CE INSTITUTE LLC BLOG

Posts in the COVID-19 category

Antiseptics versus Disinfectants - What's the Difference?

Antiseptics versus Disinfectants - What's the Difference?

Author:  Selena Belisle, Founder/Instructor, CE Institute LLC, Miami FL 

 

Antiseptics: are germicides applied to living tissue and skin.  You can use an antiseptic on yourself (or others) to try to kill germs.

Disinfectants: are antimicrobials applied only to inanimate objects.  You can apply disinfectants to objects or surface areas to try to kill germs (you should always clean prior to disinfecting an object or area).  Disinfectants are not made to apply to a human body.  You should use gloves when handling disinfectants.

In general, antiseptics are used only on the skin and not for surface disinfection, and disinfectants are not used for skin antisepsis because they can injure skin and other tissues.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Author Selena Belisle is the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

Hand Hygiene for Massage Therapists in Times of COVID-19

Hand Hygiene for Massage Therapists in Times of COVID-19

Author:  Selena Belisle, Founder/Instructor, CE Institute LLC, Miami FL

Here are Five Steps from the CDC on how to Properly Wash Your Hands [i]

Washing your hands is easy, and it’s one of the most effective ways to prevent the spread of germs. Clean hands can stop germs from spreading from one person to another and throughout an entire community—from your home and workplace to childcare facilities and hospitals.

Follow these five steps every time:

  1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails
  3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  4. Rinse your hands well under clean, running water.
  5. Dry your hands using a clean towel or air dry them.

Here/below is a diagram that shows areas that are commonly missed when using hand sanitizer, and areas that should receive extra attention when handwashing:

 

Use Hand Sanitizer When You Cannot Wash with Soap and Water

You can use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.

Washing hands with soap and water is the best way to get rid of germs in most situations. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. You can tell if the sanitizer contains at least 60% alcohol by looking at the product label.  

Sanitizers can quickly reduce the number of germs on hands in many situations. However:

  • Sanitizers do not get rid of all types of germs.
  • Hand sanitizers may not be as effective when hands are visibly dirty or greasy.
  • Hand sanitizers might not remove harmful chemicals from hands like pesticides and heavy metals.

How to use hand sanitizer:

  • Apply the gel product to the palm of one hand (read the label to learn the correct amount).
  • Rub your hands together.
  • Rub the gel over all the surfaces of your hands and fingers until your hands are dry. Use plentiful product – your hands should remain wet for at least 20 seconds until they are dry.

 

In addition to regular hand hygiene practices, during the COVID-19 pandemic, you should also clean hands:

  • After you have been in a public place and touched an item or surface that may be frequently touched by other people, such as door handles, tables, gas pumps, shopping carts, or electronic cashier registers/screens, etc.
  • Before touching your eyes, nose, or mouth because that’s how germs enter our bodies.

Sometimes massage therapists use their forearms and elbows in massage.  Any area of a therapist's body that is used during massage should be washed or sanitized before and after working on each client.

Hand hygiene is critical during this COVID-19 pandemic, where commonly spread respiratory droplets can cause serious disease.  Massage Therapists should take heed with more frequent hygiene habits to protect themselves, and to protect the health and safety of their clients as well.  The best method to prevent transmission of COVID-19 is to self-isolate and avoid contact with others, which would not allow for work as a massage therapist.  However, if you find yourself at work, or you must work, which is ill-advised, be sure to practice superior personal hygiene, take steps to improve your air quality at work and wear your PPE (personal protective equipment).  Please stay safe during these challenging times. 

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Author Selena Belisle is the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

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[i] “When and How to Wash Your Hands.” Centers for Disease Control and Prevention, 2 Apr. 2020, Found online: July 4, 2020, www.cdc.gov/handwashing/when-how-handwashing.html.

Florida State Worker's Compensation 101 for Massage Therapists, Spa & Salon Workers

Florida State Worker's Compensation 101 for Massage Therapists, Spa & Salon Workers

By: Selena Belisle, Founder/Instructor CE Institute LLC, Miami FL

The Florida State Worker’s Compensation Division is a government agency that oversees the execution of workers’ compensation.

