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Basic Protection in a Respiratory Epidemic
The novel coronavirus infection that started in China is now making its way around the world. There is no need to panic. Hopefully, our public health measures will contain the spread within the US to make it at best a minor issue. Personally, I think it would be prudent to halt travel to and from China at this point, or at least insist on a strict quarantine for anyone arriving from China.
However, what if it does get a major toehold in the US and you need to take action? What can you do to protect yourself and your family?
First, the most important factor is simple common sense and good hygiene. Wash your hands, wash your hands, wash your hands! Twenty seconds with soap and hot water is number one; if that’s not available, an alcohol-based hand sanitizer is also helpful. Next, don’t touch your face or eyes. Anytime you touch a surface in public, cleanse your hands. Make sure you have some type of sanitizer to wipe down any surfaces at home or where you work.
What if you feel the need for some more active measures to protect yourself?
Masks can be helpful. Simple cloth masks have limited utility. Actually, masks are most effective when placed on the source of infection. If you want to go to a more effective method, the N95 respirator is used by most health care providers.
These are (currently) available at hardware stores, Walmart, and Amazon. Ideally, in the hospital they do a “fit test” to ensure a proper seal.
Doing a little research I found that the effectiveness of these masks is significantly enhanced if you place a “seal” of vaseline around the edge of the mask.
Additionally, you need to protect your eyes. The virus can be caught from exposure to the mucus membranes in the eye. Get yourself a pair of goggles. Swim goggles would work well, they form a tight seal around the eye, could probably be soaked in a sanitizer to allow reuse. Otherwise, any goodies that provide a good seal around the eyes will work.
Disclaimer:
I’m a simple ER doc. I don’t claim to be a virologist or infectious disease expert. I would welcome any input from anyone here with more expertise.
Good luck all. Remember that old Chinese curse: “May you live in interesting times.”
Published in General
Making EMS calls and doing ER rotations one thing that amazes me is how often people will either not tell you everything or flat out Lie. Like the guy we strapped to a backboard to get him down off of the porch of basically a shack, and then after we got him in the ambulance his wife told us he had Hep C. Lots of LEO’s and medics get needle sticks after the patient clearly told them he or she didn’t have anything sharp in their pockets.
So you are on your own lookout for as far as protecting yourself. Assuming most people try to do the right thing is reasonable. Assuming everyone does is a mistake.
Yeah. Had multiple patients who I asked “any medical problems?” who answered no, only to find out they were HIV positive. When you confront them they get angry and tell me “it’s none of your business”.
Good thread.
Another simple piece of advice: get a flu shot.
How does getting vaccinated against a different virus help you against coronavirus? It’s because the two have very similar symptoms at first. And in a genuine epidemic situation, doctors probably won’t be able to perform a specific test for the virus on every patient who presents with a fever and respiratory symptoms. So the fewer people with respiratory infections, the less chance for misdiagnosis, the less chance that you will go to the hospital without a coronavirus infection and end up contracting the coronavirus from another patient.
And: the less chance that you will needlessly scare yourself to death thinking you have a coronavirus infection when you “just” have the flu.
Added bonus: if – as is usually the case with these highly-visible virus epidemics – the coronavirus panic ends up being less severe than currently feared, you’ll still be protected against the flu this year.
Sounds like good advice. Thanks Kozak.
It’s hard for me to know what to think of this.
I know they’re having some type of viral outbreak in China, but I don’t know anything about it, because I presume all the information released by the Chinese is not true.
My daughter is studying in Singapore this semester. She’s traveling to Thailand, Malaysia, Japan, and I’m not sure where else. She asked me if she should be concerned. And I really didn’t know what to say.
If the Chinese have had 56 deaths, I’d say that’s not bad, out of a billion people. They probably have more deaths than that every day in bicycle accidents.
But if that were true, would they shut down entire cities?
Again, I just don’t know. I’m eager for some reliable information, if anybody has some…
Fifty six deaths in a small area where contagion is plausible would be different than 56 deaths spread randomly across the country, no?
Yeah. “When you hear hoofbeats think of horses not zebras” is the saying you learn in Med School. Common things are common, so we will go to the more common diagnosis.
Flu is more common, and causes 10’s of thousands of deaths in the US every year.
