Thursday, April 16, 2020

Asepsis 101

























From Comments:

"I follow pretty strict aseptic procedure - what I learned in microbiology class 42 years ago... but *very* few others do that. If everybody wears a mask, there's no reason for lockdown or quarantine, because the mask can prevent you from passing on the virus to others, something that people just don't seem to get, and the other thing is that it stops you from touching your mouth and nose... and there are simple instructions for making masks from common household materials online."
Yes, but.

You learned this in a higher-level class when Reagan or Carter was president.
That was a different world then.

Dipshits from later generations, by actual firsthand observation:

Wearing mask and gloves, touching everything with said gloves, transmits virus to everything he touches (his car, cell phone, wallet, everything else).
Then, can't get cell phone screen to work with gloves on, so
a) pulls mask down
b) pulls infected contaminated glove off with mouth
c) touches infected contaminated cell phone screen with bare finger
d) puts glove back on and pulls up mask when finished.

Assume afterwards:
e) Can't figure out how he got Kung Flu, and asymptomatically carried and spread it to his entire office group, apartment complex, or dorm.


Fine for everyday use.
Not so bright with nitrile gloves and surgical
 masks, during a pandemic. Sorry if this is news
to you, Common Core grads.
"Virus on my fingers? Wait, whut?"




























If you therefore want to require an IQ test and mandatory sterile procedure class, with 100% as benchmark for pass/fail, for being let out of quarantine, I will march in your parade and subscribe to your newsletter.

Otherwise, most people are too stupid to let loose without a keeper, or at minimum, a class on how to do this right run by Dominican nuns with 3' sections of rebar in lieu of rulers.

Hints For Morons:
Do whatever you want. We'll be on lockdown forever. Fuck everybody else, amirite?
Suture self.

Hints For Non-Morons:

After you put it on, the outside of the mask is contaminated.
After you wear them once, the gloves are contaminated.
PERIOD.

You can remove the mask after wearing it for prolonged periods, and put it inside a bag, if you're going to decontaminate/sterilize it, using heat or disinfectants. If you don't do that, don't bother wearing the mask at all, and revert to the instructions for Morons.

The gloves are single use. You may put them on, but once you touch things (doorhandles, products in stores, counter tops, etc.) out in the Big Wide Nasty Infectious World, you cannot touch or handle anything else from the Clean World (like your cell phone, car door handles, steering wheel, wallet, glasses, keys, money, debit card, etc.) You can take the gloves off*, discard them, and then and only then touch your personal items.
You must re-glove with a fresh pair of gloves before touching new contaminated things in the Big Wide Nasty Infectious World, and the same rules for putting them on and taking them off apply, EVERY TIME, WITHOUT FAIL.

Period.

Some of us had personal decon beaten into us by wearing MOPP-4 and going through a gas chamber a time or five, and some of us learned it in well-run microbio classes, like a our commenter. And a subset got it both ways. Those who didn't get it either way ought to pay serious attention.

Don't have a BOX (or BOXES) of gloves? Every day? For every trip outside your personal bubble? Until the lockdowns end?
You can't play this game.

We tried to tell you that long, long ago. Most of you don't have enough supplies for this.
Like the honey badger, a viral pandemic doesn't give a shit.
Do it right, or stay your ass home.

Or else you're going to infect people, and possibly kill some of them with your needless, thoughtless, callous stupidity.

This is why you can't have nice things, and why we're all, most of us (okay, most of you), locked down until further notice. Because Joe Average can't handle the truth, nor follow simple directions. This is what happens when stupid people breed, and there are no saber-toothed tigers handy 24/7 to winnow out the less-than-bright. Kung Flu is standing in for the tigers this year. Mind the pathogen, folks.

The problem is the Gilligans don't have signs on their heads, or we could simply throw them into the volcano right off, and be done with it. Instead, they'll kill us all without realizing it, and have that stupid look on their face after they realize they've done it, but too late to save the non-Gilligans.
























And the very worst of them will blame the non-Gilligans for being susceptible.
Like they do.


But if you can master asepsis, and follow it, your chances of having a problem with Kung Flu approach 0% very rapidly.
Now, see if you can see both a way out of quarantine, and spot the Not-So-Hidden Flaw in this approach.







*(Approved glove removal method: Put your dominant hand in your non-dominant hand. Curl it slightly. Peel the dominant-hand glove near - but not under - the cuff, stripping it off that hand and rolling it with the non-dominant hand into a little ball. Take the ungloved hand, slip a finger under the cuff, and strip it off the other hand, turning it inside out, so the sweaty, but clean, inside is now the outside of the whole ball. You now have a dirty glove bundle you can touch with bare hands. Discard it appropriately in the trash. Which does not mean "wherever you feel like throwing it down". In the trash means in the trash, please. No one else wants to handle your nasty contaminated glove ball either.)

