CORONA VIRUS: GOOD HYGIENE PRACTICE TO STAY SAFE

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The WHO has declared COVID-19 a global pandemic. An outbreak is deemed to have become a pandemic when it has spread from human-to-human on several continents, while an epidemic is a disease that infects regions or a community over a large geographical area.

According to a recent report, there were 341,243 confirmed cases with 99, 039 recovery rate and 14,746 deaths worldwide. Covid-19 is a respiratory virus much like influenza and others in this category, it spreads when humans cough or sneeze out tiny droplets of mucus and saliva. A single cough can produce up to 3,000 droplets. These particles can land on other people, clothing and surfaces around them, but some of the smaller particles can remain in the air. There is also some evidence that the virus is also shed for longer in fecal matter, so anyone not washing their hands thoroughly after visiting the toilet could contaminate anything they touch. According to the Centers for Disease Control and Prevention, World Health Organization and other health authorities that both washing one’s hands and cleaning and disinfecting frequently touched surfaces daily are KEY in preventing Covid-19’s spread. If it lands on a hard surface like a doorknob or countertop, the virus can survive anywhere from a few hours to a few days. New research suggests that coronavirus particles may also be able to survive for a few hours in aerosol form, contained in smaller droplets suspended in the air. When you come into contact with a droplet, either by being in close proximity to a forceful sneezer or by touching a surface that said sneezer has touched with their sneezey hands, you can become infected. Though coronavirus can’t be absorbed through your skin, it can enter your system when you touch your mouth, nose or eyes, or through a cut.

The coronavirus can be shed by people even before they develop symptoms. That pre-symptomatic transmission has helped it become a stealth contagion, spreading through communities before they know what hit them. The coronavirus may take many days up to 14 before an infection flares into symptoms, and although most people recover without a serious illness and a serious case of covid-19 can last for weeks.

The virus lurks in the body even after people feel better. According to the study, the median length of time the virus remains in the respiratory tract of a patient after symptoms begin is 20 days. Among patients who survived the disease, the virus continued to be shed for between eight and 37 days.

As the coronavirus continues to spread, phrases like “quarantine,” “isolation” and “social distancing” are making news. Here are the key differences of each. The word quarantine doesn’t have to be a scary thing. It is an effective way to protect the public. People who have been exposed to the new coronavirus and who are at risk for coming down with COVID-19 might practice self-quarantine. Quarantines are for people or groups who don’t have symptoms but were exposed to the virus. Health experts recommend that self-quarantine lasts 14 days. Two weeks provides enough time for them to know whether or not they will become ill and be contagious to other people. A quarantine keeps them away from others so they don’t unknowingly infect anyone. For anyone who has close contact with someone infected with the coronavirus, it is important that you listen to instructions from your health department. Close contact is defined as being within approximately 6 feet of someone with COVID-19 for a prolonged period of time. That includes if you are living with, visiting or sharing a healthcare waiting area or room with someone with COVID-19, or if you have been coughed or sneezed on by someone with the disease. You might be asked to practice self-quarantine if you have recently returned from traveling to a part of the country or the world where COVID-19 is spreading rapidly, or if you have knowingly been exposed to an infected person. Self-quarantine involves using standard hygiene and washing hands frequently. Not sharing things like towels and utensils, staying at home, not having visitors and staying at least 6 feet away from other people in your household. Once your quarantine period has ended, if you do not have symptoms, follow your doctor’s instructions on how to return to your normal routine. According to CDC recommendations avoid leaving the house unless absolutely necessary. That means no work, school, or any social gathering. While your health department will most likely keep tabs on your health, you may need to see your doctor, too. If you’ve been exposed to COVID-19, one should avoid petting, snuggling, being kissed or licked, and sharing food with your pet during a coronavirus quarantine. Have your own stuff and don’t swap unwashed dishes, eating utensils, towels, or bedding with other people or pets in your home. Hygiene is an integral part of this, even at home. Hand washing should be your first line of defense when under quarantine. And don’t forget to cough or sneeze into your elbows or a tissue that you then immediately throw away.

For people who are confirmed to have COVID-19, isolation is appropriate. Isolation is a health care term that means keeping people who are infected with a contagious illness away from those who are not infected. Isolation can take place at home or at a hospital or care facility. Special personal protective equipment will be used to care for these patients in health care settings. Staying in isolation keeps infected people away from healthy people to prevent the sickness from spreading.

Social distancing is deliberately increasing the physical space between people to avoid spreading illness. Staying at least six feet or two meters away from other people lessens your chances of catching COVID-19. Even if you’re not sick, just stay home if you can. Being in large crowds or going out to restaurants poses unnecessary risks not just to yourself but to the people around you. The more you’re in public, the more chances the coronavirus has to hitch a ride on your hands, clothes, or person.  We all of them are very vulnerable to this virus so putting yourself at risk also puts them at risk. There will be a sizable portion of people who are older, or who have other health conditions, and if they get sick all at once, they’re going to overwhelm the health care system to decrease the number of transmissions.

