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Yale 62

Keeping Healthy, First and Foremost   COVID-19 Update #4

By Bill Stork

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First and foremost, it is important to keep a positive attitude and to avoid panic. Fear and anxiety now are unnecessary if you follow these precautions, and they weaken the body’s resilience to withstand infection.

Avoid going out! Work from home if possible. If you MUST go out, avoid crowds; this means staying away from Costco, Walmart, and Sam’s! And if you must associate with others, avoid shaking hands; instead use a wai which is made by pressing palms together in front of your chest, fingers pointing up. [There is an emoji for this on your smartphone if you need a graphic]

Find reliable local firms that do home-deliveries. Should this not be possible join Amazon Prime! They offer almost anything. Here in Hong Kong I have found five home-delivery sources for almost all our needs [except a pizza delivery, sadly!]

Find ways, if sequestered or self-quarantined, of keeping positive. In my head I keep hearing that silly jingle, ‘Be happy; Don’t worry’! Self-amusement is in order, and I have a variety of things to occupy my mind; Games and Puzzles – there are so many sources on the Internet! And if you are a family or live near friends, board games are great! My recent ‘research’ indicates that Monopoly is the longest-lasting game, so one can start it and when it gets late abandon it and resume later. Note that the Rules say that the bank can never be insolvent, and can issue IOUs if necessary! Memories: when asked by Class Leader John Stewart to pen items for the Fiftieth Reunion Book and Supplement, the class made a good response. But there might now be other things to write about! I have a laptop file labeled Memories, and I continue to add little things to it. Yesterday, upon hearing about the death of the original Trader Joe’s Joe Couloumbe, I wrote about my friendship with him and that of my parents, and the largesse at time he donated to my Pasadena events. Regularly I print out two copies of these memories to put in large envelopes to be sent to my two children upon my demise. May seem somewhat ghoulish, but I have such FUN in writing and reliving those memories… and I only choose the favourable ones! (sample: Living in southern California, often my father and I would leave in the morning at the same time. One morning on the front steps Father commented, “Bright sun!” … to which I replied, “Thank you”).  I also have made contact with college officials where I got other degrees, and with schools where earlier I have taught, both sharing my interest in their current efforts and finding out that they are really interested in my memories. But do what might be a pleasing activity for you! Knitting?

Schools here in Hong Kong have long been closed with virtual classrooms in their stead, and these will, for now, be closed until after Easter with rumors of May. For working couples who have children, childcare has been a concern. For Americans who are soon to face school closures of their own, I can provide some Hong Kong solutions.

Health Survival Suggestions:

Personal and home hygiene are critical. Washing hands1 often in the proper manner2 is basic to survival now, and also use an alcohol-based hand sanitizer3 (not a bacterial one). [While ‘washing hands’ seems obvious, most people do not. Nevertheless it is included below for grandparents to share with families and others.] Prevent germs in saliva from contaminating food.4

If you must go out, definitely follow these suggestions5 for cleaning up when you return home.
Protect yourself and prevent others from contracting diseases6. Learn how to properly/safely put on and take off a facemask7. Keep a healthy lifestyle!8 Ensure good ventilation9. Likewise good hygiene for toilet facilities!10

There are also some additional Covid-19 specific ways of keeping your home clean11. If you do not live in a house, but in a condo or apartment building where there are shared facilities, keep these measures12 in mind.

