COVID-19 Perceptions and Reality
This part of our blog, or
information share is part of study material and training HSE-RM solution has
provided, its tough to reach out to the masses, some might agree and disagree
on practices. HSE-RM Solution has always tried to be innovative and expressive
in terms of saying “The Why Spend Theory”. We prefer to adopt best
ones, always remember “TO LEARN
SOMETHING ITS IMPORTANT TO UNLEARN FIRST”
I came across an article published I remember reading which said about
the question everyone wants to know an answer for: “When people ask, ‘When will this end?’
they are asking about the social ending,” said Dr. Jeremy Greene, a historian
of medicine at Johns Hopkins.
In other words, an end can occur not because a disease has been
vanquished but because people grow tired of panic mode and learn to live with a
disease.
Searches everyday say “Coronavirus (COVID-19) events as they happen” do
really need to read all this.
Let’s understand the basics first and understand the depths of it. Few
recent terms used are first to be realised.
ð
Pandemic: A pandemic is declared when a new disease for which people do not have
immunity spreads around the world beyond expectations.
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Epidemic: An epidemic is a large outbreak, one that spreads among a population or
region. It is less severe than pandemic due to a limited area of spread.
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Endemic: A disease is called endemic when the presence or usual prevalence of
its infectious agent is constant within a given geographical area or population
group.
How to clean and disinfect? big
question asked, and panic buy, opportunity and business are flourishing. New vendors
came in market suppling products, like Fumigators, Sanitizer tunnel, hand sanitizers,
mask, gloves, PPE Kit and what not. To everyone’s surprise everyone is selling,
and demand is increasing every day. Most of the people didn’t even thought of
why buy its precaution take it or this will happen or that will happen, and fear
did its part in making opportunist market. “TRUE” but fact.
Let us argue case against each product basic which are in high demand.
1.
Mask
·
Did we see the guideline, who needs
to ware mask [person who has cold, cough so that when he sneezes, or cough
droplet spread does not happen]?
·
Now normal person to protect
himself as all will not listen started wearing mask and demand increased.
·
Which type of mask to wear? Very
simple any type any which will not let the droplet to come out. It can be
homemade with 3-4 layer of cloth as well. (NO need for common people to wear
N95)
·
Mask with face shield: super good
idea, but who is intentionally going to spit on you? Why you need the product for
style good actual use not known along with its efficiency.
·
Another major question was on
re-use of mask 80% of the mask are single use only, other then homemade cloth
mask which can be washed and re-used.
2.
Sanitizer Tunnel:
·
The concept of Sanitizer tunnel is
not new, most of pharma people are already aware of air washer and fumigation
technology. But its good for area where the fumigant is going to reside over
the surface after 10-15 min. of treatment. [without human presence]
·
Question is on effectiveness
understanding before purchase, what are you trying to do, most of the tunnels
use disinfectant spray [refer MSDS direct ingestion/exposure to eyes it is an irritant
and requires medical attention] as per MSDS of disinfectants soap solutions or
any chemical intake is not good by any means unless person is properly suited
with CBRN (chemical, biological, radiological and nuclear suit) used for
chemical rescue with self-contained breathing apparatus (SCBA) set.
·
Also medically these tunnel what
is quality test to assurance that its effective and for how long person has to stay
inside. [if person stays longer inside risk of chemical exposure & health
hazard persist and for less exposure disinfectant is of no use.] how to verify this
is simple take swab test sent it to lab for bacterial count some of places we
got the test done and result was its not at all effective.
·
Sanitizer tunnel was then
converted to Steam tunnel, it was advised to use steamer for better health. Normally
advised by ENT (Ear Nose Throat) Doctors also to take plain steam.
3.
Gloves
·
Gloves are made for single use
only especially surgical ones for they come in sterilized packing, once used
its of no use.
·
People are using cotton gloves, it
will attract bacteria and dirt so what is the use, its important to understand use
of glove. Where we should use glove, only where there is possibility that multiple
people have toughed and you are not going to get a chance to wash sooner.
