"Weekly Coronavirus Questions"

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trader32176
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Re: "Weekly Coronavirus Questions"

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Coronavirus FAQs: Are 3 Masks Better Than 1? Will Mouthwash Keep You Safe?

11/3/20


https://www.npr.org/sections/goatsandso ... p-you-safe


Does wearing more than one mask at a time make you safer?


You might have wondered that too if you were watching Monday Night Football last month and saw New England Patriots coach Bill Belichick wearing two masks after his quarterback Cam Newton tested positive for COVID-19.

Well, let's think about that. Masks block contagious droplets that an infected person breathes out. They also offer a measure of protection for a wearer who's not infected.

So yes, in theory, two is better than one and three is even better, says biosecurity expert Raina MacIntyre, who researches mask effectiveness at the University of New South Wales in Sydney.

But there are pitfalls to piling on masks. You may be more tempted to fiddle with the additional mask, and that's a bad idea if you're in a place where other people have been hanging out and possibly spreading contagious droplets. You might touch a contaminated surface, then bring the viral particles to your mask.

And while a second (or third) mask will create a more effective barrier for outgoing and incoming particles, it will also make it harder to breathe in the air you need.

Adding an additional mask isn't the only way to add a layer of protection. Dr. Abraar Karan, a physician at Brigham and Women's Hospital, recommends a multilayered single mask that fits comfortably snug over your nose and mouth.

Karan and other mask experts look for two or three layers in a mask. Some masks, for example, come with an interior pocket where you can insert a filter. So that adds up to three layers in one face covering.

If you're still interested in doubling up, you might want to consider an innovative approach we wrote about a few months ago.

As correspondent Maria Godoy reported: Researchers at Northeastern University added an outer layer made from nylon stockings to a homemade face covering. They found that the nylon layer can boost a mask's ability to filter out small particles in the air by creating a tighter seal between the mask and the wearer's face.

"Using nylon stockings to improve the fit of a mask makes sense," says Linsey Marr, a civil engineering professor at Virginia Tech who researches airborne transmission of infectious diseases. "The stocking will help reduce or eliminate gaps that would otherwise allow particles to short-circuit the mask."

Does mouthwash offer any benefit in reducing possible transmission of COVID-19?

Imagine gargling the coronavirus away with minty fresh mouthwash! That's what some media headlines suggested in the past few weeks.

The origin of this idea is a study published in September in the Journal of Medical Virology. Researchers at Pennsylvania State University grew the coronavirus in human liver cells, then flushed the cells with mouthwash for durations of 30 seconds and 1 and 2 minutes. Their finding: About 90% of the viruses treated with mouthwash lost their ability to infect cells.

But that doesn't mean gargling is the next best thing to a vaccine.

Here's what the optimistic media reports didn't point out.

First, the researchers did not test mouthwash on the coronavirus that causes COVID-19. Instead they tested the strain of coronavirus that causes the common cold.

What's more, they did not test the impact of mouthwash on the coronavirus in actual humans, which makes the study limited, according to Dr. Todd Ellerin, director of infectious diseases at South Shore Health in Weymouth, Mass.

It's not a cure, agrees Dr. Craig Meyers, the study's lead author, and it needs to be tested further on humans.

In the study, mouthwash did not kill the virus, Meyers says; rather, it temporarily stopped it from infecting more cells. The effects are local – so if they were to be replicated in human studies, he believes the mouthwash would only disable the virus that is present in your mouth at the moment of gargling.

In other words, if you're not infected, gargling doesn't protect you from getting infected, says Meyers. While in quarantine, however, an infected person can gargle as a precaution to protect the people around them.

"We're not asking people to do anything like inject this or do anything silly with mouthwash," says Meyers. "We see this as a layer of protection on top of wearing masks and social distancing."

But even a really good long gargle is unlikely to get every bit of virus on each mucus membrane, says Dr. William Schaffner, an infectious disease professor at Vanderbilt University.

"Just wear a mask," Schaffner sighs. "There is no magic solution; pun intended."
trader32176
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Re: "Weekly Coronavirus Questions"

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Coronavirus FAQs: Should I Purell My Nostrils? Can Lysol Disinfect The Air?

11/6/20


https://www.npr.org/sections/goatsandso ... ct-the-air


When I get in my car, I always use a squirt of hand sanitizer for my hands. With the tips of my forefinger and thumb, I then rub some of the sanitizer just inside my nostrils. Does this have any helpful or detrimental effect?

Wait, what? Well, good for you for remembering the hand sanitizer for your hands. The Centers for Disease Control and Prevention says keeping your hands clean is always important to reduce infection but especially so now to help prevent the spread of COVID-19.

But ... not in your nose, says Leana Wen, an emergency physician and public health professor at George Washington University who previously was Baltimore's health commissioner. "Putting hand sanitizer on your nostrils isn't a barrier to breathing in the virus."

If your hands come in contact with the virus — say by touching a steering wheel that someone with COVID-19 sneezed on, "then using hand sanitizer can kill the virus from your hands and keep it from entering your body if you touch the mucus membranes in your nose, eyes or mouth," Wen says. "But hand sanitizer on, or in, your nose, won't keep you from inhaling in virus particles which can attach to mucus membranes deep inside your nose and throat. "

Your best bet is the whole combination of protective measures: frequent washing or hand sanitizing your hands, especially if you come in contact with an item or surface that someone else might have touched, physical distancing and wearing a mask.

With so many people using hand sanitizer, some popular brands can be hard to find. But don't just settle for any brand: The Food and Drug Administration has found that some hand sanitizers contain hazardous ingredients such as methanol or wood alcohol, which "can be toxic when absorbed through the skin or ingested and can be life-threatening when ingested." Check this FDA website to see if the brand you have or are planning to buy is on its list of hand sanitizers to avoid.

