1,279 Matching Annotations
  1. Last 7 days
    1. Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19.

      Public health departments world wide are failing.

    2. Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden.

      The cure is worse than the disease.

    1. The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use.

      The takeaway: While minimal protection occurs when a mask is worn in a place where many others are not wearing a mask, community masking is associated with a reduction in COVID cases.

      The claim: In a community with modest infection rates, some social distancing, and most people not wearing masks, wearing a surgical mask did not reduce the SARS-CoV-2 infection rate by more than 50%.

      The evidence: This study showed that wearing a mask in a community where most people did not wear a mask, did not reduce the risk of getting infected by 50%. Fewer COVID infections were reported in the mask group than in the unmasked group. This study agrees with a meta analysis which showed that masks resulted in a decrease in infections but did not prevent all infections (1) According to the CDC, seven studies have shown community level benefit when masking recommendations were made (2).

      When most in the community are not wearing masks, social distancing, and washing hands, wearing a mask alone provides minimal protection to the mask wearer. Community wide masking is associated with a reduction in COVID cases (2).


      1) https://pubmed.ncbi.nlm.nih.gov/29140516/

      2) https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html

    1. Study of patients attending a hospital-based obesity service shows no difference in weight loss between those under 60 years old and those from 60 to 78 years old The University of Warwick-led study conducted at University Hospitals Coventry and Warwickshire (UHCW) concludes that lifestyle changes to manage weight loss are effective in reducing obesity regardless of age Aims to dispel myths about effectiveness of weight loss in older people
      • Researchers studied 242 patients (under 60 and over 60 years old) who attended a weight-loss programme, most of them morbidly obese.
      • Results show no differences between age groups, proving that weight loss is as important for older people - even more so - as for younger people.
      • The programme was based on lifestyle-based changes - diet, physical activity and psychological support - and showed similar results regardless of age.
      • People often don’t care about weight loss in older people, and this study shows that it’s a very harmful perspective to adopt.
    1. Human ageing reversed in ‘Holy Grail’ study, scientists say
      • Clinical trial with 35 people over 64 years old shows that oxygen therapy can reverse two key indicators of biological ageing - telomere length, and senescent cells.
      • Telomeres are protective caps at the end of chromosomes, and senescent cells are malfunctioning, old cells.
      • Patients were placed in a pressurised chamber and given pure oxygen for 90 minutes a day, 5 days a week, for 3 months.
      • At the end, telomere length increased by 20% on average, and senescent cells were reduced by 37% - equivalent to a 25 years younger biological-cellular state.
      • The results are incomparable to lifestyle changes / exercise / diets, and researchers say it’s thanks to inducing cell regeneration through hypoxia (oxygen shortage).
  2. Nov 2020
    1. You can find your mental health triggers by beginning a thought diary

      A Thought Diary will help you find triggers when you write down things that went wrong and your accompanying feelings.

      An example would be how not meeting a deadline made you feel. What happened right after you realized you didn't meet the deadline?

    2. The best course of action is to discreetly arrange a one-to-one meeting, and sensitively explore how he’s feeling. It can be useful to write a wellness action plan together. This is a document in which the employee writes down information about the mental-health problems he’s experiencing, and what triggers exist in his workplace that contribute to these feelings. You can then draw up a strategy together for how to help him improve his mental health in the workplace, and make a list of actions that both of you can take to help get him back on track.

      A manager can sit down with the affected employee and write an wellness action plan. This will include:

      • Employee's mental health problems
      • Triggers within the workplace
      • A strategy to work together with employee to help them improve in the workplace.
      • A list of actions that can be done. e.g. Counseling, reduce working time, set limits with coworkers
    1. Anxiety From Reactions to Covid-19 Will Destroy At Least Seven Times More Years of Life Than Can Be Saved by Lockdowns

      Take away: Though the number of COVID deaths prevented and the exact number of years lost due directly to decreases in mental health from lockdowns is at best a rough estimate, several facts are known. Lockdowns decrease mental health, and a decrease in mental health shortens lives too.

