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

Updated December 4, 2021
List of questions


This color text ... Quotes from the internet
This color text ... My comments
Underlined text ... My emphasis added

Table of contents:

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






Free Krispy Kreme donuts if you've been vaccinated:

fer real.

Will the vaccines be safe?

Vaccines are predictable:

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

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

September 10, 2021... · The CDC studied over 600,000 Covid-19 infections across 13 U.S. cities and states from April to July, and found just 8% of cases were among fully vaccinated patients.

· The vaccines were slightly less effective at stopping overall infections after delta became the virus' dominant strain: Unvaccinated people were 4.6 times more likely to catch the virus from late June to mid-July, down from 11.1 between early April and late June, and the vaccines' effectiveness dropped from 91% to 78% over the same period.

· Still, the vaccines held up against hospitalization and death, with vaccinated U.S. adults 10.4 times less likely to end up in the hospital and 11.3 times less likely to die after delta surged in late June, a slight decrease from 13.3 and 16.6 before delta's onset.

· The CDC said the vaccines were 90% effective at stopping hospitalization and 91% effective at staving off death after June, a small drop from 92% and 94% pre-delta.

...from https://www.forbes.com/sites/joewalsh/2021/09/10/unvaccinated-11-times-more-likely-to-die-of-covid-cdc-says/

Side effects:

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

For public awareness and in the interest of transparency, CDC is providing timely updates on the following serious adverse events of interest:

· Anaphylaxis after COVID-19 vaccination is rare and has occurred in approximately 2 to 5 people per million vaccinated in the United States. Severe allergic reactions, including anaphylaxis, can occur after any vaccination. If this occurs, vaccination providers can effectively and immediately treat the reaction. Learn more about COVID-19 vaccines and allergic reactions, including anaphylaxis.

· Thrombosis with thrombocytopenia syndrome (TTS) after Johnson & Johnson's Janssen (J&J/Janssen) COVID-19 vaccination is rare. As of July 12, 2021, more than 12.8 million doses of the J&J/Janssen COVID-19 Vaccine have been given in the United States. CDC and FDA identified 38 confirmed reports of people who got the J&J/Janssen COVID-19 Vaccine and later developed TTS. Women younger than 50 years old especially should be aware of the rare but increased risk of this adverse event. There are other COVID-19 vaccine options available for which this risk has not been seen. Learn more about J&J/Janssen COVID-19 Vaccine and TTS.

- To date, two confirmed cases of TTS following mRNA COVID-19 vaccination (Moderna) have been reported to VAERS after more than 321 million doses of mRNA COVID-19 vaccines administered in the United States. Based on available data, there is not an increased risk for TTS after mRNA COVID-19 vaccination.

· CDC and FDA are monitoring reports of Guillain-Barré Syndrome (GBS) in people who have received the J&J/Janssen COVID-19 Vaccine. GBS is a rare disorder where the body's immune system damages nerve cells, causing muscle weakness and sometimes paralysis. Most people fully recover from GBS, but some have permanent nerve damage. After 12.8 million J&J/Janssen COVID-19 Vaccine doses administered, there have been around 100 preliminary reports of GBS identified in VAERS. These cases have largely been reported about 2 weeks after vaccination and mostly in men, many 50 years and older. CDC will continue to monitor for and evaluate reports of GBS occurring after COVID-19 vaccination and will share more information as it becomes available.

· Myocarditis and pericarditis after COVID-19 vaccination are rare. As of July 12, 2021, VAERS has received 1,047 reports of myocarditis or pericarditis among people ages 30 and younger who received a COVID-19 vaccine. Most cases have been reported after mRNA COVID-19 vaccination (Pfizer-BioNTech or Moderna), particularly in male adolescents and young adults. Through follow-up, including medical record reviews, CDC and FDA have confirmed 633 reports of myocarditis or pericarditis. CDC and its partners are investigating these reports to assess whether there is a relationship to COVID-19 vaccination. Learn more about COVID-19 vaccines and myocarditis.

· Reports of death after COVID-19 vaccination are rare. More than 334 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through July 12, 2021. During this time, VAERS received 6,079 reports of death (0.0018%) among people who received a COVID-19 vaccine. FDA requires healthcare providers to report any death after COVID-19 vaccination to VAERS, even if it's unclear whether the vaccine was the cause. Reports of adverse events to VAERS following vaccination, including deaths, do not necessarily mean that a vaccine caused a health problem. A review of available clinical information, including death certificates, autopsy, and medical records, has not established a causal link to COVID-19 vaccines. However, recent reports indicate a plausible causal relationship between the J&J/Janssen COVID-19 Vaccine and TTS, a rare and serious adverse event--blood clots with low platelets--which has caused deaths.

...from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html

Long-term safety:

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/

That we don't know the long-term effects of the vaccines: That's always the case with new vaccines. But vaccine side effects usually show up within the first couple of months after vaccination, which is why the FDA insisted on two months of safety data before authorizing them. Adverse event reports since then have not detected patterns of death that would indicate a problem with the vaccines, the CDC says.

...from https://www.bloomberg.com/news/articles/2021-03-22/are-mrna-covid-vaccines-risky-what-the-experts-say-quicktake

There may be very rare side effects that aren't immediately found in clinical trials. But that's due to the extreme rarity of those side effects -- "not because it's a long-term problem," Offit said.

...from https://www.cnn.com/2021/04/28/health/covid-vaccine-myths-debunked/index.html#

Do vaccines alter your DNA?

How adenovirus vaccines work:
(Johnson & Johnson)

The Janssen COVID-19 Vaccine is manufactured using a specific type of virus called adenovirus type 26 (Ad26). The vaccine uses Ad26 to deliver a piece of the DNA, or genetic material, that is used to make the distinctive "spike" protein of the SARS-CoV-2 virus. While adenoviruses are a group of viruses that are relatively common, Ad26, which can cause cold symptoms and pink eye, has been modified for the vaccine so that it cannot replicate in the human body to cause illness. After a person receives this vaccine, the body can temporarily make the spike protein, which does not cause disease, but triggers the immune system to learn to react defensively, producing an immune response against SARS-CoV-2.

...from https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-third-covid-19-vaccine#linkedin-share

How mRNA vaccines work:
(Pfizer/BioNTech & Moderna)

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

Pfizer / BioNTech trials:

FDA Authorizes Pfizer-BioNTech COVID-19 Vaccine for Emergency Use in Children 5 through 11 Years of Age

...from https://www.fda.gov/news-events/press-announcements/fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use-children-5-through-11-years-age

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?

On August 23, 2021, the FDA approved the first COVID-19 vaccine. The vaccine has been known as the Pfizer-BioNTech COVID-19 Vaccine, and will now be marketed as Comirnaty, for the prevention of COVID-19 disease in individuals 16 years of age and older. The vaccine also continues to be available under emergency use authorization (EUA), including for individuals 12 through 15 years of age and for the administration of a third dose in certain immunocompromised individuals.

...from https://www.fda.gov/coronavirus-disease-2019-covid-19/comirnaty-and-pfizer-biontech-covid-19-vaccine

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 trials:

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

Johnson & Johnson trials:

The EUA [emergency use authorization] for the Janssen COVID-19 Vaccine was issued to Janssen Biotech Inc., a Janssen Pharmaceutical Company of Johnson & Johnson.

...from https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-third-covid-19-vaccine#linkedin-share

The Johnson & Johnson vaccine is what's called an adenovirus-vectored vaccine.

...from https://www.popsci.com/story/health/johnson-johnson-covid-vaccine/#d868a0c4-ad68-4f49-af98-b9aa27cb32ac-image

Johnson & Johnson's vaccine comes out of decades of research on adenovirus-based vaccines. In July, the first one was approved for general use -- a vaccine for Ebola, also made by Johnson & Johnson.

...from https://www.nytimes.com/interactive/2020/health/johnson-johnson-covid-19-vaccine.html#g-ai1-1

The adenovirus vector vaccine is safe because the adenovirus can't replicate in human cells or cause disease, and the SARS-CoV-2 spike protein can't cause COVID--19 without the rest of the coronavirus.

...from https://www.pbs.org/newshour/health/how-does-the-johnson-johnson-vaccine-compare-to-other-coronavirus-vaccines#

The data also show that the vaccine's known and potential benefits outweigh its known and potential risks, supporting the company's request for the vaccine's use in people 18 years of age and older.

...from https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-third-covid-19-vaccine#linkedin-share

The available safety data to support the EUA include an analysis of 43,783 participants enrolled in an ongoing randomized, placebo-controlled study being conducted in South Africa, certain countries in South America, Mexico, and the U.S. The participants, 21,895 of whom received the vaccine and 21,888 of whom received saline placebo, were followed for a median of eight weeks after vaccination. The most commonly reported side effects were pain at the injection site, headache, fatigue, muscle aches and nausea. Most of these side effects were mild to moderate in severity and lasted 1-2 days.

As part of the authorization, the FDA notes that it is mandatory for Janssen Biotech Inc. and vaccination providers to report the following to the Vaccine Adverse Event Reporting System (VAERS) for Janssen COVID-19 Vaccine: serious adverse events, cases of Multisystem Inflammatory Syndrome and cases of COVID-19 that result in hospitalization or death.

...The effectiveness data to support the EUA include an analysis of 39,321 participants in the ongoing randomized, placebo-controlled study being conducted in South Africa, certain countries in South America, Mexico, and the U.S. who did not have evidence of SARS-CoV-2 infection prior to receiving the vaccine. Among these participants, 19,630 received the vaccine and 19,691 received saline placebo. Overall, the vaccine was approximately 67% effective in preventing moderate to severe/critical COVID-19 occurring at least 14 days after vaccination and 66% effective in preventing moderate to severe/critical COVID-19 occurring at least 28 days after vaccination.

Additionally, the vaccine was approximately 77% effective in preventing severe/critical COVID-19 occurring at least 14 days after vaccination and 85% effective in preventing severe/critical COVID-19 occurring at least 28 days after vaccination.

There were 116 cases of COVID-19 in the vaccine group that occurred at least 14 days after vaccination, and 348 cases of COVID-19 in the placebo group during this time period. There were 66 cases of COVID-19 in the vaccine group that occurred at least 28 days after vaccination and 193 cases of COVID-19 in the placebo group during this time period. Starting 14 days after vaccination, there were 14 severe/critical cases in the vaccinated group versus 60 in the placebo group, and starting 28 days after vaccination, there were 5 severe/critical in the vaccine group versus 34 cases in the placebo group.

...from https://www.fda.gov/news-events/press-announcements/fda-issues-emergency-use-authorization-third-covid-19-vaccine#linkedin-share

Can you trust the vaccine data?

Long-term safety

Trials vs vaccinated people:

When the vaccines were given EUAs, there were data from tens of thousands of clinical trial participants. We now have data from close to 200 million people who have received the vaccines. We know a lot now about these vaccines, and more and more data are being published every week.

...from https://sciencebasedmedicine.org/christian-elliots-18-reasons-i-wont-be-getting-a-covid-vaccine-viral-antivaccine-misinformation/#print-cresta-c

Who authorized the vaccines?

An independent body of people "who have no allegiance to anyone, not to the administration, not to me, not to the companies" were the ones to first review the data from the companies' late stage clinical trials, Fauci said. They were the ones who "deemed it to be sound."

...from https://www.livescience.com/fauci-vaccines-not-rushed.html#article-body

Q: There are a number of vaccine candidates that are promising. But there's also a lot of skepticism because we've seen the FDA come under both commercial and, increasingly, political pressure. When will we know it's OK to take a vaccine? And which?

It's pretty easy when you have vaccines that are 95% effective. Can't get much better than that. I think what people need to appreciate -- and that's why I have said it like maybe 100 times in the last week or two -- is the process by which a decision is made. The company looks at the data. I look at the data. Then the company puts the data to the FDA. The FDA will make the decision to do an emergency use authorization or a license application approval. And they have career scientists who are really independent. They're not beholden to anybody. Then there's another independent group, the Vaccines and Related Biological Products Advisory Committee. The FDA commissioner has vowed publicly that he will go according to the opinion of the career scientists and the advisory board.

Q: You feel the career scientists will have the final say?

Yes, yes.

...from https://www.healthleadersmedia.com/covid-19/take-it-expert-faucis-hierarchy-safety-during-covid#bottom-content-mob

VAERS underreports adverse events:

Also keep in mind that VAERS isn't the only system that helps to monitor vaccine safety. We also have the Vaccine Safety Datalink project, the Clinical Immunization Safety Assessment Network, and the Vaccine Analytic Unit.

