PlagueWatch 2020-23 - Coronavirus

[OldPhiKap]

Except it isn't really if x condition then y, it is more like if conditions a,b, and c, then x. And that is where you lose people. They view a,b, and c as complicated.

Add the complication of risk range too — some may find x to be an unacceptable risk while some may not.

Oh, and sprinkle in a healthy dose of incomplete scientific understanding from both experts and lay persons.

[75Crazie]

Here is the kind of mentality (if that term even applies) that we are fighting here in Tennessee (from today's Nashville Tennessean):

The man had flu-like symptoms with a cough when he tested positive for coronavirus and came to the hospital. His condition became worse and worse. Unvaccinated and in disbelief that COVID-19 was a big deal, the man was angry at <the ICU doctor> and others in the ICU caring for him. "He said, 'You guys did this to me,'" <the ICU doctor> said. "He died."

The article went on to describe how unvaccinated victims here are expressing their anger at the very caregivers who are trying to save them. Logic has flown out the window and left the planet.

[acdevil]

As someone said upthread, getting the vaccines to children is the game changer for my family. My youngest has other health issues which would make her susceptible to a bad covid outcome so our family has sacrificed most activities until she can get vaxed. (C’mon CDC, let’s go)

As for the original question about football games, it really pisses me off everytime I see it. I understand it’s about the money, but if we still had restrictions on SEC football, I truly think we’d be in a different place. If vacs were required to go see Alabama football, I’m guessing the rate would be much, much higher. There are a bunch of real world examples now showing that mandates are working to get people vaxed.

[budwom]

I have no idea what wrinkles child vaccination will have in store for us all. Hopefully all the kids get the jab and are safe...but it's been mentioned that while Vermont has just about the highest vax rate vs Covid, our general childhood vax rate (for the other stuff) is one of the four or five worst in the country. Nothing to brag about. Hopefully recalcitrant parents will act wisely.

[dudog84]

Here is the kind of mentality (if that term even applies) that we are fighting here in Tennessee (from today's Nashville Tennessean):

The article went on to describe how unvaccinated victims here are expressing their anger at the very caregivers who are trying to save them. Logic has flown out the window and left the planet.

Screw The Oath. If patients are abusive, doctors should be able to walk away.

[sparv]

Yes I actually prefer people/policies being nimble and flexible based on conditions rather than most that are totally rigid one way or the other. With that, it's still possible to say "if x conditions exist, then y" but I guess nobody wants to held to that. I also recognize that it's impossible to predict the future. Many workplaces that were scheduled to be in n person in August/ September pivoted after the delta surge which seems warranted.

Perhaps vaccines for children will be the game changer + deltas surge probably giving a solid chunk of the unvaccinated country some natural immunity (with a lot of deaths unfortunately along the way).

Speaking of rigid policies...my daughter attends a charter school that does not require masks and has not implemented any other mitigation strategies. My daughter wears a mask every day, as do many of her classmates. We have kept her home whenever she has a cough or runny nose, and as a result, she has missed six days of school since mid-August. We got a letter last week (on her fifth missed day) warning of excessive absences and informing us that she will fail if she has nine total absences this semester. They do not distinguish between excused and unexcused absences.

There is almost zero chance she will have perfect attendance through December, so we are looking at our options. Failing first grade seems extreme to me. I figure we will keep her in the charter until she racks up eight absences and then put her back in the local public school. It's a shame because the curriculum and teaching at the charter are much better, but their policies stink.

[mph]

I’m not a big supporter of people going maskless to games.

But kids… you are inside a room with terrible ventilation (we literally just open two windows halfway and cross our fingers) for twice as long with all unvaccinated people who are constantly tugging at their masks and looking for excuses to take them off and who are sometimes literally on top of each other. Sorry, but I’m FIRMLY in the “keep masks on at school” camp, even tho I hate it.

