COVID-19 (Cont'd #6)

[Dirk Hofman]

Originally Posted by Davis Webb

I could look up the paper. But the take is that aerosol transmission means that it floats in the air, whereas droplet transmission means that it is coughed, sneezed and generally wet. COVD is droplet transmission, not aerosol, ie, the cone of the sneeze, about 6 feet is much riskier then catching it while breathing in air indoors. So unlike Hunta virus, which can be aerosolized while cleaning a basement with infected mice, this one needs wet stuff to encase in.

To summarized the German work, it was done in Italy, obtaining swabs from all manner of surfaces from door handles in emergency rooms, to floors, and so forth. He found viable particles on all of these foments (foment is the thing that a virus might cling to). However, he was unable to get them to grow in the lab. It is now fairly well established that this is the case, the virus is extremely frail. This does not mean we go play beach blanket bongos. But that simply being in a house where people are infected and touching objects, if they are not freshly sneezed on...is probably fine. You can let your friends use your bathroom when they visit, as Jenn says.

Thanks Davis, I created a burner Facebook account to see all of her updates. She's definitely got some good info (I think) and great to see someone doing this level of communication. I see people like her humor and communication style, and that's good. It's a bit folksy for me, but I think it has its place for sure. Worth noting her own disclaimers:

The views and analyses expressed here are solely my own. They do not constitute medical advice. I am a practicing pediatric pathologist with degrees in medicine from the Columbia University College of Physicians and Surgeons, infectious disease epidemiology (CID) from the London School of Hygiene and Tropical Medicine, a year's postgraduate work in the mathematical modeling of infectious disease at Oxford University, and a master's in the history of medicine and science, also from Oxford University.
Keep in mind, these are blog posts, not peer-reviewed scientific publications.

She appears more than qualified to speak on the topic, and I think the disclaimer is something you'd see any responsible scientist make, since the work isn't peer reviewed. But there's a good reason for that, the chance of her making an error is higher without review. She does occasionally cite the papers she'd referencing but I wish she'd do it more consistently. In one post she references two studies but only links and names one. She does a great job on this one: https://www.facebook.com/jenniferkas...41505610835719

All to say, looks like a great source, and she seems entirely reasonable. Thanks for the heads up.

[Dirk Hofman]

For those w/o FB accounts, the text version of the above post is worth reading, and it links to a lot of studies.

FRAMEWORK TO THINK ABOUT THE RISK OF CONTRACTING COVID-19 [transcript of video]
Firstly- who are you? I don’t mean literally- you can tell me, but I won’t hear you- but what is your psychology of risk? Is your life a non-stop X game? Or are you the person who buys 150 lbs of dried beans every time you shop, just in case your nation is invaded and the bean supply is strategically blown up along with the bridges?
As any good therapist will tell you, feelings aren’t reality. How you feel about risk- whether or not you’re cautious or cavalier- doesn’t change the actual risk, of course, but your individual psychology of risk could lead you to make different choices for yourself and your family than someone else would make.

