Preventing the spread of the coronavirus

Social distancing, hand washing, and other preventive measures

Published: March, 2020

You've gotten the basics down: you're washing your hands regularly and keeping your distance from friends and family. But you likely still have questions. Are you washing your hands often enough? How exactly will social distancing help? What's okay to do while social distancing? And how can you strategically stock your pantry and medicine cabinet in order to minimize trips to the grocery store and pharmacy?

What can I do to protect myself and others from COVID-19?

The following actions help prevent the spread of COVID-19, as well as other coronaviruses and influenza:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces every day. High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. A list of products suitable for use against COVID-19 is available here. This list has been pre-approved by the US Environmental Protection Agency (EPA) for use during the COVID-19 outbreak.
  • Wash your hands often with soap and water.

This chart illustrates how protective measures such as limiting travel, avoiding crowds, social distancing, and thorough and frequent handwashing can slow down the development of new COVID-19 cases and reduce the risk of overwhelming the health care system.

What do I need to know about washing my hands effectively?

Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; after blowing your nose, coughing, or sneezing; and after handling anything that's come from outside your home.

  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
  • Always wash hands with soap and water if hands are visibly dirty.
  • The CDC's handwashing website has detailed instructions and a video about effective handwashing procedures.

How does coronavirus spread?

The coronavirus is thought to spread mainly from person to person. This can happen between people who are in close contact with one another. Droplets that are produced when an infected person coughs or sneezes may land in the mouths or noses of people who are nearby, or possibly be inhaled into their lungs.

A person infected with coronavirus — even one with no symptoms — may emit aerosols when they talk or breathe. Aerosols are infectious viral particles that can float or drift around in the air for up to three hours. Another person can breathe in these aerosols and become infected with the coronavirus. This is why everyone should cover their nose and mouth when they go out in public.

Coronavirus can also spread from contact with infected surfaces or objects. For example, a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes.

The virus may be shed in saliva, semen, and feces; whether it is shed in vaginal fluids isn't known. Kissing can transmit the virus. Transmission of the virus through feces, or during vaginal or anal intercourse or oral sex, appears to be extremely unlikely at this time.

How could contact tracing help slow the spread of COVID-19?

Anyone who comes into close contact with someone who has COVID-19 is at increased risk of becoming infected themselves, and of potentially infecting others. Contact tracing can help prevent further transmission of the virus by quickly identifying and informing people who may be infected and contagious, so they can take steps to not infect others.

Contact tracing begins with identifying everyone that a person recently diagnosed with COVID-19 has been in contact with since they became contagious. In the case of COVID-19, a person may be contagious 48 to 72 hours before they started to experience symptoms.

The contacts are notified about their exposure. They may be told what symptoms to look out for, advised to isolate themselves for a period of time, and to seek medical attention as needed if they start to experience symptoms.

What is social distancing and why is it important?

The COVID-19 virus primarily spreads when one person breathes in droplets that are produced when an infected person coughs or sneezes. In addition, any infected person, with or without symptoms, could spread the virus by touching a surface. The coronavirus could remain on that surface and someone else could touch it and then touch their mouth, nose or eyes. That's why it's so important to try to avoid touching public surfaces or at least try to wipe them with a disinfectant.

Social distancing refers to actions taken to stop or slow down the spread of a contagious disease. For an individual, it refers to maintaining enough distance (6 feet or more) between yourself and another person to avoid getting infected or infecting someone else. School closures, directives to work from home, library closings, and cancelling meetings and larger events help enforce social distancing at a community level.

Slowing down the rate and number of new coronavirus infections is critical to reduce the risk that large numbers of critically ill patients cannot receive life-saving care. Highly realistic projections show that unless we begin extreme social distancing now — every day matters — our hospitals and other healthcare facilities will not be able to handle the likely influx of patients.

How many COVID-19 infections may have been prevented because of policies designed to slow the spread of the virus?

