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

COVID is high risk.
Vaccines are low risk.
Masks are no-risk for adults.

Act like you have COVID. (YouTube)
Protecting vulnerable individuals and populations
You will someday be old or sick.
How to discuss controversial topics

2020 & 2021 US deaths compared to past years
Unvaccinated vs vaccinated COVID deaths
Post-vaccination adverse events
Asymptomatic & presymptomatic transmission
Waning immunity

Bible / morality
CDC
Logic
Statistics
google / fact checkers
Consensus
Evaluating information sources

Current US variants
Unvaccinated vs vaccinated COVID cases and deaths

But in the review of about 20,000 COVID-19 cases between Dec. 1 through Jan. 13, when the XBB and XBB.1.5 variants were gaining dominance, researchers found the updated shots helped prevent illness in about half of the people who had previously received two to four doses of the original COVID-19 vaccine, the CDC said.

The article, published in the CDC’s Morbidity and Mortality Weekly Report, showed that among adults aged 18 to 49, the updated vaccine was 48% effective against symptomic infection by XBB/XBB.1.5, compared to 52% against BA.5. For those aged 50 to 64, the effectiveness was 40% compared to 43% against earlier variants.

Among those 65 and older, effectiveness fell to 43% against XBB/XBB.1.5 and 37% against BA.5. Early data show the bivalent shots also reduced the risk of death from COVID-19 by more than twofold in previously vaccinated people and by 13-fold compared with unvaccinated people.

1... Vaccines are predictable.
2... Side effects
3... Long-term safety
4... How mRNA vaccines work (Pfizer & Moderna)
5... How adenovirus vaccines work (Johnson & Johnson)
6... How protein subunit vaccines work (Novavax)

1... Vaccines are predictable:

2... Side effects:

3... Long-term safety:

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

5... How adenovirus vaccines work:
(Johnson & Johnson)

6... How protein subunit vaccines work:
(Novavax)

June 30, 2022... That means no human trials -- just animal trials and laboratory tests. That might sound scary to some, but regulators already use the same accelerated process to update the flu vaccine each year -- and there is no mechanism by which minor mRNA tweaks will make revised Pfizer and Moderna shots any less safe than the billions of doses administered so far worldwide. Otherwise, the U.S. will miss its fall-winter deadline, and the fast-evolving virus will continue to outrun the vaccines.

As FDA Commissioner Robert Califf recently tweeted, “as we know from prior experience, strain changes can be made without affecting safety.”

...Although these boosters mark the first time Covid-19 shots have been authorized without human testing, according to Poehling, this is the regular approach for the flu vaccine: an updated version is released annually without first undergoing new clinical trials.

...So, Pfizer and Moderna have begun human clinical trials for their updated boosters, with results anticipated later this year. But Poehling says a delay in approval would have been disastrous, as statistical models indicate that it would have caused 9700 deaths and 137,000 hospitalizations.

The new booster will be identical to the original vaccines except it will contain genetic coding for two versions of the protein the virus uses to infect cells — the protein from the original vaccine and proteins from the BA.4 and BA.5 omicron subvariants.

Instead of waiting for results from human trials, the FDA asked the drug companies to initially submit only the results of tests on mice, as NPR reported last week.

In June, an FDA advisory panel composed of independent doctors and scientists voted 19-2 that the agency should approve an Omicron-containing booster shot, and the panelists largely supported making that shot one that contained the BA.4/BA.5 strains, not the earlier Omicron strain for which Pfizer and Moderna had already collected clinical data.

The decision is based on high confidence that the vaccine platforms, which have proven effective against earlier strains, will be effective yet again. It is also based on the hard fact that smaller studies of the vaccines are unlikely to give much information about the known side effects of the vaccines. With the existing vaccines, known issues like myocarditis, an inflammation of the heart that has mostly occurred in young men, are simply too rare to detect in even the largest clinical trials that include tens of thousands of patients. Instead, they have been detected by monitoring of vaccines once they are in broad use.

But rest assured — any booster shot you receive now will be the new one, pharmacists confirmed.

When the U.S. Food and Drug Administration authorized the updated vaccine — called a bivalent vaccine — the agency also changed its authorization for the original vaccine, saying it can no longer be used as a booster for people 12 and older.

