Jill:

This is the Accidental Safety Pro brought to you by Vivid Learning Systems and the Health and Safety Institute. This is a special edition of the podcast and it was recorded on March 17th, 2020. My name is Jill James, Vivid's Chief Safety Officer and today I'm joined by Corey Martin. Corey is the Founder and CEO of Spotlight Safety. He holds a master's degree in Immunobiology from Yale University and specializes in Safety Program Development for Biotech, Life Science, and Academic Research Facilities, studying Biological Mechanisms and Infectious Disease.

As a former scientific researcher, Corey made his accidental safety pro transition as the Research Safety Officer at Dartmouth College. At Dartmouth during the Ebola breakout from 2014 to 2016 and participated in emergency response planning efforts including training and decontamination, isolation, and quarantine procedures in the event of a known or suspected case in the community.

Broadly, Corey's passion is to facilitate cutting edge research that enables disease understanding and treatment while ensuring the health and wellness of researchers performing the experiments. He focuses on the importance of foundational biosafety practices such as facility containment, engineering controls, personal protective equipment, appropriate decontamination procedures, and proper waste management policies.

Furthermore, he highlights that these controls are in place not only to protect the researchers but also their families, friends, and communities. Many of these same biosafety principles also apply to public health and safety during infectious disease outbreaks. As with safety programs, Corey acknowledges that successful containment depends on quality proactive policies developed in accordance with guidance from the experts' sources. Those being the World Health Organization, the Centers for Disease Control, the National Institute of Health, and the Environmental Protection Agency as well as others.

We've heard from Corey before. He's been our guest on episode number 46 of the podcast and we're so happy Corey's willing to come back and share his knowledge today. I specifically asked Corey on the show because I've been personally concerned about chemical interactions that could inadvertently be happening as we've all been asked to do decontamination, to do cleaning, to do disinfection.

While there are many great products available for us to use, some of them don't play well together. I'm concerned about our communities, not only in our workplace but in our homes that people might make some errors. I really wanted Corey to be able to share some of those best practices and ways to mitigate any injuries that could occur when we're trying to do our best in times like this.

Corey, thank you so much for being here and I'm interested to know how would you like to set the stage for our conversation today?

Corey:

Sure. Well, thank you first of all for having me back. I'm excited to talk about this general topic and maybe dispel some myths about how to protect the community and maybe your own personal workplace or household as things go into isolation and social distancing mode. Yeah. First of all you mentioned the deference to expert sources in the intro. I think that's a really important thing and it's one of the items that I would like to start with just because one of the things that is common in disease outbreaks or pandemics is a feeling of hysteria in some cases and sharing of misinformation or things that may be misinterpreted.

I think it's really important for everybody as they're perusing the media or social media just to go back and verify sources and make sure that things are matching the guidance from the World Health Organization or the CDC or NIH and just using that mindset to go through their everyday lives. Because again, depending on where your sources come from, there might be some truth or enough truth to believe it, but maybe it's not backed up by all the facts. I also want to kind of call out people in the position to be maybe viewed by the public as an expert, medical professionals, and safety professionals for sure, just to make sure that people in that capacity are verifying their own information so that they're not putting their name behind something that may not be 100% accurate.

Jill:

As we're all passing and sharing information. Is that one of the examples?

Corey:

Exactly. Yeah. Before you like or share something on social media, maybe just go to those primary sources and make sure that things are lining up. Because one of the things that's unique about this virus is that we've only known about it for three months and in that time, with the research efforts and the technology that we have in this day and age, we've learned a lot about it, but it's still extremely new to our academic understanding. Things are going to evolve very quickly. I'm very thankful that you timestamp these episodes because over the next few weeks, I'm sure we're going to know a lot more and learn a lot more. I think things will develop as we go.

Jill:

Yeah. Right. Corey, I had set us up to talk about cleaning and disinfection and I think that's where we should start.

Corey:

Sure. Absolutely.

Jill:

Yeah. By way of your background in that, particularly in your lab work, I'm guessing that's maybe where some of that started learning some of those best practices.

Corey:

Yeah. I think when you're going through and working in a research environment where you have potentially infectious materials and you're working with human source material that might come from the clinic, there's always an element of risk involved in those research studies. It's important to have decontamination practices that are sufficient for the material that you're working with. In the biosafety realm, we work with general biosafety levels from biosafety level one through biosafety level four. Each one of them has different control and decontamination procedures associated with them and depending on the level of risk.