I have mixed feelings about the risk/reward balance of requiring masks for elementary students. But, there's no question that ventilation is a huge issue, and one that continues to be underemphasized at the local level while we continue with expensive and dubious "deep cleanings." I wonder how many school districts have purchased HEPA air purifiers for classrooms. Most classrooms could be covered with purifiers in the $400 range and stimulus money was earmarked for this purpose. As I mentioned upthread, my breakthrough infection (and the infection of 4 other vaccinated and masked colleagues) was caused by a single symptomatic, unmasked person. We were in a large poorly ventilated classroom with a minimum of 8-10 feet between the closest breakthrough infection (me) and as much as 25 feet between one of the breakthrough infections. Things likely would have been different had the symptomatic colleague been masked but evidence also suggests that we would have benefited from proper ventilation, especially since none of us were in direct contact.

I hope that improved indoor ventilation standards will be one of the long term positives to emerge from the pandemic. We wouldn't have to wait for the next pandemic to reap the benefit of reduced transmission of flu and other airborne viruses.

[YmoBeThere]

I have mixed feelings about the risk/reward balance of requiring masks for elementary students. But, there's no question that ventilation is a huge issue, and one that continues to be underemphasized at the local level while we continue with expensive and dubious "deep cleanings." I wonder how many school districts have purchased HEPA air purifiers for classrooms. Most classrooms could be covered with purifiers in the $400 range and stimulus money was earmarked for this purpose. As I mentioned upthread, my breakthrough infection (and the infection of 4 other vaccinated and masked colleagues) was caused by a single symptomatic, unmasked person. We were in a large poorly ventilated classroom with a minimum of 8-10 feet between the closest breakthrough infection (me) and as much as 25 feet between one of the breakthrough infections. Things likely would have been different had the symptomatic colleague been masked but evidence also suggests that we would have benefited from proper ventilation, especially since none of us were in direct contact.

I hope that improved indoor ventilation standards will be one of the long term positives to emerge from the pandemic. We wouldn't have to wait for the next pandemic to reap the benefit of reduced transmission of flu and other airborne viruses.

The trouble with improved ventilation is we don't know what that looks like. As the early information was coming in from Asia, there is a well documented scenario at a restaurant covered here: https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article

As this diagram from that article shows, there were cases that were in theory up wind from the index patient.
Screenshot 2021-10-10 133451.jpg

Then there was the study of the Korean call center: https://wwwnc.cdc.gov/eid/article/26/8/20-1274_article Automatic doors between area probably reduced spread, but even the highly impacted area was a bit sporadic with regards to infection.

Screenshot 2021-10-10 134401.jpg

I think a case where an infected teacher in a classroom caused several kids to get sick was discussed earlier in this thread. I'm not disagreeing that better ventilation is needed. It is. I am very conscious about breathing air that someone else has breathed very recently. But I'm also not certain we know exactly what better ventilation looks like, it is a step beyond knowing the air volume changes per hour of a space.(Something that building science is starting to take greater interest in, at least at with some determiners of building code and builders.) Then there is the implementation issue, how do we apply what we know to the myriad different cases/room configurations? To get the appropriate engineering technology down to that level seems a herculean task given the sheer number of scenarios.

[Skydog]

The trouble with improved ventilation is we don't know what that looks like. As the early information was coming in from Asia, there is a well documented scenario at a restaurant covered here: https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article

As this diagram from that article shows, there were cases that were in theory up wind from the index patient.
Screenshot 2021-10-10 133451.jpg

Then there was the study of the Korean call center: https://wwwnc.cdc.gov/eid/article/26/8/20-1274_article Automatic doors between area probably reduced spread, but even the highly impacted area was a bit sporadic with regards to infection.

