According to the Centers for Disease Control and Prevention (CDC),1 the virus responsible for Coronavirus Disease 2019 (COVID-19) is a new virus which has been identified as the cause of an outbreak of respiratory illness in Wuhan City, Huebei Province in China. The earliest reported cases had a link to a large seafood and animal market in Wuhan, suggesting an initial animal-to-person spread, however a growing number of subsequent patients have not had exposure to animal markets, indicating that a person-to-person spread has been occurring. The CDC states2 that COVID-19 is a new disease, and that there is still much to be learned about how it spreads, the severity of the illness it causes, and the extent to which it may spread in the United States.2
Since this new strain of coronavirus3 was originally detected in China on December 31, 2019,4 it has subsequently spread throughout China,5 and is now spreading throughout the world to other countries. The first case in the United States6 was confirmed on January 21, 2020 in Snohomish County in Washington state,7 and the number of confirmed cases has continued to grow in the ensuing weeks.8 In total, according to the Coronavirus COVID-19 Global Cases map provided by the Johns Hopkins University website, there have been confirmed cases in every state in the U.S., and practically every country in the world.8
The situation continues to be closely monitored by public health officials, with active communication taking place amongst the global public health community and the governments of affected countries and communities. The CDC, World Health Organization (WHO), and the global public health community are providing instruction9 for the global population to practice good hand hygiene, cover coughs and sneezes, avoid close contact with anyone with cold or flu-like symptoms, and to clean and disinfect high touch surfaces.
Map of Countries With Confirmed Cases of COVID-19.
Image Source: CDC
According to the World Health Organization (WHO),10 Coronaviruses (CoV) are a large family of enveloped viruses which are known to cause illnesses ranging from the common cold, to the more severe illnesses such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). The coronavirus responsible for COVID-19 has been named SARS-CoV-2.11
Coronaviruses are zoonotic,12 meaning they are initially transmitted between animals and people, and these type of viruses are named for the crown-like spikes (or “coronas”) on their surface13 when viewed under an electron microscope. Human coronaviruses were first identified in the mid-1960s, and with the recent identification of the virus responsible for COVID-19, there are now seven known strains of human coronaviruses which can infect people.13
Most coronaviruses are not life threatening, and people around the world commonly get infected every year with one of the four known human strains of coronaviruses which cause the common cold.13 The COVID-19 strain is being monitored closely as a potentially more serious strain of human coronavirus similar to the strain identified as Middle East Respiratory Syndrome (MERS-CoV)14, which was responsible for an outbreak which started in Saudi Arabia in 2012, and the strain identified as Severe Acute Respiratory Syndrome (SARS-CoV)15, which was responsible for an outbreak which started in China in 2003.
For confirmed cases of COVID-19 infections, symptoms16 have ranged from infected people with little or no symptoms to infected people becoming severely ill and dying. Symptoms can include one or more of the following:
At this time, CDC believes that symptoms may appear in as few as 2 days or as long as 14 days after exposure, but since this strain is still so new and in need of further research, these assumptions are based on observations of how symptoms developed with the MERS-CoV strain.16
In the most serious cases, COVID-19 infection can lead to pneumonia, severe acute respiratory syndrome, kidney failure, and even death.12
While there is currently no vaccine available for COVID-19, CDC is recommending that the public practice everyday preventive actions17 which can help to limit the spread of respiratory viruses, including the following best practices:
Infographic – Reduce Your Risk of Coronavirus
Source: World Health Organization
Sources
At present, the virus responsible for COVID-19 is not on any EPA registered product lists, and therefore there is not a disinfectant which can make a specific claim to be effective against this new virus. However respiratory illnesses attributable to COVID-19 are caused by a coronavirus, and WAXIE can provide several broad-spectrum hard surface disinfectants that have been shown to be effective against other similar viruses, such as Human Coronavirus, SARS associated Coronavirus, Porcine Respiratory & Reproductive Syndrome Virus (PRRSV), and/or have been shown to be effective against viruses which are more difficult to inactivate such as Rotavirus, Rhinovirus Type 37, and Norovirus.