This one has unique qualities and that it's airborne transmissible, which automatically elevates the risk. It does seem to stick on surfaces for a fairly long length of time.

Jill:

Yeah. Knowing what you know and what you were taught and what you practiced in your lab setting about cleaning, I'd like to take that in, how can we transfer that knowledge to work places and to our homes? Would it make sense to talk about the different types of surfaces there are to clean and then how those would be done differently? Can we talk about that maybe?

Corey:

Sure. Yeah.

Jill:

Okay.

Corey:

In most laboratory facilities, for instance, you have hard nonporous surfaces. In that context, it seems as though this virus can stick around on the order of two to three days, which puts it in a kind of moderately hardy category in terms of risk management. Outside of that lab facility environment, in a general workplace or in a household, you might be dealing with a lot more porous surfaces.

Corey:

I think a lot of workplaces these days might have exposed beams or brick services or certainly rugs that wouldn't be found in a laboratory environment. So-

Jill:

Yeah. Talk more about... Yeah, thank you. Pardon me for interrupting. If you can maybe dig into... You've just given some examples of nonporous versus porous. Can you talk about what the differences are?

Corey:

Sure, yeah. When you're talking about disinfecting a surface, access to the material is very important. If you spray a nonporous surface but can't wipe it down and you have these nooks and crannies that the virus or the biological materials can hide from that agent, then you're not going to get sufficient decontamination when you-

Jill:

Got it.

Corey:

... do that process.

Jill:

Okay.

Corey:

Hard surfaces are a lot easier because you have better access and if you spray it and wipe it down, chances are you're going to either pick it up or disinfect it depending on what material that you're using. The application is slightly different and the level of cleaning that you might have to do for those two surfaces might vary.

Jill:

Would a wooden hand rail be an example of a nonporous surface?

Corey:

It depends on what the treatments are. If it's heavily lacquered and it's sealed appropriately, it might not be as big a risk as if you had a completely exposed beam that didn't have any treatment on it. But, yeah.

Jill:

Got it.

Corey:

That would be an example of something that you would want to keep in mind.

Jill:

Okay. How do you choose a different disinfecting or cleaning agent based on porous versus nonporous? I know CDC has guidelines exactly for this, but can you talk about, why does it make a difference?

Corey:

Sure. Yeah. Again, the access is important. In order to properly disinfect something, you have to have that agent come in contact with the disinfecting material for a certain amount of time. That contact time is going to vary depending on which disinfectant you use.

Jill:

Okay.

Corey:

That can contribute to which option you use. If you're dealing with exclusively hard porous or nonporous surfaces, you may choose standard like bleed shore 70% ethanol or some sort of ammonia solution. Those are all EPA approved generally for those applications. But if you start having issues with access to the agent and you are concerned about penetration and those types of scenarios in terms of getting into the nooks and crannies, you can start looking at non liquid options. There are vaporized hydrogen peroxide and chlorine dioxide gases that can be used in a fogging fumigating type application. That can have much better penetration to get your agents.

Jill:

For those nonporous surfaces.

Corey:

Exactly. Yeah. Or the porous surfaces. Yeah.

Jill:

Oh yes. I'm sorry. Porous surfaces. But that does not sound like something that we'd all have access to. It sounds like something you'd need some pretty specialized training and safety knowledge about if you're going to be doing fogging, correct?

Corey:

Right, yeah. That's not a kind of plug it in and let it go kind of application. That's definitely expert level commercial product. Yeah.

Jill:

Right. Right. Let's back up and talk about interactions with chemicals. You mentioned some chemicals right now. I know I heard you say ethanol a little bit ago. That also means isopropyl alcohol, correct?

Corey:

Yeah. I referred to alcohol disinfection as either being ethanol or isopropyl alcohol.

Jill:

Okay. Okay.

Corey:

Or isopropyl. You can use them reasonably interchangeably for most-

Jill:

The terms.

Corey:

... agents. Yeah. I mean, they're not the same chemical, but their application is the same.

Jill:

Okay. Got it. Thank you. Thank you. Corey, what do we need to know about things that don't act well together so we don't hurt ourselves?

Corey:

Yeah. I'll start by saying that the EPA just put out a list of about 274 disinfectants that's approved for this coronavirus and I think we're going to link to that in the show notes. If anyone has questions about those, they can review them there. My guess is that that list will continue to expand as new products are developed or things change. But basically, if you go through that list, you'll notice that the active ingredient is included with each of those products.