Footnotes

1. Washing hands thoroughly with liquid soap for at least 20 seconds can effectively prevent contracting and spreading communicable diseases.
When should we wash our hands? • Immediately after going to the toilet. • Before handling food or eating. • After changing nappies. • After handling articles soiled by faeces, respiratory or other bodily secretions. • Before and after visiting hospitals or residential care homes. • After making contact with animals or poultry.
• Viruses and bacteria can enter the body easily through the eyes, mouth and mucous membrane of the nose. So, always remember to wash hands before touching the eyes, nose and mouth. • Wash hands after touching public installations or equipment, such as escalator handrails, elevator control panels or door knobs, which are commonly used by many people and can easily gather germs. When should we wash our hands? • Immediately after going to the toilet. • Before handling food or eating. • After changing nappies. • After handling articles soiled by faeces, respiratory or other bodily secretions. • Before and after visiting hospitals or residential care homes. • After making contact with animals or poultry. 2 3 • Always carry a handkerchief or some tissue paper. Cover your nose and mouth with it when sneezing or coughing. Wash hands immediately afterwards to avoid spreading germs via respiratory droplets. • Towels should never be shared. Personal towels to be reused must be stored properly and washed thoroughly at least once daily. It is even better to have more than one towel for frequent replacement. • Keep the toilet rim clean. Flush the toilet and wash hands after using the toilet. Keep it clean for your benefit and the benefit of others. • Wash hands with liquid soap, then dry with a clean towel/tissue paper or a hand dryer. Do not use communal towels. • Be considerate. Do not make the floor wet when washing your hands or discard used tissue paper outside the trash-bin.

2. Wash hands properly! Hand washing, done correctly, is an important personal hygiene practice to prevent the spread of communicable diseases. Many diseases can be spread easily if hands soiled with faecal matter or respiratory discharges are not properly washed. Here is the government-recommended method: (a) Wet hands under running water (b) Apply liquid soap and rub hands together to make a soapy lather (c) Away from the running water, rub the palms, back of hands, between fingers, back of fingers, thumbs, finger tips and wrists. Do this for at least 20 seconds. (d) Rinse hands thoroughly under running water. (e) Dry hands thoroughly with either a clean towel, a paper towel or a hand dryer. (f) Avoid direct contact between clean hands and the taps.

3. Use alcohol-based handrub. When hands are not visibly soiled, 70-80% alcohol-based handrub is also effective for disinfection. Apply a palmful of alcohol-based handrub and cover all surfaces of the hands. Rub the palms, back of hands, between fingers, back of fingers, thumbs, finger tips and wrists for at least 20 seconds until the hands are dry.

4. For meals always use serving utensils (serving forks and serving spoons) and avoid using eating utensils from being used to get additional food. We use chopsticks for eating and other chopsticks for getting food from platters.

5. Dirt or germs can be found everywhere in the street, or on objects that you come into contact with outside. When you come home : • Wash hands and face immediately. • Wash clothes (or air them in a well-ventilated place for at least one day) to clear away dirt and germs. • Clean shoes and put them in a well-ventilated place. Wash hands immediately afterwards. We also take a very hot shower upon return, as it is said that Covid-19 is not heat-resistant as SARS was. We also take shoes off before entering and then spray them before placing them on a newspaper-covered mat. The outside door-handle also gets a spray, as do hands immediately. When we venture out we always have a pack of paper towels handy, to use when pushing elevator buttons or a shop’s door-handles.

6. • Consult a doctor promptly if you feel unwell. Wear a face mask if you have symptoms of a respiratory tract infection. • If you have a fever, do not go to school or work. • Wear a mask when visiting hospitals or clinics. When you arrive home, take a shower/bath and thoroughly wash your hair.

7. For a surgical facemask, put it on only by using the strings that go around the ears, then pinch the metal tab to affix it firmly on the nose, with the mask extending below and tightly covering the chin. The colored part should be on the outside. Most importantly, when you return home, without touching the mask remove it using only the strings and promptly put it in a sealable plastic bag for immediate disposal.

8. • Do not smoke cigarettes/cannabis or drink too much alcohol. • Exercise regularly and maintain a healthy, balanced diet. • Get plenty of rest. • Do not share personal items.

9. • Wash dust filters of air-conditioners frequently and check for drips from air-conditioners. • Create a dust-free and smoke-free environment for work, rest and play. We have an excellent air purifier and also our dehumidifier has an air purification setting.

10. • Clean toilets daily with a diluted household bleach solution (1 in 99). At home, make sure there is liquid soap and a clean towel in the toilet to wash hands. For public toilets, liquid soap and disposable towels or hand dryers should be made available. • Pour water into drain outlets regularly to prevent foul air and insects in the sewage pipe from entering the premises. • Make sure drains and pipes do not leak or are not blocked. But do not try to fix or alter them on your own. Call an expert! Most of us here in Hong Kong live in residential apartment/condo configurations, and we know to keep water in those drain pipes as it seemed, during SARS, that was how the disease was spread.

