PRACTICAL ADVICE ON INFECTION CONTROL
I spent 38 years working in the NHS Ambulance Service most of it as a member of an ambulance crew or as an operational manager.
That's 38 years of trying my best to follow Infection Control Procedures to avoid taking infections home to my young family.
That's 38 years of protecting ME from the PATIENTS and.....
38 years of protecting the PATIENTS from ME.
Am I an expert? NO, but I do have practical experience in this field.
It is very difficult to convey all that is needed to be practiced and observed in the space available, but time now seems paramount as the covid-19 coronavirus continues to spread. We cannot rely on Politicians to protect us, not when a Health Minister herself has just been diagnosed with the disease. Nor when they continue to allow flights from heavily infected areas to continue to land in the UK. Nor when the passengers are told, if anything at all, to go home and self-isolate. Yeah right, like they're going to do that aren't they? And even if they did, they have already been infecting people for a whole week before their symptoms showed. That's why the Governments current strategy will fail.
No, we have to face facts. The only people we can trust are ourselves. So how do we do it?
Below I have listed items I would recommend purchasing, and that means buy them NOW before they're all gone. We need to look at this calamity as a war, not just a war against the virus itself, but against something as dangerous - our fellow citizens. These people I have collectively named 'Wayne and Waynetta Slob', it's not meant to be a class thing, though I suppose it would be true to say that those on low income of any kind will be less likely to be able to afford to buy items which could protect themselves - and us. No, these are the people who through ignorance, selfishness, thoughtlessness or just plain old fashioned stupidity pose a risk to us all, and every time you step out your front door you'll be surrounded by them.
What makes things more complicated for us all is that individuals can have contracted, and be infectious for up to seven days before showing the symptoms of infection. That means that even the most conscientious among us will have unwittingly been infecting others for a whole week before self isolating.
So I want you to think of everybody out there as Wayne & Waynetta Slob's, who threaten your wellbeing maybe without even realising it.
In order for you to have the best chance to avoid catching this virus I want you imagine that your hands have been placed palms-down on to wet sticky red paint, and it will remain wet and sticky the whole time you're out of the house. Now imagine that's the infected matter. Once you grasp that image then it becomes much easier to understand how it can spread with what you touch, what needs to be avoided, and what needs to be cleaned as you transfer the sticky red paint from one thing to another.
Now imagine every time other exhale you see a bright red mist - that's their potentially infected droplets. The velocity it leaves their body will be greatly increased by coughing or sneezing. Hence the need to keep your distance.
Also, think of contaminated items as the virus's equivelant of Heathrow Airport. It's not where they want to be, but they'll use it to get to their intended destination, in this case your eyes, nose, mouth and ultimately your lungs.
But above all DON'T BE AFRAID - be resilient.
LINKS TO INFECTION CONTROL PRODUCTS
ISOPROYL RUBBING ALCOHOL
I bought three of these to bring away with us. Isoproyl Rubbing Alcohol is better known as Surgical Spirit in the UK
CLINELL UNIVERSAL DISINFECTANT WIPES
These are used throughout the NHS. We are carrying a couple of packs with us. The wipes are plastic based so don't dispose of them down toilets.
DIGITAL MEDICAL THERMOMETER
Useful to have but by no means essential - you'll know when you're getting hot!
MEDICAL FACE MASKS
I do not recommend paper face masks. They are designed to be used in hospitals and worn for short periods of time such as a nurse putting one on to go in to a room to carry out a procedure on a patients before leaving the room and disposing of it. Once these masks become damp from exhaled air they are worthless as the virus can then pass through it. Wearing these in public just makes people feel safer. Though in fainess it must be recognised that should a wearing suddenly cough our sneeze, the projection of their infected droplets will be contained. Though they would then need to change the mask immeadiately.
