Doing the six feet U, and other helpful COVID habits


The devastation, the number of cases, the lack of containment of the COVID-19 virus reads like a horror or at best sci-fi movie. The COVID-19 virus is a member of the corona virus family and has proven more contagious and deadly than many of its other family members such as the SARS and MERS viruses. 

The corona viruses are a group of RNA viruses that, in addition to affecting humans, can also affect birds and animals. For example, it can cause pigs or cows to develop diarrhea and has been shown to cause brain and liver infections in mice. Its most famous family member, the rhinovirus, causes the common cold, and although contagious is typically not deadly. 

They get their name because of the characteristic club-shaped spikes that project from the surface similar to a crown. While its spherical shape might fool you into thinking it is bigger than it is, the COVID-19 virus varies between 60 and 120 nanometers (nm) in size. That’s 1/1000th of a single strand of hair!

Thankfully, although it can sometimes affect the hair causing hair loss, hair loss is not one of its most common presentations. Instead, we are accustomed to the virus presenting with fevers, fatigue, decreased smell, decreased oxygen levels, GI distress, chills, extremity swelling, etc.

For the most part, treatment is supportive with hydration, rest, controlling fevers in isolation. If symptoms are not improving after a day or two or if a high fever is not responding to acetaminophen, then please make contact with your primary care clinic or the emergency room.

Here are seven habits that can decrease your risk:

1Believe the COVID-19 virus does exist!
The virus not only exists but is lethal! It affects persons without regard to economic status, skin color, ethnicity, religion, fitness level or age, although people who are younger and in better physical condition tend to have less morbidity. 

To clarify, I believe and most research shows that the main reason for people of color being so greatly affected by the coronavirus with worse outcomes than expected is related to disparity in health care and economic disparity. What this means is that it is less likely for a person of color to have an established relationship with a care provider or have access to care. Therefore chronic diseases are not being appropriately treated if at all, so when an illness strikes, persons of color may not fare as expected. 

In addition, without an established relationship with the primary care clinic, their ability to get in and be seen except in an emergency room is significantly less. Transportation to get care may also be a compromising issue.

Certainly, any language barriers, multigenerational households, not having co-pays easily accessible, not understanding how to navigate and advocate for their medical care, all these factors increase the likelihood that a person of color will have a less ideal outcome when exposed to the coronavirus.

2.  Physical distancing: The six feet U
While we have missed the embrace and company of loved ones and friends, it is important to minimize direct contact or get within 6-8 feet of people who are not in your household. Outdoor activities do help to fill the void of connection, and each day I am grateful that people desire human contact. 

Remember, though, that staying six feet apart ideally should be a U. That is, when approaching a stranger, go out to the side of them when you’re at least six feet in front of them and stay to the side of them until you have passed them by six feet. Increase the physical distancing when someone is running or biking in your path.

Doing the six feet U should help to decrease the amount of respiratory droplets that are shared. Even when outdoors it is a good idea to put your mask on when a stranger is approaching in addition to doing the 6 feet U.

3.  Wear a mask
Wearing a mask indoors is a state rule for Minnesota and many other states. It seems unthinkable that it has met with such resistance given that for years we have all been educated to sneeze into our arms to minimize spreading germs infecting others! 

Think of the mask as a covered elbow upping the effectiveness of trying to cover your cough. If you are wearing a cloth reusable mask, it is important to wash it regularly depending on your exposure. You can also sanitize it by wiping it down with a sanitizing cloth or hand sanitizer or lemon rind.

According to the Centers for Disease Control and Prevention (CDC), a cloth mask is an acceptable face-covering in the event of personal protection equipment shortage and should be made of at least three layers, ideally cotton, a filter, and outer surface fabric that is water-resistant. Ideally, purchasing a mask with the filter built-in leads to more compliance, as having to purchase and change filters adds another roadblock to compliance.

Mask fit and adjustability are crucial for protection, with ideally the mask having adjustable inter-loop straps to improve filtration and comfort. 

4. Wash more than your hands
Rightfully so, there is a lot of emphasis placed on washing your hands, as people will touch surfaces, their faces, eat, and in other ways transfer potential virus from objects or other body parts to themselves. Washing with hand sanitizer or soap and water for 20 seconds is felt to be effective in reducing the amount of potential virus on the hands. 

However, recall it is a respiratory virus and is most infectious when inhaled. Therefore similarly washing the nose with a saline spray will help to decrease the concentration of potential virus that may be in the nasal passages. 

The hair in the nose as well as the mucus does attempt to trap the majority of pathogens and dust, and our use of saline sprays further helps our natural trapping mechanism by removing and diluting the amount of viral load. As an ear, nose and throat specialist, I believe that people should wash their nasal passages with a saline solution at least twice a day and when with any suspected exposure, as well as when coming off an airplane.

5.  Leave your shoes at the door
The bottom of your shoes can transmit many infections or pathogens that people may expectorate or spit out and you may or may not witness. Therefore, it is a great idea to leave shoes that you wear outdoors near the door to avoid bringing trouble into your home.

6. Keep pets clean
Clean your pet’s nose, mouth, paws and bottom on returning from a walk for the same reasons stated above. Your pets are close to the ground, and while they may not become ill, their body parts, including nose and mouth, contact the pavement or ground where there has been expectorated secretions, increasing the chances of transfer to you. Wiping them down with a sanitary wipe on returning from a walk will be helpful in decreasing this potential route of transmission.

7.  The basics: sleep, diet, exercise
These are the basics in helping to keep your bodies in tip-top shape to defend itself should it become ill. Therefore it is important to get seven or more hours of sleep, eat a balanced diet that may need to be supplemented with multivitamins, and exercise routine to help bodies deal with the challenges and stress of any infection.

Visit the CDC website or my website,, for more details on masks.

Dr. Inell Rosario is a board-certified ENT and sleep physician practicing at Andros ENT & Sleep Center in Inver Grove Heights, Minnesota. She has many times been recognized as a Top Doctor and Best Doctor in various Minnesota magazines and can be reached at or 651-888-7800.