By Dilip H. Liyanage –

Although most legal restrictions have been lifted by the government and even though many people have been vaccinated with varies vaccines, still there is a high chance to contract and spread the COVID-19 virus. Even though if you are fully vaccinated, we are still struggling with the third wave of this COVID-19 pandemic like many other nations. Particularly, everyone should understand vaccination means, you are not 100% protected and secure from the virus. Still, you might get caught to the virus and spread the disease. This means, for an unforeseeable time we might have to live with this virus or subsequent mutations or variants. Therefore, most importantly we must adhere to the public health precautions to control and save us, and lives of others. This is a public responsibility and government only could not achieve this.

As the limitations of COVID-19 are lifted, it is important that we all must take appropriate measures to manage and mitigate our own risk. We can all play our part with common sense and with the consideration of risk. While no situation is risk-free, there are actions we can take to protect ourselves and those around us. This guide will be an eye opener and will help you to stay safe and protect others from contracting and spreading the disease. Every action you take to reduce  and mitigate spreading will reduce the likelihood of further reappearing of the virus in the coming months.

Lifting restrictions

Most of the legal restrictions to control COVID-19 have been lifted to make life easier for the country and to balance the economy. This means that you must not violate quarantine regulations. At this point, you are urged to follow the below mention precautions and recommendations for a foreseeable future.

• Stay at least two meters away from people you don’t live with and always try to limit the number of people you meet as it’s very important.

• If you happen to meet other people, try to meet outdoors, if possible in an open air other than enclosed spaces.

• Work from home if they allowed.

• COVID-19 is an air born disease and  spreads through the air by droplets and aerosols an infected persons. Therefore, always make sure to wear mask or face covering to protect you and others.

• Always try to wear a new surgical face mask. If the manufacturer does not recommend reusing the mask, always try to wear new face mask, correctly and appropriately. Try to keep the wearing of a cloth face mask to a minimum, as the evidence is still limited. Most importantly, you must wear face mask not because law is enforced to do so, but to protect yourself and others.

• Always try to wash your hands, if possible, with soap and water for at least 20 seconds,  if this is not possible, use only appropriate hand sanitizers.

• Always try to adhere to the rules and restrictions set by the Ministry of Health for weddings, civil partnerships, funerals and other necessary events (including receptions and celebrations).

If any possible symptoms, get tested and self isolate

If you developed any symptoms, please get advice from qualified doctors or from the government hospital of your area or call 1999. If you develop any of the following symptoms get tested as seen as possible for COVID-19, 

• a new continuous cough
• a high temperature
• a loss of, or change in, your normal sense of taste or smell (anosmia)
• respiratory symptoms, etc.

In such situation, you need to self-isolate until you get your test results.

Get vaccinated

If you have not vaccined yet, you should vaccinate without thinking of the best vaccine to be vaccinated. It usually takes 2 to 3 weeks to develop antibodies. You should get two doses of the vaccine to develop your maximum protection against COVID-19.

However, if you are fully vaccinated, you can still get caught to the infection  and get sick. Eventhough,  if you are still fully vaccinated, you may be susceptible to Delta or another variant and show symptoms and can still pass the disease to others. We all need to be vaccinated (at least over 60% of the population) to reduce the  and to , spreading protect others, and reduce the risk of developing new variants of spreading. Vaccines can protect yourself, friends, family, and communities, including those who have already been vaccinated.

Fresh air

If you wish to meet anyone, always it is better to consider whether you can meet them outdoors or, if indoors is not possible, think about how you can improve the ventilation. It is always worth to improve ventilation by letting in fresh air. The more fresh air you let into your home or other enclosed spaces, the less likely a person is to inhale infectious particles.

Testing, if you have symptoms

Around 1 in 3 people with COVID-19 do not have any symptoms. If you suspect to have symptoms or any suspected or confirmed contact, that is your social responsibility to get checked yourself from the closest center.

Personal hygiene

Regular hand washing is an effective way to reduce the risk of contracting infectious diseases, including COVID-19. Therefore, make sure to wash your hands with soap and running water regularly. Use hand sanitizer only, if you cannot use soap and water.

It is better to to wash your hands: after coughing, sneezing, before eating and after getting contact with public places.

Always try to avoid touching your eyes, nose, and mouth. If you do need to touch your face or mouth, clean your hands before doing so. Because infection can easily enter your body through these entry points (Eye, mouth, nose). Washing or disinfecting your hands before touching the above entry points may remove the viruses or other microorganisms, you may be less prone to catch the infection.

