Post-Exposure Prevention (PEP) Protocol, by JJ in MI

Everyone already knows about the Wuhan Coronavirus outbreak so I’ll skip an overview of what it is and why it’s dangerous. No doubt you’re also aware of the CDC’s recommended preventative measures of hand hygiene and avoiding close contact with those who may be infected. You may have also acquired items such as masks, goggles, or gloves (if you didn’t have enough already) as additional preventative measures, and those can help limit exposure when used properly, but they do not provide 100% protection either. You may also have considered social distancing, or even self-quarantine, but that’s not always possible – some will need to go to work, use public transportation, travel by plane, or otherwise interact in relatively close proximity with those that could be infected.

Given what is known so far about the Wuhan Coronavirus it’s probably premature, as well as somewhat socially unacceptable at this point, to don a full array of PPE before going to the grocery store or to the DMV to renew your driver’s license. But if you did suspect that you had been directly exposed to it, such as yourself or a loved one inadvertently getting too close to someone that was displaying the symptoms, is there anything you can do to lessen the chances of contracting it? Maybe, and if there was such a protocol it would be called post-exposure prevention, or PEP. As defined by wikipedia:

“Post-exposure prophylaxis, also known as post-exposure prevention (PEP), is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring.”.

Currently there isn’t a PEP protocol from the CDC or other authorities for the Wuhan Coronavirus, but I’ll offer a plausible one based on studies done following the SARS and MERS coronavirus outbreaks, and based on those a suggestion for a new item or two you might consider adding to your Every Day Carry or Individual First-Aid Kits.

First, a few short quotes from just a couple of the studies that I’m basing these recommendations on. From a 2004 study on the SARS coronavirus:

“Because SARS-CoV is believed to be transmitted mainly through the airborne route, PVP-I products for gargling and spraying the throat may have a prophylactic effect on SARS during outbreaks.”

And a 2015 study on the Middle East Respiratory Syndrome (MERS-CoV), which similarly concluded that:

“These data indicate that PVP-I-based hand wash products for potentially contaminated skin, and PVP-I gargle/mouthwash for reduction of viral load in the oral cavity and the oropharynx, may help to support hygiene measures to prevent transmission of MERS”

Perhaps the most significant finding from the MERS-CoV study above was that a greater than log 4 reduction (>99.99%) in viral titer counts was seen following exposure to “PVP-I” in concentrations as low as 1%, and after only 15 seconds of contact time. While the tests were done in vitro and not in a live host, it still seems clear that PVP-I is a very effective agent against coronavirues.

If you’re unfamiliar with the PVP-I acronym, it’s probably because you just know it by other names, povidone-iodine or by the brand name Betadine. The active ingredient is iodine, and iodine is a strong antimicrobial agent with activity against many different bacteria, viruses, and fungi. It’s deserving of a place in your preparations for a number of reasons, maybe the most important of which is its sporicidal activity against the spores that can cause tetanus (C. tetani), anthrax (B. anthracis), and gas gangrene (C. perfringens). Without access to tetanus vaccinations or immunoglobulin, or long courses of antibiotics in the case of anthrax or gangrene, irrigation of contaminated wounds with solutions containing iodine may be one of the best preventative measures against these diseases in a prolonged worst-case scenario. Povidone iodine is also on the World Health Organization’s model list of essential medicines, “a list of the safest and most effective medicines needed in a health system”, and it might be wise to stock up on as many of those drugs as possible as they’ll likely be in short supply after a disaster.

Back on topic, but with a note of caution first: The 10% povidone-iodine topical prep solution referred to in the rest of this article is not the same as “tincture of iodine”, nor is it the same formulation of iodine found in some water purification tablets, nor should surgical scrub solutions containing povidone-iodine be used as a replacement in the steps below. These instructions are strictly for 10% povidone iodine without added soaps or detergents, and not iodine in any other form or formulation. While PVP-I has few contraindications to its use, particularly when diluted to a 1% strength, it would be wise to refer to your physician or other medical professional to determine if there is any risk to you, or the individuals in your family, from exposure to either iodine or PVP-I first. Contact with solutions containing iodine should NOT be assumed to be safe for all individuals.

With that said, the instructions for making a simple Post-Exposure Prevention (PEP) kit suitable for EDC or an IFAK. The items needed:

An empty “5 hour energy” sized bottle (2 fluid ounces/60mL, 3.25” H x 1.375” W), with screw-on cap

10% PVP-I

Syringe (with graduations in mL/cc)

Cotton swabs ( 3” in length, standard double-tipped “Q-Tip” type)

Distilled water, grocery store variety is fine, it doesn’t need to be sterile.

To make the 1% PVP-I solution:

Clean the 60mL bottle, screw-on cap, and the syringe thoroughly, and rinse with distilled water

Add 6 mL/cc of 10% PVP-I (measured and added using the syringe) to the bottle

Add distilled water, up to the “shoulder” of the bottle, which will add approximately 54mL of distilled water, yielding a 1% solution.

Insert 2-3 cotton swabs in the bottle, and secure the cap.

The top of the 3” cotton swabs extend into the mouth of the 3.25” tall bottle, so they don’t fall over inside the container, and are relatively easy to extract with a finger tip after opening the cap. A single 60mL bottle of 1% PVP-I solution should be enough for PEP for one person.

Directions for Using PEP:

1) Shake the bottle to ensure even distribution of the PVP-I in the solution.

2) If necessary, remove any suspected virus-laden fluids (as from a cough or sneeze) off the skin by applying some of the 1% PVP-I solution to an uncontaminated cloth, paper towel, or gauze pad (or use separate PVP-I prep pads) and wiping it away. If on the face, start the wiping action from nearest to the eyes, nose, or mouth and wipe in a single direction away from them. Repeat as needed, but use a new cloth/pad for each new wipe. If near the eyes, be sure to thoroughly coat the eyelids, eyelashes, and eyebrows with the solution with your eyes closed.

3) Disinfect your hands, either with a fraction of the PVP-I solution, an alcohol based hand sanitizer, or with soap and water.

