COVID Doma

A collaborative guide to COVID-19 care

Shopping list

The standard advice is to have about 2-4 weeks of essentials like groceries and other basic household supplies in case of emergencies such as this (a global pandemic). Basically you want to have a surplus of what you normally have on hand, but with some emphasis on longer shelf-life foods, for sheltering in place. You will also want to think about some things you might not normally have on hand, namely, other supplies (e.g., fever thermometer) and personal protective equipment (PPE; e,g, mask and gloves).

Food

Your diet will likely change due to changed food availability (e.g., fewer grocery store runs or deliveries in favor of staying home or limiting contact, no more restaurants. But in most countries at this time (and probably for some time to come), you can likely still enjoy much the same sort of diverse and nutritious diet you had access to previously. Here are a few suggestions and tips for keeping 2-4 weeks’ worth of healthy food that you like on-hand.

Household supplies

Everyone and their brother has already thought to stock up on toilet paper, infamously leading to shortages and even social unrest (from organized crime to public brawling) in various places worldwide. Don’t be that person. Maybe when it comes to things that you know may be in short supply solely because of panic buying (like toilet paper), only buy a little bit every week. Share with your neighbors if you have it and they don’t. Things will be crazy throughout this crisis from time to time, but people all over the world are using the opportunity to ask the people around them what they need – and that kind of kindness builds the strength and resilience that we all need to get through this thing together. And (unlike masks), there is no global shortage of toilet paper.

That said, it probably makes sense to have a back-up of your regular household essentials. That means different things to different people, but common items to keep a back-up of in case of emergency include:

Other supplies

In addition to having approximately 2-4 weeks of essentials, here are some necessary and handy things to have if you are going to be taking care of someone with COVID-19. None of this is very expensive or requires special training to use.

If we included examples (generally on the German version of Amazon), this is not a buying recommendation and we are not making any money if you click that precise one (or any other). By showing you the example, we mean nothing more than “something like this.” Use whatever online or retail channel you like to get something similar.

 

Must have

 

Nice to have

Important Note

A note on the first two items: some medical professionals we talk to feel the non-medically trained will do more harm or good when they start taking SpO2 or blood pressure measurements. We include the devices here because they are in common use and we feel that in some places, during some periods, the health system is not going to be able to cope with the numbers of people falling ill, and we tip the balance towards the advantages in being able to see/show trends.

If you do decide you want to be able to measure blood pressure and SpO2, then at least properly familiarize yourself with the device. Practise! Also to get a good feel for what normal values in you and your loved ones look like before anyone gets sick. Read our guidance on the main page on when and when not to seek help based on the information they provide.

 

PPE (Personal Protective Equipment)

The topic of PPE is tricky for several reasons.

First, this may all be new. You may not be familiar with what kinds of protection are needed in what situations. It is important that you learn what types of PPE you need in what situations, how to fit it properly so that it works, how to safely don and doff it, and how to disinfect or dispose of it after use.

Second, advice has varied widely on this. In some countries, during some points of the pandemic, wearing masks in public is or has been mandatory. In other countries, it has been strongly encouraged as a social norm with few deviations. In others, wearing masks is mandatory if you are caring for a COVID-19 patient. And in still other countries, public health authorities have told people that wearing masks will not protect them. The protection offered by masks and other PPE is imperfect but important, especially for healthcare workers and other at-risk groups such as immunosuppressed people, and those with heart or lung disease.

Third, some people have been panic-buying and some companies have been price-gouging, making essential equipment like masks unavailable in some places even to doctors and nurses who really need them. If it’s still early in the pandemic, your government may be providing masks to people who live with and / or care for people with COVID-19. The section here describes things that you could try to get - or make - if you are ill, need to be caring for other people who are ill, or are in an at-risk group. Listen to official advice on what not to buy so as to not make things unavailable to the doctors and nurses who need them the most.