Jill:

Oh, great.

Corey:

That's what you want to focus on.

Jill:

Okay.

Corey:

When you're evaluating these materials, just know that the active ingredient is what is performing the disinfection and it's also what is likely to not play nicely with the other forms of disinfection.

Jill:

Okay. What are some of those that we should avoid?

Corey:

Yeah. I mentioned that alcohol is one of the big ones. Bleach is one of the big ones. In those technical documents, bleach is going to be referred to as hypochlorite, so just keep that in mind.

Jill:

Okay.

Corey:

And then ammonia. That's going to be referred to as quaternary ammonia in most cases.

Jill:

Okay.

Corey:

And then hydrogen peroxide. Those are the four biggest ones.

Jill:

Okay.

Corey:

Then you're also going to get some various acids and maybe some heavy metals and those types of things mixed in.

Jill:

Yeah. Thank you for explaining the lay terms that go with the chemical terms as well. Because I think when we're reading as household consumers versus workplace consumers, it's different.

Corey:

Right. Yeah. I think everyone knows what bleach is, but if you see sodium hypochlorite as the active ingredient, you may not associate those two. Most of them are going to be called Clorox something or one of the commercial names that are recognizable, but it doesn't always happen that way.

Jill:

Okay. Okay. What do we not put together?

Corey:

Sure. In general, bleach doesn't play nicely with anything else. You definitely don't want to mix bleach with alcohol or ammonia or hydrogen peroxide or any of the acids. It's slightly basic and it will off gas some pretty nasty gases if you mix it with any of the other categories. Those toxic fumes can really be damaging to your health. The last thing you want to do while you're trying to protect your health is to create something that's going to be an adverse reaction and potentially make you sick.

One of the things that I think people can focus on is the fact that each of these commercial products or mixtures, if you're making it, if you're diluting the commercial based products yourself, is just to stick with one of the classes only. The reason why they're EPA registered is because they are approved and they are sufficient to decontaminate these materials if you give them the appropriate contact time. But I think there's some element of thinking that, "Oh, if one of these is good, then three of them is better."

Jill:

Right? Like, "Let's layer it on."

Corey:

Right.

Jill:

Or no.

Corey:

Just to be extra sure. But that's where you start to get issues because if you layer them on, then they can interact and actually in a lot of these reactions that are happening on the chemical level, you're neutralizing the active ingredients. You're actually making it less effective from a decontamination standpoint and you're producing things that could potentially be hazardous to your health.

Jill:

Yeah. That's really important to know. You mentioned things that not to mix with bleach. Are there specific things that we should be calling out for ammonia or for ethanol or alcohol?

Corey:

Well, yes. Those don't tend to interact as frequently in terms of producing really nasty things. But in general, just don't mix across those categories and you'll be okay. The other thing that I want to mention is because as stores get depleted of all resources... I went shopping the other weekend. Yeah, there aren't a lot of things on the shelf in the cleaning product category. I can anticipate some people wanting to opt for more on the fly disinfection products and maybe come up with their own concoctions. That is also something to be concerned about, especially since some of the more common ones involve vinegar and maybe baking soda.

Corey:

But those can also interact with some of these commercial classes of disinfections as well especially hydrogen peroxide is one of the big ones. Hydrogen peroxide and vinegar make peracetic acid, which is definitely not something you want to have produced-

Jill:

Definitely not.

Corey:

... around the house. Yeah. Just make sure that you're not mixing and matching and you're using everything based on the manufacturer's recommendations, including how you're diluting it, and what concentrations you're using, and how long you use it for. Because those are going to be critical for the actual application. It's also going to be part of the safety element as well. Because if you start using 100% bleach or 100% ethanol, you're either not going to get the beneficial qualities or you're going to be spraying some pretty high potent compounds around your house.

Jill:

Yeah. Now is not the time to be a home chemist.

Corey:

Exactly. Yeah.

Jill:

Now is not the time to go to YouTube and ask, how do I create a disinfectant?

Corey:

Yeah.

Jill:

Yeah, yeah. Right. Yeah. You were mentioning dilution a moment ago. Let's talk about that. Let's say someone has a bottle of bleach at home or at work and a bottle of isopropyl alcohol under their bathroom sink-

Corey:

Sure.

