Why is the Coronavirus So Confusing?

photorandy2023

4 years ago

I am writing this article provided that I can find enough supporting data showing a time line of how many times “the experts” changed their minds on covid. Below I have included a little caveat to show that they may not be to blame. Since they can’t be expected to have all the answers, than maybe we should also not take everything they say as the gospel. Coronavirus is after all a very complicated virus, and it may take years to fully understand everything about it. So if we are going to cut them some slack, the media and politicians should not base all their mandates on what they say. We have closed down our economy and kept our young people out of school for months based on what they are telling us. So I am hoping after you read this article, you will understand that the coronavirus is not a black or white subject, it is all gray. We just don’t know. So cut people some slack.

I have written several articles on the coronavirus and on masks and healthcare issues. A series of links have been provided at the bottom of this article for your convenience. This article will, however address a different aspect of the virus or on Healthcare issues in general.

I have already discussed masks in a few articles, but I have decided that one more article on them is in order. So when I finish this article I will do a definitive article on masks and how they work. I am going discuss masks in a separate article, in an effort to keep this article down to a manageable length. I guess you have kind of figured it out that I will be mentioning masks in this article a few times.

A little over six months ago, the World Health Organization (WHO) officially used the p-word — pandemic — to characterize COVD-19.

Since then, our world has changed in countless ways and countless people worldwide have scrambled to understand the disease — what causes it, how it spreads, what can be done to treat it, how can we make a vaccine that prevents it.

Among the scientists on its trail is Adam Kucharski. He is an associate professor at the London School of Hygiene and Tropical Medicine, a TED Fellow and author of the book The Rules of Contagion. Kucharski analyzes data and creates mathematical models to assess disease outbreaks and efforts to control them. His work contributes to the UK government’s Scientific Advisory Group for Emergencies — which provides research-based advice to policymakers — as well as to health agencies like the WHO.

Like many researchers, Kucharski expects that COVID-19 will disrupt our lives for at least the next year or two. “The pandemic won’t end properly until there’s enough immunity – ideally from a vaccine – to stop cases and hospitalizations rising again,” he says. Below, Kucharski provides a research-based update on what scientists now know about COVID-19, as well as what they’re still trying to figure out:

Here are 5 things that scientists now know about COVID-19

1. The geographical source of the outbreaks was closer than assumed

Early in the pandemic, people in the US and Europe generally assumed that initial cases of the virus in their countries were directly imported from Asia. However, a preliminary analysis of the virus’s genetic data revealed this was a false assumption.

Since then, scientists have used the virus’s genetic signature to track how it moved from country to country, and when. As it turns out, the vast majority of early infections in the UK actually arrived from Italy and Spain back in February — and this wasbefore outbreaks were even reported in those two countries. Italy reported its first local transmission on February 21, but by that point many infections had already made their way from there to the UK. Similarly, the epidemic in New York City likely started with infections that arrived from Europe in early February.

Unfortunately, because of the mistaken assumption about where the virus was coming from, health agencies focused early efforts on screening and quarantining travelers from Asia — and not also the people returning from their European holidays.

2. Airborne transmission is important

Early on, a lot of countries and people focused on cleaning surfaces and maintaining safe distances from people as prevention measures, resulting in an emphasis on hand washing, social distancing and disinfecting. While those are still important things to do, we now have data on how short-range aerosols in enclosed spaces like meeting rooms and gyms could easily transmit the disease.

By now, we’ve seen a number of case studies that show how enormously risky indoor group gatherings can be. For example, there was a case in Germany where someone without symptoms had an all-day meeting with 13 people, and 11 became infected. There was also a study in a hospital where researchers detected infectious virus in the air 7 to 17 feet away from patients.

Now that we know about airborne transmission, we have the ability to better fine-tune our personal risk assessments. If we’re considering going somewhere, we can ask: Is the event taking place indoors or out? What is the airflow like? Where and when are masks appropriate? Regarding masks, there’s evidence that they can help reduce transmission — which is counter to what some people thought earlier. However, we also know that masks alone weren’t enough to stop outbreaks in Hong Kong.

In general, there’s no one magic thing that will keep you completely safe. Earlier in the pandemic, public health messaging in many countries was very focused on the idea that as long as you were six feet away (or a couple of meters) from someone else, you were safe. Now we know we need to think beyond that overly simple dimension of risk — for example, staying six feet away from someone in a busy indoor gym is very different from keeping that distance from someone in a park.

3. It’s possible to stifle outbreaks without a full lockdown

An enforced stay-at-home policy is a blunt tool. What it essentially says is that leaders and officials aren’t confident about exactly what measures will work. But now we have longer-term data from countries — like South Korea and Hong Kong — that didn’t enforce full stay-at-home orders. There, people did wear masks in public and worked from home, and many venues like gyms, bars, restaurants and schools were closed for a time. While those were extensive measures and life looked very different than it did during pre-pandemic times, people still had some freedom to go out in public and meet up in small groups. This shows that a more refined approach — a combination of targeted measures, along with effective contact tracing and testing — can work to keep down transmission rates.