...from https://vaxopedia.org/2017/08/26/underreporting-of-side-effects-to-vaers/#caption-attachment-23204

Underreporting can affect the ability of VAERS to detect very rare events, although this may less [sic] of a concern for clinically serious events as they are more likely to be reported than non-serious events.[29]

...from https://www.cdc.gov/vaccines/pubs/surv-manual/chpt21-surv-adverse-events.html#limitations

Have you heard the claim that only 1% of serious vaccine reactions are reported to VAERS?

That's not true.

That claim is based on an old study about drug reactions and was not specific to vaccines.

We also know that underreporting is less common for more severe adverse reactions than for those that are more mild. For example, one study found that up to 68% of cases of vaccine-associated poliomyelitis (a table injury) were reported to VAERS, while less than 1% of episodes of rash following the MMR vaccine were reported.

...from https://vaxopedia.org/2017/08/26/underreporting-of-side-effects-to-vaers/#caption-attachment-23204

Before the pandemic began, the Food and Drug Administration had scaled back a program it used successfully to track adverse events during and after the 2009 H1N1 influenza pandemic, and the agency is still ramping up its replacement, said Dr. Robert Chen, scientific director of the Brighton Collaboration, a nonprofit global vaccine safety network.

"It's purely bad luck they were in between systems when Covid hit," said Chen, who helped create the existing U.S. vaccine safety systems during nearly 30 years at the Centers for Disease Control and Prevention.

"FDA and CDC have robust safety and effectiveness surveillance systems in place to monitor Covid-19 vaccines authorized for emergency use in the U.S.," Abby Capobianco, an FDA spokesperson, wrote in an email.

...from https://www.nbcnews.com/health/health-news/covid-vaccine-safety-system-has-gaps-may-miss-unexpected-side-n1265986#

Like all passive surveillance systems, VAERS is subject to varying degrees of underreporting. The sensitivity of VAERS is affected by the likelihood that parents and/or vaccinees detect an AE; that parents and/or vaccinees bring the event to the attention of their healthcare provider(s); that parents and/or healthcare providers suspect an event is related to prior vaccination; that parents and/or healthcare providers are aware of VAERS; and that parents and/or healthcare providers report the event. The completeness of reporting of AEs associated with certain vaccines varies according to the severity of the event and the specificity of the clinical syndrome to the vaccine.[29,30] Reporting can also be stimulated by media attention on specific AEs.[31]

...from https://www.cdc.gov/vaccines/pubs/surv-manual/chpt21-surv-adverse-events.html#eval-vaers

"Underreporting" is one of the main limitations of passive surveillance systems, including VAERS. The term, underreporting refers to the fact that VAERS receives reports for only a small fraction of actual adverse events. The degree of underreporting varies widely. As an example, a great many of the millions of vaccinations administered each year by injection cause soreness, but relatively few of these episodes lead to a VAERS report. Physicians and patients understand that minor side effects of vaccinations often include this kind of discomfort, as well as low fevers. On the other hand, more serious and unexpected medical events are probably more likely to be reported than minor ones, especially when they occur soon after vaccination, even if they may be coincidental and related to other causes.

...from https://vaers.hhs.gov/data/dataguide.html#nav

A CDC study indicated that, as with all passive surveillance systems, underreporting occurs with VAERS; however, reporting efficiency is higher for severe events than for mild ones (Rosenthal and Chen, 1995). An FDA study found that the reporting rate to VAERS varies substantially by state, but those states that reported the most serious events also reported the most events of lesser severity (Braun, 1997).

The concern of some physicians about potential legal liability for an adverse event following vaccination was cited by some participants as a reason for underreporting in VAERS. Theoretically, this should no longer be the case, because the existence of the National Vaccine Injury Compensation Program (established by federal statute in 1986) has resulted in very few suits filed against physicians for vaccine-related injuries since that time.

...from https://www.ncbi.nlm.nih.gov/books/NBK232983/#_ddd00017_

Elliot asserts that these reports show that there have been "over 2,200 deaths from the current COVID vaccines, as well as close to 60,000 adverse reactions." VAERS is a self-reported system that in no way determines the cause of death or association with a vaccine. Just because someone died several months after they got a vaccine does not mean, as often claimed by activists, that a vaccine caused that death.

Using something purported to be a "Harvard study" (but that is actually a grant report on a project that could not be completed), Elliot performed some truly outrageous back-of-the-envelope math based on that report's claim that VAERS only captures 1% percent of total incidents:

If those numbers are still only 1% of the total adverse reactions … you can do the math, but that equates to somewhere around 110,000 to 220,000 deaths from the vaccines to date, and a ridiculous number of adverse reactions.

With respect to the 1% figure, extrapolating it to cases of death rests on the false assumption that reporting rates for all adverse events, regardless of severity, are the same. As a spokesperson for the Centers for Disease Control and Prevention (CDC) told Reuters, reporting rates for different types of adverse events vary:

Mild events, like a rash, tend to be reported less frequently than severe events (like a seizure). We have data to show that serious adverse events that occur after vaccination are more likely to be reported than non-serious adverse events. Events such as a sore arm at the injection site might not get reported since they are expected and therefore people don't feel the need to report them.

If your mathematical analysis leads you to claim that there have been 220,000 vaccine caused deaths that have somehow flown under the radar in a climate where six blood clotting incidents paused the distribution of a vaccine, it might make sense to challenge the assumptions that brought you to that "ridiculous number" in the first place.

...from https://www.snopes.com/news/2021/04/16/18-reasons-why/#smg-zone-post-body-4

Are fewer than 1% of vaccine injuries reported to VAERS?

It has long been suspected that reports to VAERS are under-reported, as it is a passive reporting system.

The original claims for under-reporting to VAERS were based on an old study about drug reactions and were not specific to vaccines though.

Is that the Harvard study?


"Restructuring at CDC and consequent delays in terms of decision making have made it challenging despite best efforts to move forward with discussions regarding the evaluation of ESP:VAERS performance in a randomized trial and comparison of ESP:VAERS performance to existing VAERS and Vaccine Safety Datalink data. However, Preliminary data were collected and analyzed and this initiative has been presented at a number of national symposia."

Electronic Support for Public Health--Vaccine Adverse Event Reporting System (ESP:VAERS)

They are talking about a report, Electronic Support for Public Health--Vaccine Adverse Event Reporting System (ESP:VAERS), that was conducted at Harvard Pilgrim Health Care, Inc.

"Preliminary data were collected from June 2006 through October 2009 on 715,000 patients, and 1.4 million doses (of 45 different vaccines) were given to 376,452 individuals. Of these doses, 35,570 possible reactions (2.6 percent of vaccinations) were identified."

Electronic Support for Public Health--Vaccine Adverse Event Reporting System (ESP:VAERS)

It is very important to note that all the study found is that all possible reactions, including minor reactions, like pain and fever, are not common.

They didn't actually finish the report to see how commonly those reactions were reported to VAERS.

But we already know that more serious reactions are reported to VAERS much more routinely.

...from https://vaxopedia.org/2019/09/03/percentage-of-reports-to-vaers/#post-40059

Why are vaccine makers immune from liability?

No vaccine manufacturer shall be liable in a civil action for damages arising from a vaccine-related injury or death associated with the administration of a vaccine after October 1, 1988, if the injury or death resulted from side effects that were unavoidable even though the vaccine was properly prepared and was accompanied by proper directions and warnings.

...from https://www.law.cornell.edu/uscode/text/42/300aa-22#tab_default_1

A company can still be sued if they show 'willful misconduct' in the production of their vaccine.

...from https://www.wusa9.com/article/news/verify/adverse-effects-side-effects-covid-19-can-vaccine-comapnies-be-sued-for-complications-from-symptoms-verify-fact-check/65-ae9305ac-1193-4b7a-a90f-eb8536f06058#main

DPT Lawsuits

Through the 1970s and 1980s, the number of lawsuits brought against vaccine manufacturers increased dramatically, and manufacturers made large payouts to individuals and families claiming vaccine injury, particularly from the combined diphtheria-pertussis-tetanus (DPT) immunization. In this environment of increasing litigation, mounting legal fees, and large jury rewards, many pharmaceutical companies left the vaccine business. In fact, by the end of 1984, only one U.S. company still manufactured the DPT vaccine, and other vaccines were losing manufacturers as well.


In October 1986, the U.S. Congress responded to the precarious situation in the vaccine market by passing the National Childhood Vaccine Injury Act (NCVIA). The act included a number of regulations related to informed consent and adverse event reporting. For example, the act required that providers administering certain vaccines provide a Vaccine Information Statement (VIS) to the vaccine recipient or a legal guardian. The VIS lists the risks and benefits of a particular vaccine. The NCVIA also established a system for reporting suspected vaccine-related adverse events. This system, the Vaccine Adverse Event Reporting System (VAERS), is described here. Additionally, the act contained provisions for a program that would fairly and efficiently compensate individuals harmed by certain vaccines that were properly manufactured. Such a system, it was hoped, would stabilize the legal environment for manufacturers, allowing them to limit their liability, better anticipate their legal costs, and reduce potential barriers to research into new vaccines.

...from https://www.historyofvaccines.org/content/articles/vaccine-injury-compensation-programs#body-mediaitem-switcher

Pharmaceutical companies are protected from liability regarding the COVID-19 vaccines. If someone has an allergic reaction or injury from one of the vaccines, they can petition to receive compensation from the Department of Health and Human Services' (HHS) Countermeasures Injury Compensation Program (CICP).

The National Vaccine Injury Compensation Program (VICP), which also falls under the jurisdiction of HHS, has a better record of providing compensation to people who claim injury from a vaccine than CICP but covers vaccines for diseases such as polio and seasonal influenza, not COVID-19.

...There are a few key differences between VICP and CICP.

The Associated Press reported that VICP has paid much more in compensation than CICP has. Only 29 out of 499 people who made claims under CICP received compensation.

Since the late 1980s, VICP has provided $4.4 billion in total compensation, with an average of $570,000 per claim. Since 2005, CICP has provided petitioners, who mostly made claims about the H1N1 swine flu vaccine, $6 million in compensation, with an average of $200,000 per claim. According to theAssociated Press, "payments in most death cases are capped at $370,376" for CICP.

VICP allows individuals to make claims within three years of their first symptom. CICP, on the other hand, allows petitioners only one year from the date of vaccination.

CICP doesn't pay fees for lawyers or expert witnesses or provide awards for suffering or damages; VICP does. VICP also permits appeals all the way to the Supreme Court.

In other words, people who make claims about injuries or allergic reactions to either of the COVID-19 vaccines have less time to make their petitions than people who have filed claims for injuries from vaccines related to the measles or the flu. They also are less likely to receive compensation for injuries from COVID-19 vaccines, and if they do receive compensation, it likely will be a smaller amount.

...from https://www.newsweek.com/fact-check-are-pharmaceutical-companies-immune-covid-19-vaccine-lawsuits-1562793#tvplayer

Were the COVID-19 vaccines rushed?

"There is an irresolvable tension between speed and safety," said Dr. Gregory Poland, the head of Mayo Clinic's Vaccine Research Group. "Efficacy is pretty easy to figure out. It's safety that's the issue."

...from https://khn.org/news/these-secret-safety-panels-will-pick-the-covid-vaccine-winners/#

Trials were designed such that clinical phases are overlapping and trial starts are staggered, with initial phase I/II trials followed by rapid progression to phase III trials after interim analysis of the phase I/II data.

...from https://www.nature.com/articles/s41586-020-2798-3#figure-2-desc

Moving at "warp speed" allows "a very rapid development without inappropriate corners being cut," Slaoui said. "All the risk taken is financial, logistical, and resourcing, but not on safety or efficacy." Bureaucratic obstacles have been loosened, removing the usual gaps between different phases of clinical trials and saving precious time, he said.

...from https://www.webmd.com/vaccines/covid-19-vaccine/news/20201013/what-happed-other-times-a-vaccine-was-rushed#2-2

The vaccine science would not have produced such fast results without this funding, she says. "It didn't happen with Ebola, which was devastating communities in Africa [in 2014--16]" -- and Ebola vaccines accordingly took longer to develop. The money only materialized this time because all countries, including wealthy ones, faced economic devastation: suggesting that the development of future vaccines, including for existing diseases such as malaria, will not be as speedy. "Unless you put in the money, there's no way to accelerate," says Rappuoli.

...from https://www.nature.com/articles/d41586-020-03626-1#Fig2

Research history:

The basic research on DNA vaccines began at least 25 years ago, and RNA vaccines have benefited from 10--15 years of strong research, she says, some aimed at developing cancer vaccines. The approach has matured just at the right time; five years ago, the RNA technology would not have been ready.

...from https://www.nature.com/articles/d41586-020-03626-1#Fig2

During the SARS1 (SARS-CoV-1) outbreak 18 years ago, researchers started looking at that virus, and other coronaviruses, and found a really promising vaccine target on the virus cell surface -- which is a protein called spike. That protein is what binds to human cells and leads to an infection.

