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

Updated May 13, 2022
List of questions

Legend:

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

Table of contents:

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

Youtubes:

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

CDC FAQs:

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

Too long; Didn't read:

Empathy

Protecting vulnerable individuals and populations
You will someday be old or sick.

How do you know who to believe?

Conflicting statements can't both be true.

How to discuss controversial issues

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

How to be wrong

Even the experts have been wrong.

It's better to have been wrong...
...than to still be wrong.

Act like you have COVID.

Asymptomatic & presymptomatic transmission

Vaccines:

Vaccine effectiveness against Omicron:

"Our booster vaccine regimens work against Omicron. At this point, there is no need for a variant-specific booster," Fauci told reporters at a White House briefing.

...from https://www.reuters.com/world/us/early-data-suggests-omicron-more-transmissible-than-delta-cdc-director-2021-12-15/

In a multistate analysis of 241,204 ED/UC [emergency department/urgent care] encounters and 93,408 hospitalizations among adults with COVID-19--like illness during August 26, 2021--January 22, 2022, estimates of VE [vaccine effectiveness] against laboratory-confirmed COVID-19 were lower during the Omicron-predominant than during the Delta-predominant period, after accounting for both number of vaccine doses received and time since vaccination. During both periods, VE after receipt of a third dose was always higher than VE following a second dose; however, VE waned with increasing time since vaccination. During the Omicron-predominant period, mRNA vaccination was highly effective against both COVID-19--associated ED/UC encounters (VE = 87%) and COVID-19 hospitalizations (VE = 91%) within 2 months after a third dose, but effectiveness waned, declining to 66% for prevention of COVID-19--associated ED/UC encounters by the fourth month after receipt of a third dose and to 78% for hospitalizations by the fourth month after receipt of a third dose.

...from https://www.cdc.gov/mmwr/volumes/71/wr/mm7107e2.htm

Abu-Raddad and his colleagues performed a massive observational study using vaccination records and SARS-CoV-2 test results from Qatar's health-care system. They found that Qatari residents who received two doses of either the Pfizer--BioNTech or Moderna mRNA-based vaccine enjoyed several months of substantial protection against symptomatic disease caused by either BA.1 or BA.2.

...Protection against BA.2 did not seem to wane any faster than protection against BA.1, and a booster shot brought the protection against symptomatic infection by either subvariant back to 30--60%.

...from https://www.scientificamerican.com/article/vaccines-remain-effective-against-ba-2-but-protection-from-infection-wanes-over-time/

This week, the U.K. agency estimated that, for people at least two weeks out from their booster shot, vaccine effectiveness against symptomatic disease was 63% against BA.1, versus 70% for BA.2. While that might suggest that BA.2 is less of a threat to vaccine protection than its Omicron sister, the full estimate ranges overlapped.

...from https://www.statnews.com/2022/01/28/early-data-indicate-vaccines-still-protect-against-omicrons-sister-variant-ba-2/

Will the vaccines be safe?

1... Vaccines are predictable.
2... Side effects
3... Long-term safety
4... How adenovirus vaccines work
5... How mRNA vaccines work
6... Pfizer / BioNTech trials
7... Moderna trials
8... Johnson & Johnson trials

1... Vaccines are predictable:

Vaccines reduce infections.

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

2... 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

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 5 people per one million vaccinated in the United States. Anaphylaxis, a severe type of allergic reaction, can occur after any kind of vaccination. If it happens, healthcare 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. TTS is a rare but serious adverse event that causes blood clots in large blood vessels and low platelets (blood cells that help form clots). As of December 16, 2021, more than 17.2 million doses of the J&J/Janssen COVID-19 vaccine have been given in the United States. CDC and FDA identified 57 confirmed reports of people who got the J&J/Janssen COVID-19 vaccine and later developed TTS.

CDC has also identified nine deaths that have been caused by or were directly attributed to TTS following J&J/Janssen COVID-19 vaccination. Women ages 30-49 years, especially, should be aware of the increased risk of this rare adverse event. There are other COVID-19 vaccine options available for which this risk has not been seen.

-- To date, three confirmed cases of TTS following mRNA COVID-19 vaccination (Moderna) have been reported to VAERS after more than 470 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.

· Guillain-Barré Syndrome (GBS) in people who have received the J&J/Janssen COVID-19 vaccine is rare. 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 more than 17.2 million J&J/Janssen COVID-19 vaccine doses administered, there have been around 283 preliminary reports of GBS identified in VAERS as of December 16, 2021. These cases have largely been reported about 2 weeks after vaccination and mostly in men, many in those ages 50 years and older.

Based on the data, the rate of GBS within the first 21 days following J&J/Janssen COVID-19 vaccination was found to be 21 times higher than after Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines). After the first 42 days, the rate of GBS was 11 times higher following J&J/Janssen COVID-19 vaccination. Analysis found no increased risk of GBS after Pfizer-BioNTech or Moderna (mRNA COVID-19 vaccines). CDC and FDA 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. Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of the heart. Most patients with myocarditis or pericarditis after COVID-19 vaccination responded well to medicine and rest and felt better quickly. As of December 16, 2021, VAERS has received 1,947 preliminary reports of myocarditis or pericarditis among people ages 30 years and younger who received COVID-19 vaccines.

Most cases have been reported after receiving Pfizer-BioNTech or Moderna, (mRNA COVID-19 vaccines) particularly in male adolescents and young adults. Through follow-up, including medical record reviews, CDC and FDA have verified 1,124 reports of myocarditis or pericarditis. Learn more about myocarditis and pericarditis, including clinical considerations, after mRNA COVID-19 vaccination.

· Reports of death after COVID-19 vaccination are rare. 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. More than 496 million doses of COVID-19 vaccines were administered in the United States from December 14, 2020, through December 20, 2021. During this time, VAERS received 10,688 reports of death (0.0022%) among people who received a COVID-19 vaccine. CDC and FDA clinicians review reports of death to VAERS including death certificates, autopsy, and medical records.

A review of reports indicates a causal relationship between the J&J/Janssen COVID-19 vaccine and TTS. CDC scientists have conducted detailed reviews of TTS cases and made the information available to healthcare providers and the public:

-- US Case Reports of Cerebral Venous Sinus Thrombosis With Thrombocytopenia After Ad26.COV2.S Vaccination, March 2 to April 21, 2021

-- Case Series of Thrombosis with Thrombocytopenia Syndrome following COVID-19 vaccination--United States, December 2020--August 2021

-- Updates on Thrombosis with Thrombocytopenia Syndrome (TTS) [1.3 MB, 39 Pages]

Continued monitoring has identified nine deaths causally associated with J&J/Janssen COVID-19 vaccination. CDC and FDA continue to review reports of death following COVID-19 vaccination and update information as it becomes available.

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

3... Long-term safety:

Do vaccines alter your DNA?

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/

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#

Most of the things a vaccine can do to a person's immune system take days, not weeks, months, or years to surface. It is possible for rare complications from a vaccine to surface after 30 days, though they generally take place no more than 42 days afterward, according to federal compensation rules for vaccine injuries. That's because there are three main ways that a body reacts to vaccination, and they all happen relatively fast.

The first is an allergic response to a vaccine's ingredients.

That's "15 to 30 minutes," Creech said, adding: "You have swelling, and we deal with it there in the office."

The second type of vaccine reaction a person can have is an inflammatory response. Most people experience this in the days to week after they're vaccinated.

"That's why a lot of people have arm pain, and fatigue, and fever, and achiness in the day or two after a vaccine," Creech said.

Finally, the third way a vaccine might trigger some issue in the body would be through some kind of abnormal response to vaccination. This can happen as the body is refining its response to a vaccine in the weeks to month after a vaccination. There may be genetic risk factors at play, or medical reasons some people have an unusual immune response at this point, Creech said.

"This is where we might see Bell's palsy after a vaccine, or we might see Guillain-Barré syndrome."

But can those things happen years after a vaccine has been administered?

"There's nothing left to continue to cause problems," Creech said. That's because the vaccine has left the body (for mRNA COVID-19 vaccines, it takes about 36 hours), and the subsequent immune responses it has triggered are all complete.

"If you can get to three months after vaccination, and you haven't had any side effect whatsoever, you're not going to now have a side effect," Creech added.

That's why the Food and Drug Administration requires six months of follow-up safety data on all vaccines before they receive full approval. (For emergency use authorization during a time of crisis, like the pandemic, two months of safety data is, temporarily, allowed.)

...from https://www.businessinsider.com/experts-fact-check-vaccine-claims-by-robert-malone-rogan-podcast-2022-2

4... 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

5... 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

6... Pfizer / BioNTech trials:

On August 23, 2021, FDA announced the first approval of a 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 in individuals 16 years of age and older.