When used in accordance with the directions on the label for each associated product, these hard surface disinfectants have been shown to be effective against the virus (or viruses) referenced on the master label for that product. There are a number of disinfectant products which have already successfully gone through, or are in the process of going through, the protocol for the EPA Emerging Viral Pathogens Guidance for Antimicrobial Pesticides.1
List N: Disinfectants for Use Against SARS-CoV-2
On Thursday March 5, 2020, the U.S. Environmental Protection Agency (EPA)2 released a list of EPA-registered disinfectant products that have been qualified for use against SARS-CoV-2, the novel coronavirus responsible for COVID-19. Since the date of original publication, this list of disinfectant products has been updated several times, and the EPA has been publishing a revised list each week since mid-March which includes additional disinfectants which have been approved.
This list of disinfectant products, also referred to as List N: Disinfectants for Use Against SARS-CoV-2,3 includes products which have submitted data to EPA to show that they are effective against viruses which are harder to kill than SARS-CoV-2. The products on this initial list have been selected because they are amongst the first to be recognized by the EPA’s Emerging Viral Pathogens Guidance,4 or because they have demonstrated effectiveness against previous strains of coronavirus.
Why Emerging Viral Pathogen Guidance
The EPA developed and finalized this Emerging Viral Pathogen Guidance5 in 2016 as a result of growing public health concerns in the United States and globally about response to emerging pathogens, and the fact that pre-existing EPA-registered disinfectant product labels are not able to make any specific claims against a new and previously unidentified viral pathogen.
Because it is not possible to predict the occurrence of any particular emerging viral pathogen, and because any new pathogen is most likely unavailable for testing right away, few, if any EPA-registered disinfectant product labels have typically been able to specify use against a new category of infectious agents. And because testing the efficacy of an EPA-registered disinfectant against a new emerging pathogen can be difficult to accomplish in a timely manner, the Emerging Viral Pathogen Guidance was intended to allow for a more rapid response in the event of an outbreak.
The Emerging Viral Pathogen Guidance outlines a voluntary pre-approval process for making claims against emerging viral pathogens, and in the event of an outbreak, companies with pre-approved products can make off-label claims in technical literature, non-label-related websites, and social media.
Criteria for Disinfectants to Make Claims Against Emerging Viral Pathogens
In order to be eligible to be included on this list of disinfectants which can make claims against an emerging viral pathogen, the product should meet both of the following criteria:
Viral Subgroup Classification
This approach which considers the viral subgroup classification was taken because the EPA and the Centers for Disease Control and Prevention (CDC) recognize that certain microorganisms can be ranked with respect to their tolerance to chemical disinfectants. The Spaulding Classification Model7 is used by CDC and it tiers microorganisms in accordance with the level of resistance to being killed (or inactivated) by typical disinfectant products. With this approach viruses are divided into three viral subgroups based on their relative resistance to inactivation. According to this hierarchy, if an antimicrobial product can kill a small, non-enveloped virus, it should be able to kill any large non-enveloped virus or any enveloped virus. Similarly, a product that can kill a large non-enveloped virus should be able to kill any enveloped virus. As described in the EPA Emerging Pathogen Guidance to Registrants,5 here is an overview of the three viral subgroups:
Small Non-Enveloped Viruses: these viruses can be highly resistant to inactivation by disinfectants. Despite the lack of a lipid envelope, these organisms have a very resistant protein capsid.
Large Non-Enveloped Viruses: these viruses are less resistant to inactivation than small non-enveloped viruses. Although they have a resistant protein capsid, their larger size makes them more vulnerable to inactivation than a small non-enveloped virus.
Enveloped Virus: these viruses are the least resistant to inactivation by disinfectants. The structure of these viruses includes a lipid envelope which is easily compromised by most disinfectants. Once the lipid envelope is damaged, the integrity of the virus is compromised, thereby neutralizing its infectivity.
As summarized in an article in Infection Control Today,8 the general idea of the EPA’s Emerging Viral Protection Guidance is that in order for a disinfectant to be considered effective against an emerging viral pathogen, it must demonstrate efficacy – in other words, have an EPA-approved claim – against viruses that are harder to kill than the specific emerging pathogen in question.
The SARS-CoV-2 virus which is responsible for COVID-19 is an enveloped virus and therefore it is the easiest virus to inactivate. An EPA-registered broad-spectrum hospital-grade disinfectant with a claim against at least one large non-enveloped virus or one small non-enveloped virus can be expected to be effective at inactivating an enveloped virus.
