More Covid-19 FAQs

Frequently Asked Questions about COVID-19

  “Shared expectations lead to predictability.” 

  1. AstraZeneca and Oxford University to further develop a vaccine

Q: The federal government has funded over $1 billion to get a new vaccine in just 5 months.  How can this happen?

A:  On May 22, 2020, The New York Times reported that British drug manufacturer AstraZeneca was given “up to 1.2 billion dollars” to develop a potential vaccine for coronavirus-19.  This is the fourth (and largest) disclosed agreement reached by the U.S. Department of Health and Human Services for a vaccine.  It will pay for a combined Phase 2 and Phase 3 clinical trial in America of a potential vaccine.  The vaccine being developed by Oxford University in England is now licensed by AstraZeneca and will be used for this clinical trial.

The Phase 1 trial last month in Britain was run by Oxford University.  It demonstrated the trial vaccine was safe in that it did not infect any participant with the disease. The combined Phase 2 and Phase 3 trial that now follows will evaluate if it generates antibodies that then rapidly reacts to overcome the virus when a person becomes infected.  What lies ahead involves a much larger number of healthy volunteers – about 30,000 – half of whom will receive the trial vaccination.  The other half will receive a harmless saline injection.  No individual will know which injection they get.  At the same time of this trial, a different clinical trial in England is planned to involve another 5,000 volunteers.  Months later, after the volunteers return to their populations, the number of people in each group who develop COVOID-9 will be identified.   If the trial vaccine is effective, any antibodies generated will prove to make the person receiving it immune.  It will also turn up any negative effects not previously reported.  The results will lead to a judgement of its effectiveness and authorize approval for the launch of production of doses for mass distribution – or the decision to continue to research other alternatives that can lead to future trials.

Many scientists warn that president Trump’s “Operation Warp Speed” is unlikely to succeed that rapidly – in just a few months.  It is noted that for most viral infections, vaccines take up to four years to develop, if at all.  After many years, there still is no vaccine for the viral infection causing HIV.  Many factors are cited that can delay development of a coronavirus-19 vaccine:

  • Currently, public perception is moving toward the false perception that the disease is diminishing in its prevalence. This may make it difficult to obtain the required number of volunteers to be available right away.
  • If the start of the trial is delayed, to meet a date-certain deadline the trial might not allow for examining the variabilities of effectiveness by age, gender, race and co-morbidity (other medical conditions).
  • It is anticipated there may be political pressure applied to shorten the trial period. This would further inhibit the ability to identify the variabilities in outcomes.
  • During the trial, if serious complications emerge such as the vaccine causing serious side effects, the trial will stop and new trials for other vaccines canl begin.
  • If the trial ends with no significant immunity demonstrated, this failure will also cause new vaccines to be developed.

A previous example was the Salk oral polio vaccine.  After it was approved for use, it was found in 1955 that several people receiving the vaccine became paralyzed.

Conflicting with the universal desire “right now!” develop a coronavirus-19 vaccine is the growing number of people who are against vaccinations of any kind.  These “anti-vaccers” cannot be given any reason to distrust this vaccine by having even a hint of adverse effects reported after it is approved and used world-wide.

Perhaps the best approach will be to let the scientists develop a vaccine without political or social pressure being applied.  This may actually take another year if done right.  (Shared expectations can lead to a more predictable outcome!”)

 

  1. CDC is conflating data – a report

Q: “How Could the CDC Make That Mistake?”

A: On May 21, 220, the Atlantic Magazine published an article written by Alexis C. Madrigal and Robinson Meyer with this question as its title. It is reported that CDC “is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies.” “…the government’s disease-fighting agency is overstating the country’s ability to test people who are sick with COVID-19.  …States have set quantitative guidelines for reopening their economies based on these flawed data points.”  It is also reported that each separate data source serves different functions in the epidemiology of the disease.  By merging these together, accurate study and evaluation of COVID-19 will be seriously hampered.

One can be certain more media coverage will be reported in the future.  Note: Connecticut previously decided to base its decisions on opening the economy on the number of hospitalized COVID patients – not on the number of people tested.  Connecticut controls the reporting of hospitalizations, so this CDC move will not affect Connecticut!

 

  1. Considerations for Summer Camps

Q:  What should I know before I send my child to summer camp?

A:  There are 8,400 sleep-in camps in the United states.  There are also 5.600 day camps as well.  Many parents send their children to one of these camps each summer. For many who have been there in past years, campers eagerly look forward to this “time away from home.”  Especially after spending so much time at home long before summer arrives because of school closures.  On May 19, the CDC updated their “Guidance for Youth and Summer Camps.  Earlier, the American Camp Association, an accreditation group collaborated with the National YMCA to hire a consulting firm to develop a health-related guide for opening summer camps during the coronavirus-19 pandemic.  Environmental Health and Engineering. Inc. of Newton, Massachusetts released its 80-page “Field Guide for Camps for Camps on Implementation of CDC Guidance.”   A copy can be found at:    https://acacamps.app.box.com/s/7gkh9buu3ntssx2v38gajg4z94631lag

Any parent exploring a summer camp experience might first ask if the camp is accredited by the American Camp Association (ACA).  It is important to note that compliance with the above-mentioned Field Guide is not used for ACA accreditation.  Questions need to be asked of camp leaders about the specific actions and policies outlined that they have implemented. General guidance offered in the field guide includes:

  • Staff and campers to self-monitor their temperature and other signs and symptoms of COVID-19 for 14 days before coming to camp – in place of being quarantined.
  • The camp will divide its staff and campers into separate groups or cohorts of no more than 50. These cohorts will remain together throughout, and will be separated from other cohorts by at least 6 feet during any collective meetings.
  • If any camper or staff shows signs of COVID-19 during the summer, they will be either isolated in a separate area at the camp, transported to a medical facility, or returned home.
  • Everyone should wear face cloth coverings when indoors and space is limited.
  • Increased hand washing, social distancing and other measures will be enforced.
  • Sleeping and housing arrangements need to be modified to provide greater spacing. Physical barriers should be placed between cots
  • Meals and other activities should be done in shifts. Buffet and family-style meals are not to be served.
  • All shared equipment such as baseball bats, bows and arrows, paddle boards, etc. need to be frequently disinfected.
  • Field trips and travel outside the camp should be cancelled

It is noted that Camp Courant has already cancelled their summer day camp season.

  1. Schools opening this Fall

Q: Hasn’t the CDC provided guidelines for opening schools next fall?  What’s the problem?

A: On May 19, 2020- the CDC issued an updated version of their “Considerations for Schools.”  The title is significant because the White House sent this document back to the CDC for revisions because the one ready to release earlier was “too restrictive.”  This new “guidance” now offers “considerations” that school authorities can review.  News media reports that the White House is about to embark on a campaign late May or early June to get the schools opened immediately.  With schools closed and children staying at home, many parents are not free to go to work, thus restricting the economy from opening up to a greater extent.

“Schools may consider implementing strategies to encourage behavior that reduce the spread of COVID-19.”

