Tuesday, April 28, 2020

Try Try Again

Funny once again I read and with reading comes knowledge and knowledge is power.  Today I looked at the Flu of 2017-18 and it killed more people than the current Covid pandemic. Again these numbers are fluid as we have no fucking clue if Covid killed them or that they died of another illness but due to Covid and the crush in hospitals, the lack of a consistent medical examination post mortem we may never know the true numbers.

CDC estimates that the burden of illness during the 2017–2018 season was also high with an estimated 48.8 million people getting sick with influenza, 22.7 million people going to a health care provider, 959,000 hospitalizations, and 79,400 deaths from influenza. For Covid that is 57,640 and of course is fluid.

I want a 9/11 commission on this whole Covid crisis as again I have never understood the numbers, the reality behind the White House denials, the ever changing landscape of protocols, the hysteria and fear mongering and of course when they knew and why they did nothing and still are actually doing nothing.

At my coffee shop this morning the discussion is always Covid and today I found out the owner of a local liquor store had Covid came in after having a few days off, felt better but was certainly not tested to insure he was negative, had no protective gear on to prevent transmission and staff went nuts.  Some quit and some filed complaints. What that means is nothing but okay then.  Who was his Doctor and did he not explain that the virus sheds until you are negative, not when you feel well?

And if we do in fact actually turn into a military state with regards to tracking, testing and tracing the hardest hit communities are the ones currently being hit, Black and Brown ones.  The absurdity of this is the new drug wars and of course education and information does not provide the resources that cash fines and jails do.  Good luck with this one.

Then we have the stupid, and by those I mean medical professionals who have decided for some nutty reason to come to New York and "volunteer" on the front lines and then go home with a souvenir of Covid.  Again nothing in Tennessee shocks me anymore.  So was anyone on the plane with him contacted? I doubt it.

Then my Barista told me another story of his friend in Cincinnati who has not left her home in over three weeks because she is afraid.  She lives across the street from a park and there have been endless playdates, basketball games and the like, no one socially distancing and wearing masks and is afraid. So much for Mike DeWine the forefather for this bullshit clearly he is like the rest of the Covid Brigade, full of shit.  But I do wonder why she has not left her home, is she going to the park? Well if the answer is no then what is the problem?  And it was like my fight with the idiot here in charge of Health Services who informed me that her neighborhood she had people congregating on the stoops not practicing social distancing and that is why the parks are closed.  Really what has that got to do with parks and there is already an ordinance in place that permits you to call Police to shut that down as affecting egress or public safety.  Did she get back to me on that? No.

So we are sure that Covid is flying around the air waiting to land on an unsuspecting victim to literally squeeze the life out of you. Well in some situations yes ask that Doctor about that and his seat mate or his wife. Did he hug and kiss her and the kids when he got home.  My favorite about that was he had never been home alone in his entire life for four whole days. WOW just WOW.

So once again this falls to personal responsibility, having knowledge, common sense and some way of tracking, tracing and knowing your contacts.   That is a challenge but if you are aware you can be proactive and still leave the house.   So I leave you with this before I go out to enjoy the day. Just be safe! Whatever that fucking means. How about be proactive and take care of yourself and respect yourself by modeling that and in turn respecting others by giving them space, boundaries and letting them do their thing out of your airspace.

Is the coronavirus airborne? Experts can’t agree
The World Health Organization says the evidence is not compelling, but scientists warn that gathering sufficient data could take years and cost lives.

Dyani Lewis
April 2 2020

Since early reports revealed that a new coronavirus was spreading rapidly between people, researchers have been trying to pin down whether it can travel through the air. Health officials say the virus is transported only through droplets that are coughed or sneezed out — either directly, or on objects. But some scientists say there is preliminary evidence that airborne transmission — in which the disease spreads in the much smaller particles from exhaled air, known as aerosols — is occurring, and that precautions, such as increasing ventilation indoors, should be recommended to reduce the risk of infection.

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In a scientific brief posted to its website on 27 March, the World Health Organization said that there is not sufficient evidence to suggest that SARS-CoV-2 is airborne, except in a handful of medical contexts, such as when intubating an infected patient.

But experts that work on airborne respiratory illnesses and aerosols say that gathering unequivocal evidence for airborne transmission could take years and cost lives. We shouldn’t “let perfect be the enemy of convincing”, says Michael Osterholm, an infectious-disease epidemiologist at the University of Minnesota in Minneapolis.

“In the mind of scientists working on this, there’s absolutely no doubt that the virus spreads in the air,” says aerosol scientist Lidia Morawska at the Queensland University of Technology in Brisbane, Australia. “This is a no-brainer.”
Confusing definitions

When public health officials say there isn't sufficient evidence to say that SARS-CoV-2 is airborne, they specifically mean transported in virus-laden aerosols smaller than 5 micrometres in diameter. Compared with droplets, which are heftier and thought to travel only short distances after someone coughs or sneezes before falling to the floor or onto other surfaces, aerosols can linger in the air for longer and travel further.

Most transmission occurs at close range, says Ben Cowling, an epidemiologist at the University of Hong Kong. But the distinction between droplets and aerosols is unhelpful because “the particles that come out with virus can be a wide range of sizes. Very, very large ones right down to aerosols”, he says.

And if SARS-CoV-2 is transmitting in aerosols, it is possible that virus particles can build up over time in enclosed spaces or be transmitted over greater distances.

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Aerosols are also more likely to be produced by talking and breathing, which might even constitute a bigger risk than sneezing and coughing, says virologist Julian Tang at the University of Leicester, UK. “When someone’s coughing, they turn away, and when they’re sneezing, they turn away,” he says. That’s not the case when we talk and breathe.