Large-scale emergency health measures prevented more than 500 million COVID-19 infections in six countries between January and early April 2020, according to a peer-reviewed article published in the journal Nature. The study authors looked at the impact of policies designed to slow the spread of the virus in six countries: the United States, China, South Korea, Italy, Iran, and France. They compared the growth rate of COVID-19 infections in each country before and after the policies — such as travel restrictions; business, school, and restaurant closures; and social distancing — were enacted.

These findings reinforce the importance of continuing to exercise caution and practice health-promoting behaviors as restrictions begin to ease.

What types of medications and health supplies should I have on hand for an extended stay at home?

Try to stock at least a 30-day supply of any needed prescriptions. If your insurance permits 90-day refills, that's even better. Make sure you also have over-the-counter medications and other health supplies on hand.

Medical and health supplies

  • prescription medications
  • prescribed medical supplies such as glucose and blood-pressure monitoring equipment
  • fever and pain medicine, such as acetaminophen
  • cough and cold medicines
  • antidiarrheal medication
  • thermometer
  • fluids with electrolytes
  • soap and alcohol-based hand sanitizer
  • tissues, toilet paper, disposable diapers, tampons, sanitary napkins
  • garbage bags.

Should I keep extra food at home? What kind?

Consider keeping a two-week to 30-day supply of nonperishable food at home. These items can also come in handy in other types of emergencies, such as power outages or snowstorms.

  • canned meats, fruits, vegetables, and soups
  • frozen fruits, vegetables, and meat
  • protein or fruit bars
  • dry cereal, oatmeal, or granola
  • peanut butter or nuts
  • pasta, bread, rice, and other grains
  • canned beans
  • chicken broth, canned tomatoes, jarred pasta sauce
  • oil for cooking
  • flour, sugar
  • crackers
  • coffee, tea, shelf-stable milk, canned juices
  • bottled water
  • canned or jarred baby food and formula
  • pet food
  • household supplies like laundry detergent, dish soap, and household cleaner.

What precautions can I take when grocery shopping?

The coronavirus that causes COVID-19 is primarily transmitted through droplets containing virus, or through viral particles that float in the air. The virus may be breathed in directly and can also spread when a person touches a surface or object that has the virus on it and then touches their mouth, nose, or eyes. There is no current evidence that the COVID-19 virus is transmitted through food.

Safety precautions help you avoid breathing in coronavirus or touching a contaminated surface and touching your face.

In the grocery store, maintain at least six feet of distance between yourself and other shoppers. Wipe frequently touched surfaces like grocery carts or basket handles with disinfectant wipes. Avoid touching your face. Wearing a cloth mask helps remind you not to touch your face and can further help reduce spread of the virus. Use hand sanitizer before leaving the store. Wash your hands as soon as you get home.

If you are older than 65 or at increased risk for any reason, limit trips to the grocery store. Ask a neighbor or friend to pick up groceries and leave them outside your house. See if your grocery store offers special hours for older adults or those with underlying conditions. Or have groceries delivered to your home.

What precautions can I take when unpacking my groceries?

Recent studies have shown that the COVID-19 virus may remain on surfaces or objects for up to 72 hours. This means virus on the surface of groceries will become inactivated over time after groceries are put away. If you need to use the products before 72 hours, consider washing the outside surfaces or wiping them with disinfectant. The contents of sealed containers won't be contaminated.

After unpacking your groceries, wash your hands with soap and water for at least 20 seconds. Wipe surfaces on which you placed groceries while unpacking them with household disinfectants.

Thoroughly rinse fruits and vegetables with water before consuming. And wash your hands before consuming any foods that you've recently brought home from the grocery store.

What should and shouldn't I do during this time to avoid exposure to and spread of this coronavirus? For example, what steps should I take if I need to go shopping for food and staples? What about eating at restaurants, ordering takeout, going to the gym, or swimming in a public pool?

The answer to all of the above is that it is critical that everyone begin intensive social distancing immediately. As much as possible, limit contact with people outside your family.