LATEX FREE EXAMINATION GLOVES
When I first joined the Ambulance Service back in 1976 the wearing of rubber gloves was unheard of, you wouldn't believe what we had to put our hands in to but we were protected by a strict code of infection control especially thorough hand washing. However thankfully times move on and in the current climate these gloves are in my view essential. They come in different sizes, if in doubt buy them too big, better that way than too small. As a guide my hand size is seven and I take a large. As a guide, a man's glove size is the size of his Willie measured in inches and divided by two (yeah - I wish!)
AUTOSMART G101 CLEANER
Between 2003 & 2008, in my final role as a career within the ambulance Service, I was tasked with doing all of the legwork, research and writing of Standard Operating Procedures (SOP's) to introduce a 'Quality Assured' system of ambulance cleaning and equipment preparation. G101 is one of the cleaning products we used. I asked the rep if G101 killed MRSA and he said he didn't know, but they worked with a team of chemists in the Midlands and he'd put the question to them. About two weeks later he came back to inform me that the chemists had grown MRSA cultures in the lab and G101 killed it effectively at what was its current dilution rate of one-to-forty (it looks as if it's now one-to-thirty). To be fair we often used it neat, but when I regularly took swabs to check the systems effectiveness not a thing had survived on any of the ambulance interior surfaces (not surprisingly the main areas of contamination were hand and grab rails, the side handles on the stretcher trolleys, cupboard handles and the floors - remember that the next time you see a brat kid stood or sat in the main section of a supermarket trolley being pushed by Wayne or Waynetta).
This is what I would be buying if I were back in the UK right now. In fact I now regret not having bought a five-litre container to bring with us. I would recommend having one spray container of neat G101 for stubborn jobs and one spray bottle with a one-to-twenty solution in it.
Search 'G101' on Amazon UK and you will find there are cheaper versions of the product than the one we used.
This product is slightly corrosive though, so wear gloves and a face mask or cover your nose and mouth whilst spraying it in a fine mist.
MILTON STERILISING SOLUTION
This is a very mild bleach solution, suitable for overnight soaking of baby bottles etc, but not strong enough to do any real harm which probably explains why teats soaked in them turn a much lighter colour over time. A good general purpose cleaner and if I didn't have G101 I'd be using this as a general purpose cleaner. I would also use it to soak my home made face masks in overnight.
Wilco's produce a much cheaper version of 'Milton' - Sterilising Fluid.
WILKINSON'S (Wilco's) WIPES
This link will take you to a page on Wilco's website showing various brands of sanitising wipes - take your pick. Really useful to have with you when in a public place, in the office for wiping phones, computer keyboards etc and as a general wipe around the house.
ALCOHOL SOAP (SANITISER)
Really good stuff to have available when in public places. Don't run off with the idea it's the answer to all your problems - it isn't. Firstly it needs to be used on clean hands, otherwise the dirt will act as a barrier between your skin and the soap. We used to tell the Paramedics they should only use the soap for up to about eight times before washing their hands with traditional soap and water.
Yesterday these were available - today they are not. I have a horrible feeling that as these products come back in to stock the price will go up dramatically. See my suggestion for home made masks.
TRAVIS PERKINS FACE MASK
This is where I bought my cloth face masks from, though not this exact mask, as that is no longer available. My intension, should I need to use our cloth masks is to soak them in a Milton solution overnight, rinse them well, allow to dry naturaly, then use them again (we have about 10 onboard), or back home I'd probably give the exterior surface a light spray with G101 and allow them to dry in natural light.
ANTI VIRUS HAT & FACE PROTECTION
I found these online a couple of days ago and I like them - a lot. They fulfil two needs - to cover the head (ever noticed how dirty your hair is when you wash it after a day in the city?), and provides protection to the mouth and nose - go buy these quickly before they run out. You may not need to wear them until things get pretty serious.
DISPOSABLE SHOE COVERS
We happen to have two packs of these onboard with the intension of using them on our shoes should we pull up at a particularly oily fuel pump. That way the motorhome carpet doesn't get contaminated. The added bonus now is that they can be used to cover the head should the risk increase.
