# RKS: SANTIZING & SANITIZERS - More Than Meets The Eye

 # RKS: SANTIZING & SANITIZERS 

- More Than Meets The Eye

1st October 2020

Dear Reader,

I always remember how I was pulled up in yesteryears for washing my hands - a wee bit too frequently - by family, friends, and even Dr colleagues. After touching each patient, even for checking mere BP or pulse (including a socially visiting relative or friend), always washed hands; before touching any eatable and always after finishing food washed hands with water.  In AI flights there is yet wet wipes given but the practice has stopped in other airlines but I continued washing my hands even as seated in a plane - guess how?!! 

Sanitizing is the rule today and sanitizers are ruling today. Umpteen manufacturers have entered the fray and because of COVID-19 fear I feel better hygienic environment prevailing when in close apposition to someone's else flesh-brushing - rare handshake and the like. But why do we buy, use, advocate and amply store sanitizers? What is their actual role in preventing the dreaded virus attack?

Sanitizers for hands contain alcohol and alcohols can be of several types for different uses:

• Sanitizing: Hand sanitizers typically contain some combination of isopropyl alcohol, ethanol (ethyl alcohol), or n-propanol. However, most contain 70% ethyl alcohol in hand sanitizing solution. 

• Surgical Spirit: Cleansing (rubbing alcohol) is done by denatured alcohol that contains a mixture of 70-99% ethyl alcohol, <9.5% methyl alcohol and 0.5% pyridine. It is wood alcohol that is purposely made poisonous (by adding methyl alcohol to its content), and unpalatable, to prevent from drinking - the word 'denatured' is used as description since it sounds better than referring to as 'poisoned alcohol'!

• Rectified Alcohol: Also known as neutral spirits, rectified alcohol, or ethyl alcohol of agricultural origin, is highly concentrated ethanol that has been purified by means of repeated distillation in a process called rectification. Rectified spirit contains 95% ethanol with 5% water. Rectified spirits are used in mixed drinks, in the production of liqueurs, for medicinal purposes, and as a household solvent (including personal care industry, paints, coatings, printing inks, fragrance and flavor industries).

Hand sanitizers are used for killing the novel coronavirus (SARS-CoV-2) on body surfaces that have been inadvertently, or out of compulsion, been in-touch apposition to infected or suspected infected surfaces both living beings or inanimate objects. For ADEQUATE protection, solutions of 70% (at least) alcohol should be left on surfaces for 30 seconds (including cell phones) to ensure they will kill viruses (including SARS-CoV-2). The very purpose of killing virus on the exposed parts of the body is to prevent its entry into nose and mouth by touching these body parts mistakenly with infected hands. ONLY after the virus gains entry into the nose  / mouth can it unleash its hostilities! 

So a better more sure shot way to eliminate / prevent viral survival post-entry (inadvertent) is by sterilising the nose and mouth passages. This can be achieved in two ways:

• Steam Inhalation: The viruses can be killed on surfaces using very hot water – at around 70 degrees Celsius (C), or hotter. Water is converted into steam at 100 degrees C. However, what we inhale is usually only steam as VAPOURS which are at a temperatures of 42 to 44 degrees C. This makes sense since at above 41 degrees C temperatures the steam can cause damage to cells (by a process called coagulation and resulting in closure of cell pores in its walls through nutrients otherwise enter). 

1. The SARS-CoV-2 (in particular) can only be killed at 56 degrees C AND when exposed to these temperatures for minimum 15 minutes! There is no way this is ever going to be possible because even if high temperatures exceeding 56 degrees C steam as vapours is inhaled, there will be collateral damage to air passage lining cells resulting in accentuation of symptoms of COVID-19 (on the contrary).
2. The SARS-CoV-2 replicates at 33 to 35 degree C in humans and vapour form of steam inhalation (as is done at usual tolerable temperatures), at best, can only prevent coronavirus multiplication.

• ‘Alcohol’ Inhalation: Alcohol is effective at killing different types of microbes, including both viruses and bacteria, because it unfolds and inactivates their proteins. This process, which is called denaturation, will cripple and kill the infecting microbe because its proteins will unfold and stick together. Some viruses have an outer wrapping, which is called an envelope, while others are non-enveloped. Alcohol is effective at killing enveloped viruses, including the coronavirus, but is less effective at killing non-enveloped viruses. For  viruses (or bacteria elimination) alcohol concentration of 60% or greater is needed to be effective.

There are select varieties (brands) of whisky, rum, vodka and bourbon that have alcohol content close to 60%. It could makes logical sense to inhale any one of these as an alternative to steam if virus killing is desired and not mere prevention of coronavirus replication. Introducing alcohol is physiological for the airway passages – when one drinks alcohol it is removed via the lungs and into the airways (and hence the breath analyser testing is done to detect its presence in drunken driving suspected cases). Introducing alcohol as an inhalation substance is thus not alien for the lung passages and mouth or nose linings.

Alcohol inhalation is very simple to take. No boiling or heating and no additional gadget required as for steam inhalation. Take a non-reactive glass bottle with a lid. Put sufficient quantity of any close to 60% concentrated whisky, rum, vodka or bourbon and make two holes in lid just tight enough to pierce large-diameter couple of straws. Ensure one straw’s end remains above surface of alcohol whilst the other one’s is immersed inside below the layer of whisky, rum, vodka or bourbon. Breathe in by pulling air from the unsubmerged straw held sufficiently ABOVE the layer of liquid alcohol; the air from outside atmosphere will be 'pulled in' via the straw immersed WITHIN the layer of alcohol inside the bottle - and this whisky, rum, vodka or bourbon laced air will enter inside the air passage. Then allow the air inside the lungs to exit via the nose by blowing out into the SURROUNDING atmosphere with mouth closed. This whole process will ensure that alcohol coats the passages of the mouth, throat, windpipe, and nose (too on its way out). The whole process is akin to taking a puff from a misthaler which allergy / asthma patients are usually accustomed to.

Alcohol inhalation in the fashion described above is to be done ONLY for one SINGLE breath cycle of inhalation and exhalation and NOT more than twice daily. Any alcohol, if deposited in the airways after the procedure, is eliminated via natural breathing out of air. Hence, those driving need to exercise adequate relevant caution, and the above procedure is strictly not recommended for those in whom alcohol is not agreeable or is taboo. 

Irrespective, of above precautions, the mask and gloves are irreplaceable and hand sanitizers will continue to play a positive protective role for COVID-19 prevention. My yearning to sanitise fully all exposed parts and / or vulnerable portions of the body stimulates mind to devise logical protective measures. The fear of SARS-CoV-2 infection and the scare of isolation (particularly in hospital) drives the mind to seek solutions for positive health in this pandemic scenario. The obsession with hand cleaning has gone one step ahead and culminated into respiratory cleaning with all possible and optional measures. Wearing a coronavirus repellent around the neck – now available as a Japanese FDA approved product, seems to be crowning glory in the COVID-19 protective shield.

DR R K SANGHAVI

Prophesied Enabler

Experience & Expertise: Clinician & Healthcare Industry Adviser