The original vaccine will still be used for people getting their initial vaccine doses, a CVS spokesperson confirmed.

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?

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:

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.

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

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.

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.

The bivalent BA.4 & BA.5 boosters were only trialed on mice.
Why weren't human trials completed before the FDA Emergency Use Authorization (EUA)?

"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."

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.

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.

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.

Research history:

Pfizer / BioNTech trials:

Moderna trials:

Johnson & Johnson trials:

Novavax trials:

Bivalent BA.4 & BA.5 boosters trials:

Vaccines reduce infections.
Immunity wanes following both infection and vaccination.
"Vaccines decrease your risk of COVID-19. They don't make you immortal."

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

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

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.

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.

Variants:

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 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.

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.)

Vermont:

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.

Rationale:

Usually, getting infected with any given virus produces broader immunity than getting vaccinated against it. That’s because when you’re infected, your immune system is exposed to the entire virus and can generate defenses against any parts of it. That response is typically more layered than the limited one provoked by vaccines.

However, studies of people vaccinated against COVID-19 do not bear that out. “When we compare vaccinated people vs. those who had one less vaccine and then a breakthrough infection, people with the breakthrough infection should be better protected against another infection, but they are not,” says Sahin. “The data show that adding one vaccine dose provides better protection than adding an infection.”

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.

Immunity wanes following both infection and vaccination:

It's not really about the benefit, but the risk:

Previously-infected people benefit from vaccination:

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.

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

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.

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:

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

Like other COVID-19 vaccines, Novavax does not cause COVID-19 infection. It can't get you sick. This vaccine doesn't contain either live or inactivated virus.

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."

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.

How mRNA vaccines work (Pfizer & Moderna)
How adenovirus vaccines work (Johnson & Johnson)
How protein subunit vaccines work (Novavax)

There are four approved or authorized vaccines in the United States used to prevent COVID-19. Pfizer-BioNTech and Moderna are COVID-19 mRNA vaccines. You can also get the Novavax COVID-19 protein subunit vaccine. Otherwise, you may get Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 viral vector vaccine in some situations.

These vaccines are given as a shot in the muscle of the upper arm or in the thigh. None of them affect or interact with our DNA in any way.

The genetic material delivered by mRNA vaccines never enters the nucleus of your cells, which is where your DNA is kept. Viral vector COVID-19 vaccines deliver genetic material to the cell nucleus to allow our cells to build protection against COVID-19. However, the vector virus does not have the machinery needed to integrate its genetic material into our DNA, so it cannot alter our DNA.

Long answer

Short answer:

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.

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

"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."

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.

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

...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.

"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."

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."

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."

Original antigenetic sin / Imprinting:

How many cases of myocarditis have been reported following vaccination?

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.

Myocarditis is inflammation of the heart muscle.

Pericarditis is inflammation of the outer lining of the heart.

Myocarditis and pericarditis have rarely been reported. When reported, the cases have especially been in adolescents and young adult males within several days after mRNA COVID-19 vaccination (Pfizer-BioNTech or Moderna). [Emphasis in the original]

Seek medical care if you or your child have any of the specific or general symptoms of myocarditis or pericarditis especially if it’s within a week after COVID-19 vaccination.

Today, the FDA is announcing revisions to the patient and provider fact sheets for the Moderna and Pfizer-BioNTech COVID-19 vaccines regarding the suggested increased risks of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the tissue surrounding the heart) following vaccination. For each vaccine, the Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) has been revised to include a warning about myocarditis and pericarditis and the Fact Sheet for Recipients and Caregivers has been revised to include information about myocarditis and pericarditis.

The Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) includes a warning that clinical trial data provide evidence for increased risks of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of tissue surrounding the heart) following administration of Novavax COVID-19 Vaccine, Adjuvanted. The Fact Sheet for Recipients and Caregivers informs that in most people who have had myocarditis or pericarditis after receiving the vaccine, symptoms began within 10 days following vaccination and that vaccine recipients should seek medical attention right away if they experience any of the following symptoms after vaccination: chest pain, shortness of breath, feelings of having a fast-beating, fluttering or pounding heart.

