COVID19 PRACTICAL

 

To slow the spread, focus on fresh air

As evidence has accumulated over the course of the COVID-19 pandemic, scientific understanding about the virus has changed: the majority of transmissions occur as a result of infected people spewing large droplets and small particles called aerosols when they cough, talk or breathe. Surface transmission, although possible, is not thought to be a significant risk. That doesn’t mean that cleaning doorknobs and other surfaces is pointless, but it needn’t be a priority, scientists say. “Excessive attention on making surfaces pristine takes up limited time and resources that would be better spent on ventilation or the decontamination of the air that people breathe,” says engineer Linsey Marr, who studies airborne disease transmission.

Nature | 11 min read (from February)

HEPA air filters are a very useful layer of protection in enclosed areas. Consumer reports has reviewed HEPA filters and rated several aspects.

Since originally posting this page more information about the transmission of COVID 19 has become available. While spread through fomites (touching surfaces, clothing etc.) is theoretically one mechanism of spread it is unlikely that this represents a significant component. Here is an update from John’s Hopkins.

An editorial published in Nature discusses the need to shift focus away from surface decontamination as a mechanism to reduce SARS-CoV-2 transmission risk. Multiple studies have found that transmission of SARS-CoV-2 via contaminated surfaces, or fomites, is relatively rare compared to respiratory transmission via droplets or aerosols. Despite the evidence supporting respiratory exposure as the overwhelming driver of community transmission, numerous public health entities, including the WHO and US CDC, continue to emphasize the importance of surface decontamination, which can cause confusion among the public regarding transmission risk and appropriate protective measures. Notably, surface decontamination efforts, while highly visible and easy to recognize, are costly and likely not effective means of reducing transmission risk. The editorial calls for increased focus on improving ventilation and air filtration capacity to reduce respiratory exposure. Additionally, proper physical distancing and face mask use remain key tools in mitigating exposure and transmission risk for individuals.

The key to reducing the risk of symptomatic infection, especially moderate to severe illness and death appears to be vaccination. With the recent surge in cases associated with the DELTA VARIANT, renewed efforts to slow spread have been emphasized. There is a clear relationship between vaccination rates and hospitalizations as depicted here:

Covid 19 hospital occupancy vs state vaccination rate

raise the flag

Anti Vax Pulls the flag down

50-60% of viral transmission appears to be from asymptomatic individuals. So wearing a mask, social distancing, and avoiding unventilated crowded indoor spaces remains extremely important as the more easily transmitted DELTA VARIANT circulates.

Vaccinated States keep Delta in check

The Delta variant appears to be 2.5 to 3 times more transmittable compared to the alpha variant.

Delta Variant Transmission rate

DOUBLE MASKING IS MORE EFFECTIVE THAN SINGLE MASKS.

TRIPLE LAYER MASKS OF TIGHTLY WOVEN FABRIC IS MORE EFFECTIVE THAN SINGLE OR DOUBLE LAYERS.

N95 MASKS ARE MOST EFFECTIVE BUT THEY MUST FIT THE FACE WITH A TIGHT, SNUG FIT. 

TO IMPROVE THE BARRIER FUNCTION OF MASKS WEAR A SNUG FABRIC MASK OVER A SURGICAL MASK OR OVER AN N-95. THIS WILL PROTECT BOTH THE WEARER AND THOSE AROUND THE WEARER.

Doctors and nurses in hospitals and clinics often wear a surgical mask over an N-95. 

Face shields do not protect you or those around you from infection. Face shields and goggles likely decrease the risk of infection transmitted from aerosols that hit your eyes but do nothing for the most important mechanism of spread, breathing in aerosols or droplets into your nose. Aerosols will just spread around a face shield into your nose. 

Think about smelling the pleasant odors of food cooking in a kitchen. Face shields will not block those aerosolized food vapors from entering your nose, but tightly fitting masks will do it to some degree.

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels. Supplement with Vitamin D3 to get your levels above 30 ng/ml. (read this Open Letter)
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob