Editor’s note: This document was written by Dr. Daniel Gluckstein, Lisa Gluckstein, and Divya Gopal originally as a google document shared by friends and family. I saw this and realized more people should have it available. The full original google doc can be found here.
-Shuhan He, MD
Purpose of this document: This document is designed as a conversation guide for the majority of Americans who cohabit with partners, parents, roommates, and children. The below guidance includes three checklists: (1) a conversation guide, (2) a hygiene and social distancing guide, and (3) a mental health and social well-being guide that enables each of us to prevent the spread of COVID-19.
Why this matters: Per Dr. Daniel Gluckstein, infectious disease specialist, “The COVID-19 pandemic has emerged as the major health crisis of the 21st century. If allowed to spread unabated, it promises to cause millions of hospitalizations and hundreds of thousands of deaths in the United States in the next few months. Due to the current lack of effective medical therapy to treat the infection or vaccination to prevent infection, we are dependent upon our ability to change our behavior as individuals and as a society to alter the course of the pandemic through basic infection prevention strategies. Other countries have already successfully dampened the severity of the pandemic in their respective countries through the power of individual and communal interventions. We must accept this responsibility to each other as a moral obligation, for failure to do so will condemn thousands to preventable illness and death.”
This document presents concrete tools to drive collaborative conversation around microbial hygiene, social distancing, and self-quarantining—the most powerful tools we each have to control the spread of COVID-19 at home and within our communities.
COVID-19 is highly contagious, and we share the risk of infection most closely with our housemates and/or family. Having a frank conversation and coming to an agreement on your shared expectations for good hygiene and social distancing practices with housemates/family will help your household prevent the risk of transmission to one another and to others by minimizing unnecessary exposure risk and normalizing responsible practices at home and within your social networks. Note that it may become necessary to cease social contact entirely in the coming days.
Conversation Guide for Managing COVID-19 Risks with Housemates & Family
(1) What hygiene expectations should we have for all people who enter our home?
Consider establishing an expectation that all who enter the home (residents/guests alike) will wash hands immediately upon entering, and with regularity thereafter; agreeing to a shared social distancing policy (no hugs, handshakes, or physical contact, ideally maintaining a 6+ ft distance from others).
(2) How do we define a necessary guest during quarantine? How well do we know our guests and their hygiene habits?
Consider establishing shared standards to vet any guests and social contacts and declining visits with people who appear to be assuming unnecessary risk or who fail to take the outbreak seriously.
(3) How many guests can we accommodate at a time while maintaining a safe (6ft+) distance? How many people are entering/leaving our home, and how often?
Consider maintaining empty space between people in seating and dining arrangements and limiting guests to the greatest extent possible.
(4) How do we ensure that we greet our guests safely?
The CDC recommends avoiding hugs, handshakes, and maintaining a 6+ ft distance from others as much as possible. Check out these festive ways to say hello without physical contact.
(5) If sharing food, how can we maintain a sanitary dining environment?
Consider Kindergarten rules: no sharing drinks, no double dipping, and no foods that require you to use your hands to distribute (Looking at you, charcuterie board). Use utensils as much as possible.
(6) How can we minimize trips (e.g. grocery) among all housemates?
Consider coordinating and limiting the frequency of grocery runs and errands, and having a single healthy housemate pick up items for others.
(7) What is our Household Plan of Action in the event of infection at home?
Consider defining a quarantine area within your home for sick individuals, creating a shared emergency contact list, and identifying the nearest hospital.
(8) How can we encourage our friends and social networks to adopt responsible practices?
Consider having conversations with friends and loved ones by phone, encouraging them to take precautionary measures seriously.
(9) What other considerations are important to us as a household?
Consider how to involve both children and/or older adults in your home with these best practices.
To prepare for the unknown, make sure all members of your household are clear about how you are mitigating risk, e.g. Our recommendations are:
- Establish an expectation that all who enter the home will wash hands or sanitize immediately upon entering, and with regularity thereafter.
- Agree to a shared social distancing policy—avoiding hugs, handshakes, or another physical contact as much as possible, ideally maintaining a 6+ ft distance from others
- Establish shared standards to vet any guests entering the home.
- Decline visits with people who appear to be assuming unnecessary risk or who fail to take the outbreak seriously.
- Limit the number of total guests to the greatest extent possible.
- Minimize unnecessary trips outside and coordinate errand-running.
- Encourage friends and loved ones to take precautionary measures seriously.
Discuss a Household Plan of Action
Hygiene & Social Distancing Checklist
- Clean & disinfect hands, doorknobs, phones, handrails, and other high-touch surfaces with regularity (Cleaning Guide).
- Stay at home to the greatest extent possible.
- Avoid public gathering spaces, including public transit, gyms, bars, restaurants, and gatherings at friends’ homes.
- Talk to your partner(s) about the level of risk you are willing and able to assume.
- Avoid contact with high-risk individuals, e.g. older adults and those with underlying conditions.
If you’re feeling sick at all (even if you think it’s “just a cold”): DO NOT LEAVE YOUR HOME. Follow Home Care Instructions & the Home Isolation & Cleaning Guide.
Mental Health & Social Wellbeing Checklist
- Manage Stress – Guide to Coping during outbreaks.
- Get exercise outdoors in a setting in which you can maintain 6+ feet from other people.
- Maintain contact with friends and loved ones via phone and video conferencing.
- Set personal & shared goals for the many at-home hours you will be enjoying.
- Get enough sleep, stay hydrated, and eat healthy foods.
- Someone in my home is feeling sick. What should we do?
- If that person is stable, they should quarantine at home. If they exhibit extreme shortness of breath and/or inability to take food or water, then they should seek immediate medical attention.
- Avoid all contact with the sick person. Clean all surfaces that the sick person comes in contact with. The sick individual should wear a mask. Consult this guide for home isolation and this guide to caring for a sick person.
Resources for Additional Information
- Centers for Disease Control (CDC) COVID-19 Information Page
- Johns Hopkins COVID-19 Global Cases Dashboard
- Guide to Remote Work
- Community Transmission Mitigation Strategies for schools, homes, community spaces
- Dr. Dan’s Informational Slide Deck on COVID-19 (Updated 2020-3-14)
- Flattening the Curve: Why it matters
Who made this guide? This guide is a product of the collaboration between two concerned roommates living in San Francisco, Divya and Lisa, and an infectious disease doctor, Dr. Dan Gluckstein.
Given that this is an unprecedented situation for everyone, we thought it would be important for us as roommates to have an honest conversation about what living together responsibly during a pandemic looks like. We also had the benefit of receiving information and trusted guidance from Dr. Dan, an infectious disease specialist (and Lisa’s dad). Given the overwhelming volume of information on the internet, we wanted to share his actionable advice with others who were feeling as uncertain as we were about what to do. We hope this helps.