The Pandemic Is Not Over

To the Editor of The Keene Sentinel:

Please run an error correction for your Sept. 10-11 front-page headline:

“As the pandemic subsides, college presidents course correct”

And the electronic and filename versions are even worse:

“As pandemic ends, college presidents course correct”

No responsible party is saying the pandemic is over—or even “subsiding". Just the opposite. For example, the same weekend, the Wall Street Journal ran a story: "Covid-19 Is Still Killing Hundreds of Americans Daily”. Over the past few months, the more-or-less 400 daily deaths translate to about 150,000 a year at this rate. (This is three times the highest annual flu deaths in the past decade.) In New Hampshire, our rate of community spread and deaths this summer is about twice that of last year.

And the fall surge hasn’t even started yet. The Biden administration has warned that the U.S. could see 100 million COVID-19 infections in the fall and winter. As students go back to school, and people of all ages go inside buildings with less fresh air, and the virus remains active with more variants in the pipeline, a fall/winter surge seems inevitable. Take a look at the graph below of NH deaths, courtesy of Covid Act Now.

As an engineer who has been dealing with the pandemic since the first summer, I know that there are many simple actions that people and building managers can take to reduce the spread and risk. They include increased fresh air ventilation, antigen tests by the right people at the right time, and highly effective masks for higher-risk situations. (These and other topics, including fresh air meters and other tools, are presented on my website at https://www.kohlerandlewis.com/covid-19blog .)

Instead of declaring the pandemic to be ending, it would be more useful if The Sentinel would run a weekly reminder as long as it is still here, such as a graph of the average daily covid-19 deaths over the last 6-12 months.

Roy Swain
Westmoreland

NH Covid Cases according to Covid Act Now

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Safe Airplane Flying

We all know of people who have now been flying without contracting covid-19, and perhaps some who were not so lucky. (The odds of catching the disease on a plane ranged from 0.1% (2-hour flight) to 7% (10-hour flight) in late 2020, according to an MIT simulation and a small, real-world study, respectively. That was when masks were still required, and with a less infectious variant compared to the current dominant BA-5—today’s risks will be higher. See Insider.com 8/2/22.)

I ventured out into this brave new world last month and am happy to report that I came home without the infection.

I utilized techniques and gadgets developed over the last two years, most importantly the mask systems that pair an N95 mask of your choice with a small, battery-powered HEPA filter and fan unit (see blog post Jan. 4). (You can buy them online, or from us for $100. Our version includes improved masks, plus a small modification to improve performance.)

Also useful was a Safetulator Fresh Air Meter—in this case, a new model that is even more portable, and has the added feature of a short warning beep if the CO2 level exceeds 1000 ppm. On our scale, this level is the upper end of the “yellow zone”. (These you can also buy online, or from us for $100. Our version includes improved labeling, detailed instructions, a calibration check, and recalibration if needed.)

Using the meter, I found the amount of fresh air usually was not very good. The airports ranged from 700-1200 ppm (less than 800 is the CDC recommendation), and the airplanes ranged from 650 to 2000. Once in the air, the airplanes were good or fair (650 to 1100), but on the ground, the amount of fresh air was much less, and the CO2 levels were higher.

The Portland, Oregon airport had great fresh air, less than 750, and was uncrowded when I was there. I was able to have a leisurely meal, and I set up another gadget at the table—a portable fan with HEPA filter that blew 30 cfm of virus-free air in my direction.

I did covid-19 testing frequently on both ends of the flight, and I’ve now had a negative PCR test four days after my return, so for my test case of one, everything worked well!

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Can We Please Have an Intelligent New Normal?

As we have been advocating in this blog, the “new normal” does not have to be returning to the identical life as before the pandemic, since that translates into "let-the-virus-do-what-it-wants”, which is: continuing to put 40,000 Americans into hospitals and 400 into their graves EVERY DAY. This is a rate of about 150,000 deaths a year, THREE TIMES HIGHER than the WORST flu seasons of the last decade.

Covid-19 Deaths and Hospitalizations (Washington Post, Aug. 16, 2022):

In the article linked below, a Vassar professor points out that several Asia-Pacific countries are setting an example of an intelligent new normal, with striking results compared to the U.S. For example, covid-19 mortality rates per 100,000 people:

How are they doing this? Simple stuff, which all adds up:

1 - higher vaccination rates

2 - ubiquitous indoor masking in the most important places

3 - widespread improved fresh air ventilation and air purification - - the subject of many entries in this blog, and which includes being aware of the quality of the fresh air by measuring it

I can suggest another item:

4 - effective use of antigen testing to ensure those gathering together are not contagious (see the previous blog post)

Here is the full article:

https://thediplomat.com/2022/08/how-third-way-countries-live-with-covid-19/

[The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.]

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Finally--A Simple Way to Know If You Are Contagious

Wow, I finally found an answer to a question I have had for months: are antigen tests REALLY a good measure of infectiousness? We know that a negative antigen test is poor at accurately telling if you have covid-19 (false negatives about a third of the time), but what really counts for covid-free group gatherings is not if people have some level of the disease, but are they CONTAGIOUS TODAY?

I found one study (from March 2022) that concluded they are EXCELLENT at this. It said "Interestingly, SARS-CoV-2 contagiousness is highly unlikely with a negative antigen test since it exhibited a negative predictive value of 99.9% compared to viral culture. … Thus, screening people with antigen testing is a good approach to prevent SARS-CoV-2 contagion …"

I think this means that if you do a proper job with a single antigen test, and get a negative result, this DOES reliably say that you are almost certainly not infectious to others. Therefore, the number of contagious people at a gathering apparently can be reduced to near zero if everyone does an antigen test upon or just prior to arrival.