Screenshot 2021-10-10 134401.jpg

I think a case where an infected teacher in a classroom caused several kids to get sick was discussed earlier in this thread. I'm not disagreeing that better ventilation is needed. It is. I am very conscious about breathing air that someone else has breathed very recently. But I'm also not certain we know exactly what better ventilation looks like, it is a step beyond knowing the air volume changes per hour of a space.(Something that building science is starting to take greater interest in, at least at with some determiners of building code and builders.) Then there is the implementation issue, how do we apply what we know to the myriad different cases/room configurations? To get the appropriate engineering technology down to that level seems a herculean task given the sheer number of scenarios.

In the restaurant study the “The air outlet AND the return air INLET for the central air conditioner were located above table C.” The circulating aerosolized droplets from the index case at Table A were likely carried in both directions: to table B directly by outflow then back to C via returning inflow.

[devil84]

Anybody else watch other college football games (or NFL or other things, but I happen to be watching Bama-A&M now) with 100,000 people crammed in a stadium and screaming with 0.0% masked and just feel strange? I don't understand how we reconcile that with having 2 year olds mask for 9+ hours a day...I feel like I'm witnessing an alternate universe on TV that I am not exposed to and don't participate in. I'll admit that I kinda wish I did participate in it to an extent...

But I'm kinda angry at how we have failed our young children and asked them to sacrifice so much partially due to selfishness of adults throughout this thing...

I have two grandsons. Nolan is 3 and Grayson is 1. Nolan's other grandparents got him a play McDonald's store. He was 20 months old the last time he was in a store. He doesn't know what a cash register is used for, he doesn't know anything about ordering from a menu. His idea of fast food is that you look at your phone, press a few buttons, then go in the car and get the bag from a drive-thru. Playing "grocery store" is the same -- except you use a computer to order groceries. He's unaware that you pick out items and put them in a cart to check out at the end. He doesn't recall picking out produce, finding his favorite foods in the aisle, that there are toy aisles at Target, or that there's candy at the checkout. When he reads books, he wants to know why characters aren't wearing masks. Grayson has no idea that you wear shoes on a regular basis. Other than his house, both of his grandparent's homes, the pediatrician's office, and Duke hospital where he was born, he hasn't been "in" anywhere. Their mom is (rightly) very concerned about COVID (particularly long COVID) and RSV. As soon as those two can be vaccinated for COVID, our lives will change for the better. Until then, we're not going places. If it can't be ordered for curbside pickup or delivery, it's unlikely we'll go get it. We've made a few trips to home improvement stores and the like without the kids, but we've changed our thinking on whether we really need shopping as a pastime.

What really makes us mad is my son-in-law's coworker. They recently returned to in-person in the office. Within three weeks, a manager came back from a weekend with friends. Their adult child was there, arriving with symptomatic COVID. The coworker returned to work the next day, unmasked. That morning, they found that two others (of the five in the group) tested positive. They did not return home. The following day, the person returned to work, this time with obvious symptoms. Still no mask. My son-in-law works 10' from this person with no walls or partitions in between, though he's one of the few masked people with a KN95 that he doesn't remove. This person is clearly miserable, but does not go home. They show up the next day, looking and sounding really awful, without a mask. (This municipality does have a mask mandate for all indoor environments.) HR finally steps in and requests that they leave immediately to get tested, then work from home until symptoms abate. An hour later, HR finds this person in the break room and repeats their request. With some huffing, scoffing, and eye rolls, this person says, "Oh, I GUESS I'll just HAVE to drive in the RAIN." They finally get in the car and leave to grudgingly get tested.

Childcare for the grandkids is my house, so we get a phone call from son-in-law saying that there's a possible contact, what do we do? We tell your wife to pack for at least the night and she and the kids will stay here until we learn if the co-worker is positive. The grandkids are positively jubilant at staying the night at Grandma and Grampa's! The positive results are announced, the entire office is sent to work from home again through the week and cannot return until Monday and a negative test is required. (There's a huge client deadline AND they are moving the office to another location, so this was a BIG DEAL of an interruption). Son-in-law waits another three days to get tested. Grandchildren are positively GIDDY with this new arrangement, bouncing off the walls. The adults are extremely stressed. Thankfully, son-in-law tests negative and life can return to normal. At least we weren't like another co-worker that sits between the infected person and my son-in-law. That co-worker has elderly parents who rely on him for daily help and are transitioning to assisted living. The co-worker had to put all that on hold and try to figure out how to get someone to feed and help his parents. Other co-workers were inconvenienced like we were, though most with small kids just had to go home and hope for the best. Miraculously, there were no other known cases.

