Disclaimer: We are not medical practitioners. The content here is provided for general information only. For specific information, please consult with your healthcare provider. If you want to skip the preamble then you can skip ahead to hand sanitizers here

How To Deal With A Coronavirus.

Human Coronaviruses were first ‘discovered’ in the late 1960s. Since then we’ve endured SARS-CoV in 2003, HCoV NL63 in 2004, HKU1 in 2005, MERS-CoV in 2012, and SARS-CoV-2 (formerly known as 2019-nCoV) in 2019. On 11 February 2020, ICTV announced “Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2)” as the name of the new virus, and on the same day, the World Health Organization (WHO) announced “COVID-19” as the name of the disease caused by the virus SARS-CoV-2. 

Yes, these viruses have names different to the disease they cause, as with HIV and its resulting disease, Aids. 

With SARS-CoV-2, the lastest Coronavirus, there are still many things about how it propagates through the community and beyond that we do not yet fully understand. We know that the virus passes from person to person, but we do not know what the rate of transmission is. In other words, on average, how many people will one person with the Coronavirus infect. We know that a percentage of people with the infection will die as a direct result of contracting the disease or complications arising from it. (The case fatality rate.) But we don’t know if the percentage who will die is 0.5% or 5%. 

To look for clues in what we do know, we know that influenza has a high transmission rate but a relatively low mortality rate. Yet even with one of the two parameters being ‘low’, it still kills an estimated 291,000 to 646,000 worldwide each year. [source] What if with Coronavirus, the two critical parameters are both ‘high’ – ‘high’? A high transmission rate and a high mortality rate.

Knowing what to expect is necessary to prepare for dealing with what’s to come. (medical resource shortage, economic impact, etc.)

We can look at transmission and fatality data from China and Italy to try to estimate the forthcoming impact here in the USA. Yet a key point here is that the fatality rate and rate of transmission can and do differ greatly based on the way that authorities act during the early stages of the outbreak

With China and Italy, each reacted in very different ways during the outbreak, and each experienced very different transmission and fatality rates as a consequence. In the case of China, the country felt the full force of the new virus but dealt with the all-important early stages of the outbreak in very different ways than we have here in the USA. China issued the most extensive quarantine in human history, locking down an estimated 56 million people early in the outbreak. China’s aggressive quarantine, if official state figures are reliable, appears to have been effective in capping the spread of the disease.

As a juxtaposition, we’re seeing the dire and worsening impact of Coronavirus on Italy, where their Government operated seemingly in a state of denial during the early stages of the Coronavirus. Their transmission and fatality rates are significantly higher than those encountered in China. 

So how can US authorities project the impact of Coronavirus on our nation, thus allowing for the preparation and mobilization of the necessary emergency resources? Do we look at data from Italy or China, or elsewhere? 

Compared with China, the US was slow to react during the early phase of the pandemic, and as such, we’re likely to pay a much higher price in terms of the number of people infected and the subsequent rates of mortality.

The initial reaction from the White House was more comparable with that of the Italian government, playing down the possibility of a coming pandemic and doing little to control the movements of the public. So rather than use the more positive data from China, we should be looking at data from Italy and preparing for the worst. Yet from the outset, political motivation appeared to be the prime mover, not the health and welfare of US citizens, particularly the elderly who it seems are most at risk. 

And though the past two weeks brought an improvement in the way we’re dealing with the virus as a nation, the latest Trump rhetoric indicates a shift back to the earlier stance of taking a more passive approach. Though the actual words used are different, the real meaning is to let the Coronavirus run rampant so that it can burn itself out more quickly. This logic, which obviously places economic concerns ahead of humanitarian ones, projects far higher peaks in the concurrent number of people infected, thus a higher number of mortalities, but a much shorter overall duration. In other words: get sick, get over it, and get back to work. 