·
More then gloves if we follow hand
hygiene its better washing hands. If possible avoid contact to surface.
4.
Hand Sanitizer
·
Hand sanitizers are more dangerous
for industry, for many people work near moving parts there is possibility of
static and also surface temperature can be auto ignite for sanitizer as well.
·
Few incidents also came out typically
sanitizer in car and there was fire, labour burning hand due to spark by
contact of surface with high temperature.
·
Sanitizers are good to be used
over glove not on hands, if there is possibility of washing hands avoid use of
hand sanitizer (remember its chemical also) larger exposure may cause harm to dermal
skin layers.
·
We should consider hand sanitizer
as SOS/emergency only, facilities have started putting it everywhere but use and
effect were not analysed properly.
·
Again, remember contact surface, wash
your hands with soap if not possible and its unavoidable you have to touch
surface you can use Hand Sanitizer.
5.
PPE Kits
·
Most of the kits I have seen are
single use only, but its for Medical staff, not for industry, why we are on
panic mode so much. Its like my opening statement that people want to live with
the disease then its fine.
·
I would suggest start giving this kit
to CORONA patient contain them.
·
In Pharma there is over gowning procedure
same if required can be adopted for industry as well, but only selective where
occupancy is high and in close proximity there are many people.
·
These are last resort if above
cannot be done.
SESSION: SOLUTIONS
-
Hand Hygiene
o Maintain proper Hand always wash hand prior to eating.
o Avoid touching your face when you are working.
o Before touching surface, you can use disinfectant to wipe it. [Surface
disinfectants are many in market use any or you can prepare soap solution] only
on surface where other person has touched as well.
o
Washing hands for 20 seconds is not enough properly washing hand is
required. Use proper method follow teach and guide for the same. [Training to
be Given] Refresher training to be given to people, engage them and family
prepare about hand hygiene.]
Hands are main source on contacting any contamination. Our first contact
to any surface is hand. As best practice we always force people to follow hand
hygiene. Below video link is to explain importance of it.
-
Sanitization:
o Sanitization has two parts
§ Personal and
§ Surrounding Surfaces.
o
Personal
§ Personal Sanitization include our behaviour, how we work, what type of
work we have.
§ Personal Hygiene is one of the major concerns among many people. Its one
of the reasons for the spread of any diseases.
§ Personal Hygiene is not limited to one keeping self-clean, but how we
behave what are our practices when we work, manners etc. [Most focused area]
§ Personal hygiene basic chart includes below things that most of us are
aware
§ Part of BBS (behaviour base safety)]
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ð
Sleep
o Early
to bed, early to rise. [Is known to all]
o Minimum
6-8hr of sleep is said to be completely rested.
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Teeth
o Brush
teeth every morning and night. [most of us follow morning routine but forget
in night]
o Teeth
are one of major source of providing host to any bacteria or virus, for food
is there which can decay and can help it grow.
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ð
Nails
o Trim
nails weekly, keep nails short and clean.
o Dirt
below nail can enter through ingestion when we eat with hand.
o Most people
have habit of eating with hand without ensuring proper hand cleaning and shorter
nails hence avoid eating with hand try spoon.
o Basic
Manner eating with spoon and how to avoid hand getting dirty
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ð
Hair
o Wash
your hairs often keep it neat. [Washing hair is needed for most of the time
we touch our hairs]
o Hairs
have natural static to attract dirt and dust (source of bacteria and Virus)
if hairs are not clean and we touch them contamination can spread.
o Full
bath should include washing hair every day, especially when we come from
outside/Work. Makes you feel better and fresh as well.
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ð
Exercise
o Physical
exercise is very important, only yoga sitting in one place wont work.
o Physical
exercise does not mean your work or daily household work.
o Everyday
minimum 10-15 min walk, jump, run, skipping etc. anything that exerts our
body.
o Physically
these 10-15 min workouts will help you increase your stamina and breathing.
