the virus and how frequently the surface is touched.

Scientists say many surfaces are unlikely to have sufficiently rapid action to achieve this, so regular cleaning is likely to be more effective.

9. No-touch technologies

Contactless technology can prevent cross-contamination and improve infection control, experts say.

Alongside digital approaches, there are also a range of low-touch methods such as elbow operated taps and foot operated door openers, they add.

10. New hand wash stations

Good hand hygiene is critical to stopping the spread of coronavirus and has been the message since the outbreak of the crisis.

But a lack of hand washing facilities and the visibility of sinks are major deterrents for people, experts warn.

More hand washing stations should be installed to increase frequency of hand washing and avoids potential crowding around sink facilities.

11. Screens/partitions

Physical partitions are thought to be good at blocking larger droplets of the virus.

But their effectiveness depends on design as many screens require gaps to enable items to be passed between people, experts say.

Plus say there is no available evidence yet on how effective they are specifically on the spread of Covid-19.

12. Increase fresh air ventilation

Increasing ventilation can dilute the concentration of the virus in a room.

A lower concentration means that someone is less likely to inhale an infectious dose during their time in the room.

This can be as simple as opening a window or vent, or installing a form of mechanical ventilation system such as an air purifier.

13. Change air conditioning distribution patterns

For those with the luxury of air conditioning systems, set the airflow distribution so that fresh air is reaching all areas of the space.

Pressure differences and airflow patterns can result in zones of relatively stagnant air in a room where someone may be subject to air with a higher concentration of virus, the experts warn.

They pointed to evidence from a restaurant outbreak in China where the air conditioning units created poor distribution and led to viral transmission in a poorly ventilated space.

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14. Room scale air cleaning/UV devices

Experts say there is reported evidence that room scale ultraviolet disinfection systems and air filtration devices can reduce the levels of virus in a treated space.

It’s more of a consideration for those in clinical settings where ventilation might be poor.

15. Install local air cleaning devices

Air cleaning devices could disrupt close range droplet transmission in healthcare settings, such as operating theatres.

But experts say these devices are not readily available and their effectiveness will depend significantly on design and positioning.

16. Prop open internal doors

Propping open doors can lead to larger ventilation flow rates and reduce contact risks, such as touching door handles.

This wind driven ventilation can sometimes be enhanced when opposite sides of the building are linked – by opening all doors.

But experts warn the evidence is weak and there could be issues such as fire safety and security or privacy which may undermine the mitigation in practice.

17. Personalised ventilation systems

These only really apply in office situations where air ventilation can be directed entirely at one person.

They provide a clean air stream directly to individuals and can reduce exposure to particles of the virus in the air.

But it only works when people are sitting right by the system and without careful design, one study found they could transport exhaled pathogens and increase indirect exposure.

18. Use of UV/HPV decontamination

Mobile UV and hydrogen peroxide vapour (HPV) systems can reduce surface contamination levels in room spaces of various sizes and have been applied to vehicle use in some cases.

Again, these are only really used in clinical settings such as hospitals, dentists or care homes.

There are also cost, environment and toxicity issues, according to the scientists.

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19. Close toilet seat before flushing

Toilet flushing and defective water seals have been found to show the spread of coronavirus particles, experts warn.

Ensuring good maintenance and cleaning practices can limit this risk, they say.

Scientists also advise closing the toilet before flushing and ensure bathrooms are disinfected on a regular basis.

20. Increase daylight in buildings

There is evidence that sunlight can be effective against pathogens, and some proof that it may be effective against Covid-19, experts say.

Simple measures such as keeping the blinds open is a low-cost step that could have a small benefit, they say.

However, they warn that there are downsides such as overheating and glare.

Administration

21. Clean high touch surface more often

Frequently cleaning areas that you know are touched more often can help to reduce the spread of the virus.

Bleach should be used in potentially heavy contaminated surfaces or alcohol wipes on some equipment.

In healthcare settings, they recommend using the ‘one site; one wipe; one direction’ strategy.

22. Increase surface cleaning in general

Increased frequency of cleaning general room surfaces may reduce the presence of virus and reduce the risk of contact transmission.

23. Training on quality and effectiveness of cleaning

Business owners are advised to train cleaning staff to achieve more effective results.

Experts warn that the impact can quickly wear off so repeated educational reinforcement may be needed.

24. More hand sanitiser

Increasing the number of hand sanitisers available will encourage people to clean their hands and reduce the risk of contact spread

25. Swap to paper towels

Experts warn that jet air dryers can turn water into a fine spray that spreads around the room from poorly washed hands.

And if hands aren’t completely dry it means that contaminated virus particles could still survive.

