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

[Raingirl]

21 minutes ago, Calm said:

Define "really bad flu".

When was the last time they had to get refrigeration trucks to hold all the dead from a really bad flu?

 

Anyone who thinks Covid-19 is just “a really bad flu” needs to spend time in a Covid ICU or speak to someone who works in one. 

I can even hook up anyone interested. 

The ignorance about the reality of this pandemic,  that is displayed by too many, is rather alarming. 

[smac97]

10 hours ago, Raingirl said:

Quote

Define "really bad flu".

When was the last time they had to get refrigeration trucks to hold all the dead from a really bad flu?

Anyone who thinks Covid-19 is just “a really bad flu” needs to spend time in a Covid ICU or speak to someone who works in one. 

I can even hook up anyone interested. 

The ignorance about the reality of this pandemic,  that is displayed by too many, is rather alarming. 

I didn't define "really bad flu."  I posted some blot posts.  From the OP: "I am starting a thread that questions which arise from a thread or elsewhere can be discussed.  I am opened to anything Covid being discussed here as long as it isn't taking the original topic with it, think more this is where rabbit trails become full fledged freeways."

I thought this thread was supposed to be a clearinghouse for open to "anthing Covid."  So why am I being scolded, repeatedly, for posting what I did?

-Smac

[smac97]

An article by Ted Noel, MD:

Quote

What good do the masks do, really?
By Ted Noel, MD

We are seeing jurisdictions everywhere imposing mask bans at a rate that approaches the number of bars being threatened with liquor license revocation for failing to enforce social distancing.  If that sentence seems complicated, then you are beginning to appreciate just how confusing all the arguments are about face coverings.  After all, we have N95s, surgical masks, homemade cloth masks (enjoy the video), and the classic train robber bandana.  Just for good measure, as I wore my cup-style dust mask on my last pass through Costco, I saw staff members wearing required face coverings that came from lathe section at Woodcraft.

It should be intuitively obvious to the most casual observer that these masks are not all identical in their intended use and possible function against viruses.  The bandana and face shield represent the extreme of one side of the spectrum.  The shield blocks large objects (relative to viruses) traveling from striking the user's eyes at high speeds.  The bandana blocks the good guys from seeing who the bad guy is.  In both cases, breathing around them is very easy, and aerosols aren't blocked.  They may be effective against a sneeze, but ordinary breathing or talking defeats them easily.  The cup-style dust mask falls roughly into that same category.  Let's look at the better masks.

Hmm.

Quote

I wore surgical masks daily for 36 years as an anesthesiologist.  Their purpose was to reduce the chance that I would infect an open wound with bacteria from my mouth.  This article of faith has been shown to be false.  If staff who are working outside of the immediate sterile field do not wear masks, there is no increase in wound infections.  And this is in a closed environment where staff will be present for hours.  This casts a very large cloud of doubt on the utility of masks for COVID-19.

Another problem arises when we look at the use of masks by the public.  Even accepting the uncertain premise that masks are useful, "incorrect use and disposal may actually increase the risk of pathogen transmission, rather than reduce it, especially when masks are used by non-professionals such as the lay public."  Given that most "masks" are simply kept handy for use when required, set aside, and then re-used, most mask-wearing by the public is likely to increase virus exposure, not reduce it.

But do properly used surgical masks reduce disease spread in the general public?  To say there are almost no data would not be overstating the case.  When households with sick kids were examined, even rigorous mask-wearing provided no statistically significant improvement in adult infections.

Let's put that in plain English.  Even if you did everything to protect yourself with surgical masks, even keeping it on when your kid wants to see your face, it might reduce your chance of getting sick, but we can't prove it.  And that's in a well designed study intended to get a meaningful result.  "[H]ousehold use of face masks is associated with low adherence and is ineffective for controlling seasonal respiratory disease" (emphasis added).

Well?  Is wearing a mask just an update on tossing salt over one's left shoulder?

Quote

What about homemade cloth masks?  In a study using influenza, masks made from cotton T-shirts "should only be considered as a last resort to prevent droplet transmission from infected individuals."  They were only one third as effective when worn by the sick person as a surgical mask.  If you're sick, they're better than nothing, but that's not much.  The CDC says, "Cloth face coverings may slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others."  Translation: It might help, but we don't have any data to back that up.

Again, hmm.

So should we still wear masks, just in case they might help?  Perhaps not:

Quote

As we can see from other studies, even surgical masks have minimal benefit in preventing you from getting sick.  This was confirmed in a hospital study.  Cloth masks had a "relative risk" of flu infection thirteen times greater than medical masks.  "Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection."