SNAP HOOKS OR CARIBINERS
To reduce contamination of your hands and personal items it is important to have easy access to your alcohol soap. This can be achieved as follows:
Take one bottle of alcohol soap and unscrew its lid.
Tie a short length of nylon string tightly around the top of the bottle.
Burn the end of the nylon string with a lighter to stop it fraying.
Replace the screw top tightly.
Tie the other end of the nylon string to a snap hook or caribiners and burn that end with a lighter also Distance between the bottle and the clip need only be about two inches.
Clip to your belt and dispense soap without removing it from the belt.
The Chef carries the smaller one in her bag for using on ATM keypads as well as shop card readers. After using on the screens just dab a tiny amount of sanitizer on to the palm of your hand and clean the tip of the pen in it. If such pens are not available use the end of a biro pen. Whatever you use clean it immediately afterwards.
So as well as items from the list above you may also need to buy:
A ball of nylon string
A good length of elastic or cotton tape ( for the DIY masks)
A small roll of thin plastic (usually green coloured) covered steel wire from the gardening section of a store or a Garden centre (to use a short length within the DIY masks which will bend and allow the mask to fit around the nose. If you can find something better to do the just use it)
Re-sealable clear plastic bags - very important. These are the clear bags which can be sealed at the top by pressing the two edges together along the top (various uses including carrying one in the Infection Control Kit in which wet contaminated tissues can be isolated until disposal).
Dettol disinfectant (to wipe sufaces neat or dilute down and use use as a spray). 'Savers' sell a much cheaper alternative - 'Antiseptic Disinfectant', it's less that a pound a bottle and it's what we use.
CHEAPER ALTERNATIVES TO ABOVE
Don't underestimate the effectiveness of plain soap and water, a nail brush and sunshine (ultraviolet light).
Bars of hard soap are a very efficient way to buy soap. Remember to buy plastic soap dishes to go with them.
MAKE YOUR OWN FACE MASKS
Use a COTTON sheet, ideally a white one (buy a cheapie from somewhere like Wilkinson's (Wilco's) or go hunting in your airing cupboard).
Use sheets of A4 paper or newspaper as templates to mark out the oblongish shapes, as there will be different size needs for different members of the family.
Cut out the pieces of mask and place about 3 layers on top of each other, this will make it multi-layer (experiment with the number of layers prior to sewing them together).
To provide a means of shaping the mask around the nose sew in between the layers one piece of something like the green plastic covered thin steel wire you find in garden centres right at the top of the mask. Failing that maybe use those large paper clips about three inches long hich can be straightened out for use. If you can think of something else that will do the job better - go for it.
Sew the layers together.
Sew elastic strips to the top and bottom of the masks, the length being dependant on the size of the user and whether or not they are to be worn with two straps over the head or two over the ears.
To save money it is envisaged that these masks could be used a number of times, and as the elastic won't like boiling water or an overnight soak in a solution of 'Milton' consider using lengths of white cotton tape cut to length so that they can be tied behind the head in a bow.
Make about five for each member of the family ( one to wear, two to take as replacements and two back at home still drying)
Mark each mask with the initial or name of the person it was made for.
Soak cotton masks overnight in Milton solution, rinse thoroughly under running water, then allow to dry naturally outside in sunshine and fresh air. Alternately place them in to a container with a lid. Bring the water to the boil and then once that temperature is reached turn off the hjeat and allow to cool.Rince well and dry naturaly
Make your own using Surgical Spirit and ordinary hand soap at a ratio of seven parts spirit to three parts soap. Decant this it to small containers.
Carry a small plastic bottle with ordinary liquid hand soap in it and an all-plastic nail brush. This will ensure you will always have the means to wash your hands. Wipe your hands dry with a paper tissue or let them dry naturally.
Why people are rushing out to buy and hoard toilet paper I do not know, after all this virus doesn't give you the trots.