4) Using the cotton swabs removed from the 1% PVP-I solution bottle, thoroughly clean the insides of each nostril. Use a twisting motion to clean/coat as much of the interior surface as deeply as is comfortably possible. Use a new swab for each nostril, and pay particular attention to cleaning the small cavity inside the tip of the nose. Do not re-dip a used swab back into the solution.

5) Use the remaining PVP-I solution in the bottle to gargle and vigorously swish around in your mouth for a minimum of 30 seconds, then spit it out (do not swallow the solution).

In case you were wondering about safety (or toxicity) at this point, PVP-I solutions for use both as a mouth wash and as a nasal cavity antiseptic are FDA approved and available in products such as 1% Betadine mouth wash and 3M skin and nasal antiseptic.

PVP-I Eye Drops

A second precaution you may wish to take is to obtain, or make, PVP-I eye drops. As recently reported, a Chinese physician believes he contracted the Wuhan Coronavirus via contamination though his eyes while treating patients without wearing eye protection. Contracting a respiratory virus through the eyes isn’t unique to 2019-nCoV, the nasolacrimal ducts act as the pathway that any virus can use to reach the respiratory system from the eyes. Luckily, PVP-I is also available in ophthalmic solutions (eye drops), such as Betadine 5% Ophthalmic Prep Solution. That product does require a prescription however, as well as being a stronger concentration than is required. A couple alternative possibilities for making your own 1% PVP-I ophthalmic solution are:

A.) The World Health Organization (WHO) first published information on the small scale manufacture of some ophthalmic solutions for use in rural clinics where access to commercial pharmaceuticals was limited in 1990. The instructions were later updated in 2002 and can be downloaded here. The instructions for making 1% PVP-I eye drops in that document are arguably the easiest of all the ophthalmic solutions listed, partly due to only having two ingredients and the over-the-counter availability of each, but also because sterilization of the final solution is not required since, quoting the WHO, povidone iodine “is such a strong antiseptic that it DOES NOT REQUIRE STERILIZATION”. Note that pre-sterilization of the eye drop container IS still required, and the instructions on how to do so are included in the document. Suitable eye drop bottles to hold and dispense the solution are available in glass or plastic from Amazon, as is the sterile 0.9% sodium chloride (normal saline) in pre-filled IV flush syringes.

B.) A much simpler method however would be to purchase over-the-counter “Artifical Tears” in 15 mL size bottles, and add 1.65 mL of 10% PVP-I to the bottle to obtain a 1% solution (with a final total volume of 16.5 mL). I purchased the artificial tears locally in the same 15 mL size, and because the bottles weren’t completely filled to the top there was enough remaining capacity to add the 1.65 mL of PVP-I without overflowing the container. The easiest, and cleanest, method to add the PVP-I is using a sterile syringe and needle, and ‘inject’ the correct amount of PVP-I through the opening in the top of the eye drop bottle (the same opening where the drops are dispensed from). I’m not a physician nor a pharmacist, but this process does appear to meet all the requirements for the 1% PVP-I drops from the WHO document in option A – being already a sterile solution in a sterile bottle, with PVP-I added, and no further sterilization required due to the strong antiseptic properties of iodine. At room temperatures the solution has a shelf life of 1 month (per the WHO).

If you choose to add 1% PVP-I eye drops to your PEP, instill 2-3 drops in each eye after cleaning the external area around the eyes, and then clean your hands, and then insert the drops.

In conclusion, this isn’t suggesting a therapy for treatment, but simply a plausible PEP protocol to be taken in the first minutes after having some reasonable suspicion that you’d been exposed to the virus. The goal being to inactivate as much of the virus as possible before they bind to your cells, giving your immune system a greater chance of fighting off the remainder successfully, and thus reducing the risk of developing a respiratory infection from the Wuhan Coronavirus. Of course, any additional warnings, recommendations, and/or clarifications would be most welcome as they could prove useful to refine the process to make it more effective, whether for use in the current Wuhan Coronavirus outbreak or some future pandemic.




61 Comments

  1. Surprised no one has pointed out that “picking your nose is bad… And by picking I mean any activity that removes in a rough way mucus from your nose.

    Same thing with long finger nail … Any thing that gives a good scratch on an itch is gonna carry stuff and help introduce it to ya.

  2. Good Morning Dear Readers,

    I just want to thank you all for your prayers for us. The girls and I, are recovering and have entered the coughing stage, which for us has been thankfully, mild. Jim did go to the doctor and was diagnosed with a terrible bronchitis. He has been put on antibiotics. He has shown improvement over the last 24 hours, but is still not quite out of the woods, yet. Please continue praying for us.

    May you all have a very blessed and healthy day!

    Lily

    1. Our prayers are lifted up for all of you… So sorry for the news of that bronchitis which is such a miserable illness and battle. We’re thankful for the news of progress. Get well. Stay well. Be safe. You are all greatly loved and appreciated.

  3. Word of warning, if you are allergic to shellfish, or IV contrast for CT scans, or possible other procedures, do not use the above product. For people with the above allergies it’s very possible to have an anaphylactic reaction, which can be life threatening. If not treated right away, usually with epinephrine it can result in unconsciousness or death. Anaphylactic shock severely restricts your airway.

    1. Newer studies show iodine in shellfish is not necessarily what causes a reaction, but I’ve had several patients with anaphylactic reactions who state they are allergic to IV contrast containing iodine, and also shellfish. Studies think what causes a reaction to shellfish can be a protein called tropomyosins. But I know we usually still ask people who are about to have an IV contrast containing iodine if they are allergic to shellfish. I’m not sure why, but some fish and shellfish can absorb more iodine over their lives.

      1. TXnurse… This is very important information, especially since allergies can emerge at any time in life. Just because a person hasn’t had an allergic reaction in the past doesn’t mean it can’t happen in the future.

        I have an alleged shellfish iodine allergy, although only one occurrence as a child (severe), and there is some question in my mind as to whether or not that was shellfish related or something else since I’ve never had another problem with shellfish but do now have a consistent problem with almonds.

        Every person is different, and so I caution reliance on the situations of others except in so far as these add broad insight and perspective that might be helpful. In my case, I have early signs that tell me I’ve been exposed to almonds (never consume these intentionally, but can be exposed incidentally). My eyes start to itch insatiably, I have an emergency run to the restroom, and then comes an asthma like reaction including wheezing. As soon as my eyes start to itch insatiably, I know what’s happening, and I quickly chew up Benadryl.

