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COVID-19 Q & A...
...with photographer Mark Lehigh

Updated February 21, 2021
List of questions

Legend:

This color text ... Quotes from the internet
This color text ... My comments

Table of contents:

Youtubes
CDC FAQs
How do you know who to believe?
I'm tired of COVID-19.
Is the juice worth the squeeze?
How bad is it, really?
What's the risk?
How do we kill it?
How to be wrong
Just the facts
Church people

Youtubes:

https://www.youtube.com/playlist?list=PLEb9Wh_GlgF5VUpBmG1G_4WkgoGRdWT6u

CDC FAQs:

https://www.cdc.gov/coronavirus/2019-ncov/faq.html

How do you know who to believe?

Wait, the author of this page is just a photographer?

I'm good at asking questions.
It's important to know what you don't know.
Maybe questions are more important than answers.

This is not academic research.
I'm just googling stuff.
My fact-checking is very basic, not like publications do.

I often have trouble reading scientific studies and the CDC's technical language, so I rely on the media's analysis of scientific data.
Or better yet, meta-analysis of multiple studies.
I also am biased toward dumbed-down stuff.

Sometimes I just link to an article, because I think the answer's there, even though I don't really understand the data.

Sources used on this webpage:

% of
links on
this page...
...that are from this website:
18% CDC
8% Wikipedia
6% YouTube
4% ClinicalTrials.gov
3% each Nature
NY Times
Washington Post
2% each AP
Business Insider
CNN
Forbes
National Institutes of Health
WHO
1% each Johns Hopkins
New England Journal of Medicine
The Atlantic
The Lancet
Vox
Media Bias / Fact Check
BBC
healthline
Mayo Clinic
medRxiv
NPR
Reuters
The Guardian
31% 69 other websites

How do you know who to believe?

When the CDC says to mask, and someone else says not to mask, one of them is wrong.
When there's conflicting info, I prioritize information from the CDC.

How to Avoid Misinformation About COVID-19
Search sources for bias
Wikipedia's list of sources with ratings

Providing sources:

Many facebook posts don't provide sources.
If it's not sourced, it didn't happen.

Readers must be able to check that any of the information within Wikipedia articles is not just made up. This means all material must be attributable to reliable, published sources.

...from https://en.wikipedia.org/wiki/Wikipedia:Verifiability

I have found Wikipedia invaluable for controversial subjects:

Articles must not take sides, but should explain the sides, fairly and without editorial bias. This applies to both what you say and how you say it.

...from https://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_view

Articles should be based on reliable, independent, published sources with a reputation for fact-checking and accuracy.

...from https://en.wikipedia.org/wiki/Wikipedia:Reliable_sources#Overview

Is Wikipedia reliable?

Some unreliable information sources on COVID-19 are:

...President Trump
...church people
...facebook
...family

information bubble:

facebook is a good example of an information bubble.
You see what you want to see.
The algorithm suggests stuff based on what you previously liked.

confirmation bias:

...Like when you're googling something controversial...
...and you only visit sites that agree with you.

leading the witness:

If you google, "Is covid worse in us than other countries?"...
...The search results will say that COVID-19 is worse in the US than in other countries.

A better search may be, "covid deaths statistics".
Also, I don't understand COVID-19 mortality rates.

bias:

All encyclopedic content on Wikipedia must be written from a neutral point of view (NPOV), which means representing fairly, proportionately, and, as far as possible, without editorial bias, all the significant views that have been published by reliable sources on a topic.

...from https://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_view

LEFT-CENTER BIAS

These media sources have a slight to moderate liberal bias. They often publish factual information that utilizes loaded words (wording that attempts to influence an audience by using appeal to emotion or stereotypes) to favor liberal causes. These sources are generally trustworthy for information, but may require further investigation.

...from https://mediabiasfactcheck.com/washington-post/

fact-checking:

Wikipedia's list of fact checkers
Another list of fact checkers

consensus:

Yes, we are human just like you and we like some things and dislike others. Like you, we want the things we think we see and the easy solutions to be true. Sometimes they are not. In order to prevent bias, MBFC relies 100% on consensus science. In other words, there may be outlying studies that prove differently than the consensus, but we have to abide by the consensus until the consensus changes. For example, GMOs are deadly? There is zero evidence of this. When there is enough evidence to support that claim we will change too and publish accordingly. We do not want to be poisoned or die either. We are opposed to false information for any benefit! Regarding Climate Change, the consensus is it is occurring and influenced by humans… until the consensus tilts otherwise we have no choice but to draw our line and be factual. Sorry. If you consider science to be affiliated with a political party that is sad and we hope to help you navigate through that.

...from https://mediabiasfactcheck.com/frequently-asked-questions/

opinion pieces:

Editorial commentary, analysis and opinion pieces, whether written by the editors of the publication (editorials) or outside authors (op-eds) are reliable primary sources for statements attributed to that editor or author, but are rarely reliable for statements of fact.

...When taking information from opinion content, the identity of the author may help determine reliability. The opinions of specialists and recognized experts are more likely to be reliable and to reflect a significant viewpoint.

...from https://en.wikipedia.org/wiki/Wikipedia:Reliable_sources#News_organizations

peer review:

Material such as an article, book, monograph, or research paper that has been vetted by the scholarly community is regarded as reliable, where the material has been published in reputable peer-reviewed sources or by well-regarded academic presses.

...from https://en.wikipedia.org/wiki/Wikipedia:Reliable_sources#Scholarship

It's not about who's right and who's wrong...
...It's about what's right and what's wrong:

People are more important than ideas.
Actions are more important than beliefs.

It's easier to admit you were wrong...
...than to admit you are wrong.

Facts are better than opinions.
Questions are better than opinions.
Consensus is better than one opinion.

Information is good.
More information is better.
Information that challenges your worldview is best.

Can you trust the mainstream media?

Much of mainstream media is left-center biased.
Mainstream media reports scientific studies.
Science isn't biased.
The CDC is the best information source.

You can check your source for bias here.
Information sources need evaluated.

Known sources are more likely to have been fact checked or peer reviewed.
Lesser-known sources can get away with more misinformation, because they aren't on the fact checker's radar.

Many of the videos and articles on this page are from April, 2020.
Is the info still accurate?

What has changed since April?

I view COVID-19 news daily.
And I update this page regularly.
Hopefully my sources do the same.

Can you trust the CDC?

A lot of our early assumptions about the new coronavirus have flip-flopped.

This is normal. That's how science works --it's a process of being less and less wrong over time. COVID-19 is new, so there's lots of uncertainty. And the pandemic's size and scale caught us by surprise. As we learn more, our understanding of the virus continues to change.

...from https://www.mercurynews.com/2020/06/10/coronavirus-8-things-we-got-wrong-at-first-about-the-deadly-pandemic/

The Trump administration undermined the CDC.

The CDC is still the best information source.

Who checks the fact-checkers?

The trouble is, fact-checkers have expanded their purview from checking strictly empirical statements to "checking" contestable political statements.

...from https://newrepublic.com/article/156039/political-fact-checkers-distort-truth

Fact checkers also often "check" opinions, rather than factual claims, even though two people can form diametrically opposed opinions based on the same facts.

...from https://www.investors.com/politics/editorials/fact-checkers-big-media/

Trump allies, largely unconstrained by Facebook's rules against repeated falsehoods, cement pre-election dominance

She said that, at the moment, there is more misinformation posted from right-wing sources than by the left. This is in part due to Trump, she said, as many of his supporters are repeating things he has said that are not supported by evidence and facts.

...from https://www.cnn.com/2020/10/29/tech/fact-checkers-facebook-trump/index.html

A post-2016 innovation, the labels aren't placed by Facebook but by harried subcontractors, fact-checkers and journalists, and scientists who are fed a never-ending feed of potential misinformation.

...In some cases, Facebook may intervene if it thinks that a piece of content was mistakenly rated, by asking fact-checkers to adjust their ratings, a spokesperson acknowledged to Fast Company.

This would seem to break with a policy that says fact-checkers, not Facebook, are responsible for determining the rating on a piece of content, and that publishers must appeal their ratings to the fact-checkers directly.

...Any content is eligible for review, except politicians' posts and opinion content, an exemption designed in part to avoid appearing to be an "arbiter of truth"--and more pointedly, to deter persistent allegations of anti-right-wing censorship. (Those allegations remain as loud as ever, notwithstanding a lack of evidence that Facebook perpetrates systematic bias against conservatives, and despite Facebook's own data showing that right-wing content is consistently the platform's most engaging.)

...from https://www.fastcompany.com/90538655/facebook-is-quietly-pressuring-its-independent-fact-checkers-to-change-their-rulings

Will Joe Biden save us from COVID-19?

Only if he gets enough votes.
No, seriously, stop saying the election was rigged.
Also, I voted for Trump. Twice. Because abortion, I guess.

November 13... It was, they declare, resorting to Trump's sort of dramatic language, "the most secure in American history."

...from https://apnews.com/article/top-officials-elections-most-secure-66f9361084ccbc461e3bbf42861057a5

December 1... Barr told the AP that U.S. attorneys and FBI agents have been working to follow up specific complaints and information they've received, but "to date, we have not seen fraud on a scale that could have effected a different outcome in the election."

...from https://apnews.com/article/william-barr-no-evidence-election-fraud-b1f1488796c9a98c4b1a9061a6c7f49d

January 5, 2021... Despite pressure from U.S. President Donald Trump to help overturn his election loss, Vice President Mike Pence will stick to his ceremonial duties and not block Wednesday's certification by Congress of President-elect Joe Biden's victory, advisers said.

...from https://www.reuters.com/article/us-usa-election-pence/despite-trump-pressure-pence-will-not-block-bidens-election-certification-advisers-idUSKBN29A2J0

January 6, 2021... I've supported the president's right to use the legal system, dozens of lawsuits, perceived hearings in courtrooms all across our country. But over and over, the courts rejected these claims -- including all-star judges whom the president himself has nominated. [-Mitch McConnell]

...from https://www.washingtonpost.com/politics/2021/01/06/mitch-mcconnells-forceful-rejection-trumps-election-conspiracy-theories/

January 16, 2021... The campaign lost 64 of 65 lawsuits.

...from https://en.wikipedia.org/wiki/Electoral_fraud#United_States

January 26, 2021... 100 lawsuits, in 15 states and the District of Columbia, have been filed (66 have concluded).

...Two presidential recounts (in Georgia and Wisconsin) have been conducted.

...from https://ballotpedia.org/Ballotpedia%27s_2020_Election_Help_Desk:_Tracking_election_disputes,_lawsuits,_and_recounts

Lawsuits related to the 2020 United States presidential election

MyPillow guy scares off Newsmax anchor by talking about voting machine fraud

One America News has quietly scrubbed its website of references to election conspiracy theories, a possible attempt to fend off a lawsuit from the election technology companies it had targeted in its stories.

...from https://www.businessinsider.com/oan-deletes-articles-about-dominion-voting-election-conspiracy-2021-1

"Do not conflate voting system security and SolarWinds," tweeted Krebs, who served as US Cybersecurity and Infrastructure Security Agency Director until late November. "The proof is in the paper. You can audit or recount again to confirm the outcome. Like they did in Georgia. And Michigan. And Wisconsin. And Arizona. Can't hack paper."

