With the entire world worrying about COVID-19 (the novel coronavirus), especially NICU moms and dads, it’s important to be sure everyone has a basic understanding of respiratory viruses and how they spread. Because if you don’t really understand how they get spread from one person to another, it is impossible for you to really do your best job keeping yourself and your baby safe from them.
Even though this is a new sense of panic for most of the world, in NICUs across the globe, staff are used to following very strict infection-prevention precautions all of the time. Because any baby in the NICU, whether there for prematurity, surgery or any other cause, is very likely to have a stressed & weak immune system. It is an everyday practice in the NICU to use strict hand-washing and infection-prevention measures. In the midst of this coronavirus outbreak, it’s obvious that extra precaution is called for. But if we use the same NICU practices we always use, babies should remain as safe as possible.
So let’s talk about viruses!
VIRUS BASICS
A virus is a microscopic bit of biology that multiplies inside the cells of another being, usually making the infected person (the “host”) quite sick.
Viruses are highly contagious, which means that they are really, really good at getting from one host to another.
Viruses can stay infectious on countertops and other surfaces. Sometimes only for less than an hour, but oftentimes for much longer. 1
Viruses are different than bacteria, even though they can behave very similarly and both are highly contagious. The important thing about this is that bacteria can be killed quite often by antibiotics, but antibiotics don’t work on viruses. Viral infections require vaccines to prevent them, or antivirals to treat them. (There currently are no vaccines or antivirals to kill COVID-19) 2
A person can have a virus in their body with or without any obvious signs, and can spread that virus even if they don’t any symptoms. 3 (This depends on the virus. It appears that COVID-19 may be highly contagious even before symptoms of illness arise. But not all viruses are infectious during the incubation period)
HOW DO YOU PREVENT GETTING (OR GIVING) A RESPIRATORY VIRUS TO SOMEONE ELSE?
We all know when we “have the flu” - it feels miserable! But the truth is if you have the flu today, you’ve actually had it for a little while. Several days, probably.
When an individual gets infected with (“catches”) a respiratory virus, whether it’s the flu or a cold or a coronavirus like COVID-19, that virus will start reproducing like crazy in their body. As the virus multiplies in the person, it may take days before the person starts to feel sick. It may take days before a fever starts, or before the cough starts.
But even before the cough or the fever starts, if the infected person does cough, the virus can be in those droplets. Even before the fever, if a person touches his mouth or nose, the virus will then be on his hand and will be transferred to anything he touches.
So you have to treat everyone as if they might be sick even if they don’t have obvious symptoms.
HOW A RESPIRATORY VIRUS MIGHT SPREAD ON A TYPICAL DAY
So let’s imagine it’s Monday, and before you head in to the NICU to be with your baby, you go out to the grocery store. You grab a cart and start shopping. You grab some bread, some veggies, some cereal and milk. You see a good friend and chat for a few minutes, take a selfie with her for fun. You check out, hand over your cash and get your change, and then head back to your car. Absolutely nobody you saw in the store seemed sick at all - no cough, no runny nose, no sneeze. Nothing.
But the person who used the cart before you was super sick. That obnoxious person annoyingly went out shopping even with a bad cough and sore throat, and of course they touched their nose and mouth without even thinking of it, in between touching the products on the shelf and the cart handle. So you might pick up a virus from the cart, because yes, infections like COVID-19 and the flu can survive on surfaces and objects like countertops, cereal boxes and shopping cart handles.
The friend you chatted with definitely doesn’t seem sick at all. But even though she feels fine, she’s unlucky and doesn’t realize that she’s hosting a virus which is multiplying like crazy inside her. By tomorrow, she’ll be feeling awful. But right now, she seems fine, and that quick handshake may have happened right after your friend absentmindedly rubbed her nose, which means that the virus is now on your hands. And on your phone, because remember that selfie you took? The virus would now be lingering on your phone case.
The checker could be in the same situation - sick but not yet knowing it - and when he touches the cash and hands it to you, guess what? You could pick up a virus from him.
Once the respiratory virus gets on your hands, it won’t automatically start reproducing in your body. These respiratory viruses usually need to directly contact your mouth or nose. So if those viruses stay on your hands only, you’re safe.
But do you realize how many times people touch their faces without even realizing it? A LOT. Like, somewhere around 23 times per hour, on average. So you’ve only got a little bit of time before you accidentally transfer that virus from your hand to your face, and then you’re gonna become infected. It will start going to work reproducing like crazy in your body.
You probably won’t start feeling sick until Wednesday, maybe Thursday… but just think how many people you might share that virus with in the meantime?
You could even share it with your baby, or the nurses and doctors at the hospital, without realizing it until too late.
HOW TO AVOID A RESPIRATORY VIRUS ON A TYPICAL DAY
So how would you go about avoiding getting this virus while you’re at the store?
The number one way is to not go to the store at all.
Normally, when we aren’t in the midst of a full-blown actual global pandemic, that’s not all that practical. But right now? It’s actually the smartest way to guarantee you don’t pick up a virus. (Read more about social distancing here and here)
But what if you have to go out in the world? Let’s look at the scenario again:
You grab a cart. But this time you use the sanitizing wipes that you brought with you (don’t count on the store having them available) and thoroughly wipe down the handle. Now, whatever virus is on the handle won’t be anything you pick up. You’ll eliminate it before you ever get it on your hands.
When you see your good friend, you don’t shake hands (do the namaste or the elbow bump) and you stand farther apart than usual, just in case of a surprise cough or sneeze. Now you won’t get the virus from her that she doesn’t even know she’s carrying.
When you check out, you don’t exchange anything with the checker - no cash handed back and forth, no receipt; just your credit card or virtual payment.
And then you wash your hands or use sanitizer as soon as possible - preferably as soon as you get to your car.
Now, your trip to the store has gotten a whole lot safer.
But there are still two more very important things to do to make it as safe as possible:
Try SUPER hard not to touch your own nose and mouth at any time in the store. Because that loaf of bread or box of cereal may have been stocked by someone sick; any surface may be covered with germs.
Sanitize / wash your hands as soon as possible, so that any virus you may have picked up from anywhere will be eliminated before you touch your nose or mouth.
HOW DO YOU PREVENT GETTING (OR GIVING) A RESPIRATORY VIRUS WHEN YOU’RE AT THE NICU?
If you’ve been doing everything possible to keep yourself from germs, you still want to be cautious when you’re with your baby in the NICU. This includes:
Trying SUPER hard not to touch your nose and mouth when you’re there. When you inevitably do touch your face, go sanitize right away. Before you touch the chair you are sitting in, or the counter where milk gets mixed, or the latches of the incubator…
Sanitize your phone, or put it completely away. It’s a highly germ-covered device.
Absolutely sanitize your hands before touching your baby. Every time.
Ask for sanitizer while you’re holding your baby if you realize you’ve touched your phone or your face.
Most importantly, if you realize you’re starting to feel sick at all, or if you realize you’ve been exposed to someone sick, talk to your NICU staff right away.
1 https://www.aappublications.org/content/35/1/1.2
2 https://www.drugs.com/medical-answers/difference-between-bacteria-virus-3503840/