Pfizer-BioNTech COVID-19 Vaccine is authorized for emergency use and is available under the EUA as a two-dose primary series for individuals 5 years of age and older, as a third primary series dose for individuals 5 years of age and older who have been determined to have certain kinds of immunocompromise, and as a single booster dose for individuals 12 years of age and older at least five months after completing a primary series of the vaccine.

...from https://www.fda.gov/emergency-preparedness-and-response/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

7... Moderna trials:

Today, the U.S. Food and Drug Administration approved a second COVID-19 vaccine. The vaccine has been known as the Moderna COVID-19 Vaccine; the approved vaccine will be marketed as Spikevax for the prevention of COVID-19 in individuals 18 years of age and older.

...from https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-takes-key-action-approving-second-covid-19-vaccine

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

8... 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

VAERS underreports adverse events:

1... How many adverse events have been reported?
2... Only 1% of adverse events are reported. (Harvard study)
3... How many adverse events are not reported?
4... Healthcare providers are required to report serious adverse events.
5... Serious adverse events are reported more often than minor ones.
6... VAERS cannot determine causality.

1... How many adverse events have been reported?

Five rare serious adverse events that the CDC is concerned about

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

2... Only 1% of adverse events are reported. (Harvard study):

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?

Nope.

"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

3... How many adverse events are not reported?

Underreporting; FDA does not get most reports of adverse events that occur in the United States. Estimates suggest that FDA receives reports of about 1 to 10 percent of the adverse events that occur.

...from https://www.accessdata.fda.gov/scripts/cderworld/index.cfm?action=drugsafety:main&unit=1&lesson=1&topic=8&page=4

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" 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

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

In their report, Rose and Crawford claim to back up their analysis by citing a CDC study on underreporting levels from previous years (here).

The FDA told Reuters it was aware of the reference but that Rose and Crawford’s paper failed to address "spontaneous adverse event reporting in the context of emergency use authorization (EUA)."

It noted that VAERS reporting levels of adverse events were at their highest after the 2009 H1N1 inactivated pandemic influenza vaccine. The CDC’s study showed 76% of cases of anaphylaxis were captured.

"This suggests that the degree of under reporting in VAERS may be mitigated in the setting of a pandemic where there is a heavy emphasis on vaccine safety," the spokesperson said.

They added that there is also likely to be increased capturing of death reports associated with the COVID-19 vaccine programme, given it has operated on an unprecedented scale under "Emergency Use Authorization" in the United States, which mandates vaccine administrators and manufacturers to report all adverse reactions.

...from https://www.reuters.com/article/factcheck-coronavirus-usa/fact-check-vaers-data-does-not-suggest-covid-19-vaccines-killed-150000-people-as-analysis-claims-idUSL1N2R00KP

In Kirsch’s paper and committee meeting presentation, Kirsch calculates a so-called "underreporting factor" of adverse reactions by comparing the number of VAERS reports of anaphylaxis (severe allergic reaction) after vaccination with estimates of people vaccinated in the United States. He subsequently applies this number to reported deaths, claiming that more than 150,000 people have died in the United States as a result of COVID-19 vaccines.

Reuters presented these calculations to the FDA, who said: "FDA strongly disagrees with the analysis Mr. Kirsch put forth during the VRBPAC meeting, as we believe the data from VAERS that he referenced were not properly interpreted."

They added: "Although under reporting is a limitation in VAERS with regard to COVID-19 vaccine safety monitoring, there currently is not evidence to suggest it would underestimate the amount of COVID-19 vaccine-related deaths to such a large degree."

As well as VAERS, there are multiple systems the FDA and CDC use to monitor vaccine safety. Given the COVID-19 vaccine is operated under "Emergency Use Authorization" in the United States, vaccine administrators and manufacturers are mandated to report all adverse reactions. This would likely result in increased recording of suspected deaths associated with the COVID-19 vaccine, the FDA spokesperson said.

...from https://www.reuters.com/article/factcheck-coronavirus-usa-idUSL1N2QP18K

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_

4... Healthcare providers are required to report serious adverse events:

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.

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

The reporting requirements for COVID-19 vaccines are the same for those authorized under emergency use or licensed by the FDA. Healthcare providers who administer COVID-19 vaccines are required to report the following to VAERS:

...· Serious AEs regardless of whether the reporter thinks the vaccine caused the AE. Serious AEs per FDA are defined as:

· Death
· A life-threatening AE
· Inpatient hospitalization or prolongation of existing hospitalization
· A persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions
· A congenital anomaly/birth defect
· An important medical event that based on appropriate medical judgement may jeopardize the individual and may require medical or surgical intervention to prevent one of the outcomes listed above

· Cases of Multisystem Inflammatory Syndrome
· Cases of COVID-19 that result in hospitalization or death

...from https://vaers.hhs.gov/reportevent.html

5... Serious adverse events are reported more often than minor ones:

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

6... VAERS cannot determine causality:

As VAERS does not contain data from unvaccinated populations, VAERS cannot confirm if a vaccine caused something. In other words, without a comparison control group, we don’t know if the adverse events (including deaths) reported to VAERS are actually coincidences that would have happened regardless of the vaccine.

...from https://medium.com/microbial-instincts/underreporting-and-post-vaccine-deaths-in-vaccine-adverse-event-reporting-system-vaers-explained-14fe22b2a65f

If VAERS contains unverified information and can’t show the causal relationship between an adverse event and a treatment, then what is VAERS’ use? VAERS is only the first step of the surveillance process. As we explained in a previous fact-check, serious adverse events such as death are then investigated by experts from the FDA. In other words, VAERS collects data that are used by authorities as the basis for further investigation.

...from https://healthfeedback.org/claimreview/misinterpretation-of-vaers-database-leads-tucker-carlson-to-wrongly-suggests-that-covid-19-vaccines-are-linked-to-higher-mortality-on-fox-news/

The key issue is not the URF [underreporting factor]. It is whether it is possible to estimate the number of vaccine-caused deaths from VAERs in the first place (it's not).

And it is what other more rigorous data have to say on the question of vaccine-caused deaths. These can serve as a feasibility check or validation of your VAERs-based estimates. Data like these CMS data covering essentially the entire 65yr+ USA population, lacking the reporting bias problem, and with a natural control group. Data like all-cause death data, including the UK all cause deaths data with deaths split out by vaccination status and age group, as I have posted on recently here and here and here. Data like all-cause death data showing total excess deaths in 2020 and 2021 over time, data that for many countries show the lowest excess death rates in the pandemic during the months when most vaccination was done.

...from https://www.covid-datascience.com/post/response-to-steve-kirsch-s-ad-hominem-attack-and-clarifying-the-key-sleight-of-hand-in-his-argument

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.

NCVIA/NCVIP

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

Breakthrough infections (post-vaccination):

Vaccines reduce infections.

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

People with vaccine breakthrough infections may spread COVID-19 to others.

...from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html

With more people getting vaccinated, and protection declining over time since the initial vaccination series, breakthrough cases are to be expected, experts concurred.

...from https://abcnews.go.com/Health/breakthrough-covid-19-infections-deaths-rose-delta-outpaced/story?id=81822930

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

Among 1,228,664 persons who completed primary vaccination during December 2020--October 2021, severe COVID-19--associated outcomes (0.015%) or death (0.0033%) were rare. Risk factors for severe outcomes included age ≥65 years, immunosuppressed, and six other underlying conditions. All persons with severe outcomes had at least one risk factor; 78% of persons who died had at least four.

...from https://www.cdc.gov/mmwr/volumes/71/wr/mm7101a4.htm?s_cid=mm7101a4_w

Variants:

Vaccine effectiveness against BA.2

Low levels of vaccination can also contribute to new variants that could be more lethal or have more immune-escape capabilities, Pekosz says.

...from https://publichealth.jhu.edu/2022/omicron-qa-making-some-sense-of-the-messiness-of-this-moment

Why did more vaccinated than unvaccinated people get infected? (Massachusetts, Israel, Vermont)

Unvaccinated vs vaccinated COVID cases and deaths

...In April, after months of public-health experts cautiously promoting the merits of vaccination, CDC Director Rochelle Walensky cited new real-world data of the shots' effectiveness to jubilantly proclaim that "vaccinated people do not carry the virus.

...An outbreak in Provincetown, Massachusetts--in which 74 percent of the 469 cases were in the fully vaccinated--forced the CDC to update its mask guidance and issue a sad and sobering warning: Vaccinated people infected with the SARS-CoV-2 Delta variant can be just as contagious as unvaccinated people.

...To spread the coronavirus, you have to have the coronavirus. And vaccinated people are far less likely to have the coronavirus--period.

...from https://www.theatlantic.com/ideas/archive/2021/09/the-vaccinated-arent-just-as-likely-to-spread-covid/620161/

"From a clinical perspective, we expect to see the number of breakthrough cases go up as more people get vaccinated. It is like what we saw with seat belt use years ago. As the number of people wearing seatbelts increased, the number of car accidents involving people wearing seatbelts went up. However, the overall fatality rate from car accidents dropped. Your chances of dying in a car accident drop dramatically if you wear a seatbelt. So too, your chances of dying from COVID-19 drop substantially if you are fully vaccinated," Acting PA Physician General Denise Johnson said.