PRINCIPLES

1) Children are at lower risk than adults of contracting COVID, passing on COVID, being terribly sickened by COVID, and dying of COVID (though they do have their serious complication). If you have to arrange a playdate, do so for preschoolers and not the over-80 canasta club.
2) Outdoor transmission is much less likely than indoor. If you ever wanted to shoot a family and neighbor spin-off of Naked and Afraid, now’s your golden moment.
3) Activities where people aren’t artificially packed in together immobile are lower risk. It’s best to avoid sardines, twister, the straightjacket enthusiasts club, indoor arena concerts, etc.
4) People who have been sensible in the first wave, and are being sensible now, are likely lower risk than the X games people. If you’ve ever wanted to openly and hostilely judge your neighbor’s lifestyle choices, good news- it’s now medically sound to do so!
5) Masking remains the easiest, most effective, lowest-burden risk reduction strategy. Now matter what the risk is, masking reduces it. And staying 6’ apart is still A Thing.
6) Respiratory routes are orders of magnitude more important than inanimate object routes. Coughing / sneezing > singing > bellowing > normal speaking > breathing. Don’t worry about objects, like water in a pool, or cutlery in a restaurant, or letting someone use your bathroom. Worry about people, especially people being gross.
7) As people mix again- your network of potential infectious contacts is going to explode. And you simply have to relinquish some degree of control. An example from the weekend- an infected hair stylist in Missouri exposed 91 people just at work, and also visited a big box store, gym and fast food restaurant. This is what inevitably happens as people mingle again.
8) I’m frequently asked to put numbers to a specific risk, like grandparents visiting their grandchildren. I can’t do that and neither can anyone else- but risk is. Indexed to PLACE. Until your place has good local numbers, you’re flying blind. You have no idea who is infected, how many there are, who they’ve come into contact with, and how many are immune. How risky a particular thing is- in numbers- depends on testing data, and if your place is high-prevalence or low-prevalence.
9) And again- nothing is zero. It’s much more likely you’d contract COVID at a church service with elderly people packed in together for 2 hours singing, versus a kids’ pool party, but the pool party can still be a transmission site. It’s not zero. It’s equally unlikely that we’d get to see Tom Brady’s pants split open in glorious technicolor real-time, but hey, check the tape.

SOURCES

TRANSMISSION ROUTES

1. https://www.cdc.gov/coronavirus/2019...i5M82dBhgmxmBM
2. R. Wölfel, V. M. Corman, C. Wendtner et al. Virological assessment of hospitalized patients with COVID-2019. Nature. https://doi.org/10.1038/s41586-020-2196-x
3. Xiao F, Sun J, Xu Y, Li F, Huang X, Li H, et al. Infectious SARS-CoV-2 in feces of patient with severe COVID-19. Emerg Infect Dis. 2020 Aug. https://doi.org/10.3201/eid2608.200681
4. Valentyn Stadnytsky Christina E. Bax, Adriaan Bax, and Philip Anfinrud. The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmissionPNAS May 13, 2020 https://doi.org/10.1073/pnas.2006874117
5. S. Asadi et al., Aerosol emission and superemission during human speech increase with voice loudness. Sci. Rep. 9, 2348 (2019).

MASKS

1. Gunnel AB et al. To mask or not to mask: Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic. Inf Dis Model 5;293-308.
2. Tracht SMDV, Hyman J. Mathematical modeling of the effectiveness of facemasks in reducing the spread of novel influenza A (H1N1). PLoS One 2010;5(2)e:9018.
3. Kim SH et al. Effectiveness of Surgical and Cotton Masks in Blocking SARS–CoV-2: A Controlled Comparison in 4 Patients. Ann Int Med https://doi.org/10.7326/M20-1342
4. Leung NHL et al. Respiratory virus shedding in exhaled breath and the efficacy of face masks. Nat. Med. 2020. https://doi.org/10.1038/s41591-020-0843-2
5. Long Y, Hu T, Liu L, Chen R, Guo Q, Yang L, Cheng Y, Huang J, Du L. Effectiveness of N95 respirators versus surgical masks against influenza: a systematic review and meta‐analysis. J. Evid. Based Med. 2020. Mar 13. https://doi.org/10.1111/jebm.12381
6. Davies A, Thompson K‐A, Giri K, Kafatos G, Walker J, Bennett A. Testing the efficacy of homemade masks: would they protect in an influenza pandemic? Disaster Med. Public Health Prep. 2013; 7: 413– 8.
7. Ma Q‐X, Shan H, Zhang H‐L, Li G‐M, Yang R‐M, Chen J‐M. Potential utilities of mask wearing and instant hand hygiene for fighting SARS‐CoV‐2. J. Med. Virol. 2020 Mar 31. https://doi.org/10.1002/jmv.25805

The CDC report she links to on surface transmission reads very differently than the way she words it.