We expect this to happen regularly now that he's back in the office. This is not fun. I realize that we are really privileged. Up until a month ago, all of us were working from home, until son-in-law was called back into the office. We had our tight bubble to keep the kids safe. Not everyone is able to do this. It's totally our choice to not go into stores and businesses until they can be vaccinated. But it's getting really monotonous to have a choice between our house and their house for meals and entertainment. Others have to send their kids to school or daycare and have to be in public-facing jobs or with co-workers who think this is a hoax and don't have this luxury. We could do more, but we'd rather be safe. What's another few months? Beats finding out that the kids got a mild case of COVID but have life-long issues. My grandmother was 10 in 1918 when she brought home the flu from school, which she shared with her 21 year old sister, who had a 4 month old baby. Her sister died a swift and awful death from the flu. The grief Grandma shouldered for the next 80 years was something I don't want to experience first hand with COVID and my family.

And then we watch 100,000 people shoulder to shoulder, chanting and shouting at a football game. We wind up inconvenienced for days because somebody traveled for a weekend with friends, then chose not to quarantine or wear a mask (despite a mask ordinance). We are scared to go visit my vaccinated 88 and 90 year old in-laws, because we fear exposure on the 8 hour drive up and giving it to them, or getting exposed when the unvaccinated rest of the family wants to visit, indoors and sans masks, of course. My Facebook feed is full of pictures of friends dining indoors and taking all kinds of trips. An alternate universe, indeed.

[acdevil]

Sounds like your SIL’s co-worker should be fired for numerous reasons.

[devil84]

Sounds like your SIL’s co-worker should be fired for numerous reasons.

Right?! The general consensus around that workplace is that some significant disciplinary action needs to be taken, and firing wouldn't be out-of-bounds.

[wavedukefan70s]

Speaking of rigid policies...my daughter attends a charter school that does not require masks and has not implemented any other mitigation strategies. My daughter wears a mask every day, as do many of her classmates. We have kept her home whenever she has a cough or runny nose, and as a result, she has missed six days of school since mid-August. We got a letter last week (on her fifth missed day) warning of excessive absences and informing us that she will fail if she has nine total absences this semester. They do not distinguish between excused and unexcused absences.

There is almost zero chance she will have perfect attendance through December, so we are looking at our options. Failing first grade seems extreme to me. I figure we will keep her in the charter until she racks up eight absences and then put her back in the local public school. It's a shame because the curriculum and teaching at the charter are much better, but their policies stink.

Thats insane .in the unfortunate event
Of being near someone . Its a 10 day quarantine.
You would think it would adjust due to covid proticalls.

[kshepinthehouse]

I have mixed feelings about the risk/reward balance of requiring masks for elementary students. But, there's no question that ventilation is a huge issue, and one that continues to be underemphasized at the local level while we continue with expensive and dubious "deep cleanings." I wonder how many school districts have purchased HEPA air purifiers for classrooms. Most classrooms could be covered with purifiers in the $400 range and stimulus money was earmarked for this purpose. As I mentioned upthread, my breakthrough infection (and the infection of 4 other vaccinated and masked colleagues) was caused by a single symptomatic, unmasked person. We were in a large poorly ventilated classroom with a minimum of 8-10 feet between the closest breakthrough infection (me) and as much as 25 feet between one of the breakthrough infections. Things likely would have been different had the symptomatic colleague been masked but evidence also suggests that we would have benefited from proper ventilation, especially since none of us were in direct contact.

