The infection is spread by two routes:

1. Droplets spread by sneezing or coughing are inhaled into airway; this can carry a distance of up to 1m/3 ft.

2. Virus droplets dried up on surfaces, being transferred by human hands and rubbed into mucous membrane of eyes, nose and mouth. It is estimated that the virus can survive for a period of 3-6 hours after drying up.

   Logically, there is more chance of 2 happening than 1, so prevention of 2 is a priority!

Effective Preventive Measures:

1. Boosting Immunity:

   • Adequate rest and suitable amount of exercise.
   • Balance diet with increase Vitamin C and adequate hydration (6-8 glasses water-based beverage daily).
   • Stop or decrease smoking; this habit actively suppresses immunity of the respiratory tract.

2. Stopping hands transfer:

   • WASH HANDS FREQUENTLY: This is by far the most effective way to prevent infection. Wash hands IMMEDIATELY on entering clean premises, e.g. home, BEFORE removing mask, or touching your face, and REPEATEDLY in public places, e.g. office, school.
   • Wash with soap and wipe dry by paper towel which should be discarded into covered bin.

3. Indoor Area Hygiene

   • Clean all surfaces REPEATEDLY with household bleach (1 part: 49parts water) or 70% alcohol daily.
   • Toys to be soaked in diluted household bleach (1part: 99parts water) for 30mins and rinse thoroughly by clean water afterwards.
   • If possible, allow good air circulation at home.

4. Use of mask

   • Mask is easily contaminated by respiratory condensation and saliva on the inside surface and dirt on the outside surface, so limit use to expected exposure highlighted in E.
   • Snug fitting is required for efficacy.
   • Anyone having sneezes and coughs must wear a mask to avoid spread of disease to others.
   • Present evidence shows that the virus is not air-borne, so constant mask wearing is not required.

5. Stopping airway inhalation:

   • Maintain a distance more than 1m/3ft from anyone who is actively sneezing or coughing.
   • Wear a mask in crowded confined area, e.g. MTR, bus, enclosed compartment of ferry.
   • Avoid crowded places if possible.

6. Anyone who has fallen ill: 'COUGHS AND SNEEZES, STILL SPREAD DISEASES'

   • Always wear mask and hand wash repeatedly to avoid spread to your families and the public.
   • Stay at home if you are actively sneezing and coughing.
   • Cancel travel arrangement, particularly if it involves being confined in an enclosed area for a long period of time.
   • Consult a doctor when there is a temperature together with either persistent chills, or excessive cough, or respiratory discomfort.

Dr. Wendy Lo
MBBCh MRCGP DFM