photo: ESPN

Q. The way people are talking, it sounds like we’re all likely to die…are we?

A. No. The chance of dying from Covid-19 is only one in a hundred, 1%. That is a low rate, but keep in mind that it is 10 times higher than the death rate from the flu, which is one in a thousand, or 0.1%. That is the average: the rate of serious illness and death from Covid-19 increases with older age and underlying medical conditions (more on this below.)

The chance of becoming infected with Covid-19 is much higher, over 50% by the time the epidemic is over. During the course of this epidemic, most people will be infected. Most will not be seriously ill, and many will never be aware of being infected (see below.)

Q. Can you get Coronavirus from sex?

A. Yes, very easily. During any kind of close physical contact, you are surrounded by the other person’s exhaled breath, which contains tiny drops of saliva (spit) and nasal mucus. Coronavirus is transferred mainly in the saliva and nasal mucus of infected people, so kissing is an easy way to become infected. The virus is also present in feces (poop), so rimming is especially risky.

In our current situation, the only truly safe sex is sex by yourself (masturbation) or remote sex, like phone, video, email or text sex.

Q. Is sex safer if the person doesn’t look sick and isn’t coughing or sneezing?

A. Not necessarily. People can be infected with the virus for as long as 2 weeks before they feel sick at all. Even though the person feels fine, the amount of virus produced in the body and transmitted to other people during the early days of infection can be very high. Also, about one-quarter of people who become infected never feel or look sick, even though they can pass on the infection to others for weeks.

That is why social distancing is absolutely required to control this epidemic: it won’t keep you safe to just avoid people who look sick.

Q. What if you only have oral sex? Can you have safe sex that way?

A. Only of you can do it without inhaling the other person’s breath, and I don’t think that’s possible. Air is a gas: it flows, swirls, rises and falls.

Q. Is it safe to have sex with a long-term partner?

A. First, it’s unsafe to have sex with a partner unless you live with them, because if you live separately, you have had different exposures and risks of infection.

Second, have you and your partner both been staying at least 6 feet away from everyone other than the people you live with? Have you completely avoided being sexual/physically affectionate with anyone else – no hugs, air-kisses, or handshakes? (Why no air-kisses? Because you are not staying 6 feet away from the person you air-kiss, are you?) Have you both been washing your hands for at least 20 seconds before eating and every time you return home from any trip away front home? Have you both been able to avoid being in a room with anyone who might be sick and with anyone who recently visited anyone sick? If you can answer “yes” to all of these questions, then sex with your long term partner is the safest sex after masturbating.

If you or your partner are at high risk of becoming dangerously ill if you do get infected, it would be smart not to have any type of physical contact and not to sleep in the same bed. High risk people include smokers, anyone over 65, and people of any age with diabetes, lung disease, high blood pressure, heart disease, kidney disease, cancer, or immunosuppression, including HIV.

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Dr. Eva Hersh, MD
Dr. Eva Hersh, MD
Eva Hersh is a family physician. Send your comments and questions to her by email at dreva@baltimoreoutloud.com