        With this in mind, we keep Benadryl and an Epi-Pen available among our preps. Thus far the Benadryl has been a life-saver when there has been an inadvertent exposure to almonds. I have, thankfully, never had to use the Epi-Pen.

        Also a tip… For anyone who needs the Epi-Pen Rx, I saved A LOT of money with a GoodRx coupon (as in hundreds of dollars).

        Allergies as an umbrella topic is another important area of consideration for everyone committed to preparedness. Allergic reactions can be serious and truly life threatening. When the airway closes, it can happen very, very quickly — and it is a terrifying event.

        We do also keep iodine in the home as well, and my personal situation is that I’ve never had an adverse reaction to topical use. This may not be true for others.

        I hope the example of a personal and anecdotal “case” will help others with some insights even though these can never substitute for the evaluation of a medical doctor related to an individual’s specific situation.

        BE CAREFUL. BE SAFE. STAY WELL EVERYONE!!!

        1. Telesilla of Argos,

          Yes, I agree and am sorry you have these serious allergic reactions. I mention the iodine because this can be a somewhat common allergic reaction, whether it’s topical, intravenous, or ingested. Many people have probably never had to have IV contrast with iodine or surgery where this is a skin scrub, and may be completely unaware they may be allergic. In a situation where medical help is not readily available this would be a horrible time to find out. I doubt very many people have Epi pens in their medical supplies, although a great thing to have if you can. Always have over the counter diphenhydramine (Benadryl) at home. Your are right, you can develop a serious allergy at anytime, from anything. I just think iodine seems to be one of the more common allergies. I’m not allergic to iodine thankfully, but knowing what I know I would probably be hard pressed to put it in my mouth or eye if I didn’t already know I wasn’t allergic.
          Also if you are not very good at identifying what type of pine trees are in your area, please be careful making pine tree tea, some trees that people believe to be in the pine family are actually very toxic.

          1. TXnurse… Thank you for sharing excellent insights and caring information. We all learn from one another. It’s one of the best parts of being part of such an attentive and caring community dedicated to surviving and thriving — even in the face of adversity.

            It was interesting to hear your thoughts that iodine may be a very common allergy.

            …and thank you for the tip on pine tree tea. We haven’t ever made or used this, but appreciate the heads-up. Our thinking is that while people understand some kinds of risks, they are unaware of many of these (and may have very innocent thoughts that lead to naive choices — and that these may have potentially serious and adverse consequences). We are very, very cautious with all this in mind.

            There is an interesting neuropsychological concept that essentially translates: “You don’t know what you don’t know.” We should all be cautious with this in mind. The sharing of professional experiences like your own, or anecdotal experiences in this arena like mine, hopefully will help add to the information pool of the entire community.

            Stay well. Be safe!

          2. As a nurse and “mommy” with family members who have anaphylactic responses to several common food items, I’ve found that the new Auvi-Q brand epinephrine injectables are less expensive than the EpiPen brand we’ve been using for 20+ years. And, because my clan is seemingly allergic to a zillion things (not life-threatening allergies, but annoyingly allergic just the same), I keep Benadryl liquid (not just chewables) on hand. The liquid is easier to administer quickly, especially with children who may refuse to chew a tablet.

            Praying for health for all of you! And remember… “Wash yore hands”, as my father used to say. 🙂

  4. Avalanche Lily,

    All the best to you and your entire family. I hope that all of you are fully recovered soon.

    I am hoping that a reader with a SERIOUS medical background (not just someone who heard something or read something), can answer a question I have.

    I saw one professionally produced video from a hospital in Singapore on YouTube that gave directions concerning how to wear, store and re-use the N95 mask. Most of the articles I have read, however, state that standard N95 masks should be disposed of after a single use. Of course, such advice is probably intended for situations where there is an endless supply of these masks in the stockroom inventory. (On Monday, I had a minor medical procedure at a local hospital. Once the blood pressure cuff was used on me, it was tossed rather than being cleaned properly and re-used for the next patient. The nurse told me that this was now standard protocol for the hospital. )

    As anyone who is paying attention to the situation knows, N95 masks are hard to come by, and the situation is going to become worse. Two weeks ago, I was able to add to my stock of masks and purchase a large number of masks from one vendor for $8.95 for 25 masks. Yesterday, about the best price I could find on the internet was close to $4.00 each for masks purchased in large quantities.

    Even for people who wisely stored masks in advance, and for people who have acquired a few in the past couple of weeks, the number of masks they have available will likely be quickly depleted at some point.

    If it is not essential that they be tossed after that one use, would simply hanging them on the equivalent of a clothes line in bright sunlight for a few days kill any virus clinging to them? Would placing them in a stove oven for, say, 15 minutes (or more), at 170 degrees kill the virus? Will the integrity and function of the N95 mask be compromised by using either method?

    While in normal times, no one would likely bother re-using N95 masks, but for “desperate times, desperate measures.”

    Asking for a friend. 🙂

    1. For sanitizing non-soiled items that cannot be washed or discarded, consider: exposure to direct sunlight (not obstructed by glass) for a couple hours, or exposure to a black light and fresh air. If you have an ozone generator (available online for as little as $20), it has potential to have a similar effect.

      Another possibility might be some of the anti-viral essential oils, including conifer.

      Please keep in mind that for internal use, an anti-viral must be able to go inside human cells. Many anti-biotics cannot do this without killing the cell.

      I have used N95’s for industrial purposes, and they do NOT benefit from being washed.

    2. A mask is no longer useful(meaning it NO longer filters particles) after it becomes wet/moist, as in from your breath or fluid introduction, rain, splash etc., hence need to be disposed of.
      To remove the mask use the strings/ties and do not touch the mask.
      I have read articles that say the 2019 novel corona virus lives on surfaces 5-28 days, rendering the mask nonreusable given that you should fit the mask to your face, squeeze over the bridge of the nose and adjust it to fit snuggly on your face.
      Thinking about reusable masks you could use silver impregnanted material such as Norwex clothes. Not sure if it would work but it’s a thought.
      DO NOT wear more than one mask, you will cause the air to enter thru edges if it cannot get in easily. It is not more effective to wear more than one.
      To the average person who has never worn a mask, especially N95, it can be difficult to get used to it. Practice at home, some people can induce panic attacks if they are claustrophobic.

