COVID-19 Symptom Correction, Soap vs. Sanitizer & Clever Video That Explains a Lot

by Ann Gerhardt, MD                        March 22, 2020
Hand-washing is by far the best way to rid yourself of virus  you picked-up from a hand-rail or someone's pen. Soap interacts with fat-soluble molecules on virus' surfaces, emulsifying the virus into the suds, and water washes them down the drain. Soap rids the surface of virus. 

I'm convinced that  hand sanitizer, which is supposed to inactivate virus, doesn't do nearly as effective a job. The product must be at least 60% alcohol, but not 100%. The user must spread sanitizer evenly over the entire hand/finger surface and let it sit while wet until it dries on its own. It takes at least that time, possibly up to four minutes for alcohol to inactivate a virus particle. This certainly is not going to happen with the tiny amount of sanitizer dispensed from machines, which people rub on their palms and wipe off on their pants.

I said that  new information might prove me wrong , and it already has with respect to COVID-19 symptoms. The New England Journal of Medicine just published a case description of the first U.S. citizen to acquire the disease. That patient had diarrhea and multiple other cold-like symptoms. Doctors even found the virus in his stool. A recent report out of China adds to possible symptoms from COVID-19, confirming that  diarrhea, nausea and upper respiratory cold-like symptoms are consistent with COVID-19. Note the wording - "Consistent with", not definitive for the disease. So much for a simple way to know if you should worry.  (I will update the symptom chart now posted on our website.) 

China provides us with the best information about the virus SARS-CoV-2 and disease COVID-19. They've been studying it since their treating their first case on November 17 and recognizing a cluster of severe pneumonias of unknown etiology in December. Concerning a few other theories I have, I've been assured by my Chinese-American physician colleagues that if something is an important clue to the disease, I can be sure that the Chinese, with the most comprehensive data-base, are studying it.

Back to the U.S., I got my symptom guidelines from the CDC and WHO, who issued guidelines that non-fever/cough/respiratory distress symptoms were not signs of COVID-19. Perhaps those guidelines came from a decision that was a coalescence of rationing the deplorably inadequate U.S. test-kit supplies and knowledge that this is cold, flu and allergy season in which millions of people without COVID-19 will experience non-COVID specific symptoms.

What that decision did was to permit testing only for people who most assuredly had the disease. One could argue that those patients don't need testing unless and until we have specific treatment regimens to save the patient - Otherwise their treatment would just be supportive. Also, we are far past the notion that we can save lives by identifying and quarantining the sick's contacts. As long as we have a shortage, we should be using test kits to diagnose those SARS-CoV-2 carriers among us who have mild or even no symptoms, in order to contain disease spread.

Clever video that explains SARS-CoV-2 spread and disease pathogenesis, including cytokine storm, titled "The Coronavirus explained and what you should do about it." Click Here  -Thanks to Wynde Heim for finding the video and it's link.


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