The Law of Unintended Consequences.  Bummer.

Quote

What about the fabled N95 respirator masks?  "Respirators work as PPE only when they are the right size and have been fit-tested to demonstrate they achieve an adequate protection factor."  Translation: If you haven't gone through the fit-testing I've been through (the first model didn't fit!), N95s won't reduce your exposure to the virus.  Sorry.

I think it's pretty easy to see that a mask is not a mask is not a mask.  There are wide variations, and some face coverings are utterly ineffective at preventing the spread of infection.  Others may provide a small degree of protection to other people if you are infected.  Surgical masks are reasonably effective, but carrying a folded cloth to cough into is just as effective.  And you'll probably put it in the laundry more frequently than your mask.

To protect yourself, you need an N95 respirator mask that is properly fitted.  Then you need to re-sterilize it every four hours using UV light or properly dispose of it and start over with a new one.  That is too expensive for most people.

Can any appreciable percentage of the U.S. populace hope to be properly fitted with an N95 respirator mask, and also have the means to re-sterilize it every four hours?

What about the "received wisdom" of forcing people to say indoors to contain the spread of COVID?  Well...

Quote

The outside world is the safest place you can be.  The state of Florida has zero cases of COVID-19 that can be traced to outside transmission.  During the day, solar UV kills all viruses very quickly, and there's always enough air movement to disperse aerosols, making them non-infective.  It has become clear that virtually all cases have been spread in closed spaces with prolonged (>10 minute) exposure.  And as the studies I've cited show, other than N95s, masks are no help there.  For that matter, six-foot spacing doesn't help, either, since the aerosols that transmit the virus aren't adequately dispersed.

Caregivers in a high-intensity environment should have all the fitted N95s they need.  Beyond that, it's time to recognize that the only person who should be wearing a mask is the Lone Ranger.

Thoughts?

Thanks,

-Spencer

EDIT TO ADD: It looks like Dr. Noel is something of a political partisan.  Snopes reports that he presumed to diagnose Hillary Clinton as having Parkinson's even though he never examined her.  I understood that to be a fairly serious breach of medical ethics.  So perhaps his conclusions should be taken with a grain of salt.

Edited June 26, 2020 by smac97

[smac97]

Potential news from Israel (and Italy):

Quote

While still very contagious, there are signs the coronavirus is mutating and becoming less deadly. Israeli scientists are working to prove that is truly the case.

By Yakir Benzion, United With Israel

Israel’s Health Ministry is checking to confirm indications that the coronavirus is mutating and getting weaker, Times of Israel reported Thursday.

The research is based on claims like that of Italian doctor Prof. Matteo Bassetti, who told the Sunday Telegraph that the power of the coronavirus has gone down from being like “an aggressive tiger in March and April” to being more like “a wild cat.”

Thanks,

-Smac

[CV75]

38 minutes ago, smac97 said:

An article by Ted Noel, MD:

Hmm.

Well?  Is wearing a mask just an update on tossing salt over one's left shoulder?

Again, hmm.

So should we still wear masks, just in case they might help?  Perhaps not:

The Law of Unintended Consequences.  Bummer.

Can any appreciable percentage of the U.S. populace hope to be properly fitted with an N95 respirator mask, and also have the means to re-sterilize it every four hours?

What about the "received wisdom" of forcing people to say indoors to contain the spread of COVID?  Well...

Thoughts?

Thanks,

-Spencer

EDIT TO ADD: It looks like Dr. Noel is something of a political partisan.  Snopes reports that he presumed to diagnose Hillary Clinton as having Parkinson's even though he never examined her.  I understood that to be a fairly serious breach of medical ethics.  So perhaps his conclusions should be taken with a grain of salt.

Cloth face-coverings (not N-95 masks) are but a backup to social distancing and hand-washing, the rationale being to not spread the virus to someone else over not catching it. This is why the CDC qualifies their wearing as follows (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html  ) :

"A cloth face covering may not protect the wearer, but it may keep the wearer from spreading the virus to others." https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

"CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain..." https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

Mandates and requirements (as opposed to recommendations) imposed by governments, employers and other powers-that-be are hopefully being made in good faith given the context of a new virus we are still learning about and surprising us during a pandemic. Our most reliable sources (not bloggers -- my goodness the youtube grocery store doctor was off the rails) are in new territory but they are the best we've got.

Unless someone is going by the Spirit, then nobody can argue that... and that is good for them and them alone.

Edited to Remove: The Sad-Face emoji from the parentheses...

