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A Lifestyle Medicine Approach to Preventing Transmission of Covid-19

By Paul E. Lemanski, MD, MS, FACP

The Covid-19 pandemic is threatening the health of our population in an accelerating and dangerous way. Because it may be possible to shed virus for 10 days with no symptoms, prevention of transmission is key and should include the following:

  • Social distancing or staying at least six feet away from other individuals, whenever possible.

  • Everyone, even those without symptoms, wearing a mask at all times when in the presence of others.

  • Practiced avoidance of touching your face, rubbing your eyes, and scratching your nose.

  • Hand washing on a schedule and after touching anything that could have been touched by someone else.

  • Hand sanitizing (60-95% alcohol) when hand washing is not practical.

  • Quarantine yourself per most recent CDC recommendations.

Social distancing is important because not everyone will wear a mask and a sick individual coughing into a mask may still release some virus particles around the mask. Additionally, even talking can aerosolize Covid droplets in those who have no symptoms.

Masking is critical to protecting others because you can transmit the virus (aerosolize droplets) by talking. The mask will capture 99% of such droplets. It also may offer some protection to you (air and droplets can still be breathed in by coming around the sides of your mask), and so will best protect you when combined with social distancing which lowers droplet exposure. Thus, by each of us protecting others, we protect ourselves.

It is NOT necessary to have a store-bought mask. Two pieces of paper towel, masking tape, aluminum foil, and rubber bands may be used to construct a high-quality mask as good as anything you can buy. Please see this link from the US surgeon general showing how to make a mask at home:

The N95 respirators have to be fit to individuals to be effective in protecting from high concentration of droplets in surrounding air. (Homemade masks, described above, and social distancing are effective for lower concentration droplets outside of healthcare settings). N95 masks need to be reserved for healthcare workers exposed to high concentrations of droplets, so they may continue to care for those who become sick. Reserving them in this way is, in everyone’s best interests, not just healthcare workers.

Avoidance of touching your face takes practice. It should be practiced even when you are home and alone. Use a cotton swab or Q-tip to scratch a facial itch and carry it with you everywhere.

Handwashing should be practiced at least five times a day, last two to three minutes, using soap, running warm water, and should include a set pattern Please see YouTube: Hand Washing Steps Using the WHO Technique ( Hand sanitizer should be used when you cannot wash.

Paul E. Lemanski, MD, MS, FACP ( is a board-certified internist practicing internal medicine and lifestyle medicine in Albany, NY. Paul has a master’s degree in human nutrition, he’s an assistant clinical professor of medicine at Albany Medical College, and a fellow of the American College of Physicians.

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