  • Staying home when appropriate, including when students become sick, have close contact with an infected person, or are tested positive.
  • Hand hygiene and respiratory etiquette will be taught and reinforced.
  • Cloth face coverings are to be used whenever possible, especially when in close contact with others.
  • Adequate supplies will be available including soap, hand sanitizer, paper towels, tissues disinfectant wipes, cloth face coverings and trash cans.
  • Signs and messages are visibly displayed as reminders of safe behavior.

Considerations for maintaining a healthy environment include:

  • Frequent, specified cleaning and disinfecting activities.
  • Discourage use of shared objects.
  • Adequate ventilation and air exchange.
  • Students and staff to bring their own water
  • Modified layout – seating and desks are at least 6 feet apart, and have children in buses will sit at least 6 feet apart.
  • Physical barriers and guides including sneeze guards and partitions are in congested areas.
  • Communal areas are closed, including cafeterias, playgrounds, gym areas OR Stagger their use to keep people are at least 6 feet apart.
  • Food Service is modified by having students bring in their own lunch OR serve individually bagged meals delivered to classrooms,

Considerations for maintaining healthy operations include:

  • Offer options (e.g. virtual education, etc.) for those at higher risk of infection including staff over age 65, children with chronic medical conditions, etc.
  • Regulatory awareness by knowing what activities or events may be restricted by the locality or state.
  • Restrict visitors, limit field trips, limit or stop having sports events, and not hold events where large groups may gather, use virtual methods as substitutes.
  • Stagger scheduling for arrivals and departures from school perhaps also flexible use of alternative spaces or schedules to reduce the number of participants in each session.
  • Modify time off (vacation and sick leave) policies.

Obviously, each school district has to examine how they will adopt these considerations.  Perhaps each parent might want to communicate early with their local school board to find out what to expect as plans emerge.  And to communicate back with constructive ideas on ways to move forward.  Several officials have repeated the obvious – “This is not going to be easy.”

 

More Covid-19 FAQs

31      Children as super-spreaders

Q: I’ve been hearing lately that some children who have the virus but without COVID-19 symptoms can spread this infection to large numbers of others.  Is this true?

A:  A “super-spreader” is an infected person who can infect a greater number of people than can a typically infected person.  For many diseases, individuals have been identified as causing more than the expected number of infected persons.  One familiar example is Mary Mallon who was an asymptomatic carrier of typhoid fever in New York City.  She was a cook who infected 51 people in a 7-year period starting in 1902.  After finally identifying who this super-spreader was, she became known as “Typhoid Mary.”

Some diseases are known to be highly infectious when children carry the pathogens. Measles is one example in which children are all super-spreaders.  But this high rate of infection by any one particular person is halted when the child develops symptoms and is no longer in contact with others.  Speculation that asymptomatic children might be spreading COVID-19 to others apparently began in Great Britain as well as Australia.  Some of this speculation has been carried over to the United States.  After all, young children love to run up to people, touching and hugging.  And they love to pick up objects and put them in their mouths.  They are really good at all the behaviors we now associate with the spread of the coronavirus-19.

With increasing concerns focused on sending children back to school in the fall, a study is being concluded by Australian researchers.  This study will be submitted for peer-review publication.  The preliminary data shows that children are not very good at spreading the coronavirus-19 at all.  Australia was one of the few countries that kept schools open during this pandemic. Public health officials in the state of New South Wales traced hundreds of close contacts with the nine students and nine teachers who contracted COVID-19.  Of the nearly 900 people who were in contact with these infected people, only 2 had become infected.  Officials are waiting to see the full report on the study to learn what influences any social distancing and other variables were at play.  But the data so far is “exciting and reassuring” according to one investigator   The consensus is developing that children are not super-spreaders of COVID-19.

 

  1. Accuracy of testing options

Q: Why were some corovinus-19 tests approved when we hear they are not accurate?

A: The White House in April created a checklist of things it needed to accomplish to hasten the opening of the economy to avert a depression. One of these tasks was to have the FDA issue Emergency Use Authorizations (EUAs) for additional testing capabilities.  The FDA then processed a large number of applications for testing kits and laboratory processes to satisfy this goal.  Usually, the FDA conducts trials and evaluates the validity of such tests before approving them for use.  But under the declaration of a national public health emergency, approval under the Emergency Use Authority (EUA) is possible.  To qualify, the vendor or agency applying agrees to monitor the accuracy of the tests. So far, 90 different EUAs have been granted to different groups, creating a confusing environment for states seeking a testing system.  One such test granted an EUA was the Abbott Labs “ID NOW” “ready test.” This is a diagnostic test evaluating the existence of the coronavirus-19 in a sample specimen. This device allows for testing “at the point of care.”  If a patient tests positive, they can be immediately moved to an isolation area.  Abbott was Issued its Emergency Use Authorization on March 27.   Later, the White House promoted this product during one of the Coronavirus Task Force press briefings because it can deliver a positive finding in just 5 minutes.  A negative finding will take up to 12 minutes.  The unit is self-contained, and the White House medical staff has decided to use this for periodic testing of the president, vice president and White House staff.

Recently, researchers at the New York University reported on a study they completed with about 100 patients comparing results of the Abbott “ID NOW” unit with a proven accurate test developed by Cepheid.  The results were that 48% of the samples testing positive by the Cepheid test were found to be negative with the “ID NOW” test.  This false negative result means that a significant number (about half) of the people who are actually infected walk away believing they are not sick and cannot infect other people.   Abbott is challenging this finding for several reasons, and the FDA is investigating.  Meanwhile, the FDA has issued instructions to physicians using the Abbott test to be aware of the accuracy issues.  All negative findings should be retested before assuming the patient is not infected.  This means the Abbott “ID NOW” still has FDA authority to continue to sell this test and people continue to be told their test results.  Again, this is the test the White House is using daily to determine if any officials – the president and those around him – may actually have the disease.

  1. Remdesiver update

Q: Is Remdesiver still being tested as a treatment for COVID-19?

A: On May 8, it was reported that the National Institute of Health has begun a clinical study combining Remdesiver with an anti-inflammatory drug, Baricidinib, produced by Eli Lilly and Co. The study will involve more than 1,000 adult hospitalized patients in the United States.   There is strong anecdotal evidence that anti-inflammatory medications have an effect to control some of the serious conditions often found in COVOID-19, especially in its advanced stages.  This is one of a continuing series of scientific studies hopefully leading to effective therapies reducing the mortality and morbidity of this pandemic.

More Covid-19 FAQs

  1. Symptoms: allergies v. Covid-19

Q: Each Spring, I suffer from hay fever and allergies.  How do I know that my sneezing and stuffiness are not symptoms of Covid-19?