Experts advise temporarily taking dryers out of action and providing paper towels instead.

COVID-19 secure guidelines for non-essential shops

BEFORE non-essential shops will be allowed to reopen they must ensure that:

  • Individuals are able to keep their distance from people outside of their households.
  • They’re reducing the risk of transmission by limiting the number of people that individuals come into contact with.
  • Changing shift patterns to reduce the number of people in the office at one time.
  • Keeping workspaces ventilated.

26. Avoid sharing equipment – and no hotdesking

Shared surfaces create a route for indirect contact transmission via touch.

Several studies have found SARS-CoV-2 – the virus that causes Covid – on shared equipment such as computer mice and keyboards.

So, sharing equipment and hot desking should be avoided.

Where it is not possible to do so, a cleaning regime between users must. be implemented, the experts say.

27. Waste management

There’s evidence that the virus can survive on different materials for a considerable time.

Manual handling of waste may be areas of concern and businesses should take extra caution when clearing bins.

28. Bathroom hygiene

Bathrooms have multiple high touch surfaces and the virus may be dispersed through flushing.

Changing behaviours when using the bathroom need to change, experts say.

Putting the toilet seat down before flushing and washing your hands every time you use the bathroom are vital.

29. Don’t touch your face

On a similar note, it’s important that it becomes instinctive not to touch your face – as much as you want to.

The mouth, nasal passages and eyes are viral entry points for coronavirus, so reducing the urge to touch those places is key.

30. Reduce workforce

Limiting the number of people that need to be in the same place at the same time could help lower the risk of transmission.

Experts say it reduces the probability of an infectious person being present and makes distancing easier.

Alternative strategies for work or activities such as remote meetings could be beneficial.

31. Maintain 2m distancing

Increased distancing reduces the risk of spreading and catching the virus.

Studies show cough droplets are greatly reduced by a distance of around two metres from the source.

Keeping two metres apart therefore doubles the protection offered than staying one metre away.

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But experts add: “Distancing needs to recognise that people are not static and hence allow leeway for real world.”

32. One-way systems

Introducing one way systems enables more effective physical distancing and prevents crowding, especially. incorridor type spaces.

It’s more appropriate for places such as transport hubs, shops or corridors in busy offices or schools.

Clear signage is needed and the system needs to be carefully thought through or people will ignore it, experts warn.

33. Sit to side or back-to-back

Sitting or standing to the side of someone or back-to-back can reduce close range exposure, experts say.

That’s because they are no longer facing the direct plume or high concentrations of potential virus particles.

But. theexperts are mindful that it will depend on whether people remain in a position where they don’t face each other for it to be effective.

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PPE

34. Respirator (N95/FFP3) face masks

These masks significantly reduce exposure to droplets when they have been fit tested for the wearer and worn properly.

They were widely used in jobs that exposed people to toxins before the pandemic.

But they should be reserved for those in healthcare or very high risk environments, experts say.

35. Surgical face masks

Surgical masks work be reducing potential droplet exposure by reducing the amount that reaches the nasal membranes.

Experts say they are potentially effective as a source to block the spread of the wearer’s own droplets by reducing the force of emissions so they will travel a shorter distance.

But effectiveness depends on the material and the fit and the biggest issue is user compliance and wearing them properly, experts say.

36. Face coverings

Face coverings such as scarves of homemade cloth masks are potentially effective at reducing the spread of the virus from the person wearing it.

As with surgical masks they can reduce the force of respiratory emissions so they travel a shorter distance.

But they have minimal impact on exposure and probably won’t stop you catching the virus from someone else.

37. Gloves

Wearing gloves can reduce the likelihood of contamination on hands but are only effective if discarded of afterwards, experts say.

Studies show that gloves can become contaminated and could therefore present a transmission risk to others.

Also, people who wear gloves feel themselves to be protected and may miss opportunities for hand hygiene, scientists warn.

They should only be recommended for high risk settings with a proper protocol for use.

38. Protective clothing

Protective gowns, overalls and gloves offer the wearer physical barrier protection from droplet splash and other contaminated bodily fluids and waste, studies show.

Experts say that donning and doffing of protective clothing is important and wearer contamination may occur if not done with care.

Usage is only likely to be appropriate in a high risk environment.

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39. Face shields/goggles

Wearing a face shield or goggles can reduce the potential for droplet exposure – either through nasal membrane or the eyes.

They are only likely to be appropriate for people who are at high risk of exposure and/or will struggle to maintain physical distancing.

As with protective clothing, visor/face shield removal technique is important and wearer contamination may occur if not done with care.

Sir Patrick Vallance and Chris Whitty asked about potential relaxing of two-metre coronavirus social distancing rule





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