Preparing to Shelter in Place During the Coronavirus Outbreak

In a nutshell…
This article provides guidance on preparing to shelter in place in the event that becomes necessary during the current coronavirus (COVID-19) outbreak. The interactive “Dr. Ralph’s Emergency Preparedness Closet” illustrates the supplies families will need to stay healthy and secure while confined to their homes. Also addressed are tactics for staying mentally and emotionally healthy while sheltering in place.


As the COVID-19 virus expands its reach around the globe, many people are preparing for “social distancing”—physically distancing themselves and their families from others—to avoid being infected with the virus. Periods of social distancing may last as little as two weeks or many more weeks depending on how and when the virus strikes different areas of the country. Others may be in areas that require self- or mandated-quarantining (of exposed or potentially exposed individuals who are not sick) or permit only limited social gathering. Still others who have contracted the disease might be placed in isolation (individuals sick from the virus but not requiring hospitalization) for the duration of their illness. 

Schools have closed in certain outbreak areas (e.g., Seattle) and whole cities and countries have been isolated (e.g., Wuhan, China; Milan and Lombardy, Italy), to help prevent the spread of the virus. When families are required to shelter in place in their homes, life changes overnight. You may immediately become the steward of your family’s health. Are you prepared? 

Dr. Ralph’s Closet

In addition to 2009, the world experienced pandemic flu in 1968 and 1918.

In 2009, an H1N1 influenza virus emerged and reached pandemic status as it spread across the world. The Water Quality & Health Council recommended the public take steps to prepare to shelter in place in the event of pandemic flu and introduced “Dr. Ralph’s Flu Preparedness Closet.” In 2019 we updated the closet and renamed it “Dr. Ralph’s Emergency Preparedness Closet” to include all shelter-in-place emergencies. We presented it as a set of recommended supplies you, your loved ones, and your pets may need to survive in your home for an extended period of time. Explore the interactive version of the closet. Additionally, CDC has preparation tips and recommended contingency plans for people at higher risk for coronavirus.

View the interactive version of Dr. Ralph’s Closet

Staying Mentally and Emotionally Healthy during a Shelter-in-Place Emergency

There is more to preparing for a shelter-in-place emergency than gathering goods. Quarantine and isolation can lead to frustration and boredom, fear of infection, and inadequate information. Consider what you will need to be intellectually occupied and emotionally healthy over an extended period of time. Will you be able to work from home? Home-school your children? Read? Write? Engage in hobbies, crafts, or repairs? Organize family photos? Board games? Don’t forget to have a supply of “comfort food/drink” put away, items that are particularly relevant to the people in your shelter, whether cookies, chocolate, wine, etc.

If you are in isolation with a sick (or potentially sick) family member, be sure that you have adequate medications and medical supplies to care for them. Ensure a good supply of your routine medications (e.g., heart and diabetes meds). It is equally important to protect well members of the family from getting sick with good home infection control practices. Sick individuals should be separated from those who are well as much as possible including a separate bedroom, bathroom, and eating area. A face mask should be worn (if tolerated) by the sick when around those who are well. A good supply of nitrile gloves should be on hand to be used while caring for the sick.

Common areas should be disinfected frequently. See the list of EPA’s Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-CoV-2, the Cause of COVID-19. If these products cannot be procured, surfaces may be disinfected by applying a dilute chlorine bleach solution (made by adding ⅓ cup of regular household bleach in 1 gallon of water) after first cleaning the surface with soap and water. 

Finally, there is already much dis/misinformation and lack of information circulating about COVID-19. Find trustworthy sources with reliable guidance. A good place for information is your local and/or state health departments as well as the Centers for Disease Control and Prevention. The authors of this newsletter will endeavor to publish accurate, timely and useful information on this website as events unfold. 

Surviving Day to Day

Recently Vox interviewed people in five different countries who have had their lives disrupted by forced or voluntary “social distancing” due to COVID-19. A 65-year old Chinese woman in Wuhan who is confined to her home said at first she vacillated between worry and boredom, but gradually adapted to her new life of isolation by writing in her journal, sketching pictures, and creative cooking. She reported feeling comforted by the knowledge that her quarantine would help control the epidemic. 

A 17-year old high school student in South Korea whose school has been closed admitted that while he attends classes and church services online, he often feels lethargic or restless. Many events he would like to take part in have been cancelled. He admitted he would much rather be enjoying high school than “holed up in my room watching unhealthy amounts of YouTube.” Parents of infants and young children may be particularly challenged to keep their offspring occupied and entertained without the usual outdoor excursions and visits with friends. We heard of one young mother who is storing novel objects that can be used to entertain her toddler in the event that the COVID-19 spread requires her family to shelter in place. These include a few new inexpensive toys and books, odd-shaped boxes, and swatches of colorful felt. 

You know yourself and your family best. When it comes to preparing for a possible shelter-in-place emergency, first ensure you have the necessary supplies to help keep everyone physically safe and healthy. Then give some thought to preparing to keep everyone on an even keel mentally and emotionally. Remember, if you are the guardian of health within your shelter: Be prepared for the worst and hope for the best.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN. Bruce K. Bernard, PhD, is President of SRA Consulting, Inc., Associate Editor of the International Journal of Toxicology, and lives in Cambridge, MD. 

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