Years ago when times were hard folk would use newspaper and I suggest you make preparations now to drop back to this should the need arise.
Start saving your old newspaper now (The Sun & Daily Mirror are made for it!).
If the newspapers have to be used cut the pages in to four. Make a small pile of them then make a hole in one corner through which you thread some string. This will keep it all together and provide a means to hang it somewhere should you wish.
Those who are morbidly obese may wish to use half pages of the Daily Telegraph - they should be big enough to cover the job.
This could earn you a 'Blue Peter' badge.
(I do not recommend putting the newspaper down the toilet as it could cause a blockage. Use a small bin like the skanky Greeks then dispose of in the dustbin).
HANDKERCHIEFS OR PAPER TISSUES?
I tend to disagree with the official advice of using disposable paper tissues. It is being suggested that you quite simply pull out a paper tissue, have a lovely old cough or sneeze in to it and then dispose of it. Well I'm afraid reality is not that simple. Let's look at it step by step.
You carry tissues with you - but where do you keep them?
If they're in a nice little pack then how quickly can you get one out to use?
To save time, do you just stick a couple in your pocket just in case?
When you need it in a hurry, will you need to pull it out, then flatten it before it's ready?
Where are you going to keep the tissue until you can find a bin? Chances are there won't be one right next to you.
Do a dummy run. Put your tissues in the normal place you keep them on your person. Then get a friend to shout something like 'SNEEZE' when you're not quite expecting it. See how quickly you can get your tissue out and use it for its intended purpose.
If you can pull it off then well done - audition as a gunslinger in a Hollywood Western.
If you weren't quick enough then you could have contaminated everybody within a six-foot radius. If you were quick enough then you now have a wet tissue and a damp hand loaded with 'Sticky Wet Paint'.
Carry a re-sealable clear plastic bag with you so that you can put each used paper tissue in it for disposal at the first available bin, though only tip the bag out, don't throw it away as you may still need it, plus it can be decontaminated, dried and used again. Remove the 'Sticky Wet Paint' immediately with a sanitiser.
My preferred option. I feel at a loss if I don't have a clean handkerchief in my pocket each and every day. I do understand that some will say that they are not as hygienic as disposable tissues, and in normal circumstances I would agree. But we're entering unusual circumstances, and I bet you could pull a cotton hankie from your pocket and use it far quicker and easier than you could a paper tissue. And that's the point.
Clean hands with sanitiser after each use.
Carry more than one hankie if you need to.
There will be some contamination but it will be less and the hankies can be taken home for a soak in 'Milton'.
To wash them place the hankies in a pan with a lid. Add water and then bring it to the boil. Once the water has reached that temperature, turn off he heat and allow to cool. Remove the hankies and then launder in the usual way.
If I've failed to convince you of the merits of using cotton handkerchiefs then at least consider carrying sheets of thicker, larger kitchen towel folded up in your left pocket so that you can pull one out at a time and use with your right hand.
MAKE A 'MILTON' STERILISING SOLUTION
Bottles of plain ordinary bleach should still be plentiful. The supermarket own brands arer the cheapest. You don't need anything fancy.
In a pint of cold water add about 4 - 6 drops of bleach then stir (do some research on the amount to add, but that would be my first best guess). Use an eye dropper which should be vailable from chemists. This solution will be single use due to it being weak.
MAKE UP AN INFECTION CONTROL KIT
I would suggest you wear a bum bag in to which you place:
A small pack of sanitising wipes (wet wipes), or decant some from a large pack carried in a re-sealable plastic bag to keep them moist.
An all-plastic nail brush, don't use one with a wooden handle.
Alcohol soap, or if not available then ordinary liquid soap used with the nail brush.
Two packs of disposable tissues
Face masks, up to five.
Two re-sealable plastic bags, one to place used paper tissues in and one for used face masks.
A re-sealable bag with some latex free rubber gloves in.
+ Anything else you would feel happier having with you - it's your kit after all.
