Too Many Gloves, Not Enough Love

This week, I was driving down Pico, and it was one of those annoying short trips where I hit every red light along the way. It doesn’t even seem possible sometimes to get that unlucky, but we’ve all been there – just as your light becomes green, you see the next one turning yellow. This gave me a lot of time to watch people on the sidewalk, and more specifically, people entering and leaving stores. Here’s what I saw at one of the popular kosher markets on Pico during a sixty second stretch, with no need for me to exaggerate:

• • 5 people waiting in line to enter the store, all wearing gloves.
  • 1 employee standing guard, also wearing gloves.
  • 2 people leaving the store, each wearing gloves as they walked away.

Let’s analyze these eight people during the one minute I was sitting at the light. Their ages ranged from twenty something to seventy something. None appeared to be from the same family unit.

The ones entering the market were patiently waiting in line to be let in, like they were next on Disney’s Space Mountain. As they stood there looking bored, not one of them was waiting to put on the gloves last minute as they entered. They simply had them on. Two of the five were talking on their cell phones while waiting, holding the phones with their gloves. One of those same five was picking the underwear out of his buttocks, while wearing the gloves. The employee who was controlling the line was holding a walkie talkie or an old phone (it was hard to exactly see) and repeatedly touched parts of his body and equipment as he did his job…with gloves on. And the two people leaving each kept them on as they grabbed the door to exit, and kept walking away with the gloves still on as far as I could watch; and one of them was a lady who brushed her hair away from her eyes – with the used glove still on.

If this was an elementary school, this story would make an easy teaching tool. “Hey kids, how many mistakes can you find in this scene? Was the man touching his bottom with gloves on being clean? That’s right Timmy, he wasn’t! What about the lady leaving the store touching her hair? That’s right Sally, she was making things worse too!” But sadly, these are all adults, and although no doubt each person feels confident they will be the exception who wears them “properly” in public, I continued down my depressing Pico Boulevard road trip, and passed 3 other markets and 2 banks; each and every one of them involved people wearing gloves inappropriately. That may have been a relatively small sample size, but it is highly indicative of a growing public health concern in our society, that will only worsen this already tragic pandemic.

When I interviewed Lakshmy Menon, the response was phenomenal. By far the most viral (no pun intended) story I’ve ever reported, countless people told me that even though everything is still scary, just understanding things better gave them a sense of calm that they did not previously have. She gave many explanations, and many recommendations, and none were answered as bluntly as the following:

Boaz Hepner – When should people be wearing gloves in public?

Lakshmy Menon, MPH, Epidemiologist, Infection Preventionist, and CDC Health Scientist 2008-2015 – It is never appropriate to wear gloves in public. It’s not appropriate, ever. Because those gloves are dirty and everywhere you go, everything you touch you end up spreading everywhere else you go and touch. Things will stick to gloves even more than hands, and they should not be wiped down and cleaned like hands; so using gloves on more than one surface is dangerous. People gain a false sense of security as a result of having them on and are truly putting themselves and others at more risk because of this. Please never wear gloves in public — just wash your hands before touching your face or eating.

Each of her recommendations were in line with the CDC, the WHO and the Department of Public Health. This one was a simple question with a simple answer. Sure, as data is collected, some recommendations might change. Case in point, the general public was told not to wear a mask if they were symptom-free, and technically that has not changed; people are now told to wear a face covering in many situations. The purpose behind people not wearing masks when asymptomatic was in large part due to the shortage of masks for health care providers who need it far more. So thus they changed their recommendations, and still requested that the symptom-free general public not wear masks, and instead send those masks to health care workers; and when being in public spaces where social distancing is not easily possible, such as markets and pharmacies, to use what they refer to as face coverings.

Back to the matter at hand. The recommendation for gloves was always, and continues to be a matter not of supply, but actual public health safety. It is highly unlikely for any person to use gloves while shopping in a way that makes things safer for them and others rather than simply using their bare hands. The WHO found this so important, they even created a simple infographic about it:

But then, a few days later the trouble started to trickle in. First I was sent a notice that a Jewish health agency sent out, full of solid recommendations, but one of them included wearing gloves. Soon after I was sent an email from a popular kosher LA market giving a new set of safety rules for shopping there, and one of them was – you guessed it – customers must wear gloves. This was bad. Where was this info coming from? It certainly was not and is not from the Department of Public Health, it was not from the CDC, and it was not from the WHO, but a new bad precedent was being set. I found email addresses for both places, and sent messages about their glove and masking policies/recommendations. I must add that twenty-four hours later the face covering recommendations were released, so that aspect was now a moot point, but the gloves were and continued to be the main issue at hand (no pun intended again). No response from either place. I included links and explanations to both stating that in their sincere efforts to make the public safer, they were going against official recommendations. No response.