I hope that improved indoor ventilation standards will be one of the long term positives to emerge from the pandemic. We wouldn't have to wait for the next pandemic to reap the benefit of reduced transmission of flu and other airborne viruses.

I’m thinking about purchasing one for my son’s classroom. Is there one you suggest?

[mph]

I’m thinking about purchasing one for my son’s classroom. Is there one you suggest?

Conway is a South Korean brand that makes highly regarded purifiers. I purchased this model for home use and have been very happy with it. It will cycle the air in a 930 sqft room 2X/hour. That’s much larger than most classrooms. It goes for around $350.

I purchased this Honeywell model for my office, Its rated for 190 sqft and costs between $130 and $150 at Best Buy and Walmart. It’s also worked very well. They make a 500 sqft model that would be suitable for many classrooms.

[PackMan97]

.

There is almost zero chance she will have perfect attendance through December, so we are looking at our options. Failing first grade seems extreme to me. I figure we will keep her in the charter until she racks up eight absences and then put her back in the local public school. It's a shame because the curriculum and teaching at the charter are much better, but their policies stink.

If you are in nC, happy to talk to you about homeschooling. I know some great curriculum fue that age.

[kshepinthehouse]

Conway is a South Korean brand that makes highly regarded purifiers. I purchased this model for home use and have been very happy with it. It will cycle the air in a 930 sqft room 2X/hour. That’s much larger than most classrooms. It goes for around $350.

I purchased this Honeywell model for my office, Its rated for 190 sqft and costs between $130 and $150 at Best Buy and Walmart. It’s also worked very well. They make a 500 sqft model that would be suitable for many classrooms.

Aren’t Covid particles smaller than what your machine is rated to extract from the air?

[johnb]

I have two grandsons. Nolan is 3 and Grayson is 1. Nolan's other grandparents got him a play McDonald's store. He was 20 months old the last time he was in a store. He doesn't know what a cash register is used for, he doesn't know anything about ordering from a menu. His idea of fast food is that you look at your phone, press a few buttons, then go in the car and get the bag from a drive-thru. Playing "grocery store" is the same -- except you use a computer to order groceries. He's unaware that you pick out items and put them in a cart to check out at the end. He doesn't recall picking out produce, finding his favorite foods in the aisle, that there are toy aisles at Target, or that there's candy at the checkout. When he reads books, he wants to know why characters aren't wearing masks. Grayson has no idea that you wear shoes on a regular basis. Other than his house, both of his grandparent's homes, the pediatrician's office, and Duke hospital where he was born, he hasn't been "in" anywhere. Their mom is (rightly) very concerned about COVID (particularly long COVID) and RSV. As soon as those two can be vaccinated for COVID, our lives will change for the better. Until then, we're not going places. If it can't be ordered for curbside pickup or delivery, it's unlikely we'll go get it. We've made a few trips to home improvement stores and the like without the kids, but we've changed our thinking on whether we really need shopping as a pastime.

What really makes us mad is my son-in-law's coworker. They recently returned to in-person in the office. Within three weeks, a manager came back from a weekend with friends. Their adult child was there, arriving with symptomatic COVID. The coworker returned to work the next day, unmasked. That morning, they found that two others (of the five in the group) tested positive. They did not return home. The following day, the person returned to work, this time with obvious symptoms. Still no mask. My son-in-law works 10' from this person with no walls or partitions in between, though he's one of the few masked people with a KN95 that he doesn't remove. This person is clearly miserable, but does not go home. They show up the next day, looking and sounding really awful, without a mask. (This municipality does have a mask mandate for all indoor environments.) HR finally steps in and requests that they leave immediately to get tested, then work from home until symptoms abate. An hour later, HR finds this person in the break room and repeats their request. With some huffing, scoffing, and eye rolls, this person says, "Oh, I GUESS I'll just HAVE to drive in the RAIN." They finally get in the car and leave to grudgingly get tested.

