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Old Dog New Trick 02-11-2020 07:13

Quote:

Originally Posted by InTheBlack (Post 655492)
Got instructions - time & temp & pressure for various materials? Otherwise your results can't be presumed to be any better than just boiling in an open pot. I don't even know how long for that...

I'm having trouble finding details on killing various organisms; its become a black-box process with commercial autoclaves.

https://www.cdc.gov/infectioncontrol...ion/steam.html


https://ehs.research.uiowa.edu/biolo...d-content-id-6

Standard Autoclave Cycles for Commonly Used Material

Laundry: 121°C for 30 minutes with 15 minutes pre-vacuum of 27 inches of mercury (in. Hg).
Glassware and trash: 121°C for 1 hour with 15 minutes pre-vacuum of 27 in. Hg.
Liquids: 121°C for 1 hour for each gallon.

I can’t recall specifics from school (too many years ago) but both a pressure cooker with water turned to steam for 50 or more minutes or the newer insta-pots with a steam sterilization cycle would sufficiently sterilize many hard items or even bandages (they then would need to be dried before use.)

IIRC boiling technique to sterilize a variety of hard or silicon items is 15-minutes. But this only a field expedient method to kill bacteria.

An oven or toaster oven is another technique above 250* for more than hour or above 350* for 30-minutes or more.

Obviously without test strips, heat tape, or other devices used to insure sterilization you are guessing but it is better to error on the side of caution than to just dump stuff in cold sterilization techniques available over the counter. (i.e., Hydrogen-Peroxide, > 70% to 90% Alcohol, bleach, soap and hot water, and well of course drinkable alcohols - whiskey, vodka what’s available.)

As for most household items used to treat or obtain information like an oral/rectal thermometer (laser and touch ones more better), stethoscope or cups used for administering medications either use disposable items or clean thoroughly with rubbing alcohol, bleach wipes and allow to air dry several hours before use and wash hands well before and after all contact. Washing clothes and bedding more often and if the washer or dryer have steam cycles use them.

Old Dog New Trick 02-11-2020 07:36

Quote:

Originally Posted by JJ_BPK (Post 655501)
Doesn't the autoclave & pressure cookers break/disturb most bonding agents? Fine for metal medical tools, but not so good for things that are made using epoxy glues, wood, plastics? :confused:

Mostly correct. Anything that absorbs moisture and retains that moisture would not be a good candidate for steam sterilization.

Most hard plastics would be fine and most silicons are okay to steam sterilization but yes it’s mostly for hard metal tools and to disinfect/sterilize waste before disposal.

Been awhile but when sterilizing medical instruments everything is wrapped with layers of cotton cloth to keep metal from metal or other tools from touching each other and placed within and outside that wrapping were heat activated test strips so you could inspect before use. IIRC When things came out of an autoclave or other steam pressure device they are still a bit damp and needed to sit on drying racks before returned to service.

doctom54 02-11-2020 07:50

Quote:

Originally Posted by JJ_BPK (Post 655501)
Doesn't the autoclave & pressure cookers break/disturb most bonding agents? Fine for metal medical tools, but not so good for things that are made using epoxy glues, wood, plastics? :confused:

That is true. There are other sterilization methods but none that work well enough on wood (too porous). There are cold sterilization techniques, such as the liquid gluteraldehyde, or gas ethylene oxide.

Here is a nice quick accurate overview of the options.

http://www.vetsurgeryonline.com/ster...ion-techniques

doctom54 02-11-2020 07:55

Quote:

Originally Posted by Old Dog New Trick (Post 655502)
I can’t recall specifics from school (too many years ago) but both a pressure cooker with water turned to steam for 50 or more minutes or the newer insta-pots with a steam sterilization cycle would sufficiently sterilize many hard items or even bandages (they then would need to be dried before use.)

Your memory is pretty good

IIRC boiling technique to sterilize a variety of hard or silicon items is 15-minutes. But this only a field expedient method to kill bacteria.
True it won't kill bacterial spores

An oven or toaster oven is another technique above 250* for more than hour or above 350* for 30-minutes or more.