...from https://www.fox43.com/article/news/health/coronavirus/vaccinated-breakthrough-cases-shots-covid-coronavirus-vaccine-unvaccinated-pennsylvania-hospitalization-death/521-6b1869b7-9348-41fc-870b-3c3c216697a1

Clearly, the vaccines are impressively effective. Still, overall, more vaccinated Israelis were in the hospital than unvaccinated ones. This is a natural consequence of the fact that if you prioritize the most vulnerable people for vaccination -- which is what you should do -- then vaccinated people will be disproportionately drawn from the vulnerable population. That means more of them than you might otherwise expect will end up sick. (Since Aug. 15, the picture has changed somewhat: Israel now has more unvaccinated hospitalized patients than vaccinated hospitalized patients, possibly related to the rollout of booster doses at the end of July.)

...from https://www.washingtonpost.com/outlook/2021/08/31/covid-israel-hospitalization-rates-simpsons-paradox/

Vermont:

Positive cases have been climbing in Vermont in recent weeks despite the state's having one of the highest vaccination rates against the virus in the U.S. Cases rose last year around this time as well as people spent more time indoors, but the state still enjoyed one of the lowest case rates in the country then.

...Unvaccinated Vermonters are still the people getting sick and being hospitalized at the highest rates.

...The highly contagious delta variant is still one of the main factors affecting cases in Vermont, as it has been for most of the year, Levine said. The variant has even been able to spread among vaccinated people.

...There were fewer Vermonters who got sick early in the pandemic, but this also meant that fewer residents were able to build up any level of immunity from having the virus.

...Vermont's success in vaccinating its residents quickly, starting with the oldest Vermonters, means immunity among the highest-risk people in the state is likely waning now, Levine said.

...Finally, Vermonters are also traveling more and hosting visitors, often taking part in indoor activities, more frequently than they would have at this time last year. They are also wearing masks less often.

...from https://news.yahoo.com/highly-vaccinated-vermont-more-covid-152537112.html

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

Current mask recommendations

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#

Rationale:

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?

Immunity wanes following both infection and vaccination:

Recovery from many viral infectious diseases is followed by a period of infection-induced immunologic protection against reinfection. This phenomenon is widely observed with many respiratory viral infections, including both influenza and the endemic coronaviruses, for which acquired immunity also wanes over time making individuals susceptible to reinfection.

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

Protection against COVID-19 after 2 doses of mRNA vaccine wanes, but little is known about durability of protection after 3 doses.

...from https://www.cdc.gov/mmwr/volumes/71/wr/mm7107e2.htm

It is true that natural infection almost always causes better immunity than vaccines. Whereas immunity from disease often follows a single natural infection, immunity from vaccines usually occurs only after several doses. However, the difference between vaccination and natural infection is the price paid for immunity:

...from https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-safety/immune-system-and-health

The findings highlight an advantage bestowed by natural infection rather than vaccination, but the authors caution that the benefits of stronger memory B cells do not outweigh the risk of disability and death from COVID-19.

...from https://www.rockefeller.edu/news/30919-natural-infection-versus-vaccination-differences-in-covid-antibody-responses-emerge/

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#

What is already known about this topic?

Data are limited regarding the risks for SARS-CoV-2 infection and hospitalization after COVID-19 vaccination and previous infection.

What is added by this report?

During May--November 2021, case and hospitalization rates were highest among persons who were unvaccinated without a previous diagnosis. Before Delta became the predominant variant in June, case rates were higher among persons who survived a previous infection than persons who were vaccinated alone. By early October, persons who survived a previous infection had lower case rates than persons who were vaccinated alone.

What are the implications for public health practice?

Although the epidemiology of COVID-19 might change as new variants emerge, vaccination remains the safest strategy for averting future SARS-CoV-2 infections, hospitalizations, long-term sequelae, and death. Primary vaccination, additional doses, and booster doses are recommended for all eligible persons. Additional future recommendations for vaccine doses might be warranted as the virus and immunity levels change.

...from https://www.cdc.gov/mmwr/volumes/71/wr/mm7104e1.htm

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-naïve 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 study period predated the identification of Omicron, which might upend the authors' conclusions, says Amit Huppert, a mathematical biologist at the Gertner Institute for Epidemiology and Health Policy Research in Tel HaShomer, Israel, and a co-author of the study. "Two weeks ago, I might have said 'don't deal with the recovered population in their first year of recovery and focus your efforts on vaccinating other populations'," he says. But the latest data showing that reinfections and breakthrough infections are more likely with the Omicron variant suggest that hybrid or boosted immunity will be key to preventing severe infection, he adds.

Dowdy says although these data will help public health officials to identify the most effective vaccine regimen, they should not have any bearing on policy today.

Huppert agrees. "At the end of the day, these are subtleties," he says. "The main message is get vaccinated."

...from https://www.nature.com/articles/d41586-021-03674-1

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

Do vaccines or boosters weaken the immune system?

There has been no evidence that the COVID-19 vaccines weaken the immune system.

...from https://www.politifact.com/factchecks/2021/dec/10/blog-posting/no-getting-covid-19-vaccine-wont-weaken-your-immun/

"After COVID-19 vaccination, your immune system is just as able to fight off infections by cold or flu viruses, and it will be better prepared to protect you against COVID-19."

...from https://www.reuters.com/article/factcheck-coronavirus-britain/fact-check-covid-19-vaccines-do-not-weaken-peoples-immune-systems-like-chemotherapy-idUSL1N2SY1SP

The vaccines that children receive in the first two years of life are just a drop in the ocean when compared with the tens of thousands of environmental challenges that babies successfully manage every day.

...By the end of the first week of life, the child's skin, nose, throat and intestines are covered with tens of thousands of different bacteria.

...from https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-safety/immune-system-and-health

40% of patients with weakened immune system mount lower response to vaccines

...from https://www.bmj.com/content/374/bmj.n2098

...In early January, the CDC issued guidelines stating that those who are moderately or severely immunocompromised and have difficulty retaining immunity should get a booster and additional primary shot, for a total of 4 shots.

...from https://www.healthline.com/health-news/why-a-4th-covid-19-shot-likely-wont-provide-more-protection

"Despite what some people have incorrectly reported, Dr. Cavaleri has never said or implied that the repeated administration of boosters would weaken the immune system in any way," Zala Grudnik, a spokesperson for the agency, said in an email. "What he said is that repeated administration of boosters might lead to the immune response to the vaccine being lower, which means the vaccines could become less effective."

...from https://www.usatoday.com/story/news/factcheck/2022/02/16/fact-check-booster-shots-strengthen-dont-destroy-immune-system/6683432001/

I HAVE AN AUTOIMMUNE DISEASE -- AM I AT RISK OF EXPERIENCING A FLARE-UP FROM THE VACCINE?

There is a risk that flare-ups may occur. That being said, it has been observed that people living with autoimmune and inflammatory conditions are at higher risk of experiencing severe symptoms from a COVID-19 infection. Due to this concern, the American College of Rheumatology has stated that "the benefit of COVID-19 vaccination outweighs any small, possible risks for new autoimmune reactions or disease flare after vaccination."

...from https://www.autoimmuneinstitute.org/vaccine-autoimmune-disease-faq/

Explaining why the common cold may be in wider circulation this year, he added: "Last winter we were in lockdown and social mixing, especially indoors, was very limited. This was very effective in limiting the spread of the coronavirus but also had other consequences. At the same time, it reduced our exposure to common cold viruses. Cases were very low indeed, meaning that the annual immunity top-up we normally received through virus infection did not occur.

"Unfortunately, our natural protection to the common cold will have declined to some degree, and this is reflected in the reports of increased severity of symptoms. But this is not at all due to impacts of the COVID-19 vaccination on our immune systems."

A spokesperson for the University of Oxford COVID-19 Vaccine Team said: "There is no truth at all that vaccines weaken the immune system and that this causes death. This suggestion goes against every scientific principle of vaccination."

...from https://www.reuters.com/article/factcheck-coronavirus-britain/fact-check-covid-19-vaccines-do-not-weaken-peoples-immune-systems-like-chemotherapy-idUSL1N2SY1SP

Myocarditis:

In particular, the CDC emphasized that young men, between the ages of 12--39 years, who may be at increased risk for myocarditis, should consider this extended time series.

"Extending the interval between the first and second mRNA vaccine dose to 8 weeks might reduce the risk [of myocarditis]," the agency wrote.

The original waiting period between the first and second dose is still recommended for immunocompromised Americans, adults over the age of 65, and those who may need more rapid protection, due to an increased risk of infection or severe disease.

