librewolf's picture

    Living Clean and Reducing Risk of Infection

    We are living in a dangerous time, dealing with something the majority rarely, if ever, even consider – Fighting a contagious, and possibly deadly, microbe. It is a virus known as Covid-19. Many will be sickened, few will escape unscathed, and some of us will die. How many don’t die largely depends on their being able to protect themselves, but more importantly, it depends on the vigilance of everyone else. If you are in my place (the highest risk group) your heart just sank. And every time you watch/read/listen to the news your heart drops a bit further.

    I am not an expert, but I have been living with a double-lung transplant and suppressed immune system for going on 9 years. I also once worked for one of the largest sterilizer companies in the United States earlier in life. So here are my ideas, and what I am practicing, in these perilous times.

    1. Assume that the virus is everywhere and that everyone is a carrier.
    2. In environments you think are safe – your home and car, etc. you still need to clean surfaces regularly and stop the virus from entering.

    To Mask or Not Mask

    To mask or not to mask. Everyone who is out in public should be wearing a mask if they can (in my opinion). The only reason I can see for the recommendations to NOT wear a mask is that they are in short supply (like the tests).

    I am so outraged about the testing, and the drumbeat of “if you feel sick” … What we now know from China is that of folks who tested positive for the virus 4 out of 5 (80%) were exposed by contact with people WHO THOUGHT THEY WERE HEALTHY!! This was discovered by tracing the contacts of those who were initially tested. This means that you can be positive for Covid-19 and be spreading it to everyone you encounter, without feeling ill. The current restrictions on testing are because the government has totally failed to get enough tests where they are needed, or to even test front line workers and those who are seriously ill. Therefore, I assume that everyone is a carrier unless I am intimately aware of the precautions they are taking.

    Going shopping

    Rather than detailing every possible scenario, I am just going to do one in detail – a (safer) trip to the grocery store.

    Getting ready

    • Get a bucket of soapy water (with a bit of bleach if you have it) and a rag of some sort and put it outside your home (or apartment), or just inside your door. You can alternatively use some sort of disinfectant (carefully). This is for cleaning your groceries (and shoes) when you get home.
    • Get a clean box or bags to leave at home. You will place your cleaned groceries in these.
    • Get dressed in a double layer of clothes as you are going to strip off the outer layer outside when you get back.
    • If you have cloth grocery bags, then bring them with you.
    • If you have rubber or exam gloves, stick them in your pocket.
    • If you have a hat, scarf, or dew rag, wear it. (Or sweatshirt with hood)
    • If you have a mask, take it.
    • You should always have hand sanitizer with you
    • If you are driving, take a sheet to throw over your car seat

    Arriving at the store

    • If there are a ton of folks there, try a different store or come back another time.
    • Put on a mask, head covering, and gloves. Grab your bags (if you have them)
    • Get your cart and clean the handle (if you can).
    • Try to keep your distance from others
    • Do your shopping
    • At the checkout, don’t rest anything on the check-writing stand, and if they have a separate person bagging, bag your own groceries (to reduce others handling them). Most times I would argue against self-checkout, but during this emergency, I recommend self-checkout to reduce the number of people handling your groceries.

    Back at the car. The goal here is to not contaminate your car.

    • Remove ONE glove, or sanitize your hands, BEFORE you touch your keys or car.
    • Use the clean hand to get your keys and open your car.
    • Load your bags with the gloved hand and close the car
    • Put the cart away
    • Remove the other glove (or re-sanitize hands) and head for home.

    At home

    • Re-glove and haul groceries to your door, or place where you can clean them
    • Grab the sheet as well. It will need to be washed and you can also put your outer layer of clothes in it.
    • If the cleansing water and clean grocery containers are not outside, then grab them.
    • Strip your outer layer (you can put in your empty bag(s) shortly, and these you will wash)
    • Wipe down each item thoroughly and place in your clean box/bag
    • Set aside fruits and vegetables to clean separately. (Unless prepackaged)
    • When all groceries (except fresh) are washed, wipe your door handle and then either remove your shoes or wash the soles of your shoes (they have been in contact with the most likely disease vector – the floor and parking lot)

    Fruits and veggies

    • You will need to clean fruits and vegetables. I have been putting solid fruits and veggies in a soapy water bath, rinsing thoroughly, drying, and then bagging if going in the fridge. Veggies like artichokes, broccoli, and greens are rinsed thoroughly, let dry, and the bag sealed. These are for cooking only.
    • If you have bought prepackaged fresh veggies, wash the containers outside and then clean as usual before use.

