Frequent and proper hand washing is still the most effective protection against infectious outbreaks. Assoc Prof Piotr Chlebicki, Senior Consultant from the Department of Infectious Diseases at Singapore General Hospital (SGH), explains.​

 HANDWASHING frequently with soap and water is still the most effective protection against infections.
Coronaviruses like COVID-19 (Coronavirus Disease 2019) are named for their crown-like spikes on their surface, but should they be feared like kings of the virus world? HealthXchange shouts a resounding “No!” – because together we can overcome as SGUnited. Because #healthiswealth #healthforgood

We highlight simple prevention measures that you (and your loved ones) can take to stay protected from COVID-19 (Coronavirus Disease 2019).

Although a common first instinct during an infectious outbreak is to think about wearing a face mask, do remember that wearing a face mask is just one part of an overall infection control strategy that should also include frequent hand washing, self-monitoring and responsible behavior.

1. The importance of frequent hand washing
“The simple act of frequently and properly washing your hands remains the most effective protection against infection,” says Assoc Prof Piotr Chlebicki, Senior Consultant from the Department of Infectious Disease at Singapore General Hospital (SGH), a member of the SingHealth​ group. Viral and bacterial infections are often transmitted either through hand contact or commonly touched surfaces. To properly wash your hands, you should:

Wet your hands with clean running water (warm or cold) and apply soap.
Rub your hands together to make a lather and scrub them well. Be sure to scrub the backs of your hands, between your fingers and under your nails.
Continue rubbing your hands for 20 seconds (roughly equivalent to the time it takes to hum ‘Happy Birthday’ twice).
Rinse your hands well under running water.
Dry your hands with a clean towel or air dry.
If soap and water are not available, using an alcohol-based hand sanitiser (with at least 60 per cent alcohol) is your best alternative for hand washing. It quickly reduces the number of germs on your hands, but is ineffective in removing dirt.

2. Monitor changes in your health
Paying close attention to changes in your health, especially if you’ve recently returned from an overseas trip.

Singapore health authorities are closely monitoring the recent outbreak of the​​ COVID-19 (Coronavirus Disease 2019), a new SARS-related virus. If you experience flu-like symptoms, such as a fever, cough or sore throat, within 14 days upon returning to Singapore, you should:

Wear a mask and seek medical attention. Call the clinic ahead of your visit and inform the attending physician of your recent travel history;
Avoid visiting loved ones in a hospital, as warded patients are more susceptible to infection.

3. Other precautions to take
Observe good personal hygiene
Practise frequent hand washing with soap – we can’t emphasise this enough (e.g. before handling food or eating, after going to toilet, or when hands are dirtied by respiratory secretions after coughing or sneezing)
Wear a mask if you have respiratory symptoms such as a cough or runny nose
Cover your mouth with a tissue paper when coughing or sneezing, and dispose the soiled tissue paper in the rubbish bin immediately
Avoid close contact with people who are unwell or showing symptoms of illness
Seek medical attention promptly if you are feeling unwell
From 15 Mar 2020, Singaporeans are advised to defer all non-essential travel abroad. This advisory will apply for 30 days, and will be reviewed thereafter. Check the MOH website for the latest measures.

4. What you should know about face masks
Face masks provide a physical barrier to prevent contaminants and pathogens from entering your nose and mouth. Conversely, they protect others from your own nose and mouth secretions. The two common types of face masks are:

a) Surgical mask

When worn properly, a surgical mask helps block out large particle droplets, splashes or sprays that may contain germs. It is however unable to filter very small particles and its loose shape offers less protection than a properly fitted N95 mask.

Surgical masks are intended for single-use only. If your face mask is damaged or soiled, replace it with a new one.

In light of the COVID-19 (Coronavirus Disease 2019) outbreak, the Ministry of Health (MOH) Singapore has provided an infographic (below) indicating when you should wear a mask (information is up to date as of 4 Feb 2020).

b) N95 mask

Once properly fitted, the N95 mask (also known as an N95 respirator) should have no air gaps. Besides blocking splashes, sprays and droplets, the N95 mask is also capable of filtering very small particles such as viruses and tuberculosis. The ‘N95’ designation means that the respirator has been approved by NIOSH, a US occupational health and safety federal agency, and can block out at least 95 per cent of small test particles. This makes the N95 mask ideal for infection control purposes.

An N95 mask is reusable but should be replaced when it gets soiled or distorted in shape. It is important to note that using an N95 mask requires added effort in breathing and may cause discomfort, tiredness or headaches. For most users, this does not pose any serious dangers.

However, people who already have reduced lung volumes or breathing issues, e.g. the elderly, people with lung or heart conditions and women in their later stages of pregnancy, should stop using the N95 mask immediately if they feel any discomfort.

Those with severe lung or heart problems and who have difficulty breathing at rest or on exertion should first check with a doctor before wearing a N95 mask.

As a precaution, women in their second and third trimesters of pregnancy are advised not to use the N95 mask for more than a short duration each time. N95 masks are not certified for children use. They also cannot protect men with facial hair as it prevents a proper seal.