...from https://www.businessinsider.com/krebs-do-not-conflate-voting-security-solarwinds-hack-2020-12

December 24... That transition is still in progress, but paperless machines have been eliminated in Georgia, Michigan, Pennsylvania and Wisconsin -- the states Trump supporters have focused on since November. Wherever paper ballots are used, officials can check behind the machines with recounts and audits to find out whether the software was honest.

...from https://www.washingtonpost.com/outlook/five-myths/five-myths-about-voting-machines/2020/12/24/ac2e02a2-453f-11eb-b0e4-0f182923a025_story.html

Mail-in ballot security:

While mail ballots are more susceptible to fraud than in-person voting, it is still more likely for an American to be struck by lightning than to commit mail voting fraud.

...from https://www.brennancenter.org/our-work/analysis-opinion/false-narrative-vote-mail-fraud

The lightning statistic above disagrees with the lightning statistic below.

In terms of security, both mail-in and absentee ballots are paper ballots hand-marked by the voter, which the National Conference of State Legislatures considers the "gold standard of election security." Forty-four states have signature verification protocols for mail ballots.

...from https://www.nytimes.com/article/fact-checking-mail-in-voting.html

To create a counterfeit ballot, its' physical parameters would have to be exactly matched, as well as the printing with precise timing marks which control how the ballot is scanned by tabulator machines. To have any impact on a national election, many counterfeit ballots would have to be generated and entered.

...While a physical envelope could be created, the barcode voter ID number must match with the election data base maintained in every jurisdiction. Unless the numbers match, law enforcement would be notified.

...The number of envelopes must match the number of physical ballots that are processed by the tabulators. This would prevent the wholesale entry of non-official ballots into the system. The likelihood of pallets of illegal ballots being entered into the process is virtually non-existent and impossible.

...from https://www.forbes.com/sites/marcwebertobias/2020/10/22/voting-by-absentee-ballot-can-the-security-of-these-systems-be-defeated/?sh=729ae67835c3

In April 2020, a 20-year voter fraud study by MIT found the level of fraud in the United States "exceedingly rare" since it occurs only in "0.00006 percent" of instances nationally, and, in one state, "0.000004 percent--about five times less likely than getting hit by lightning."[6]

...from https://en.wikipedia.org/wiki/Electoral_fraud

Trump's long White House campaign against verifiable reality has culminated with his lie that he is the true winner of the 2020 presidential election he clearly, certifiably and fairly lost.

To many of us, it's ludicrous nonsense. But to millions of deluded Americans, it's the truth. And it has now gotten people killed.

...from https://www.cnn.com/2021/01/16/politics/fact-check-dale-top-15-donald-trump-lies/index.html?utm_source=digg

Is Wikipedia reliable?

What I think about Wikipedia

I'm tired of COVID-19:

What's the risk if I don't do all this stuff?
Which precautions are actually necessary?

Some of these precatuions are harder to do than others.
If you are at high risk, you should do all this stuff.
We'll probably be fine if we all do all this stuff.
But all of us aren't doing all this stuff.
And we're not 100% sure how to stop COVID-19.

There's no silver bullet.
Multiple imperfect precautions work together.

Masks are uncomfortable.

Yeah, it took me awhile to find a comfortable one.
It's still pretty annoying, but it's worth it.

Is masking bad for you?

I don't feel like cleaning.

Clearing the air is probably more important than cleaning surfaces:

Ventilation

Does cleaning high-touch surfaces only reduce surface transmission?
Or does it also reduce airborne and respiratory transmission?

The primary and most important mode of transmission for COVID-19 is through close contact from person-to-person. Based on data from lab studies on COVID-19 and what we know about similar respiratory diseases, it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this isn't thought to be the main way the virus spreads.

...from https://www.cdc.gov/media/releases/2020/s0522-cdc-updates-covid-transmission.html

How to get motivated to clean:

Prioritize bathrooms.
Clean something daily or weekly instead of cleaning everything at once.
Don't de-clutter while you're cleaning.
Or, de-clutter to make it easier to clean.
Reward yourself when you're done.

Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.

If surfaces are dirty, clean them. Use detergent or soap and water prior to disinfection.

Then, use a household disinfectant. Use products from EPA's List N: Disinfectants for Coronavirus (COVID-19) according to manufacturer's labeled directions.

...from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

It's hard not to touch your face.

Washing hands and not touching your face eliminates the risk from surface contamination.
Unless you're licking stuff.

Social distancing and masking probably eliminate the risk from close contact.

The primary and most important mode of transmission for COVID-19 is through close contact from person-to-person. Based on data from lab studies on COVID-19 and what we know about similar respiratory diseases, it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this isn't thought to be the main way the virus spreads.

...from https://www.cdc.gov/media/releases/2020/s0522-cdc-updates-covid-transmission.html

Is it ok to be lazy?
The pandemic has me stressed out, and I don't feel like doing anything.

"We did nothing..."

Not knowing stuff is exhausting.

We're faced with a lot of the same decisions from our pre-corona lives -- except now, even the most mundane activities have turned into moral dilemmas. Whether it's trying to decide if you should visit a sick family member, order delivery, take public transit, or take a trip to the grocery store, we now have to think through the potential implications of many of our totally normal, everyday actions and decisions in a way we never had to before, because of how they could affect others. This is called "moral fatigue," and it's exhausting.

...from https://www.rollingstone.com/culture/culture-features/corona-exhausted-moral-fatigue-974311/

Is the juice worth the squeeze?

herd immunity...
Should we just let COVID-19 run its course?

Herd immunity against COVID-19 should be achieved by protecting people through vaccination, not by exposing them to the pathogen that causes the disease.

...from https://www.who.int/news-room/q-a-detail/herd-immunity-lockdowns-and-covid-19

Unlike vaccination, herd immunity does not give a high level of individual protection, and so it is not a good alternative to getting vaccinated.

...from https://vk.ovg.ox.ac.uk/vk/herd-immunity

And although scientists can estimate herd-immunity thresholds, they won't know the actual numbers in real time, says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security in Baltimore. Instead, herd immunity is something that can be observed with certainty only by analysing the data in retrospect, maybe as long as ten years afterwards, she says.

...from https://www.nature.com/articles/d41586-020-02948-4

"Herd immunity is a concept used for vaccination, in which a population can be protected from a certain virus if a threshold of vaccination is reached ... Herd immunity is achieved by protecting people from a virus, not by exposing them to it."[10][13] Tedros said that trying to achieve herd immunity by letting the virus spread unchecked would be "scientifically and ethically problematic", especially given that the long-term effects of the disease are still not fully understood.[10][13] He said that though "there has been some discussion recently about the concept of reaching so-called 'herd immunity' by letting the virus spread", "never in the history of public health has herd immunity been used as a strategy for responding to an outbreak, let alone a pandemic."[10][13][39]

...from https://en.wikipedia.org/wiki/Great_Barrington_Declaration#Reception

Have the economic and emotional impacts of lockdown been worse than the impact of COVID-19?

"After pointing out, correctly, the indirect damage caused by the pandemic, they respond that the answer is to increase the direct damage caused by it"[5]

...from https://en.wikipedia.org/wiki/Great_Barrington_Declaration#Reception

Different views on lockdowns

If you're sick, stay home.
The rest of us should get on with our lives.

We don't know who's sick.

The vulnerable population should be protected.
The rest of us should get on with our lives.

For example, if someone with measles is surrounded by people who are vaccinated against measles, the disease cannot easily be passed on to anyone, and it will quickly disappear again. This is called ‘herd immunity', 'community immunity' or 'herd protection', and it gives protection to vulnerable people such as newborn babies, elderly people and those who are too sick to be vaccinated.

...from https://vk.ovg.ox.ac.uk/vk/herd-immunity

But as soon as you try to figure out exactly how it would work, you quickly see that it is actually a remarkably efficient way to kill an unthinkable number of people, which is why Britain, which had initially considered using essentially this strategy, soon abandoned the idea, and moved to the same strategy as the rest of the world: try to reduce transmission until the disease can be controlled by testing and spot-quarantines, rather than national lockdowns. There is no easy way out of this, no simple solution that somehow eluded the experts. There is only a miserable tradeoff between economic production and human lives.

... from https://www.washingtonpost.com/opinions/2020/04/03/heres-why-it-wont-work-just-isolate-elderly-vulnerable/?itid=lk_inline_manual_59

What are the emotional effects of social distancing?

Coping with Stress
Mental health during the COVID-19 pandemic

How bad is it, really?

Are COVID-19 infections overreported?

Cases are more underreported than deaths:

An estimated 17-50+% of infections are asymptopmatic.
These people are less likely than symptomatic people to be tested.

We find COVID-19 prevalence and deaths are widely under-reported. Across the 91 nations, the estimated ratio of actual to reported cumulative cases (through 30 October 2020) is 8.5, corresponding to 314 million undetected cases (95% CI 295-321 million). Underreporting varies substantially across nations (10th-90th percentile range 3.2-22; Figure 4)

...from PDF at https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3635047

November 26... Total Covid-19 Cases In U.S. May Be Eight Times Higher Than Reported, Scientists Estimate

Excess deaths:

Raw numbers of deaths from all causes compared to previous years, United States
CDC: Excess deaths dashboards

In times of upheaval --wars, natural disasters, outbreaks of disease --researchers need to tally deaths rapidly, and usually turn to a blunt but reliable metric: excess mortality.

...from https://www.nature.com/articles/d41586-020-02497-w

Simply put, excess deaths are the difference between the number of deaths that were expected to occur during a given time period and the number of deaths that actually occurred.

...from https://www.cdc.gov/coronavirus/2019-ncov/cdcresponse/accomplishments/excess-death-data.html

As of October 15, 216,025 deaths from COVID-19 have been reported in the United States; however, this might underestimate the total impact of the pandemic on mortality.

...Overall, an estimated 299,028 excess deaths occurred from late January through October 3, 2020, with 198,081 (66%) excess deaths attributed to COVID-19.

...from https://www.cdc.gov/mmwr/volumes/69/wr/mm6942e2.htm?s_cid=mm6942e2_w

This week the CDC quietly updated the Covid number to admit that only 6% of all the 153,504 deaths recorded actually died from Covid.
That's 9,210 deaths.

What is the mortality rate of COVID-19?

Mortality analyses
Are COVID-19 infections overreported?

How does the COVID-19 mortality rate compare to abortion, flu, SARS, etc.?

(US)... 2017... abortion... 862,320 deaths (est.)

...from https://www.guttmacher.org/report/abortion-incidence-service-availability-us-2017

(US)... 2019... flu... 24,000-62,000 deaths (est.)

...from https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm

Cases... Recovered... Deaths
May 22... Comparison to other pandemics
Infographic with old COVID-19 numbers.

Don't live in fear.

I'm not scared, because I'm informed.
There are a lot of unknowns.
But we know how to protect ourselves.

I'm not scared of dying at the moment.
I'm scared of killing someone else.

Flu has been underreported this flu season.

During this 36-year period, flu activity most often peaked in February (15 seasons), followed by December (7 seasons), January (6 seasons) and March (6 seasons).

...from https://www.cdc.gov/flu/about/season/flu-season.htm

One silver lining is that lockdowns and behaviour changes such as mask wearing and hand washing might have prevented deaths from other causes --particularly other infectious diseases, such as flu.

...from https://www.nature.com/articles/d41586-020-02497-w

"The specific nature of these sequences means that someone with flu or a common cold virus is highly unlikely to test positive for COVID-19," he told Reuters.