Selecting the Right Disinfectant Product
As referenced on the EPA website,3 the List N: Disinfectants for Use Against SARS-CoV-2 is not an exhaustive list of disinfectant products which can be used to inactivate the new strain of coronavirus, “there may be additional disinfectants that meet the criteria for use against SARS-CoV-2”, and the EPA is expediting review of submissions to identify additional disinfectant products which can potentially be used due to the outbreak of the novel coronavirus.21
WAXIE has several disinfectant products which meet the criteria to qualify for the emerging viral pathogen claim for an enveloped virus, and several have been submitted following EPA’s guidance for expedited emerging viral pathogens claim submissions.9 In addition, there are several products which have already successfully gone through the process, and are currently recognized on List N: Disinfectants for Use Against SARS-CoV-2.
Confirming A Disinfectant Product Is On The EPA List N
Just to reiterate, at this time there is not a product which can make a specific claim to be effective against SARS-CoV-2, the virus responsible for COVID-19. However, as referenced before the EPA has published a list of disinfectants,10 also known as List N: Disinfectants for Use Against SARS-CoV-2, which meet the EPA’s criteria for use against this new strain of coronavirus based upon the disinfectant product satisfying at least one of the following two criteria:
This List N has been a helpful resource to identify disinfectant products which can be used as part of a cleaning and disinfecting regimen to combat the current pandemic. However, if the list on the EPA website is searched using the product name only (for example “WAXIE HP Disinfectant Cleaner” or even just “WAXIE Disinfectant”), it may appear that the product you are looking for is not included on this list. This circumstance can be a potential source of confusion and alarm, but please be aware that the easiest way to find a product on the list is to enter the first two sets of its EPA registration number in the search bar on the webpage in order to confirm whether or not a specific disinfectant is in fact on the list.
The EPA has provided the following guidance for consumers searching on List N, “When purchasing a product, check if its EPA registration number is included on this list. If it is, you have a match and the product can be used against SARS-CoV-2. You can find this number on the product label – just look for the EPA Reg. No. These products may be marketed and sold under different brand names, but if they have the same EPA registration number, they are the same product.”10
For example, the EPA Reg. No. for WAXIE HP Disinfectant Cleaner is “45745-11-14994”. Please see image below taken from EPA website displaying the search result for EPA Reg. No. “45745-11”, which is the first two sets of numbers in the EPA Reg. No. for this WAXIE brand product.
Please note that the “45745” in the EPA registration number is a reference to the company which provides the active ingredient used to make the disinfectant (in this case the active ingredient is “hydrogen peroxide”, and the company which makes this ingredient is “Midlab”), and the “11” is a reference to the specific product name or formula which is made using these raw materials (which Midlab calls “HP2O2”).
Other helpful information on this list on the EPA website includes guidance on what directions to follow when using the product – for example, for the WAXIE HP Disinfectant Cleaner, the applicable directions to use when trying to inactivate the SARS-CoV-2 virus would be the same directions on the master label to use to kill “Rotavirus; Norovirus; Rhinovirus”, with a recommended contact time of “5 minutes”.
Image: EPA Website, List N Search for WAXIE HP Disinfectant Cleaner
Reading A WAXIE Brand Disinfectant Product Label
For a list of WAXIE brand disinfectant products which are on EPA’s List N and their associated EPA registration numbers, please refer to COVID-19 Prevention Guide. Please note that the additional “14994” at the end of the first two sets of numbers of the EPA registration number for each WAXIE brand product is a reference to WAXIE’s sub-registration number for that particular product, and that in each instance the formula for the WAXIE brand product is the same as the formula for the master label which is included on the EPA List N.
To view this EPA registration number information on the WAXIE product label, please see example below for WAXIE HP Disinfectant Cleaner:
Image: WAXIE HP Disinfectant Label, WAXIE Item #170058
Please note that the EPA registration number for each disinfectant product is referenced on every label and secondary label for WAXIE brand disinfectant products, and this information may also be found when searching for each product in the WAXIE Product Catalog, as well as the WAXIE Online Catalog and the associated WAXIE Spec Sheets for each disinfectant.
In addition, your WAXIE Account Consultant or Chemical Specialist are also great resources to help answer any questions you may have regarding disinfectants, other cleaning chemicals, and hand hygiene.