So I tried another way. On April 1^st a long email chain was born. I contacted my friend at the Mayor’s office, who connected me to someone else in the Mayor’s office, who referred me to someone at the County Supervisor’s office, who referred me to someone specific at the Department of Public Health. Phew. On April 7^th, I finally heard back from the appropriate person at the Department of Public Health. She was very nice, and told me that she personally worked as the point person for that market that had sent out the “Please wear gloves” email. But here is where the red tape began. She told me she was well aware that although some employees must wear gloves, that customers from a public health standpoint should not. But she also said that she and her department could only enforce policy if it was specifically ordered by the Health Officer, and that she was aware of them not being a fan but that it wasn’t enforceable. She told me however, that she would be happy to call that store and tell them the “recommendations”. By April 7^th though, the stores telling their customers to wear gloves were multiplying like Gremlins getting wet; this incorrect practice was being copied like wildfire. She also advised me to call the Department of Consumer & Business Affairs to try to get this policy changed so she COULD enforce it, and also to call back her own Department of Public Health to tell them about other locations that were out of her jurisdiction.

So first I called back her department where they told me they don’t inform businesses what to do unless it’s ordered policy, and don’t follow the CDC or WHO; and this person in particular actually told me, “I thought people are supposed to wear gloves in the stores, I see that all the time, isn’t that right?” My God, someone at the Department of Public Health was asking me?! Then I called Consumer & Business Affairs where I had the following chat that I still can’t believe was real:

Me – I was referred to you by someone at Public Health. I’m an RN and I recently published an interview for the Jewish Journal about COVID-19, and

Her – Wait, you’re a reporter? I’ve got a story for you!

Me – Umm, I’m a blogger, and I don’t know if–

Her – Okay, just listen. So people call here all the time. I’m just a lowly clerk, but just last week this guy called and reported that the place he’s renting has an owner who is thinking of selling the property now, and wants to show the property right now. He calls me and says that he doesn’t feel safe with the landlord and other people coming into his place right now when he’s social distancing and he hasn’t let anyone come over. I took the report. Then this week I get a call back from the same guy, and I remembered him right away because he’s really scared of people coming to his house, and he tells me the story again, and I tell him I remember because it was me who talked to him last time – what a coincidence! And he says, okay, but now they called him back and said there’s nothing they can do about it because it’s clearly not safe for others to come but there are no laws specifically to address his situation. It’s like, here we are with big new changes but there’s a ripple effect of things that are affected and no change in regulations for each thing. So he’s calling me freaking out that he has no legal right to stop them from entering the house and walking all over the place, and I told him, “Honey, sometimes in life you have to think outside the box. What I would totally do in your shoes is leave a note on your door that you’re sick, coughing, running a fever, and under social isolation self-quarantine”. And then I bet they won’t want to come in, even though they legally can. And he said, “I can really do that?” and I said, “It’s not official policy, but that’s what I’d do!” and he was so thankful! So what I’m saying is, sometimes we have to think outside the box because there’s a lot of things missing in policies that haven’t been addressed.

Me – Wow, amazing story, and kind of fits in the bubble of what I’m calling about, something that there is no Health Officer policy for yet and needs to be.

Her – That’s right, thank you for calling!

Me – Wait wait, I didn’t even get to talk yet and tell you my situation.

Her – Whatever it is, you have to think outside the box.

Me – I get that, but I need to tell you what it is to see if a process can begin to notify the right people that this is happening without a policy in place.

(I then gave her a brief description of the glove situation.)

Her – Wait, you shouldn’t wear gloves in the store? I didn’t know that!

(She then spent the last 5 minutes of this call asking me questions about ways she could be safer in public. And told me that the only way to get policy changed is to contact my district’s “Board of Supervisors who meet every Tuesday, and ask them to start a process to make this policy”.)

That gloriously ridiculous phone call was somehow completely useless but yet also quite telling of the larger problem. The WHO and CDC give strong recommendations, the Department of Public Health creates policies based on those recommendations, epidemiologists and infection control specialists and hospitals generally follow these policies, but any of the details missed simply fall through the cracks. The man who on a normal Sunday would be obligated to allow his landlord to show people around his place had no new recourse other than pretending to be sick. And the public health officials in the city are a mixture of either being unaware about the recommendations of gloves, or fully aware and yet hands tied until policy is in place. Red tape wins again.

So here we are, a week after the first kosher market enforced a glove-only policy, most of them have now done the same, and let’s be honest, most stores and supermarkets may not have that unhealthy policy, but oh-so-many customers are doing it anyway. And touching their phones. And their faces. And 100 items on the shelves. And their phones. And their faces. And their wallets. And the door handles. And the steering wheels.

