Of masks, gloves and condoms

WITH the pandemic of the novel coronavirus infection, which has a scary treacherous incubation period of up to 14 days and where victims could spread the virus even before any symptoms appear, avoiding exposure to the virus is the next best thing to vaccination (which might be available soon).

As of February 3, 2020, new estimates report 75,000 cases of nCorona virus infection in Wuhan, Hubei, China, with 362 deaths (including the first death outside of China, a 44-year-old in the Philippines), 11 cases in the USA, and 150 cases in 24 other countries, making it a pandemic.

During the SARS outbreak, there were 8096 cases, with 349 deaths This has been surpassed by the nCorona virus infection of today. The MERS, between June 2012 and December 2019, has 2499 Cases, with 861 deaths. The plague (Black Death) of 1347 (the late Middle Ages), one third of the population of Europe was wiped out.

Putting all these in the proper perspective: In the United States, in the 2019-2020 flu season, 180,000 patients were hospitalized and 10,000 died, according to the CDC. This, however, does not mean we could lower our guard when it comes to the nCorona infection.

Well-known protection aids to prevent germ contamination or infection are masks, gloves, condoms, etc. But they are useless and ineffective, if not used properly.

In the health/medical and food industry, these protective aids are utilized to protect and prevent infection for the public, the consumers, less for the users, in general. Masks and gloves are worn by healthcare providers, especially in the operating rooms and surgical areas, ERs, ICUs, etc. to prevent germs from infecting patients. In food service, as in restaurants, fast-food chains, etc., masks and gloves are used to prevent bacterial contamination of food items, which would cause gastrointestinal infection, some being serious or even fatal. And the same thing with condoms, which are used to prevent both partners from acquiring sexually transmitted diseases (STDs). If not used properly and making sure the condom does not touch any surfaces with germs (practically all surfaces, tables, beds, doorknobs, handles, rails, etc.) or contaminated fingers, this protective rubber, is useless.

As a cardiac surgeon who had acquired a “sterility radar-detector” discipline from decades of training and practicing sterile technique, I could quickly discern even a tiny (subtle) breach in sterility among those using masks or gloves. The general public is obviously not trained to a degree of sophistication about sterility like a trained surgical nurse or surgeon would be, so lay people could easily misinterpret or misunderstand or minimize the significance of “total” sterility. It is either sterile or not. Ninety-nine percent “sterile” is not sterile. Allowing 100 germs out of a million to contaminate is not sterile. Like pregnancy, it is either pregnant or not pregnant.

The mask

There are a variety of masks on the market: the popular round-of-the-mill surgical masks, the favored more effective N95 respirator masks, cold avenger pro soft shell masks, and more sophisticated and specialized ones.

Masks of any type must be worn properly, covering the nose and the mouth, snug-fit, to filter air that is inhaled and exhaled. Sometimes we see people with masks on, with their nose exposed. That is wrong – it defeats the purpose of wearing a mask. The goal is to filter outside air before it is inhaled, and for those with respiratory infection, to filter the bugs in, minimizing the dose of the bacteria that is exhaled, to protect the healthy ones.

Gloves

To show concern for the health and safety of their customers, food handlers in some restaurants use gloves. But, like masks, if gloves are not used properly, bacterial contamination of food will never be contained or minimized. All bacterial infection from contaminated vegetables, poultry, and meat results from contacts with germs and inadequate washing and cleaning. Water is an effective cleansing agent. Refrigeration is essential in food preservation. Ultraviolet C lamps have been used to help sterilize food raw items in farms, warehouses, factories, and even in stores. UVC light kills bacteria, viruses, molds and fungi and some parasites.

Frequently, I observe food handlers wearing gloves touching utensils, microwave door handles, chopping board, table, and other items, as they touch the food items they are preparing, like sandwiches, the bread, lettuce, tomatoes, cheese, peppers, and the wrappers. The proper use of gloves in this situation starts with clean gloves that are held only at their “entry edge,” without touching the palm and finger parts of the gloves. Once worn, they much touch only food items, and not anything else. So, the practical way to do is to glove the non-dominant hand, which will handle food items only, and the dominant ungloved hand to hold the knife, and other utensils, the edge of the plate or paper wrapper, the microwave door handle, etc. Obviously, the gloved hand (or one of the fingers) must not be used to scratch oneself. The glove should be changed every couple of hours, since they too could harbor germs from the atmosphere.

If gloves could not be used properly, it is better not to use them at all, and simply wash the hands before preparing any sandwich or handling any food item. Indeed, the sight of gloved hands among food handlers could give a false sense of security…and carelessness among food handlers.

No material things on earth, including money, are worth more than health and life. Billionaires in their hospital or death beds, including cancer victim Steve Jobs, iconic Apple founder, knew only too well how wealth becomes meaningless and useless to a dying person. Jobs was quoted as having said these last words as he was dying:

“I reached the pinnacle of success in the business world. In others’ eyes my life is an epitome of success. However, aside from work, I have little joy. In the end, wealth is only a fact of life that I am accustomed to. At this moment, lying on the sick bed and recalling my whole life, I realize that all the recognition and wealth that I took so much pride in, have paled and become meaningless in the face of impending death….(and paraphrasing: that family, loved ones, are our true wealth.”

While fact-checking found this famous quoted statement, which went viral on the internet, to be false, the wisdom, the truth, validity, and eloquence in it are touching, inspiring, and an eye-opener.

So, let’s take good care of ourselves, our health, our life. After all, we have only one life to live. No spare. No back-up.

***

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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