Safely inviting in repairmen during the pandemic

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Just imagine. You can't get any hot water, so you go down to the basement and find your water heater has given up the ghost, and it's flooding the floor.

Or, you decide to turn on your air conditioning for the first time of the season, flip the thermostat to cool, press the on button and—nothing.

Or, your refrigerator dies, and you need to get a new one before everything in the old one spoils.

Before COVID-19, these inevitabilities of living in a were equal parts maddening and expensive. But now, with an end to the pandemic nowhere in sight, addressing these home repairs is fraught as well. Health officials tell us not to let people who aren't part of our households into our homes. Researchers say the virus that causes COVID-19 is more likely to spread in tight, enclosed spaces, which is the description of many homes.

So, what's the best way to stay safe when you must let a repair or delivery person into your home? Doctors and researchers say it is not impossible to be safe. They also say that because it could be years before there is a vaccine for the virus and at least several months before there are safe, effective treatments to treat the virus before it becomes acute in a patient, people need to embrace new protocols for daily life. And daily life is going to involve some malfunction or breakdown of essential equipment in your home.

The first thing to keep in mind is protection and contraction is a two-way street. You want to protect yourself from getting the virus, but in case you are asymptomatic or have extremely mild symptoms, you also want to protect the repair or delivery person from you. That starts with screening even before someone arrives at your home, said Dr. Steve Lawrence, an infectious disease researcher at Washington University in St. Louis. While rudimentary, that can be accomplished not with a testing kit, but with a set of questions.

"Call ahead or look online to find out what kind of safety procedures and protocols they have in place to protect workers and customers," Dr. Lawrence said. "That should include masks, cleaning supplies, sanitizer that they bring with them."

Once they arrive, it's important to ask a series of questions before letting them in, but do so respectfully, at a and while wearing a mask.

"'Have you been feeling okay? Have you been around anyone with COVID-19? Have you been tested?" Lawrence said. "And make sure they don't have a cough or fever. But at the same time you're asking about them, don't let anyone come in your house if you're not feeling well."

And don't be surprised if the company you're booking a service with asks you a similar set of questions.

While wearing masks has been made into a political and ideological fight, the science around wearing them remains the same, researchers say. Masks work to prevent you from infecting someone, and if both you and the worker are wearing them, the chances of transmission fall dramatically. Just as important is washing or sanitizing hands before, during and after the delivery or service. For that reason, keep a bottle of sanitizer by the entry to your home and ask the service person to use it before entering. The risk of transmission is low if you get closer than six feet to someone as they are coming into your home, but maintaining at least six feet of distance while they are working is key.

"It's all about time and contact," said Phil Santangelo, a professor of biomedical engineering at Georgia Tech. "Don't stand there if they are working. The mask is not a panacea. If it's in a bathroom, run an exhaust fan while they are working and maybe for a while after they leave. Open a window in the room where they are working. If there's no PPE, I wouldn't be anywhere near them."

If a person has to work in your home for several hours on a repair, it's still possible to be safe, said Maria Sundaram, a post-doctoral fellow in infectious disease at Emory University, even if that person works up a sweat while doing their job. Since the virus is contracted mainly through respiratory transmission; respiratory droplets are of more concern than sweat, which is why masks at all times are important, she said.

"The is replicating in little sacs in your lungs called alveoli," Sundaram said. "They (alveoli) look like an upside-down broccoli, and the ends are shaped like little bulbs. They are a nice ground for viruses to grow when you are sick. The liquid in sweat is coming from a completely different place. It's not impossible to have transmission that way, but it's pretty unlikely."

Shoes aren't considered at high risk of transmission, so there's no need to ask a person to remove them unless that is the practice in your home, researchers say. Gloves are of little help because most people don't know how to wear them and remove them properly, Sundaram said. "A lot of people find it challenging not to touch their face. And gloves are not antimicrobial surfaces, so coughing into a glove is like coughing into your hand."

If someone in your home is at risk, or immuno-compromised, keep them in an area of the home as far away from where the work is taking place as possible. Also, if, for example, you or a loved one is elderly and concerned about transmission, getting someone who is healthy and who has been observing stay-at-home protocols to greet the repair person and showing them where to work is an option, Sundaram said.

Cleaning every surface with soap and water, or a household cleaner such as Lysol or with an alcohol base is a must once the work is done, all of the researchers say.

"There's not a single thing that eliminates risk, but when you add layers of intervention, it greatly reduces risk," Dr. Lawrence said.


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