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)
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).
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.
Many countries have implemented international travel bans/closed their borders, have issued advice for domestic travel, and are requesting that citizens travelling abroad should come home immediately if they are able to. Some countries are restricting entry to foreign nationals who have been to affected areas in the preceding 14 days, or are enforcing 14-day quarantine periods where the person’s health should be closely monitored (e.g., twice-daily temperature readings).
Consult local guidance for specific travel restriction recommendations in your country:
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.
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). Transmission between cats has also been reported.
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.
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.
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.
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