Obviously without test strips, heat tape, or other devices used to insure sterilization you are guessing but it is better to error on the side of caution than to just dump stuff in cold sterilization techniques available over the counter. (i.e., Hydrogen-Peroxide, > 70% to 90% Alcohol, bleach, soap and hot water, and well of course drinkable alcohols - whiskey, vodka what’s available.)
Bleach is also a very good disinfectant

As for most household items used to treat or obtain information like an oral/rectal thermometer (laser and touch ones more better), stethoscope or cups used for administering medications either use disposable items or clean thoroughly with rubbing alcohol, bleach wipes and allow to air dry several hours before use and wash hands well before and after all contact. Washing clothes and bedding more often and if the washer or dryer have steam cycles use them.

Hand sanitizer is even more effective than washing from some studies recently done with surgeons

InTheBlack 02-11-2020 10:18

Some Statistics
 
When did the WHO small group arrive in China? I _think_ these statements ought to be updated once WHO gets closer to the data...

https://www.reuters.com/article/us-h...91f60001a28893

Reuters February 10, 2020 / 1:37 PM
Here is what WHO experts are watching on the coronavirus' spread

To what extent people who have mild disease,
which according to Chinese data on 18,000 cases is some 82%, shed the virus and potentially expose others. Some 15% of cases are severe and 3% critical, according to its data shared with WHO.

Why some people die.
People who are older or have underlying medical conditions - including cancer, diabetes, and hypertension - are most at risk. The overall death rate among reported cases is some 2%. People above 80 have the highest death rates, WHO says, citing Chinese data. WHO wants more data about the disease that can cause pneumonia and organ failure.

“We have recently released a clinical case report form which we are encouraging hospitals and clinicians to use so that standardised data collection can be captured from patients who are hospitalised,” van Kerkhove said.

InTheBlack 02-11-2020 10:30

offical name is Covid-19, says WHO
 
What's the "d" stand for?

>
The name Covid-19 is made up of the first letters of the words ‘coronavirus’, ‘virus’ and ‘disease’, Dr Ghebreyesus said.
>
“We had to find a name that did not refer to a geographical location, an animal, or an individual or group of people,” WHO's director-general, Dr. Tedros Adhanom Ghebreyesus, said in a call with reporters.

It’s also easy to pronounce, he added.
>
"‘Having a name matters to prevent the use of other names that can be inaccurate or stigmatising."
>

Such PC nonsense. Its useful for a name to reveal something about it.

How about "WuWACK?"

Wuhan
Weaponized
Asian
Chinese
Killer

mugwump 02-11-2020 13:29

A new study from China was released yesterday and is undergoing peer review.

“...The team collected data from 1,099 confirmed coronavirus patients at 552 hospitals in 31 Chinese provinces and municipalities, the report said.

Analysis found that the average incubation period was three days – shorter than 5.2 days suggested in a previous paper – but the range of the a patient’s incubation period could extend from zero to 24 days.”

That’s why they test asymptomatic cases, In the Black. The study points to the mechanism behind the reported “super spreaders”. Three weeks being infectious without symptoms. Yikes. Up a full 10 days from the 14 days previously reported.

The same study states that the virus is viable and infectious on surfaces for up to 9 days. Which might explain the mass disinfection attempts by the PLA fogging/spraying everything in sight.

mugwump 02-11-2020 13:38

DOD/DHS are setting up more quarantine centers on military bases:

JB Pearl Harbor-Hickam, Hawaii (HNL)
Great Lakes Training Center Navy Base, Illinois (ORD)
Naval Air Station Joint Reserve Base, Texas (DFW)
March ARB, California (LAX)
Travis AFB, California (SFO)
Dobbins ARB, Georgia (ATL)
Fort Hamilton, New York (JFK)
Naval Base Kitsap, Washington (SEA)
Joint Base Anacostia, Washington DC (IAD)
Joint Base McGuire-Dix-Lakehurst, New Jersey (EWR)
Fort Custer Training Center, Michigan (DTW)

