Pandemic

The card's structure is right: sick room, one carer, its own things, the doorway as an airlock. This adds the measure that outranks all of them and the conflict it creates with the rest of this app.

Ventilation against warmth

For anything that spreads through the air, ventilation is the single most effective thing a household can do. More than surfaces, more than gloves, comparable to masks. Fresh air dilutes what is in the room, and there is no substitute.

And every other page in this app about winter tells you to seal the house up. Blanket the doorways. Roll a towel along the bottom of the door. Live in one small room with the family in it. Those instructions and this one are in direct opposition, and no card has room to say so.

The workable compromise is short and sharp. Open windows wide for a few minutes several times an hour rather than a little all day: it exchanges the air without cooling the fabric of the building, so the room recovers quickly. Ten minutes an hour, wide open, does more than a window cracked all day.

Ventilate the sick room to the outside, not to the rest of the house. Window open, door shut, and if there is an extractor fan in that room, leave it running.

The bleach dilution, exactly

The card gives one part to fifty. Worth pinning down, because bleach is the one number in this scenario that people guess at.

• One part household bleach at around 5 per cent to 50 parts water. That is roughly 20 ml, a large tablespoon, in a litre of water.
• That gives about 1,000 parts per million available chlorine, which is the general surface disinfection strength and is what handles the gut bugs the gut companion covers.
• Make it fresh each day. It loses strength quickly once diluted, and yesterday's bottle is weaker than it looks.
• Clean first, then disinfect. Bleach is deactivated by dirt and grease, so a surface must be washed before it is disinfected. This is the step people skip.
• Leave it wet on the surface for a few minutes before wiping. Contact time is what does the work.
• Cool water, not hot, which drives off the chlorine.

One bathroom

The card assumes the sick room can have its own toilet. Most British houses have one bathroom, and that changes the plan.

If the bathroom must be shared:

1. The ill person uses a bucket toilet in the sick room if they can manage it, which removes the problem entirely. This is what the twin-bucket page is for and it is the cleanest answer.
2. If not, they go last, and everything is disinfected afterwards: seat, flush handle, taps, door handle, light switch.
3. Lid down before flushing, every time. Flushing aerosolises what is in the bowl.
4. Separate towels, marked or coloured, never shared, and washed hot.
5. No shared toothbrush pot, no shared soap bar. Liquid soap or an individual bar each.
6. Ventilate it between uses, window open or extractor running.

Soap and water beats hand gel for the gut infections, which is where households get caught out because gel feels more thorough. Hand washing, properly, on the way out of the bathroom and before every meal.

Protecting the one carer

The card's single-carer rule is the most important line on it, because it limits total household exposure rather than spreading it thin.

• Pick the carer deliberately. The healthiest adult, not the most anxious, and not somebody older, pregnant, immunosuppressed or with a heart or lung condition.
• Nobody else goes in. Meals to the door, laundry into a bag at the door, conversation through it.
• Mask on before entering, off after leaving, as the card says. A valved mask protects the wearer and not the patient, so for a carer with a valved respirator, the ill person should also be masked if they can tolerate it.
• Do not touch your face while in the room, and wash hands immediately on leaving, every time, no exceptions.
• The carer needs sleep and food more than anyone. A carer who becomes exhausted becomes the second patient, and then the household has no reserve.
• Second person trained but not exposed. Somebody who knows the routine and steps in only if the carer falls ill, which is exactly the redundancy the knowledge vault argues for.

Watch for the signs of deterioration rather than watching a thermometer: breathlessness at rest, confusion, blue or grey lips, not passing urine, unable to keep fluids down, or a rash that does not fade under a glass. Any of those is a 999 call, and the card's instruction not to go out does not apply to getting somebody real care.