Jill:

... right now and they want to use it as a cleaning agent and they want to dilute it. Can you talk about the dilutions and then contact time. You mentioned that too, but let's get into dilutions first and how long these dilutions last.

Corey:

Yeah. Your alcohols, your ethanols, and your isopropyl alcohols, they're going to generally be used in the 70% range in an application standpoint. They might come anywhere. You might buy them in 70% already and then you can just use them as is or you might find that you're buying 91% or 100% ethanol or isopropyl alcohol. In those cases, you definitely want to add some water to dilute it down.

As long as you keep it above 60%, I think that's the current recommendation certainly for hand sanitizers and any disinfection percentage. I like to use 70% because it kind of gives you a little buffer if your dilution is not exact. But-

Jill:

Okay. Add enough water to that 90 to 100% isopropyl alcohol or ethanol so that we're diluting it by about 20% if you have that high of a rate, right?

Corey:

Right. Yeah. You're generally adding three parts to seven if you're dealing with 100% or you're adding two parts to seven, if you're dealing with 90%, generally somewhere in that range.

Jill:

Yeah. If you have 70%, you just use it straight up.

Corey:

Yeah. You can just use it straight out of the bottle.

Jill:

Okay. Put some on a paper towel and clean your phone, right?

Corey:

Yeah, exactly.

Jill:

Okay.

Corey:

Get the phones. That's important.

Jill:

Yeah. Yeah. Then what about bleach?

Corey:

Yeah. Bleach is interesting because it comes in multiple different concentrations from the bottle. You can get concentrated bleach or you can get more generic household bleach and those are different concentrations. You don't want to just... I don't have a set dilution percentage that I can just give everybody to use because it is going to depend on what the initial concentration of those sodium hypochlorite molecules are. Because what actually is important for the disinfection is the final concentration of chloride ions when you're using bleach. That's going to be specified in the use procedure on the bottle.

Jill:

On the bottle. Okay.

Corey:

Make sure that you're just following that. Be careful with the initial bottle if you're dealing with a concentrated bleach solution because those fumes will be pretty heavy if they're super concentrated.

Jill:

Right. You're not going to be wanting to pour this directly over your face.

Corey:

Exactly.

Jill:

Every time you grab a different bottle, whether you're at home or work, you really want to read what it says about dilution.

Corey:

Right. Yeah. Especially since at least in the laboratory environments that I'm used to, you typically buy a slightly higher concentration than you would pick up from your local pharmacy. It doesn't necessarily have to be that way, but in my experience, that typically is how it works.

Jill:

Yeah. You mentioned ammonias, which I think you said are called quaternaries, is that correct if I remember?

Corey:

Yeah. The quaternary ammonia is typically what's written as the active ingredient in most of those products.

Jill:

Okay. From an ammonia perspective, we're not talking about household ammonia, right?

Corey:

Well-

Jill:

Are we?

Corey:

Yeah. You could use household ammonia, but most of the time when you're using ammonia, it's in the context of a cleaner that you can just pick up off the shelf.

Jill:

Okay.

Corey:

There might be some dilution elements with those recommendations, but a lot of them are just buy and spray kind of solutions.

Jill:

Okay.

Corey:

Yeah. Again, that would be a consult the bottle type of recommendation.

Jill:

Yeah. Right. Let's say we've made a dilution of bleach and water or alcohol and water and we have it in a spray bottle or in a bucket. How long is it viable to be able to clean with?

Corey:

Yeah, that's a great question. The bleach solutions in diluted form actually degrade pretty quickly, and it's because the chloride ions that are so important for disinfection actually get bound to by water contaminants. It's going to depend a little bit on the water that you're using. If you have really hard water coming out of your tap, it might not last quite as long. But there are a lot of factors. The general rule of thumb that I use is 24 hours. Fresh dilution every 24 hours, and you're pretty safe. There are some guidance documents out there that say up to a week. But again, it's going to vary. At least in my opinion, you want to make sure it's going to work. So, fresh dilutions every 24 hours are certainly my rule of thumb.

Jill:

Okay. Is it different for alcohol or ethanol?

Corey:

Alcohol and ethanol at 70% tends to last a lot longer. My rule of thumb there is about a month.

Jill:

Okay. Okay. Very good to know. Very good to know. Then let's talk about contact time and maybe back up. What does contact time mean?