Many will read this article and feel that I have gone completely O.T.T. Maybe they're right, but these suggestions can be graded and introduced gradually as the situation deteriorates. The advantage of implementing many of them now is that by the time things get even worse, you'll be well practised in the acts which will help to keep you safe.
Remember we're in uncharted territory ...........................what if Covid-19 mutates in to something more deadly that will attack and kill younger people with NO underlying medical conditions?
The virus is being spread unwittingly by people who don't adopt safe practices and have come in to contact with others who do not either - that's how it spreads. It is therefore everybody's responsibility to protect themselves and by default, family members and fellow citizens, by 'upping their game', as they like to say on 'Masterchef'
Keep your hair short if possible because it's easier to wash and maintain.
Ensure there is liquid soap, a nylon nailbrush and a hand towel at every sink in the house.
Shower every morning, including hair, if you have long hair and it's a problem then wear a shower cap.
Maintain good oral hygiene by cleaning teeth after every meal followed by rinsing the mouth with mouthwash.
Keep your nails short and clean.
If you spend the day out of the house at work or out among the public then shower again on returning home, this time washing the hair without fail (ever noticed how dirty your hair gets if you spend a day in a city, only now it may not just be dirt that hitched a ride home with you).
When the situation becomes more serious remove all facial hair (that's men as well!!).
Change in to different clothes once home and wash or maybe spray the clothes you wore outside with a dilution of G101 or disinfectant. You must not use anything with bleach in it as this will harm the clothes.
Clean your teeth and use mouthwash just before bedtime.
Regular hand washing and exposure to chemicals will dry the hands and render them susceptible to cracking thus creating open wounds. Use a moisturising hand cream before bed and use it regularly, though not in public places as it will create a barrier between the sanitiser and the skin.
Don't wear a watch - it will prevent you washing your wrists as part of the hand cleaning process, and can itself become a carrier of the virus. Consider buying a cheap nurses watch which pins to the jacket or shirt. I'm sure they are available online.
To reduce the cost of additional showering ie heating the water and the water itself shower as follows:
Rub shampoo in to the hair and let it sit there - that's the bit that's going to do the killing and cleaning.
Rub neat shower gel all over the body with the hand.
Turn on the shower and as soon as the water is hot enough get under it and quickly rinse off the shampoo and shower gel.
Turn off the shower.
Whenever possible wear cotton clothes when out in public. Man made material requires washing at a lower temperature. That may well save on electricity to heat the water in the washing machine but at temperatures as low as 30˚C or 40˚C all your doing is giving the virus the equivalent of a day out at a Spa Centre. Imagine them lying there soaking up all that warmth and steam. The only temperature that will KILL them is 60˚C and above, and that means cotton. If that isn't possible then maybe an overnight soak in a weak solution of antiseptic disinfectant. Don't hold your breath on the experts giving you a definitive, sensible answer to that one.
Dry clothing outside in the sunshine whenever possible. That sunshine and fresh air will itself be a very effective cure to any remaining infection.
Ensure all clothes are perfectly dry before putting them away, otherwise you will be inadvertently creating an ideal environment for any virus or bacteria somehow remaining on the material. You will be putting it away in a warm, moist, dark environment.
Remove and replace all hand towels every morning. Any bacteria on the towels will have enjoyed a night in a warm, moist dark environment before you plunge them in to a G101, disinfectant, or if they're white, a 'Milton' solution for a nice long soak to be followed by a hot wash.
WHEN OUT IN PUBLIC PLACES
Wear a hat (due to gravity, any infected exhaled water droplets in the air will fall to the ground if they don't land on something else first, and that something may be your hair). Glasses, any sort will do, including sunglasses but the most effective will be those with a rounded frame which are used for skiing or sold as safety glasses with clear lenses. These will help to protect your eyes from any airborn infected droplets as well as act as a reminder when you inadvertantly go to rub your eye.
Don't bunch up and crowd other people, i.e. when numerous people are waiting to cross on a pelican crossing. Stay back or to one side.
