The information in the PDF below is suggested for inclusion into local safety guidelines. It may be helpful to stimulate personal thought, research, and consideration as it compares with information provided by “medical experts”. The articles in following sections provide depth to the summary information in the Safety Protocols below.
The following guidelines have been proposed to various government entities for integration into “official” guidelines. They represent a simplified condensation of more scientific data. They are not a substitute for good judgement – they are a helpful starting point for those with limited science backgrounds.
Please use the condensed Safety Protocols until you have the time to read and understand the more detailed source articles.
If these ideas can benefit and add to your area’s “official” guidelines, please benefit.
COVID19SafetyPrototols2020909a
Coronavirus Safety
If you’re wondering how to stay safe from Coronavirus, here are some tips and precautions you can take right now to limit the spread including supplies and social distancing measures.
COVID-19 Home Safety
Warm weather is arriving across the United States, and consumers are heading outside to do yard work, perform outdoor home repairs and to play and exercise. While you practice safe social distancing and other COVID-19 precautions to protect those you love, CPSC urges you to safeguard your family fro…
Statewide industry guidance to reduce risk
As California reopens, every business will need to create a safer, low-risk environment. If you own or manage a business, follow the guidance below to protect your workers and customers. The industry-specific guidance below applies to businesses statewide. Review the guidance that is relevant to you…
Safety and Health Topics | COVID-19 – Standards | Occupational Safety and Health Administration
Safety and Health Topics | COVID-19 – Standards
Coronavirus Disease 2019 (COVID-19) – Interim Guidance for Businesses and Employers
Coronavirus disease 2019 (COVID-19) – Interim Guidance for Businesses and Employers
Cal/OSHA Interim Guidelines for General Industry on 2019 Novel Coronavirus Disease (COVID-19)
May 14, 2020
“All identified outbreaks of three or more cases occurred in an indoor environment, which confirms that sharing indoor space is a major SARS-CoV-2 infection risk.”
Indoor transmission of SARS-CoV-2
Background: By early April 2020, the COVID-19 pandemic had infected nearly one million people and had spread to nearly all countries worldwide. It is essential to understand where and how SARS-CoV-2 is transmitted. Methods: Case reports were extracted from the local Municipal Health Commissions of 3…
2020.04.04.20053058v1.full.pdf
While aerosolized indoor transmission has been recognized herein since April 2020, on October 5th, 2020, the
CDC formally recognized that aerosol transmission of SARS-CoV-2
is a significant contributor to COVID-19 infections.
The CDC currently defines a close contact as “
Someone who was within 6 feet of an infected person for at least 15 minutes
“. It appears to indicate that the CDC considers brief contact on the order of a few minutes or few seconds as very unlikely to cause transmission. Unfortunately, the CDC is not more specific about the very large differences between indoor and outdoor transmission risks. Outdoor areas, such as parks and
ocean beaches
, with natural high volume air exchange that greatly dilutes any
viral loads
which may be present, results in
dramatically decreased levels of transmission relative to indoor areas
.
A larger initial exposure viral load can cause increased severity because the exponential viral replication reaches much higher levels before the immune system can respond
. This results in dramatically greater viral damage. The increased viral presence also tends to activate a more intense immune response which may result in increased systemic damage from the immune response.
Reducing viral loads
into a
variolative
or minor infection range can significantly reduce the likelihood of a severe case.
A regular regimen of a few cycles of normal daily exercise improves immune response / speed pre-exposure and immediately following exposure to minimize likelihood of illness
.
It is possible to minimize severity of illness by slowing the exponential growth of viral load that develops shortly after exposure which helps the adaptive immune response to mature before exponential viral growth becomes extremely large. The innate immune response tends to slow natural infections; and intelligent behavior (such as using
viral inactivation
substances such as mouthwash, toothpaste, essential oils / breath-mints / breath-strips, zinc, small amounts of ethyl alcohol, etc.), can slow the exponential growth such that B/T cell activation /maturation occurs before exponential growth of antigen becomes large. Mints and
essential oils
have been recognized as
helpful for many centuries
, and many modern mouthwashes that kill bacteria and inactivate viruses are now essential oil rather than alcohol based. Swishing fractions of an ounce of high-percentage ethyl alcohol (hard liquor) into the throat area with tickle/minor-irritation every few hours tends to slow viral growth, although once viral damage to the tissues becomes significant, this tends to create further irritation / tissue damage; and larger amounts of ethyl alcohol may negatively impact immune system response, so this tends to be optimal only for very early “tickle” stages of illness. Placing 1/16th of a zinc supplement (nibble off a small piece) and/or a few grains of salt in room temperature or slightly warm water will make the water much more pleasant to drink, which may help you to remain well hydrated. The zinc also seems to have a throat soothing effect (try it) and may have some mild topical protective characteristics and this tends to be effective in both early and later stages of illness. Just a nibble of a zinc mineral supplement and a few grains of salt go a long way and also tend to make water less irritating to the sore throat – thus encouraging increased hydration which is also helpful. Salt water gargling tends to be helpful. Swishing saliva around within the mouth and onto irritated areas helps to keep them moist and in some cases will help mucosal antibodies find and bind to viruses that may be present near the irritated area that is replicating virus. This can be particularly helpful during re-exposures and in later stages of infections where significant virus specific antibodies may be present within the saliva.
Histamine responses
also tend to increase likelihood of antibody encounters with viruses within mucosal tissues and also help to purge virus from the body through sneeze and runny nose responses.
It is likely that many infections and transmissions can be avoided or minimized through the use of breath-mints / breath strips during and following potential exposure encounters.