11. • Clean and disinfect frequently touched surfaces, furniture, toys, utensils, toilet, bath room and floor at least daily by using appropriate disinfectant (e.g. 1 part of 5.25% household bleach in 99 parts of water for non-metallic surface or 70% alcohol for metallic surface), wait until dry and then rinse with water. • If places/utensils/clothes are contaminated by respiratory secretions, vomitus or excreta, use disposable towels to wipe them away. Then disinfect the surface and the neighbouring area with appropriate disinfectant (e.g. 1 part of 5.25% household bleach in 49 parts of water for non-metallic surface or 70% alcohol for metallic surface), leave for 15-30 minutes, and then rinse with water. • Clean the floor regularly and increase the frequency as the circumstances required, and keep it dry. • Carpets should be kept clean by daily vacuum cleaning and regular washing. • Clean and change bed sheets, pillow cases, towels and clothes regularly. • If pets (such as cats and dogs) are kept, increase the frequency of cleansing.

12. • Make sure that common facilities such as staircases, lifts, lobbies, refuse collection and recycling bins/chambers, canopies and ventilation fans are cleaned, disinfected and maintained regularly. Share you concern with others if no compliance. Complain!

 
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We invite your comments below.

9 comments to COVID-19 Update 4

  • Harry Ward

    Bill:

    What a list! I don’t know how you do it. But I guess it fits the old question when I took safety training: “Can you do it if your life depends on it?”

    You talk about using home delivery. But if it is a meal, then there was a person that cooked it, someone else packaged it, and a third person delivered it. Haven’t you just exposed yourself to three strangers?

    I also have a related question for which I have never been able to find an answer. That is, can the virus be transferred from one surface to another? For example, if the bottom of the carton your meal came in was contaminated, and you placed that container on your kitchen counter, is your counter now also contaminated?

    Harry Ward
    ’62E

    • William Stork

      Great questions, Harry!

      The ‘home delivery’ services that we use do not deliver prepared food, just packaged items, and all items are individually sprayed with a 60%-alcohol sanitizer before storage. We unpack outside our front door, with the carton that these all come in placed on several sheets of newspaper. After unpacking and spraying the purchased items the empty box-and-newspaper are all carefully transferred to a hefty bag for disposal, and then hands are thoroughly washed. And the tap is turned off with a disposable paper towel since the faucet might have gotten dirty when it was turned on!
      The virus can be transferred from one surface to another, and that is why surgical gloves are not recommended for wearing by the general public.

      All best regards!
      William.Stork@aya.yale.edu

    • William Stork

      A further reply, Harry, as this is the first ‘media’ mention of a reply to your incipient query!

      https://www.bbc.com/future/article/20200317-covid-19-how-long-does-the-coronavirus-last-on-surfaces?xtor=ES-213-%5BBBC%20Features%20Newsletter%5D-2020March20-%5BFuture%7c+Button%5D

      Like many respiratory viruses, including flu, Covid-19 can be spread in tiny droplets released from the nose and mouth of an infected person as they cough. A single cough can produce up to 3,000 droplets. Amazing! And so dangerous [if you have a cough, DO use a mask! If it is not recurrent, keep a pack of antiseptic tissues handy!]

