How to keep safe in supermarkets, schools and on public transport

Advice on how to reduce your risk and those around you of contracting Covid-19

Marc Mendelson, Shaheen Mehtar, Shabir Madhi and Nathan Geffen

29 May 2020

Hand-washing, masks and keeping your distance from other people are key to reducing the risk of contracting Covid-19 or infecting others. Photo: Ashraf Hendricks

Lockdown is easing and schools are returning. But in some parts of the country the coronavirus epidemic is escalating. It’s an anxious time, and there are likely to be multiple waves of outbreaks of Covid-19 over the next two years, unless a vaccine becomes available sooner. If we are to live our lives, there are no guarantees against infection. But it’s all about reducing risk to ourselves and others by not becoming infected over a very short period of time which will overwhelm our health care services. We must also protect the most vulnerable (elderly and those with chronic medical conditions) from severe illness and death.

Things we can do to reduce the chance of becoming infected with any pathogen are rarely foolproof. So it’s important to understand that even if all the advice here is followed, the chances of being infected remain but will be much less and the rate of spread of the virus will be slowed down.

There is no shame in being infected with any infectious disease, coronavirus included. It doesn’t mean you have poor hygiene or have necessarily been careless if you become infected. And if you are infected you can still take steps to reduce the risk of passing the virus on to other people.

Whenever you are outside of your home, there are key steps that you can take to reduce your risk of being infected, as well as lowering the risk of you infecting others. These include:

Social distancing: This means physically keeping a distance of 1.5 metres or more from other people whenever possible, thereby reducing the chance of droplets containing virus from their breath or cough, being inhaled or landing on your skin and being transferred to your eyes, mouth and nose when you touch your body, and then your face.

Hand Hygiene: Washing your hands with soap and water or alcohol-based hand sanitizer is very important in reducing the chance of you inadvertently transferring virus from contaminated surfaces to your eyes, mouth and nose. Carry hand sanitizer with you if possible and perform hand hygiene after touching items in public places such as shops, malls and public transport.

Keep your hands away from your face: One of the main ways that we become infected with coronavirus is when we touch our mouth, nose and eyes with contaminated hands. Learn not to touch your face when out and about, and as little as possible even at home.

Masking: Wearing a cloth mask is more about collective responsibility than protecting yourself. The principle is that the cloth mask will reduce the spread of virus from people who are infected. As 50-80% of people that are infected with the virus will not have any signs of an illness, but can still transmit the virus, it’s important that we all wear a cloth mask when out in public. In that way, we are all protecting each other.

Make sure your mask is comfortable on your face, covers your nose and mouth, and is secure, because once you put it on, you don’t want to touch it until you get home and take it off. Don’t lower it to speak to people, in person and or on your phone, but if you do touch the outside of the mask, wash your hands immediately.

How to reduce infections in supermarkets

Plan your shop so that you need to go less often - practice social distancing (e.g. keep the shopping trolley between you and the next person), carry hand sanitizer whenever possible (or make good use of it if provided in stores), and wear a cloth mask at all times, keeping hands away from your face.

Don’t touch lots of items. The days of testing the fruit and vegetables before buying them are over, for now. If you touch it, consider buying it. If you need to cough or sneeze, turn your head away from other shoppers and the products, and do it into your elbow if you can. When you get home, wash your hands and your mask

If you manage a store, make sure that there are markers 1.5m apart for shoppers at strategic points such as queues to enter and at the till. In bigger stores, consider arranging staff into teams to reduce the number of contacts between workers. Make sure your staff are educated about social distancing and hand hygiene, and try to arrange the staff common area to enable distancing. Make sure frequently touched surfaces such as door handles, computer equipment and other surfaces are wiped frequently with disinfectant, and that floors, shelves, and other surfaces are cleaned at least twice a day (standard household cleaners are fine). Make sure there’s soap in the toilets and it’s also a good idea for wipes to be available to clean toilet flushing handles.

Encourage employees not to come to work if they are feeling ill. Screen employees when they come to work everyday by asking if they have flu-like symptoms. Ensure they have masks and hand sanitizer. Temperature taking is probably pointless, because fever is not a universal symptom in infected persons, but it doesn’t harm either; just not a priority.

If an employee tests positive for Covid-19, ask staff to step forward to decide their level of risk and whether they need to quarantine. Having arranged staff into teams could limit the number that have to quarantine.

