To all,
COVID19-OBSERVATIONS:
I am probably preaching to the choir as everybody in our Division is experienced in airborne contamination and respiratory protection.
I have more than 40 years' respiratory protection experience including: specifying, procurement and testing as well as developing and implementing training programs, procedures for medical evaluations, fit-testing, decontamination and disposal of the masks. My experience includes Full-Face and Half-Face Filtering and supplied air as well as SCBA and specifying Levels A through D PPE. I perform qualitative and quantitative fit testing.
I have also worked in contaminated atmospheres while wearing just about every type of respirator in existence for the past 40 years. I have been fit tested dozens of times and have fit tested others thousands of times.
I have also sampled the atmospheres, analyzed the samples, performed initial assessments, monitored employees working in those environments and prepared the reports and assessment.
I have spent much of my professional life involved in respiratory protection.
The manner in which the general public are wearing N95 FF Respirators does not qualify as actually wear these masks as a "respirator". None of these people have been trained to wear them nor have they been fit tested.
In my opinion, wearing these masks by the general public is at best a placebo and at worst may even exacerbate the problem by providing a false sense of security. Inhalation without a face seal may even accelerate the air flow around the gaps between the masks because the differential pressure across filtering face piece media restricts air flow causing the inhaled air to travel through those gaps.
My own observations while out and about shopping reveal that stores require 6 foot separation when entering and when checking out at the registers but the people are milling about right next to each other while shopping.
Shoppers are constantly milling around touching products after others have touched them.
Many store workers and shoppers are wearing rubber gloves but they never change them, this practice achieves nothing.
Most people have never been trained on how to remove gloves or masks to prevent cross contamination.
Very few people I observe are wearing N95 Filtering Face respirators and I would hazard that those that do wear them have not been trained on how to don and doff them nor have they been fit tested.
Even with all the problems associated with equipment and technique statistics reveal that so far there have been 4 fatalities of grocery store employees out of 4,000,000 grocery workers nationwide.
Although I do not want to minimize this pandemic I would like to mention the following:
Let's not lose perspective:
- 25% of America's counties in have been totally unaffected by COVID19.
- More than 50% of the fatalities are in NY City and the surrounding suburbs where massive public transportation and close quarter living is the rule of the day.
- 95 % of the fatalities are 70 to 80 years with multiple serious health issues.
- No Americans under 10 years have died from Covid19
- 50% of those infected do not even know they had this virus.
- As of March 14th this years an estimated 35,000 Americans died of the H1N1 flu.
- Last year (2018-1019) 80,000 Americans died of the flu.
- On average between 12,000 and 56,000 Americans die of seasonal flu related issues.
- We do not know how many of the Covid19 fatalities also had the seasonal flu also.
- Anecdotal stories aside: very, very few otherwise healthy people under the age of 60 died from this virus
Lets' hope what we are learning from this Covid 19 pandemic will help us develop practical strategies for reducing the unacceptable death rates we continue to experience from the seasonal flu.
Perhaps we can better inform the people of the dangers associated with seasonal flu and engender an appropriate level of voluntary caution on the part of the elderly and otherwise high risk members of the public.
My hope is that in the future we can more than make a dent in the abovementioned statistics and keep those wise old folks around a bit longer.
Respectfully,
Jim Keating
From: ACS Division of Chemical Health and Safety <DCHAS-L**At_Symbol_Here**PRINCETON.EDU> On Behalf Of Zack Mansdorf
Sent: Wednesday, April 15, 2020 11:04 AM
To: DCHAS-L**At_Symbol_Here**PRINCETON.EDU
Subject: Re: [DCHAS-L] [EXTERNAL] Re: [DCHAS-L] Ask Dr. Safety: Recovery and Contingency - A Virtual Symposium Wednesday Evening April 15th
Risking life and limb, I will once more go into the breech.
There has been a tremendous emphasis on testing and some very hopeful developments (e.g., the salvia test). Many have pointed out that while we have done more tests than anybody else, but we have not done more on a per capita basis. This is in part due to our regulatory system where whatever testing we do must be reliable and accurate (while not so much in some other countries). There is some indication this (false negative) may have led to what some are calling reinfections.
Dr. Hall can weigh in, but the normal course is to test symptomatic persons. We will never be in a position to test everyone (320 million) and unless you need it and are very sick or becoming very sick, it does not change anything for those with mild symptoms. More importantly, what does a negative test do. I could test negative on Tuesday and become infected on Wednesday and then infect others the following week. Are we suggesting daily testing?
