Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crisis and how to manage it. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laity. ALWAYS prioritize advice from qualified healthcare experts over some person on Facebook.
This is also available as an email newsletter at https://lunchtimepandemic.substack.com if you prefer the update in your inbox.
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Georgia Tech's gathering risk tool is very handy. Put in a gathering size and based on current data, it will tell you the probability that at least one person at that gathering is COVID-19 positive.
Source: https://covid19risk.biosci.gatech.edu/
Commentary: This is a very handy tool for any public space. Going to the grocery store? How many patrons are in the store? In Massachusetts, our state has mandated that stores may not have more than 40% of their legal maximum capacity in at the same time. That's about 50-ish people for the average grocery store. Right now, in the county where I live, that means there's about a 24% chance someone in a full grocery store is COVID-10 positive.
Given that rate, it'd be CRAZY to be in that space without a mask. I'd even say it's inadvisable to be in that space with a mask rated less than N99/P99. If I worked in the office I used to be work in, my risk in the workplace would be 51% - crazy high.
Try out the tool and judge the places you need to go to - and work to reduce your risk by going when those places are least busy.
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Dr. Fauci advises that for healthcare professionals, and by extension anyone in a high-risk environment, that in addition to a mask, use eye protection.
"If an infectious person coughs or sneezes in your face, and you breathe in through your mouth or nose, not only are you going to receive a sizable viral dose, "you're going to get a fairly direct hit into your airways," Steinemann says.
But to infect you via your eyes, the virus would have to penetrate your eyes' mucous membrane, be washed by tears behind your cheeks into your nasal cavity, and then flow from the nose into your throat. "It's a more circuitous route," says Steinemann."
Source:
Source: https://www.npr.org/sections/goatsandsoda/2020/05/22/861299427/coronavirus-faqs-can-i-catch-it-through-the-eyes-will-googles-help
Commentary: The route to infection is more circuitous than your nose and mouth - a mask is still the most important thing. That said, if you are high-risk, or if you are venturing into a high-risk place, wear goggles.
Does it cost me anything to wear eye protection? No. (I already own several sets of safety goggles that are airtight)
Does it harm me in any way to wear it, especially if I'm going into an enclosed indoor space like the grocery store? No.
Does it inhibit what I'm going to do? No.
Does it harm or inconvenience people around me? No.
Does it further reduce the likelihood of catching COVID-19? Yes.
So wearing eye protection plus a mask is no cost, all benefit, even if the benefit is relatively small.
Regular workplace safety goggles are good enough; if you want to be super careful, look for goggles that are non-vented on the ecommerce shopping site of your choice.
That and until you sanitize your hands, don't touch ANY part of your face.
So, in the words of Bill Nye, goggles on!
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Some experts now believe aerosol is the main form of transmission, not surface contacts. "What I have learned has convinced me that aerosols are actually a main, and likely the dominant, mode of transmission for SARS-CoV-2."
Source:
Commentary: The change in perspective to an airborne, aerosol-based disease changes how we think about stopping the pandemic. It makes things like ventilation paramount; a mask that blocks 95% of particles (N95) means that 5% still get through. In a well-ventilated space or outside, that means the chances of contracting COVID-19 are very, very low. In a poorly-ventilated, highly-infectious space, that means even the best masks still can't cut your risk entirely.
Here's an easy benchmark to judge whether a space is safe to return to, like an office or school: if the windows don't FULLY open, it's not FULLY safe. That hermetically sealed, climate-controlled office downtown? It's a virus breeding ground unless they've added HEPA MERV 14/16 filters (effective against 0.3 micron particles) into the ventilation system. And that's the key- not only does it need to be a HEPA filter, it needs to be MERV 14 or MERV 16 rated to catch viruses - and turn over the air VERY frequently. A HEPA designation alone doesn't tell you whether the air is safe.
Source: https://www.epa.gov/indoor-air-quality-iaq/what-hepa-filter-1
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COVID-19 causes concern about heart damage. "Two new studies from Germany paint a sobering picture of the toll that Covid-19 takes on the heart, raising the specter of long-term damage after people recover, even if their illness was not severe enough to require hospitalization.
One study examined the cardiac MRIs of 100 people who had recovered from Covid-19 and compared them to heart images from 100 people who were similar but not infected with the virus. Their average age was 49 and two-thirds of the patients had recovered at home. More than two months later, infected patients were more likely to have troubling cardiac signs than people in the control group: 78 patients showed structural changes to their hearts, 76 had evidence of a biomarker signaling cardiac injury typically found after a heart attack, and 60 had signs of inflammation.