Control the number of people who enter the shop. Insist that shoppers wear masks and make sure that when people enter the store, a staff member sprays an approved alcohol-based hand sanitizer on their hands and/or a touch-free hand sanitizer dispenser is available and kept well-stocked.

If you work in a shop, all the rules that apply to shoppers apply to you too. We are social animals so it’s easy to forget the rules, especially during lunch and tea breaks, which can be staggered and taken in teams to reduce mixing. These are high risk times of the day, so be vigilant. Please do not go to work if you feel unwell, but call your line-manager or your provincial hotline for advice.

There are also some things that are unnecessary, or even potentially harmful. Disinfection tunnels are a no-no. Under no circumstances should shops be spraying staff or customers with disinfectants, other than hand sanitizer directly onto the hands. Besides being of no significant value in reducing virus transmission, they can cause skin and eye irritations, and affect your lungs. Another waste of money are these so-called deep cleanses offered by some companies. Normal cleaning is fine. There is no need to close a shop just because a staff member has tested positive.

In some supermarkets people are using full face visors instead of masks. The problem with these is that breath condenses on the inside of the visors and can drip onto products. They’re probably ok though for staff who are not handling products, but universal masking is more appropriate.

How to reduce your risk on public transport

Try to use public transport only when necessary. Wearing a mask and carrying hand sanitizer are vital. Try to avoid taxis, buses or train carriages that are full. And if your mode of transport is becoming full, kick up a fuss. It’s impossible to keep 1.5 metres away from people on taxis, but at the same time taxi drivers need to follow regulations about the number of passengers they are allowed to carry.

It’s best to travel with windows open to increase air exchanges and therefore dilute the amount of potential virus droplets inside the vehicle. That isn’t easy as we enter winter.

Sanitize your hands after receiving money. Avoid chatting to others when in public transport and any over-crowded place, as virus contaminated droplets are released even when talking.

Transport owners or managers should wash interiors at least twice a day (standard cleaning products are fine).

As with supermarkets, no customers or staff should be sprayed with disinfectants, but all customers should be offered a dash of hand sanitizer upon entering a taxi, bus or train carriage.

How to reduce your risk at school

While people of school-going age are much less likely to become very ill from Covid-19, it’s equally important to focus on key aspects of prevention to reduce transmission between their peers, teachers, and family members.

Planning is needed to reduce risk across the school: classrooms, staff rooms, food preparation, eating areas, change rooms, toilets etc. Universal masking should be standard especially for children older than five years. Facilities should be made available to perform regular hand hygiene. Regularly used surfaces should be disinfected often, including computer mice, keyboards, door and locker handles, etc.

Staff members should probably have their own blackboard dusters and chalk. Teachers should avoid gathering for tea and lunch breaks, as they are more likely to infect each other than to be infected by a child. Staff meetings should ideally be held in the open area, while maintaining social distancing.

Also, teachers should maintain distance from the learners wherever possible. Although this might be more challenging for early childhood development and special needs schools, if teachers wear a face mask or visor and do regular hand hygiene they will reduce the risk of infecting children.

Many schools are overcrowded. As learners return it may be a good idea to split them into groups that come to school every alternate week. Yes, this may mean reducing the syllabus this year, but that’s not a catastrophe. Minimise non-essential activities where social distancing isn’t possible.

On the very first day that learners return, ensure that every single one of them is taught about Covid-19 in an age-appropriate manner, as well as the prevention measures that they must take. Explain the reasons behind what we are asking learners to do. But also re-assure them that children are fortunate because they rarely develop a severe illness even when infected with this virus that is so troublesome to older adults.

Disinfection tunnels should not be used, nor should large-scale environmental spraying of communal areas. It’s also unnecessary to close the school every time a learner or staff member tests positive. The same advice for supermarkets applies when this happens.

Also, teenagers will be teenagers; it’s pointless and cruel to stop them from playing games like soccer, and the usual things that teenagers do. The idea is to counsel them on the need to minimise physical contact; not eradicate it and destroy the fun of childhood.

Sticking to all this advice 100% of the time is impossible. But the more diligently we all apply these measures the more we reduce the risk of contracting Covid-19 and infecting others.

Mendelson is Professor of Infectious Diseases and Head of the Division of Infectious Diseases & HIV Medicine at Groote Schuur Hospital. Mehtar is an Infection Prevention and Control specialist at Stellenbosch University and head of the IPC unit at Tygerberg Hospital. Shabir Madhi is Professor of Vaccinology at Wits. Geffen is GroundUp’s editor.