Thursday, February 27, 2020

Good advice on infection prevention from the WHO, and a great deal of caution

I think all the advice provided here (dated today 2/27/20) is sound, and is not alarmist. This virus has spread remarkably quickly, frequently triggers lethal illness, and there has not been anything like it since the 1918 flu.   COVID-19 must be spreading within the US in ways we don't know yet.  The lack of available testing massively exacerbates this problem.

WHO has issued simple but practical guidelines for how to do the best we can given the current situation, even if people lack access to masks, gloves, etc.

The only WHO advice that I am not sure is correct is the advice to use hand sanitizer (generally 70% alcohol).  I have not seen any country guidance that says alcohol sanitizer has been tested on COVID-19 and works.  The only decontaminant that US and UK authorities recommended is bleach, at a specified dilution.  Be aware that viral killing might require more than a quick swipe with a "wipe" that has been wet with dilute bleach.  So far we have not been told the details on how to effectively decontaminate surfaces, although testing should have been done by now.

I should note that while China has been widely criticized for hiding or underreporting COVID cases, the US is doing the same thing by withholding testing from all but a tiny number of potential patients.  Furthermore, lack of clear identification of potential cases opens the door to massive spread, as noted in this piece today by Helen Branswell of STAT:

... Eventually, more than 10 days after she went into hospital, the CDC agreed she could be tested. Dozens of health workers who may have come into contact with her at NorthBay VacaValley Hospital, in Vacaville, Calif., are now being monitored.California Gov. Gavin Newsom was critical of the testing debacle in a press conference on Thursday. His state has only 200 kits to test for the new coronavirus, he said.
“Testing protocols have been a point of frustration for many of us,” Newsom said. He added that, based on conversations with the CDC, states have been informed new protocols are coming and they have been promised an “exponentially” increased capacity to test.
Indeed, on Thursday the CDC announced a new testing protocol that will greatly expand the number of people who should be tested.
Requests for comment from the CDC on Thursday went unanswered... 

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