The Covid-19 Silent Surge is Here

The Silent Surge 

We are now in the middle of this year’s covid-19 winter surge, and it is turning out to have the highest virus levels of the last two years (since the huge Omicron peak of January 2022). This conclusion comes from the testing of wastewater, which continues to be active and accurate nationwide. The Northeast has the highest virus levels (yellow in the graph below), and the highest percentage of the latest variant, JN.1. The Midwest (purple) is second. [ https://biobot.io/data/covid-19 ]

Biobot Graph

Individual states and localities are already higher than last year (as we showed in the Dec. 15, 2023 blog post for Keene, NH). Another example is Des Moines/Polk County, Iowa (which is currently beset by numerous presidential candidates and their superspreading gatherings)!

Polk County, IA Wastewater Graph

Nationally, the peak is expected mid to late this month. "According to the model of Dr. Mike Hoerger of Tulane University, … by January 10, there will be roughly 2 million daily new cases in the US, with nearly 14 million infectious people.” This means more than one out of every 30 Americans will be infected (and half to three-quarters not aware of it!) [ https://www.wsws.org/en/articles/2023/12/29/pers-d29.html ]

So What?

Readers of this blog know all the effective measures you can take if you would like to reduce your risk. See past blog issues, especially Dec. 1, 2023 Blog Post. 

At whatever risk level you are comfortable with, now would be a good time to up your game a notch.

And note that this latest variant may affect your gut: "Cases of diarrhea, which may or may not be related, are reportedly on the rise. This comes as speculation swirls that the virus might be taking up residence in the gut — versus the upper respiratory tract, where Omicron tends to hang out, or the lower respiratory tract, where initial strains of COVID wreaked havoc. Keep an eye out for Gastro-Intestinal symptoms and realize they could be signs of COVID, not just the stomach flu, experts advise.” [ https://fortune.com/well/article/covid19-variant-jn1-symptoms-pirola-omicron/ ]

To Protect Others

The bottom line for protecting others is that you can usually avoid passing it on to your family and others close to you if you take immediate action to find out if your illness is indeed covid-19. Fortunately, this is easy to do. Anyone with a GI or flu-like illness should get tested for covid-19: either go to a clinic for a PCR test, or wait three days after symptoms began, and do a home antigen test — one test on day 3 and again on day 4.

Good news is that if you test positive, it’s not too late to start isolating from everyone else in the household — exposure is cumulative and the immune system can in many cases fight it off if exposure is mild in intensity and/or duration. Complete directions for isolation can be found in our Feb. 9, 2022 blog post — and we have good feedback from one reader who followed this procedure with no spread of the disease!

[ https://www.kohlerandlewis.com/covid-19blog/2022/2/9-you-can-isolate-and-not-spread-covid-19-geanc ]

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A Jump Start to the Winter Surge - and a New Meter to Help

A Jump Start to the Winter Surge?

Nationally, "COVID-19 is on the rise again, yet another indicator that the pandemic isn't truly over."

https://www.salon.com/2023/12/14/respiratory-are-on-the-rise-did-19-make-us-more-vulnerable-to-other-illnesses/

Covid modeler J.P. Weiland showed on December 4th, 2023 that the winter surge is about the same as it was last year at this point based on wastewater virus samples.

https://twitter.com/jpweiland?lang=en

Graph of Estimated Covid Infections/Day US

And of course there are spots where the surge is even higher. One such spot appears to be here in Keene, NH, where the wastewater virus levels are off to a jump start — eight times the levels of a year ago, and already higher than last winter’s peak! (Note that the national graph above covers more than three years, and the Keene graph below is for the last 15 months.)

https://wisdom.dhhs.nh.gov/wisdom/dashboard.html?topic=covid-19&subtopic=recurring-updates&indicator=covid-19-wastewater#wisdom

Graph of Keene Wastewater Treatment Plant

And a New Meter to Help

So it looks like something in the order of one out of every 40 or 50 people have covid-19 today, and of course most of these people don’t know it, due to symptoms not appearing yet, or being hardly noticeable, or the disease being mistaken for something else without testing being done.

Given this, it’s good timing to have a new Safetulator™ Fresh Air Meter available for those who want to use the best tool for reducing transmission in group settings. We have learned from meter users that it is often difficult to know the best way to use a meter, to take readings, and to interpret them. (We gave some tips in the Sept. 15, 2023 blog post.)

This new meter is the easiest to use yet. It has the rarest of features compared to the hundreds of meters out there — that you can take it out of the box and plug it in and it works — accurately and stays accurate — without any adjustments or set-up on your part. There is a single button on the back that lets you cycle through three levels of display brightness and that’s it! 

Photo of meter

It's great for your office, workplace, or classroom—where you have the means to adjust the amount of fresh air ventilation. Your control over the fresh air might be moving a lever on an air register, controlling a fan speed, or cracking open one or more windows.

