Advice to New Gardeners from COVID-19 Medical Advisors: Staying Well During the COVID-19 Pandemic
We recognize that New Gardeners may want to consider for themselves the risks and benefits associated with making in-person contact with non-household members during the upcoming holidays. Sadly, these risks have increased significantly in recent weeks. On November 18, the NC Department of Health and Human Services reported a record number of new COVID-19 cases in the state, and hospitalizations for COVID-19 have increased. Because considerations of risk must be highly individualized to both the people and the circumstances, we respectfully leave decisions to those involved. We offer the following information to assist New Gardeners in making these decisions.
What we know about transmission of the coronavirus
The coronavirus is highly contagious. Persons of any age may become infected and spread the virus to others, even without appearing ill or experiencing symptoms themselves. Adolescents are as likely as adults to transmit the virus. Younger children may also harbor and transmit the virus; however, their role in transmission is unclear because they often have minimal symptoms, even if infected, and have been tested less frequently than people in other age groups.
Transmission of the virus is mostly through airborne droplets from the nose or mouth of an infected person after that person speaks or breathes in close proximity to another person or sings, sneezes, shouts, or coughs from a greater distance. Transmission is much more likely indoors than outdoors. It is unknown how long the air inside a room occupied by an infected person remains potentially infectious. Factors affecting the risk of infection in a contaminated interior space include the duration of time spent in the room and room characteristics: size of the room, ventilation system design, location of supply and exhaust vents. Maximizing ventilation (eg, opening windows and doors) shortens the time for any respiratory droplets to be removed from the air. Riding in a vehicle is an indoor activity: risk of virus transmission from an infected person is high because of physical proximity of passengers in the enclosed space.
Although the virus can survive on surfaces, anywhere from hours to days, spreading the virus by touching a contaminated surface and then touching your own mouth or eyes and/or touching others appears to be much less frequent than airborne transmission.
Those who wear a face covering across their nose and mouth are less likely to transmit the virus to others and are less likely to become infected themselves than those who do not wear face coverings. Frequently washing or sanitizing hands is also critical to preventing spread of the virus.
Decision-making about in-person contacts
An individual’s risk of becoming infected increases as that individual’s number, duration, and frequency of in-person contacts increase; and that risk is multiplied, in turn, by the number, duration, and frequency of exposures experienced by those contacts. The nature of in-person contacts is also a factor: contacts made without protection are more likely to result in transmission than contacts made with protection, and indoor contacts are more likely than outdoor. An individual’s decision-making as to whether and how to make in-person contact with non-household members should weigh the risks against any potential benefits. People whose age or health condition makes them more likely to suffer serious illness if infected by the virus should give added weight to the risks. Likewise, people with a high-risk person in their household should give added weight to the risks. Any individual choosing to make in-person contact with non-household members bears responsibility for informing others potentially affected by his or her choice.
Reducing the risk of in-person contacts
It is far safer to visit or exercise with non-household members outdoors than indoors. If planning to be with members of another household, arrange separate transportation to your destination. If sharing a car with a non-household member is unavoidable for some reason, open windows and space occupants as far apart as possible. Regardless of health risk status or location, wear a cloth or disposable mask during in-person contact with anyone who is not a member of your own household and remain socially distanced, at least 6 feet apart. Also, you can and should request that other people remain masked in your presence. Treat the outward-facing surface of your own mask as potentially contaminated: do not touch your mask; wash your own cloth mask between exposures to others, or use disposable masks and discard after each exposure. Sanitize your hands after contact with your own contaminated mask, another person, or a potentially contaminated object or surface.
If using the bathroom in another person’s home (or in a public rest room, for that matter), you can use a tissue or wipe to open and close doors, touch the light or fan switch, flush the toilet, and handle faucets. Either use a paper towel to dry hands or use no towel at all. After using the bathroom, leave the door standing open to maximize ventilation, if feasible.
Having a meal with non-household members adds to the risk of virus transmission because people are necessarily unmasked while eating. The fewer households involved, the better. Members of one household should be separated as far apart as possible from members of other households. All should mask when not eating. Using common serving utensils; handling others’ used cutlery, napkins, plates, and glasses; and passing food among guests all add to the risk of virus transmission. These risks can be somewhat reduced by having all guests bring their own food, drinks, and disposable tableware from home, then discarding waste directly into a trash bag. Alcohol consumption appears to add risk to a social gathering, presumably by relaxing inhibitions and social distancing.
The safety of including young children in such gatherings depends on the level of supervision and/or the children’s ability to follow the guidelines above. Both multi-family gatherings and play dates are risky unless the children involved follow safety practices, closely monitored by adults. Outdoor activities that require spacing, such as family picnics at separate socially-distanced tables (each family eating its own food) or bike-riding, are safer than interactive games or contact sports.
Adolescents are among those most adversely affected by social isolation. We urge that adolescents wear face coverings, practice social distancing, and share decision-making with parents about meeting in person with friends. Connecting with friends virtually is, of course, the safest option. A note to parents of adolescents: if a young person in your family suffers from symptoms of depression (for example, unusual irritability, low mood, demoralization), loses interest in friends, or becomes oppositional about schooling or household rules, increase one-on-one time with your son or daughter to the extent possible, explore his/her general well-being, and contact his/her primary care physician or clinic for assistance in seeking mental health care.
Kathleen Rice, MD, co-clerk Francis P. Wong, MD
Jennifer Schaal, MD, co-clerk Maria Azucena Ibarra-Wong, MD
Jane Foy, MD Fred Wilson, MD
Ron Pudlo, MD