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Winston

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The result of the study below is just as valid for COVID-19 which is subject to fecal spread.

On a somewhat related topic, you should have outdoor shoes and indoor shoes. I saw an extensive piece on TV on the safe handling and disinfecting of groceries and packages, but the MD said nothing about the shoes he'd just walked into his home wearing. What do you think could have easily settled on the floors of high traffic public areas like grocery stores via sneeze and cough droplets or tracked in on shoes via the toilet plume route from the infected, but not yet symptomatic? Get the same in your carpet or on your floors, especially with rug rats or pets, and the stuff will spread everywhere, eventually to hands and then faces.

I can't believe how this isn't getting coverage. People in serious hazmat gear wear disposable booties over their shoes/boots or special boots just to wear in the contaminated areas. I saw some poor old gal in China wearing empty grocery bags over her shoes.

Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk.
- Jan 2012

https://www.ncbi.nlm.nih.gov/pubmed/22137761

Abstract

BACKGROUND: Toilet facilities in healthcare settings vary widely, but patient toilets are commonly shared and do not have lids. When a toilet is flushed without the lid closed, aerosol production may lead to surface contamination within the toilet environment.

AIM: To substantiate the risks of airborne dissemination of C. difficile following flushing a toilet, in particular when lids are not fitted.

FINDINGS: C. difficile was recoverable from air sampled at heights up to 25 cm above the toilet seat. The highest numbers of C. difficile were recovered from air sampled immediately following flushing, and then declined 8-fold after 60 min and a further 3-fold after 90 min. Surface contamination with C. difficile occurred within 90 min after flushing, demonstrating that relatively large droplets are released which then contaminate the immediate environment. The mean numbers of droplets emitted upon flushing by the lidless toilets in clinical areas were 15-47, depending on design. C. difficile aerosolization and surrounding environmental contamination occur when a lidless toilet is flushed.

CONCLUSION: Lidless conventional toilets increase the risk of C. difficile environmental contamination, and we suggest that their use is discouraged, particularly in settings where CDI is common.
 
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Speaknoevil

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I read in an Asian medical journal about removal of shoes and spraying the soles with disinfectant. I've been doing it for over three weeks. I believe, like masks, the U.S. is behind in dealing with mass infectious disease.
 

TSMILLER

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My Mrs is European. I learned to take my shoes OFF before entering the house. After time in Europe and following the practice after marrying the Lady, I just don’t understand how people can not think about removing your shoes!
 

Speaknoevil

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My Mrs is European. I learned to take my shoes OFF before entering the house. After time in Europe and following the practice after marrying the Lady, I just don’t understand how people can not think about removing your shoes!
Removing shoes alone is not enough. We have always done that at our home. The report said "outside shoes" should be disinfected each time you return home.
 

TSMILLER

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Mrs does do so, I’ll have to ask if she is increasing the amount she is doing it during this mess.
She says “Of course, do you think I am сумасшедший!”
That translates as “Out of my mind!“
 

Bill S

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I have been wiping my shoes down with disinfectant wipes after a trip the grocery store. I do it before I enter the car, which I am sure it looks strange, but I don't care. :)
 

timbucktoo

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So how does the virus get from your shoes/floor to your eyes/mouth/nose?
 

NateB

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So how does the virus get from your shoes/floor to your eyes/mouth/nose?
Take your shoes off then adjust your glasses, rub your eyes, scratch your nose, etc...

With regards to c-diff or other bugs that pass around through fecal matter, think about your tooth brush if sits on the sink counter in a jar or holder.
 

ksaves2

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My Mrs is European. I learned to take my shoes OFF before entering the house. After time in Europe and following the practice after marrying the Lady, I just don’t understand how people can not think about removing your shoes!
My lovely deceased spouse wouldn’t allow one to go past the back door without changing to “indoor only” house slippers. Was weird because everything was tile in that area. I could see how it would be reasonable not to track on the carpeted area of the house though and continue doing that since she’s gone. Kurt
 

cwbullet

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Leave it open a breath deeply.
 

timbucktoo

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What if you drop delicious grilled chicken on the kitchen floor, (which had been walked on with outside shoes), immediately grab said chicken and then chuck in your pie hole?

Asking for a friend...:headspinning:
10 second rule.
 

Winston

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So how does the virus get from your shoes/floor to your eyes/mouth/nose?
Handling of very small kids (aka rug rats) or pets which you hold, but I'd rather just not have the viruses there in the first place for avenues of movement I don't foresee.
 

Winston

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My lovely deceased spouse wouldn’t allow one to go past the back door without changing to “indoor only” house slippers. Was weird because everything was tile in that area. I could see how it would be reasonable not to track on the carpeted area of the house though and continue doing that since she’s gone. Kurt
Culturally acquired wisdom for the Asian cultures, I suspect. My mom was German and an incredibly clean-aware housewife who also worked as a high school English teacher. The family was also very clean MOUTHED. She said that, "The use of profanity is a sign of a limited vocabulary" to which I replied, "So, what the f*** are you tryin' to tell me, mom?" [only the first part of that is true]

Consider the thousands of years of collective wisdom and experience probably behind some religious edicts. The Ten Commandments comes to mind.
 