(For better Immune system)
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ð
Hygiene
o Bath
or Shower and change personal garments daily, wash hands after visiting
toilet and before eating.
o Most people
avoid taking full bath when they return home from work this is bad hygiene,
you must.
o Also,
at work, personal hygiene is must washing hands before eating, cleaning them
before using your electronics (Personal phones).
o Communication
system used at offices should be speaker based if possible, if unavoidable
try using hands free system
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§ Explaining use of electronics in Personal hygiene
·
While picking up phone if you feel
your ands are dirty try simple device like hands free on auto answer mode.
·
Mobile phones are most venerable
source of contamination try and avoid use in public. Also, at work if extremely
necessary try touch pencil with cover or put a plastic cover over your phone
and then touch.
o Procedure will be washing hands with clean hands take a Ziplock bag/
cover bag mostly used during rains. now while removing cover also first clean
the surface where you want to place your phone, remove cover don’t touch it and
wash your hands now you are ready to go try not to do it in work premises its
better you do it at home.
o At home always have a dedicated place for keeping mobile phones away
from bedroom (have fix time schedule of phone at home, give time to family)
o As part of personal hygiene its must to ensure anything that we get from
outside is cleaned first, as soon we are back home first try not to touch any
surface but wash your hands, change clothes (if you were been to a place of
public access, workplace, shops, malls, bus stand, or any public place)
§
Surrounding Surfaces
·
Surface sanitization is most easy
to understand and follow, guidelines clearly states contact surfaces only, we
try and overdo by spraying the entire facility.
·
In panic people are sanitizing
entire factory premises, containers, dispatch vehicles etc. few incidents that
came across was self-ignition material burned, person injury due to spillage,
fumes causing harm etc.
·
Surface sanitation should be done
with normal disinfectant only most of the surfaces to be covered with wipeable coating
covers so that disinfectant can be used, specially workstations. Files,
stationary to be touched by one-person at a time only ensuring he has washed
hand before touching them.
SESSION : BASICS
OF UNDERSTANDING VIRUS & BACTERIA
How do viruses differ from
bacteria?
By Definition:
Viruses are tinier than bacteria. In fact, the largest virus is smaller
than the smallest bacterium. All viruses have is a protein coat and a core of
genetic material, either RNA or DNA. Unlike bacteria, viruses can't survive without a host.
They can only reproduce by attaching themselves to cells. In most cases, they reprogram the cells to make
new viruses until the cells burst and die. In other cases, they turn normal cells into
malignant or cancerous cells.
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S.N.
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Character
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Bacteria
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Virus
|
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1
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Cell type
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Prokaryotic cells
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Acellular
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2
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Number of cells
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Single-celled
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No cell
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3
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Size
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Larger than viruses (0.3-2 μ)
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Minute (0.02-0.3 μ)
|
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4
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Microscopy
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Visible under Light Microscope.
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Visible only under an Electron
Microscope.
|
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5
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Shape
|
Common bacterial cell shapes include
ð
cocci (spherical),
ð
bacilli (rod-shaped),
ð
spiral, and
ð
vibrio (comma-shaped).
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Viruses typically have
ð
spherical (polyhedral),
ð
rod-shaped, or
ð
helically shaped capsids
ð
while some viruses, such as bacteriophages, have complex shapes.
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|
6
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Cellular Machinery
|
Possesses a cellular machinery
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Lack of cellular machinery
|
|
7
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Type of organism
|
Mostly intercellular organisms (i.e.
they live in-between cells); some intracellular.
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Intracellular organisms (they
infiltrate the host cell and live inside the cell).
|
|
8
|
Structure
|
Organelles and genetic material
within a cell wall
|
Genetic material within a capsid,
some have an envelope membrane.
|
|
9
|
Cell wall
|
Cell wall made of peptidoglycan and lipopolysaccharide.
