What works vs COVID

A call again for cautious optimism. On one hand, it’s encouraging to see the economy coming back to life. I’ve been especially saddened seeing small businesses closing up but businesses now have a fighting chance with holiday spending.

Now for the caution part. I worry about a return to partying, the large crowds, and carelessness with masks and physical distancing. Just as worrisome are the unproven, and even harmful, measures being used because of claims that they can prevent, or even cure, COVID-19.

Let’s look at what scientists have to say. A good local resource is the Philippine Society for Microbiology and Infectious Diseases (PSMID), which has been putting up “Living Recommendations” on their website on many COVID-related issues: Philippine COVID-19 Living Recommendations.

I’ve categorized and summarized the most important recommendations they have for non-clinical settings (i.e., offices, homes). Do visit their website for more details.

Not recommended:

Ionizing air purifiers; foot baths; misting tents and disinfection; UV lamps or other UV devices in any place outside of a controlled clinic or hospital setting.

Some readers will be disappointed here but PSMID says that because of insufficient evidence on efficacy, they do not recommend all of the following: zinc, vitamin C, vitamin D supplements, melatonin, virgin coconut oil, intravenous N-acetylcysteine, B vitamins, oral fatty acids, lagundi, tawa-tawa, statins (medicines used to control cholesterol).

Recommended:

HEPA filter as an option to improve air quality for COVID-19 prevention and control in indoor spaces with inadequate ventilation.

Carbon dioxide monitors in enclosed spaces to guide actions to improve ventilation and reduce transmission of SARS-CoV-2.

Protective physical barriers in areas where physical distancing cannot be adhered to (e.g., offices, reception desk). They also have a footnote recommending adequate ventilation, physical distancing, use of face masks, and personal hygiene.

Cleaning and disinfecting surfaces using the appropriate disinfecting chemical agents such as 0.5 percent sodium hypochlorite solution (bleach) or 70 percent alcohol.

For high touch surfaces and high traffic areas, such as in the workplace, disinfection should be done before shift, intermittently during shift, and after the shift.

For household disinfection, once daily disinfection on high touch surfaces is recommended.

Finally, the “it depends” ones:

On cloth masks: not recommended for “… health care workers not directly taking care of COVID-19 patients, and other persons with high risk of exposure to COVID-19.”

For “the general public with low risk of exposure to COVID-19 in outdoor or indoor areas” PSMID recommends using “a cloth mask that fits snugly on the face and made of at least two layers of cotton (e.g., t- shirt fabric) or non-woven nylon with aluminum nose bridge.”

On face shields in addition to face masks: recommend “among health care workers in the outpatient setting not performing aerosol generating procedures. Additional PPE such as medical gowns and gloves should be worn as part of standard precautions during the performance of other procedures.”

Still on face shields in addition to face masks: not recommended for the general public in non-healthcare settings but recommended in areas with sustained community of SARS-CoV-2.

Really complicated these face shields with one more recommendation: Recommended among health care workers not directly involved in the care of COVID-19 patients (but) in areas with sustained community transmission of SARS-CoV-2.

Government must listen to the scientists to be consistent and clear. The Department of Transportation should be commended for declaring that plastic dividers would no longer be required in jeepneys and buses.

But look now at the conflicting messages with schools being required to put up plastic dividers between students’ desks. Then Inquirer carried a front-page article featuring a Makati school without dividers between seats (Correct!) but boasting they were now using UV disinfectants, which PSMID does not recommend.

To carry us into 2022’s challenges, we need a whole-of-government approach that listens to science.

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