4. It’s hard to predict which countries will fare best in a pandemic

If you look at lists of pandemic preparedness rankings from a year ago, it’s very different from where we’ve ended up. In the 2019 Global Health Security Index, the US and UK were at numbers 1 and 2 in overall ranking. Meanwhile, as of this writing, those two countries are at number 1 and number 5, respectively, for total reported COVID-19 deaths. Few people would probably have predicted this situation.

I think it comes down in part to the nature of the virus — one that has rapid, hard-to-detect transmission — and in part to countries’ early responses. Countries’ outcomes have also been affected by how they structure their health systems and what they prioritize. Many countries — most notably, the US and the UK — have cut back their public health funding a great deal, and we’re seeing that hinder their capacity to counter the pandemic.

Of course, some countries that have experienced epidemics in recent decades have been able to put what they’ve learned into practice. Due to their previous responses to SARS and MERS, South Korea, Taiwan and Singapore already had legislation and capacity in place and responded more efficiently. By contrast, in the West, I detected an attitude among many politicians and journalists that COVID-19 was someone else’s problem. Globally, we need honest reflection about what constitutes preparedness in health systems.

A lot of how populations have responded is likely to be influenced by messaging from the top, which is crucial in outbreaks. You can’t expect people to change their behavior if they’re not aware of the risks, or if they don’t have confidence in the messaging. In epidemics, countries with both clear leadership and communication will tend to have more effective responses. Governments that don’t communicate well will risk reducing adherence and effectiveness.

5. When control measures are relaxed, outbreaks can quickly return

As case counts, hospitalizations and deaths declined in many countries in May and June, there was public speculation that the worst was all over. As a result, people relaxed their behaviors. But now researchers have seen very clear data from all over the world — from Australia and Israel to the US and Spain — that if people let their guard down and have too many risky interactions and gatherings, COVID-19 will come right back.

And here are 5 things that scientists still don’t know about COVID-19

1. Exactly how much do asymptomatic people contribute to transmission?

We know that people in younger age groups, especially schoolchildren, are less likely to develop COVID-19 symptoms. Unfortunately, this has made it difficult to understand the role that they play in driving outbreaks.

To do that kind of study, you need to identify infectious people and look at how they transmit. However, if those infectious people don’t show any symptoms, then you’re less likely to be able to spot them in the first place.

One of the additional challenges to gathering data is that schools have been closed in much of the world for a time. Once they’re open again, researchers will need to be monitoring and testing students so they can work out what’s happening and how much transmission is occurring between students and teachers, family members and other close contacts.

2. Why are some people less susceptible than others?

It seems that some people are just less likely to get infected in the first place. Even though they’re exposed, the virus doesn’t take hold in them. We don’t yet know what’s influencing that. Could there be some pre-existing component of their immune response that’s fighting it off?

To study this properly, you need to track the particular immunological characteristics of a group of people that shows evidence of infection with COVID-19, as well as of another group that doesn’t. If there is a significant difference between the two groups, it could suggest that those characteristics might be associated with a sort of protection against infection and against symptoms. These studies are now getting underway, but it will take time for scientists to fully understand what drives — and what decreases — infection risk.

3. Why do some people get sicker than others?

We’ve seen a clear and dramatic increase in the severity of infection with age, but even within age groups, some seemingly healthy people get hit quite hard by COVID-19 while others don’t. What accounts for the inconsistencies?

Recent exposure to other related coronaviruses could potentially provide some cross-protective immunity, and there are other health factors that researchers are identifying — for example, there’s a higher risk of severe COVID-19 that’s been linked to heart disease and immunosuppression.

Based on other viruses, I think there could also be some genetic or biological factors. Some people may have genes that lead to increased risk of severe COVID disease, either directly or indirectly through another condition.

4. What control measures can countries sustain without significantly disrupting the lives of their citizens?

Different control measures have been tried around the world, and they all work — to one degree or another — by keeping infectious people away from at-risk people. New Zealand, for example, has tried to do it at the border level. After an initial lockdown, everyone within their country’s borders went back to behaving normally, but they faced stringent restrictions aimed to keep infection out of the country. A second lockdown in Auckland after a recent outbreak aims to repeat this process.

By contrast, in countries like South Korea, measures have been aimed at the individual level. There, people who may be infected are tracked, tested and quarantined from the rest of the population. As a result, the latter then don’t have to live with stringent lockdown restrictions.

However, all control measures involve some amount of economic and social disruption. It looks like a safe, effective vaccine might not be available for a number of months at best, so the question is: What combination of control measures can countries actually sustain? And for what length of time?