...Partly false: The claim that tests can misdiagnose a common cold as COVID-19 are misleading. Swab tests used to diagnose COVID-19 are highly specific, experts say. Antibody tests, however, can establish if someone has antibodies from other coronaviruses, but they are not being used to diagnose COVID-19.

...from https://www.reuters.com/article/uk-factcheck-swab/fact-check-a-swab-test-is-highly-unlikely-to-misdiagnose-flu-or-common-cold-as-covid-19-idUSKBN26R3DH

The southern hemisphere avoided such an eventuality. Their recently concluded flu season was exceptionally mild. It is possible that behind the apparently low caseload lay thousands of undetected patients. Perhaps influenza testing fell away as countries concentrated their resources on COVID-19. Large numbers of people might have struggled through bouts of influenza at home, hidden from the statisticians. In a briefing to the media on June 15, 2020, WHO director-general Tedros Adhanom Ghebreyesus noted that "influenza surveillance has either been suspended or is declining in many countries, and there has been a sharp decline in sharing of influenza information and viruses because of the COVID-19 pandemic". He added that "compared with the last 3 years, we've seen a dramatic decrease in the number of specimens tested for influenza globally".

...from https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30508-7/fulltext

Why are cancer and heart disease not being reported?

COVID outpaced seven top killers in 2020

...from https://www.scientificamerican.com/article/covid-is-on-track-to-become-the-u-s-s-leading-cause-of-death-yet-again1/

underlying medical conditions that increase a person's risk of severe illness from COVID-19

The institute’s study had nothing to do with cancer -- many federal researchers have shifted to coronavirus work because of the pandemic.

...from https://www.timesofisrael.com/new-studies-indicate-immunity-to-virus-lasts-at-least-6-8-months-after-recovery/#attachment_2389100

April 16, 2020... Further evidence is emerging of dramatic falls in numbers of hospital patients presenting with serious medical conditions such as strokes and heart attacks since the beginning of the coronavirus pandemic.

A US study found that interventions for serious heart attacks have fallen 38% since 1 March. Similar reductions were reported in Spain, while in Lombardy, the worst affected region of Italy, the figure was 70%.

On Wednesday the Guardian revealed that doctors and paramedics in the UK had warned of a sharp rise in the number of seriously ill people dying at home because they were reluctant to call for an ambulance.

Andrew Goddard, the president of the Royal College of Physicians, said: "Consultants in cardiology and emergency medicine are reporting significant reductions in admissions with heart attack symptoms."

Something similar has been happening with stroke. The neurologist David Werring, who chairs the Association of British Neurologists’ stroke advisory group, said University College London hospitals NHS foundation trust, where he works, saw a 30% reduction in people being referred with stroke, or treated for stroke, compared with the same period last year.

"There is no reason to assume that the incidence of stroke declined since the onset of the Covid-19 crisis, but in many countries fewer people with symptoms suggestive of stroke present to the hospital," stated the European Stroke Organisation last week, on publishing findings that 80% of stroke care providers across 55 countries were experiencing reduced demand.

"Patients are waiting longer to present with their symptoms," said Goddard.

...Patrik Michel, a neurologist at the Centre Hospitalier Universitaire Vaudois in Lausanne, Switzerland, said that the constraints on indulging in strenuous exercise under lockdown may actually have spared a few people with ailing hearts from a heart attack -- though this is unlikely to have had a major effect on numbers.

Werring said social distancing could similarly be protecting some of those at risk of stroke, because it means that they are less exposed to infections of all kinds. "There’s a strong association between infections and stroke," he said.

..."The most important message to patients is that the NHS [UK] is very much open for business as usual for heart attacks and strokes," said Goddard. "The risks of catching Covid-19 are small as the units managing such patients are very distinct from wards looking after Covid-19 patients. The risks of dying from heart diseases or being left with significant long-term effects are much greater."

...from https://www.theguardian.com/world/2020/apr/16/coronavirus-concern-heart-attack-stroke-patients-delay-seeking-help#comment-count-root

Are increased numbers of infections the result of increased testing?

Case-fatality rates depend on testing: a country that tests only people with severe symptoms, for example, will have an outsized case-fatality rate compared with one in which asymptomatic testing is widespread.

...from https://www.nature.com/articles/d41586-020-03132-4

Daily State-by-State Testing Trends
How Coronavirus Cases Compare With Expectations
Track Trends in COVID-19 Cases and Tests
Cases... Tests... Hospitalizations... Outcomes

Are hospitals still overwhelmed?

February 9, 2021... Effective Wednesday, February 10, due to the decline of positive COVID-19 cases and hospitalizations across south central Pennsylvania, WellSpan facilities will allow visitation of one family/support person for inpatient, emergency department, clinic visits, and outpatient locations per stay.

...from https://www.wellspan.org/news/story/wellspan-health-implements-new-visitation-guidelines-effective-wednesday-feb-10/N6279?fbclid=IwAR1_z81ZhtSzTUm7Sx9xfTRTUA9HIKZL_IkjOCj4NYmIFbTf0OLhlrbauno#ContentPlaceHolderDefault_ctl06_bs-news-v2-story_6_lblContent

April 2020 - April 2021... % of ICU beds occupied by COVID-19 patients

...from https://www.facebook.com/IHMEUW/photos/a.132262553512027/4773452256059677

Search by county... Current % of beds & ICU beds occupied by COVID-19 patients

Search by county... Current % of beds occupied by COVID-19 patients

Search by county... Typical % of beds occupied by COVID-19 patients

December 5... Hospitals are becoming overwhelmed, causing them to restrict whom they admit and leading more Americans to die needlessly.

...from https://www.theatlantic.com/health/archive/2020/12/the-worst-case-scenario-is-happening-hospitals-are-overwhelmed/617301

January 24, 2021... An Associated Press analysis of federal hospital data shows that since November, the share of U.S. hospitals nearing the breaking point has doubled. More than 40% of Americans now live in areas running out of ICU space, with only 15% of beds still available.

...from https://apnews.com/article/us-news-coronavirus-pandemic-faf144ff9442077a9f2bb292614e1342

Are surgical and N95 masks still in short supply?

January 27, 2021... "Global demand continues to outpace production," says Nancy Foster, vice president of quality and patient safety at the American Hospital Association. Availability of N95 masks has improved since last spring, Foster says, but "we are continuing to use conservation measures within hospitals to protect the supplies we have, to extend the wear of N95s designed for one-time use."

...from https://www.npr.org/sections/health-shots/2021/01/27/960336778/why-n95-masks-are-still-in-short-supply-in-the-u-s

How effective are treatments for COVID-19?

COVID-19 treatments and drugs

Increased testing and better treatments since the start of the pandemic, have seen the fatality fall, but there is still much unknown.

...from https://www.weforum.org/agenda/2020/09/death-rate-fatality-covid-19-coronavirus-disease-pandemic-science/

"We have very much replicated what's been seen worldwide, which is over time the mortality in ICUs have decreased," says Dr. Craig Coopersmith, director of the Emory Critical Care Center. He oversees ICUs at five hospitals in the Emory system, including Johns Creek.

The decline in mortality related to COVID-19 varies month to month. At Emory it has been in the range of 20% to 50%. Coopersmith says there are lots of reasons for that.

A big one is that, when the first wave of Covid-19 hit Atlanta's hospitals in April, doctors had no experience with the disease. Medical management of these patients is now, by comparison, routine.

...from https://www.npr.org/sections/health-shots/2020/09/20/914374901/advances-in-icu-care-are-saving-more-patients-who-have-covid-19

Are there different strains or variants of SARS-CoV-2?

UK variants:

December 23... A team of British scientists released a worrying study on Wednesday of the new coronavirus variant sweeping the United Kingdom.

...The study found no evidence that the variant was more deadly than others. But the researchers estimated that it was 56 percent more contagious. On Monday, the British government released an initial estimate of 70 percent.

...Dr. Davies and his colleagues found more evidence that the variant does indeed spread more rapidly than others. For example, they ruled out the possibility that it was becoming more common in some regions of the U.K. because people in those places move around more and are more likely to come into contact with each other. Data recorded by Google, indicating the movements of individual cellphone users over time, showed no such difference.

...from https://www.nytimes.com/2020/12/23/health/coronavirus-uk-variant.html

January 5, 2021... The lack of evidence--so far--that the new variant makes people sicker is little consolation. Increased transmissibility of a virus is much more treacherous than increased pathogenicity because its effects grow exponentially, Kucharski says. "If you have something that kills 1% of people but a huge number of people get it, that's going to result in more deaths than something that a small number of people get but it kills 2% of them."

...from https://www.sciencemag.org/news/2021/01/viral-mutations-may-cause-another-very-very-bad-covid-19-wave-scientists-warn

February 18, 2021... The authors write, "These data offer evidence that SARS-CoV-2 variant B.1.1.7 may cause longer infections with similar peak viral concentration compared to non-B.1.1.7 SARS-CoV-2, and this extended duration may contribute to B.1.1.7 SARS-CoV-2’s increased transmissibility. The findings are preliminary, as they are based on seven B.1.1.7 cases. However, if borne out by additional data, a longer isolation period than the currently recommended 10 days after symptom onset may be needed to effectively interrupt secondary infections by this variant."

...from https://coronavirus.medium.com/nba-data-reveals-new-information-about-the-b-1-1-7-variant-dc460db532ec?gi=sd#a4fc

January 20, 2021... In the new study, researchers engineered what are called pseudoviruses (these are more practical to work with in lab experiments than actual live specimens of dangerous viruses like SARS-2) to have the full suite of mutations as B.1.1.7. They then tested blood taken from 16 people who had received the [Pfizer-BioNTech] vaccine against the variant, and found it could neutralize the variant as well as it could an earlier form of the virus. "These data ... make it unlikely that the B.1.1.7 lineage will escape" protection from the vaccine, the researchers wrote.

...from https://www.statnews.com/2021/01/20/pfizer-biontech-covid-19-vaccine-works-just-as-well-against-variant-first-detected-in-u-k-study-indicates/

February 18, 2021... The two coronavirus vaccines developed by Pfizer-BioNTech and Moderna appear to be highly effective against the more transmissible variant of the virus first detected in Britain, according to newly published studies in the New England Journal of Medicine, in a potential boost for vaccination efforts around the globe.

The vaccines, however, showed a decreased ability to neutralize the strain now dominant in South Africa, worrying some researchers and prompting Pfizer and BioNTech to announce they were taking necessary steps to develop a booster shot or updated vaccine. A day after Pfizer’s announcement, a top White House coronavirus adviser said each vaccine developer is planning to update shots to address variants.

...from https://www.washingtonpost.com/nation/2021/02/18/coronavirus-covid-live-updates-us/#main-content

Is the US mortality rate worse than other countries?

Mortality analyses

How many cases are asymptomatic?

September 22... 20% of Coronavirus Infections Are Asymptomatic but Still Contagious

... from https://www.healthline.com/health-news/20-percent-of-people-with-covid-19-are-asymptomatic-but-can-spread-the-disease#Only-20%-remained-asymptomatic

November 5... Studies show that at least 40-to-50% of people who test positive for COVID-19 have no symptoms.

...from https://www.uchealth.org/today/the-truth-about-asymptomatic-spread-of-covid-19/

November 20... Masks are primarily intended to reduce the emission of virus-laden droplets ("source control"), which is especially relevant for asymptomatic or presymptomatic infected wearers who feel well and may be unaware of their infectiousness to others, and who are estimated to account for more than 50% of transmissions.1

...from https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html

November 23... But a meta-analysis published last month1, which included 13 studies involving 21,708 people, calculated the rate of asymptomatic presentation to be 17%.

