Co-vid 19: What Is and Isn't Known, Discussion and Debate

[pogi]

1 hour ago, california boy said:

I listened to one of the leading doctors in Los Angeles address face shields.  Yes you can get Covid through the eyes, but it is very rare.  Almost all infections come through the nose and mouth.  Face shields are most effective when within a foot of the patient such as health workers.  Since they aren't tight, even that has limited effectiveness.  His take is, yes there is a very minor benefit to eye shields, but probably not worth the practical use of them unless you are within a foot of an infected person.  Hope that is helpful.

I agree that respiratory passages are the primary route of infection, but any barrier to droplets and touching our face, the better.  Goggles would be more effective that face shields.   If every American wore a fitted N95 mask with goggles for a month straight, we would nearly wipe this virus out. 

I do wonder why the government is not making any investment or effort in producing and distributing N95 masks for any American who wanted one.  We could get that done a LOT quicker than a vaccine, with no side-effects and longer lasting protection (likely). 

Edited July 31, 2020 by pogi

[The Nehor]

20 minutes ago, pogi said:

I agree that respiratory passages are the primary route of infection, but any barrier to droplets and touching our face, the better.  Goggles would be more effective that face shields.   If every American wore a fitted N95 mask with goggles for a month straight, we would nearly wipe this virus out. 

I do wonder why the government is not making any investment or effort in producing and distributing N95 masks for any American who wanted one.  We could get that done a LOT quicker than a vaccine, with no side-effects and longer lasting protection (likely). 

We can't get everyone to wear cloth masks. Even if we had the supply I doubt we could get a month of everyone wearing an N95. I also vaguely recall their being a problem building the machines to construct N95 filters quickly making it difficult to ramp up construction but I could be thinking of another mask type.

[pogi]

26 minutes ago, The Nehor said:

We can't get everyone to wear cloth masks. Even if we had the supply I doubt we could get a month of everyone wearing an N95. I also vaguely recall their being a problem building the machines to construct N95 filters quickly making it difficult to ramp up construction but I could be thinking of another mask type.

I doubt we will convince everyone to get the vaccine either, but having the option helps.   

We also ran into problems with respirator production, but with a little governmental pressure, money, and ingenuity, we over came that hurdle fairly quickly (for something we didn't end up needing).  I have no doubt that we could ramp up N95 production quickly if Trump made it a priority.  I just don' think that masks are a priority for this president.  That is the American way though - we focus way more on treatment rather than prevention.  As his favorite witch doctor once said, "we don't need masks, there is a cure".    

Edited July 31, 2020 by pogi

[Calm]

Okay guys, can we move on now? (From video)

Edited July 31, 2020 by Calm

[The Nehor]

24 minutes ago, pogi said:

I doubt we will convince everyone to get the vaccine either, but having the option helps.   

Depending on how the vaccine comes out I might refuse it. If you had told me a year ago that I would be an antivaxxer I would have laughed in your face but here we are.

[pogi]

29 minutes ago, The Nehor said:

Depending on how the vaccine comes out I might refuse it. If you had told me a year ago that I would be an antivaxxer I would have laughed in your face but here we are.

If that is being an antivaxer, then count me as one too.

I would call that being a prudent medical consumer.

[Calm]

4 hours ago, The Nehor said:

Depending on how the vaccine comes out I might refuse it. If you had told me a year ago that I would be an antivaxxer I would have laughed in your face but here we are.

Explain please

[The Nehor]

21 hours ago, Calm said:

Explain please

If it comes out any time before very early November with a rushed and heavily altered FDA approval with one of the campaigns hailing it as proof that they have solved the problem I will hold off for a while unless it is also approved by overseas agencies I trust.

I know the normal FDA process makes it pretty easy for a whistleblower to scream to high heaven if something is being concealed and many of the people who can blow the whistle are not affiliated with the company or with the government so I would probably be okay if that is the situation. If it happened only a few days before the election I would scour the internet for whistleblowers trying to get the word out. I am not taking the Russian vaccine at all unless a LOT of agencies approve it.