And as long as we're talking about hand sanitizer, here are some refresher tips you might have forgotten since the beginning of the pandemic, courtesy of the CDC and University of Pennsylvania:

Use an alcohol-based hand sanitizer that contains at least 60% alcohol, a recommended percentage for wiping out viral particles.
Squeeze out enough sanitizer to cover all surfaces on your hands.
After applying sanitizer, rub your hands together until they feel dry — about 20 seconds.
Don't rinse or wipe off the hand sanitizer before it's dry or it may not work well against germs.
Hand sanitizer does have a shelf life, so get a new bottle when this one reaches its expiration date.
Consider storing that sanitizer in the purse or any carrying case you typically bring with you when you get in the car. Sanitizer can evaporate from heat if left in the car, and you may find yourself with none to use when you need it.

We want to plan a birthday party for 13 people. We are all committed to wearing masks and social distancing. Would it help to spray Lysol in the rooms every 30 to 60 minutes to help with disinfecting the air?

The only time we wouldn't have on a mask is to eat.

We hate to be a literal party pooper, but, in a word, no, says Steve Bennett, senior vice president of scientific and regulatory affairs at the Household & Commercial Products Association, the trade association for cleaning products such as Lysol.

"A disinfectant spray is actually designed for surface use, so spraying it in the air will not be effective in protecting indoor guests from COVID-19," Bennett says. He adds that there are no sprayable household products currently registered with the Environmental Protection Agency that can be used to disinfect the air. (And as we reported in an earlier FAQ: "Portable air cleaners can limit the spread of the virus via long-range airborne particles by capturing most of those particles in a HEPA filter and cleaning the air at a rate of up to six times per hour.")

It would be nice to think we could spray away the virus, but the problem with disinfecting spray is that "it only lasts in the air for a few seconds and then falls to the ground, or evaporates, ending any protection," says James Malley, a professor of civil and environmental engineering at the University of New Hampshire in Durham. So even if you sprayed the air with disinfectant, it wouldn't linger long enough to be effective in the next moment if anyone who's contagious (and not showing symptoms) has resumed talking or breathing in the indoor space.

Like Bennett, Malley says disinfectant sprays are really meant for cleaning surfaces such as kitchen countertops or doorknobs — though he prefers disinfecting wipes. With wipes, you can be sure you've disinfected the entire surface because "you can visually see what has gotten wet and what hasn't," he says. With spray disinfectant, it can be harder to distribute the product across a surface and harder to tell where you've already sprayed. If you do choose to use wipes, Malley has a tip: To ensure a surface is fully disinfected, wait for the surface to dry before touching it.
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Re: "Weekly Coronavirus Questions"

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Coronavirus FAQ: Could COVID-19 Ever Be Considered A Preexisting Condition?

11/9/20


https://www.npr.org/sections/goatsandso ... -condition


Health insurers used to be able to deny coverage – or charge more – for an applicant who had a preexisting medical condition. That's the industry term for a condition that could range from allergies to cancer.

The Affordable Care Act changed all that as of 2014, guaranteeing coverage for those with preexisting conditions. But now the Supreme Court is hearing oral arguments, starting Tuesday, on a case filed to overturn the Affordable Care Act.

And people are wondering: If preexisting conditions were again to become a cause to deny coverage, would a COVID-19 survivor be in jeopardy?

Before we discuss this question, it's important to note that you shouldn't worry ... yet. It's unlikely the court will rule on the case before next spring.

And even if the Supreme Court were to overturn the law, existing coverage contracts would likely stay in place for at least a couple of months, said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, in a briefing Monday with reporters.

Now on to the FAQ about COVID-19.

In pre-ACA days, a bout with a virus might not have been considered a preexisting condition. That's because many people tend to recover quickly from viruses.

But in a blog post last week, researchers at the Rand Corp. suggested that COVID-19 could be seen differently by insurers. "Given the chronic problems [which can include organ damage, fatigue and confusion] associated with some COVID-19 cases, it is possible that some insurers would place restrictions on anyone who had a confirmed case of COVID-19," wrote Carter C. Price, Rand's senior mathematician, and Raffaele Vardavas, a mathematician at Rand who specializes in infectious disease models.

The researchers said that exclusion might also extend to people who didn't have a positive coronavirus test but did test positive for antibodies to the virus, which indicates they had it or were previously exposed.

"While a mild case of COVID-19 might not be subject to a preexisting clause, that would be up to insurers to determine," said Karen Pollitz, senior fellow, health reform and private insurance at the Kaiser Family Foundation.

Pollitz added that insurers could also impose a preexisting exclusion for COVID-19 for anyone at higher risk of getting the virus — such as grocery store clerks or ride-share drivers who are exposed to the public and who test frequently to determine if they have COVID-19.

"Just a history of frequent testing could be something insurers could act on," Pollitz said.

And that's not all. Someone who developed anxiety and/or depression since the start of the pandemic might also be considered to have a preexisting condition. Twenty years ago, Kaiser surveyed health insurance underwriters and asked about a similar situation: a hypothetical applicant in perfect health except for "situational depression" following the death of a spouse. According to the survey, "in 60 applications for coverage, this applicant was denied a quarter of the time, and offered coverage with a surcharged premium and/or benefit exclusions 60% of the time."

So both experts and consumers are concerned that invalidating the Affordable Care Act could mean that once again, individuals with preexisting conditions might not be covered — and such conditions could include COVID-19.
trader32176
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Re: "Weekly Coronavirus Questions"

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Coronavirus FAQ: How Do I Clean My Mask — Washing Machine? Oven? Broccoli Steamer?

11/13/20


https://www.npr.org/sections/goatsandso ... li-steamer


Does putting a reusable mask in the oven for 30 minutes at 165 degrees Fahrenheit kill the virus that causes COVID-19 and other pathogens? If not, how do I clean it?


The good news: Yes, baking your cloth or synthetic mask would probably kill the SARS-CoV-2 virus that causes COVID-19. Several studies have shown that the virus dies when exposed to 158 degrees Fahrenheit for a length of time somewhere between 2 1/2 minutes and an hour.

The bad news: It may also singe your mask.

