April 2020

How to Protect yourself  during the Pandemic

This is a travel blog…

Why am I writing about this?

While waiting in the 45 minutes line to get into Trader Joe’s this past weekend, I noticed so many people walking out of the store with gloves on… gloves that touched everything in the store… and then they were touching their phone… mask… steering wheel. This cross contamination is why we are stuck in COVID cycles! Then when out with Kevin, he continued to fidget with his mask – “Do not touch your face!!!” I realized, the authorities are telling people to wear masks and gloves but NOT instructing them on how to properly use them. This is actually causing more problems giving people a false sense of security in wearing them instead of being more cautious about what they touch when they have gloves and masks on.  Touching your face with potentially contaminated hands is the worst thing you can do – and we touch our faces a lot – over 25 times an hour! So it is so important to be mindful at all times where your hands are when you are outside your house.

What qualifies me to give this information?

I am a hospital pharmacist. I have been making sterile IV medications since 2008 and that means I have been wearing personal protective equipment (PPE) for awhile. The goal of PPE in this setting is to protect the IV medication from getting contaminated by the person making the preparation (keeping it sterile!). Pharmacy clean rooms – where these sterile IVs are made – are cleaner than the OR in the hospital. I also teach this exact topic at the pharmacy school.

So I took to Instagram and did my first ever live stream for an eager group of learners!

…and now it is gone. I tried to save the video and clearly failed. Which is why I am taking to the medium I am most comfortable with and writing a post!

Masks

• Make sure to wear the mask properly – masks with ties or ear loops should be secured, the top should go completed over the nose with nose bridge secured to the nose, and the bottom should cover the entire mouth.

• Medical grade masks are best – does not need to be an N95, surgical masks are good, then construction grade masks. If you can’t get either like most people during the pandemic, wear a cloth mask.
• Once the mask is on, DO NOT TOUCH IT!
  • If the mask slides or falls, resist the urge to fix it unless you just washed your hands – this is the biggest contamination risk – you are better off not touching or fixing the mask
  • Absolutely do not touch the mask with gloves on!
• When taking the mask off, do not touch the outside of the mask – only work with the ear loops or straps

Gloves

• Honestly, you may be better off not wearing them if you can’t get the principles of cross contamination down cause you may be at a higher risk of contaminating yourself with them on
• If you can, find gloves that fit your hands snugly – if the gloves are too big, you will not be able to control the movements as well which increases your risk of touching things you shouldn’t
• Assume when you put your gloves on you have COVID germs all over the outside of them
• Scenario demonstrating the dangers of gloves with cross contamination
  • Image you are in the store with your gloves on and you touch a box that had COVID germs… now the COVID germs are on your gloves… then you touch your mask to fix it… now the COVID germs are on your mask (potentially your face!)… then you get a text message and take out your phone… not the COVID germs are on your cell phone… then you go to check out at the store… you reach deep into your pockets or purse to get a form of payment… now the COVID germs are on your pockets or purse, form of payment, and wallet… then you put your items in the car and drive home… now the COVID germs are all over your steering wheel, gear shift, etc. This is just an example of how the virus spreads! Will you remember to disinfect every single item that may have gotten the COVID germs???
• Here is how I recommend you wear gloves
  • Put them on right before you need to use them – so when I am in line to get into the store, I put them on right before it is my turn
  • Only touch what you need to touch
  • DO NOT TOUCH your belongings, your mask, or your face!
  • When I am done at the store, I put the cart next to my car and take one glove off – the un-gloved hand touches the car opening the door and the gloved hand moved the items into the car. Put the cart back (if you have a cart) and take off the other glove without touching the outside of it (grab it from the inside). Bring a plastic bag with you and put the gloves into the bag so the germs are sealed up (DO NOT LEAVE THEM ON THE GROUND).

When you get home with your items- bring them in and then IMMEDIATELY WASH YOUR HANDS – do not touch anything else, do not take your jacket off, nothing. Bring the items in then wash your hands. We will talk about having a decontamination station in your house coming up.

Go with as little stuff as possible

• If you go out, bring as few items as possible
• Of what you bring, make it as accessible as possible
  • I bring my phone (which never leaves my pocket / sling), a credit card for payment that goes into the most accessible pocket I have at the moment, and my car keys (which I never touch with gloves)
• Never bring food or beverages (water bottles, coffee, etc) – it is just an unnecessary risk
• And any one with longer hair – put it in a ponytail, get a hair clip or head band – anything to keep the hair out of your face and decrease the need to fix or touch it

Hand washing

• Hand washing = chemical (soap) + mechanical (scrubbing and wiping) components
  • This is what makes hand washing the best measure in preventing the spread of germs!
• At least 20 seconds of scrubbing – not a 20 second total hand wash
• Rise your hands –> apply soap –> now you start counting –> scrub for at least 20 seconds –> then rinse –> the wipe dry
• How I do it:
  • 5 to 10 seconds scrubbing the fingertips on right hand
  • 5 to 10 seconds scrubbing the fingertips on left hand
  • 10 seconds lathering the rest of both hands
• Do not ignore the fingertips! They are what does all the touching and require special attention
• Long and fake nails are bad for this – they harbor germs under those nails like you would not believe (gross)
• Every time you leave the house, the first thing you should be doing immediately is hand washing.
• Here is a great how-to from the CDC!

Do not forget to moisturize!

• All the extra hand washing = dry skin
• Dry skin = cracked skin
• Cracked skin = entryway for germs like COVID into your body
• Always apply some lotion after hand washing
• If you have cracked skin, cuts, etc – wear a bandaid to cover it when going out

What about hand sanitizer?

• Not superior to hand washing – Why? Two reasons:
  • It does not kill all types of germs
  • There is not wiping action (mechanical component) that gets rid of the germs
• But if you have no alternative, it is better than nothing
• I like using hand sanitizer or wipes after I take my gloves off before I get into the car
  • Do not forget to rub this onto your finger tips (the tippy tips) and under your nail bed

Set up a decontamination station

• Set up an area as close to the entry point of your house where “dirty” items will be place awaiting decontamination from the outside world
  • You do not want to drag the items across your house!
• We set up a chair right next to our door
• We put cleaning wipes and spray next to it so it is nearby
• Items to be disinfected – boxes, groceries, masks, gloves, etc – are placed on the chair
• When everything is placed, I immediately wash my hands – then start the disinfecting process
• Then (guess what!) I wash my hands again before putting everything away
• READ THE CLEANING AGENT INSTRUCTIONS 
  • It is not a wipe and done – there is a contact time
  • What is contact time? It is the time the cleaning agent must be in contact with the item you are disinfecting to reach 100% of the effectiveness it advertises
  • This spray disinfectant says surfaces have to be wet for 10 seconds in order for the full effect of sanitizing to occur – 10 seconds it a longer time than you think

I hope you find these tips valuable as we all navigate through this challenging time together. I truly hope we emerge a cleaner society that is more mindful of how we spread germs. As I think of more tips, I will be updated this post. If you have questions, I am happy to answer them in the comments!

Be safe!