 

Edited June 26, 2020 by CV75

[smac97]

1 minute ago, CV75 said:

Cloth face-coverings (not N-95 masks) are but a backup to social distancing and hand-washing, the rationale being to not spread the virus to someone else over not catching it. This is why the CDC qualifies their wearing as follows (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html 😞

"A cloth face covering may not protect the wearer, but it may keep the wearer from spreading the virus to others." https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

"CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain..." https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

Mandates and requirements (as opposed to recommendations) imposed by governments, employers and other powers-that-be are hopefully being made in good faith given the context of a new virus we are still learning about and surprising us during a pandemic. Our most reliable sources (not bloggers -- my goodness the youtube grocery store doctor was off the rails) are in new territory but they are the best we've got.

Unless someone is going by the Spirit, then nobody can argue that... and that is good for them and them alone.

I also understand that wearing masks may help reduce our tendency to touch our mouth or nose with our fingers.

I think good faith is generally present in recommendations, but it's always a good idea to second guess government restrictions on individual liberties.  Just to be sure.

Thanks,

-Smac

[CV75]

7 minutes ago, smac97 said:

I also understand that wearing masks may help reduce our tendency to touch our mouth or nose with our fingers.

I think good faith is generally present in recommendations, but it's always a good idea to second guess government restrictions on individual liberties.  Just to be sure.

Thanks,

-Smac

Yes, there are other rational explanations for wearing a mask as well. Being close to the decision-makers where I reside, there is so much second-guessing within the powers-that-be, among them our liberties, it is a miracle they come out with anything somewhat timely at all! Granted, other jurisdictions may lack that dynamic. The arguments then continue in public (as well they should) and as long as people are acting in good faith -- meaning they are both civil and informed. 

Edited June 26, 2020 by CV75

[pogi]

57 minutes ago, smac97 said:

An article by Ted Noel, MD:

The other side:

Quote

 

The studies examined the effects of social distancing, face masks and eye protection (such as face shields, goggles and glasses) on virus transmission. (The researchers considered these measures separately rather than in combination. They were not able to examine how a person's duration of potential exposure affected their risk of infection.) 

With social distancing, the chances of infection or transmission of these coronaviruses was about 3% when people kept a distance of at least 3 feet from others, compared with 13% when people kept a distance of less than that. What's more, for every extra 3 feet (up to 10 feet, or 3 m), the risk of infection or transmission of these coronaviruses was reduced by half.

With face masks, the chance of infection or transmission was 3% with a mask compared with 17% without a mask, a reduction of more than 80%. And for eye protection, the chance of infection or transmission was 6% with protection and 16% without.

"Our findings are the first to synthesize all direct information on COVID-19, SARS and MERS, and provide the currently best available evidence on the optimum use of these common and simple interventions to help 'flatten the curve,'" study senior author Holger Schünemann, a professor at McMaster University, said in the statement.

Additional analysis in health care settings found that N95 respirators were 96% effective at protecting workers in these settings, while other types of masks (such as surgical masks) were 77% effective.

These findings show that "for health care workers on COVID-19 wards, a [N95] respirator should be the minimum standard of care," Raina MacIntyre, a professor of global biosecurity at the University of New South Wales' Kirby Institute in Australia, and colleagues, wrote in a commentary accompanying the study. 

The review also "supports universal face mask use, because masks were equally effective in both health care and community settings," the commentary said.

https://www.livescience.com/face-masks-eye-protection-covid-19-prevention.html

 

This video is a demonstration of the effectiveness of a cloth mask at reducing droplets.  Researchers also found that "micro-droplets fell out of the air within 1.5 meters of the person who was wearing a mask, versus 5 meters for those not wearing masks. When combined with social distancing, this suggests that masks can effectively reduce transmission via micro-droplets."

Quote

 

Take, for example, a meta-analysis of 172 studies that looked at various interventions to prevent the transmission of COVID-19, SARS and MERS from an infected person to people close to them. The analysis, which was published in The Lancet on June 1, found that mask wearing significantly reduces the risk of viral transmission. 

"What this evidence supports is that, if there is a policy around using face masks in place, it does actually come with a fairly large effect," says study co-author Holger Schünemann, an epidemiologist at McMaster University.

One study, published in late May in BMJ Global Health, looked at people in households in Beijing where one person was confirmed to have COVID-19. At the time, explains study co-author Raina MacIntyre, research was already showing that the majority of transmission of the virus was happening inside households, and China already had a culture of mask wearing. The study found that in households where everyone was wearing a face mask indoors as a precaution before they knew anyone who lived there was sick, the risk of transmission was cut by 79%.