When sick, highly aerobic activity can undesirably facilitate virus movement deeper within the airway and into the lungs, yet light exercise such as walking can stimulate blood/lymph flow without resulting the deep respiration that internally spreads virus within the airway. Similarly, fresh air and
avoiding rebreathing “sick-room” viral laden air
can help avoid spreading the infection within the airway. Perhaps obviously, keeping considerable physical distance from others while enjoying fresh outdoor air will dilute any viral load that might be
shedding
when sick and wearing masks can help while in careful transit to some wide open personal space containing fresh air.
A study entitled “
COVID-19 Aerosolized Viral Loads, Environment, Ventilation, Masks, Exposure Time, Severity, And Immune Response : A Pragmatic Guide Of Estimates
” provides example scenarios and estimates infection risk for people who are not yet immune via vaccine or natural infection recovery. The study is built upon a reference case of a non-infected person in an indoor environment within 2 to 4.8 meters of 2 infected persons. It uses that reference data to estimate the time necessary to cause various exposure levels and resulting infection potential in various indoor and outdoor settings of both Influenza A and COVID-19.
The study helps answer the questions:
How long may a person safely remain within various environments?
What exposure levels could result in immunity without becoming ill via
asymptomatic
graduated inoculation?
A few observations from this study include:
- It can be shown that over 94% of COVID-19 superspreading events occurred in limited ventilation areas suggesting that aerosolized transmission is a strong contributor to COVID-19 infections.
- In a defined outdoor area with 3 MPH wind has 1056 air exchanges/hour. Typical office is 6 ACPH. Typical home/windows-closed, 0.3 ACPH. Outdoors dilute viral load over 3000x relative to home and over 150x relative to office. Typical office dilutes viral load 20x relative to closed home.
- A level of exercise after exposure can improve the probability and speed of immune response by accelerating viral movement into the Secondary Lymphoid Organs’ (SLO) germinal centers. Regular light to moderate intensity exercise can improve immune response. Light intensity exercise can improve recovery times.
- Specific time duration estimates and likely symptom result estimates given a person with very good general health for many example scenarios
- It could take about 3 hours exercising hard (60 LPM) in a 3 MPH outdoor wind 2 meters from a sick person with neither wearing masks to reach the Minor “cold like” Illness exposure level estimate
- It could take about 15 hours doing light work (12 LPM) in a 3 MPH outdoor wind 2 meters from a sick person with neither wearing masks to reach the Minor “cold like” Illness exposure level estimate
- It could take about 1 hour doing light work (12 LPM) in a 6 ACPH office 2 meters from a sick person with both wearing surgical masks to reach the Minor “cold like” Illness exposure level estimate
- It could take about 8 hours doing light work (12 LPM) in a 6 ACPH office 2 meters from a sick person with both wearing surgical
masks to reach the Mild “flu like” Illness exposure level estimate
- It could take about 1 hour doing light work (12 LPM) in a 6 ACPH office 2 meters from a sick person with neither wearing masks to reach the Mild “flu like” Illness exposure level estimate
- It could take about 2 minutes doing light work (12 LPM) in a 0.2 ACPH closed home 2 meters from a where a sick person was resting for many hours (loading up the room air with virus) with neither wearing masks to reach the Mild “flu like” Illness exposure level estimate
.
- It could take about 20 minutes doing light work (12 LPM) in a 0.2 ACPH closed home 2 meters from a where a sick person was resting for many hours (loading up the room air with virus) with neither wearing masks to reach the Possibly Severe Illness exposure level estimate.
- Raising ventilation of an indoor space from 6 to 24 ACPH would likely extend these estimates by about 4x. Many activities could become safer with increased ventilation.
- Both sick and exposed individuals wearing surgical masks would likely extend non-masked estimates by about 9x. Many activities could become safer with mask use. Combining increased ventilation further extends safer periods.
- Increasing the exposure level by 10x is likely to step a Minor “cold like” exposure to a Mild “flu like” exposure.
- Increasing the exposure level by 10x is likely to step a Mild “flu like” exposure to a “Possibly Severe” exposure level.
- It is likely that most severe cases develop from exposures that occur within poor ventilation environments such as closed homes or from very close contact scenarios.
- Every individual’s risk tolerance and optimal exposure level is different. Individuals with health concerns should seek to avoid all exposure. Those already recovered may benefit from light re-exposure challenges that preserve IgA and IgG antibody titer levels and related protective or even sterilizing immunity
- The estimates in the study may help efforts to strike a balance in developing holistic epidemiologic interventions that consider the effects of these interventions on economic, civic, social, and mental health, which have pathologies within their own realms
- In the absence of better information, these estimates should be considered only with additional good judgement and after further verification. Human response to pathogens is widely variant and these estimations assume the normal healthy population with better than average immune response, no co-morbidities, and a very specific set of scenarios.
The estimates found in this study could be a significant improvement over current WHO and CDC guidelines in that they provide specific quantitative number estimates based on data from peer-reviewed studies. The estimates cover various environments include typical ASHRAE office ventilation standards, one example of dramatically improved ventilation (4x), and outdoor 3 MPH conditions. The estimates also consider the infected person as either very sick or pre-symptomatic, the level of exertion of those breathing the air in the vicinity of the infected, with and without masks, and then identifies 4 levels of various Likely Outcomes from Not Ill to Possible Severe Illness.