So about 10 years ago the science wheels started churning out strategies to vaccinate against SARS1. Unfortunately, funding dried up for SARS1 as that virus never made its way to the U.S., so a vaccine didn't actually get developed. However, the research on the virus and ideas of how to vaccinate against it were already available.

Thankfully SARS2 (SARS-CoV-2, our current situation) uses almost the exact same version of that protein to infect cells and uses the exact same receptor on human cells. Due to these similarities, scientists were able to pick up where they left off, which sped up the process dramatically.

Further, vaccination strategies have improved significantly in the last 10-plus years, particularly in the past couple of years with the mRNA technology that Moderna and Pfizer have utilized. All of these companies basically just took the DNA or RNA backbone of a vaccine that they had already built and plugged in the SARS2 spike protein's genetic information.

...from https://www.sltrib.com/opinion/commentary/2020/11/20/allison-weis-covid/#navbar

Researchers have been developing and researching an mRNA vaccine platform for over 10 years. After SARS-CoV-2 was sequenced, it took just a few days to make the mRNA vaccine candidates. The spike protein's genetic code was plugged into preexisting technology with an already working process that had been evaluated for other vaccine uses, such as in the fight against dengue.

...from https://www.nebraskamed.com/COVID/were-the-covid-19-vaccines-rushed#block-mainpagecontent

The third vaccine to show efficacy in phase III clinical trials in November, made by the pharmaceutical firm AstraZeneca with the University of Oxford, UK, does not use mRNA. Instead, a viral vector (or carrier) holds extra genetic material that codes for the SARS-CoV-2 spike protein. This, too, benefited from years of research to select the vector; in this case, the firm chose a modified form of adenovirus isolated from chimpanzee stool. Advances in conventional vaccines such as these have also come from research on SARS, MERS, Ebola and malaria, says Beate Kampmann, director of the Vaccine Centre at the London School of Hygiene & Tropical Medicine, and such approaches remain cheaper than using mRNA.

...from https://www.nature.com/articles/d41586-020-03626-1#Fig2

Post-vaccination infection:

"Vaccines decrease your risk of COVID-19. They don't make you immortal."

Of course there are people who catch COVID-19 after being fully vaccinated. No vaccine is 100% effective; so we always knew that this would happen. Again, this is the Nirvana fallacy, in which antivaxxers suggest that if a vaccine isn't 100% effective it's crap.

...from https://sciencebasedmedicine.org/christian-elliots-18-reasons-i-wont-be-getting-a-covid-vaccine-viral-antivaccine-misinformation/#print-cresta-c

"What the issue is, is that the level of virus in your nasal pharynx, which is correlated with whether or not you were going to transmit it to someone else, is considerably lower," he said. "So even though there are breakthrough infections with vaccinated people, almost always the people are asymptomatic, and the level of virus is so low, it makes it extremely unlikely, not impossible, but very, very low likelihood that they are going to transmit it."

...from https://www.cbsnews.com/news/cdc-guidelines-mask-evolution-science-fauci/#:~:text=low-,What%20the%20issue%20is,going%20to%20transmit%20it

As of April 26, 2021, more than 95 million people in the United States had been fully vaccinated against COVID-19. During the same time, CDC received reports of vaccine breakthrough infections from 46 U.S. states and territories.

Total number of vaccine breakthrough infections reported to CDC9,245
Females5,827 (63%)
People aged ≥60 years4,245 (45%)
Asymptomatic infections2,525 (27%)
Hospitalizations*835 (9%)
Deaths†132 (1%)

*241 (29%) of the 835 hospitalizations were reported as asymptomatic or not related to COVID-19.
†20 (15%) of the 132 fatal cases were reported as asymptomatic or not related to COVID-19.

...from https://www.cdc.gov/vaccines/covid-19/health-departments/past-breakthrough-data.html

As of May 1, 2021, CDC transitioned from monitoring all reported vaccine breakthrough cases to focus on identifying and investigating only hospitalized or fatal cases due to any cause. This shift will help maximize the quality of the data collected on cases of greatest clinical and public health importance. Previous case counts, which were last updated on April 26, 2021, are available for reference only and will not be updated moving forward.

...from https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html#

As of June 7, 2021, more than 139 million people in the United States had been fully vaccinated against COVID-19.

During the same time, CDC received reports from 47 U.S. states and territories of 3,459 patients with COVID-19 vaccine breakthrough infection who were hospitalized or died.

Hospitalized or fatal vaccine breakthrough cases reported to CDC 3,459
Female 1,691 (49%)
People aged ≥65 years 2,642 (76%)
Asymptomatic infections 617 (18%)
Hospitalizations* 3,275 (95%)
Deaths† 603 (17%)

*802 (24%) of 3,275 hospitalizations reported as asymptomatic or not related to COVID-19.
†100 (17%) of 603 fatal cases reported as asymptomatic or not related to COVID-19.

...from https://www.cdc.gov/vaccines/covid-19/health-departments/breakthrough-cases.html

Why do they recommend masks, social distancing, etc. post-vaccination?

Current recommendations:
(as of December 1, 2021)

· To reduce the risk of being infected with the Delta variant and possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.

· You might choose to wear a mask regardless of the level of transmission if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if a member of your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated.

...· COVID-19 vaccines are effective against severe disease and death from variants of the virus that causes COVID-19 currently circulating in the United States, including the Delta variant.

· Infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant. When these infections occur among vaccinated people, they tend to be mild.

· If you are fully vaccinated and become infected with the Delta variant, you can spread the virus to others.

...from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#

The new guidance is likely to open the door to confusion, since there is no surefire way for businesses or others to distinguish between those who are fully vaccinated and those who are not.

...And while some people still get COVID-19 despite being vaccinated, Walensky said that's rare and cited evidence that those infections tend to be milder, shorter and harder to spread to others. If people who are vaccinated do develop COVID-19 symptoms, they should immediately put their mask back on and get tested, she said.

...from https://apnews.com/article/coronavirus-masks-cdc-guidelines-9d10c8b5f80a4ac720fa1df2a4fb93e5#


There simply aren't enough people who have been vaccinated yet.

...from https://uihc.org/health-topics/3-reasons-why-we-need-wear-mask-after-covid-19-vaccination#row-13556

In indoor public spaces, the vaccination status of other people or whether they are at increased risk for severe COVID-19 is likely unknown. Therefore, fully vaccinated people should continue to wear a mask that fits snugly against the sides of your face and doesn't have gaps, cover coughs and sneezes, wash hands often, and follow any applicable workplace or school guidance.

...from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#

Paul to Fauci: Given that no scientific studies have shown significant numbers of reinfections of patients previously infected, or previously vaccinated, what specific studies do you cite to argue that the public should be wearing masks well into 2022?

Fauci to Paul: In the South African study, conducted by J&J, they found that people who were infected with wild type and were exposed to the variant in South Africa--the 3.5.1--it was if they had never been infected before--they had no protection.

...from https://www.youtube.com/watch?v=RrpEOg1cFj0&list=PLEb9Wh_GlgF5VUpBmG1G_4WkgoGRdWT6u

Before approving the Moderna and Pfizer vaccines, the FDA asked the vaccine manufacturers only whether their products protect people from COVID-19 symptoms. They didn't ask if the vaccines stop people who've been vaccinated from nevertheless spreading the virus to others. The emergency authorizations by the FDA that have allowed distribution of the two new vaccines cite only their ability to keep you -- the person vaccinated -- from becoming severely sick with COVID-19.

...from https://www.npr.org/sections/health-shots/2021/01/12/956051995/why-you-should-still-wear-a-mask-and-avoid-crowds-after-getting-the-covid-19-vac#ad-backstage-News_Health

With cases and deaths surging throughout the U.S., the people who are treating COVID-19 patients really want you to continue to wear a mask, keep your distance and wash your hands, even if you've been vaccinated, until the research on shedding has yielded some answers. Dr. Carlos del Rio of Emory University says he knows taking precautions can be taxing, but he urges us all to hang on and keep it up.

"It's not like you'll need to wear a mask for the rest of your life," he says. "You need to wear your mask until we have the data, and we're trying to get the answers as fast as we can."

...from https://www.npr.org/sections/health-shots/2021/01/12/956051995/why-you-should-still-wear-a-mask-and-avoid-crowds-after-getting-the-covid-19-vac#featuredStackSquareImage953653373

Until proven otherwise, people should consider asymptomatic infections and transmission to be a possibility. "There's a concern that people could get the vaccine and feel like they are safe, but they could be actually infected with the virus and carry it in their nasal passages and in their airways. And because they're feeling safe, they might be less cautious and actually spread the disease," said Boslett. With this in mind, health officials are urging everyone, even people who have received the vaccination, to continue to wear masks, stay six feet apart from people not in their own household and to wash their hands frequently.

...from https://www.ucsf.edu/news/2021/01/419691/covid-19-vaccine-fact-vs-fiction-expert-weighs-common-fears#

How does natural immunity compare to post-vaccination immunity?

In comparing the two types of immunity, scientists said research shows vaccination provides a "higher, more robust, and more consistent level of immunity to protect people from COVID-19 than infection alone."

...But for most countries and the United States, the definition of fully vaccinated does not incorporate previous infection. The White House strategy for ending the pandemic relies heavily on vaccinating as many people as possible, including those who have already had covid-19 or tested positive for the virus.

..."We would like clear guidance from CDC on how to handle previous infection in planning the timing of infection for people who have to be vaccinated," Pavia said.

...from https://www.washingtonpost.com/health/2021/11/01/what-works-better-vaccines-or-natural-immunity/

A systematic review and meta-analysis including data from three vaccine efficacy trials and four observational studies from the US, Israel, and the United Kingdom, found no significant difference in the overall level of protection provided by infection as compared with protection provided by vaccination; this included studies from both prior to and during the period in which Delta was the predominant variant [79]. In this review, the randomized controlled trials appeared to show higher protection from mRNA vaccines whereas the observational studies appeared to show protection to be higher following infection.

...from https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/vaccine-induced-immunity.html

To Mr. Paul's point: Natural immunity from the coronavirus is fortunately quite strong. A vast majority of people infected produce at least some antibodies and immune cells that can fight off the infection. And the evidence so far suggests that this protection will persist for years, preventing serious illness, if not reinfection.

But there is a "massive dynamic range" in that immune response, with a 200-fold difference in antibody levels.

In people who are only mildly ill, the immune protection that can prevent a second infection may wane within a few months. "Those people might benefit more from the vaccine than others would," said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health.

With a vaccine, everyone gets the same dose. "We know the dose that is being administered, and we know that that dose is effective at eliciting an immune response," Dr. Gommerman said. "So that becomes a variable that's taken off the table when you get the vaccine."

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

Israeli Maccabi Study, August 25, 2021:

The natural immune protection that develops after a SARS-CoV-2 infection offers considerably more of a shield against the Delta variant of the pandemic coronavirus than two doses of the Pfizer-BioNTech vaccine, according to a large Israeli study that some scientists wish came with a "Don't try this at home" label.

...The study shows the benefits of natural immunity, but "doesn't take into account what this virus does to the body to get to that point," says Marion Pepper, an immunologist at the University of Washington, Seattle.

...from https://www.science.org/content/article/having-sars-cov-2-once-confers-much-greater-immunity-vaccine-vaccination-remains-vital

The paper from researchers in Israel contrasts with earlier studies, which showed that immunizations offered better protection than an earlier infection, though those studies were not of the delta variant.

...from https://www.bloomberg.com/news/articles/2021-08-27/previous-covid-prevents-delta-infection-better-than-pfizer-shot

Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant.

...We conducted a retrospective observational study comparing three groups: (1)SARS-CoV-2-naďve individuals who received a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine, (2)previously infected individuals who have not been vaccinated, and (3)previously infected and single dose vaccinated individuals.

...from https://www.medrxiv.org/content/10.1101/2021.08.24.21262415v1.full

The researchers said the study is "the largest real-world observational study comparing natural immunity" gained from infection by the coronavirus, with immunity provided by the Pfizer-BioNTech vaccine. They looked at patient records from June through August 2021, when the delta variant was dominant in Israel.

They found:

· People who received both doses of the Pfizer vaccine in January or February 2021 were 13 times more likely to get a breakthrough infection with the delta variant than unvaccinated people who had COVID-19 during the same period were to be reinfected.

· Over a longer period of time -- with infection occurring anytime from March 2020 to February 2021, when different variants were dominant in Israel -- fully vaccinated people in the study were six times more likely to become infected and seven times more likely to experience "symptomatic disease" than unvaccinated people in the study.

...from https://www.politifact.com/factchecks/2021/sep/01/gateway-pundit/immunity-gained-covid-19-infection-ignores-risks-g/

"The differences are huge," says Thĺlin, although she cautions that the numbers for infections and other events analyzed for the comparisons were "small." For instance, the higher hospitalization rate in the 32,000-person analysis was based on just eight hospitalizations in a vaccinated group and one in a previously infected group. And the 13-fold increased risk of infection in the same analysis was based on just 238 infections in the vaccinated population, less than 1.5% of the more than 16,000 people, versus 19 reinfections among a similar number of people who once had SARS-CoV-2.

No one in the study who got a new SARS-CoV-2 infection died--which prevented a comparison of death rates but is a clear sign that vaccines still offer a formidable shield against serious disease, even if not as good as natural immunity. Moreover, natural immunity is far from perfect. Although reinfections with SARS-CoV-2 are rare, and often asymptomatic or mild, they can be severe.

...from https://www.science.org/content/article/having-sars-cov-2-once-confers-much-greater-immunity-vaccine-vaccination-remains-vital

In the Pfizer trials, there were "3,410 total cases of suspected, but unconfirmed covid-19 in the overall study population, 1,594 occurred in the vaccine group vs. 1,816 in the placebo group."

But "suspected but unconfirmed" doesn't refer to participants who were probably sick with COVID-19. On the contrary, it refers to participants who reported various symptoms, such as a cough or a sore throat, and then took a PCR test--and then that test came back negative.

...from https://www.theatlantic.com/ideas/archive/2021/04/pandemics-wrongest-man/618475/#injected-recirculation-link-0

With 20 times more suspected than confirmed cases, this category of disease cannot be ignored simply because there was no positive PCR test result.

...from https://blogs.bmj.com/bmj/2021/01/04/peter-doshi-pfizer-and-modernas-95-effective-vaccines-we-need-more-details-and-the-raw-data/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+bmj%2Fblogs+%28Latest+BMJ+blogs%29&g=w_bmj-com#shr_canvas1

We are very concerned about data mentioned exclusively in an FDA briefing document (p.42) describing 3410 'suspected but unconfirmed' cases of COVID-19, including 1594 vaccine and 1816 placebo subjects. This statistic points to a critical, but missing, datapoint: the number tested for COVID-19 in each group. As per the study protocol (p89) all subjects should have been tested. However, neither the published manuscript nor the FDA document describes how many in each group were tested.

...from https://www.thennt.com/review-covid-analysis-2020/#staticpage

As described in Section 8.13, page 88/137 of the protocol, they did this by instructing subjects to immediately contact the site for a SARS-CoV-2 PCR test if they experienced any of the following symptoms anew that COULD indicate potential COVID-19: fever, cough, shortness of breath, chills, muscle pain, sore throat, loss of taste/smell, diarrhea, and vomiting. The protocol states that anyone reporting one of these symptoms (except within 7 days of receiving shot) is a suspected COVID-19 patient who should immediately arrange a potential COVID-19 illness visit to receive a PCR test to determine if they are infected with the SARS-CoV-2 virus or not. Those who receive a positive PCR test are "confirmed COVID-19 cases" that are included in the primary efficacy analysis, and those whose PCR test is negative (or if done multiple times, repeatedly negative) are "suspected but unconfirmed COVID-19 cases."

Thus, it is clear that "suspected but unconfirmed COVID-19 cases" are all of those who reported one of those flu-like symptoms but whose SARS-CoV-2 PCR test came back negative. [Emphasis in the original]

The only reason why it might be appropriate to include these in the efficacy endpoint are if one believes that most or all of them are false negative test results, which Doshi implies is a possibility given his statement "If many or most of these suspected cases were in people who had a false negative PCR test result, this would dramatically decrease vaccine efficacy." However, it is completely implausible that many or most of these 3410 were COVID-19 cases with false negative SARS-CoV-2 PCR tests, given that for this to be the case it would have to be true that:

· 3410/~30,000 = ~11.4% of study participants were infected with symptomatic COVID-19 within ~2 months during a time in which the confirmed case rate was ~0.5%/month in USA.

· Since "suspected case" implies symptoms were reported, this would not even include asymptomatic cases, which are estimated to be 50-80% of all cases, suggesting that the true infection rate in the population of trial subjects would then be ~20-50%, which is clearly implausible.

· the false negative rate would have to be FAR beyond any documented or reasonably posited levels. The nominal false negative rate for the PCR test mentioned in the Pfizer protocol is 2% (see table 3 of FDA report for this PCR test), which would suggest that 3/3410 of these suspected cases were in fact false negative COVID-19 cases, and the updated efficacy would be (174-10)/174 x 100 =93.9% if we pessimistically assumed the vaccine efficacy was 0% for all false negative cases. Even if we assumed the FNR was 10x higher than reported, say 20%, this would mean we expected 43/3410 of these suspected cases to in fact be false negative COVID-19 cases, which would correspond to an updated efficacy of (183-29)/183 x 100 =84.2% if were pessimistically assumed the vaccine efficacy was 0% for all false negative cases. Even assuming a high 20% FNR, this would only result in ~1% of the 3410 being false negatives, obviously far short of "many or most".

· The high false negative rates that would have to be assumed to propose "many or most of the 3410" are false negatives would imply that essentially everyone in the USA has already been infected with SARS-CoV-2 given the >24 million confirmed cases in the USA for which the individual received a PCR test and a positive test result was obtained.

· To expect "many or most" of these to be false positive COVID-19 cases also implies that there were very few cases of common cold, seasonal allergies, or food-based nausea or diarrhea in this cohort of ~30,000 patients for the study duration that may have produced any of those common flu-like symptoms outside of COVID-19.

It is obvious that to suggest that "many or most" of these are false negative COVID-19 cases is patently absurd.

...from https://www.covid-datascience.com/post/refuting-peter-doshi-s-claims-doubting-trustworthiness-meaningfulness-of-covid-vaccine-results#viewer-10bgn

Can COVID-19 vaccines give you COVID-19?

Some vaccines, such as the measles or oral polio vaccines, contain a weakened form of the live virus, and in very rare cases these can cause disease. "But this isn't one of those," said Boslett. "The mRNA vaccines just contain a message that encodes the spike protein. It is not a live virus, so there's no chance that the vaccine can give you COVID."

...from https://www.ucsf.edu/news/2021/01/419691/covid-19-vaccine-fact-vs-fiction-expert-weighs-common-fears#

The J&J shot is based on a different technology than the Moderna and Pfizer vaccines. Those use mRNA, or messenger RNA, to deliver bits of genetic code to cells. This code serves as a sort of instruction sheet -- telling cells how to make a harmless piece of the spike protein that sticks out of the surface of the coronavirus. The immune system then learns to recognize the spike protein and fight it.

The Johnson & Johnson vaccine, by contrast, is what's known as a viral vector vaccine -- the same technology that's been proven safe and effective in creating an Ebola vaccine and others currently in the works. Basically, Johnson & Johnson started with an adenovirus, which causes the common cold, and modified it so it can't make anybody sick. They then used this harmless cold virus to deliver the genetic blueprint of the protein spike to cells, so the immune system will learn to recognize that spike when it runs into the coronavirus.

To be clear, the J&J vaccine "can't give you the cold virus, and it definitely cannot give you COVID," says Dr. Cassandra Pierre, an infectious disease specialist and acting hospital epidemiologist at Boston Medical Center.

...from https://www.npr.org/sections/health-shots/2021/03/04/973436193/got-questions-about-johnson-johnsons-covid-19-vaccine-we-have-answers#

How mRNA vaccines work
How adenovirus vaccines work

Do COVID-19 vaccines alter your DNA?

Will a COVID-19 vaccine alter my DNA?

No. COVID-19 vaccines do not change or interact with your DNA in any way.

There are currently two types of COVID-19 vaccines that have been authorized for use in the United States: messenger RNA (mRNA) vaccines and viral vector vaccines.

The Pfizer-BioNTech and Moderna vaccines are mRNA vaccines, which teach our cells how to make a protein that triggers an immune response. The mRNA from a COVID-19 vaccine never enters the nucleus of the cell, which is where our DNA is kept. This means the mRNA cannot affect or interact with our DNA in any way. Instead, COVID-19 mRNA vaccines work with the body's natural defenses to safely develop immunity to disease. Learn more about how COVID-19 mRNA vaccines work.

Johnson & Johnson's Janssen COVID-19 vaccine is a viral vector vaccine. Viral vector vaccines use a modified version of a different, harmless virus (the vector) to deliver important instructions to our cells to start building protection. The instructions are delivered in the form of genetic material. This material does not integrate into a person's DNA. These instructions tell the cell to produce a harmless piece of virus that causes COVID-19. This is a spike protein and is only found on the surface of the virus that causes COVID-19. This triggers our immune system to recognize the virus that causes COVID-19 and to begin producing antibodies and activating other immune cells to fight off what it thinks is an infection. Learn more about how viral vector vaccines work.

At the end of the process, our bodies have learned how to protect against future infection from COVID-19. That immune response and the antibodies that our bodies make protect us from getting infected if the real virus enters our bodies.

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

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 Archdiocese of New Orleans, in light of guidance from the Vatican, the United States Conference of Catholic Bishops, and The National Catholic Bioethics Center affirm that though there was some lab testing that utilized the abortion-derived cell line, the two vaccines currently available from Pfizer and Moderna do not rely on cell lines from abortions in the manufacturing process and therefore can be morally acceptable for Catholics as the connection to abortion is extremely remote.

It is under the same guidance that the archdiocese must instruct Catholics that the latest vaccine from Janssen/Johnson & Johnson is morally compromised as it uses the abortion-derived cell line in development and production of the vaccine as well as the testing.

We maintain that the decision to receive the COVID-19 vaccine remains one of individual conscience in consultation with one's healthcare provider. We also maintain that in no way does the Church's position diminish the wrongdoing of those who decided to use cell lines from abortions to make vaccines. In doing so, we advise that if the Moderna or Pfizer vaccine is available, Catholics should choose to receive either of those vaccines rather than to receive the new Johnson & Johnson vaccine because of its extensive use of abortion-derived cell lines.

...from https://nolacatholic.org/news/a-statement-regarding-the-janssen-johnson-johnson-covid-19-vaccine#content1

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

18 Reasons I Won't Be Getting a Covid Vaccine

Response to 18 Reasons I Won't Be Getting a Covid Vaccine

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
National Institutes of Health
1% each Johns Hopkins
New England Journal of Medicine
The Atlantic
The Lancet
Media Bias / Fact Check
Mayo Clinic
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

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.


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


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/


Start by googling the topic or claim.
Wikipedia's list of fact checkers
Another list of fact checkers


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.

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?
Some stuff has changed, but the basics remain the same.
Stuff we still don't know

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

Can you trust the CDC?

Some stuff has changed, but the basics remain the same.

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.

What has the CDC flip-flopped on?

DATE: March 10, 2021

TO: Rochelle P. Walensky, MD, MPH
Director, CDC, and Administrator, ATSDR

FROM: Anne Schuchat, MD (RADM, USPHS, Ret.)
Principal Deputy Director, CDC

SUBJECT: Summary of Guidance Review


As part of your pledge to lead an effort to restore the public's trust in the CDC, you asked me to begin a comprehensive review to ensure that all of CDC's existing guidance related to COVID-19 is evidence-based and free of politics.

...General observations: [emphasis in the original] There were a variety of issues identified including a) guidance that was not primarily authored by CDC staff; b) reliance on less directive language (e.g., 'considerations') than response leadership felt could be supported by existing evidence; and c) availability of new data or evolving scientific understanding that necessitated updated recommendations.

...Guidance removed: [emphasis in the original] By the time of my review in late January and February 2021, two documents developed or finalized outside of the agency had already been removed ("The Importance of Reopening of America's Schools this Fall" posted July 23, 2020 -- removed October 29, 2020) or replaced (Overview of Testing for SARS-COV-2 posted August 24, 2020, replaced September 18, 2020). A link to a third document ("Opening up America Again" which was released on April 16, 2020 through a link posted on CDC's web) was removed February 7, 2021 during the process of my review (Table 1).

...from PDF (pp 1-2) at https://www.cdc.gov/coronavirus/2019-ncov/downloads/communication/Guidance-Review.pdf

[Insert highly-credentialed expert here] disagrees with the scientific consensus.


I like making an important point about authorities and false authorities -- credentials actually don't matter, but what does matter is evidence. And we want high quantity and quality of said evidence, something absolutely missing from the claims that Doshi makes.

However, there are substantial reasons why credentials can matter. They imply many things -- a broad education in the science of the subject matter, hard work in the minutiae of that field of science, and approval by one's peers. Getting a Ph.D. in epidemiology is not simply taking classes, but it's actually doing research in the laboratory and field with a published thesis that is reviewed by numerous peer-scientists.