38 comments:

Domo said...

The number of people I've seen eating crisps (chips) with gloves on is staggering.
PPE, it works by magic.....

Robin Datta said...

Maintaining an uncontaminated state inside in a contaminated environment is orders of magnitude more difficult than maintaining external sterility with a non-sterile inside. The former is well above the pay grade of most of the poochpulation, and will be observed more in the breach than in practice, even with dedicated formal training as in the military. Sans such training, it is idiotic to expect the masses to perform in any manner even remotely resembling an effort to avoid conramination.

FredLewers said...

None of this shit is gonna make a damn bit of difference because there's too many dumbass people out there. Actually had to go to the store today. Social distancing signs EVERYWHERE. ON STANDS AT CHEST HEIGHT IN BOLD LETTERS. SIGNS ON THE FLOOR INDICATING APPROPRIATE INTERVALS! PEOPLE WEARING MASKS TOO. An individual with the following traits: clearly Hispanic and immigrant, dirty and sweaty, no mask, arms full of items she's purchasing walks right up to me. So close I bumped her as I moved back 6"-12" from counter after setting my two items down.
Yeah... This one is gonna go the distance. Third world immigrants and local white trash are why we can't have nice things and friendly customs...
Yup, WE ARE GOING TO BE SHUT DOWN FOREVER! Or until the grownups say fuck it. We're talking our government back at gunpoint! You immigrants can go home or join a chain gang for a year or so and then go home. You dumbass local knuckleheads go get in that line for your beating and labor crew assignments. Grandma, go home and stay put. Well drop off groceries in sanitized containers once every two weeks. Mr ambassador from PRC? Yes you. GTFO. And take that cargo ship of crappy products with you. When you lying communist bastards can act like humans we'll talk. Until then fuck off and die. Wall Street, DNC & RNC, we're reneging on the national debt. If y'all want to deal with the IMF have at it but we the people ain't cosigning for shit!
And by the way constitutional carry is now in effect. Y'all get some manners or get shot. Your choice.

Unknown said...

So...I have a question about this proposed thesis that no one needs to stay at home if we all wear a mask, up to and including the homemade ones: how are the homemade masks supposed to protect from the virus? If you're wearing a cloth mask made at home, how do the tiny virus particles not get through the cloth? Coffee filters? How does that work as an effective filter?

I'm not too sure but something seems to be missing here. To keep people from touching their faces the cloth ones are good, but they are not hospital level PPE.

-Rhea

Unknownsailor said...

"Social distancing signs EVERYWHERE. ON STANDS AT CHEST HEIGHT IN BOLD LETTERS."

My second to last duty office in the Navy was running the HAZMAT issue office on an aircraft carrier. If you needed any sort of HAZMAT that was not spray paint, or paint for the ship, you came to my office for what you needed. Grease, aircraft paint, detergents, Simple Green, etc. etc. I had a storeroom full of the stuff.

I was open for limited times during the day so I could do storeroom maintenance, catch up on paperwork, send my minions to chow, etc. I would post my hours on the outside door, in printed signs, 72 point font. Eye level.

People would still knock on the door when we were closed and ask if we were open, when we would open, etc.

No, people don't read signs, even when they are literally right in front of their face.

I also know about wearing of nitrile gloves because of that job. Once on, they stay on, and anything they touch is by definition "unclean" after I handle the first piece of HAZMAT while wearing a pair. Nothing I handled went into my mouth, and I did not touch myself or others while wearing them. Need to visit the head, go eat, etc? Take them off by turning inside out as they come off, throw them away, and wash my hands, then handle stuff.

We didn't stock anything with exotic handling procedures, or highly toxic, so we didn't need anything more than your average car mechanic does, but still, I didn't want to ingest moly grease, so I wore my gloves.

Phelps said...

Dunning Kruger. The problem is all the gilligans THINK they are the professor.

Bill Quick said...

The guidelines for Making America Open Again are out:

https://www.cnn.com/2020/04/16/politics/read-guidelines-for-opening-america/index.html

Just a hunch, but I think we're probably bum-humped at this point.

Phelps said...

PPE is magic.

That is actually how they think. That is why they take the mask off their nose “to breathe easier.” They have no concept of the mechanisms, and think it is just a magic talisman that wards off sickness. They rationalize it to sound smart, but until they think about it, it’s magic.