In places like South Africa and India, lockdowns were lifted after around two months because they weren’t economically sustainable; people were going hungry. We may find places that are more isolated — like New Zealand — will find it easier to essentially shut their borders, while places that rely heavily on international trade and migration – such as South Asia or Europe – will find it much harder to do.

5. How long does immunity last after a person is infected?

As we’ve learned by now, there are many coronaviruses out there. Some of the seasonal coronaviruses cause respiratory illnesses like the common cold, and scientists know that this infection can confer some short-term immunity on people that eventually wanes, which means people can get reinfected, sometimes a year or so later.

That’s why we see seasonal coronaviruses circulate over time in populations, and for these, reinfections tend to result in less severe symptoms. So far, we’ve seen only rare reports of reinfections during this pandemic.

Populations that have had big outbreaks of this coronavirus — such as in parts of India or Latin America — have potentially built a degree of short-term immunity that could help suppress future outbreaks. But the question remains to be answered: How long will that protective effect last? This duration of immunity is important for vaccine development. Will we be able to get a vaccine once that will last us years, like the measles vaccine? Or will we have to get it annually, like a flu shot?

As we learn more, some things we believe about COVID today will be revised. Signals that looked promising might fade, while patterns will emerge from what we thought was noise.

As often as I can, I go back to the data to reflect honestly on how well we interpreted it. How did I evaluate the evidence at the time? Was I too cautious in my conclusions? Was I not cautious enough?

Some of our early analysis of transmission risk and disease severity has held up pretty well, but looking back I wonder if we could have gotten there sooner, or publicized the findings earlier. As the pandemic goes on, we scientists will all have to continue to hold ourselves to the process of regular, honest review.

The Timeline on wearing Masks:

– January 23, 2020; when the virus was starting to become important to Americans, The New York Times asked the question, “do masks block Coronavirus?” No conclusive answer was offered, and it was just stressed that washing hands and general hygiene would be sufficient to block the virus.

-Feb 17, 2020; Using the words of Dr. Fauci, The US News and World Report stated on February 17: “skip the masks unless you are contagious.” Even though there was no good way of knowing whether one was contagious, the mediated advice was not to use the mask. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and other health experts did recommend against wearing masks in the early days of the pandemic amid fears about shortages for health care workers, but that guidance was updated in the spring.

-March, 2020; With the steep increase in the count of infections, in the second week of March, Americans were under a national emergency and the mask returned to the forefront. But no clear agenda could be set about masks.

-March 28, 2020; In the short history of the pandemic, Americans were never clearly told what Science reported on March 28: That the benefit of the mask “comes not from shielding the mouths of the healthy but from covering the mouths of people already infected.”

-April 3, 2020; As the infection and deaths grew exponentially, on April 3, five weeks after their story in February, The US News and World Report reported that U.S. health officials are now saying: “Americans should cover their face if they have to go in public.” “The Trump administration remains deeply divided over whether to tell all Americans to cover their faces in public to stop the spread of coronavirus.” The media began to split the mask agenda along political lines.

-April 6, 2020; WHO says wearing a medical mask if you have respiratory symptoms and performing hand hygiene after disposing of the mask.

-May 16, 2020; The politicization of a health agenda continued to be fueled by media commentators who broadcast videos such as the one on May 16 titled The masks are off, which shows President Donald Trump speaking without a mask while his key health officials stand in the background with masks.

-Jun 5, 2020; WHO; 1) Those who are sick should wear a mask if they must go out. (Ideally, however, those who are sick should stay at home and those confirmed to have COVID-19 should be isolated and cared for in a health facility and their contacts quarantined). In areas with widespread transmission, the WHO advises medical masks for all people working in clinical areas of a health facility, not only workers dealing with patients with COVID-19. 2) In areas with community transmission, the WHO now advises that members of the general public aged 60 and older and those with underlying conditions should wear a medical mask in situations where physical distancing is not possible. 3) The general public should wear non-medical masks where there is widespread transmission and when physical distancing is difficult, such as on public transport, in shops or in other confined or crowded environments. 4) Additionally, the WHO has released new guidance on cloth masks, recommending that they consist of at least three layers of different materials: an inner layer being an absorbent material like cotton, a middle layer of non-woven materials such as polypropylene (for the filter) and an outer layer, which is a non absorbent material such as a polyester or a polyester blend.

-July 5, 2020; general consensus among scientists, wear masks in public, when social distancing is not possible. Bu they also say the studies also emphasize that masks don’t fully replace the need for other precautions against Covid-19. So even with a mask, everyone should continue to wash their hands, keep 6 feet from others, and avoid large gatherings, particularly indoors. While masks appear to be a net good, researchers also caution that there needs to be further study on how they may enable reckless behaviors by making people feel invincible or less vulnerable. Even if the evidence isn’t definitive, there’s enough of it to suggest that it’s better to be safe than sorry and recommend the use of masks. With Covid-19, we know the virus spreads through droplets that fly through the air — and, at least in some cases, likely linger for some time — before reaching another host. Masks block at least some of those droplets, creating a literal physical barrier from infection.

-Aug. 7, 2020 CDC; 1) CDC recommends that people wear masks in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain. 2) Masks may help prevent people who have COVID-19 from spreading the virus to others. 3) Masks are most likely to reduce the spread of COVID-19 when they are widely used by people in public settings. 4) Masks should NOT be worn by children under the age of 2 or anyone who has trouble breathing, is unconscious, incapacitated, or otherwise unable to remove the mask without assistance. 5) Masks with exhalation valves or vents should NOT be worn to help prevent the person wearing the mask from spreading COVID-19 to others (source control).

-August 21, 2020 WHO; 1) Based on the expert opinion gathered through online meetings and consultative processes, children aged up to five years should not wear masks for source control. 2) For children between six and 11 years of age, a risk-based approach should be applied to the decision to use of a mask. 3) Advice on mask use in children and adolescents 12 years or older should follow the WHO guidance for mask use in adults and/or the national mask guidelines for adults.

-Sep 22, 2020; She co-authored newly published research in the New England Journal of Medicine that theorizes that not only do masks protect the wearer but they may even reduce the severity of the coronavirus when someone gets infected. “We realized that we should be messaging more strongly masks protect you as the wearer and protects others,” said Dr. Gandhi. It theoretically works much like the early days of vaccines that used small amounts of viruses to illicit an immune response in the body. So, by wearing a mask, you are only exposed to lesser amounts of the virus, if any, potentially building up a sort of immunity. “The more virus you get inside, the sicker you are, the less virus you have, the less sick you are. This is called a dose response and it’s true of many infections,” said Dr. Emily Landon, an epidemiologist and infectious disease specialist at University of Chicago Medicine. And while the research is still theoretical, if it bears out, experts say universal mask-wearing could drive up the proportion of people who get less sick from the virus if they do contract it.

-Sep 30, 2020; All top public health experts now agree that wearing masks is enormously important and effective in slowing the spread of COVID-19. “Face masks, these face masks, are the most important, powerful public health tool we have,” CDC Director Robert Redfield said in Congressional testimony in September. “I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine,” Redfield added. Now Dr. Fauci, like other public health experts, recommends “universal wearing of masks” as a key factor in curbing the pandemic.

We’re still learning a lot about the coronavirus and how to respond to it

The situation with masks and the evidence for them shows how quickly things can change in the midst of a fast-moving disease outbreak. In just a few months, the US has gone from no government recommendations and wide expert skepticism of masks to embracing them. Experts caution that this kind of situation is going to happen again and again with Covid-19. There’s simply going to be a lot of uncertainty with the coronavirus for some time, even after we’ve — hopefully — vanquished it with a vaccine. This is a virus that’s new to humans, causing a pandemic of the likes that modern society hasn’t seen. We’re still learning, for example, just how airborne the coronavirus is, if children widely spread it, what kinds of medical treatments work against it, and whether immunity is long-lasting.

Given how new this all is, experts say the public and its leaders need to be ready to act on changing evidence, and officials shouldn’t be criticized too harshly for adapting on the fly. “It’s never too late to say the right thing,” Wehby said. So while it’s unfortunate that the CDC and surgeon general worked against public mask use at first, and they arguably moved too slowly, it’s also good that they rigorously reviewed the research and embraced change once they felt there was enough evidence to do so. It’s the kind of model that everyone should be encouraged to follow.

There’s still a more philosophical debate about what the government can and should tell people to do. But experts say it’s important to acknowledge the trade-offs — in terms of not just deaths, but the broader effects of the pandemic on normal life and the economy. “People say, ‘It’s a free country. I can do what I want.’ I get that. Americans are very individualistic,” Marr said. “But right now, with the economy shut down, if we wear masks, that would give us the freedom to reopen the economy more while not overwhelming hospitals.”

Given that, most experts I spoke to were bullish on masks — arguing that different levels of government should not only educate and persuade people to wear masks, but even flat-out mandate masks in public spaces. The research, at least, increasingly backs such steps. “It’s a good way to curb transmission,” Pagkas-Bather said. “Especially if we’re going to open up economies, open up public spaces, and encourage people to live as closely to how they did pre-pandemic — which is what it seems like the nation is moving toward.” Really, we need to remember that, in the hierarchy of controls, PPE is the last resort—it’s been shown for many years that wearing things like masks and gloves is the least effective factor at controlling exposure. That’s why social distancing, cleaning, and washing hands are the best ways to protect yourself from the virus.