The Florida State Workers’ Compensation Division’s GOAL is to actively ensure the self-execution of the workers' compensation system by:

  • educating system participants of their rights and responsibilities
  • leveraging data to deliver exceptional value
  • holding participants accountable for fulfilling their obligations.[i]

You can contact the Florida State’s Workers’ Compensation Division directly at:

Phone:           850/413-1613

Fax:                850/413-1982

Email:            workers.compmedservice@myfloridacfo.com

Website:       www.myfloridacfo.com/Division/WC/


Injured Worker Responsibilities

If you have an accident or are injured on the job you must:

  • Tell your employer you have been injured, as soon as possible. The law requires that you report the accident or your knowledge of a job-related injury within 30 days of your knowledge of the accident or injury, or within 30 days of a doctor determining you are suffering from a work-related injury.
  • When you do so, you must ask your employer what doctor you can see. You must see a doctor authorized by your employer or the insurance company.
  • Your employer may tell you to call the insurance company handling your claim; the name and phone number should be on the “Broken Arm” poster that should be posted at your workplace.
  • If it is an emergency and your employer is not available to tell you where to go for treatment, go to the nearest emergency room and let your employer know as soon as possible what has happened.
  • After you or your employer report the injury to the insurance company, many companies will have an insurance claim adjuster call you within 24 hours to explain your rights and obligations.

If you receive a message and a number to call, you should call as soon as possible to find out what you need to do to get medical treatment.

  • Within 3-5 business days after you or your employer report the accident, you should receive an informational brochure explaining your rights and obligations, and a Notification Letter explaining the services provided by the Employee Assistance Office of the Division of Workers’ Compensation. These forms may be part of a packet which may include some or all of the following:
  • A copy of your accident report or “First Report of Injury or Illness,” which you should read to make sure it is correct;
  • A fraud statement, which you must read, sign and return as soon as possible, or benefits may be temporarily withheld until you do so;
  • A release of medical records for you to sign and return; and
  • Medical mileage reimbursement forms that you should fill out, after seeking medical treatment, and send to your claims adjuster for reimbursement.

If you do not receive a call or the information packet from the insurance company, you can call the workers’ compensation hotline for assistance at 1-800-342-1741.

Your employer is required by law to report your injury to the insurance company within 7 days of when you report your accident or injury. If they do not do this, and they do not give you a phone number for the insurance company to call, you can call the workers’ compensation (WC) hotline for assistance at 1-800-342-1741.

The entire contents of this single Worker's Compensation BLOG Post was taken directly from the Florida State Workers’ Compensation Website in May 2018.  You should check with your worker's compensation plan, employer and/or Florida State’s Workers’ Compensation Division for any updates to rules or regulations regarding workers compensation.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

______________________

This BLOG was written by Selena Belisle, the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

[i] “About the Division.” Frequently Asked Questions, Retrieved online: 17 May 2018, www.myfloridacfo.com/Division/WC/contactUs.htm.

 

 

Sanitation Chemical Hazards & Safety 101 in a Massage Therapy Practice, Spa or Salon

Sanitation Chemical Hazards & Safety 101 in a Massage Therapy Practice, Spa or Salon

By: Selena Belisle, Owner/Instructor CE Institute LLC, Miami FL

Most massage therapy, spa or salon workplaces share a large amount of personal interaction which will require regular sanitation effort.  Unfortunately, there are a lot of negative health side-effects when chemical agents are used.  As such, this BLOG is to provide some basic information to help service providers and owners make the best decisions they can to keep their workspace healthy and clean:

Common Cleaner Chemicals and Known Side-effects

  • Ammonia & bleach (sodium hypochlorite) cause asthma in workers who breathe too much at work. It can trigger asthma attacks in people who already have asthma. It can also irritate the skin, eyes, and respiratory tract.
  • Quaternary ammonium compounds (also known as QUATs, QACs, or QATs) are not volatile compounds, but using them as sprays can cause nose and throat irritation. Benzalkonium chloride is a severe eye irritant and causes and triggers asthma. Exposures to QUATs may cause allergic skin reactions. Use of QUATs has been associated with the growth of bacteria that are resistant to disinfection. Sometimes this resistance also transfers to antibiotics. In laboratory studies, QUATs were found to damage genetic material (genes).
  • Triclosan is a suspected endocrine disruptor and may lead to the development of antibiotic resistant bacteria.
  • Phthalates are used in fragrances that are found in air fresheners and cleaning and sanitizing products. They are endocrine disruptors. Research indicates that phthalates increase the risk of allergies and asthma and can affect children's neurodevelopment and thyroid function. Studies show links between phthalates in mothers to abnormal genital development in boys. Phthalates have been found in human urine, blood, semen, amniotic fluid, and breast milk.
  • Volatile organic compounds (VOCs) are chemicals that vaporize at room temperature. Many VOCs that are released by cleaning supplies have been linked to chronic respiratory problems such as asthma, allergic reactions, and headaches.
    • Fragrances are mixtures of many chemicals, including VOCs. They can contain up to 3,000 separate ingredients. There is no requirement that fragrance ingredients be listed on the product label. Many of these chemicals:
      • can trigger asthma and allergies;
      • may be hazardous to humans.
    • Terpenes are chemicals found in pine, lemon, and orange oils that are used in many cleaning and disinfecting products as well as in fragrances. Terpenes react with ozone, especially on hot smoggy days, forming very small particles like those found in smog and haze that can irritate the lungs and may cause other health problems.
    • Formaldehyde, which:
      • causes cancer,
      • is a sensitizer that is linked to asthma and allergic reactions,
      • has damaged genes in lab tests,
      • is a central nervous system depressant (slows down brain activity),
      • may cause joint pain, depression, headaches, chest pains, ear infections, chronic fatigue, dizziness, and loss of sleep.

Each year about 6 out of every 100 professional custodians are injured by the chemicals they use to clean, sanitize, and disinfect. Burns to the eyes and skin are the most common injuries, followed closely by breathing toxic mists or vapors. Many of these injuries are due to improper use of cleaning, sanitizing, and disinfecting products. For example, many chemicals used for cleaning, sanitizing, and disinfecting come in a concentrated form. To be used, they have to be correctly diluted with water:

  • When diluting concentrated products unsafely, the user increases their exposure to the health hazards of the product. Humans are exposed by breathing the fumes of the concentrated product into the lungs or absorbing the liquid through the skin.
  • If the wrong chemicals are mixed together, they can react to form a toxic gas and the health effects can be much worse. For example, when bleach is mixed with ammonia or quaternary ammonium compounds (found in some disinfectants), chloramine gas is created, which is highly toxic.
  • If a chemical is too concentrated (the user doesn’t add the amount of water indicated on the product label), then the health effects of using that product are increased. They are increased for the person who is using the product. They are also increased for the people who occupy the indoor space where it is used.
  • It is important to follow dilution instructions carefully to avoid harm to the person doing the diluting, as well as to the others in the same work areas. Personal protective equipment such as gloves and goggle, when indicated on the product label, should be worn while working with concentrated chemicals. Better yet, avoid using products that require personal protective equipment!

Because there have been so many cleaning solutions and sanitary products that have caused occupational injury, the EPA has formed a list of Safer Choice Products which can be viewed by clicking HERE .

We hope this information helps readers understand some of the hazards that can happen at work with sanitation efforts and using chemicals.  To learn more about massage therapy, spa and salon sanitation, please click HERE.

The 101 on Germs: What Massage Therapists & Personal Care Services Providers Should Know

The 101 on Germs: What Massage Therapists & Personal Care Services Providers Should Know

By: Selena Belisle, Owner/Instructor CE Institute LLC, Miami FL

When working in the spa, salon or massage therapy industry, you may find yourself in close continuous contact with other people. As such, it is important to learn about pathology and the different types of germs that may enter your workspace or be transmitted through your daily practices. 

