Joey Wahler (Host): It's a prevention alternative, so we're discussing infection protection without vaccines. Our guest is Elizabeth Richardson. She's a Registered Nurse and also Director of Infection Prevention for Beebe Healthcare. This is the Beebe Healthcare podcast. Thanks so much for joining us. I am Joey Wahler. Hi there, Beth. Welcome.

Beth Richardson, MSN: Hi. Thanks for having me.

Host: Great to have you aboard. We appreciate the time. So first, what are the most effective everyday habits that people can apply to try and prevent respiratory illness?

Beth Richardson, MSN: Sure, great question. There's a number of things that we can do every day, ranging from cleaning our hands, cleaning the environment where we live and making sure that we protect ourselves when we're going into areas or situations where there may be a higher risk for exposure. So, hand hygiene, washing your hands or using hand sanitizer is very important.

And once you clean those hands, avoid touching your face with your fingers. That's a direct way of transmitting what you pick up on surfaces to what we call mucus membranes. Your nose, your eyes, your ears, and that's a great way the respiratory virus can get into your system. We have something in healthcare we call respiratory etiquette, where we want to make sure that we're always covering our cough, either by coughing into our elbow or by covering our cough with a tissue. And then immediately cleaning our hands. That goes a, a long way, every day in keeping us safe. And then of course, cleaning and disinfecting surfaces and keeping our environment as clean as possible. These viruses tend to live a little bit, and we can pick them up and then again by touching our face or touching our mouth, our nose, we can bring those respiratory viruses into our system and that can make us sick.

Host: Absolutely. So let me ask you to follow-up on a few of those things. You mentioned etiquette and coughing into your elbow. Can you tell people once and for all right here, Beth, that just looking in the other direction when they cough or sneeze is really not enough, right?

Beth Richardson, MSN: It isn't. When you sneeze or cough or even when you talk, you are eliciting droplets, you're putting droplets out into the air. Those droplets don't go very far, but three feet to six feet is enough to contaminate surfaces and certainly expose other people. Simply by turning away and coughing into your elbow, you are interrupting that spray of droplets, if you will.

And, that's a great way to keep everybody safe. And then of course always cleaning our hands as soon as we've sneezed or coughed. And disposing of the tissue after we wash our hands is a great way to keep us safe as well. Again, it's all about reducing exposure and reducing the level of what we could come in contact with in our environment to as low as possible through these general practices.

Host: Absolutely. And so you touched on it a moment ago, hand hygiene. What's the quote, unquote, right way to do it according to an expert like yourself.

Beth Richardson, MSN: Well, there's two ways, right? We can wash our hands with soap and water, and when we do that, we want to spend about 20 seconds and we want to make sure that we lather up really well. We want to use water as well as soap, and we want to make sure that we get all of the surfaces of our hands covered with that water and rinse those bacteria or viruses away, ending up with clean, fresh water.

We want to dry our hands or pat our hands, and move on. With hand sanitizer, we're doing simply a shorter version of hand hygiene where we're putting a dollop of hand sanitizer, usually alcohol based into our hands and rubbing it all over. And I'm making sure that we get coverage across all the areas of hands.

One of the areas that we tend to forget is right here. I forget the technical name for it, so I apologize. But there's a, a part of our body right here between the thumb and the first finger that we typically will miss, and that we see is a huge source of contamination after hand hygiene if it's not done properly. And of course, we can't do anything without our thumbs, so there you go.

Host: All right, so fill in that gap between thumb and forefinger.

Beth Richardson, MSN: Mm-hmm. And making sure you're getting in between your fingers, top of the hand, palms, and even around the wrists is a great way to go, with soap and water or with hand sanitizer, which is certainly easier to carry around with you in the community or when you're going from place to place than soap and water is.

Host: And speaking of cleaning, how about cleaning and disinfecting surfaces? What should you use and what needs to be cleaned?

Beth Richardson, MSN: Sure. So, in healthcare we, we refer to something called high touch surfaces. So if you think about your environment and what's typically becoming contaminated, it is the things you use every day, the surfaces you touch every day, where you clean, where you sit, where you spend time, your desk, your keyboard, your mouse, those types of things, your phone, right?

All of those things, cleaning them up on a regular basis can really reduce the number of organisms or things that can make you sick on those surfaces. It's not very hard. You can use a disinfectant wipe that you can buy at the grocery store or the drug store, or even just a clean cloth that's dampened.

I like to say, you know, in the hospital we have lots of rules and lots of things where we have to use certain types of disinfectants with certain strengths, et cetera. But a minute of really good elbow grease and friction will do a good job in the environment along with, anything you can get at the grocery store or the drug store to try and kill some of these viruses and these other bacteria and keep the number of live organisms in your environment down to a minimum.

Host: And we, we talk about keyboard cleaning. How important is it? For instance, I've got a keyboard right in front of me here. You can't see it. I'm typically the only one that uses this keyboard. Is it still a good idea for me to wipe it down periodically in case I picked up something along the way?

Beth Richardson, MSN: It is, um, meaning certainly, in shared environments, we're more concerned with keyboards and, and, the mice and the telephone pieces that go to our face when we're talking on the telephone, because they're being shared across people. But even you, using your own keyboard over time, you're not always sitting in that one place, right?

You're going from place to place. You're using, other things in your home and you're touching lots of different surfaces and when you come back to that keyboard, everything that's on your fingers is getting transferred to that keyboard and if we can continue to regularly clean that, you can reduce when you might be exposed to that. And then of course, you easily touch your face or your nose or your mouth and we go from there. So, regular cleaning, we ask everybody here in the hospital to at least start their day by cleaning their keyboard at the beginning of the day and cleaning it before they go home. And that's usually sufficient.

