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Friday, March 13, 2020

All Right, Let's Talk About Coronavirus


coronavirus common sense precautions for libraries


NOTICE: This situation now calls for drastic action. Please refer to my more recent article, written on March 17th - Coronavirus, Continued - Flatten the Curve, Close Your Library!  

[If you're reading this long after the 2020 Coronavirus crisis and just looking for general best practices for sanitizing toys and such, proceed below to the original article, which was written right before the first confirmed case was announced in my area, and edited and updated as the situation rapidly progressed.]
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Original Article, written 3/6/2020, edited 3/11, 3/12, and 3/13:

First off, everybody take a deep breath and calm down.

So far, CDC estimates that 31 million Americans have gotten sick, at least 210,000 hospitalized, and 12,000 have died. But not from coronavirus; FROM THE FLU! You know, that disease that happens every year, that disease we know is coming but don't take adequate precautions for, that disease for which there is a vaccine that so many refuse to get. Right now, the flu is still a more serious health threat than coronavirus for most of us.

Does that mean we shouldn't be concerned about coronavirus? No, as that is rapidly changing. Coronavirus cases are now in almost every state, with community spread already established in several. It is more serious than the flu because for one there is no vaccine or treatment for coronavirus as there is for the flu, it seems to be more contagious and spreads faster than the flu, and may cause more serious illness than the flu, so it is something to be concerned about, but panic and misinformation don't help anyone. I will admit, I am now much more concerned that I was just a few days ago.

However, t
he things we CAN and SHOULD be doing to protect ourselves and our patrons are the same things we really should have been doing already because of cold and flu season, and most of it is easy, though slightly inconvenient, and should be common sense.

No, I am not a medical doctor or public health specialist. However, I do have master's degree in Microbiology and I worked for several years in biomedical research on disease-causing microorganisms and vaccine research and development in private industry, for the military, and for NIH. My thesis research was on adenovirus pathogensis, studying the how and why the virus causes disease at a molecular level. Adenovirus is not related to Coronavirus, but causes similar disease patterns and has a similar transmission. So while I am not an expert and I don't claim to know everything, I know a little something.

So, what should we, as library staff be doing to protect ourselves and our patrons? As I said, nothing you haven't heard before, and the same stuff we should have been doing all along, because it is cold and flu season. Here are my suggestions:

Coronavirus common sense precautions for librarians
  1. WASH YOUR HANDS! With soap, for 20-30 seconds. This is the number one method for minimizing transmission. Wash before eating, after going to the bathroom, after changing diapers, after handling library books, etc.

  2. KEEP YOUR HANDS AWAY FROM YOUR FACE! This is probably almost equal to hand-washing as a preventative measure. Most germs enter the body through our mouth, nose, or eyes.

  3. Cover coughs and sneezes by coughing into a tissue, then wash hands, or cough into your shoulder or elbow.

  4. Provide tissues and hand sanitizer for patrons and staff.

  5. Put away toys that can't be easily cleaned/disinfected for the time being, such as stuffed animals, your nice Folkmanis puppets. Wash scarves in hot water and dry with heat after every use, or better yet, put away and don't use for now.

  6. Stick with hard plastic toys that can be easily cleaned and disinfected. Ideally, things should be routinely disinfected weekly, though I know this is not always possible due to limited staff (and now, due to hoarding of disinfectant due to the hysteria creating temporary shortages), but do the best you can. Anything that has been used by infants/toddlers should really be sanitized between uses, though. Disinfectant wipes are good for things that can't be immersed in liquids and quickly wiping down surfaces.

  7. The standard method for disinfecting is a diluted bleach solution. "But bleach is so 
    toxic!" I hear some of you exclaiming. Well, yeah, that's the point! You WANT something toxic in order to KILL the germs; we don't just want to annoy them.

    3% bleach is what most daycares use for routine sanitizing, which is 1/4 C bleach in 1 gallon water; soak toys for 20 minutes, then rinse and let dry. Every lab I worked in used 10% bleach to disinfect work surfaces, and this concentration is only necessary for surfaces that are known to be heavily contaminated. Some people are needlessly concerned about using bleach on children's toys that may be mouthed for some reason, but a simple rinse takes care of that.

    *And note, all "bleach" products are not the same. Make sure it is regular old bleach. Also, bleach does expire so check labels. The  solution needs to be made fresh each day for maximum effectiveness.

  8. No, hydrogen peroxide is not as effective; many germs are resistant to it. It's great for washing dirt and debris out of a wound, but not for disinfecting. And most definitely not vinegar. Vinegar is NOT a disinfectant. It's fine if you want to use it for routine cleaning at home when you're not really worried about disinfecting or preventing an epidemic, but it is not much better than plain water as a disinfectant.

  9. I know many libraries do not like using bleach, and may not have the space or facilities to make soaking toys a practical option. Another option is a dishwasher with a hot wash cycle; some even have a steam sanitizing cycle. These reach temperatures high enough to kill most germs. 70% alcohol is also effective, but must be used sparingly and in a well-ventilated area due to the fumes and flammability. The CDC also posted this list of effective disinfectants:  https://www.epa.gov/sites/production/files/2020-03/documents/sars-cov-2-list_03-03-2020.pdf

  10. Once it hits your area and is  spreading, not just an isolated case or two, I'd just stop using anything that can't be easily disinfected, and I'd try to disinfect as frequently as possible. In this case, it makes sense to put out fewer toys so that this is manageable, or even just put them away for now.