    Your home – however humble or grand

    The goal is to make and keep, your home a safe environment. That means regularly cleaning all surfaces, handles, switches, and devices. It also means cleaning EVERYTHING that comes into your home. Shoes and hands are the most easily contaminated and they must be cleaned. The message of “wash your hands” is everywhere, but those shoes need to be wiped down – especially the soles.

    People are a problem. If they have been out in the world in the last two weeks, then they are possibly carrying the virus —whether they feel sick or not. If you feel they have been as cautious as you have been, then let them in. If they haven’t then visit by video chat.

    Packages

    Many people are having things shipped to them, and most get mail. Assume all packages are contaminated and the items inside are contaminated. I carefully open all mail and packages outside. I then putt all boxes and envelopes directly into the recycling and clean all packages (and my hands) before bringing them inside.

    In Closing

    Many are going to see the directions above as either over the top or obsessive. Unfortunately, keeping a clean space and avoiding contamination is exactly that. It requires focus because it is so easy to cross-contaminate. At one point in my life journey, I had a medication that was delivered under the skin with a pump. I followed an equally long list in preparing to refill the pump and set the subcutaneous patch. It was a written list and I used the buddy system with both of us checking each step. If one of us dropped something off the clean area, or unconsciously scratched our nose, then we’d call a halt and change gloves.

    All of us are now dealing with a pathogen that has a long incubation period which continues even after a person is “well”. Many who come in contact with it will not experience symptoms or only mild symptoms, but who are carrying the virus and can both shed it and spread it. Seemingly healthy people are the biggest threat of contagion (in my opinion). Lastly, the virus should be assumed to be everywhere on everything.

    Comments

    Hi librewolf, thanks for posting your essay here. I myself thought I was savvy about disinfection and keeping a sterile environment from a serious bout in the 90's with auto-immune due to long untreated mold allergy and then my mom, due to problems too complex to get into, went through antibiotic resistant sepsis and multitude of sepsis infections over years, including a period at home when there was the cryptospiridium infection with her city's water!

    I know things like how to take a window air conditioner apart and thoroughly disinfect it and put it back together because: you can't trust anyone else to do a decent job. Long ago I knew all about all the variety of air filters out there.I don't think I've touched a public faucet with my hands in decades

    BUT believe or not, even I never thought about the danger of one's shoes until I read about it lately. Never gave the shoes two thoughts, go figure!

    Never hurts to have more input on these things....


    Many(?) countries you simply don't use outdoor shoes inside - even guests get houseshoes.


    yes of course, many cultures really, so it's in the U.S. too, but for some reason I always thought of that as about dragging in dirt, not about germs. Mostly people aren't hanging around breathing near the floor nor eating off of it, the floor is one place you didn't have to worry about so much, except with crawling babies, then you made sure the floor was clean if you could. It strikes how his really is a super monster bug, I feel for those who have to be extra extra careful like librewolf, it really is a chore trying to live in a hygenic bubble.


    Viruses clarified (oddly by Scientific American, not typically the "for Dummies" go-to): 

    https://www.scientificamerican.com/article/are-viruses-alive-2004/

    "Viruses are found in almost every ecosystem on Earth and are the most numerous type of biological entity.[5][6]"

    That is, viruses outnumber every other biological entity put together.


    Thanks for the article link. I have a strong dislike of viruses because they are so sneaky, and they don't go away. They hijack our cells and they reemerge to make us sick all over again. How Stuff Works does a nice job of explaining how viruses replicate. 

    Lysogenic Cycle

    In the lysogenic cycle, the virus reproduces by first injecting its genetic material, indicated by the red line, into the host cell's genetic instructions.

    In the lysogenic cycle, the virus reproduces by first injecting its genetic material, indicated by the red line, into the host cell's genetic instructions.

    Once inside the host cell, some viruses, such as herpes and HIV, do not reproduce right away. Instead, they mix their genetic instructions into the host cell's genetic instructions. When the host cell reproduces, the viral genetic instructions get copied into the host cell's offspring.

    The host cells may undergo many rounds of reproduction, and then some environmental or predetermined genetic signal will stir the "sleeping" viral instructions. The viral genetic instructions will then take over the host's machinery and make new viruses as described above. This cycle, called the lysogenic cycle, is shown in the accompanying figure.

    Because a virus is merely a set of genetic instructions surrounded by a protein coat, and because it does not carry out any biochemical reactions of its own, viruses can live for years or longer outside a host cell. Some viruses can "sleep" inside the genetic instructions of the host cells for years before reproducing. For example, a person infected with HIV can live without showing symptoms of AIDS for years, but he or she can still spread the virus to others.

    ©HowStuffWorks


    While I don't spend a lot of time on the floor, I do seem to drop things there on a regular basis. How many people follow the "5-second rule?" I also handle my shoes on a regular basis putting them on and off, mostly.

