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The last few years, there's been a lot of encouragement to cough into your elbow instead of covering your mouth with your hand or a tissue. It sounds good, but does it help?
A team in Edmonton compared different "cough etiquette" maneuvers to see whether they would prevent the spread of viruses. Covering your mouth with both hands, a tissue, a clothed elbow, or the usual , including covering your mouth with both hands, a tissue, a clothed elbow, or a surgical mask are all equally ineffective.
The basic problem is that aerosol drops are too small to be blocked by any of those things.
So that leaves us with vaccination, hand-washing, and staying home when sick, which of course many people can't afford to do. (And that person on the bus who is coughing or sneezing might be reacting to an allergy, which is not contagious.)
As a side note, you have read every scientific study that supports coughing into your elbow. Really. There aren't any.
After noting the problem, the authors encourage research to find evidence-based procedures that do block the transmission of respiratory disease. In the meantime, I think I'm going to start carrying hand sanitizer. If you're in the Northern Hemisphere and haven't already gotten a flu vaccine, they're widely available in the U.S. and Canada (I haven't checked on other countries). If you're in the U.S. and have health insurance, it's probably covered. If you're in Canada, the categories of people who can get it free vary by province.
[Via the Science-Based Medicine blog, tucked in near the end of a piece about osteopathic manipulation.]
A team in Edmonton compared different "cough etiquette" maneuvers to see whether they would prevent the spread of viruses. Covering your mouth with both hands, a tissue, a clothed elbow, or the usual , including covering your mouth with both hands, a tissue, a clothed elbow, or a surgical mask are all equally ineffective.
The basic problem is that aerosol drops are too small to be blocked by any of those things.
So that leaves us with vaccination, hand-washing, and staying home when sick, which of course many people can't afford to do. (And that person on the bus who is coughing or sneezing might be reacting to an allergy, which is not contagious.)
As a side note, you have read every scientific study that supports coughing into your elbow. Really. There aren't any.
After noting the problem, the authors encourage research to find evidence-based procedures that do block the transmission of respiratory disease. In the meantime, I think I'm going to start carrying hand sanitizer. If you're in the Northern Hemisphere and haven't already gotten a flu vaccine, they're widely available in the U.S. and Canada (I haven't checked on other countries). If you're in the U.S. and have health insurance, it's probably covered. If you're in Canada, the categories of people who can get it free vary by province.
Conclusions
All the assessed cough etiquette maneuvers, performed as recommended, do not block droplets expelled as aerosol when coughing. This aerosol can penetrate profound levels of the respiratory system. Practicing these assessed primary respiratory hygiene/cough etiquette maneuvers would still permit direct, indirect, and/or airborne transmission and spread of IRD, such as influenza and Tuberculosis. All the assessed cough etiquette maneuvers, as recommended, do not fully interrupt the chain of transmission of IRD. This knowledge urges us all to critically review recommended CE and to search for new evidence-based procedures that effectively disrupt the transmission of respiratory pathogens. Interrupting the chain of transmission of IRD will optimize the protection of first responders, paramedics, nurses, and doctors working in triage sites, emergency rooms, intensive care units, and the general public against cough-droplet-spread diseases.
[Via the Science-Based Medicine blog, tucked in near the end of a piece about osteopathic manipulation.]