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Improving COVID-19 safety
Aug. 14th, 2020 06:52 pmThis is a rough the final draft of a letter that I am sending throughout my workplace. Feel free to share it at yours. I'm also open to suggestions. My aim is to usefully educate and persuade.
Subject: Let's save some lives.
Hi all,
As we start to reopen some departments, I want to make sure to get critical safety information out to everyone. Most of us are too swamped to spend the time and effort to stay current on the research ourselves, and the official government channels on which we usually rely have proven insufficient.
By now, we're all familiar with social distancing and masks. But those are not enough when spending extended periods in indoor places with stale or recirculating air. If you have to meet in parson for more than a few minutes, the most effective thing you can do is to be outside or to ventilate the room with plenty of fresh air from open windows or doors.
https://www.icpcovid.com/sites/default/files/2020-08/Addressing%20airborne%20transmission%20Morawska%20CID%20July%202020.pdf
I cannot stress the importance of fresh air enough. Even though crowds and loud vocal noises (such as singing or yelling) are among the highest known risk factors, there has been no correlation of COVID-19 spikes with places where people have been gathering outdoors, with masks, for the largest protest in history.
https://www.healthline.com/health-news/black-lives-matter-protests-didnt-contribute-to-covid19-surge
https://www.nber.org/papers/w27408.pdf
I can't believe I have to say this, but the sheer number of people I've seen doing it is staggering: Wearing a mask below your nose is as effective as wearing your pants around your ankles. Anyone who does this is needlessly endangering others and themselves. Masks are there to block droplets carrying viruses, on the way to and from your lungs. Breathing around the mask defeats the purpose of having a mask. Do your best to eliminate gaps, so that your breathing goes through the mask, rather than around it. (I like to clip the ear loops to each other behind my head. It makes the mask more snug, and is more comfortable for my ears, too!)
https://www.nytimes.com/2020/04/08/well/live/coronavirus-face-mask-mistakes.html
"It's okay, I'm not sick" is no excuse for unsafe behavior. Typically, you will start showing symptoms 5 to 12 days after your exposure. (In rare cases, this incubation period could be as few as 2 days, or as many as 14 or more.) You don't know if you are sick! People who "feel fine" are causing super-spreader events. Every interaction that I have with my coworkers, with the folks I support, and with the public carries the knowledge that I might already be infected and presymptomatic. I take whatever steps I have to, to minimize the risk of spreading the disease, just in case I am sick and don't know it. I do this for all of us. I hope you will, too.
https://www.webmd.com/lung/coronavirus-incubation-period
Temperature is a poor indicator of this disease. You can have COVID-19 without a fever, and lots of people do.
https://bgr.com/2020/04/27/coronavirus-symptoms-fever-might-not-always-appear-study-says/
"I'm following the CDC recommendations: Six feet or a mask. Isn't that enough?" No, not when it might get people killed. Consensus in the research community is that the CDC and the WHO are not staying up to date and are, in their advice regarding airborne transmission of COVID-19, failing to account for infectious microdroplets that are known to hang suspended in the air for hours.
https://www.nytimes.com/2020/07/04/health/239-experts-with-one-big-claim-the-coronavirus-is-airborne.html
The following video by pulmonologist Mike Hanson is an illustrative compilation of things we need to know:
https://www.youtube.com/watch?v=xJ4Epf8i1uk
To better understand the transmission risk factors and save lives, a well researched and clearly written article on the subject is here:
https://www.erinbromage.com/post/the-risks-know-them-avoid-them
The takeaway quote: "Social distancing guidelines don't hold in indoor spaces where you spend a lot of time, as people on the opposite side of the room were infected. The principle is viral exposure over an extended period of time. In all these cases, people were exposed to the virus in the air for a prolonged period (hours). Even if they were 50 feet away (choir or call center), even a low dose of the virus in the air reaching them, over a sustained period, was enough to cause infection and in some cases, death."
If you, or someone you can talk to, is in charge of building maintenance, please take into account the conclusions from this article, whose advice about schools can apply to any building:
https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/
The relevant quote:
---
Teaching could move outdoors, at least some of the time, the way it did during the 1918 pandemic. Moreover, even when indoors or during rainy days, opening the doors and windows would greatly improve air circulation inside, especially if classrooms had fans at the windows that pushed air out.
When windows cannot be opened, classrooms could run portable HEPA filters, which are capable of trapping viruses this small, and which sell for as little as a few hundred dollars. Marr advises schools to measure airflow rates in each classroom, upgrade filters in the HVAC system to MERV 13 or higher (these are air filter grades), and aspire to meet or exceed ASHRAE (the professional society that provides HVAC guidance and standards) standards. Jimenez told me that many building-wide air-conditioning systems have a setting for how much air they take in from outside, and that it is usually minimized to be energy-efficient. During a pandemic, saving lives is more important than saving energy, so schools could, when the setting exists, crank it up to dilute the air (Jimenez told me that Shelly Miller, a fellow professor at the University of Colorado specializing in indoor air quality, persuaded the university to do just that.)
---
While I'm on the subject, here are a few other things to know:
Rashes resembling frostbite (a.k.a. "COVID toes") may be a symptom, especially in younger people who are otherwise asymptomatic or presymptomatic.
https://www.health.com/condition/infectious-diseases/coronavirus/covid-toes
So can stroke, heart attack, and cardiac arrest:
https://siderea.dreamwidth.org/1617381.html
"Stroke can be the first sign of COVID-19 in otherwise asymptomatic or barely-symptomatic young (20-50yo) people WITHOUT stroke risk factors. If you are having stroke symptoms - slurred speech, confusion, drooping face on one side, trouble moving one limb – go to the hospital immediately."
Whether or not you have become sick, please stop taking any cough medicine containing dextromethorphan:
https://siderea.dreamwidth.org/1620157.html
Please be safe, everyone.