      The claim: Anxiety from reactions to COVID-19 will destroy at least seven times more years of life than can be saved by lockdowns.

      The evidence: This article references many studies detailing the anxiety surrounding COVID-19 (1-4). These studies indicate that many people have increased stress due to COVID. Nature Public Health Emergency Collection reports that the mental health cost of widespread lockdowns may negate the lives saved by this policy (5). This article lists many articles which describe the effect of stay-at-home orders on mental health. Additionally, the effect of poor mental health on physical outcomes is well-defined. Poor mental health shortens lives. Other factors with COVID such as negative media coverage and dealing with job loss and death are also described as negatively affecting mental health. It is unclear how much of the negative mental health outcomes is directly related to lockdowns and what is contributed to the disease, job loss, future uncertainty, and continuous media coverage.

      Several supporting facts used in this article are now outdated or could use clarification. Many assumptions are detailed in this article to estimate the number of years lost due to mental harm caused by lockdowns. One example is the authors used a survey of 1,266 patients to estimate the number of people in the United States who have suffered mental harm from lockdowns. These estimates are challenging to conclusively verify. The authors did choose the conservative estimate for each of their numbers. One example of an outdated number is the predicted number of deaths was 114,228 by August 4th. The actual number of deaths per Johns Hopkins was 157,500 (6).

      Based on the facts, anxiety and mental disorders can be deadly. Lockdowns result in an increase in poor mental health. The exact number of years lost due to poor mental health directly resulting from lockdowns is less clear. Poor mental health may also result from constant media coverage, loss of loved ones and fear of the future.

      The sources:

      1) https://www.psychiatry.org/newsroom/news-releases/new-poll-covid-19-impacting-mental-well-being-americans-feeling-anxious-especially-for-loved-ones-older-adults-are-less-anxious

      2) https://www.kff.org/health-reform/report/kff-health-tracking-poll-early-april-2020/

      3) https://www.bsgco.com/post/coronavirus-and-americans-mental-health-insights-from-bsg-s-pulse-of-america-poll

      4) https://www.kff.org/report-section/kff-health-tracking-poll-late-april-2020-economic-and-mental-health-impacts-of-coronavirus/

      5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431738/#

      6) https://coronavirus.jhu.edu/us-map

    1. Refactoring at scale is challenging and a significant investment, so communicating the progress is important both from a business perspective but also as a motivational effect to developers. In this case we used a combination of complexity trend visualizations and Code Health Metric as shown in the preceding example.

      [[refactoring at scale]]

    1. 3. They're fighting misinformation.

      Agree or disagree with how they obtained info and what that means for digital rights; how much the Chinese government informed or not their people - this is what China did in terms of alerting their population of covid cases.

    1. mink are now considered a public health risk

      Takeaway: Mink are capable of contracting and transmitting SARS-CoV-2 to each other and to humans which had resulted in mutated SARS-CoV-2.

      The claim: Mink are now considered a public health risk.

      The evidence: SARS-CoV-2 infects and kills mink (1). The lung damage in mink from SARS-CoV-2 is similar to the damage in human lungs from SARS-CoV-2. The range of symptoms from asymptomatic to deadly is exhibited by the mink. Based on this pre-print article, SARS-CoV-2 is mutating in mink farms and had documented transmission from mink to humans (2).

      Extensive sequencing of SARS-CoV-2 genomes has been done (3). Mutations tend to occur in certain hot spots of the genome. The stated purpose of the sequencing research is to identify relatively stable parts of the genome to use as vaccine targets to help avoid mutant escape. The genomes of SARS-CoV-2 from mink infections had more nucleotide differences than SARS-CoV-2 from human COVID outbreaks (2). This may be due to a faster mutation rate or to the fact that so many mink were infected.