The symptom overlap between the Flu, and Corona viruses makes clinical diagnosis nearly impossible. During the SARS and MERS scares ( I was working in Saudi during MERS) it was difficult. Until we get a rapid test for Corona, like the one for flu ( this is going to be a very lucrative opportunity for some biotech company), we will be stuck with limited utility of travel hx and contact tracing.
My thoughts exactly. I’m willing to accept that this coronavirus isn’t really worse than the flu. But why are the ChiComs quarantining multiple large cities?
I suppose “because they can” is a reason?
Kozak,
First, I don’t know nothing about birthing no babies and I don’t know nothing about no pandemics. However, my old process control roving problem-solving subroutine from my ROM (brain) kicked in. So here are my thoughts.
Regards,
Jim
That was created by an American reporter in the 1920’s.
The one thing you can reliably say about the current regime in China: Any statement they release is probably not true.
It’s true that much of the information coming from China is likely unreliable. We usually assume that means the actual situation is much worse than what they are reporting. But it could just as easily be the other way around, and the epidemic isn’t as bad as feared.
After all, as Kozak said, it’s very difficult to distinguish between coronavirus pneumonia and other forms of infectious respiratory illness. And they certainly aren’t giving everyone lined up in those hospital hallways a specific test that can distinguish between coronavirus and something else.
And are those people infected at all? How many of them just started coughing in the morning because their country is one of the most polluted in the world, thought they must have that new virus they heard a little about from their neighbors, and ran to the hospital? How many of the people with a fever in the hospital just got a normal flu because they’re packed in there like sardines?
Not to mention the fact that many of the patients who actually died were elderly and/or had other severe conditions. How many of them actually died from this virus vs. some other cause, or simply overheating in an overcrowded hospital?
Having worked in the field, I’ve been very close to several influenza epidemics, and in every case the “body counts” reported during the first few days were wildly overexaggerated, as every death within 100 miles of the index case that had the word “fever” in the deceased’s medical record was immediately attributed to the pandemic virus.
Bottom line: we’ve been through several global virus pandemic scares over the past 15 years: H5N1, swine flu, Ebola, MERS-CoV, and others. In every case, the initial panic was unjustified. Even in the swine flu case -the worst epidemic of them all – the final number of patients and deaths was well below the initial projections.
So don’t panic yet about your daughter.
Kozak has made some good points, and I don’t really disagree with them. I’m an industrial hygienist and safety professional, not a doctor, although my group does work with nasty pathogens.
I’ll add that you can get a good pair of laboratory splash goggles for less than a pizza, and they have versions that can be worn over glasses. Bonus – you can protect your eyes when working with oven cleaner, bleach sprayers, or other nasty stuff.
However, I would like to caution people about N95 masks. They are certified and rated respirator, not just dust masks.
If you have trouble breathing normally, or heart issues – talk with your doctor before wearing an N95 mask. They restrict airflow – that’s how the filter works – and they become more restrictive as more junk is caught in the filter. This means that the mask gets better at removing germs and such, but it also becomes harder to breath through. This especially applies if you are working hard / running. I’ve done remediation work in an N95 mask, and it gets unpleasant.
Also, you need a secure face seal for this to work. This means the respirator needs to fit – they come in different sizes, naturally. Also, beards are a problem, as they break up the seal. Mustaches are fine – which is why I continue to rock the ‘stache.
Surgical masks are cheaper, easier to wear, and provide some protection. Even keeping you from touching your mouth/nose is a plus. We recommend them for lab workers over N95 respirators in most cases, but N95s will provide more complete protection.
So, China is ruled by Democrats? 😉
I think there are two reasons.
The first is because the Chinese are only capable of using blunt tools for public health. In the US and Western Europe, we have enough infrastructure, organization, and expertise to test/quarantine/warn people in a targeted manner. The Chinese aren’t anywhere near that far along. So their choices are pretty much “widespread quarantine” vs. “nothing”.
The second is because of reports that the virus might be contagious before symptoms start. If that’s true (and it’s still unconfirmed), that does up the stakes of the epidemic, since it means many people might currently be infected and not know it.
Adding those criteria up make widespread quarantine seem like the wiser option of the two.
See comments by @saintaugustine numbered 167 and 168 at link.
http://ricochet.com/675720/divine-help-september/comment-page-6/#comment-4683005
A more reassuring take by the CDC via Wattsupwiththat.
Don’t ruin it with facts.