      1. OR.RN.GA,

        So the takeaway from your comment is that if a reader has, say, a box of 20 N95 masks, a reader can last a maximum of 20 days, if he/she wears no more than one mask a day, doesn’t breathe too hard and cause exhalation to make it too wet, and (presumably) doesn’t wear it more than 8 hours a day. (Sleeping is definitely out due to cross-contamination.)

        Is that the brutal truth for readers, like it or not?

        1. That sounds a bit negative and fatalistic. To be a bit more pragmatically realistic: If in family self-quarantine mode, then your masks could be reserved for only when you MUST leave your front door. So a well-shepherded box of 20 might last a rural family several months.

          1. Jim, but what about the comments from readers who have said to wear the mask only once?

            I think you can see the frustration in reconciling all of these opinions.

            Some readers said that any mask was better than no mask. I get that. Who could disagree with that? But that was not very helpful and, unless a specific alternative was offered, it was nearly in the category of deflection.

            What bowled me over was when a reader posted the link to the JAMA article which said that N95 mask were no better than surgical masks in protecting the user from infection. (I suspect that both mask users were infected themselves via contact with their eyes, but I am speculating.) These study results are contrary to almost every opinion I have read about N95 mask in the last couple of years on various internet sites. Yet, the study was a broad, well-funded study from a recognized academic and medical institution, and the American Medical Association thought that the results were important enough to publish in its journal.

            I am reminded of the time I got my first horse. It drove me crazy listening to all of the conflicting advice I received about its care and use. One person would tell me to do this. Another person will tell me something to the contrary.

    1. Couple of points:

      If your mask has any valves or plastic parts, you’d risk distorting them to the point of uselessness by autoclaving (baking).

      Leaving them out in the sun for a few days would also degrade the masks, but I can’t say by how much. The virus is only viable (capable of causing infection) for a few days on a surface, so you could theoretically leave them alone for say, double that time.

      The biggest problem is that the masks would start to fall apart just from extended use, I’m not sure how much mileage you could really milk out of them.

      Disposable is the way to go normally because then you don’t have to worry about decontamination and re-exposure.

      Personally, if it came down to that, I would put used respirator/ gas mask cartridges in dated bags outside, and cycle through them after a period of time, say 10 days.

  5. Here’s one more question for someone with a SERIOUS medical background, or a background in a related field.

    To decontaminate clothes and rid them of viruses, will simply washing them in standard washing machine using the hottest water temperature available and then running them through a dryer with the highest temperature available eliminate all viruses clinging to them?

    I expect that adding bleach will work well in decontaminating them, but it would also mean that colored clothes will be damaged if much bleach is used. Perhaps simply leaving the clothes on a line in bright sunlight for a couple of days will work?

    If washing machines and dryers don’t work, for those who are trying to be as careful as possible, I can imagine large piles of dirty, contaminated clothes building up outside homes as people work their way through their clothing inventory.

    1. I’m going to submit and article on decontamination soon.

      Short answer is yes, washing and drying would kill pathogens, especially the dryer. Get things hot and keep them hot for a while. If you don’t have a dryer I would hot wash. Think Victorian times when they would wash clothes in a boiling kettle.

      Longer answer is that I would recommend against bringing contaminated clothes inside to wash for fear of spreading the pathogen. Once you use your washer and dryer, it could become potentially contaminated as well, so you’d have to run bleach through the washer and run the drier, and wipe them both down, etc.

  6. A very interesting article. If you are allergic to shellfish you may be allergic to Betadine or iodine. This is a question we ask all our patients in the Operating Room and determines what scrub solutions we use in their surgeries. Also Betadine can be irritating in the eye and when used in OR as a diluted prep solution, is followed by a flush with sterile water. This also helps with the stain factor. These Patients also have a topical anesthetic. I imagine that using this in the eye would be irritating, so be ready for that possibility. I would not recommend that the use of an Energy Drink container method be used in anything instilled in the eye. Best Practices in OR’s these days are to discard anything mixed after 24 hours and these would be mixes that were done in a very clean environment by trained nurses. While I think our OSHA, and other governing bodies can be a bit overkill, instilling anything in the eye should be done under the cleanest of methods. I am guessing the WHO would be recommending the 30 day shelf life of this method being done at the most primitive level, and recommended using an eyedropper that had been boiled as part of the process. Don’t take chances with your eyes. What I think is needed here is a Pharmacist to come up with a way that is better. They would be the experts in what over the counter items are available and how to best mix them. I like the idea of the Artifical tears method better. I noticed that it has a 0.6% ingredient of Povidone as well as Polyvinyl Alcohol. Overall this has an interesting aspect of post exposure treatment and I await the Pharmacist out there to help. Thanks for submitting.

  7. Survivormann99
    What ever type of mask you end up using for the eventual nCoV coming here to the US everyone should understand all masks are a one time use only. Of course N95 are more affordable for most people than N100, or full NBC type of equipment, but those are essentially unavailable now, and some maybe faced with wearing simple surgical masks. Any mask is probably better than none, but all must be worn correctly, and disposed of after each use. You run a much higher chance of contaminating yourself if you reuse masks. The limit of use for any mask is at tops 8 hours or until the mask becomes moist from your respiration’s (usually much less than 8 hours), this includes N95’s. After the mask becomes moist from respiration’s it negates any protective property. An excellent YouTube to watch regarding how to properly put on and take off PPE’s is by: RegisteredNurseRN, donning and doffing PPE’s. Also if you are wearing a mask be sure to also wear goggles (which I believe can still be found), look for ones that say splash and droplet protection. Also be wearing nitrile gloves that fit properly. These items are mandatory to wear together, everything is SINGLE use except your goggles which can be cleaned with germicidal wipes, soap and water or at least >than 60% alcohol. We are all seeing all these people wearing only simple surgical masks, with no goggles and no gloves,in my opinion this is why so many people are catching this virus. People in China are very used to wearing surgical masks out for many reasons, including pollution, I’m sure they also use masks over and over. Many people will catch this virus simply by using what they have incorrectly and contaminating themselves

    1. Essentially NOT available?

      This is the time of year when I normally re-order my filters. The other time is normally in the middle of summer.