...from https://www.skepticalraptor.com/skepticalraptorblog.php/anti-vaccine-peter-doshi-attacking-about-covid-19-vaccine-clinical-trials/#more-17057

From an opinion of physicians around the country--many of them, maybe all of them, are really well-meaning and quite competent--They're doing that. But they're doing it on the hunch that it will work and be safe. When you get a formal recommendation from a regulatory agency, or a public health agency--like the FDA and the CDC respectively--that will be based on data that's accumulated. We're not there yet--That doesn't mean it's not gonna ultimately happen--but the data don't show that right now.

...from https://youtu.be/BGyr_zUUChk?t=93

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 President 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, 2020... 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, 2020... 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

April 9, 2021... 100 lawsuits, in 15 states and the District of Columbia, have been filed (78 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, 2020... 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 University found the level of fraud "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 in the United States.[99]

...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.

Washing hands and not touching your face eliminates the risk of surface transmission, unless you're licking stuff.
Ventilation clears the air of the virus.
Masking filters out virus that is in the air.
Social distancing isolates you from the virus.
Vaccination reduces risk if you are exposed to the virus.

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?

Mask fogging up your glasses?

4 Tips to Keep Your Glasses from Fogging Up
Adam Savage uses Graf Lanz masks

I don't feel like cleaning.

Clearing the air is more important than cleaning surfaces:


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

People can be infected with SARS-CoV-2 through contact with surfaces. However, based on available epidemiological data and studies of environmental transmission factors, surface transmission is not the main route by which SARS-CoV-2 spreads, and the risk is considered to be low. The principal mode by which people are infected with SARS-CoV-2 is through exposure to respiratory droplets carrying infectious virus.

...from https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html#languageDropDownMenu

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.

Cleaning with a household cleaner that contains soap or detergent reduces the amount of germs on surfaces and decreases risk of infection from surfaces. In most situations, cleaning alone removes most virus particles on surfaces. Disinfection to reduce transmission of COVID-19 at home is likely not needed unless someone in your home is sick or if someone who is positive for COVID-19 has been in your home within the last 24 hours.

...· Clean high-touch surfaces regularly (for example, daily) and after you have visitors in your home.

· Focus on high-touch surfaces such as doorknobs, tables, handles, light switches, and countertops.

...from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/disinfecting-your-home.html#languageDropDownMenu

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.

People can be infected with SARS-CoV-2 through contact with surfaces. However, based on available epidemiological data and studies of environmental transmission factors, surface transmission is not the main route by which SARS-CoV-2 spreads, and the risk is considered to be low. The principal mode by which people are infected with SARS-CoV-2 is through exposure to respiratory droplets carrying infectious virus.

...from https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html#languageDropDownMenu

Ventilation clears the air of the virus.
Masking filters out virus that is in the air.
Social distancing isolates you from the virus.
Vaccination reduces risk if you are exposed to the virus.

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 is not the same as letting COVID-19 run its course.
Can we eradicate COVID-19?

Vaccination vs. natural immunity:

How is herd immunity achieved?

There are two main paths to herd immunity for COVID-19 -- infection and vaccines.

Natural infection

Herd immunity can be reached when enough people in the population have recovered from a disease and have developed protective antibodies against future infection.

However, there are some major problems with relying on community infection to create herd immunity to the virus that causes COVID-19:

· Reinfection. It's not clear how long you are protected from getting sick again after recovering from COVID-19. Even if you have antibodies, it's possible that you could get COVID-19 again.

· Health impact. Experts estimate that in the U.S., 70% of the population -- more than 200 million people -- would have to recover from COVID-19 to halt the pandemic. This number of infections could lead to serious complications and millions of deaths, especially among older people and those who have existing health conditions. The health care system could quickly become overwhelmed.


Herd immunity also can be reached when enough people have been vaccinated against a disease and have developed protective antibodies against future infection. Unlike the natural infection method, vaccines create immunity without causing illness or resulting complications. Using the concept of herd immunity, vaccines have successfully controlled contagious diseases such as smallpox, polio, diphtheria, rubella and many others.

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

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

"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][40]

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

Achieving 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

May 2, 2021... But herd immunity is slipping away because a quarter of Americans are refusing to get the COVID-19 vaccine. "There is no eradication at this point, it's off the table," Dr. Gregory Poland, director of the Mayo Clinic's Vaccine Research Group, recently said. "We as a society have rejected" herd immunity.

Hmm, no! "We" have not rejected anything. A quarter of the country is ruining it for all of us.

...from https://news.yahoo.com/time-start-shunning-vaccine-hesitant-080043779.html#

Dr. George Rutherford, an epidemiologist at UC San Francisco, said he thought the Bay Area region would experience some form of herd immunity first -- perhaps by mid-June or early July -- followed by urban and suburban Southern California sometime later and with agricultural California coming after that.

...from https://www.latimes.com/california/story/2021-05-10/l-a-county-expected-covid-19-herd-immunity-by-end-of-july#

Cases in the U.S. started declining when about 40% of the population was vaccinated with at least one dose, which happened around April 14, said Monica Gandhi, an infectious diseases specialist at the University of California, San Francisco. Infectious diseases experts call this moment the inflection point -- when there was enough immunity in the population to change the tide of the pandemic.

Israel saw an inflection point early March, when 40% of the adult population became fully vaccinated. After the inflection points in Israel and the U.S., cases have steadily declined day after day, week after week.

...from https://www.huffpost.com/entry/examples-covid-19-vaccines-working_l_60b63be1e4b0f2a82eeea4f0?utm_source=digg

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"

...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?

Feb 19, 2021... Why are cases declining?


Are COVID-19 infections and deaths overreported?

CDC tracks COVID-19 illnesses, hospitalizations, and deaths to monitor trends, detect where outbreaks are occurring, and determine whether public health measures are working. However, counting exact numbers of COVID-19 cases is not possible because COVID-19 can cause mild illness, symptoms might not appear immediately, there are delays in reporting and testing, not everyone who is infected gets tested or seeks medical care, and there are differences in how completely states and territories report their cases.

...from https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/about-us-cases-deaths.html#

Cases are more underreported than deaths:

An estimated 17-30% 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, 2020... 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

Excess deaths are typically defined as the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods.

...from https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

US deaths, all causes:

2010: 2,468,435
2011: 2,515,458
2012: 2,543,279
2013: 2,596,993
2014: 2,626,418
2015: 2,712,630
2016: 2,744,248
2017: 2,813,503
2018: 2,839,205
2019: 2,854,838
2020: 3,358,814 (est.)

...from https://www.cdc.gov/mmwr/volumes/70/wr/mm7014e1.htm#:~:text=in%202020%2C%20approximately%203%2C358%2C814%20deaths%E2%80%A0%20occurred%20in%20the%20united%20states.

...and https://www.snopes.com/tachyon/2021/01/Screen-Shot-2021-01-05-at-3.11.31-PM.png (image) at https://www.snopes.com/fact-check/typical-year-covid-deaths/#:~:text=The%20verified,Next

Our approach to estimating the total COVID-19 death rate is based on measurement of the excess death rate during the pandemic week by week compared to what would have been expected based on past trends and seasonality. However, the excess death rate does not equal the total COVID-19 death rate. Excess mortality is influenced by six drivers of all-cause mortality that relate to the pandemic and the social distancing mandates that came with the pandemic. These six drivers are: a) the total COVID-19 death rate, that is, all deaths directly related to COVID-19 infection; b) the increase in mortality due to needed health care being delayed or deferred during the pandemic; c) the increase in mortality due to increases in mental health disorders including depression, increased alcohol use, and increased opioid use; d) the reduction in mortality due to decreases in injuries because of general reductions in mobility associated with social distancing mandates; e) the reductions in mortality due to reduced transmission of other viruses, most notably influenza, respiratory syncytial virus, and measles; and f) the reductions in mortality due to some chronic conditions, such as cardiovascular disease and chronic respiratory disease, that occur when frail individuals who would have died from these conditions died earlier from COVID-19 instead. To correctly estimate the total COVID-19 mortality, we need to take into account all six of these drivers of change in mortality that have happened since the onset of the pandemic.

...from http://www.healthdata.org/special-analysis/estimation-excess-mortality-due-covid-19-and-scalars-reported-covid-19-deaths

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, 2020... Comparison to other pandemics
Historical pandemics including COVID-19
The deadliest viruses on earth

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.

Although we think of the flu as highly contagious given how many of us catch it, it seems to be the case that we have never bothered trying to not spread it around in the past. It is in fact much less contagious than the novel coronavirus, and the measures we have in place to deal with the latter are effectively stamping out the former.

...from https://www.ft.com/content/879f2a2b-e366-47ac-b67a-8d1326d40b5e

"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 does the CDC group together pneumonia, flu and COVID-19 deaths (PIC)?

On June 11, the CDC implemented its current format that reports COVID-19, pneumonia and influenza-related deaths.

The webpage with provisional deaths includes columns for:

· "Deaths involving Pneumonia, with or without COVID-19, excluding Influenza deaths."
· "Deaths involving COVID-19 and Pneumonia, excluding Influenza."
· "All deaths involving Influenza, with or without COVID-19 or pneumonia" or including COVID-19 or pneumonia.
· "Deaths involving Pneumonia, Influenza or COVID-19."

The variations of pneumonia and influenza deaths are reported alongside COVID-19 deaths because the illnesses exhibit similar symptoms. Considering all three tallies can provide a better understanding of the extent of COVID-19 cases that may have gone undiagnosed.

"Deaths due to COVID-19 may be misclassified as pneumonia or influenza deaths in the absence of positive test results, and pneumonia or influenza may appear on death certificates as a comorbid (when a person has two diseases at once) condition," the CDC's website says. "Additionally, COVID-19 symptoms can be similar to influenza-like illness, thus deaths may be misclassified as influenza."

Despite these new variations, the total provisional count of deaths involving COVID-19 was not significantly reduced. The same goes for confirmed and probable deaths, which continued to increase.

Our ruling: False

Although it's unclear where the Facebook user found the numbers, the CDC did not lower the death count, nor did it admit adding influenza and pneumonia to its COVID-19 death count. The user may have confused the CDC's additional reporting of influenza and pneumonia-related deaths or the fact that the CDC reports two different counts for COVID-19 deaths. We rate this claim FALSE because it is not supported by our research.

...from https://www.usatoday.com/story/news/factcheck/2020/06/28/fact-check-confusion-cdcs-covid-19-death-count/3254404001/#gnt_atomsnc

The CDC's measure at the root of the claim -- one that looks at pneumonia, influenza and COVID-19 together -- is one that has a public health rationale and that is consistent with past practices, experts told us.

The CDC has for years monitored deaths of pneumonia and influenza together as one measure of the flu's mortality -- as archived CDC pages, such as one from January 2016, show. Influenza can cause pneumonia, and so can the novel coronavirus.

"The PIC category was created as a surveillance indicator to monitor COVID-19 mortality, in the same way that we have used combined pneumonia and influenza deaths, for many years, to monitor influenza mortality," Anderson said. "Pneumonia tends to fluctuate in response to and along with influenza (and COVID-19). This is particularly useful where influenza (or COVID-19) mortality is underreported."

...from https://www.factcheck.org/2020/12/instagram-post-distorts-facts-on-covid-19-death-reporting/#dpsp-post-content-markup

Why are cancer and heart disease not being reported?

Heart disease and cancer were the two leading causes of US deaths in 2020.

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

Coronavirus vaccinations can cause enlarged lymph nodes in the armpit or near the collarbone, which may be mistaken for a sign of cancer.

...from https://www.nytimes.com/2021/03/01/health/covid-vaccine-lymph-nodes.html#article-summary

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?

Current visitor policies:

PennState Health

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

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

Are surgical and N95 masks still in short supply?

FDA Device Shortage List

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

March 6, 2021... Even as vaccines roll out, the pandemic's holy grail -- a drug to successfully treat COVID-19 -- continues to elude medicine.

..."The bottom line of what we need to do looking forward, and the clear need in this, is the development of potent antivirals directly acting on SARS-CoV-2," Anthony Fauci, chief of the National Institute of Allergy and Infectious Diseases, said at a White House briefing last week. Antivirals would revolutionize the fight against SARS-CoV-2, since they block viruses from replicating and can stop people from getting very sick or dying.

But efforts to develop such drugs have languished because of a lack of funding and coordination: While Operation Warp Speed devoted nearly $18.75 billion to develop vaccines, it only set aside $6.34 billion for drugs. Instead, scientists tried to repurpose older drugs, including antivirals for other diseases, to see if they worked against COVID-19.

"Everyone was looking for a quick fix," Fauci told BuzzFeed News. The FDA has so far only authorized one drug to treat COVID-19, remdesivir, initially developed against Ebola. But it is far from a perfect drug: Results on how it affects the length of hospital stays have been mixed, and it has not been shown to reduce deaths.

