As Coronavirus Spreads, Poison Hotlines See Rise in Accidents With Cleaning Products

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As Coronavirus Spreads, Poison Hotlines See Rise in Accidents With Cleaning Products

David Waldstein

As awareness of the coronavirus pandemic has spread throughout the United States, doctors who monitor activity at poison call centers have noticed an alarming trend: a significant increase in accidental exposures to household cleaners and disinfectants.

A study released Monday by the Centers for Disease Control and Prevention shows that calls to poison hotlines this year for cases involving cleaners and disinfectants rose significantly compared with the same period over the previous two years, and charts a dramatic spike in March for both categories.

Some of the physicians who collaborated on the research with the C.D.C. had discussed their observations with one another last month.

“I was like: ‘Am I the only one seeing a big increase in exposures to these disinfectants?’” said Dr. Diane P. Calello, the medical director of the New Jersey Poison Information and Education System, and one of the authors of the report.

Others saw the same trend, and wondered if the accidental poisonings were an insidious, secondary result of the coronavirus’s spread. The group initiated the study to determine if there was a possible link between the rise in exposures and the recommendations from public health agencies to clean and disinfect as much as possible.

From January through March, poison centers received 45,550 exposure calls related to cleaners (28,158) and disinfectants (17,392), the report said, representing overall increases of 20.4 percent compared with the same period in 2019 and 16.4 percent more than 2018.

The authors warned that the actual number of exposures was likely even higher because the data only came from reported calls for help, and some people who were exposed probably did not report their cases to the hotlines.

The call centers also did not record information about the reasons for an exposure — whether, for instance, it was because of a direct concern over the coronavirus. But the authors indicated that a connection was likely because the timing corresponded to the increase in media coverage of the coronavirus, as well as stay-at-home orders and other instructions from public health officials.

“There appears to be a clear temporal association with increased use of these products,” the authors wrote.

Dr. Calello said she works regular shifts at the New Jersey poison hotline, and she recently took a call from someone who had mistakenly wiped her face and hands with a powerful disinfectant. Dr. Calello also said she heard several calls from parents whose small children had ingested hand sanitizer.

The C.D.C. report included two anonymous cases. In one, family members found an unresponsive preschool-age child who had ingested an unknown amount of a 64-ounce bottle of ethanol-based hand sanitizer. The bottle was found open on the kitchen table.

The child was rushed to a hospital in an ambulance and admitted to the pediatric intensive care unit overnight. She was discharged and sent home after 48 hours, the report said.

In another case, an adult woman, who had heard about the importance of cleaning market produce, mixed bleach and vinegar in hot water in her kitchen sink to wash the food. The mixture of bleach and vinegar created chlorine gas, which the woman inhaled.

She was able to call 911, and recovered after being rushed to a hospital. But in more severe cases, chlorine gas, combined with moisture in the lungs, can create hydrochloric acid, which can cause severe lung damage.

“People are home and they are frightened and they want to get their home and their food as clean as possible,” Dr. Calello said. “Common sense can take a back seat.”

Dr. David Gummin, the medical director of the Wisconsin Poison Center, who was not involved in the study, said he and his colleagues have also noticed a significant uptick in calls. Similarly, they have received reports that some people have been improvising with things like ethanol and alcoholic beverages in order to navigate around shortages of hand sanitizers.

“Products are generally fairly safe if used appropriately,” Dr. Gummin said. “But now with every American trying to stay Covid-free, people are not only utilizing cleaners and hand sanitizers at record rates, but also trying to identify alternate mechanisms to keep things sanitized. The important thing is to keep them locked up and out of the reach of children.”

Dr. Calello said cleanliness is vital in fighting the disease, but some people have been “overzealous” about disinfecting.

“Educating people about what is safe is the key,” she said, “but I have a hunch the numbers will go up in April.”

  • Updated April 11, 2020

    • When will this end?

      This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • How can I help?

      The Times Neediest Cases Fund has started a special campaign to help those who have been affected, which accepts donations here. Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. More than 30,000 coronavirus-related GoFundMe fund-raisers have started in the past few weeks. (The sheer number of fund-raisers means more of them are likely to fail to meet their goal, though.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • How do I get tested?

      If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • Is there a vaccine yet?

      No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Can I go to the park?

      Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

    • What should I do with my 401(k)?

      Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”


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