If you need to get food, staples, medications or healthcare, try to stay at least six feet away from others, and wash your hands thoroughly after the trip, avoiding contact with your face and mouth throughout. Prepare your own food as much as possible. If you do order takeout, open the bag, box or containers, then wash your hands. Lift, fork or spoon out the contents into your own dishes. After you dispose of these outside containers, wash your hands again. Most restaurants, gyms and public pools are closed; but even if one is open, now is not the time to go.

Here are some other things to avoid: playdates, parties, sleepovers, having friends or family over for meals or visits, and going to coffee shops — essentially any nonessential activity that involves close contact with others.

What can I do when social distancing?

Try to look at this period of social distancing as an opportunity to get to things you've been meaning to do.

Though you shouldn't go to the gym right now, that doesn't mean you can't exercise. Take long walks or run outside (do your best to maintain at least six feet between you and non-family members when you're outside). Do some yoga or other indoor exercise routines when the weather isn't cooperating.

Kids need exercise too, so try to get them outside every day for walks or a backyard family soccer game (remember, this isn't the time to invite the neighborhood kids over to play). Avoid public playground structures, which aren't cleaned regularly and can spread the virus.

Pull out board games that are gathering dust on your shelves. Have family movie nights. Catch up on books you've been meaning to read, or do a family read-aloud every evening.

It's important to stay connected even though we should not do so in person. Keep in touch virtually through phone calls, Skype, video, and other social media. Enjoy a leisurely chat with an old friend you've been meaning to call.

If all else fails, go to bed early and get some extra sleep!

Should I wear a face mask?

The CDC now recommends that everyone in the US wear nonsurgical masks when going out in public.

Coronavirus primarily spreads when someone breathes in droplets containing virus that are produced when an infected person coughs or sneezes or when a person touches a contaminated surface and then touches their eyes, nose, or mouth. But people who are infected but do not have symptoms, or have not yet developed symptoms, can also infect others. That's where masks come in.

A person infected with coronavirus — even one with no symptoms — may emit aerosols when they talk or breathe. Aerosols are infectious viral particles that can float or drift around in the air. Another person can breathe in these aerosols and become infected with the virus. A mask can help prevent that spread. An article published in NEJM in March reported that aerosolized coronavirus could remain in the air for up to three hours.

What kind of mask should you wear? Because of the short supply, people without symptoms or without exposure to someone known to be infected with the coronavirus can wear a cloth face covering over their nose and mouth. They do help prevent others from becoming infected if you happen to be carrying the virus unknowingly.

While N95 masks are the most effective, these medical-grade masks are in short supply and should be reserved for healthcare workers.

Some parts of the US also have inadequate supplies of surgical masks. If you have a surgical mask, you may need to reuse it at this time. But never share your mask.

Surgical masks are preferred if you are caring for someone who has COVID-19 or you have any respiratory symptoms (even mild symptoms) and must go out in public.

Masks are more effective when they are tight-fitting and cover your entire nose and mouth. They can help discourage you from touching your face (be sure you're not touching your face more often to adjust the mask). Masks are meant to be used in addition to, not instead of, physical distancing.

The CDC has information on how to make, wear, and clean nonsurgical masks.

The WHO offers videos and illustrations on when and how to use a mask.

What types of masks are most and least effective?

We know that wearing masks can help prevent the spread of coronavirus by blocking droplets that are emitted when someone coughs, sneezes, talks, or breathes. But which masks are best and worst?

Researchers at Duke University created a simple setup that allowed them to count the number of droplet particles released when people spoke the phrase "Stay healthy, people" five times in a row. First, the study participants spoke without a mask, and then they repeated the same words, each time wearing one of 14 different types of face masks and coverings.

As expected, medical grade N95 masks performed best, meaning that the fewest number of droplets got through. They were followed by surgical masks. Several masks made of polypropylene, a cotton/propylene blend, and 2-layer cotton masks sewn in different styles also performed well.

