Published on 14 June 2018
- SAFE SURGERY: RISK OF GLOVE PERFORATION DURING SURGERY
- Self-Assessment and Segregation of HIV-Infected Surgeons to HIV-Infected Patient Groups
- SAFE INCARCERATION: MITIGATING HIV / AIDS ‘BLOOMS’ IN PENAL INSTITUTIONS
- COMPARISON OF SURGICAL GLOVE PERFORATION STATISTICS TO STATISTICS ON CONDOM BREAKAGE
- RISK MITIGATION THROUGH DOUBLE BAGGING
- Glove Perforation Risk Mitigation by Double Bagging During Surgery
- Risk Mitigation by Double Bagging Condoms During Sexual Intercourse
- THE IMPORTANCE OF SLOWING DOWN THE COURSE OF A PANDEMIC
- Uninfected Children Can Help Strengthen the Workforce of the Next 5 Decades
- Are HIV-Positive Newborns Who Are Resistant to HIV Being Born Worldwide?
- Insurance Availability of Voluntary Annual HIV Testing in the United States
- Nurturing HIV-Positive Newborns Who Are Resistant to HIV Will Strengthen Our Gene Pool
- ATTENUATION: THE NORMAL COURSE OF A PANDEMIC
- Mortality Rate During the 1918 Flu Pandemic, Compared to the 2009 Swine Flu Pandemic
- Pandemics: A More Benign Infecting Agent Over Time? Or a Stronger Human Gene Pool?
SAFE SURGERY: RISK OF GLOVE PERFORATION DURING SURGERY
A while ago I did a blog on the effectiveness of surgical gloving in preventing blood taint during surgeries …
Link: “Overview of Surgical Risk, HIV / AIDS, Hepatitis, and Hard Drugs,” by Alice B. Clagett, updated on 6 July 2017; originally published on 17 October 2016, https://wp.me/p2Rkym-6gY ..
Here is the paper that was reviewed in the blog …
Link: “Occult Glove Perforation during Ophthalmic Surgery,” by Leonard Apt, MD, and (by invitation) Kevin M. Miller, MD, http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC1298427&blobtype=pdf ..
In the paper, if I understand it correctly, Drs. Apt and Miller found a 15.0% incidence of surgically induced glove perforations over 7 months.
In other words, if there is a 15% chance that a doctor’s surgical gloves might be perforated in 7 months, then there is a 15% chance of blood tainting during a medical procedure that involves exposure to a patient’s blood while it is in his or her body. According to the laws of probability, as I understand it, that would be a 15% chance of virus transmission with each surgery.
Self-Assessment and Segregation of HIV-Infected Surgeons to HIV-Infected Patient Groups
From this I deduced the possible danger to doctors of their being infected with HIV or hepatitis while they were wearing surgical gloves while doing operations. This then, might be a source point for HIV / AIDS ‘blooms’ as the pandemic progresses, unless the medical self-assesses and limits surgeries by infected surgeons to infected patient groups.
SAFE INCARCERATION: MITIGATING HIV / AIDS ‘BLOOMS’ IN PENAL INSTITUTIONS
As an aside, I feel that the incidence of HIV / AIDS ‘blooms’ in penal institutions … correctional facilities or prison … might be mitigated in a similar manner; that is, if correctional institutions self-assess and limit policing by infected correctional officers to infected groups of prisoners. The possibility of a correctional facility HIV / AIDS ‘bloom’ has to do with the practice of rape in these facilities, whether among prisoners, or by correctional facility officers. Prison rape is a practice just now beginning to be brought to light and figured into the pandemic equation.
COMPARISON OF SURGICAL GLOVE PERFORATION STATISTICS TO STATISTICS ON CONDOM BREAKAGE
To return to the article by Drs. Apt and Miller: That article got me thinking about how that finding might apply to the wearing of condoms during sexual intercourse. I think that there’s some congruence there.
Other factors being equal, might it be that wearing a condom during the act of sex might incur a 15% chance of HIV, hepatitis, or other virus transmission with every act of sexual intercourse? I’ve read an article by Planned Parenthood that supports this …
Link: “What are the chances of getting pregnant with a condom?,” by Emily @ Planned Parenthood, 18 December 2017, 9:13 p.m., https://www.plannedparenthood.org/learn/teens/ask-experts/what-are-the-chances-of-getting-pregnant-with-a-condom ..
According to the article, among heterosexual couples where the man uses a condom during sexual intercourse, 18 in 100 of the women will become pregnant each year.
Among heterosexual couples where the woman uses a female condom, 21 in 100 women yearly will become pregnant.