To use the meter, plug it in to the wall adapter and set it up at a representative spot — not where any air is blowing on the meter, and not within two feet of a window or a person.

Then just let it run for a while — come back later and you will find a 24-hour visual history of the average amount of fresh air per person (CO2 concentration) at that spot in the room. You will be able to see when people were in the room, and when the room was empty or nearly empty. Here is a chart that explains the colors and meanings. 

Chart of Fresh Air Meter

Now you can experiment with your fresh air adjustments. As we have discussed before, you will be reducing airborne infections by 80% by “keeping it in the green”. If the meter shows all three green bars, this indicates the optimal level, with the displayed number being in the range 667 to 799. And if you have a properly-sized room air purifier that is running and has a clean filter, all the green plus the lowest yellow bar is OK too.

We are in the early stages of handling this meter, so we have limited supplies. We check the calibration of each meter, add some labels and instructions, and include a wall adapter. The package is available from us for $125 — if you’re interested in ordering one, please email safetulator@kohlerandlewis.com. Shipping and handling is $25 for one to three meters, and free shipping if you buy four or more.

Wishing you and yours Happy Holidays with lots of fresh air!

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The Fourth Covid Winter

Here we go again

We are beginning another seasonal rise in covid-19 infections as we have more family gatherings, more airplane travel, and more time inside buildings with poor fresh air ventilation. The amount of covid-19 virus in circulation is on the upswing again—not quite up to the levels of a year ago, and perhaps headed for a peak similar to last year’s (but NOT the huge Omicron surge of January 2022!). In the national wastewater virus sampling graph shown below (from Biobot), you can see that such a peak would put us at about five times the low virus levels of this past summer.

Biobot graph

And we have several very effective ways to reduce the spread and reduce our own risk. All of these we have discussed before—here is a handy listing of them, and references to the more detailed reports.

Healthy fresh air ventilation

Of course, this is the least intrusive method—equivalent to a good mask for everyone, without the masks! And air purifiers can augment actual fresh air and save energy at the same time. There is a review of the practical methods to accomplish good fresh air ventilation in our Sept. 15, 2023 posting. If you are gathering in someone’s house and don’t have a Fresh Air (CO2) Meter, the simplest way to tell how much fresh air is enough is to open one or more windows fully, but not so many windows that your heating system cannot keep up with it. At our family’s Thanksgiving with seven people, we had one window open fully, the wood stove cranking away, and the CO2 always less than 700 ppm (“in the green”).

Photo of air purifier

“Sweet spot” humidity

This is a very important and usually ignored aspect of healthy indoor air quality - humidity, the moisture in the air. In the winter in cold climates, we ADD moisture to the air to achieve the ideal minimum of 40% RH (Relative Humidity). This level helps your air passages stay hydrated and be effective in their immune system function, and also impedes the airborne circulation of viruses. (See Dec. 1, 2022 post.)

Photo of humidifier

Antigen tests

For cases where you are gathering with like-minded people who want to avoid unnecessary covid-19 risk, the easiest way is for everyone to get a negative antigen test result that morning. [See Dec. 16, 2022 blog post.] These tests are now readily available and cost as little as $6.50 each (or free, in limited supply, from the federal government). The hardest part of this strategy is to have a compassionate and inclusive way to deal with those members of your group if anyone tests positive. While a negative test should mean the person is not contagious that day, I like having good fresh air ventilation also, which cuts by 80% the risk of transmission of all airborne diseases.

Photo of InBios self-test

The best masks

There is a very fine assortment of N95 or equivalent masks now, all readily available, as presented in our Oct. 19, 2023 post. Remember the first covid winter of 2020-2021? That year, when most people were wearing masks most of the time, there were hardly any flu cases in the U.S.! (https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm)

This is a testament to the effectiveness of masks, and perhaps other factors as well. Of course, the most important time to wear a mask is when you are part of a large number of people in close quarters, as on an airplane, or at a holiday music concert. Remember, more than one out of every 100 people is currently infected with covid-19 and many of them do not even know it.

Photo of mask

If you do get covid-19, you can avoid passing it on

If you do get covid-19 again and know it, you can follow the best practices to avoid spreading it to others in your family. See Feb. 9, 2023 Blog Post. I just heard from a reader who followed our instructions when one family member contracted covid-19, and everything worked perfectly—it did not spread! And you can avoid spreading it beyond the family if you delay returning to circulation until you get a negative antigen test. 

Again, we’re in much better shape than the huge Omicron surge of January 2022! Be well!

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"The Coronavirus Still Doesn’t Care About Your Feelings"

This is a short blog post because I want you to click on the link at the bottom and read the whole article.

It’s "The Coronavirus Still Doesn’t Care About Your Feelings” from The Nation, Oct. 13, 2023. 

The title stems from the history of the government’s repeatedly telling us how we should feel about the latest covid-19 development. As in “don’t panic”. But this particular message "puts the cart before the horse unless tangible measures are being taken to prevent panic-worthy outcomes.” 