Corey:

Sure. Contact time is how long it's going to take that disinfectant to actually render the agent that you're trying to disinfect to be non viable. So how long it takes to kill that particular infectious agent. Bleach in a diluted form and ready to go form takes about 20 to 30 minutes. It's one of those things where you want to spray it on, let it sit, and then wipe it off in 20 to 30 minutes. That way, it has enough time to actually render those biological agents inert.

Jill:

That's a long time for those of us who are anxious and we just want to get going, right?

Corey:

Exactly. Yeah.

Jill:

Okay. What about for alcohol and ethanol then?

Corey:

Alcohol seems to work a little bit faster. It's one of those things where you also want to spray it and then wipe it down. But the reason why to our earlier point about dilution, it's important to use 70% ethanol instead of 100% ethanol because 100% ethanol evaporates much quicker. The water that you're adding to the ethanol or isopropyl alcohol actually slows down the evaporation time and gives a little bit more contact time for alcohol to do its work.

Jill:

Okay.

Corey:

The other thing that alcohol does is the ethanol or isopropyl alcohol portion will basically give access to the genetic material of the virus or cell. In the context of 70% ethanol or isopropyl alcohol, you actually need that contact time to allow it to act upon that agent. The water is actually critical in that process because it's a combination of the alcohol providing access to the material and actually performing the disinfectant and the water through these kind of... it's called osmotic pressure. But basically, it will give the alcohol a better path to the actual disinfection process.

Jill:

Okay. Okay. With alcohols, we can spray or wipe.

Corey:

Yeah. You can you use it a little bit faster. Yeah.

Jill:

Okay. Okay. Very good and you let it evaporate. What about with all of these wipes-

Corey:

Sure.

Jill:

... that people use? Can you talk about that?

Corey:

Yeah. I think bleach wipes are definitely a hot thing or Lysol wipes or whatever types of wipes you're using. I view those as more of a routine disinfection process rather than your more thorough spray and wipe type process.

Jill:

Okay.

Corey:

If you're just doing a quick wipe down, if you're at work and you just want to do a quick go over of your desk or workstation, those wipes are good in those contexts but for a more thorough cleaning. If you knew that there was a case or there was a suspected case that would be where you would want to do a more thorough cleaning.

Jill:

Okay. Very good. Corey, we're talking about interactions and cautions with that and how they could hurt people. There really are statistics around that as well. It does happen. This is a real thing. Can you talk about some reports on that?

Oh, sure. Yeah. Unfortunately, there are a lot of hospitalizations and even fatalities every year from adverse chemical reactions. This happens in the context of cleaning products as well. I think we're going to post in the show notes a resource that looked at cases of inhalation hazards from 2011 to 2017. I think it was something like nine out of 297 cases were actually directly resulting from cleaning products and those were fatalities over that timeframe. Certainly, not something that anyone has to or wants to deal with.

It's not just the fatality situation that we want to avoid, it's any adverse reaction. It might just be respiratory distress, which when you're dealing with protection from airborne transmissible type virus like coronaviruses, you want to make sure that you're protecting your airways as much as possible. Hurting them in the disinfection-

Jill:

Is it going to help?

Corey:

... process is not going to help.

Jill:

Right.

Corey:

It's really important to maintain those safety elements for a number of reasons in this case.

Jill:

Definitely. Many employers right now might be asking questions of contractors that they hire for cleaning.

Corey:

Sure.

Jill:

Maybe whereas we just hired them to clean and they clean, but now we're asking them, "What are you using and how are you doing that?" Or maybe they're trying to source that right now. What should people be asking and paying attention to?

Corey:

Sure. Yeah. I would certainly ask how long they've been operating. In these types of cases, you run the risk of popup shops who are catering to that time of need. It doesn't necessarily mean that those people aren't capable of doing a good job. It's just you want to have a sense of security when you're working with this type of practice. I think it's also important to request information on the products that they'll be using, especially get a safety data sheet so that you can review what the active ingredients are and whether or not they're approved for those types of applications that you're trying to use them for.

If you have a lot of porous surfaces or you had a case where you had a positive test in your workplace, you might want to consider something more than just surface cleaning and get a specialized commercial vendor who can do a vaporized hydrogen peroxide or chlorine dioxide treatment. But those are all things that you kind of need to evaluate on a case by case basis.

Jill:

Right, right. Very important. You mentioned SDS, Safety Data Sheets a moment ago. Can we talk a little bit about the importance of having access to those in a moment like this?