Gaiters ranked dead last. In a surprise, they allowed more particles to get through than wearing no mask at all. Also called neck fleeces, gaiters tend to be made of lightweight fabric and are often worn by athletes. In the study, gaiters broke up larger droplets into smaller droplets that could spread more easily to others. Bandanas also ranked poorly, but better than no mask.

A couple of simple tests can help you gauge the effectiveness of your mask: If you can see through your mask when you hold it up to the light, or can breathe through it easily, it's probably not doing much to prevent spread.

Who do masks protect: the wearer, others, or both?

We've known for some time that masks help prevent people from spreading the coronavirus to others. Based on an analysis of existing information, a new study contends that masks may also protect mask wearers from becoming infected themselves.

Different masks, writes the study author, block viral particles to varying degrees. If masks lead to lower "doses" of virus being inhaled, then fewer people may become infected, and those who do may have milder illness.

Researchers in China experimented with hamsters to test the effect of masks. They put healthy hamsters and hamsters infected with SARS-CoV-2 (the COVID-19 coronavirus) in a cage, and separated some of the healthy and infected hamsters with a barrier made of surgical masks. Many of the "masked" healthy hamsters did not get infected, and those who did got less sick than previously healthy "maskless" hamsters.

A similar experiment cannot ethically be done in humans. But researchers have studied doses of flu virus and found that people who inhaled a higher dose of flu virus were more likely to get sick and experience symptoms. Observations of coronavirus outbreaks in processing plants and on cruise ships also support the idea that masks may help protect mask wearers.

Without more research, we can't be certain that masks protect the wearer. But we do know they don't hurt, and that they protect others.

How much difference will masks and physical distancing make as states begin to reopen?

Although we don't know exactly how much masks and physical distancing help, we do know that these measures are needed to open the economy in the safest way possible and are our best chance of keeping it open. But in order to work, everyone must comply.

Coronavirus spreads when someone breathes in virus that an infected person emits through coughs or sneezes, or when they talk or breathe, or when a person touches a contaminated surface and then touches their eyes, nose, or mouth. Physical distancing of at least six feet and wearing a tight-fitting cloth mask that covers your nose and mouth can help prevent spread. (Medical-grade N95 masks are more effective than cloth masks, but are in short supply and should be reserved for healthcare workers.) Continue to wash your hands frequently as well.

Researchers at Columbia University recently affirmed the importance of these health-promoting behaviors. They reported that 36,000 fewer people would have died in the coronavirus outbreak if physical distancing measures has started one week earlier; if physical distancing had begun two weeks earlier, 54,000 fewer people may have died.

As I start seeing more friends and family, does it matter whether we meet indoors or outdoors?

As you gradually expand your social circle, you are better off meeting friends and family outdoors. We know that coronavirus spreads when someone breathes in virus that an infected person emits through coughs or sneezes, or when they talk or breathe. A recent study found that in a confined, laboratory setting, droplets containing viral particles can remain afloat for eight to 14 minutes. Smaller infectious viral particles, called aerosols, can drift around in the air even longer.

Outdoors, air currents are more likely to scatter and dilute the virus, making transmission less likely than in a home, office, or other confined space with limited air circulation. Even outdoors, however, it's important to maintain a physical distance of at least six feet and wear a mask, to reduce risk even further.

Coronavirus also spreads when a person touches a contaminated surface and then touches their eyes, nose, or mouth. If you are participating in an outdoor gathering, bring your own foods, drinks, plates, and utensils.

Can the COVID-19 virus spread through air conditioning?

We don't know for certain if the COVID-19 virus spreads through air conditioning. But we do know that when it's hot and humid, people are more likely to stay indoors, with the windows closed — giving the virus more opportunity to spread.

Coronavirus spreads through droplets that an infected person emits through coughs or sneezes and through smaller, infectious viral particles that can drift around in the air for several hours. Outdoors, air currents can scatter and dilute the virus, making transmission less likely. You're more likely to inhale the virus indoors, with the windows closed, whether or not you have the air conditioning on.