[bsjkki]

Informative article. Something we should pay attention to. https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/

[provoman]

On 7/31/2020 at 8:52 AM, pogi said:

I'm not sure I understand, can you elaborate?  

I educate people about this everyday so I am curious as to what you saw as off-putting in that definition, it might help me better educate my patients.  People seem to accept it just fine, but if there is some way I could teach it better, I would like to know.  I guess I don't quite understand what you are saying about masks and how that alters your perception of this definition. 

Thanks     

I was put off because I believe there is a popular misperception about infection. So I work in an office, two people test positive  I stood at one of their desk for two minutes...I would not be considered close contact, and it is off putting that while I was within 6ft of that person, the current medical posistion is I should not be concerned. 

So I think if more people understood about close contact there would not be so much animosity about casually passing someone in public not wearing a mask

[Calm]

Pogi, have you looked into hepa air filters and what kind works best for viruses?  Feel free to PM me if you do t want to make a public endorsement. 
 

After reading the Atlantic article, I am thinking of my sister and daughter-in-law school teachers and what might help them and the kids most. If the school allows and won’t buy themselves, I am thinking the family can go in on getting them large air filters. 
 

Probably should so sooner than later as I expect a run on them soon. 

Edited August 2, 2020 by Calm

[provoman]

On 7/31/2020 at 8:52 AM, pogi said:

I'm not sure I understand, can you elaborate?  

I educate people about this everyday so I am curious as to what you saw as off-putting in that definition, it might help me better educate my patients.  People seem to accept it just fine, but if there is some way I could teach it better, I would like to know.  I guess I don't quite understand what you are saying about masks and how that alters your perception of this definition. 

Thanks     

Want to add....

 

For being "off put". By way of example, the guidelines for sacrament preparation do not require masks. At first glance, I thought "What, why isn't it required". Then I started to think about it, and think about all the mask videos I watched. The mask videos I have watched, in a secondary manner, demonstrate what I will call "leakage". As I thought about the "leakage" I was not too concerned about the lack of a mask mandate. In my non-medical field opinion, at the proximity of the face to sacrament preparation while wearing a mask due to leakage, does not stop germs from getting on the emblems...so my initial reaction subsided.  Currently on reddit there is a discussion about Utah schools and the guidelines regarding covid infections and notification, many people are bothered that if a teacher is infected the students will not be notified, same applies when a student is infected; it is my current understanding - having relied that a post on reddit contained accurate information - that notification will only be made based on the "close contact" time and distance guidelines.   Maybe it is a matter of better educating the public on transmission, much like was done in the early stages of the AIDS crisis. I recall having a lesson discussing mode of HIV transmission and that a mosquito is not a mode.

[Tacenda]

On 7/31/2020 at 11:17 AM, The Nehor said:

We can't get everyone to wear cloth masks. Even if we had the supply I doubt we could get a month of everyone wearing an N95. I also vaguely recall their being a problem building the machines to construct N95 filters quickly making it difficult to ramp up construction but I could be thinking of another mask type.

Saturday I went to a celebration of my brother-in-law's mother who passed away at the beginning of Covid and couldn't have a funeral. In the invitation they requested that we wear masks. But sadly there were people there that chose not to.

[pogi]

19 hours ago, provoman said:

I was put off because I believe there is a popular misperception about infection. So I work in an office, two people test positive  I stood at one of their desk for two minutes...I would not be considered close contact, and it is off putting that while I was within 6ft of that person, the current medical posistion is I should not be concerned. 

So I think if more people understood about close contact there would not be so much animosity about casually passing someone in public not wearing a mask

No one is saying that you shouldn't be concerned in that scenario.  While you are not considered a high risk close contact, you are still considered a contact at risk (low risk).  You could still potentially get infected as a low risk contact, we just don't go to the extreme of requiring quarantine for you.

I still understand the animosity towards people who refuse to wear masks, even if the casual contact risk is considered low, they are still putting people at unnecessary risk.  It just feels disrespectful. 