The virus may be spread in other ways
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but we are still learning more about how this virus spreads.

Seems generally more cautious.

[robj144]

Gyms are starting to open and folks are posting pics and videos on social media. Most places, as far as I can tell, have clients that aren't social distancing and they're not wearing face masks. I can't possibly think of a worse place to not be cautious than a gym wear people are breathing very heavily in an indoor space.

We'll see what happens soon...

[robj144]

Originally Posted by RP

Who records those deaths? What if that reflects the day of the week when people who would otherwise deal with and record deaths are off from work or are short-handed? Are there spikes on Mondays when said people come back to work??? If so, that would be the day that Sunday and Monday deaths get recorded. Just a thought...

Originally Posted by buddyhu

Looks like spikes are often on Mondays or Tuesdays, which favors an interpretation that the stats are not reported 7 days a week in some locations, and that Monday’s and Tuesdays are catch up days.

Originally Posted by Dirk Hofman

Been wondering about that cycle for a while. It's more than just Sundays, it peaks mid week and tapers to the weekend. My best guess so far is that many areas aren't compiling numbers every day, and not on the weekend. But that doesn't totally explain it and I'm not sure that's even the case.

Yeah, I was thinking it was something like that too. But, if you go to the daily reporting sites, each state is reported every day. However, maybe there's a delay in all the reporting.

[Dirk Hofman]

Originally Posted by robj144

Yeah, I was thinking it was something like that too. But, if you go to the daily reporting sites, each state is reported every day. However, maybe there's a delay in all the reporting.

Yeah that's where my questions remain. Not sure how else to explain it though.

[slide496]

Originally Posted by robj144

Gyms are starting to open and folks are posting pics and videos on social media. Most places, as far as I can tell, have clients that aren't social distancing and they're not wearing face masks. I can't possibly think of a worse place to not be cautious than a gym wear people are breathing very heavily in an indoor space.

We'll see what happens soon...

I agree with you. That's a tough one for gym owers to regulate being as their customers are on a subscription basis. I guess the initial group of returnees will be beta testers and the government will step in if need be with reinstituting lockdowns if the owners can't regulate. Sad. The ongoing administrative expense and manpower being required to regulate the resisting public so far has been pathetic - IMHO.

[RP]

Originally Posted by robj144

...I can't possibly think of a worse place to not be cautious than a gym wear people are breathing very heavily in an indoor space.

I'm (or was) an avid swimmer, but thought the same thing a week before my club opted to shut down. We have many seniors like myself, and I just couldn't think of a greater Petri dish than the locker room at the club. They've stopped charging membership dues until all the facilities reopen which is a good thing; but I very much miss my daily swim times...

[rmp]

Originally Posted by robj144

I think it's kind of strange that the reported numbers on every Sunday are a weekly minimum in the US:



See all those dips the last 6 weeks? Those are all Sundays. That makes no logical sense.

I'm sorry if this is offending to any one, BUT, you can't trust the numbers, any of them.

the likely reason is people who would be "taylling" these numbers, don't work on Sunday,

much like the deaths. My best friends mother in law passed away last Tuesday from complications from a stroke in January, she was on comfort care for 2 weeks. she tested + a day before she passed.
this was listed as a COVID19 death... Was it??? I think no.. So, is any thing believable? Sorry,, it's not.

[RP]

Originally Posted by rmp

...you can't trust the numbers, any of them.

the likely reason is people who would be "tallying" these numbers, don't work on Sunday...

I agree and posted the same several weeks ago. I was shouted down and told that even bad data is helpful. HUH? I just let it go, and chalked it up to the notion that many folks needed something to hang their hats on in very uncertain times. But again, I agree with rmp. GIGO - garbage in, garbage out - still means something to me. I also accept that in uncertain times many things are well, uncertain...

