There is a thread of magical thinking that says that since a problem exists, the government can provide an answer to it. A related magical thread says that for every problem there is a possible man-created solution. The facts say “NO.” You are entitled to your own opinion. You are not entitled to your own fact, and facts are stubborn things.
In this case, COVID-19 will supposedly be solved by some combination of mask mandates, lockdowns, hand sanitizer, social distancing and vaccines. None of this is possible. This virus is in the wild, has been in the wild since before we realized it was here, and attempting to contain it is like trying to block mosquitoes with a chain-link fence. No human intervention can stop the epidemic. It has to run its course.
For individuals at risk, the answer is somewhat different. There are individual steps that can reduce risk in very specific settings.
Now, for the Rest of the Story:
The nattering nabobs of negativism in the media went ballistic when President Trump said, “It is what it is.” Instead of seeing this blunt recognition of reality for what it is, it somehow became an admission of failure. That meant that Sleepy Joe should immediately take up residence at 1600 Pennsylvania Avenue without the need for an election. That leaves us to sort out the facts.
One thing we will not discuss is the proper mode of therapy for established COVID-19 infections. This is a fast-moving field, and anyone who suggests that he knows the proper answer(s) doesn’t.
Vaccines are another area where no assurance is possible. Even with accelerated work and a possible Russian candidate (call James Comey!), there’s no guarantee that an effective vaccine will ever be created. Lots of news reporting lauds “Phase 2” successes, but, as any vaccine researcher knows, it ain’t over till it’s over. We still don’t have vaccines for the common cold, SARS, MERS, HIV, or Ebola. Even the flu vaccine is hit or miss in its efficacy. So don’t hold your breath. But there are some areas where the facts are clear.
The first one is very simple. The primary way a sick person passes COVID-19 to someone else is through aerosols. That doesn’t mean you can’t get it through contact, but taking the rakes out of bunkers on golf courses and wiping every door handle with Clorox is wasted effort. And don’t give me that “If it saves one life” malarkey. All that effort takes away from things you can do to help a lot more people survive the plague.
Let’s look at the proof. When the Diamond Princess Cruise ship was quarantined, people kept getting sick. They holed up in their rooms, but they got sick anyway. Crewmembers got sick, too. This happened because the ship’s air conditioning system took air from sick passengers’ rooms and returned it to staterooms of well people. When they got sick, the vicious cycle kept going.
Droplet spread can’t account for that. Even a sneeze, which can send droplets as far as twelve feet, can’t spread the bug from my room to yours. All that yucky stuff drops to the floor where it doesn’t participate any more. Even contact doesn’t make you sick very often, because people who stayed in cleaned areas got sick.
The next argument comes from the Skagit Valley Chorale practice session. The arguments for droplet and contact spread fail completely, since most people who got sick were never exposed that way. Only aerosol spread answers the question. If we continue to the Guangzhou restaurant case, we have clear proof.
Note that this was published by the CDC. (The information was public months before the publication date.) The only sick person at dinner was A1. All the people who got sick after the ninety minute exposure are in red circles. People further away at table C got sick while closer people at table E didn’t. The only logical explanation is that the A/C unit picked up virus-laden aerosols from A1 after passing over table B, ran them through the air handler and returned them over table C. “As people go indoors in hot weather and the rebreathed air fraction goes up, the risk of infection is quite dramatic.” As time goes by, more and more infected aerosol builds up. This is exactly what happened when one sick person went to work at a call center in Seoul, South Korea.
This brings us to a serious question. “What can be done to reduce aerosol spreading of COVID-19?” All of us produce those aerosols every time we breathe. If everyone stopped breathing for two weeks, the virus would die out. Somehow that seems to be less than ideal.