Childcare for the grandkids is my house, so we get a phone call from son-in-law saying that there's a possible contact, what do we do? We tell your wife to pack for at least the night and she and the kids will stay here until we learn if the co-worker is positive. The grandkids are positively jubilant at staying the night at Grandma and Grampa's! The positive results are announced, the entire office is sent to work from home again through the week and cannot return until Monday and a negative test is required. (There's a huge client deadline AND they are moving the office to another location, so this was a BIG DEAL of an interruption). Son-in-law waits another three days to get tested. Grandchildren are positively GIDDY with this new arrangement, bouncing off the walls. The adults are extremely stressed. Thankfully, son-in-law tests negative and life can return to normal. At least we weren't like another co-worker that sits between the infected person and my son-in-law. That co-worker has elderly parents who rely on him for daily help and are transitioning to assisted living. The co-worker had to put all that on hold and try to figure out how to get someone to feed and help his parents. Other co-workers were inconvenienced like we were, though most with small kids just had to go home and hope for the best. Miraculously, there were no other known cases.

We expect this to happen regularly now that he's back in the office. This is not fun. I realize that we are really privileged. Up until a month ago, all of us were working from home, until son-in-law was called back into the office. We had our tight bubble to keep the kids safe. Not everyone is able to do this. It's totally our choice to not go into stores and businesses until they can be vaccinated. But it's getting really monotonous to have a choice between our house and their house for meals and entertainment. Others have to send their kids to school or daycare and have to be in public-facing jobs or with co-workers who think this is a hoax and don't have this luxury. We could do more, but we'd rather be safe. What's another few months? Beats finding out that the kids got a mild case of COVID but have life-long issues. My grandmother was 10 in 1918 when she brought home the flu from school, which she shared with her 21 year old sister, who had a 4 month old baby. Her sister died a swift and awful death from the flu. The grief Grandma shouldered for the next 80 years was something I don't want to experience first hand with COVID and my family.

And then we watch 100,000 people shoulder to shoulder, chanting and shouting at a football game. We wind up inconvenienced for days because somebody traveled for a weekend with friends, then chose not to quarantine or wear a mask (despite a mask ordinance). We are scared to go visit my vaccinated 88 and 90 year old in-laws, because we fear exposure on the 8 hour drive up and giving it to them, or getting exposed when the unvaccinated rest of the family wants to visit, indoors and sans masks, of course. My Facebook feed is full of pictures of friends dining indoors and taking all kinds of trips. An alternate universe, indeed.

You lost me me with the names of your grandchildren. Nolan and Grayson? Wow!

[YmoBeThere]

In the restaurant study the “The air outlet AND the return air INLET for the central air conditioner were located above table C.” The circulating aerosolized droplets from the index case at Table A were likely carried in both directions: to table B directly by outflow then back to C via returning inflow.

Good catch, I hadn't looked at it since it was a media story last year. But it highlights another issue, in place infrastructure that needs to be re-engineered to meet new requirements. I know this was a building in China but the same thing applies here. It also emphasizes the need to get the engineering down to that level. Hopefully we can figure out best practices quickly(maybe they already exist) and start incorporating them point forward.

[mph]

Aren’t Covid particles smaller than what your machine is rated to extract from the air?

From the NYT:

The virus that causes COVID-19 is approximately 0.125 micron (125 nanometers) in diameter. It falls squarely within the particle-size range that HEPA filters capture with extraordinary efficiency: 0.01 micron (10 nanometers) and above. Many media outlets have incorrectly stated that HEPA filters don’t filter below 0.3 micron and therefore could not capture airborne coronaviruses. That’s wrong. This NASA study of HEPA filtration is quite technical, but the graph on page 7 and the preceding paragraph do a good job of explaining why HEPA filters are actually most efficient—almost 100% at 0.01 micron—at capturing ultrafine particles below the 0.3-micron HEPA test standard.