Thus there is an 18% or 21% ‘ineffectiveness’ rate through condom use amongst heterosexual couples yearly. This figure is reasonably close to the 15% ‘ineffectiveness’ factor found by Drs. Apt and Miller for surgical glove protection.
Thus, we might extrapolate that a 15% to 21% annual effectiveness rate for prevention of STD virus transmission might be attained by using condoms, whether M2F, M2M, or F2F.
In other words, 15% to 21% of people using condoms for ‘safe sex’ might be anticipated to contract HIV or hepatitis annually, if their partner is infected.
RISK MITIGATION THROUGH DOUBLE BAGGING
Glove Perforation Risk Mitigation by Double Bagging During Surgery
The study by Drs. Apt and Miller discussed at some length the advantages of wearing two pairs of surgical gloves during surgery … of ‘double gloving’. Their retroactive findings were interesting, but inconclusive. One of the factors that needed to be looked at in future studies was correlation of location of punctures in inner and outer gloves worn during surgery. Were these to correlate … in other words, in cases of perforation of both gloves at one location … then, most likely, the risk of viral transmission, in cases where either the surgeon or the patient is infected, would be greater.
Then, in surgical cases, much might depend on the type of surgery being performed. For instance, hip arthroplasties … that is, total hip replacement surgeries … there is rough work involved. These surgeries must be done by physically strong surgeons. Manipulation of the joints may, I feel, result in greater likelihood of glove puncture. That is just my thought on it, without my doing any research on it. So it seemed to me that studies ought to be planned regarding correlation of location of punctures in inner and outer gloves worn during these types of surgery.
Risk Mitigation by Double Bagging Condoms During Sexual Intercourse
Wikipedia states that ‘double bagging’ … using two condoms instead of one … offers greater protection …
“‘Double bagging’, using two condoms at once, is often believed to cause a higher rate of failure due to the friction of rubber on rubber. This claim is not supported by research. The limited studies that have been done found that the simultaneous use of multiple condoms decreases the risk of condom breakage.” –from “Condom,” in Wikipedia, https://en.wikipedia.org/wiki/Condom … CC BY-SA 3.0
Planned Parenthood has more to say on this …
Link: “The Truth about Condoms,” by Planned Parenthood, July 2011, https://www.plannedparenthood.org/files/9313/9611/6384/truth_about_condoms.pdf ..
Under the subheading “Double Bagging,” they mention that three studies indicate double bagging … wearing two condoms … is effective in decreasing the risk of condoms breaking. One of the studies stated that double bagging decreased the risk of HIV transmission from 1.8% to only 0.2%. The study in question was …
Citation: ” Multiple Condom Use and Decreased Condom Breakage and Shippage in Thailand,” by Rugpao, Sugwal, et al., February 1997, in Journal of Acquired Immune Deficiency Syndrome
and Human Retrovirology,14(2), 169–173.
That would mean that single bagging results in a 98.2% effectiveness (that is 100% less 1.8%), and that double bagging results in 99.8% effectiveness (that is, 100% less 0.2%), as to the risks of condom breakage during sexual intercourse.
What do these percentages mean, in terms of the probability of HIV transmission? If the risk of condom breakage decreases from 1.8% to 0.2% with double bagging, then the risk, with double bagging, is only 10% as great as with single bagging.
Planned Parenthood translates 98% effectiveness as meaning, in a practical context, that 18% of heterosexual women using condoms will become pregnant each year. Were this risk to be 10% as great, then, presumably, only 2 women in 100 would become pregnant annually.
This pregnancy rate presumably correlates to condom breakage or slippage; thus the statistics might also apply to transmission of HIV and hepatitis. What we have then, is a potentially very significant mitigation of the rate of transmission of HIV and hepatitis through double bagging during sexual intercourse.
THE IMPORTANCE OF SLOWING DOWN THE COURSE OF A PANDEMIC
Slowing down the course of the HIV pandemic is important, both in terms of mitigation of human suffering, and also in terms of stabilization of the work force, and of available manpower, so as to keep our economy as strong and healthy as that of other nations, all of which are being impacted by the HIV / AIDS pandemic.
Uninfected Children Can Help Strengthen the Workforce of the Next 5 Decades
The more we are able to slow down the course of the pandemic, worldwide, the greater will be the numbers of uninfected children born to the upcoming generation. These children, along with people now adults and uninfected, will strengthen our workforce during the next 5 decades.
Are HIV-Positive Newborns Who Are Resistant to HIV Being Born Worldwide?