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.

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

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."

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

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.

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.

1... Morality / Bible:

2... CDC:

3... Logic:

4... Statistics:

5... google / fact checking:

6... Consensus:

7... Evaluating information sources:

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 sources for bias here.
Information sources need evaluated.

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

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

"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

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

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.

CDC Director Rochelle Walensky is reorganizing the agency, saying it didn't react quickly enough during the Covid pandemic, according an internal review of the agency's operations released on Wednesday.

...Walensky launched the review in April after the massive winter surge of infections from the omicron variant upended the nation's public health response.

...The organizational changes are focused on sharing data more quickly and making public health guidance easier for people to understand.

The CDC restructuring follows two reviews conducted in recent months, one by Health Resources and Services Administration official Jim Macrae into the CDC’s pandemic response and another by CDC Chief of Staff Sherri Berger into agency operations.

The reviews concluded that the “traditional scientific and communication processes were not adequate to effectively respond to a crisis the size and scope of the COVID-19 pandemic,” according to an agency statement.

Specifically, Macrae’s review, which included 120 interviews with CDC staffers and people outside the agency, recommended a series of improvements, including releasing scientific findings and data more quickly to improve transparency, translating science into practical and easy-to-understand policy, improving communication with the public, working better with other agencies and public health partners, and training and incentivizing the agency’s workforce to respond better to public health emergencies.

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).

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 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.

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

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

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.

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.)

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

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.

4 Tips to Keep Your Glasses from Fogging Up (YouTube)
If your mask has a nose wire, pinch it before and/or after donning your mask to make a tighter fit. (YouTube)
Adam Savage used Graf Lanz cloth masks with glasses.

Clearing the air is more important than cleaning surfaces:

How to get motivated to clean:

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.

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.

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.

Vaccination vs. natural immunity:

Achieving herd immunity:

Leading causes of death, US, 2021, provisional
5 Leading causes of death, By age, US, March 2020 - October 2021
Different views on lockdowns

"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"

The intensity of the sudden stop induced by the COVID-19 outbreak produces effects which are similar to those of a large-scale, extreme, natural disaster (6–11).

This is why it’s important to distinguish between “short-term lockdowns with underlying goals” and “long-term lockdowns that hope to beat the odds and keep Covid out indefinitely,” said Miller. Brief lockdowns that helped “flatten the curve” were effective and helped keep hospitalizations and deaths down. But extended lockdowns, like the ones seen in China, failed to contain the virus and damaged the country’s economy and well-being.

Research suggests the pandemic's social, economic, and healthcare system disruptions precipitated excess deaths through a variety of mechanisms. Drug overdoses spiked, homicides soared. Patients and providers postponed preventive health and cancer screenings. Medical care diverted to COVID-19 patients delayed treatment of acute conditions such as heart attacks and strokes. Though road traffic decreased during stay-at-home orders in 2020, certain risky behaviors such as driving under the influence and speeding increased among some groups.

Arguments for the proposition that the “cure is worse than the disease” and the key counter arguments

Health domain	Argument	Key counterarguments
Short-term mortality	Lockdowns themselves caused an increase in short-term excess mortality (defined as mortality greater than the anticipated modelled number of deaths given existing trends)	Countries that imposed several strict lockdowns without experiencing large COVID-19 epidemics (eg, Australia, New Zealand) did not have large numbers of excess deaths. This provides strong evidence that lockdowns themselves are not sufficient to cause surges in deaths
Disruption to health services	Lockdowns are directly responsible for reduced access to and use of healthcare services, which in turn causes harms to health in the long term	The association between large outbreaks of COVID-19, government interventions and reduced use of non-COVID health services is well established. However, this association may be due to healthcare services being redirected to handle COVID-19 cases or other impacts of the pandemic itself rather than by lockdowns. In addition, there is evidence that people fear becoming infected by SARS-CoV-2 in healthcare settings and thus stay home rather than attend health services
Suicide and mental health	Lockdowns have driven increases in the suicide rate	There is consistent and robust evidence from many countries that government interventions to control COVID-19 have not been associated with increased deaths from suicide
Global health programmes	Lockdowns have disrupted services for HIV, TB, malaria and vaccination programmes	Such service disruptions are well documented, but the evidence shows that these have been caused by multiple complex direct and indirect consequences of COVID-19, not just stay-at-home orders

One lesson that Klimek takes from lockdown studies is that there was an early window of opportunity when the virus could have been eliminated — as it was, in effect, in countries such as China, Australia and New Zealand. Had harsher measures been adopted sooner, and more widely, the pandemic might have played out very differently.