And they won’t think about it.

ThatWouldBeTelling said...

FredLewers: I've been thinking about how the standout exceptions to handling COVID-19 are ethnically homogeneous, with high IQ "high Asian" populations, Singapore a partial exception that perhaps proves the rule. Although it of course doesn't hurt that Taiwan and Japan (not sure if they're handling it well) are islands, and South Korea effectively so.

You Latino example? From a population generically 1/2 SD IQ below the American average, which has been dropping for some time.

I don't know how this is going to play out, except it's hard to see it being anything but ugly. We'll loosen up, "Trump/Republicans are killing peopleeeeee!!!", cases, followed by deaths, will increase unless we find effective therapies. We'll tighten down, we'll get more upset at our current rulers and Those Who Are No Longer (or Never Were) Our Countrymen, it's going to be a mess.

Especially as various things get in shorter supply. Which we don't see Team Trump caring much about, when there should for example be a major push to redirect the food service supply chain to consumers. Although as far as I know they're not getting in the way of this happening at the state and lower levels.

Will things get "better" in the way you envision? I don't think we can confidently predict that the liberalism that has prevented us from handling this intelligently will be easily dispensed with, its proponents certainly haven't cared about the millions it's already killed, tens of millions in its more virulent forms in the 20th Century. "We're talking our government back at gunpoint!" is hot shooting Civil War 2.0, when our cold civil war is already hindering our response. E.g. we're pretty clearly entitled to think the FDA's blocking of non-CDC testing prior to February 29th was malicious, given how insane some of their off the cuff roadblocks were.

Greg said...

Pessimism is very much warranted. Thank you for the post Aesop, but teaching aseptic technique to the masses is hopeless. My wife was watching some viral pandemic movie (I don't know which one) yesterday, and the (gorgeous) lead doctor garbs up in a full hazmat suit, visits the patient in the negative pressure chamber, comes back out of the room and removes the hood, gown, and gloves with exactly the contaminating process of touching everything on the outside, exposed surfaces with bare hands, and dropping it all on the counter at the nurses station.
I learned the hard way by violating a sterile field about 40 years ago, and I'll never forget the chewing out I got. We all make mistakes, but I've always tried to make my mistakes ONCE only.
Even the best PPE, properly donned and DOFFED, only helps your odds. It's never 100%.
Wishing you the best of luck Aesop, I am so relieved to be retired from the hellhole of sepsis that I worked in. I've been lucky.

Night driver said...

NOR do we want to step out of our car and step on your nasty, contaminated sweaty, germy glove, because you pulled it off and dropped it next to your car as you opened the door.
AND because you just yanked it off and dropped it, *I* can't tell whether it is "clean side" out or not.
Congrats doofus, you just enlisted ME in your efforts to spread this thing around a LOT MORE. EVERY STEP I TAKE with that foot I'm printing a footprint of China Grippe because I couldn't see your donation to the cause until I was OUT of my car.
Which means I don't get to deliver to you what you have so CLEARLY EARNED and so RICHLY DESERVE!!!

I spent a BUNCH of years learning the HARD way that these things are NOT COMFORTABLE to live in, and to forget JUST ONCE can fuck you up PERMANENTLY and pretty damn FAST as well.

MY learning wasn't limited to hospitals where the temps are nice. MINE was in the streets where SUMMER is DAMN HOT and WINTER is FRIGGIN COLD, and my gloves were ALWAYS TRYING to fuck me up.

PLEASE try to unfuck your selves before the next round shows up.

Because there is ALWAYS a "next round".


Night Driver

FredLewers said...

Well I watched the presser about opening the country up again. Seeing how I live in a rural area, we might get an early release. Y'all city slickers are well and truly fucked. I'm gonna watch the numbers closely and be looking for that 14 day decline.
On another note, this is going to hammer people on property taxes since TPTB ain't gonna give up those cushy benefits... There's gonna be some epic incumbent firing in the next year or two. And if we're lucky some defenestrations. The lawyers are going to have a field day.

Domo said...

Oh yep, thats another one, mask under nose at all times, taking mask off to sneeze or cough too

Test Blog said...