In health care settings like hospitals, similar studies are needed to tease apart which types of face masks are best for different situations. The study found that medical-grade N95 masks and surgical paper masks used in medical settings offered the best protection, but that self-made cloth masks are still effective for the general public. These data, Shunemann says, support wearing a mask both to reduce the risk of spreading of the virus if you’re infected, and to lower the possibility of becoming infected if you’ve not yet caught the virus. “The type of masks that should be worn, and who wears the masks, should be investigated further in randomized controlled trials,” says Schunemann. “But having said that, my interpretation is that wearing even a self-made mask is better than not wearing anything.”

Social Distancing Views

April 9, 2020; Banning gatherings, having people stay at home, closing schools, and other measures to reduce the spread of Covid-19 are working so well that an influential model of the pandemic’s course now projects that the number of U.S deaths from the new coronavirus by early August will be 60,415 rather than the minimum of 100,000 that it forecast last month. Like other countries, the U.S. has taken an everything-but-the-kitchen-sink approach to social distancing: close schools and ban many international arrivals and close restaurants and ban church services (and other events that bring people together, even funerals) and order those who can to work from home. As a result, officials can’t tell which measures have been the most effective. “Sustained universal mask-wearing and frequent hand-washing have the potential to dramatically reduce the transmission rate of the virus after the first wave,” Chowell said. They “have the potential to help us safely return to work and school,” though he’s in favor of “remote learning and telework as much as possible.”

June 1, 2020; The best practices for controlling an infectious disease like COVID-19 aren’t easy to follow—keeping six feet apart from others, wearing face masks in public, and, if you’re a health care worker, wearing shields to protect your eyes as well. But in a study published Monday in The Lancet, researchers provide the strongest evidence yet that these practices do indeed lower the risk of spreading the virus. When it comes to social distancing, the analysis showed that, on average, the risk of getting infected when remaining 1 meter (a little more than 3 ft) from an infected person was about 3%, while staying less than 1 meter apart upped the risk to 13%. The further people stand away from one another, the lower their risk. In fact, the risk drops by half for every additional meter of distancing up to 3 meters (about 10 ft). “What we tried to do was bring everything together and sort out what distance might be the most effective, rather than an arbitrary threshold,” says Schunemann. Based on how far respiratory droplets from coughs or sneezes generally travel, most public health policies currently recommend standing at least 2 meters (about 6.7 ft) apart in public areas, which the study findings support. “The virus doesn’t know what a meter is, or what six feet is,” says Schunemann. “What this evidence suggests is that two meters, or 6.7 feet, appears that it might be more protective than one meter or three feet.”

Sep 28, 2020; Forecasting the spreading of a pandemic is paramount in helping governments to enforce a number of social and economic measures, apt at curbing the pandemic and dealing with its aftermath. Now researchers present an efficient model to study and forecast the spreading dynamics and containment across different regions of the world. We discover that social distancing measures are more effective than travel limitations across borders in delaying the epidemic peak, says Professor of theoretical physics, Francesco Sannino, University of Southern Denmark and Danish Institute of Advanced Science, continuing: Development in individual regions. The results corroborate our finding that the travel across regions sparks the epidemic diffusion, which then develops in each region independently.

Views on How Covid is spread.

June 28, 2020; Experts disagree over whether or not the SARS-CoV-2 coronavirus is airborne. The argument is central to health policy because if droplets can only travel two metres through the air before falling to the ground, for instance, it would help support the six-foot rule for physical distancing. As the size of a droplet influences how far it might fly, scientists also argue over the distinction between an ‘aerosol’ — a fine mist of liquid particles in air — and a ‘droplet’. Some researchers think expiratory particles should be so tiny that anything wider than 0.005mm (five microns) is a droplet, while others believe 0.01mm is a better cut-off. The figure is arbitrary and distinction is irrelevant to the average person, but it’s relevant to public health authorities: if a virus is carried via aerosols, you could conclude that it’s also ‘airborne’. As a trained biologist and science communicator, I’m going to give you a clear statement: Yes, Coronavirus is airborne. That comes with an important caveat, which is that whether a virus remains in the air long enough to worry about will depend on the environment — your surroundings and people it contains.

July 6, 2020; Research scientists want less emphasis on hand-washing, more on masks. A group of 239 scientists from 32 countries is asking the World Health Organization (WHO) to revise its position on the airborne spread of COVID-19. Many of us have been doing things like wearing masks inside stores and other businesses, keeping our distance from others within them, and avoiding them if they’re too crowded—regardless of, or with no idea about, what the WHO recommends. We’ve been hearing for months that droplets from people infected with the new coronavirus could linger in the air and cause new infections, and doing our best to take precautions. Precisely how much danger aerosol droplets from COVID-19 patients pose is still unclear. “There is no incontrovertible proof that SARS-CoV-2 travels or is transmitted significantly by aerosols, but there is absolutely no evidence that it’s not,” Trish Greenhalgh, a doctor at the University of Oxford, told The New York Times. For a while, however, most scientists have seemed more worried about the airborne spread of COVID-19 than surface-based spread.