...Most scientists agree that lockdowns did curb COVID-19 deaths and that governments had little option but to restrict people’s social contacts in early 2020, to stem SARS-CoV-2’s spread and avert the collapse of health-care systems. “We needed to buy ourselves some time,” says Lauren Meyers, a biological data scientist at the University of Texas at Austin.

...And lockdown policies did bring costs. Although they delayed outbreaks, saving lives by allowing countries to hang on for vaccines and drugs, they also brought significant social isolation and associated mental-health problems, rising rates of domestic violence and violence against women, cancelled medical appointments and disruption to education for children and university students. And they were often (although not always) accompanied by economic downturns.

Enforcement of Zero-Covid, in the absence of targeted and sufficient vaccination and boosting of the elderly and others, creates higher—not lower—danger for vulnerable populations. Having hundreds of thousands of health workers presently dedicated to testing, isolation, and quarantine leaves far fewer staff available to accelerate vaccinations. The refusal on nationalist grounds to move strategically on introducing Western mRNA vaccines and antivirals at scale (combined with China’s failure thus far to develop its own mRNA vaccines and effective antivirals) means that closing China’s immunity gap is being unnecessarily delayed.

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

We don't know who's sick. (YouTube)
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?"

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.

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.

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.

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

"The common cold is generally not lethal, with some rare exceptions", the Digital Health Lab explains. "The flu, which is deadlier than the common cold, killed 0.1% of the people who contracted it in 2019. It is still too early to discern accurate global death estimates for people who have contracted COVID-19, but estimates have ranged from 1% to 25% of all cases, depending on the country".

The experts argue that a conservative death rate of 1% would therefore make COVID-19 at least 10 times as deadly as the flu, and therefore "significantly more lethal" than the common cold.

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.

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."

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.

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

Complicating the country’s understanding of this BA.5 wave is a dearth of data. Not since the earliest months of the pandemic has there been so little precise information about the number of actual infections in the United States. As public testing sites have closed and at-home testing — if people test at all — has grown common, the publicly reported data has become scarce and spotty.

While CDC strives to provide complete and accurate data, there are a few challenges. First, COVID-19 can cause mild illness, and symptoms might not appear immediately. This can lead to delays in testing and reporting. Also, not every infected person will get tested or seek medical care, especially if symptoms are not present. Finally, there are differences in how states and territories report cases. The number of new cases reported each day can fluctuate, and reporting frequency can vary by jurisdiction. Health departments may also update case data over time as they receive more complete information.

For these reasons, there might be discrepancies between numbers reported by CDC versus by health departments. When this occurs, data reported by health departments should be considered the most accurate.

Cases are more underreported than deaths:

Excess 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.

Viral posts wrongly suggest that the COVID-19 death toll is exaggerated because “the state” has instructed that “anyone who didnt die by a gun shot wound or car accident” be listed as a coronavirus victim. Experts say there is no such default classification — and that the U.S. death count is probably underestimated.

Are people who have died in car accidents counted as COVID-19 deaths?

...The Verify team started with a simple Google search.

We found two articles from this year which say that a person who was in a motor vehicle crash was counted as a COVID-19 death. We reached out to health officials in those cases to find out what happened.

In Berks County, Pennsylvania, a local news station reported that a man who was hospitalized after a car accident died of COVID-19.

So what really happened?

We contacted the county coroner, Jonn M. Hollenbach, D-ABMDI, to get more details on the incident. Hollenbach told us first responders were told the man had a coughing spell which caused him to lose consciousness and crash. On the county death certificate, the man's death is labeled as virus-related respiratory failure.

Hollenbach explained further that while the coughing fit happened inside a car, it wasn't the injuries from the car-crash that resulted in his death.