...from https://abcnews.go.com/Health/cdc-recommends-americans-wait-longer-covid-vaccine-shots/story?id=83070150

mRNA COVID-19 vaccines are safe and effective at the FDA-approved or FDA-authorized intervals, but a longer interval may be considered for some populations. While absolute risk remains small, the risk for myocarditis is higher for males ages 12-39 years, and this risk might be reduced by extending the interval between the first and second dose. Some studies in adolescents (ages 12-17 years) and adults have shown the small risk of myocarditis associated with mRNA COVID-19 vaccines might be reduced and peak antibody responses and vaccine effectiveness may be increased with an interval longer than 4 weeks. Extending the interval beyond 8 weeks has not been shown to provide additional benefit. There are currently no data available for children ages 11 years and younger. In summary, an 8-week interval may be optimal for people who are not moderately or severely immunocompromised and ages 12-64 years, especially for males ages 12–39 years.

...from https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html

· Cases of myocarditis reported to the Vaccine Adverse Event Reporting System (VAERS) have occurred:

- After mRNA COVID-19 vaccination (Pfizer-BioNTech or Moderna), especially in male adolescents and young adults

- More often after the second dose

- Usually within a week of vaccination

· Most patients with myocarditis or pericarditis who received care responded well to medicine and rest and felt better quickly.

· Patients can usually return to their normal daily activities after their symptoms improve. Those who have been diagnosed with myocarditis should consult with their cardiologist (heart doctor) about return to exercise or sports. More information will be shared as it becomes available.

Both myocarditis and pericarditis have the following symptoms:

· Chest pain

· Shortness of breath

· Feelings of having a fast-beating, fluttering, or pounding heart

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

One of the largest studies to date on myocarditis after COVID-19 vaccination confirms an increased risk with both the Pfizer and Moderna vaccines in young men, and shows that the risk is higher with the Moderna than with the Pfizer vaccine.

The study also suggests for the first time that in young men 16 to 24 years of age, the risk for myocarditis after vaccination with either the Pfizer or Moderna vaccine is higher than the risk for myocarditis after COVID-19 infection.

The population-based study involved data on 23.1 million residents across four Scandinavian countries -- Denmark, Finland, Norway, and Sweden --74% of whom had received two vaccine doses and 7% of whom had received one dose.

...from https://www.medscape.com/viewarticle/972453

Participants were 23 122 522 residents aged 12 years or older. They were followed up from December 27, 2020, until incident myocarditis or pericarditis, censoring, or study end (October 5, 2021).

...from https://jamanetwork.com/journals/jamacardiology/fullarticle/2791253

"In the group at highest risk of myocarditis after COVID vaccination -- young men aged 16 to 24 -- the Pfizer vaccine shows a five times higher risk of myocarditis versus the unvaccinated cohort, while the Moderna vaccine shows a 15 times higher risk," Ljung noted.

After seeing these data, the Swedish regulatory authority is no longer recommending use of the Moderna vaccine for people younger than 30 years, Ljung said. Similar recommendations have been made in Norway and Finland.

...from https://www.medscape.com/viewarticle/972453

Design, Setting, and Participants Descriptive study of reports of myocarditis to the Vaccine Adverse Event Reporting System (VAERS) that occurred after mRNA-based COVID-19 vaccine administration between December 2020 and August 2021 in 192 405 448 individuals older than 12 years of age in the US; data were processed by VAERS as of September 30, 2021.

...First, the greater frequency noted among vaccine recipients aged 12 to 29 years vs those aged 30 years or older was similar to the age distribution seen in typical cases of myocarditis.2,4 This pattern may explain why cases of myocarditis were not discovered until months after initial Emergency Use Authorization of the vaccines in the US (ie, until the vaccines were widely available to younger persons).

...from https://jamanetwork.com/journals/jama/fullarticle/2788346

Risk ratios (RR) were calculated to compare risk for cardiac outcomes after SARS-CoV-2 infection to that after mRNA COVID-19 vaccination. The incidence of cardiac outcomes after mRNA COVID-19 vaccination was highest for males aged 12--17 years after the second vaccine dose; however, within this demographic group, the risk for cardiac outcomes was 1.8--5.6 times as high after SARS-CoV-2 infection than after the second vaccine dose. The risk for cardiac outcomes was likewise significantly higher after SARS-CoV-2 infection than after first, second, or unspecified dose of mRNA COVID-19 vaccination for all other groups by sex and age (RR 2.2--115.2). These findings support continued use of mRNA COVID-19 vaccines among all eligible persons aged ≥5 years.

...The study population consisted of 15,215,178 persons aged ≥5 years, including 814,524 in the infection cohort; 2,548,334 in the first dose cohort; 2,483,597 in the second dose cohort; 1,681,169 in the unspecified dose cohort; and 6,713,100 in the any dose cohort (Table 1).

...This study used EHR data from 40 health care systems* participating in PCORnet, the National Patient-Centered Clinical Research Network (7), during January 1, 2021--January 31, 2022.

...from https://www.cdc.gov/mmwr/volumes/71/wr/mm7114e1.htm?s_cid=mm7114e1_x

Myth: Children with congenital heart disease are at a higher risk of developing post-vaccine myocarditis.

Fact: "Congenital heart disease is not a risk factor for developing post-vaccine myocarditis. However, it has been identified by the CDC as a risk factor for severe infection for COVID-19."

...Recent data provided by the CDC suggests that among 100,000 vaccinated adolescent males, only about four to seven would be expected to develop post-vaccine myocarditis. If this group was not vaccinated, however, more than 5,500 would be likely to become infected with COVID-19 over a period of three months, with infections resulting in 50 hospitalizations, potential MIS-C, myocarditis and possible death.

...from https://www.chop.edu/news/health-tip/myocarditis-and-covid-19-get-facts

18 Reasons I Won't Be Getting a Covid Vaccine

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

Did Bill Gates recommend vaccines for population control?

The misinterpretation stems from a comment Gates made during a TED talk in 2010 about methods for reducing the world’s carbon emissions to zero (here). Crucially, one of the factors pushing carbon emissions to an unsustainable level is population growth.

"First, we’ve got population," he said during the talk organized by TED, a non-profit organization devoted to spreading ideas. "The world today has 6.8 billion people. That’s headed up to about nine billion. Now, if we do a really great job on new vaccines, health care, reproductive health services, we could lower that by, perhaps, 10 or 15 percent. But there, we see an increase of about 1.3."

...from https://www.reuters.com/article/factcheck-gates-vaccine/fact-check-bill-gates-quoteabout-vaccines-and-population-growth-has-beentaken-out-of-contextagain-idUSL1N2MF1L8

Gates wasn’t talking about decreasing the population -- he was talking about decreasing its rate of growth.

...from https://www.politifact.com/factchecks/2021/jan/27/instagram-posts/bill-gates-didnt-say-3-billion-people-need-die-rev/

The talk was about reducing global carbon dioxide emissions to zero. It was not describing a plan to use vaccinations to kill people. In fact, his hope for vaccinations is quite the opposite--that good healthcare would lower the risk of death, thereby encouraging parents to have fewer children. This is about slowing the growth of the world population, not reducing the population that exists now.

In an article in Forbes in 2011, Mr Gates said that whilst his initial work in public health focused on contraception, he switched focus to vaccinations, when it became clear that reduced mortality rates and better childhood survival allows individuals to make the choice to reduce their family size, and therefore reduces birth rates.

...from https://fullfact.org/health/viral-video-contains-several-false-pandemic-claims/

Gates is talking about the need to reduce CO2 emissions by humans and he presents this formula for calculating how big these emissions are: CO2 = P x S x E x C (= People x Services per Person x Energy per Service x CO2 per unit of Energy)

It is a mathematical rule that to get something to zero by multiplying you have to multiply it by zero. So, Gates is saying, if you want zero CO2 emissions one of the values on the other side of the equation will have to be zero.

He then goes over them one by one and lists why that wouldn't be practical, ethical or even possible, except maybe with "CO2 per Unit of Energy".

..."If you gave me only one wish for the next 50 years -- I could pick who's president, I could pick a vaccine, which is something I love, or I could pick that this thing that's half the cost with no CO2 gets invented -- this is the wish I would pick."

In other words: Bill Gates would prefer seeing new zero-emission power generation technologies being invented over getting a better and newer vaccine.

So what Gates is saying in his TED talk is almost the opposite of what people using the quote in isolation are claiming. Gates is making the point that reducing the population to zero or even slowing down the growth is not a practical option to stop CO2 emissions and that better power generaton [sic] technology would be a better solution.

...from https://leadstories.com/hoax-alert/2020/05/fact-check-bill-gates-ted-talk-eliminate-10-to-15-percent.html

How do you know who to believe?

