Everyone agrees the best way to treat this illness is test, trace and confine. That is what was done in the Asian countries. I heard that both in Hong Kong and Taiwan because of their experience with the SARS coronavirus outbreak back in 2003 which resulted in 8,096 cases and 774 deaths the people immediately started to isolate themselves and wear masks. (Again I suggest wearing masks is one of the most important things we can do but few seem to want to do it.) I’m told by Billy Fitz that in Taiwan they have had only two deaths.
We no longer can use the best method throughout the United States, as they say it is too late to close the stable doors after the horses have escaped. Yet it seems in some states where the cases are low it could still be followed but there is no national voice suggesting to those governors that this be done. It seems in Hong Kong the tracing was done by using cell phone tracking to determine where the person had been in the previous forty-eight hours.
Governor Cuomo of New York recently had this to say. “What we did was close everything down. That was our public health strategy. Just close everything. All businesses, all workers, young people, old people, short people, tall people, every school, close everything. If you re-thought that or had time to analyze that public health strategy, I don’t know that you would say quarantine everyone. I don’t even know that that was the best public health policy.
Young people being quarantined with older people was probably not the best public health strategy because the younger people could have been exposing the older people to an infection. So how do you modify the public health strategy to make it smarter from the public health point of view but also starts to get you back to work. Younger people can go back to work. People who have resolved can go back to work. People who, once we get this antibody test that shows that they had the virus and resolved it they can go back to work.”
I’m not quite sure that not doing what he did was as bad as he thinks. Of course, after this is all over there will be a time for reviewing it. Cuomo saying “young people being quarantined with older people was probably not the best public health strategy” is somewhat obtuse. I assume those young people were living with the older people in their homes. What then were to be done with the young people if they couldn’t go to where they lived? The way Cuomo presented it was as if he was putting young people into houses where they did not live.
Perhaps those young people living by themselves or with other young people could have been exempt from the lock down which would have made sense but otherwise not. As for who can go back to work you can have young people go back but they will still be spreading the virus among themselves even though in most cases it won’t be serious but many will need hospitalized: “According to official figures released last week, twelve per cent of those who have been treated in intensive care are aged between 19 and 50.”
Those who “have resolved”, I assume that means they have had the virus and can return is assuming they won’t catch it again. That would seem to be the case but that is still uncertain. Here’s one report: “Doctors in China say patients who recover from coronavirus can be reinfected — and if that happens, they become significantly more likely to suffer fatal heart attacks due to the nature of the virus and the effect of the medicine used to treat it, according to the Taiwan News.”
The last category requires getting the antibody tests which are not available now, never mind at the time the original order to stay at home was given. Without tests, this suggestion makes no sense.
I understand that people will second guess themselves but sometimes when doing it they forget what was available to them in the first place or the original reason they made the order. The best thing is the stay at home order from my point of view. The fewer people who catch the virus the better. Cuomo’s second guessing probably has already impacted the effect of his order. Sending people back into the workplace at this time is really foolhardy.
Stress is in the mind of the beholder. Most paranoid germaphobes live life in a stressed out condition. People are afraid of everything. You name it and it causes great mental discomfort in someone.
I live in the suburb of McLean, Virginia. One third transient diplomats, one third permanent residents and one third “others”. People are taking advantage of the silver linings in this pandemic. Everywhere I look I see a more relaxed town than ever before in my 25 years down here. I would call it concern rather than stress. That is completely normal during a time like this. I’m a carpenter and work in and around people’s homes. My regular customers are all for having me in their houses. I’m taking precautions and they are too. Yesterday I did a bit of painting on a project I created in a medical office building. No problems and I got fifty pair of surgical gloves as a tip. I wore a mask and gloves as did everyone else I saw working there.
It seems to be sinking in that whoever you support in politics or believe in as a deity, this crises can and will be survived by the great majority of Americans. I understand that people still have to be fervent about their political beliefs. I give the Savin Hill Billy shit because its what I do. His posts and assumptions are valid but I have to do my thing, too.
Blogs like this are exactly what we need in times like this. It keeps us on our rails. Keeps us normal. And another thing that many people of (average?) intelligence know is that nothing any of us say on sites like this will have much effect on what this crow virus does. (I call it crow virus because all crows in the world are in the genus of birds called corvids.)
I’m going fishing.
Honest:
Nice post. Hope you catch something (not the virus but the fish)
Statistics-the life’s blood of the of the Dismal Science” and other charades. They can only be truly evaluated by analysis of the structure, methodology, and other minutia (variables, sample size, geography, political economy and on and on). They can be bent, twisted, spindled and mutilated according to the whims of the client. Outcomes are rarely the product of freely operating analysts. But, they are not completely useless. Care must be taken.
Comparisons are a futile attempt at cookie-cutter application recommendations. Political, societal, cultural and economic norms may, and usually do, render the assumptions useless.
Hutch:
You are reading too many scientific treatises. Perhaps some day you will translate what you wrote to our local patois. You’d have caused yourself to be chased out of the Woods if you ever said that during one of the breaks in the games.