      1) https://journals.sagepub.com/doi/10.1177/0300985820943535?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&

      2) https://www.biorxiv.org/content/10.1101/2020.09.01.277152v1

      3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199730/

  3. Oct 2020
    1. We found that those medications, some of them at least 40 years past their manufacture date, still retained full potency
    1. Experts say closing borders early and tightly regulating travel have gone a long way toward fighting the virus. Other factors include rigorous contact tracing, technology-enforced quarantine and universal mask wearing. Further, Taiwan’s deadly experience with SARS has scared people into compliance.

      The Takeaway: The combination of closing borders, tightly regulating travel, effective quarantine of all exposed people using cell phone data for enforcement, and universal mask wearing contributed to effectively keeping COVID-19 from infecting most of Taiwan's population.

      The claim: Closing borders early, tightly regulating travel, contact tracing, technology-enforced quarantine, universal mask wearing, and Taiwan's previous deadly experience with SARS resulted in control of SARS-CoV-2 in Taiwan.

      The evidence: The earlier COVID-19 cases are stopped from entering a country, the fewer cases will be present to spread the disease to others. To illustrate, it is easier to stop a trickle of water than to try to dam up a flood and easier to extinguish a candle than a forest fire. Taiwan closed its borders on January 23rd, 2020 (1). The Philippines closed their borders on February 2nd, 2020 (2). Tightly regulating travel will help to stop cases before they enter the country. Effective quarantining the few cases and contacts of the cases which do enter a country is critical to preventing the spread of the disease within the country. Taiwan used mobile telephone data to enforce quarantine (1). Without quarantine, each infected person will spread COVID-19 to 2-6 additional people based on the R0 (3, 4). Universal masking will help slow the spread of disease (5). Previous experience with controlling a deadly disease will most likely increase compliance to methods to control the disease.

      Per Our World in Data website, Taiwan had one of the least stringent government responses to COVID-19 (6). The biweekly number of COVID-19 cases in Taiwan was 23 on October 29, 2020 (7). Neighboring countries had biweekly COVID-19 cases of 372 (China), 28,644 (Philippines), 11,871 (Malaysia), 51 (Vietnam), and 8,142 (Japan). These neighboring countries had more stringent government responses to COVID-19 (6).


      1) https://focustaiwan.tw/society/202001230011


      3) https://pubmed.ncbi.nlm.nih.gov/32234343/

      4) https://pubmed.ncbi.nlm.nih.gov/32097725/

      5) https://www.nature.com/articles/s41591-020-1132-9#annotations:7jRWRheWEeuY8x_rXDuRjg

      6) https://ourworldindata.org/grapher/covid-stringency-index

      7) https://ourworldindata.org/grapher/biweekly-confirmed-covid-19-cases

    1. Structural Racism as SDH: -Examples: 1) Home Health workers not eligible for paid leave causing disproportionate harm when injured 2) Nursing Home: SSA funded private long term care for the elderly and prohibited funding for institutions for AA individuals Laws 1) Often don't address root causes. For example, anti-discrimination laws legitimizes existing structures

    1. But that could be a drop in the ocean compared to the humanitarian fallout. “We’ve seen 400,000 die from COVID-19,” David Beasley, the Executive Director of the World Food Programme, warned in June. “We could see 300,000 die a day, for several months, if we don’t handle this right.”

      Take away: The humanitarian fallout from prolonged lockdowns to control COVID-19 could be worse than the deaths due to COVID-19.

      The claim: The humanitarian fallout from COVID-19 could be worse than the deaths caused directly by the disease.

      The evidence: Food supply chains have been disrupted due to COVID-19 (1). The World Health Organization predicts that 130 million additional people could become chronically hungry due to COVID-19 (2). Per the International Labor Organization, 1.6 billion workers have the prospect of their employment destroyed, at least partially due to the prolonged lockdowns (3).