COVID-19 Aerosolized Viral Loads, Environment, Ventilation, Masks, Exposure Time, Severity, And Immune Response: A Pragmatic Guide Of Estimates
It can be shown that over 94% of COVID-19 superspreading events occurred in limited ventilation areas suggesting aerosolized transmission is a strong contributor to COVID-19 infections. This study helps answer “How long may a person safely remain within various environments?” And “What exposure lev…
A typical $20 box fan provides ventilation of approximately 1000 to 2000 CFM. A typical school classroom is about 1000 square feet with ceiling heights ranging from 8 to 12 feet, which calculates to volumes up to 12,000 cubic feet. If 2 fans (inlet/exhaust) were used at 2 openings to achieve a fresh air flow of 2000 CFM in a 10,000 cubic foot room, this would translate to 12 ACPH, or even higher when used in conjunction with existing ventilation. Given distance to avoid large droplets, surgical mask use indoors, and Table 2 from the above study, this would result in a scenario that would be about 50% likely to result in minor “cold like” illness levels (not flu “MMID” like) after 22 hours of exposure with an early pre-symptomatic individual present, or about 1.5 hours with a sick individual present. Mild flu-like (MMID) symptoms would be about 20% likely to develop after 16 hours with a sick individual present. In younger adults and children, all of these scenarios would be likely to result in no infection or an asymptomatic case that has some probability of generating immunity without symptoms. Protective focus on teachers could use greater distance between them and students. Vaccinated and natural-infection-recovered teachers likely remove so much overall risk such that no interventions are necessary. Until then, it is likely that 2 box fans per classroom arranged to create a through-flow air exchange would create a dramatically improved and likely tolerable infection risk level for most students and teachers. Special considerations could be applied for those at higher risk for a severe infection. Given that acquiring 2 box fans per-classroom of 20+ students might create a supply issue, it is likely that family / community loans from concerned Parent / Teacher Associations could meet needs for the first year of this intervention. If a box fan lacks the desired elegance of a public entity, examine how potholes are fixed in the streets of major cities so that roads may be used without damaging auto suspension. Cost-effective solutions can be acquired more rapidly than those of great elegance, such as the vaccines to come, which are more like re-paving the road for the long-term. Many office buildings with ASHRAE standard 6 ACPH would likely support low-risk part-time adult in-office work and fans can help assist with ventilation there as well by diluting average viral load to a level below symptomatic infectious dose, which could result in immunity without illness.
Again, those at higher risk for severity require special consideration
.
For those on the go: Introductory video blog brief overview of
COVID-19 Aerosolized Viral Loads, Environment, Ventilation, Masks, Exposure Time, Severity, And Immune Response: A Pragmatic Guide Of Estimates
Outdoor transmission accounts for 0.1% of State’s Covid-19 cases
Just 262 cases traced to outdoor activities since pandemic began, official figures reveal
Exposure to SARS-CoV-2 within the household is associated with greater symptom severity and stronger antibody responses in a community-based sample of seropositive adults
Magnitude of SARS-CoV-2 virus exposure may contribute to symptom severity. In a sample of seropositive adults (n=1101), we found that individuals who lived with a known COVID-19 case exhibited greater symptom severity and IgG concentrations compared to individuals who were seropositive but did not l…
The Reason for the Season: why flu strikes in winter – Science in the News
“Did you get your flu shot?” If your friends are anything like mine, you heard this question at least a dozen times before Thanksgiving. You probably got your fair share of disdainful looks too, if you answered “No.” But why are we worried about getting the flu shot now and not in May? Why is there …
Study explores Southern Hemisphere pandemic patterns
(CIDRAP News) ? A review of how the first wave of the 2009 H1N1 pandemic affected Southern Hemisphere countries found many similarities with Northern Hemisphere countries, though many patients had no underlying risk factors for flu complications and pregnant women didn’t seem to have severe outcomes…
Flu season – Wikipedia
“Influenza epidemic” redirects here. It is not to be confused with Influenza pandemic.
COVID-19 transmission?up in the air
As we approach the end of 2020, and a year since the outbreak of COVID-19 began, cases
are increasing again. We have learnt a lot about SARS-CoV-2 and our ability to test
for and manage COVID-19 has improved, but ongoing debate remains about how SARS-CoV-2
is transmitted.
Fact check: Research papers have put forward evidence for airborne transmission of SARS-CoV-2
Posts shared widely on social media allege there is no scientific basis behind the use of face coverings during the COVID-19 pandemic. This is false.
How can airborne transmission of COVID-19 indoors be minimised?
During the rapid rise in COVID-19 illnesses and deaths globally, and notwithstanding recommended precautions, questions are voiced about routes of tra…
How much of the coronavirus does it take to make you sick? – STAT
The minimum infectious dose of SARS-CoV-2, the virus that causes Covid-19, is unknown so far, but researchers suspect it is low.
How Much of the Coronavirus Must Be Present to Get Sick? – ASH Clinical News
How Much of the Coronavirus Must Be Present to Get Sick? – COVID-19 News, News, Online Exclusives – ASH Clinical News
SARS-CoV-2 Viral Load Predicts COVID-19 Mortality
The need for reliable and widely available SARS-CoV-2 testing is well recognized, but it will be equally necessary to develop quantitative methods that determine viral load in order to guide patient triage and medical decision making. We are the first to report that SARS-CoV-2 viral load at the time…
SARS-CoV-2 viral load and the severity of COVID-19 – CEBM
The relationship of viral load and severity of the disease in SARs, SARs-CoV-2 and Influenza, and a summary of the sources on healthcare workers mortality.
Impact of SARS-CoV-2 Viral Load on Risk of Intubation and Mortality Among Hospitalized Patients with Coronavirus Disease 2019
AbstractBackground. Patients hospitalized with coronavirus disease 2019 (COVID-19) frequently require mechanical ventilation and have high mortality rates, but
Coronaviruses are a type of virus that have an outer wrapping or envelope that contains the RNA that enables the virus to replicate. This envelope comes from the infected cell, or host, in a process called “budding”. During the budding process, newly formed virus particles become “enveloped” or wrapped in an outer coat that is made from a small piece of the cell’s plasma membrane which is usually delicate mucousal cellular tissue.