Remember, says professor Raina MacIntyre, head of the Biosecurity Research Program at the University of New South Wales' Kirby Institute, "An oven is designed to burn things!"

The jury is still out on exactly how important it is to wash your mask to prevent COVID-19 infection, but MacIntyre dug into some data from her 2015 study on cloth masks and found evidence that washing masks in a machine, instead of by hand, helps prevent infections of other seasonal viruses in health care workers. Her theory is that the longer wash cycle and hotter water temperatures in a machine kill viruses more efficiently than washing by hand.

In lieu of data specific to SARS-CoV-2, many experts said what we know from studies such as this one make it seem prudent to wash masks on a regular basis. And, certainly, laundering them does not hurt with the possible exception of shortening their life span.

Here's how experts advise you care for your masks (to the best of current knowledge, of course):

During the day: For those of us who now work from home, you're probably taking your mask on and off throughout the day. You don't need a new one every time you run an errand, but it's probably best to toss your mask in a clean plastic or paper bag to keep it free of debris when you're not wearing it. (We'll leave it up to you whether to zip the bag or not — some experts think it keeps contaminants out, but others worry about microbial growth.)

After a full day out of the house: The World Health Organization and the Centers for Disease Control and Prevention say that masks should be washed after a day's use. Based on her data analysis, MacIntyre agrees: "Both surgical and cloth masks get contaminated with viruses, so washing is really important," she says. "If you don't wash it properly, then it may not protect you, because the contamination gets greater and greater over time." After one day of use, her study showed viral contamination — though not with SARS-CoV-2, which hadn't yet been discovered. However, viruses can remain viable for days, she points out, and one recent study found that SARS-CoV-2 can live up to seven days on cotton. "The point is, if you put on an unwashed mask, you may be putting on a mask which is contaminated with viruses," she says.

In addition, WHO recommends taking care when removing your mask: "The wearer should be careful not to touch the outside of the mask. If the outside of the mask is touched during the removal process, the wearer must wash their hands immediately. Also, after removing the mask, the wearer should be careful not to touch their face until they can wash their hands."

MacIntyre suggests that laundering should happen in a washing machine if you have one, with the temp set to 140 to 194 degrees Fahrenheit (the hot setting on most machines).

One note: Check washing instructions before you buy. If you prefer to machine-wash, don't buy the type that requires hand-washing.

A mesh wash bag for delicate items may help protect masks from tearing in the machine.

MacIntyre recommends tossing masks in the dryer as well since that step can reduce the size of the pores in the fabric, which improves performance. And if your mask has a pocket for a filter, throw the filter away after using it once, she says.

Alternatives to the washing machine:
If there isn't a washing machine in your home (or if you're avoiding a communal laundry setting during the pandemic), WHO advises hand soaking masks in cold water with .05% chlorine for 30 minutes, then rinsing them with water and laundry detergent. Air dry in a clean space — not on a dirty kitchen counter, for example. (Here's how to make .05% chlorine water.)

Sunlight could help, MacIntyre adds. This study showed that UVB light can kill SARS-CoV-2.

And if you're washing in a sink, Christopher Friese, nursing professor and director of the Center for Improving Patient and Population Health at the University of Michigan, reminds you to wash your hands before and afterward.

If you want to get creative, a steamer is another option, MacIntyre says. Wash the mask in the sink to get rid of any particulate matter, she suggests, and then place it in the compartment of the steamer where the broccoli usually goes. Heat water and steam the mask for five minutes. But be wary of doing this in the microwave — masks may have metal components that could be hazardous if microwaved.

If all of that sounds way too daunting, take heart from internal medicine physician Abraar Karan of Harvard Medical School, who notes there isn't data to confirm whether washing masks every day, or every few days — or even at all — reduces the transmission of COVID-19.

To be clear, he is in favor of washing masks. The potential benefits outweigh any harm ... not to mention the stink factor.

"When I leave work, I wear a cloth mask. And I wash that probably every few days; I have a couple I rotate between," he says. "You may want to wash it because of moisture or smell or dirt, but it's not like, 'Oh, I'm cleaning the COVID off of it.' "

When to retire a mask:
Just like your favorite pair of jeans or T-shirt, you can keep using a mask as long as it holds its structural integrity. Follow Friese's morning routine: "Before I put it on, I inspect it and make sure it's not ripped or torn or has holes, and I make sure it's clean. If not, I throw it out or clean it." He also checks that it still fits on a regular basis: Put it on, take a deep breath and blow out, he says. "If it's feeling looser on your face, then it's probably time to retire it."

As for disposables: In general, follow the manufacturer's instructions, which usually recommend one day of use. If you're only using a disposable mask briefly while doing errands, store it in a bag and don't use it for more than eight hours total since it is designed for single use. You can even give it a light spray with an aerosolized disinfectant before you put it in the bag, MacIntyre says.

One last note: Wearing a mask reduces the risk of spreading COVID-19, but it doesn't eliminate it.

"We've got to hunker down," Friese says. "We're heading into very perilous times."

That's why Karan advises avoiding the 3 C's: crowds, closed spaces and prolonged, close contacts. That will help protect the people you live with and spend unmasked time with, he says.

When you do go out, do not skip the mask if you're worried it's not clean, Karan says. The most important thing you can do with a mask is wear it, he says.
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Re: "Weekly Coronavirus Questions"

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Coronavirus FAQ: How Safe Is It To Work Out In A Gym Or Play Indoor Sports?

11/20/20


https://www.npr.org/sections/goatsandso ... oor-sports


I have been playing tennis outdoors and would like to play indoors now that winter is coming. How safe is it to exercise, work out and play sports indoors? Or in an outdoor tent next to a gym or sports facility?

In the pandemic, it's much riskier to do these types of activities indoors, according to guidance from the Centers for Disease Control and Prevention. But as winter temperatures set in, exercising or playing sports outside may not be feasible for everyone.

While some fitness studios and indoor sports facilities are rolling out coronavirus safety plans that include upgraded air filtration systems and meticulous cleaning, our experts say this isn't enough to keep you safe from infection.

