Why Toilet Hygiene is Must: Coronavirus Sheds in the Stool
Toilet hygiene in the time of coronavirus and tips for quarantine
The world is bracing for the impact of COVID-19 which has been reported from 119 countries and territories around the world infecting more than 121,000 people with close to 4400 deaths globally as of March 11th. A better understanding of how this virus is transmitted and disseminating this knowledge is key to preventing its spread as the epidemiologists fear that it may affect 70% of world population.
In two new papers published online in a very reputed journal ‘Gastroenterology’, investigators from China report that a good number of coronavirus patients have diarrhea, nausea, vomiting and/or abdominal discomfort before respiratory symptoms come up. While these are all very non specific symptoms, a high index of suspicion is called for under the current circumstances. Monitoring of patients with initial GI distress, would facilitate earlier detection and diagnosis, as it is now clear that the virus sheds into the stool. This would lead to timely isolation and intervention.
Another important fact that has come to light is that viral gastrointestinal infection and potential fecal-oral transmission can last even after viral clearance in respiratory tract. Therefore, prevention of feco-oral transmission assumes importance to control the spread the virus.
People With Diabetes, Heart & Lung Disease Need to be Very Careful
Chances of developing COVID-19 increase with age, starting at age 60. People over 80 are the most vulnerable to develop full blown disease. Mortality rate is the highest in this group.
Further, people with diabetes, heart disease, lung disease and other serious underlying conditions are more likely to develop “serious outcomes, including death,”
It is strongly recommended that people at higher risk avoid non-essential travel, visiting crowded places, touching “high-touch” surfaces in public areas and close contact with people who are sick.
Here's What You Can Do to Stay Safe
Tips for Self-Quarantine
Quarantine and Isolation are different. The former is for healthy people who may fall sick following a suspected or a possible exposure. The latter is for people who are ill with Covid 19 — they are a danger to any one they come in contact with and must be watched carefully in case they deteriorate.
So, those who suspect they might have come in contact with a high risk case (Travellers from the affected countries, or a known active case in India) are advised to self quarantine, that is, stay home unless you must see a doctor. If you must come out of your room, wear a surgical mask. And don’t share towels and certainly other toiletries. It will be great if no one else uses your toilet.
Mostly, people who returned from any affected country and have symptoms of fever and a dry cough are being checked at the port of entry by the government authorities and quarantined or isolated, as the case may be, after the tests.
Home quarantine of 2 weeks might be a tall order, especially if you have young children or elderly relatives to look after.
Tips For Isolation
If you are potentially infectious, it is important that you separate yourself from every one around, including your spouse / partner and your children and especially your elderly parents. Avoid even petting your dog as he may be the vehicle of transmission of the virus if somebody else pets him.
Masks: If circumstances force you to be around other people — in your home, or for example, in a car ( avoid public transport) because you are visiting your doctor— wear a surgical mask. If that is not available, a home made three layered mask is as good.
Hygiene: If you cough or sneeze, you should cover your mouth and nose with a tissue, and discard the used tissue in a lined trash can. Then immediately wash your hands thoroughly with soap and water for at least 20 seconds. You can use alcohol based sanitizer, as an alternative.
Toilet Paper vs Washing: Especially with the new evidence coming in, ablution with the health faucet is definitely preferable to using toilet papers. Even if you are a housemate of a quarantined or suspected case, it is strongly advisable to wash your hands frequently, and avoid touching your eyes, nose and mouth, with unwashed hands.
Disinfect: Let family sharing the dining table wait for some time until you are in the clear. Countertops, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets and bedside tables are considered “high-touch surfaces” — wipe them often with a household cleanser or 0.1% bleach.
Monitoring: Call a doctor at the first appearance of any symptom like diarrhea, pain abdomen, dry cough or fever. Make sure to tell the medical staff that you are at risk of COVID 19.
Household members can go to their respective work or school, but someone would need to be there to take care of the quarantined and keep the place clean.
When around a symptomatic patient, household members must wear a face mask, as well as gloves if they have contact with his or her bodily fluids. These should be disposed off immediately and never reused.
(Dr Ashwini Setya is a Gastroenterologist and Programme Director in Delhi’s Max Super Speciality Hospital. His endeavor is to help people lead a healthy life without medication. He can be reached at email@example.com)
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