Corey:

Sure. Yeah. I mean, even in normal scenarios, it's important to have access to Safety Data Sheets and-

Jill:

It sure is.

Corey:

... make sure that you have all of your inventory covered by a safety data sheet for each chemical especially when you're dealing with maybe new cleaning products that you're just bringing on site for this application. Or you find that your traditional cleaning product that you've been using for a number of years is out of stock because everyone's buying it up, and you need to make a transition to something else. Make sure that you're reviewing that safety data sheet and don't assume that it's going to act exactly like your former cleaning product.

Make sure that you're looking at the active ingredient and you know the dilution and you train your employees to use that product in the new manufacturer recommendation way so that you're not getting crossover between two different products or you're not using something in a way that's ineffective.

Jill:

Yeah. Could you also talk about not using these products on the human person? I know I have at least one friend who has had a coworker ask like, "Can't I just spray Lysol on my hands?"

Corey:

Yeah.

Jill:

Can you-

Corey:

Actually-

Jill:

Can you talk about that?

Corey:

... thank you for prompting that question because I think there's a misnomer out there that hand sanitizer and whatever other product that you could put on your hand is better than simply using soap and water and that's not the case. Soap and water is perfectly effective at getting rid of any viral materials that you might have on your hand.

Jill:

Right.

Corey:

If you're doing it for 20 seconds and you're using soap, doesn't even have to be antibacterial soap. This is a virus, doesn't matter. Just make sure that you're doing your due diligence in your personal hygiene and your hand washing because it's actually more effective than sanitizers and other chemical products that you could be using on your hands. So yes, please don't be putting Lysol on your hands or bleach or wiping down with bleach wipes or whatever else you've heard as being effective because again, there's contact time there and it's going to take longer to actually disinfect it than it would be to just wash it off.

So, soap and water. If you're not in a position where soap and water is possible, use approved hand sanitizer with at least 60% alcohol.

Jill:

Yeah, which are intended for skin versus these commercial grade products and household cleaners that are definitely not compatible with our skin.

Corey:

They have aloe, they're not going to dry your hands out. They're not going to open up your hands to other issues because you've now dried out your hands and they're cracking and now they become another form of potential source of infection and all that kind of stuff.

Jill:

Yeah. So, soap and water. Bottom line, soap and water first line of defense for us human beings-

Corey:

Absolutely.

Jill:

... not for the porous and nonporous surfaces. We don't fit into those categories.

Corey:

Right.

Jill:

Yeah. Corey, wondering, could we talk about maybe social distancing?

Corey:

Yeah.

Jill:

We're talking about cleaning. Obviously, that's huge. But let's talk about social distancing in this context, particularly with COVID-19.

Corey:

Yeah. I think there are a lot of different ways that social distancing is being used right now and speaking about it with other people. Social distancing isn't a really complicated concept. If you deal with infectious material that can spread from person to person and it's spreading and in this case it's airborne transmissible, the fewer contact points you can have with other people, the less likely it is to spread through a population.

From a social distancing standpoint, some people are using it interchangeably with social isolation and that's kind of the most extreme form of social distancing. But certainly self quarantining and not going out to public places and gathering in large groups, it's all part of social distancing. But then there's also concepts of social distancing in smaller groups. Not getting within three to six feet of somebody especially if they're coughing or symptomatic and just being a little bit more aware of your presence, and your environment, and-

Jill:

Your personal space.

Corey:

Exactly. You're not shaking hands or giving hugs right now, hopefully. No one that I've interacted with has been offended by that. So far I think everyone's on board with it. But, yeah. I think it's just a matter of keeping your distance and making good choices socially to try to flatten the curve is the colloquial term right now that the media is using because you're trying to get this exponential growth phase down into a linear plateau.

Jill:

Right.

Corey:

That's really from an epidemiological standpoint, what we're trying to do.

Jill:

Yeah. Right. Yeah. Flattening the curve that we're all hearing about in media that is based on science.

Corey:

Oh yeah. Absolutely.

Jill:

Yeah.