      So I hoped my happy lil self down to Amazon and re-ordered today.

      And as of noon EST there are still plenty in stock
      Here is the links:

      https://www.amazon.com/MSA-10028997-Advantage-Full-Facepiece-Respirator/dp/B005QQDF9G/ref=mp_s_a_1_3?keywords=msa+respirator&qid=1580934348&sprefix=msa+re&sr=8-3

      https://www.amazon.com/MSA-815366-Advantage-Combination-Cartridge/dp/B001VXVU2C/ref=pd_aw_fbt_img_2/143-4863176-1653052?_encoding=UTF8&pd_rd_i=B001VXVU2C&pd_rd_r=6b520448-8f16-4a8f-857d-b950a6c96dfd&pd_rd_w=yUDbh&pd_rd_wg=ENOx9&pf_rd_p=215d774e-4afa-463c-bfa3-69f69256620f&pf_rd_r=3SGAJDJNTDFMN9B5YJ3G&psc=1&refRID=3SGAJDJNTDFMN9B5YJ3G&th=1

      https://www.amazon.com/gp/aw/d/B000P9D6DE/ref=sspa_mw_detail_2?ie=UTF8&psc=1

      And yes if you read the direction (always read the directions) it states that it does protect against the swine flu etc viruses (I bought my first one shortly after the h1n1 scare) on the half mask. It even went so far as to say that additional product #icantremember eye protection would complete flu protection. The full face mask came with the same no flu worries.

      And like I said you can wear each cartridge Fer like a week or so (depending on dust).

      Mix up your fav anti-bac spray \ wipe and yer good to go.

      Honestly I would never trust my life to any paper mask regardless of N rating. They are just too ill-fitting. And expensive.

      1. J.m.z.b.

        Actually when I said essentially not available, I was referring to N95’s. These are much cheaper in the quantity that you would need to possibly out last a novel infection that may take 1 year to possibly 18 months to survive (unless you are able to lockdown at home). Many of those military grade NBC masks are expensive and so are replacement cartridges. The cartridges do not usually last more than about 24 hours, depending on your situation. I do not believe any of them will last several weeks. My own, and only my own opinion is I would not be able to afford numerous cartridges, and would not trust the filtering systems to even last 24 hours. I have been wearing full PPE apparel for 30 years now, through infectious diseases such as bacterial & viral meningitis, TB, H1N1, strep fasciitis of the lung (this patient was alert and talking when I received him, and within hours he was intubated and I was suctioning out parts of his lungs, he died 5 hours later), my point is i’m Going with what I know and what I know how to use properly. I’m still here. I think everyone needs to do research on personal protection, how long they actually last and what they can afford in a long term situation. I have gas masks (with a few cartridge replacements for family) but those will be saved for some sort of weaponized biological event…..if we know ahead of time. Hope that ever happens!

        1. With those cartridges listed and cutting concrete and working in shops with fog like clouds of debris (with my own prefilter) I get a solid week out of a cartridge.

          I don’t have good lungs. Point of fact I fail every pft (even the children’s)
          and I am still able to do my work which is very strenuous with out any breathing problem.

          Could I run a marathon in it after a week …
          No.
          Could I have run a marathon before …
          No.

          But could I hike over 10 miles up hill with a week old used on the job cartridge yup….

          And given that if used for the purpose of virus prevention unless there is a Saharan type dust storm your filtering mostly clean dust free air … I’d be willing to bet that the filter will be clear and functional for multiple weeks.

          And note until right now with qualifying statements I never said months or weeks.

          And yes I’ve worked on jobs with respirator (not paper mask) requirements for about 2 decades from hydro blasting geothermal plants to asbestos abatement (Infact before I let it lapse I was certified)

          And for the record it is uncontrolled asthma that affects my lung capacity. When I receive propped treatment I can pass the pft.

          1. I concur. I wear N95 respirator almost daily for hours at a time and am always amazed hearing medical folks say they cant last 45 minutes. Working contaminated sites, with hazardous materials, and now in my own production shop I find no degradation with masks after short periods.

            Check out soft seal masks folks!

        2. Btw if I seem rude or anti social I’m sorry that it’s interpreted that way I don’t translate well to text. Everything I say is said with a flat monotone voice (just to try and give some context)

    2. TXNurse,

      Note that this is the video from Singapore General Hospital that mentions re-using the mask; https://youtu.be/zoxpvDVo_NI

      My concern is that when this virus hits the US in a big way–and it is likely going to be when, not if–that we will all be having to make the best of a bad situation. As I said, “Desperate times, desperate measures.”

      Doctors’ offices and clinics have been using blood pressure cuffs over and over again since they have been invented, or at least I believe so. Yet, my local hospital now does not permit a blood pressure cuff to be re-used. Is this safer? Of course it is (and, it is also more billable).

      But what would be the Plan B if no more blood pressure cuffs were in the store room or in the delivery pipeline? I am confident that the cuffs would be re-used and would be sprayed and wiped after each use. If there was a massive pandemic of some disease where vaccination was helpful, and if there was a massive shortage of syringes, I would expect that the use of autoclaves would return rather than to let the patient go unvaccinated. Am I wrong?

      The fact that the Normalcy Bias controls most peoples’ behavior explains the rush to find masks now. I have a large number of masks on hand. I didn’t wait for the rest of the country to wake up to the threat before I added masks to my preps. Yet, even my supply is finite. Who’s isn’t?

      While it was an effort at humor when I finished my comment with “Asking for a friend,” I suppose that I really was. I was asking about what I should tell those who might have a box of 25 masks, but who would run out of fresh masks if this pandemic causes them to be hunkered down in their home for a month or more. It is of little value for me to tell them what hospital protocol is in normal times.

      So, quite simply, let’s take it as a given that, in a perfect world, every N95 mask should be tossed after a maximum of 8 hours of use. (Frankly, if simple moisture on the mask is the criterion, it would likely be after one hour’s use–and less–with normal exhalation.) What is the next best choice, i.e., to sanitize the mask for re-use?