“In this case, the man did not have any life-threatening injuries as a result of the crash," Hollenbach told Verify researchers in an email. "He was tested for COVID-19 upon admission to the hospital due to his symptoms. There was never any report that the crash caused his death."

This past July, Fox 35 Orlando reported that "a person who died in a motorcycle accident was added to Florida’s COVID-19 death count." In an updated story, they say their investigation led to another investigation, and that the death was ultimately removed from the county's COVID-19 death totals.

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

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

September 16, 2022... Kids are at increased risk for respiratory diseases this flu season.

September 6, 2022... Flu season has only just begun, but some health officials are warning that this year it may start sooner and be more severe.

This prediction comes from looking at Australia, where flu season is now coming to an end.

"We inform what we see in our flu season mainly by Australia and New Zealand-- in the other part of the world where seasons are flipped," explains Dr. Joshua Lenchus, Chief Medical Officer at Broward Health. "What they are seeing there are higher incidents of flu than we have seen in years prior."

In fact, data shows Australia has had its worst flu season in five years.

According to the Australian Department of Health's annual Flu Surveillance Report, in 2021, there were only three patients hospitalized due to flu and no deaths.

This year, however, there have already been 1,708 hospital admissions and 288 deaths.

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.

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.

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.

Some newer coronavirus tests can now also simultaneously test whether a patient is positive for influenza, but the CDC’s February 2020 PCR test only has the capacity to detect signs of a COVID-19 infection.

...She said the agency was encouraging labs to switch to tests that can also detect influenza at the same time, since it will "save both time and resources."

...Some posts online falsely said the test was unable to differentiate between coronavirus and influenza, leading to inflated COVID-19 counts and depressed flu counts.

In fact, PCR tests are designed to detect very specific areas of the viral genome, so tests do not get confused between which virus is present, said Matthew Binnicker, director of the clinical virology lab at the Mayo Clinic in Rochester, Minnesota.

"PCR tests, including the one developed by the CDC, are highly accurate and are able to differentiate between SARS-CoV-2 and influenza," Binnicker said. "In other words, a COVID-19 test will not be positive if a person really has influenza, and vice versa."

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.

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".

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.

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:

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.

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."

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

COVID outpaced seven top killers in 2020 (image)

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.

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

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.

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."

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.

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.

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

Current visitor policies:

County risk estimates

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.

Omicron sub-lineage BQ.1.1 is the first variant resistant to all antibody therapies currently approved by the EMA (European Medicines Agency) and/or FDA (US Food and Drug Administration).

...Particularly in regions where BQ.1.1 is widespread, physicians should not rely on antibody therapies alone when treating infected high-risk patients, but should also consider administering other drugs such as paxlovid or molnupiravir,” comments study leader Markus Hoffmann on the results of the study.

Case fatality rate by country

Although the U.S. health care system is among the best in the world, Americans suffer from what experts have called “the U.S. health disadvantage,” an amalgam of influences that erode well-being, Dr. Woolf said.

These include a fragmented, profit-driven health care system; poor diet and a lack of physical activity; and pervasive risk factors such as smoking, widespread access to guns, poverty and pollution. The problems are compounded for marginalized groups by racism and segregation, he added.

The result is a high disease burden among Americans, and shorter life expectancy compared with that in comparable high-income nations over the last two decades, Dr. Woolf said.

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.

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.

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}

Variant:	R0:
original	2.6 (Also, see here)
Alpha	4
Delta	6.3 (Also, see here)
Omicron BA.1	9.5
Omicron BA.2	6-10?
Omicron BA.2.12.1	?
Omicron BA.5	6-10? (not 18.6)
Omicron BQ.1.1	?
Omicron XBB.1.5	?

Current US variants

A variant can have a growth advantage and not actually be intrinsically more transmissible. In fact, the R0 of variant A may be higher, lower, or the same as variant B.

This is because the growth advantage of variant A, compared to variant B, may be driven by any combination of:

Experts say it would be difficult to accurately calculate the variants’ infectiousness using R0, let alone compare it to other viruses, as the measure is only applicable to populations with no exposure to a virus, and doesn’t account for prior infection or vaccination.