 A:  The American College of Allergy, Asthma and Immunology points out that allergies generally occur when an immune system overreacts to something that is typically harmless in others.  Pollen, grass and ragweed are typical triggers each Spring.  One main difference between these conditions is that Covid-19 can cause a fever – allergies don’t.  Another difference is that allergies can come with some level of itchiness – Covid-19 does not.  Sneezing can occur with Covid-19 but is usually doesn’t last long.  Sneezing due to allergies is usually constant and long term.  Allergy sufferers usually are aware of their symptoms from previous episodes.  If anyone has concerns or questions, they should call their physician.

 27. Isolation vs. Quarantine

Q: Is a lockdown and a quarantine the same thing?

A:Many people use these terms interchangeably. But there is a difference.  Isolation is when someone is tested positive and known to be infected with Covid-19 – with or without symptoms – is kept away from others who have not tested positive for the disease. The purpose is to prevent others from being infected.

Quarantine is when someone who has been in contact with an infected person is kept away from others for a period of time.  The purpose is to determine if the quarantined person has actually been infected.  If so, separation from others prevents new infections from occurring.  If not, they can return to normal activities.

A Connecticut state law exists to make either enforceable.  “In the event or a statewide or regional health emergency, the Governor may authorize the public health commissioner to quarantine or isolate individuals reasonably suspected as being infected or exposed to a communicable disease.”  “Anyone who violates the provisions of a quarantine order… shall be fined no more than $1,000 and/or imprisoned for no more than one year.”  One can expect that strict enforcement would only take place once Covid-19 has been nearly eliminated and a person flagrantly violates an order in a way that could cause the pandemic to resurge.

 

  1. Children and Covid-19

Q: What is this I am hearing about children can be affected by Covid-19?

A: In January 1961, a syndrome (defined as a group of pathological conditions) was identified by a physician in Tokyo, Japan.  The patient was a four-year old child, and the physician was Tomisaku Kawasaki (that’s his name, not his location).  He later published a report on 50 similar conditions.  As a result, this condition is named the “Kawasaki syndrome.”  This is a rare condition in children from ages 5 to 18.  Only about 3,000 cases are diagnosed in the US each year.   80% of the cases are under the age of 5.  It affects boys more than girls, and Asians have an increased incidence.  It does not appear to be contagious.  There is no single cause identified for this syndrome.  It is often correlated with a diagnosis of other diseases such as scarlet fever, measles, and Rocky Mountain fever.  Concern is now being expressed that the COVID-19 may be another disease correlated with the Kasasaki syndrome.  The CDC is investigating this possible link.

The syndrome’s presentation is inflammation of blood vessels and multiple organs and bodily systems.  It can include any, but not necessarily all of the following: a prolonged fever, extremely red eyes (conjunctivitis), a rash on the body, red and dried cracked lips, swollen red palms of the hands and soles of the feet, joint pain, diarrhea, vomiting, and abdominal pain.  The most threatening delayed condition is an inflammation of the blood vessels that can sometimes lead to an aneurism (rupture) of the aorta resulting in death.  Consultation with a physician is necessary for an accurate diagnosis, and treatment usually must be undertaken in a hospital but is quite successful if diagnosed early.

In New York, it was recently reported that 73 Covid-19 infected children have been diagnosed with “symptoms similar to Kawasaki disease.”  Most were toddlers and elementary-age children.  Recent deaths in this group include a 5-year-old boy, a 7-year-old and a teenager.  The Connecticut Children’s Hospital on Tuesday of this week has reported they are treating two children with the Kawasaki syndrome.

 

  1. CDC “Extended Guidelines”

Q:  Wasn’t the CDC preparing specific guidelines to help churches open up to more normal activities?  What happened?

A:  Earlier, the CDC submitted a 17-page guideline to the White House prior to releasing them publicly.  Later reports showed that these guidelines were approved by the CDC for release.  Six types of organizations are covered:

  • Child care programs,
  • Schools and day camps,
  • Communities of faith,
  • Employers with vulnerable workers,
  • Restaurants and bars, and
  • Mass transit administrators

It was publicly announced on May 7 that the White House had “shelved” this document.  It was reported that federal officials felt many of the recommendations were “too restrictive.”  Most of the concern apparently focused on businesses opening up.

This embargoed document defines several steps for churches to follow as state governments move into each of the 3 stages of loosening restrictions.  Connecticut is planning to begin Phase 1 as early as May 20.  The Interim Guidelines relevant to our congregation includes what we are already doing:

  • Coordinate with state and local mitigation strategies, and
  • Conduct meetings and services virtually, and
  • Provide spiritual and emotional care virtually,

In a word, we are already in compliance with these CDC guidelines, even if they were not formally approved.  And this compliance will continue into the near future.  The document offers excellent suggestions for church functions and activity as we move toward meeting as a group  These will be reviewed by our leadership and will guide us in steps to  be announced in the future.

 

  1. Slowing the spread of the disease

   Q: How do we slow the infection of new Covid-19 patients?

A: The long-standing public health approach to eliminating a disease is wide-spread testing to find those who are infected.  When a person tests positive, a public health investigator conducts an interview to identify past contacts with others.  The infected patient is then ordered to remain in isolation to prevent further contacts.  Evaluating the duration and situation surrounding each encounter reported, the investigator reaches out to these people and explains they may have been infected.  Each contact is then tested and if positive, they are ordered into isolation.  If any tested negative, they can expect they might be ordered into quarantine.   Of course, rapid turn-around for test results is essential for this process to work.  Waiting several days or a week for results to come back would leave an impossibly long list of contacts to be reached, many of whom may already be showing symptoms.

Public health investigators do not currently exist in the numbers required to participate in this approach for COVID-19.  Tens of thousands will be needed!  Funding has been requested and opportunities soon will exist for hiring lay people to do this.  Currently, some states doing case tracking are focusing on telephone calls to contact these people.  John Hopkins University has developed a training program describing and offering instruction for this role.  This free course is available for anyone who wants to learn more:

https://abcnews.go.com/Health/johns-hopkins-launches-free-contact-tracing-amid-covid/story?id=70618298

More Covid-19 Frequently Asked Questions

Frequently Asked Questions about COVID-19

  “Shared expectations lead to predictability.”

 

  1. Washing clothes after shopping

Q: Does it help if you wash clothing after grocery shopping?

          A:  Coronavirus particles collecting in clothing while shopping presents a very low risk for later infection.   The concentration of virus in the air six or more feet distant from an infected person is the standard for social distancing.  Any lingering virus particles that fall on one’s clothing is quickly enmeshed in the fibers of the clothing, preventing their easily being carried by hand to the healthy person’s face.  If one doesn’t usually wash their clothing after shopping, they should use judgement to evaluate the rare situations that might present a risk.  If somebody without a cloth face covering repeatedly coughs only a foot away, you could be at risk.  After quickly stepping away, in addition to being concerned about having inhaled aerosoled virus particles, you might want to consider washing your clothes once you get home.  It also has to be recognized that even after a routine shopping trip, washing your clothing might be psychologically a meaningful activity.  Washing and showering can leave you more comfortable having rid yourself of the image of being “dirtied” by this invisible and threatening enemy.

