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Frequently Asked Questions about COVID-19

07/07/20 by

Shared expectations lead to predictability.

61. Coronavirus-19 Mutations

Q: Have any mutations been detected in coronavirus-19?

A: In 1918, when The Great Influenza Pandemic first emerged, those who contracted the disease were mildly affected. During the 1919 second wave when it returned to the US, the fatality rate was very much higher. Scientists learned that the virus had mutated as it spread around the world. This history has caused today’s scientists to critically look for this possibility with coronavirus-19. A recent U.S. study by Scripps Research has identified one mutation that has occurred. This mutation has resulted in an increase in the number of “spikes” on the surface of each single virus particle called a virion. “The number of functional spikes on the virus is 4 or 5 times greater due to this mutation,” said Hyeryun Choe, a senior researcher. The spikes are the structures that allow the virion to enter host cells to reproduce – causing the person to become infected. It appears that this mutation increases the rate of infection – the ease with which the disease can be passed from one person to another. This research may explain why early outbreaks in some parts of the world did not overwhelm hospitals and health systems as much as others, such as Italy and New York. Concern is growing that this mutation is becoming the dominant agent of infection over time. This study has been presented for peer-review publication and advance notice has been given to encourage further research efforts. Other mutation studies are underway around the world and have already found different mutations. Future studies will focus on increased disease severity, mortality, and resistance to antibodies resulting from other mutations.

62. Latest on vaccine development – China

Q: Everyone is focused on having a vaccine. Are other countries at work on this?

A: Concern has recently been expressed over a recent report in the Philippine newspaper The Manila Times that China is widely testing one of its new vaccines. The article stated that the World Health Organization has identified 17 candidate vaccinations of which more than half involve Chinese companies or organizations. The specific vaccine being reported was developed by CanSino Biologies jointly with the Chinese Academy of Military Medical Sciences. It is claimed to have a “good safety profile” and a potential to prevent the disease caused by coronavirus-19. The current third phase testing has been authorized by China’s Central Military Commission for a period of up to one year and may include all members of the extensive Chinese military before testing is concluded. The report stated, “Its use cannot be expanded without further approvals.” The Chinese Military Defense authorities have refused reporters’ questions for clarification. The newspaper also reported, “CanSino added that it cannot guarantee the vaccine will ultimately be commercialized.”

All of this has led to widespread speculation that China’s strategy is to increase its military’s immunity from the disease without allowing the vaccine to be used by other country’s military leaders. It also raises the economic benefit to China if it can sell to others at a monopoly-level expanded price. The military and economic impact on international relations could be tremendous.

63. Fraud alert: scam contact tracing

Q: I received a call telling me I was in contact with someone who tested positive. I was asked to state my Medicare Number to verify that I was the person contacted. Is this appropriate?

A: A recent warning was released jointly by the US Department of Justice the US Health and Human Services and the US Trade Commission. “COVID-19 fraud is rapidly expanding. Operating contact tracing schemes is just one method that criminals use to target unsuspecting patients nationwide, attempting to steal their personal information and commit healthcare fraud,” said HHS Deputy Inspector General for Investigations Gary Cantrell, Asking for Medicare or Social Security Numbers is not part of legitimate contact tracing.

64. Mitigation processes in North Central Connecticut

Q. Is there a relationship between federal mitigation efforts and local officials?

A. In Connecticut, planning for disaster and emergencies since 2007 has been facilitated by five designated regions. Unlike most other states, Connecticut has no county government, and these five regions were created to be the focus for coordinating local programs and resources under the state-level program. The north-central region is called the Capitol Region Emergency Planning Council (CREPC). This region is made up of 41 towns centered around Hartford. The current pandemic is considered a health emergency, and each level of government (local, regional, state, and federal) have emergency management sections organized to lead specific responses. Thus, within the region in which Manchester, Vernon, Ellington, Hartford, and 37 other towns belong, the health and medical section has identified the local needs for personal protective equipment (PPE).” This includes face masks, gloves and gowns. The needs of hospitals, nursing homes, local health departments, and ambulance providers in the 41 towns and cities were included. This information is then sent to the state level Division of Emergency Management and Homeland Security (DEMHS). The state then consolidates the requests for all five regions and gives it to the national-level FEMA (Federal Emergency Management Agency). This is an elaborate, but familiar system for those who frequently use it to manage disasters.