Outdoors, aerosols are a non-problem. During the day, solar UV, which penetrates clouds, sterilizes everything, including aerosols. Further, aerosols disperse very rapidly due to air movement. That means that your chance of getting COVID-19 outdoors, even at night, is pretty slim. Outside there’s just too much air and too much air movement. That’s why Florida Governor DeSantis was able to announce that there hasn’t been a single case in the state that can be traced to outdoors spread. We should note that there hasn’t been a notable outbreak from the massive protests and riots we’ve watched for two months. You’ve got to get a certain amount of exposure before you’re likely to get sick.
But let’s not let facts derail us from being effective virtue signalers! Somehow New York Governor Cuomo who was “shocked” that over 60% of COVID-19 cases in his state came from people who couldn’t play dominos in the park due to his lockdown order. Those people got the bug from aerosols recirculated by air conditioning systems. Just like the Diamond Princess. Just like the Seoul call center. And just like our elders who died in nursing homes. Kirkland, Washington; New York; Michigan… but not in Florida where Governor DeSantis kept sick people out of nursing homes.
So how should we handle those pesky aerosols? Every authority who hasn’t been censored by Google, Facebook, or Twitter seems to discover masks are the ultimate answer. But all face coverings aren’t the same. That face shield the guy at Costco wears will protect him when operating machine tools, but it doesn’t even make a pretense of filtering anything. And then there’s the guy who wears a bandana over his two-month-old N-95. He’s legal anywhere in my county, but will it keep out the Wuhan Flu?
To find out, I ran a simple test. (You can find it here if YouTube hasn’t taken it down. A coffee-break sized version is here.) Vaping “smoke” has particles that are typically about 2.5 microns in size. This is slightly larger than the common aerosols from breathing or speaking, so it should be stopped more easily than your aerosols that might transmit COVID-19. Because it’s very visible, it makes a good demonstration without expensive equipment. (Before anyone gets excited, I don’t smoke or vape, and had to be taught what to do. I also used nicotine-free vaping fluid.)
As you can see from the first two pictures, vaping “smoke” is a great way to see your breath without needing to go outside on a cold day. Now things get interesting. The top right pictures are both surgical masks, but with a small difference. The one on the right has a foam strip to keep my glasses from fogging up. But neither one has any meaningful effect on the aerosol. It just goes around the mask. And because it goes around on the way out, it goes around on the way in as well. Neither one has any protection against aerosols, in either direction. That’s why California’s Air Resources Board warned that surgical masks won’t protect from particles in smoke. And the drama continues!
The bottom row starts with a lovely cup mask. It redirects the aerosol, but a huge plume goes straight through this legal mask. So I tried a “Guard” mask with a “high efficiency filter.” It’s as bad as the cup. My wife’s fabric mask is worse, consistent with studies that show fabric masks let 97% of viruses through. But who cares? They let aerosols go around, too. Finally, my industrial respirator (stand-in for an N95) may filter well on the way in, but on the way out, the valve lets it fly.
There is no way any mask short of an N95 will protect you at all. Let me say that again. Hospitals use N95 masks as Personal Protective Equipment because they may protect the person wearing them. And studies show that staff seem to have some protection, even though they were designed to stop TB bacteria, not viruses that are twenty times smaller. But no lesser mask will do you any good. And if you don’t handle it properly or replace it regularly, it’s no good either. In short, the general public has no benefit from any mask. No mask will protect me from you, and no mask will protect you from me.
Is there any way to protect ourselves from aerosols? If we think back a few paragraphs, the answer is obvious. Go outside! UV from the sun sterilizes everything, and air movement disperses the aerosols so quickly that they’re never a problem. If you have to stay inside, open a window for fresh air. But if you’re working on the forty-third floor, the management will look poorly on you opening that window. And you’re stuck with air conditioning that keeps recirculating stale air.
Not surprisingly (except to Governor Cuomo), sixty-six percent of all COVID cases in New York were people whose work was “non-essential” and were locked down inside air conditioned spaces. Enough people in those spaces were deemed “essential workers” that had to go out where they got exposed. They brought it back and infected the residential building. It worked almost as effectively as Governors Whitmer’s and Cuomo’s deliberate placement of ill COVID patients into nursing homes, where the A/C led to multiple deaths.