Hi Aesop,
I'm a bit of a germaphobe and I was wiping all the touch surfaces in hotel rooms before it became a thing, but I digress...
I agree that giving people a false sense of security that if they wear some type of PPE, they will be fine. In my few forays out, if I do see someone in PPE, the majority of the time they are not wearing it properly. They also forget about all the other small things that are disease vectors. For women, that would be their purses. I used to tote around a canvas type "library" bag as my purse/catchall for everyday use. I ditched the purse and use a very cheap plastic zip bag like they sell for stadium events at the dollar store. It's easy to wipe down and keep (marginally) clean - at least, cleaner than my regular duty "purse". I am shocked at the number of women who will bring their purse/bag home and plop it down on a kitchen counter, table, etc ..... GROSS.
As far as gloves, I don't expect to be able to maintain perfect aseptic technique. All I am hoping for is to minimize my exposure and viral load. Same with a N95 mask, which I wear under another bandana to help keep the mask in place, both of which I reuse and I sanitize the N95 mask in the oven. I do keep a box of gloves, and a grocery store bag to dispose them in, in my car. I also take just one payment card that day for whatever I am buying, and I have a sani-wipe with me while I wait in line to pay. I then wipe down the payment card, and my gloved hands, before it goes back in the clear plastic "purse". I dispose of them before I enter my car and I also wipe down my "purses" etc before I get in my car. I live in Florida, and normally, I would keep a sunshade in the windows to help keep the car cooler, but I am not using them and letting the interior of the car get hot, and stay hot, as another way of helping reduce the viral load. I frequently wipe down touch surfaces in my car as well. Also a microbiology student back in the early 80's - in no way shape or form do I kid myself that my efforts are maintaining aseptic technique or are some magic bullet against getting tagged with the Rona.

I can only hope that people will pay as much attention to looking after their nutrition and supplementation, making sure that they have adequate Vit A, D, C, Zinc, Selenium, Copper, etc in their system. I am still seeing shopping carts filled with absolute crap - soda, frozen pizza, easy to heat and consume items - and very few people actually buying nutritional foods that will help support their immune system and help keep them healthy.
People don't want to change, and therefore, won't. I think there is a not-insignificant subset of the population that is enjoying the fear pr0n and "being scared".

Test Blog said...

@Night Driver
It appears ditching gloves in parking lots is the new dirty diaper surprise.
My daughter is also reporting she is more aware of people spitting and hawking up phlegm balls than she was before which disturbs her greatly. Beyond gross.
Anecdotally, my daughter's place of work is having the Rona work its way through, three shifts are down to one shift operational because of the Rona, and my daughter was sent home from work on Friday by the plant hygienist for "bronchitis". She had been using a mask at work and some OTC nasal saline spray. She was not offered, nor did she take, a CVD test. Our local public health says you must phone them for a phone screening, and then they will direct you to a clinic or hospital with a confirmation code type thing. She had been "sick" for about a week prior to being sent home.

She did neti pot rinse with some solutions additives that include zinc drops and some essential oils every 8 hrs and nebulizer with plain saline every 12 hrs (no albuterol or similar etc), and supplemented with quercetin, zinc, zinc lozenges, selenium and NAC (N-Acetyl Cysteine). The neti pot seemed to really help with the swelling and inflammation of the nose/sinus area. She started feeling better after 12 hrs, the gunk in the chest started loosening up, with 24 hrs she didn't feel like she wanted to sleep constantly from being ultra fatigued, and within 48 hrs she was back at work feeling her regular self and no longer with fever, fatigue, chest involvement, etc. Not a case study by any stretch, and she's typically very healthy (eats well, is on her corporate bike team, etc) but I have also used the same combo when getting run down and had similar results. I think the main thing is to try and get ahead of it, so hopefully you don't need to seek more aggressive medical intervention. YMMV.

Don RN said...

I trained with MOPP4 as a Navy Nurse.

Most important lesson I learned? ... If I was in an environment that required MOPP4, my first step after donning it should probably be to bend over and kiss my a** good bye, because I was most likely going to end up screwed no matter how careful I was.

Still, wear the MOPP4 & follow protocol, might just get lucky.

Robin Datta said...

One of hospitals in the area many moons ago had a rash of patients with implantation of prosthetic heart valves and post-op MRSA infections of those valves. To make a long story short, it was traced to a cardiac surgeon who wore the mask to the upper lip at the base of his nostrils so he could breathe easier.

And Fauxi is the head of the National Institute of Allergic and Infectious Diseases (NIAID) which comes under the HHS, as does the FDA, the CDC and the FDA. It was the FDA that was instrumental in delaying the production of COVID-19 tests and blocking the importation of fully functional and effectively deployed tests from places like South Korea.

Aesop said...

@Don RN,

My experience with NBC and MOPP gear was similar: like 4WD, it's only use is to get you out of a problem, not into it.

