Like many people in the UK, I live in a house of multiple occupation (HMO). We make an improvised family of five. Three of us work in the NHS: one junior doctor on a geriatric ward, one junior doctor on a psychiatric dementia ward (me) and one working in administration. The other two are finishing off their studies as mature students.
Last week, we went into self-isolation as my housemate in admin had developed a fever and cough the week before. It was a strange time, none of us became ill as a result but we had to make big adjustments quickly at a time when the country was still getting its head around the emerging pandemic.
Now that we are going back to work, I am actually more anxious about how this will affect the health of our patients and of each other. While my other doctor housemate will likely be working with patients who have COVID-19, my patients in psychiatry are highly vulnerable if they contract the virus. If one of them does, it will be hard to contain the spread, as we cannot force patients to stay in their rooms if they wish to wander. The last thing I want now is to pick up the virus at home and bring it to my patients.
There are around 500,000 HMOs in England and Wales. People who live here tend to be young single adults choosing HMO living because it is a more economically viable and social option.
HMOs present a challenge in controlling the spread of disease. Apart from the fact that people are living closer together and sharing communal spaces, there is also housemate etiquette that can make it challenging to use the space in a harmonious way. Social distancing is understandable when going to the shops, park or to visit friends, but to change behaviour within the home is a change in behaviour that asks much more of us. When you share a bed and eating spaces with other people, where do you draw the line in this time of social distancing?
To answer this, I have tried to compile some simple tips for minimising the spread of disease in the home:
Wash your hands as soon as you come in. The alternative to this is rigorous washing of front/back door handles and keys. I think it is more achievable to make sure that hands are washed after this, especially if you have just been shopping.
If you have been working in a clinical environment, try to change your clothes at work or as soon as you get home. I am also going to leave a change of clothes at work to make this easier. If you will be working in areas with covid-19 then ask for scrubs to help protect yourself and others.
Have your own mug/glass/bowl/cutlery and wash them well after use. This minimises on washing up and means there won’t be any accidental cross contamination.
Have your own assigned tea towel/towel in the kitchen and bathroom. Slightly more tricky as it can result in there being also of fabric everywhere. Hand washing is all very well, but drying hands on a contaminated cloth will only re-contaminate them. If you don’t have endless supplies of paper towels (which we definitely don’t) then an individual towel will help.
Shared meals mean less people in the kitchen at once and it’s great not to have to cook every night. Practice hand hygiene in preparing meals. Communal living can still be isolating at times and shared meals are the perfect opportunity to check in on everyone.
Daily clean of: cupboard, door and appliance handles, light switches and taps. Any surface that is going to be used by multiple people could be a source of spread. The number of times a day to clean is not evidence-based, just realistic!
Physical distancing not social distancing: enjoy each other’s company from a safe distance and combat loneliness! Ultimately, if unwell people in your house are well looked after, this will allow them to stay isolated and make them feel cared for.
Rachel Hallam is a junior doctor and member of Doctors in Unite