Host: Good rule of thumb there. How about masking? Every now and then I still see people out and about wearing masks. Sometimes you're not too sure? Well, if it's a stranger, of course you're never too sure of exactly why they're wearing them, if they're protecting themselves or other's, or maybe both, but what role is masking playing these days and when should people consider that?

Beth Richardson, MSN: Sure. The scientific evidence continues to show that wearing a mask when you're in a, situation where you are at-risk for or a higher risk for exposure to other's, or you want to protect other's from your own potential illness is an effective thing to do. So when you wear a mask, that's going to stop the spray of droplets from getting into the air and getting onto surfaces when you cough, sneeze. So we do ask when people are ill, if they're going into an area where there are vulnerable people, like a hospital, or where they think they might be exposed. Wearing a mask kind of does it double duty, right? It protects you from other people and it also protects other people from you.

Host: How about ventilation and air quality? How can they help to reduce risk, be it at home, work or wherever? And what, if anything, can be done to improve that if you have some control there, particularly in your own home.

Beth Richardson, MSN: Sure. I mean, basic ventilation systems in our homes, and in the spaces that we go to, whether it be the grocery store, other drug store, church, et cetera. Basically over what period of time does that air change and get replaced with fresh air coming in.

So your HVAC system in your home is pulling fresh air in and getting old air out. But old air stays around for a long period of time, even just opening a window, a crack. Certainly I don't want anybody to spend a ton of money wasting heat, in these very cold days.

But, getting access to fresh air, is always a good idea. Certainly it's easier in the less cold months, but that's something that we always recommend people do. Keeping your HVAC system in good repair, making sure it's clean. People tend to get maintenance twice a year.

Very good recommendation because you want your system that's moving the air through your house, and exchanging that air, to be as efficient and as an effective as possible, and regular maintenance is a good idea.

Host: Couple other things. Generally speaking, Beth, who are the most high-risk people or caregivers when it comes to getting sick through the air and what precautions can they take?

Beth Richardson, MSN: Sure. Again, we refer to masking, washing or cleaning of your hands with hand sanitizer, reducing the number of pathogens or bacteria, viruses you have in your home on surfaces are all good things. People who are at higher risk for getting ill, during a respiratory season like the one we're having now, if they can avoid going into places that are crowded, where there's more risk for exposure to a wider variety of people with a wider variety of illnesses, that's always a good idea.

We can't always do that. So when we have to go into those situations, wearing a mask, cleaning our hands, following respiratory etiquette are all good things to do.

Host: Is there a myth or misconception or two? You're smiling already, so I'm guessing there is that you often hear in your line of work about prevention, things that maybe people are misinformed about that you can clear up for us right here.

Beth Richardson, MSN: Sure. I mean, there's a couple of things, and I believe that my colleague, Dr. Chaznoff, talked about vaccines on a different podcast. There are some myths related to vaccines in terms of timing. We do a lot of education with our healthcare workers, in terms of going ahead and getting a flu vaccine in September or October and not waiting until December when the burden of respiratory illnesses is much higher and they're much more likely to be exposed to a respiratory illness without having that protection of the vaccine on board, it's not going to wear off.

It's going to last you the entire respiratory season, whether you get it in September or October. Waiting till December is not going to keep you safer further into the next year, if you will. We also do a lot of education about whether or not getting a vaccine makes you sick. Whether or not wearing a mask makes you sick.

Some people, believe that because they're wearing a mask, they're keeping all their pathogens to themselves and they're actually infecting themselves and it's a bad thing. So we do a lot of education to kind of clear up the myths and replace different things that you might see in the lay media or on the internet, with solid evidence that supports the practices that we ask people to follow every single day.

Host: And then finally, Beth in summary here, for those joining us that are thinking well, I want to protect myself as best as possible, but on the other hand, I also want to live my life. Right. So what's your best piece of advice for balancing the two?

Beth Richardson, MSN: Sure. I think common sense comes into play, you know yourself, you know, the people that you're typically around and the types of risks you may encounter on a regular basis. I think everybody should be aware of their own risk factors, you know, if you have chronic illnesses, if you're going into areas or places where a lot of sick people may be, like the doctor's office, like the emergency room, like a hospital; perhaps you need to do a little extra or take a few extra steps to protect yourself when you're in those higher risk situations than you might have to do at home. Hand hygiene is the number one way. I mean, we as infection preventionists we talk about the, the cycle of infection transmission.

Washing your hands and getting rid of bacteria and viruses that you've picked up and that have contaminated your hands is the number one way to stop the transmission of infections and that can keep you healthy every single day, regardless of what's going on. Whether it's respiratory season or something else, is, on the forefront of potentially making us sick.

Host: So people should keep in mind then that hands can be the portal, so to speak, of a lot of these germs, right?

Beth Richardson, MSN: They really are. Yep.

Host: Well folks, therefore we trust you are now more familiar with vaccine free protection. Beth, great advice indeed. Have a very, uh, safe and healthy season of getting through this along with the rest of us, and thanks so much again.

Beth Richardson, MSN: Sure. Thank you for the opportunity.

Host: Absolutely, and for more information, please do visit beebehealthcare.org/mychart. If you found this podcast helpful, please do share it on your social media. I'm Joey Wahler, and thanks so much again for being part of the Beebe Healthcare Podcast.