      “For millions of workers, no income means no food, no security and no future. [...] As the pandemic and the jobs crisis evolve, the need to protect the most vulnerable becomes even more urgent."

      Guy Ryder, ILO Director-General

      A number of socio-economic consequences have resulted from COVID-19 lock-down measures to control the virus (4). 900 million learners are affected by lockdowns which results in high risk children lacking access to free meals provided by school systems, drop out rates, and social isolation/mental health (4). Affects have been seen in the agricultural, manufacturing, petroleum and oil, finance industry, travel and aviation industry, hospitality, and others (4).

      Considering the drastic increase in job loss with resulting hunger from financial instability and other social-economic factors resulting from lock-downs, the fall out from prolonged lockdowns to control COVID-19 will most likely be worse than the number of deaths due to COVID-19 directly.

      Disclaimer: This annotation is not intended to downplay the seriousness of COVID-19. Rather it is intended to put the seriousness of the disease in context of other problems that are resulting from measures to control COVID-19.


      1) https://www.nature.com/articles/d41586-020-01181-3

      2) https://www.who.int/news/item/13-07-2020-as-more-go-hungry-and-malnutrition-persists-achieving-zero-hunger-by-2030-in-doubt-un-report-warns#:~:text=Across%20the%20planet%2C%20the%20report,by%20the%20end%20of%202020.&text=further%20at%20times.)-,The%20State%20of%20Food%20Security%20and%20Nutrition%20in%20the%20World,towards%20ending%20hunger%20and%20malnutrition.

      3) https://www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_743036/lang--en/index.htm

      4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162753/

    1. 50 percent effective

      Take away: Cloth face masks filter approximately 50% of bacteriophage five times smaller than one SARS-CoV-2 virus. Therefore it is reasonable to assume that masks, including cloth masks, are 50% effective.

      The claim: Masks are assumed to be 50% effective.

      The evidence: Face masks, including home made face masks, were shown to reduce aerosol exposure (1). Masks made from various materials were shown to filter 50-68% of Bacteriophage CS2 which is 20 nm (2). When NaCl aerosols were used instead of a bacteriophage, penetration by NaCl occurred 9-98% of the time depending on the size of the particles (3). Two well written reviews detail the efficacy of facemasks (4, 5). SARS-CoV-2 virus is ~100 nm in size (6).

      Sources: 1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/

      2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108646/

      3 https://academic.oup.com/annweh/article/54/7/789/202744

      4 https://www.preprints.org/manuscript/202004.0203/v1

      5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7497125/#ref23

      6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7224694/#:~:text=SARS%2DCoV%2D2%20is%20an,they%20do%20more%20than%20that.

    1. Daydreaming at Work Can Fuel Creativity

      Summary of the article:

      • We spend nearly half of each day daydreaming, and usually think that it’s a bad thing, but it turns out that highly demanding tasks make us daydream more.
      • It allows us to turn off our surroundings, and can be a way of imagining solutions to the problem at hand.
      • To find this out, researchers did two studies of employees and managers in South America, including mainly surveys about daydreaming.
      • Daydreaming turned out to happen more when the tasks required a lot of focus - it can boost creative problem-solving as long as we’re personally invested in our work.
      • However, for people who don’t identify with their work, daydreaming was linked to worse performance.
    1. In comparison, the ratio is approximately 2.5 times greater than the estimated IFR for seasonal influenza

      Take away:

      If correct numerators and denominators are used, COVID-19 is at least 10 times as deadly as seasonal influenza.

      The claim:

      The Infection Fatality Ratio for COVID-19 is “approximately 2.5 times higher than the estimated IFR for seasonal influenza.”

