Outdoor Cough Etiquette: Protecting Your Child's Health

Q: Outdoor Cough Etiquette: Protecting Your Child's Health

Dear Ms. Mei： 1. Covering your mouth and nose while coughing to prevent droplet spread is a basic etiquette and a measure for infectious disease protection. Unfortunately, there are still a very small number of individuals who do not pay attention to this. Curr

Outdoor Cough Etiquette Inquiry

Hello Doctor,
During lunchtime, I accompanied my younger sister home from school, and on the way, we encountered a man who was coughing without wearing a mask and sprayed towards us.
When we got home, I quickly told my sister to wash her hands and rinse her mouth before watching TV.
The infectious disease doctor had previously informed us that my sister, who is in second grade, has low white blood cell counts and poor bronchial health, making her more susceptible to colds.
We are worried about her being infected during this pandemic, and although we don't want her to go to school every day, she really wants to attend classes and even cried about it.
Therefore, our family has advised her to pay attention to her hygiene, wash her hands before meals, and keep her mask on when not eating, among other precautions.
We also placed hand sanitizer in her pencil case.
I understand that we cannot expect everyone to wear masks outdoors, but at that moment, I really wished the man would at least cover his mouth, as the school hygiene staff had previously instructed us to use a handkerchief or our sleeves to cover our mouths when coughing.
I would like to ask the doctor if there is a possibility of transmission from this encounter, and whether we need to manage our health proactively.
My mother reminds my sister to check her temperature every day.
At that time, my sister wasn't wearing glasses like I do, and I recall news reports stating that viruses could enter through the eyes, which makes me concerned.
However, my sister herself said it was okay since she often catches colds anyway.

As a middle school student, I hope to become a healthcare worker in the future to help my sister, but I am currently uncertain about the level of risk involved in this situation.
I apologize for adding to your burdens during this pandemic by asking my questions, and I appreciate your help.
Thank you.

mei, 10~19 year old female. Ask Date: 2020/04/13

Dr. Xiao Yongxun reply Family Medicine

Dear Ms.
Mei:
1.
Covering your mouth and nose while coughing to prevent droplet spread is a basic etiquette and a measure for infectious disease protection.
Unfortunately, there are still a very small number of individuals who do not pay attention to this.
Currently, we are facing a global outbreak of COVID-19; however, our country has only seen sporadic community cases, and most of them can trace their sources of infection.
If your sister was wearing a mask at that time, and was also gargling and washing her hands frequently, I believe there is no need to worry too much.
You can advise your sister to continue wearing a mask in indoor settings or crowded places, and to maintain good hand hygiene.
2.
Although the incubation period for COVID-19 can be as long as 14 days, symptoms typically appear around five days after exposure.
Therefore, please be vigilant for any symptoms such as sore throat, runny nose, fever, cough, loss of taste or smell, or diarrhea.
If any of these symptoms occur, she should seek medical attention at an infectious disease clinic in a regional hospital or higher.
Of course, it is also advisable to discuss with your family physician before making any decisions.

Reply Date: 2020/04/13

More Info

When it comes to outdoor cough etiquette, especially in the context of protecting children’s health, it’s essential to understand both the risks involved and the preventive measures that can be taken. Your concerns about your sister's health, particularly given her history of low white blood cell count and bronchial issues, are valid and reflect a responsible approach to her well-being.

Firstly, the risk of transmission from someone who is coughing without a mask depends on several factors, including the nature of the illness (viral or bacterial), the distance from the person, and environmental conditions. Respiratory illnesses, such as the common cold or flu, are primarily spread through droplets that are expelled when an infected person coughs or sneezes. If these droplets land on surfaces or are inhaled by someone nearby, transmission can occur. While outdoor settings can reduce the risk of transmission due to better air circulation, it is still possible to contract an illness if you are in close proximity to someone who is symptomatic.

Given your sister's compromised immune system, it is wise to take extra precautions. Here are some strategies to help protect her health:
1. Encourage Good Hygiene Practices: As you mentioned, handwashing is crucial. Ensure that your sister washes her hands frequently, especially after being in public spaces or after contact with potentially contaminated surfaces. Using hand sanitizer can also be effective when soap and water are not available.

2. Use Masks When Necessary: While it may not be feasible to require everyone to wear masks outdoors, it is a good practice for your sister to wear a mask in crowded or enclosed spaces, especially if she is around individuals who are coughing or showing signs of illness.

3. Maintain Distance: Encourage your sister to keep a safe distance from individuals who are coughing or sneezing. This is particularly important in situations where social distancing may be difficult to maintain.

4. Monitor Symptoms: Keep an eye on your sister for any signs of illness, such as fever, cough, or difficulty breathing. Regular temperature checks, as you mentioned, can help in early detection of any potential illness.

5. Educate on Cough Etiquette: Teach your sister about the importance of covering her mouth and nose with a tissue or her elbow when she coughs or sneezes. This not only protects her but also helps prevent the spread of germs to others.

6. Consult Healthcare Providers: Given your sister's medical history, regular check-ups with her healthcare provider are essential. They can offer personalized advice and may recommend additional precautions or treatments to bolster her immune system.

7. Healthy Lifestyle Choices: Encourage a balanced diet rich in fruits, vegetables, and whole grains to support her immune system. Regular physical activity and adequate sleep are also vital for maintaining good health.

8. Stay Informed: Keep up with public health recommendations regarding respiratory illnesses, especially during flu season or outbreaks of contagious diseases.

In conclusion, while the risk of transmission from an outdoor encounter with someone coughing is present, taking proactive measures can significantly reduce that risk. Your sister's health and safety are paramount, and by fostering good hygiene practices and being mindful of her environment, you can help protect her from potential infections. It’s commendable that you are considering a future in healthcare to support her, and your proactive approach now is a great foundation for that aspiration.

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