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

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

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

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

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

Sources used on this webpage:

~% of
links on
this page...
...that are from this website:
21% CDC
6% YouTube
5% Wikipedia
3% each Nature
NY Times
2% each Vox
Johns Hopkins
AP
CNN
Reuters
The Atlantic
Forbes
Mayo Clinic
Media Bias / Fact Check
NIH
NiemanLab
Snopes
WHO
1% each FDA
Business Insider
BBC
NPR
Washington Post
medRxiv
35% ~117 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 here.
Media Bias ratings... allsides.com
Wikipedia's list of sources with ratings

Providing sources:

Many facebook posts don't provide sources.
Things that didn't happen are often poorly documented.

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

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

I have found Wikipedia invaluable for controversial subjects:

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

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

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

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

Is Wikipedia reliable?

Some unreliable information sources on COVID-19 are:

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

It really comes down to public trust. And, unfortunately, when political leaders make a political issue out of simple biology, which is that the virus is deadly and the vaccines protect people, it unfortunately deters people from getting vaccinated.

...from https://www.pbs.org/newshour/show/why-the-covid-death-rate-in-the-u-s-is-so-much-higher-than-other-wealthy-nations

Information bubble:

facebook is a good example of an information bubble.
You see what you want to see.

As you keep searching, you get more of the same. That's how misinformation campaigns get rooted -- a search for a conspiracy theory brings up all kinds of links, which teaches the algorithm that this is what you want. If you want to evaluate a claim, she says, or the person making the claim, do your research in your browser's private or "incognito" mode.

...from https://www.niemanlab.org/2022/02/its-o-k-to-abandon-ship-how-to-critically-evaluate-scientific-claims-before-pursuing-a-story/

Confirmation bias:

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

Also essential is understanding our own biases -- what we wish to be true, and how that plays into our decision making.

...from https://www.niemanlab.org/2022/02/its-o-k-to-abandon-ship-how-to-critically-evaluate-scientific-claims-before-pursuing-a-story/

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".

Bias:

Search sources for bias here.
Media Bias ratings... allsides.com
Wikipedia's list of sources with ratings

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

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

LEFT-CENTER BIAS

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

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

Press releases are just as much about getting attention for the institution, the company, or the researcher, as they are about the research, says Janet Stemwedel, a philosophy professor at San José State University who has written on the topic of evaluating claims in research.

...from https://www.niemanlab.org/2022/02/its-o-k-to-abandon-ship-how-to-critically-evaluate-scientific-claims-before-pursuing-a-story/

Fact-checking:

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

Consensus:

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

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

Misinterpreting the data:

How big is the study? The more people, the better for statistical analysis.

...from https://www.niemanlab.org/2022/02/its-o-k-to-abandon-ship-how-to-critically-evaluate-scientific-claims-before-pursuing-a-story/

We need to look at the numbers over the whole course of the pandemic, or even over a single wave of infection, to see things more clearly. A single set of numbers does not show the whole picture.

...from https://theconversation.com/covid-death-data-can-be-shared-to-make-it-look-like-vaccines-dont-work-or-worse-but-thats-not-the-whole-picture-172411

Conspiracy theorists quote stastistics just like scientists. But they misinterpret the data. Some examples:

99.97% of infected people recover.

Omicron presents as a cold.

Breakthrough infections (post-vaccination)

Why did more vaccinated than unvaccinated people get infected? (Massachusetts, Israel, Vermont)

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.

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

VAERS underreports adverse events.

18 Reasons I Won't Be Getting a Covid Vaccine

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

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."

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?

"What we know so far"
Some stuff has changed, but the basics remain the same.
The Trump administration undermined the CDC.
The CDC is still the best information source.

What has the CDC flip-flopped on?

Centers for Disease Control and Prevention (CDC)

...Bias Rating: PRO-SCIENCE
Factual Reporting: VERY HIGH

...from https://mediabiasfactcheck.com/centers-disease-control-prevention-cdc/

Why are public health officials so bad at talking to us?

...from https://www.vox.com/coronavirus-covid19/22870268/cdc-covid-19-guidelines-isolation-boosters-masks

One problem is, the CDC usually functions more like an academic institution, excelling at producing detailed reports months after an outbreak or episode. It wasn't built to provide real-time analyses or communicate complicated, fast-moving science to the public.

...While there's a limit to how quickly any agency can process the deluge of data created by Covid-19, these experts highlighted the need to improve communication, specifically. "For the longest time, the federal government has treated science communication as an afterthought," Rivera said.

...from https://newrepublic.com/article/165827/cdc-communication-face-masks-walensky-risk

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

BACKGROUND:

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.

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

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?

We are certainly safer, just not safe.

...from https://www.politico.com/news/magazine/2022/03/30/covid-parachute-risk-adaptive-recovery-00021496

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:

Ventilation

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

Current cleaning recommendations

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?

Well, everyone should understand that this virus is not going away. It's going to be with us for a long time.

So, any hope that you can sort of sit it out and ride out the storm is an unrealistic one, again, another reason why it's great to arm yourself against the virus, your first contact with the virus, through vaccines.

...from https://www.pbs.org/newshour/show/why-the-covid-death-rate-in-the-u-s-is-so-much-higher-than-other-wealthy-nations

Vaccination vs. natural immunity:

Although it is not clear how strong or long-lasting that immunity will be, especially from Omicron, Americans may slowly be developing the protection from past bouts with Covid that other countries generated through vaccinations -- at the cost, scientists said, of many thousands of American lives.

...from https://www.nytimes.com/interactive/2022/02/01/science/covid-deaths-united-states.html

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.

Vaccines

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:

The IHME model estimates a wide range -- from 63% to 81% of Americans.

...The omicron wave that assaulted the United States this winter also bolstered its defenses, leaving enough protection against the coronavirus that future spikes will likely require much less -- if any -- dramatic disruption to society.

...from https://apnews.com/article/coronavirus-pandemic-science-health-united-states-3e7ab3f74080bac8480aa6de3e65ecce

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

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. (YouTube 6:30)
How many cases are asymptomatic?

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

We don't know who's sick. (YouTube 6:30)
How many cases are asymptomatic?

Respecting the needs of immunocompromised people isn't about disproportionately accommodating some tiny minority; it's really about empathizing with your future self. "Everyone's going to deal with illness at some point in their life," Levantovskaya said. "Don't you want a better world for yourself when that time comes?"

...from https://www.theatlantic.com/health/archive/2022/02/covid-pandemic-immunocompromised-risk-vaccines/622094/

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?

Omicron presents as a cold.

New data from the Zoe symptom-tracker app suggests one in two people with new coldlike symptoms will have COVID-19 rather than the common cold.

Tim Spector, an epidemiologist and the study's lead author, said in a press release on Thursday that for most people, getting infected with Omicron would feel "much more like the common cold, starting with a sore throat, runny nose and a headache," rather than fevers, continuous cough, or loss of taste or smell.

...from https://www.businessinsider.com/cold-symptoms-headache-fatigue-sore-throat-sneeze-covid-omicron-study-2021-12

Experts have warned that we can't tell Omicron's severity from the early data we have.

...from https://www.businessinsider.com/is-omicron-severe-covid-hospitalization-rate-severity-2021-12

Jeremy Luban, an infectious disease expert at the University of Massachusetts Chan Medical School, said via email that while vulnerable people can occasionally die from a rhinovirus infection, it is "relatively rare" and the coronavirus is "far more serious and lethal" than the common cold.

...from https://www.usatoday.com/story/news/factcheck/2021/12/30/fact-check-omicron-coronavirus-variant-not-common-cold/9037174002/

These early studies indicated that COVID-19 illness caused by Omicron tended to be milder than Delta in relatively young populations with high levels of immunity, whether from vaccination or prior infection. But experts said that the data can't tell us if the virus is inherently less deadly than Delta, while others warned Omicron's transmissibility may pose the biggest threat.

...For example, if it takes longer for people with Omicron to need hospital treatment than those with Delta, the results will be an "underestimate," the researchers said in the briefing.

...from https://www.businessinsider.com/is-omicron-severe-covid-hospitalization-rate-severity-2021-12

However, laboratory studies have also shown changes in how Omicron infects our bodies. It is better at infecting our airways rather than the deep tissues of the lungs - this could make it easier for the variant to spread, but milder as it is further away from the delicate parts of the lungs.

...However, a milder virus could still put pressure on hospitals because it spreads so fast.

The issue remains that any benefit of a milder virus could be wiped out by large numbers of people catching Omicron.

..."Vaccination remains vital to protect against severe disease and also to protect against future variants."

...from https://www.bbc.com/news/health-59769969

William Hanage, epidemiologist at the Harvard T.H. Chan School of Public Health, told The New York Times that the new findings showed unvaccinated people who hadn't yet caught COVID-19 were at "especially high risk."

"If you are unvaccinated and you have never been infected, it is a little less severe than Delta," Dr. Hanage said about the findings, per the Times. "But that's a bit like saying you're being hit over the head with one hammer instead of two hammers. And the hammers are more likely to hit you now," he added.