If anyone coughs or sneezes near you immediately hold your breath. Do not breath in deeply before holding it, just stop breathing, that way you won't breath in any infected droplets. Continue breathing normally again just as soon as you are away from the infected area ideally having wiped your nose and face before doing so.
Be ever vigilant regarding cross infection opportunities which will present to you. Wayne & Waynetta are everywhere. And if you see somebody being totally irresponsible then don't be afraid to challenge their behaviour, nice and loudly so that you make the point not only to them but others.
To reduce the risk of sneezing have a short little blow of the nose regularly. This will reduce the risk of the body detecting a foreign invader in the nose and use a sneeze to expel it.
Drink water regularly. A little every 15 minutes should do it. The theory is that if you have any infected matter in your mouth the water will wash it in to your stomach where the acids down there are more than capable of dealing with it. It will also prevent it from making its way down the air passageways to your lungs. (If you're already wearing a face mask do not remove it to sip water).
Continue to use sanitiser after each potential risky contact.
Don't shake hands or do kissy kissy, huggy huggy. That's stupid - just ask the Italians. In the current situation there is nothing wrong with saying something like "I don't shake hands at the present time".
At the end of each day that the car has been used, ideally wearing disposable gloves spray or wipe all control surfaces such as steering wheel, hand brake, steering column stalks for things like indicators etc, seat belt buckles and clips, radio buttons, interior door handles, then spray briefly in the general interior area allowing the sanitiser to land on seats etc. Finally wipe all interior handles followed by exterior handles and the boot if it has been used.
The car will now be decontaminated and ready to be used the following morning.
If plastic gloves are available at the pump put them on but back this up with a square of kitchen roll as the gloves are full of microscopic holes. Better still, use a pair of your own gloves.
Use the gloves to remove the filler cap and hold the pump handle to refuel the car.
Pay for the fuel at the pump as this avoids more door handles and card reading machines.
Wipe the bank card after it comes out of the machine as it is very possible Wayne & Waynetta stopped by for fuel and used the same pump just before you arrived.
Clean the replaced fuel filler cap (by this stage the gloves will have become contaminated) and clean hands with a little alcohol soap.
Once completed throw the gloves and kitchen roll away.
Right now, back in the UK, there is no way I would use public transport, especially in cities, without wearing a hat, gloves, glasses and a face mask.
Wear the gloves and face mask for the whole of the journey, including the distance you need to walk to reach your destination. Once you're there dispose of the gloves in a bin, replace the face mask with another one if neccesary, and clean your hands with a little sanitiser.
I can offer no expertise when it comes to pets, but I'm confident that owners of pets put themselves and their families at more risk of infection than those who don't have them. So trying to adapt my experience to this subject I can only suggest the following:
If it is an appropriate breed get the dog's fur cut short. This will make it easier to keep clean.
Having cats or dogs free to roam outside is no longer acceptable. Both should be on a short lead when out in public. It will, I'm sure be an unwelcomed experience for cats but owners need to get control, and it's better the animals get fresh air and exercise in a safe and responsible manner than not at all.
Consider buying one of those covers that dogs wear in cold weather. Better still make one out of cotton material so that it simply ties in place. This will provide a barrier for the dog should it pass through a contaminated area where infected droplets will fall to the ground (unlikely in the countryside but very likely in a crowded town or city). The cover can then be removed when arriving back home and washed.
Prevent dogs from socialising with each other - bum sniffing for the foreseeable future is a no no.
General sniffing around during the walk should be discouraged.
Dogs could be walked with a muzzle on which can then be covered with some cotton cloth thus creating a mask for the animal - good luck if you want to try that on a cat.
Don't forget to clean paws thoroughly on returning home.
PLACE OF WORK
You and your employer need to work together during this crisis. They don't want to go bust during it and you want to continue having a job to go to.
