Treating a COVID19 patient in a shared space

This story is from a Russian scientist working in London. Auto-translated but I though it was good.

COVID19. What to do if someone gets sick at home and is not taken to the hospital, because the case is not the worst?

Yesterday, closing the laboratory for an indefinite, possibly very long time, I thought that we all – physiologists, immunologists, virologists, microbiologists and epidemiologists, along with surgeons and infectious disease specialists – had unique knowledge … I turned off the laminar, twisted the carbon dioxide cylinder , drained the incubator and the water bath, pulled out the plugs of all centrifuges, weights, stirrers and other things, did the hands, and it turned in my head that the University of Cambridge was quarantined many times in 800 years. Those epidemics of the plague have passed, and this one will pass … And yet it is the twilight of mankind, and no matter how many times they come, and whatever name they carry – cholera, plague, foot and mouth disease, AIDS, COVID19 – the invisible enemy is scary and paralyzing, it seems that he is everywhere and can attack at any moment. But in fact, in war as in war, the enemy also has Achilles heels,
So what should I do if someone starts coughing in the house and his temperature rises? And you suspect it might be COVID19? How to minimize the likelihood of infection of everyone else, but at the same time be able to care for the patient?

1. Immediately provide the patient with a separate room. If your apartment consists of one room and a kitchen, move to the kitchen, and leave the room for him. Remove from this room all the things that you may need — your clothes from the closet, from the table — a computer, etc. Wipe cleaned items with a cloth dampened in detergent, then wipe dry. It is very important. Where there is water, the infection lives longer.
Therefore, rule number one – wipe everything dry.
Rule two – if you are afraid that the patient touched the clothes, then it can be ironed – the virus dies at 56C or 133F.
1a. After you have isolated the patient in a separate room, disinfect the whole house if possible. Do not vacuum in any case, only wet cleaning with disinfectants, see point 7. It is better to remove carpets from all rooms right now, so as not to suffer. Those with carpeted floors are only cleaned with a hot vacuum cleaner. Quartz and other ultraviolet lamps will help you a lot if you have them. Ultraviolet light C (any radiation wavelength from 100 to 280 nm) perfectly kills the virus.
2. There should be a lot of drink in the patient’s room – thermoses with hot water or a kettle. A lot of big bottles of cold water. A lot, because with illness you have to drink a lot, and you should not run there with every cup.
3. Get a double bag in the room to collect garbage (napkins, food debris, etc.). In England, the collection of the murder of patients with COVID19 occurs separately from the main garbage, in Russia – I do not know. In any case, the garbage should be very tightly packed and tied up when you throw it away. Garbage is a source of infection for both you and other people.
4. Open a double bag for collecting dirty laundry in the room. The virus, as already mentioned, dies at 56C or 133F, so wash the patient’s things at 60 degrees and above. If your things can withstand such a washing temperature – you can wash them together with the things of the patient.
5. The room should contain all the medicines. Most likely, the infection will get stuck in the trachea or bronchi, so collect everything that you usually use with bronchitis in a separate box and place it in the patient’s room. And all the medicines with which you treat colds, and all the antipyretic drugs – collect everything and take it to this room. Do not run around the house and into the patient’s room with every tablet or spoon of medicine. Put ants for brewing tea in the patient’s room, too.
6. Get the patient a set of dishes and also keep it in the room. Not one cup, plate, spoon, but several. A person is sick – do not be greedy , he will not manage one cup. When he stains a lot of dishes, then bring them to wash (do not run around the house with every dirty spoon, I beg you!). The dishes can be washed with your dishes in the dishwasher if it washes with water above 56C or 133F. If you wash the dishes in the sink, pour the patient’s dishes with boiling water for 5 minutes, then wash with detergent. Then disinfect the sink.
7. About disinfectants. Detergent washes the virus well. Chlorine is good, it also perfectly kills this virus. And of course, 70% alcohol is also wonderful; it kills this virus in 30 seconds. An article appeared on the Bioarchive that the virus also kills ordinary vodka, but it has not yet been reviewed. Reviewed – we will know for sure. In the meantime, you can use vodka if there is no alcohol, detergent and bleach, but suddenly there is vodka . Just do not mix it up – use it externally, not inside  . And wipe all surfaces after vodka dry.
8. If you had the urge to wash the floor in the patient’s room (you’d better refrain from any cleaning in his room, I swear), but if it’s impatient, wipe the surfaces with detergents and disposable rags and napkins. And throw them in the same double garbage bag that stands in the patient’s room.
9. But it is necessary to ventilate the patient’s room. And do not open the window, but arrange a real draft. Let the patient lie down for 3 minutes under the covers. Do not stand on this draft yourself – he blows out the infection, you do not need to cling to it.
10. How to enter the patient’s room ?. Oh, get ready, this is a whole process, you will always need 3 minutes to do this. A long-sleeved robe on a carnation on the inside of the story. Preferably not fluffy. Put gloves next to them. And if you are so unlucky in life that you have excellent eyesight, then sunglasses. All other bespectacled men can and should use their day vision devices – Remove the lenses until better times. And the mask, of course. Because it is unlikely that your patient will agree to be masked all the time, 24 hours a day. If you agree – honor and praise be to him, it will be happiness. But old people and children are intractable. They are stuffy, tickled, hurt, uncomfortable coughing and sleeping in a mask, and they can be understood. So wear the mask yourself. We entered the room, put on gloves, a bathrobe, glasses, a mask. Children should like this ghost very much. Wouldn’t the kerchief hurt your hair? – Men, you also very fit this outfit! Now you can read a book to them, measure the temperature, dilute the seagull, make a cough massage, feed and sing a song. It would be better if you didn’t sit there for a long time, but how will it turn out …
11. How to leave the patient’s room? In reverse order . Remove sun-protection glasses, a scarf, a dressing gown, gloves, a mask, leave them in the room on the door on the carnation and go out. [It would be nice to throw the mask into a double bag for rubbish, and the rudder too if you have a disposable supply. It would be better to make a transitional gateway from the patient’s room to the common space and keep a bathrobe and stuff there]. How did you get out – immediately go to the bathroom, wash your face, glasses and hands with soap. And eat the candy, you are well done, you are already almost a microbiologist, virologist, physiologist and immunologist combined! Keep it up!
12. The general rule for all entertainment items – that the patient’s room is missing. Books from his room cannot be taken out at all. And soft toys too. Do not take out anything made of cloth, cardboard and paper. Do not run around the house, showing everyone his children’s drawing. The child will recover, the virus will die in 2-3 days – then you will boast. Washable toys would also be better not to endure, but if it is impatient, then wash them with soap or bleach. Or vodka – what do you have there for such cases. IPad and other computer toys would be better if it were his individual. But if you really need to make it, then wipe it with 70% alcohol. Not vodka. If there is no alcohol – do not take it. Once again, that fell into the patient’s room, it disappeared.
13. Bathroom and toilet – there is an ambush. It’s good when the patient has his own bathroom and toilet. Because the bastard virus in the intestine lives as well as in the lungs. Therefore, if it so happened that you share a bathroom with a patient and a toilet, then you will have to wash the toilet with bleach every time, and the bath and sink also with bleach or detergent. Wipe handles and switches with disposable wipes. And get him separate towels, and soak them at 60C or higher.
14. Well, the last. Both you and the patient need to sleep well. Nothing destroys immunity like bad sleep. Therefore, use all the sedatives that you usually take if you are nervous and cannot fall asleep. I’m getting around valerian.