...from https://www.nature.com/articles/d41586-020-03141-3

December 21... Earlier estimates that 80% of infections are asymptomatic were too high and have since been revised down to between 17% and 20% of people with infections.

...from https://www.bmj.com/content/371/bmj.m4851.full

If soap can kill it, it must not be that bad.

Soap physically tears apart SARS-CoV-2.

What's the risk?

99.97% of infected people recover.

December 4... 279,634 deaths ÷ 14,281,380 total confirmed cases = 1.95%

"What's the big deal?" is a harder question, because the person-to-person outcomes of this disease are so maddeningly variable. The most universal answer must begin with the observation that death is not a synonym for risk.

...from https://www.theatlantic.com/ideas/archive/2020/09/what-young-healthy-people-have-fear-covid-19/616087/

Other risks of COVID-19:

...Anyone may be contagious.

...Small businesses are struggling.

...Long-term effects on infected persons

...Hospitals are overwhelmed with COVID-19...
...and struggle to treat other medical issues.

...An infected person infects 1.8 - 3.6 people.

... from (PDF) https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(20)30484-9.pdf

It's mostly old people that are at risk.

COVID-19 deaths by age
Anyone may be contagious.

This 40,000-person study found that children under 15 were about half as likely as adults to be infected, and only half as likely as adults to transmit the virus to others. Almost all the coronavirus transmissions to children came from adults.

...from https://www.nationalgeographic.com/science/2020/12/we-now-know-how-much-children-spread-coronavirus/

Children can be infected with the virus that causes COVID-19 and can get sick with COVID-19. Most children with COVID-19 have mild symptoms or they may have no symptoms at all ("asymptomatic"). Fewer children have been sick with COVID-19 compared to adults. However, children with certain underlying medical conditions and infants (less than 1 year old) might be at increased risk for severe illness from COVID-19. Some children have developed a rare but serious disease that is linked to COVID-19 called multisystem inflammatory syndrome (MIS-C).

...from https://www.cdc.gov/coronavirus/2019-ncov/faq.html#Children

Most people have mild or no symptoms.

Anyone may be contagious.

All coronavirus infections start mild, doctors say, and the majority -- about 80% -- stay that way.

...from https://www.cnn.com/2020/10/08/health/covid-19-symptoms-mild-moderate-severe-wellness/index.html

Most deaths have been in nursing homes.

August 20... 68% of Pennsylvania coronavirus deaths are from nursing and personal care homes

January 15, 2021... Norwegian officials have adjusted their advice on who gets the COVID-19 vaccine in light of a small number of deaths in older people, leaving it up to each doctor to consider who should be vaccinated.

The Norwegian Medicines Agency on Thursday reported a total of 29 people had suffered side effects, 13 of them fatal. All the deaths occurred among patients in nursing homes and all were over the age of 80.

..."We are not alarmed by this. It is quite clear that these vaccines have very little risk, with a small exception for the frailest patients," Steinar Madsen, medical director with the agency, told Norwegian broadcaster NRK.

...from https://apnews.com/article/denmark-coronavirus-pandemic-norway-coronavirus-vaccine-europe-51e350b246b4bc4ad92e009626c15844

Is it safe to go to a restaurant?

Take-out vs Outdoor vs Indoor
Crowd size risk estimator
County risk estimates
The risks are unknown.
How much risk are you willing to take?

Should I go to family gatherings?

Risk of going out
Crowd size risk estimator
County risk estimates
The risks are unknown.
How much risk are you willing to take?

Should I send my kids to school?

School Decision-Making Tool for Parents, Caregivers, and Guardians

December 10... This 40,000-person study found that children under 15 were about half as likely as adults to be infected, and only half as likely as adults to transmit the virus to others. Almost all the coronavirus transmissions to children came from adults.

...The takeaway is that a critical shift appears somewhere between the ages of 10 and 12. Around the time of puberty, the risk of teenagers both getting and transmitting the virus increases. The COVID Monitor, a group tracking information from more than 7,000 U.S. school districts, found that high school case rates are nearly three times that of elementary schools.

...from https://www.nationalgeographic.com/science/2020/12/we-now-know-how-much-children-spread-coronavirus/

January 26, 2021... As many schools have reopened for in-person instruction in some parts of the US as well as internationally, school-related cases of COVID-19 have been reported, but there has been little evidence that schools have contributed meaningfully to increased community transmission.4 A case-control study of exposures among children aged 0 through 18 years with (n = 154) and without (n = 243) SARS-CoV-2 infection in Mississippi found that having attended gatherings and social functions outside the home as well as having had visitors in the home was associated with increased risk of infection; however, in-person school attendance during the 14 days prior to diagnosis was not.5 In the fall of 2020, 11 school districts in North Carolina with more than 90 000 students and staff were open for in-person education for 9 weeks.6 During this time, within-school transmissions were very rare (32 infections acquired in schools; 773 community-acquired infections) and there were no cases of student-to-staff transmission. Similarly, in a report released by CDC on January 26, 2021, with data from 17 K-12 schools in rural Wisconsin with high mask adherence (4876 students and 654 staff), COVID-19 incidence was lower in schools than in the community.7 During 13 weeks in the fall of 2020, there were 191 COVID-19 cases in staff and students, with only 7 of these cases determined to result from in-school transmission.

...Preventing transmission in school settings will require addressing and reducing levels of transmission in the surrounding communities through policies to interrupt transmission (eg, restrictions on indoor dining at restaurants). In addition, all recommended mitigation measures in schools must continue: requiring universal face mask use, increasing physical distance by dedensifying classrooms and common areas, using hybrid attendance models when needed to limit the total number of contacts and prevent crowding, increasing room air ventilation, and expanding screening testing to rapidly identify and isolate asymptomatic infected individuals. Staff and students should continue to have options for online education, particularly those at increased risk of severe illness or death if infected with SARS-CoV-2.

...Numerous media reports of COVID-19 outbreaks among US high school athletic teams suggest that contact during both practices and competition, and at social gatherings associated with team sports, increase risk.

...from https://jamanetwork.com/journals/jama/fullarticle/2775875

Will the vaccines be safe?

Given all of the unknowns--like a region's hospital capacity, or the strength of a person's immune response--choosing the disease over the vaccine is "a very bad decision," she said.

The primary advantage of a vaccine is that it's predictable and safe, she said. "It's been optimally tailored to generate an effective immune response."

...from https://www.nytimes.com/2020/12/05/health/covid-natural-immunity.html

Vaccines create immunity without causing illness or resulting complications.

...from https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/herd-immunity-and-coronavirus/art-20486808

The data is based on submissions to the agency's text messaging system v-safe and the Vaccine Adverse Event Reporting System, a national vaccine safety surveillance program. The analysis used data from the first month of vaccinations, between Dec. 14 and Jan. 13., when there were more than 13.7 million doses administered.

The CDC said there were 6,994 reports of so-called adverse events after vaccination, including 6,354 that were classified as "non-serious" and 640 as "serious," which included 113 deaths.

...There were 46 reports of anaphylaxis, a severe and potentially life-threatening allergic reaction, from those who received Pfizer's vaccine and 16 cases for those who received Moderna's, according to the CDC. The agency said the occurrence of the reaction is in the range of those reported for the influenza vaccine.

Out of the 113 deaths reported, two-thirds occurred in long-term care facilities, the agency said.

Medical experts say side effects for vaccines are common and are actually an indication the shots are working as intended. Many physicians are advising the public to brace for some stronger-than-usual side effects from the Covid-19 shots, especially after the second dose.

...from https://www.cnbc.com/2021/02/19/cdc-says-these-are-the-most-common-side-effects-people-report-after-getting-covid-vaccine.html#InlineVideo-0

Long-term safety:

Millions of people in the United States have received COVID-19 vaccines, and these vaccines will undergo the most intensive safety monitoring in U.S. history. This monitoring includes using both established and new safety monitoring systems to make sure that COVID-19 vaccines are safe.

...from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/safety-of-vaccines.html#languageDropDownMenu

Could there be effects decades down the track we haven't predicted? Potentially, but the transient nature of mRNA makes it one of the safer molecules we can use to combat disease.

...from https://www.cnet.com/news/covid-19-vaccines-are-safe-even-if-long-term-data-is-lacking/

Pfizer / BioNTech vaccine:

A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Safety over a median of 2 months was similar to that of other viral vaccines. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.)

...from https://www.nejm.org/doi/full/10.1056/NEJMoa2034577?

A pivotal Phase 2/3 trial of more than 43,000 healthy participants around the world (NCT04368728) published in NEJM,
a Phase 2 trial of 960 participants in China in conjunction with Shanghai Fosun Pharmaceutical (NCT04649021),
a Phase 1/2 trial in the US and Germany of 200 healthy participants between aged 18-55 years (NCT04380701),
and a combined Phase 1/2 trial of 160 participants (NCT04588480) in Japan.

...from https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker

Moderna vaccine:

The Moderna vaccine is recommended for people aged 18 years and older.

...from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html

Its safety profile is also similar to Pfizer's, with fatigue, headaches and pain at the site of injection among the most often cited side effects.

...from https://www.nature.com/articles/d41586-020-03593-7#correction-0

In the pivotal Phase 3 trial of 30,000 participants at high risk for COVID-19, participants received a 100 µg dose of mRNA-1273 and another 4 weeks later or placebo injections and then be followed for up to 2 years (COVE trial; NCT04470427). Moderna posted the full trial protocol for COVE on 17 September.

Previously, a Phase 1 trial (NCT04283461) of 105 healthy participants provided the basis for Moderna's investigational new drug application (IND), which was successfully reviewed by the FDA and set the stage for Phase 2 testing.

A Phase 2 trial of 600 healthy participants evaluating 25 µg, 100 µg, and 250 µg dose levels of the vaccine was completed.

(NCT04405076). Moderna has also launched a Phase 2/3 trial testing mRNA-1273 in about 3,000 adolescents 12 years to less than 18 years old (NCT04649151).

...from https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker

How mRNA vaccines work:

COVID-19 mRNA vaccines give instructions for our cells to make a harmless piece of what is called the "spike protein." The spike protein is found on the surface of the virus that causes COVID-19.

COVID-19 mRNA vaccines are given in the upper arm muscle. Once the instructions (mRNA) are inside the immune cells, the cells use them to make the protein piece. After the protein piece is made, the cell breaks down the instructions and gets rid of them.

Next, the cell displays the protein piece on its surface. Our immune systems recognize that the protein doesn't belong there and begin building an immune response and making antibodies, like what happens in natural infection against COVID-19.

At the end of the process, our bodies have learned how to protect against future infection. The benefit of mRNA vaccines, like all vaccines, is those vaccinated gain this protection without ever having to risk the serious consequences of getting sick with COVID-19.

...from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html

Does infection make you immune to reinfection?

Having antibodies to the virus that causes COVID-19 might provide some protection from getting infected with the virus again. If it does, we do not know how much protection the antibodies might provide or how long this protection might last. Confirmed and suspected cases of reinfection have been reported, but remain rare.

You should continue to protect yourself and others since you could get infected with the virus again.

