“Stealth”spread is one of today’s headlines. It means that most who become ill are contaminated by carriers of the virus who manifest minimal or no symptoms. This is hardly an unknown medical circumstance. It has been long known about tuberculosis. As to TB, the carrier state is fairly easily recognized using routine chest X-ray and/or Tine test; not so easy for coronavirus, so far. This state of affairs is thus hardly surprising and it is important to know. It ought to inform some particular behaviors going forward. Several epidemiologists are saying what I have been suggesting to my family for some time now – that for every confirmed case, there are at least six others. I have been saying there are ten carriers for every confirmed case of illness. I still suspect my guess is closer to reality.
Be that as it may, I will share with you what I am doing to protect my family in light of these facts. Today, Amazon announced it was prioritizing deliveries. It will, prudently, first deliver medical products and staples. As with mail, it is important to remember that coronavirus, it is believed, persists on fomites for anywhere from minutes to hours to days. Now, mail and packages are not sterile – far from it. Thus if any individual who handles the product is a carrier, your deliveries may be contaminated with virus and you may become infected by merely handling them!
I now assume everything coming into my home is contaminated. So, as a good NRA member, as I know to never point my gun at anything I am unwilling to destroy, in analogous fashion, I handle every incoming item as though it is contaminated. What do I do? I wear disposable gloves (I reuse them as long as they stay intact, by washing them with soap & water then sanitizing them with alcohol or sanitizer – I don’t have an infinite supply of gloves and they are likely to remain scarce for some time) when getting the mail and when opening packages. I do both things outside on the front porch with the trash can beside me. I do not open any junk mail. It goes straight to the trash. I open all real mail and discard the envelope. At minimum, I set the contents aside for at least a few hours or even a day to ‘age’. When possible, I leave them to sit in the sun.
I open packages on the porch as well, wearing gloves. Containers or shipping envelopes go straight to the trash once I remove the contents. Depending on the contents, I spray them with Lysol or wipe them with disinfectant wipes. Although I have not yet done it, an option for something I deem to be high-risk for some reason, is to put it in the oven at say 175 – 200 degrees F for an hour or so. Obviously, the wisdom of doing this depends on the nature of the item and its tolerance to heat. I don’t know the effect of low temperature on viruses, so I haven’t considered that option. It is probably ineffective.
There are likely other implications of the so-called “stealth” infection mechanism. I am thinking it implies the need for our current isolation to continue for many weeks or months. Otherwise, the moment we stop isolating, the spread of infection will resume its exponential rate of growth from whatever point to which it has (hopefully) decreased.
Do you think me paranoid? Prudent? The coronavirus, after all, is out to get me.
In passing, I want to share an upcoming quandary and solicit your thoughts. I work at an inpatient drug/alcohol detox unit every Saturday. I always work with another doc or PA, so I am not there alone. With a normal census, it takes two people to see all the patients in a 5 – 8 hour workday. The census is low and will likely stay that way, so a single provider can do the job. I am considering asking to not be required to come to work as long as the others can cary the reduced load without me. If I ask to not have to work under present conditions, I would explicitly say that, should any of the other provider(s) become sick and unable to work, I would be willing to fulfill my duty and come to work.
I am at much higher risk than any of the other providers (I hate that word, but it does include several categories of professionals), who are far younger and generally healthy. This is because I am 75 and have heart, lung, and immunologic conditions. In addition to the risk to me personally, it adds risk to my co-habiting family (wife and son). Reducing the risk of my outside contact to them would be quite onerous. In addition to covering myself and disinfecting at work (which I would do anyway), I would have to isolate myself at home. On the assumption I would be infected and lacking symptoms, I would have to sleep in another bedroom, use a separate bathroom reserved only for me, wear a face mask at all times, not prepare or touch any food, plates or utensils… you get the picture. For a week or so, I contemplate this to be manageable. For a month or more, I can’t imagine I could be scrupulous enough for the efforts to remain effective. After all, the chain of separation is only as strong as the weakest link and bugs will be bugs.
I would value any thoughts, especially on the work issue.