Anything that sufficiently damages that membrane / envelope (or the spike) will inactivate / kill the virus
because the envelope and it’s exterior spike protein protrusions are what enable it to invade a new cell. The RNA still exists, and can
fool a PCR viral presence test into a false positive
, but without the envelope and spike protein structure, there is no way for the viral RNA to invade a cell. Additionally, damage to the RNA is also likely to inactivate the virus.
Coronaviruses tend to remain viable longest on smooth, non-porous surfaces and in low temperatures. Any “slimy” mucous or liquid surrounding the viruses may help protect the virus envelope from damage. Higher temperatures result in increased brownian-motion which tends to damage the viral envelope over time. Porous surfaces which are generally not smooth to the touch, tend to abrade, chemically react with, help dissolve, or otherwise damage the delicate viral envelope or spike protein.
One study
shows that coronaviruses tend to be inactivated most at relative humidity of around 50%, gain survival at higher humidity, and survive best at around 20% RH.
Another study
shows that coronaviruses tend to be inactivated with higher humidity and survive best at lower humidity. Humidity impact appears to be dependent upon many factors. Soap, alcohol, and “essential oils” are known to provide some level of inactivation. Most enveloped viruses are fairly easy to damage / inactivate.
Physically, the
SARS-CoV-2 virus is about 0.1 micrometers diameter
. An average grain of sand in Hermosa Beach, CA is about 300 micrometers diameter (“average” grains measured with digital caliper). This means that the average grain of sand is about 3000 times larger than the delicate viral envelope. If trapped between grains of sand being walked-upon or vigorously agitated between hands with pressure and rolling action, the virus would likely be destroyed and/or separated from other virions reducing available
viral load
. It has been demonstrated that viruses are inactivated by
high pressure
, mechanical
agitation
, very high frequency
ultrasound
(and possibly lower frequencies), and mechanical
shear forces.
Much is still unknown about surface transmission. Many studies that use PCR testing (
for example this CDC publication / Chinese Study
) may not be valid as noted above. There are many scholars that believe it is not easily transmitted on surfaces beyond approximately 30 minutes (German scientists in publication below). There are other studies that indicate otherwise. The general consensus appears to be that surface transmission is
more rare
than aerosol and droplet transmission. Those who are at high-risk for a severe case would likely want to use additional surface sanitizing precautions, erring on the side of safety versus convenience.
How German scientists hope to find coronavirus answers in country’s worst-hit spot
Researchers in Germany are trying to find out how more about how coronavirus spreads and how to contain it. They’ve set up a centre in one of Germany’s worst-hit spots to find answers.
Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents
Currently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global
health concern causing severe respiratory tract infections in humans. Human-to-human
transmissions have been described with incubation times between 2-10 days, facilitating
its spread via droplets, contaminated ha…
Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 | NEJM
Correspondence from The New England Journal of Medicine ? Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1
Effects of Air Temperature and Relative Humidity on Coronavirus Survival on Surfaces
Assessment of the risks posed by severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) on surfaces requires data on survival of this virus on environmental surfaces and on how survival is affected by environmental variables, such as air temperature …
The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus
The main route of transmission of SARS CoV infection is presumed to be respiratory droplets. However the virus is also detectable in other body fluids and excreta. The stability of the virus at different temperatures and relative humidity on smooth surfaces were studied. The dried virus on smooth su…
Humidity is a consistent climatic factor contributing to SARS?CoV?2 transmission
There is growing evidence that climatic factors could influence the evolution of the current COVID?19 pandemic. Here, we build on this evidence base, focusing on the southern hemisphere summer and au…
Human Coronavirus 229E Remains Infectious on Common Touch Surface Materials
The evolution of new and reemerging historic virulent strains of respiratory viruses from animal reservoirs is a significant threat to human health. Inefficient human-to-human transmission of zoonotic strains may initially limit the spread of transmission, but an infection may be contracted by touch…
The effect of temperature on persistence of SARS-CoV-2 on common surfaces | Virology Journal
How Long Can Coronavirus Survive on Clothes?
We’ve heard about surfaces. But what about our clothes?
Longitudinal monitoring of SARS-CoV-2 RNA on high-touch surfaces in a community setting
Environmental surveillance of surface contamination is an unexplored tool for understanding transmission of SARS-CoV-2 in community settings. We conducted longitudinal swab sampling of high-touch non-porous surfaces in a Massachusetts town during a COVID-19 outbreak from April to June 2020. Twenty-n…
SARS-CoV-2 viability under different meteorological conditions, surfaces, fluids and transmission between animals
Since the COVID-19 outbreak, researchers have tried to characterise the novel coronavirus SARS-CoV-2 to better understand the pathogenic mechanisms of…
Virus Inactivation
Essential Oils as Antiviral Agents, Potential of Essential Oils to Treat SARS-CoV-2 Infection: An In-Silico Investigation
Essential oils have shown promise as antiviral agents against several pathogenic viruses. In this work we hypothesized that essential oil components may interact with key protein targets of the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). …
Inactivation of the coronavirus that induces severe acute respiratory syndrome, SARS-CoV
Severe acute respiratory syndrome (SARS) is a life-threatening disease caused by a novel coronavirus termed SARS-CoV. Due to the severity of this disease, the World Health Organization (WHO) recommends that manipulation of active viral cultures of SARS-CoV …
Coronavirus: Why soap works better than hand sanitizer – UCHealth Today
Both soap and hand sanitizer neutralize the coronavirus, but soap and water work better because soap disrupts sticky bonds so the coronavirus slides off.
inactivation-of-avian-influenza-viruses-by-chemical-agents-and-physical-conditions-a-review-7-638.jpg?cb=1491374678
Evaluation of inactivation methods for severe acute respiratory syndrome coronavirus in noncellular blood products – PubMed
Heat, UVC irradiation, and S/D treatments effectively inactivate SARS-CoV, whereas octanoic acid treatment is insufficient for inactivation of the virus.
