The Five Second Rule

You know the five second rule. You drop food on the floor and as long as you pick it up before five seconds have passed, you can still eat it without worry of getting sick from the bacteria that was on the floor. That is because the bacteria as a fellow living species gives us those five seconds. Now whether they do it as a courtesy or whether it just takes them 5 seconds to recover from the asteroid falling out of the sky and killing their neighborhood, before they can get their act together and shout, “Let’s get em!” I don’t know. I just know you have five seconds.

The CDC’s “prolonged contact” rule” which has been interpreted as 15 minutes by a local hospital, is of the same scientific school of thought as the five second rule. It seems they have inside information that COVID, which has been terrorizing the planet, is willing to wait until 14:59 plus one second before it latches on to anyone. Maybe killing has come so easy to it, it has decided to take a breather and give us that 15 minute safe zone. When I see, nurses gowned up in space suits to test a drive-up patient, I want to say them, “You don’t need all that as long as you plan to keep your patient encounter under 15 minutes.”

The CDC must know this too, or maybe they know the rule only applies to EMS workers. Maybe they held a secret negotiating sessions with Covid, and Covid seeing what easy prey we were agreed to cut us some courtesy time because it knows it’s going to get us in the end anyway.

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Below is the CDC recommendation, and I see they only say a few minutes is reasonable to be considered prolonged.  I am trying to find out why some local hospitals have extended that to 15 minutes.

Close contact for healthcare exposures is defined as follows: a) being within approximately 6 feet (2 meters), of a person with COVID-19 for a prolonged period of time (such as caring for or visiting the patient; or sitting within 6 feet of the patient in a healthcare waiting area or room); or b) having unprotected direct contact with infectious secretions or excretions of the patient (e.g., being coughed on, touching used tissues with a bare hand).

Data are limited for definitions of close contact. Factors for consideration include the duration of exposure (e.g., longer exposure time likely increases exposure risk), clinical symptoms of the patient (e.g., coughing likely increases exposure risk) and whether the patient was wearing a facemask (which can efficiently block respiratory secretions from contaminating others and the environment), PPE used by personnel, and whether aerosol-generating procedures were performed.

Data are insufficient to precisely define the duration of time that constitutes a prolonged exposure. However, until more is known about transmission risks, it is reasonable to consider an exposure greater than a few minutes as a prolonged exposure. Brief interactions are less likely to result in transmission; however, clinical symptoms of the patient and type of interaction (e.g., did the patient cough directly into the face of the HCP) remain important. Recommendations will be updated as more information becomes available.

Risk stratification can be made in consultation with public health authorities. Examples of brief interactions include: briefly entering the patient room without having direct contact with the patient or their secretions/excretions, brief conversation at a triage desk with a patient who was not wearing a facemask. See Table 1 for more detailed information.

Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19)

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