PPE against COVID19 reviewed and finalized

PPE stands for Personal Protective Equipment.

PPE against COVID19 stands for Personal Protective Equipment to avoid getting COVID19, or coronavirus disease 2019.

In April 4, 2020, I have written an article on PPE against COVID19 when I got confused with the use of the acronym of PPE in donation campaign.

“I want to donate PPE.” What does this “PPE” mean?
“We are seeking donations of PPE.” What does this “PPE” mean?

Definitions and Categorization of PPE

https://sites.google.com/site/rojosontporsoncovid19/definitions-and-categorization-of-ppe

In this article, I proposed the following:

ROJoson’s Proposal:
1. Basic or elemental PPE – gloves, surgical face masks, etc.
2. Hazmat PPE – complete attire covering the entire body (coveralls, googles, masks, face shields, boots or shoe covers, gloves, etc.)
3 Accessory PPE – face shields, googles, acrylic boxes, acrylic swab shields, etc. (used individually or in combination but falling short of complete hazmat PPE.
Then, I came across this article:

Questions on the Costs of PPE Being Procured by Government

PPE against COVID19
 
Two issues to clarify before the differing costs are cited, if not raised with suspicion: 
 
1. What really comprises PPE against COVID19?  
 
2. What is the quality of each component of PPE?
Then, I attended the webinar of the Philippine College of Surgeons on the use of PPE on May 15, 2020 and made notes.

PCS Webinar on Guidelines on Use of PPE by Surgeons Amidst COVID19

I came to the following conclusions:

Personal Protective Equipment against COVID19 is a collective term for wearable equipment, gear and other special covering that aim to protect the wearer from being infected with “splashes and sprays” from COVID19 patients.

Categorization:
  • Respirators – face masks, N95, KN85, others
  • Eye Protectors – goggles, face shields, others
  • Protective clothing – overalls, coveralls, surgical caps, gloves, shoe covers, others
Alcohol is not part of the definition of PPE – not worn.
Aerosol shield boxes are not part of the definition of PPE – not worn.
This will be the definition or meaning of PPE against COVID19 that I will use.
There was one slide on the levels of PPE that I saw:
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Alcohol hand wash / spray, strictly speaking, should not be considered as PPE.
Another table which I saw:
psmid2a
Alcohol or alcohol-based hand hygiene solution(s) should not be considered as PPE.
There are a lot of interpretations not to say misconceptions going on among authors.

ROJ@20may29

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My Gumamela History

My Gumamela History

19sept21 – Jho Espiritu – gave me RHIANA – pink with red streaks
19dec14 – Jho Espiritu – gave me JELLY – yellow with red streaks

Started with first plant – RHIANA – given to me by Jho Espiritu on 19sept21 – kept this in Sta. Ana – bloomed for the first time on December2, 2019 (2 months)

Thanks to Jho Espiritu who gave me a gumamela plant to appreciate and grow – to help me in my productivity, contentment, enjoyment, happiness and longevity program.

Another plant – JELLY – given to me by Jho Espiritu on 19dec14 – kept in Makati – only bloomed for the first time on May 24, 2020 (5 months)


ROJ@20may24

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Sleep on It

“Sleep on it” is an English idiom which means to wait until the next day (in order to think carefully) before making an important decision.

“Sleep on it” has indications to promote “better” problem-solving and decision-making in life.

The indications basically consist of doing “sleep on it” when you are not dealing with a life and death problem-solving and decision-making situation; when you are not dealing with a medical emergency; when you are not dealing with an extremely urgent situation; and when the situation allows you to have more time to get more data and information and to study the pros and cons of some decision options.

Case in point:

20may22

I have a breast cancer patient who needs and wants parenteral chemotherapy to decrease the size of her cancer prior to operation.  This is in the midst of the COVID19 crisis.

For the past one week, I have been trying to do problem-solving and decision-making in order to help her.

As an elderly physician (71 years old), I am hesitant to do it because of the safety issues during the COVID19 epidemic.  I am hesitant to go to the hospital to my clinic to do the chemotherapy for her.  However, the thought has still been lingering in my mind during the past days whether I should do it out of compassion for her overriding my personal safety concern.

Another option is that I can refer her to other oncologists to do the chemotherapy but the patient does not like to as there will be a lot of tests that will be ordered and she cannot afford the expenses.

Another option is that I can ask my residents in the hospitals that I am connected with to do the chemotherapy but the hospital clinics are not yet fully operational.

After my telemedical consultation with her today which finished at 1 pm, we have no shared decision yet.  I told her to give me one to 2 more days for me to look for a solution.

At 2 pm, I decided to take a siesta.  I literally “slept on it.”  I slept on or over the problem on hand.  When I woke up, I was happy a new option cropped up in my mind which I think is the best.  I will refer her to a physician whom I am closed to, to do the chemotherapy under my instructions, in a clinic outside the hospital.  I think he will agree.   I found a solution to the problem of my patient.

I was so happy with what transpired and I asked my daughter for the English idiom that connotes you don’t make a decision right away, you delay the decision-making.

She told me: “SLEEP ON IT.”

Yes, “sleep on it” has the advantage of arriving to a “better” problem-solving and decision-making as long as there is no extreme urgency.

sleep-on-it-idiom-meaning


ROJ@20may22

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My son reporting for duty in PGH amid COVID19 – 20may18

20may18

I woke up early enough to see my son off to report for duty in the Philippine General Hospital amid COVID19.

