Extract from ABC News
This time two years ago, many Australians were organising their bushfire go-bag; a kit of emergency items set aside to ensure families were able to evacuate safely at a moments notice.
We're now facing a different disaster: a growing COVID-19 outbreak that has seen cases around the country skyrocket to previously unfathomable numbers.
And like bushfires, it can pay to be prepared — especially if you live in a sharehouse or multigenerational household. Only this time the preparation will not be for an evacuation but quite the opposite: being isolated at home if someone in the household tests positive.
"Lots and lots of people have COVID, far more in Australia than any other time … so people have to realise that this is something that might happen to them," says James McCaw, an epidemiologist at the University of Melbourne.
"If you don't spread it to your housemates, or you spread it to fewer of them, you're not just helping them — you're helping the whole of society."
When a household case is detected, you should act as if everyone in the home is infected until proven otherwise. Under the current close contact rules, household members of a positive case are required to isolate for seven days, even if they test negative.
So what things should you discuss with your household before an infection happens? And if it does, how can you ensure everyone gets through an isolation period safely?
Before a positive test
COVID-19 is at its most infectious in the days before symptoms hit. This means, unfortunately, you may not know that there's a positive case in the house until it's too late.
With the virus circulating widely, the first step should be establishing whether anyone in your household is particularly vulnerable to the disease and what everybody's risk tolerance is.
Depending on your level of concern, this may mean: wearing masks in common areas in the home even before symptoms, limiting visitors, and doing regular rapid antigen tests after high-risk events.
"Right now, when there's very high community transmission, everyone can take some simple steps to reduce the risk in the household," says Raina MacIntyre, an infectious diseases expert at the Kirby Institute.
"Because most transmission happens in the household."
This is also a good time to seal gaps around doors, especially if you live in an apartment. Professor MacIntyre says a good test is whether you can smell your neighbour's cooking — if you can, it means you are breathing in air that could be carrying the virus.
To do this you can use adhesive strips, which attach to the bottom of the door, or fabric door stops. "That means your household is prepared," she says. "If somebody gets the virus, it's prepared for a bedroom to be an isolation space."
Can you isolate within your home?
The next step is figuring out whether you could safely isolate a positive case away from others who test negative.
This means separate bedrooms, but also, bathrooms, balconies, and other common areas. Having a plan in place for how you will manage this will make things easier if you have to quickly respond to an infection.
If
two people are sharing a bedroom, can one person sleep on the couch or
even, as Deakin University epidemiologist Catherine Bennett suggests, in
a tent or campervan in the backyard? Alternatively, it may be worth
considering whether there's another location — away from other people —
where part of the household can isolate, especially if there are people
in the home particularly vulnerable to COVID-19.
When deciding where an infected person should isolate, it makes sense to pick a room that isn't adjacent to common areas, like the kitchen, where other household members will be gathering.
If the house has more than one bathroom, one should be set aside for COVID-positive people to use. If there's a bedroom with an ensuite, Dr Bennett suggests switching rooms if necessary so the person with an infection can remain as isolated as possible.
In households with only one bathroom, it's important for there to be as little crossover as possible. After every use, it should be wiped down with disinfectant. Any windows in the bathroom should remain open, fans on and the toilet flushed with the lid closed.
As it's unlikely your home will have more than one kitchen, it's also important to consider how to get meals to the COVID positive person. In most cases, this will mean other household members delivering food, snacks and essentials to the infected person's door. When doing so, wear a mask and consider the next point — airflow.
What's the airflow like?
COVID-19 is an airborne virus, meaning you don't have to be in the immediate vicinity of a positive case to contract it.
In a household, that means making sure the building is as ventilated as possible. "This virus is spread through the air you breathe, you can scrub your hands till the cows come home but if you don't pay attention to safe indoor air you're going to get infected," Professor MacIntyre says.
Can you open windows and doors at each end of the house, forcing air to disperse and circulate more quickly? If you have an air purifier, put it in corridors or low-ventilated spaces near where the positive person is isolated.
When delivering food to the COVID-positive person, Professor Bennett says you should leave some time after the door was last opened to allow any infected air to move on. "If I was walking up to the door, I'd put my mask on, I'd fan the air away in front of me to make sure it's not still air, and I'd pick up the tray and go away," she says.
She also warns that air conditioning can pose a risk if the air is recycled throughout the house. "If you've got someone who's locked away, and it's a really hot day and you have your aircon on, you've got to understand where your return is, where the air is drawn back out," Professor Bennett says. "Is it going to take that person's air back through common areas?"
And what about surfaces? Professor Bennett says surface transmission is relatively low risk compared to airborne transmission, but it's still something to be mindful of "especially if the person is symptomatic and they're coughing".
To combat this she recommends being "fastidious" about hand washing and hygiene.
What things should you have in your COVID kit?
Once a household case is detected, it's too late for any member of the household to go shopping — that's why it may be helpful to have some basic things on hand, both for infection control and managing symptoms.
Having them all in one place will also allow you to act quickly, limiting the positive person's exposure to the rest of the household. So, what should you have on hand?
For infection control, Professor Bennett says surgical masks should be enough for most scenarios but if you want to be extra careful, it may be worth investing in a stash of N95 masks.
Disposable gloves for handling dishes may provide an extra layer of protection, but shouldn't substitute good hand hygiene. Cleaning products such as household disinfectants, hand soap, hand sanitiser and disinfection wipes will also be useful.
It'll also be important to have a supply of rapid antigen tests available, ideally at least two per person in the household; one to establish whether there's an infection and another to follow up with later on in the isolation period.
When it comes to symptom management, Professor Bennett says what will be most needed will be different for everyone. Some basics include pain medication, like Panadol or Nurofen, Hydralyte or iceblocks, a thermometer to monitor fevers, and a pulse oximeter to measure oxygen levels. These devices can be purchased for around $30 and are a good way to indicate whether a COVID-19 case needs medical treatment.
It's also important to ensure you have at least a two-week supply of any regular medication, enough food — having some frozen meals ready to go could be a lifesaver when fatigue hits — and the contact details for medical support or assistance.
And lastly, don't forget activities to keep you entertained throughout the isolation period.
"I would have in my personal kit, if I was going to put one together, Panadol and a good book," Professor Bennett says. "Pull it out, put it beside the bed, and relax, because [you're] going to feel tired and won't want to do a whole lot — it's a care kit."
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