Sunday, March 1, 2020

My Coronavirus Hygiene Protocol


By Glenn Campbell, last revised 20 March 2020

I stopped updating this document in mid-March 2020, when I was admitted to a hospital in Boston for an affliction not related to COVID-19 (lymphoma cancer). In my ward, everyone is screened for COVID, so I don't need to worry about it anymore. You should regard the advice below only as a starting point.

I travel continuously within the USA for work—driving other people's cars and pets around the country. I travel by car, plane and public transit, and I visit stores, restaurants and public restrooms almost every day. I am reasonably fearful of the coronavirus, since I am a not-technically-young citizen with some past health issues, but I believe I can reduce my chances of exposure with the steps and observations below. I don't mean these instructions to be definitive. They are just a starting point. At this early stage of the pandemic (March 2020), there's a lot we don't know, but we can make some reasonable assumptions based on past outbreaks and known information.

I know that I can't completely eliminate all risks, but I believe I can reduce them by 99%. Instead of protecting myself from every possible vector of contamination, I focus on the most likely ones.

These are my assumptions, based on current information:
  1. There's no risk in touching something that no one else has touched within the past three days (the maximum external life of the virus according to study).
    — This means I can enjoy complete freedom in nature and other places people rarely visit. It also means you can "sterilize" an object simply by not touching it for 3 days. 
  2. Unlike bacteria, viruses can't "grow" on surfaces, they can only be deposited there and degrade from that point on.
    This suggests that I should focus attention on surfaces that other people have touched recently with less concern about objects touched days ago.
  3. The virus prefers cool, dry environments. It is more likely to degrade in warm, humid environments. This contrasts with bacteria, which usually prefer the opposite.
    Virus is more of a concern in winter and in cold climates. Virus won't survive very long in places where you are sweating.
  4. Porous surfaces like fabric or paper are less likely to transfer the virus than non-porous surfaces. This is because the virus becomes embedded in the fibers and can't easily transfer to the skin.
    — This suggests that if you touch objects with your clothing or with paper products like tissues, the virus is unlikely to transfer to you before it degrades.
  5. The main vector of entry for the virus is touching an infected object with your hands then touching your face with your hands.
    This means the most important rule is to not touch your face at times when your hands might be tainted.
  6. The highest risk comes from touching something that a lot of people have touched, like elevator buttons, door handles, gasoline dispensers, etc. There is less risk from an object that only one or two people have touched.
    — This means my highest vigilance should focus on "high-traffic" surfaces.
  7. When people cough or sneeze, the highest risk is within about two meters of them, since the droplets they emit tend to settle from the air quickly.
    This means you should stay more than 2 meters away from anyone coughing or sneeze. However, you do need to worry about the surfaces where the droplets may have settled.
  8. "Aerosolization"  may be possible, but I assume it is unlikely until I hear evidence otherwise. Aerosolization is the distribution of the virus in "microdroplets" that can travel long distances of more than 2 meters, as opposed to bigger droplets from sneezes that fall out of the air quickly.
    Aerosolization, if a significant vector, is something I can do very little about, so I am choosing to ignore it for now. If it were a real source of infection, then you could never go to a store or other public indoor space.
  9. Masks are relatively useless for protecting yourself from the disease.
  10. Handwashing with soap is the most effective way to sanitize your hands, since it destroys the lipids that form part of the virus' shell.
  11. In the absence of soap and water, hand sanitizer and alcohol are effective ways to sanitize your hands.
I am only ASSUMING these things are true. I am always watching the news for evidence otherwise.

Based on these assumptions, I can assemble a "good enough" protocol that protects me from most sources of infection. I am concerned not just about protecting myself but protecting others. I also don't want be a jerk to people who aren't following the same protocol. I still want to engage in normal human interactions.

Here is some specific aspects of my protocol:

My Safe Zone

I consider the car I am driving (or my home if I had one) to be my Safe Zone, assuming it hasn't had much traffic from other people. I am also safe in nature or places that other humans rarely visit. I can do anything I want in my Safe Zone, the same as before; I can touch my face anytime, and I don't need to use hand sanitizer or wash my hands. I have to take special precautions only when I step out of this zone.

Hand Washing

I wash my hands with soap and water whenever I have the opportunity. Soap is said to be highly effective in killing the virus because it neutralizes lipids, which are a component of a virus. It is okay to touch a soap dispenser or faucet before I wash, but not after, so I use my elbow to turn off the faucet. Paper towels are safe, since no one has touched them, so long as I don't have to touch a dispenser. I use a paper towel or toilet tissue to turn a doorknob or pull a handle to exit a restroom.

Hand Sanitizer

I always travel with a bottle of hand sanitizer and a small bottle of alcohol (over 70%) for times when I can't wash my hands. I prefer hand sanitizer, but I can use alcohol instead. Since these things are currently in short supply, I use them sparingly. I apply just enough to wet the parts of my hand that actually touched a foreign surface. (There's no point in applying it to the back of my hand or between my fingers.) To apply alcohol, I purchase a bottle of perfume with a spritzer top (available at the dollar store). I throw away the perfume and replace it with alcohol. This lets me spray just enough alcohol to do the job without wasting any.