...from https://www.buzzfeednews.com/article/danvergano/coronavirus-treatments-antivirals-fauci#126620059

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

Variants in the US over time

delta variant:

Vaccine efficacy against delta

It's too early to tell if the delta variant causes more severe disease in children, but experts say the variant seems to be causing more symptomatic infections than the original virus.

"Because it's the most highly contagious variant to date based on all the data we've accumulated so far, we expect to see more rapid transmission of this virus from adults and adolescents to children," said Dr. James Versalovic, pathologist-in-chief and interim pediatrician-in-chief at Texas Children's Hospital.

...from https://www.usatoday.com/story/news/health/2021/07/03/covid-kids-make-up-growing-share-new-weekly-cases-what-know/7842661002/

Is the US mortality rate worse than other countries?

Mortality analyses

How many cases are asymptomatic?

Early studies reported that asymptomatic cases accounted for 30 to 80% of infections (3), but more recent data point to a rate of asymptomatic cases between 17 and 30% (4).

...from https://science.sciencemag.org/content/371/6535/1206#p-6

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.

The 99% isn't the problem. It's the 1%.

Personal mortality risk calculator

December 4, 2020... 279,634 deaths ÷ 14,281,380 total confirmed cases = 1.95%

It's very difficult to estimate mortality risk - when you have something that varies at least by over 1000-fold depending on your age or risk factors, the average is pretty pointless.

...from https://www.ft.com/content/879f2a2b-e366-47ac-b67a-8d1326d40b5e

"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:

An infected person infects 5-10 people. (p 15)

...Anyone may be contagious.
...20% of infections are severe.
...Long-term effects on infected persons
...Small businesses are struggling.

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

It's mostly old people that are at risk.

COVID-19 deaths by age
Anyone may be contagious.
Incidence of COVID cases in kids is comparable to that in adults.

The frail people who died of COVID-19 would have died anyway.

The problem, says Saad Omer, director of the Yale Institute for Global Health, is that many of those deaths in the VAERS database were caused by other illnesses that happened around the same time as the immunization and had nothing to do with a vaccine: "Vaccines decrease your risk of COVID-19," Omer notes. "They don't make you immortal."

In fact, COVID-19 vaccines were given first to some of the oldest and sickest people in America. Their risk of dying from COVID was high, but "their risk of mortality due to other causes was also high. In fact, very high," Omer says.

...from https://www.npr.org/sections/health-shots/2021/06/14/1004757554/anti-vaccine-activists-use-a-federal-database-to-spread-fear-about-covid-vaccine

Unfortunately, the message that covid-19 risk was about the same as the annual risk (and hence that catching the virus roughly doubles the risk of dying this year) was misinterpreted by some as meaning that it did not increase the annual risk at all. In fact, if the risk of dying this year from covid-19 is p, and the risk of independently dying from something else is also p, then probability theory tells us that the overall risk of dying this year is one minus the chance of surviving both hazards--that is, 1-(1-p)(1-p) or 2p-p2. For low p, this will be very close to 2p, and so it is generally fine to say that covid-19 would roughly double the risk of dying. But if you were frail and had a 60% risk of dying next year, then with infection this would rise to 2×0.6–0.62=0.84, so altogether you would have an 84% chance of dying. (The events may also not be independent: survivors may be weakened by the disease or show increased resilience.)

...Importantly, all the risks quoted are the average (mean) risks for people of the relevant age but are not the risks of the average person. This is because, both for covid-19 and in normal circumstances, much of the risk is held by people who are already chronically ill.

...It should always be remembered that these are risks to the individual: there is still a responsibility to consider the potential risks an individual may cause to others.

...from https://www.bmj.com/content/370/bmj.m3259

Most deaths have been in nursing homes.

August 20, 2020... 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

Outbreak in a Kentucky nursing home... March 2021:

COVID-19 vaccines have demonstrated high efficacy in clinical trials. Limited data are available on effectiveness in skilled nursing facilities (SNFs) and against emerging variants.

...Among 83 residents and 116 HCP [health care personnel], 75 (90.4%) and 61 (52.6%), respectively, received 2 vaccine doses.

...In a SNF with 90.4% of residents vaccinated, an outbreak of COVID-19 occurred after introduction from an unvaccinated, symptomatic HCP. WGS identified an R.1 lineage variant, characterized by E484K and other mutations within the spike protein. Attack rates were three to four times as high among unvaccinated residents and HCP as among those who were vaccinated; vaccinated persons were significantly less likely to experience symptoms or require hospitalization.

...To protect SNF residents, it is imperative that HCP, as well as SNF residents, be vaccinated.

...from https://www.cdc.gov/mmwr/volumes/70/wr/mm7017e2.htm?s_cid=mm7017e2_w

Most of those who were infected with the coronavirus despite being vaccinated did not develop symptoms or require hospitalization, but one vaccinated individual, who was a resident of the nursing home, died, according to the study released by the Centers for Disease Control and Prevention.

Altogether, 26 facility residents were infected, including 18 who had been vaccinated, and 20 health care personnel were infected, including four who had been vaccinated. Two unvaccinated residents also died.

...from https://www.nytimes.com/2021/04/21/health/vaccine-nursing-homes-infections.html

Are COVID-19 cases in nursing homes a risk to the general population and vice versa?

Caregivers likely infected residents. Residents are isolated from the general population, but caregivers are not.

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

Is it safe to go to a restaurant?

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

Should I send my kids to school or daycare?

COVID-19 cases in schools by state
Schools & Childcare
Incidence of COVID cases in kids is comparable to that in adults.

Does infection make you immune to reinfection?

Cases of reinfection with COVID-19 have been reported, but remain rare.

...The Delta variant causes more infections and spreads faster than earlier forms of the virus that causes COVID-19. It might cause more severe illness than previous strains in unvaccinated people.

· Vaccines continue to reduce a person’s risk of contracting the virus that cause COVID-19, including this variant.
· Vaccines continue to be highly effective at preventing hospitalization and death, including against this variant.
· Fully vaccinated people with breakthrough infections from this variant appear to be infectious for a shorter period.
· Get vaccinated and wear masks indoors in public spaces to reduce the spread of this variant.

...from https://www.cdc.gov/coronavirus/2019-ncov/your-health/reinfection.html

After a SARS-CoV-2 infection, a person's antibody and T cell responses may be strong enough to provide protection against reinfection. Research shows that 91% of people who develop antibodies against the coronavirus are unlikely to be infected again for six months, even after a mild infection. People who had no symptoms during the infection are also likely to develop immunity, though they tend to make fewer antibodies than those who felt ill.

...from https://theconversation.com/why-you-should-get-a-covid-19-vaccine-even-if-youve-already-had-the-coronavirus-155712#

Available evidence shows that fully vaccinated individuals and those previously infected with SARS-CoV-2 each have a low risk of subsequent infection for at least 6 months. Data are presently insufficient to determine an antibody titer threshold that indicates when an individual is protected from infection. At this time, there is no FDA-authorized or approved test that providers or the public can use to reliably determine whether a person is protected from infection.

...from https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/vaccine-induced-immunity.html

The first large-scale investigation to tackle that question was published in The Lancet this week, and it found that the vast majority of people who have had COVID-19 are indeed protected from catching it again -- for at least six months. However, people ages 65 and older are far more likely than younger individuals to experience repeat infection.

The researchers analyzed data from Denmark's national COVID-19 testing program, which has offered free PCR testing to roughly 4 million people living in the country. Overall, they found that a very small percentage of the population -- 0.65% -- experienced reinfection.

For those 65 and under, getting the coronavirus once provided roughly 80% protection against reinfection. But for people 65 and older, it provided only about 47% protection against getting COVID-19 again, further highlighting how dangerous this disease can be for older adults.

...A vaccine study in South Africa -- where a variant is circulating that experts fear is more contagious and may make the current vaccines less effective -- found new infections in 2% of people who'd previously been infected with a different variant of the coronavirus.

The large new study out of Denmark did not examine the role of variants in reinfection, given the time frame of the research. So it does not offer any clues about whether variants make it more likely for someone to come down with COVID-19 more than once.

...from https://www.huffpost.com/entry/study-covid-19-reinfection_l_60533d0dc5b6f93a1d04a8d4#entry-body

Is a healthy immune system important?

Having a weakened immune system can make you more likely to get severely ill from COVID-19. Many conditions and treatments can cause a person to be immunocompromised or have a weakened immune system. Primary immunodeficiency is caused by genetic defects that can be inherited. Prolonged use of corticosteroids or other immune weakening medicines can lead to secondary or acquired immunodeficiency.

...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, 2020... 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

There have been few reports of COVID-19 cases potentially attributed to fomite transmission 1, 2.

...from https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html

December 11, 2020... 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/

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

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

April 5, 2021... Numerous researchers have studied how long SARS-CoV-2 can survive on a variety of porous and non-porous surfaces 10, 11, 12, 13, 14, 15. On porous surfaces, studies report inability to detect viable virus within minutes to hours; on non-porous surfaces, viable virus can be detected for days to weeks. The apparent, relatively faster inactivation of SARS-CoV-2 on porous compared with non-porous surfaces might be attributable to capillary action within pores and faster aerosol droplet evaporation 16.

Data from surface survival studies indicate that a 99% reduction in infectious SARS-CoV-2 and other coronaviruses can be expected under typical indoor environmental conditions within 3 days (72 hours) on common non-porous surfaces like stainless steel, plastic, and glass 10, 11, 12, 13, 15. However, experimental conditions on both porous and non-porous surfaces do not necessarily reflect real-world conditions, such as initial virus amount (e.g., viral load in respiratory droplets) and factors that can remove or degrade the virus, such as ventilation and changing environmental conditions 8, 9.

...from https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html#languageDropDownMenu

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

· The virus that causes COVID-19 can spread from people to animals including pets in some situations, mostly during close contact.

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

...from https://www.cdc.gov/healthypets/covid-19/pets.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fdaily-life-coping%2Fpets.html

Another concern, Saif says, is that SARS-CoV-2 could evolve inside the deer and create new strains of the virus. Researchers have already documented such a scenario with minks on farms in the Netherlands and Poland, she points out.

In those studies, farmworkers passed the virus on to captive animals. As the virus spread through the minks, it mutated and created new variants. These new versions of the virus then spilled back to the humans, the researchers reported.

...from https://www.npr.org/sections/goatsandsoda/2021/11/10/1054224204/how-sars-cov-2-in-american-deer-could-alter-the-course-of-the-global-pandemic

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

When a person with suspected or confirmed COVID-19 has been indoors, virus can remain suspended in the air for minutes to hours. The length of time virus remains suspended and is infectious depends on numerous factors, including viral load in respiratory droplets or in small particles, disturbance of air and surfaces, ventilation, temperature, and humidity 27, 28, 29, 30, 31. Wearing masks consistently and correctly can substantially reduce the amount of virus indoors, including the amount of virus that lands on surfaces 32.

Based on limited epidemiologic and experimental data, the risk of infection from entering a space where a person with COVID-19 has been is low after 24 hours. During the first 24 hours, the risk can be reduced by increasing ventilation and waiting as long as possible before entering the space (at least several hours, based on documented airborne transmission cases), and using personal protective equipment (including any protection needed for the cleaning and disinfection products) to reduce risk.

...from https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html#languageDropDownMenu

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/

Vitamin D:

Supplement safe but ineffectual

...from https://www.cidrap.umn.edu/news-perspective/2021/02/vitamin-d-not-effective-moderate-severe-covid-study-finds#file-72101--2

Higher levels of vitamin D than traditionally considered sufficient may help prevent COVID-19 infection--particularly in Black patients--or lead to less severe outcomes, two new US studies suggest.

...from https://www.cidrap.umn.edu/news-perspective/2021/03/vitamin-d-may-prevent-covid-especially-black-patients#file-73546--2

The fascination with vitamin D supplementation began with the discovery in the early 1920s that vitamin D prevented rickets and was further driven by the recognition of other potential roles of vitamin D in non-skeletal outcomes, including immune function, cardiovascular health, and cancer. However, whereas data on the function of vitamin D in bone growth and maintenance is clear-cut and has informed practical clinical guidelines and public health policies over the years, evidence supporting the role of vitamin D in other health and disease processes, in particular in acute respiratory tract infection, remains patchy. Data from observational studies have suggested that vitamin D supplementation can lower the odds of developing respiratory infections, particularly in vitamin D-deficient groups, but randomised trials have yielded mixed results.

...It has long been clear that groups that traditionally exhibit vitamin D deficiency or insufficiency, such as older adults and nursing home residents, and Black, Asian, and minority ethnic populations, are the same groups that have also been disproportionately impacted by COVID-19. Additionally, increased time spent indoors due to strict lockdowns and shielding triggered concerns that some people might not obtain the necessary physiological levels of vitamin D from sunlight.