Study: Coronavirus appears to die quickly in direct sunlight
Biodefense reseachers say tests show sunlight is detrimental to the coronavirus responsible for the current pandemic.
Far-UVC light (222?nm) efficiently and safely inactivates airborne human coronaviruses
Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses
Simulated Sunlight Rapidly Inactivates SARS-CoV-2 on Surfaces
This study provides the first evidence that sunlight may rapidly inactivate SARS-CoV-2 on surfaces, suggesting that persistence, and subsequently exposure risk,
Inactivation of Viruses on Surfaces by Ultraviolet Germicidal Irradiation
In many outbreaks caused by viruses, the transmission of the agents can occur through contaminated environmental surfaces. Because of the increasing incidence of viral infections, there is a need to evaluate novel engineering control methods for inactivation …
Predicted Inactivation of Viruses of Relevance to Biodefense by Solar Radiation
UV radiation from the sun is the primary germicide in the environment. The goal of this study was to estimate inactivation of viruses by solar exposure. We reviewed published reports on 254-nm UV inactivation and tabulated the sensitivities of a wide variety of viruses, including those with double-s…
UV-LED disinfection of Coronavirus: Wavelength effect
UV light-emitting diodes (UV LEDs) are an emerging technology and a UV source for pathogen inactivation, however low UV-LED wavelengths are costly and…
Virucidal Efficacy of Different Oral Rinses Against Severe Acute Respiratory Syndrome Coronavirus 2
Several oral rinses show significant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inactivating properties in vitro, supporting the idea that ora
Lowering the transmission and spread of human coronavirus
The emergence of the severe acute respiratory syndrome coronavirus 2 pandemic has created an unprecedented healthcare, social, and economic disaster. Wearing of masks and social distancing can signif…
Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva
Patients with coronavirus disease 2019 (COVID-19) can unknowingly spread the virus to several people during the early subclinical period.We evaluated the viral dynamics in various body fluid specimens, such as nasopharyngeal swab, oropharyngeal swab, …
Outdoor areas, such as parks and
ocean beaches
, with natural high volume air exchange that greatly dilutes any
viral loads
which may be present, results in
dramatically decreased levels of transmission relative to indoor areas
. General population use of masks in essential shared indoor areas such as grocery stores and other businesses helps to keep that indoor air pristine and free of viruses so that care-givers are less likely to bring the virus into areas where they are
caring for those at high risk for a severe case
.
This Is Where You’re 19 Times More Likely to Get Coronavirus
Two new studies reveal where COVID-19 is most likely to spread, indoors or outdoors. And the results are likely to hit a little too close to home.
Regarding
viral transmission
, outdoor groups and professional office settings appear to be statistically safer than indoor families.
“The riskiest place could be our homes”
“Possible rates of household transmission ? anywhere from 5 to 30 percent”
Due to the potential for
large viral loads
to be transmitted over long periods of time in close proximity within the home, the probability of transmission / increased-severity are higher among people co-habitating relative to many other settings.
Outdoors
environments and professional office settings with ventilation and air-exchange disease prevention optimizations are much
lower risk
.
When co-habitating, it may be important to wear face coverings and improve ventilation so that the risk more closely approaches the many order of magnitude safer outdoor environments; which data shows to be very low even without use of safety protocols and
Non Pharmaceutical Interventions (NPI)
.
However impractical it may be, it would be more
epidemiologically prudent
to mandate that people temporarily suspend co-habitation than nearly any other non-super-spreading activity.
With that challenge in mind, education and innovation can
enable intelligent, situationally specific, solutions
that surpass government mandated edicts that tend to lead to
social dysfunction and mental health challenges
. The importance of holistic community health includes factors that include and surpass simply limiting viral transmission.
Regarding
viral transmission
, outdoor groups and well ventilated professional settings appear to be statistically safer than indoor families.
Household Deemed Most Common Place for COVID-19 Transmission – UNC Research
UNC infectious disease researcher Jessica Lin is leading a study to address the infection rates of household members living with someone who has tested positive for COVID-19.
Characteristics of Household Transmission of COVID-19
The secondary transmission rate of SARS-CoV-2 in households is 16.3%. Age of contacts and spousal relationship to the index case are risk factors for transmissi
Transmission of SARS-COV-2 Infections in Households …
This report describes findings from a household study that indicate transmission of SARS-CoV-2 among household members was frequent from either children or adults.
You’re most likely to catch the coronavirus in a poorly ventilated space. That makes offices very risky.
COVID-19 spreads via droplets from infected people. It’s much more likely to jump between people in an indoor space with little air flow.
Royal Society publishes rapid review of the science of infection and COVID-19 | Royal Society
The paper SARS-CoV-2: Where Do People Acquire Infection and ‘Who Infects Whom’? has been published by the Royal Society’s SET-C (Science in Emergencies Tasking: COVID-19) group.
Indoor transmission of SARS-CoV-2
Background: By early April 2020, the COVID-19 pandemic had infected nearly one million people and had spread to nearly all countries worldwide. It is essential to understand where and how SARS-CoV-2 is transmitted. Methods: Case reports were extracted from the local Municipal Health Commissions of 3…
Household Transmission of SARS-CoV-2
This systematic review and meta-analysis examines evidence for household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), disaggregated by several covariates, and compares it with other coronaviruses
“Household contact was the main setting for transmission of SARS-CoV-2, and the risk for transmission of SARS-CoV-2 among close contacts increased with the severity of index cases”
Contact Settings and Risk for Transmission in 3410 Close Contacts of Patients With COVID-19 in Guangzhou, China: A Prospective Cohort Study: Annals of Internal Medicine: Vol 0, No 0
Background: Risk for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to close contacts of infected persons has not been well estimated. Objective: To evaluate the risk …
Coronavirus super-spreader events all have notable similarities ? and they reveal the types of gatherings we should avoid for years
Super-spreader events involve lots of people getting infected by one person with the coronavirus. Most are large, indoor gatherings.
