As the country disinfects, diabetes patients can’t find rubbing alcohol

Reviewed by James Ives, M.Psych. (Editor)Apr 3 2020

While the masses hunt for toilet paper, Caroline Gregory and other people with diabetes are on a different mission: scouring stores for the rubbing alcohol or alcohol swabs needed to manage their disease.

Gregory stopped in Carlie C's, Dollar General and then Harris Teeter in Fayetteville, North Carolina, in pursuit of this vital component of her medical routine.

"We're all supposed to be staying at home, and I'm out going to 10 different stores," said Gregory, 33, whose diabetes could heighten her risk for COVID-19 complications. "That's also not safe."

Rubbing alcohol and alcohol swabs or wipes are the latest products swept up by the nation's demand for anything and everything seen as a disinfectant against the novel coronavirus — by hospitals and average consumers alike.

Andy Lerman, vice president of operations for Hydrox Laboratories, a manufacturer based outside Chicago, said the majority of the low-profit-margin medical product his company makes is headed to hospitals, which are going through it faster than they have in the past. He has seen distributors order more than five times the amount they typically do.

"Hospitals are wiping down everything all the time — with every type of virucide that they have at their disposal," he said. "I'm making it as fast as I can, but I have more orders than I have capacity to manufacture."

Isopropyl alcohol — a primary ingredient in some types of rubbing alcohol — has been touted as a cleaner that neutralizes the coronavirus on everything from kitchen countertops to phones. And with the depletion of supplies of hand sanitizer, also seen as a defense against COVID-19, demand has exploded to make homemade versions. The Food and Drug Administration and the World Health Organization list isopropyl alcohol as a critical ingredient in their recommended recipes.

So, for those with diabetes or other chronic medical conditions, the general public's resulting panic-buying spree has threatened their medical routines, such as when patients use an alcohol swab or a rubbing alcohol-soaked cotton ball to disinfect their skin before they inject insulin.

Alternatives like witch hazel may not have the same antiviral properties, and the proof of most brands of vodka isn't high enough to be effective. Other compounds, like hydrogen peroxide and liquid iodine, can be unwieldy for diabetes patients to manage while changing insulin pump sites on the go, Gregory said.

Despite the inability to obtain their usual products, people with diabetes still need to maintain their blood sugar levels, said Kelly Mueller, vice president of community impact at the American Diabetes Association. She encouraged patients to wash their hands and pump sites carefully and let them air-dry.

But in the midst of the coronavirus panic, the problem is compounded by a dearth of antibacterial soap or hand sanitizer to replace the disinfecting swabs or rubbing alcohol needed to keep prick sites clean, said Alison Dvorchik. She lives in Orlando, Florida, with her 17-year-old son, Matthew, who has Type 1 diabetes.

"I'm worried for the entire Type 1 diabetic community," she said. "That's a cesspool of infection waiting to happen."

Any potential infection is a strain on an already overburdened health care system, Dvorchik said. For now, she's trying to ward off that fate for Matthew with a stash of 100 alcohol wipes from a friend — they use about three a day with Matthew's insulin pump.

The madness began about three weeks ago, according to New Jersey-based AvaCare Medical CEO Steven Zeldes, who runs one of the nation's larger online medical supply companies.

Overnight his site was swamped with "thousands and thousands" of orders around the country for rubbing alcohol and rubbing alcohol swabs — medical supply items that had not been a primary focus for the company.

At first, he suspected some sort of pricing mishap. Then, he realized rubbing alcohol was a primary ingredient in making homemade hand sanitizer.

The tsunami of orders cleared out the warehouses of AvaCare Medical's distributors in under two days. Zeldes said the company was out of stock so fast that it received thousands of orders before being able to take down the listings.

"Our company was always a medical supply company for seniors or nursing homes or hospitals," Zeldes said. "Now we're a company for every single citizen of America."

Cathi Carothers, an operations assistant at Lab Alley, a chemical supplier in Austin, Texas, said her company saw a similar explosion of interest in alcohol products from fire departments and post offices as well as Tesla, the Department of Homeland Security and Johns Hopkins University.

"No one could have anticipated this much demand in a month," Carothers said.

When Lab Alley called Dow and ExxonMobil — two of the largest raw-component manufacturers of isopropyl alcohol in the U.S. — to procure more, she said, the companies told Lab Alley they're prioritizing hospitals.

Dow confirmed to KHN it was working with the FDA and state officials to maximize production of all its high-demand products. ExxonMobil directed KHN to a news release stating it was actively working with hard-hit New York and Louisiana to send isopropyl alcohol from its Baton Rouge Chemical Plant, which it says is "home to the world's largest" isopropyl alcohol production site.

Both Medline, a major supplier in Chicago, and New Jersey-based Becton, Dickinson and Co., a health care product manufacturer and supplier, have felt the crush of demand. Medline spokesperson Stacy Rubenstein cited a 100% increase in March this year over last. Accordingly, both companies said they have ramped up production and enforced fair distribution measures.

Down the supply chain, Gregory, the Fayetteville woman with diabetes, said she lost it in line at Walgreens when she saw a sign saying the store was limiting customers to four bottles, which is more than she would go through in a year. (She uses it several times weekly to disinfect the sites of her insulin pump and every 10 days for her glucose monitor.)

"How much hand sanitizer are you making?" Gregory asked. "You certainly don't need to be cleaning your kitchen with it — it's not necessary. I think people are just panicking."

Many forms of rubbing alcohol were sold out on Walgreens online site as of Sunday. Both Target and Rite Aid had also sold out of some rubbing alcohol and rubbing alcohol-related products online.

Finally, Gregory was able to snag one of the last orders for 100 wipes available through Healthcare Supply Pros, an online medical supply company. It should last her for about five months. She fears for older, poorer people with diabetes who may not have internet access or the money to do the same.

Plus, similar listings show the product is now sold out.

"Don't hoard something that you don't really need," said Dvorchik, the mother of the teenager with diabetes. "Because the people who really need it can't get it."