Sources
The topic of COVID-19 has dominated the news and collective psyche of the world1 for the last several months – and it may be the height of understatement to say that this intense focus has had a dramatic and oversized impact on many of the facets of our everyday lives which we may have previously taken for granted.
In addition to the implementation of social distancing measures2 which have kept us separated and unable to enjoy many of the daily opportunities for interpersonal interactions we are used to being able to have with our friends, families, and neighbors, the COVID-19 pandemic has also shined a very bright light on the global supply chain3 and our collective ability to be able to source and buy the products which are typically viewed as basic staples of our everyday lives, as well as those supplies which we can all agree are needed by those responsible for facilities maintenance in the buildings where we work, learn, heal, and relax in order to combat this new viral threat.
According to a recent survey of businesses and their supply chains by the Institute for Supply Management,6 95% of respondents are expecting to be impacted by supply chain disruptions as a result of COVID-19, with 86% of respondents seeing longer lead times for products sourced from China, 74% seeing longer lead times for products sourced from Europe, and 34-44% seeing longer lead times for products sourced from North America.
And while the global supply chain has shown resiliency and the ability to overcome specific short term traumatic events in the past,7 it is fair to say that the supply chain was not built to successfully accommodate the level of disruption which is occurring today as a result of COVID-19.
Government lockdowns of countries, unavailable and/or sick factory workers, factory shutdowns, international border closings, decreased international shipments via ocean and air, immediate and dramatically huge surges in demand for products across many disparate product categories, international competition for finite product resources, panic buying, and product hoarding are all contributing factors to create a situation where product shortages within the supply chain can be expected to occur.
And since the supply chain has become so global, a worldwide event like COVID-19 is proving to have far- reaching impacts on product availability throughout the supply chain.
What is a “supply chain”, and what does it have to do with viral pathogens and facility maintenance supplies?
According to Investopedia, a supply chain4 is “a network between a company and its suppliers to produce and distribute a specific product to a final buyer...The supply chain also represents the steps it takes to get the product or service from its original state to the customer.”
In short, the supply chain is the process which is ultimately responsible for putting products on the shelves of grocery markets, big box stores, and wholesale distributors like WAXIE and others. In “normal” times, and prior to COVID-19, the global supply chain which has been developed over the course of the last several decades has shown itself to be extremely efficient at putting products where the need to be, when they need to be there, and at the lowest cost for all stakeholders.
Supply chain efficiencies have been improved by adopting just-in-time delivery. The practice of “just-in-time”5 delivery means that the individual components which will ultimately be combined to make a finished product arrive at the manufacturing plant shortly before they are needed in the assembly process. And as a result of this blend of meticulous forecasting, planning, and execution, products can be made and then purchased for lower prices, while simultaneously minimizing the expense and waste of holding excess inventory for manufacturers, wholesalers, and consumers alike.
Although there are always seasonal fluctuations and local market conditions to consider which may temporarily lead to some product scarcity, for the most part consumers in the U.S.A. have not been given a compelling reason in the recent past to have to think that hard about product availability. As a matter of fact, the average U.S. consumer has been conditioned by a plethora of recent purchasing experiences to expect to receive a product the next day, or at least very soon after placing an order for it.
However, COVID-19 has now given us a reason to think about the availability of products for consumers to purchase, the availability of products for wholesalers to sell, and the availability of raw material components for manufacturers to use to make the products which will ultimately go into the supply chain which serves us all.
Here in the United States, American shoppers and businesses have been stocking up on items such as face masks, gloves, hand sanitizers, disinfectants, and toilet paper (among other items), with the subsequent and ongoing demand consistently managing to successfully outpace available supply.
Since the start of the COVID-19 outbreak, severe and mounting disruptions to the global supply of PPE like face masks and gloves – caused by rising demand, panic buying, hoarding, and misuse – has left healthcare workers ill-equipped to care for patients, and has also led to a big surge in prices, according to the World Health Organization (WHO).8
One of the initial causes for this disruption in availability of PPE happened at the epicenter of the burgeoning pandemic, as the Chinese government moved to corner the global market9 for these products in early January and February, just as the world was beginning to fully grasp the extent of the new coronavirus threat.
