Category: Epidemiology

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The Ultimate Winter 2021 PPE + SHTF List

Last Update: 01.14.2021

Also, please see my other posts on PPE as they have more information. Special continuing coverage of SARS-CoV-2. I’ve personally purchased AAMI Level 3 and Level 4 gear in the anticipation that I may have to transport/manage sick family members, God-forbid they get COVID-19.

Stay Tuned! The Spring “Mother of a List” is coming soon!

Masks & Respirators

CBRN + Half Masks

Hand Sanitizers (Gel and Liquid)

Faceshields

Tip: A ratcheting system is well worth extra money. It’s the best. You’ll thank me for it!

** Faceshields that I’ve purchased. Love the Uvex and 3M ones are great in my workshop because I’m an artist and sculptor as well.

PPE Clothing

Nitrile Gloves

Everyone has their favorite brand. If you’re having a tough time Tacoma Screw might be helpful for the XL XXL sizes.

Work Gloves

  • Mechanix (cut-resistant gloves), https://www.mechanix.com/

UV-C

Air Purifier

Power

Water

Fire

Food/Seeds

Other Equipment

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FLCCC: Front Line COVID-19 Critical Care Alliance

The FLCCC is Front Line COVID-19 Critical Care Alliance–Prophylaxis & Treatment Protocols for COVID-19.

This URL here: https://covid19criticalcare.com/

I came across the FLCCC today and as healthcare and wellcare providers, this is a very informative page to keep your eye on. By “informative” I mean it’s interesting to see what’s going on from critical thinking and research point of view.

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Duke Studies Mask Types and Efficacy Reducing Viral Dose and Viral Load

This is a brief note to point you to the news story and research article.

The best mask is an N95 medical mask (the 3M blue masks without valve). The mask that is most realistically obtainable by the general population is a homemade mask made of quilter’s cotton, double layer with a polypropylene filter in the filter pocket. The polypropylene (PP) that is most available are the blue shop towels. Please also reference Suay’s findings.

None of this news should be “new” to my readers. I just wanted to give you some additional resources to consider. Please see my previous posts/coverage.

CNN: https://www.cnn.com/2020/08/08/us/duke-university-face-mask-test-trnd/index.html

Duke research paper: https://advances.sciencemag.org/content/early/2020/08/07/sciadv.abd3083/tab-pdf 

Suay: https://suayla.com/pages/suay-community-mask-coalition

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Fall 2020 PPE List

Last Update: 07.29.2020

This is the Fall 2020 PPE list. Please see my other posts on PPE as they have more information.

Masks & Respirators

CBRN + PPE

Hand Sanitizers (Gel and Liquid)

Faceshields

** Faceshields that I’ve purchased. Love the Uvex and 3M ones are great in my workshop because I’m an artist and sculptor as well.

PPE Clothing

UV-C

Air Purifier

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Dynatomy Products . Com

So we have a mini-update on disposeable face shields. I am looking to stock up on some gear. I found this company that makes FDA Registered Single-Use Face Shields (10 shields per pack) and made in USA. They were fast to confirm shipment and update me (I like having a papertrail). They shipped the shields very securely (no damaged product). The shields feel like a good quality product and substantial for a “disposeable” item.

Anywhere else and the price is double. If you want to try them, buy direct from the company. I like having a few options in case things get worse. I also have the hard-shell ratchet (construction work or heavy duty use non-disposeable) face shields. Go see my PPE post for those.

Dynatomy also sells hand/finger exercises (like for hand physical therapy). Those are nice to work your hand and finger mobility and grip (and extension) strength.

Link here.

www.dynatomyproducts.com

and specifically for the face shields here https://www.dynatomyproducts.com/products/dynatomy/single-use-face-shield-10-pack/?fbclid=IwAR22zqLhfix4XCPfT2OSPDGHYSpBZMgm74Z6z8vwUo_d5e9X3qlz-viU7Ss

Their info video here.

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Gain-of-Function (GOF) Research, Part 1

Gain-of-function (GOF) research are studies that involve exploring, manipulating, and augmenting the pathogenicity and/or transmissibility of pathogens—especially with the possibilities of launching a pandemic, biowarfare, bioterrorism, and “other” military uses. GOF literally means that the pathogen has “gained a new level of function” (as compared to its original function), whatever that may be. GOF research challenges biosafety, biosecurity, and bioethics—like teetering on the edge of the Grand Canyon.

These are highly controversial studies with PPP (potential pandemic pathogens) that most people probably won’t know is going on. GOF research is not something you advertise.