Unknown said...

I remember getting a lesson in how quick contamination can get out of hand from my kid. We had just come out of the field doing NBC (nuclear chemical biological) training. This was back when field artillery was a nuclear/chemical delivery system. Decontamination procedures we're fresh on my mind. Being the good husband/father I took a turn changing my kid's diaper -they we're maybe one year old. Things were going swell when I noticed a bit of poop on the table. No problem - just a quick wipe and Charlie Mike. Then it was on my elbow. And my shirt. Wipe, wipe. Then just a little on the wall. I had no clue how it got there. Then on the back of my hand. Not much...just a little. WTF?!? It was everywhere out of hand quick. In a 'controled'environment. I remember thinking if this was persistent nerve agent I would be doing the kicking chicken real quick. Shit got out of hand quick but with my kid I could see and smell it to track the spread. The same principle applies to the beer virus. Contamination will get out of hand quick even when you think you have a handle on it.Only you cannot see you smell where it has spread. And remember It only takes a little dab to infect you. Bad juju.

RSR said...

https://www.boston25news.com/news/cdc-reviewing-stunning-universal-testing-results-boston-homeless-shelter/Z253TFBO6RG4HCUAARBO4YWO64/

" The Centers for Disease Control and Prevention is now “actively looking into” results from universal COVID-19 testing at Pine Street Inn homeless shelter.

The broad-scale testing took place at the shelter in Boston’s South End a week and a half ago because of a small cluster of cases there.

Of the 397 people tested, 146 people tested positive. Not a single one had any symptoms.

“It was like a double knockout punch. The number of positives was shocking, but the fact that 100 percent of the positives had no symptoms was equally shocking,” said Dr. Jim O’Connell, president of Boston Health Care for the Homeless Program, which provides medical care at the city’s shelters.

O’Connell said that the findings have changed the future of COVID-19 screenings at Boston’s homeless shelters.

“All the screening we were doing before this was based on whether you had a fever above 100.4 and whether you had symptoms,” said O’Connell. “How much of the COVID virus is being passed by people who don’t even know they have it?”

The 146 people who tested positive were immediately moved to two different temporary isolation facilities in Boston. According to O’Connell, only one of those patients needed hospital care, and many continue to show no symptoms.

The Centers for Disease Control and Prevention is now "actively looking into" results from universal COVID-19 testing at Pine Street Inn homeless shelter.
“If we did universal testing among the general population, would these numbers be similar?” said Lyndia Downie, president and executive director at the Pine Street Inn. “I think there are no many asymptomatic people right now. We just don’t know. We don’t have enough data on universal testing to understand how many asymptomatic people are contagious.”"

Robin Datta said...

Rationing COVID-19 tests for only sufficiently symptomatic persons leaves out the very substantial asymptomatic part of the infected population, so they are free to spread the wealth until they become immune. That's (depending on whose numbers you use) 25% to 50% of the infected population.

The solution is to get MOAR (by several orders of magnitude) tests: from South Korea or Germany or wherever, if necessary. They need to get it to displace the cranial ordure that they must t-effing e-effing s-effing t-effing the entire population or close to it, if necessary several times over.

Aesop said...

I repeat: you have to test everybody, and see who's got it, and who's had it. Unless you don't have it, or had it and got over it, you stay in the bag until you're clean.

Otherwise we're just going to do NYFC another 50 or 100 times.

Robin Datta said...

When the priestly class in medicine have impervious ordure filled crania into which it is well nigh impossible to implant the concept of universal testing, it was time a couple of months ago to do something drastic and irreversible to get the priests out of policymaking.
And if the test for the virus returns a negative result, it means uninfected (and susceptible) or previously infected, cleared the virus and became immune (and has the antibody for which there should be an antibody test).

Bill Quick said...

Phelps: That is actually how they think. That is why they take the mask off their nose “to breathe easier.” They have no concept of the mechanisms, and think it is just a magic talisman that wards off sickness. They rationalize it to sound smart, but until they think about it, it’s magic.

Which is why people swallowed without a murmur the notion that masks would work for people with MD and RN after their names, but not for common folk like themselves. The masks were magic, you see.

TechieDude said...

I made the mistake of going to the local walmart. I knew better. One of the supermarket chains here - Tom Thumb (aka randalls, safeway) are the best run. They are well stocked, and Normal people are in there shopping. They are a little more expensive.

But no walmartians.

I can't even begin to describe what half these people were wearing. Saw a dude in a face shield, many in bandannas shear enough you could see their gob flapping under it. More than a few vibrants with the mask under their noses.