 

  1. Testing swabs

Q. What is the problem we keep hearing about not being able to get the appropriate swabs for testing?

A. The initial diagnostic test authorized by the FDA was based on a previously developed testing process. This involved a swab with a long flexible shaft and a fiber tip to collect a nasopharyngeal specimen – through the nose deeply inserted to the back of the throat.  This test procedure was further developed to permit collecting the specimen from just the nasal passages – making it easier for people to collect their own specimens to return to the laboratory for evaluation.  A shorter swab is needed but was not approved.  The approved long flexible swabs are specialized, and the manufacturer was unable to produce them in quantity rapidly enough for widespread use.  Any different swab had to be separately approved by the FDA before testing could continue.

Samples of a spun-polyester on a shorter “Q-Tip similar” swab were submitted to the FDA for testing by U.S. Cotton, a subsidiary of Parkdale, INC of North Carolina.  On April 16, the FDA recognized this fully synthetic product for compatibility with coronavirus-19 testing.  Production began and the shortage of appropriate swabs now seems to have been alleviated.

 

  1. Readiness for “opening up”

Q. What, exactly, is required before a state can decide to open up?

A: On April 16, 2020, the White House released an undated 15-page document listing criteria recommended for opening the economy from current restrictions.  The front cover shows the White House logo and that of the CDC.  On the cover, it is stated

“President Trump has unveiled Guidelines for Opening Up America Again, a three-phased approach based on the advice of public health experts.  These steps will help state and local officials when reopening their economies, getting back to work, and continuing to protect American lives.”

(Note: the following summarizes the requirements before opening up.  The full document can be found at:  https://dig.abclocal.go.com/wpvi/pdf/trump-state-reopen-Guidelines.pdf )

Before beginning to open up, states need to satisfy the following pre-qualifications:

  • 3 statements addressing the reduction of influenza, COVID cases or positive COVID test within a 14-day period,
  • Hospitals can treat all patients with routine care,
  • Robust testing program including antibody testing at-risk healthcare workers,
  • 3 statements addressing the ability to test flu patients, asymptomatic people and trace contacts of resulting positive tested COVID patients,
  • 2 statements addressing ability to supply sufficient hospital personnel protective equipment and critical medical equipment when needed, and surged ICU capacity,
  • 5 statements calling for plans being created to protect workers in critical industries, those living and working in high-risk facilities such as nursing homes, employees and users of mass transit, for communicating protocols for social distancing, and for monitoring conditions to immediately reinstate any limitations needed to mitigate when needed.

The first observation is that the criteria released by the White House defines the roles and responsibilities of the states; none are given for federal agencies or the White House.

The second observation is that many of the guidelines are not objectively measurable.  Subjective evaluation allows different observers to form variable conclusions.  A “robust testing program” for antibody might be seen qualifying by a public official while a public health official might not agree because the test system is not FDA authorized.  Giving cloth face coverings to bus drivers may be seen by a governor as “protecting employers and users” when such protection is minimal at best.

The third observation: these guidelines are not enforceable.  Indeed, the title states they are “Proposed State or Regional” guidelines.  While issued by the White House, the president has already violated these guidelines.  He recently invoked the Defense Production Act to mandate that meat processing plants remain open – contrary to the White House guideline to “protect workers in critical industries.”

  1. Remdesiver

Q:  How important is the new drug remdesivir in treating COVID-19?

A:  Gilead Sciences, Inc. is a research-based biopharmaceutical company headquartered in California.  It had previously worked to develop therapeutics against other coronavirus-related viruses. One of these is remdesivir, which interrupts the replication of other corona-like virus inside host cells.  This experimental pharmaceutical required human clinical testing on the coronavirus-19 before it can be FDA authorized.

A previous trial in China was stopped because of a lack of qualified candidates.  The initial unpublished report indicated that remdesivir did not significantly improve clinical improvement or elimination of the virus.  That report was later revised and published as being inconclusive; more testing is needed

A further clinical trial was begun in the United States. The primary test hypothesis was to evaluate the clinical impact between a 5-dose treatment and that using 10 doses.   1,000 hospitalized adult COVID-19 seriously ill but not on a ventilator volunteered to begin the study.  Half were given the medication and the other half were given a placebo – a sugar pill.  Findings for each group were compared.  As the testing proceeded, it was found that the survivors receiving remdesivir were discharged from the hospital an average of 11 days while those who did not receive it averaged 15 days.  The entire group receiving the drug had a mortality rate of 8% contrasted with 11.6% for those not given remdesivir.  Ethics standards dictated that with these findings, the study could not continue.  Those not given the drug had to be given the opportunity to take remdesivir.  As the study ended, the data collected indicated no statistical difference between the groups taking the 5-dose and the 10-dose therapies.  This is important because manufacturing the medication can result in double the number of future patients that can be treatment.

On May 1, the FDA granted Gilead an Emergency Use Authorization (EUA) allowing remdesivir to be used on non-ventilator seriously ill COVID-19 hospital patients as a therapeutic while continuing further studies.  Such studies can include comparing results when paired with other promising drugs.  Gilead had already produced 1.5 million vials of the drug and given it to the government for use in the United States.  This is enough for 240,000 patients getting 5-dose treatments.  The consensus of the scientific community is, “It’s is not a silver bullet.”  Benefits are there but they are minimal.  This can serve as a foundation for developing additional therapeutics that will be more effective.

  1. Insect transmission

 Q: Can insects like ticks, and mosquitoes infect someone with coronavirus-19?

A: No!  Coronavirus-19 infects a person through the respiratory system entering through the mouth, nose or moist tissues of the eyes.  Other virus infections enter through the bloodstream.  An example is Eastern Equine Encephalitis (EEE).  Blood-drawing insects do transmit these other virus infections, but do not infect with respiratory a virus.

More Frequently Asked Questions about Covid-19

  “Shared expectations lead to predictability.”

 16      Cats and Pets – COVID-19

Q: Can cats and pets be infected with coronavirus-19; if so, can they give it to humans?

          A: To create an infection, virus particles must first multiply in great numbers within cells of the host.  Each virion does this in cells specific to a species.  Thus, birds that inhale polio virus do not get polio; cows do not get mumps.  Distemper virus does not infect humans.  Coronavirus-19 is genetically programmed to enter human cells.  Distemper virus is genetically limited to cats and dogs.  However, viruses are known to mutate.  It is generally assumed that coronavirus-19 originated in bats.  The current pandemic probably began in China as a mutation from the virus that specifically attacks bats into one that is specific to humans.  That mutated virion in a human multiplied and infected one or more additional people and our current pandemic was born.

The CDC on April 22, 2020 provided guidance on managing pets that may have COVID-19.  Two cats with this disease had just been confirmed!  They are the first pets in the United States to test positive for coronavirus-19.  Both cases, in different locations in New York state, had mild cases and are recovering.  One had no contact in the household with any human testing positive for coronavirus-19.  The other showed symptoms after a person developed COVID-19.  Two questions remain under investigation by CDC: were the cats infected by humans?  And can an infected cat give the disease to humans?  Could it be that a mutation of the coronavirus-19 may have occurred and infected a cat?  Might this contagion be spreading unnoticed among cats that are allowed outside to freely roam about?

