infection control

Sometimes it’s a good idea to stay at arm’s-length.

What is your understanding of arm’s-length?

It can have a legal definition related to contracts and mortgages.

It can be used as a term to avoid intimacy with something or someone. To distance yourself from an organization or an issue. To avoid connection.

As a medical professional when I refer to keeping someone at arm’s-length. I may mean to keep professional distance or I may have a more literal meaning. Meaning; keep back from a person at least the distance of the length of your arm. Medical professionals often refer to this as “social distancing”, but again, there may be a variety of interpretations of “social distancing”.

So now that we have finally established that I am speaking of an approximate unit of measurement; approximately being one yard or meter, why is it sometimes good to stay an arms-length from someone?

I have only been sick twice in the last 12 years, but that all changed recently. It was Valentines day and I thought, lets go out for dinner. I let my guard down, walked into the crowded restaurant and woke up sick the next day.

Viruses and bacteria, even though bacteria are much larger than viruses, can not be carried on a water vapor droplet smaller than 5 micrometers 4 (mcm or μm if you prefer). Normal breathing only produces <0.8 to 2 µm size of droplet.1 Speaking and coughing can cause any range from 16 to 125 µm2&3, but anything larger than 5 µm can not travel more than 1 meter4 under normal circumstance. Circumstances can change, exhalation accompanied by projection such as a cough or sneeze. That is reason for the importance turning away and covering your mouth.

If you are sick you should stay home, but if you need to go out; keep your distance from people and try not to touch anything. Those of us that are not sick would like to stay that way! If you are not sick a few Lysol wipes for high contact areas, such as, shopping carts, door handles, stair railings, restaurant or food court table tops are a good idea. If you are sick wipes for the areas you use are just common courtesy, kind of like covering your mouth when you cough or sneezing into your sleeve. Thank you.

Written by: The Training Medic

1. Morawska L, Johnson GR, Ristovski ZD, Hargreaves M, Mengersen K, Corbett S, et al. Size distribution and sites of origin of droplets expelled from the human respiratory tract during expiratory activities. Aero Sci. 2009;40:256–69. doi: 10.1016/j.jaerosci.2008.11.002.

2.Chao CYH, Wan MP, Morawska L, Johnson GR, Ritovski ZD, Hargreaves M, et al. Characterization of expiration air jets and droplet size distributions immediately at the mouth opening. Aerosol Sci. 2009;40:122–33. doi: 10.1016/j.jaerosci.2008.10.003.

3. Xie X, Li Y, Sun H, Liu L. Exhaled droplets due to talking and coughing. J R Soc Interface. 2009;6(Suppl 6):S703–14. doi: 10.1098/rsif.2009.0388.focus

4. The Flu Pandemic and You, A Canadian Guide

Written by  Vincent Lam and Dr. Colin Lee

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