The National Science Advisory Board for Biosecurity (NSABB) was a federally formed committee (consisting of up to 25 voting members) to advise the White House Office of Science and Technology regarding GOF research. NSABB reports directly to the Secretary of the United States Department of Health and Human Services. NSABB members represented expertise including (but not limited to): molecular biology/genomics; bacteriology; virology; clinical infectious diseases/diagnostics; institutional and/or laboratory biosafety and biosecurity; public health/epidemiology; health physicist/radiation safety; pharmaceutical production; veterinary medicine; plant health; food production; bioethics; national security; military biodefense programs and military medicine; intelligence; biodefense; law; law enforcement; academia; scientific publishing; export controls; industry perspective; public perspective. [2]

To quote directly from the NSABB’s objective and scope of activities:

“The purpose of the NSABB is to provide, as requested, advice, guidance, and recommendations regarding biosecurity oversight of dual use research, defined as biological research with legitimate scientific purpose that may be misused to pose a biologic threat to public health and/or national security. The NSABB will provide advice on and recommend specific strategies for the efficient and effective oversight of federally conducted or supported dual use biological research, taking into consideration both national security concerns and the needs of the research community to foster continued rapid progress in public health and agricultural research. Toward this end, the NSABB will also provide strategies to raise awareness of dual use issues relevant to the life science and related interdisciplinary research communities. In addition, pursuant to Section 205 of the PAHPA, when requested by the Secretary of Health and Human Services (HHS), the NSABB shall also provide to relevant Federal departments and agencies, advice, guidance, or recommendations concerning (1) a core curriculum and training requirements for workers in maximum containment and biological laboratories; and (2) periodic evaluation of maximum containment biological laboratory capacity nationwide and assessments of the future need for increased laboratory capacity.” [2]

NSABB has deliberated on influenza, MERS, and SARS—most recently in January 2020. Some of NSABB’s activity is part of public record, or what government likes to call Government in the Sunshine Act (U.S. Law passed in 1976) which is one aspect of the Freedom of Information Acts—”supposedly” with the goal of operating “more transparently”. Read into that what you will.

Interestingly enough, there is recorded video of some of their sessions at this link: https://videocast.nih.gov/watch=35665

References

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Hand Sanitizers, Anyone?

A number of distilleries and other companies have altered their manufacturing in order to provide hand sanitizers. They’re using a formula recommended by WHO and CDC. I am very thankful to these companies. I am absolutely loving the 80% alcohol v/v liquid because it’s not nasty-sticky like gel formulas are. I love the liquid even better than the Purell Naturals. You can buy spray bottles (I like the blue glass ones commonly used for essential oils) and fill them with the liquid sanitizers.

Also, a lot of the converted distilleries (and other manufacturing) are donating bottles to healthcare professionals, first responders, etc. Some distilleries are not able to ship (local pick-up only) so check your local resources.

**TIP: If you’re located in an area with warm temperatures, DO NOT leave Clorox/Lysol/Wet Ones wipes OR sanitizers in the car. I’ve found those wipes and especially the gel-based sanitizers destabilize/breakdown in the heat and become really gummy/tacky feeling on your hand (and I’m honestly not sure if that’s even healthy).

Example, I had a bottle of wipes in the car for emergencies. It’s been there for 2-3 yrs. I found that it really destabilized. Also, I kept a gel sanitizer in my glove-box for a few warm weeks and the next time I used it…it was really gummy and tacky. I went home to wash my hands and it was horrible to try get off. That cannot be good.

The well-known big-name companies are (with the exception of Wet Ones wipes, these are gel-based):

  • Germ-X®, Vi-Jon, Inc.
  • Purell® Advanced, Gojo Industries, Inc.
  • Purell® Advanced Naturals, Gojo Industries, Inc.
  • Wet Ones®, Edgewell Personal Care

These are “new” companies that you can still get sanitizer from (I’m listing the ones that will ship):

References

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Spun Bond Fabric

[Also see my article on Melt Blown Fabric]

Spun bond fabric is a type of non-woven fabric. Fine filaments of polypropylene are extruded from a die and are gathered onto a collector (usually has very tiny holes for air currents to go through) thus forming a “web”. The arrangements of such filaments can be customized by changing the direction of the collector. The goal is to gather these filaments uniformly on the collector. The next stage is passing the collected filaments through hot rollers (or bed of hot needles) to heat-bond the fibers.

Polypropylene is a common spun bond product from polyester flakes. Spun bond polypropylene has desirable characteristics such as (but not limited to): moldability to different shapes/applications; durability; permeability; stability; tensile strength; UV stable.

Common uses for such material include (but not limited to): shoe covers (booties), bags, craft projects; aprons, masks, and medical gowns.