It is estimated that from January 24 to the end of February, the Chinese government purchased over 2.2 billion face masks on the global market.9 Given the fact that over 50% of the global supply of face masks came from China before this pandemic crisis began in the first place, combined with the Chinese government commandeering all of their domestic production right away and then moving to purchase other available supplies from the rest of the world, followed by the ensuing competition between other countries for any remaining supply capacity once the virus began to spread throughout the globe, and it is easy to see in hindsight how there would now be a global shortage of PPE products like face masks.10
As this analysis is being written, availability of face masks has begun to increase slightly as China allows some excess inventory to be exported, and as additional manufacturing assets are being brought online throughout the world to increase production. Nevertheless, face masks are expected to continue to be in short supply in the coming months as governments and companies compete for a finite amount of available inventory.
Face masks are not the only PPE product to experience this shortage in supply – the product category of gloves has also seen a dramatic surge in demand in the U.S. and Europe as the COVID-19 outbreak has expanded from Asia and the eastern part of the globe to hit hard in the western part of the globe.
As a matter of fact, one of the largest glove makers in the world11 located in Malaysia has predicted an ongoing shortage as demand has increased more than 100% since the onset of the pandemic. Top Glove Corporation Bhd, which is responsible for approximately 20% of the total global production of gloves, has extended shipping times and increased capacity in an effort to cope with this surge in demand, according to executive chairman Lim Wee Chai.11
“Some customers panic order; normally they order 10 containers a month but now they suddenly increase to 20 containers,” Lim said. “Definitely there is a shortage. They order 100% more, we can only increase 20% so there is a shortage of about 50% to 80%”.11
To add an additional complication to this surge in demand, the entire country of Malaysia, where a large percentage of the world’s nitrile gloves are made, was on lock down by their government until April 14.12 Although many companies which manufacture gloves in this country have been allowed to have employees come back to work, conditions there remain challenging to achieve maximum manufacturing efficiency and output, and it is estimated that factories are only producing at around 50% capacity at this time.
And for a product category where purchase orders are typically placed with manufacturers in Asia three months prior to eventual delivery in the U.S., it will take some time to rebuild the domestic safety stock which has supplied and sustained the first wave of demand in Q1 2020 for healthcare facilities and other JanSan companies.
As this analysis is being written, availability of gloves is expected to continue to be tight for the next several months as factories in Asia ramp up production to respond to the surge in demand, and as international, national, and state governments as well as the private sector compete on the open market for a finite amount of available inventory.
Availability of hand sanitizers and disinfectants has also been dramatically impacted by this surge in demand. According to Adobe Analytics (as attributed in a recent article in Bloomberg Business Week),13 demand for PURELL® hand sanitizer from GOJO Industries spiked 1400% from December to January, and has not shown any signs of letting up since.
The demand for these categories of types of products has spiked so much that manufacturers are saying that current stockpiling is “more frenzied than that which occurs before a natural disaster”.13 According to Rick McLeod, Vice President of Product Supply for Procter & Gamble Co.’s Family Unit, “What’s different here is that it’s not as concentrated as you would see in a hurricane response – it’s obviously more widespread.”13
As a matter of fact, the surge in demand has been so extreme during this time period, the U.S. Food & Drug Administration (FDA) has even taken the extraordinary step of issuing guidance for the temporary manufacture of certain alcohol-based hand sanitizer products by manufacturers who don’t typically make this product in an effort to help boost supply to protect public health.
“We are aware of significant supply disruptions for alcohol-based hand sanitizers. Many manufacturers make hand sanitizers, and several have indicated that they are working to increase supply,” said FDA Commissioner Stephen M. Hahn, M.D. “In the meantime, these guidances provide flexibility to help meet demand during this outbreak. We will continue to work with manufacturers, compounders, state boards of pharmacy, and the public to increase the supply of alcohol-based hand sanitizer available to Americans.”14
Using this guidance from the FDA, and with a waiver from the Alcohol and Tobacco Tax and Trade Bureau which allows distilled spirit makers to produce hand sanitizer, several companies from the alcoholic beverage industry15 have started to pitch in and produce hand sanitizers from denatured raw alcohol, glycerin, and hydrogen peroxide. But the alcohol industry is seeing shortages in raw materials they will need as well.