      If the answer remains that re-use of an N95 mask is a no-no under all circumstances, then almost everyone in a hot zone should simply kiss their derriere good-bye if the pandemic last a few weeks because they will run out of masks.

      Is that the brutal truth? And is the only viable alternative if one doesn’t have an endless supply of masks to evacuate now to a Montana mountaintop?

      1. Survivormann99,

        I will try to answer your questions. First I watched the video link, good info, the take off demo was really good, but then she puts it in a baggie to reuse numerous times with possibly numerous patients. The front of the mask may be contaminated,
        In the video she puts her hand over the complete front to put on, this is not a good idea to be doing more than once, plus every time she puts it back in the bag she is contaminating probably both sides of the bag, which in turn may directly contaminate her face. I’m not trying to say everything has to be by hospital protocol, but watching Chinese videos on infection control is probably not a good idea (that’s why we have all these viruses that mostly originate in China), their idea of sanitation is not always the best.
        Yes we always used to reuse BP cuffs, with germicidal cleaning in between. Over the last 10 years a new fungal infection in the candida family has emerged called candida auris, this is an extremely resistant skin infection that is easily transmitted, and can cause death in approximately 30% of people who catch it. We have had about 500+ cases here in the states, in Texas last year I believe there was 5 cases. We have over used so many of our antibiotics, antivirals and antifungals that so many infections have become resistant. We are in deep trouble with this. People continue to demand an antibiotic for the common cold,it does no good to tell people it’s a virus, antibiotics are for bacterial infections. So consequently so many infections are resistant. Be glad they don’t reuse BP cuffs anymore, candida auris is going to become much more widespread. I ‘m off topic, sorry.
        I don’t think autoclaving would work for syringes, the needles although detachable still have plastic on the ends, the actual syringe part is also all plastic.

        For your friends who do not have many masks, gloves or any goggles, they may have to figure out a way to be very careful with reuse to not contaminate themselves.
        At some point if this is our worse case scenario, we all need to make a decision to just stay home or live (or die) with our decisions.
        Unless you are a very heavy breather with very wet respirations a mask can last hours.
        Also a true pandemic will last much longer than a few weeks. Try to plan accordingly.

  8. One bit of good news, on the CDC’s update this morning, no new cases were announced and 33 of the people under investigation tested negative. There are still 76 cases waiting to be tested.

    The State Department announced that two more flights left Wuhan, China last night for the US.

  9. My former work associates and neighbors laughed at me during the previous events of various highly contagious diseases. Although the diseases never materialized in the USA, I now have enough pandemic supplies I don’t have to rush out and pay high prices for items in high demand. People who laugh at us for being prepared ahead of time or those who waited “to see” if this disease will rampage through American cities are having to pay scalper prices for basic items.

    To me, the best post-exposture-protocol is to self-quarantine. I am fortunate I don’t have to go into an office to work, so we plan on locking up and hunkering down. We can walk down the farm road when no one is around, to pick up the mail and check the package drop box we set up for deliveries outside the gates. We can spray items down in an out-building before bringing it into the house. Unless we have a broken bone or other situation which requires a doctor visit, we won’t be going anywhere.

    My prayers for those who are stuck in a city.

  10. A few years back, some hospitals were allowing surgical scrubs to be laundered at home. Thankfully, all the facilities that I worked in did not have that recommendation, as I would have been uncomfortable bring home dirty linen and washing in my machine. That being said, the answer to the question regarding viruses and laundering them at home, is unless you have turned the hot water temp. way down in your hot water heater, they should be fine in the hot water cycle and dry cycle. I would consider leaving my shoes at the door, as well as changing clothes just inside my house. Someone posted in an earlier post how they took care of this and it was very well thought out. I suggest that everyone think through this procedure for your self and be ready. I, for one will always double glove when I go out or take in mail etc. I haven’t thought through the process for myself yet as I have been concentrating on topping off preps. Gloves are as important for me as mask, maybe more so. If any of you have latex gloves that you have had in your preps for years please be aware they are very prone to tearing from dry rot. I am not sure that the nitrile gloves will do the same as so far, I have not experienced these problems. Please do not reuse Personal Protective equipment, especially gloves and mask. Now is not the time to put your life in danger. If we get to the point you are running through your stock, we will all be in lock down. Also, there is a possibility that some of these items will be restocked along the way. Just keep an eye out. On reflection of the above article, be sure that if you are going to irrigate eyes and nose that you do the eyes first. The lacrimal ducts are located in the eye corner next to the nose. When you cry, your nose runs. This is the mechanism for that process. Therefore you would want to flush the virus into the nose and then prep the nose. If you did it in opposite, you would just recontaminate the eyes. Your mask should be a tight seal around your face. I look at all those mask in videos being worn by people incorrectly. Look at the gaps at the cheeks. Also, if any of you have narrow small faces, check to make sure your N95 fits snuggly. Now is the time to be thinking through these process as we have time. There is no reason to panic, just be aware and keep up with people like Medcram, and Peak Prosperity.

    1. sewNurse

      I’ve spent many years in PPE’s with very infectious patients, and I always double glove also. If I was doing direct care of someone at home, I would be doing this, also if I had to be out in town or something like getting gas, double gloving allows you to be able to discard the first set that touched possible contaminated surfaces and then be fairly safe getting back into your car.
      If you are forced to wear a simple surgical mask take the elastic part that goes over your ears and tie a small knot on each side, this helps to make the mask fit tighter to your face, also you can double up on theses surgical masks and still breathe pretty easily, (I mentioned this in an earlier post the other day. But again I will state the most important thing is to watch some YouTube videos on how to safely use PPE’s without contaminating yourself……this makes all the difference.

    2. My wife has a pretty strong reaction to the normal work dust I bring home. So this is my daily house entry proceedure.

      I open the door. I step out of my boots (artist h20 composite toe) I step inside into my slippers. I bring in boots . I close the door. I slowly and generally take off my shirt turning it in side out. I step out of pants the same way (inside out). I gently Rolle them up I put on robe or lounge pants. I take clothes into hamper then take a shower. Then I put on house clothes.

      I suppose I will be doing the same minus the storage location of dirty clothes if this gets bad. And prolly walking into shower sans first change of robe \ lounge pants.