On Dec 17, 2020, the National Institute for Health and Care Excellence (NICE), in collaboration with Public Health England and the Scientific Advisory Committee on Nutrition, published an updated rapid review of recent studies on vitamin D and COVID-19. Their recommendations support the current government advice, revised in April, 2020, during the first lockdown in the UK, for everyone to take vitamin D supplements to maintain bone and muscle health during the autumn and winter months. The recommendations are also in line with new guidance from the UK government, released on Dec 22, 2020, allowing extremely clinically vulnerable people to opt in to receive a free 4-month supply of daily vitamin D supplements--similar to an initiative launched earlier in Scotland.

...from https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00003-6/fulltext#related-links-container

Vitamin D toxicity:

Vitamin D toxicity is usually caused by large doses of vitamin D supplements -- not by diet or sun exposure. That's because your body regulates the amount of vitamin D produced by sun exposure, and even fortified foods don't contain large amounts of vitamin D.

...Taking 60,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity. This level is many times higher than the U.S. Recommended Dietary Allowance (RDA) for most adults of 600 IU of vitamin D a day.

...from https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-toxicity/faq-20058108#

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

Soap and pepper experiment

What if someone I live with is infected?

Cleaning your home when someone is sick

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...

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?

Low or no-cost testing by state
Cost, Place, Insurance

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?

Is another test needed...

MOLECULAR TEST... Not usually. This type of test is typically highly accurate and usually does not need to be repeated. Some may indicate the need to re-test in certain circumstances.

ANTIGEN TEST... Maybe. 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, 2020... 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, 2020... 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

After getting a COVID-19 vaccine, will I test positive for COVID-19 on a viral test?

No. None of the authorized and recommended COVID-19 vaccines cause you to test positive on viral tests, which are used to see if you have a current infection. Neither can any of the COVID-19 vaccines currently in clinical trials in the United States.

If your body develops an immune response to vaccination, which is the goal, you may test positive on some antibody tests. Antibody tests indicate you had a previous infection and that you may have some level of protection against the virus.

...from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html#

In a world with perfect coronavirus tests, people could swab their nose or spit in a tube and get near-instant answers about their SARS-CoV-2 status. The products would be free, fast, and completely reliable. Positives would immediately shuttle people out of public spaces and, if needed, into treatment; negatives could green-light entry into every store, school, and office, and spring people out of isolation with no second thought. Tests would guarantee whether someone is contagious, or merely infected, or neither. And that status would hold true until each person had the chance to test again.

Unfortunately, that is not the reality we live in--nor will it ever be. "No such test exists," K. C. Coffey, an infectious-disease physician and diagnostics expert at the University of Maryland School of Medicine, told me. Not for this virus, and "not for any disease that I know of."

...from https://www.theatlantic.com/health/archive/2021/11/coronavirus-testing-still-confusing/620783/?utm_source=digg

Cleaning and sanitizing toys:

...cited at https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-childcare.html#anchor_1612986010643

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/


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.

I neither believe nor doubt. I am simply trying to verify her assertions.

...from https://www.youtube.com/watch?v=awRJ9tpHdds

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?

Although how we understand transmission occurs has shifted, the ways to prevent infection with this virus have not. All prevention measures that CDC recommends remain effective for these forms of transmission.

...from https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html#

The public may be tired of shifting guidance from the CDC about wearing face masks, but Dr. Anthony Fauci says the latest change wasn’t made arbitrarily. Rather, it was forced by the Delta variant. "It isn’t that they decided in a vacuum to flip-flop -- the virus changed," he explained in an interview with LX News Now host Eric Alvarez.

...from https://www.nbcconnecticut.com/news/local/not-a-flip-flop-fauci-says-the-delta-variant-forced-the-cdcs-mask-shift/2548860/

This happened:Implication:
Asymptomatic transmissionMasks were recommended for sick people.
But now you can't tell who's sick, so masks are recommended for all.
Surface transmission probably hasn't been documented.COVID spreads primarily or exclusively through the air.
Airborne / aerosol transmissionAeorosols can drift further than six feet.
Immunity wanes following both infection & vaccination.Recovered people should be vaccinated.
Vaccinated people should get boosters.
DeltaVaccinated people can get infected.
People who were infected with the legacy strain can get reinfected.

Current recommendations:
(as of December 1, 2021)

post-vaccination precautions

Children and adolescents can be infected with SARS-CoV-2, can get sick with COVID-19, and can spread the virus to others.9-15 In the United States through March 2021, the estimated cumulative rates of SARS-CoV-2 infection and COVID-19 symptomatic illness in children ages 5-17 years were comparable to infection and symptomatic illness rates in adults ages 18-49 and higher than rates in adults ages 50 and older.16 Estimated cumulative rates of infection and symptomatic illness in children ages 0-4 years are roughly half of those in children ages 5-17 years, but are comparable to those in adults ages 65 years or older. These cumulative rates were estimated from CDC models that account for under-detection among reported cases.17

Several studies conducted early during the COVID-19 pandemic suggested that the incidence rate among children and adolescents was lower than among adults.9, 10, 18-23 However, the lower incidence rates may have been due in part to children, when compared to adults, having fewer opportunities for exposure (due to school, daycare, and activity closures) and a lower probability of being tested.17 Studies that have systematically tested children and adolescents, irrespective of symptoms, for acute SARS-CoV-2 infection (using antigen or RT-PCR assays) or prior infection (through antibody testing) have found their rates of infection can be comparable, and in some settings higher, than in adults.12, 15, 24-29

...from https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/transmission_k_12_schools.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fmore%2Fscience-and-research%2Ftransmission_k_12_schools.html

Based on evolving evidence, CDC recommends fully vaccinated people get tested 5-7 days after close contact with a person with suspected or confirmed COVID-19.

View Previous Updates

Key Points

· Persons with signs or symptoms of COVID-19 should have diagnostic testing.

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

People can be infected with SARS-CoV-2 through contact with surfaces. However, based on available epidemiological data and studies of environmental transmission factors, surface transmission is not the main route by which SARS-CoV-2 spreads, and the risk is considered to be low. The principal mode by which people are infected with SARS-CoV-2 is through exposure to respiratory droplets carrying infectious virus.

...from https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html

Transmission of SARS-CoV-2 from inhalation of virus in the air farther than six feet from an infectious source can occur

With increasing distance from the source, the role of inhalation likewise increases. Although infections through inhalation at distances greater than six feet from an infectious source are less likely than at closer distances, the phenomenon has been repeatedly documented under certain preventable circumstances.10-21 These transmission events have involved the presence of an infectious person exhaling virus indoors for an extended time (more than 15 minutes and in some cases hours) leading to virus concentrations in the air space sufficient to transmit infections to people more than 6 feet away, and in some cases to people who have passed through that space soon after the infectious person left. Per published reports, factors that increase the risk of SARS-CoV-2 infection under these circumstances include:

· Enclosed spaces with inadequate ventilation or air handling within which the concentration of exhaled respiratory fluids, especially very fine droplets and aerosol particles, can build-up in the air space.

· Increased exhalation of respiratory fluids if the infectious person is engaged in physical exertion or raises their voice (e.g., exercising, shouting, singing).

· Prolonged exposure to these conditions, typically more than 15 minutes.

...from https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html#

After quarantine

· Watch for symptoms until 14 days after exposure.
· If you have symptoms, immediately self-isolate and contact your local public health authority or healthcare provider.

You may be able to shorten your quarantine

Your local public health authorities make the final decisions about how long quarantine should last, based on local conditions and needs. Follow the recommendations of your local public health department if you need to quarantine. Options they will consider include stopping quarantine

· After day 10 without testing
· After day 7 after receiving a negative test result (test must occur on day 5 or later)

...from https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html

"What we know so far":

Some stuff has changed, but the basics remain the same.

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.
...How long immunity lasts.
...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.

But we know how to protect ourselves.

Social distancing is recommended in the Bible.
Vaccines have been around for decades.
The scientific consensus has evolved during the pandemic to support ventilation and masking.

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/

What has the CDC flip-flopped on?

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 2020 showing 7%.
Here's one from July 2020.

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

The 6 percent number touted by Trump and QAnon comes from a weekly CDC report stating that in 6 percent of the coronavirus mortality cases it counted, COVID-19 was the only condition listed on the death certificate. That observation most likely means that those death certificates were incomplete because the certifiers gave only the underlying cause of death and not the full causal sequence that led to it, Anderson says.

...from https://www.scientificamerican.com/article/debunking-the-false-claim-that-covid-death-counts-are-inflated1/#dfp-right-article-mobile

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?

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

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

Why does COVID-19 continue to spread?

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

Controlling the virus requires controlling your behavior. Americans have shown an appalling lack of self-control, so, yes, maybe the governement is trying to control our behavior.

If COVID-19 is a government conspiracy, what should we do?
The CDC recommends specific precautions.
What do the conspiracy theorists suggest we do?

If COVID was intentional/planned/lab leak, does that affect individual citizen's responses?
i.e., we still need to kill it, even if it was intentional/planned/lab leak.

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?


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.
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.

The medical consensus favors masking:

Observational and epidemiological studies on masks

Limitations of mask studies:

January 26, 2021... Cochrane (7) and the World Health Organization (8) both point out that, for population health measures, we should not generally expect to be able to find controlled trials, due to logistical and ethical reasons, and should therefore instead seek a wider evidence base. This issue has been identified for studying community use of masks for COVID-19 in particular (9). Therefore, we should not be surprised to find that there is no RCT for the impact of masks on community transmission of any respiratory infection in a pandemic.

...from https://www.pnas.org/content/118/4/e2014564118#

October 6, 2020... In hospitals and other health-care facilities, the use of medical-grade masks clearly cuts down transmission of the SARS-CoV-2 virus. But for the variety of masks in use by the public, the data are messy, disparate and often hastily assembled.

...To be clear, the science supports using masks, with recent studies suggesting that they could save lives in different ways: research shows that they cut down the chances of both transmitting and catching the coronavirus, and some studies hint that masks might reduce the severity of infection if people do contract the disease.

...The standard mask for use in health-care settings is the N95 respirator, which is designed to protect the wearer by filtering out 95% of airborne particles that measure 0.3 micrometres (µm) and larger. As the pandemic ramped up, these respirators quickly fell into short supply. That raised the now contentious question: should members of the public bother wearing basic surgical masks or cloth masks? If so, under what conditions? "Those are the things we normally [sort out] in clinical trials," says Kate Grabowski, an infectious-disease epidemiologist at Johns Hopkins School of Medicine in Baltimore, Maryland. "But we just didn't have time for that."

So, scientists have relied on observational and laboratory studies. There is also indirect evidence from other infectious diseases. "If you look at any one paper -- it's not a slam dunk. But, taken all together, I'm convinced that they are working," says Grabowski.

..."You can't do randomized trials for everything -- and you shouldn't." As clinical researchers are sometimes fond of saying, parachutes have never been tested in a randomized controlled trial, either.

...For now, Osterholm, in Minnesota, wears a mask. Yet he laments the "lack of scientific rigour" that has so far been brought to the topic. "We criticize people all the time in the science world for making statements without any data," he says. "We're doing a lot of the same thing here."

Nevertheless, most scientists are confident that they can say something prescriptive about wearing masks. It's not the only solution, says Gandhi, "but I think it is a profoundly important pillar of pandemic control". As Digard puts it: "Masks work, but they are not infallible. And, therefore, keep your distance."

...from https://www.nature.com/articles/d41586-020-02801-8#Fig2

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

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

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

Why is social media censoring stuff?

1. Is the content advancing a claim of fact regarding COVID-19?

...2. Is the claim demonstrably false or misleading?

...3. Would belief in this information, as presented, lead to harm?

...We are most concerned with misleading information that:

· May increase the likelihood of exposure to the virus;

· May have adverse effects on the public health system's capacity to cope with the crisis;

· Could lead to discrimination and avoidance of communities and/or places of business based on their perceived affiliation with protected groups.

...from https://blog.twitter.com/en_us/topics/company/2020/covid-19.html#misleadinginformationupdate

A BBC team tracking coronavirus misinformation has found links to assaults, arsons and deaths. And experts say the potential for indirect harm caused by rumours, conspiracy theories and bad health information could be much bigger.

...from https://www.bbc.com/news/stories-52731624#main-heading

At least 800 people may have died around the world because of coronavirus-related misinformation in the first three months of this year, researchers say.

A study published in the American Journal of Tropical Medicine and Hygiene also estimates that about 5,800 people were admitted to hospital as a result of false information on social media.