Corey:

Yeah. We have enough information now to kind of ballpark what the transmissibility of COVID-19 is. It seems that for every one person who's infected you give it to... I think the current figure is between two and 2.5 other people, which when you're talking about exponential growth, anytime you're turning one into two for each generation, you're going to get that exponential growth phase. The more we can do to limit contact and keep numbers down, the more likely we are to get ahead of this. Obviously, testing and self quarantining are all part of that. But even people who are feeling healthy and don't have symptoms, there's a big proponent of that as well because one of the unique things about this virus is that there are a large number of mild cases. It's not the kind of thing where you have symptoms, you become contagious, but you're in bed because it's just knocked you.

Because of that, it's a lot more likely that people are walking around without symptoms and could potentially be spreading it. I think everyone kind of has their own responsibility to participate in this social distancing, even if they don't feel like they're in a position where they've been exposed or they don't have symptoms.

Jill:

Right. Right. We all have a role to play. I mean, literally, we can all change that curve right now. One practice at a time by us as individuals.

Corey:

Yeah, absolutely.

Jill:

Yeah. Yeah, yeah. I guess that speaks to risk, right? I mean, those of us who are safety professionals who are listening to this podcast, we're all about risk analysis. Yeah. What should safety professionals be thinking? Where do you put this in what we know about the way that we do our work as safety professionals?

Corey:

Yeah. I think there are a number of elements of just the normal day to day life of a safety professional that can go into the risk analysis and assessment portion of this. If you're dealing with a facility that has the opportunity to have a lot of workers work from home, very good opportunity to do that in this context and try to mitigate those social interactions as much as possible. Maybe you go to alternative production methods where you spread workers out a little bit more or have internal kind of controls in place to prevent close interaction. I've seen some reports where companies are going to multiple shifts when they haven't before just to kind of keep production up but still have fewer people and less density in the facility to kind of mitigate some of that.

Corey:

But yeah. I mean, a lot of what's being done on a larger level at these expert agencies is a large scale risk analysis and how can we put policies in place to try to flatten this curve as quickly as possible while not disrupting so much of the economy? There are a lot of other things that go into it. That's what they're playing with right now on a much larger scale. They're trying to use as much information that they have from the previous cases to see what's making sense from a epidemiological control kind of standpoint.

Jill:

Yeah. Right. As we've been talking today, Corey, you've been very careful to talk about as we know it and what we know today because it really is changing that fast. One of those terms associated with this particular outbreak is the word novel. Can you share for our audience what that means to put in context why we're clarifying things as often as we are?

Corey:

Yeah, so I mentioned earlier on that we've only known about this for about three months and it's because it only just recently made the jump to humans. Coronaviruses in the wild are typically spread from animal species to animal species or even within those species, but they rarely make the jump to humans. When they do, we call them zoonotic agents.

Jill:

Yes, okay.

Corey:

You might have heard that term kind of being thrown around, but that means that it made the jump from an animal to a human. What we typically look for at that point is how quickly it can spread from human to human. Some viruses or other biological materials will go from an animal to a human but then not pass from human to human. In this case, it's not only passing from human to human, but it's doing so through the air and it seems to be doing so very well. That's where you get the highly contagious kind of monikers that are being used.

Jill:

Yeah, yeah.

Corey:

That's where you kind of need to be a little bit careful about how you project what the curves are going to look like especially, if there are differences in how some populations are controlling it versus others.

Jill:

Yeah. Right, right. That makes sense and explains why we're continually getting updates. The CDC and our departments of health on a state and national levels are giving us almost daily and sometimes multiple times a day updates because we're making discoveries all the time. Science is making discoveries all the time.

Corey:

Right. We can make best guesses based on previous iterations of other viruses that act like this. I think that's very consistent with the safety world in terms of using other things or things that are closely related and controlling for them in similar ways. You might have heard it be... This one is being called COVID-19, but it's also been referred to as SARS-Coronavirus 2.

Jill:

Oh, okay.

Because that's what it's most similar to. But again, it's not the same and it didn't develop from SARS in humans. It's a completely different kind of path that it's taken to the human transmissibility. But there are other things about this virus that are just strange. It's not resulting in a lot of severe cases for kids.

Jill:

Yeah.

Corey:

That is very different from things like seasonal flu and other viruses that tend to hit both the very young and the very old. It's also not always symptomatic, which from a community control standpoint makes it very difficult. When there are large flu outbreaks, everyone's getting their temperature taken all the time and that's because in most cases, flu is most contagious when you're symptomatic. If you have a fever, chances are you want to be self quarantined. In cases like this, a virus which has a lot of cases where tests are positive but the actual symptoms are not there, you can have people who kind of fly under the radar and continue to spread it without knowing that.