The 99% isn't the problem. The 1% is.

Current case fatality rate

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.

"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.

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

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.

Moreover, excluding COVID-19 deaths, Americans in the 65 and older group had lower mortality risks in 2021 than in 2015-2019. This decrease can be explained by mortality displacement: COVID-19 deaths in year 1 of the pandemic for these age groups replaced expected deaths in year 2 from other causes.

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.

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.

...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.

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

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

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

Immunity wanes following both recovery and vaccination.

So if someone was recently infected with a BA.2 lineage, are they mostly protected against reinfection with BA.4 or BA.5?

Probably not, infectious disease experts say.

...Lawler said it's "quite likely and highly predictable that people who were infected with BA.2 will be susceptible to infection with BA.4 or BA.5, and that susceptibility will grow as time goes on, as you get further away from your prior infection."

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.

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.

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.

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.

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.

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

Findings of these studies suggest that the risk of SARS-CoV-2 infection via the fomite transmission route is low, and generally less than 1 in 10,000, which means that each contact with a contaminated surface has less than a 1 in 10,000 chance of causing an infection ^{7, 8, 9}.

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

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.

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.

The risk of surface transmission is low.
Washing hands and not touching your face eliminates the risk from surface transmission.
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}.

· 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.

We already know that the virus can infect and spread within wild mink and white-tailed deer—and for both species, there is at least one verified instance in which the virus has gone from humans to the animals and back again to humans.

The cases of COVID transmission from minks and hamsters both happened in situations where people were caretakers for a large number of animals. But just last month, the first evidence of COVID being passed from a cat to a person was reported. According to a study published last month in Emerging Infectious Diseases, the cat sneezed in the face of a veterinary surgeon who was testing the animal for COVID. Three days later the vet tested positive for COVID, but none of the vet's close contacts did, suggesting the vet got the virus from the infected cat.

There's also a concern that wildlife infected with COVID — like a population of deer in Pennsylvania and other parts of North America — could become reservoirs for the virus, meaning the virus can circulate in them, perhaps even mutate into more transmissible or virulent strains and get passed back to humans. "That could mean that there is a continuing risk from those animals for public health," says van der Poel. "But we have not seen [evidence of a wildlife animal reservoir] yet."

Scientists still don't know how those deer got COVID. It's unlikely the deer caught it from direct contact with humans, though transmission from contaminated wastewater or other infected animals, like feral cats, are possibilities.

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.

Currently there is no evidence of food, food containers, or food packaging being associated with transmission of COVID-19.

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

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

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.

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.

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.)

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'.

The risk of surface transmission is low.

Covid virus 'survives for 28 days' in lab conditions

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.

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.

In the case of surgical or N95 masks, sunlight could actually be a bad thing, Flinn said. "We know that prolonged direct sunlight can degrade some of the plastic materials, even the foam in some of our surgical masks," she said. Instructions on a package for a surgical mask sold at a CVS in Potomac, Md., included a similar warning: "Avoid direct exposure of sunlight during storage as the filter media in this mask can be degraded by extended exposure to sunlight."

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.

Two large clinical trials published by The BMJ today show that boosting vitamin D levels in adults during the SARS-CoV-2 pandemic was not associated with protection against respiratory tract infections or COVID-19.

...The first trial was carried out in the UK between December 2020 and June 2021 and involved 6,200 adults (16 years and over) not using vitamin D supplements at enrollment.

Half (3,100 participants) were offered a vitamin D blood test and those found to have low vitamin D levels (2,674; 86%) received either 3200 IU/day or 800 IU/day of vitamin D supplements for six months, while the other half (controls) received no test or supplements.

...The second trial was conducted in Norway between November 2020 and June 2021 using cod liver oil, which contains low doses of vitamin D and vitamin A as well as omega-3 fatty acids.

A total of 34,741 adults (18-75 years) who were not using vitamin D supplements received either 5 mL cod liver oil or 5 mL placebo (corn oil) daily for six months. The majority of participants (86%) who were tested had adequate vitamin D levels at the start of the study.

...In a linked editorial, Professor Peter Bergman at the Karolinska Institutet in Sweden says vaccination is still the most effective way to protect people from COVID-19, and vitamin D and cod liver oil supplementation should not be offered to healthy people with normal vitamin D levels.