The Department of Defense already has quarantine centers at Fort Carson in Colorado, Travis Air Force Base and Marine Corps Air Station Miramar in California, and Lackland Air Force Base in Texas.

https://www.miamiherald.com/news/nat...#storylink=cpy

Old Dog New Trick 02-11-2020 13:47

Quote:

Originally Posted by mugwump (Post 655516)
DOD/DHS are setting up more quarantine centers on military bases:

JB Pearl Harbor-Hickam, Hawaii (HNL)
Great Lakes Training Center Navy Base, Illinois (ORD)
Naval Air Station Joint Reserve Base, Texas (DFW)
March ARB, California (LAX)
Travis AFB, California (SFO)
Dobbins ARB, Georgia (ATL)
Fort Hamilton, New York (JFK)
Naval Base Kitsap, Washington (SEA)
Joint Base Anacostia, Washington DC (IAD)
Joint Base McGuire-Dix-Lakehurst, New Jersey (EWR)
Fort Custer Training Center, Michigan (DTW)

The Department of Defense already has quarantine centers at Fort Carson in Colorado, Travis Air Force Base and Marine Corps Air Station Miramar in California, and Lackland Air Force Base in Texas.

https://www.miamiherald.com/news/nat...#storylink=cpy

Is this not the most forward thinking and simplistic approach ever...thank you Mr. President, for providing real leadership. Most presidents before you would have floundered.

InTheBlack 02-11-2020 13:53

Source of "stays active up to 9 days"
 
I hate having to play six degrees of Kevin Bacon to find the actual research behind claims.

NOTE: that B.A.C is less effective than alcohol.

https://www.journalofhospitalinfecti...046-3/fulltext

Journal Pre-proof
Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal
agents
Gunter Kampf, Daniel Todt, Stephanie Pfaender, Eike Steinmann
PII: S0195-6701(20)30046-3
DOI: https://doi.org/10.1016/j.jhin.2020.01.022
Reference: YJHIN 5905
To appear in: Journal of Hospital Infection
Received Date: 31 January 2020
Accepted Date: 31 January 2020

Summary
Currently, the emergence of a novel human coronavirus, temporary named 2019-nCoV, has become
a global health concern causing severe respiratory tract infections in humans. Human-to-human
transmissions have been described with incubation times between 2-10 days, facilitating its spread
via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available
information about the persistence of human and veterinary coronaviruses on inanimate surfaces as
well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare
facilities. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute
Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or
endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic
for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62-71%
ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents
such as 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no
specific therapies are available for 2019-nCoV, early containment and prevention of further spread
will be crucial to stop the ongoing outbreak and to control this novel infectious thread.
Keywords: coronavirus; persistence; inanimate surfaces; chemical inactivation; biocidal agents;
disinfection

InTheBlack 02-11-2020 13:57

"That’s why they test asymptomatic cases, In the Black."

Yes but how do they determine whom to test? An asymptomatic person is not going to the doctor -- are they doing a random epidemiologic survey within some geographic area?

And its been claimed that they only have the capacity to perform 3000 tests a day, so would they use that precious capacity to test people who are not at all sick?

mugwump 02-11-2020 16:35

Quote:

Originally Posted by InTheBlack (Post 655519)
"That’s why they test asymptomatic cases, In the Black."

Yes but how do they determine whom to test? An asymptomatic person is not going to the doctor -- are they doing a random epidemiologic survey within some geographic area?

And its been claimed that they only have the capacity to perform 3000 tests a day, so would they use that precious capacity to test people who are not at all sick?

A better question is why do they test symptomatic patients in the middle of a pandemic? Odds are, if they have symptoms, they’ve got it. And if they throw a few folks with the common cold into quarantine, luck of the toss. Shoulda stayed home.