      The evidence:

      Blackburn et al. report an infection fatality ratio among community-living adults of 0.26% (1). If institutionalized adults had been included the ratio would be higher, likely approximating the 0.6% mortality rate among exposed individuals readily calculated by combining official death tolls, the known 30% undercount (2), and a definitive CDC study that found 10 times as many people have been exposed to the novel coronavirus than are reported as cases (3). Among the elderly, Blackburn et al. calculate COVID-19 is 2.5 times deadlier than seasonal flu. This is clearly an underestimate:

      1) Blackburn et al. use CDC estimates of case-fatality rates calculated on the basis of all Americans, including the institutionalized, not limited to much healthier community-dwellers.

      2) The seasonal influenza case fatality rates reported by the CDC, including the often cited 0.1% overall, are for symptomatic cases. Their denominators are estimated by using the reported number of influenza hospitalizations to guess the burden of clinical illness (4). But antibody studies show that 65%-85% of people infected with influenza never develop symptoms (5). The 0.6% mortality rate calculated here for SARS-CoV-2-exposed individuals is 6 times higher than the 0.1% usually cited for seasonal influenza. Given the overestimation of commonly accepted influenza mortality rates due to failure to take asymptomatic infections into account, SARS-CoV-2 can be seen to be not 2.5 times, or even 6 times, but at least 10 times as lethal as seasonal flu.


      1 http://www.acpjournals.org/doi/10.7326/M20-5352

      2 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767980

      3 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768834

      4 https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm

      5 https://pubmed.ncbi.nlm.nih.gov/26133025/

    1. A 2016 Lancet study found that universal breast-feeding would prevent 800,000 child deaths a year across the globe and yield $300 billion in savings from reduced health care costs and improved economic outcomes for those reared on breast milk.

      Pure corruption here. Protectionism to prop up profits of approximately 630 million versus major benefits and savings of 300 billion. Even if you look at the calculus of the entire industry of 70 billion it becomes a no brainer.

    1. She reached behind her to her bookshelf, which held about a dozen blue bottles of something called Real Water, which is not stripped of “valuable electrons,” which supposedly creates free radicals something something from the body’s cells.

      I question her credibility to market claims like this. I suspect she has no staff scientist or people with the sort of background to make such claims. Even snake oil salesmen like Dr. Oz are pointedly putting us in hands way too make a buck.

    1. Bad economic times could lead to deaths of people with low income who are most vulnerable to an economic downturn.

      This is the most likely place that governments and the richer ruling elites are likely to fail their societies. Even the United States is like to do this and one need look no further than their response to the hurricane aftermath in Puerto Rico to see this.

    1. many Indians continue to defecate in the open. Bangladesh’s government and charities have built latrines, too, but they have worked harder to stigmatise open defecation. Often they install latrines for the poor and then prod richer folk into following their example. A new, surprising, finding is that this works better than expecting people to copy their social superiors.
    2. Many lives have been saved by parents doing something simple. Beginning in the 1960s American military doctors and researchers in Dhaka developed a therapy for acute diarrhoea—a sweet, salty oral rehydration solution. This is now dirt cheap and widely available. At the last count, fully 84% of Bangladeshi parents with stricken children fed it to them (only a third saw a doctor). Thinly populated African countries are struggling to match that. One promising idea is to distribute the sachets along with Coca-Cola—which gets everywhere.

      amazing the reach of Coca-Cola!

    1. To find a cure for what ails America, Chetty will need to understand all of this wild variation. Which factors foster opportunity, and which impede it? The next step will be to find local interventions that can address these factors—and to prove, with experimental trials, that the interventions work

      I suspect that racial inequalities like Redlining, school support, and public housing issues (including evictions and predatory lending) will overlay these unmobile areas. cf Scarlet E series from On the Media.

    1. How this phenomenon translates into absolute, rather than relative, risk, however, is a bit thorny. A large study published in 2018, for instance, found that among women who had children between 34 and 47, 2.2 percent developed breast cancer within three to seven years after they gave birth (among women who never had children, the rate was 1.9 percent). Over all, according to the American Cancer Society, women between 40 and 49 have a 1.5 percent chance of developing breast cancer.