Slowing down the course of the pandemic will also allow the human gene pool a ‘leg up’ in the natural course of selecting for a population that is resistant to HIV. More and more babies are being born already infected with HIV. The scant literature on mortality rates leans toward these babies not surviving to adulthood; but the truth is, data on this topic are woefully inadequate, as yet.
For instance, it is possible that babies are being born in the world today, who have the HIV infection. But because they appear to be perfectly normal, no one knows that they carry HIV. This might be the case, for instance, in Africa, where health care resources are less available.
Insurance Availability of Voluntary Annual HIV Testing in the United States
It might also be the case here in the United States, where annual HIV testing … though paid for by Medicare and other government programs … is seldom taken advantage of. This is most likely due, I feel, to backwardness of physician guidelines regarding the HIV pandemic. That would be easy to fix, though, by updating physicians on the advisability of annual HIV testing, and of testing newborns for HIV.
Nurturing HIV-Positive Newborns Who Are Resistant to HIV Will Strengthen Our Gene Pool
Thus it is possible that children are being born, here in the United States, and also worldwide, who are resistant to the HIV virus; who are able to lead healthy lives, and to bear healthy children. On this very likely possibility, it would be wholly inadvisable to react to the birth of HIV-positive children in our hospitals, with a policy of euthanasia. This type of policy would place our nation at a disadvantage, as regards other nations, in birthing a generation of children who have HIV, but are naturally resistant to the virus.
Putting the breaks on the rate of the pandemic … through double bagging, through voluntary annual testing and voluntary testing of newborns, and also through education on the risks and rewards of various sexual lifestyle choices … will allow the United States time and resources to nurture HIV-positive newborns, rather than making the short-sighted choice to euthanize them as a cost-saving measure.
These will be children who will be able to bear viable children, despite the infection, in years to come. Thus, slowing down the course of the pandemic will allow our human gene pool a ‘leg up’ in the natural course of selecting for a population that is resistant to HIV.
ATTENUATION: THE NORMAL COURSE OF A PANDEMIC
Mortality Rate During the 1918 Flu Pandemic, Compared to the 2009 Swine Flu Pandemic
We can expect that the HIV of future generations will be much different from the HIV of today. Such was the case with the influenza epidemic of the early 1900s … In the 1900s, the flu was very deadly, striking down one in every 10 to 20 people …
“The global mortality rate from the 1918/1919 pandemic is not known, but an estimated 10% to 20% of those who were infected died. With about a third of the world population infected, this case-fatality ratio means 3% to 6% of the entire global population died.” –from “1918 Flu Pandemic,” in Wikipedia, https://en.wikipedia.org/wiki/1918_flu_pandemic … CC BY 3.0
Yet today, many people successfully survive infection with influenza. For instance, in the 2009-2010 Swine flu … H1N1 … pandemic, 1 in 5 people were infected, but the mortality rate was only 0.2% …
Link: “Swine flu infected 1 in 5, death rate low, study shows,” by Kate Kelland, 25 January 2013, https://www.reuters.com/article/us-flu-h1n1-pandemic/swine-flu-infected-1-in-5-death-rate-low-study-shows-idUSBRE90O0T720130125 ..
Pandemics: A More Benign Infecting Agent Over Time? Or a Stronger Human Gene Pool?
As I understand it, this is the normal progress of a pandemic: Those who are genetically most susceptible to the infecting agent are likely to pass on, in either the first or the second generation of the pandemic. Others, with genes more capable of withstanding the impact of the infecting agent, survive. The result, over time, is a gene pool more capable of resisting the impact of the infecting agent.
From our human standpoint, over time, it appears that the infecting agent has become more benign. But in fact, it is our human gene pool that has become more viable.
This is the normal course of pandemics in human populations. Were we to look at the course of pandemics in domestic animal populations, we would most likely find correlation.
In love, light and joy,
I Am of the Stars
Link: “Overview of Surgical Risk, HIV / AIDS, Hepatitis, and Hard Drugs,” by Alice B. Clagett, Updated on 6 July 2017; new text is in green font; originally published on 17 October 2016, https://wp.me/p2Rkym-6gY ..
Except where otherwise noted, this work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
HIV, HIV pandemic, AIDS, AIDS pandemic, economic, work force, manpower, safe surgery, safe sex, surgical glove perforation, safe incarceration, HIV blooms, AIDS blooms, penal institutions, correctional facilities, prisons, condom breakage, double bagging, HIV-positive newborns, HIV-resistant children, 1918 Flu pandemic, 1918 influenza pandemic, 2009 swine flu pandemic, H1N1 pandemic, pandemic attenuation, viral attenuation, gene pool, viable gene pool, genetic, correctional system,