Leaving My Car

Whenever I leave my car, I take some paper napkins with me, and I leave a bottle of hand sanitizer on the driver's seat to remind me to use it when I return. I usually leave my cellphone in the car. This prevents me from being tempted to use it and cross-contaminate myself.

Using My Left Hand

After I leave my car, I try to use only my left hand to touch foreign objects that other people may of touched, like door handles. Once my hand has touched these objects, I treat it as "poisonous". I avoid touching my face or my right hand with it until I can wash or sanitize that hand. I use my left hand to leave my right hand free to touch my face or operate my cellphone (if I have it with me).

Napkins

I try to carry restaurant napkins in my pocket wherever I go. I can use them to protect my hands when I open doors. When practical the napkin can be thrown away immediately, but even if I keep it with me, I figure it is better than touching a door handle directly. Porous surfaces like paper and cloth are said to transfer the virus less effectively than non-porous surfaces. I consider a napkin or paper towel safe because no one is likely to have touched it prior to my taking it from the dispenser.

Air

For the time being I assume that the air in stores, airports, restrooms and most other places is safe, so long as I am not in close proximity to someone who looks sick. I can't do much about the air I breathe, so for now I am mainly concerned with surfaces, including places where droplet from an infected person may have settled.

Touching My Face

Not touching my face is a lot more difficult than it seems. It requires a lot of attention, so I attempt to do it only for short periods when I am away from my safe zone. If there is an itch on my face that I must scratch, I use a napkin from my pocket.

Money

Handling cash could be a problem, since it changes hands frequently. Bills are a porous surface, which less likely to transfer the virus, but coins are non-porous.

One way to avoid money is to use a credit card. Unfortunately, a credit card transaction usually requires you to use a keypad or touchscreen to enter information. These will have been touched by far more people than money you receive in change.

Instead, I "quarantine" the money I receive. As soon as I receive change for a cashier, I put it in a pocket that I only use for this purpose. Thereafter, I treat my pocket and my hand that handled the cash as "poisoned". When I return to my car or home base, I put the money in a plastic bag and don't touch it for a couple of days. I assume the virus will expire on its own.

Restrooms

I consider public restrooms to be easy to handle, since there are washing facilities on-site. After I wash my hands, I use my elbow to turn off the faucet, and I use a paper towel or toilet tissue to open the restroom door. 

Contact between buttocks and toilet seat is a potential source of infection, but I don't think it is a significant one. Outside a restroom, I don't often touch my own buttocks, so moving the virus from there to my face would be a long journey.

Restaurant Food

Restaurant food could be a big problem. It is not the food I'm worried about but the packaging and other things that the server or preparer might have handled. I have to analyze each situation to see what I should do to avoid touching something that someone else has touched.

Store Products

I see store products as relatively low risk. Someone has touched the product when they put it on the shelves, but it is likely only one person many hours ago. I try to use my left hand to touch products. If the epidemic becomes severe, I may wipe down the products with alcohol after I buy it, but for now it doesn't seem necessary.

Clothing

When possible I use my sleeve or another part of my clothing to open doors or otherwise touch foreign objects. For example, I can push open a door with my shoulder or hip. I also use my sleeve to touch elevator buttons. I figure virus in my clothing is highly unlikely to reach my face before it dies.

Shaking Hands

The custom of shaking hands should clearly be avoided, but I'm not going to be a jerk about it. If someone wants to shake my hand, I do it warmly, but I consider that hand "poisoned" until I can sanitize it.

Public Transit

Public transit can be a nightmare, especially when it is crowded. It's nearly impossible not to breathe other people's air and touch things that other people have touched. If things get bad, I may avoid public transit altogether. In the meantime, I am careful not to touch my face until I get off the bus/train and can sanitize my hands.

Health Club

A health club represents a special set of challenges. You are touching all sorts of equipment others have touched, and you're surrounded by a lot of sweating and heavily breathing people, no doubt spewing water droplets. There is not a lot I can do about the ambient air, but at least I rarely come within 2 meters of anyone else (except when the club is crowded). The one thing I have control over is what I touch. The only equipment I use is a treadmill and the showers. I usually use the treadmill for 30 minutes, and during this time I am touching the equipment, touching my face and touching my iPhone (because I can't live without it for 30 minutes).

My solution: I bring two clean rags with me, preferably of different colors. I wash my hands before my workout and take a shower after. During my workout I use one rag to touch my face when I feel I need to. I use the other rag to operate the equipment. This means I can keep my hands clean to operate my cellphone. 

There are a lot of risks in the health club, but at present I feel the benefits outweigh them. I want to be in top cardio-pulmonery shape when the coronavirus finally strikes me.

——

These are my starting rules. Since I'm now in the hospital with unrelated cancer, I will not be updating them.



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