Given the very rare occurrence of pets being infected, the CDC concluded, “…there is no evidence that pets play a role in spreading the virus in the United States.  Therefore, there is no justification in taking measures against companion animals that may compromise their welfare.”

The CDC recommends that  “until more is known,

  • Do not let pets interact with pets and animals of other people outside the household.
  • Keep cats indoors when possible to prevent them from interacting with other animals or people.
  • Walk dogs on a leash, maintaining at least 6 feet from other people and animals.
  • Avoid dog parks or public places where a large number of people and dogs gather.
  • If you are sick with COVID-19, either suspected or confirmed by a test, restrict contact with your pets and other animals, just like you would around other people.
  • When possible, have another member of your household care for your pets while you are sick.
  • Avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food or bedding.
  • If you must care for your pet or be around animals while you are sick, wear a cloth face covering and wash your hands before and after you interact with them.”

 

17. How long before we get back to normal? 

Q: Given the importance of testing and other guidelines issued by the president of the United States, how long must we remain in “stay-at-home” and “keep-your-distance” status?

The US initially ignored the WHO’s fully developed diagnostic testing for the presence of the virus, and instead used the CDC to develop its own testing system.  After weeks of delay, this test was introduced and found to not provide valid results.  It was removed from use.  The decision was then made to ask the private sector to develop alternative diagnostic tests.  By late April, 115 laboratories had submitted proposals for FDA review.  Each has been allowed to offer their tests having “self-verified” the validity of results.  Of these, 11 labs have now been authorized after the FDA verified the test validity.  111 labs are still pending this FDA authorization.

At the end of April, the FDA reports there are no authorized tests for the presence of antibodies.  Many of the tests being used have shown false positive and false negative results.  These cannot accurately identify a person’s existence of antibodies.   Science dictates that valid testing is a preliminary requirement before any jurisdiction should begin to open up.  The FDA has published a list of all the laboratories in each state that governors can turn to for testing.  But governor Cuomo of New York articulated the problem to national authorities:  Many separate labs use different manufacturers’ products.  Each propriety system has its unique testing supplies and reagents.  To ramp up for the millions of tests required, no manufacturer has the ability to provide supplies in that quantity.  Thus, expectations for testing are limited by the supply chains required.   Delays in testing further extend the time to when ending of the existing program of isolation can be predicted.

Recently, a new and conflicting strategy has been imposed: “Liberate (name a state)!”  This economic “Open up early” strategy serves the objective of limiting the damage to the economy by quickly getting people back to work.  Science predicts that opening up too early will only create a new wave of infected people, requiring a longer future period of staying at home.  But a public momentum of expectation to return to normal has now been created.

Add to all this the latest discovery about COVID-19 as a factor that must be investigated.  The World Health Organization is now reporting that “There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.”   More study is needed.  Does the severity of the disease indicate the point where immunity is provided?  How does this finding affect the eventual development of a vaccine that encourages antibody development in healthy individuals granting them immunity?  The third phase of testing of a vaccine leading to its approval is a clinical trial showing it creates immunity.

Conflicting expectations leads to unpredictability.  Perhaps the wiser choice is to not get hopes up too high, but to follow the science as it develops answers to the problems at hand.

Again, “Being patient is better than being a patient!”

Today, there are two conflicting strategies at play. Protecting the public health and recovering the economy.  In public health, one tracks contacts of an infected person and orders those contacts into quarantine to stop the spread of the disease.  Without testing to identify individuals that are infected, the strategy was initially taken to “quarantine” the entire populace – “stay at home, and social distancing.”

 

18. Reading a graph.

Q: When reading a graph that shows we are “flattening the curve, how come the line stays steady even though the number of cases is declining?

A: There are two types of graphs used to report COVID-19 data.  The combined or total information and the daily statistics.  In the combined graph, the vertical height of each entry includes all the previous data with the new data added from the previous entry.  Thus, a point showing 100 cases the day before with 10 new cases would be shown as 110.  Over the next several days with no new cases, the points would remain at 110 showing a level or flat line.  Future entries will always include past cases.  This graph is often used to illustrate the acceleration as the case load increases exponentially over time.

The other daily graph is the vertical point showing the reported cases for each day in progression.  In this graph, one can visualize the daily increase and decrease in cases over time, at the point of highest volume, the apex is shown with daily totals then displaying a future decline in cases.  This is the graph often used to predict and display when hospital resources are being stretched and later relieved.

In conversation, people tend to use a general “The graph show…”  It helps to better understand the data by knowing what type of graph it is.

19. Herd immunity

Q: What is herd immunity?

A: Herd immunity is the point where enough people in a population have developed immunity to significantly reduce the spread of the disease by contagion.  This immunity is achieved by those surviving the disease generating antibodies.  It can also be achieved by receiving a vaccination, when one is available.  Estimates for herd immunity from COVID-19 range between 60% and 80% of a population.  One social experiment is now underway in Sweden.  The policy has been adopted that there will not be a shut down of the economy by issuing universal stay at home orders.  Sweden has a current population of 10,086,000.  In this pandemic, there have been 18,640 reported cases of COVID-19 with 2,200 reported deaths, a 12% case fatality rate.  Contrast this with neighboring Norway: population of 5,413,800 with a reported 7,600 cases and a reported 201 deaths, a case fatality rate of 2.7%.

Even though schools, stores, restaurants, bars, and retail establishments remain open, and cloth face coverings are not required, recent visitors have reported that many people are observing social-distancing and taking many of the personal protective actions.  Protective measures have been implemented to protect the elderly and the sick.

The actual number of those having recovering from the disease may be far greater than that reported.  A conservative 60% of the population needed to gain herd immunity by being vaccinated or contracting the disease would be 6 million people.  At the current case fatality rate, without a vaccine being available, would result in over 720,000 additional deaths.  Time will tell, but this appears too great a price to pay for not locking down as the rest of the world is doing.

20. Symptoms of COVID-19

Q: What are the currently defined signs and symptoms of COVID-19?

A: Originally, CDC defined three symptoms defining that a person might have COVID-19:

  • Fever
  • Cough
  • Difficulty breathing

Late in April, the CDC added 6 additional symptoms to the list making 9 indicators that a person might have COVI-19:

  • Cough
  • Difficulty breathing (or shortness of breath)

Or at least two of the following:

  • Fever
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell

CDC guidance continued with a list of emergency warning signs indicating a person should call 911:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

When calling 911, notify the operator that you have or think you may have COVID-19, and put on a cloth face covering before medical help arrives.

MOre Covid-19 Frequently Asked Questions

Frequently Asked Questions about COVID-19

  “Shared expectations lead to predictability.”