He came home for the 2nd time on May 4, 2020, isolated himself; observed himself for symptoms of COVID19 (fortunately none); studying and attending online learning sessions from PGH; resting; and eating with full delight the foods being served by his mother.

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I have to keep a distance from him on his arrival and on his leaving lest I get contaminated.

His schedule of duty and isolation:

One week of full duty: 1)   April 6 to 12;  2) April 27 to May 4, 2020

Two weeks of isolation: 1) April 13 to 26, 2020; 2) May 4 to May 17, 2020

I gave him the same instruction that I gave on April 4, 2020:


Farewell instructions and advices to a son who will report back to duty in PGH after 14 days of self-isolation in the house (for self-observation and building back host resistance):

Go back to PGH and continue to serve the Filipino people with potential and actual surgical health problems amidst the COVID19 crisis. You are needed there.

As much as possible and try your very best to avoid being infected with COVID19 infection.

Best strategies against being infected with COVID19 infection: 1) mindfulness; vigilance; learn from the “experience” of others who got infected and died of COVID19 infection; 2) use personal protective equipment to the optimum and maximum when managing patients – consider all patients as potentially contaminated; 3) practice safe care when managing patients – if there is such a thing as patient safety measures there should also be a counterpart – physician safety measures; 4) practice physical distancing even with colleagues – consider them as potentially contaminated; and 5) continuously maintain and even increase your host resistance, especially with adequate nutrition, rest and exercises.

20apr4
11pm

What I cannot do he can do – frontline in the treatment of patients who are potentially contaminated with COVID19 in the hospital setting.

I wish him the best.  I will pray for his safety.


ROJ@20may18

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My bathroom amid COVID19 and beyond

On April 24, 2020, I wrote a blog with the following title:

In it, I have this one paragraph that mentioned about my bathroom.

The other small shifts to a “new normal” for me as an offshoot of COVID19 crisis consist of 1) intensifying my exercise regimen at home without going out of the house because I am not allowed to and 2) doing a lot of household chores in the absence of house helps because of community lockdown (I now include cleaning the bathrooms aside from other household chores that I have been doing before).

Yes, I now include cleaning my own small bathroom as part of my “new normal” amid COVID19 crisis. Most likely, cleaning my own bathroom will continue even after COVID19 crisis as we don’t have regular house help for so many years now.  Before COVID19, we have just been engaging a  house help to do general cleaning and laundry once  a week.  As I said, this cleaning of my own bathroom will most likely continue after the COVID19 crisis unless I become disabled.  One, we don’t know when the COVID19 crisis will completely end, probably 6 months, 12 months, or even longer.  Second, I like to protect myself and my family members from being contaminated and eventually infected with COVID19 as a result of a house help.  Thus, most likely, cleaning my own bathroom will become my “new normal” even after the COVID19 crisis.

May 11, 2020 – had an extensive general cleaning of my bathroom.

Will schedule general cleaning at least once a week.

Lessons learned:

Cannot completely clean to the utmost and perfect degree in one sitting – one that is completely without any dirt, without any stain, etc. whatsoever.  Probably 90% will be good enough. Just have to do repeated general cleaning on a planned and regular interval to maintain cleanliness at 90% degree.  Every now and then, outside the weekly schedule, I may have to do a little additional or contingency cleaning as I discover old or new dirt or stain that needs to be clean.  Target: at least 90% cleanliness at all times, not 100%.

bathroom_roj_20may11a

bathroom_roj_20may11b

I have at least 3 shorts (swimming trunks) that I use regularly, one a day or even two or three a day, whenever I go out to the garage to wash car, whenever I do gardening, and whenever I get myself dirtied with whatever chores and activities outside my room and house.  These swimming trunks are easy to wash and dry.

bathroom_roj_20may11cbathroom_roj_20may11dbathroom_roj_20may11e

Small area for stockroom which I should constantly clean and maintain at the minimum stock.

bathroom_roj_20may11f


ROJ@20may11

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I am not the plastic surgeon with a Joson surname!

Monthly reminder!

 

I am Dr. Reynaldo O. Joson.

 I do extirpational surgery on the breast, face and elsewhere but not plastic surgery.

There is a plastic surgeon who has the same surname (Joson) as mine.

He does plastic surgery on the breast, face and elsewhere.

Pls. do not confuse me with this surgeon and don’t bother me with mistaken messages.

 

wrong_joson_20may7


ROJ@20may7

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ROJoson Telemedical Consultation – Monthly Reminder

Monthly Reminder

ROJOSON TELEMEDICAL CONSULTATION

https://sites.google.com/site/rojosontelemedicalconsultation/primer-on-rojoson-telemedical-consultation

roj_telemedical_consulation_roj_20apr17

Telemedical Consultation – New Normal_roj_20may15_16

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telemedical_consultation_covid_roj_20apr24

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You can avail of my ROJoson Telemedical Consultation with Video Chat.

Read first Primer on ROJoson Telemedical Consultation:

https://sites.google.com/site/rojosontelemedicalconsultation/primer-on-rojoson-telemedical-consultation

If interested, set appointment through cellphone.

SMS or text ROJoson at 09188040304 with the following messages:
Complete name, age and sex
Concern to consult ROJoson:
I like to set an appointment for ROJoson Telemedical Consultation on DATE (specify the date).
My cell number is:
My email address is:
My Facebook account is:

Then, wait for ROJoson’s response through SMS.


 

ROJ@20may2;31

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