      But honestly this is a virus that spreads via body mist… Not some genetic super true airborne killer or radioactive element or self mobile critter like lice and ticks. So careful handling and quick washing of your body is most of the prevention you need (and don’t run your eyes pick your nose or leave broken skin uncovered)

    1. In case anyone missed the key paragraph in that Science Daily story, here it is below. The headline should have read, “Surgical masks as BAD as respirators for flu and respiratory virus protection”. That’s why these are called N95 masks, they only block out 95% of the garbage, not 100%. In this study, 8.6% of the N95 mask participants got the flu anyway and 8.0% of the surgical mask wearers got the flu. And since there were only 2,400 in the study, it looks like most of the rest of them also got one sort of illness or another! (2,734 vs 3,039 laboratory confirmed respiratory infections). Once again, these masks cannot keep you safe, only lower the probabilities that you will become infected.

      “In the end, 207 laboratory-confirmed influenza infections occurred in the N95 groups versus 193 among medical mask wearers, according to the report. In addition, there were 2,734 cases of influenza-like symptoms, laboratory-confirmed respiratory illnesses, and acute or laboratory-detected respiratory infections (where the worker may not have felt ill) in the N95 groups, compared with 3,039 such events among medical mask wearers.”

      1. The question then becomes, did those wearing both types of masks actually contract the flu because they were infected by causes unrelated to the masks? Did they touch their eyes, for example, even unconsciously/accidentally, and infect themselves that way?

        1. Hey Survivormann99, since the eyes are another route of entry, and since the masks don’t cover the eyes, I would guess that at least some of those 8.6% using the N95 masks who became infected received some flu viruses directly from the air into their eyes, which viruses were then washed with their tears down into their noses via their lacrimal canals. And some were probably infected via the routes you mention as well.

  11. cb,

    O….M…G!!! Thank you!

    Did you note that I asked that anyone who replied to my queries about re-using N95 masks have SERIOUS medical training? I wasn’t interested in hearing from someone about their “ex, ex, ex, ex-boyfriend” who might have an opinion. (I’m alluding to the Legal Zoom commercial with the young woman who needed a lawyer.)

    I have studied the issue seriously now for a couple of weeks. I couldn’t begin to count how many bloggers, much less the commenters, who have probably cut-and-pasted information about masks and probably had no significant medical foundation for offering an opinion.

    Time after time, I have seen people say that surgical masks were woefully inadequate. I often suspected that even the professionals were offering an opinion were simply regurgitating by rote memory “the company line.”

    Maybe this is another “Coffee is good. Coffee is bad.” study, “but it seems to be a gamechanger. The fact that it was reported in the Journal of the American Medical Association is highly persuasive.

    Maybe I should engage in a little profiteering now by placing some of my N95 masks on eBay? 🙂

    1. Survivorman

      Agree. Think for your self.

      I will self quarantine and only use protective gear if forced to go into public, especially in stores of any kind, especially those with high traffic. I can still do business, but at a distance. PPE only reduces the chance of infection, and I would not bet my life on it. The longer one is exposed, the higher the odds that you will become infected. In a warm moist environment that might be a busy store, will accumulate a higher concentration of this sub mircon particle that is the virus. Any sub micro particle can float in the air for sometime, if only minutes, or hours, and get through. I can do level 4, but it not a realistic. Some estimate an R0 of 3.8 to 4.2. That is uncomfortably high. Even if some one was younger and healthy, they can be asymptomatic for up to two weeks, or they may become slightly ill and recover, and continue to spread the virus to the family.

      As of today, I will no longer need anything for several years, yet I can do a limited amount of business at a distance. Fortunately my income requirements are near zero. I ain’t no expert on nuth’n, but do have many years of college level courses in the biological sciences, and decades of life experience in many areas related and unrelated. And I am on old research dog as well. ‘Experts’ are often not the best sources of information. Sorry, it is the truth, not a personal attack. I am alive to day, because I ignored the advice of many top doctors, and proved them wrong with first class medical evidence. They often regurgitate what they have been indoctrinated with. I think for myself. Education, and common sense is your best guild.

  12. Corona virus, Taiwan News. Tencent may have accidentally leaked real data on Wuhan virus deaths. Tencent briefly lists 154,023 infections and 23,589 deaths in Wuhan, China.

    https://www.taiwannews.com.tw/en/news/3871594

    A 15% kill rate as been estimated by pulmonologist Dr. Seheult of https://www.MedCram.com. This is the video:

    https://youtu.be/gPwfiQgGsFo.

    If this is true in China, it might be lower in the U.S. for a variety of reasons, yet it only has to be 2 to 3% to mimic the effect of the Spanish Flu. I would prepare for self quarantine. As a long time survivalist, I can pull the plug immediately. We’ve got probably a month or two, or may three to complete our preps. After today, I will need nothing from the outside world. I would not delay.

    I already have this iodine and thanks for explaining how to use it for this virus. I would use a full face shield and goggles, and I do not care if I do not look socially unacceptable. As a hard core prepper, I’ve looked like a fool for well over a decade.

    (the original post was lost, so this is a repeat)

  13. Survivormann99 and TXnurse had an excellent discussion on reusing a Mask, and if there is a method to clean a used Mask.

    In a long emergency, >would it be possible to use a Clothing Iron with a Steamer capability to >apply Steam to a Filter Mask?
    [Steam may destroy rubber and elastic, but Steam should kill a Flu Virus on the filter.] Afterwards, it should be possible to cobble together a method to hold the mask to the face.

    This would only be used in a dire situation, and if ~electricity was available. If heat kills Viruses. The scalding hot Steam out of a household clothing iron may work.

    I don’t know! It just might be a desperate option, if a Mask had to be reused.

    1. GGHD,

      I don’t know how to say this any clearer than I have already tried, don’t put any solutions on any mask you are using, do not try to bake/autoclave them, steam them, do nothing that will destroy the integrity of the filtration system. Your own respirations will break down the effectiveness of which ever mask you use soon enough. No, N95’s are not perfect, less for the surgical masks, but this may be all you have, so if you need to reuse, just take precautions on putting on/taking off to not contaminate yourself. Other wise don’t mess with them, you cannot “clean” them! I don’t mean to sound harsh, but this is true. Wear goggles & gloves, wash with soap & water, use hand sanitizer, try to not go out if you can, and when out stay at least 10 feet away from others. I have survived many years during flu and cold season with just surgical masks, gloves and goggles. With life threatening infectious patients I have survived many years wearing full PPE’s. Educate yourself and watch medical videos on donning & doffing PPE’s. At the end of the day this is all most of us can do, and most of us hopefully will be ok.