Jill:

It's kind of stealthy.

Corey:

Right. Exactly. While it's good that a vast percent of the population isn't going to have really severe cases. The fact that there is a demographic and people with preexisting conditions that will experience really severe illness from it, you need to kind of across the board from a community standpoint, all buy in to that protection. Because there are some people who are going to have really adverse effects.

Jill:

Yeah. Yeah. Why it's so important for all of us to do our part. Corey, as we begin to close out our time today, what are some key takeaways that you would like to leave with our audience today?

Corey:

Yeah. For me, I'm going to go right back to the initial point that I made. As things evolve, know that these viruses are not always going to stay the same and they will evolve, and mutate, and kind of go through their own general process. There are certainly experts out there who are doing a lot of work to track this and stay ahead of it and test for it and develop treatments and vaccines and all that kind of stuff. But just make sure that you're validating those resources and not contributing to any misinformation out there about this particular virus.

I think we both need to take it seriously but also not jump to conclusions and pipe it up as the next ex big pandemic event. It is a pandemic. I think all of the scientists and expert agencies agree with that. But there's such a range of reporting out there as to what the min and max is going to be for this outbreak. I think we just need to be really careful about projecting beyond a very scientific look at the numbers and what the ultimate outcome is going to be.

We've heard about, okay, it might be seasonal and it might come back stronger in the fall. These are all just speculations. Until we have a better sense of what this virus is from a very basic biology standpoint, I think we just need to be careful about generating a lot of that type of speculation.

Jill:

Yeah. Corey, would it be accurate to say that if we all as a human body do our part to slow this, it gives the scientific community more time to be able to make those projections, to be able to figure out ways to protect us. Would that be accurate if we do our part to slow it gives science more time?

Corey:

Oh yeah, absolutely. In this and most biological research applications, the more time we have to study something, the more understanding we're going to have. Because it's relatively new, I mean, the nice thing is that we have the technology to sequence everything, right? Within a month, this thing was sequenced and we had tests developed for it. Those are such routine biological practices. The actual test that's being used to find this in the population is something that almost every biological lab in the country could do.

Now, there are certain elemental and quality control elements that are making it harder because you have the... it's called RTPCR, the actual process. Many, many, many labs have the equipment to do that. The challenge comes from the actual primers and reagents, basically the ingredients in the recipe. If one of those isn't optimal, then you can have false positives or false negatives. Those are the optimizing steps that the testing kits are going through right now. If you hear reports about testing may not be where we need it to be, those are some of the kind of factors that drive that.

Jill:

Right.

Corey:

Because you need to have high reliance on your testing materials and you need to be able to distribute them to all the facilities. So yeah, that's all going into it.

Jill:

Yeah. When we hear things like presume positive, that means perhaps that at a local level, like you said, labs have to be able to test, but then they're going to send it further for confirmation somewhere else.

Corey:

Right. Yeah. That could either mean that they have all of the hallmark symptoms and they haven't had a positive test yet or they had a mostly positive test that they want to verify.

Jill:

Yeah. Okay, okay. Very good, very good. Well, Corey, thank you for doing your part to help all of us who are listening as we are making decisions to flatten that curve and to help the greater good and all of us doing our part. I'm sure the information that you shared today will enable people to do just that. So, thank you so much.

Corey:

Yeah, I appreciate that. Actually, I want to put in one more point about flattening the curve because I've been tracking these cases very diligently over the past couple of weeks and the early reports out of China, and South Korea, and Japan are that they're now ahead of it and hopefully that continues. But they have shown a lot of progress in flattening their curves in their own countries. It seems from the initial data that it is going to be very possible to get ahead of it. It's just going to take a little bit of bump in the road from a social distancing standpoint to kind of have everybody get to that point.

Jill:

Yeah. It takes all of us to do that.

Corey:

Absolutely, yeah.

Jill:

Yeah, yeah. Thank you. Thank you all for spending your time listening today. More importantly, thank you for your contribution, making sure your workers, including your temporary workers, make it home safe to your families every day. If you'd like to join the conversation about this episode or any of our previous episodes, follow our page and join the Accidental Safety Pro Community Group on Facebook. If you're not subscribed yet and want to hear past or future episodes, including Corey's episode number 46 when he was a guest with us before, you can subscribe in iTunes, the Apple podcast app, or any other podcast player that you'd like.

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