How Coronavirus Spreads through the Air: What We Know So Far
The virus that causes COVID-19 can persist in aerosol form, some studies suggest. But the potential for transmission depends on many factors, including infectiousness, dose and ventilation
Infection and ventilation – Natural Ventilation for Infection Control in Health-Care Settings – NCBI Bookshelf
There is little evidence that ventilation directly reduces the risk of disease transmission, but many studies suggest that insufficient ventilation increases disease transmission. A number of studies have looked at the possible transmission routes of diseases, but few have looked at the direct impac…
We Need to Talk About Ventilation
How is it that six months into a respiratory pandemic, we are still doing so little to mitigate airborne transmission?
Indoor Air and Coronavirus (COVID-19) | US EPA
EPA recommends precautions to reduce the potential airborne transmission of the virus, such as ventilation and air filtration as a part of a larger strategy that includes minimizing close contact, surface cleaning, handwashing, and other precautions.
Ventilation and Coronavirus (COVID-19) | US EPA
EPA recommends precautions to reduce the potential airborne transmission of the virus, such as ventilation and air filtration as a part of a larger strategy that includes minimizing close contact, surface cleaning, handwashing, and other precautions.
Indoor Air and COVID-19 Key References and Publications | US EPA
Review a list of some of the technical publications addressing the science related to transmission of SARS-Co-V-2 through aerosol in indoor environments.
Can indoor sports centers be allowed to re-open during the COVID-19 pandemic based on a certificate of equivalence?
Within a time span of only a few months, the SARS-CoV-2 virus has managed to spread across the world. This virus can spread by close contact, which includes large droplet spray and inhalation of microscopic droplets, and by indirect contact via contaminated …
It is Time to Address Airborne Transmission of COVID-19
Lidia Morawska, Donald K Milton; It is Time to Address Airborne Transmission of COVID-19, Clinical Infectious Diseases, , ciaa939, https://doi.org/10.1093/cid/
COVID-19 Superspreading Events Around the World
Covid-19 Superspread Events
README
,Code,Country,City/Region,Lat,Long,Setting1,Description,Indoor / Outdoor,Cases,Index Date,Reference,Flu Season,Setting2,Setting3,Setting 4:
Vocalizing,Setting5: Refrigeration,Date added/Last updated
ATA1,Antarctica,Antarctica Peninsu…
Coronavirus research updates: Massive contact-tracing effort finds hundreds of cases linked to nightclubs
A selection of the latest research on the new coronavirus.
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Hamner-Choir-Outbreak-MMWR-051220
Particle transport and deposition: basic physics of particle kinetics
The human body interacts with the environment in many different ways. The lungs interact with the external environment through breathing. The enormously large surface area of the lung with its extremely thin air-blood barrier is exposed to particles suspended …
What aerosol physics tells us about airborne pathogen transmission
(2020). What aerosol physics tells us about airborne pathogen transmission. Aerosol Science and Technology: Vol. 54, No. 6, pp. 639-643.
Aerosols, Droplets, and Airborne Spread: Everything you could possibly want to know – First10EM
A review of the scientific literature aimed at providing a better understanding of aerosols and droplets, and their importance in airborne spread of disease
“Some situations may be particularly risky. Meatpacking plants are likely vulnerable because many people work closely together in spaces where low temperature helps the virus survive. But it may also be relevant that they tend to be loud places, Knight says. The report about the choir in Washington made her realize that one thing links numerous clusters: They happened in places where people shout or sing. And although Zumba classes have been connected to outbreaks, Pilates classes, which are not as intense, have not, Knight notes. “Maybe slow, gentle breathing is not a risk factor, but heavy, deep, or rapid breathing and shouting is.””
Why do some COVID-19 patients infect many others, whereas most don’t spread the virus at all?
Preventing big clusters of cases would help curb the pandemic, scientists say
Jun 15, 2020: “Right now, I’m feeling pretty upset, pretty sad because they’re good people,” she said. “There’s a lot of good people in there.”
COVID-19 outbreak in Union Co.; health officials say many cases linked to church in La Grande
PORTLAND, OR (KPTV) ? The Oregon Health Authority has reported the highest number of new COVID-19 cases in a single day to date.
People are getting sick from coronavirus spreading through the air ? and that’s a big challenge for reopening
I am a scientist that studies infectious diseases and I specialize in severe respiratory infections, but I also serve as a member of my church’s safety team….
The coronavirus may have spread through bathroom drains 12 stories apart in a high-rise, raising concerns about fecal transmission
Under certain conditions, aerosols from feces could travel upward through an apartment building after a person flushes a toilet.
Disease transmission may occur when “water traps” in floor and bathtub drains are allowed to dry out. If a bathtub or floor drain is left unused and not re-filled with water for a few weeks, sewage gases can enter the room because they are not trapped by water in the “U” shaped water barrier used in plumbing to trap sewer gases. This is particularly important in apartments, condominiums. high-rise buildings, and other high-density housing. “Bioaerosols can be controlled at the source by avoiding any potential gas leaks from the drainage system to indoor spaces. For example, to block fecal aerosol transmission, drainage traps, such as U-shaped water traps, should not be allowed to dry out.” Viral loads allowed to enter and concentrate indoors when lack of ventilation does not allow the viral load to diffuse, dilute, and escape can be particularly infectious when people remain indoors for long periods of time such as sleeping. This can be particularly problematic during colder periods when windows may be closed.