If you must be indoors with anyone outside of your household, increase air circulation by keeping the windows open as much as possible.

Does vitamin D protect against COVID-19?

There is some evidence to suggest that vitamin D might help protect against becoming infected with, and developing serious symptoms of, COVID-19. We know, for example, that people with low vitamin D levels may be more susceptible to upper respiratory tract infections. One meta-analysis found that people who took vitamin D supplements, particularly those who had low vitamin D levels, were less likely to develop acute respiratory tract infections than those who didn't.

Vitamin D may protect against COVID-19 in two ways. First, it may help boost our bodies' natural defense against viruses and bacteria. Second, it may help prevent an exaggerated inflammatory response, which has been shown to contribute to severe illness in some people with COVID-19.

Our bodies make vitamin D when exposed to sunshine. Five to 10 minutes of sun exposure on some or most days of the week to the arms, legs, or back without sunscreen will enable you to make enough of the vitamin. Good food sources of vitamin D include fatty fish (such as tuna, mackerel, and salmon), foods fortified with vitamin D (such as dairy products, soy milk, and cereals), cheese, and egg yolks.

The recommended dietary dose of vitamin D is 600 IU each day for adults 70 and younger and 800 IU each day for adults over 70. A daily supplement containing 1,000 to 2,000 IU of vitamin D is likely safe for most people. For adults, the risk of harmful effects increases above 4,000 IU per day.

Is it safe to travel by airplane?

Stay current on travel advisories from regulatory agencies. This is a rapidly changing situation.

Anyone who has a fever and respiratory symptoms should not fly if at all possible. Even if a person has symptoms that feel like just a cold, he or she should wear a mask on an airplane.

Is there a vaccine available?

No vaccine is available, although scientists will be starting human testing on a vaccine very soon. However, it may be a year or more before we even know if we have a vaccine that works.

What needs to happen before we have a vaccine for COVID-19?

A successful COVID-19 vaccine will safely and effectively stimulate the body's immune system to create antibodies that protect against the COVID-19 coronavirus. More than 100 COVID-19 vaccines are currently in various stages of development and testing, and more than one may eventually be approved.

Anti-virus vaccine development traditionally requires the following steps:

  • Pre-clinical testing: Animals are infected with the virus. Scientists study their immune response to see what aspects of the immune response might be critical for protection. Normally, a vaccine is first tested in animals. However, in the setting of a pandemic such as this one, the animal testing stage can be skipped.
  • Phase 1 trials: A vaccine is tested in small groups of people to determine what dose safely and consistently stimulates the immune system. At this stage, scientists don't yet know if the immune response triggered by the vaccine will protect against the virus.
  • Phase 2 trials: The vaccine is given to hundreds or thousands of people. Scientists continue to focus on whether the vaccine is safe and produces a consistent immune response.
  • Phase 3 trials: These trials typically enroll tens of thousands of people. This is the first phase that involves a placebo group. It compares the number of people who get sick in the vaccine group to the number of people who get sick in the placebo group. This is the only phase that can show whether or not the immune response triggered by the vaccine actually protects against infection in the real world.

Some researchers are combining trial phases in an effort to speed up the COVID-19 vaccine development process. In addition, the US government has created Operation WARP Speed, which will identify and support mass production of the most promising vaccines before they have been approved, so that they will be available quickly if they are ultimately found to be safe and effective. It's likely that a COVID-19 vaccine will be available before we know how long that vaccine's protective effect will last.

Are there any promising vaccines for COVID-19 under investigation?

Around the world, there are currently over 100 different COVID-19 vaccines in various stages of testing and development: preclinical work using animal models, followed by Phase 1 (safety), Phase 2 (optimal dose, schedule, and proof of concept), and Phase 3 (effectiveness, side effects) trials in humans.

The following three vaccine approaches are among the first to be tested clinically in the United States.