Hello Matt, I see you used your Kilkenny Cat in your Blog today☘️. It turned out to be the answer to a question asked in “Jeopardy” tonight. We are all hunkering down in Lauderdale by the Sea trying to stay alive and I find your discussions, both pro and con , very helpful in staying alive: Your responders are all very insightful and I enjoy reading their words of wisdom. I believe that is what makes America function as a true Democracy. Wash your hands frequently , wear gloves whenever necessary, keep your distances from others, be kinder to your also closeted significant other and we will all live to fight another day! Slainte
Jim:
Good to hear from you and that you are well holding up in Florida. I escaped a week or so ago when I saw everyone going on with business as usual especially all the college kids on breaks. But it is good to see you are following the advice of washing hands and keeping a decent distance from others. As you know I’ve been absent from blogging a while but doing this helps break the inconvenience of being isolated from others. Of course we have Duo or Skype to stay in touch with the grand kids and kids which is some compensation. Then for guys like you who look forward to things relating to the Patriots you have the draft coming up. I guess they are still trying to figure out how to carry it off. Maybe they’ll pipe in noise as if an audience is present. Sammy (Neal) is convinced that Belichick is a bum who will come up with a lousy record because of Brady’s flight. That will add interest to watching this fall as well as seeing how well Brady does without Belichick. But the question is will there be an NFL season in the fall.
I was looking forward to college football. I wanted to see how long I’d give BC’s new coach before I started to complain about him; I also wanted to see how the recently departed coach does out at Colorado State. It is strange that we have all that up in the air.
It was good to hear from you and know everything is well. Keep it that way. Say hello the the significant other and your suggestion as to the relationship with one’s significant other is well taken for if we are kinder to her we will live to fight another day.
Slainte: Stay Healthy
• According to Harvard’s Women Health Watch from Harvard Medical School, “Evidence suggests that people with anxiety disorders are at greater risk for developing a number of chronic medical conditions.” And from Psychology Today, March 14, 2020: “When stress, anxiety, worry, overwhelm, depression and isolation are left unchecked they actually reduce the effectiveness of your immune system and make you, and those around you much more susceptible to getting sick.” Stressing out over Coronavirus and being paranoid about Coronavirus can impair your immune system and also make you sick.
• 2. As previously posted, neither the WHO nor CDC recommend wearing face masks, unless you’re sick.
• 3. Another long term study for epidemiologists will be what adverse effect the orders “stay at home, businesses closures, school closures” have had on the physical and mental health of Americans, what adverse health consequences there have been from increasing stress and fear in the American Public, and whether or not our drastic measures have impaired our immune systems and impaired the development of Herd Immunity in the general population.
• Japan is showing a decrease in both the common flu and coronavirus. Some attribute this to the extraordinary safety measures taken. One study I read, said it is not the masks that make you safer, it is that people who wear the masks are more likely to social distance, wash hands, etc.
• Many factors to consider.
Here’s a question. In a country of 320 million people, what percentage are likely to contact the virus from packages, letters? What is is the risk? One in ten million? Compared to what other risks in daily living? Driving a car? Should we stress about low risk circumstance, when stress itself causes illness?
William:
1, They won’t have stress and anxiety if they are dead or if a friend or relative dies. Isn’t it better people be alive and stressed than dead.
2. WHO and CDC don’t recommend masks because they aren’t available. They are plainly wrong. It is the one distinction between the countries that control the virus and those decimated against it. Masks should be made at home if not available. People are now catching on that the difference between Asia and the West is the wearing of masks. It is a common practice in Asia where the virus is under control; it is not practiced in the West where the virus is running out of control.
3. The adverse effects of staying at home will pale in significance to the deaths caused by those who don’t. I don’t understand what you are advocating. We all go outside and mingle so that we will have better health in the future. Are you doing that?
4. Bottom line in Japan is they all wear masks. We are doing the social distancing and hand washing but it is having no effect. I’d like you to cite the study for it is wrong.
5. I’m still amazed you come up with all sorts of objections – now it is stress – you offer the Trumpian idea that we have stress about driving automobiles. There is a real crises at hand. Hospitals cannot handle the influx of patients. Hospital workers are getting ill. Over 105 thousand American infected; over 1,700 American deaths. It seems your proposal to deal with it is to allow it to continue spreading to avoid stressing people out.
Matt: Stress causes death and disease. Stress impairs the immune system. You know that.
We can study this till we’re blue in the face, and we do and the people at the CDC do, too. I assure you.
I found that the Japanese Health Ministry itself, historically, has only advised that the sick (those with the flu or coughing) wear masks.
You’ll admit the Japanese and other Asians have been wearing masks for a long time. I submit it’s not the masks that protect. It’s when people take other extraordinary precautions (social distancing, frequent hand-washing, staying-home when sick.)
