Most people are either indifferent to swine flu or fearful, but the makers of Purell hand sanitizer and Chlorox are happy. It’s been a boon to the business of sanitizing everything in sight as a way to ward off swine flu. Here’s a story about Chlorox (bleach):
The company has secured additional suppliers and will increase production if needed, says Benno Dorer, senior vice president- general manager of Clorox?s cleaning division. Some retailers have already asked for more bleach, he said in a Sept. 4 telephone interview, declining to name specific companies.
An outbreak of the flu may add 2 percent or more to Clorox?s per-share earnings for the duration of the outbreak, says Ali Dibadj, a New York-based analyst with Sanford C. Bernstein & Co. That benefit isn?t reflected in Clorox?s shares or analysts? projections, he said.
?Sales of bleach and wipes, which are about a quarter of Clorox?s profit, could grow in the high single digits or more,? Dibadj said in an e-mail. ?It depends on how severe the outbreak might be, but the fear of an outbreak is enough.?
Bleach shipments increased in the U.S. and Latin America during the quarter ended June 30, Dorer said.
?There is a clear correlation to those sales and concerns about H1N1,? Dorer said. He declined to say if sales in the current quarter had risen due to swine flu.
Clorox hasn?t increased inventory because it can quickly boost production at any of its seven U.S. bleach- related plants, Dorer said. Most products can go from factory to retailer in a week, he said.
The company is working closely with the WHO, the American Red Cross and the CDC, he said. Clorox donated 18,000 cases of bleach to relief and government agencies during the first swine flu outbreak, he said.
?We?re prepared to do that that again if the need arises,? Dorer says. (Clean link)
One of the things that surprises people the most about what we know about influenza is what we don’t know. One of the things we don’t know is the principal mode of transmission of flu. It’s probably one of three: large droplets that fall out quickly and don’t remain suspended; much smaller aerosols of virus-laden particles that remain suspended in the air for hours or even days; and flu that’s on inanimate objects (known as fomites). We’ve discussed the first two modes pretty often here (examples here and here) and they have a direct bearing on things like what kind of mask might or might not work. We still don’t know the answer. The third mode, inanimate objects, is what hand sanitizers and Chlorox bleach are all about.
Obviously if your hands are laden with virus because you cough or sneeze into them, it’s good to sanitize your hands. But the evidence that you can get flu from virus particles you pick up from a doorknob, desk top, keyboard or even someone else’s uncoughed-on hands is pretty meager. In fact, it’s almost non-existent. So why do all the public health authorities, including CDC, keep telling people that the best defense is to wash your hands? That’s the question that Dr. Arthur Reingold, head of epidemiology at the University of California, Berkeley, and codirector of the CDC-funded California Emerging Infections Program wanted to know. So he sent a letter to CDC asking it:
Dr. Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, says the CDC’s emphasis on hand-washing is guided by the “science that supports hand-washing against respiratory infections in general.” In particular, she cites a study conducted in Pakistan that showed that hand hygiene measures cut the rate of pneumonia in half. One of the unique features of swine flu?the fact that it causes diarrhea?also suggests to some that it could be transmitted on the hands like other diarrhea-causing diseases that do not belong to the influenza family. Schuchat stresses that the best way to protect yourself will be to get the vaccine once it becomes available in October, but adds that the CDC continues to believe that “contact precautions are useful with this flu.” (Newsweek)
Most epidemiologists agree that hand hygiene plays a part in a number of diseases, both respiratory and intestinal. It’s good to have clean hands as a general principle. You can over do it, of course, and overdoing it is something germ-phobic Americans are pretty good at. But, yes, wash your hands. This doesn’t answer Reingold’s question, however. Evidence for contact infection specifically for influenza is very, very hard to come by. But we keep hearing it. Why?
We will hazard two answers. The first is that many of the people at CDC and in health departments say it because they think it’s true. They don’t really know the scientific evidence for it. They think it’s there, even though it isn’t. Mistatements of facts by authorities isn’t so uncommon. Even CDC’s Dr. Schuchat, who is really a skilled and credible spokesperson on flu for her agency, continues to say that seasonal flu kills 36,000 people every year, even though that is misleading and wrong. All she has to do is say, “our experience over many flu seasons, is that on average there are some 30,000 – 40,000 extra deaths we believe wouldn’t have happened if the people hadn’t gotten the flu. Some years it’s much more, some years it’s much less.” Or some such thing. It’s both clearer and easier to understand. It also has the virtue of being what we think is actually the case.
Which brings us to the second reason CDC and state public health officials repeat the handwashing mantra. They not only believe it, but in fact without a vaccine they have nothing much else to offer. Giving people something to do affords a feeling of empowerment, which is also probably a good thing. The power they think they have (literally) in their hands might not be real, but it is comforting for most of us to think there is something we can do. And of course for public health officials, who are always being asked by the public what they should do, it’s nice to have something to say, something that doesn’t even require anything from the public health system. Like any placebo, it works best when both the patient and the doctor believe it works.
Or maybe not. Maybe it’s like Niels Bohr’s famous answer to the reporter when asked why he had a lucky horseshoe over the lab bench: “You don’t believe it will bring you good luck, do you Professor?” “No,” Bohr replied. “But I understand it works even if you don’t believe in it.”