It’s true that the sooner we’re free from Coronavirus, at least as a national headline, the sooner people can return to work and the stock markets can begin to bounce back. Yet we’ve all come to understand the crux of the problem with opening the flood gates and allowing nature to take over. The peaks (concurrent serious illnesses) will overwhelm our medical system, and many more people will die than would have died had the rate of spread of the Virus been more aggressively controlled –  “Flattening the Curve”, as it has come to be known. 

So, a higher number of deaths or a less dire economy?

Regardless of which way the Government bends in the following days and weeks, there’s little doubt that we’re in for a long, long haul. But there are things we can do at a personal level to mitigate our risks. Your age, your state of wellbeing, the age and health of those around you, and your economic situation should dictate the stance you take.

My strategy for dealing with the Coronavirus is to push the event as far into the future as possible. I’m resigned to the fact that, with a projected 60% plus rate of infection over the next 12 months, I’m statistically likely to contract the virus within that time. But delaying the event improves my chances of there being a functional healthcare system on hand should my symptoms require hospitalization, and possibly even having some drug available shown to be effective in treating the symptoms.

So, for now, I’m in a full self-enforced quarantine, along with my partner and pets! We’ve established many protocols for both home and work environments, which increase our chances of staying virus-free into the foreseeable future, including social distancing and various procedures for keeping our home and workspace clean and contamination-free. 

Which brings me to the main topic of this post: Hand Sanitation.

It’s accepted that hand sanitizers help to prevent harmful pathogens from being passed around the community, person to person, either directly or indirectly. With Coronavirus, we don’t know for sure which types of hand sanitizer are best able to neutralize the virus. Still, in the absence of any definitive test data, it’s better to take some precautions than to do nothing.

First, I want to touch on some of the misinformation that I see propagated relating to safe working practices and hand sanitation. 

MISINFORMATION ON HAND SANITIZING

Claim: Washing your hands frequently will prevent you from contracting Coronavirus. CV is passed mostly from secretions exhaled by infected persons when coughing or sneezing. Think about the fine ‘mist’ that you sometimes see when people sneeze into the open air. These secretions carry the virus, and the secretions emitted are of a different size and weight. Smaller particles can remain airborne for several hours and have the capacity to infect others coming into their contact. Rooms with poor air movement and low rates of air exchange are the worst places for airborne pathogens. Heavier particles will fall downwards more rapidly and settle on whatever surface is within their range. Hard, shiny surfaces such as door handles or the aluminum shelving and counter-tops used in most grocery stores may have the capacity to sustain the living virus for over 24 hours. 

Washing your hands frequently, in conjunction with other preventative measures, does have the capacity to improve your odds of not contracting the virus, but it isn’t a strategy you should enforce on its own.

Claim: Any hand sanitizer will work. I would say that any hand sanitizer is better than nothing, but given a choice, I would steer toward a product made from an isopropyl alcohol base of between 60% and 70%. Don’t fall into the trap of thinking that 99% IPA must be better and more effective than a 70% Isopropyl Alcohol product. In simple terms, IPA requires the addition of water for it to be effective as a hand sanitizer. Water slows the evaporation rate and gives the IPA time to work on killing bacteria on the skin. So if you’ve purchased a 99% IPA product, or you have one in your medicine cabinet, be sure to cut the product with the appropriate amount of distilled water and emollient. 

Health authorities advise us that handwashing with soap and water is sufficient to rid us of a virus that has come into contact with our hands, provided that we scrub thoroughly for at least 20 seconds. While I feel more secure with a 70% blend of IPA than a basic soap product, I’d take the soap and water over nothing. So if you can’t find what you need to make an IPA based hand sanitizer, just mix up a small bottle of soap and water to carry around with you for times when wash facilities are hard to find.

Claim: Don’t try to make your own hand sanitizer. This article, on the CNN website of all places, has to be one of the worst for spreading misinformation with truly dire consequences. Titled “Don’t try to make your own hand sanitizer just because there’s a shortage from coronavirus” the article offers no empirical evidence whatsoever to support the potentially life-threatening recommendation, and relies on the following two misplaced anecdotes:

“For hand sanitizer to be effective, it must have at least 60% alcohol content”
 
“Store-bought hand sanitizers will also often have emollients to counter the harshness of the alcohol on the skin. If you don’t have that in your homemade recipe, you could risk hurting your hands”

Let’s pull those two statements apart- 

1 – “For hand sanitizer to be effective, it must have at least 60% alcohol content”.  