Probable Evidence of Fecal Aerosol Transmission of SARS-CoV-2 in a High-Rise Building | Annals of Internal Medicine
Background: The role of fecal aerosols in the transmission of severe acute respiratory syndrome coronavirus 2 has been suspected. Objective: To investigate the temporal and spatial distributions of…
Ocean beaches and other land areas close to extremely large bodies of water
develop breezes
due to water and land temperature differences. These breezes effectively create strong natural sources of ventilation and air exchange which greatly dilutes any viral loads which may be present resulting in
dramatically decreased levels of transmission relative to indoor areas
. During the day,
UV light from the sun very significantly helps to inactivate coronaviruses
. Higher
temperatures
help as well. Since the eyes are one of the primary viral entry points, sunglasses and other
protective eye-wear has been shown to significantly reduce infection probability
.
Porous surfaces
such as sand tend to damage the viral envelope (think cellular membrane since coronaviruses “bud” from cellular tissue and use that cellular membrane to create the viral envelope). Anything that sufficiently damages that fragile membrane / envelope will inactivate / kill the virus. Exercise, walking, running, or other activity will increase blood and lymph flow increasing
the random chance that any pathogen will encounter a leukocyte
that will slow or halt infection. In addition, when moving along outdoor bike / foot paths,
transmission is very unlikely during brief encounters
. While these attributes of typical ocean beaches use are each helpful individually, the combination of voluminous fresh air exchange, bright sunlight including UV, warmer temperatures, protective eye-wear, harsh surfaces. and exercise work together to drastically
reduce any viral load encountered
and minimize probability of becoming sick. In fact, with a small viral load and a highly responsive immune system,
it may be possible to gain some level of immunity with no or very mild symptoms.
Pool Parties
Significant numbers of outbreaks have been traced to pool parties. Some physical science realities may be linked to the occurrence of transmission at pool parties. Given many of the principles noted above, there exists convincing evidence that contained airspace increases chance of transmission as the virus accumulates in that limited airspace. Keeping in mind that, when swimming, one’s mouth, nose, and eyes are only inches away from the water surface, it may easily be understood that the volume of airspace below the face is not the same in a pool as it is when standing upright (5 feet or so). Any breeze is also often limited as the pool surface is several inches below ground level. This often creates a slow moving “contained airspace” which enables the viral loads to accumulate within the walls of the pool rather than blow away as easily as when one’s head is 5 feet above ground level where the wind blows more strongly than it does only inches above the pool water surface. Additionally, pools tend to be enclosed within walled areas to protect children from entering inadvertently, further limiting open air space and air movement at the water level. While the chlorine in the pool does help inactivate any virus present and any UV light from the sun does as well, the stagnant air volume between the surface of the water and the pool edges makes for a very limited airspace. Using fans to create additional ventilation over the pool surface can be helpful. Also, since most pool parties include an indoor element, using appropriate safety protocols in the indoor areas can also be helpful. Pools in wide open spaces, lakes, and certainly ocean areas with wave motion tend to have greater air movement which reduces the risk of a contained air-space.
Masks are important when people are in close proximity for significant periods of time. If just passing somebody briefly or keeping a good distance masks are unnecessary (barring an ill-timed point blank range sneeze or cough). Masks are most helpful indoors where someone who doesn’t yet know they are sick will contain many virus containing droplets within the mask and help keep the indoor air cleaner, especially helpful when air volume per person is small, ventilation is inadequate, and people are in close proximity. Masks are extremely helpful for protecting our high-risk populations in environments such as grocery and other places where low-risk, high-risk, and those caring for high-risk populations intermingle. Mask usage in commonly shared indoor environments enables low-risk populations to continue day to day economic and socially helpful behavior while helping to shield high-risk populations from exposure in the shared environments. High risk populations should use masks and avoid crowded areas.
Masks also accumulate and grow bacteria over time and can be unhelpful to the wearer which should be balanced against any benefit they provide toward containing viral laden droplets. Oxygen level changes due to wearing a mask are generally not a concern at most altitudes. Importantly, face masks also provide a barrier that helps one avoid touching their nose. It also provides a psychological benefit of feeling protected which can reduce stress in some people during viral outbreaks and subsidence transitional times; and lower stress helps improve immune health.
Face Masks for Coronavirus (COVID-19)
Learn how a face mask can protect you against the coronavirus (COVID-19), materials you can use to make a mask, and how to wear and clean it the right way.
Best Face Mask Options for Coronavirus Protection
Many health experts consider the use of face masks to be key in helping to prevent the spread of COVID-19. Although respirators and surgical masks work well, they need to be reserved for frontline workers. Homemade cloth masks may not be as effective, but they offer more protection than not wearing …
Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks
The emergence of a pandemic affecting the respiratory system can result in a significant demand for face masks. This includes the use of cloth masks by large sections of the public, as can be seen during the current global spread of COVID-19. However, there is limited knowledge available on the perf…
Respiratory virus shedding in exhaled breath and efficacy of face masks
A study of 246 individuals with seasonal respiratory virus infections randomized to wear or not wear a surgical face mask showed that masks can significantly reduce detection of coronavirus and influenza virus in exhaled breath and may help interrupt virus transmission.
Eye Protection Could Decrease COVID-19 Spread
New reports suggest eye protection, when paired with face masks and social distancing, could provide additional protection against COVID-19 for those in high-risk categories.
Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis
The findings of this systematic review and meta-analysis support physical distancing
of 1 m or more and provide quantitative estimates for models and contact tracing to
inform policy. Optimum use of face masks, respirators, and eye protection in public
and health-care settings should be informed by …
SARS-CoV-2 Infection Before and After Face Shields
This Research Letter reports on the effect of full face shields on SARs-CoV-2 transmission among community health workers in India counseling family members in households with an infected member.