As we said in our Aug. 31st, 2023 blog, the amount of covid-19 virus in circulation is “at an historically medium level, not counting the huge Omicron surge of the winter of 2022-2023. At the current level, in the past when we were counting carefully, there were 300-600 deaths a day attributable to covid-19. That means 100,000+ a year!” Here is the current national graph:

Wastewater graph

And some more snippets from the article:

"Despite the end of the Public Health Emergency in May, Covid-19 remains a pandemic, by definition.”

 “[To achieve] a good outcome, concrete interventions are required—including improvements in air quality and other measures aimed at limiting spread in public buildings…”

"Despite messages to the contrary, our situation remains unstable, because the virus continues to evolve rapidly…” 

"If our increasingly relaxed attitude toward public health measures and the relatively unchecked spread of the virus continue, most people will get Covid at least once a year; one in five infections leads to long Covid. Although it’s not talked about a lot, anyone can get long Covid; vaccines reduce this risk, but only modestly.”

Here’s the link—there’s a lot to ponder here:

https://www.thenation.com/article/society/covid-pandemic-panic-calm-advice/

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The Best Masks for the Immunocompromised

7 Million People

"Immunocompromised people account for at least 2.7% of U.S. adults—about 7 million people,” according to the American Medical Association (AMA). This includes those with primary immunodeficiency, as well as those whose immune system has been medically suppressed due to recent procedures including organ transplants and cancer treatments.

https://www.ama-assn.org/delivering-care/public-health/what-tell-immunocompromised-patients-about-covid-19-vaccines

Of course the immunocompromised are at greater risk for all communicable diseases including covid-19. For example, they accounted for 12% of all adult COVID-19 hospitalizations in a 2022 study.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7127a3.htm

I had a call on this subject a few days ago, so I thought this would be a good time to share what we have discovered and developed regarding masks for the immunocompromised (and everyone else).

The Best Masks and How to Use Them:

Easy-to-breathe, 100% effective fan/HEPA filter mask. We have been using these since April 2021, the "BROAD AirPro Mask Rechargeable Reusable Air Purifying Respirator with a HEPA Filter”, from Amazon ($46) and other sellers. The HEPA filter is 99.97% effective for virus-sized particles, and the fan slightly pressurizes the mask, giving you a much higher percentage of cool, fresh air compared to regular N95 or N100 masks. Really a breath of fresh air! Replacement HEPA filters, rechargeable batteries, etc. are readily available.

Another nice feature about this system is that you can pair the fan/filter mechanism with any N95 mask of your choice. (You can use any mask really, but the N95 works best for us—our current favorite is the Kimberly-Clark PROFESSIONAL N95 Pouch Respirator (53358), NIOSH-Approved, Made in U.S.A., from Amazon or others.)

In the blog posts, we have talked about these Airpro masks several times over the last two years. Our Jan. 4, 2022 blog post includes helpful information with four videos sharing information on the Airpro mask, how to sterilize masks, as well as how to modify an N95 mask to fit the Airpro hose. And there is a post about safe air travel using them [see Sept 2, 2022 blog post].

For the immunocompromised, we sell a version that we have modified to give slightly better performance for $100 plus shipping.

Masks with Exhalation Valves. If you are not contagious, you can use this type of mask without endangering those around you. These masks are a simpler version of the Airpro mask in that they give you a higher percentage of cool, fresh air—better quality air to breathe and less of your own exhaled air. They are also your best protection if you have to be out in the smoke-filled air from wildfires or locally-generated dust.

The best models are “N100” masks, tested to be 100% effective. I tried out one of these (3M Personal Protective Equipment Particulate Respirator 8233, Amazon, $10/mask) and found it to be serious, well-made, and readily adjustable for a good fit. Breathing was no more annoying than with N95 masks.

Our current favorite N95 valved mask is the Dräger X-plore 1350 V N95 Particulate Respirator with Exhalation Valve (Amazon, $26 for ten). However, they are not always a tight fit around everyone’s face and may be too loose at the chin. (See July 20, 2023 blog post.)

A good fit around all the edges is essential for any mask. (Not so much for the Airpro, where a little air leaking out is normal.) If you exhale, and feel air leaking out, perhaps blowing toward your eyes, then there also will be unfiltered air leaking in when you breathe in. Try bending the nose area of the mask. If you can’t get a good fit, you may need to select another brand.

Hot air mask sterilization and reuse. There was a study done in August 2020 at the University of Illinois which documented how to sterilize your disposable masks, rather than throwing them away after each use (https://hmntl.illinois.edu/news/17342). We have a video demonstrating this—all it takes is a standard crockpot set on “Low”! See Sterilizing Masks video.

Note that sterilizing the Airpro mask is not so important since the incoming virus is trapped in the HEPA filter, not in the mask. Do not put the fan-filter unit in your crockpot — this would reduce the lifetime of the lithium battery.

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