 

11      Q: What is the best way to sanitize money?

          A:  The consensus is that money is not an important vector of infection for coronavirus-19!  Each sub-microscopic virus particle, called a virion, is 1/10,000 of a millimeter wide.  This is so small it can only be seen using an electron microscope.  If a virion had eyes, which of course it doesn’t, it would find dollar bills quite porous – a honeycomb of spaces between fibers.  There is a greatly reduced concentration of virus on the top surfaces for humans to carry to their mouth, nose or eyes.  In addition, bills placed in ATM machines, have been counted and sorted by machine, and moved in large stacks, greatly minimizing the surfaces any aerosoled virus would contact.

The NIH has defined the viability of virus on cardboard (and paper) as lasting up to 24 hours, and on hard metallic surfaces for up to 3 days.

For people who want to be extremely over-cautious, use a hand sanitizer before and after placing bills into wallets and purses or simply set them safely aside and leave them there for a few days.

For coins, consider leaving them at the store as change for use by others.  If metallic coins are brought home, consider disinfecting them using a bleach solution (1/3 cup of bleach to 1 gallon of water).

Again, it is important to stress the consensus: money is not an important vector of infection for COVID-19. 

 

12      Q: What is the controversy about using an approved drug to treat COVID-19?

          A:  Hydroxychloroquine is also known by the brand name Plaquenil.  It is an established, approved prescription for treatment of malaria and some symptoms of rheumatoid arthritis and autoimmune diseases.  Laboratory testing has indicated the possibility of effectiveness against COVID-19.  But Deborah Birx, MD of the president’s task force has publicly stated that efficacy in test tubes doesn’t mean it will work in humans.

Small human studies in China and France showed conflicting results.   One showed a “good prognosis” and the other showed “no evidence of rapid antiviral clearance or clinical benefit.”  Yet, president Trump repeatedly promotes this medication as a “game-changer.”  On April 3, 2020, the FDA issued an “emergency use authorization” (EUA) for trial testing of the drug as a last resort treatment of COVID-19 patients.

Cited in this EUA are several contraindications including the presence of vision and heart abnormalities, and abnormal liver or kidney functions.

In spite of additional doses of the drug being manufactured for this testing,  there are now shortages available for traditional treatment of rheumatoid arthritis and lupus patients.  Test results have yet to be evaluated.  Politicians have falsely stated this testing “has given good results,” “and even can be used to prevent the disease in hospital workers.”  These are false conclusions because testing is limited to “last resort” use on patients who are near death.  Scientists and experts encourage everyone to wait until clinical trials are over and facts are known.

 

13      Q:  For some time now there has been a promise that a vaccine will be available in from 12 to 18 months.  When did this period start? When can we expect it to be available?

          A  The development of a vaccine for COVID-19 must go through three separate phases of clinical development before it can be approved.  Each requires a minimum time to be completed.  If any negative findings emerge within a step, additional time will be needed to rectify the problems found.

The clock has already started.  Many countries are separately at work to identify treatment and vaccination products.  Any vaccination safely replicates the disease in an individual leading to their immune system generating specific antigens that would be available if the virus later infects the person.

The first challenge is identifying that the trial vaccine is safe.  Can it introduce the disease in a healthy individual without actually infecting them?

The next challenge is to determine if the trial vaccine generates the requisite antigens.

The third phase involves thousands of people given the trial vaccine and evaluating them over months to determine if immunity is actually provided before it is then approved.

Only then will production of the trial vaccine be undertaken over time to produce the hundreds of millions of doses required for the public to receive it.

 

  1. Q: It is widely assumed that someone who has recovered from COVID-19 has immunity and could later safely return to work.  Is this true?

A:   A mid-April finding by the World Health Organization (WHO) puts this assumption in doubt!  Dr. Maria Van Kerkhove, who is the WHO’s technical lead on COVID-19, stated that recent findings evaluating immunity suggest different immunity levels exist from previously infected patients.  “Right now, we don’t have a full picture of what immunity looks like,” Dr. Van Kerkhove said.  “And until we do, we can’t give a complete answer.”

Many of the serology tests being developed are pinprick blood tests that measure raised levels of antibodies used in the body to fight against the virus.  It is now reported there is no evidence that this testing can effectively determine levels of immunity in the population.  “These tests will be able to measure the level of antibodies, but that does not mean that somebody with antibodies is immune.”

And with the lack of a coordinated federal program for testing, many companies are selling testing kits that are not approved by the FDA!  It is suggested that many such kits are giving false negative results – people are identified with antigens that in fact they do not have.

These findings raise questions on developing a safe vaccine that provides immunity.  It cautions that groups should not rush to return to normal assuming those with antibodies can safely return to work.  To do so before science verifies the level of immunity may place these people at risk of suffering a second attack of COVID-19.

Scientists are working now to study this issue of immunity before any vaccine reaches that third phase of testing.

15      Q: I saw something on the Internet that said hair dryers could be used to destroy live virus on objects and surfaces.  Is this true?

  1. There is a lot of misinformation on the Internet and social media.  Hair dryers and several herbs to destroy the virus or reduce the chance of infection are among these.  There are also many scams trying to feed on people’s fears to make money.  Private sale of face masks guaranteed to filter COVID-19 and specific foods and “medicines” guaranteed to prevent symptoms all can be bought with “free delivery” offered as an incentive

Some sites are even falsely using the CDC emblem or logo to mislead the unwary.  Double check any information before you decide to either make purchases, give credit card information, or practice the recommended activities.  For example, one can Google “What is the CDC guideline for using hair dryers?”  After looking at several sites that don’t identify such a guideline, you will actually find one that states this rumor comes from as an unauthorized video and suggests this advice should not be followed!

More Covid-19 — More Frequently Asked Questions

Frequently Asked Questions about COVID-19

  “Shared expectations lead to predictability.”

 06      Q: Why is the 6-foot social distance rule so hard to apply?

A:       We are creatures of habit.  Our environment is organized allowing us to habitually be close to others.  Unless you constantly think about it, this environment will make it difficult to walk and stand among others at a distance.  Some examples include:

  • Most sidewalks are narrow encouraging people to walk side-by side.
  • Store aisles do not allow people to pass with distance between.
  • Floors at checkout counters have restricted space.
  • People standing in line 6 feet apart to enter a building will have others cutting in front of them.

The only answer is to constantly assess each situation and manage risk by standing aside, waiting, or finding other routes to prevent crowding.  Governor Lamont recently stated guidelines for all retail stores to address some of these usual problems of spacing.  Even then, you may discover new problems when shopping.  Thinking about them early will prepare you to react appropriately instead of habitually.  By creating one-way traffic up and down store aisles, passing carts coming the other way can be eliminated.  But we all have found someone ahead blocking the aisle while carefully selecting an item – and we quickly and closely pass by.  Are we now willing to pause and wait?  If we ourselves want to stop to find the right product and people are behind us, are we willing to walk ahead to come back up the aisle so others won’t have to pass us?  If lines are painted on the floor 6 feet apart, how will you react when you find several people ahead of you standing in the one space between lines?  Will you just ignore them and line up behind them anyway?  Or, in case they were unaware of this spacing requirement, would you speak pleasantly to them as a reminder?  Another new recommendation is for stores to limit the number of shoppers to 50% of a store’s total capacity.  Many stores have elected to limit the number to much less – say 30% of even 20% of the usual traffic.  Once inside, if you feel really crowded, would you leave and shop elsewhere?  If you waited outside to get in, would it be harder for you to leave immediately to find a less crowded store?