...from https://www.cdc.gov/coronavirus/2019-ncov/faq.html#Testing

January 7, 2021...The human body typically retains a robust immune response to the coronavirus for at least eight months after an infection, and potentially much longer, researchers said in a study published in the journal Science. About 90 percent of the [188] patients studied showed lingering, stable immunity, the study found.

...from https://www.washingtonpost.com/health/post-infection-coronavirus-immunity-usually-robust-after-8-months-study-shows/2021/01/07/d7d369a6-511a-11eb-b96e-0e54447b23a1_story.html

December 25... Research published in Science Immunology this week examined 25 patients recovering from the illness. Though antibodies --the immune system proteins that attack virus particles --began dropping in blood samples some 20 days after symptoms appeared, memory B cells that produce antibodies continued to rise in the blood for 150 days and remained high until the 240-day point. This signals subjects' bodies were primed to fight off the virus for some eight months.

...A study published Wednesday by the New England Journal of Medicine involved more than 12,500 health workers at Oxford University Hospitals in the United Kingdom. Among the 1,265 who had coronavirus antibodies at the outset, only two had positive results on tests to detect active infection in the following six months and neither developed symptoms.

That contrasts with the 11,364 workers who initially did not have antibodies; 223 of them tested positive for infection in the roughly six months that followed.

A third study by the National Cancer Institute study involved more than 3 million people who had antibody tests from two private labs in the United States. Only 0.3% of those who initially had antibodies later tested positive for the coronavirus, compared with 3% of those who lacked such antibodies.

...from https://www.timesofisrael.com/new-studies-indicate-immunity-to-virus-lasts-at-least-6-8-months-after-recovery/

Is a healthy immune system important?

Having a weakened immune system might increase your risk of severe illness from COVID-19.

...from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html#:~:text=Many%20conditions%20and%20treatments%20can,from%20COVID%2D19

It is believed that cytokine storms were responsible for the disproportionate number of healthy young adult deaths during the 1918 influenza pandemic, which killed 17 to 50 million people. In this case, a healthy immune system may have been a liability rather than an asset.[15]

...from https://en.wikipedia.org/wiki/Cytokine_storm#History

What is a cytokine storm?

At some time quite early in infection, our 'innate immune system' detects there's a virus infection and mounts an innate immune response. This is not the virus-specific, 'acquired immune response' with which people are generally familiar (i.e. antibodies) but rather a broad, non-specific, anti-viral response (characterised by interferon and cytokines, small proteins that have the side effect of causing many of the symptoms: fever, headaches, muscle pain). This response serves two purposes: to slow down the replication and spread of the virus, keeping us alive until the 'acquired immune response' kicks in (which, for a virus we haven't seen, is about 2 to 3 weeks) and to call-up and commission the 'acquired immune response' which will stop and finally clear the infection, as well as laying-down immune memory to allow a faster response if we are infected again in the future (this is the basis of the expected immunity in survivors and of vaccination).

With COVID-19, these two arms of the immune system (innate and acquired) obviously work well for 80% of the population who recover from more or less mild influenza-like illness.

In older people, or people with immunodeficiencies, the activation of the acquired immune system may be delayed. This means that the virus can carry on replicating and spreading in the body, causing chaos and damage as it does, but there's another consequence. Another job of the acquired immune system is to stand-down the innate immune system; until that's done the innate immune response will keep increasing as the virus replicates and spreads. Part of the innate immune response is to cause 'inflammation'. That is useful in containing the virus early in an infection but can result in widespread damage of uninfected tissue (we call this a 'bystander effect') if it becomes too large and uncontrolled, a situation named 'cytokine storm' when it was first seen with SARS and avian influenza H5N1. It is difficult to manage clinically, requiring intensive care and treatment and carries with it high risk of death.

...from https://www.sciencemediacentre.org/expert-reaction-to-questions-about-covid-19-and-viral-load/

How long does SARS-CoV-2 survive on surfaces?

October 11... Covid-19 spreads primarily through the air. Studies have shown that the virus can remain infectious in airborne particles for more than three hours. What's less certain is the degree to which it can spread via surfaces such as banknotes and touchscreens.

...from https://www.bbc.com/news/health-54500673

December 11... The coronavirus's genetic material has been found on all kinds of surfaces in hospitals and in the air, but, interestingly, it has only been successfully cultured from the air. No data studies that we are aware of have cultured the virus from surfaces.

...from https://www.washingtonpost.com/opinions/2020/12/11/covid-19-airborne-transmission-cleaning-surfaces/

If your workplace, school, or business has been unoccupied for 7 days or more, it will only need your normal routine cleaning to open the area. This is because the virus that causes COVID-19 has not been shown to survive on surfaces longer than this time.

...from https://www.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html

Washing hands and not touching your face eliminates the risk from surface contamination.
Unless you're licking stuff.

Social distancing and masking probably eliminate the risk from close contact.

Does cleaning high-touch surfaces only reduce surface transmission?
Or does it also reduce airborne and respiratory transmission?

March 14... A study out this week finds that the virus can survive on hard surfaces such as plastic and stainless steel for up to 72 hours and on cardboard for up to 24 hours.

...flat surfaces and hard surfaces are more friendly to viruses than cloth or rough surfaces.

...from https://www.npr.org/sections/health-shots/2020/03/14/811609026/the-new-coronavirus-can-live-on-surfaces-for-2-3-days-heres-how-to-clean-them

Scientists now know that the early surface studies were done in pristine lab conditions using much larger amounts of virus than would be found in a real-life scenario.

...from https://www.npr.org/sections/health-shots/2020/12/28/948936133/still-disinfecting-surfaces-it-might-not-be-worth-it?utm_source=digg

Can animals infect humans or vice versa?

A small number of pets worldwide, including cats and dogs, have been reported to be infected with the virus that causes COVID-19, mostly after close contact with people with COVID-19.

Based on the limited information available to date, the risk of animals spreading COVID-19 to people is considered to be low.

It appears that the virus that causes COVID-19 can spread from people to animals in some situations.

Treat pets as you would other human family members -- do not let pets interact with people outside the household.

If a person inside the household becomes sick, isolate that person from everyone else, including pets.

This is a rapidly evolving situation and information will be updated as it becomes available.

...from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/pets.html

Should I disinfect my groceries?

Do NOT use disinfectants designed for hard surfaces, such as bleach or ammonia, on food packaged in cardboard or plastic wrap.

...Do NOT wash produce with soap, bleach, sanitizer, alcohol, disinfectant or any other chemical.

...The risk of infection by the virus from food products, food packaging, or bags is thought to be very low. Currently, no cases of COVID-19 have been identified where infection was thought to have occurred by touching food, food packaging, or shopping bags.

...from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/food-and-COVID-19.html

Can you get infected from food?

Officials believe the coronavirus was able to survive in the ice cream due to the cold temperature and was likely transferred from a person who had the disease.

...from https://www.foxnews.com/world/chinese-ice-cream-contaminated-covid-19

The risk of getting COVID-19 from food you cook yourself or from handling and consuming food from restaurants and takeout or drive-thru meals is thought to be very low. Currently, there is no evidence that food is associated with spreading the virus that causes COVID-19.

...Although some people who work in food production and processing facilities have gotten COVID-19, there is no evidence of the virus spreading to consumers through the food or packaging that workers in these facilities may have handled.

...from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/food-and-COVID-19.html

Does stomach acid "kill" SARS-CoV-2?

There is no evidence that drinking lots of water flushes out the new coronavirus or the stomach acid kills the virus.

...from (PDF) https://www.who.int/docs/default-source/nepal-documents/novel-coronavirus/un-rumour-tracking-english-issue-2.pdf

And SARS-CoV-2, the virus that causes Covid-19, doesn't seem to hate acid as much as other viruses.

...from https://medium.com/@adrien.burch/can-stomach-acid-kill-coronavirus-b73a2032028f

Which is riskier this winter?...
Not getting a flu shot...
...Or going out to get a flu shot?

Getting a flu vaccine is more important than ever during 2020-2021 to protect yourself and the people around you from flu, and to help reduce the strain on healthcare systems responding to the COVID-19 pandemic.

...from https://www.cdc.gov/flu/prevent/flushot.htm

Should I mask outdoors?

How coronavirus spreads outdoors vs. indoors

How long do aerosols persist in the air?

The amount of time that the air inside an examination room remains potentially infectious is not known and may depend on a number of factors including the size of the room, the number of air changes per hour, how long the patient was in the room, if the patient was coughing or sneezing, and if an aerosol-generating procedure was performed. Facilities will need to consider these factors when deciding when the vacated room can be entered by someone who is not wearing PPE.

...from https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html

SARS-CoV-2 remained viable in aerosols throughout the duration of our experiment (3 hours), with a reduction in infectious titer from 103.5 to 102.7 TCID50 per liter of air.

...from https://www.nejm.org/doi/10.1056/nejmc2004973

Experimental studies have generated aerosols of infectious samples using high-powered jet nebulizers under controlled laboratory conditions. These studies found SARS-CoV-2 virus RNA in air samples within aerosols for up to 3 hours in one study (21) and 16 hours in another, which also found viable replication-competent virus.(22) These findings were from experimentally induced aerosols that do not reflect normal human cough conditions.

...from https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions

COVID-19 can sometimes be spread by airborne transmission

Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours. These viruses may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left the space.

This kind of spread is referred to as airborne transmission and is an important way that infections like tuberculosis, measles, and chicken pox are spread.

There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising.

Under these circumstances, scientists believe that the amount of infectious smaller droplet and particles produced by the people with COVID-19 became concentrated enough to spread the virus to other people. The people who were infected were in the same space during the same time or shortly after the person with COVID-19 had left.

Available data indicate that it is much more common for the virus that causes COVID-19 to spread through close contact with a person who has COVID-19 than through airborne transmission. [1]

...from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

Are tissues or handkerchiefs more sanitary?

When using tissues, you get mucus on your hands, because they're less absorbent.

Handkerchiefs are adequately sanitary if stored away immediately after use (e.g., in a pocket or purse), followed by the user washing his or her hands.
(Exposure risk remains for the person laundering handkerchiefs.)

Tissues are adequately sanitary if disposed of immediately after use, followed by the user washing his or her hands.
(Exposure risk remains for the person removing trash.)

...from https://waterandhealth.org/disinfect/handkerchief-tissues-question/

If you are suffering from a cold or the flu, then yes, tissues are a better option. The reason for this is you are essentially blowing nasal secretions containing the virus - that is causing your illness - into the tissue. As long as you throw that tissue into the bin (without re-using) and wash your hands, tissues are the most hygienic option. By using a handkerchief, you are increasing the chance of spreading the virus (not to yourself, as you already have it -- but to those around you). Saliva doesn't contain as much of the virus as nasal secretion, so by blowing your nose several times into a hanky, which is potentially already feeling a little 'damp', you are increasing the spread of virus when touching other items such as door knobs and computer keyboards with your 'hanky hands'.

...from https://www.bhg.com.au/handkerchief-versus-tissues-which-is-more-hygienic

Can SARS-CoV-2 survive for 28 days on paper or polymer currency?

Covid virus ‘survives for 28 days' in lab conditions

...cites The effect of temperature on persistence of SARS-CoV-2 on common surfaces

How do we kill it?

What products "kill" SARS-CoV-2?

Regular household cleaning and disinfection products will effectively eliminate the virus from household surfaces. For cleaning and disinfecting households with suspected or confirmed COVID19, surface virucidal disinfectants, such as 0.05% sodium hypochlorite (NaClO) and products based on ethanol (at least 70%), should be used.

