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The Next 6 to 12 Months

I wrote this mainly for a few of my aunts and uncles in India, in their 80s and 90s, and a few people right here in the US, who seem to be overloaded with a mix of information, misinformation, and downright nonsense. Maybe it’s useful to others as well.

How does the virus spread?

1. Droplets: these get scattered when you sneeze or cough forcefully. Some droplets may be very small, and you may not even notice they landed on you. These droplets carry the virus that is in your lungs and wind-pipe.

2. Aerosols: these are extremely tiny droplets, not visible, and are light enough to remain in the air for some time. You may remember using “Flit” for mosquitoes, or Windex or other household cleaners. A pump is used to push air through a liquid which comes out as a fine mist. Aerosol particles are often smaller than that. When you breathe on your spectacles to clean them, the moisture that forms on the glass is humidity coming out of your lungs in the form of aerosols. The aerosols you breathe out also contain the virus.

What’s the fuss about washing your hands with soap for 20 seconds?
When an infected person sneezes or coughs, the droplets or aerosols eventually settle on to whatever is around. If you touch a contaminated object, the virus is now on your hands. Without thinking, you may touch your face. The virus is now on your face. Depending on where you touched your face, the virus may enter into the mucous membranes in your mouth, nose, or eyes. From there the virus gets into your lungs. A virus is a protein. This one is shaped like a ‘corona’, a crown, and hence the name coronavirus. The virus sticks to your hands like oil, and will not wash off with just water. Soap breaks and dislodges the virus, and makes it easier to wash off. Exactly like oil. Hand-washing is to prevent this route to infection.

According to the National Institutes of Health, the virus is “detectable in aerosols for up to three hours, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel”.

When my groceries arrive, I leave dry goods, anything that does not need to be refrigerated, in a corner for 3 days. I remove vegetables from their plastic bags, throw the bags in the dustbin, wash my hands, and then I rinse the vegetables before chopping and freezing them, or putting them in the fridge. Cooking kills the virus, so that’s one less worry. Though I wipe down milk and other cartons/containers with a cleaner before putting them in the fridge or freezer, I wash my hands whenever I get something from the fridge that was delivered less than 3 days ago. I find this easier, and more reassuring, than overloading the cartons/packaging with toxic chemicals. But I can see how it makes more sense to just do a thorough job with the house-hold cleaners if there is more than one of you at home.

Back to aerosols: an infected person may not show any symptoms, or may have very mild symptoms, but they will be expelling aerosols when breathing. They may sneeze due to an allergy, or cough because of some random irritant. If their mouth and nose are covered with a mask, the droplets get trapped in the mask itself and fewer aerosols escape into the air to infect other people. None of us can render perfect accounting for the air we breathe in or out. That silent-spreader could just as easily be me or you. Or your adorable little kid. It is important to remember that.

There are many symptoms, but the main ones are a fever of 100 or more, a cough, heaviness in the chest and difficulty breathing, a sore throat etc. Remember not everyone has a “normal temperature of 37ºC (98.6ºF). My temp first thing in the morning before drinking anything is 97.2ºF (36.2ºC), so I would begin to worry at two degrees above my normal, at 99.2ºF. If your normal is 98.6º, 99.2º means nothing for you. If you don’t know your normal temp, get a reading every morning for a week. It is hard to tell if somebody is infected if they have no symptoms. Current research suggests that a lot of infected people do not show any symptoms. This is why it is important that everybody wear a mask when near other people – especially when near older people and/or people with conditions like hypertension, diabetes, heart disease etc.

You may have read that Italians were affected more severely by the virus. Older people in Italy, like in India, baby-sit / take care of their grandchildren. They routinely pick them up from school and look after them till the parents get home. The children showed no symptoms, or seemed to have a mild cold or cough, so no one paid attention till the older people started to get sick. It is important for people over 60, especially with other conditions like hypertension, diabetes, etc., to be extra careful with children of all ages for the next several months.

A treatment that reduces the severity of the disease is many months away. Six months to a year. It will take even longer for a vaccine. Current research says that aerosols can remain airborne for up to 4 hours. For the next six months, I plan to reduce aerosol exposure as much as possible. How?

First on my list is to avoid crowded places that recycle air – air-conditioned public spaces. Theaters, restaurants, the subway, airplanes. Grocery stores. When I meet anyone, including friends or relatives, I will be wearing a mask. I will not meet them if they are not wearing a mask. I will avoid eating in restaurants. I will be extra careful with people under 40 – a lot of them are recklessly running around without masks. Such people seem to understand their health risks, which are low. But they seem to not understand that they have a longer working life than a person over 60, and the longer this pandemic goes on, the greater their economic cost. I will cut out idiots who blame god, the Chinese, Muslims, refugees etc. Such people do not take responsibility for themselves, for anything. Everything is someone else’s fault.

N95 masks block the virus more efficiently, but they are in such short supply, even most healthcare workers don’t have them. In the US, the 3M company has a production capacity of 35 million masks a month. If all 330 million Americans get one mask per person, it would take 10 months of production. There may be other manufacturers and the waiting time may come down. When N95 masks are freely available to everyone, I may change some of my public-spaces do’s and don’ts. For now, a homemade cloth mask or a basic surgical mask will have to do for the foreseeable future.

To summarize: avoid air-conditioned public spaces, do as much of your own work as you can, wear a mask whenever outdoors; those of you in India, wear a mask even indoors if you have servants/help, who should also be wearing a mask, which you paid for and provided. If anybody visits without a mask, I may slam the door in their face, but you can ask them come back wearing a mask or sit/stand 10 feet away at all times. I saw a flyer, directed at reckless people not wearing a mask: “How many people did you murder yesterday without meaning to?”

Remember: you may have the virus and give it to another person without knowing it. Others may have the virus and give it to you, also without realizing it. The safest course is for everybody to wear a mask. And keep washing your hands. The goal (especially for anyone over 60) is to evade infection till there is a treatment that makes symptoms less severe.

A useful way of thinking about the usefulness of masks, not based on any study, is this graphic floating around on the internet:

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