[robj144]

Originally Posted by slide496

I agree with you. That's a tough one for gym owers to regulate being as their customers are on a subscription basis. I guess the initial group of returnees will be beta testers and the government will step in if need be with reinstituting lockdowns if the owners can't regulate. Sad. The ongoing administrative expense and manpower being required to regulate the resisting public so far has been pathetic - IMHO.

Some gyms though are being responsible and they have spread out there equipment and require a facemask. It's not too hard to do.

[robj144]

Originally Posted by rmp

I'm sorry if this is offending to any one, BUT, you can't trust the numbers, any of them.

the likely reason is people who would be "taylling" these numbers, don't work on Sunday,

much like the deaths. My best friends mother in law passed away last Tuesday from complications from a stroke in January, she was on comfort care for 2 weeks. she tested + a day before she passed.
this was listed as a COVID19 death... Was it??? I think no.. So, is any thing believable? Sorry,, it's not.

I don't know if you're implying that nothing much is going on or if you just don't trust the accuracy of the exact numbers (tough to tell without more context). But, if it's the former, here is the total number of deaths in the US over time:

https://www.cdc.gov/nchs/nvss/vsrr/c...ess_deaths.htm

And, also the excess deaths compared to historical and projected norms. More total people are definitely dying. So, even if you one says that they would have died anyhow due some comorbidity, that's not really the case.

[Dirk Hofman]

Originally Posted by rmp

I'm sorry if this is offending to any one, BUT, you can't trust the numbers, any of them.

Any of them? That's a pretty unequivocal statement.

Originally Posted by rmp

the likely reason is people who would be "taylling" these numbers, don't work on Sunday,

Well they probably don't work on Saturday either. The charts go lower on the weekends, raise quickly on Mondays, and tail off during the rest of the week. Probably reasonable to assume the reason is that some areas are not doing a full count on the weekends and catching up on Mondays. Curious, why is "tallying" in quotes?

Originally Posted by rmp

much like the deaths. My best friends mother in law passed away last Tuesday from complications from a stroke in January, she was on comfort care for 2 weeks. she tested + a day before she passed.
this was listed as a COVID19 death... Was it??? I think no.. So, is any thing believable? Sorry,, it's not.

So because of one potentially questionable case that you know about, you're willing to not believe any of the data from hundreds of different counties in the US, and the entire world? Or is it just the US data? That the number of these potentially questionable cases is so great as to meaningfully throw off the numbers? That it's happening consistently across all the datasets?

Personally I would want to see a lot more, and more definitive evidence before deciding not to believe "any" of the data.

[imwjl]

Originally Posted by rmp

I'm sorry if this is offending to any one, BUT, you can't trust the numbers, any of them.

the likely reason is people who would be "taylling" these numbers, don't work on Sunday,

much like the deaths. My best friends mother in law passed away last Tuesday from complications from a stroke in January, she was on comfort care for 2 weeks. she tested + a day before she passed.
this was listed as a COVID19 death... Was it??? I think no.. So, is any thing believable? Sorry,, it's not.

Did the death certificate not have the underlying causes filled in? That's been covered in earlier threads here. People I trust - family members in this, a medical examiner from my high school - have clarified this.

I can't help you if you're in the camp prone to believing conspiracies or with little trust, but I believe most health care and medical examiner pros can be trusted. I believe that general formula of cause and underlying cause of death is a better system than no data at all.

[Dirk Hofman]

The best thing about this chart is the trend line clearly going down. Still a high number, but great news.

And, exactly as was predicted by the models. Sharp rise, intervention, and slow decrease.

[Mr. Jelly]

Originally Posted by rmp

I'm sorry if this is offending to any one, BUT, you can't trust the numbers, any of them.

the likely reason is people who would be "taylling" these numbers, don't work on Sunday,.

I find this humorous. Takes a day off. All departments in all walks of life take days off and somehow the results of the data entry isn't all garbage. This is like nobody in management positions think about these types of things. I understand that mistakes do happen but I also understand that not everybody in the world is stupid except for you and I. Not that I think the numbers are totally correct but I can come up with better reasons than taking a day off.