Because fresh air is safe, all the closures of outdoor facilities were panic reactions with no evidence to support them. Perhaps the dumbest was closing beaches. The unobstructed UV there sterilizes everything, and almost always has a breeze. That combination makes a beach the safest possible place to be. We should note that Florida has had zero cases that can be traced to outdoor exposure.
Next in line was the closure of many golf courses and the absurd requirements to take rakes out of bunkers, never touch the flagstick and allow only one person to ride in each cart. None of these have any effect on COVID-19, which is already wiped out by solar UV. Close on the heels of this stupidity is the PGA cancelling a number of tournaments due to the virus. Everything I’ve just said applies there, and the crowds are safe because of the same factors. Yes, large crowds follow the stars, but they are always moving around. They aren’t in those “closed spaces for extended periods” that the CDC has properly recognized as the highest risk circumstance.
Social distancing would be violated if we allowed galleries that might follow Tiger, Justin, or Ricky. But we have to ask what social distancing has to do with preventing transmission of COVID-19. The short answer is: nothing. Social distancing was built on the early theory that the bug is spread by droplets. If you’re within six feet, you’ll get droplets from the next person and get sick. There are two major problems with this.
First is the idea that six feet is somehow magic. Many countries have adopted one meter (about three feet) as the proper distance. There wasn’t any scientific evidence, so they adopted it as a feel-good number. Others are scared because droplets from a sneeze can go more than twelve feet. But a handkerchief or elbow cuts that down to inches. Normal speaking leads to droplets that travel a couple of feet.
But droplets aren’t the problem. They are heavy and follow a ballistic path to the floor, where they no longer participate. They “rain out.” People don’t rub their hands on the floor and then stick their fingers in their mouths. Even the Skagit Chorale episode, which was originally thought to be a droplet event can only be explained by aerosols.
Aerosols are like clouds, and can stay suspended in the air for hours. That’s how an air conditioner can increase their levels. The first bit runs through the air handler while the sick person breathes out more. This adds to the total level of virus in the air, and keeps going for a while. After a few minutes the levels plateau, and that’s how people who weren’t in contact with the sick person get sick. The only fix is to move to fresh air or somehow sterilize the inside air. Of course, this condemns all attempts to open restaurants and bars at half capacity. If someone is sick, they’ll pollute the entire facility over time. Which brings us back to the great outdoors.
The only way to make a closed indoor environment really safe is to make it like the outdoors. And there are only two ways to do that. The first is to bring the outdoors in by using fresh outside air the way your car does on a hot day when you don’t push the “Recirc” button. Fresh air comes through the air handler and then into the car. But that takes more energy to keep things cool than simply cooling the same air over and over again.
The second way to bring the outdoors in is to use sunlight. Oops, UV lights. The first method is high intensity UV inside the air ducts. It kills viruses, bacteria, and molds. Because it’s inside the ducts, it doesn’t cause sunburn or skin cancer. For a restaurant that will rise ‘n shine better than the rest, far UVC (<220 nm) lights in occupied areas can also be used to destroy viruses in the room without harming anyone. These aren’t new approaches. Hospitals use them to sterilize rooms after patients leave, and Amazon cleans their warehouses with UV robots. And this is about the only thing on a mass scale that will help to eliminate COVID-19.
Never in history have the well been protected from the sick by isolating the well. The theory is that if we can somehow separate sick people from well, then the well people won’t get sick. That’s what the lockdown was supposed to do. “We don’t know who’s sick, so because you aren’t sick, we’ll prevent you from having contact with anyone who is sick by preventing you from working. We won’t pay any attention to how many million jobs are destroyed.” Of course, poverty is a deadly disease, too. To paraphrase President Trump, “We’ve made the cure worse than the disease.”
