**These steps are in NO WAY medical advice or a guarantee against becoming infected. This advice it meant to educate the public in best practices to reduce COVID-19 exposure and reduce the chance of transmission within our society.

• • Pay by Credit Card/Venmo/Paypal when possible. Forgo cash if you can. The cash you hand over can be contaminated. Change can be contaminated. This creates an opportunity to contaminate both ways.

• • Be mindful of touching door knobs, buttons, and commonly touched or handled surfaces in public places (elevator buttons, door handles, etc.) If you must touch them, sanitize as soon as possible afterwards.

• • Keep tissues in your pocket, to use to cough into, or to touch surfaces. Throw them away after use. Do not cough into your sleeve. If you are infected and asymptomatic, your sleeve will be teeming with virus for hours, possibly days. Do not use handkerchief’s, as they will be heavily contaminated by the end of the day.

• • Get into the habit of wiping down commonly handled surfaces of your car once a day, preferably before exiting the car when you get home. The first surfaces you’ll touch with contaminated hands will be the door handles, seatbelt latches, steering wheel, radio knobs, and gear shifter. Pay attention to wiping these clean before and/or after driving.

• • If still working at a workplace with a breakroom, be aware of commonly touched surfaces, such as refrigerator door handles, sink handles, water handles, condiment and spice containers (switch to single serve packets), and buttons on vending machines/coffee machines. Wipe these surfaces down with disinfecting wipes before touching, and wash your hands with soap and water after handling/touching.

• • Wear masks in public. Preferably surgical masks, but cloth if none available. Surgical masks prevent 40-70 percent of viral projection from your mouth and nose. Cloth prevents roughly 10 percent. Both masks can prevent you from touching your nose and mouth. Masks with kids designs are readily available online and can be particularly useful to prevent them from touching their nose or mouth. Only remove it after their hands are sanitized and you are home or in a controlled environment.

• • Carry your own pen. Never touch communal pens. These are designed to transmit virus as you’re getting a large number of touches on a very small surface area.

• • Do not wear gloves in public. It causes a false sense of security, and they quickly become contaminated. When I see people in public with these on, I get a visual of what kids look with hands covered in finger paints.

• • Do NOT use hand dryers in public restrooms. Ever. https://health.clevelandclinic.org/the-dirty-truth-about-hand-dryers/

• • Do not wear shoes into the home. Aerosolized virus settles to the floor by gravity, covering floors in virus in public areas. If shoes must enter the home at all, sterilize bottom surfaces in trays with bleach. NOT ALCOHOL (flame risk), and BE CAREFUL WITH PETS (poisoning).

• • Flush toilets with lids down, and keep bathroom fans on. The virus is confirmed to be passed via the oro-fecal route (via saliva and feces). We know from prior studies that toilet flushing causes a contaminating “toilet plume” up to six feet away. https://www.today.com/today/amp/tdna143776

• • Wipe down commonly handled surfaces in the household every day. Commonly forgotten surfaces include: remote controls, tablets, door knobs, handrails, buttons and knobs on appliances, cabinet handles, refrigerator handles, sink handles, etc.

• • Wipe down personal items every night. Including glasses, watches, phones (remove cases), credit cards, wedding ring, wallet, work ID’s, etc.

• • Read the instructions on any disinfectant. Lysol instructs to leave wet for 20 minutes! Make sure your products are on the list of cleaning products that are effective against the COVID virus on the EPA website. https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

• • Learn proper hand hygiene. Wash your hands properly. https://www.nbcnews.com/better/amp/ncna1102746  – Correct way to use hand sanitizer—do it like a surgeon! https://youtu.be/5-XIl6EGYDs

• • Keep tablets and cell phones away from kids at any meals. The kids touch the iPhone/tablet, then touch their food. The food is contaminated.

• • Don’t open your mail for 48hrs. Mail carriers (bless them for still showing up in these times) can be infected. (Seattle example)

• • Check your temperature three times a day. There is normal variations in your temperature, but fevers are never normal. Over 100.4 is notable and over 101 is definitely a sign there could be something wrong. If you feel you are high risk for infection, call your doctor first before showing up. Please try not to show up and announce after you’re in the office that you may be sick.

• • Avoid NSAIDS (Ibuprofen, Aleve, Advil, Motrin, etc.). Early evidence suggests they increase the severity and risk of disease. Tylenol is safe.

• • DO NOT stop taking blood pressure medication. There is current conflicting evidence that it may be protective of infection, and at the same time may predispose to severe infection after it occurs. The jury is still out, and for now, the consensus is to continue as is.

• • Take zinc, 50 to 75mg every day. Never more than 200mg/day, where you approach overdose levels which can actually suppress immune function. This is well documented to lessen the strength and severity of infection with coronaviruses, but more importantly, works in synergy with hydroxychloroquine.