I do not think the list is complete. I will add if I remember or read something.
Do not be ill. And get sick – fight!

Mask Reuse Advice from China During Covid 19

Advice collected from doctors posting on various Chinese social websites by Xiaotang Jiang

Two principles to reusing your masks:

1. high temperature  

2. no-water contact

For Covid-19 30 minutes at temperature above 56 degrees (133 F) is needed to deactivate the virus.

Do not wash the mask! The secret of strong protection ability of N95 is electrostatic adsorption. (See here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164087/ )

If you open a N95 mask, you would see a layer of meltblown non-woven fabric, which made of polypropylene and is a kind of ultra-fine electrostatic fiber. When you breathe through the non-woven fabric, the air passes normally, and all the dust and toxic droplets are all electrostatically captured. If you think about how your hair gets stuck to a a sweater in winter, the principle of N95 protection is similar.

After the air dust is electrostatically adsorbed, it is extremely difficult to detach, and there is no way to clean it. As long as the static electricity is present, the dust and germs are always there. 

Static electricity fears water. If the static electricity is gone, the mask will be useless and become a normal cotton mask.

Three major measures people practice in China to reuse masks:

  1. UV Sterilization   
  2. dry heater (e.g hot portable heater at home)   
  3. old style (seal the masks in a jar and put the bottle in boiling water for 10 mins)

Some people recommend spraying with 75% medical alcohol and leaving it to dry. 75% alcohol is ideal – 95% need to be diluted (when the concentration high, the dehydration reaction will be too fast, causing the contacted proteins to quickly coagulate, forming a protective hard film on the surface of the virus to prevent the penetration of alcohol)

 N95 mask is designed for medical professionals to use in high density contaminated environment. If you don’t go to hospital with N95, you can keep using it for more than a week.

 Medical and surgical masks (3 layers) are enough for public space, but not masks without the layer of meltblown non-woven fabric.

With these tips, you can maximize protection using limited mask resources.

 

Self-Quarantine Story of a Chinese Family Infected by Covid19 Virus

wanqianSource: Personal Weibo of QianWan, instructor of architecture

Translated excerpts from Phoenix TV Starface, written by YeShan, translated by Xiaotang Jiang, lightly edited by Max Kesin

Published on http://theresilient.us

 

Qian Wan (Wan), an instructor of architecture, in his mid 40s and lives with his wife, daughter and mother-in-law.

Wan’s wife is a doctor in a Wuhan hospital. At the beginning of the epidemic, his wife was doing virus infection testing at a hospital.