 

[pogi]

12 hours ago, provoman said:

Want to add....

 

For being "off put". By way of example, the guidelines for sacrament preparation do not require masks. At first glance, I thought "What, why isn't it required". Then I started to think about it, and think about all the mask videos I watched. The mask videos I have watched, in a secondary manner, demonstrate what I will call "leakage". As I thought about the "leakage" I was not too concerned about the lack of a mask mandate. In my non-medical field opinion, at the proximity of the face to sacrament preparation while wearing a mask due to leakage, does not stop germs from getting on the emblems...so my initial reaction subsided.  Currently on reddit there is a discussion about Utah schools and the guidelines regarding covid infections and notification, many people are bothered that if a teacher is infected the students will not be notified, same applies when a student is infected; it is my current understanding - having relied that a post on reddit contained accurate information - that notification will only be made based on the "close contact" time and distance guidelines.   Maybe it is a matter of better educating the public on transmission, much like was done in the early stages of the AIDS crisis. I recall having a lesson discussing mode of HIV transmission and that a mosquito is not a mode.

Are you sure sacrament preparation doesn't require masks?  I thought it did.  

Yes, there can be some leakage through masks, that doesn't mean that they are not at all effective at reducing risk.  Just because precautionary measures are not 100% effective, doesn't mean they are not worth doing.  Condoms aren't 100% effective either, maybe people should not be concerned about wearing them. 

It is my understanding that high-risk close contacts to infected teachers and students will be contacted by the school (who will be performing their own contact tracing).  They will not be allowed to know who they had contact with as that is a violation of HIPPA, but their families will be informed of the exposure and educated. 

I think you are misunderstanding the guidelines.  Simply because someone does not meet the criteria of a high-risk close contact, it doesn't mean they are not at risk.  You mentioned previously that it doesn't matter if a person is wearing a mask or not if they are within 6 feet for more than 15 minutes, they are still considered a close contact.   That is true, they are considered a close contact, but "close contacts" are further defined as "high-risk" and "medium-risk".  A close contact who is consistently using recommended precautions (wearing a mask) is considered medium-risk.  Mask precautions do matter and make a difference.   

Edited August 3, 2020 by pogi

[pogi]

More bad news as we learn from accumulating evidence:

Quote

It has been a comforting refrain in the national conversation about reopening schools: Young children are mostly spared by the coronavirus and don’t seem to spread it to others, at least not very often.  But on Thursday, a study introduced an unwelcome wrinkle into this smooth narrative.  Infected children have at least as much of the coronavirus in their noses and throats as infected adults, according to the research. Indeed, children younger than age 5 may host up to 100 times as much of the virus in the upper respiratory tract as adults, the authors found.  That measurement does not necessarily prove children are passing the virus to others. Still, the findings should influence the debate over reopening schools, several experts said.

https://www.nytimes.com/2020/07/30/health/coronavirus-children.html

So, this shows evidence that kids may be just as likely to spread the disease (with 100 X as much virus in upper respiratory tracts - maybe way more likely to spread the disease under 5 years old).  This article does state that it doesn't necessarily prove that children are passing the virus to others.  This was published on 7/30.  The very next day (7/31) the CDC published a finding which demonstrates that they are indeed transmitting it, and may play an "important role in transmission":

1 overnight summer camp with 597 in attendance - within 2 weeks of attendance at the over nighter, nearly half of them (260) tested positive for Covid.  And not all of them tested either, the actual numbers may be higher.

Quote

This investigation adds to the body of evidence demonstrating that children of all ages are susceptible to SARS-CoV-2 infection (1–3) and, contrary to early reports (5,6), might play an important role in transmission (7,8).

https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm

This should send shivers through the spines of school boards.  I have a feeling we have some dark days ahead when school starts. 

 

 

Edited August 3, 2020 by pogi

[let’s roll]

Here’s one thing we know.  From the CDC website as of today, number of deaths “involving COVID-19” as a percentage of total deaths reported to the CDC by each state, the CDC listed NYC and the state of NY (excluding NYC) separately.