North Carolina State’s Nonwovens Institue (NWI) is using a special process of spun bond fabric to make masks to help combat COVID-19. NWI’s process does not require the meltblown filtration layer. Instead the mask material is made by putting two different polymers together. This saves production time and resources. ExxonMobile and NatureWorks are two companies offering staple materials to NWI for making PPE.

https://youtu.be/zHPbJtq4YJc

References

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What is a Cytokine Storm?

A “cytokine storm” (CSS, cytokine storm syndrome or cytokine release syndrome) is when the body reacts to a situation, and releases a massive amount of inappropriate cytokines into the bloodstream too quickly during an immune response (NCI, n.d.). This overproduction of inappropriate cytokines (and release thereof) can then stimulate even more inappropriate cytokines to be released (positive feedback loop)—hence the “storm” (hypercytokinemia) descriptor. While the release of cytokines is a normal immunological response, higher (or much higher) than normal amounts of cytokines can promote severe adverse reactions (including but not limited to multiple organ failure). Cytokine storms are a characteristic of Systemic Inflammatory Response Syndrome (SIRS).

When the body’s immune response goes haywire and starts attacking itself in an “overreaction”, it can cause leaky blood vessels, fluid build-up in the lungs (from leaky vessels), blood clots forming (further impeding blood flow), a steep drop in blood pressure, and multiple organ failure as seen in some of the COVID-19 cases (Dance, 2020). Symptoms may include (but not limited to) fever, headache, impaired nervous system, seizures, and coma (Dance, 2020).

In COVID-19 patients, the onset of CSS can present quickly. It is a very fine line to walk. While respiratory failure from acute respiratory distress syndrome (ARDS) remains the primary cause of COVID-19 deaths, the second leading cause of deaths seems to be due to secondary (or acquired) haemophagocytic lymphohistiocytosis (sHLH) with ensuing hypercytokinemia and multiorgan failure from the inappropriate persistence of histiocytes and cytotoxic T-lymphocytes (CTL) (Mehta et al., 2020; Sandler et al., 2019).

Severe COVID-19 cases presented with sHLH have a profile of: “increased interleukin (IL)-2, IL-7, granulocyte-colony stimulating factor, interferon-γ inducible protein 10, monocyte chemoattractant protein 1, macrophage inflammatory protein 1-α, and tumor necrosis factor-α” (Mehta et al., 2020).

There is no single test/diagnostic that can detect CSS. Doctors have noted elevated levels of ferritin and C-reactive protein (CRP) in a study of 150 confirmed COVID-19 cases: “mean 1297·6 nanograms/ml in non-survivors vs 614·0 ng/ml in survivors; p<0·001) and IL-6 (p<0·0001)” (Mehta et al., 2020).

It is posited that this hyperinflammatory state/response may be an additional outcome of the COVID-19 disease.

References

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Melt Blown Fabric

[Also see my post on Spun Bond Fabric]

Melt blown fabrics have long been used in medicine. These fabrics are best known in the personal protective equipment arena (e.g. masks, gowns, etc.), but they are also known for tissue engineering among other processes. China has a large industry creating this type of fabric technology. But what is “melt blown” fabric?

Melt blown fabric (patented in 1939) is a method of creating a polymer fabric that does not involve knitting or weaving. Instead, the process uses heat or chemicals to form the fabric. Polymer material is heat-treated and extruded through a die. As the polymer material comes out of the die, nano- or microfilaments densely come together in the cooling/blowing process to form a fabric. Non-woven fabric can be produced quickly–5000 meters/minute.

By adjusting the characteristics of the die from which the polymer fibers are extruded, one can customize the fibers produced, such as (but not limited to): fiber diameter, density of fibers, alignment, melt viscosity, elasticity, relaxation time, absorbency, bacterial barrier, cushioning, filtering, flame retardancy, liquid repellency, resilience, softness, sterility, strength, and washability (Jenkins, Meehan, Pourdeyhimi, & Little, 2017; Tan et al., 2010).

Also, different polymers can be used. One such biopolymer is polylactic acid (or polylactide or lactic acid polymer). It is biodegradeable, eco-friendly, non-toxic, high strength profile (as compared to other polymers), high stiffness, and more efficiently produced (Omnexus, n.d.).

With regards to making medical/procedural masks, the outer layer is the liquid/droplet/aerosol barrier layer. The innermost layer (closest to the face) is a moisture-absorber. The middle layer (collection/filtration layer) consists of the melt blown fabric whose fibers range in diameters of 0.1 microns to 15 microns.

https://youtu.be/zHPbJtq4YJc

References