Dear Colleagues, as some of you may recall, when I was a professor of
pathology at the University of California San Diego,
I was one of the first molecular virologists in the world to work on
coronaviruses (the 1970s). I was the first to
demonstrate the number of genes the virus contained. Since then, I have
kept up with the coronavirus field and its multiple
clinical transfers into the human population (e.g., SARS, MERS), from
different animal sources.
The current projections for its expansion in the US are only probable,
due to continued insufficient worldwide data, but it
is most likely to be widespread in the US by mid to late March and April.
Here is what I have done and the precautions that I take and will take.
These are the same precautions I currently use
during our influenza seasons, except for the mask and gloves.:
1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
2) Use ONLY your knuckle to touch light switches. elevator buttons,
etc.. Lift the gasoline dispenser with a paper towel or
use a disposable glove.
3) Open doors with your closed fist or hip - do not grasp the handle
with your hand, unless there is no other way to open
the door. Especially important on bathroom and post office/commercial doors.
4) Use disinfectant wipes at the stores when they are available,
including wiping the handle and child seat in grocery
carts.
5) Wash your hands with soap for 10-20 seconds and/or use a greater than
60% alcohol-based hand sanitizer whenever you
return home from ANY activity that involves locations where other people
have been.
6) Keep a bottle of sanitizer available at each of your home's
entrances. AND in your car for use after getting gas or
touching other contaminated objects when you can't immediately wash your
hands.
7) If possible, cough or sneeze into a disposable tissue and discard.
Use your elbow only if you have to. The clothing on
your elbow will contain infectious virus that can be passed on for up to
a week or more!
What I have stocked in preparation for the pandemic spread to the US:
1) Latex or nitrile latex disposable gloves for use when going shopping,
using the gasoline pump, and all other outside
activity when you come in contact with contaminated areas.
Note: This virus is spread in large droplets by coughing and sneezing.
This means that the air will not infect you! BUT all
the surfaces where these droplets land are infectious for about a week
on average - everything that is associated with
infected people will be contaminated and potentially infectious. The
virus is on surfaces and you will not be infected
unless your unprotected face is directly coughed or sneezed upon. This
virus only has cell receptors for lung cells (it
only infects your lungs) The only way for the virus to infect you is
through your nose or mouth via your hands or an
infected cough or sneeze onto or into your nose or mouth.
2) Stock up now with disposable surgical masks and use them to prevent
you from touching your nose and/or mouth (We touch
our nose/mouth 90X/day without knowing it!). This is the only way this
virus can infect you - it is lung-specific. The mask
will not prevent the virus in a direct sneeze from getting into your
nose or mouth - it is only to keep you from touching
your nose or mouth.
3) Stock up now with hand sanitizers and latex/nitrile gloves (get the
appropriate sizes for your family). The hand
sanitizers must be alcohol-based and greater than 60% alcohol to be
effective.
4) Stock up now with zinc lozenges. These lozenges have been proven to
be effective in blocking coronavirus (and most other
viruses) from multiplying in your throat and nasopharynx. Use as
directed several times each day when you begin to feel ANY
"cold-like" symptoms beginning. It is best to lie down and let the
lozenge dissolve in the back of your throat and
nasopharynx. Cold-Eeze lozenges is one brand available, but there are
other brands available.
I, as many others do, hope that this pandemic will be reasonably
contained, BUT I personally do not think it will be.
Humans have never seen this snake-associated virus before and have no
internal defense against it. Tremendous worldwide
efforts are being made to understand the molecular and clinical virology
of this virus. Unbelievable molecular knowledge
about the genomics, structure, and virulence of this virus has already
been achieved. BUT, there will be NO drugs or
vaccines available this year to protect us or limit the infection within
us. Only symptomatic support is available.
I hope these personal thoughts will be helpful during this potentially
catastrophic pandemic. You are welcome to share this
email. Good luck to all of us! Jim
James Robb, MD FCAP