Interim Guidance for the Use of Masks to Control Seasonal Influenza Virus Transmission | CDC
Role of masks for controlling influenza when suboptimal immunization of the public could increase the frequency of influenza infection – CDC
Mask Facts – AAPS | Association of American Physicians and Surgeons
Register today: https://us02web.zoom.us/webinar/register/WN_xXdHU_zpRqOZaonjy7teKA Cost: $25.00 2020 has become an unprecedented year for reasons that don\’t need to be explained. And it is with disappointment that AAPS had to announce that our in-person?annual?meeting?would not be held largely d…
Is It Normal For Face Masks To Smell Bad?
It could be normal, or it could be a sign that it’s time to throw out the face mask.
Microbial Contamination on Used Surgical Masks among Hospital Personnel and Microbial Air Quality in their Working Wards: A Hospital in Bangkok
To assess the relationship of bacterial and fungal contamination on used surgical masks worn by the hospital personnel and microbial air quality in their working wards.This is a cross-sectional study of 230 used surgical masks collected from 214 hospital …
Surgical masks as source of bacterial contamination during operative procedures
Surgical masks (SMs) are used to reduce bacterial shedding from the mouth, nose?and face. This study aimed to investigate whether SMs may be a potential source of bacterial shedding leading to an increased risk of surgical site infection.Bacterial …
Regarding concern about lower oxygen levels wearing masks, keep in mind that respiration rate autonomously changes to keep blood oxygen saturation levels (and CO2 levels) appropriate for whatever level of physical exertion / oxygen use is occurring from moment to moment.
Oxygen Levels at High Altitudes – Altitude Safety 101
Oxygen Levels at Altitude Although the percentage of oxygen in inspired air is constant at different altitudes, the fall in atmospheric pressure at higher
Coronavirus (COVID-19) Update: FDA Reissues Emergency Use Authorizations Revising Which Types of Respirators Can Be Decontaminated for Reuse
Coronavirus Update: FDA Reissues Emergency Use Authorizations Revising Which Types of Respirators Can Be Decontaminated for Reuse
Two Doctors Explore The Physical ? And Psychological ? Science Behind Masks
Dogmatic ideologies, often based on limited science, have led people to question and stigmatize those that dared to disagree.
Miscellaneous
YMCA camp on Lake Burton, Georgia, the weather on June 17 low of 53 and high of 62 and June 20 had a low of 55 and high of 81.
First symptom report of “chills” was June 22
? Per promo video, many fresh water lake activities, indoor activities, and possibly wind-sheltered areas, close proximity activities, shared surfaces / fomites, mostly pre-teens?
Rapid review: What is the specific role of daycares and schools in COVID-19 transmission? | Child care Canada
CRRU’s online documents database contains thousands of resources relevant to ECEC policy and practice in Canada and internationally. CRRU’s website allows the user to quickly search or browse the database of documents.
Scent dog identification of samples from COVID-19 patients ? a pilot study
As the COVID-19 pandemic continues to spread, early, ideally real-time, identification of SARS-CoV-2 infected individuals is pivotal in interrupting infection chains. Volatile organic compounds produced during respiratory infections can cause specific scent imprints, which can be detected by trained…
Reopening Primary Schools during the Pandemic | NEJM
Medicine and Society from The New England Journal of Medicine ? Reopening Primary Schools during the Pandemic
Temperature significantly changes COVID-19 transmission in (sub)tropical cities of Brazil
The coronavirus disease 2019 (COVID-19) outbreak has become a severe public health issue. The novelty of the virus prompts a search for understanding …
CED Engineering
CED Engineering offers online PDH Courses for continuing education. PE Continuing Education.
Optimizing Building Ventilation for COVID-19 | Allana Buick & Bers, Inc.
Optimizing Building Ventilation ? Why and How? As life in the US returns to normal, HVAC systems ? particularly ventilation and balanced air circulation ? will play a significant role in public health and confidence. Here are the most convincing reasons why and the most cost-effective measures you…
Indoor Air and Coronavirus (COVID-19) | US EPA
EPA recommends precautions to reduce the potential airborne transmission of the virus, such as ventilation and air filtration as a part of a larger strategy that includes minimizing close contact, surface cleaning, handwashing, and other precautions.
Particle sizes of infectious aerosols: implications for infection control
The global pandemic of COVID-19 has been associated with infections and deaths among
health-care workers. This Viewpoint of infectious aerosols is intended to inform appropriate
infection control measures to protect health-care workers. Studies of cough aerosols
and of exhaled breath from patients w…
RoleofACHinTransmissionofAirborneInfections508.pdf
Asthma, while somewhat increasing risk, does not appear to be a large contributor to increased risk. In this study, the 2 of 26 patients with asthma who did not survive also had hypertension and other heart-related comorbidities that were very high risk factors.
Causes of Death and Comorbidities in Patients with COVID-19
Infection by the new corona virus strain SARS-CoV-2 and its related syndrome COVID-19 has caused several hundreds of thousands of deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed information o…
One study indicates surprising results:
“Lead researcher on this team Dan Nicolau, an associate professor at QUT, explained that the asthmatics and those with chronic lung disease and chronic obstructive pulmonary disease (COPD) were on regular inhaler therapy with corticosteroids, were found to have a lesser risk of severe illness in the early phase of the pandemic. He said that this was paradoxical because those with long term lung disease were initially considered to be at a higher risk of a respiratory viral infection such as SARS-CoV-2. He said in his statement, “This seemed paradoxical because COVID-19 affects the lungs ? and these patients have lung problems ? so they should be more at risk of severe disease from the virus.”” The results in asthma patients are also correlating positively with
steroidal treatment benefits in non-asthma patients
.
Asthma inhalers being trialed for treatment of COVID-19
Researchers from Queensland University of Technology and Oxford University are working in collaboration to begin human clinical trials of inhaled corticosteroids, commonly used for asthma patients, on patients with COVID-19. The researchers believe that this could be useful for patients with the nov…