    It IS a chore, and also somewhat limiting. For example, open food service (buffets, open salad, and soup bars) are forever off-limits.

    Thanks for sharing your experience artappraiser!


    Thanks, very good advice. 

    Also, hang on to your two or three sterile wipes from the store entrance. Keep them to wipe down the self checkout screen and weight tray, and your hands after departing front entrance. If you can, don't use the automatic checkout conveyor, remove items from cart one at a time. If the store is all out of front entrance wipes, try another place next time.


    Oh, the blasted conveyor belt! They have long promised that we would be able to just walk out of store and the RFID tags would be read and ring up our bill. Perhaps good on contagion, but lousy for clerks who will lose their jobs to technology.


    But ppl are able to handle barcodes already - it's only free standing fruit & bread, along with alcohol checks that slows things down, but I regularly do self checkout now.

    Putting RFID tags on everything would be a large expense, and again, how do you do fruit, veggies & bread, aside from plastic bags for each?


    I'm not saying I approve, just that it would be useful in this situation. 

    I remember an ad for RFID years ago that had a person walking straight out of the store with their shopping bag and the contents being deleted from the card (or put on their card) automatically with no transaction, no checkout. 

    My experience with RFID is that I scan the strip and sometimes it works and sometimes it doesn't - especially on fresh vegetables. This seems to be because the code wraps on the label - apparently making it unreadable by readers and scanners,


    Actually think you're using NFC (shorter range bonk-n-pay that wouldn't work on a bag 2-4 feet away). In the end it comes down to store costs, only a bit customer convenience).


    Some positive news, Abbott Labs, Chicago, will have a 5 minute test for Co-19 ready for use this week, runs on portable Abbott analyzer, they can produce 50,000 tests a day very soon.

    Production of another Abbott coronavirus test released last week will be produced at 5 million level per month starting in April.


    NCD, I put more here on this thread. It IS major game changing news, the FDA has approved experimental use. Unless results turn out to have major inaccuracy.

    I just had an instinct as soon as I saw the announcement tweet on my feed retweeted by some political person or another: wow, looks like the awesome, they guy is sticking the swab right on the pad and getting results? Could this be true? 

    (now let's see at the FDA who bought stock before the announcement? Just sign me "learned to be cynical")


    And the CDC messed around with some defective test that had to be sent back to Atlanta. If only they had collaborated with state of the art labs like Abbott in January.


    Well this is potentially a wonderful advancement. Imagine if we had had this even a month ago. Wonder what the actual production schedule might be. Rapid (and hopefully cheap) tests would change things radically.


    Just a reminder how the alternative is not a joke. From a pulmonologist found retweeted by NYTimes reporter Sheera Frenkel:

    Today.

    I told a 28 year old that he needs intubation. He was scared. Couldn’t breathe.

    I told the wife of a 47 year old that he is dying over FaceTime.

    I bronched a #COVID19 patient who mucous plugged. It saved his life. Risked mine.

    — Anna Podolanczuk (@AnnaPodolanczuk) March 29, 2020

    Having been on a ventilator, the thought of being on one again terrifies me. Being on a ventilator with 1-3 OTHER people is unimaginable. I have told all friends and family that if I need to go on a vent to PLEASE keep me knocked out. I would probably rip it out otherwise, and likely not come out sane. I never had claustrophobia before my transplant, not so now. I had to retrain myself to just wear an N95 mask, but beyond that, I can't go. I know how critical bi-paps and ventilators are in saving lives of people whose lungs have filled with fluid or are otherwise not working, but there is only one experience I have had that invoked more fear than having a machine force you to breathe and that is to suffocate.

    This is indeed deadly serious and the people who think they are "safe" from this angers me beyond measure. People can feel fine and carry this virus to all those around them. Carry it to people who may catch it and not "feel fine", but suffer terrible consequences. As I said in the article, I assume that everyone is a carrier of Covid-19 and that it is everywhere. Further, this is only going to get worse over the next few months as more and more people are exposed and the virus is seeded into stores, streets, and warehouses. The possibility of contaminated packages and letters arriving at our doors will continue to rise. 



    read about this research at another article a week or so ago. Made me angrier about past advice that uninfected/asymptomatic people don't need to wear masks. Once a few of those nasty guys get into your mouth or nose, it's extremely likely they are going to set up shop and if so, count yourself one of the lucky ones if they don't make it to deep into your lungs.


    Thanks for the article link. I'm looking for the original article. It would be interesting to know when thr study was actually done.

