COVID Q&A

COVID Q&A

Norman Umberger, The Safety Dude?

Director, The Leadership Project at The Southwest Institute, Kingman, AZ USA

V1 08JUL20

[email protected]

I wrote the Best Practices for Infectious Diseases and the Mask Primer and continue to receive questions about COVID and other infectious diseases from folks, that is great, and continue to read terrible advice from too many people that ought to know better, that is sad.  Below, I answer the great questions with simple, real answers.  No hype, no BS, just great questions and good answers.

What steps should I take to prevent getting COVID?

Nothing can prevent you from getting COVID except to seclude oneself forever, but one can take steps to reduce the likelihood of being exposed and infected, that is, getting sick, or suffering severe impacts from the infection.

Exposure happens when you come within the breathing zone of a person actively infected with the virus, that is one who is shedding the virus.

If you are not near other people who are near other people (and one of those is actively infected), you will not get infected.  If you are near other people, the chance that you will get infected increases with the time spent with an actively infected person and the distance from the sick person’s breathing zone, especially if the person coughs, sneezes, spits, or otherwise shares mucus.

Since it is not clear who is sick, the less time in, and the more distance from, another’s breathing zone, the better.

The mechanism in which the COVID virus spreads is not well understood.  If it is direct contact as was originally believed (and still widely believed), then a three (3) feet distance from another’s breathing zone ought to be adequate to ensure that respiratory droplets fall down and out of one’s breathing zone.  If the virus can become airborne or aerosolized (as some believe), the distance that the virus can travel would be significantly greater.

But the best way to avoid getting sick is to stay healthy.  Eat right, sleep well, exercise, stay mentally balanced, do not smoke, practice moderation, and promptly correct deviances from those.

The best way to avoid spreading the disease is for sick folk to stay away from others and for folks to stay away from sick folk.  However, most people cannot afford to stay home if sick, so society needs to encourage policies/processes  to help make that easier; an appropriate role for government, employers, along with retail/service providers.  Pay-to-stay-home-while-sick policies and processes to bring services and supplies to the sick and susceptible, the high-risk population, are amazing.

Should I get tested for COVID or its antibodies?

Yes, if you are participating in a scientific study.  Yes, if you are curious to know if you might have COVID or might have had COVID, respectively.

No, otherwise.  The tests have issues and the results do not change treatment. If one tests positive for COVID, a best practice is to isolate, separate oneself from others who are not sick, for fourteen (14) days; the same is recommended for those exhibiting symptoms.  That is the only concrete action recommended based on a test result.

If the test is accurate for your COVID status, all you will get is a snapshot of active infection.  The results mean nothing if you are not shedding the virus because you are newly infected or get infected during or after the test.  Since the results often take days, the tests are not very useful.

Should I wear a mask?

Yes, if you are caring for someone with COVID or another communicable disease.  You should wear a mask to protect them from you spitting into them.  The mask does not provide you any protection.  

Yes, if you are caring for someone who is high-risk for infection.  You should wear an FDA surgical mask to protect them from you spitting into them.  The mask does not provide you any protection.

Yes, if you are a healthcare professional caring for sick folk.  You must wear a mask to protect them from you spitting into them.  The mask does not provide you any protection.

Yes, if you are exposed to occupational respiratory hazards, including bloodborne pathogens and airborne or aerosolized infectious pathogens.  You must wear the appropriate respiratory protection specified in your employer’s respiratory protection plan.

No, otherwise. Yes, that is the vast majority of folks.  A mask that is not a respirator provides NO respiratory protection nor source control, that is protection for others other than the potential to stop the wearer from spitting into another.

Should I wear a surgical mask?  

Yes, if you are a healthcare professional conducting medical procedures likely to splatter bodily fluids.  A surgical mask is fluid-resistant and helps block large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria) from reaching you.  They do NOT provide protection by filtration, only as a physical barrier.  They provide no respiratory protection.  A mask that is not a respiratory provides NOT respiratory protection nor source control, that is protection for others other than the potential to stop the wearer from spitting into another.

Should I wash my hands?

Yes.   We believe that hand washing prevents the spread of disease, but the evidence is sketchy at best.  We have some evidence that hand washing and cleaning and sterilizing objects prior to invasive procedures on the injured, sick, or immunocompromised help prevent the spread of disease.  We do not have evidence that washing hands helps prevent disease transmission in general terms.  

We do not have any reports of transmission of the COVID virus through hands, skin, objects, feces, blood, or other bodily fluids, food, nor other fluids.  We believe there is a remote possibility that some of these may play a role in introducing the virus into our bodies.  It may be possible that the COVID virus survives on the skin or objects and could enter the respiratory system if the skin or object is placed in a mucous membrane.  So, touching contaminated skin or objects to the eyes, ears, nose, mouth, or genitals is not advised and sharing objects, fluids, and foods is also not advised.  We know other contaminants can be transferred into the body in those fashions.

The human skin is an amazing organ that serves as a great barrier against penetration of most contaminants.  The protection stems from the oils/fats on and of the unbroken skin.

We are concerned that frequent and extended washings of hands strips fats/oils and helpful or symbiotic microorganisms or dry out the skin, which will then crack and present a pathway for contaminants.  In addition, chemicals such as alcohol or other antibacterial materials, such as some soaps, can promote antibiotic resistance, which is real and not desirable.