  • A vaccine created by Moderna in Cambridge, Massachusetts, uses a type of molecule called messenger RNA (mRNA) that can be mass-manufactured very rapidly. In this vaccine, mRNA induces human cells to make a molecule called the spike protein, which studs the surface of the coronavirus and enables it to enter human cells. The vaccine then triggers the immune system to make antibodies against the spike protein. Phase 1 human trials were started in March 2020 by the NIH. Initial results have shown the vaccine is safe and generates high levels of neutralizing antibodies. The vaccine is expected to enter Phase 3 clinical trials in July 2020.
  • A hybrid vaccine uses a modified, harmless form of a chimpanzee common-cold adenovirus to deliver the coronavirus spike protein into the body and to stimulate immune response. This platform was developed at the Jenner Institute at Oxford University in collaboration with AstraZeneca. Already in later stage clinical trials in many parts of the world, this vaccine is expected to enter clinical trials in the United States in August 2020.
  • Another hybrid vaccine uses a human common-cold adenovirus to deliver the coronavirus spike protein into the body. That platform was developed by Harvard Medical School scientists in collaboration with Johnson and Johnson. This vaccine launched Phase 1/2 clinical trials in July 2020.

In animal models, all three vaccines provide protective immunity against SARS-CoV-2, the COVID-19 virus. Upcoming trials will help establish their long-term effectiveness and potential side effects. A central question will be how long protection might last.

Do the antibodies produced by a person who has been infected with coronavirus protect them from becoming infected again?

Most people who are infected with the COVID-19 virus, whether or not they have symptoms, produce antibodies (proteins that fight infections). New research published in Nature Medicine looked at how long those antibodies last. Results from this small study suggest that levels of one type of antibody dropped sharply within two to three months. However, the decrease in neutralizing antibodies, which target the spike protein on the coronavirus and can help protect against reinfection, was much smaller.

Whether or not the remaining antibodies protect against reinfection, and for how long, is still unclear. It's possible that even low levels of neutralizing antibodies may be able to protect against reinfection. On the other hand, the presence of antibodies does not guarantee immunity.

Another consideration is that antibodies are only one part of the body's immune response. Memory B cells, for example, can quickly generate a strong antibody response to a virus the body has encountered before.

What is herd immunity, and could it play a role in stopping the spread of COVID-19?

Herd immunity occurs when enough people become immune to a disease to make its spread unlikely. As a result, the entire community is protected, even those who are not themselves immune. Herd immunity is usually achieved through vaccination, but it can also occur through natural infection.

Based on what we know about the contagiousness of the COVID-19 virus, experts estimate that somewhere between 60% and 70% of the population needs to be immune in order to achieve herd immunity. That's close to 200 million people in the United States, and nearly five billion people worldwide. (As of now, we are nowhere close to the numbers needed to achieve herd immunity.)

Achieving herd immunity through natural infection means many people would become ill and many would die. These risks may fall as we develop effective treatments. However, we still don't know how long people who recover from COVID-19 will remain immune to reinfection.

Ideally, we will achieve herd immunity through a safe vaccine (or vaccines) that will confer lasting immunity.

Will a pneumococcal vaccine help protect me against coronavirus?

Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B (Hib) vaccine, only help protect people from these specific bacterial infections. They do not protect against any coronavirus pneumonia, including pneumonia that may be part of COVID-19. However, even though these vaccines do not specifically protect against the coronavirus that causes COVID-19, they are highly recommended to protect against other respiratory illnesses.

My husband and I are in our 70s. I'm otherwise healthy. My husband is doing well but does have heart disease and diabetes. My grandkids' school has been closed for the next several weeks. We'd like to help out by watching our grandkids but don't know if that would be safe for us. Can you offer some guidance?

People who are older and older people with chronic medical conditions, especially cardiovascular disease, high blood pressure, diabetes, and lung disease are more likely to have severe disease or death from COVID-19, and should engage in strict social distancing without delay. This is also the case for people or who are immunocompromised because of a condition or treatment that weakens their immune response.