Hold discussions with them, maybe around hot air dryers being replaced by paper towels. Staff cleaning their own desk workspace i.e. phones keyboards etc (I'd want to do my own rather than rely on cowboys coming in during the evening and doing who knows what or nothing at all).
Unless they are fire doors, maybe there are doors which could be wedged open to avoid hand contact on the handles.
If air conditioning can be turned off, then get it off and open the windows. If it can't be, then I'd be sat there with a face mask on.
The Receptionist would be the first line of defence. It would be their job to ensure each and every visitor sanitised their hand properly in front of them, and told of any new etiquettes which have been introduced in to the workplace which they must observe.
If you go shopping yourself then remember all the Wayne & Waynetta's were in there just before you arrived. All the shopping baskets and trolleys will be contaminated with who knows what, the fresh food etc will be covered in 'sticky red paint' by those who just love to good old fumble about to find the firmest etc. The card machines at the till will also be infected. Use contactless if the bill is less than £30 otherwise use a pen or screen pen to punch in the PIN number, and remember to wipe the bank card with a tissue and sanitiser as it comes out of the machine.
Consider buying all of your food shopping online, most of the big supermarkets do it. Open an account now and get practicing ready for when things become more serious. When it is delivered wipe all tins and packages with sanitiser before putting them away because who know what Juan last scratched just before he picked your shopping off the shelves, or if the till operator actually did wash their hands before putting it through the till.
Don't be fooled by shop assistants wearing gloves (serving food etc and also taking money). If they don't remove them between serving the food and taking the money then they may as well not bother.
We used to have problems with the operational Paramedics when the driver on that day would leave the back of the vehicle with contaminated gloves on, close the back doors behind them and climb in to the cab to drive the ambulance to hospital still wearing the gloves, thus contaminating the handles and control surfaces. And that's people who are mindful of the risks of cross infection so what chance do the rest of us have?
This is the routine I have practiced for years, my having no confidence in the hygiene standards of my fellow man:
Push the entry door to the toilets open with your elbow
Push cubicle door open with your elbow
Pull a little toilet roll off and use to close the lock on the door behind you.
If no toilet paper available take three or more paper tissues from your pack. Use one to close the lock on the door.
Use the tip of your shoe to kick up the seat.
Crouch to use the toilet, not allowing any part of your body to come in to contact with the toilet pedestal.
Use all but one of the toilet tissues you pulled from the pack to clean yourself.
Use the remaining tissue to open the locked cubicle door
Use the same tissue to push the flush button on the cistern and then drop that tissue in to the pan to be flushed away.
Wash hands using soap and water provided. Use minimal touch on any surface.
Avoid using hot air hand dryers. These distribute bacteria in a warm moist atmosphere. Use paper towels.
If hand cleaning facilities are unacceptable wash hands with liquid soap.
To exit the toilet without contamination:
If it is a busy toilet unit wait until somebody enters from outside, then if necessary use you foot as a wedge to slip out after they have entered and before the door closes.
Use another paper tissue to act as a barrier between your hand and the door handle. Pull the door open, then let the tissue fall to the ground (the unhygienic design of the toilet is not your problem).
If no tissues are available then pull the door open by hooking only your little finger around the very top or bottom of the handle (minimal previous contact at those points).
Pull the door open then pass through then clean the little finger and surrounding area with alcohol soap.
EATING OUT & TAKE AWAYS
That's an easy one - I just wouldn't. So many restaurants look lovely and clean in the dining area (the bullshit department) yet have filthy kitchens which customers don't get to see. Ask any Environmental Health Officer.
As for roadside eateries - forget it. By law they must all have a hand basin in which they can wash their hands. Ever seen one of them use it? And have you ever asked yourself where they go to the toilet?
My gauge has always been a simple one. If I'm looking at an individual on the other side of the counter I ask myself:
Does he look as if he shaved this morning?
If he didn't shave is it likely he didn't wash either?
Does he look the sort who would wash his hands thoroughly, if at all, after going to the toilet?
