A guide for effective home quarantine during the COVID-19 pandemic
While COVID-19 is spreading rapidly, it is important for members of vulnerable groups to avoid contracting the virus. This includes people over 60 years old and people with underlying medical conditions.
Until the COVID-19 pandemic is under control, the best way to avoid contracting COVID-19 is to stay inside your own home and not interact with people from outside of your household. This document contains guidelines and techniques for self-quarantine in your own home.
Why you need to stay at home
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With the rapid spread of COVID-19, hospitals are facing two immediate shortages to treat patients: the available number of ICU beds, and the available number of mechanical ventilators. A large number of people who contract COVID-19 will require hospitalization, and the likelihood you will need to go to the hospital increases with age.
If infected, current estimates indicate that 16.6% of people above 60, 24.3% of people above 70, and 27.3% of people above 80 will require hospitalization. Estimates also show that 30% of those hospitalized will need to be treated with oxygen using a ventilator.1
As hospitals continue to fill with COVID-19 patients, there is chance that there will not be an ICU bed or a ventilator for you if you get sick.
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Fortunately, regular soap and water is very effective at breaking down coronavirus.2 Washing your hands frequently is an important way to stay healthy, but you will need to scrub your hands for at least twenty seconds, which might be longer than you are used to. Also, you will need to use a six-step handwashing technique to make sure you get all the parts: palms, backs, between fingers, thumbs, knuckles, and nails.
This video demonstrates proper handwashing technique:
After you have finished washing, make sure you completely dry your hands with a clean towel.
Coronavirus is very transmissible, and it is possible to contract the virus after touching a contaminated surface and then touching your eyes, nose, or mouth.3 Make sure to you wash your hands before eating and before preparing food, but also make sure to wash them anytime you touch a surface someone else might have touched or coughed on.
Avoid touching your face, especially if you are outside your house. Wearing gloves and a mask or scarf will help keep you from touching your face.
Frequent handwashing will leave your hands dry. At least once a day, use hand lotion to moisturize your hands so your skin does not crack and bleed. Also, be sure to keep your fingernails trimmed.
There are a couple tools that are useful to have to monitor your health. The first is a thermometer. Forehead thermometers or in-ear thermometers are quick and work well. It is important to know what your baseline temperature is, so that if you start to feel sick, you will know what temperature is normal for you. Check your temperature regularly and write it down in a log.
Another tool that is useful to have is a pulse oximeter. These are inexpensive tools that clip to your fingertip and measure your blood oxygen level. An oxygen saturation level of 95 and above is considered normal for most people. It is good to know what level is normal for you. In case you get sick and have difficulty breathing, a pulse oximeter can let you know if your blood oxygen level is too low.
You will need to disinfect frequently-touched surfaces and anything that comes into your house, in order to keep yourself from being infected. Disinfecting deliveries and groceries is time-consuming, but easier when you get the hang of it.
The EPA provides a list of disinfectants to use against the SARS-Cov-2 virus.4 The CDC provides a detailed guide on how to disinfect surfaces.5
The most common household cleaners that are effective are listed below. Pay care to allow the cleaner to sit on the surface for the specified amount of time before wiping it off. If you don’t let the cleaner sit long enough, you risk spreading the virus from one surface to another when you wipe it off.
| Cleaner | Contact Time |
|---|---|
| Lysol Disinfectant Spray | 10 minutes |
| Lysol Disinfecting Wipes | 10 minutes |
| Clorox Bleach (not “splashless bleach”) | 10 minutes |
| Isopropyl alcohol (at least 70% strength) | 30 seconds |
| Hydrogen Peroxide (3%) | 1 minute |
If a surface is dirty clean it with soap and water first. Note that bleach expires in one year, and hydrogen peroxide expires in 6 months after opening and needs to be kept in a brown bottle because it breaks down in sunlight.
Hydrogen Peroxide can be carefully poured into a spray bottle and used to spray outdoor surfaces without wiping them down afterwards, since it decomposes into water and oxygen. However, the surface should not be touched until it is dry.
Indoor surfaces that should be disinfected daily include phones, remotes, light switches, tables, faucets, doorknobs, sinks, and toilets. Outdoor surfaces include doorknobs, doorbells, and handrails. Apple provides guidance for cleaning iPhones using alcohol wipes.6
You should wear gloves when disinfecting surfaces or food. Be careful not to touch clean surfaces with contaminated gloves. Before disinfecting, you will want to clear a path to your trash or laundry area so you don’t need to touch doorknobs.
Here is a video on how to properly remove disposable gloves.
Remember to always wash your hands afterwards.
Assume all deliveries and mail are contaminated, and wear gloves when handling them. SARS-CoV-2 can survive on cardboard for 24 hours.7 If possible, carry non-perishable packages to an isolated area (garage, backyard) without bringing them though your home, and leave them there for 2 days before handling them further. For packages that need to be opened immediatey, spray or wipe the package with disinfectant before handling it. If you can, open the package outside and only bring the contents into your home. Disinfect the contents, as well as the surface you placed them on.
Alghough disposable gloves work, having a supply of reusable gloves near your door for handling deliveries is useful. You can use cotton gloves, which can we washed in the laundry, or rubber gloves, which can be left outside for 3 days before being used again.
To avoid interacting with other people, have the deliveries left at your door. Before putting on your gloves to get the delivery, make sure there is a clear path with no closed doors between the package, the area where the package will be decontaminated, the garbage, the place where you will take off gloves, and the place where you will wash your hands. After touching the delivery, be careful to not contaminate other surfaces with your hands. Wash your hands with soap and water after removing gloves. Use a fresh pair of gloves for handling the next delivery.
Thankfully, COVID-19 is not thought to be transmitted via food.8 However, the virus can live on the surface of food or packaging, so groceries and takeout food will have to be disinfected. This video is a good overview, so please watch it first:
As this video points out, no one over 60 should be going to the grocery store (or any store) right now.
One more thing to note: After touching packaging, consider that your hands are also now contaminated. So in the video, after opening a cereal box and pulling out the bag inside, that bag would also need to be disinfected.
Washing fruit and vegetables with dish soap and water is also recommended in this LA Times article, which also provides specific guidance for washing many kinds of fruits and vegetables9:
If you would prefer more extensive vegetable cleaning, here is what food scientist Harold McGee wrote in his book “On Food and Cooking”: “Soapy water and commercial produce washes are more effective than water alone. Washing can reduce microbial populations a hundredfold, but it’s impossible to eliminate all microbes from uncooked lettuce and other produce — they can evade even heavily chlorinated water by hiding in microscopic pores and cracks in the plant tissue. Raw salads are therefore not advised for people who are especially vulnerable to infections. Once fruits and vegetables are cut up, they should be kept refrigerated and used as soon as possible.”
Shelf-stable food, and fruits like apples, oranges, and bananas can also be left in your garage for several days without refrigeration, before bringing them into your house for washing. Since SARS-CoV-2 only survives on porous surfaces for 24 hours3, food that is left to sit for a few days should be safer to handle.
Fruits with thick skins that you peel are good, since any dish soap residue after washing will only be on the peel.
Consider switching to frozen vegetables instead of fresh ones, since bags of frozen food can be disinfected more easily before being put away.
Consider switching to cooked foods only, and foregoing salads for now. Raw, leafy greens are particularly hard to disinfect.
The director of the World Health Organization has stated that if you are over 60 of have underlying medical conditions, you should avoid the grocery store and all other crowded areas.10
In order to minimize your contact with other people, it is best if you arrange for someone to deliver groceries and other supplies for you.
You can also have groceries and takeout food delivered to your house. Be sure to disinfect deliveries and reheat takeout food as described above. If you can, prepay by credit card and have the delivery person leave food at your door.
Many community-supported agriculture (CSA) services are still delivering fresh produce on a weekly schedule. This is a good way to have get a regular delivery of fresh food. CSA boxes are delivered from farms, not grocery stores, so the food has probably been touched by fewer people.
Mealkit services like Sunbasket and Blue Apron are also delivering nationwide. These are another good source for regular, weekly food deliveries.
Instacart offers deliveries from many stores, including Costco, Safeway, Target, and many local grocers. Instacart is currently seeing large demand, and are often not able to offer same day delivery. It is good to plan for deliveries to take several days, and some items might be out of stock and not delivered.
Amazon offers same-day or next-day delivery through their Prime Now service, from both Amazon warehouses, as well as Whole Foods. Their service is also currently overloaded. You will need to check several times to find an available delivery slot.
There has been a rise in door-to-door and online scams targeting the elderly.
It is important to avoid going to the gym, and exercising in popular parks. However, it is important to get exercise and sunshine as often as you can. Consider walking in your own home or yard, online yoga and zumba classes, exercise DVDs, stretching at home, and Wii Fit as alternatives to going to a gym.
While you are staying isolated in your own house, it is also important to keep in contact with other people. Arrange regular video calls with family and friends over FaceTime, Whatsapp, or Facebook Messenger. Having regular contact with other people is an important part to staying healthy.
Imperial College COVID-19 Response Team, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, 16 March 2020, page 5. ↩
Vox Media, How soap kills the coronavirus, 18 March 2020. ↩
NIH, New coronavirus stable for hours on surfaces, 17 March 2020. ↩ ↩2
EPA, Disinfectants for Use Against SARS-CoV-2, 26 March 2020. ↩
CDC, Detailed Disinfection Guidance, 6 March 2020. ↩
Apple, Cleaning your iPhone, 9 March 2020. ↩
Doremalen, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1, NEJM, 17 March 2020. ↩
López-Alt, J. Kenji. _Food Safety and Coronavirus: A Comprehensive Guide, 27 March 2020. ↩
Ko, Genevieve. How to wash fruits and vegetables during the coronavirus crisis, 16 March 2020. ↩
WHO, WHO Director-General’s opening remarks at the media briefing on COVID-19, 28 Feb 2020 ↩
Stanton et al., Authorities warn elderly about COVID-19 scams, Boston Globe, 24 March 2020 ↩ ↩2
FTC, Avoid Coronavirus Scams. ↩
Washington State Attorney General, Beware Of Scams Related To Stimulus Checks, 31 March 2020 ↩