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As three co-workers talked over coffee in downtown Minneapolis on Tuesday morning, one listened intently by folding her hands and pressing them against her lips while another rubbed her eyes.

If the best way to avoid coronavirus infection is not to touch your mouth, lips or nose, this coffee klatch is in trouble.

"It would be so hard," said Ashley Sinclair of East Bethel. "I'm always fixing my lip gloss, touching my hair, touching my eyelashes."

Advising people to not touch their faces is one of several recommendations that Minnesota health officials have made in the past month as they prepare for the global outbreak of a novel corona­virus to reach this state — along with asking people to cough into their elbows, wash their hands thoroughly and stock up on medications and provisions so they can stay home from work or school if sick.

The reason is simple enough: Pathogens such as the new coronavirus that emerged in China three months ago can live for short periods of time on surfaces such as doorknobs and railings. People touching those surfaces with their hands can then cause their own illnesses, a process known as self-inoculation, if they then touch orifices on their body.

The solution? Not so simple. Studies have found that most people subconsciously touch their faces multiple times per hour. At the University of New South Wales in Australia, researchers videotaped medical students at a lecture and found they touched their faces 23 times per hour, on average. And nearly half those face-touches involved the eyes, nose or mouth.

"Take note of when you're doing it next time," said Marylouise McLaws, the lead researcher of the study, in an e-mail. "I noticed I'm more likely to put my hands to my face as I read my e-mails. Once we take notice, we can then try to retrain ourselves."

Years of habits aren't easy to undo, said Kris Ehresmann, infectious disease director for the Minnesota Department of Health, who was rubbing her eyes when asked by a reporter about face-touching.

"It's absolutely really difficult to change those behaviors because some of those are kind of reflexive," Ehresmann said. "I struggle with it myself, but if you're aware that it's another way you can possibly become infected, you at least have a little opportunity to influence your behavior."

Among the coffee group, Amanda Stockman of Minneapolis figured she could cut out the face-touching. She has concerns about the corona­virus and has made little changes to her routine such as mailing in a return rather than going back to the mall where she made a purchase.

"It's serious, you know," she said.

Maren Zirbel of Burnsville didn't think she could stop her "thinking pose" of pressing her hands against her mouth when listening to conversation. She said she will try to do what is recommended to protect herself and others, but as the mother of three she figures she's in trouble if the virus spreads widely in Minnesota.

School "is a petri dish, my friend," she said.

Common cold and flu viruses often spread when infected people cough and project droplets in the air that fall on other people. That is why health officials want people exposed to the virus to call their health care providers and to practice social distancing and keep at least 6 feet away from others. Some of those people might be asked to stay at home for 14 days to determine if they are infected.

"If a health care provider or public health worker tells you to stay home for 14 days unless you need medical care, please do that," said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention. "Individual actions can have an impact on how this plays out."

At least one study has found that other coronaviruses — which cause up to a third of common colds — last longer on surfaces than flu viruses. If that holds true for the new coronavirus, it increases the need to wash hands and avoid face-touching, but Michael Osterholm of the University of Minnesota's Center for Infectious Disease Research and Policy said he believes airborne transmission is the greater threat.

"Respiratory transmission, just breathing in the virus, is by the far the driving force," said Osterholm, who as a result believes that social distancing and covering coughs will prevent more illnesses than refraining from face-touching.

Roughly 80% of people suffer mild symptoms when infected by the new virus, according to initial studies, but 1 to 2% of those infected die. The death rate escalates for people who are elderly or have other health problems.

No cases have been confirmed yet in Minnesota, but health officials believe it is only a matter of time given the coronavirus' spread from China to more than 60 countries and 12 U.S. states.

Empty store shelves reflect public concern, as many retailers are running out of soap, face masks and cleaning supplies. Minnesota Health Commissioner Jan Malcolm said people should follow state recommendations to reduce the spread of the virus, particularly to others in the community who are most at risk of severe symptoms.

"It's just so vital," she said, "for all of us to realize there are things we can do to protect ourselves and our family, but also to help with this community response."

Jeremy Olson • 612-673-7744