Practical Advice on COVID-19 for Watch Enthusiasts

Disclaimer: In case it wasn’t obvious, an online watch magazine may not be the best place to get health information. I am a medical doctor and this represents my informed opinion based on the best science available at this time. As always, for the best and most current information please ask your doctor. For additional information check out the CDC website here.

This autumn there is no more pressing issue than the ongoing COVID-19 pandemic, especially in North America and Europe. As a medical doctor and a watch enthusiast I would like to offer some practical advice for enjoying watches during this health crisis. I hope I can shed some light on common misconceptions as well as give some evidence based advice.

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Cannonballs versus Smoke Bombs

When the pandemic started we thought that COVID-19 spread only through droplets. The idea is that when an infected person coughs or sneezes, thousands of virus containing particles fly out of their mouth and nose. In order to enter another person’s body, the virus needs to come in contact with a mucus membrane such as the eye or inside of the nose or mouth. Of course it is possible to be close enough and unlucky enough to have your eye sneezed on but this mostly happens by touching a surface containing the virus and then rubbing your eye or scratching your nose. The reason for this is that droplets are heavy. You can think of them like cannonballs. When they come out, gravity pulls on them and they quickly fall to the ground or onto a convenient surface like a countertop. The droplets typically do not travel more than 6 feet which is the rationale for staying 6 feet away from others. However, there have been experiments that have indicated that some people have a more powerful sneeze that others and may propel viral particles further than 6 feet. Wearing a mask will trap most of the particles and the ones that escape around the mask will not travel far. That is why a mask is a better and more reliable prevention measure than staying 6 feet apart.

What goes up must come down if you are talking about droplets

This cannonball concept is the rationale behind the advice to frequently wash your hands, not touch your face, and use hand sanitizer frequently. This is probably good advice in general especially in cold and flu season. If you get sick you should isolate yourself and get tested for COVID-19 so it is best not to get sick at all if you can avoid it. One of the benefits of wearing a mask was thought to be that it prevented you from inadvertently touching your face. When the pandemic started I made a point when outside the house not to touch my face unless I had just washed my hands and then to wash them again immediately afterwards.

There was an early and rather alarming article in the New England Journal of Medicine which reported that the virus that causes COVID-19 was found on plastic and metal surfaces for up to 3 days and cardboard for up to 24 hours. More porous surfaces lead to more rapid drying which destroys the virus. This led to behavior such as wiping down groceries, quarantining the mail, and so on. Virus that lives on surfaces and then gets you sick is referred to as fomites. The idea is that for example someone coughs on their hand, touches a subway pole, you touch the same pole and then rub your eye, and then you have COVID-19.

As time has gone on, fomite based transmission seems to be less important than initially thought. The best evidence is probably that eating takeout from restaurants has not been associated with any outbreaks. You should still not touch your face before washing your hands with soap and water or using hand sanitizer but wiping down groceries and quarantining the mail is probably not necessary. The initial surface contact studies were done in a laboratory which may not reflect real world conditions and the amount of virus that can be detected in a lab may not be enough to infect a person. Also presumably people in service industries know enough to not sneeze into your food or onto your mail or groceries. 

A common practice for health care workers during the pandemic was to conserve and reuse disposable N95 masks. N95s are a high filtration mask that fits tightly to the face and removes small particles from the air. Although the virus was not thought to be airborne initially, many health care workers were concerned by the rapid spread and sought to use maximum protection. There were supply chain limitations and not enough N95s to go around. At times, a hospital might issue one N95 mask per week or have only poorly fitting extra small masks in stock, or only have the less well fitted KN95s. The response was to take previously used disposable N95s and reuse them by placing them into paper bags for 4 days. The paper bags were thought to provide better aeration to dry out the virus and the 4 day period was because of the previously discussed study which indicated that the virus could survive up to 3 days on the metal nose strip on the N95 mask.

“Disposable” N95 mask

This background provides the rationale for some of my practices around watch wearing. If I get a new modern watch I will wash it thoroughly with soap and water before wearing it. If I get a vintage watch with no water resistance I will make sure that it has been 4 days since the previous owner has handled it before wearing it. I usually start the timing from the ship date based on the tracking number and discard the outside packaging. The risk is probably small but since I tend to buy from private individuals in potentially high prevalence areas in the United States I prefer to be cautious.

I generally prefer to wear modern watches at this point so I can wash the watch with soap and water after returning home from work. If I were to wear a vintage watch to work I would put it away for 4 days before taking it out again. I work in a medical environment so this may not apply to you if you are working at home with minimal outside exposure but I would consider washing your watch when returning home if you are working outside the home.

When considering in person watch events, you should consider airborne transmission. I think of this as the “smoke bomb” effect. There was an initial reluctance to consider that COVID-19 had airborne spread. You can think of airborne spread as a sick person instead of spewing tiny cannonballs out of their mouth and nose that fall quickly to the ground, instead sets off a smoke bomb like an ninja movie from the 1980’s.