Few old ladies in what appeared to be n95 masks, with the folds of their jowels leaving big air gaps.

I was joking about them to the wife, and she says "Well, it's better than nothing". I replied, no, It's the same as nothing.

Worst is the gloves I see discarded on the ground. FFS, I was mowing my yard, and in the front was a glove. One glove. They just peeled it off and left it.

If there wasn't corona around, I'd swear someone got a hooker handjob in my yard.

ThatWouldBeTelling said...

frozen pizza

While I agree filling your cart with stuff like it is unwise in many ways, I consider such to be treats to help maintain morale, along with a favorite type of bratwurst, chocolate, etc.

On the other hand, something recognized back in the days of nuclear war grade "survivalism" is that too radical, too quick a change of people's diet is bad. Some people will simply refuse to eat completely different and much less appealing rations. I'm easing myself into my new diet, nothing more than eggs and my midday treat of various Asian style noodles (most as healthy as any variety of pasta) which I've long stockpiled to take advantage of quantity discounts looks like it's going to remain. Can't even get any of the types of bacon I find worth eating.

The solution [to only testing the very symptomatic] is to get MOAR (by several orders of magnitude) tests: from South Korea or Germany or wherever, if necessary.

More likely we're hitting limits on capacity to process tests, than the raw materials that make up test kits (and the latter is about the only thing the media is capable of understanding). CMS was also capping CDC protocol tests at or below break even for lab, non-CDC tests at $51, which appears to have been a mistake, since they just doubled that if you're using high capacity machines like the Roche cobas 6800 and 8800. Price controls are one of the very most reliable ways to create shortages, and existing labs are getting hammered by the massive decrease in normal everyday testing. Quest has lost 40% of its business overall, that's including all the SARS-CoV-2 testing they're now doing.

Unknown: Corona-chan is slightly a bit more favorable to us than persistent nerve agents like VX, getting it on your skin is OK as long as you don't let it spread like your baby poop example, and then inoculate your eyes, nose, or probably mouth. It dies on its own accord, fairly quickly depending on the material it's on, and the more it's spread, the less likely any one spot has an infective dose. Or perhaps enough of a dose to make you very sick, we're speculating the level of the initial dose has a big influence on outcomes.

But your example is a very good illustration; every time you go out into an environment with likely high viral loads, there's a significant chance you're going to infect yourself, and/or being an infective dose back to your dwelling.

Phelps said...

@Testblog

Get her a pulse-ox meter and keep an eye on her O2 levels. In my layperson's opinion, that's a much better indicator than our hit-and-miss tests.

Also, with just general crud, I've had a lot of success with big doses of Liposomal Vitamin C. LivOn Labs makes the stuff I use, but it's crazy expensive right now. Liposomal is the only way short of an IV that you can get 3-5 grams of the stuff into your system at once without stomach cramps and explosive diarrhea (not something you want when you are sick.) Taking 2g (2000mg) every four hours usually kicks the shit out of whatever I have in 24-36 hours.

Survivormann99 said...

In a perfect world, it is my understanding that in the medical profession, N95 masks are used while treating one patient and are then tossed. I have heard that recently in many institutions, healthcare workers have been issued one mask to use for the entire day because supplies of masks were limited.

Regarding nitrile or latex gloves, I certainly understand that using them just once is the best choice. However, if the supply of gloves is limited, wouldn't simply submerging them in either an alcohol or hydrogen peroxide bath for a significant period remove the contamination? I would also think that washing them well would remove any virus, though the risk of failure would increase.

Am I wrong?

Survivormann99 said...

I seem to recall that the coronavirus remains viable for up to 9 days on most surfaces. (I saw that the virus was found on one of those cruise ships well beyond 9 days, but I believe that this was described as being an aberration.)

Here is what appears to be an authoritative source concerning disinfecting N95 masks: https://utrf.tennessee.edu/information-faqs-performance-protection-sterilization-of-masks-against-covid-19/ Note that he is saying that you can't simply put them in an oven without damaging them if they are too close to metal. Obviously, this would include the sides of the oven and the metal racks.

for those who might be reluctant to try this disinfection method, wouldn't simply setting a used mask aside for 9 days and re-using it on the 10th day work?

Aesop said...

Washing gloves to reuse them is iffy at best. Many have micro-holes as well. So using them twice, like a mosquito net with a hole, makes you the bait.

With masks, there are a number of methods, and usually, the only problem is that the mask is sturdier than the elastic straps that hold it in place.

If possible in health care, they, like gloves, are single use, but with current shortages, one-and-done has become a luxury.