...from https://www.who.int/westernpacific/news/q-a-detail/coronavirus-disease-covid-19-food-safety-and-nutrition

Look for products with active ingredients such as ethanol, hydrogen peroxide or quaternary ammonium. In the U.S., check labels for EPA registration numbers.

...from https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-transmission/art-20482397

(PDF)... COVID-19-fighting products

Does freezing "kill" SARS-CoV-2?

Ice cream tests positive for COVID-19

Those questions can be put to bed, experts say, because while the novel coronavirus can survive being frozen, it's highly unlikely to survive in a state that would be able to transmit an infection.

...from https://www.healthline.com/health-news/coronavirus-transmitted-by-frozen-foods-unlikely

Researchers have demonstrated that SARS-CoV-2 can survive conditions as low as minus 20 degrees Celsius and that the virus thrives in damp, cold conditions. Because the coronavirus can linger on a cold surface, there's a chance humans may become infected by handling products contaminated with viral particles. There's been a moderate incidence of COVID-19 outbreaks in meat packaging facilities in the US, the UK, Germany, Australia and a handful of other nations.

...from https://www.cnet.com/news/a-frozen-food-fallacy-the-coronavirus-origin-story-that-doesnt-stack-up/#article-body"

Does sunlight "kill" SARS-CoV-2?

When researchers at the National Biodefense Analysis and Countermeasures Center exposed SARS-CoV-2 in simulated saliva to artificial sunlight (equivalent to a sunny day), 90% of viruses were inactivated within seven minutes. This result suggests that Coronavirus is less able to survive under the Sun's rays and that your risk of exposure is significantly lower in outdoor environments.

...from https://www.forbes.com/sites/jvchamary/2020/06/29/light-coronavirus/

How do I get my kids to follow COVID-19 precautions?

Soap and pepper experiment

What if someone I live with is infected?

Follow your doctor's orders.

If you are advised to stay home:

Monitor symptoms.
Use separate bathrooms.
Designate a "sick room" for the infected person to stay in.
Run a humidifier in the infected person's room.
Turn on bathroom exhaust fans.
Isolate pets from infected person.
Ask for help.

...clean more...
...clear the air...
...wash hands more...
...mask...

When should I call a doctor?

When to seek emergency medical attention

What if my workplace is unsafe?

Options when your workplace is unsafe
Role of Businesses and Employers in Responding to COVID-19
US Dept. of Labor FAQs

Should I get tested?

Coronavirus Self-Checker

Is a COVID-19 test free?

The Families First Coronavirus Response Act ensures that COVID-19 testing is free to anyone in the U.S., including the uninsured.

...from https://www.hhs.gov/coronavirus/community-based-testing-sites/index.html

How long does it take to get test results for COVID-19?

Find a Testing Location Near You
How long it takes to get results...

Are COVID-19 tests accurate?

Can a COVID-19 Test Be Wrong?

Molecular test... This test is typically highly accurate and usually does not need to be repeated.

Antigen Test... Positive results are usually highly accurate, but false positives can happen, especially in areas where very few people have the virus. Negative results may need to be confirmed with a molecular test.

Antibody Test... Sometimes a second antibody test is needed for accurate results.

...from https://www.fda.gov/consumers/consumer-updates/coronavirus-disease-2019-testing-basics

October 12... Looking at the most commonly used type of COVID-19 test (the PCR test, typically done with a swab), researchers found that the test can return a false-negative result as often as 67% of the time during the first 4 days of an infection.

...from https://blogs.webmd.com/public-health/20201012/can-a-covid19-test-be-wrong

August 29... The standard tests [PCR] are diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus.

Most of these people are not likely to be contagious, and identifying them may contribute to bottlenecks that prevent those who are contagious from being found in time. But researchers say the solution is not to test less, or to skip testing people without symptoms, as recently suggested by the Centers for Disease Control and Prevention.

Instead, new data underscore the need for more widespread use of rapid tests, even if they are less sensitive.

...from https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

Does cleaning high-touch surfaces only reduce surface transmission?
Or does it also reduce airborne and respiratory transmission?

When you're out in public, be aware of surfaces you touch, and wash your hands often. It's much more effective to wash your hands thoroughly than try to clean everything you touch.

...from https://www.npr.org/sections/health-shots/2020/12/28/948936133/still-disinfecting-surfaces-it-might-not-be-worth-it?utm_source=digg

By funneling our anxieties into empty cleaning rituals, we lose focus on the more common modes of COVID-19 transmission and the most crucial policies to stop this plague. "My point is not to relax, but rather to focus on what matters and what works," Goldman said. "Masks, social distancing, and moving activities outdoors. That's it. That's how we protect ourselves. That's how we beat this thing."

...from https://www.theatlantic.com/ideas/archive/2020/07/scourge-hygiene-theater/614599/

The best analogy we've used for how this virus is spread is to think about a smoker. If you're near a smoker outside, you may not notice the smell, especially if you're not standing too close. But if you're indoors, you could definitely detect it, even if you're across the room, depending on how far away you are and how well-ventilated or filtered the air is.

How much could you protect yourself from that smoke by scrubbing down countertops, doorknobs and all the other surfaces in the room? Not much. Shared air is the problem, not shared surfaces.

...from https://www.washingtonpost.com/opinions/2020/12/11/covid-19-airborne-transmission-cleaning-surfaces/

Ventilation:

How coronavirus spreads outdoors vs. indoors
Windows... Filters... Air cleaners... Fans...

DIY Box Fan Air Purifier

More info on DIY Box Fan Air Purifier

January 11, 2021... It's important to note that the effectiveness of portable air filtration devices in reducing the transmission of the SARS-CoV-2 virus hasn't yet been demonstrated. As such, they should not be used alone or as replacement for adequate ventilation, physical distancing and hygienic measures. Whenever possible, consider the use of an alternative space, or preferably gathering outdoors rather than indoors, when interacting with people from outside your household.

...from https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/guidance-documents/guide-indoor-ventilation-covid-19-pandemic.html

What about opening windows in the winter?

Opening windows in winter may not always be comfortable or possible. Doing so for a few minutes at a time during the day can still improve air quality, with minimal impact on the indoor temperature. If occupants will be indoors for longer periods, for example at schools, occupants should have regular outdoor breaks, to allow for ventilation of the room.

...from https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/guidance-documents/guide-indoor-ventilation-covid-19-pandemic.html#a10

Some steam radiators built in older apartment buildings in cities like New York were designed to keep dwellings warm with windows open due to the 1918 pandemic.

...from https://www.snopes.com/fact-check/apartment-radiator-pandemic-spread/

Should you open your windows in the city?

"I think the possibility would be vanishingly small of a virus coming in through a window situated well above the ground," he says. But if you have a ground-floor or basement window that looks out onto a sidewalk or some other pedestrian-trafficked area, it may be possible -- albeit unlikely -- for a virus to enter your home via a sick passerby, he adds.

...from https://elemental.medium.com/the-germ-cleaning-power-of-an-open-window-a0ea832934ce

The airborne transmission of infection between flats in high-rise residential buildings

Mask or open windows when driving with someone.

It's impossible to social distance in the car so the next time you're in a car with others, open up the windows at least 3 inches to increase ventilation and lower potential virus levels.

...from (PDF) https://phpa.health.maryland.gov/Documents/Clean%20Your%20Car%20English.pdf

It's important to note, the researchers say, that airflow adjustments are no substitute for mask-wearing by both occupants when inside a car.

...The researchers stress that there's no way to eliminate risk completely -- and, of course, current guidance from the U.S. Centers for Disease Control (CDC) notes that postponing travel and staying home is the best way to protect personal and community health. The goal of the study was simply to study how changes in airflow inside a car may worsen or reduce risk of pathogen transmission.

...from https://www.sciencedaily.com/releases/2020/12/201205143458.htm

How to be wrong:

It's not about who's right and wrong...
...It's about what's right and wrong.

People are more important than ideas.
Actions are more important than beliefs.

It's easier to admit you were wrong...
...than to admit you are wrong.

Facts are better than opinions.
Questions are better than opinions.
Consensus is better than one opinion.

Information is good.
More information is better.
Information that challenges your worldview is best.

What has the CDC flip flopped on?

Can you trust the CDC?

masks

COVID-19 can sometimes be spread by airborne transmission

...There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation.

...from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

The prevention benefit of masking is derived from the combination of source control and personal protection for the mask wearer.

...from https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html

If you have been in close contact (less than 6 feet for a total of 15 minutes or more) with documented SARS-CoV-2 infection and do not have symptoms.

- You need a test. Please consult with your healthcare provider or public health official. Testing is recommended for all close contacts of persons with SARS-CoV-2 infection. Because of the potential for asymptomatic and pre-symptomatic transmission, it is important that contacts of individuals with SARS-CoV-2 infection be quickly identified and tested.

...from https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html

[The following quote may be outdated.] To be sure, the best available evidence from countries that have reopened schools indicates that COVID-19 poses low risks to school-aged children -- at least in areas with low community transmission. That said, the body of evidence is growing that children of all ages are susceptible to SARS-CoV-2 infection (3-7) and, contrary to early reports (11, 12), might play a role in transmission

...from https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/schools.html

The primary and most important mode of transmission for COVID-19 is through close contact from person-to-person. Based on data from lab studies on COVID-19 and what we know about similar respiratory diseases, it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this isn't thought to be the main way the virus spreads.

...from https://www.cdc.gov/media/releases/2020/s0522-cdc-updates-covid-transmission.html

Local public health authorities determine and establish the quarantine options for their jurisdictions. CDC currently recommends a quarantine period of 14 days. However, based on local circumstances and resources, the following options to shorten quarantine are acceptable alternatives.

Quarantine can end after Day 10 without testing and if no symptoms have been reported during daily monitoring.

With this strategy, residual post-quarantine transmission risk is estimated to be about 1% with an upper limit of about 10%.

When diagnostic testing resources are sufficient and available (see bullet 3, below), then quarantine can end after Day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring. The specimen may be collected and tested within 48 hours before the time of planned quarantine discontinuation (e.g., in anticipation of testing delays), but quarantine cannot be discontinued earlier than after Day 7.

With this strategy, the residual post-quarantine transmission risk is estimated to be about 5% with an upper limit of about 12%.

In both cases, additional criteria (e.g., continued symptom monitoring and masking through Day 14) must be met and are outlined in the full text.

...from https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-options-to-reduce-quarantine.html

"What we know so far"

We don't know:

...who's infected.
...why some people have no symptoms and others die.
...why some people are superspreaders.
...what precautions are specifically necessary for me.
...how long it will last.
...the long-term effects on infected people.
...the long-term safety of vaccines.
...If the vaccines are safe for kids.
...If the vaccines will protect against the new strains
...How many people with immunity are needed to achieve herd immunity.

Part of being an expert is knowing what you don't know...
...and knowing what you can't know.

A lot of our early assumptions about the new coronavirus have flip-flopped.

This is normal. That's how science works --it's a process of being less and less wrong over time. COVID-19 is new, so there's lots of uncertainty. And the pandemic's size and scale caught us by surprise. As we learn more, our understanding of the virus continues to change.

...from https://www.mercurynews.com/2020/06/10/coronavirus-8-things-we-got-wrong-at-first-about-the-deadly-pandemic/

Why is a vaccine necessary when the COVID-19 survival rate (98%?) exceeds the effectiveness of the vaccine (~95%)?