A study of people with influenza found that 39% of people exhaled infectious aerosols. As long as we are sharing an airspace with someone else, breathing in the air that they exhale, airborne transmission is possible, says Tang. *what kind of airspace, outdoors or indoors? ***What is the radius or square foot transmission rate, three or six feet, or no feet just sharing airspace in the world? 

The evidence so far

Evidence from preliminary studies and field reports that SARS-CoV-2 is spreading in aerosols is mixed. At the height of the coronavirus outbreak in Wuhan, China, virologist Ke Lan at Wuhan University collected samples of aerosols in and around hospitals treating people with COVID-19, as well as at the busy entrances of two department stores.

In an unreviewed preprint1, Lan and his colleagues report finding viral RNA from SARS-CoV-2 in a number of locations, including the department stores.

The study doesn’t ascertain whether the aerosols collected were able to infect cells. But, in an e-mail to Nature, Lan says the work demonstrates that “during breathing or talking, SARS-CoV-2 aerosol transmission might occur and impact people both near and far from the source”. As a precaution, the general public should avoid crowds, he writes, and should also wear masks, “to reduce the risk of airborne virus exposure”.  **in other words you are responsible for yourself and be smart and proactive or paranoid whatever works.

Another study failed to find evidence of SARS-CoV-2 in air samples in isolation rooms at an outbreak centre dedicated to treating people with COVID-19 in Singapore. Surface samples from an air outlet fan did return a positive result2, but two of the authors — Kalisvar Marimuthu and Oon Tek Ng at the National Centre for Infectious Diseases in Singapore — told Nature in an e-mail that the outlet was close enough to a person with COVID-19 that it could have been contaminated by respiratory droplets from a cough or sneeze.

A similar study by researchers in Nebraska found viral RNA in nearly two-thirds of air samples collected in isolation rooms in a hospital treating people with severe COVID-19 and in a quarantine facility housing those with mild infections3. Surfaces in ventilation grates also tested positive. None of the air samples was infectious in cell culture, but the data suggest that “viral aerosol particles are produced by individuals that have the COVID-19 disease, even in the absence of cough”, the authors write.**meaning that in a confined space there is a higher liklihood of transmission you know like hospital rooms, old folks rooms and jail cells.. or cabins on cruise ships, same diff. 

The WHO writes in its latest scientific brief that the evidence of viral RNA “is not indicative of viable virus that could be transmissible”. The brief also points to its own analysis of more than 75,000 COVID-19 cases in China that did not report finding airborne transmission. But Ben Cowling says that “there wasn't a lot of evidence put forward to support the assessment” and, an absence of evidence does not mean SARS-CoV-2 is not airborne. The WHO did not respond to Nature’s questions about the evidence in time for publication.

Scientists in the United States have shown in the laboratory that the virus can survive in an aerosol and remain infectious for at least 3 hours. Although the conditions in the study were “highly artificial”, there is probably “a non-zero risk of longer-range spread through the air”, says co-author Jamie Lloyd-Smith, an infectious-diseases researcher at the University of California, Los Angeles.  *meaning we fuck all don't know but hey that closed in idea applies like airplanes

Gaps to fill

Leo Poon, a virologist at the University of Hong Kong, doesn’t think there’s enough evidence yet to say SARS-CoV-2 is airborne. He’d like to see experiments showing that the virus is infectious in droplets of different sizes.

Whether people with COVID-19 produce enough virus-laden aerosols to constitute a risk is also unknown, says Lloyd-Smith. Air sampling from people when they talk, breathe, cough and sneeze — and testing for viable virus in those samples — “would be another big part of the puzzle”, he says. One such study failed to detect viral RNA in air collected 10 centimetres in front of one person with COVID-19 who was breathing, speaking and coughing, but the authors didn’t rule out airborne transmission entirely6.

Another crucial unknown is the infectious dose: the number of SARS-CoV-2 particles necessary to cause an infection, says Lloyd-Smith. “If you’re breathing aerosolized virus, we don’t know what the infectious dose is that gives a significant chance of being infected,” he says. An experiment to get at that number — deliberately exposing people and measuring the infection rate at different doses — would be unethical given the disease’s severity.

Whatever the infectious dose, length of exposure is probably an important factor too, says Tang. Each breath might not produce much virus, he says, but “if you’re standing beside [someone who’s infected], sharing the same airspace with them for 45 minutes, you’re going to inhale enough virus to cause infection”.

But capturing those small concentrations of aerosols that, given the right combination of airflow, humidity and temperature, might build to an infectious dose over time, is “extremely difficult”, says Morawska. “We could say that we need more data, but then we should acknowledge the difficulty of collecting the data,” she says.

Cautious approach

The assumption should be that airborne transmission is possible unless experimental evidence rules it out, not the other way around, says Tang. That way people can take precautions to protect themselves, he says.

Increasing ventilation indoors and not recirculating air can go some way to ensuring that infectious aerosols are diluted and flushed out, says Morawska. Indoor meetings should be banned just in case, she says.

Meanwhile, Lan and others are calling for the public to wear masks to reduce transmission. Masks are ubiquitous in many countries in Asia. In the United States and some European countries, however, health officials have discouraged people from wearing them, in part because supplies are low and health-care workers need them. The Czech Republic and Slovakia, however, have made it mandatory for people to wear masks outside the home. Tang thinks those countries have taken the right approach. “They are following the southeast Asia approach. If everyone can mask, it is double, two-way protection,” he says.

But Cowling thinks masks should be recommended for the public only after supplies have been secured for health-care workers, people with symptoms, and vulnerable populations such as the elderly.

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