Thursday, June 18, 2020

Origins of COVID and other Zoonotic diseases





U of Minnesota Origins of COVID and other Zoonotic Diseases


This webinar covers the origin of HIV via the SIV in primates in Africa. Other wildlife based or zoonotic diseases are also covered.

Saturday, June 6, 2020

Use of Face Shields to Protect Against Transmission of COVID-19



Medical Xpress - Could Face Shields replace masks in preventing COVID-19. 


CDC - Efficacy of Face Shields - CDC report that face shields are protective for health care workers from initial large droplets but provide very little protection over longer periods. 


MDH - Best practices for masks and face shields for persons with disabilities. - Information on masks with clear openings for lip reading and when face shields are appropriate as sole protection. 

JAMA ...Face Shields and the Containment of COVID-19. The authors suggest that using face shields to prevent COVID-19 transmission would be easy to implement. Data suggest that they may protect the person wearing it from large aerosol transmission. They will not protect against small aerosol transmission. 

Contagion Live - Interview with an author of the JAMA paper. Encouraging the universal use of face shields could reduce the r naught to below one. The use is based on similar diseases but not specifically on COVID-19. 

PMC - Safety Guidelines for Sterility of Face Shields for the COVID-19 outbreak - They list specifications for the design and cleaning of face shields. The chemical list is rather limited. 

Lancet - Physical Distancing, Face Masks, and Eye Protection ... Distances of 2 meters or greater are recommended to reduce transmission. All three of these measures can combine to potentially reduce exposure but not eliminate it. There is a need form more specific COVID - 19 data. 

FDA - Emergency Use Authorization for the production of face shields - The authorization lists the specific approved methods for the production of face shields. 



Interview with Michael B. Edmund on the use of face sheilds - 11:30 min. 






Wednesday, May 6, 2020

The use of Heat for SARS-CoV-2 disinfection




There are four main methods to disinfect SARS-CoV-2 the virus that causes COVID-19.

  1. Time: The virus eventually no longer will be viable after a period of time. This depends on several things including the surface type, the temperature, and relative humidity. 
  2. Ultraviolet light (UV-C) also known as UVGI (Ultraviolet Germicidal Irradiation) at 254 nm works to alter the RNA of the SARS-CoV-2.
  3. Vaporized Hydrogen Peroxide 
  4. Temperature. Elevated temperatures reduce the viability of the virus.  

Links:




Decontamination of respirators was effective at 70 degrees Celsius for 60 minutes. These elevated temperatures may cause damage to respirator components.  

Stanford Medicine has done multiple studies decontaminating respirators with UV-C and heat. In there study they found repeated heating of masks with hot air at 75C for 20 cycles did not damage a respirator. An 8 W UVGI (254 nm) for 30 minutes for 10 cycles did not damage the respirator.

As I reviewed the 3M website masks appeared to have different temperature tolerances. 

Friday, May 1, 2020

Guidelines for Reopening Businesses and schools during COVID-19





The deeper you look the more you find - photo N. Carlson

Many places of employment are working through plans to reopen while minimizing transmission of SARS cov 2 the virus that causes COVID-19. The following is a list of guidances primarily from the CDC about opening businesses, schools and Universities. In the near future more specific information will become available, and this information will be added to the post. 

General guidance:

Back to Work Safely - AIHA offers industry specific guidance for getting back to work safely.

Business guide for responding to COVID-19 - CDC

Reopening Guidance for Schools and Businesses - CDC


How to clean and conduct risk management for COVID-19:

Cleaning and Disinfecting Tool - CDC

Disinfect Non-Emergency Vehicle with COVID-19 positive occupant - CDC

Reopening guidance for cleaning and disinfecting areas - CDC

Cleaning and Disinfecting Your Facility - CDC

Guidance for Schools for COVID-19  - CDC

Guidance for Higher Education Administration - CDC

Cleaning for CoVID -19 - Sustainable Mycology summary


LBC - General information on Deep Cleaning for Coronavirus - 3 min. 



Private Sector call on COVID-19 response from CDC 4/29/2020 -46 Min.



COVID-19 School response - March 26, 2020 - CDC - 61 min.








Saturday, April 25, 2020

CDC updates symptom list for COVID-19

Symptom Chart Provided by MNChildrens


The above chart helps individuals differentiate between the cold, flu, and COVID-19. The CDC has recently published and updated list of COVID-19 symptoms.  The list previously included the top three symptoms. The symptoms in Bold are new additions to the list.