It is worth exploring methods to reduce the need for washing.  For example, hands-free operation of otherwise high-touch surfaces/objects may reduce the number of surfaces that need to be cleaned, as well as reduce the need or frequency for handwashing.

Should I wear gloves?

To protect against COVID: Probably not.  Unless there is a documented dermal/skin hazard as specified in your employer’s protection plan, the negatives of wearing gloves for the general public easily outweighs any benefits.

If you are caring for someone with COVID or another communicable disease or otherwise sick or immunocompromised, gloves can help protect you and them, if worn properly and disposed of properly.  Otherwise, gloves can help transfer contaminants and pose other risks.

Can I get COVID from someone simply breathing on me?

We are not sure.  We know that COVID and other diseases can be transmitted through coughs and sneezes and other releases of mucus and some other diseases can be transmitted through breaths (or contaminants from breaths) that exit an infected person and are breathed in by another person.  Coughs and sneezes, by far, propel contaminants to farthest from the infected person’s nose/mouth into the environment.  That said, one ought to be selective with whom one breathes on.

Should I wear eye or ear protection?

It is not clear if COVID can be spread through those mucous membranes, but other diseases are known to spread through introduction of contaminants to those membranes.  For the general public, it is unlikely that such measures provide much protection.  If you are exposed to occupational hazards, including bloodborne pathogens and airborne or aerosolized infectious pathogens, you must wear the appropriate respiratory protection specified in your employer’s respiratory protection plan.

Do masks pose dangers, harm, hazards, risks, or other costs?

Yes.  Masks are known to pose physical and psychological risks that can be significant.  Masks also pose the transfer risks similar to gloves.

As stated above, we know of no purpose of, or benefits from, the vast majority of masks you see on folks (often worn in a ridiculous fashion too).  They offer imaginary benefits with real risks and costs.

Masks that filter out contaminants like respirators pose clear challenges to breathing.  OSHA requires respirator wearers to have been medically evaluated prior to, and periodically, thereafter.  Wearers also must take off respirators if breathing becomes difficult or other issues arise.  Note: respirator safety is specialized and more complex than this document.

Despite the real risks, there are some spreading false information on the dangers of masks.  Masks which remain permeable, that is, allow air and gases (and some portion of some contaminants) to pass through, do NOT pose a hazard of low oxygen or high carbon dioxide, despite what some have said.  Masks can collect contaminants and become less permeable or allow contaminants to come in contact with the wearer or others.

Despite some spreading information from organizations which are either nonexistent or falsely suggesting some official governmental approval for an ADA (Americans with Disabilities Act) exemption from mask-wearing, organizations need to consider how they plan to accommodate folks with disabilities.  Processes to bring services and supplies to the sick and susceptible, the high-risk population, are amazing, good business, and simply the right thing to do and may help organizations need their ADA obligations.  Accommodations might include those processes and other practices, such as remote working.  Note:  the ADA is specialized and more complex than this document.

How do I dispose of masks?

For most uses, masks can be disposed of in ordinary trash.  Some masks are contaminated and need to be disposed of in specialty waste streams.  Note: contaminated waste disposal is specialized and more complex than this document.

What if I need to cough or sneeze?

Coughing and sneezing is an important part of our immune system.  Cough/sneeze into the crux of your elbow or your hand if your elbow is not available.  Those physical barriers provide some protection by physically catching the cough or sneeze and the saliva and mucus that often comes with it.  Of course, you then need to wash up.

How do I know if I have cleaned (and disinfected) properly?

You should follow the product manufacturer’s instructions as approved by USEPA; “deep cleaning” is not necessary for the general public.  It is a best practice to make cleaners visible (colored) and smellable, so that (nearly) everyone can see and smell that the cleaners were used.  The goal is to make it so everyone can tell quickly that an area or object has been recently cleaned (and disinfected).

Should I quarantine?

Isolation, seclusion, and quarantine are jargo for forms of separation which can help protect the public by preventing exposure to people who may have a contagious disease, that is an infectious disease that can spread from human to human.

The CDC defines the terms isolation and quarantine: Isolation separates sick people with a contagious disease from people who are not sick and quarantine separates and restricts the movement of people who were exposed to a person with a contagious disease to see if they become infected/sick.  Most people actually fall into the category of seclusion, which is a separation if it is suspected that they have been exposed to someone suspected of being infected/sick.  In most circumstances, it is not important to make a distinction between the three terms.  Strict separation prevents disease transmission, but also prevents life and living.  Separation after exposure can prevent the future transmission to others with whom one would have interacted, but does not prevent one from getting sick.  Isolation can prevent the future transmission to others with whom one would have interacted, but, by definition, happens only after one is known to be sick.  Since the moment of infection is never clear, isolation always starts too late to be entirely effective.  

If you suspect you are sick, you ought to separate from others.  Everyone in contact with you is at some risk of getting infected/sick.  Of course, if the symptoms are severe enough, you need to seek medical advice/attention, which generally requires breaking the separation.

As always, feedback is always welcome on my Facebook and LinkedIn pages or direct, via email.  Be well and wise. Serving the world from Kingman, AZ USA.