Thursday, May 07, 2020

My Thoughts on PPE for COVID19

First of all, a disclaimer. It has been decades since I've worked in the medical industry, and it is entirely possible that standards have changed much since my time.

I admit, I thought it odd when the government started calling for citizens to wear PPE to prevent the spread of the Novel Coronavirus associated with the COVID19 outbreak (SARS-CoV-2). It seemed to contradict what I'd been taught during my time working in the hospital when dealing with contagious diseases.

Back in the early 90's, our primary worry was Hepatitus, Tubercolosis (TB), Scabies (body lice), and, of course, AIDS. Admittance of a patient even suspected of having any of these would mean putting the patient in isolation. Outside an isolated patient's door would be a cart where healthcare workers could dress out in PPE before entering the patient's room.

And, there were rules. Of course, wearing gloves and handwashing was stressed for all patient interaction, except perhaps something simple like taking vital signs. But the PPE required for isolation patients included masks, gowns, booties, hair nets, and of course, gloves.

The rule was simple. If entrance into a room required a mask, it also required full PPE dress-out. The logic was as follows. Masks primarily protects the patient from the healthcare worker, not the other way around. If a patient was immuno-compromised, such as a HIV positive patient, or a patient who had recently received Cancer treatment, it was imperative to protect the patient from outside contagions. But masks were considered fairly useless in protecting healthcare workers from contracting contagious diseases from patients. And if you were caught entering a isolated patient's room wearing only a mask, you would have been, at the very least, laughed at, if not disciplined for not following hospital procedure in dealing with isolation patients.

Now, I understand the logic that any barrier is better than no barrier. But think about it. If an individual with the Coronavirus sneezes around you, the mask might prevent direct inhalation of the contaminated water vapor, but it will still settle on your skin and clothing. And when you undress for the day, most likely your skin and clothes will touch your face. But, if you were wearing full PPE, you had significantly less to worry about. The virus would have likely settled on the gowns and other PPE worn, which is discarded in a biohazard bin as soon as interaction with the patient is completed.

Again, my experience was decades ago, and maybe some standards have changed.

So, that begs the question, if a simple mask isn't as effective as the government would like us to believe, why are they stressing it's use? Well, I can only speculate, but I think it is a psychological ploy. When facing an emergency, the best way to prevent a full-blown panic is to occupy people. The old "go-boil-some-water" tactic that is used on husbands whose wives are in childbirth. People who wear masks BELIEVE they are doing something that is contributing to "flattening the curve" or whatever nomenclature the government wants to give to its efforts to combat the spread of the virus. It is keeping the people busy. They are taking advantage of the fact that we have essentially become a nation of "useful idiots", who have completely lost the ability to recognize when we are being manipulated and exploited.

Now, I'm not suggesting we don't take these precautions. But I suggest we do the homework. There's evidence that these efforts could prolong the pandemic. What do I fear more than a virus ravaging the world? The answer is simple. I fear an unthinking populace that will blindly follow its government off the side of a cliff like mindless lemmings when they perceive danger.