Stay home unless you must see a doctor. No work, school or shopping. If you must come out of your room, wear a mask. And don’t share towels.
If you are among the thousands of Americans now self-quarantined because of possible infection with the coronavirus, these are a few of the new house rules, courtesy of your local health officials and the Centers for Disease Control and Prevention.
Among people told to self-quarantine, isolate themselves or stay home are people returning from parts of China and Iran, those who developed symptoms after spending time in other countries with sustained community transmission, and those with no known exposure who are sick.
But many individuals who don’t fit neatly into any of these categories and weren’t asked to stay home are choosing to seclude themselves anyway, because they don’t want to put others at risk. California has more than 5,500 people in self-quarantine. More than 2,700 are in seclusion in New York City alone.
It may sound like a vacation from reality, an ideal time to binge on Netflix and catch up on sleep. In fact, it’s not easy to lock yourself away from family and friends. There are practical and logistical challenges, and yawning gaps in the official advice that make it even harder.
The terms of home isolation can be onerous and may last for two weeks, which is the presumed incubation period for the virus. It is especially challenging if you have young children or elderly relatives to care for, or live in cramped quarters with a lot of roommates.
Isolation If you are infected or have been exposed to the coronavirus, you must seclude yourself from your partner, your housemates, your children, your elderly aunt. You shouldn’t even pet your dog. And definitely no snuggling with your pet (no licking).
If you don’t have your own room, one should be designated for your exclusive use. You should use a separate bathroom, if you have one.
No visitors, and no staff, unless it’s absolutely essential. Don’t take the bus or subway, not even a taxi.
Masks If you must be around other people — in your home, or in a car, because you’re on your way to see a doctor, and only after you called first — you should wear a mask, and everyone else should, too.
But first, you or one of your friends or family members have to find masks, which are sold out almost everywhere.
Hygiene If you cough or sneeze, you should cover your mouth and nose with a tissue, and discard the used tissue in a lined trash can. Then you must immediately wash your hands with soap and water for at least 20 seconds.
You can use sanitizer, if you can find it, but soap and water are preferred.
Even if you haven’t coughed or sneezed, you should wash your hands frequently, and avoid touching your eyes, nose and mouth, if you haven’t just washed them.
Disinfect Don’t share dishes, drinking glasses, cups, eating utensils, towels or bedding with anyone (including your pets). Wash these items after you use them.
Countertops, tabletops, doorknobs, bathrooms fixtures, toilets, phones, keyboards, tablets and bedside tables are considered “high-touch surfaces” — wipe them often with a household cleanser.
Frequently wipe down surfaces that may be contaminated by bodily fluids, including blood and stool.
Monitoring Keep an eye on your health and call a doctor if your symptoms are getting worse. Make sure to tell the medical staff you are being monitored for the coronavirus.
Household members Family members and other occupants should monitor the patient’s symptoms and call a health provider if they see a turn for the worse.
Housemates can go to work or school, but it’s going to be their job to stock up on groceries, pick up prescriptions, take care of the quarantined and keep the place clean. They’ll be wiping down doorknobs and countertops, doing loads of laundry and washing their hands — a lot.
When around the patient, household members must wear a face mask, and both mask and gloves if they have contact with his or her bodily fluids. These should be thrown away immediately, never reused.
Elderly members of the household and those with chronic medical conditions are at particular risk if they are infected. Contact with the secluded individual should be minimized.
Other occupants of the home should wash their hands frequently and avoid touching eyes, nose and mouth with unwashed hands. They should stay in a room separate from that of the exposed or sick individual. If feasible, other members of the household should not share a bathroom with the secluded person.
They should monitor their own health, too, and call a doctor if they develop a cough, fever or shortness of breath.
No one pays you for self-quarantine. There is no reimbursement for products you may need, no government-paid nurse to stop by the home and help out. Self-quarantine is a hardship for both those who have families and those who live alone.
Not everyone can work remotely. A two-week absence from work can take an enormous financial toll on hourly wage workers who have to clock in and show up to get paid, or who are part of the gig economy with no single employer.
Many Americans, maybe most, live paycheck to paycheck.
“We have to have social interventions to incentivize and support isolation, or we are doomed,” said Arthur Caplan, professor of bioethics at New York University Langone Medical Center.
People with no health insurance, inadequate insurance or no regular doctor will be reluctant to seek care if they have symptoms, fearing steep medical bills, he noted. Undocumented individuals, fearful of being discovered and deported, may avoid diagnosis and care.
“I don’t see the state or federal government preparing for this in any way,” Dr. Caplan added.
Senator Patty Murray, Democrat of Washington, and Representative Rosa DeLauro, Democrat of Connecticut, have introduced legislation that would require all employers to let workers accrue seven days of sick leave, while providing another 14 days for immediate use during a public health emergency.
Washington State’s website says the health department can help with groceries for those unable to leave their homes and even intervene with employers on their behalf if necessary.
Providing for people who make sacrifices for the greater good is crucial, said Lawrence Gostin, a law professor at Georgetown University and director of the World Health Organization Collaborating Center on National and Global Health Law.
“We ought to have a social compact: If you’re sick, whether you’ve got Covid-19 or not, you should separate yourself from society,” Mr. Gostin said. “That’s your part of the bargain, you’re doing it for your neighbors, your family and your community.”
“In exchange,” he said, “we as a nation owe you the right to a humane period of separation, where we meet your essential needs like medicine, health care, food and sick pay.”