On January 23, in order to prevent problems beforehand, the director of his wife’s department, asked the staff and their families to get tested. Unexpectedly, her entire family has been diagnosed positive.

At the time medical resources were limited and hospital beds were in short supply. Since they were lower risk patients, they decided to quarantine at home and take medicine as prescribed by their doctor.

The diagnosis of the entire family meant that the patient cannot get all of the family’s attention and sometimes has to face difficulties alone. Wan, as the head of the family, can also sometimes be weak and self-doubtful. However his performance was exceptional. He and his family demonstrated a “textbook-like self-quarantine”

Wan is a rational person. He set himself a goal: “Protect yourself, in order to protect your family and others. How do I do it?”

“To protect yourself, first be calm and rational. Calmly analyze your illness, review the conditions of your family, analyze the various coping strategies, and make the most reasonable choices.”

First of all, they made an inventory of home supplies. Even before receiving the diagnosis the doctor wife had prepared enough toilet paper, alcohol, bleach, masks, and large garbage bags.

Then, Wan thought: a family of four are all patients, and whose fitness is relatively better?
Wan exercises regularly, swimming 4 times a week. Good exercise habits allow Wan to maintain good fitness and immunity.
Naturally Wan took the responsibility of the kitchen and bathroom cleaning.

In addition, while their symptoms were still mild, Wan and his wife made many plans.
The wife printed a sheet for taking medicine. It is marked with the times of medicines taken each day, hour and precautions. Tick it every time you take medicine. This is especially necessary for the elderly and children, to avoid forgetting or taking the wrong medicine.

Wan was also wondere: if the whole family gets worse at the same point, how to ensure the nutrition of the whole family? So he prepared a big bucket to prepare a large chicken soup. Without appetite, chicken soup can ensure basic nutrition and everyone has energy to carry on.

Extraordinary times also require extraordinary measures. To avoid cross-infection, the whole family decided to live separately. The mother-in-law lived in a separate room downstairs, and Wan and her daughter lived upstairs (wife was also isolated at home at the beginning, and then admitted to the hospital for treatment due to bilateral lung infection).

The washbasin, water cup and tableware used by everyone should be strictly distinguished, and to be boiled in boiling water. Mobile phones should also be disinfected with alcohol everyday. They wore masks even at home to prevent droplets from staying on the air and objects.

Wan video chatted with his mother-in-law every day to confirm her physical and mental state.

He paid great attention to disinfecting the toilet. There was research at that time that showed that the waste contained a virus, even aerosol transmission was suspected. A large amount of virus is excreted every day by his family. In order to prevent the virus from spreading, Wan strictly disinfected it according to the guidelines.

Masks and used paper towels will not be thrown into the public trash bins. Because tons of droplets on the masks and domestic garbage, once people touch it, the consequences are severe. Wan asked the entire family to use bleach to disinfect used masks. The small bag of garbage containing domestic waste is then packed and placed in a large garbage bag, to be disposed of after 20 minutes of disinfection.He also reminded the sanitation workers about the garbage bag: it is disinfected, still do not touch the inside.

A small move, rigorous and caring, to protect others.

January 24, Wan was diagnosed and started racing against time.

He tried to prepare everything he could before the worst onset. Arrangement of room, medication plan, diet preparation, disinfection and sanitation ……. While supplementing nutrition, he insisted on bed rest. Because he knew it would be a hard battle, he had to save energy.

January 28 was the hardest day for Wan.
A high fever started in the early morning and lasted for more than an hour. The body was out of control, but the consciousness was sober.
When someone asked him if he was worried about a high fever, he said lightly: I was never very worried because I have confidence in my body.

After the fever had gone down, he knew the worst was behind him.

From January 29th through February 4th, the virus and his body function continued to fight. Body temperature was continuously high and low. He stabilized the mentality of his family, watched his favorite movies, his daughter watched cartoons, his mother-in-law was bedridden, and his wife was treated in the hospital … He believed that as long as he followed the steps to live a good daily life, he had hope.

On February 4, the temperature of Wan and his family began to return to normal, and his lungs also recovered. This positive feedback continued from there.

Throughout the whole experience, Wan faced mood swings and self-doubts.
It’s not that he had no break down moment which is more due to his distrust of himself. He suspects that the knowledge and common sense in the brain will be overturned by this epidemic. But after hesitation, he figured out the nature of fear. “Fear is the most terrifying existence for everyone in the community. Facing panic, you will lose all reason, and only rely on the original desire to survive. The most important thing is the mentality. Don’t let anxiety get you while you are sick.”

He told himself: “Hope always exists. Once the medical system eases from the initial overload, it can play a normal role in dealing with the disease, and the vast majority of patients will be cured.”

Fate continued to play a joke on him. On February 15, the whole family went to the hospital for a nucleic acid test. The results remained positive, and they were still carriers of the virus. Wan had to move to a designated isolated hotel. He himself knew very well: “Whether it is negative” is only a matter of time, because the whole family was indeed recovering. The wife treated in the hospital is about to recover and be discharged.