You still have to practice social distancing and wear a mask while gathering indoors, says Dr. Thomas Tsai, a professor at the Harvard T.H. Chan School of Public Health.

Indoor exercise has resulted in recent clusters of infections.

In Hamilton, Ontario, over 60 positive coronavirus cases were linked to one spin studio last month. In Massachusetts, the governor had to shut down indoor ice rinks in October after at least 30 coronavirus clusters were tied to youth ice hockey. It reopened this month after two weeks of closure.

But not all indoor activities carry the same risk level, Tsai says, and assessing that risk is not a simple matter of checking off boxes. It depends on many different factors, including the facility, your community and your own health.

A facility can do a lot to mitigate the risk of transmission, says Dr. William Schaffner, an infectious disease professor at Vanderbilt University. He points out that masks were not worn during exercise in most transmissions linked to indoor activity, including the Hamilton outbreak.

"If you walk into a place and see people not wearing masks," Schaffner says. "Turn around and walk out."

Facilities must be strict with enforcing mask-wearing and social distancing at all times, even during exercise. Staff should be regularly disinfecting high-touch surfaces and conducting COVID-19 screenings on patrons and employees.

A crucial indoor variable is airflow, says Richard Corsi, an air quality expert and dean of engineering at Portland State University. Outside air must be exchanged frequently and at the right amount. Air filtration systems help if proper filters are used and replaced properly, but nothing comes close to being outside, where coronavirus droplets disperse more quickly into the air.

Unfortunately, there are no surefire ways of determining if you're in a well-ventilated space, Corsi says, other than asking a staff member at the facility and taking the staffer's word for it. And a tent set up outside to exercise in, once all the flaps are closed, is just another room with walls and a ceiling that offers no more significant ventilation than exercising indoors, he says.

Large indoor spaces – such as a stadium-size gymnasium or domed indoor tennis courts – with only a few people playing far apart, are less risky, Tsai says. But basketball and hockey, in those same types of environments, with players so close together is much riskier.

You should also consider who else is indoors. If the local infection rate in your community is high, that's a risk factor, Tsai says. There's more of a chance of you encountering the virus. To find out how risky being indoors is in your community, Georgia Tech maintains an interactive map that assesses your risk based on location and the size of the gathering.

Think of your own personal risk before you decide to exercise indoors, Schaffner says. Everyone is susceptible to being infected, but it is much more likely to affect the elderly severely. According to the CDC, 8 out of 10 coronavirus-related deaths reported in the U.S. have been among adults 65 and older. But you can be of any age and be at a high risk of being hospitalized if you have serious health problems such as diabetes or are immunocompromised. If you're in a vulnerable group, you may not want to put yourself in a higher-risk situation.

How far you are from other people while doing indoor activities is crucial, experts say.

Exercising without social distancing is risky especially when it involves sweating and heavy breathing, says Lisa Lee, a population health sciences professor at Virginia Tech. Heavy breathing means more breath is coming out of your mouth with more force. That's more virus in the air travelling farther.

"The harder we exhale, the greater the risk," Lee says.

For this reason, we should go well beyond the 6-foot distance and keep masks on even during physical activity, Schaffner says, and don't forget to wash your hands. Although chances are slim, touching equipment or picking up a ball could transmit the virus.

There are ways to take matters in your own hands and reduce the risk of infection. Exercise at home or outdoors, and if you do go to a gym or an indoor court, spend less time exercising there. You can decrease your risk by reducing exposure time, says Dr. Todd B. Ellerin, director of infectious diseases at South Shore Health in Weymouth, Mass.

At a time when COVID-19 cases are rising worldwide, our experts say it's best to avoid playing or exercising in an indoor facility for now.

"You really do have to ask yourself is this something so important to me that I need to do this," Schaffner says.
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Re: "Weekly Coronavirus Questions"

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Coronavirus FAQs: Are Playgrounds Too Risky? Do I Need A Mask For Outdoor Exercise?

12/4/20


https://www.npr.org/sections/goatsandso ... r-exercise


After a long and toilsome week of Fortnite and family flicks, beleaguered parents of young children might well see a trip to the playground as a needed reprieve.

The benefits seem obvious enough: Catch some precious outdoor time while turning your child loose on swings and slides to the point of exhaustion — bringing the week to a tranquil close. Ahh. (Sigh of relief).
Yet with COVID-19 in play (no pun intended) it's not always so simple.

This week, L.A. closed down its playgrounds for the second time, drawing furor from parents. And across the country, at least 16 states have done the same since the start of the pandemic.

With the specter of an ever-increasing infection count, it's fair to wonder, are playgrounds really a good idea right now?

According to Harvard Medical School physician Abraar Karan, if you're prudent, a playground trip is actually a great idea.

The first thing to note is that the risks of picking up the virus from surfaces — so in the context of playgrounds, think: jungle gyms, rock walls, slides and swings — are lower than initially assumed.

We know this thanks to breakthroughs in COVID-19 fomite research. A fomite is any object or particle that is covered with virus particles, possibly because someone recently sneezed or coughed respiratory droplets onto it. Fomites can include utensils, clothing ... and sliding boards ... says Sonali Advani, an assistant professor of medicine at Duke University.

If you touch a fomite, then bring your hands to your mouth, nose or eyes, you could become infected.

Even though there was concern early in the pandemic about this possible mode of transmission, the Centers for Disease Control and Prevention said in May that surfaces are "not the main way" the coronavirus spreads. Successive studies have fortified that belief.

Still, Advani says, while the risk of transmission from surfaces is low, "it is not absent."

What does this mean for playgrounds?


Well, Karan explains, since fomites, epidemiologically, are not a huge source of viral transfer, it's probably not likely that children will pick up the virus and later infect themselves while careening down a slide or monkeying around on the monkey bars. The bigger risk is respiratory transmission— so it's critical you follow some of the general guidelines: masking, sanitizing hands after visiting, and physical distancing while on the scene.