Infectious diseases are caused by germs (also called microbes or microorganisms).  Germs can get into our bodies and reproduce, causing symptoms that make us feel sick. Germs can spread by leaving one person and entering another which is why some sometimes infectious diseases are also called communicable or contagious disease. Germs that cause disease are also called pathogens.  How to eliminate germs are covered in some of our other BLOGs here at CE Institute LLC.

Here is some basic information about the most common 4 types of germs and how they can spread from one person to another.  The 4 types of germs that we will review in this BLOG for massage therapists and personal care services providers are virus, bacteria fungi and protozoa:

1. Viruses

Viruses are the most common cause of illness. They are very small. Viruses can’t live on surfaces for very long. The common cold is a group of symptoms caused by 200 different viruses. There are always more cold viruses that they haven’t had yet identified. Viruses also cause intestinal and respiratory flu. Antibiotics kill bacteria but cannot kill viruses! Antibiotics should not be used to treat illnesses caused by viruses because they cannot eliminate a virus. Luckily, we get better from most viral illnesses without medical treatment.  

2. Bacteria

Bacteria are more complex than viruses. They can live and reproduce independently. Some can survive on surfaces for a long time, feeding off dirt or food and water. Most are harmless or even beneficial to us. They help us to digest food as well as prevent infections caused by harmful bacteria. Common bacterial infections include some ear infections, some cases of diarrhea, strep throat, and urinary tract infections. Bacteria can also cause more serious infections such as tuberculosis, whooping cough, staph infections and the less often but very serious bacterial pneumonia or bacterial meningitis.

3. Fungi

Fungi includes yeasts and molds and they are everywhere. They can survive on surfaces for long periods. Fungi can cause common skin infections such as:

  • thrush
  • ringworm
  • athlete's foot
  • scalp infections, i.e. tinea capitis
  • nail infections
  • many many many different types of infections

Fungal infections are bothersome and can sometimes take months to go away, but they don’t cause serious illness in people with healthy immune systems. They regularly do not spread and cause infection in the rest of the body in healthy people.

Mold can be found anywhere there is constant moisture, like salons, spas or bathrooms. You cannot “catch” mold from another person. Mold can cause irritations of the eye, skin, nose, throat, and lungs, and can trigger asthma. It can produce an allergic reaction in some people. The best way to control mold indoors is to get rid of moisture seeing mold thrives in a damp environment.

4. Protozoa

Protozoa are microscopic germs – some are considered “good”, some are “bad”.  They are one-celled organisms that can be free-living or parasitic in nature[i]. They are able to multiply in humans, which contributes to their survival.  Protozoa can also create serious infections in humans from one single organism.

How Bodily Fluid Germs are Spread

  1. Direct Contact is when body fluids are directly transferred from one person to another. Examples of direct contact are touching and kissing. An animal bite is another example.
  1. Droplets is when secretions fly out of noses and mouths (when we sneeze, cough, spit, drool, slobber, or vomit) into the air and then land on a hard surface or are inhaled by another person - which is how COVID-19 is thought to spread today.
  • Droplets can fly only a short distance (such as a sneeze). If these human droplets land on another’s eye, nose, or mouth they can spread disease.
  • Germs can also be spread when we touch droplets (from another person) that land on a surface like a table and then touch our own eyes, mouth, or nose before washing their hands.
  • Most of the germs that can be spread by direct contact can also be spread by droplets.
  • Germs that can spread by droplets are more contagious than germs that require direct contact. When an infection can spread between people that are only near each other, the infection is more contagious. Diseases caused by viruses and bacteria can be spread this way.
  • Fungi and parasites are not transmitted by droplets.

Germs can live longer on stainless steel, plastic, and similar hard surfaces than they do on fabric and other soft surfaces. Germs also live longer when the surface is wet and dirty. Food and water on a surface provide germs with all they need to survive and multiply! When droplets land on a hard surface like a table or a doorknob, the viruses in those droplets can live several hours or more. Bacteria can live for even longer.

