08/22/2021
HAND SANITZERS
The following article, written by Scott Froum, DDS, is from the Perio-Implant Advisory website. I thought it was a timely article. I've seen many of our patients with anxiety about public touch surfaces.
Statistics show that an individual touches their face 16 times an hour on average. When you are out in public make a conscious effort to NOT TOUCH YOUR FACE. When you return home wash your hands thoroughly with plenty of soap and water for at least 20 seconds.
COVID will be with us from now on. Being cautious about touching your face will not only help prevent you from contracting this virus, but help in preventing you from catching the common cold, flu and other illnesses.
Background
The COVID-19 pandemic has thrust disinfectant hand sanitizers into the forefront of hygiene rituals to protect against disease transmission. In the United States alone, sales of hand sanitizer jumped 600% in 2020 to become a $1.3 billion industry. Most of this craze buying was the result of an article published in March 2020 at the beginning of the pandemic, showing that SARS-CoV-2 had the ability to live on some surfaces for hours and other surfaces for days. Unfortunately, much of the data gained from this study has since been deemed both unrealistic and unreproducible. The lab study used large, unrealistic amounts of virus in nonreal-life settings in a vacuum with no air exchange. Since the study’s publication, newer studies have cautioned against concluding that COVID-19 can be transmitted by surfaces infected with the virus.
Most recent studies have shown that although the virus can be found on surfaces, they are not infectious and do not represent the major source of disease transmission. Although the theory of surface transmission had not been fully reproduced by other research teams outside the laboratory setting, the media began to publicize these results, and the surface disinfectant market in the US grew by 30% to become a $4.5 billion industry.
The problem
Because of supply and demand, companies that typically did not make products such as hand sanitizer started to produce it at mass quantity levels with temporary authorization from the Food and Drug Administration (FDA). With so many new companies manufacturing hand sanitizer, combined with an unregulated black market, incidents of contamination and toxicity poisoning started to climb. Toxicity issues have been reported as companies began to substitute methanol for isopropyl alcohol or ethyl alcohol, resulting in death.
In addition, the FDA announced a major recall of hand sanitizers due to contamination with high levels of Burkholderia cepacia complexand Ralstonia pickettii, which can lead to serious infections including infection of the skin, soft tissues, lungs, or bloodstream. Incidences of bacterial transmission from doctors who use this hand sanitizer to immunocompromised patients have been reported.
Toxicity has also been reported from hand sanitizer due to overuse. Because most hand sanitizers contain alcohol at a concentration of 60%–95%, common side effects of overuse—especially in children—include dermatitis, dry skin, intestinal issues, and alcohol poisoning. In the first five months of 2020, more than 9,500 cases of alcohol poisoning were reported in children under age 12 due to alcohol in hand sanitizer.
A safer alternative
Washing hands with soap and clean water for at least 20 seconds has always been the gold standard of hygiene and safety, particularly for children younger than 12. Even a small amount of alcohol can cause alcohol poisoning in children that is responsible for confusion, vomiting, drowsiness, and, in severe cases, respiratory arrest and death.
If hand sanitizer must be used, make sure you evaluate the active and inactive ingredients. Although there are no studies on frequency of use for hand sanitizer, a general rule of thumb is once an hour unless your job dictates increased frequency. For the makeup of hand sanitizer, isopropyl alcohol should be in the range of 65%–95%, and ethyl alcohol should ideally be 80% or higher. If you are using hand sanitizer multiple times a day—as is the case with many health-care providers/dental professionals—it would be beneficial for your hand sanitizer to contain skin care elements.
Stella Life makes a hand sanitizer that contains 80% ethanol and hydrogen peroxide with aloe vera, frankincense oil, lavender oil, lemongrass oil, tea tree oil, and vitamin E oil (figure 2). In addition, Stella Life hand sanitizer contains no methanol, dyes, triclosan, parabens, or phthalates, which can lead to dermatitis and toxicity. In conclusion, nothing beats soap and water!
COVID FACTS UPDATE
The Delta variant of the original SARS-CoV-2 virus has been shown to be nearly 2 1/2 times as infectous as the original virus we were previously dealing with. It now accounts for over 83% of the COVID cases in the US, and greater than 90% in some areas of the country.
The Delta variant is affecting a younger population, including children. 50% of the COVID cases in Florida are those 50 years of age and younger.
Presently, nearly all deaths in the US due to COVID are among the unvaccinated.
"Breakthrough" infections in fully vaccinated people account for only 1.1% of the hospitalizations.
98% to 99% of Americans dying from COVID are unvaccinated.
All three available vaccines have shown excellent effectiveness against the Delta variant. After 6 months the Moderna vaccine's effective against developing severe illness drops from 95% to 93%. Pfizer-BioNTech drops from 95% to 84% after 6 months. In a recent South African study, the Johnson & Johnson vaccine has shown to be 71% effective against hospitalizations and 96% effective in preventing deaths from the Delta variant. I've been unable to find a reliable source regarding its drop in effectiveness after 6 months.
However, there seems to be a general consensus that we will be needing a booster shot at some point in the future. The World Health Organization feels that wealthy nations should not be giving booster shots until the shortfall in vaccine supplies and distribution is addressed in poorer nations. What do you think?
No vaccine is 100% effective. Vaccine immune-boosting capabilities varies from one individual to another. Those with compromised immune systems may not get as strong a protective response as others.
Wearing a mask in crowds and indoor places is not just to protect the unvaccinated, children under 12 included, it's also to protect those for whom the vaccine was not as effective. That individual might even be you or your child or another loved one!
INFLUENZA
COVID may never go away. The remnants of the Pandemic of 1918 virus (Spanish Flu) are still with us today as part of our influenza virus. Did you notice that last winter the "flu season" was practically non-existent due to mask wearing and social distancing?
A shortcoming of traditional vaccines is their slow and complex manufacturing process. In the 6 months it takes to use chicken eggs to produce the flu vaccine, the influenza virus frequently mutates. This renders the vaccine produced for that season less effective.
Pfizer, Moderna, GlaxoSmithKline, Sanofi and others are working on a messenger RNA vaccine against the influenza virus as they are simpler and quicker to make. This is why the COVID vaccines can be manufactured so efficiently.
In the future, an mRNA vaccine producing facility may be able to produce vaccines for many different diseases quickly and with great cost savings.
OUR INFECTION CONTROL PROTOCOL
My office shall remain meticulous in following all infection control protocol set forth by the American Dental Association, the NYS Dental Association and the CDC.
Please call us from your car when you arrive. We will tell you when you may enter the building wearing a mask.
We will call you the day before your appointment to make sure you are well. Do not come for your appointment if you are feeling sick in any way. We will make a follow-up call 2 days after your appointment to be sure you are still healthy and comfortable after your visit.
For information on our office infection control protocol please click the link below:
https://www.merrickdentistry.com/patient-information/infection-control/coronavirus-enhanced-precautions/
Wishing you all good health!
Steve Levy DMD
516-378-8600
[email protected]
Progressive Dentistry in Merrick, NY provides general & cosmetic dentistry services, including dental implants, veneers, teeth whitening, and more.