      1. TXnurse, thank you for emphatic reply. This was the pertinent part of your comment. =
        “… so if you need to ~reuse, just take precautions on putting on/taking off to not contaminate yourself. Other wise don’t mess with them, you cannot “clean” them! I don’t mean to sound harsh, but this is true.”

        Another question, = is placing a Mask in direct Sunlight for a period of time effective for Sterilization. Will direct Sunlight destroy the Flu Virus on a face mask? There’s a ‘time period’ question here too.

      2. Thank you for all the patience in addressing our discussions of patients;)

        I watched the NurseRN video mentioned on donning and removing PPE. I think the gown concept may be OK, but as soon as body fluids start flying, more coverage would be wise.

        I suggest folks get several of the disposable TYVEK or Tychem suits, with foot coverings, etc. Practicing for the level required for Corona 19 is good, but stocking up plans should include a Level 3 or 4 capability and proficiency for the future.

        My PPE training was for pesticides, and NBC warfare.

        Gloves: heavy thick nitrile sleeve length over gloves on top of your nitrile gloves, because in a contaminated environment we’ll be doing more than sick room attendance like is shown in Ebola workload settings.

        Aprons and rubber boots: I fully agree with trying to properly dispose of disposable PPE, but at home or in contaminated settings like your house or immediate outdoors area, it should be possible to decontaminate and reuse heavy boots, gloves, and over-apron, in a long term situation with dwindling resources.

        That said, the book Crisis In The Red Zone mentions a trained nurse used garbage bags for her suit in her successful poverty-stricken home efforts to save several family members from Ebola. It can be done.

        In NBC training and pesticide training, we carefully ensured fluids could not run down sleeves or pantlegs into the tops of gloves or boots, by putting them on and off in certain sequence. Something to think about in response to what your home patient has going on.

        Once again, thank you for sharing.
        May God Bless you all.

        1. Thank you for your replies. Thank you to everyone providing good personal safety ideas.

          Most of us do NOT have extensive medical preps to outlast a ~Virulent Pandemic. … The Wuhan Coronavirus Flu >might become a serious problem in the USA.
          With typical ~Flu Seasons~, a flu outbreak, comes around in an area, lingers, then dies down, and then maybe reappears, when people think it’s gone. … It’s a Flu >Season.

          It’s time to start home schooling your kids. … It’s time to spend some time with your parents; thank them for all they did for you, when you were young.

          We don’t know much about the Wuhan Flu at the moment; will it even show-up extensively in the USA? … Ordinary Flu can be deadly to the old, the young and the sick. … It’s always time to pray. Life can be very unpredictable. We do know, there’s a beginning and then an >end to life. Death, Judgement, Heaven or Hell.

          “For now we see through a glass, darkly; but then face to face: now I know in part; but then shall I know even as also I am known.”

        2. Wheatley Fisher,

          This beta coronavirus is not like Ebola where people can hemorrhage and bleed out through every orifice, and I don’t really believe bodily fluids will start “flying”. The most contaminated I have ever become with bodily fluids is with people with esophageal varices, or stomach ulcers with a lot of vomited blood, or people with pulmonary edema (during intubation). I have never been covered in bodily fluids with this type of virus that a normal fluid resistant disposable gown was insufficient. I think sometimes we can promote more fear than is necessary.

          1. Sorry to seem like a fear monger, but I was trying to point out that what needs to be done now for this level of prevention is not near what level of protection we should consider in planning for future possible disease outbreaks.

            Right here in the central US, historically there were severe outbreaks of high mortality diseases which killed within 48 hours of symptoms appearing. Railroad camps, military bases, wagon trains especially. I advocate awareness and education, with focused preparation rather than panic buying or reaction. Collectivization within our cities and towns provide new opportunities for rapid spread.

            I didn’t share this before, but my original medical training was at Walter Reed Army Institute of Research at Forest Glen. It was almost a half century ago, but at the time we were the forefront of animal testing, strange disease research and testing. Yes, compared to now, we were in the dark ages of medical knowledge.

            My sister worked for several years as the night shift floor RN for a hospital outside Boston where terminally ill children are kept. She suffers from debilitating medical health herself yet keeps giving year after year. This struggle against disease is not an academic one for us.

            . I praise God Almighty for people like you who are in the forefront of medical care now, and sincerely appreciate all you are helping us with.

            The fight against Ebola is still raging, and is not under control globally, noting that in the DCR alone, over 110 ebola-trained medical specialists got infected and 38 died in
            the past 24 months. I weep for the loss of gentle caring medical staff who literally sacrificed their lives trying to save others.

            The smart people in the struggle against viral diseases are telling us to be prepared to fight future virus pandemics at home, because science shows us that worse RNA viruses are expected,and we already know how our excellent medical professionals and facilities can be overwhelmed by sheer numbers.

            Again, I praise God for all you medical pro folks do. Thank you so very much.

  14. Wheatley Fisher,

    I agree with you that if people have the resources to buy higher level protection PPE’s now ahead of time, before something like Ebola were to become endemic in this country then they should. I bought all that gear in 2014, and hope we never have to use it. I look at most of what we do with becoming self sufficient as an insurance policy, we insure our selves, our cars, our homes and so forth. Becoming self sufficient with food, skills and medicine only makes sense. The general population usually see this as crazy, even though they carry all those other insurance policies. I believe most of what they consider as crazy is simply because they can not wrap their heads around something really bad happening here in this country. They ignore most of all….. history! Fear tends to make people deny what may be right in front of them. Better to call other people who insure in survival crazy.
    I appreciate your comments. I do what I do to give my family a shot at having a life after a massive event, as I think that’s what we here are all trying to do. We all die someday, it’s nice to think my children and grandchildren will have some sort life by being more prepared. We all need to get right with God and our families
    Thank you for your nice comments.

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.