The inference here is that somehow it is beyond most people’s capabilities to produce a hand sanitizer from an isopropyl alcohol base that has at least 60% isopropyl alcohol content. Most IPA products are sold as either 70%, 90%, or 99%, so the math required to dilute something from, say 99% down to 60%, isn’t that difficult. 

2 – “Store-bought hand sanitizers will also often have emollients to counter the harshness of the alcohol on the skin. If you don’t have that in your homemade recipe, you could risk hurting your hands.” 

So, according to CNN, having Coronavirus is better than having a little chaffed skin on your hands because you used a sanitizer without an emollient!

The above is senseless click-bait journalism that could cause people to die.

 

Hand Sanitizer DIY Recipes

Many online resources are circulating links to information provided by the WHO (World Health Organization) and the CDC (Center For Disease Control) with each having commented on specific types of hand sanitizer products to help prevent the spread of pathogens associated with the Coronavirus.

Since hand sanitizers have, by and large, been wiped-out from retail store inventory, both on and offline, a document published by the WHO in 2009 has become the go-to recipe of choice when it comes to producing DIY hand sanitizers. However, the problem of depleted inventory has now extended to the actual raw materials required to make your own effective hand sanitizer, these materials are also largely ‘sold-out’, at the time of writing this post. (3/23/202).

With the shortage of available raw materials, it’s easy to deflect one’s gaze from mainstream ingredients to something more esoteric and readily available. Before you decide to go down a different path, be aware that both the CDC and WHO recommend largely similar approaches to hand sanitizer formulation. Both concur on the use of alcohol-based hand sanitizers with greater than 60% Isopropanol (Isopropyl Alcohol) as the preferred method of killing harmful bacteria and viruses on the hands.

So what are the recommended ingredients for a DIY hand sanitizer, according to CDC/WHO, and where can you buy them?

There are several recipes on the WHO worksheet, the one I’m focusing on here is designed around fairly common household ingredients:

  • Isopropyl alcohol, or ‘rubbing alcohol’, is the only active ingredient. It is generally sold in 70%, 90% and 99%, and marked clearly for use as a topical sanitizing agent.
  • Glycerin (Aloe Vera Gel can be substituted) Acts as an emollient/humectant. The high rate of evaporation of the isopropyl alcohol can cause the skin to become dry and sore.
  • Hydrogen Peroxide (H202). Acts as a sterilizing agent to kill harmful bacterial spores present in the other ingredients.
  • Water – Filtered or distilled is preferred, boiled tap water is fine too. The water is used to bring the alcohol content down to around 60-70% and also slows down the evaporation of the alcohol to allow it more time to work.

You can download the full WHO recipe for larger 10L batches of hand sanitizer here

Finding The Raw Materials.

If you search the web looking for the above ingredients, you’ll draw a blank, or you’ll be lead down the path of buying something that may be unsafe. I’ve spent several hours looking at what’s selling as a hand sanitizer ingredient on eBay, and there are some very unscrupulous sellers, not just those with jacked-up prices, but also those willing to risk people’s health and safety by selling products intended for a very different application than hand sanitation.

The biggest culprit I see is in the sale of IPA – Isopropyl Alcohol. Many of the products on eBay are for Industrial grade IPA, which is produced for the cleaning and degreasing of mechanical equipment. I’m not going to say that an industrial-grade IPA is better than nothing, that’s your choice, but know that It has impurities which could be harmful if it came into contact with your skin. So if you’re one of the millions of people trying to buy something online to put together your own product in a hurry, try to invest in raw ingredients intended for safe topical applications.

What If You Have Rubbing Alcohol In Your Home First Aid Cabinet?

You can get creative, within certain limits.