US total 9%

Higher than 20%: NYC 38%, NJ 26%, CT 23%, MASS 21%

Higher than 10%, less than 20%: NYState 18%, DC18%, RI 17%, LA 13%, Maryland 12%

Between 10% and 5%: DE 10%, Mich. 10%, PA 10%, AZ 9%, Colo 8%, Indiana 8%, Miss 8%, Minn 7%, CA 6%, GA 6%,  NH 6%, NM 6%, VA 6%, AL 5%, FL 5%, IA 5%, NV 5%, OH 5%, TX 5%, WA 5%

Less than 5%: NE 4%, NC 4%, SC 4%, Ark 3%, Kan 3%, Kent 3%, Missouri 3%, ND 3%, SD 3%, Wisc 3%, Idaho 2%, Maine 2%, OK 2%, OR 2%, TN 2%, UT 2%, VT 2%, WV 1%, WY 1%

Less than 1%: Alaska, HI, MT

Edited August 3, 2020 by let’s roll

[The Nehor]

1 hour ago, pogi said:

More bad news as we learn from accumulating evidence:

So, this shows evidence that kids may be just as likely to spread the disease (with 100 X as much virus in upper respiratory tracts - maybe way more likely to spread the disease under 5 years old).  This article does state that it doesn't necessarily prove that children are passing the virus to others.  This was published on 7/30.  The very next day (7/31) the CDC published a finding which demonstrates that they are indeed transmitting it, and may play an "important role in transmission":

1 overnight summer camp with 597 in attendance - within 2 weeks of attendance at the over nighter, nearly half of them (260) tested positive for Covid.  And not all of them tested either, the actual numbers may be higher.

This should send shivers through the spines of school boards.  I have a feeling we have some dark days ahead when school starts. 

We should never have opened the schools at all. It is already backfiring. It would be hilarious if it was not so morbid and so easily predictable.

We can't get adults to socially distance and children and teens are going to pull it off? And we have established pretty well that even with those guidelines followed it can still spread. Children are packed into schools in a way that almost no business operates and offices have been bad enough in terms of spread.

Add in that we do not know the long term impact of this virus (blood clots, heart muscle shifts, slow recoveries) and I think the decision many made to open schools and send kids back is, to take a line from Captain Picard, "not just dishonorable, it was downright criminal".

[Tacenda]

19 minutes ago, The Nehor said:

We should never have opened the schools at all. It is already backfiring. It would be hilarious if it was not so morbid and so easily predictable.

We can't get adults to socially distance and children and teens are going to pull it off? And we have established pretty well that even with those guidelines followed it can still spread. Children are packed into schools in a way that almost no business operates and offices have been bad enough in terms of spread.

Add in that we do not know the long term impact of this virus (blood clots, heart muscle shifts, slow recoveries) and I think the decision many made to open schools and send kids back is, to take a line from Captain Picard, "not just dishonorable, it was downright criminal".

I was pro school for a bit, thinking that it would be an impossible situation to figure out how their working parents can find suitable places for them. But wonder if we need to do as a whole people what's right to save lives. But hopefully that in turn won't take lives or harm lives in other ways. It's truly the scariest and bleakest thing to have happen all around.

[pogi]

1 hour ago, The Nehor said:

We should never have opened the schools at all. It is already backfiring. It would be hilarious if it was not so morbid and so easily predictable.

We can't get adults to socially distance and children and teens are going to pull it off? And we have established pretty well that even with those guidelines followed it can still spread. Children are packed into schools in a way that almost no business operates and offices have been bad enough in terms of spread.

Add in that we do not know the long term impact of this virus (blood clots, heart muscle shifts, slow recoveries) and I think the decision many made to open schools and send kids back is, to take a line from Captain Picard, "not just dishonorable, it was downright criminal".