The decision to provide on-site help with your children and grandchildren is a difficult one. If there is an alternative to support their needs without being there, that would be safest.

Can my pet infect me with the virus that causes COVID-19?

At present, it is considered unlikely that pets such as dogs or cats can spread the COVID-19 virus to humans. However, pets can spread other infections that cause illness, including E. coli and Salmonella, so wash your hands thoroughly with soap and water after interacting with pets.

Can people infect pets with the COVID-19 virus?

The virus that causes COVID-19 does appear to spread from people to pets, according to the FDA. Research has found that cats and ferrets are more likely to become infected than dogs.

If you have a pet, do the following to reduce their risk of infection:

  • Avoid letting pets interact with people or animals that do not live in your household.
  • Keep cats indoors when possible to prevent them from interacting with other animals or people.
  • Walk dogs on a leash maintaining at least six feet from other people and animals.
  • Avoid dog parks or public places where a large number of people and dogs gather.

If you become sick with COVID-19, restrict contact with your pets, just like you would around other people. This means you should forgo petting, snuggling, being kissed or licked, and sharing food or bedding with your pet until you are feeling better. When possible, have another member of your household care for your pets while you are sick. If you must care for your pet while you are sick, wash your hands before and after you interact with your pets and wear a face mask.

At present, it is considered unlikely that pets can spread the COVID-19 virus to humans. However, pets can spread other infections that cause illness, including E. coli and Salmonella, so wash your hands thoroughly with soap and water after interacting with your animal companions.

What can I do to keep my immune system strong?

Your immune system is your body's defense system. When a harmful invader — like a cold or flu virus, or the coronavirus that causes COVID-19 — gets into your body, your immune system mounts an attack. Known as an immune response, this attack is a sequence of events that involves various cells and unfolds over time.

Following general health guidelines is the best step you can take toward keeping your immune system strong and healthy. Every part of your body, including your immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies such as these:

  • Don't smoke or vape.
  • Eat a diet high in fruits, vegetables, and whole grains.
  • Take a multivitamin if you suspect that you may not be getting all the nutrients you need through your diet.
  • Exercise regularly.
  • Maintain a healthy weight.
  • Control your stress level.
  • Control your blood pressure.
  • If you drink alcohol, drink only in moderation (no more than one to two drinks a day for men, no more than one a day for women).
  • Get enough sleep.
  • Take steps to avoid infection, such as washing your hands frequently and trying not to touch your hands to your face, since harmful germs can enter through your eyes, nose, and mouth.

Should I go to the doctor or dentist for nonurgent appointments?

Many medical and dental practices now have sufficient personal protective equipment and have instituted comprehensive safety measures to help protect you, the doctor and office staff, and other patients. If you feel anxious about visiting in person, call the practice.

Many doctor's offices are increasingly providing telehealth services. This may mean appointments by phone call, or virtual visits using a video chat service. Ask to schedule a telehealth appointment with your doctor for a new or ongoing nonurgent matter. If, after speaking to you, your doctor would like to see you in person, he or she will let you know.

What if your appointments are not urgent but also don't fall into the low-risk category? For example, if you have been advised to have periodic scans after cancer remission, if your doctor sees you regularly to monitor for a condition for which you're at increased risk, or if your treatment varies based on your most recent test results? In these and similar cases, call your doctor for advice.

Should I postpone my elective surgery?

Doctors have restarted performing elective surgeries and procedures in many communities. But the situation in the United States is very fluid, with a rapid increase in cases in some states. For those states with rising COVID-19 cases, it's quite possible that you already have been canceled or rescheduled by the hospital or medical center in which you are scheduled to have the procedure. If not, then during this period of social distancing, you should consider postponing any procedure that can wait.

That being said, keep in mind that "elective" is a relative term. For instance, you may not have needed immediate surgery for sciatica caused by a herniated disc. But the pain may be so severe that you would not be able to endure postponing the surgery for weeks or perhaps months. In that case, you and your doctor should make a shared decision about proceeding.

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