Take steps to limit the number of people you come into close contact with. Social distancing includes talking to your supervisor, manager, or employer about the possibility of working from home where possible, closing schools or switching to online classes, avoiding visits to Long-Term Care Homes, retirement homes, supportive housing, hospices, and other congregate care settings unless the visit is absolutely essential. Avoiding non-essential trips in the community. If possible, limit or consider canceling group gatherings. If you have meetings planned, consider doing them virtually instead of in person. If you need groceries, go to the store but make sure to avoid crowds and maintain a distance of 6 feet from those around you.

The National Institute of Health compared the lifespan of coronavirus on different types of surfaces and found that it could last up to three days on stainless steel and plastic; common materials used in toys, door hands, and everyday appliances. Nonporous surfaces like plastics and metals can allow the virus to live for longer periods of time and glass and metal a smartphone is made out of can make it the perfect environment for coronavirus to live on, so it’s important to disinfect at least once a day, if not more. According to new research from The University of Arizona found that cellphones carry 10 times more bacteria than a toilet seat. You can scrub your phone with a microfiber cloth and you can also consider UV phone sanitizers, which uses UV-C light to break down germs and bacteria.

Some experiments also found that at least some coronavirus can potentially remain viable capable of infecting a person for up to 24 hours on cardboard and up to three days on plastic and stainless steel. When aerosolized into fine, floating particles, the virus remained viable for three hours. On a copper surface, it was four hours. The median length of viability for the virus on stainless steel was 13 hours, and 16 hours on polypropylene, a common type of plastic.

The researchers used a nebulizer to aerosolize the virus, but in a natural environment, the virus does not spread through aerosol particles. Certain hospital treatments can result in an aerosolized virus, but the main way the virus has been spreading has been through droplets such as when someone sneezes or coughs. Such droplets can travel up to six feet. According to the National Institutes of Health (NIH), the virus could survive in droplets for up to three hours after being coughed out into the air. Fine droplets between 1-5 micrometers in size about 30 times smaller than the width of a human hair can remain airborne for several hours in still air. It means that the virus circulating in unfiltered air conditioning systems will only persist for a couple of hours at the most, especially as aerosol droplets tend to settle on surfaces faster in disturbed air. The findings suggest the virus might last this long on door handles, plastic-coated or laminated worktops and other hard surfaces.  

According to some research, coronaviruses can be inactivated within a minute by disinfecting surfaces with 62-71 % alcohol, or 0.5% hydrogen peroxide bleach or household bleach containing 0.1% sodium hypochlorite. Higher temperatures and humidity also tend to result in coronavirus dying quicker, although research has shown that a related coronavirus that causes SARS could be killed by temperatures above 56°C or 132 °F at a rate of about 10,000 viral particles every 15 minutes. The ability of the virus to linger for so long only underlines the importance of hand hygiene and cleaning of surfaces by different approved household disinfectants like disinfectants with ethanol, hydrogen peroxide or sodium hypochlorite (bleach) can “efficiently” inactivate coronaviruses within a minute. Its life span will also vary, depending on the type of surface, temperature and/or humidity. Bathrooms are a welcoming environment for coronaviruses and previous coronaviruses can remain viable in cold, moist surfaces up to nine days, so if sharing a home with someone who has coronavirus avoid sharing the same bathroom.

It’s good to wear disposable gloves when cleaning and disinfecting surfaces. Gloves should be discarded after each cleaning. Consult the manufacturer’s instructions for cleaning and disinfection products used and clean hands immediately after gloves are removed. If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection. For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective. Diluted household bleach solutions can be used if appropriate for the surface. Follow the manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.

For soft (porous) surfaces such as carpeted floor, rugs, and drapes, remove visible contamination if present and clean with appropriate cleaners indicated for use on these surfaces. After cleaning Launder items as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Wear disposable gloves when handling dirty laundry from an ill person and then discard after each use and clean hands immediately after gloves are removed. If no gloves are used when handling dirty laundry, be sure to wash hands afterward. Try to do not to shake dirty laundry because this will minimize the possibility of dispersing the virus through the air. Launder items using the warmest appropriate water setting for the items and dry items completely. Household members should clean hands often, including immediately after removing gloves and after contact with an ill person, by washing hands with soap and water for 20 seconds. If soap and water are not available and hands are not visibly dirty, an alcohol-based hand sanitizer that contains at least 60% alcohol may be used. However, if hands are visibly dirty, always wash hands with soap and water. Household members should follow normal preventive actions while at work and home including proper hand hygiene and avoiding touching eyes, nose, or mouth with unwashed hands. Follow the key times to clean hands include After blowing one’s nose, coughing, or sneezing, after using the restroom, before eating or preparing food, after contact with animals or pets and before and after providing routine care for another person who needs assistance. The isolated person should eat/be fed in their room if possible. Non-disposable food service items used should be handled with gloves and washed with hot water or in a dishwasher and clean hands after handling used food service items. Try to dedicate a lined trash can for the ill person. Use gloves when removing garbage bags, handling, and disposing of trash and wash hands after handling or disposing of trash.