"Outdoor playgrounds do have the benefit of being outdoors, of being able to space children out," Advani says. Outdoor airflow disrupts the flow of droplets and airborne particles. "But if everyone goes to the playground, it's going to get crowded."

As an extra precaution, Advani advises practicing situational awareness: If there are a lot of families at the playground when you arrive, try coming back in a few hours. And carry along a set of disinfectant wipes with you, wiping down surfaces before your kid gets on them — just to be extra safe!

The last stage of a safe and successful playground trip in the age of COVID-19 is the cleanup.

"Washing your clothes isn't a bad idea [once you arrive home], Advani says. "It's not that hard to do, and you'll probably want to do it in any case." Even though the risk that your garb was contaminated by contact with fomites is low, it's better to be safe.

And don't forget to wash hands after a visit with soap and water. You can keep the playground spirit going by singing the alphabet song to make sure you hit the 20-to-30 second mark.

What should we make of the WHO's guidelines on no-masking while doing exercise?


This week, the World Health Organization released a controversial statement: masks shouldn't be worn during "vigorous intensity physical activity."

The message was intended to tighten guidelines the organization laid out in June, when WHO released an infographic detailing why it may be a bad idea to wear masks while exercising.

During vigorous activity, the WHO says, "sweat can make the mask become ... wet" — which, the agency went on to say, can lead to bacterial growth on masks, and impede breathing ability.

Experts don't all agree with WHO's approach, and many flat-out rebuke it. So it can be hard to figure out what to do.

Indeed, the experts we spoke to say that while it has been well documented that the risk of non-masked outdoor exercise is pretty low, there can be important symbolic and public health advantages to having a mask on you. In deciding what to do, you should come up with a strategy that gives you options to tailor your approach to your environment, your perceived risk levels and other factors.

"Walking around, wearing a mask shows respect and it sends the message that you believe masking is important," Karan explains. "And the downside of masks is minimal."

In general, Karan says, it's fine to exercise with a mask on. And as long as you're washing your mask after a workout, you can ensure there's not a constant buildup of bacteria. He adds that there's been no large body of data to suggest that bacteria buildup has caused any medical issues.

But Advani acknowledges that it can be hard to mask while engaging in high-intensity exercise, simply on a breathing level. She proposes a solution: Carry a mask with you, and at traffic lights or stretches in the run where you may be around others, put it on if you feel inclined.

"It's not necessary to do while running [without anyone around], but having one on hand will always be helpful."

One other component of the WHO's brief stated that if distancing and ventilation are well-managed in a gym, it's OK to take off a mask while working out in that setting. To that point, both experts interviewed for this FAQ stressed that it's preferable to keep your exercise outdoors, where it's more difficult for the virus to spread.
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Re: "Weekly Coronavirus Questions"

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Coronavirus FAQ: Should I Wash My Kid's Clothes Every Day After School?

12/16/20



https://www.npr.org/sections/goatsandso ... ter-school


My kid is back in school. Do I need to wash their clothes after they come home each day to be safe?


It's normal to wonder what you can do to minimize the risk of virus transmission if you're in a region where schools have reopened or plan on reopening soon. And clothing is of particular concern. Young kids don't exactly have the greatest hygiene: They pick their nose, put their hands in their mouths, wipe dirt on their clothes, touch other kids — you get the idea.

So it makes sense to worry that viral particles could somehow get on your kid's clothing and be a source of infection. A sick kid could accidentally cough on the sleeve of another child's clothes, and the kid could use that same sleeve to rub their nose or mouth. Or parents could be strapping their kid into a car seat and accidentally touch a bit of clothing that has been compromised, then use those same hands to touch the nose or mouth or eyes.

Your instinct might be to wash your kid's clothes once they get home from school so they'll be not only clean but free of viral particles. But does it make sense to do that? Every day?

As Christopher Friese, nursing professor and director of the Center for Improving Patient and Population Health at the University of Michigan, puts it, washing clothes certainly can't hurt.

"The practical solution would simply be to [set aside] those clothes and not wear them immediately the next day." In other words, it's perfectly fine to just dump it in the hamper until your next laundry day. No need to ramp up your laundry schedule or separate them from other clothing in a different hamper.

In fact, the Centers for Disease Control and Prevention outlines that dirty laundry from a person who is sick can be washed with other people's items. Use the warmest water possible and thoroughly dry the clothes. Just make sure to clean and disinfect your clothes hamper from time to time, wiping them down with a standard household disinfectant.

But given what we know about the virus and how it tends to transmit, clothes are probably not something to stress too much about.

To explain, Friese points to a recent paper that models how SARS-CoV-2 can make us sick if the virus is on skin, currency and clothing.

"After eight hours on fabric [made of a mix of cotton], [researchers] weren't able to find traces of the virus," Friese explains. "This is an encouraging sign that clothing is less of a transmission risk than previously noted. The evidence would say not to worry too much."

Stephen Morse, an epidemiology professor at Columbia University says this advice can be applied to any other scenario where your clothes would be exposed to many surfaces, for example, sitting in a public bus or being in a place like an airport or airplane where you'd have sustained contact with seats or equipment touched frequently by other people. It's probably a good idea to wash your clothes — or not rewear them for eight hours — after these trips anyway, but if you don't, it's unlikely to be the potential source of disease transmission.

Clean clothes aside, our sources stress it is far more important to focus energy on making sure your child follows the other precautions at school: physical distancing, face masking and hand hygiene. These changes, Morse and Friese explain, are most likely to make the biggest difference in keeping your kid safe.

"The real challenge is going to be washing hands," Friese emphasizes. "Even in good times, it's really hard to get kids to do this."

Could the coronavirus hibernate inside your body and reemerge years later, like chickenpox?

"Obviously, time will tell," Morse says, "but we have no evidence this is likely to happen."

Morse explains that chickenpox is a herpes virus — and its "lifestyle" is very different from the virus we're currently dealing with. As Morse puts it, herpes viruses really like to "hang out" in the human body, placing their genetic material into certain cells, so they can stay dormant for a long time.