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Speaknoevil

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Winston

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I finally found the research (well at least one) I was referring to regarding the virus spread by shoes: https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article#r5
My latest text file on the topic. The "experts" should be recommending indoor/outdoor shoes and closed lids before flushing, very easy to implement measures... but they aren't.

Polio had a HUGE R0 of 5 to 7 and was spread via the fecal-oral (hand-face) route. I've heard that most respiratory viruses don't spread that way. SARS-CoV-2 does.

A contamination source:

Fecal transmission may be responsible for coronavirus’s rapid spread
February 19, 2020

https://fortune.com/2020/02/20/coronavirus-fecal-transmission/

The novel coronavirus is shed in the feces of infected people, which may help explain why it’s spread so fast, according to Chinese researchers.

The finding of live virus particles in stool specimens indicates a fecal-oral route for coronavirus, which may be why it’s caused outbreaks on cruise ships with an intensity often seen with gastro-causing norovirus, which also spreads along that pathway. More than 600 Covid-19 infections were confirmed among passengers and crew aboard the Diamond Princess, the ship quarantined for two weeks in Yokohama, Japan.


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“This virus has many routes of transmission, which can partially explain” its rapid spread, the Chinese Center for Disease Control and Prevention said in a report Saturday:

Notes from the Field: Isolation of 2019-nCoV from a Stool Specimen of a Laboratory-Confirmed Case of the Coronavirus Disease 2019 (COVID-19)

http://weekly.chinacdc.cn/en/article/id/ffa97a96-db2a-4715-9dfb-ef662660e89d

Excerpt:

This finding has important public health significance. Suggestions to strengthen the control of fecal oral transmission of 2019-nCoV include strengthening health publicity and education; maintaining environmental health and personal hygiene; drinking boiled water, avoiding raw food consumption, and implementing separate meal systems in epidemic areas; frequently washing hands and disinfecting of surfaces of objects in households, toilets, public places, and transportation vehicles; and disinfecting the excreta and environment of patients in medical facilities to prevent water and food contamination from patients’ stool samples.

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Here's how it can get airborne, to then be breathed in or settling onto the floor to be tracked everywhere by everyone, even from the bathrooms of asymptomatic persons. Authorities should be calling for a policy of separate indoor shoes and outdoor shoes to be used by everyone to avoid tracking the virus onto their home floors and carpets to be brought to faces by contact with pets, very small children, or into lungs by vacuuming:

Potential for aerosolization of Clostridium difficile after flushing toilets: The role of toilet lids in reducing environmental contamination risk - Dec 2011

https://www.journalofhospitalinfection.com/article/S0195-6701(11)00339-2/pdf

Background: Toilet facilities in healthcare settings vary widely, but patient toilets are commonly shared and do not have lids. When a toilet is flushed without the lid closed, aerosol production may lead to surface contamination within the toilet environment.

Findings: C. difficile was recoverable from air sampled at heights up to 25 cm above the toilet seat. The highest numbers of C. difficile were recovered from air sampled immediately following flushing, and then declined 8-fold after 60 min and a further 3-fold after 90 min. Surface contamination with C. difficile occurred within 90 min after flushing, demonstrating that relatively large droplets are released which then contaminate the immediate environment. The mean numbers of droplets emitted upon flushing by the lidless toilets in clinical areas were 15e47, depending on design. C. difficile aerosolization and surrounding environmental contamination occur when a lidless toilet is flushed.

Conclusion: Lidless conventional toilets increase the risk of C. difficile environmental contamination, and we suggest that their use is discouraged, particularly in settings where CDI is common.

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The potential spread of infection caused by aerosol contamination of surfaces after flushing a domestic toilet - 26 Jul 2004

https://sfamjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-2672.2005.02610.x

Aims: To determine the level of aerosol formation and fallout within a toilet cubicle after flushing a toilet contaminated with indicator organisms at levels required to mimic pathogen shedding during infectious diarrhea.

Conclusions: Although a single flush reduced the level of micro-organisms in the toilet bowl water when contaminated at concentrations reflecting pathogen shedding, large numbers of micro-organisms persisted on the toilet bowl surface and in the bowl water which were disseminated into the air by further flushes.

Significance and Impact of the Study: Many individuals may be unaware of the risk of air-borne dissemination of microbes when flushing the toilet and the consequent surface contamination that may spread infection within the household, via direct surface-to-hand-to mouth contact. Some enteric viruses could persist in the air after toilet flushing and infection may be acquired after inhalation and swallowing.


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Tracking it around:

New CDC Study Shows Coronavirus Can Survive For Hours On Floors, Walls, Shoes
13 Apr 2020

https://www.zerohedge.com/geopoliti...onavirus-can-survive-hours-floors-walls-shoes

A preview of a new study by the US Centers for Disease Control and Prevention - the CDC, for short - released last night offers some distressing news for health-care workers, as well as their families, partners and friends: New research suggests that nurses, doctors and others can track the virus out of the ward and into another - perhaps a more public, or less well-protected - environment, helping to spread the disease in a new way that public health officials haven't really considered.