At least he’s wearing a mask

Airborne spread has several important implications which may have led to some reluctance to embrace it. Firstly, it means that patients need to be isolated in “negative pressure” rooms where the room pressure is less than the pressure outside so that air is constantly sucked into the room. These rooms are expensive and few of them exist in a hospital. This problem was quickly dealt with by designating specific floors for COVID-19 patients only. Second, health care workers need N95 masks rather than regular surgical masks, which were in short supply. Third, airborne spread is rather rapid, hard to contain, and much more alarming than droplet spread. The original New England Journal of Medicine article indicated that the virus remained in the air for up to 3 hours but this finding was greeted by some skepticism. After some initial hesitation that it could be airborne at all, the guidance changed to that it may become airborne during “aersolizing procedures” such as inserting a breathing tube. More study has shown that the virus is likely to be airborne to some degree. Basically if someone is sick the virus may get airborne and spread like a cloud from a smoke bomb. To escape the smoke it is better to be further away, be near ventilation like a fan, be outdoors, or muffle the smoke bomb in the first place by throwing a bucket over it which is the equivalent of the sick person wearing a mask.

We thought it was like Ebola but it’s more like measles

As time has gone by we have found that the virus is rapidly spread by “superspreader” events where a large number of people became infected. The superspreader events are more often indoors and more likely to occur in poorly ventilated settings. While the virus does not seem to linger in the air and float down the block for example, it does have some airborne spread which is accelerated by being indoors, being in a poorly ventilated area, or by doing activities that lead to a vigorous expulsion of air from the lungs such as singing. This leads to a more dense cloud of virus which is more likely to infect others. An indoor poorly ventilated bar, for example, where people are drinking alcohol and letting down their guard and their masks, not staying apart, and talking loudly would be a high risk area for spread. Indeed, many cases have been traced back to bars. Another issue is that the virus can be spread for up to 48 hours before symptoms appear so a seemingly well person can be spreading it. This is why it is important to wear a mask even if you feel well because you may have it but not know it yet. If you are sick in any way you should stay away from others and get tested for COVID-19.

Morawska et al: Clin Inf Dis 2020. Ventilation is good, outdoors is better

In our area in the suburbs of New York I think it was ok to have small get togethers over the summer with masks while remaining preferably outside and around 6 feet apart. Another important aspect is to make sure you have a sign in sheet with the contact information for everyone at the event so that if someone becomes sick the next day, the contact tracers can find and quarantine everyone at the event to prevent further spread. Now that our numbers are rising I would discourage get togethers altogether. A good number to watch is the positivity rate which is the percentage of people positive for COVID-19 out of the all the people tested that day. Over the summer our positivity rate lingered around 1% which is fantastic but as of this writing it is closer to 3-4% and rising. In the higher prevalence areas which Governor Cuomo has designated “micro-clusters” and are subject to further restrictions, the positivity rate is getting close to 6%, an alarming number.

In summary, COVID-19 has both droplet and airborne spread so the most important preventative measures to protect yourself and to protect others are to wear a mask, stay away from others and get tested if you are sick, and wash your hands. Wash your watches thoroughly with soap and water especially if it is coming from another location or you have been in a crowded or high touch environment. If you have a vintage watch without water resistance consider leaving it for four days before wearing it if it is newly acquired or if it may have been contaminated.

I would also like to debunk a few common myths:

“Wearing a mask makes my immune system weak”

This is false. An excessively clean environment in infancy predisposes to allergies later in life due to lack of exposures but this has nothing to do with infections.

“It’s better to let it go through the population and have herd immunity”

This is a dangerous and false idea. Even in the worst affected boroughs in New York, COVID-19 antibodies are only at about 10%. If it burns through the population like this many people will die unnecessarily.

“I’m young and healthy, I can’t get sick”

This is false and one of the most common misconceptions about the disease. Although young and healthy people are less likely to become seriously ill, it can still happen. The virus is new and some people are more susceptible to serious disease for unknown reasons. Young people can still die or get seriously ill and have long term problems like chronic exhaustion or permanent heart or lung damage. Young people are also more likely to spread it without knowing they are sick, which is a danger to us all.

“When they make a vaccine the pandemic will be over”

Unfortunately this is false. When a vaccine is approved, it needs to be produced in huge quantities and shipped. Large scale transportation and storage for a refrigerated vaccine is a problem, especially if the vaccine needs to be stored at -70 degrees Celsius like the Pfizer vaccine. Doctor’s offices do not currently have the refrigerators that can handle that low a temperature. Hundred of millions of tiny glass vials and needles need to be produced and you can double that number if more than one dose is needed. Once approved, it will likely take several months to roll out a vaccine in sufficient quantities for the entire population.

“Masks don’t work”

This is false. A mask will trap droplets and most aerosols, preventing the virus from escaping and infecting others. There is also some evidence that even a surgical mask can filter out the virus. A larger dose of the virus is more likely to cause serious illness so reducing the amount of inhaled virus by wearing a face mask can potentially be a life saving measure. A mask that is fitted to the face works better than a loose fitting face covering such as a bandana. At this point masks are widely available so there is no reason to be using a bandana.