      The Chinese University of Hong Kong has established that the BEST testing for Covid-19 is by using stool samples. They have shown that even patients that have shown ‘no’ symptoms after a throat culture can still be harboring the virus, seen in the stool samples that they have investigated. Does this mean that that the test that are now being put forward by WHO and T-rump are incomplete, I will therein reserve judgement! [But I do think so!]
      Nevertheless, both washing one’s hands and cleaning and disinfecting frequently touched surfaces daily remain key in preventing Covid-19’s spread. There is also some evidence that the virus is also shed for longer in faecal matter, so anyone NOT washing their hands thoroughly after visiting the toilet could contaminate anything they touch.
      Their study, which has been published in the New England Journal of Medicine, shows that the virus could survive in droplets for up to three hours after being coughed out into the air. Fine droplets between 1-5 micrometres in size – about 30 times small than the width of a human hair – can remain airborne for several hours in still air.
      It means that the virus circulating in unfiltered air conditioning systems will only persist for a couple of hours at the most, especially as aerosol droplets tend to settle on surfaces faster in disturbed air.
      But the NIH study found that the SARS-CoV-2 virus survives for longer on CARDBOARD – up to 24 hours – and up to 2-3 days on PLASTIC and STAINLESS STEEL surfaces. Having an effective spraer handy is essential were one to get deliveries or to even venture out to one’s postal box!
      As for how long droplets stay effective on clothing is yet being investigated! The Rocky Mountain labs say, “We speculate due to the porous material, it desiccates rapidly and might be stuck to the fibres. Changes in temperature and humidity may also affect how long it can survive, and so may explain why it was less stable in suspended droplets in the air, as they are more exposed. “[We’re] currently running follow-up experiments to investigate the effect of temperature and humidity in more detail.”

      Stay tuned!!

      William.Stork@aya.Yale.edu

  • Lee Bolman

    Bill,

    Thanks for your very informative and helpful posts. You’ve been providing the rest of us a preview of coming attractions, with Covid-19 now accelerating almost everywhere around the globe. It’s good that this virus poses very low risks for kids, but sobering that folks in our demographic was highly vulnerable.

    Let’s all try to stay safe.

    Lee

    • William Stork

      Thanks for the kind words, Lee!

      And in addition to ‘safe’, we need to stay ‘positive’ even as this crisis spawns other concerns about the stock market and recession, campus closures including Yale’s, political leadership, cancellation of sporting events (I awoke this morning to watch the Australian F1 Gran Prix only to find it cancelled) … and more.

      Yesterday a Washington Post columnist wrote a column titled ‘Hong Kong learned from SARS; what can we learn now from Hong Kong?’ I am most happy to pass on to classmates some of those lessons learned!

      All best regards.

      William.Stork@aya.Yale.edu

  • Ken Luke

    This reminds me of the motto of Andy Grove, one of the founders of Intel and its longtime former chairman: “Only the paranoid survive.”

    • William Stork

      My good friend! I have always so enjoyed your incisive humour and insights!

      Having lived (and worked) through the SARS episode in Hong Kong, even with the widespread panic here at that time, I seemed to have kept positive — even though there was at that early time no idea as to how that killing-disease was being spread.
      With that lesson well-learned, I now know that there are really two epidemics at play — the disease itself and the mental health concerns that fear/anxiety do bring!

      So while I do plan to ‘survive’, I reject any suggestion of ‘paranoia’! My concern is not ‘fear’ nor is it ‘irrational’. I just call it ‘preparedness’ and ‘keeping a good humour’ by self-amusement with all sorts of fun distractions, like creating Challenge Contests and sending family members outrageous puns.

      Stay safe, stay healthy, stay positive — and keep scrubbing your mitts!

      Mahalo nui loa!

      William.Stork@aya.Yale.edu

      • Ken Luke

        Bill my good friend! Thanks for your descriptive and thought-provoking commentaries of life in East Asia. Sometimes we have to become scared in order to do what needs to be done. I think that few of us would want to take the extreme measures you are describing, but they have kept you – and apparently the general Hong Kong population – free of the worst ravages of the pandemic. Continue to stay healthy, and continue to keep us informed.

        • William Stork

          Thank you, Ken, for the kind words! I hope that you are following the new orders by your California governor to stay home … the first all-state lock-down. For those of us on the cusp of living for eight decades, we are at the most vulnerable level for infection. Here in Hong Kong we are experiencing ‘the second wave’ caused by H K residents returning from abroad with a spike of 48 new cases yesterday after having a week in which there were but a couple of new cases.

          There is still much that is unknown about this virus. Despite CNN’s report that food delivery is safe, local reports indicate that the virus can remain potent for a long time on cardboard! It’s best to stay safe and follow all possible precautions.

          The most critical aspect is the ‘secondary epidemic’ caused by self-isolation — maintaining good mental health! I continue to find new ways to self-amuse!

          Keep safe, keep healthy, keep positive!

          William.Stork@aya.yale.edu

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