Though the team insisted that "respiratory droplets and close contact" remain the primary vectors for the disease, the possibility for hospital workers to transmit the virus on their shoes and clothes wasn't really well understood, until now.

And unfortunately, if the data are confirmed, it would suggest that wards where coronavirus patients are treated are literally crawling with the virus, placing these health-care workers at extremely high risk for infection.

According to the research, "94% of swabs taken from the ICU floor and 100% of swabs taken from one of the general wards used to treat patients with severe symptoms tested positive for coronavirus."

The authors suggested that "air flow" and the forces of gravity might be responsible for moving the samples to the floors and the walls. But this certainly doesn't bode well for anybody arguing that the subway and restaurants will be able to go quickly back to normal, since an asymptomatic diner can leave the virus at their table for the next customer to pick up even if the table sits empty for hours - or even overnight.
[or on the floor of supermarkets - W]

The study:

Aerosol and Surface Distribution of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospital Wards, Wuhan, China, 2020

https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article

Excerpt:

Abstract

To determine distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards in Wuhan, China, we tested air and surface samples. Contamination was greater in intensive care units than general wards. Virus was widely distributed on floors, computer mice, trash cans, and sickbed handrails and was detected in air ≈4 m (13 feet) from patients.

The rate of positivity was relatively high for floor swab samples (ICU 7/10, 70%; GW 2/13, 15.4%), perhaps because of gravity and air flow causing most virus droplets to float to the ground.
 

ksaves2

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Old age? Or contaminated Charmin?
 

Winston

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The following is, of course, equally valid for viruses like SARS-CoV-2 which causes COVID-19. Both of these were authored before COVID-19:

Study Reveals High Bacteria Levels on Footwear
3 May 2008

https://www.ciriscience.org/a_96-Study-Reveals-High-Bacteria-Levels-on-Footwear

A study which investigated germs collected on footwear, by Dr. Charles Gerba, microbiologist and professor at the University of Arizona, and The Rockport® Company, found large numbers of bacteria both on the bottom and inside of shoes; averaging 421,000 units of bacteria on the outside of the shoe and 2,887 on the inside. Some of the bacteria found on the shoes included: Escherichia coli, known to cause intestinal and urinary tract infections, meningitis and diarrheal disease; Klebsiella pneumonia, a common source for wound and bloodstream infections as well as pneumonia; and Serratia ficaria, a rare cause of infections in the respiratory tract and wounds.

The goal of the study was to verify bacteria levels on footwear and the effectiveness of machine washable shoes in reducing those levels inside and outside the shoe surface. The project also investigated the role of shoes in the movement of bacteria from contaminated floor spaces to other surfaces.
"The common occurrence (96 percent) of coliform and E. coli bacteria on the outside of the shoes indicates frequent contact with fecal material, which most likely originates from floors in public restrooms or contact with animal fecal material outdoors," said Gerba. "Our study also indicated that bacteria can be tracked by shoes over a long distance into your home or personal space after the shoes were contaminated with bacteria."

Simply washing the shoes with detergent was found to eliminate the fecal bacteria and reduce all bacteria by 90 percent or more. [70% alcohol or a diluted bleach solution is also effective]

Snapshot: Footwear Study Results:

- Coliforms were detected outside of the shoes on 96% of the shoes. E. coli was detected on 7 of the shoe bottoms (27%). No coliforms were detected on the inside of the shoe.
- Transfer of bacteria from the shoes to uncontaminated tiles ranged from 90% to 99%.
- The average number of bacteria on Rockport shoes before washing and after washing is showing a 99% reduction in the numbers of bacteria on the outside of the shoe and a 90% reduction of bacteria on the inside of the shoe after washing.
- Specifically there was a 99% reduction of the bacteria coliform on the outside of the shoes after washing.


Leave your shoes at the door: Science says they're covered in poop and could make you sick
4 Jul 2019

https://www.usatoday.com/story/news...est-theyre-covered-fecal-bacteria/1637780001/

Your clodhoppers track in dirt, yes, but also fecal germs and diarrhea-inducing bacteria, studies show, and the shoes themselves can get dirtier than a toilet seat. And science has shown just what makes up that filth, too.

Even Charles Gerba, a University of Arizona microbiologist who conducted a seminal study on the subject, was surprised.

"I'm starting to make myself paranoid," Gerba told the Baltimore Sun when his study debuted in 2008. "It seems like we step in a lot more poop than I thought."

For the study, 10 people wore brand-new shoes for two weeks before their kicks were sampled for bacteria. The outside of the shoes averaged 421,000 units of bacteria, compared with 2,887 on the inside. And fecal bacteria appeared on 96% of the shoes.

That fecal bacteria "indicates frequent contact with fecal material, which most likely originates from floors in public restrooms or contact with animal fecal material outdoors," Gerba said for the study.
 
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