Hope@ZeroKelvin said...

Still running about 9-14% of people tested being positive for covid19 here in Texas. We have not instituted mass testing, just testing people with travel or exposure risk factors.

Of note, testing centers have been set up all over the Houston metroplex area.

Our mortality rate in our hospital systems in Houston is between 1-3% of positive tests done at the hospitals and contact traced to # of deaths. Statewide for Texas is 2.4% of total positive tests and deaths. (A crude way to estimate CFR but I am not an epidemiologist.)

With the revised IMHE modeling, we are projected to have adequate total hospital beds, ICUs, ventilators and PPE in the Houston area. (I think this is the first time that all these hospitals actually know how many beds, ICU beds, staff and ventilators in their histories, lol).

Of course, all elective non-emergent surgeries/procedures have been cancelled, even imaging if done in a hospital, and patients triaged in the ER to be treated at home for conditions that would have otherwise resulted in admission.

We are scheduled to reach our peak 4/24 in Texas.

One huge caveat on Texas numbers. I do not think the numbers of positive cases in the Texas Dept of Corrections & Justice (TDCJ) are being reported and I know there is currently outbreaks in all the TCDJ units. Texas is not releasing anyone from prisons, which are under state control but some of our lunatic progtard county judges have released people from the county jails. Good thing most Texans are heavily armed at all times and people are rarely, if ever, convicted with shooting criminals, as long as it is in defense of life or property.

The other caveat about covid death stats is that patients are being classed as a covid death whether they are tested positive or only suspected of being positive but never tested or the test not confirmed by the CDC. That is U07.1 for the icd10 coding geeks out there.

Since the states are getting $15,000 (or so) per covid death from the feds, well, you can see where that is going.

Here is the pdf from CMS that speaks to this. It is the usual word salad from CMS for any of you that have to read their guidelines, for your sins.

https://www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf

In a previous post, I estimated that the total US death rate was going to be between 71-120K, based on the data that had been reported, not those models which were all wildly overblown. Hope I am at the lower level but we are not yet at our peak.

I have read through the fed.gov plan for opening the country. Here it is: https://www.scribd.com/document/456768927/Opening-Up-America-Again#from_embed

It seems reasonable on first pass but assumes a compliant public and erosion of most of our civil liberties (with permanent government intrusion into our private lives). It also requires a level of accuracy and verifiability of numbers that may not be achievable in real time.

It is the 2nd 3rd and 4th order economic effects that keep me up at night, particularly the effects on the food chain.

Stay safe, stay sane, stay vigilant.




ThatWouldBeTelling said...

I seem to recall that the coronavirus remains viable for up to 9 days on most surfaces.

Fortunately not true, that would be extraordinarily bad. If you want the science details, learn about the lipid bilayer that makes Corona-chans "envelope", it's a bit of membrane stolen from a host cell as the virus buds off. For the hard core details, this is the best I've come across.

TL;DR: about two dimensions, like and unlike, porous and non-porous. Porous and enough alike, American (uncoated) cardboard is probably a nearly instant death sentence to an enveloped virus, it's likely to tear apart its envelope as more and more of it clings to the flat surface. Polished steel and other non-virucidal metals are non-porous (note how many disinfectants only discus how they work on non-porous surfaces), and very unlike the surfaces of a virus, so with the right environmental conditions, you might get that 9 day life. Or so scientists have coaxed out of viruses in the lab, I use 7 days for my max.

And since they're unlike, the viruses don't stick well to metal non-porous surfaces, potentially leading to your touching one laden with viruses from a carrier, transferring enough to your hands, skin that it'll stick more to, and then if you touch your eyes, nose, or probably mouth for this, you may get an infective dose. Although I think we're more and more thinking breathing in a cloud of droplets filled with viruses is the major transmission mechanism, perhaps unlike the common cold and the flu.

I saw that the virus was found on one of those cruise ships well beyond 9 days, but I believe that this was described as being an aberration.

There's likely to be a long tail distribution, but first, did they really check for viable viruses, or just the few bits of them that RT-PCR tests check for. Only way to do that is by proxy, can you you fully sequence the viruses genetic code, which is a single strand of RNA, or for real in a BSL-3 lab, can you culture it in cells.

for those who might be reluctant to try this disinfection method, wouldn't simply setting a used mask aside for 9 days and re-using it on the 10th day work?

That's what I'd do with my P100 filters, but I'm entirely unconfident about my ability to go outside, get covered in viruses (might be hard here, we have community spread but very few confirmed cases), and then take off my PPE and otherwise decontaminate myself without also inoculating myself. As others have superbly commented on.