According to CDC definitions Cleaning is about removing contaminants from a surface while Disinfecting is about killing pathogens and try to do both daily if anything or anyone has entered or exited your home. Transmission from person-to-person is a much greater risk than transmission via surfaces, but according to CDC recommendations we clean and disinfect high-touch surfaces in our homes at least once daily just to be safe, assuming we have had contact with the outside world in some way, either a person leaving and returning or goods coming in. High-Touch Surfaces to clean and disinfect daily areDoorknobs, Table surfaces, Hard dining chairs (seat, back, and arms), Kitchen counters, bathroom counters, Faucets and faucet knobs, Toilets (seat and handle), Light switches, TV remote controls, Game controllers, mobile phone and Laptop etc. First of all, clean the surfaces, removing any contaminants, dust, or debris by wiping them with soapy water and a hand towel. Then apply a surface-appropriate disinfectant. The Environmental Protection Agency (EPA) has a full list of disinfectants that can destroy the virus of Corona, but here are a few essentials to keep an eye out for. If a disinfectant product has an indication for killing influenza, RSB, SARS virus, or other coronaviruses, then it should work against this one also. These included Disinfecting wipes; Clorox, Lysol, Disinfectant spray; Purell, Clorox, Lysol, Isopropyl alcohol and Hydrogen peroxide. The CDC also has a recommended recipe for a homemade cleaning solution using household bleach.

Prepare a bleach solution by mixing: 5 tablespoons (1/3rd cup) bleach per gallon of water or 4 teaspoons bleach per quart of water. Pour both into a one-quart spray bottle, shake vigorously and Spray on surface to disinfect, let sit for 10 minutes, wipe away with a wet cloth. But some precautions also mandatory to follow that never ever mix bleach solution with any other cleaning chemical, and it’s likely to damage or discolor sensitive surfaces. Use it as a last resort if you can’t source or acquire any other kind of disinfectant. With bleach, remember to wear gloves, open your windows for ventilation is your friend and be careful.

According to the FDA, there is no evidence to suggest that food or food packaging can transmit the novel coronavirus, so there is currently no need to disinfect food or food packaging any more than you usually would. Just observe standard food safety during food preparation and packaging.

Our devices might be all that’s keeping you sane during your self-isolation but they’re high-touch surfaces you carry with you everywhere, so we have to clean and disinfect them, too. The best way to clean your devices like iPhone or Android phone with a disinfecting wipe or alcohol solution (at least 70 percent) properly and make sure you remove any case that’s on your phone or tablet, clean underneath, put it back on, and clean the outside. Laptop displays should be cleaned with isopropyl alcohol (70 percent) solution and a soft towel. Make sure you wipe down the keyboard, the trackpad, the exterior, and where your wrists rest on the laptop and make sure wipe down the mouse (top, sides, and bottom), the keys on your keyboard, the exterior of the keyboard, and any mousepad you might have. For cleaning any other electronic device, if the exterior is largely plastic-like gaming mice, gamepads, TV remotes use disinfecting wipe or isopropyl alcohol solution.

There’s a lot going on right now. Of course, it’s stressful and scary. It can be hard to know what you should do or what’s going on. Stay home as much as possible, avoid large gatherings and stay at least six feet away from other people in public, wash your hands frequently for at least 20 seconds or use hand sanitizer, if you’re coughing or sneezing, wear a protective mask, avoid close contact with people who are sick, avoid touching your eyes, nose, and mouth, cover your cough or sneeze with a tissue, then throw the tissue in the trash, clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

While fear is normal, try to stay informed from reliable sources to counteract any anxiety you may have and cooperating with the authorities and following quarantines, isolation, social distancing and other public health mandates will help slow and eventually stop the spread of contagious diseases.

DR. SYEDA SADAF AKBER
HASHMANIS GROUP OF HOSPITALS

References:

https://www.bbc.com/future/article/20200317-covid-19-how-long-does-the-coronavirus-last-on-surfaces

https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces

https://www.washingtonpost.com/health/coronavirus-can-stay-infectious-for-days-on-surfaces/2020/03/12/9b54a99e-6472-11ea-845d-e35b0234b136_story.html

https://www.cdc.gov/coronavirus/2019-ncov/prepare/cleaning-disinfection.html

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