They’re not trying to help people, they’re trying to identify spreaders. Asymptomatic family members of sick folk, medical and transport staff, the actual testing staff themselves, response teams interacting with the public, just a few types of asymptomatic people I’d test. You don’t want one med tech bringing down the whole shift. Testing symptomatic people seems a waste of resources in their situation.

mugwump 02-11-2020 16:43

If you want to attend a masterclass on public communication, search “ PM Lee urges Singapore to take courage amid coronavirus outbreak”. Short, clear, emphasis on flexibility of response. The guy's freaking brilliant.

Stobey 02-11-2020 18:02

Quote:

Originally Posted by PedOncoDoc (Post 655477)
Not a lot of good OTC meds for nausea - diphenhydramine (benadryl) can be used, but it has sedating effects. Pepto-Bismol and similar compounds may help some.

Best safe antiemeitc by prescription in my book is ondansetron (zofran) - and I treat a lot of nausea in my profession.


Speaking of sedating effects from diphenhydramine, is compazine still available for nausea?

InTheBlack 02-11-2020 18:10

Details in - Source of "stays active up to 9 days"
 
Looked thru the report I referenced below. Here's another URL to it, the Pre-Press draft:
https://sci-hub.tw/10.1016/j.jhin.2020.01.022

In-Press version:
https://www.journalofhospitalinfecti...ulltext#sec3.1

They seem to be different drafts, at least the tables appear differently formatted on my computer.

They aggregated a lot of recent studies. But its not very good for answering "does the stuff under my kitchen sink work?"

ETHANOL at 78% for 30 seconds reduced infectivity by >5.5 on a log scale. But is there any hard liquor with that much? Some state's don't sell grain alcohol, vodka is only 50% alcohol...

For hand sanitizing, does alcohol gel hand have that much, in effective contact? I think its only 70%.

70% ethanol took 10 minutes to get to 3.3 or 3.9 (different strains). It will evaporate before that in real life, unless you are soaking something in a closed container.

SO HAND CLEANING IS DIFFICULT - 78% is harder on your skin.

Lysol Spray is only 58% ethanol, and 0.10% B.A. saccharinate (not B.A.C.), which was not tested in these research papers.


B.A.C. (BENZALKONIUM CHLORIDE) at 0.2% for 10 minutes killed ZERO. Very odd. But 0.5% required 10 minutes to reach >3.7, so similar to 70% ethanol for 10 min . But a smaller concentration for 10 days still killed something... its not clear if they inoculated that surface after 10 days to learn the effectiveness of the residual product, or merely checked it.

SO ACHIEVING THE RIGHT DILUTION FOR BAC IS PROBLEMATIC


SODIUM HYPOCHLORITE (BLEACH) 0.21% took 30 seconds to reduce by >= 4.0.
>
Inactivation of coronaviruses by biocidal agents in suspension tests
...
Sodium hypochlorite required a minimal concentration of at least 0.21% to be effective.
...

Inactivation of coronaviruses by biocidal agents in carrier tests
Concentrations of 0.1- 0.5% sodium hypochlorite ... <3.0
...

Discussion
Human coronaviruses can remain infectious on inanimate surfaces at room temperature for up to 9
days. At a temperature of 30°C or more the duration of persistence is shorter. Veterinary
coronaviruses have been shown to persist even longer for 28 d
...
The typical use of bleach is at a dilution of 1:100 of 5% sodium hypochlorite
resulting in a final concentration of 0.05% [13]. Our summarized data with coronaviruses suggest that a concentration of 0.1% is effective in 1 min (Table 3). That is why it seems appropriate to recommend a dilution 1:50 of standard bleach in the coronavirus setting
>

But I think they probably used lab grade, known fresh -- the bleach by your washing machine could be old, and my Clorox bottle does not even state its percentage anymore !!! EDIT: the powder form is Calcium hypochlorite, I think sometimes used for pools, but less of a disinfectant?

What is a "suspension" vs a "carrier" situation?


HYDROGEN PEROXIDE 0.5% for 1 minute reduced by >4.0.
My Lysol spray cleaner says its 0.88% but of course no data on the percentage a month after you have opened the container.


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