Tag: Masks

Do Lockdowns Work for Covid-19?

Maybe the World Health Organization (WHO) is finally getting something right.

This week Dr. Nabarro of the World Health Organization stated that world leaders should “stop using lockdowns as your primary health control measure.” He went on to say that “the only time we believe a lockdown is justified is to buy you time to reorganize, regroup, rebalance your resources, protect your health care workers who are exhausted, but by and large, we’d rather not do it.” This is a sobering approach that comes into line with what many experts in this country and elsewhere have been espousing for months now. Yes, indeed, this coronavirus is one bad virus that got exported to us and the rest of the world from China, but sometimes the cure is worse than the disease. Again, this is not to say that Covid-19 cannot cause very serious illness and death particularly in the elderly and those with so called co-morbidities like pulmonary disease, heart disease, diabetes, obesity, immunocompromised states and other ailments. For these patients and their families the illness can be devastating. However, for the vast majority of people who get infected with this disease and get ill their symptoms are fortunately relatively mild.

Dr. Nabarro went on to point some of the negative consequences that lockdowns have caused across the world, including devastated tourism industries and increased hunger and poverty in parts of the world already suffering from these problems. In addition, in this country as well as in many others we are seeing increased rates of alcoholism, drug abuse, violence, depression, anxiety. Also, many people are delaying visits to see their doctors resulting in lost opportunities to practice preventive medicine. Our educational system is likewise being badly affected and along with that the health and welling being of our children. All this and the Stress related to the lockdowns may very well cause much more death in the long run than the lockdowns will save.

Photo by Nandhu Kumar on Pexels.com

So maybe it is time for some common sense to arrive on the scene to help make us whole again while our vaccines and therapeutics are being developed. Remember, these things are already here or on the way. We will eventually get through this. To quote Franklin Delano Roosevelt, “we have nothing to fear but fear itself.” That was in 1933 when the U.S. was going through an even more difficult period.

So what are some of the common sense things to do?

  • Use masks rationally. Take a look at my previous blog about mask use, To Mask or Not to Mask…That Is The Question. If you are out in the open air, at the beach, walking in the park or on a country road, riding a bike or doing anything else where you are not in close proximity to people, i.e., not likely to be within 6 feet or so of anyone, there is really no need to wear a mask. Doing so only instills a sense of fear or dread which is totally unnecessary. Unless you are using mask wearing as a political statement. If you are in a crowded elevator or conference room, then by all means use a mask. But remember that simple cloth masks do not really provide protection against airborne aerosolized virus. They may give you some protection against droplets but not airborne virus particles. Only N-95 masks or better stand a chance of capturing the virus particles if you are on the receiving end. If you are on the giving end, in other words, the person with the virus and you cough or sneeze into your face mask, droplets and tiny aerosolized virus particles will still be dispersed. Even the CDC, which has flip flopped back and forth about the use of masks, recently reported a study showing that 70% of the patients who came down with Covid-19 wore masks regularly. So this study really puts into question the utility of wearing face masks. Nonetheless, the practice of wearing a mask (really an N-95 mask or better) may provide some degree of prevention and perhaps emotional security as well if needed, but to wear a mask (cloth, surgical or N-95) in the great outdoors where you are not in close proximity to anyone, or in environments where social distancing and good ventilation can be easily maintained seems fruitless and perhaps a bit paranoid.
  • It goes without saying that frequent hand washing and use of hand sanitizers should continue, but this is true even if the virus that causes Covid-19 were to disappear.
  • Society has to open again. That means restaurants, gyms, businesses, social gatherings, schools and so forth all using social distancing as much as reasonably possible and masks when appropriate.
  • Protect the elderly and most vulnerable. That means people with underlying medical conditions that may tend to weaken the immune system. In such instances, these folks should be kept away from situations such as large gatherings where they may be more likely exposed unless precautions can be taken to limit their exposure.
  • Continue to exercise, take Zinc and Vitamin D which seem to have some antiviral activity.
  • In short time more diagnostic tests with greater reliability and shorter turnaround times will become more widely available. While this may not completely solve the problem of identifying people who are potential spreaders, it will go a long way in alerting us to who has the virus and may be communicable. So screening before attending large gatherings may become more common and alert us to potentially dangerous situations.
  • In short time we will also have vaccines and better medications. The calvary is on the way to save the day.
  • We have to open up the country again soon. If we don’t, we won’t have a country to open up, or we will have one that is desperate and on the verge of collapse. People have lost their jobs. Educating our children has become a major difficulty. Alcoholism, suicide, drug abuse are all on the rise. People are not following up with their routine doctor visits and diagnostic tests. Some businesses are at risk of failing or have already failed. As many have already said, if we use lockdown as a cure for this virus, then the cure may indeed be worse than the disease.

