Slow the spread; stop hugging and shaking hands

All the news has been full of Coronavirus. It feels like it did before Hurricane Iniki with a strange quiet before a storm that might hit us hard. A big question on all of our minds is: how serious will it become for the United States and what can we do about it?

Italy had a few cases in late February, and then within three weeks had 9,000 cases. While a lack of test kits has hampered our ability to detect and respond to the virus, reports show that we are likely facing the same exponential growth curve as Italy and that the illness is likely already widespread throughout our country.

And while much remains unknown about exactly how deadly it is, the director of the National Institute of Allergy and Infectious Diseases testified to Congress recently that the fatality rate is likely around 1% — which makes it 10 times deadlier than the seasonal flu.

The former director of the Centers for Disease Control and Prevention who oversaw the U.S. response to Ebola and Zika predicted that in a worst-case scenario the U.S. could be facing up to one million deaths from the virus. But if we take fast action to slow the transmission from person to person, then we can help ensure that our health-care system doesn’t become overwhelmed and we can avoid coming anywhere close to that nightmare scenario. How bad this gets depends almost entirely on how well we prepare.

Below is a list of methods that individuals can take to slow the spread of the virus. The virus infects by droplets. Droplets come from a person with the virus speaking, coughing, sneezing, or mucous from the nose going through the air and landing on you or landing on objects like your hands, a phone, or a doorknob, etc., that you might touch. If the droplets from the person with the virus get on your face or eyes you may become sick, and before you know you are sick you may spread it to others.

To avoid droplets, consider these actions:

• Wash your hands frequently, particularly after touching doorknobs etc. in public spaces;

• Stop shaking hands. Consider a fist or elbow bump or even a simple “hello;”

• Stop hugging and giving polite kisses to people you meet out in the world;

• Stand a little further from people as you talk to them (three to six feet away);

• Avoid touching your face, which may bring the droplets from your hand to your face.

To avoid giving this virus to someone else or catching it yourself:

• Stay home if you are sick;

• Even if you are not sick, consider going out less and avoiding all crowded spaces;

• Our older kids are coming home on spring break or because their schools have closed down. They are coming from colleges across the country. The states of Massachusetts, Washington and New York have rapidly-growing epidemics. As hard as it may seem, avoiding hugging or shaking hands with these returning students is probably a good idea, and if some of these students are from schools with known cases or the suspicion of known cases, they might need to self-quarantine;

• This disease tends to be very mild in children, mild in younger adults (sometimes not), and more serious in adults over the age of 60, particularly if they have other medical conditions;

• Protect older adults by breaking long traditions of hugging them or shaking their hands, and don’t visit if you are at all sick, particularly with a cough or fever;

• Older people in care homes are particularly vulnerable. Limit the number of people who visit the very elderly;

• If you are sick with a fever and a cough, call your doctor’s office before visiting to get instructions from the office staff;

• Consider getting enough supplies to just stay home for a few weeks;

I know these are very hard concepts from all of us in Hawai‘i, as hugging, handshakes and honoring our elders are a big part of our culture. But slowing the spread is more important than then putting a temporary hold on these traditions. Even if you are young and healthy and this virus does not make you too nervous, remember that your actions could pass it on to others who may not be as healthy.

Please help yourselves and help the community. Join all of us in slowing the spread.


Lee A. Evslin, MD, is a board-certified pediatrician and fellow of The American Academy of Pediatrics. He was a former health-care administrator at Wilcox Medical Center and periodically writes a column for The Garden Island.

  1. Kauaidoug March 13, 2020 8:46 am Reply

    I visited the hospital a couple days ago and then to Costco. Both places could do a lot more. One thing is all those shopping carts that get used and reused by very germy hands! I hadn’t been out and around much for a week and I was shocked at all the usual hugs and greetings going on, especially by older folks. Very dismayed by what I observed. With the cruise ships that have dropped the world off at our shores it just seems certain the virus is amongst us and until people get sick. As we take care of ourselves we take care of each other.

  2. Jai March 14, 2020 2:34 am Reply

    Mahalo for your kokua Dr. May all be safe, may all be well.

  3. Chamundi Sabanathan March 14, 2020 11:00 am Reply

    All banks should install a face screen (clear barrier) at every teller window.

  4. Tombo March 14, 2020 11:16 am Reply

    No, STOP TOURISM! Stop letting cruise ships offload their sick passengers to roam around the island.

    1. Michael Diamant March 15, 2020 9:30 am Reply

      In addition to keeping cruise ships/passengers from off-loading, apply the same standard to airlines who come to the Hawaiian Islands from elsewhere.

    2. Michael Diamant March 15, 2020 9:32 am Reply

      In addition, ban airlines from bringing non-essential passengers to Hawaii.

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