      The rates here are so low as to be nearly negligible on their face. Why bother reporting it?

    1. They’re mostly things that everyone was supposed to be doing all along, such as ensuring that bathrooms have exhaust fans and that air filters are changed regularly and of high-enough quality to catch the virus. That means they should be high-efficiency particulate air (HEPA) filters or MERV-rated 13 or 14, which are essentially the N-95 masks of air filters.
    2. During the SARS coronavirus outbreak, in 2003, a cluster of cases in Hong Kong was attributed to one person with diarrhea in a poorly ventilated apartment building.

      toilet plume, two words everyone just loves!

    1. “We ought to have a social compact: If you’re sick, whether you’ve got Covid-19 or not, you should separate yourself from society,” Mr. Gostin said. “That’s your part of the bargain, you’re doing it for your neighbors, your family and your community.”“In exchange,” he said, “we as a nation owe you the right to a humane period of separation, where we meet your essential needs like medicine, health care, food and sick pay.”
    1. Reporting on a study at Queensborough Community College, also in the CUNY system, Sheila Beck notes that the library’s reserve textbook collection is “heavily used,” however, staffing and other concerns have prompted librarians to consider “less labor intensive and less costly alternatives.“ Beyond textbook reserves, academic librarians can help students to locate required course readings in other ways: older editions of their required textbook, pre- or post-prints of articles in institutional repositories, articles or other texts in databases subscribed to by the library, or readings that may be in the public domain or otherwise available on the open web.

      The basic economics of this system would indicate (especially as classes become larger and larger) that more careful consideration of choice, economics, accessibility, availability, etc. on a larger institutional level creates larger marginal gains for those in the class. If a staff librarian, teacher, or someone else within the system does the leg-work up front and does it well, then the dozens or even hundreds of students in the course don't need to spend (read: waste) their own time re-inventing the proverbial textbook wheel once they're in the class.

      Portions of the situation here make me wonder if we might pull a page from Dr. Peter Pronovost's playbook in the health care space and create a simple checklist of what to do when planning for textbooks and readings. Checklists that include things like:

      • will the texts actually be used?
      • will they be primary to the subject or are they supplementary?
      • What are their prices?
      • Are alternate materials available?
      • Are older editions available?
      • are public domain or open web versions available?
      • are there copies in the library? reserves? pirated versions? pre/post prints?
      • etc.

      Once such a checklist is available, institutions should require that it be available along with syllabi and other course listings.

      cross references:

    1. A scientific review of the science behind lockdown concludes the policy was a MISTAKE & will have caused MORE deaths from Covid-19

      Take Away: The new scientific paper confirms earlier modeling work and should not be interpreted as a detailed prediction for future deaths due to the ongoing pandemic.

      The Claim: "A scientific review of the science behind lockdown concludes the policy was a MISTAKE & will have caused MORE deaths from Covid-19"

      The Evidence: The scientific process involves replication and confirmation of experiments and studies. A new paper replicates and expands on an early modeling study of the COVID-19 pandemic in England (1). Their findings support the earlier results. However, there are limitations to the replication paper, which does not accurately reflect the current state of the pandemic response and does not make detailed predictions for a second wave of infections and deaths.

      A recent expert response to the paper further explains (2):

      "It needs to be stressed that all the simulations assume that interventions are only in place for 3 months (18th April – 18th July) and then completely relaxed. This gives rise to a strange set of scenarios where a second wave is allowed to progress in an uncontrolled manner."