To recap, there are a number of ways that these germs can be transmitted from one person to another. Contaminated work surfaces, inadequate cleaning, dirty hands or work equipment and coughing or sneezing without covering your mouth are popular methods for the spread of germs.  As such, it is important to not work when you are sick and practice good hand hygiene plus effective cleaning and disinfection practices to prevent the spread of germs.  Frequent and extra sanitation efforts should be made in high-traffic areas to minimize the growth and/or spread of these tiny microbes.  It is our duty as service providers to be aware of what germs are, and how they spread, so that we know what may be lingering around our office.  Please click HERE to view our Sanitation BLOG where you can find information about how to eliminate germs in the workplace.

To learn more, you can also register for quality, affordable, professional training at: https://ceinstitute.com/

________________________

Author Selena Belisle is the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

[i] “Parasites”, Centers for Disease Control and Prevention, 22 April 2016, https://www.cdc.gov/parasites/about.html

COVID-19 & Pandemics 101 - The Basics for Massage Therapists

COVID-19 & Pandemics 101 - The Basics for Massage Therapists

By: Selena Belisle, Owner/Instructor CE Institute LLC, Miami FL

pandemic is a widespread occurrence of an infectious disease (usually across a large region, multiple continents, or worldwide) for a particular period of time.  Here is a partial list of pandemic examples throughout history:

  • 14th Century: The Black Death aka “The Plague”:  It killed an estimated 75-200 million people worldwide.
  • 1918 Influenza Pandemic aka “The Spanish Flu” (H1N1 virus) [i]: It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.

The 1918 Influenza Pandemic mortality was high in people younger than 5 years old, 20-40 years old, and 65+ years old. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic. In 1918, there were no flu vaccines and limited pharmaceuticals to treat secondary bacterial infections.  As such, worldwide control of this 1918 pandemic was limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings. Interestingly enough, today in 2020, we are still applying similar control measures that were used 100 years ago during the Influenza Pandemic to prevent the spread of COVID-19.

  • 1957-1958 Pandemic aka “Asian Flu” (H2N2 virus) [ii]: In February 1957, a new influenza A (H2N2) virus emerged in East Asia, triggering a pandemic (“Asian Flu”). It was first reported in Singapore in February 1957, Hong Kong in April 1957, and in coastal cities in the United States in summer 1957. The estimated number of deaths was 1.1 million worldwide and 116,000 in the United States.
  • 2009 H1N1 Pandemic aka “Swine Flu” or “2009 Novel Influenza A” (Influenza A (H1N1)pdm09 virus)[iii]: The 2009 H1N1 flu was regularly referred to as the “Swine Flu”. It was called Swine Flu because the people who caught it had direct contact with pigs. The “Swine Flu” label changed years later when people who were infected had not been around pigs.[iv]

 

 

The 2009 Novel Influenza A (H1N1) virus emerged first in the United States and spread quickly across the United States and the world. From April 2009 to April  2010, the CDC estimated that in the United States there were 60.8 million cases with 12,469 deaths.  It is also estimated that between 151,700 to 575,400 people worldwide died from this infection during it’s first year.[v] Globally, 80% of 2009 H1N1 virus-related deaths were estimated to have occurred in people younger than 65 years of age.

When we look at history, pandemics are not new to our world.  Different age groups can be more or less susceptible with each unique pandemic.  And there are varying amounts of populations, infections and deaths between each unique pandemic.

COVID-19: On February 11, 2020 the World Health Organization (WHO) announced an official name for the disease that is causing the 2019 Novel Coronavirus outbreak which is now known as COVID-19.[vi]  COVID-19 is caused by a coronavirus called SARS-CoV-2.

COVID-19 stands for:

  • “CO” stands for “corona”
  • “VI” stands for “virus”
  • “D” stands for “disease”
  • 2019 stands for year it was identified

A novel coronavirus is a new coronavirus that has not been previously identified.  There are many types of human coronaviruses including some that can cause the common cold and/or mild upper-respiratory tract illnesses.  COVID-19 is a new disease, caused by a novel (or new) coronavirus that has not previously identified in humans.  COVID-19 is not the same as other coronaviruses that can commonly circulate amongst our population.