On the other hand, this is not a trait that scientists have observed with other coronaviruses – which typically don't tend to stay latent for years as those herpes viruses do, Morse explains.
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Re: "Weekly Coronavirus Questions"

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COVID Vaccines Appear Safe and Effective, but Key Questions Remain

12/23/20


https://khn.org/news/article/covid-vacc ... ns-remain/


The recent rollout of two newly authorized COVID-19 vaccines is a bright ray of hope at the pandemic’s darkest hour.

We now have a path that can lead us to happier times — even as we watch and suffer from the horrible onslaught of new infections, hospitalizations and deaths that mark the end of this regrettable year.

Health care workers and nursing home residents have already begun to get shots in the first phase of the rollout. Vaccinations should start to be available to the general public sometime in the first few months of next year.

The two vaccines — one developed by Pfizer and BioNTech, the other by Moderna — use the same novel genetic approach. Their development in under a year, shattering all records, is a marvel of science. It’s also a cause for concern for millions of Americans who fear the uncertainty of an unknown technology.

The clinical trial data for the Pfizer and Moderna vaccines show that when both shots of the dual-injection immunization are taken, three weeks to a month apart, they are about 95% effective — at least at preventing severe COVID illness.

However, “a vaccine that remains in the vial is 0% effective no matter what the data show,” says Dr. Walter Orenstein, a professor of infectious diseases at the Emory University School of Medicine in Atlanta and associate director of the Emory Vaccine Center.

Hence, the imperative of persuading millions of people, across racial, cultural, religious, political and generational lines, to get immunized when a vaccine becomes available to them. A survey published this month showed 45% of respondents are taking a wait-and-see approach to vaccination.

Because the vaccines were developed under duress as the coronavirus exacted its deadly toll, the premium was on speed — “warp speed.” So although the number of people in the trials is as large as or larger than in previous vaccine trials, some key questions won’t be answered until millions more are vaccinated.

For example, we don’t know to what extent the vaccines will keep us from transmitting or contracting the virus — though the protection from potentially fatal illness they are likely to confer is in itself something of a miracle.

We don’t know whether irreversible side effects might emerge, or who is at higher risk from them. And we don’t know whether we’ll need to get vaccinated every year, every three years, or never again.

These unknowns add to the challenges faced by the federal government, local health authorities, medical professionals and private sector entities as they seek to persuade people across the broadest possible swath of the population to get a vaccine.

Skepticism resides in many quarters, including among African Americans, many of whom have a long-standing mistrust of the medical world; the vocal “anti-vaxxers”; and people of all stripes with perfectly understandable doubts. Not to mention communities with language barriers and immigrants without documents — more than 2 million strong in California — who may fear coming forward.

Here are answers to some questions you might be asking yourself about the new vaccines:

Q: How can I be sure they’re safe?

There’s no ironclad guarantee. But the federal Food and Drug Administration, in authorizing the Moderna and Pfizer vaccines, determined that their benefits outweighed their risks.

The side effects observed in trial participants were common to other vaccines: pain at the injection site, fatigue, headache, muscle pain and chills. “Those are minor side effects, and the benefit is not dying from this disease,” says Dr. George Rutherford, a professor of epidemiology at the University of California-San Francisco.

Saturday, the Centers for Disease Control and Prevention reported six cases of anaphylactic allergic reaction in the first 272,000 people who got the Pfizer vaccine outside the clinical trials. This has led the CDC to recommend that people receiving the vaccine be observed for up to 30 minutes afterward.

It’s possible other unexpected adverse effects could pop up down the road. “The chances are low, but they are not zero,” says Orenstein. There’s not enough data yet to know if the vaccines pose an elevated risk to pregnant or lactating women, for example, or to immunocompromised people, such as those with HIV. And we know very little about the effects in children, who were not in the initial trials and for whom the vaccines are not authorized.

Q: Why should my family and I take it?

First of all, because you will protect yourselves from the possibility of severe illness or even death. Also, by getting vaccinated you will be doing your part to achieve a vaccination rate high enough to end the pandemic. Nobody knows exactly what percentage of the population needs to get inoculated for that to happen, but infectious disease experts put the number somewhere between 60% and 70% — perhaps even a little higher. Think of it as a civic duty to get your shots.

Q: So, when can I get mine?

It depends on your health status, age and work. In the first phase, already underway, health care workers and nursing home residents are getting vaccinated. The 40 million Moderna and Pfizer doses expected to be available by year’s end should immunize most of them.

Next in line are people 75 and older and essential workers in various public-facing jobs. They will be followed by people ages 65-74 and those under 65 with certain medical conditions that put them at high risk. Enough vaccine could be available for the rest of the population by late spring, but summer or even fall is more likely. Already, some distribution bottlenecks have developed.

On the bright side, two other vaccines — one from Johnson & Johnson, the other from AstraZeneca and Oxford University — could win FDA authorization early next year, significantly increasing the supply.

Q: Once I’m vaccinated, can I finally stop wearing a mask and physical distancing?


No. Especially not early on, before a lot of people have been vaccinated. One reason for that is self-protection. The Moderna and Pfizer vaccines are 95% effective, but that means you still have a 5% chance of falling ill if you are exposed to someone who hasn’t been vaccinated — or who has been but is still transmitting the virus.

Another reason is to protect others, since you could be the one shedding virus despite the vaccination.

Q: I’ve already had COVID-19, so I don’t need the vaccine, right?

We don’t know for sure how long exposure to the virus protects you from reinfection. Protection probably lasts at least a few months, but public health experts say it’s a good idea to get vaccinated when your turn comes up — especially if it’s been many months since you tested positive.

There’s been some talk among health officials of pushing those who’ve been infected in the last 90 days or so toward the back of the line, to ensure adequate supply for those who might be at higher risk.

Q: How long before our lives get back to normal?