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No cell wall. Protein coat presents
instead.
|
|
10
|
Cellular membrane
|
Cell membranes present. No sterol
except in Mycoplasma cells which have cholesterol.
|
Some are enveloped, but no membrane
function.
|
|
11
|
Genome
|
DNA and RNA
|
DNA or RNA
|
|
1 chromosome
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1 nucleocapsid except in segmented or
diploid viruses
|
||
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No histones
|
|
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12
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Nucleic acid
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DNA and RNA floating freely in the
cytoplasm.
|
DNA or RNA is enclosed inside a coat
of protein.
|
|
13
|
mRNA
|
Mono- and poly-cistronic mRNA
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Some have poly-cistronic mRNA and
post-translational cleavage.
|
|
14
|
Cell organelles
|
Presence of non-membrane bound cell
organelles.
|
Absent. Uses host organelles;
obligate intracellular parasites
|
|
15
|
Ribosomes
|
70s ribosomes (30s+50s)
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No ribosomes
|
|
16
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Living
attributes
|
Living
organisms.
|
Between
living and non-living things.
|
|
17
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Replication
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Binary fission (asexual). DNA
replicates cells continuously.
|
It invades a host cell and takes over
the cell causing it to make copies of the viral DNA/RNA. Destroys the host
cell releasing new viruses.
|
|
18
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The
need for host cell
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Able
to reproduce by itself.
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Need
a living cell to reproduce
|
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19
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Other forms
|
In some spore-forming bacteria,
sporulating forms can be seen.
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Besides viruses, two other acellular
forms exist Viroids and Prions.
|
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20
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Cells Infected
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Animal, Plant, Fungi
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Animal, Plant, Protozoa, Fungi,
Bacteria, Archaea
|
|
21
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Infection
|
Localized
|
Systemic
|
|
22
|
Induction
of Fever
|
A
bacterial illness notoriously causes a fever
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A
viral infection may or may not cause a fever.
|
|
23
|
Duration
of illness
|
A
bacterial illness commonly will last longer than 10 days.
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Most
viral illnesses last 2 to 10 days.
|
|
24
|
Diseases/Infections
|
Food
poisoning, gastritis, and ulcers, meningitis, pneumonia, etc
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AIDS,
common cold, influenza, chickenpox, etc
|
|
25
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Susceptibility to Antibiotics
|
Most bacteria are susceptible to
antibiotics.
|
The virus does not respond to
antibiotics.
|
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26
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Treatment
|
Antibiotics
|
Antiviral drugs
|
|
27
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Beneficial use
|
Some bacteria are beneficial (as
normal flora, probiotics, fermenters, etc.)
|
Viruses are not beneficial. However,
a particular virus may be able to destroy brain tumors. Viruses can be useful
in genetic engineering.
|
|
28
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Examples
|
E.coli, Salmonella spp., Listeria
spp., Mycobacteria spp., Staphylococcus spp., Bacillus
anthracis, etc.
|
HIV, Hepatitis A virus, Rhino Virus,
Ebola virus, etc. now CORONA as well.
|
SESSION : SOURCE OF
INFORMATION
India and Known Source of Information
The National Institute of Virology is one of the major Institutes of the
Indian Council of Medical Research (ICMR). It was established at Pune,
Maharashtra, India in 1952 as Virus Research Centre (VRC) under the auspices of
the ICMR and the Rockefeller Foundation (RF), USA. It was an outcome of the
global programme of the RF for investigating the Arthropod Borne viruses. Since
the studies on arboviruses and their arthropod vectors involve most of the
basic principles and techniques of general virology, entomology and zoology,
these viruses were also considered to be an ideal group, to begin with, for
intensive training and research in virology. The RF withdrew its support in
1967 and since then the institute has been funded by the ICMR.
The institute was designated as one of the collaborating laboratories of
the World Health Organization (WHO) in 1967 and it started functioning as the
regional centre of the WHO for South-East Asia for arbovirus studies from 1969.
Since 1974, it has been functioning as a WHO collaborating centre for arbovirus
reference and research. In 1995 it has been redesignated as the WHO
Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and
Research and Rapid Diagnosis of Viral Diseases.