According to Marie-Louise Landry, MD, an infectious disease expert at Yale Medicine, four common human coronaviruses cause 15-30% of common colds amongst humans.  However, COVID-19 is a new or novel coronavirus, “meaning that it mutated in some way and became more deadly” explains Jeremy Brown, MD, director of the Office of Emergency Care Research at the National Institutes of Health. “That is what happened when SARS and MERS occurred. They too are coronaviruses that changed and became very much more deadly."[vii]

Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. It is not often that an animal coronavirus could infect humans and then spread amongst people. This animal to human transmission is thought to have occurred with MERS-CoV and SARS-CoV and has now happened with COVID-19.

COVID-19 is thought to spread from person to person, mainly through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land or be inhaled in the mouths or noses of people nearby.  COVID-19 has been detected in both symptomatic and asymptomatic people (people who are infected but do not show any symptoms). 

Some people have said that COVID-19 is less infectious in hotter climates or temperatures and others have said that cold weather can kill the virus.  All these suggestions are mostly speculative.  While some coronaviruses survive for shorter periods at higher temperatures and higher humidity than in cooler or dryer environments, the CDC clearly states that they “don’t have direct data for this virus”.[viii]  And more importantly, the World Health Organization states: “…the COVID-19 virus can be transmitted in ALL AREAS, including areas with hot and humid weather.”[ix]  The fact is, COVID-19 is a very new virus (less than 1-year old).  It can take months or years to perform the research and studies required to obtain this type of information.

The CDC states the best way to prevent transmission of COVID-19 “is to avoid being exposed to this virus”.  There are people who are infected by COVID-19 who appear to be perfectly healthy but are also “shedding” and infecting others without knowing. The World Health Organization published that it can take between 2 and 10 days before an infected person may become sick or develop a fever. As such, it is not regarded as “safe” to provide close, in-person services to the general public until better testing and medical advisement is available.   What is most important is protect yourself and your customers during this pandemic.  Taking someone’s temperature, looking at or talking to someone is not a reliable way to detect if someone is infected with COVID-19.   The best operation may be to assume that everyone is infected and to practice social distancing with good hygiene until better information is available.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Author Selena Belisle is the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider by NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at www.CeInstitute.com

_____________

 [i] “1918 Pandemic (H1N1 Virus).” Centers for Disease Control and Prevention, 20 Mar. 2019, www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html. Found online April 4, 2020.

[ii] “1957-1958 Pandemic (H2N2 Virus).” Centers for Disease Control and Prevention, Jan. 2019, www.cdc.gov/flu/pandemic-resources/1957-1958-pandemic.html. Found online April 4, 2020.

[iii] “2009 H1N1 Pandemic (H1N1pdm09 Virus).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 June 2019, www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html. Found online April 4, 2020.

[iv] DerSarkissian, Carol. “H1N1 Flu Virus (Swine Flu): Symptoms, Causes, Tests, and Treatments.” WebMD, WebMD, 19 May 2019, www.webmd.com/cold-and-flu/flu-guide/h1n1-flu-virus-swine-flu#1. Found online April 4, 2020.

[v] Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modelling study, the Lancet Infection Diseases, 1 September 2021, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(12)70121-4/fulltext. Found online April 4, 2020.

[vi] “Frequently Asked Questions.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Apr. 2020, www.cdc.gov/coronavirus/2019-ncov/faq.html. Found online April 4, 2020.

[vii] Groth, Leah. “These Are the Key Differences Between Coronavirus and the Common Cold.” Health.com, www.health.com/condition/infectious-diseases/coronavirus/coronavirus-symptoms-vs-cold.  Found online April 4, 2020.

[viii] “Frequently Asked Questions.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Apr. 2020, www.cdc.gov/coronavirus/2019-ncov/faq.html. Found online April 4, 2020.