I hear you, but I have a hard time thinking of an acceptable alternative.  We have to think long-term here as this virus is not going away any time soon.  If kids are not in school, many will simply replace daycare for school, which will not be much of a help in controlling spread.  With working parents, many don't have other alternatives.  I think the best solution is to do a hybrid system of on-line learning and in-class school where we could cut attendance by 1/3 if we have 2 days on-line and 1 day in-class.  

There really is no good answer to this problem.  Every solution seem to creates more problems. 

Edited August 3, 2020 by pogi

[Tacenda]

16 minutes ago, pogi said:

I hear you, but I have a hard time thinking of an acceptable alternative.  We have to think long-term here as this virus is not going away any time soon.  If kids are not in school, many will simply replace daycare for school, which will not be much of a help in controlling spread.  With working parents, many don't have other alternatives.  I think the best solution is to do a hybrid system of on-line learning and in-class school where we could cut attendance by 1/3 if we have 2 days on-line and 1 day in-class.  

There really is no good answer to this problem.  Every solution seem to creates more problems. 

That's what my school district is doing. I still wonder if children with working parents will be affected in a not so good way.

[provoman]

4 hours ago, pogi said:

Are you sure sacrament preparation doesn't require masks?  I thought it did.  

Yes, there can be some leakage through masks, that doesn't mean that they are not at all effective at reducing risk.  Just because precautionary measures are not 100% effective, doesn't mean they are not worth doing.  Condoms aren't 100% effective either, maybe people should not be concerned about wearing them. 

It is my understanding that high-risk close contacts to infected teachers and students will be contacted by the school (who will be performing their own contact tracing).  They will not be allowed to know who they had contact with as that is a violation of HIPPA, but their families will be informed of the exposure and educated. 

I think you are misunderstanding the guidelines.  Simply because someone does not meet the criteria of a high-risk close contact, it doesn't mean they are not at risk.  You mentioned previously that it doesn't matter if a person is wearing a mask or not if they are within 6 feet for more than 15 minutes, they are still considered a close contact.   That is true, they are considered a close contact, but "close contacts" are further defined as "high-risk" and "medium-risk".  A close contact who is consistently using recommended precautions (wearing a mask) is considered medium-risk.  Mask precautions do matter and make a difference.   

The guidelines released by the First Presidency do not require masks for sacrament preparation. Individual wards have required it.

According to the document released by the Utah Department of health for schools, schools will follow the within 6 ft for 15 minutes definition for close contact. And based on my reading of the document ONLY for close contact individuals will there "contact tracing".

[pogi]

7 minutes ago, provoman said:

According to the document released by the Utah Department of health for schools, schools will follow the within 6 ft for 15 minutes definition for close contact. And based on my reading of the document ONLY for close contact individuals will there "contact tracing".

Right, I must have misunderstood you.  I thought you were saying they would not be made aware of contacts period.  I guess I am unclear as to what your objection is to this?  That is how all contact tracing is done County wide, not just in schools.  In the beginning stages, when numbers were low, we actually were contacting all contacts, even low-risk ones, but as numbers grew, that became impractical.   We had to focus our resources on the highest risk contacts, or there is no way we could keep up with the numbers.  That is the best we can do with the resources we have.   Imagine the number of potential low-risk contacts in a school setting, and the number of parent's that would need to be notified is astronomical.  Could you imagine the logistics of having to notify every student's parents about every potential low-risk contact they might have had at school?  It's just not realistic.

23 minutes ago, provoman said:

The guidelines released by the First Presidency do not require masks for sacrament preparation. Individual wards have required it.

 You are right, I just looked up the guidelines:

Quote

Where available, priesthood holders may wear face masks while preparing, blessing, and passing the sacrament.

That is pretty weak sauce.  It is equivalent to saying "masks are not forbidden".

In Utah, we at least have the Area Presidency who asked us to wear masks in pubic (that includes church).  So, while not technically required, it creates a stronger expectation. 