Instead, he suggests clinicians could focus on risk groups, including people with dark skin, or skin that is rarely exposed to the sun, pregnant women, and elderly people with chronic diseases, who could be tested before supplementation.

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.

Vitamin D toxicity:

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

Free rapid tests... Insurance... Free testing sites
Low or no-cost testing by state
Cost, Place, Insurance

Starting in May, though, beneficiaries in original Medicare and many people with private, job-based insurance will have to start paying out-of-pocket for the rapid antigen test kits.

· The federal program allowing people to order free COVID rapid tests from the government will end on September 2 due to lack of Congressional funding.

· For now, insurance providers must cover up to eight free tests per plan member per month.

· Even without health insurance, there are still several ways to find free or low-cost COVID 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.

When you perform an at-home COVID-19 antigen test, and you get a positive result, the results are typically accurate. However, if you perform an at-home COVID-19 antigen test, you could get a false negative result.

...COVID-19 antigen tests may not detect the SARS-CoV-2 virus early in an infection, meaning testing soon after you were exposed to someone with COVID-19 could lead to a false-negative result, especially if you don't have symptoms. This is the reason why repeat testing is important.

...· If you receive a positive result initially or after a repeat test, this means the test detected the SARS-CoV-2 virus and you most likely have COVID-19.

· If you receive a negative result, the test did not detect the SARS-CoV-2 virus at the time of that test.

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.

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."

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

The risk of surface transmission is low.

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.

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."

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.

DIY Box Fan Air Purifier (YouTube)

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.

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.

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.

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.

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.

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.

Current recommendations:

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.

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].

What has the CDC flip-flopped on?

The 6% figure is not new:

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

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.

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?

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

Why does COVID-19 continue to spread?

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?

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.

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 scientific consensus recommends masking:

Limitations of mask studies:

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.

Effective November 23, 2022, Twitter is no longer enforcing the COVID-19 misleading information policy.

...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.

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.

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.

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.

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

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

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.

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

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.

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.

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.

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:

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, social distancing, ventilation and masking. Maybe the difference is just that we don't trust the scientific consensus yet on COVID-19.

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

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

Can we eradicate COVID-19? (YouTube)

New Covid-19 variants are likely to keep on emerging until the whole world is vaccinated against the virus, experts warn.

Cases tend to rise in areas where:

What makes COVID-19 so resistant to eradication?

A candidate for eradication will typically possess three qualities: an effective intervention that can stop transmission, readily available diagnostic tools that can rapidly detect infection, and a lack of the disease among nonhuman animals. COVID-19 fails on all three counts.

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.

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.

"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."

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

COVID is high-risk.
COVID vaccines are low-risk.
Masks are no-risk for adults.

The virus is encountering a highly vulnerable population of babies and children who were sheltered from common bugs during the pandemic lockdowns.

Immune systems might not be as prepared to fight the virus after more than two years of masking, which offered protection, according to Dr. Elizabeth Mack of Medical University of South Carolina.

“South Carolina is drowning in RSV,” Mack said in a news release. The surge arrived earlier this year than normal, she said.

For babies, their mothers may not have been infected with RSV during pregnancy, which could have given the children some immunity.

Non-pharmaceutical interventions (NPIs) and societal behavioural changes during the COVID-19 pandemic altered not only the spread of SARS-CoV-2, but also the predictable seasonal circulation patterns of many endemic viral illnesses in children.¹

...Although many infections and their associated morbidity and mortality were prevented by NPIs, decreased exposure to endemic viruses created an immunity gap—a group of susceptible individuals who avoided infection and therefore lack pathogen-specific immunity to protect against future infection. Decreases in childhood vaccinations with pandemic disruptions to health-care delivery contribute to this immunity gap for vaccine-preventable diseases, such as influenza, measles, and polio.¹⁴ The cumulative effect of new susceptible birth cohorts, waning immunity over time with decreased exposures to usual endemic viruses, and lagging vaccination rates in some settings widens this immunity gap and increases the potential for future outbreaks of endemic viruses (figure).

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.