...from https://www.businessinsider.com/is-omicron-severe-covid-hospitalization-rate-severity-2021-12

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

https://www.youtube.com/watch?v=r7-3vpx3FjY

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:

CDC estimates that from February 2020--September 2021:

1 in 4.0 (95% UI* 3.4 -- 4.7) COVID--19 infections were reported.

1 in 3.4 (95% UI* 3.0 -- 3.8) COVID--19 symptomatic illnesses were reported.

1 in 1.9 (95% UI* 1.7 -- 2.1) COVID--19 hospitalizations were reported.

1 in 1.32 (95% UI* 1.29 -- 1.34) COVID-19 deaths were reported.

...from https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burden.html

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

The study authors noted that all-cause death data are better measures of the true impact of the pandemic than reported COVID-19 deaths because they are less sensitive to coding errors, competing risks, and possible misclassifications in the cause of death; as such, they facilitate comparisons between countries.

...from https://www.cidrap.umn.edu/news-perspective/2021/11/pandemic-marked-premature-deaths-lost-years-life

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: 3,383,729
2021: 3,465,000 (estimated)

...2010-2019 data from https://www.snopes.com/tachyon/2021/01/Screen-Shot-2021-01-05-at-3.11.31-PM.png (image)

...from https://www.snopes.com/fact-check/typical-year-covid-deaths/

...from https://wonder.cdc.gov/controller/saved/D76/D287F156

The global excess mortality associated with COVID-19 was 14.91 million in the 24 months between 1 January 2020 and 31 December 2021, representing 9.49 million more deaths than those globally reported as directly attributable to COVID-19.

...from https://www.who.int/data/stories/global-excess-deaths-associated-with-covid-19-january-2020-december-2021

Countries have reported some five million COVID-19 deaths in two years, but global excess deaths are estimated at double or even quadruple that figure.

...The Economist magazine in London has used a machine-learning approach to produce an estimate of 12 million to 22 million excess deaths -- or between 2 and 4 times the pandemic's official toll so far (see go.nature.com/3qjtyge and 'Global toll').

...The 116 countries and territories in the World Mortality Dataset have reported 4.1 million COVID-19 deaths so far, but their combined excess mortality is around 1.6 times higher, at 6.5 million.

...from https://www.nature.com/articles/d41586-022-00104-8

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)... 2019... abortion... 629,898 deaths

...from https://www.cdc.gov/reproductivehealth/data_stats/abortion.htm

(US)... 2017-2018 season... flu... 52,000 deaths (est.)

...from https://www.cdc.gov/flu/about/burden/2017-2018.htm

The number of cases of flu-related illness that occurred during 2017-2018 was the highest since the 2009 H1N1 pandemic, when an estimated 60 million people were sick with flu (2).

..from https://www.cdc.gov/flu/about/burden/2017-2018.htm

Cases... Recovered... Deaths
Death toll of major pandemics
Historical pandemics including COVID-19
The deadliest viruses on earth

Don't live in fear.

I'm not scared, because I'm informed and vaccinated.
I understand the risks.
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.

January 18, 2022... The flu hospitalization rate is still about half of the pre-Covid normal, but it is eight times higher than it was last year when one side effect of pandemic restrictions was that flu cases fell off dramatically.

...from https://www.vox.com/coronavirus-covid19/22878202/us-covid-19-flu-cases-hospitals-vaccines

November 20, 2020?... 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

You cannot tell the difference between flu and COVID-19 just by looking at the symptoms alone because they have some of the same symptoms. That's why testing is needed to tell what the illness is and to confirm a diagnosis. Testing is also important because it can reveal if someone has both the flu and COVID-19 at the same time.

...from https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm

October 22, 2020... 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)?

They argued that public health officials should begin by discarding distinct case and death counts for flu, Covid-19, RSV, and other respiratory illnesses. Instead, they say we should focus on the aggregate risk of all these diseases combined.

...from https://www.vox.com/coronavirus-covid19/22878202/us-covid-19-flu-cases-hospitals-vaccines

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.

...from https://www.cdc.gov/nchs/products/databriefs/db427.htm

COVID outpaced seven top killers in 2020 (image)

...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

Screenings for several major cancers fell significantly during 2020, according to a study published in December 2021 in the journal Cancer. Colonoscopies dropped by nearly half compared to 2019, prostate biopsies by more than 25 percent. New diagnoses declined by 13 percent to 23 percent, depending on the cancer -- not because there was less cancer in the world, but because less of it was being detected.

...from https://www.vox.com/coronavirus-covid19/22841229/covid-19-us-cancer-screenings

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?

The increase, or decrease, in the number of detected cases is directly impacted by the number of tests being administered.

...Unless testing of the population is done randomly, the percentage of tested cases that are positive will not reflect the real percentage of the population infected.

...The case fatality rate (CFR), percentage of fatalities in detected cases, is an overestimate of the real infection fatality rate (IFR), and will invariably decrease as testing ramps up.

...from https://towardsdatascience.com/8-key-points-you-might-want-to-think-about-before-sharing-that-next-covid-19-stat-with-your-friends-812c134de124?gi=cf883e37afef

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:

Wellspan
UPMC
Geisinger
PennState Health

County risk estimates
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?

January 11, 2022... When N95 respirators were in short supply early in the pandemic, the CDC established "crisis capacity" strategies for health care facilities, but noted that this is no longer necessary because respirator supply has increased significantly.

...from https://www.sfchronicle.com/health/article/How-long-can-I-keep-using-the-same-N95-respirator-16765593.php 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

Is the US mortality rate worse than other countries?

Mortality analyses

In recent months, the United States passed Britain and Belgium to have, among rich nations, the largest share of its population to have died from Covid over the entire pandemic.

...Chief among the reasons is the country's faltering effort to vaccinate its most vulnerable people at the levels achieved by more successful European countries.

...from https://www.nytimes.com/interactive/2022/02/01/science/covid-deaths-united-states.html

How many cases are asymptomatic?

A significant proportion of COVID-19 transmission is asymptomatic or presymptomatic -- potentially as high as 60%, according to a 2021 JAMA Network Open modeling study.

...Estimates of asymptomatic disease rates with COVID-19 -- the proportion who are infected but never manifest symptoms -- have ranged from about 25% to 40% throughout the pandemic, with a number of papers, including one in the Annals of Internal Medicine, coming in at about a third of cases.

...from https://www.medpagetoday.com/special-reports/exclusives/98632

Masks are primarily intended to reduce the emission of virus-laden droplets by the wearer ("source control"), which is especially relevant for asymptomatic or presymptomatic infected wearers who feel well and may be unaware of their infectiousness to others (estimated to account for more than 50% of SARS-CoV-2 transmissions).1, 2

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

New variants replace old variants, because they are more contagious. (R0)

Variant:R0:
original2.6 (Also, see here)
Alpha4
Delta6.3 (Also, see here)
Omicron BA.18.2 (Also, see here)
Omicron BA.212
Omicron BA.2.12.115

Current US variants

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. The 1% is.

Personal mortality risk calculator
Current case-fatality ratios

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:

A person infected with BA.2.12.1 may infect 15 people.

...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 virus deaths of older people have sometimes been dismissed as losses that might have occurred anyway, from other causes, but analyses of "excess deaths" challenge that suggestion. Eighteen percent more older people died of all causes in 2020 than would have died in an ordinary year, according to data from the C.D.C.

...from https://www.nytimes.com/2021/12/13/us/covid-deaths-elderly-americans.html

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.

Staff and residents at long-term care facilities were particularly hard-hit by the first year of the pandemic, accounting for 31% of all COVID-19 deaths in the US as of June 30, 2021.

...Nursing home cases grew by 440% (from 9,000 to 48,800) between July and August 2021, with a slightly higher increase in resident cases (483%, growing from 3,200 to 19,000) than staff cases (416%, growing from 5,700 to 29,600). Cases outside of nursing homes increased by 224% in the same time period, growing from 1.3 million to 4.2 million (Table 1). Similar to COVID-19 deaths, the vast majority of COVID-19 cases occurred outside of nursing homes. However, the high rate of increase of nursing home cases shows the connection between community spread and the spread of the virus in nursing homes.

...from https://www.kff.org/coronavirus-covid-19/issue-brief/nursing-homes-experienced-steeper-increase-in-covid-19-cases-and-deaths-in-august-2021-than-the-rest-of-the-country/

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

Yes.
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
Some 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
Some 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?

After recovering from COVID-19, most individuals will have some protection from repeat infections. However, reinfections do occur after COVID-19. We are still learning more about these reinfections.

...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

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 droplet 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?

· The virus that causes COVID-19 can spread from people to animals during close contact.

· The risk of animals spreading COVID-19 to people is low.

· Pets can get serious illness from infection with the virus that causes COVID-19, but this is extremely rare.

...Protect pets if you are sick

If you are sick with COVID-19 (either suspected or confirmed by a test), you should avoid contact with your pets and other animals, just like you would with people. Contact includes petting, snuggling, kissing, licking, sharing food, and sleeping in the same bed.