In a recent report from the north-central Connecticut emergency planning group (CREPC), the following information was provided: “The regional distribution center in West Hartford was opened on March 25 and operates every Tuesday, Wednesday, and Thursday. The site continues to receive, stage, and distribute personal protective equipment (PPE) as it becomes available.” Trained volunteers and staff members from various towns and organizations organize the logistics of sorting and loading allocated supplies onto vehicles sent by the different local groups requesting these items. “Last week… we distributed 2.7 million pieces of PPE to first responder (fire, police, and EMS) agencies within the 41 communities, 99 long term care and assisted living (nursing home) facilities, and 37 home care and hospice agencies.” (In addition,) to date there have been 1.07 million pieces of PPE distributed to the 14 local public health agencies in (North Central Connecticut) Region 3.”

It is significant to note that many local people, groups, and agencies are effectively at work in Connecticut positively contributing to successful mitigation efforts during this pandemic.

65. “and one more thing…”

Q: What are some of the other coronavirus-19 bits of information people are talking about?

A: First, Crisis Standard of Care: When hospital capacity cannot meet the increasing demands of people in need, the usual standard of care cannot be provided.

  • In Texas, it was reported last week that ambulances bringing in COVID, as well as trauma, cardiac and other patients, are being held in the parking lot outside the emergency department entrance before the crew can bring the patient inside to be seen by a physician. This wait sometimes takes more than an hour, delaying medical care as well as tying up the ambulance from being available for other calls. This, with an increasing number of EMTs and paramedics becoming infected reduces the EMS responder’s ability to respond to other calls and the level of pre-hospital care available to a community.
  • In other jurisdictions, it is reported that ambulance crews responding to patients who are in cardiac arrest are directed not to perform CPR. Instead, they are to make themselves available for other calls. As a result, it will be up to the family or others calling 911 to arrange for the removal of the body.

Secondly, Waiver of liability at colleges: Heidi Li Feildman, a law professor at Georgetown University, published a column in the Los Angeles Times (reprinted in the July 2 edition of the local Journal Inquirer). She strongly urges readers to NOT to sign any COVID-19 waiver of liability for students entering college. From the college’s viewpoint, such waivers protect against possibly expensive judgments that could threaten the future of the institution. But Heidi points out that “the technical term for this sort of defense is “primary assumption of risk.” This prevents lawsuits from even being considered when the college fails to conform to CDC and other standards of prevention. This in turn may reduce the vigilance of college officials to strictly enforce appropriate standards. Heidi concludes, “under no circumstances should anyone sign a waiver for harm inflicted by COVID-19 caused by their college’s policies.” It could be said the same advice should apply to waivers requested by any group or agency providing a service to the consumer.

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More Frequently Asked Questions about Covid-19

04/28/20 by

  “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.

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MOre Covid-19 Frequently Asked Questions

04/21/20 by

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!

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More Covid-19 — More Frequently Asked Questions

04/14/20 by

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!”

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We Can Make Face Masks #2

04/09/20 by
Last weekend a number of UUS:E members dropped off homemade face masks in the bin outside the entrance to the UUS:E office. On Monday, UUS:E member Pamela Johnson brought the face masks to Hartford Hospital where she works. She reported back:
They were HUGELY appreciated!!  There is already a shortage in some areas and they went like hot cakes.  I work next to the Covid 19 testing center and delivered them directly to the manager there…. These masks are soooooooooooo appreciated!  Please, if you have it in you, continue to make them.  I will continue to deliver as I have to work in the hospital about 1 day a week.  I’m trying to stay away but it’s a busy time for research. Thank you again so very much! — Pamela
(Pamela also sent along these photos of Hartford Hospital staff  wearing our donated face masks.)
If you are making face masks and you’d like to donate them to Hartford Hospital, please know you can drop them during the week in the bin outside the entrance to the UUS:E office.  They will be picked up at 3:00 on Sunday afternoons.
Furthermore, if you yourself are in need of a homemade face mask, some of the UUS:E sewers are willing to send one or two to you. Contact Rev. Josh at his home office (listed in the UUS:E Directory) and we can get a face mask to you!
Filed Under: Previous Events Tagged With: ,

Covid-19 — More Frequently Asked Questions

04/07/20 by

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_log —JPhttps://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.

 

 

Filed Under: Emergency Preparedness Tagged With: , , , , , , , , ,