Sep 21, 2020; The CDC pulled its guidelines on how Covid spreads by aerosols shortly after posting them online. CDC Reverses Guidelines. In a move sure to cause confusion the CDC Removes Guidelines Saying Coronavirus Can Spread From Tiny Air Particles. For months, the CDC said the new coronavirus is primarily transmitted between people in close contact through large droplets that land in the mouths or noses of people nearby. On Friday, however, it added that tiny particles known as aerosols could transmit the virus. Then abruptly on Monday, the CDC reversed course and removed the additions. Much of the guidelines’ earlier description of Covid-19 transmission, emphasizing spread via large droplets, was restored. The agency last week walked back a controversial recommendation that close contacts of Covid-19 patients don’t need to get tested if they don’t have symptoms. “The tide had turned toward science when the CDC said” aerosol transmission is possible, said Joseph Allen, a health scientist and director of Harvard University’s Healthy Buildings program, which studies how buildings affect human health. “It was a watershed moment where people would believe this.” “To backtrack instantly is devastating,” he said. Aerosol and respiratory viruses experts have been arguing for months that Covid-19 is an airborne virus, pointing to studies of outbreaks that have shown that the new coronavirus spread even when close contact among people was avoided. More than 200 scientists asked public-health agencies, in a letter published in July in the journal Clinical Infectious Diseases, to acknowledge airborne transmission of Covid-19.

Summary:

I covered 3 different areas where there has been confusion in the coronavirus pandemic. The efficacy of masks, how it is spread airborne or droplet and social distancing how far is safe? The purpose of this article was not necessarily to answer these questions but to show that there is still confusion on these matters. So what do we do, hide in a cave, or do we try to remain safe and live our lives as best as possible. I just recently went to Mt Charleston in Las Vegas, Nevada for a hike. The trail was at 8,000 feet of elevation. During the two hours my wife and I hiked we met 10 people. We were probably exposed to each other 30 secs max as we passed each other. Only 2 people wore masks, the rest did not. We were all safe. My question is why the people wearing the masks? How healthy is it to be hiking at elevation, with reduced oxygen and to be breathing in your exhaled CO2? People have to treat Covid-19 with respect, but they also have to use common sense as well. The media needs to stop their fear mongering, and our government needs to trust its citizens to do the right thing and allow us to return to our lives. Too many people have lost their lives and too many people their livelihood and self respect. We are now living in a cancel culture and a shame society. We live in a society where the criminals are lauded and the law abiding citizens are ostracized. We can’t even protect ourselves and our property, because we have no rights. If we speak out against the injustices, we are called racist and xenophobic (a term until recently I have never heard of).

Resources:

ideas.ted, “5 things scientists now know about COVID-19 — and 5 they’re still figuring out,” By Karen Frances Eng; forbes.com, “The Media And Masks: A Confusing Narrative For Americans,” By Ananda Mitra; weforum.org, “WHO updates guidance on masks for health workers and the public – here’s what you need to know,” By Linda Lacina;who.int, “Coronavirus disease (COVID-19) advice for the public: When and how to use masks;” cdc.gov, “Considerations for Wearing Masks;” forbes.com, “Scientists Have Been Right About The Coronavirus. Why Are People Still Not Listening?”By Marshall Shepherd; statnews.com, “Scientists who express different views on Covid-19 should be heard, not demonized,” By Vinay Prasad and Jeffrey S. Flier; vox.com, “The growing scientific evidence for masks to fight Covid-19, explained,” By German Lopez; hub.jhu.edu, “UNDERSTANDING CHANGING GUIDANCE ON MASK USE,” By Kirsten Koehler and Ana Rule; thedenverchannel.com, “Study suggests mask-wearing can lessen COVID-19 severity,” By: Ash-har Quraishi; time.com, “Fact-Checking COVID-19 Falsehoods From the Presidential Debate,” By Abby Vesoulis; sciencenewsforstudents.org, “Learning will change with COVID-19’s social distancing,” By Rachel Kehoe; forbes.com, “Interventions Meant To Slow The Spread Of Covid-19 Have All But Stopped The Spread Of Flu,” By John Drake; time.com, “Wearing Face Masks and Social Distancing Actually Work to Contain COVID-19, According to a New Study,” BY ALICE PARK; ucusa.org, “COVID-19 Disinformation; How to Spot It—and Stop It;” statnews.com, “Social distancing is controlling Covid-19; now scientists need to figure out which measures are most effective,” By Sharon Begley; eurekalert.org, “Covid-19: Social distancing is more effective than travel bans;” reason.com, “239 Scientists Ask WHO To Change Its Position on How COVID-19 Spreads Through Air,” By Elizabeth Nolan Brown; thestreet.com, “CDC Spreads Confusion and Anger With a Stunning Covid Reversal,” By Mish; bloomberg.com, “Covid Spread Can’t Only Be Explained by Who’s Being ‘Bad’,” By Faye Flam; forbes.com, “Coronavirus Is Airborne, But That Doesn’t Mean You’re Always At Risk,” By JV Chamary;