There is no “right answer.”  But thinking it through, we all can make safer judgements to stop acting out old habits.

07      Q: We hear there are different Covid-19 tests available (or not available!).  Why is this?

A: To effectively manage this pandemic, two different sets of information are required.  These are the presence of live virus in a person, and a later determination that the person has recovered from the disease.

Diagnostic: the “COVID-19 RT-PCR” was the first test we were told about.  This determines if the patient is infected and contagious. A mucous sample is swabbed and taken to a laboratory.  In a series of steps, this sample is tested for the presence of the genetic template that causes the virus to replicate itself inside cells of the infected person.  A genetic map is created of any ribonuclear molecules present.  This map is then compared to the genetic map of a known coronavirus-19 sample.  A positive result shows the person was infected and had live virus cells at the time the sample was taken.  If negative, it does not indicate their future status if they later become infected.  This test in the laboratory takes several hours.  A large batch of samples can be combined, but even then, there’s a long delay to learn of a positive result.

On March 27, 2020, the Food and Drug administration issued an “Emergency Use Authorization” to Abbott Laboratories for trial use limited to hospitals and laboratories of its rapid testing kit, “ID NOW.”.  This test also amplifies the nucleic acid in samples taken, and analyzes if it is specific to the coronavirus-9 pathogen.  But this is done in a small portable unit located at the testing site.  A full laboratory is not required.  Positive results are available in 5 minutes; negative results take longer, up to 13 minutes.  This test is not yet approved, and requires FDA evaluation before it can have widespread public application.

Diagnostic testing is most useful to identify anyone with COVI-19 requiring isolation from those not infected with coronavirus-19.  (Note: the term COVID-19 names the disease caused by the coronavirus-19 virus.)  When tests are not available, all admissions have to be considered highly infectious.  This results in stockpiles of personal protective equipment (PPE) being rapidly depleted.

Diagnostic testing is also required for wide-spread public testing to identify those not showing symptoms but may be shedding virus leading to their being quarantined.

Testing for antigens: The other test is to take a blood sample and test the serum for the antibodies that show the person had previously been infected with coronavirus-19.  This is not used as a diagnostic tool as many tested positive would already have recovered.  This test helps to more accurately identify the population of previously infected patients.  Public health officials can than more accurately map the geographic locations of the epidemic to predict future outbreaks of the disease.  Because of the apparent immunity in those who have recovered from (or “resolved”) their disease, this test would be necessary to identify individuals who might be able to return to work early.

08      Q: It’s so confusing!  First, they tell us not wear facemasks in public unless we are sick.  Now we hear that if we do wear facemasks, it might be helpful?  Why is this?

A: We have all learned that surgical face masks, and the specialized N95 masks protect the wearer from having virus particles reach their nose and mouth. Early on, fearing hoarding by the public, CDC recommended that medical facemasks not be worn by healthy people.

Evidence has increased that infected people “shed” infectious virus particles before they show symptoms.  If these asymptomatic people were wearing a cloth covering over their mouths and noses, the resulting aerosol of infectious spray will be disbursed over shorter distances.  Considerations include:

  • Face coverings do not need to be sterile. Do not use medical facemasks designed for use by healthcare workers!  These are in critical shortage.  You can make your own fabric face covering.
  • Use of face coverings do not substitute for social distancing and washing hands. They only provide the same protection as when among infected people with symptoms who are wearing a face cloth.
  • One advantage is that reaching up to touch the face as a habitual action will touch the cloth, reminding them of this habit without actually touching their mouth or nose.
  • Another advantage is that others may initially assume you are infected and move away making it easier to maintain the 6-foot separation.
  • What do you do if you see someone not wearing a cloth face covering? If they don’t understand its purpose, would you pleasantly remind them they should wear one for your (not their) protection?  Would you speak to someone else nearby wearing one stating your appreciation for protecting others?  This new guideline is hard to reinforce when some of our political leaders have openly stated this is only a recommendation – that they will not personally use a face cloth.  Group reinforcement may help this recommendation become universal.

09      Q: Why do some grocery stores open early and limit shoppers to only those over age 60?

A:  This idea was originated by grocery stores as an idea to encourage older people to feel safe shopping for food.  Many (but not all) stores offer access to stores after the areas have been disinfected overnight.  Also, these early shoppers would avoid being surrounded by a larger group of shoppers of all ages – including children.

There are several issues emerging indicating this might not be such a good idea.

First is the notion that not all stores are following the same procedures.  Most stores may disinfect their shopping cart handles, but some may not.  Other options not universally followed by grocers would be spray disinfecting the aisles, and wiping all counters, open shelving and checkout areas.  Fewer stores will actually disinfect the separate cans, jars and packaged goods on the shelves.

Another concern is the assumption that none of the older shoppers are not infected and shedding virus without showing any symptoms.   This might not be true!  The greater the numbers of older individuals coming in to shop, the denser that group will become.  This places the greater number of people who are at risk of complications in one confined place.

Perhaps the better advice would be simply to let others do the shopping for you.

10      Q: Family members are used to closely sharing space as a group.  How and when should social distancing and continuous hand washing be carried out at home?

A: When living as a family unit, people are used to sharing space, hugging each other, and doing many other activities that place each comfortably in close contact.  It is important to understand that the coronavirus-19 particles do not act differently among families than in the population.  Whenever a member of a family goes out of the house to shop, to work, or do any other activity, the virus will behave the same as if they were a total stranger out there.

For the family member going outside, be rigid in following the standard guidelines.  Keep at least 6 feet away from others.  Whenever possible, wash your hands and use hand sanitizer.  You are not just protecting yourself, but your whole family.  Consider using a cloth face covering and encourage others to do the same to avoid infection from anyone without symptoms.  In an office or other locations where possible, disinfect surfaces (door handles, tables, chairs, computer keyboards, phones, etc.) before touching them.  After leaving, wash your hands and use hand sanitizer.  On returning home, leave outside any packages or shopping bags containing items purchased.  These can be sanitized before being separately brought in.  Once inside, again wash hands or use hand sanitizer, then disinfect all door knobs and surfaces you touched coming in.  Consider washing clothes if you were unable to follow the social-distancing guidelines.

For all family members at home: be patient!  Encourage and support each other to follow the coronavirus-19 guidelines.  Consider the person who is returning from outside as possibly infected.  Washing hands, using hand sanitizer and disinfecting surfaces should not be ignored.  “Old habits are hard to break!”

Covid-19 — More Frequently Asked Questions

Frequently Asked Questions about COVID-19

  “Shared expectations lead to predictability.”

