Dear Reader,
Welcome to a special edition of our newsletter. We’re making an exception to our usual schedule of every-first-Monday to bring you some eminently practical and scientifically sound advice on keeping the coronavirus, aka Covid-19, out of your household.
James Robb, a virus expert and doctor in San Diego, recently e-mailed his friends and family about ways to protect themselves from Covid-19, the coronavirus that exploded out of central China and has since infected tens of thousands, killed thousands, and created global health concerns.
He wrote in his now widely shared missive:
“[A]s some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.
“The current projections for its expansion in the U.S. are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the U.S. by mid to late March and April.
“Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves ….
“I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.”
He said he hoped “these personal thoughts will be helpful during this potentially catastrophic pandemic.” I thought his expert counsel was worth sharing, so here in a special edition of the firm’s newsletter are his approaches, with some added thoughts from me.
A virologist’s suggested protections:
Minimize contacts to reduce the bug’s spread
D. Robb’s suggested personal precautions (with his emphases included):
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NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
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Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
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Open doors with your closed fist or hip — do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
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Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
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Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
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Keep a bottle of sanitizer available at each of your home’s entrances. AND in your car for use after getting gas or touching other contaminated objects when you can’t immediately wash your hands.
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If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
Supplies to stock up on
Dr. Robb’s suggested shopping list for sanitary practices (*see sidebars below):
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Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.
Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average — everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth. -
Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you — it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth — it is only to keep you from touching your nose or mouth.
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Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
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Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY “cold-like” symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.
A word about zinc
A well-known internet fact-checking site reached out to Dr. James Robb about his widely shared email with his ideas about how the public can protect itself from the coronavirus officially named Covid-19.
He confirmed he wrote the note and the Snopes site verified his credentials. Robb also extrapolated in his reply on his much-commented on views about zinc, underscoring that he has not endorsed or recommended any specific brands or products:
“In my experience as a virologist and pathologist, zinc will inhibit the replication of many viruses, including coronaviruses. I expect Covid-19 [the disease caused by the novel coronavirus] will be inhibited similarly, but I have no direct experimental support for this claim. I must add, however, that using zinc lozenges as directed by the manufacturer is no guarantee against being infected by the virus, even if it inhibits the viral replication in the nasopharynx.”
The site added this about zinc:
“In general terms, research suggests that zinc may be able to inhibit the spread of some viral infections, but the question remains scientifically unsettled. A 2010 study using cell cultures published in PLOS One found evidence that increasing intra-cellular zinc concentrations ‘can efficiently impair the replication of a variety of RNA viruses’ including coronaviruses. According to the Cochrane Database of Systematic Reviews, ‘trials conducted in high-income countries since 1984 investigating the role of zinc for the common cold symptoms have had mixed results.” The common cold is caused by a virus also classified as a coronavirus.'”
Controversy abounds over medical gear buying
The nation’s top doctor recently took to social media to express his frustration over the public’s coronavirus-related, panic-buying of medical-style face masks.
“Seriously people — STOP BUYING MASKS!” the U.S. Surgeon general Jerome M. Adams said in his Tweet. “They are NOT effective in preventing general public from catching #Coronavirus, but if health care providers can’t get them to care for sick patients, it puts them and our communities at risk!”
The New York Times reported his emphatic comments, along with this:
“Health officials around the world have been imploring the public to stop buying masks if they are healthy or not caring for someone who is ill. Medical professionals need a large supply of the masks because they are in direct contact with infected patients and must change their masks repeatedly. ‘There are severe strains on protective equipment around the world,’ said Dr. Michael J. Ryan, executive director of the health emergency program at the World Health Organization … ‘Our primary concern is to ensure that our front line health workers are protected and that they have the equipment they need to do their jobs.’”
Hundreds of health care workers in China have been infected and several have died of Covid-19. U.S. health workers and first-responders have been exposed to the virus, with some infections reported. Their concerns are rising — and they should not be taken lightly, nor should their insistence on having appropriate protective items available to them and not in short supply due to ill-advised, ineffective public purchases and use.
News media reports nationwide also have found shoppers hitting stores hard for hand sanitizer, toilet paper, bottled water, disposable disinfecting wipes, and nonperishable foods. Officials have warned of price-gouging and possible shortages of consumer goods that rely heavily on supply chains that track back to Asian nations struggling with the virus, including China, Korea, and Japan.
Recent Health Care Blog Posts
Here are some recent posts on our patient safety blog that might interest you:
- The Patrick Malone firm’s blog has tried to help readers sort through the flood of Covid-19 news. You can read the coronavirus-related posts and much more patient safety information by clicking here.
- The firm’s March newsletter offered a virology 411, available by clicking here, and answering: What are viruses, anyway, and why should we care? They’re microscopic specks that scientists aren’t even sure are alive. Why can’t humanity deal better with viruses? Some answers in our newsletter here, and some solid advice on protecting yourself.
- Vaccinations, by the way, are an important way for patients to protect themselves against viral infections, and a recent firm newsletter, available by clicking here, may be worth a timely, deep read now.
Sincerely,
Patrick Malone
Patrick Malone & Associates