These were relatively young, healthy patients who fell ill in the spring, Valentina Puntmann, who led the MRI study, pointed out in an interview. Many of them had just returned from ski vacations. None of them thought they had anything wrong with their hearts.
“The fact that 78% of ‘recovered’ [patients] had evidence of ongoing heart involvement means that the heart is involved in a majority of patients, even if Covid-19 illness does not scream out with the classical heart symptoms, such as anginal chest pain,” she told STAT. She is a cardiologist at University Hospital Frankfurt. “In my view, the relatively clear onset of Covid-19 illness provides an opportunity to take proactive action and to look for heart involvement early.”
“If this high rate of risk is confirmed, … then the crisis of COVID-19 will not abate but will instead shift to a new de novo incidence of heart failure and other chronic cardiovascular complications,” they wrote. “We are inclined to raise a new and very evident concern that cardiomyopathy and heart failure related to Covid-19 may potentially evolve as the natural history of this infection becomes clearer.” "
Source: https://www.statnews.com/2020/07/27/covid19-concerns-about-lasting-heart-damage/
Commentary: COVID-19 continues to surprise us in unpleasant ways. Between heart and lung damage, we may have an entire generation of people - millions - who have serious, long-term health consequences that will put a drag on healthcare and the economy for decades to come.
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Kids can carry adult-size portions of the virus. "It has been a comforting refrain in the national conversation about reopening schools: Young children are mostly spared by the coronavirus and don’t seem to spread it to others, at least not very often.
But on Thursday, a study introduced an unwelcome wrinkle into this smooth narrative.
Infected children have at least as much of the coronavirus in their noses and throats as infected adults, according to the research. Indeed, children younger than age 5 may host up to 100 times as much of the virus in the upper respiratory tract as adults, the authors found.
That measurement does not necessarily prove children are passing the virus to others. Still, the findings should influence the debate over reopening schools, several experts said.
“The school situation is so complicated — there are many nuances beyond just the scientific one,” said Dr. Taylor Heald-Sargent, a pediatric infectious diseases expert at the Ann and Robert H. Lurie Children’s Hospital of Chicago, who led the study, published in JAMA Pediatrics.
“But one takeaway from this is that we can’t assume that just because kids aren’t getting sick, or very sick, that they don’t have the virus.”"
Source: https://www.nytimes.com/2020/07/30/health/coronavirus-children.html
Commentary: Cutting community spread is key to reopening... well, anything, including schools. If the virus is entrenched in a community, then opening schools in that community is only going to accelerate spread.
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home. Remember that cleaners are never to be ingested or injected.
2. Wear a mask when out of your home and if going to a high risk area, wear goggles. Respirators are back in stock at online retailers, too.
3. Stay home as much as possible. Minimize your contact with others and maintain physical distance of at LEAST 6 feet / 2 meters. Avoid indoor places as much as you can; indoor spaces spread the disease through aerosols and distance is less effective at mitigating your risks.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Replenish your supplies as you use them. Avoid reducing your stores to pre-pandemic levels in case an outbreak causes unexpected supply chain disruptions.
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Common misinformation debunked!
There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
There is no evidence SARS-CoV-2 was engineered, nor that it escaped a lab somewhere.
Source: https://www.washingtonpost.com/world/2020/01/29/experts-debunk-fringe-theory-linking-chinas-coronavirus-weapons-research/
Source: https://www.nature.com/articles/s41591-020-0820-9
Source: https://www.nationalgeographic.com/science/2020/05/anthony-fauci-no-scientific-evidence-the-coronavirus-was-made-in-a-chinese-lab-cvd/
There is no evidence a flu shot increases your COVID-19 risk.
Source: https://www.factcheck.org/2020/04/no-evidence-that-flu-shot-increases-risk-of-covid-19/
Source: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa626/5842161
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A common request I'm asked is who I follow. Here's a public Twitter list of many of the sources I read.
https://twitter.com/i/lists/1260956929205112834
This list is biased by design. It is limited to authors who predominantly post in the English language. It is heavily biased towards individual researchers and away from institutions. It is biased towards those who publish or share research, data, papers, etc. I have made an attempt to follow researchers from different countries, and also to make the list reasonably gender-balanced, because multiple, diverse perspectives on research data are essential.