[provoman]

29 minutes ago, pogi said:

Right, I must have misunderstood you.  I thought you were saying they would not be made aware of contacts period.  I guess I am unclear as to what your objection is to this?  That is how all contact tracing is done County wide, not just in schools.  In the beginning stages, when numbers were low, we actually were contacting all contacts, even low-risk ones, but as numbers grew, that became impractical.   We had to focus our resources on the highest risk contacts, or there is no way we could keep up with the numbers.  That is the best we can do with the resources we have.   Imagine the number of potential low-risk contacts in a school setting, and the number of parent's that would need to be notified is astronomical.  Could you imagine the logistics of having to notify every student's parents about every potential low-risk contact they might have had at school?  It's just not realistic.

It is that I have an objection, right now. Any objection, in my opinion, is based on a lack of understanding and a lack of informing oneself. People are rightly concerned about infection.

It seems the common perception is 1 student in a confined classroom requires that everyone in that class room be notified of possible infection....I think the objection is that that is not the practice. And it would not be difficult for a government to notify everyone that was in a class room....this could be accomplished by a robo caller or even 2  - 3 people calling less than 30 people and saying what ever is said concerning "close contact".  The guidelines released by the Utah Department of Health are to ONLY contact those who were within 6 ft for more than 15 minutes...that is upsetting to parents, because the parents feel everyone in a classroom should be notified.
 

Edited August 3, 2020 by provoman

[pogi]

49 minutes ago, provoman said:

It is that I have an objection, right now. Any objection, in my opinion, is based on a lack of understanding and a lack of informing oneself. People are rightly concerned about infection.

It seems the common perception is 1 student in a confined classroom requires that everyone in that class room be notified of possible infection....I think the objection is that that is not the practice. And it would not be difficult for a government to notify everyone that was in a class room....this could be accomplished by a robo caller or even 2  - 3 people calling less than 30 people and saying what ever is said concerning "close contact".  The guidelines released by the Utah Department of Health are to ONLY contact those who were within 6 ft for more than 15 minutes...that is upsetting to parents, because the parents feel everyone in a classroom should be notified.
 

I just think this is silly perception of what should be required.  Going to school in a pandemic naturally is a given presumed risk of exposure and infection, no need for a call every time a potential exposure happens.  Parents may be getting several calls a day when school opens.   What good will it serve to call about every single low-risk exposure? 

Here is what happens in those low risk calls - 

Contact Tracer: "Hi, I am calling to inform you that your child may have been exposed to someone infected with Covid while at school." 

Parent: "Who were they exposed to?" 

Contact tracer: "I can't tell you that because of HIPPA laws, but they are considered low-risk and don't need to quarantine or do anything different at this time." 

Parent: "Why are you calling me if you can't tell me anything useful?"

Contact tracer: "We are just calling to inform you of a potential exposure." 

Parent: "We are in a pandemic with wide-spread transmission.  They are in school with kids passing them all over the place in narrow hallways and stacked like sardines in classrooms, I am aware that they have likely ongoing exposures". 

Contact tracer: "Umm, ok, well watch for any signs of infection and get tested if any present themselves." 

Parent: "No kidding (with a sarcastic tone)?  Anything else?

Contact tracer: "Make sure they wear a mask and practice other preventive measures."

Parent: "Serious (said again with a sarcastic tone)?" 

Contact tracer: "Ok, well thank you, bye!"

10 minutes to 1 week later...same call happens from a different Contact tracer...and on and on... 

Total waste of time.  

Why waste our time making those individual calls, (which practically speaking do absolutely nothing other than potentially create anxiety and don't necessarily reduce any risk of transmission), when we could simply make a general announcement that all students should assume ongoing low risk exposures while at school and monitor for symptoms daily, and that they will be notified of any high-risk exposures.

If we have to call every low risk exposure, families will be getting calls on a weekly basis, and potentially multiple times a day, for different low risk exposures to different students/faculty.  It is a waste of time and resources, and families will quickly become annoyed at the number of calls.  Every student in the school will have a low risk exposure in a matter of weeks.  Those exposures will be ongoing throughout the year. 

Edited August 3, 2020 by pogi