Some further comments about “lockdowns” and herd immunity.

Maybe Sweden did have the right idea. After months of being criticized by the “experts” for not locking down as vigorously as its other European neighbors and seeing an early spike in cases, it now seems to be doing a lot better than many other nations in Europe and elsewhere. This may be due to the fact that the Swedes as a nation are developing a greater degree of herd immunity more quickly than other countries simply because they did not lockdown to the same degree as other countries which does seem to make some sense. Herd immunity, immunity related to widespread vaccination, better therapeutics and perhaps weakening of the virus itself will hopefully bring an end to this pandemic. However, we should also keep in mind that for a variety of reasons we may be seeing more of these viruses as time goes on. Therefor, from a scientific point of view we need to do more research on therapeutics and rapid vaccine development so as to be better prepared for the next battle.

A Tale of Two Illnesses

We in the U.S. are currently battling two major illnesses that may change the social fabric, customs and morality of our country for years to come if not forever.  Both are very different but certainly intertwined.  Together they will test our strength as a nation.

The first of these is Covid-19. While as a whole the country seems to be doing better handling this pandemic, we are by no means out of danger.  More illness and death is yet to come.  However, keep in mind that as time goes on and more and more people are exposed to the virus more herd immunity will occur, and that is really what we need in order to overcome the threat of pandemic. We achieve that “herd immunity” in two ways (see The Dilemma of Immunity).  One way is by immunization.  The second way is through naturally occuring infection.  This means that as more and more people are exposed to the virus naturally in the environment and recover, then fewer and fewer people are left susceptible to the virus.  The corollary to this concept is that people who have had the disease and recovered would be unlikely to spread the disease to the remaining others who might still be susceptible.  Hence there will be less communicability as time goes on.  This may seem obvious, but it is an important concept and probably as important as immunization if not more so.  However, there are some caveats to be considered here.  For example, we are assuming with good reason that having had the infection confirms immunity. While this is likely it has not yet been completely validated at this point. Neither has it been validated that the immunity will be lifelong..  Another issue which remains open yet is whether the virus will mutate to such a degree that prior immunity will no longer be effective as often happens with the influenza virus for which new vaccines are required on a yearly basis.  Of course the alternative is also possible; namely,  that the virus will mutate and become in and of itself less infectious as time goes on.  We will likely have a vaccine (or vaccines) for Covid-19 early next year and newer antiviral medications will likely be developed in the months ahead as well.  Also, very importantly,  other medications to treat the lethal inflammatory sequelae of the virus will soon be developed thanks to our robust pharmaceutical industry.  All of this should save lives. However, other new viruses and infectious agents will also likely come to our shores in time to come, and we will need to be better prepared for this future possibility.  Please see my previous blog about what we have learned from this pandemic (seeWhat Have We Learned From Covid-19).  In the meantime our experience with Covid-19 has had dramatic effects on how we live our lives and conduct our business.  There is no more hand shaking. Social gatherings are limited.  People walk around in fear of getting a dreaded illness, which by the way, has a mortality rate far lower that initially projected.  People are wearing face masks in situations where there is no rational reason to do so (see Pandemic). Uncertainty about our economic future and security is causing fear and panic in the population leading to unreasonable doubts about our survival as a nation.  We will survive the Covid-19 pandemic and other infectious disease threats that may follow. Not only will we survive these threats, but will will do well once we learn how to cope with them.

The greater threat to our health, both individually and as a nation, is the emergence of various anarchist groups threatening to overthrow our government and the rule of law without which no society can survive.  The widespread violence and destruction that we are now seeing and the inability of local governments, particularly those in left wing democratic cities, to control this is a greater risk to the health and wellbeing of the nation as a whole compared to any viral pandemic. We can face pandemics together as one nation and do what is necessary to overcome them if we put petty politics aside and use good judgement.  Instead, what we see happening is our politicians using this pandemic as a political tool to destroy the opposition putting power before country.  Beyond this we see some of our elected leaders, principally socialist democrats, on a state and local basis permitting, condoning and even encouraging rioting and destruction.  There is absolutely no doubt that we have social problems that need to be urgently addressed, but destroying the country is not the healthy way to do so.  The wanton destruction of private property, the desecration of  monuments, the attacks on law abiding citizens does nothing but create more fear and hostility at a time when what we need is unity.  The health of the nation and its citizens depends on it.  To destroy our government and our institutions, as the leftists and particularly the anarchists want to do, is like seeing a sick patient in the hospital who has an excellent chance of recovery and saying he has to be euthanized because he is not worth saving.