Basic epidemiology says that if there’s an illness we want to contain, we should contain the illness. In other words, if you don’t want sick people to spread what they’ve got, you have to quarantine those sick people. Duh! When somebody gets the plague du jour, you lock them up and find out who they’ve been in contact with. This should identify where they got it and to whom they might have spread it. That’s called “track and trace,” and it has worked very well in South Korea, Taiwan, and Japan. Those countries minimized public inconvenience and job losses by rational actions. We did the opposite.
Of course, track and trace has now been supplanted by “TESTING!” President Trump touts how many tests are done every day. But does testing help us? Probably not. There’s a principle in medicine that you don’t do a test if the result doesn’t tell you something to do or not do. (I am a doctor, I do not play one on TV like Anthony Fauci.) Most COVID-19 tests share a common problem. They take days to get results. And if you’re positive, you may find that you’ve exposed others without knowing it while you’ve waited for the result. Or you locked down without needing to, keeping you away from work. All this assumes that the tests are actually useful and measure COVID-19. But they don’t.
The RTR-PCR test takes bits of DNA or RNA and replicates them. Ultimately there is enough to check to see if it’s what you’re looking for. The problem comes with the fact that COVID-19 shares most of its genome with the common cold. Is that bit that got multiplied from the cold you just got over? In a lot of cases, we just don’t know, and so we have so many false positives that we can’t be sure (up to 56%). On the flip side, there are plenty of false negatives (up to 38%) as well.
Without getting horribly technical, the problems arise from sensitivity (Can I detect it?) and specificity (Is what I detected what I think it is?). And there are a lot of different tests out there with different sensitivity and specificity. In short, testing doesn’t tell us a whole lot. Congress didn’t help much on this. They appropriated huge sums, giving hospitals an extra $5,000 for every COVID admission, $13,000 if it’s COVID pneumonia, and $39,000 if the patient ends up on a ventilator. That creates a huge incentive to tag everything as COVID. So if appendicitis brings you to the ER, you’ll get a COVID test as well. Your diagnosis becomes COVID if it comes back positive.
Before you throw the other size 9, one of my best friends points out that the hospital where he practices employs “coders” who strong-arm doctors into “coding” patients into the highest paying category possible. He refuses, but how many doctors bother? It’s easier to play along. But this isn’t the worst. FOX35 in Orlando learned that AdventHealth’s urgent care chain was instructed by the state of Florida to only report positive cases. Orlando Health was reported to have 98% positive tests by the state, when the actual number was 9.7%. And lots of labs reported 100% positives. Perhaps the wildest was the motorcycle rider who died in an accident and was reported as a COVID death.
Ultimately we have to say that in most cases, testing for COVID-19 is at best inaccurate, and at worst downright fraudulent. Massive extra payments for a diagnosis guarantee a lot of extra diagnoses. That strongly suggests that our current death toll of over 160,000 is very inflated. Deborah Birx of the President’s COVID Response Team frankly admits that the government counts anyone who dies with COVID-19 as a COVID death, whether COVID had any part in the patient’s illness or not. Need I say more?
For epidemiologic purposes, testing has generally proven to be less than generally useful because the bug is “in the wild.” This term describes a disease that’s essentially everywhere. Anyone with an attention span longer than a three year old will recall that China let five million people travel to far-flung parts of the world from Wuhan after the epidemic was already established there. It’s quite certain that’s how Italy got hit so hard early on. In the US, New York was the epicenter. But in neither case was it possible to identify specific “index patients” who brought the disease in. Both areas had strong connections to China, and the presumption is that some specific patient brought it, but that’s not provable. There could have been many.
The Kirkland, Washington nursing home story that brought COVID-19 to the headlines in the US can’t even provide us with detailed tracking. There are suppositions, but no answers. And this is typical. COVID-19 was already spreading, undetected, in a lot of places. The mosquitoes had already gotten through the chain link fence, and all you could do is swat one here and there. The CDC report on Smithfield Foods in South Dakota tells how an outbreak was contained, but offers no idea how the index patient got sick in the first place. It seems that Anthony Fauci is very late to the party in realizing that this horse is out of the barn. “Community spread” is another way of saying “in the wild,” which has been obvious from early on.
