Your House is Your Fortress

Posted: March 23, 2020 in COVID-19
Tags: , , , ,

You’re socially distanced and “your home is your fortress,” at least against COVID-19.  But as you pull up the drawbridge and slam the portcullis, it’s important to realize your greatest risk is not from what you keep out, but from who you let inside.

Most people are infected through contact with others, not by touching things!


  • Living in the same house as someone infected with COVID-19 virus
      • The infected person may be completely asymptomatic
  • “Closed” communities with COVID-19 infection inside
    • Nursing homes, cruise ships, etc
  • Direct patient care of infected/potentially infected
    • Healthcare, personal aides, senior facility workers, home caregivers
      • Without full protective equipment
  • ? Sharing enclosed spaces for 2 hours or more, even if 6 feet apart
    • Not an “official” risk at this time
      • Scientific concern, based on infection patterns and lab study of virus
      • If real, greatest risk is small rooms with poor air exchange


  • Prolonged close contact with other people = 6 feet for over 15 minutes
    • The longer the contact, the higher the risk
      • Eg: Sharing a car for an hour is riskier than sharing for 15 minutes
    • The closer the contact, the higher the risk
      • Snuggling with someone is riskier than standing by them
    • The more people you have close contact with, the higher the risk
      • More chances to be exposed


  • Brief contact with others within 6 feet
  • Prolonged contact > 6 feet
    • Particularly in large spaces and open air
Contaminated surfaces/objects are secondary sources of COVID-19 infection:


  • Anything in infected person’s environment (even if asymptomatic)
    • Bedside tables, shared bathrooms, used dishes
    • Clothes, towels, and bedding
    • Shared surfaces – tabletops, kitchen counters
    • Household pets? Virus could hitchhike on their fur from one room to another


  • High-touch objects (touched by many other people)
    • Countertops, doorknobs, faucets, light switches, computer monitors
  • The more things you touch, the higher your risk
  • Risk goes away completely with hand washing


  • Household surfaces after cleaning and disinfection
  • Household surfaces after 14 days of isolation by all household members
Person with highest infection risk determines household risk

In your home, the greatest risk is not from shopping or deliveries, but from other people who share your space. Their risk of infection is your risk. Here’s some examples:

  1. Your husband is a hospital nurse = high risk of infection for himself—and for you. In your home, you share air space, multiple surfaces, food and dishes, and probably a bed. If he becomes infected, you might not even know it, yet these would all be contaminated.
  2. The grandkids come to visit. Their risk of infection depends on a) risk from their parents and b) risk from other kids or households they spend time with. Grandkids could be high risk if a parent works in healthcare or if they still have playgroups. Grandkids might be low risk if their only contacts are their own low risk family.
  3. Your live-at-home daughter delivers packages from her own van and never spends more than a few minutes with anyone. She washes her hands regularly and disinfects van surfaces daily. Her risk of infection is low—and so is yours. Of course, if she goes out partying with her friends at night, all bets are off!
  4. Everyone in your house has been completely isolated for 14 days. You are all now “risk-free”—but only as long as you remain isolated. Zero risk households could spend risk-free time together, but only if you trust their isolation.
Difficult choices in difficult times

Talk about emotional—and financial—dilemmas! It’s hard enough to isolate yourself at home. Do you also have to separate yourself from loved ones until the pandemic is over? Everyone has to make their own choices, but here are some things to consider.

People over age 60 or with chronic medical conditions are much more likely to develop serious illness or even die if infected. Surviving the pandemic is probably more important than family visits. Ideally, this group should completely isolate at home and keep anyone with medium or high risk of infection out of the house.

For those under 60 and healthy, it becomes less clear. As far as we can tell, age doesn’t change the risk of infection. It just changes what the infection does to you. The younger you are, the more likely you’ll be asymptomatic. The older you are, the more likely you will die. In between comes everything from mild flu-like symptoms to critically ill in the hospital.  In fact, quite a few people in the twenty-to-sixty age group require hospitalization. They just have better odds of making it out alive.

People with high risk of infection should consider isolation from lower risk family members. Some hospitals are arranging for healthcare workers to stay in hotels for this reason.  If your extended family has two or more places to live (eg the family home and an adult child’s apartment), another option is for high risk family members to live one place while everyone else stays at the other—and avoid exposure between the two.

If people of different infection risk levels must share a living space, people with higher risk should segregate from those with lower risks: separate bedrooms and bathrooms, minimize use of shared spaces (and shared air), kitchen access only for low risk household members (who cook and distribute food to bedroom doors). Attention to handwashing, cleaning, and disinfecting also helps keep family members safer.

Unfortunately, snuggles, hugs, and kisses probably don’t belong in any scenario except the 14-day complete isolation group. Think of them as an eventual reward for all we’re going through now!

Stay healthy!

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