When to use PPE

The World Health Organization offers public advice on when to wear a mask and how to use masks. You should wear a mask if you are ill with known or suspected COVID-19 (fever, cough, shortness of breath) but absolutely_have_to go out; this protects other people. Wear one whenever you are in the same room with someone who is ill with known or suspected COVID-19; this is even mandatory in some countries’ COVID-19 quarantine home care protocols. If you live somewhere with additional requirements such as wearing a mask in public, your government will let you know. Check under what circumstances authorities will provide you with masks. If you are in a special risk group for COVID-19 severity, then it probably also makes sense to wear a mask when you go out (if you have to go out) while the pandemic is ongoing. Similarly, if you are in a group that has more probable exposure, such as healthcare workers, teachers, or grocery store clerks, then it probably makes sense to treat yourself as a potential asymptomatic carrier, and wear a mask in public to protect others. See the main text about further things to think about when it comes to containing the spread of the virus as much as possible.

Studies have shown that high-filtration respirators like the N95 work best to prevent respiratory disease transmission, followed by high-filtration surgical masks, and then low-filtration surgical masks. Research also shows that a home-made mask is better than no mask at all when it comes to filtering potentially dangerous particulate. So if you cannot find a respirator or mask, try making one yourself.

If you do nothing but wear a mask when appropriate and practice good hand hygiene, for most people, that’s most of the PPE battle. But in addition to this, it makes sense to wear gloves when taking out the trash, as that involves touching fomites, objects like doorknobs and trash receptacle lids that are especially likely to transmit disease because many people touch them. Wearing gloves also makes sense when caring for someone who is ill. Gowns, caps, and eye protection probably only make sense for healthcare workers and people caring for someone with COVID-19 at home. Healthcare workers and others with particularly high exposures may even need to take additional PPE precautions where possible, like double-gowning, because worse initial exposures may be associated with worse disease outcomes (perhaps by causing higher starting viral loads).

How to fit it properly

Much PPE is one-size-fits all (such as caps) or sized in large category chunks like small, medium, and large (such as gloves and gowns). Respirators are the hardest piece of PPE to fit. Take the time to look up some videos on how to properly mold one to your face with your fingers, covering your nose and cheekbones closely. Don’t squeeze the bridge. Mask and respirator fit are especially important for keeping potentially dangerous particulate out (in the case of going out in public or taking care of patients) or in (in case you are ill, or an asymptomatic carrier).

How to safely don and doff it

To put it on: Create a clean zone (other than wearing your “dirty” / patient care / outside clothes) before donning PPE. Wash your hands first, then put on your mask, and keep your hands off your mask while you’re wearing it. Then put on your gown and any other protective equipment – while keeping it “clean.” This means, for example, ripping the gown’s back-of-the-neck fastening so that you can put your arms into it without putting it over your head (to avoid smearing the gown against the mask). Always maintain good hand hygiene while wearing PPE.

To take it off: First remove your gloves and wash your hands. Then remove your gown and wash your hands again. Then remove any remaining PPE and wash your hands again. Then remove your “dirty” clothes and wash your hands again. Then put on your “clean” clothes and proceed to a zone you know is “clean.”

How to disinfect or dispose of it after use

If you are disposing of PPE after use, you will want to place it in a disposable trash bag. Some municipalities recommend double-bagging that bag / any possibly contaminated waste. Then place the trash aside for 72 hours before external disposal in a communal area or trash bin.

Under normal circumstances, most PPE is considered disposal, i.e., intended to be thrown away after one use. But a global pandemic with shortages in many countries of critical equipment including respirators / masks for healthcare workers and others, does not present a normal set of circumstances. Now is a time to use what you have to the fullest. That means disinfecting rather than disposing of PPE whenever possible.

The best way to reuse PPE during this pandemic is probably to mark seven masks or sets of PPE – one for each day of the week. Rotate them after wearing to sit in a clean place for a week. The virus should be dead after that period of time. There do not presently seem to be shortages of other PPE, but the same rotation decontamination strategy would apply. Alternately, if you need the mask(s) / respirator(s) decontaminated faster, bake them in the oven at 70° Celsius (around 160° Farenheit) for 30 minutes. For hard surfaces like face shields and goggles, normal disinfectant solutions like Windex should kill the virus. For soft surfaces like cotton masks, spraying or soaking with alcohol or diluted hydrogen peroxide should do the trick. It seems likely, however, that using heat, chemicals, or other, faster potential decontamination techniques will result in worse overall wear and tear on the PPE than rotating a weekly set in and out of a clean place. Less wear and tear means better-protecting PPE.