01      Q: How can I protect myself if someone else gets groceries for me?

A: When you or others bring groceries to your home, leave them outside until you are ready to safely disinfect the items.  Remove each product from shopping bags and using a standard disinfectant, wipe or spray the outer surfaces of each plastic, metal or glass product container, leaving the surface appearing “wet” for at least 10 seconds.  Place on a clean disinfected surface.   Pour or dump items such as bread, cereal and crackers in properly cleaned storage containers, safely placing the wrappers and coverings aside.  Thoroughly wash all fruit and vegetables with soap and water for at least 20 seconds.  Valuable suggestions and methods to carry out these important procedures are discussed and demonstrated in this 13-minute video:

https://www.youtube.com/watch?time_continue=4&v=sjDuwc9KBps&feature=emb_logJPhttps://www.youtube.com/watch?time_continue=4&v=sjDuwc9KBps&feature=emb_logo

 02      Q: I sent my family and friends the 13-minute video on safely unpacking groceries.  My son tells me not to do this – it has been debunked.  He sent me back an Internet article saying the CDC does not recommend sanitizing groceries nor does the World Health Organization.  The FDA stated there is no evidence of human or animal food or food packaging being associated with transmission of the coronavirus.  Is this true?

A: It is true that neither the CDC nor the WHO specify groceries in its recommendations for sanitizing.  But that doesn’t mean they recommend not doing it!  They also haven’t specified sanitizing automobile steering wheels, computer keyboards, and tray tables.  But all of these are covered under the broad guideline defining the need to disinfect “surfaces.”  It is also true that the Food and Drug Administration (FDA) has not reported any studies of virus contamination of food.  But the absence of such studies doesn’t prove that food can’t be contaminated.

Following these conclusions that protective actions are not necessary can be quite dangerous.  Consider the following.  A cereal package was handled by a stocking clerk loading store shelves while coughing.  If we believe the scientific fact that this virus remains viable – can infect others – on cardboard for up to 24 hours, why would anyone assume that handling that carton a few hours later at home was safe?  Until proven otherwise, we have to assume that all surfaces can be contaminated by coronavirus-19.

03  Q: How long does coronavirus-19 remain infectious on different surfaces?

A: Many early reports answered this question with widely differing time intervals.  To clarify this scientifically, the National Institute of Health in March 2020 published the definitive answer:

  • “In aerosols for up to 3 hours”; (this refers to airborne particles)
  • “On copper for up to 4 hours”;
  • “On cardboard for up to 24 hours”;
  • “On plastic and stainless steel for up to up to 3 days.”
    • Per previous guidance – all “hard surfaces” are in this above group.)
  • In a related earlier study, similar coronavirus particles remained infectious for 2 years or more when frozen.

These data guides us in how best to schedule disinfecting surfaces.

04  Q: If you send out for prepared meals, should we worry that the delivered food may be contaminated with coronavirus-19 particles?

          A: The safest prepared food to order from others is likely cooked and “served hot” meals.  Have these delivered and left outside with no personal contact.  Remove cardboard or paper containers placing the meals on clean dishes and bring inside.  Wash hands or use hand sanitizer.  Using a microwave, reheat the food until steam is visible.  Heat destroys virus particles.  Cold meals including salads cannot be microwaved, washed with soap and water, or have disinfectant chemicals put on them.  Existing research doesn’t yet provide a definitive answer, but indications are the risk is probably quite low.

05  Q: How did authorities come up with 6 feet as the distance for “social- separation?”

A: We are asked to follow many guidelines, but are given minimal information why these rules were developed.  One leading way infection occurs is by hand contact with the virus on surfaces, then touching the face.  The other common way of transmission is direct contact with the virus suspended in the air.  There is a greater risk of infection when the virus particles are in greater concentration.  We hear that an infected person releases the virus when they exhale the virus “droplets” that come in contact with a healthy person’s mouth or nose.  The term “droplets” can be misleading – it implies visible specks of water that quickly drop to the ground.  A more accurate term is often used: “aerosol” transmission.  Breathe on a mirror, and the invisible aerosol mist appears as a visible patch of condensed moisture.

When anyone infected coughs or sneezes, a denser aerosol spray of microscopic virus particles is discharged over greater distance than when breathing normally.  They float in the air, and drift away becoming increasingly less concentrated over time and distance.  Consider this “thought experiment” (you don’t need to actually do this while shopping!)  Using a spray can of room air freshener, point it away from you and release a short split-second puff of spray.  Imaging walking forward and note how long you can go before you can’t smell the resulting spray.  Next, imagine spraying another short puff into your bent elbow.  Note how closer to you the scent remains – how aerosol particles are more confined in their density and spread.   Imagine that the distance you can smell the aerosol odor as the same distance that coronavirus-19 particles are spread in concentrations that enable them to infect you.

Many situations influence the concentration and spread of this aerosol.  Outdoors, especially when there is a breeze, these distances are nearer the source.  In a living room with the windows closed, they concentration may be farther away.  Rather than asking us to remember and calculate for each situation we may be in, authorities have agreed upon the distance of 6 feet separation as being uniformly safe for different situations.

 

 

Emergency Preparedness #2

#2 ELECTRICAL OUTAGE

Our newly created Emergency Operations Plan defines actions to be taken when a critical situation
occurs on the property. This “all hazards plan” identifies twelve situations that could risk personal
safety or property damage. Each emergency situation is designated as a separate annex with specific
instructions.
DID YOU KNOW?
If the power goes out while people are in the building, it might be caused by our circuit breakers. Did
you know where the two main circuit breakers are located so you can check? One is inside the
storage room off the back of the sanctuary where the chairs and tables are stored. The other is in the
Mechanical Room, opposite the downstairs kitchen. Before entering these areas, check first if there is
smoke coming from behind the doors. An electrical fire could result from a short circuit. Check for
smoke and feel the door to see if it is hot before entering.
DO YOU KNOW WHAT TO DO IF THE ELECTRICAL POWER GOES OUT?
The following procedures are to be followed:
1. If the building is occupied, check to see if the cause is internal and may pose a risk. Check the
circuit breakers to see if there is a short circuit or an electrical fire. Reset the breakers if they
have tripped.
2. If there is an internal safety hazard, call 911.
3. Do not run water (faucets or toilets) to maintain remaining water pressure. The water pump
does not function without power. Check the plan, Annex K: Loss of Water Supply for more
instructions.
4. If an electrical fire is discovered, fire extinguishers can be used by a person trained in their
use.
5. If smoke or fire is found evacuate the building after pulling the fire alarm.
6. Close all doors and windows.
7. If the outage is throughout the neighborhood or community, notify the power company, and
then the sexton.

We Can Make Home Made Face Masks for Medical Workers

Have time to sew? Have the requisite materials on hand?

As we’ve been hearing on the news, medical providers are running low on personal protective equipment due to the surge in Covid19 cases. The shortages include face masks. If you have time to sew, and if you have the requisite materials on hand, please consider producing face masks.

If you produce some face masks but aren’t sure what to do with them, let Rev. Josh know at (860) 652-8961.