...from https://www.cdc.gov/healthypets/covid-19/pets.html

Ever since the coronavirus started spreading around the world, scientists have worried that it could leap from people into wild animals. If so, it might lurk in various species, possibly mutate and then resurge in humans even after the pandemic has subsided.

...from https://www.nature.com/articles/d41586-021-00531-z

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?

Not usually.
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:

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

Half the vitamin-deficient people developed severe, life-threatening illness compared to fewer than 10 percent of those who had normal levels. The study is the first to examine existing vitamin levels in people before they contracted COVID. "We found it remarkable, and striking," said the lead author, "to see the difference in the chances of becoming a severe patient when you are lacking in vitamin D compared to when you're not."

The data come from 253 people who were admitted to a hospital between April 7, 2020 and February 4, 2021--a period of time before the highly-infectious Omicron variant appeared. The results, however, are "equally relevant" for Omicron as for previous strains, say the study authors.

...from https://www.psychologytoday.com/us/blog/the-fallible-mind/202202/striking-link-between-vitamin-d-levels-and-omicron

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?

Quarantine recommendations
Cleaning your home when someone is sick
Contact tracing
Follow your doctor's orders.

If you are advised to stay home:

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

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

When should I call a doctor?

When to seek emergency medical attention

Symptoms, testing & quarantine flowchart

...from https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html

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

Symptoms, testing & quarantine flowchart

...from https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html

Is a COVID-19 test free?

Free rapid tests

Americans with private insurance will be able to ask for reimbursement for rapid COVID-19 tests beginning Saturday -- but any tests purchased before January 15 will not qualify.

...from https://www.cbsnews.com/news/covid-home-test-insurance-reimbursement-saturday/

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?

Rapid-test advocates have long emphasized the technology's public-health potential: Despite the fact that these affordable devices miss many cases overall, they still diagnose the majority of actively infectious people (especially with repeated testing).

...from https://www.theatlantic.com/health/archive/2022/03/ba2-variant-rapid-testing/627591/

...Antigen tests for SARS-CoV-2 are generally less sensitive than real-time reverse transcription polymerase chain reaction (RT-PCR) and other nucleic acid amplification tests (NAATs), which detect and amplify the presence of viral nucleic acid.

...Both antigen tests and NAATs perform best if the person is tested when they are symptomatic.

...Studies have shown that antigen tests have comparable sensitivity to laboratory-based NAATs when viral load in the specimen is high and the person is likely to be most contagious.

...from https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html

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/

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 droplet 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

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

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

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

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

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

Ventilation:

How coronavirus spreads outdoors vs. indoors
Windows... Filters... Air cleaners... Fans...
DIY Box Fan Air Purifier

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

How to discuss controversial subjects

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 wasn't documented.COVID spreads primarily or exclusively through the air.
Cleaning surfaces, washing hands and not touching your face don't prevent airborne or droplet transmission.
Airborne / aerosol transmissionAerosols can drift further than six feet.
Cloth masks are better at filtering droplets than aerosols.
Immunity wanes following both infection & vaccination.Recovered people should be vaccinated.
Vaccinated people should get boosters.
DeltaVaccinated people can get infected.
Hospitalization and death are more important than infection.
People previously infected with legacy varaints can get reinfected with a new variant.
High rates of transmission result in more variants.
New variants replace old variants, because they are more contagious.
OmicronOmicron presents as a cold.
Hospitalizations are more important than case numbers.
Cloth masks aren't as effective against Omicron.

Current recommendations:
(as of February 28, 2022)

Post-vaccination precautions

Symptoms, testing & quarantine flowchart

...from https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antigen-tests-guidelines.html

Quarantine... Short version (YouTube)
Quarantine... Long version

It is important to wear a mask or respirator when you are sick or caring for someone who is sick with COVID-19. When caring for someone who is sick with COVID-19, a respirator will provide you the best level of protection.

...COVID-19 Community Levels are a tool to help communities decide what prevention steps to take based on the latest data.

Low

· Wear a mask based on your personal preference, informed by your personal level of risk

Medium

· If you are immunocompromised or at high risk for severe illness

- Talk to your healthcare provider about additional precautions, such as wearing masks or respirators indoors in public

· If you live with or have social contact with someone at high risk for severe illness, consider testing yourself for infection before you get together and wearing a mask when indoors with them.

High

· Wear a well-fitting mask indoors in public, regardless of vaccination status or individual risk (including in K-12 schools and other community settings)

· If you are immunocompromised or at high risk for severe illness

- Wear a mask or respirator that provides you with greater protection

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

· Masking is a critical public health tool for preventing spread of COVID-19, and it is important to remember that any mask is better than no mask.

· To protect yourself and others from COVID-19, CDC continues to recommend that you wear the most protective mask you can that fits well and that you will wear consistently.

· Masks and respirators are effective at reducing transmission of SARS-CoV-2, the virus that causes COVID-19, when worn consistently and correctly.

· Some masks and respirators offer higher levels of protection than others, and some may be harder to tolerate or wear consistently than others. It is most important to wear a well-fitting mask or respirator correctly that is comfortable for you and that provides good protection.

· While all masks and respirators provide some level of protection, properly fitting respirators provide the highest level of protection. Wearing a highly protective mask or respirator may be most important for certain higher risk situations, or by some people at increased risk for severe disease.

· CDC's mask recommendations provide information that people can use to improve how well their masks protect them.

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

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

· People who have symptoms of COVID-19 or who have had known close contact to someone with COVID-19 should be tested for COVID-19.

...Regardless of their vaccination status, people who have had a close contact exposure with someone known or suspected of having COVID-19 should be tested at least 5 days after the incident, if possible, or earlier if symptoms develop.

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

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.

When and how to clean surfaces in your home

· Clean high-touch surfaces such as doorknobs, tables, and light switches regularly.

· Clean them more frequently if someone in your household is more likely to get very sick from COVID-19.

· Clean surfaces using a product suitable for each surface, following instructions on the product label.

Reduce contamination of surfaces

Take steps in your home to limit contamination of surfaces from airborne particles or from touching surfaces with contaminated hands.

· If someone in your home has COVID-19, have them isolate within the home.

· Have everyone in your household wash hands

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

"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 variants.
...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/

The global community is not used to seeing rapidly emerging science and changing policy, and has therefore been desperate for immediate, unambiguous answers. Naturally, intolerance of uncertainty has driven some people to fill this void with deceptive narratives [11, 12].

...from https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06357-4

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

Was COVID engineered intentionally, or are the conspirators just taking advantage of the chaos?

What are the conspirators' motives?

COVID has resulted in death.

Was death the conspirators' desired result?

Or were the deaths caused by COVID vaccines and COVID restrictions?

If so, was death the goal of the conspirators?

If the conspirators are trying to kill people, why?

Is the goal population control?
Are specific group(s) being targeted?

Does masking mean you think you are infected?

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

What good does it do to mask in a restaurant?

SEATED ANTI-GERM FORCEFIELD ENGAGE!!!

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

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

Don't discourage masks.

My mask isn't hurting you.
Not masking is harmful.
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 governors 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

U.S., Food and Drug Administration commissioner Robert Califf told CNN on Saturday evening "almost no one" in the U.S. should be dying from COVID-19, but misinformation was impacting the death toll.

...Califf acknowledged to CNN's Pamela Brow that there's "no way to quantify" his belief that misinformation is the leading cause of death in the U.S., but pointed to "an erosion" of life expectancy" that's on average five years shorter than other high-income countries.

..."Almost no one in this country should be dying from COVID, if we were up to date on our vaccinations and got appropriate anti-viral treatment," Califf said.

Worth noting: Califf, a cardiologist by training, told Brow that what's concerned him for a long time since before the pandemic was the "reduction of life expectancy from common diseases like heart disease," for which a lot of information was available on preventing bad outcomes.

...Califf told a health conference in Austin, Texas, last month he believed misinformation "is now our leading cause of death" in the U.S., per an Association of Health Care Journalists blog.

He pointed to examples including vaccine hesitancy and the popularity of the anti-parasitic ivermectin, which the FDA has urged people not to take as a treatment for the virus, to support his point, according to the AHCJ.

...from https://www.axios.com/2022/05/08/misinformation-us-life-expectancy-drop-fda-chief

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 changes as we get more data. 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:

Free N95 masks:

https://www.cdc.gov/coronavirus/2019-ncov/your-health/free-masks.html

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/

"There's no evidence of hospitals gaming the system to boost payments inappropriately, and there needs to be a documentation of a positive lab test for COVID-19 in the patient's medical record in order to qualify for the 20% payment bump. If they did falsify records to get a pay bump, that would be fraud."

