488 Matching Annotations
  1. Last 7 days
    1. Science says the risk of transmission outdoors is roughly 20 times lower than it is inside.Even a faint breeze helps to disperse most virus particles that hang in the air.The risk is low, but it's not zero.
  2. Dec 2020
    1. Bu Experts {@BU Experts} (2020) How can we navigate daily life during the pandemic? #Publichealth expert & epidemiologist @EpiEllie will be on @reddit_AMA this Thursday (8/27) at 12pm ET to answer all of your #COVID19-related questions. She'll discuss how to safely see friends and family, travel & more. @BUSPH. Twitter. Retrieved from: https://twitter.com/BUexperts/status/1297932614909792258

    1. When they did pay attention, they invariably blamed the victims — their “unhealthy” behaviors and diets, their genes, the under-resourced neighborhoods they “chose” to live in and the low-paying jobs they “chose” to work. Their chronic illnesses were seen as failures of personal responsibility. Their shorter life expectancy was written off to addiction and the myth of “black-on-black” violence. Many of those arguments were legacies of the slave and Jim Crow eras, when the white medical and science establishment promoted the idea of innate Black inferiority and criminality to rationalize systems built on servitude and segregation.

      Is this an example of de jure or de facto racism and discrimination? Explain your thinking.

    2. public health experts mostly ignored the disparities

      Who do you think these experts were? How might that have changed?

    1. Evidence and experience suggest that in pandemic phase 6 (increased and sustained transmission in the general population), aggressive interventions to isolate patients and quarantine contacts, even if they are the first patients detected in a community, would probably be ineffective, not a good use of limited health resources, and socially disruptive.

      Ontario going in lockdown after the 26 December.

    2. Field studies coordinated by WHO will be needed to assess virus transmission characteristics, amplifying groups (e.g., children vs. adults), and attack and death rates. Information on these factors will be needed urgently at the onset of a pandemic because the pandemic subtype may behave differently than previous pandemic or seasonal strains. Such studies will also be needed throughout the pandemic period to determine if these factors are changing and, if so, to make informed decisions regarding public health response measures, especially those that are more costly or disruptive.

      Public Health Ontario are you following this? If this is not the case the entire "brain trust" should summarily dismissed.

    1. The official definition of a “close contact” — 15 minutes, within six feet — isn’t foolproof.

      The takeaway: The official definition of a "close contact" for COVID-19 is not foolproof.

      The claim: The official definition of a "close contact" - 15 minutes, within six feet - isn't foolproof.

      The evidence: In Korea, a person sitting in a restaurant 6.5 meters (>20ft) away from the COVID index case for five minutes was infected, most likely because airflow from the air conditioner carried droplets with COVID-19 from the infected person to the person who became infected (1). How common transmission across large distances occurs is still debated (2). As several indoor outbreaks were attributed to airborne transmission, precautions to prevent airborne COVID transmission are needed (3). Examples include better air filtration/UV to kill virus in the system, increased air flow from outside, avoidance of recirculating interior air, and avoiding overcrowding in interior spaces.

      Sources:

      1) https://jkms.org/DOIx.php?id=10.3346/jkms.2020.35.e415

      2) https://www.sciencedirect.com/science/article/pii/S0166093420302858?via%3Dihub

      3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454469/pdf/ciaa939.pdf

    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.

  3. Nov 2020
    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).

      Sources:

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

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

    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. 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.

      Sources:

      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/

  4. Oct 2020
    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.

      Sources:

      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. 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. 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)

      Citations

      (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

  5. Sep 2020
  6. www.itv.com