“Do you have enough face masks?” has become the first question we ask our friends and family here in Hong Kong, as the city braces for an outbreak of a novel coronavirus (aka COVID-19), which was first identified in Wuhan, China in December 2019. As of February 12, there have been over 40,000 confirmed cases worldwide, with more than 40 confirmed cases and one death in Hong Kong. There have been more than 1,100 deaths in total, most within mainland China. 

To save all of us from some worry, we put together this guide on best practices during an outbreak. 

What do we know about the coronavirus?

The 2019 Novel Coronavirus is a new strain of virus first identified as the cause of an outbreak of respiratory illness in Wuhan, China. Experts still don’t know how the virus is spread among people and how deadly it is. The initial mortality rate based on published figures is around 2.2%, compared to SARS’ 10%. SARS, similarly, is caused by a coronavirus. 

The incubation period is believed to be as few as two days and as long as 14 days. Symptoms include fever, cough, shortness of breath, and diarrhea, with cases ranging from being only mildly unwell to severely ill and dying. Infectious diseases expert Yuen Kwok-yung, also the chairman for infectious diseases at the University of Hong Kong, said in a press conference that some stable cases do not require medicine, and speculated that some might be able to recover from the disease on their own. This also represents the possibility of people who appear to be perfectly healthy but might be carrying and spreading the disease within the community.

Does a face-covering mask actually work, and how do I get my hands on one anyway?

There is lots of different advice floating around, but Hong Kong experts including Yuen Kwok-yung and HKU top microbiologist Dr Ho Pak-leung are in unison on wearing a face mask as a general preventive measure. It’s believed that viruses like the coronavirus are mainly transmitted through respiratory droplets. Those produced when a person coughs or sneezes usually measure around 0.4 microns. A three-ply surgical mask can effectively filter out particles larger than 0.3 microns. 

A surgical mask only works if fitted properly. The colored side should face outwards, and the edge with the wiring upwards. N95 masks also work but these should be reserved for medical professionals who need them to perform their jobs; a surgical mask is enough to do the trick for the common populace. 

But with masks sold out in most shops and people queuing up overnight whenever there’s new stock, how do you get your hands on these masks? Chain stores such as Watson’s, Park’n’Shop and HKTVMall are restocking their online shop occasionally, so it’s worth checking their website every day. Other chains such as Bonjour and JHC have taken to posting on Facebook prior to the arrival of a new batch of masks. You can also consider ordering reusable masks from individual companies like Cambridge Mask, Debrief Me, or BrealaxLab, or from online retailers like Amazon or eBay

Also do remember to use face masks responsibly, and to only get enough for your needs. If you have extra masks to share — especially with those who are more vulnerable in society — please consider donating them to these charities.

Washing your hands is the best thing you can do

The best thing you can do to protect yourself is to regularly wash your hands with soap and for more than 20 seconds. Wash every part of your hands, following this sequence: palms, back of your hands, fingerwebs, fingertips, thumbs, wrists. It’s what every expert recommends and is a fail-safe way to get rid of bacteria and viruses. If you’re unable to wash your hands, say when you’re outside, the best alternative is to use an alcohol-based hand sanitizer with an alcohol concentration between 70 to 95%. Can’t buy one? The HKU Pharmacology and Pharmacy department has a video on how to make your own.

Do not touch your eyes and nose

In the Steven Soderbergh movie “Contagion”, which documents the spread of a deadly virus and has been hitting iTunes’ top charts these past weeks, Kate Winslet’s Dr. Erin Mears explains: “The average person touches their face two or three thousand times a day. Three to five times every waking minute. In between, we’re touching doorknobs, water fountains, elevator buttons … and each other.”

So, stop doing that! That’s another reason why wearing a mask can help, by acting as a barrier and potentially lowering the chance you’ll rub your nose and touch your face in public. 

Sanitize your electronic devices

In this day and age, our phones, tablets and laptops are basically an extension of our bodies. We touch them once we wake up, when we go to the bathroom, when we eat, and before we sleep. Biology professor at the Hong Kong University of Science and Technology Dr. Melody Leung advises that we “use alcohol to clean the surfaces of objects you frequently touch, such as mobile phones and computer keyboards.”

Learn from SARS: Keep your drains hydrated

During the 2003 SARS epidemic, one heavy outbreak zone in Hong Kong was Amoy Gardens Block E. A total of 321 residents were sickened and 42 died. An investigation concluded that the cause was dried-out U-shaped water traps. When filled with sufficient water, the U-traps will act as a barrier between bacteria in the sewage system and your bathroom. But with a dried out U-trap, the virus entered the air when the exhaust fan was switched on. It then spread to other units via open windows. There is currently speculation about piping problems in a Tsing Yi public housing estate where several COVID-19 cases have been confirmed. 

Experts recommend pouring at least half a liter of water down all drains in your apartment weekly. 

I have a fever/cough. What should I do?

If you have a fever or display upper respiratory tract infection symptoms such as coughing, sore throat, and runny nose, don’t worry. It’s peak flu season, so chances are that you have influenza or the common cold. Go to a private clinic to avoid cross-infection. But if you suspect you do have the coronavirus, call ahead and explain your travel history to your doctor beforehand. 

Wear a mask always, and establish good personal hygiene habits such as washing your hands regularly. 

Stay Informed

A group of Hongkongers launched a website providing real-time updates on the coronavirus: wars.vote4.hk. It tracks the latest news including the number of confirmed cases, and gathers useful information such as hygiene tips from local experts and real-time updates of A&E wait times across Hong Kong hospitals. 

Another useful website is this map that tracks the coronavirus outbreak across the world in real time. It was developed by the Johns Hopkins University’s Center for Systems Science and Engineering, using data from various global health agencies. 

[Updated Feb 12, 2020]