“If everything goes well, next Thanksgiving might be near normal, and we might be getting close to that by the summer,” says Dr. William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tennessee. ”But there would have to be substantial acceptance of the vaccine and data showing the virus moving in a downward direction.”
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Re: "Weekly Coronavirus Questions"

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A Q&A about the new coronavirus variant with the Fred Hutch scientist who’s been tracking its spread

12/29/20


https://www.seattletimes.com/seattle-ne ... ts-spread/


With the U.S. on Tuesday recording its first known case of the novel coronavirus variant that’s been sweeping across the U.K., the pressure is on to track the variant’s spread and parse out why it seems to be more contagious — and what that means for the future of the pandemic.

At the center of those efforts is a group at the Seattle-based Fred Hutchison Cancer Research Center that has been cataloging and analyzing genetic changes in the virus since the pandemic began. Nexstrain, co-founded by Hutch computational biologist Trevor Bedford, is an uber-dashboard of genomics, mapping out mutations and the routes followed by every known variation of the virus so far.

Now, Bedford and the project’s far-flung team of bioinformatics experts are helping figure out how widespread the variant might already be in the U.S. and how quickly it could become dominant here, as it did in the U.K.

On Tuesday, Bedford answered questions about the new variant, including its potential impacts on vaccine effectiveness and development of herd immunity and whether additional measures might be needed to keep it in check.

The conversation has been edited for clarity and brevity.

Q: Detecting and monitoring the new variant requires sequencing the genomes of viruses from large numbers of infected people. How is that being done in the U.S.?

A: The U.K. early on decided to have a consolidated national approach to doing this genomic surveillance. They were able to have a few big labs do a lot of testing and then share positive specimens with a handful of big sequencing labs. In the U.S., most of public health is really at the state level. So what’s happened is that there are a handful of public health labs that are doing a good job of sequencing viruses that are collected in their state and sharing that. But there isn’t really a national strategy.

The CDC has given grants to help support academic labs and states to do this work, but it’s a bit slower than it should be. Because this work is done at the state labs, issues of personnel and resources mean that the sequencing often doesn’t end up as the top priority.

Q: The U.S. ranks 43rd in the world in the percentage of positive cases that are sequenced, and you were recently quoted in a New York Times editorial that called for a major expansion. Is anything being done?

A: The U.S. has sequenced and shared over 50,000 virus genomes, more than any country in the world, except for the U.K. However, the turnaround times have not been great. There are thousands of viruses that were shared in the database in December, but a great many of those were from specimens collected back in March.

The CDC has plans to (start) receiving specimens from the state labs and then doing the sequencing more centrally and share the data. So there are plans to have thousands more genomes sequenced every month, but I don’t know when that will come online.

Q: The first U.S. infection with the U.K. variant was reported Tuesday in a Colorado man in his 20s with no recent travel history. How prevalent do you think that variant and a similar one detected in South Africa are in the U. S.?

A: My working hypothesis is that they are here but circulating at very low levels. And if they are more transmissible, which I think is likely, then they will be expanding, and we’ll catch them when they hit some frequency threshold.

Q: Travelers from the U.K. now need a negative coronavirus test to enter the U.S. How effective do you think that will be in slowing the spread of the variant?

TB: I think it’s smart at this point. I don’t have hope that we will be able to contain the U.K. variant in the U.K. in the same way I didn’t have hope in February that we were going to contain COVID in China. But testing to reduce the number of infected individuals traveling can still slow things down.

I think it might stop mattering so much once these variants become more common here.

Q: You’ve said the new variant might be slightly less susceptible to vaccine-induced immunity, but that it isn’t different enough to completely foil existing vaccines. Why?

A: The main reason I think that is because there’s a particular mutation in the U.K. variant that removes two different (portions) of the spike protein, and that tucks in a bit of protein that was sticking out and was an antibody target. So it removes that target for antibodies.

And there was a study from a lab in Cambridge … where they took serum from people who had recovered from COVID and measured it against wild type virus and against viruses that have this deletion. And they saw that the antibodies of the recovered individuals neutralize the mutated virus significantly less than the wild type virus.

If I had to hazard a guess, I believe we could see a modest reduction, like from 95% vaccine effectiveness to 85% or so, but I don’t think it would really severely inhibit the vaccine.

Q: If this variant becomes common and lowers the overall effectiveness of the vaccines even slightly, what are the implications for the development of herd immunity?

A: I think we’ll still get there. It’s just going to be a bit more challenging.

Two weeks ago, my expectation for the U.S. and for Washington state was that by March things start to get under control, (due to) seasonality and a hundred million doses of vaccines by the end of February, theoretically. Also, people are continuing to get infected and have immunity after they recover. So you could imagine those three things combining to have an effect.

But now, that’s roughly the time frame I’d expect for the variant to start to become predominant in the U.S., given that it appeared to have emerged in London around September and became predominant around December. So it took about three months there.

Q: Will we have to change our behavior and do things differently to prevent the spread of the new variant?

A: If you look at the U.K. data, when you compare the wild type virus to the variant virus, people infected with the variant have 10 to a hundred times higher viral loads on average.

So people who are infected by the variant will be breathing out more virus than someone infected by the wild type. Public Health England had a really good … case-controlled study where they showed that for individuals infected with the wild type, 10% of their contacts ended up with COVID, whereas individuals with the variant had about 15% of their contacts ending up with COVID.

So that means that in March, or whenever the variant starts becoming predominant here, a larger proportion of household contacts and close contacts of infected people will also become infected.

But the things that are safe now should still be safe then. The same strategies that we’re using to try to limit the spread now — social distancing and wearing masks and so forth — are the right strategies. It’s just that there will be more contagiousness to deal with.

Q: What does the rapid emergence of this new variant suggest about the future? Are we going to eventually see strains that are resistant to all of vaccines?

A: It was surprising to me, and I think, to most evolutionary virologists. The evolutionary mechanism definitely appears to be selection for more transmissibility. The virus evolves to more transmissible because that’s what evolution is selecting for.