NIV is also the National Centre for Hepatitis and Influenza. The field
unit of NIV at Bengaluru is one of the centres under National Polio
Surveillance Programme conducting surveillance of acute flaccid paralysis cases
from Karnataka as a part of Global Polio Eradication Programme of the WHO
South-East Asia region since 1997. World Health Organization (WHO) Regional
Collaborating Centre for Reference and Research on Arboviruses, Influenza and
Measles as well as National Reference Centre for Hepatitis, Avian Influenza and
emerging infectious diseases.
ICMR Guidelines
COVID-19: Guidelines on disinfection of common public places including
offices
Scope: This document aims to provide interim guidance about the environmental
cleaning /decontamination of common public places including offices in areas
reporting COVID-19.
Coronavirus Disease 2019 (COVID -19) is an acute respiratory disease
caused by a novel Coronavirus (SARS-CoV-2), transmitted in most instances
through respiratory droplets, direct contact with cases and also through
contaminated surfaces/objects. Though the virus survives on environmental
surfaces for varied period of time, it gets easily inactivated by
chemical disinfectants.
In view of the above, the following guidelines are to be followed,
especially in areas reporting COVID-19. For ease of implementation the
guideline divided these areas into (i) indoor areas, (ii) outdoor areas and
(iii) public toilets.
Office spaces, including conference
rooms should be cleaned every evening after office hours or early in the
morning before the rooms are occupied. If contact surface is visibly dirty, it
should be cleaned with soap and water prior to disinfection. Prior to cleaning,
the worker should wear disposable rubber boots, gloves (heavy duty), and a
triple layer mask.
[Remark: As stated all above we were already doing, What we should
understand is that we need to ensure its done. Guidelines specifies to clean
contact surfaces surface, also it states to discard PPE not to be reused.]
Outdoor areas
Outdoor areas have less risk then
indoor areas due to air currents and exposure to sunlight. These include bus
stops, railway platforms, parks, roads, etc. Cleaning and disinfection efforts
should be targeted to frequently touched / contaminated surfaces as already
detailed above.
· To prevent cross contamination, discard cleaning material made of cloth
(mop and wiping cloth) in appropriate bags after cleaning and disinfecting.
Wear new pair of gloves and fasten the bag.
· Disinfect all cleaning equipment after use and before using in other
area
· Disinfect buckets by soaking in bleach solution or rinse in hot water
Information on initiatives
Box 1.1. Global and national initiatives for infection prevention and
control
Global action
· International Health Regulations, 2005
o containment of AMR, a strategic priority
· United Nations Sustainable Development Goals
o emphasis on safe water, sanitation and hygiene (WASH)
· World Alliance for Patient Safety
· WHO Patient Safety Programme
o “clean care is safer care”
· Regional Strategy for Patient Safety (2016–2025), WHO South-East Asia
Region
· WHO Guidelines on Core Components of Infection Control Programmes
National initiatives
· Biomedical Waste Management Rules in 1998 (revised in 2016 and 2018) by
Ministry of Environment and Forests
· The “Kayakalp” programme by the Government of India, 2015
· National Guidelines on Clean Hospitals (Swacchhta Guidelines), 2015
· National Quality Assurance Standards for Public Health Facilities, 2017
· National Patient Safety Implementation Framework, 2018–2025
Annex 2: IPC precautions pending confirmation of diagnosis
|
Clinical Syndrome or Condition
|
Suspected Pathogen
|
Empirical precautions (always includes standard Precautions)
|
|
Cough/ fever/ pulmonary infiltrate in any lung location in a patient
with a history of recent travel (10–21 days) to countries with active
outbreaks of SARS, avian influenza
|
Severe acute respiratory syndrome virus (SARSCoV), avian influenza,
novel coronavirus, M. tuberculosis
|
Airborne plus contact precautions plus eye protection; droplet
precautions instead of airborne precautions if tuberculosis unlikely
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