Dr Greg Poland, Mayo Clinic, Methanol Poisoning discussed on Mayo Clinic Q&A
Welcome to Mayo Clinic. Dr Halina Gonzaga will recording this broadcast on August the twenty four, th twenty twenty. You're with us again today we have Dr Greg Poland are virologist and infectious disease expert from Mayo Clinic. And today I'm really looking forward to this greg because we're going to be answering some questions from our listeners. It's great. Yes. Should be fun to find out what people want to know about. Our first question is about hand sanitizer for there's been a lot in the news about us on this. One of our listeners states that they have seen some issues with hand sanitizers that have been discussed. In the news, how do you know if one a safe? What's wrong with the ones that are out there that we're supposed to avoid and how do we know which ones they are? First of all, it might be worth saying that the best thing we can do for hand sanitation is washing with soap and water. The hand rubs or hand liquid hand sanitizers are a second best they were but they don't work well when your hands are soiled with visible dirt or have mucus on them. So it is a second best nonetheless when you're out and about you don't really have a choice. So you WanNa do is you want to select a hand sanitizer with at least sixty, ideally seventy percent ethyl alcohol, and you do not want to hand sanitizer that has methyl alcohol. Methyl alcohol is a Taxon and should not be used unfortunately what unethical Producers are doing in order to meet the demand and sell their product for hand sanitizer using methyl alcohol, which is very cheap the other thing that can fool you is that it can say ethyl alcohol. And rarely says more than that. You do not WANNA product that lists one pro panel alcohol that is also a toxin. So how would the average consumer know that you've pick up your phone? You can go to the FDA website put in the product number and boom it will tell you whether this is an approved or unapproved hand sanitizer. The other thing I want to comment on is too old hand sanitizers that do not have ethyl alcohol and they have very a winsome names herbal green. You know things like that. Those are ineffective and should not be used I'm finally why the prohibition about methyl alcohol as I mentioned, it's toxin and to unfortunate things happen. One is that little children could use enough of it to experience some symptoms of methanol poisoning but the other really unfortunate one and it seems hard to believe. But hand sanitizer is not infrequently used as an alcohol ingestion substitute among alcoholics and. When that happens that can be disastrous. I've worked enough years in emergency rooms to see what methanol poisoning can do. It can completely ruin your liver. It can cause profound CNS central nervous system side effects. So it is truly a toxin and should be avoided greg do hand sanitizers ever expire now that's a great question, and in fact, all products they do expire over time generally speaking. The ethanol based hand sanitizers have about a three year window and the reason for a why it has a three year window is that the alcohol content decreases over time and you know we've mentioned many times that we wanted a hand rubbed it has sixty to seventy percent alcohol content. Once it falls below sixty percent, it begins to lose its effectiveness. So the expiration is based on that. About three year time window I have one other question that I'd like to throw in I have seen that many of the large distilleries in the United States have volunteered to close down the production limited so that they could make hand sanitizer can people make their own hand sanitizer in their home and does the alcohol that they may have in their liquor cabinets have anything to do with it. Again, you know don't want a complete drink alcohol with hand sanitizer but you know commendable has been an and we've seen it here at Mayo Clinic of people volunteering companies volunteering to provide us with some of the ingredients that you need for a safe and effective and sanitizer, and as I say that's that's to be commended. I think the issue involves the idea that could you make your own and you can go on the Internet, FDA and others do have a recipe. In fact has a recipe for how to make your own. Hand sanitizer with ethyl alcohol kind would be in rubbing alcohol that you can buy and you can safely make your own because it. It has been a problem. Let's face it to to buy a hand sanitizer and unfortunately a number of producers have. Tripled and quadrupled the price of it. So definitely, you can do that again far better is wash your hands with soap and water. So when the liquor companies are making hand sanitizer, they're changing type of alcohol they used to reduce it will no. They're actually using an ethanol which is appropriate. They are not using methods alcohol Greg. The next listener would like to know about plastic face shields. So you know We were all told that we should be wearing masks in many communities and states have instituted. Some are regulation around wearing masks and Thera- people who are wearing the plastic face shields along with masks but also people who are just wearing the plastic facial themselves. Thinking the bats protective is just wearing the face shields acceptable or does one need to parrot with a mass and In my opinion, the face shield alone is inadequate compared to the face shield plus mass. So at Mayo Clinic is you know we are wearing when we're with patients were wearing a mask and Faye shield or some kind of eye protection the problem with a face shield and we're talking about it as it's one entity obscene many different types and therein lies the problem. But the problem with a face shield is that you still have air you're breathing in that air has to come from around or under knee the face shield. Now it's value is in reducing exposure to the larger droplets, somebody coughs or sneeze. You actually have a physical barrier for the large droplets and you have your mask underneath for the smaller and the aerosolize droplets. If. There was somebody who for some valid reason could not wear a mask. A inched yield would be better than nothing for example, but is a face shield alone of the same efficacy as face mask. The data does not support that CDC does not recommend that. So I would say, no at this point that's very helpful in this this listener indicated that there had an issue with asthma was having difficulty wearing face masks or was exempt from doing so in there are few. Individuals who have disorders where they cannot wear face masks. But in that case, one of the facials covers the mouth. I wouldn't. I wouldn't be surprised to lean it if in the evolution of face shields that we get to a point, for example, where we have a fait, she'll that goes to the ears and then goes below the Chin with cloth. That would that would in essence act as a kind of mask so that even though air is being breathed through, it would nonetheless. Filter in some in some way that there are other difficulties associated with it. Some people get headaches the thing I don't like about it and and I wear it is it is not an. You know it's a very curved piece of plastic usually and it's not optically clear it the store it's like having spectacles on were the lenses aren't quite right in distorts your vision a little bit and you know for for you and I in the medical setting having clear visions important. There's a lot of ingenuity out bear Cocaine, and I hear some things waiting to be developed there when you describe types of facials mass zone interesting to see what we see the next number of months. I say I think we could probably get there but the current administration of a shields right now I think are not sufficient, but we may get there all Gregg. The next listener wants to now if someone is exposed to cove it and they know that they have been how long do they need to self isolate and? What if they are living with other people, how do they protect those individuals and the the answer? So little bit complicated because as we've learned more the sciences changed and therefore the recommendations have been updated to reflect that. So I'll try to break it down to kind of three clear categories. Number One if you've been exposed to somebody with Kobe, you need to self quarantine for fourteen days after your last exposure. If you had exposure to somebody you went into quarantine and then got exposed again you start the clack over fourteen days. One of the things that's changed is will what about travel particularly international travel? The CDC dropped the requirement for fourteen days of. Quarantine so and then just refers to local state or community rules while respecting masking physical distancing, etc.. Now, this is the tougher one in some ways after you have recovered from then. Okay. So you've had co bid and you you. It's now been ten days or more since your symptoms have appeared, you have no fever end those symptoms are improving. You don't have to quarantine after that ten day.