      “It is this that leads to the counter-intuitive headline finding “that school closures would result in more overall covid-19 deaths than no school closures” – actually what the authors find is that a short period of intense lock-down (including the closure of schools) leads to a large second wave if it is allowed to run with no controls. To be fair the authors do highlight this in the paper, but it is not in the reported press release." -Prof Matt Keeling, Professor of Populations and Disease, University of Warwick


      (1) https://www.bmj.com/content/371/bmj.m3588

      (2) https://www.sciencemediacentre.org/expert-reaction-to-reanalysis-of-model-used-for-imperial-report-9-and-impact-of-school-closures/

    1. The model predicted that school closures and isolation of younger people would increase the total number of deaths, albeit postponed to a second and subsequent waves. The findings of this study suggest that prompt interventions were shown to be highly effective at reducing peak demand for intensive care unit (ICU) beds but also prolong the epidemic, in some cases resulting in more deaths long term. This happens because covid-19 related mortality is highly skewed towards older age groups. In the absence of an effective vaccination programme, none of the proposed mitigation strategies in the UK would reduce the predicted total number of deaths below 200 000.

      Take away: This model excludes the possibility of vaccination. As many vaccines are in stage three clinical trials, the conclusion that more people will die from closing schools, etc. will most likely not be realized.

      The claim: School closures and isolation of younger people will increase total number of deaths from second and subsequent waves of COVID-19 when restrictions are lifted.

      The evidence: This model predicts more deaths from the combination of place closures such as schools, case isolations, household quarantine, and social distancing of over 70s than for the combination of case isolation, household quarantine, and social distancing for over 70s. The majority of the deaths for the combination of place closures, case isolations, household quarantine, and social distancing of over 70s occur once the restrictions are lifted. This model excludes the possibility of a vaccine reducing the size of the second wave.

      At least ten companies have a COVID-19 vaccine in the final stage (Phase III) of clinical trials (1). Therefore a model which excludes vaccination will most likely not be accurate to reality once a vaccine is widely administered.


      1 https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines

    1. CDC reverses course on testing for asymptomatic people who had Covid-19 contact

      Take Away

      Transmission of viable SARS-CoV-2 RNA can occur even from an infected but asymptomatic individual. Some people never become symptomatic. That group usually becomes non-infectious after 14 days from initial infection. For persons displaying symptoms , the SARS-CoV-2 RNA can be detected for 1 to 2 days prior to symptomatology. (1)

      The Claim

      Asymptomatic people who had SARS-CoV-2 contact should be tested.

      The Evidence

      Yes, this is a reversal of August 2020 advice. What is the importance of asymptomatic testing?

      Studies show that asymptomatic individuals have infected others prior to displaying symptoms. (1)

      According to the CDC’s September 10th 2020 update approximately 40% of infected Americans are asymptomatic at time of testing. Those persons are still contagious and are estimated to have already transmitted the virus to some of their close contacts. (2)

      In a report appearing in the July 2020 Journal of Medical Virology, 15.6% of SARS-CoV-2 positive patients in China are asymptomatic at time of testing. (3)

      Asymptomatic infection also varies by age group as older persons often have more comorbidities causing them to be susceptible to displaying symptoms earlier. A larger percentage of children remain asymptomatic but are still able to transmit the virus to their contacts. (1) (3)

      Transmission modes

      Droplet transmission is the primary proven mode of transmission of the SARS-CoV-2 virus, although it is believed that touching a contaminated surface then touching mucous membranes, for example, the mouth and nose can also serve to transmit the virus. (1)

      It is still unclear how big or small a dose of exposure to viable viral particles is needed for transmission; more research is needed to elucidate this. (1)


      (1) https://www.who.int/news- room/commentaries/detail/transmission-of-sars-cov-2- implications-for-infection-prevention-precautions

      (2) https://www.cdc.gov/coronavirus/2019- ncov/hcp/planning-scenarios.html

      (3) He J, Guo Y, Mao R, Zhang J. Proportion of asymptomatic coronavirus disease 2019: A systematic review and metaanalysis. J Med Virol. 2020;1– 11.https://doi.org/10.1002/jmv.26326

    1. Multiply that number by 85 percent to roughly approximate an effort cap for easy runs (though adjusting to a different percentage if you feel like that’s a bit too hard or too easy).

      Another article suggests subtracting 20bpm