One part of community spread was supposed to be the “asymptomatic carrier.” I originally bought into this, since we didn’t have good data to explain the explosive spread of the disease. Supposedly “The “healthy” sick would have so much of the virus in their throats that a normal conversation between two people would be enough for the “healthy one” to infect the other healthy one.” That would explain why so many people seem to have immunity without obvious illness. This original theory has since been debunked, because in order to have viral shedding, you have to have a virus killing cells which are then shed, along with the virus. Translation: You have to be sick. Even the WHO has come around to this understanding.
But how are people immune without becoming exposed? Not all immunity requires antibodies. Rather, long-lasting immunity lives in T-cells, a specialized segment of your white cells. If you were exposed to a different coronavirus, your T-cells “remember” it. Since COVID-19 is really just small changes away from SARS, MERS, and the common cold, if you were ever infected with one of those, you have a good chance of immunity to COVID-19. That’s why 60-70% if the population is already immune to the current plague. You read that right. Most of us can’t catch this bug because we’ve been immunized without getting infected or vaccinated.
But how bad is it if you do get infected? If you are elderly and infirm, you’ve got a real problem. The vast majority of real COVID deaths have been in patients over 75 with other bad medical problems. Italy showed the pattern, and it’s consistent around the world. And this is where we can make a difference against the bug. Grandma must make sure that when the grandkids come over, their parents are careful to make sure they aren’t sick. Not even with the sniffles. If she wants to be more secure, she can wear an N95 mask during the visit. At the upper end of the “abundance of caution” scale, Grandma can put UV in her own A/C unit. That will probably make even her bridge club safe.
What about the grandkids? They have a higher risk from the flu than they do from COVID. In Florida, the risk of death from confirmed COVID-19 under the age of 25 is 0.02%. That’s not a misprint. School kids have much higher risk from a host of causes if they stay at home than if they go to school. But what about teachers? As long as they’re under age 45, their risk from confirmed infection only increases to 0.03%. In other words, the overall risk is almost unmeasurable. But as teachers get older and acquire more medical problems, they may need to make individual judgments as to whether they will go to work. But even then, they still have higher risks in the community, so the difference at work or at home is almost none. But schools can be like restaurants and use UV sterilization in their air conditioning systems. It’s a low cost tool.
I can’t finish this without revisiting the “social distancing” nonsense. As I mentioned above, there’s no data to suggest that any distance, be it one meter, six feet, two club lengths, or line of sight, makes any difference. The disease is airborne, spread by aerosol, and that means by extended exposure in a closed space where virus can build up. Inside such a space, social distancing is meaningless, because the air isn’t refreshed. A restaurant at half capacity will saturate at the same rate from a single sick patron as at full capacity. If nobody sick is there, nobody else will get sick. If it’s a newer building with a twenty-foot ceiling, it will take longer than an old New York diner with a ten or twelve foot ceiling. But it will still saturate. Outside, social distancing is complete nonsense for the reasons we’ve already discussed.
Churches suffer from the same issues as restaurants. But churches typically have high internal volumes, slowing saturation. At the same time, if they vigorously exclude ill people and use UV sterilization, they can also become safe.
Masks, social distancing and hand washing are futile in efforts to stop an airborne disease. They may satisfy the psychological need to “do something,” but ultimately have no effect.
This epidemic is going to run its course regardless of what we do. No society-wide measures will make any ultimate difference whatever. It is what it is!
Individuals can reduce their personal risks. If you’re elderly and infirm, isolation, UV, and PPE are all sensible, because your risk if you catch the Wuhan Flu is significant. But if you’re younger and healthy, all that effort will be wasted. Your risk from the bug is insignificant. So get on with your life.
We need to open America for business yesterday. Children need to be back in school, regardless of the panic porn being spread by teachers’ unions. We need to carefully assess how to do the small targeted changes that actually can reduce the spread of the plague in specific sites. Anything else is wasted effort.
COVID-19 may take down an independent news outlet
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