Many of you are still wondering, okay I still don’t get it, don’t gloves protect me and my skin if I’m more careful? Let me tell you another story. Early on in my nursing career, my hospital gave us a helpful exercise. They gave us a liquid solution that could only show up in black light, told us to put on gloves and start by “contaminating” one of the gloves by touching this invisible solution. Think of it as fecal matter. Or a virus. They turned on the black light to show that the room was clean other than our glove. Then, rather than immediately taking off that one contaminated glove, they told us to really carefully do a few other basic tasks in that pretend “patient room”. After two or three minutes, they yelled “stop” and turned on the black lights. None of us had kept even mildly contained. It was now on the mannequin, the bed sheets, the equipment, and in about half of the cases, on our faces and scrubs, and in almost ever case on our clean glove hand. We then removed our gloves and lo and behold the solution had also gone through the gloves in some cases, and needed to be washed off of our hands underneath. We were a combination of new and experienced nurses, but the results were the same. People put on gloves and feel safer. They feel like the glove is their safety net. They stop thinking. They stop trying. Those who do try, as we certainly were for those two or three minutes, STILL don’t succeed. And a typical shopping experience is far more than two or three minutes, and your hands are touching far more things. Our hands were still dirty underneath in some cases because gloves are porous. They protect but only to a degree; when we remove them we STILL need to use hand hygiene and disinfect and assume we were not fully clean. They tear easily. They cannot be disinfected. I repeat you are not supposed to ever take disposable gloves and wash or disinfect them like other materials.

What you should be doing at the store is bringing hand sanitizer as a backup so that you can perform hand hygiene; many markets have a hand washing station. Put your phone away. Wash or disinfect when you begin. As soon as you start touching anything within the market, remember you are now dirty, so do not touch your face, your phone, or anything but more dirty products. If you ever get to the point where you feel the need to touch your face, or pick up your phone, or your purse, do hand hygiene first. Then continue, and rinse repeat. When you leave the store, immediately perform hand hygiene again. Be conscious of all of these actions. People who do this without gloves have been proven to be more careful with all of this. It is on your skin, it is more visceral. You do not feel that false sense of security. And when I’m at the store I will wash my hands with their water or hand sanitizer a few times from the start to finish. The people who enter the store with gloves and leave with those same gloves have touched exponentially more things since the time they first touched a contaminant. Their spread is simply far greater than the person without the gloves.

Yes I understand that there are plenty of individuals who claim wearing gloves makes them more conscious and careful, but that is not what the evidence has shown. That is not what a room full of nurses were able to demonstrate. What makes so many people think they can outsmart the research?

But, if you are one of those stubborn individuals who continue to insist on incorrectly wearing gloves in public:

-Write your grocery list down on a piece of paper so you do not have to touch your phone.

-Put away your phone and wallet/purse somewhere you will not touch until necessary.

-Wash your hands or use hand sanitizer upon entry.

-Put on the gloves (but do not put them on until entering the store).

-Do your grocery shopping, while consciously NEVER touching your face, phone or anything unnecessary.

-If needing to pick up phone, wallet, purse, touch face, or noticing a tear in the gloves, remove them immediately, and fold inward, and dispose safely in trash can, and perform hand hygiene all before actually touching your face or anything.

-Then put back on new set of gloves and continue with those same steps.

-When checking out, throw away your grocery list; then once again follow steps to remove gloves safely and perform hand hygiene so you can touch your purse/wallet. Perform hand hygiene again and go to car.

Ideally remove every step I mentioned gloves and simply do the hand hygiene in between, and touch things with your bare hands, but as you can see, if you insist on not following recommended practice then major adjustments must be made – because I assure you that almost nobody who is using gloves is following all of those steps each time. And the virus is being spread far more as a result, if not to your own face and belongings, than certainly to others.

And my greatest wish for anyone reading this, in addition to changing many of your own health practices, is that if you know any of the ownership or management of any markets and stores that are still open, please share this article with them and encourage the changes to come from them. Because it seems nobody will force them to, but given that they are trying to help, point them in the safer, correct direction. Right now I am avoiding shopping at places that require me to put myself and others at risk with gloves, but soon I fear they will all do the same, and I will have no choice, so let’s get this fixed now, please.

Boaz Hepner is a registered nurse in Santa Monica. He grew up in LA in Pico/Robertson and now lives here with his wife and baby girl. Thus, the neighborhood is very important to him. He helped clean up the area by adding dozens of trash cans that can still be seen from Roxbury to La Cienega. When he is not working, he can be found with his wife and daughter enjoying his passions: his multitude of friends, movies, poker and traveling.