    One interesting piece in the Guardian article is the virus binding in the nose and throat " causing mild cold-like symptoms ". I have seen an article by a Russian doctor who argued that many people have "cold symptoms" (runny nose in particular) had the virus, though this has been denied by US specialists. However, one man who almost died of Covid -19 had these "atypical" symptoms. In fact, it delayed his treatment significantly because the doctors told him he didn't have the right symptomology for Covid-19. In other words, a runny nose can definitely be a symptom.



    From one of the guys who sequenced the virus

    Q: What mistakes are other countries making? 

    A: The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.

    https://www.sciencemag.org/news/2020/03/not-wearing-masks-protect-against-coronavirus-big-mistake-top-chinese-scientist-says

     


    A little cheer: mammals can learn and change habits!


    Clearly more attentive than many less hairy bipeds.


    article on new rules for NYC's greenmarkets:


    I purchased produce through that method this weekend.
    It slackened some of the stress for all involved.


    Librewolf, Thank you for such a comprehensive explanation of what to do.  I also never thought once about shoes.  The Whole Foods here in Charlottesville has what I call "Geezer Hour."  They clean the store well every night and open one hour early for people over 60, and they do not let younger people in.  Period.

    When I went in (only once) I had Nitril gloves and a mask that I made.  I have made several, and used a N-95 mask that I had as a model.  I never believed the BS about not needing a mask when it was so obvious that asymptomatic people were spreading it.  I also wore an apron that I made that covers the whole front of me and my upper back, which I took off before I got back in the car.  The experience in the store was weird.  Several people had masks on, and several had gloves but many did not.  Some people had purses hanging off their shoulders.  Everyone was moving slowly and zombie-like.  The 6-foot distance was respected except by one guy, who would dash between people because he was very busy and also very important, obviously.  None of the employees had masks on, and I think they should for their own protection.
     

    I am now ordering foods on line, and will take care of them before I bring them in, although I have not been worried about regular mail.  My little mom-and-pop store has the bottom half of their front door closed and the counter set up there.  I had to go to the PO to mail masks to my daughter and boyfriend in NYC, and when I saw the little store I went over and got a bottle of wine.  You ask for what you want and they hand it to you.  Pretty slick, huh?  The owner told me he is just glad to have a job.

     

    The one thing that I do that you did not bring up, was that I put my credit card in a pocket before I leave home.  That way I don't contaminate anything when I pay.  I clean it off when I get back.  No cash because I don't want to get handed any change.

     

    Best of luck to you and all Dagbloggers!  Stay safe!  


    You can use alcohol wipes, though if find the small med ones tend to have more alcohol than the PC/tech wipes.


    Or you can make your own! I have an alcohol mix (alcohol 1: water 1/2) actual mix depends on the strength of your alcohol (70% would be about 1:1/3) as anything below 60% is not really effective.

    Just soapy water is effective against this virus

    Or peroxide mix. If using regular peroxide, use it virtually straight, It using "food grade" (which I also have for situations like this) I use 1:1/2 the site has a dilution guide https://www.intothegardenofeden.com/35-food-grade-hydrogen-peroxide

    If you are using the cleaning wipes, I cut them in 1/2 or 1/4 and place in plastic bag as Handy wipes for taking places where you might need them. One doc who posted a shopping and grocery cleaning video at youtube (van wiggen i think) recommended sterilizing the inside of the cart as well as the handle.


    I do the same with credit card.

    I have an issue with the set aside hours. Here, there is little rhyme or reason, but the vulnerable population extends beyond those over 60. All those folks out there who are immune compromised for one reason or another need access to this service regardless of their age. For example, all the folks currently on chemo therapy, those with auto-immune disorders, transplant recipients. Then you have all the folks with heart or lung problems.

    Regarding masks....

    I have been using N95 masks since my double-lung transplant in 2011. The transplant team told me then to wear them in public as the standard "loop" masks would offer me no protection. Now the CDC et al. are saying that folks should use "facial covering" - including bandanas and home made masks. Further that N95 masks should be reserved for "first responders" only. Now I am worried that if I go out in my n95 mask (of which I keep a supply on hand at all times) that I will be hassled. Personally, I think all the following groups SHOULD be wearing N95 (or better) masks and respirators:

    All people in infection "vulnerable" groups, and caregivers, family members thereof.

    First responders

    medical personnel and staff at medical facilities

    ALL people in direct contact with the public (clerks, cab drivers,  bus drivers, grub hub etc.). I am outraged that the folks in service and retail - especially folks like cashiers - are left totally unprotected. NOW, stores are putting up the equivalent of "sneeze guards" that offer virtually no protection for these (low paid and often uninsured) workers who deal one on one, face to face, with hundreds of people every shift.

     

    I'm so glad I got THAT off my chest. ;~>


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