Are we allowed to take a drive? A Toronto doctor answers your COVID-19 questions

As more people contract COVID-19 and health experts plead for social distancing, you likely still have many questions.

Dr. Jerome Leis is the medical director of infection prevention and control at Sunnybrook Health Sciences Centre. He took questions from listeners Monday on CBC Radio's Metro Morning.

These questions have been edited for length and clarity.

Can people take the garbage out?

Q: I live in a small condo building, and we have a number of folks who just returned from the United States who are self isolating. What should they be doing when it comes to things like walking to their car — perhaps to pick something up — or taking the garbage out? Can they do that?

A: When people are in home quarantine they're really being asked to stay in their home. The practicality of that is they will still need some food and resources for the 14-day quarantine. The ideal approach is if they have friends or family members who have not traveled and are able to support them, they can get a drop-off of supplies at their door. And then a text message that the stuff is there and they don't need to go out at all. 

Obviously that may not be always possible. If they have to go out it's for brief moments where they're using physical distancing. They certainly cannot be going out beyond the bare essentials when they're in quarantine.

How long are people contagious?

Q: At what point will people know they are no longer contagious and shedding the virus?

A: We're still learning about the virus, but it appears that when symptoms fully resolve, the viral loads — the level of the infection — it decreases significantly.

It looks like nearly all the shedding [of the virus] is finished by about days seven to 10 from the onset of symptoms. 

I think that the practical approach should be: if you have cold-like symptoms, flu-like symptoms, but feel otherwise OK —  you're not feeling extremely unwell, short of breath, dizzy — then stay in your home environment rather than go out to seek attention, just to limit the number of exposures, limit overcrowding of places like assessment centres and emergency departments. 

If you haven't been tested you might be a bit unclear about how long you need to home-isolate to interrupt the transmission [prevent passing it on] to another person. The best recommendation right now is that you should be in really strict home isolation for a minimum of seven days and until [you have] full resolution of symptoms for at least 48 hours. 

So if the illness lasts 10 days and then it finishes completely, that would be 12 days of home isolation. 

Can I go for a drive?

Q: My husband and I returned from the UK and went into self-isolation for 14 days. Are we allowed to take a drive in our car? Are we allowed to go to the self-pay at the gas station? Mail a letter in an outdoor mailbox? Or do we just simply have to stay in our house?

A: Some of the examples that you're mentioning sound like they're not necessarily urgent. So essentially, the answer to that would be no.

I think one should be staying in their home. And hopefully with the social supports that they have, getting some assistance in terms of any supplies that they might need. But otherwise, really staying put in their home for 14 days. 

Why don't they take my temperature at work?

Q: My spouse works in one of the hospitals in Toronto and the staff are screened as they go in. But they don't take their temperatures. Wouldn't that be a standard procedure?

A: The evidence behind taking routine temperatures as a screening method is not great. I know that people have probably seen it on television and some countries are using that. I would look at it as a tool that can be considered, but it's definitely not the definitive test. 

People may not have a rise in temperature at the time that they're being tested and they could have a rise in temperature  later in the day. So it can actually miss a large number of individuals. 

There's also some practical concerns related to taking a temperature. [Like] using a device on every single individual that goes through and making sure that device is being cleaned and not contaminated. The downside also of the extra time that it takes, which can lead to longer queues of people trying to get into a facility, which of course can increase the risk of exposure.

So there's a number of downsides that you need to weigh against. And at the end of the day it's not the definitive screening test. Across hospitals in Ontario the approach is fairly standard. There's a number of other ways that we can do active screening based on questions. 

Can UV light kill the virus on a surface?

Q: Is UV light an effective way to sanitize and kill this virus on a surface?

A: It might be surprising, but this virus is actually not very hard to kill.  It for sure can survive in the environment if we do nothing. But there's actually a number of disinfectants and UV light is another approach that can readily kill this virus. 

But our hospital-grade disinfectants — things like quaternary ammonium, hydrogen peroxide, bleach, and UV light as well — all readily kill the virus.

Can gargling kill the virus?

Q: There's a recommendation floating around that people gargle with hot water to somehow flush the virus out of their throat and into their stomach, where acids would kill it. What would you say to that?

A: I'm not aware of any evidence to support that.

It is true that the gastric acid in our stomach is protective against a number of infections. But as for that particular gargling approach, I don't think that's been rigorously studied and I certainly don't think it's being recommended by medical experts at this time.

Should people in the community wear masks?

Q: I've been reading about the successes in Taiwan in keeping down the spread. It seems like a lot of this is due to wearing masks. Are Canadian health professionals considering the use of masks [in the community]?

A: There's a tonne of things we can learn from Taiwan, and I would caution us to think that masks were the quick fix to this. There are clearly a number of factors and a whole other level of public health intervention that was proactively implemented. 

They're clearly at a level of sophistication where they can provide rapid testing, they have tracking of certain individuals, they're enforcing the physical separations.

 

[In Canada] we need to be as strict as possible with the physical distancing right now. That is of utmost importance right now. 

In terms of personal protective equipment, things like masks ... in [Canada] we have a finite supply. Right now our highest priority is to have all [masks] used within healthcare, where we're going to be caring for a large number of patients. 

In the community we can use physical distancing and should not need to have masks routinely. If people feel unwell they need to be home isolating.

Masks worn in the community right now would border on a bit of an ethical dilemma, because there are institutions, hospitals, nursing homes, long term care facilities and other areas that are at risk of running out of masks. So any mask in the system needs to be diverted to health care right now.