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

Take away: Lower COVID-19 spread occurred after stay-at home orders were issued. Room for debate exists on how restrictive lockdowns should be.

The claim: Mandatory stay-at home orders are "useless" in helping lower the spread of SARS-CoV-2.

The evidence: Two publications showed that lower COVID-19 spread occurred after stay-at home orders were issued (1, 2). Hospitalizations were lower than predicted exponential growth rates after implementation of stay-at home orders (3). Some caveats to consider include that it is impossible to tease apart the effects of the stay-at home orders from other measure implemented simultaneously with stay-at home orders such as increased hygiene measures, social distancing guidelines, and school closures. It is also impossible to conclusively state that the effect is from the stay-at home order and not the natural progression of the disease.

The comparison between Illinois with stay-at home orders and Iowa without stay-at home orders resulted in an estimated 217 additional COVID-19 cases in Iowa over the course of a month (2). This small number raises the question, "are stay-at home orders worth it?" It is important to remember that comparison of Iowa and Illinois is the comparison of two social distancing strategies. Stay-at home orders close everything and then write the exceptions that can remain open. Iowa took the approach of leaving everything open except what the government choose to close (4). Some businesses in Iowa were still closed and many federal guidelines were still followed. A negative control showing disease progression without any mitigation measures does not exist in published literature.

Sources:

1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246016/

2 https://pubmed.ncbi.nlm.nih.gov/32413112/

3 https://www.desmoinesregister.com/story/news/2020/04/07/iowa-equivalent-stay-at-home-order-coronavirus-kim-reynolds/2961810001/

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254451/

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.

Kavanagh, M. M. (2020). US elections and a foreign policy for pandemics. The Lancet Public Health, 5(10), e517–e518. https://doi.org/10.1016/S2468-2667(20)30211-5

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.

Source:

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

https://www.azdhs.gov/documents/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/novel-coronavirus/sdmac/covid-19-addendum.pdf

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Holmes, E. A., O’Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Cohen Silver, R., Everall, I., Ford, T., John, A., Kabir, T., King, K., Madan, I., Michie, S., Przybylski, A. K., Shafran, R., Sweeney, A., … Bullmore, E. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science. The Lancet Psychiatry, S2215036620301681. https://doi.org/10.1016/S2215-0366(20)30168-1

Apply to switch your existing funding to Covid-19 priority areas—UK Research and Innovation. (n.d.). Retrieved April 9, 2020, from https://www.ukri.org/funding/funding-opportunities/ukri-open-call-for-research-and-innovation-ideas-to-address-covid-19/apply-to-switch-your-existing-funding-to-covid-19-priority-areas/

31-05-2019

I read this book for a class and highly enjoyed the priority lesson Menasche included in the overall theme of the book.

Page 223

This is Borgman discussing the role of priority in the humanities

cultural and historical events can be reinterpreted repeatedly. Prizes are based on the best interpretation rather than on the first claim to a finding.