"The more people that were wearing a mask, the more protective it was," says MacIntyre, head of the biosecurity program at the Kirby Institute at the University of New South Wales in Australia. In other words, when everyone wore a mask, it protected the whole household. 

Researchers will tell you that masks won't provide full protection. And teasing out the science of masks will take time. But Marr says there's enough evidence already to say that, combined with measures like social distancing, masks really do help.

https://www.npr.org/sections/health-shots/2020/06/21/880832213/yes-wearing-masks-helps-heres-why

 

I agree with that last comment.  There's enough evidence.  It is not a perfect science, but I am not about to gamble with someone else's life because it is inconvenient.  That is not being a good neighbor. Err on the side of caution.  There is no mask conspiracy going on here. 

 

Edited June 26, 2020 by pogi

[pogi]

Oh, and P.S., if you  live in Salt Lake County, wearing a mask is now required by law as of 12:00 am this morning.

Edited June 26, 2020 by pogi

[MustardSeed]

I like looking to other countries who have been successful in reducing cases. 
 

IMO I don’t think Americans can look past themselves to know what’s best for the whole.  We are far too self interested. 

[ksfisher]

44 minutes ago, pogi said:

Oh, and P.S., if you  live in Salt Lake County, wearing a mask is now required by law as of 12:00 am this morning.

When you're in a business and you can't maintain a 6ft distance or in a healthcare  setting.

I can't copy and past from the actual document for some reason, but here is a link to the order. 

https://slco.org/globalassets/1-site-files/health/programs/covid/pho/pho9.pdf

#3 on page 5 is the relevant section.

Edited June 26, 2020 by ksfisher

[ksfisher]

11 minutes ago, MustardSeed said:

I like looking to other countries who have been successful in reducing cases. 
 

IMO I don’t think Americans can look past themselves to know what’s best for the whole.  We are far too self interested. 

People in general have a difficult time giving up what they perceive to be short term benefits in favor of the long time good.

 

[Tacenda]

I think there's some screws loose in these people's heads. Sorry if this offends those that talk about their civil liberties.

https://www.cnn.com/videos/politics/2020/06/24/mask-mandate-florida-anger-erupts-coronavirus-vpx.cnn

 

Edited June 26, 2020 by Tacenda

[ksfisher]

46 minutes ago, pogi said:

Oh, and P.S., if you  live in Salt Lake County, wearing a mask is now required by law as of 12:00 am this morning.

If this wasn't real it would be hilarious.

Piute County commissioner compares Utah governor to Hitler over Salt Lake mask rule

https://www.deseret.com/utah/2020/6/26/21304457/coronavirus-mask-mandate-piute-county-commissioner-governor-gary-herbert-hitler-nazi-salt-lake

[Rain]

 

 

17 hours ago, pogi said:

Wow!  That is good reason to question it for sure.  611 patients in ICU with Covid right now and 2,453 hospitalized!?  I can't imagine!  Are the hospitals totally overwhelmed there or are they handling the cases pretty well?

Saw a post elsewhere last night that I couldn't copy on my phone and now I can't find it.  Things are getting bad in a number of hospitals.  Code purple in several.  Children's floors becoming adult covid floors.  Staff to patient ratio dangerously increasing.  Staff are not doing well physically and emotionally.  Travel staff being brought in.  Not good. 

[pogi]

58 minutes ago, Rain said:

Saw a post elsewhere last night that I couldn't copy on my phone and now I can't find it.  Things are getting bad in a number of hospitals.  Code purple in several.  Children's floors becoming adult covid floors.  Staff to patient ratio dangerously increasing.  Staff are not doing well physically and emotionally.  Travel staff being brought in.  Not good. 

That is terrible news.  We may be in the same boat here in Utah in the not so distant future if things don't change soon.

[Calm]

2 hours ago, ksfisher said:

If this wasn't real it would be hilarious.

Piute County commissioner compares Utah governor to Hitler over Salt Lake mask rule

https://www.deseret.com/utah/2020/6/26/21304457/coronavirus-mask-mandate-piute-county-commissioner-governor-gary-herbert-hitler-nazi-salt-lake

I am not sure about him lacking a moral compass, my fear would be his apparent inability to judge reality. I wouldn’t want him making decisions about my life.