Even 99% medical-grade IPA can contain harmful bacterial spores, so it’s better to add a small amount of Hydrogen Peroxide to kill the spores if you have it. And since pure rubbing alcohol can be a skin irritant when used frequently, adding an emollient/humectant is an excellent idea. (However, as I stated earlier, I’d rather have chaffed hands, in the absence of an emollient, than Coronavirus).

If you want to create a 70% IPA based hand sanitizer from an available bottle of 100ml 99% IPA, then you need to work out the ideal volume of the diluting agents. 

Formula as follows:

Assumes 100ml bottle of 99% isopropyl alcohol: 

= (100ml x 99%) / 70%= 141.4ml

Since you already have 100ml IPA, you can add 41.4 ml of diluting agents to make it into a 70% IPA solution, and you’ll have 141 ml of the finished product.

What you do next depends on what you have available.

If you have Hydrogen Peroxide in your medicine cabinet, then you’re looking for 3% of the total volume of the compound. Doing the math – 

141 x 0.03 = 4.23 ml of Hydrogen Peroxide. So about a teaspoon. 

You now have:

41.4 – 4.23 = 37.17 ml to add.

If you have Aloe Vera Gel or Glycerin, I would recommend adding 5ml of one or the other and making up the balance with cold, boiled water, or distilled water if you have it. So the final product would look like this, based on a 100 ml bottle of 99% IPA:

  • 100ml IPA
  • 4.23ml Hydrogen Peroxide
  • 5ml Aloe Vera
  • 32ml water

To mix, use sanitized equipment and tools. Add the IPA first then the H202. Add the Glycerin or Aloe Vera next and stir gently until dissolved. Add the water last, placed the compound into a sealed container, and gently shake the contents to blend. If you plan to divide the finished product into multiple jars or containers, then do that right away. Now, wait for 72 hours before using, to allow the H202 to kill any spores.

For 70%  Isopropyl Alcohol

If you have 70% Isopropyl Alcohol and not 99%, then you need to remember that the target operating range for IPA is 60% to 70% of the final solution. In this case, you must use a lower volume of diluting agents and aim for a 60% alcohol content.

What if you can’t find what you need in local stores or online? Hopefully, soon, we’ll be in a better position regarding the availability of commercial hand sanitizers and the ingredients required to make them yourself. For now, you may be able to source what you need from your own network of friends or neighbors. Though it’s improbable that one person has all of these materials, it’s likely that you should be able to round them up from a group of friends. This sounds like I’m promoting social contact, I’m not. Work out a suitable protocol for the exchange that keeps all parties safe. The incentive for others to contribute materials to the project might be that you produce enough sanitizer to supply some of the finished product to your ingredient contributors.  

Lastly…

One of the concerns I have with alcohol-based hand sanitizers is their very low active lifespan when applied to the hands. Given the evaporation rate of the alcohol, the sanitizer does all of its work in around 10-15 seconds, after which it is gone and provides no residual protection. So I’m presently finalizing a hand sanitizer containing bee propolis as both a sterilizing agent and an ingredient that provides some residual protection. Since one of the most common extraction processes for propolis utilizes concentrated alcohol or ethanol, there’s no harmful effect on the propolis when suspended in an alcohol base. So the main active component in the formula will still be Isopropyl Alcohol in its optimum strength of 65%.

Why Propolis? Propolis is known to be an extremely potent natural sanitizer and sterilization substance. That is its primary function within the beehive. Small rodents and other insects commonly find their way into the hive interior and are unable to exit. Honeybees use propolis to smother the carcasses of these invaders, locking them up inside of a sanitary cocoon, thus preventing the hive from becoming bacterially infected.

Utilizing a propolis solution in conjunction with isopropyl alcohol and an aloe vera emollient, may provide an even more potent compound to kill bacteria and viruses quickly, and also protect the hands, albeit at a diminished rate of effectiveness, for some period after the initial application.

Stay Safe

CH.

Update April 2, 2020 – we now have our Hand Sanitizer product available for shipping. Limited supplies only – while stocks last click here