  • Fever
  • Cough
  • Shortness of breath or difficulty breathing
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell
The CDC has a Coronavirus Self-Checker to help people get a better idea if they have symptoms of COVID-19

Please see below about gastrointestinal symptoms and a recent NEJM publication noting a higher than normal incidents of stroke in younger coronavirus patients in New York City.


A doctor at the Mayo Clinic notes that patients can have gastrointestinal symptoms that are associated with COVID-19 with or without respiratory symptoms.  1 min. 


Washington Post summary of symptoms - 1 min. 



Dr. Justin Springer on the association between COVID-19 and increase incidence of stroke - 3 min. 







Tuesday, April 21, 2020

Cleaning for COVID-19


CDC guidance for cleaning and disinfecting facilities

There are several guidance documents on general cleaning guidelines for a COVID-19 area of concern.

Role of hand washing and surface cleaning - Click to enlarge graphic


MMWR reported on increased health concerns associated with use of cleaning chemicals.

The CDC has some good general guidelines.

CDC room clearance based on ventilation rates. How long do you have to wait before cleaning and putting another patient in the room?

CDC guidelines for household cleaning.

OSHA has some minimal guidance with references to the CDC. 

The US Army has a very good detailed protocol that may help answer specific questions about what is the proper order to clean an area.  

One minute summary of CDC's cleaning guidelines



How to disinfect home with COVID-19 patient - 2 min.


Portland State University deep cleaning high contact surfaces - 2 min.

Sunday, April 19, 2020

UV-C disinfection of hospital rooms

Electromagnetic spectrum - Stanford University
UV-C light in the range of 280 to 200 nm (254 nm the most effective) is a disinfectant used in laboratories and ventilation systems. Direct exposure to the light at this wavelength can severely damage skin and damage vision. UV light can also produce ozone, Ozone health effects are noted by the CDC.

The following links describe the use of UV-C lights for room disinfection.  One of the concerns is making sure that the light exposes all surfaces.  There are also concerns about the length of time needed.  The light does generate heat so no flammable objects can be close to the light. The UV-C light will decay in effectiveness over time. Specific meters are used in the UV-C light range to determine the level of exposure needed to kill the virus. Refer to the Wikipedia article on Ultraviolet Germicidal irradiation

Links:

CDC methods of disinfection  UVC kills bacteria and viruses more easily than bacterial spores.

Research Gate: inactivation of mold spores by UVC Aspergillus niger conidia are difficult to kill with UV-C light

Science Direct -Programmable and low cost UV-C room disinfection

NIH - Using UV-C light to disinfect high touch surfaces in hospitals.

Asian Journal - UVC kills bugs at home.

Indian J. of Med. and Biology - Surface disinfection by germicidal UV-C light


Dangers of UV-C light - 4 minutes



Applications of UV-C disinfection - BBC News - 2 min.



Duke Health: Benefits of room UV-C disinfection - 2 min.

Friday, April 17, 2020

MDH and CDC guidance for using paper bag to extend the life of N-95 respirators but not surgical masks




Paper bag with handles 8.5" x 6.5" x 3.5"  Name and date are clearly marked on the bag


Respirator straps are hung from paper bag handles


The respirator is suspended above the bottom of the bag

A 2 gram desiccant pack is placed at the bottom of the bag to absorb moisture from the mask to slow down bacterial and fungal growth. The amount of desiccant needed may vary dependent on storage conditions.

Please see the disposable respirator post for links to the Minnesota Department of Health and the CDC for the number of times these respirators can be used. Guidance on the number of uses will vary by health care provider. The length of storage time will vary from 5 to 7 days. This is based on the anticipated COVID-19 survival time on surfaces.

Experience from nurses indicate that moisture in the masks is an issue. The straps also tend to wear out after repeated use.

To reduce particle loading on the mask, staff are asked to refrain from wearing make-up in areas that will contact the surface of the mask.

Surgical Masks:  Surgical masks provide some protection from droplets but they are primarily designed to protect the patient from the provider because the mask does not provide a tight face seal. Never reuse, wash or disinfect surgical masks. Please see Delaware Health and Social Services Division of Public Health - Proper use of surgical masks