  11. Also disinfect other heavily used surfaces, like computer keyboards, mice, doors/doorknobs, light switches, etc. For these, it's probably easiest to use disinfectant wipes or spray.

  12. Masks - Healthy people do not need to wear a mask, and wearing one really doesn't provide you much protection; the virus is so tiny a paper or cloth mask really doesn't provide much of a barrier. However, persons who are sick should wear a mask to help contain any secretions released from coughing and sneezing to lesson viral transmission.

  13. Books - I know some small libraries are wiping down books as they come in. If your volume is small enough and you have the staffing and time to that, great, but the reality is that just isn't a feasible for larger libraries, and I don't know how much that really accomplishes because you can't disinfect the pages inside.

  14. Stay home if you are sick! 
With all that being said, I recognize ideal isn't always practical or possible, especially with the mass hysteria causing shortages of supplies. And there are alternatives to bleach, which I know generally libraries would rather not use because it can damage clothing or carpets, and often just don't have the space or facilities to allow for soaking items in dilute bleach solution. But we do what we can. It's not possible to disinfect or sanitize everything, so pick your battles and do what you can, and we are all figuring it out as we go.

There's talk of whether libraries should close or not. Just a few days ago I thought talking of closing schools, libraries, etc., was an overreaction. But after reading about how dire the situation now is in Italy, with their healthcare system being completely overwhelmed and in crisis, having to resort to wartime triage, I am re-thinking that. Mass closures and keeping everyone at home for an extended time, just a week or even two probably wouldn't be enough, may be necessary to keep our system from being overwhelmed.

But, such closures would have to be coordinated, and the timing would have to be just right. If schools or other places where people congregate are still open, closing the library probably won't have much effect overall. I know such drastic action as extended, mass closures would cause other issues and economic hardships, and I really don't know when would be the right timing, but probably soon after community spread has been confirmed in the area. If the CDC, state or local public health service advises or requests places like schools and churches close to encourage people to stay at home, then I think libraries should close, too.

In the meantime, I'd really be pushing all the digital media available through the virtual library via the library website, Overdrive or Libby apps, etc., curbside pickup if you have it, and post messages and signage asking people to please stay home if they are sick. Suspend overdue fines, and employers should be more flexible about extended absences since the CDC is asking people to self-quarantine for 2 weeks if they get or are exposed to the coronavirus. It may be time to just put all the toys away, and think about cancelling programs; though it is so opposite of our usual mission, we might better serve the public by not encouraging them to come in a hang around for a while.

For now, I don't think there is reason to panic, but to be very conscientious and vigilant about hand-washing, staying home if sick, and disinfecting toys and surfaces, and start thinking about additional measures to take and how closures might be handled when and if they happen. This has reached pandemic proportions, so I think it is inevitable that it will reach all of our communities eventually. The good news for our young patrons is that children seem to get less sick with it than adults; the bad news is that means they can be carriers and contribute to more community spread.

But for now, let's all stay calm, stay informed, and stay vigilant about good hygiene! 

Update 3/11/2020 to add what my system is currently doing - we have stepped up cleaning and sanitizing in general, particularly high-touch points like computer keyboards, mice, and touchscreens, table tops. We have a sanitizing spray that is labeled safe for food-prep areas that we are using to sanitize toys at least once a day, and we have removed toys that cannot be easily sanitized or would not hold up to being cleaned that frequently, and are still working on winnowing them down to a manageable amount. The public schools currently have no plans to close, but again, this is a rapidly changing situation.

Update 3/12/2020 - As of this afternoon, my library system has canceled all programming, as have several nearby systems, but still open. We are almost out of hand sanitizer. I was authorized to pull all the toys, manipulatives, and crayons off the floor as sanitizing was becoming too labor intensive, and we have community spread, so risk is increasing. Tonight, the governor asked all schools to close for at least two weeks starting on Monday. We now have 11 confirmed cases of Covid-19 in our area. 

Update 3/13/2020 - As of today, my library system announced they are closing at the end of business today through April 5th. Several other systems in the area have made similar announcements. Staff will be paid, as is our policy for emergency closings (part-time included). We have gone from 0 cases to 12 confirmed cases across 4 counties in the last week since I first began writing the original article. It is not contained, and community spread has been established. Schools are closed as well, and the governor has requested non-essential personal stay home or work from home as much as possible.


Library closures are not taken lightly, but slowing the spread of a pandemic than could potentially cause our healthcare system to crash as is happening in Italy is much more important than providing library services for the next month. Too many have blinders on and want to martyr themselves to continue to provide services. Please don't! You can best serve your community right now by taking the drastic actions necessary to slow the spread. It may not be in your area now, but it likely will be, eventually.

If your library is still open, I strongly urge you to at least pull all toys and boardbooks and cancel all programming, step up cleaning and sanitizing procedures, practice social distancing, be vigilant about hygiene. But if your schools close, then libraries should close as well. More drastic action than is described below is now necessary for fighting COVID-19, but the sanitizing procedures below are good practice for routine sanitizing, and especially during a normal cold & flu season.


2 comments:

  1. Thank you, Jen, this is very common-sense and I appreciate your calm and thoughtful approach!

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    Replies
    1. I hope it is helpful. It is a rapidly evolving situation, and I have gone from not being overly concerned to being extremely concerned in the span of a few days. As an update, my system just canceled all programming through the first week of April, as has the library for which I am on the board of trustees.

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