...from https://www.bbc.com/news/world-53755067#

5G coronavirus conspiracy theory leads to 77 mobile towers burned in UK

...from https://www.cnet.com/health/5g-coronavirus-conspiracy-theory-sees-77-mobile-towers-burned-report-says/#page-5g-coronavirus-conspiracy-theory-sees-77-mobile-towers-burned-report-says

In Nigeria, hospital admissions from hydroxychloroquine poisoning provoked Lagos state health officials to warn people against using the drug.

...from https://www.bbc.com/news/stories-52731624#piano-inline3

In Iran, authorities say hundreds have died from alcohol poisoning after viral rumours about its curative effects.

The total was put at 796 by the end of April by Kambiz Soltaninejad, an official from Iran's Legal Medicine Organisation, who said it was the result of "fake news on social media."

The truth behind the number is murky in a country where alcohol is banned in Iran and bootleg moonshine is routinely contaminated.

...from https://www.bbc.com/news/stories-52731624#piano-inline3

During the initial days of the HIV epidemic,47 the rumor that HIV did not exist and its treatment was toxic to humans resulted in people refusing antiretroviral therapies in South Africa. Furthermore, the government promoted traditional medicines that fueled the vertical transmission of HIV in communities and cost >300,000 lives.47

...from https://www.ajtmh.org/view/journals/tpmd/103/4/article-p1621.xml#ref_b46

Brian's may be an extreme case, but with the sheer amount of information circulating - the WHO has called it an "infodemic" - many other people have been misled by what they read online.

They're not killing themselves by taking fake cures. Instead, they're lowering their chances of survival by not thinking coronavirus is real or serious.

...from https://www.bbc.com/news/stories-52731624#piano-inline3

Using a self-administered online survey during the COVID-19 pandemic, the study obtained 483 useable responses and after test, finds that all-inclusive, the propagation of misinformation on social media undermines the COVID-19 individual responses.

...Individual responses, however, regarding the COVID-19 is influenced by the information they received through different media. As mentioned before, the person who died in the USA after consuming chloroquine could be said that he was largely influenced by the message that chloroquine can cure COVID-19.

...from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373041/#__p1

Mis- and disinformation can be harmful to people's physical and mental health; increase stigmatization; threaten precious health gains; and lead to poor observance of public health measures, thus reducing their effectiveness and endangering countries' ability to stop the pandemic.

Misinformation costs lives. Without the appropriate trust and correct information, diagnostic tests go unused, immunization campaigns (or campaigns to promote effective vaccines) will not meet their targets, and the virus will continue to thrive.

...from https://www.who.int/news/item/23-09-2020-managing-the-covid-19-infodemic-promoting-healthy-behaviours-and-mitigating-the-harm-from-misinformation-and-disinformation#PageContent_T0643CD2A003_Col00

President Trump's lie that "COVID-19 isn't as bad as they say" is why COVID-19 continues to spread--Too many people don't take COVID-19 seriously and aren't vaccinating, social distancing, ventilating and masking. This is why President Trump was kicked off social media.

Hannity & Carlson:

Conservative hosts Sean Hannity and Tucker Carlson support President Donald Trump, and they are at the helm of the two, most-widely viewed cable news shows in the U.S. But they took different broadcasting paths when the coronavirus first hit the U.S.

The paper notes that Carlson was an outlier on Fox and, as early as Jan. 28, spent a chunk of his show discussing the dangers of a global pandemic. He continued to warn of deadly consequences.

...Meanwhile, Hannity downplayed coronavirus as just the flu and emphasized that Democrats were politicizing the virus to undermine Trump.

...To examine the relationship between viewership of Hannity and Tucker Carlson Tonight and their changes in behavior in response to the coronavirus -- washing hands more often, practicing social distancing and cancelling travel plans -- the authors surveyed 1,045 Fox News viewers aged 55 or older in early April 2020.

The paper says viewership of Hannity relative to Carlson is associated with approximately 30% more COVID-19 cases by March 14, and 21% more COVID-19 deaths by March 28.

...from https://www.npr.org/local/309/2020/05/04/849109486/study-finds-more-c-o-v-i-d-19-cases-among-viewers-of-fox-news-host-who-downplayed-pandemic#res849111246

The Center for Disease Control has not as yet officially declared exposure to Sean Hannity a public health risk.

...from https://www.fastcompany.com/90521195/exposure-to-sean-hannity-may-be-lethal-studies-on-covid-19-suggest#fc-anyclip

"The selective cherry-picked clips of Sean Hannity's coverage used in this study are not only reckless and irresponsible, but down right factually wrong," said a Fox News spokesperson in a statement obtained by Newsweek.

"As this timeline proves, Hannity has covered Covid-19 since the early days of the story." the statement continues. "The 'study' almost completely ignores his coverage and repeated, specific warnings and concerns from January 27-February 26 including an early interview with Dr. Fauci in January. This is a reckless disregard for the truth."

...from https://www.newsweek.com/coronavirus-deaths-greater-among-fox-news-viewers-that-prefer-hannity-over-tucker-carlson-study-1499354#v_embed

In response, the study's lead author Leonardo Bursztyn noted that their analysis encompasses the entirety of Fox's prime-time coverage through the end of March, including Hannity's interview with Fauci. "There's no 'cherry-picking' possible because our independent MTurk coders read every transcript between late January and late March."

...from https://www.washingtonpost.com/business/2020/06/25/fox-news-hannity-coronavirus-misinformation/#main-content

What's the difference betweeen ordinary safety precautions like seatbelts and COVID-19 recommendations?

One difference is that SARS-CoV-2 is a "novel" coronavirus, and the scientific consensus is changing, because there are many unknowns. But the scientific consensus clearly suggests vaccination, socially distancing, ventilation and masking. Maybe the difference is just that we don't trust the scientific consensus yet on COVID-19.

Just the facts:

Why does COVID-19 continue to spread?

Because we haven't reached herd immunity, because not enough people are vaccinated or have post-infection immunity.

(We're probably not going to reach herd immunity.)

President Trump's lie that "COVID-19 isn't as bad as they say" is why COVID-19 continues to spread--Too many people don't take COVID-19 seriously and aren't vaccinating, social distancing, ventilating and masking.

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."

Is masking bad for you?

Most people with underlying medical conditions can and should wear masks.

· If you have respiratory conditions and are concerned about wearing a mask safely, discuss with your healthcare provider the benefits and potential risks of wearing a mask.

· If you have asthma, you can wear a mask. Discuss with your healthcare provider if you have any concerns about wearing a mask.

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

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 of 38 million articles in English-language media around the world found that US President Donald Trump was the single largest driver of the misinformation.[22][23]

...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, 2020... 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.[468] In mid-March, the Trump administration started to purchase large quantities of medical equipment,[469] and in late March, it invoked the Defense Production Act to direct industries to produce medical equipment.[470]

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

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

Even if you’re not making cloth masks at home, they’re generally more affordable than surgical masks because they are meant to be reused. (That being said, the Bangladesh study found that even a surgical mask that had been washed 10 times was more effective at filtering particles than a cloth one.)

...from https://www.theatlantic.com/health/archive/2021/10/why-americans-wear-cloth-masks/620296/

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.[92]

...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.[94]

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

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 was 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,[5] 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.[6][7]

...from https://en.wikipedia.org/wiki/COVID-19_pandemic#cite_note-9

Someone who has been within 6 feet of an infected person (laboratory-confirmed or a clinically compatible illness) for a cumulative total of 15 minutes or more over a 24-hour period (for example, three individual 5-minute exposures for a total of 15 minutes in one day). An infected person can spread SARS-CoV-2 starting from 2 days before they have any symptoms (or, for asymptomatic patients, 2 days before the positive specimen collection date), until they meet criteria for discontinuing home isolation.

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

Cloth masks aren't very effective.

Mask math
More masks = less risk
There's no silver bullet.
Multiple imperfect precautions work together.
Observational and epidemiological studies on masks
Limitations of mask studies

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

Correct and consistent mask use is a critical step that people can take to protect themselves and others from COVID-19. However, the type of masks used, and whether or not they are used consistently and correctly varies throughout the general population. Therefore, mask use is not considered when determining COVID-19 exposure and the definition of a close contact during case investigation and contact tracing, regardless of whether the person diagnosed with and/or the person exposed to COVID-19 was wearing a mask. (Note: Exposure risk in the healthcare setting is determined separately and outlined in CDC guidance).

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

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

October 4, 2021... A recent study in Bangladesh, which has yet to be peer-reviewed but is considered one of the most rigorous to date to tackle masking, linked wearing surgical masks with a 11.2 percent decrease in COVID-19 symptoms and antibodies, while cloth masks were associated with only a 5 percent decrease.

...from https://www.theatlantic.com/health/archive/2021/10/why-americans-wear-cloth-masks/620296/

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 President Biden support a national lockdown?

November 19, 2020... "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 virus that causes coronavirus disease 2019 (COVID-19), the respiratory illness responsible for the COVID-19 pandemic.[4]

...from https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2#cite_ref-NYT-SpikyBlob_1-4

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


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 pray?
Or do you go to the doctor?

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

Modern scientists rely on the regularities of nature that are a product of God's wisdom and faithfulness. But for many, a distortion enters in, because they think that the regularities or "laws of nature" are ultimately impersonal. If they are impersonal, they are basically like a mechanism, for which there can be no exceptions. So before even reading the Bible or listening to the evidence, they think they "know" that there can be no exceptions and no miracles.

This antibiblical view of the world has consequences. Science can still succeed in many ways, because the distorted conception is close enough to the reality to enable advances. At the same time, it is bound to come into conflict with the Bible when it comes to reconstructions of the past.

...from https://www.thegospelcoalition.org/essay/the-bible-and-science/

The same scientists who say that we came from monkeys are telling us to mask and socially distance.

Scientists are specialists. I don't think evolutionary biologists are making COVID-19 recommendations. I don't think virologists, epidemiologists and immunologists are pushing evolution.

My speciality is the Bible. I don't know as much about evolution as an evolutionary biologist does. Does evolution address origins? Does the Bible say how God created the universe? Could God have used evolution in the creation process? There may be some answers here and here... I haven't read those two pages yet, but I have found Wikipedia invaluable for controversial subjects.

I think it's important to know what you don't know. We rely on specialists when our knowledge is limited. If we can't read Greek or Hebrew, we use English Bible translations.

The Bible doesn't say how to treat COVID-19. It provides general principles, but I think COVID-19 needs to be scientifically discerned, similar to Bible translations.

Can a scientist who believes in evolution do good COVID-19 science? Does your religion affect the quality of your work? Can unbelievers do worthwhile work?

Science isn't biased.
Is science opposed to faith?

At this point, most people realize that the debate is not about operation science, which is based in the present. The debate is about origin science and conflicting assumptions, or beliefs, about the past.

...from https://answersingenesis.org/what-is-science/science-or-the-bible/

God will protect me.

We are responsibile to protect the vulnerable.

Jesus' forgiveness is not a license to sin.
God's protection is not a Get-out-of-jail-free card.

Should we cower in fear before a virus? Certainly not.

Should we obey every last whim and dictate of the government, even when local administrations are guilty of dangerous overreach? Absolutely not, as the Department of Justice recently affirmed as well.

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

COVID-19 is not your enemy, fear is. You will not die one day sooner or one day later than God has planned for you. But he did not create you to live in fear. The Bible says, 'God has not given us a spirit of fear, but of power, and of love, and of a sound mind.' 2 Timothy 1:7.

25"For this reason I say to you, do not be worried about your life, as to what you will eat or what you will drink; nor for your body, as to what you will put on. Is not life more than food, and the body more than clothing? 26"Look at the birds of the air, that they do not sow, nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not worth much more than they? 27"And who of you by being worried can add a single hour to his life? 28"And why are you worried about clothing? Observe how the lilies of the field grow; they do not toil nor do they spin, 29yet I say to you that not even Solomon in all his glory clothed himself like one of these. 30"But if God so clothes the grass of the field, which is alive today and tomorrow is thrown into the furnace, will He not much more clothe you? You of little faith! 31"Do not worry then, saying, 'What will we eat?' or 'What will we drink?' or 'What will we wear for clothing?' 32"For the Gentiles eagerly seek all these things; for your heavenly Father knows that you need all these things. 33"But seek first His kingdom and His righteousness, and all these things will be added to you.

34"So do not worry about tomorrow; for tomorrow will care for itself. Each day has enough trouble of its own.

(Matthew 6:25-34, NASB95)

We can't prolong our life by worrying.
But we can shorten our life by taking unnecessary risks.
If you engage in risky behaviors around an infected person, you're more likely to get infected.

US life expectancy drops a year in pandemic, most since WWII

...from https://apnews.com/article/us-life-expectancy-huge-decline-f4caaf4555563d09e927f1798136a869#root

How does the Bible inform these issues?

Should I go to church?

Risk of different venues
Crowd size risk estimator
County risk estimates
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#languageDropDownMenu