In terms of mask-wearing for people with asthma, the CDC explains that in most cases, people with asthma can safely wear masks. And having asthma doesn’t qualify for a mask exemption if and when mask mandates are in place.

Both the Asthma and Allergy Foundation of America (AAFA) and the American Academy of Allergy, Asthma & Immunology (AAAAI) have also lent support to the idea that people with asthma can safely wear facemasks.

The AAFA has stated that in people with well-controlled asthma, wearing a facemask shouldn’t be a safety issue. But people with asthma should take care to manage their condition and take their prescribed medications.

The AAAAI published a 2012 study in The Journal of Allergy and Clinical Immunology that found that oxygen levels didn’t decrease among asthma patients who wore masks. This was the case regardless of the duration of mask-wearing or the type of mask worn.

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.

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.

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.

The report noted that the Trump administration recruited Scott Atlas, MD, a radiologist with no background in infectious diseases to serve as an advisor on the response to COVID-19, adding that Atlas received unfettered access to the Trump White House, and became an influential voice pushing for herd immunity policies.

At Atlas's urging, Trump administration officials promoted the herd immunity strategy with "deadly consequences," according to the report.

Specifically, the report stated that Atlas pushed the Trump administration to change CDC guidance to limit the amount of testing conducted in the U.S., and undermined and politicized mask wearing as a mitigation tool, without proposing any alternate measures.

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.

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]

N95 filtering facepiece respirators can be reused until they are dirty, damaged, or difficult to breathe through. You should inspect your N95 respirator before each time you put it on. If the straps or noseclip are broken, it’s torn, dirty, or otherwise damaged, then you should dispose of it. You should always wash your hands before and after handling your respirator.

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.

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

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.

"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.

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.

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.

...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]

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).

"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.

Mask math (YouTube)
More masks = less risk
There's no silver bullet.
Multiple imperfect precautions work together. (YouTube)
RSV surged when we stopped masking.
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.

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.

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).

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?

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.

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.

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.

Multi-layer cloth masks can both block 50-70% of these fine droplets and particles^{3, 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}

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.

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).

"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."

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.

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.

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.

For any style [of beard], hair should not cross under the respirator sealing surface.

Gaps can be caused by choosing the wrong size or type of mask and when a mask is worn with facial hair.

How beard length affects different types of masks

Though variable, N95 respirators offer the best respiratory protection for bearded men. While KF94 and KN95 FFE is compromised considerably by increasing beard length, they proved better options than procedure and cotton face masks. A simple exercise band improves FFE for face masks commonly used by bearded men during the COVID-19 pandemic.

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.

White Americans are far more likely to outlive Black Americans. They live longer for a whole myriad of reasons, like differences in access to care, trauma, stress, etc. This is important because age is the strongest risk factor, by far, for dying of COVID.

If we account for age, we see a very different story. Below is data from a database called CDC WONDER. The 2022 death data is provisional (which means it’s not the official count because death certificates take a long time to process), but it’s the best we have. I pulled all COVID deaths for 2022 and organized by race. Before adjusting for age, White Americans account for 43 per 100,000 in 2022 compared to, for example, Black Americans, who account for 37 per 100,000. After we adjust for age, the story changes: Whites account for 31 per 100,000 while Blacks account for 40 per 100,000. A complete switch.

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."

What do you do when you're sick?

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.

Therefore 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 infect and pollute others, and so cause their death as a result of my negligence.

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.

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.

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.

Therefore 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 infect and pollute others, and so cause their death as a result of my negligence. If God should wish to take me, he will surely find me and I have done what he has expected of me and so I am not responsible for either my own death or the death of others. If my neighbor needs me, however, I shall not avoid place or person but will go freely, as stated above. See, this is such a God-fearing faith because it is neither brash nor foolhardy and does not tempt God.

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.

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.

In 2020, life expectancy at birth in the U.S. dropped by 1.8 years, the biggest yearly decrease since World War II.

Life expectancy at birth decreased 0.6 year from 77.0 in 2020 to 76.4 in 2021, largely because of increases in mortality due to COVID-19, unintentional injuries, chronic liver disease and cirrhosis, suicide, and homicide.

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 results^21,28,29,30