Persons who are symptomatic or thought to have the disease definitely should be absolutely tested.
I think our ultimate salivation will be a combination of smart public health and the immuno-assay.
Stay safe and well
Zack
What I have yet to see so far are the positive and negative predictive values for any available tests. I'm doing a literature search on this issue today, but limited internet bandwidth at least where I live is seriously hampering this effort. There is also the emerging issue of re-infection which certainly has implications for return-to-work status.
If I come up with anything relevant, I'll share it with the group.
Saying we have "tested more people in this country than any other country" is not helpful. The truth is, we have tested less than 1% of our population. We cannot expect people to go back to work, school, socializing, etc, until we know who is a carrier and potential infector versus who isn't.
The temperature screening will catch the really low-hanging fruit of those who are actively sick and showing fever symptoms. It will not catch anyone who is shedding virus before or after having symptoms, or shedding without showing any symptoms at all. I just saw a case today of a woman who was "presumptive COVID-19 positive" (because she couldn't get a test while showing symptoms), who tested positive for COVID-19 4 weeks post-symptoms!
This virus is not behaving according to other viruses we have dealt with. And all the information is not even known yet. We must remain super-vigilant in using all the protective gear we can when dealing with other people.
Stefanie Gangano
Some people can not realize that they have a low grade temp because they don't feel cruddy until later, if at all. They may just think that they are tired, stressed or generally run down. In fact some of those folks that classified as asymptomatic, might be better classified as mildly symptomatic.
Have you considered having the person use the thermometer while the screening person is maintaining the 6 ft distance? The screening person could then come and read the thermometer after the incoming person sets it down. In that case all that would need to be done is the screening person would need gloves and appropriate disinfectant wipes to clean the thermometers and other touched surfaces. If that would logistically work?
Monna:
First, we actually have tested more people than any other country in the world. Some of the testing in some countries (such as China) had poor reliability. Antibodies normally indicate that you are over the infection if you are walking around versus being treated and I am not aware of any test for "shedding". Tests for having the infection would not make sense if you have no symptoms (it is not practical to test 320 million people). Having a negative test on Tuesday, means you do not have the virus on Tuesday. Maybe you get it Wednesday.
Zack
Gee, how about we test people? There are tests for shedding, tests for anitbodies (doesn't mean you still aren't shedding) and tests for just plain having the virus. We see a lot more testing in other countries. You can't fix what you can't track. Monona
-----Original Message-----
To: DCHAS-L**At_Symbol_Here**PRINCETON.EDU
Sent: Fri, Apr 10, 2020 11:33 am
Subject: Re: [DCHAS-L] Ask Dr. Safety: Recovery and Contingency - A Virtual Symposium Wednesday Evening April 15th
While it is true that perhaps as much as 50% or those infected are asymptomatic, what else can be done as a screen in the absence of a readily available quick turn-around test for the virus or antibodies?
Temperature screening was more effective with SARS-1 since it looked like the asymptomatic were not infectious.
At least a temperature screen will identify _some_ of those infected. These days, the perfect cannot be the enemy of the "sort-of OK."
That sounds about right on the PPE, with the mask an N95 if possible. But the policy is flawed because the asymptomatic carriers will waltz through your test and into the building. Monona
WE ARE INSTITUTING A MANADATORY TEMPERATURE BE TAKEN OF EVERY PERSON ENTERING OUR BUILDING. THE QUESTION CAME UP AFTER WE PURCHASED THE TEMORAL THERMOMETERS, WHAT SHOULD THE PPE BE FOR THIS PERSON? OBVIOUSLY THEY CANT BE 6 FEET APART.
OUR SHORT ANSWERT WAS LAB COAT, MASK, FACE SHIELD AND GLOVES.
ANY OTHER RECOMMENDATIONS FOR NON MEDICAL FACILITIES?
Michael I. Schaffer, Ph.D., F.A.B.F.T., NRCC-TC
(800) 522-7424 (toll free) Extension 140
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This Message Originated Outside the Company
Last night, Neal and I hosted a version of "Ask Dr. Safety" and it was a hit - so much so that people wanted more and they told us what they wanted to talk about: Recovery and Contingency planning for post-COVID-19 activities.
So, Wednesday, April 15th, 9PM Eastern (8PM Central, 7PM Mountain, 6PM Pacific) we will be having a second round of Ask Dr. Safety on Google Meet.
Harry J. Elston, Ph.D., CIH, PMP
Principal, Midwest Chemical Safety
Standard confidentiality terms apply to this e-mail message.
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