I work in a place where the bathrooms have all automatic faucets. The user has NO control over the temperature of the water that comes out. They also restrict the amount of water you can use per wash, so you end up pushing the lever multiple times to get your hands clean and rinsed off. Environmental wackos have determined that “Conserving” water is more important than getting your hands clean. When I can, I use the little kitchen sink near my work area, so I can get really hot water, and as much as I want.
In my eyes that puts you ahead of 99.99% of the population. Thanks.
Kozak & Ari,
Things are getting more interesting in China by the minute.
Chinese Media Scapegoat Local Officials After Mayor Blames Beijing for Secrecy on Outbreak
The viral sh*t is hitting the fan.
Regards,
Jim
What are you supposed to do, wear a mask and goggles in public?
vegans
There are some more fashionable options out there…
One of these might work: https://www.amazon.com/JOLIN-Anti-Dust-Industrial-Chemical-Respirator/dp/B01M32808Y/
Maybe Dr. Cossack could advise. I recently bought a new mask for use while staining and urethaning wood, but I didn’t get a full mask that covers the eyes as well. I bought a 3M-brand mask; I understand the 3M brand is selling well in China now. I have a short beard that probably does make the seal less than complete, but I’ve noticed that the mask completely cuts the smell of the stain, pre-stain, or urethane as far as I can tell. When I take the mask off at the end of a session, the odor hits me immediately. And it’s reasonably comfortable to wear and breath through the thing. Maybe most virus particles go for a ride on the same type of aerosol particles that these things are designed to trap. I don’t know that for a fact, though.
I don’t usually step outside the house while wearing my mask, so I haven’t been able to gauge the reaction of others to the sight.
Here is the one I bought: https://www.amazon.com/JOLIN-Anti-Dust-Industrial-Chemical-Respirator/dp/B01M32808Y/
Molded by it? Some people wear masks to keep out mold. I keep telling them that mold is everywhere, and that we would all die without it, but they do it anyway.
Ready, sarge.
There are in vitro studies which suggest that black elderberry (Sambucus nigra) extracts (no, Sambuca doesn’t count) can interfere with the ability of enveloped viruses such as coronavirus and influenza virus to invade animal cells, which blunts their ability to cause disease. Other plants with similar properties in vitro include St John’s Wort, Astragalus membranaceous (this is the Chinese medicine astragalus,) and IIRC marine algaes and seaweeds.
Elderberry has at least one smallish double blind study which supports the idea that it actually works. The syrups taste good, but are more expensive per dose than capsules and tend to contain a fair amount of sugar.
St John’s Wort should be used with caution if you are taking medications, since it alters the metabolism of many drugs– clearing some too soon, and activating others more than they otherwise would be.
Astragalus tastes doesn’t taste bad, and can be (traditionally often is) incorporated into soups and stews; you can do the same with seaweeds.
All culinary mushrooms provide some cell mediated immune support.
Depressed zinc status, which is actually fairly common, can impair immune response in general. Nutrition expert Chris Masterjohn suggests testing plasma zinc rather than serum levels:
You can indeed take too much, and it’s immunosuppressive among other things. The average male ejaculation contains about 5 mg. Oysters are indeed a good dietary source of zinc.
10 or so mg/d is probably safe long term dosing; 25-50 mg/d is conservative dosing for repletion. Unless you know for sure that you need more.
Masterjohn suggests a short term regimen using zinc acetate or acetate and gluconate lozenges; the acetate is more effective. The lozenges must be big enough to take about 30 minutes to dissolve, since a big part of what you’re after is a topical effect in the throat, and the application must be repeated every couple of hours. Total daily dose with this approach is 75 mg/d, which is too much to take long term.
For colds, very early in the illness is best. By the third day, it won’t help much.
So some strategies: Probably good vitamin D status. The above foods and herbs. If you have to go to the ER, in addition to masks and hand washing, consider preloading with zinc acetate and continuing the dosing through the visit (sorry, @kozak this is a temporary expedient, though you could reserve it for one of those “uh oh” days.)
And. We, from the position of a half century of relative security, have tilted the legal system radically towards individuals, banking on superior medicine to cover any danger created by exposing other people in the name of individual rights.
One of the most reliable sources for information on infectious disease outbreaks is ProMed. It’s an email listserve that I’ve been participating in for over 20 years.
They also have a searchable website. Here’s one of their recent posts on the novel Coronavirus. Scroll down to the “See Also” listing for previous entries on the topic.