...from https://www.businessinsider.com/experts-fact-check-vaccine-claims-by-robert-malone-rogan-podcast-2022-2

"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

Potential Adverse Health Effects of Mask Wearing

Adults

Research supports that under most circumstances, mask wearing has no significant adverse health effects for wearers. Studies of healthy hospital workers, older adults, and adults with chronic obstructive pulmonary disease (COPD) reported no to minimal changes in oxygen or carbon dioxide levels while wearing a cloth or surgical mask either during rest or moderate physical activity.61-65 The safety of mask use during low to moderate levels of exercise has been confirmed in studies of healthy adults and adolescents.64, 66-70 Some,71-74 but not all,67 studies have found that during intense exercise, especially when approaching the aerobic threshold, wearing a mask can increase dyspnea (difficulty breathing), perceived exertion, and claustrophobia, and produce modest negative effects on measured cardiopulmonary parameters. In some people, face masks worn for longer durations might be associated with skin reactions such as acne, itching, dry skin and worsening of existing dermatoses.75-77 Wearing a surgical mask and N95 respirator may have a higher risk of skin reactions compared with a cloth mask.76-78

Children

A study of 60 elementary school children reported no adverse cardiovascular (e.g., heart rate) or pulmonary (e.g., peripheral oxygen saturation) effects among children while wearing a cloth face covering in a classroom for 30 consecutive minutes of instructional time.79 A separate study observed no oxygen desaturation or respiratory distress after 60 minutes of monitoring among children less than 2 years of age when masked during normal play.80 A randomized trial among 40 children aged 3--10 years old scheduled for elective surgery, found that protective surgical face masks could be used safely in the postoperative period.81 In a prospective school-based cohort study of children aged 10--17 years who wore masks for 6--7 hours during the school day, some children self-reported general (4--7%) or situation-specific (2--4%) side-effects such as skin irritation, headache, or difficulty breathing during physical education.82

The potential impact of masks on language and emotional development has been examined in several studies.83-89 Some research suggests children and adults, and especially toddlers (aged 3--5 years) can have difficulty inferring emotion from facial features presented on photographs of persons with their lower facial features covered by a mask.83 However, a study of 7- to 13-year-old children determined the decrement in emotional inference observed when the lower half of a photographed face was covered with a mask was equivalent to that associated with covering the eyes with sunglasses, leading the authors to conclude that in combination with other contextual cues, masks are unlikely to produce serious impairments of children's social interactions.84 A study of 2-year-old children concluded that they were able to recognize familiar words presented without a mask and when hearing words through opaque masks.85 Among children with autism spectrum disorders (ASD), interventions including positive reinforcement and coaching caregivers to teach mask wearing have improved participants' ability to wear a face mask.86-88 These findings suggest that even children who may have difficulty wearing a mask can do so effectively through targeted interventions.

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

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.

...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?

The CDC does not recommend the reuse of disposable surgical masks that are intended to be used once.

...from https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/face-masks-barrier-face-coverings-surgical-masks-and-respirators-covid-19

The U.S. Centers of Disease Control and Prevention says health care workers can wear an N95 mask up to five times. But experts say how often the average person can safely wear one will vary depending on how it's used.

Using the same mask to run to the grocery store, for example, is very different than wearing it all day at work.

The amount of time a mask is worn is more important than how frequently it's worn, says Richard Flagan, who studies masks and aerosols at the California Institute of Technology.

In general, he recommends limiting the use of an N95 mask to about two or three days.

With every breath you take in an N95, particles accumulate on the mask, Flagan says. That could make it more difficult to breathe if the mask has trapped a lot of particles.

"They are degrading the performance of the mask," Flagan says.

The elastic band on the mask could also get worn out and not fit around your face as snugly. It might also get dirty or wet, especially if you're using it while exercising.

If you notice any of these changes to your mask, it's time to stop using it -- even if you've only used it a few hours. And since N95 masks can't be washed, they should be thrown away once you can no longer use them.

...from https://apnews.com/article/coronavirus-pandemic-science-health-528c5bc4fa4e6d1e73386bcb748176c1

Keep it in a dry, breathable bag (like a paper or mesh fabric bag) to keep it clean between uses.

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

Our experts recommend storing your mask in a paper bag for 24 to 48 hours in a dry place.

..."It's not the bag that's doing the magic trick, it's actually the process of keeping the mask away from decontaminating someone else or a surface, and also keeping a dry environment in order for the virus to not spread or stay on the mask," explained Dr. Shepherd.

...from https://www.10tv.com/article/news/verify/verify-kn95-n95-masks-brown-paper-bag/530-c8281e88-8e51-4e71-89ab-1bde783df7d8

"There have been technologies shown to effectively decontaminate disposable respirators, but those technologies are only available to health care organizations, and are only to be used in crisis situations," Carlson said.

...from https://www.sfchronicle.com/health/article/How-long-can-I-keep-using-the-same-N95-respirator-16765593.php

But the latest finding is based on a randomized trial involving nearly 350,000 people across rural Bangladesh.

...The data show that even after 10 washes, surgical masks filter out 76% of small particles capable of airborne transmission of SARS-CoV-2, says Mushfiq Mobarak, an economist at Yale University in New Haven, Connecticut, and a co-author of the study. By contrast, the team found that 3-layered cloth masks had a filtration efficiency of only 37% before washing or use.

...from https://www.nature.com/articles/d41586-021-02457-y

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

Close Contact through proximity and duration of exposure: Someone who was less than 6 feet away from an infected person (laboratory-confirmed or a clinical diagnosis) 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). An infected person can spread SARS-CoV-2 starting 2 days before they have any symptoms (or, for asymptomatic people, 2 days before the positive specimen collection date).

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

Cloth masks aren't very effective.

"One thing that might be different with the variants is that people could be shedding more virus into the air.... You're exposed to more virus, so your chances of infection are higher," she said. "Another thing that might be different is that the infectious dose could be lower."

Marr said there seems to be a "significant change" with masks against Omicron and its subvariants, meaning a cloth mask that may have been somewhat protective before is no longer sufficient and that higher-quality masks may be necessary.

...from https://www.cbc.ca/news/health/covid-19-risk-canada-omicron-sixth-wave-1.6420210

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

The relationship between source control and wearer protection is likely complementary and possibly synergistic, so that individual benefit increases with increasing community mask use.

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

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?

How long are you safe with different kinds of 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

But the latest finding is based on a randomized trial involving nearly 350,000 people across rural Bangladesh.

...The study linked surgical masks with an 11% drop in risk, compared with a 5% drop for cloth.

...from https://www.nature.com/articles/d41586-021-02457-y

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

Although cloth masks may appear to be more substantial than the paper surgical mask option, surgical masks as well as KN95 and N95 masks are infused with an electrostatic charge that helps filter out particles.

...from https://www.poynter.org/fact-checking/2022/is-a-cloth-mask-effective-enough-against-the-omicron-variant/

Multi-layer cloth masks can both block 50-70% of these fine droplets and particles3, 14 and limit the forward spread of those that are not captured.5, 6, 15, 16 Upwards of 80% blockage has been achieved in human experiments,4 with cloth masks in some studies performing on par with surgical masks as barriers for source control.3, 9, 14, 17

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

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?

Axios/Ipsos Coronavirus Index (PDF, pp 20-21, from https://www.ipsos.com/en-us/news-polls/axios-ipsos-coronavirus-index )

Page 1 of the above PDF says, All results show percentages among all respondents, unless otherwise labeled.

Does President Biden support a national lockdown?

November 19, 2020... "no national shutdown."

Why are minorities more at risk for COVID-19?

"Blanket booster programmes are likely to prolong the pandemic, rather than ending it, by diverting supply to countries that already have high levels of vaccination coverage, giving the virus more opportunity to spread and mutate," said Tedros.

...from https://news.un.org/en/story/2021/12/1108622

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.

ikr

Where did COVID-19 originate?

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

Church people:

Is science opposed to faith?

What do you do when you're sick?

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

The Bible gives general principles, but it doesn't say how many people died in 2020 and 2021 or how many unvaccinated vs vaccinated people died of COVID or how natural immunity compares to vaccine-induced immunity.

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.

Life expectancy at birth decreased 1.8 years from 78.8 years in 2019 to 77.0 in 2020, largely because of increases in mortality due to COVID-19, unintentional injuries, heart disease, homicide, and diabetes.

...In 2020, a total of 3,383,729 resident deaths were registered in the United States--528,891 more deaths than in 2019. The number of deaths for which COVID-19 was the underlying cause of death was 350,831 (10.4% of the total number of deaths in 2020). From 2019 to 2020, the age-adjusted death rate for the total population increased 16.8%. This single-year increase is the largest since the first year that annual mortality data for the entire United States became available (2). The decrease in life expectancy for the total population of 1.8 years from 2019 to 2020 is the largest single-year decrease in more than 75 years (3).

...from https://www.cdc.gov/nchs/products/databriefs/db427.htm

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
Some 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 does SARS-CoV-2 survive on surfaces?

Provide masks?
Cancel services?
Clean between services?

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




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