Most people haven’t yet been infected and don’t have immunity, but as we have more and more individuals with immunity from natural infection or vaccination, you do have more evolutionary pressure on the virus to evolve in ways that escape from that immunity.

However, my main expectation here comes from what we know about seasonal coronavirus, which account for 30% of common colds. We can look at their evolution and they seem to infect people every three years or so and evolve at a slightly slower rate than influenza. That suggests to me a kind of flu-like pattern where you might need to update the vaccine every two or three years, and where evolving strains might be able to reinfect people on that sort of time scale as well.
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Re: "Weekly Coronavirus Questions"

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Coronavirus FAQ: I'm Using A UV Light To Disinfect Stuff. Is That A Good Idea?

1/29/21


https://www.npr.org/sections/goatsandso ... -good-idea


I'm using a lamp that emits UV light in my house to try and kill pathogens — the coronavirus in particular. Is it doing any good?

And ... could exposure to the light be risky for me in any way?

Let's start with the good news: Some recent studies confirm that SARS-CoV-2 is one of the viruses, along with other types of coronaviruses, that can be killed by ultraviolet light rays.

Actually, we've known that UV light kills a lot of different germs since the late 1800s when scientists discovered that shorter wavelengths of ultraviolet light rays emitted by the sun — what we now call ultraviolet-C rays or UVC light — could kill bacteria. And unlike the longer wavelengths of the sun's UV light, UVC rays don't naturally hit the Earth's surface, so they're particularly lethal for microbes that haven't had a chance to adapt to them.

Since then, UVC technology has been used for sanitation. Hospitals and water treatment plants, for example, rely on the rays to kill mold, viruses and bacteria. And with the promising research into COVID-19-killing potential, UVC light-emitting machines are being utilized more — popping up in empty subway cars and even the air ducts of many public places, including restaurants.

And the technology is making its way into consumer culture as well, with free-standing UVC lamps meant for your home or office. They're often labeled as desk lamps or table lights and priced in the $50 to $100 range. Alternatively, there are even cheaper, more mobile ultraviolet gadgets such as handheld wands, or light boxes with lids, that are promoted as safe, easy-cleaning tools for small objects such as phones, computer keyboards and eyeglasses.

But here's the bad news.

Although it's been proven that ultraviolet-C light can kill the coronavirus in controlled research environments using specific doses, there's no guarantee that a lamp will.

Manufacturers use pleasant words such as "sterilizing" and "germicidal" to reference the lamp's ability to kill germs. But they are careful when it comes to stating which germs. Although they do typically list some specific bugs susceptible to the light — think influenza or E. coli, for example — you won't see the coronavirus in the mix. The Food and Drug Administration says we still don't have enough data about the dose, wavelength or duration of UVC light rays needed to kill the coronavirus in the air or on surfaces, which means there's no certainty that any ultraviolet lamp can get rid of it.

Another issue is that the UVC lamps you can buy online are often smaller than the industrial lamps used to kill viruses in labs. Or they emit light from only one angle, which can become a big problem since the light rays aren't effective at wiping out pathogens if they're obstructed by really anything — such as dust, crevices or room angles that form shadows.

Maybe more problematic is the temptation to turn on these portable lamps throughout the day to fight germs. But the room must be cleared of absolutely everyone before you use it: Otherwise, ultraviolet light lamps could hurt your eyes — or the eyes of your co-workers or family members or roommates — if used incorrectly.

Guillermo Amescua, an ophthalmology specialist with the Bascom Palmer Eye Institute at the University of Miami, warns of a condition called photokeratitis. It is like a sunburn causing inflammatory damage to several layers of the eye, not just the skin around it, with symptoms such as severe eye pain or redness, blurry vision, eye twitching, light sensitivity or even temporary loss of vision.

Though photokeratitis can be caused by looking directly into a lamp as it radiates ultraviolet light (similar to bare eyes staring at the solar eclipse back in 2017), it can also happen if you're in the same room as a UVC device that produces light, which is why using them can get tricky.

While some manufacturers are quite clear in their recommendation that the room, big or small, must be free of living creatures (including animals) when the lamp is turned on, others use generic language such as "no people or pets around," which might imply it's OK to distance yourself a bit and hang around in the same room — but it's not. When the light is on, you should be out.

Amescua has been hearing about a lot of patients diagnosed with photokeratitis after staying in the room while their UVC lamp was on before coming in with symptoms. And there's been a lot more of them than usual. So many, in fact, that he and his colleagues authored a research article to alert people of the danger after a big uptick in cases following the start of the pandemic.

Many times, the harmful effects are quick to reveal themselves. "It could be four to six hours after being exposed that patients come in with eye damage, depending on the amount of energy of the lamp and the amount of time exposed," Amescua says, noting it can happen in as quickly as 15 or 20 minutes. Luckily, he says most patients fully recover with treatments such as prescription eye drops, eye rest and sometimes a special contact lens.

But the buck doesn't stop at short-term eye damage when we're talking humans using UV lights for sanitizing. The FDA warns of other serious and long-term risks of repeatedly exposing your eyes or skin by being in the same room with them, including deadly skin cancers or long-term eye damage such as cataracts.

And to complicate things further, some UVC lamps sold online also emit ozone, an invisible gas that can also kill microbes. Most of these lamps, which often boast of their "ozone power" in marketing lingo, also require an "air-out" period — a block of time when humans and pets shouldn't come back in the room even after the lamp turns off — to give the ozone gas time to dissipate, as it can irritate the lungs if inhaled.

So you can draw your conclusions about UVC lamps from the data — and warnings — now available. But whatever you conclude, keep in mind that they can't take the place of other ways we fight the spread of the coronavirus, says Peter Gulick, an infectious disease doctor and virus expert at Michigan State University. He emphasizes the importance of wearing masks, staying 6 feet away from people and washing your hands often.

"If you're going to use [UV light] then use it, very carefully. But don't think it's going to substitute for other protective practices that we know are working," Gulick says. "We don't want to have situations where people say, 'Ah, we've used UV light in here, so it's safe to forget everything else.' "
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