Patient discussions

General prevention measures

  • Wash hands often with soap and water for at least 20 seconds or an alcohol-based hand sanitiser (that contains at least 60% alcohol), especially after being in a public place, blowing your nose, or coughing/sneezing. Avoid touching the eyes, nose, and mouth with unwashed hands.

  • Avoid close contact with people (i.e., maintain a distance of at least 1 metre [3 feet]) including shaking hands, particularly those who are sick, have a fever, or are coughing or sneezing. It is important to note that recommended distances differ between countries (for example, 2 metres [6 feet] is recommended in the US and UK) and you should consult local guidance.

  • Practice respiratory hygiene (i.e., cover mouth and nose when coughing or sneezing, discard tissue immediately in a closed bin, and wash hands).

  • Stay at home if you are sick, even with mild symptoms, until you recover (except to get medical care)

  • Clean and disinfect frequently touched surfaces daily (e.g., light switches, door knobs, countertops, handles, phones).[299][300]

  • BMJ Learning: Covid-19 – handwashing technique and PPE videos external link opens in a new window

Face masks

  • The World Health Organization (WHO) recommends that people with symptoms of COVID-19 should wear a medical mask, self-isolate, and seek medical advice as soon as possible. The WHO also now encourages the general public to wear medical or cloth masks in specific situations and settings (e.g., areas with known or suspected widespread transmission and limited or no capacity to implement other containment measures such as social distancing, contact tracing, and testing; settings where social distancing cannot be achieved, particularly in vulnerable populations).[77]

  • The Centers for Disease Control and Prevention recommends that homemade cloth face coverings can be worn in public settings where social distancing measures are difficult to maintain (e.g., pharmacies, supermarkets), especially in areas where there is significant community transmission.[306]

  • WHO: coronavirus disease (COVID-19) advice for the public – when and how to use masks external link opens in a new window

  • Public Health England: how to make a cloth face covering external link opens in a new window

  • CDC: use of masks to help slow the spread of COVID-19 (includes instructions on how to make masks) external link opens in a new window

Travel advice

Pets

  • At this time, there is no evidence that companion animals (including pets and other animals) play a significant role in the spread of COVID-19, and the risk of animals spreading COVID-19 to people is considered to be very low. There is no evidence that the virus can spread to people from the skin or fur of companion animals.[938]

  • A very small number of pets have been reported to be infected with the virus after close contact with people with confirmed COVID-19; however, thousands of pets have been tested in the US with none testing positive. There is emerging evidence that cats and ferrets are highly susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while dogs and other livestock have no or low susceptibility. A tiger tested positive in a zoo and two domestic pet cats tested positive in New York (both cats were owned by people with suspected or confirmed infection and both fully recovered).[939][940][941][942] Transmission between cats has also been reported.[943]

  • Advise patients to limit their contact with their pets and other animals, especially while they are symptomatic. Advise people to not let pets interact with people or animals outside the household, and if a member of the household becomes unwell to isolate them from everyone else, including pets.[944]

  • CDC: coronavirus disease 2019 (COVID-19) – pets and other animals external link opens in a new window

Athletes and highly active people

  • Advise asymptomatic patients who test positive not to exercise for 2 weeks after their test result, with slow resumption of activity under the guidance of a healthcare team. Advise mildly symptomatic patients who test positive not to exercise until 2 weeks after symptom resolution and only after a thorough cardiac evaluation. If the assessment is normal, slow resumption of activity under the guidance of a healthcare team can be considered with close monitoring for clinical deterioration.[945]

  • Young athletes with moderate symptoms must be asymptomatic for at least 14 days and obtain clearance from their primary care physician before returning to exercise and competition. Any individual with a history of moderate symptoms (e.g., prolonged fever), cardiac symptoms, or other concerning findings on examination should have an electrocardiography performed and potentially be referred to a paediatric cardiologist for further assessment and clearance prior to returning to play sports.[946]

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