ThatWouldBeTelling said...

When the priestly class in medicine have impervious ordure filled crania into which it is well nigh impossible to implant the concept of universal testing, it was time a couple of months ago to do something drastic and irreversible to get the priests out of policymaking.

It's iffy to advocate something we wouldn't be able to do for months, while everyone knows testing is a catastrophic disaster that is killing people right now, and until recently in for example the case of CMS we were too damned cheap to pay for lots of testing, they setting reimbursement at or below cost. At the same time labs that also do normal testing are getting crushed by massively less testing for other stuff, Quest reported they're getting 40% less, which includes all the SARS-CoV-2 tests they're now doing.

The biggest problem is that the CDC and especially the FDA, with the help of an insane law, sandbagged the rest of the nation for 1 and 2/3rds months, during which only 4,000 people were tested. The FDA got spanked for what I'm suspecting was deliberate malice, and stared opening the gates on testing February 29th, but by then way too many Americans had it, and our leaders were denied hard data that might have prompted serious action. Although I doubt it, liberalism is way more important than people's lives for now.

And if the test for the virus returns a negative result, it means uninfected (and susceptible) or previously infected, cleared the virus and became immune (and has the antibody for which there should be an antibody test).

Or false negative, infected but some part of the testing process didn't work. And I've seen credible claims tests for antibodies generically have a 4% false positive rate due to the messiness of our immune systems.

I just don't see a way testing alone will get us out of this, something our host with his universal testing scheme agrees with. Strict contact tracing is needed, for example, but people's privacy to infect other people is more important than saving lives.

ThatWouldBeTelling said...

Washing gloves to reuse them is iffy at best. Many have micro-holes as well. So using them twice, like a mosquito net with a hole, makes you the bait.

Maybe depends on the purpose of the glove?? Do you think I'm incorrect in believing that using a scrub brush and generic liquid soap for 10s of seconds will destroy or wash off all/enough of any SARS-CoV-2 viruses on my hands after they may have been contaminated by, probable worst case because no time for them to die off by themselves, handling delivered groceries and their plastic bags?

I've been doing that to conserve my not tiny but still quite limited glove supply, but maybe that's a mistake, especially as the risk goes up, my state as a whole is not flattening the curve, but the numbers of confirmed cases in my area are too small to draw any conclusions from. Plus you've got to be symptomatic to get a test (#(*&^%#* FDA).

For you, I know there's also the fervent desire not to get for example a blood borne disease, and with severe shortages of PPE, the hard to achieve desire of not transferring something from patient A to B (and C, D, etc...).

From Norway said...

Today we were prepared for the future here in Norway by the government. Worst is over. Next week starts phase two. Start opening schools in groups of six, everyone to work with care, but no groups of people. They mentioned phase three, were it would be still limited, with no mass activity. Phase three will last 2 years they claim.

I do not understand why they do not isolate every kommune ( like a county I suppose) for a month, with exchange of goods in designated locations, and problem solved.

Test Blog said...

@Phelps
Yes, we just ordered a pulse oximeter as part of our at-home medical kit, along with stethoscope, BP cuff & nebulizer. The oximeter hadn't arrived when we got sick, so we had to make do with what we had on hand.

Ominous Cowherd said...

I repeat: you have to test everybody, and see who's got it, and who's had it. Unless you don't have it, or had it and got over it, you stay in the bag until you're clean.

South Korea made that work, because they started in time.

Thanks to the CCP and their allies in the CDC and FDA, most states didn't even begin testing until we were deep into ``everybody gets it'' territory. By now, it's possible that in places like New York everyone who is susceptible has already gotten it. When new cases start to drop off, it might be effective control measures ... or it might be nobody left to get it.

Ominous Cowherd said...

Liposomal is the only way short of an IV that you can get 3-5 grams of the stuff into your system at once without stomach cramps and explosive diarrhea (not something you want when you are sick.) Taking 2g (2000mg) every four hours usually kicks the shit out of whatever I have in 24-36 hours.

People keep writing that digestive upset stuff. I've never experienced it. If you think you're sick, gorge on C until you start to get diarrhea, or until you get better.

I routinely take 4 grams of ascorbic acid per hour when I might have a virus, and I'll usually lead off with 10 grams or so in the first hour. I'll suck on 500mg chewable C tablets too, if I have a sore throat. I've never had any sort of digestive upset from it. My grown children do the same thing, with the same results: the illness is gone in 24 hours.