The 6-Foot Rule for Cystic Fibrosis

In early 2019, a movie began showing in theaters across the country called Five Feet Apart. The previews that aired on television showed two teenagers falling in love. Both of the characters had cystic fibrosis (CF) and were in and out of hospitals as they started a relationship. Although the movie was titled Five Feet Apart, it is based on the 6-foot rule that applies to people with cystic fibrosis.

Why 6 feet apart?

In people with CF, the mucus in the lungs can trap bacteria, causing infection. These infections can be dangerous – even life-threatening – to people with CF. This is why doctors say that patients with CF should stay 6 feet (or more) away from anyone who is sick.

In addition, people with CF should try to stay as far as possible from someone else with CF. This is because people with CF get infections that the general population generally does not catch, and they’re more likely to pass those germs to others with the disease.¹ Experts chose the distance of 6 feet because this is how far germs can spread when a person coughs, sneezes, or even speaks. Keeping 6 feet away from someone else who is sick helps to keep a cystic fibrosis patient from catching the bacteria.

The 6-foot rule is widely known, and some hospitals have strict rules about keeping CF patients away from each other. Others, however, have no policy at all. And many other medical facilities have rules that are somewhere in between.¹

Spreading germs

There are some germs and bacteria that are considered especially dangerous for people with CF. One of those types of bacteria is called pseudomonas. Pseudomonas is one of the most commonly found bacteria in people with cystic fibrosis. Approximately half of all people with CF have pseudomonas. Research says that people with CF can get pseudomonas from other infected people.

The germs can spread via indirect or direct contact. Direct contact includes shaking hands, hugging, kissing, etc. Indirect contact includes touching objects that a person with the germ has recently touched, such as door handles or writing utensils. This is referred to as cross-infection. Cross-infection can occur anywhere, such as on public transportation or in a meeting at work.²

Once pseudomonas is found in a CF patient’s airways, it is very difficult to get rid of the bacteria. Strong medications or other forms of treatments can delay the development of an infection.²

Preventing infection

At a hospital, the healthcare team practices caution to ensure the containment of pseudomonas between people with CF by:²

• Frequent hand-washing and use of hand-sanitizer
• Wearing clean gloves and medical gowns
• Helping people with cystic fibrosis maintain a safe distance (hence the 6-foot rule) between one another when they visit their medical center

Reducing your risk

There are some things you can do to reduce your risk of catching bacteria that causes infection:

1. Keep a safe distance away from anyone who’s sick. Take one long step away from someone who is sick. That’s usually equal to about 6 feet.³
2. Cystic fibrosis patients should not be in the same space as each other. People with CF get infections that people without CF do not catch, and they’re especially likely to transmit those germs to others with the disease.³
3. If you are a student, talk to school leaders about the six-foot rule. This may include being placed in a different classroom, having lunch at different times and scheduling separate times for the use of common spaces such as the library.³
4. Get your shots. Check to make sure that you are up-to-date on all of your immunizations.³
5. Have your own water bottle. Do not use a public water fountain.³
6. Keep your hands clean. Wash your hands and use hand sanitizer throughout the day, especially after you sneeze, cough, and touch shared items.³

Like the characters in Five Feet Apart, life with CF means that you have to make some changes to your daily life to stay as healthy as possible. This includes following the 6-foot rule around other cystic fibrosis patients. There are many lifestyle tips and tricks that can be used to avoid dangerous bacteria.