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How not to spread the flu

Expert advice on how to avoid spreading or getting infected by the flu virus

By Vincent Lam, M.D. and Colin Lee, M.D.

Don't shake hands, don't kiss; people, don't share snacks
During Phase 6 of a pandemic, greet and interact with people in ways that do not involve direct physical contact. Consider this during Phases 4 and 5. Avoid eating food that someone else has recently handled. When you greet someone, just say hello, or bow slightly if you feel that a touch of formality is in order. During Phase 6 of a pandemic, it's really not sensible to shake the hands of everyone you meet, or to greet all your friends with a peck on each cheek.

This is not an exhaustive list of activities to avoid, so you will need to consider situations individually. For example, eating at buffets is not a good idea, since lots of people use the same serving utensils and take food from common platters. Religious ceremonies that involve drinking from a common cup or eating parts of a commonly handled piece of food should possibly be replaced simply by worshipping without physical contact. Maybe you should avoid contact sports. However, tai chi would pose no problem, nor would cycling or running. Consider the principles we discussed above, take note of activities that involve touching other people, many people handling common objects, or putting food that others have touched in your mouth. If these actions are not essential, don't do them during Phase 6 of a pandemic. Consider avoiding them in Phases 4 and 5, and stay tuned because your local public health authorities may have a timely recommendation on this topic during Phases 4 and 5. They're not directly relevant to pandemic influenza in Phases 1, 2, and 3, although following this advice might reduce your chance of getting a cold or a case of seasonal influenza. During Phases 4, 5, and 6 of a pandemic, if there are certain things that you feel are essential, such as communion or other religious activities, your religious institution may think about how to do these things in a way that reduces the risk of transmitting infection.

Social distancing and the "1 metre rule"
During Phase 6 of a pandemic, try to stay more than 1 metre away from other people. Whether this will be relevant during Phases 4 and 5 will depend on your local situation. The transfer of contaminated droplets directly from one person to another without physical contact occurs through coughing, sneezing, and talking when there is less than 1 metre between people. Keep yourself posted on local public health advice. This is not relevant during Phase 3.

When going about your day during Phase 6, avoid non-essential activities that would put you in close quarters with others. Certain essential tasks may require that you are less than 1 metre from other people. For example, if you are a health care worker, caring for sick people will necessitate that you are closer to others. If you are a police officer, you may have direct contact with people in order to enforce the law. Such essential workers, with unavoidable potential risk exposures, will probably have specific risk-reduction measures for those tasks, such as the wearing of masks, gloves, or goggles.

Otherwise, during Phase 6 avoid crowded bars, busy markets, theatres, sports events, public transit, and basically any non-essential situation in which you will end up being close to other people. If there are essential activities in your life that you can't cut out, think about whether you can do these things differently to minimize the number of times you will be less than 1 metre from another person and to avoid large gatherings of closely packed people.

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Excerpted from The Flu Pandemic and You: A Canadian Guide by Vincent Lam, M.D. and Colin Lee, M.D. Copyright 2006 Vincent Lam and Colin Lee. Reprinted by permission of Doubleday Canada.

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