Addendum:

Affect of Mask Wearing on the Flu

In March 2020, most of the world implemented non-pharmaceutical interventions (NPIs) including the use of face masks, social distancing, school closures, and teleworking to prevent the spread of Covid-19. We don’t yet know exactly how well these interventions worked to slow the Covid-19 pandemic. But we do know now that they have helped to slow the spread of influenza

Ideally, the effectiveness of an intervention (e.g. wearing a face mask), is measured by looking at the outcomes one is trying to affect (e.g. the number of cases of Covid-19). With seasonal diseases like flu, the ability to compare the current year to previous years makes this easy. But with Covid-19, we have no history for comparison. It’s also difficult to assess the effectiveness of interventions on Covid-19 by other means due to variable test availability, lack of study design, and changing criteria to receive a test. So some deniers have argued that NPIs have had little epidemiological impact.

But since influenza, like Covid-19, is a respiratory disease, it is reasonable to suppose interventions targeting Covid-19 should also affect the spread of flu. And if we see Covid-19 NPIs working on the flu, we should infer they are working to some degree on Covid-19, too. Now, a new study in the CDC’s Morbidity and Mortality Weekly Report (MMWR) looks at the relationship between national responses to Covid-19 and the decline in cases of influenza in the US and three Southern Hemisphere countries. In the US, there was a clear difference in the trajectory of this year’s flu season, timed to the arrival of Covid-19. First, the 2020 summer flu all but disappeared. Although not widely known, people can ‘catch the flu’ anytime of year, not just during the winter. Influenza transmission intensity is measured with the positivity rate, the fraction of respiratory infections that test positive for influenza. During a typical US summer, influenza positivity tends to be around 1% or 2%. In 2017, it was 2.36%. In 2018 it was 1.04%. In 2019 it was 2.35%. And in the first summer with Covid-19, it was reduced five to ten fold to 0.20%.

Second, the arrival of Covid-19 in the U.S. (marked by the President’s declaration of a state of national emergency) coincided with the decline of the usual winter influenza season. By comparing the speed at which the 2020 flu seasons “ended” compared with other years, the authors could get an idea about how NPIs cut off flu transmission. Whereas most flu seasons tail off gradually, the 2020 season stopped precipitously. If we count the “end” of the influenza season as the time that the positivity rate drops to it’s normal inter-seasonal level around 2%, it appears that the 2020 flu season ended almost two months early.

Finally, the authors looked at influenza in three countries — Australia, Chile, and South Africa — in the Southern Hemisphere. This is important because winter in the Southern Hemisphere corresponds to summer in the Northern Hemisphere. Just as the U.S. influenza season is winding down, influenza in the Southern Hemisphere should be heating up. But that’s not what happened in 2020. This year, influenza has been almost undetectable in the Southern Hemisphere with Australia, Chile, and South Africa reporting a total of only 51 positive specimens out of 83,307 samples tested for an unheard of positivity rate of 0.06%. For comparison, the average positivity during 2017-2019 in these countries was 13.7% meaning that cases of influenza in the Southern Hemisphere have dropped by more than 99%.

The upshot of these analyses is that the NPIs adopted to mitigate the spread of Covid-19 are almost certainly also responsible for drastic reductions in the transmission of influenza.

COVID-19 Disinformation

During a crisis, people need accurate information to make good decisions and stay safe. With the COVID-19 pandemic devastating communities—especially communities of color, Indigenous communities and low-income communities—the need for reliable information is more urgent than ever.

In this environment, disinformation is deadly. In many cases, harmful disinformation on COVID-19 has spread just as quickly as the disease itself, drowning out credible sources of scientific information and causing immense confusion about how to protect people’s health and safety. Knowing how to identify disinformation and prevent its spread can save lives.

COVID-19 disinformation: Why and how it’s happening

UCS has studied the disinformation playbook— strategies used by corporate actors to undermine science. The goal of disinformation, whether it’s disseminated by corporations or other sources, is the same: to confuse the public and control the narrative for financial, political, or ideological gain. In the case of COVID-19, political leaders are spreading misinformation to minimize the severity of the disease, discredit preventative social distancing measures, and sow distrust of government data.