Of course, this is not quite perfect, as in the morning someone could be in the beginning stages of a covid-19 infection, with their virus load increasing but just below the threshold for being significantly infectious, and by the end of the day could be testing positive and starting to be contagious.

But that small level of risk can be easily managed by proper levels of fresh air ventilation and, if needed, supplemental air purification, both of which I expect will scrub the virus out of the air as fast as it’s being introduced by only a very small percentage of people.

I don’t understand why this news has not been "trumpeted from the treetops”! Am I missing something here? So I had an email exchange with the corresponding author of the study. Here’s what he said:

From: Wbeimar Aguilar <wbeimar.aguilar@udea.edu.co>
Subject: Re: antigen test study
Date: August 4, 2022 at 9:17:57 AM EDT

Dear Roy

I totally agree with you and the blog contents you plan to share.

Our conclusion is wordy to be scientifically precise, but it is true; the simple interpretation of the
conclusion is just a negative antigen test = not contagious.

Regards, Wbeimar

Wbeimar Aguilar Jiménez
Biologist, MSc, PhD in Biomedical Sciences
Grupo Inmunovirología
Sede de Investigación Universitaria
Universidad de Antioquia
Medellín-Colombia

Here is the link to his group’s study: https://journals.asm.org/doi/10.1128/spectrum.01962-21

[The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.]

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Someone in the Room Has COVID-19

The overall increase of cases, hospitalizations, and deaths continues. A month ago, the daily U.S. figures were about 30,000 hospitalizations and 300 deaths. Now we are at 40,000 and 400—so approaching 150,000 deaths a year at this rate! Maybe this is the new way, but I sure wouldn’t call it normal. From the Washington Post:

Immunity from a recent infection does not last very long. Australia is figuring that the protective window of prior infection is 28 days. Of course not always exactly, but that’s the early end of the bell curve. After that, with any symptoms, you need to take a covid-19 test right away in order to protect those around you.

https://scroll.in/article/1028215/covid-19-reinfections-are-happening-sooner-than-expected-as-the-virus-evolves-continually

How does all this translate this into your daily life? Just realize that there are a LOT of infected and infectious people around—who don’t realize they are sick.

At one hospital, they made a calculation based on their admissions. “At UC San Francisco’s hospitals, 5.7% of asymptomatic patients are testing positive for the coronavirus, meaning 1 in 18 people who feel fine nonetheless have the coronavirus. In other words, in a group of 100 people, there’s a 99.7% chance that someone there has the coronavirus and is potentially contagious. ‘Think about that the next time you go into a crowded bar or or get onto an airplane with 100 people,’ said Dr. Robert Wachter, chair of the UC San Francisco Department of Medicine.”

Every airplane flight will have infected people and thus some amount of virus in the air. So will every large, indoor group. Know this, and choose where you go, how long you spend there, how good a mask you wear, and what you do to monitor or increase the amount of fresh air ventilation once you get there.

https://www.latimes.com/california/story/2022-07-18/californias-summer-covid-wave-could-top-winter-surge

[The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.]

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(Bad) News Roundup

BA.4 and BA.5 are now dominant

This is an article from Nebraska, but talks about the national covid-19 situation: “Our national COVID-19 case rate is at an 'elevated plateau.' … There are more than 300 deaths per day, and hospitalizations have increased 13% over the last two weeks.” Omicron variants BA.4 and BA.5 are estimated to be two-thirds of the cases nationally. They call it “plateau” but I expect it to be steadily rising all summer. At the current death rate, this would be 100,000 deaths annually.

https://www.nebraskamed.com/COVID/what-covid-19-variants-are-going-around-in-july-2022


We are in a silent surge

We all know a lot of people who have gotten covid-19 lately. Ignore the case counts. Here’s an example of sewage monitoring in California that has reached all-time highs. ‘The sewage never lies.’

https://www.sacbee.com/news/coronavirus/article263044553.html

And I don’t know if this is true, but at least one doctor "estimates 80 percent of infections with Omicron [variants] are actually asymptomatic."

https://archive.ph/JGCdF


"The new omicron variants ... have been shown to be not only more contagious but also capable of causing reinfection.”

And more good info in this article, local to San Francisco but with many national topics.

https://missionlocal.org/2022/07/7-6-22-tracker/


Getting repeat infections is not a good idea

The bottom line seems to be that each new covid-19 infection essentially rolls the dice again with no credit or penalty from the prior infections. Repeat cases are not necessarily the same, or less severe.

The study was for patients in the Veteran Affairs health system, so it is not a representative sample of the U.S. population as a whole. Still, it found that "compared with those with just one Covid-19 infection, those with two or more documented infections had more than twice the risk of dying and three times the risk of being hospitalized within six months of their last infection."

https://www.cnn.com/2022/07/05/health/covid-reinfection-risk/index.html

And from the Washington Post covid-19 newsletter of June 27th:

"Q-How many times can a person ... be infected with Coronavirus after taking both shots of the vaccine and a booster shot?

A-The short answer, unfortunately, is that the number of times a vaccinated and boosted person can get infected is probably limitless."


"Patients With COVID-19 May Have Loss of Taste, Smell for Years After Infection, But Remain Unaware”

One of the many “long covid” effects.

https://www.pharmacytimes.com/view/expert-patients-with-covid-19-may-have-loss-of-taste-smell-for-years-after-infection-but-remain-unaware

[The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.]

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