Always, try to cover your mouth and nose with a handkerchief, disposable wipes or

cough/sneeze into the bend of your elbow, not into your hand. Because coughing and sneezing increases the number of droplets and aerosols you emit. Make sure to wash your hands with soap and water after coughing and sneezing and discard your tissues only into a garbage bag.

Staying home when unwell

If you don’t feel well, but you don’t have COVID-19 symptoms or your COVID-19 test is negative, you may still have the disease that can be passed on to others. Therefore, that is your social responsibility to stay at home until you feel better and to be self-isolate until you feel well.

Close contact

COVID-19 is an infectious disease, which may spread through close contact with an infected person/s. When a COVID-19 infected person breathes, talks, coughs, or sneezes, he/she may release droplets and aerosols particles that may contain the virus which may causes COVID-19 infection. These particles can be inhaled by another person who is with close contact. Therefore, you are advised to limit close contact with people whom you do not normally live with. This is a personal choice that may reduce the risk of contracting or spreading of COVID-19.

Understanding the risks of COVID-19

In common, the risk of contracting or transmitting COVID-19 is higher,

• in crowded places, where there are infectious people
• in closed spaces with limited supply of fresh air

Certain activities can also increase the risk of contracting or transmitting COVID-19, such as singing, dancing, playing sports or etc. The risk is higher when these factors overlap, for example in crowded places where people are singing and dancing. In situations like this, where the risk of contracting or transmitting COVID-19 is higher, we should be very careful to follow and adhere to public health advice to protect yourself and others.  Every little action may help us to stay safe and save many lives.

If you are clinically vulnerable person

People who are clinically very vulnerable are at a greater risk of becoming seriously ill if they contract COVID-19. Therefore, they are advised to take extra precautions than others. These precautions are as follows,

• Vaccination
• To avoid crowded and close places as much as possible
• Working from home
• If you happened to meet someone, if possible, try to meet them outside
• Restrict your travels unless it is unavoidable
• Stay home, increase regular exercises, eat fresh fruits and vegetables, and improve your immunity
• Etc.

People with the following conditions are extremely vulnerable:

• Transplant recipients
• Cancer Patients
• Patients with respiratory diseases such as Bronchial Asthma, chronic obstructive pulmonary disease (COPD), lung fibrosis, etc.
• people with immunodeficiency syndromes and immunosuppression therapies
• problems with your spleen, for example splenectomy (having your spleen removed)
• People on dialysis or with chronic kidney diseases
• Pregnant mothers with congenital heart diseases or any other co-morbidities
• People with non-communicable diseases such as, Diabetes Mellitus, stroke, and heart disease, COPD, etc.

If you are pregnant

If you are pregnant, you should take extra precautions and should adhere to public guidelines always. you may always be advised to limit your close contact with only close and family members in order to reduce the risk of contracting the COVID-19.

International and local travel

Unless urgent and important try to minimize your traveling. If you happened to travel, please adhere to all given public health measures and instructions to minimize the contracting of diseases.

References

Adams SH, Park MJ, Schaub JP, Brindis CD, Irwin Jr CE. Medical vulnerability of young adults to severe COVID-19 illness—data from the national health interview survey. Journal of Adolescent Health. 2020 Sep 1;67(3):362-8.

Aguilar JB, Faust JS, Westafer LM, Gutierrez JB. Investigating the impact of asymptomatic carriers on COVID-19 transmission. MedRxiv. 2020 Jan 1.

Blain H, Tuaillon E, Gamon L, Pisoni A, Miot S, Picot MC, Bousquet J. Spike antibody levels of nursing home residents with or without prior COVID-19 3 weeks after a single BNT162b2 vaccine dose. Jama. 2021 May 11;325(18):1898-9.

Howard J, Huang A, Li Z, Tufekci Z, Zdimal V, van der Westhuizen HM, von Delft A, Price A, Fridman L, Tang LH, Tang V. An evidence review of face masks against COVID-19. Proceedings of the National Academy of Sciences. 2021 Jan 26;118(4).

Jayaweera M, Perera H, Gunawardana B, Manatunge J. Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy. Environmental research. 2020 Sep 1;188:109819.

Munnoli PM, Nabapure S, Yeshavanth G. Post-COVID-19 precautions based on lessons learned from past pandemics: a review. Journal of Public Health. 2020 Aug 4:1-9.

Ruppel A, Halim MI, Kikon R, Mohamed NS, Saebipour MR. Could COVID-19 be contained in poor populations by herd immunity rather than by strategies designed for affluent societies or potential vaccine (s)?. Global Health Action. 2021 Jan 1;14(1):1863129.

*Dr. Dilip H Liyanage. MD, Honorary Fellow – Medical Directors Office (MDO)- Milton Keynes University Hospital NHS Foundation Trust, UK