Vaccine effectiveness is an estimate of the risk of getting infected.
The survival rate of COVID-19 is an estimate of the risk of death if you get infected.

Vaccination protects against all the risks of COVID-19, including death.
Getting infected exposes you to all the risks of COVID-19, including death.

Vaccines are statistically safer than getting infected.

The best way to prevent illness is to avoid being exposed to this virus.

...from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

This week the CDC quietly updated the Covid number to admit that only 6% of all the 153,504 deaths recorded actually died from Covid.
That's 9,210 deaths.

The 6% figure is not new. Here's an archived page from May showing 7%.
Here's one from July.

The CDC did not change their death count.
A doctor talking really fast
underlying medical conditions that increase a person's risk of severe illness from COVID-19
How to fill out a death certificate

I'm not worried about COVID-19.

The good thing about Science is that it's true whether or not you believe in it.

...from https://twitter.com/neiltyson/status/345551599382446081?lang=en

It doesn't matter what you think.
It matters what you do.

The CDC has identified risky behaviors.
If you engage in risky behavior around an infected person, you're more likely to get sick.
If you follow all the recommended precautions, you won't get sick.

What's the difference between COVID-19 precautions and ordinary safety precautions?

Do you use seatbelts?
Do you have insurance?
Do you look both ways before crossing the street?

Is this all a government conspiracy to see if they can control us?

If so, what should we do?
The CDC recommends specific precautions.
What do the conspiracy theorists suggest we do?

Less-educated Americans more inclined to see some truth in conspiracy theory that COVID-19 was planned

Does masking mean you think you are infected?

We don't know who's infected.
Act like you have COVID-19.

What good does it do to mask in a restaurant?

SEATED ANTI-GERM FORCEFIELD ENGAGE!!!

A better question may be, "Is it safe to go to a restuarant?".

Working in retail is stressful, because people act stupid.
Retail workers don't need anyone else giving them a hard time during a pandemic.

Don't discourage masks.

My mask isn't hurting you.
Not masking is harmful.
The medical consensus favors masking.

Scientific studies on masks

It's not a choice.
It's a responsibility.

If you can't mask, don't.
Getting emotional about masks may indicate a guilty conscience.
i.e., you're looking for an excuse not to mask.

Why are they restricting small businesses, restaurants, weddings and funerals, but not Wal-Marts and protests?

Some restrictions are silly or inconsistent.
Our governers are doing the best they can.

There is no easy way out of this, no simple solution that somehow eluded the experts. There is only a miserable tradeoff between economic production and human lives.

...from https://www.washingtonpost.com/opinions/2020/04/03/heres-why-it-wont-work-just-isolate-elderly-vulnerable/?itid=lk_inline_manual_59#main-content

After the White House declined to pursue a unified national strategy, governors faced off against lobbyists, health experts and a restless public consumed by misinformation.

...from https://www.nytimes.com/2021/01/17/us/covid-deaths-2020.html#link-4e7d5c01

Stuff is restricted in areas where COVID-19 continues to spread.
Why does COVID-19 continue to spread?

Because we haven't reached herd immunity yet.
And because we're not all masking and social distancing.

COVID-19 primarily spreads through the air.

Social distancing and masking probably eliminate the risk from close contact.

Washing hands and not touching your face eliminates the risk from surface contamination.
Unless you're licking stuff.

Just the facts:

If masks work, why does COVID-19 continue to spread?

Because we haven't reached herd immunity yet.
And because we're not all masking and social distancing.

Social distancing and masking probably eliminate the risk from close contact.

Washing hands and not touching your face eliminates the risk from surface contamination.
Unless you're licking stuff.

Are hospitals compensated for COVID-19 diagnoses?

The initial comment was made by Minnesota State Sen. Scott Jensen, a family physician, who spoke with Fox News host Laura Ingraham on April 8 about the idea that the number of COVID-19 deaths may be inflated.

...In an interview with FactCheck.org, however, Jensen said he did not think that hospitals were intentionally misclassifying cases for financial reasons.

...from https://www.factcheck.org/2020/04/hospital-payments-and-the-covid-19-death-count/?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1

It is standard for Medicare to pay roughly three times more for a patient with a respiratory condition who goes on a ventilator than for one who does not. That has nothing to do with the coronavirus.

As part of a federal stimulus bill, Medicare is paying hospitals 20% more than standard rates for COVID-19 patients.

Indications are that due to a lack of testing and other factors, the number of coronavirus cases has been undercounted, not padded.

...from https://www.politifact.com/factchecks/2020/apr/21/facebook-posts/Fact-check-Hospitals-COVID-19-payments/

"It's like, $2,000 more, so you get more money."

Do vaccines use fetal tissues from abortions?

Long answer

Short answer:

The use of fetal tissue in vaccine development is the practice of researching, developing, and producing vaccines through growing viruses in cultured (laboratory-grown) human fetal cells.[1] Since the cell strains in use originate from abortions,[2] there has been opposition to the practice and the resulting vaccines on religious and moral grounds.[1][3][4]

Vaccine experts and manufacturers state that vaccines do not contain any of the original fetal tissue or cells, that the abortions occurred decades ago and replenishment with new tissue has not occurred.[5] Although the vaccines are purified from cell debris, traces of human DNA fragments inevitably remain.[6][7][8]

The Catholic Church has encouraged its members to use alternative vaccines, produced without human cell lines, if possible. However, in cases where the public health risks of refusing vaccination may outweigh "the legitimate concern about the origins of the vaccine", believers are "morally free to use the vaccine regardless of its historical association with abortion".[1][3]

...from https://en.wikipedia.org/wiki/Use_of_fetal_tissue_in_vaccine_development#mw-content

The bishops said it is morally acceptable for Catholics to use either of the two vaccines approved for use in the U.S. -- made by Pfizer and Moderna -- despite a "remote connection to morally compromised cell lines." This entailed the use of fetal cell lines for lab tests seeking to confirm the vaccines' effectiveness.

Another leading vaccine, made by AstraZeneca and approved for use in Britain and some other countries, is "more morally compromised," and should be avoided if there are alternatives available, the bishops said.

...from https://apnews.com/article/baptist-health-abortion-coronavirus-pandemic-coronavirus-vaccine-8deb3edf4fa590a784e4bfd56a80e8da

Is masking bad for you?

Masks should not be worn by

Children younger than 2 years old

Anyone who has trouble breathing

Anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance

Wearing masks may be difficult for some people with sensory, cognitive, or behavioral issues. If they are unable to wear a mask properly or cannot tolerate a mask, they should not wear one, and adaptations and alternatives should be considered

...from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html

Carbon dioxide molecules are tiny - far smaller than droplets containing coronavirus which the masks are designed to stop - and won't be trapped by a breathable material, particularly during relatively short periods like a bus journey.

When you breathe out, the carbon dioxide will go through and round the type of masks most commonly worn, and is unlikely to build up to the extent that it causes health issues.

Surgeons regularly wear much heavier-duty face coverings all day without coming to harm.

...from https://www.bbc.com/news/53108405

"Masks may make it more difficult to breathe. If you've ever worn a mask walking uphill, it makes it substantially harder. But it has absolutely no impact on your oxygenation level and has no impact on your ability of your body to receive oxygen or expel carbon dioxide" he said.

...from https://www.nbcnews.com/health/health-news/wearing-mask-has-become-politicized-science-says-it-shouldn-t-n1232604

Now, there are those who may experience anxiety or claustrophobia when wearing a mask, the same way some panic when getting into an elevator or CT scanner. This can be hard to combat, especially when you're in the middle of it. But there are a few things you can do to try to calm yourself: long, slow breaths may steady you, as will the knowledge that despite how you're feeling, your lungs are getting exactly what they need.

...from https://wexnermedical.osu.edu/blog/masks-oxygen-levels

Did President Trump mess up COVID-19 response?

A Cornell University study found that US President Donald Trump was "likely the largest driver" of the COVID-19 misinformation infodemic in English-language media.[2]

...from https://en.wikipedia.org/wiki/Misinformation_related_to_the_COVID-19_pandemic

After the White House declined to pursue a unified national strategy, governors faced off against lobbyists, health experts and a restless public consumed by misinformation.

...from https://www.nytimes.com/2021/01/17/us/covid-deaths-2020.html#link-4e7d5c01

November 3... Last month, a coronavirus-crisis sub-committee within the US House of Representatives released a report documenting 47 instances in which government scientists had been sidelined or their recommendations altered. And the report notes that the frequency of meddling has been increasing in the lead-up to the US election.

...from https://www.nature.com/articles/d41586-020-03035-4

The following quote is from the report cited above:

The analysis shows that President Trump, Vice President Pence, White House officials, and political appointees at the Department of Health and Human Services (HHS) and other agencies have:

· Pressured health experts to adopt the Administration's talking points, even when they conflict with the science;

· Criticized, sidelined, and fired experts who insisted on sharing accurate scientific information with the public;

· Altered, delayed, and suppressed guidance and scientific reports on testing, protecting children, reopening schools, voting safely, and other topics;

· Authorized questionable virus treatments over the objections of scientists;

· Resisted efforts to ensure the safe development of a vaccine; and

· Diverted $265 million from the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration for an ad campaign to "defeat despair and inspire hope" weeks before Election Day.

...from https://coronavirus.house.gov/news/press-releases/select-subcommittee-analysis-shows-pattern-political-interference-trump

On March 13, President Trump declared a national emergency.[456] The Trump administration largely waited until mid-March to start purchasing large quantities of medical equipment.[457] In late March, the administration started to use the Defense Production Act to direct industries to produce medical equipment.

...from https://en.wikipedia.org/wiki/COVID-19_pandemic#North_America

Can you reuse surgical and N95 masks?

Standard disposable surgical masks are not designed to be washed.

...from https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic#Surgical_masks

Respirator disinfection and reuse
Extended use or re-use of single-use surgical masks and filtering facepiece respirators: A rapid evidence review

A good option: a mask made of two layers of a thick-weave fabric with a built-in pocket where you can place a filter, says May Chu, an epidemiologist at the Colorado School of Public Health who co-authored a paper published on June 2 in NANO Letters on the filtration efficiency of household mask materials.

The best bet for the material to slip in as a filter is polypropylene, which is derived from plastic, says Chu. "If you go to WalMart, you look for Oly-Fun, which is the brand name of that fabric. It's also called spunbond," says Chu, who's a scientific adviser to the World Health Organization and helped craft its recent detailed guidance on cloth masks.

Chu says polypropylene is great as a physical filter but has another benefit: it holds an electrostatic charge -- in other words, it uses the power of static electricity. Think of the static cling that can happen when you rub two pieces of fabric together, says Chu. That's basically what's happening with this fabric: That "cling" effect traps incoming -- and outgoing -- droplets. "That's what you want -- the cling is what's important," Chu says.

And unlike other materials, polypropylene keeps its electrostatic charge in the humidity created when you breathe out, says Yi Cui, a professor of materials science and engineering at Stanford University who co-authored the Nano Letters study with Chu.

Cui and Chu note that polypropylene will lose its electrostatic charge when you wash it, but you can recharge it by ironing it or by rubbing it with a plastic glove for around 20 seconds. Once you've got static cling, ka-ching -- you're back in business.

...from https://www.opb.org/news/article/npr-a-users-guide-to-masks-whats-best-at-protecting-others-and-yourself/

Why did the CDC discourage masks at first?