These standard apply to females as well, though I excuse them the shaving.
Most of the time they fail the test and I walk away empty handed.
All though it's far from fine dining, establishments like 'McDonalds' are a safer bet because they will have strict operating procedures laid down for their employees and very importantly they are open plan so you can see what's going on in the cooking area.
Right now I'd be cancelling any holiday I had booked which required a long haul flight.
If it involved a flight of about 3-4 hours then I would wear a mask and continue with infection control using my bum bag etc
Note: Check if airlines will allow passengers to now carry on sanitising soap. If the answer is no - then cancel the flight/holiday and tell them why.
Consider staying in the UK this year and spend your money at local holiday resorts. They sure as hell are going to need all the support they can get.
YOUR HOME AS A PLACE OF SAFETY
I would have no hesitation in creating this safe space if things became more serious, especially if I had a young family or elderly relatives living with me. Basically it's a bit like barrier nursing. It's drastic, but it has a very good chance of keeping you protected.
NOTHING gets more than six feet past your front door which carries a risk of contamination.
Seal letter box up on the outside with gaffa tape and leave a plastic box with lid on the doorstep for mail and papers to be placed in. You can check the contents at your convenience wearing gloves.
Wipe front door handles inside and out after each arrival and departure (for some reason brass has a sanitising effect, but don't take any chances).
Place a plastic bin liner on the floor on which shoes must be placed. The soles will be sprayed with diluted antiseptic disinfectant or G101 and left there.
Make up a dilution of 'Milton' spray
Make up G101 solution diluted one part G101 to 20 parts water
Have a separate sprayer with neat G101 to use should the need arise.
Place a small table in the hallway by the front door on which are antiseptic wipes, alcohol soap, hand sprays of G101, disinfectant and 'Milton' available to be used by all those who arrive home or who enter at your invitation.
Spray the outer layer of clothing with diluted G101 prior to hanging up.
Have a steel bowl on the table containing a sanitising solution. Cotton handkerchiefs and used face masks will be placed in the solution for decontamination prior to laundering.
All food etc delivered will be unpacked and the tins and packets wiped with sanitising wipes, or perhaps kitchen roll which has been sprayed with a sanitising solution, before being taken to the kitchen etc.
All items such as mobile phones, other devices, bunches of keys etc are wipped thoroughly before being allowed beyond the six foot limit.
If you have one, use the dishwasher to clean crockery and utensils at a hot temperature. If not then wash by hand and place in a draining rack and allow to dry naturally
If you do use a tea towel wash it every day. Ideally having soaked it overnight in a 'Milton' solution.
Wash hand towels every day
Wash bath towels every couple of days (consider instead using smaller hand towels for each member of the family as they will be easier and quicker to wash and dry and can then be replaced every day).
Use a one inch clean paintbrush to brush computer keyboards, then wipe keyboard, any switches and accessories used with a sanitising cloth or a cloth lightly dampened with 'Milton' or G101 solution daily.
At the end of every day spray and wipe down all surfaces in the kitchen, followed by all light switches and handles and then the bathroom.
CONSIDER THE CREATION OF A SANITISING SPACE USING ULTRA VIOLET LIGHT.
- Go to Amazon.co.uk and search 'Clothes rail on wheels'. Buy whichever one you can afford or need, but ideally it should include a shoe rack at the bottom.
- Search 'Ultra Violet lamps'. Buy something appropriate.
- Place the clothes rail with the shoe rack at the bottom in the hallway or a room close by.
- Place the UV lamp on the shoe rack.
- Cover the whole clothes rail with a white sheet, or better still one of those silver survival blankets.
- Place shoes and outdoor clothing which have just been removed on to the rail and rack, keeping them spread apart so that the UV light can reach all parts, then cover and turn on the UV lamp.
- Consider placing your shopping items oinside it for a coupleof hours after returninh home.
- Without the use of any chemicals your items will become sanitised over a number of hours.