Edited June 26, 2020 by Calm

[Rain]

Found it posted several places now

Quote

Banner Desert:
3 COVID telemetry units full (❤️ patients)
1 medsurg (regular floor) COVID unit full
2/3 ICU dedicated to COVID only, 3 patients to 1 RN ratio (normally 2:1)
Expanded regular ER into pediatric ER
Using some peds floors for adults
Code purple (hospital full or approaching full and not enough staff to cover upcoming shifts)
Interventional radiology (vascular procedures) filling separate, additional ICU

Banner Boswell:
Converting several regular units to COVID. Stopped elective surgeries

Banner Baywood:
ICU 3:1 ratio. Code purple

Banner Estrella:
Doubling up patients in rooms
6 COVID units

Banner Cardons Children’s Hospital:
3 of 5 floors dedicated to adults
ER has lots of hallway beds (patients don’t get a real room)

Banner University Phoenix:
2 of 3 ICUs dedicated to COVID.
Progressive Care Unit (PCU) dedicated to COVID patients with a second one coming soon.
2 COVID medsurg floors

Valleywise Hospital:
2 COVID ICUs, 4 COVID medsurg units
Code lavender (same as code purple)
Asked for 26 travel RNs, only received 6

St. Joe’s:
4 COVID ICUs. Now placing double beds in rooms. 64 beds currently occupied
Stopped elective surgeries today.
Difficulty accommodating traumas, strokes, brain aneurysms due to shortage of ICU beds.
Pulmonologist Intensivist (critical care lung doctor) working 7 days a week.

Dignity Chandler:
27 vented COVID - will double patients in rooms once they get to 32, max 64
3 medsurg floors COVID

Mercy Gilbert:
2 ICUs COVID full
2 medsurg floors COVID full

Honor Health Shea:
45 medsurg COVID beds full
Plus preparing 27 more beds
One ICU unit full, took 5 beds from the “clean” (non-COVID) ICU.

Honor Health Osborn:
40 COVID medsurg beds full
3/4 ICUs dedicated to COVID and overflowing into ER & PACU (post anesthesia care unit)
10 rooms available for COVID patients but no one to staff them

Helicopter pilot from Yuma medical center flying patients to Phx because Yuma is full

Tucson Medical Center called me at 9pm saying they are in desperate need of ICU NPs and will require an 8-12 week contract. (I’m not trained in critical care).

*Lots of stories of Arizona healthcare workers breaking down crying at work, calling out sick therefore being very short staffed for the next shift, and actually getting sick with COVID. EVERYONE is working overtime. Healthcare workers are getting slammed. My heart goes out to all of them

 

[Calm]

So depressing. 

[Tacenda]

2 hours ago, Rain said:

Found it posted several places now

 

I wonder if heat is a problem, which AZ has a lot of.

[Rain]

1 hour ago, Tacenda said:

I wonder if heat is a problem, which AZ has a lot of.

No. It's people not social distancing and not wearing masks, Arizona opening up before standards were met, people gathering in bars with a ton of people drinking out of the same huge margarita because "covid is over"  etc.

[MustardSeed]

16 hours ago, Calm said:

I am not sure about him lacking a moral compass, my fear would be his apparent inability to judge reality. I wouldn’t want him making decisions about my life.

We have a LOT of people like this guy in my state.  In my ward.  I feel as though I’m in a twilight zone. 

[smac97]

[pogi]

45 minutes ago, smac97 said:

This graph can be very deceptive.  Just what exactly are you trying to say with it?

126,924

Let that number sink in.  No end in sight. Most experts I have heard believe that number is low.

Can you point to a flu season in your life time when we ever approached that number?  And things are just barely picking up.  We will be topping 200,000 in no time. 

Senior and Vulnerable Lives Matter!  We should start a new campaign with that slogan. 

 

Edited June 27, 2020 by pogi

[Scott Lloyd]

On 6/26/2020 at 10:04 AM, CV75 said:

Cloth face-coverings (not N-95 masks) are but a backup to social distancing and hand-washing, the rationale being to not spread the virus to someone else over not catching it. This is why the CDC qualifies their wearing as follows (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html  ) :

"A cloth face covering may not protect the wearer, but it may keep the wearer from spreading the virus to others." https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

"CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain..." https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

Mandates and requirements (as opposed to recommendations) imposed by governments, employers and other powers-that-be are hopefully being made in good faith given the context of a new virus we are still learning about and surprising us during a pandemic. Our most reliable sources (not bloggers -- my goodness the youtube grocery store doctor was off the rails) are in new territory but they are the best we've got.

Unless someone is going by the Spirit, then nobody can argue that... and that is good for them and them alone.

Edited to Remove: The Sad-Face emoji from the parentheses...

 

Thank you for coming clean about removing the sad-face emoji. As they say, confession is good for the soul.