Thanks for your time,
Joe Levy
Subject: Let's save some lives.
Hi all,
As we start to reopen some departments, I want to make sure to get critical safety information out to everyone. Most of us are too swamped to spend the time and effort to stay current on the research ourselves, and the official government channels on which we usually rely have proven insufficient.
By now, we're all familiar with social distancing and masks. But those are not enough when spending extended periods in indoor places with stale or recirculating air. If you have to meet in parson for more than a few minutes, the most effective thing you can do is to be outside or to ventilate the room with plenty of fresh air from open windows or doors.
https://www.icpcovid.com/sites/default/files/2020-08/Addressing%20airborne%20transmission%20Morawska%20CID%20July%202020.pdf
I cannot stress the importance of fresh air enough. Even though crowds and loud vocal noises (such as singing or yelling) are among the highest known risk factors, there has been no correlation of COVID-19 spikes with places where people have been gathering outdoors, with masks, for the largest protest in history.
https://www.healthline.com/health-news/black-lives-matter-protests-didnt-contribute-to-covid19-surge
https://www.nber.org/papers/w27408.pdf
I can't believe I have to say this, but the sheer number of people I've seen doing it is staggering: Wearing a mask below your nose is as effective as wearing your pants around your ankles. Anyone who does this is needlessly endangering others and themselves. Masks are there to block droplets carrying viruses, on the way to and from your lungs. Breathing around the mask defeats the purpose of having a mask. Do your best to eliminate gaps, so that your breathing goes through the mask, rather than around it. (I like to clip the ear loops to each other behind my head. It makes the mask more snug, and is more comfortable for my ears, too!)
https://www.nytimes.com/2020/04/08/well/live/coronavirus-face-mask-mistakes.html
"It's okay, I'm not sick" is no excuse for unsafe behavior. Typically, you will start showing symptoms 5 to 12 days after your exposure. (In rare cases, this incubation period could be as few as 2 days, or as many as 14 or more.) You don't know if you are sick! People who "feel fine" are causing super-spreader events. Every interaction that I have with my coworkers, with the folks I support, and with the public carries the knowledge that I might already be infected and presymptomatic. I take whatever steps I have to, to minimize the risk of spreading the disease, just in case I am sick and don't know it. I do this for all of us. I hope you will, too.
https://www.webmd.com/lung/coronavirus-incubation-period
Temperature is a poor indicator of this disease. You can have COVID-19 without a fever, and lots of people do.
https://bgr.com/2020/04/27/coronavirus-symptoms-fever-might-not-always-appear-study-says/
"I'm following the CDC recommendations: Six feet or a mask. Isn't that enough?" No, not when it might get people killed. Consensus in the research community is that the CDC and the WHO are not staying up to date and are, in their advice regarding airborne transmission of COVID-19, failing to account for infectious microdroplets that are known to hang suspended in the air for hours.
https://www.nytimes.com/2020/07/04/health/239-experts-with-one-big-claim-the-coronavirus-is-airborne.html
The following video by pulmonologist Mike Hanson is an illustrative compilation of things we need to know:
https://www.youtube.com/watch?v=xJ4Epf8i1uk
To better understand the transmission risk factors and save lives, a well researched and clearly written article on the subject is here:
https://www.erinbromage.com/post/the-risks-know-them-avoid-them
The takeaway quote: "Social distancing guidelines don't hold in indoor spaces where you spend a lot of time, as people on the opposite side of the room were infected. The principle is viral exposure over an extended period of time. In all these cases, people were exposed to the virus in the air for a prolonged period (hours). Even if they were 50 feet away (choir or call center), even a low dose of the virus in the air reaching them, over a sustained period, was enough to cause infection and in some cases, death."
If you, or someone you can talk to, is in charge of building maintenance, please take into account the conclusions from this article, whose advice about schools can apply to any building:
https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/
The relevant quote:
---
Teaching could move outdoors, at least some of the time, the way it did during the 1918 pandemic. Moreover, even when indoors or during rainy days, opening the doors and windows would greatly improve air circulation inside, especially if classrooms had fans at the windows that pushed air out.
When windows cannot be opened, classrooms could run portable HEPA filters, which are capable of trapping viruses this small, and which sell for as little as a few hundred dollars. Marr advises schools to measure airflow rates in each classroom, upgrade filters in the HVAC system to MERV 13 or higher (these are air filter grades), and aspire to meet or exceed ASHRAE (the professional society that provides HVAC guidance and standards) standards. Jimenez told me that many building-wide air-conditioning systems have a setting for how much air they take in from outside, and that it is usually minimized to be energy-efficient. During a pandemic, saving lives is more important than saving energy, so schools could, when the setting exists, crank it up to dilute the air (Jimenez told me that Shelly Miller, a fellow professor at the University of Colorado specializing in indoor air quality, persuaded the university to do just that.)
---
While I'm on the subject, here are a few other things to know:
Rashes resembling frostbite (a.k.a. "COVID toes") may be a symptom, especially in younger people who are otherwise asymptomatic or presymptomatic.
https://www.health.com/condition/infectious-diseases/coronavirus/covid-toes
So can stroke, heart attack, and cardiac arrest:
https://siderea.dreamwidth.org/1617381.html
"Stroke can be the first sign of COVID-19 in otherwise asymptomatic or barely-symptomatic young (20-50yo) people WITHOUT stroke risk factors. If you are having stroke symptoms - slurred speech, confusion, drooping face on one side, trouble moving one limb – go to the hospital immediately."
Whether or not you have become sick, please stop taking any cough medicine containing dextromethorphan:
https://siderea.dreamwidth.org/1620157.html
Please be safe, everyone.
Thanks for your time,
Joe Levy