The demand for hard surface disinfectants – both chemicals and wipes – has also led to raw material shortages. Manufacturers report seeing supply interruptions for items such as the polypropylene material used to make wipes – ironically, it has been reported that some of this raw material is being diverted from the production of wipes to the production of face masks.
In addition, some of the ingredients needed to make quaternary ammonium-based disinfectants stopped arriving from China in March,15 and as a result, manufacturers of quat-based disinfectants report that there will potentially be a shortage of finished products through the months of May and June at a minimum. As if these shortages in quat weren’t enough, bottles and packaging are also concerns, and even if a manufacturer can find itself with enough chemical ingredients to make a batch of disinfectant, it is possible to not have enough bottles and packaging to make a finished product which can be ready for shipment to consumers.
As this analysis is being written, availability of alcohol-based hand sanitizer and quat-based disinfectant products (both chemicals and wipes) are expected to continue to be difficult for the next several months through at least June. Other options to consider during this time include hydrogen peroxide-based disinfectant products and bleach-based disinfectant products, although each of these products is also subject to allocation.
Many articles have been written about the psychology behind the huge surge in demand for toilet paper in response to the coronavirus pandemic.16 Needless to say, there has been an enormous uptick in the amount of toilet paper being purchased over the course of the last several months, and the companies who manufacture this product are still playing catch up so that they can refill the supply chain.
According to NCSolutions,17 a data and consulting firm quoted in an article in the New York Post, online and in-store sales of toilet paper rose 51% between February 24 and March 10, as consumers began to grow concerned over the rising number of COVID-19 cases. And when several states announced lockdowns on March 11 and 12, sales skyrocketed 845%.17 Needless to say, this surge has led to shortages.
Although not a frequent occurrence, there have been toilet paper shortages before.
Some notable examples include the months-long toilet paper shortage in Hawaii in July 1971,18 when a strike by the International Longshore and Warehouse Union shut down every dock on the West Coast, which in turn led to the ceasing of shipments of a variety of goods including toilet paper. The shortages lasted for months, and left such a lasting impression on the Islands that there was a run on toilet paper in stores across the state when there were concerns that there would be another strike in 1999, and again in 2002 during a dock worker lockout.18
And late night king Johnny Carson caused a toilet paper scare on December 19, 197319 after delivering his monologue on the “Tonight Show” when he said, “There is an acute shortage of toilet paper in the good old United States. We gotta quit writing on it!” It turns out his writers had been misinformed about a shortage, but the damage was done – the resulting excessive demand at retail outlets caused by the monologue led to an actual shortage, and the need to implement an allocation system for the national distribution of toilet paper.19
And while there are some differences between the most recent shortages of toilet paper caused by COVID-19 and shortages caused by other reasons in the past, the similarities are that once consumers begin to feel uneasy about availability of product and the panic buying begins, it is difficult for the toilet paper supply chain to keep up with demand right away.
In “normal” times, toilet paper flows from paper mills to retail stores and wholesale distributors through a tight and efficient supply chain, and retailers typically receive frequent shipments to restock their inventory to satisfy a relatively predictable demand. The amount of toilet paper the average American uses has remained constant for many years (around 141 rolls per year, according to AlixPartners, a consulting firm quoted in an article in the New York Post), and even small changes in buying habits can throw everything into disarray, let along big changes such as those which have been associated with COVID-19.17
Why don’t the toilet paper companies just make more?
The reality is making toilet paper is a lower-margin business proposition, and in order to make a profit, the big three U.S. toilet paper companies – Georgia-Pacific, Proctor & Gamble, and Kimberly-Clark – were already running their toilet paper plants 24 hours a day before this new coronavirus pandemic hit.17 In an effort to increase total output during this surge in demand, these manufacturers are making fewer varieties of toilet paper to avoid the down-time which is associated with changing machines to produce a different product SKU.
As this analysis is being written, availability of toilet paper is expected to increase in the coming weeks and months. The good news is that consumer demand is beginning to level off, and more toilet paper is being made and is on its way to grocery stores and wholesale distribution warehouses every day.
Sources:
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WAXIE Sanitary Supply
9353 WAXIE Way
San Diego, CA 92123
(800) 995-4466
© 2021 WAXIE Sanitary Supply, An Envoy Solutions Company. All Rights Reserved.