Pandemic

More on masks….and the Confusion Surrounding Their Use

So much has already been written and discussed about the appropriate use of masks during this pandemic, but it still remains a confusing topic especially for those who are not front line care givers, first responders or in high risk occupations.  For those of us who are, the need to wear all the appropriate personal protective equipment (PPE) including the N-95 face masks and the like is quite clear.  The risk of exposure for such individuals is great, and therefore so is the the need for protection.  However, for those who are not on the frontline wearing a mask may simply be an expression of  an unreasonable fear or perhaps confusion about what should be done to protect oneself and others in a low risk environment.  A lot of this fear and confusion may be perpetuated by governmental authorities who feel that they need to control in every aspect what we do as individuals because ordinary people are not really capable of making sound judgements regarding their own care.  Dr. Fauci says he wears a mask because he wants to protect himself as well as others and also because he wants to make a mask a “symbol” for people to see that it’s “the kind of thing you should be doing.” However, do we really need a symbol in place of real information about what we should be doing and why so we can make our own sensible judgements?  Or, is the promotion of this “symbol” just something to help enforce compliance with a lot of rules and regulations that at this point in the pandemic are of questionable value?  Countless times I have seen people riding alone in cars with face masks on, riding bicycles on country roads or walking along deserted streets with face masks on.  Just recently I saw a woman leave her suburban house to walk down her driveway to her mailbox with mask and gloves on to pick up her mail with no one within a hundred feet of her.  I don’t think the use of a mask in situations such as these reflects symbolism or appropriate protectiveness to any degree.  Instead, I think this type of behavior reflects a paranoia engendered by the media and to some extent by governmental bodies which are confused, but none the less determined, to control our activities by telling us what we need to do even though there may be little or no proof that what they are telling us is indeed correct.  So having said all of this let’s take another realistic look at how and when masks might be used in the daily lives of ordinary people and not those of first responders, front line care givers or workers in high risk occupations.  To do so let’s also take a realistic look at how this virus spreads realizing that there is still a lot that needs to be learned. 

First, the virus can indeed spread between people interacting in close proximity.  For example, speaking, coughing, or sneezing can spread the virus from an infected individual to an uninfected individual.  However, the key words here are “close proximity.”  Usually that means within 6 to 9 feet of each other.  In light of this evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (for example, grocery stores, pharmacies, subways, buses, public buildings, etc. ) especially in areas where there is significant evidence of disease spread.  However, keep in mind that simple cloth masks will only help prevent large droplet transmission and not small airborne viral particle transmission.  So simple cloth masks may help somewhat in certain circumstances where close proximity is an unavoidable issue because large droplets will be retained by the cloth mask.  However, small airborne viral particles will not be retained by a cloth mask, nor will a cloth mask filter out such particles and prevent them from being inhaled by someone else.  So for the person with the virus who is coughing the cloth mask will help stop the droplets containing the virus from settling on another person, but it will not stop the tiny airborne viral particles themselves from being dispersed to others.  For the person who is not infected and wearing a cloth mask, the cloth mask will only help prevent the large droplets from reaching that individual but not the tiny airborne viral particles themselves. To help prevent airborne viral particle transmission which would be necessary in situations of close contact, an N-95 mask or better would be needed. Therefor, it makes very little sense to wear a mask of any kind when you are out and about away from people like when going for a walk or bike ride on country road, driving in your car alone, walking along a beach, etc.

 

More on Other Modes of Transmission

The coronavirus can live for hours to days on surfaces like countertops and doorknobs, but how long it survives depends on a number of factors like the texture of the surface, heat and humidity.  There is also evidence for fecal oral transmission.  A lot still has to be learned about how long this virus can survive outside the body, but as of now it seems that you are much more likely to catch it directly from another person than from surfaces.

Finally a Word About Mutation of the Virus

 

Viruses can mutate and that can cause a problem in terms of vaccines and treatments. However, mutation is not always a bad thing. Sometimes mutations can lead to a weakening of the virus so that it eventually dies out. The Sars C0V -2 virus seems to have a slower mutation rate than the influenza virus so that may be a good thing for vaccine development.