In June 2020 Anthony Fauci, a leading infectious disease expert for the United States government, admitted that the delay in recommending general mask use was motivated by a desire to conserve dwindling supplies for medical professionals.[81]

...Early in the pandemic, the Centers for Disease Control and Prevention (CDC) recommended that anyone symptomatic for suspected coronavirus disease 2019 (COVID-19) should wear a face covering during transport to medical care and prior to isolation to reduce the spread of respiratory droplets. After emerging data documented transmission of SARS-CoV-2 from persons without symptoms, the recommendation was expanded to the general community, with an emphasis on cloth face coverings that could be made more widely available in the community than surgical masks and to preserve personal protective equipment such as N95 respirators to the highest-risk exposures in health care settings. Now, there is ample evidence that persons without symptoms spread infection and may be the critical driver needed to maintain epidemic momentum.[83]

...from https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic#US_Centers_for_Disease_Control_and_Prevention

Mask fogging up your glasses?

4 Tips to Keep Your Glasses from Fogging Up

What is "close contact"?

Airborne transmission is not only possible while dining, it is possible beyond our current distance guidelines in time periods as short as five minutes! What we consider close contact for purposes of tracing and testing in this country (generally an unmasked interaction within less than six feet for more than fifteen minutes) is inadequate.

...from https://zeynep.substack.com/p/small-data-big-implications

Known as "close contact" which is variously defined, including within ~1.8 metres (six feet) by the US Centers for Disease Control and Prevention (CDC), and being face to face for a cumulative total of 15 minutes,[6] or either 15 minutes of face to face proximity or sharing an enclosed space for a prolonged period such as two hours by the Australian Health Department.[7]

...from https://en.wikipedia.org/wiki/COVID-19_pandemic#cite_note-10 Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period* starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.

* Individual exposures added together over a 24-hour period (e.g., three 5-minute exposures for a total of 15 minutes). Data are limited, making it difficult to precisely define "close contact;" however, 15 cumulative minutes of exposure at a distance of 6 feet or less can be used as an operational definition for contact investigation. Factors to consider when defining close contact include proximity (closer distance likely increases exposure risk), the duration of exposure (longer exposure time likely increases exposure risk), whether the infected individual has symptoms (the period around onset of symptoms is associated with the highest levels of viral shedding), if the infected person was likely to generate respiratory aerosols (e.g., was coughing, singing, shouting), and other environmental factors (crowding, adequacy of ventilation, whether exposure was indoors or outdoors). Because the general public has not received training on proper selection and use of respiratory PPE, such as an N95, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE. At this time, differential determination of close contact for those using fabric face coverings is not recommended.

...from https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/appendix.html#contact

Cloth masks aren't very effective.

Mask math
More masks = less risk
There's no silver bullet.
Multiple imperfect precautions work together.

Start with a surgical mask closest to your face, says Marr, and then add a cloth one on top. You want a surgical mask made out of a nonwoven material called polypropylene, because that material holds an electrostatic charge that allows it to trap particles. (Some surgical masks are made of paper.)

The downside of surgical masks is that many of them fit loosely -- and a mask's ability to filter out particles depends partly on how well it seals to your face. By layering a cloth mask on top, you can achieve a tighter fit while also adding an extra layer of filtration, says Marr, who co-wrote a recent commentary recommending double-masking.

...from https://www.npr.org/sections/health-shots/2021/02/03/962197192/5-hacks-to-make-your-face-mask-more-protective

How do cloth masks compare to surgical medical masks?

Different materials... Filtration efficiency
Different materials... Protection efficiency... Inward & outward
Different materials... How many particles get through?

...from https://www.medrxiv.org/content/10.1101/2020.11.18.20233353v1.full

There have been some studies of cloth masks, which have been found to be less protective than surgical masks in most, but not all, cases.

...from https://www.medrxiv.org/content/10.1101/2020.11.18.20233353v1.full-text

According to fit tests on 21 adults in the same study, homemade, 100% cotton masks provided median inward filtration efficiencies of 50%, compared to 80% for surgical masks.

...from https://www.medrxiv.org/content/10.1101/2020.11.18.20233353v1.full

Homemade masks made from tea cloths and worn by volunteers had a median inward filtration efficiency of 60%, compared to 76% for a surgical mask (van der Sande, Teunis and Sabel 2008).

...from https://www.medrxiv.org/content/10.1101/2020.11.18.20233353v1.full

"a surgical mask is better than a cloth mask, a tight-fitting surgical mask is better than a loose-fitting mask, and an N95 is better than a surgical mask."

...from https://www.vox.com/22220301/covid-spread-new-strain-variants-safe-grocery-store-n95-masks-vaccine

The best homemade cloth masks actually achieved better filtration (79 percent) than surgical masks (62 percent to 65 percent) in a peer-reviewed study at the Wake Forest Institute of Regenerative Medicine published in April. In the study, the best cloth masks were made of heavyweight quilter's cotton with a thread count of 180 or more. Masks with even thicker thread, tightly woven like a batik, and double-layer masks with a basic cotton outer and flannel inner also proved effective.

...from https://hartfordhealthcare.org/about-us/news-press/news-detail?articleId=26004&publicid=745

An N95 must be able to protect an individual worker in high-risk situations. A critical component of its efficacy is the fit test to ensure that the respirator seals completely to the face with no leaks. On the other hand, the overall goal of wearing cloth masks during the COVID-19 pandemic is to reduce community transmission.

...from https://www.medrxiv.org/content/10.1101/2020.11.18.20233353v1.full

The filtration, effectiveness, fit, and performance of cloth masks are inferior to those of medical masks and respirators. Cloth mask use should not be mandated for healthcare workers, who should as a priority be provided proper respiratory protection. Cloth masks are a more suitable option for community use when medical masks are unavailable. Protection provided by cloth masks may be improved by selecting appropriate material, increasing the number of mask layers, and using those with a design that provides filtration and fit. Cloth masks should be washed daily and after high-exposure use by using soap and water or other appropriate methods.

...from https://wwwnc.cdc.gov/eid/article/26/10/20-0948_article

What percentage of people mask in public?

% of population wearing face masks in public, by country

Does Joe Biden support a national lockdown?

November 19... "no national shutdown."

Why are minorities more at risk for COVID-19?

Health Equity Considerations and Racial and Ethnic Minority Groups

Of course, not everyone has the privilege of social distancing. From the United Kingdom to Sweden to Canada, we have evidence that the virus preys on people employed in "essential service" jobs (bus drivers, nurses, factory workers), which don't allow for telecommuting or paid sick leave; people in low-income neighborhoods; and people in "congregate housing" like shelters, prisons, and retirement homes.

People of color tend to be overrepresented in these groups -- but there's no biological reason they're more likely to get sick and die from the virus. Simply put: They tend to work jobs that take them outside the home and into close contact with other people, live in crowded environments ideal for coronavirus contagion, or both.

...from https://www.vox.com/22220301/covid-spread-new-strain-variants-safe-grocery-store-n95-masks-vaccine

But what started as a health emergency concentrated in travelers, urban minority communities, and other crowded places (such as nursing homes and prisons) fanned out into rural areas of the country, leading to a surge in deaths among white people, too.

...By October, some of the most sparsely populated areas of the country -- Wyoming, the Dakotas, Nebraska -- were grappling with America’s worst outbreaks. The relative share of deaths among white people started rising.

"The politics of 2020 led governors in [these] parts of the country to be less aggressive in dealing with the virus or actively discourage public health safeguards," Woolf said.

At the same time, more states adopted face-mask orders and other safety measures. Mask mandates helped bring case numbers down, and may have saved the lives of some essential workers.

The result: In August, Black people died at 2.5 times the rate of white people. By November, the rate was 2.2. In early February, it was 1.5.

...To prevent more needless suffering, we need to heed the lesson of the Covid-19 deaths in 2020: "The health haves cannot keep ignoring the health have-nots," Sandro Galea said. "Because everyone is susceptible to Covid, the fact [that] higher-risk groups exist makes everybody vulnerable."

...from https://www.vox.com/22252693/covid-19-deaths-us-who-died#t3SKUw

What does SARS-CoV-2 have to do with COVID-19?
Isn't that SARS?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)[2][3] is the strain of coronavirus that causes coronavirus disease 2019 (COVID-19), the respiratory illness responsible for the COVID-19 pandemic.

...from https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2

I thought a respirator is a breathing machine, not an N95 mask.

ikr

Where did COVID-19 originate?

How wildlife trade is linked to coronavirus
60 Minutes: Undercover at wet markets

Church people:

Is science opposed to faith?

What do you do when you're sick?

Do you open your Bible?
Or do you go to the doctor?
Or do you pray?

The Bible gives general principles, but it doesn't say how to treat COVID-19.

I shall ask God mercifully to protect us. Then I shall fumigate, help purify the air, administer medicine, and take it. I shall avoid places and persons where my presence is not needed in order not to become contaminated and thus perchance inflict and pollute others and so cause their death as a result of my negligence.

...from https://www.reddit.com/r/Pennsylvania/comments/i04513/lutheran_leaders_respond_to_mastriano/fzmy0gy/?utm_source=reddit&utm_medium=web2x&context=3

God will protect me.

We are responsibile to protect the vulnerable.

But we should not put the Lord to a test. In other words, we should not willingly and needlessly put ourselves in harm's way and expect a miracle from Him.

...from https://www.christianpost.com/voices/do-not-put-the-lord-your-god-to-the-test.html

I shall ask God mercifully to protect us. Then I shall fumigate, help purify the air, administer medicine, and take it. I shall avoid places and persons where my presence is not needed in order not to become contaminated and thus perchance inflict and pollute others and so cause their death as a result of my negligence.

...from https://www.reddit.com/r/Pennsylvania/comments/i04513/lutheran_leaders_respond_to_mastriano/fzmy0gy/?utm_source=reddit&utm_medium=web2x&context=3

How does the Bible inform these issues?

Should I go to church?

Risk of different venues
Crowd size risk estimator
County risk estimates
The risks are unknown.
How much risk are you willing to take?

Here are my recommendations for my church:

Play recorded music instead of singing.
Open windows & doors.
Hand sanitizer
No-touch garbage cans.

Post signs / announce the following:

Don't come to church if you have cold symptoms.
Don't touch your face.
Wear a mask to protect others.
Don't touch other people.
Bring a jacket or sweater, because windows may be open.

No multiple services on the same day:

How long do aerosols persist in the air?
How long dows SARS-CoV-2 survive on surfaces?

Provide masks?
Cancel services?
Clean between services?

CDC recommendations for faith communities

Should I sing at church?

Risks Associated With Types of Vocal Performance.

Similarly, Loudon and Roberts investigated the role of singing in the spread of tuberculosis and showed that the percentage of airborne droplet nuclei generated by singing is 6 times more than that emitted during normal talking and approximately equivalent to that released by coughing27. More recent work using advanced particle characterization techniques have yielded similar results21,28,29,30

...from https://www.nature.com/articles/s41598-019-38808-z#ref-CR

Should I handle hymnals at church?

Consistent with the community's faith tradition, consider temporarily limiting the sharing of frequently touched objects, such as worship aids, prayer rugs, prayer books, hymnals, religious texts and other bulletins, books, or other items passed or shared among congregants, and encouraging congregants to bring their own such items, if possible, or photocopying or projecting prayers, songs, and texts using electronic means.

...from https://www.cdc.gov/coronavirus/2019-ncov/community/faith-based.html




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