Disinformation is more likely to take root and proliferate if people lack reliable access to accurate, up-to-date information. In the past, scientific experts have played a key role in providing such information to the public. During the COVID-19 pandemic, however, federal scientists, especially CDC scientists, have been silenced in a way that would have been unthinkable during previous epidemics.

In their place, the Trump administration has amplified insidious forms of disinformation, such as distrusting healthcare workers concerned about the lack of capacity and resources to treat COVID-19 patients; inciting confusion over available COVID-19 treatments and the vaccine development process; and pressuring states and cities to reopen without considering scientific evidence.

In an environment where scientists are restricted from speaking and government officials announce falsehoods to the public, disinformation is all the more likely to occur and spread, with disastrous results. Strong beliefs in disinformation can result in consumers doing dangerous things (like this couple who ingested a form of chloroquine), government shelving important scientific work (like this NIH study), scientists facing serious harassment (like this researcher in Brazil), and the longterm loss of public trust in government science, which we need to be able to rely on to help keep us safe during this and future crises.

How to spot disinformation

Knowing where to find good, science-based information, and how to distinguish it from misinformation, saves lives. If you come across a piece of information, ask yourself the following questions. If the answer is “yes” to one or more of these factors, you may want to further scrutinize the information to determine its validity.

Does it seem implausible?
Does it confirm your beliefs or play to your emotions?
Is it difficult to separate facts from opinions?
Does it ignore experts (from government or reputable public health organizations)?
Is the original source hard to pin down?
Does the source have a stake in the claim (financial, political, etc)?

How can you tell if a source is reliable? Ask yourself these questions. If the answer to any of them is “no,” this is a source you should be wary of amplifying.

News article, video, or social media post:

Does it identify original sources of factual content?
Does it link to independent experts with relevant knowledge and/or to peer-reviewed science?
Does it make it easy to identify funding sources or ideological or policy positions?
Is it produced by an individual or organization that has an established position on the topic?
Does it present diverse points of view fairly while acknowledging the importance of expertise?
Does it treat individuals who have diverse perspectives with respect?
Does it distinguish facts from opinions?
Does it back up its statements with evidence?
Are other news sources presenting the information similarly?
Is the content free from racial, gendered, or otherwise problematic stereotypes?
Is the information consistent with what scientists and other experts have said on the topic?

Report or study:

Are the authors experts on the subject?
Is the study peer-reviewed?
Have the authors disclosed their conflicts of interest and funding sources? If yes, does the sponsor have a vested interest in the outcome of the study?
Does the publisher have a preexisting policy or ideological position on the topic?
Is the tone objective?
Does it describe potential positives and negatives in clear terms? Does it cite and critique conflicting findings?
If other scientists have commented about the study, are they raising major concerns with how the study was conducted?

How to stop disinformation

When you encounter a piece of disinformation, the best thing to do is stop its spread. A good first step is to practice the “inoculation method”: instead of repeating the disinformation, warn your friends, family, and co-workers about the types of COVID-19 disinformation and tactics. Research shows that when we are alerted that disinformation may occur, we tend to think more critically about the information we are encountering, thereby inoculating us from further deception.

Note that it’s critical that you don’t reshare the disinformation—even if it’s in an effort to point out that it is wrong—as you are still helping the disinformation to spread. For instance, if you share a piece of disinformation on social media in an attempt to debunk it, you are telling a social media algorithm that this item is popular, and thus encouraging it to spread even more widely. Instead, you can try the fact-myth-fallacy framework: lead with the facts, then provide a summary of the disinformation and an explanation of how or why it distorts the science.

In place of disinformation, share clear, accurate information from reputable sources. The following international and U.S. agencies, organizations, and academic institutions are trusted sources of information related to COVID-19.

Do your part to ensure that public health decisions are informed by the best available science, not disinformation. Ask your elected officials and other key decisionmakers these questions:

How will methods of collecting, assessing, and reporting COVID-19 surveillance data be made public? Are data broken down by race/ethnicity (including Indigenous groups?)
How are CDC recommendations being incorporated into decisionmaking? Are the impacts to underserved communities being incorporated into reopening plans?
Do marginalized communities have adequate access to affordable testing for COVID-19?
How are testing kits and PPE being used and distributed?
How are decisionmakers ensuring that treatments and vaccines (when available) are distributed where they are needed most? What transparency and accountability mechanisms will be built into those decisionmaking processes?

The responsibility for parsing out disinformation should not fall entirely on individuals. Social media companies, journalists, and government agencies have an important role to play in limiting disinformation and its spread. First and foremost, the federal government needs to allow the free flow of information, including amongst its own scientists, and affirm the independence of the news media. The news media needs to responsibly cover COVID-19 news by interviewing health experts, directing readers to official sources, and debunking disinformation. Social media companies have taken some steps toward removing harmful disinformation from their sites, but more must be done to improve transparency and to reduce the echo chamber effect.