Here’s my evidence:
Here’s one study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815659/
“The mean annual global influenza-associated respiratory mortality rate per 100 000 was 5.9, with regional estimates ranging from 4.5 in Eastern Mediterranean to 6.2 in the Americas (Table 2). SEE BELOW, JAPAN’S ANNUAL RATE IS 6.0)
“Globally, the excess mortality rate was on average 26 times higher in older adults than in the <65 age group (ranging from 18 times higher in Sub-Saharan Africa to 32 times higher in the Americas). The highest estimated rates were in the <65 age group in Sub-Saharan Africa and the ≥65 group in South-East Asia. Some countries experienced particularly high mortality rates in the ≥65 group, including those in the Americas (eg, Argentina), Sub-Saharan Africa, the Middle East, South-East Asia and parts of Western Pacific (eg, China Figure 2, panel B). The WHO European region had the lowest influenza-associated respiratory mortality rates in both the <65 and ≥65 age groups.”
REPEAT: “THE WHO EUROPEAN REGION HAD THE LOWEST INFLUENZA-ASSOCIATED RESPIRATORY MORTALITY RATES IN BOTH THE 65 AGE GROUPS.”
THE LOWEST MORTALITY RATES were WHERE THEY DON’TWEAR MASKS.
This study seems to conclude that less mortality is associated with places with advanced medical care and higher standards of living.
Again, the mean annual global influenza related death rate of (5.9 per 100,000) is equal to Japan’s (6.0 per 100,000) See first sentence above and the article below.
2.From the Journal of Infectious Diseases: The burden of influenza and respiratory syncytial viruses in Japan, 2006-2014: A region and age-specific excess mortality study. “Across the 8 seasons (2006–2014), seasonal influenza was on average associated with about 27,000 annual deaths in Japan, or about 20 per 100,000 population (and only about 8,100 annual deaths, about 6.0 deaths per 100,000 population in the 2009 influenza pandemic). . . .(and) Strikingly, we report greater estimates of influenza-associated mortality for Japan compared to estimates published over a decade ago. Moreover, our results revealed comparable mortality burdens exerted by RSV and influenza in Japan. In particular, seniors are disproportionately affected, especially those aged ≥ 80 years, indicating that a rapidly aging population could exacerbate mortality associated with these respiratory diseases.”
So, Japan has 20 deaths per hundred thousand in the regular flu season. But during the Swine Flu, when people took extraordinary protections, that rate dropped to 6 per hundred thousand. Swine Flu itself only took about 200 lives in Japan. However, among the top 10 countries with per capita Swine Flu cases were three Asian Countries: Hong Kong, South Korea and Macau. (Do they wear masks in those Asian countries?)
Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Disease, put it plainly: “The seasonal flu that we deal with every year has a mortality of 0.1%,” So, one in one thousand, is 10 per hundred thousand. HALF OF JAPAN’S ANNUAL RATE.
The Swine Flu (2009) in U.S. killed 12,469 (CDC) (divide that by 307 million Americans. So, 40 per million died, or 4 per hundred thousand.
Japan had about 12,000 cases and 200 deaths. (128 million population) during Swine Flu, but Hong Kong, Macau and South Korea were among the top 10 countries with confirmed cases of Swine Flu. See Wikipedia.
Now please show me your data, that requiring everyone to wear masks would lower the infectious rate of viruses. I submit it is the extraordinary extra precautions we take during pandemics (social distancing, frequent hand-washing, temporary business closures) that lessen disease. I also submit that if we prolong closed businesses and prolong social isolation (stay at home orders) this too will have devastating adverse public health effects.
What harm does it do if everyone wear masks? We’ll miss all those smiling faces. Normal social interactions are good for us, are healthy for us, give us pleasure and joy, fortify the mind, immune system, body and soul.
Correction, if the mean annual influenza death rate was 5.9 per 100,000 (first study), Japan’s (from 2006-2014) was 20 per 100,000. Six per 100,000 was Japan’s 2009 rate during the Swine Flu epidemic which claimed only about 200 (198) deaths in Japan.
Dr. Amesh Adalja, a scholar at the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, and a spokesman for the American Infectious Disease Society:
“Even during H1N1 [flu epidemic], there was no recommendation to wear face masks,” he said. They “end up creating a false sense of security and most people don’t wear them appropriately,” he said.
“People who are not in the medical field who wear the masks often come in contact with germs when they lift the mask up to eat or slip their fingers under the mask to blow their nose,” he said. (Other experts noted many improperly touch the front of their masks while they’re wearing them or taking them off; some re-use them.)
Panic-driven demand for face masks, Adalja said, is particularly worrisome because it could have “a negative supply shock” effect on hospital personnel who need these masks more than the general public.
Like the surgeon general, Adalja said, “the best ways [for the general public] to protect themselves are the basic hygienic measures.” That includes washing your hands regularly and covering sneezes and coughs. But if you are “sick and need to go out you should wear a mask.”
No one has yet assessed the adverse psychological effects of creating a FEARFUL FACELESS SOCIETY.
Good post. I generally agree. The question is: For how long will businesses close and the “stay at home orders” be prolonged.
It’s a bit like Vietnam. (An officer said, “We had to destroy the village to save it.”) Well, we don’t want to destroy the economy, because we know that too causes illness and suffering. Also, we knew when we left Vietnam many Allies would die. (150,000 were killed.) And we know when we lift the “stay at home orders” , more will contract the Coronavirus. However, we also knew that staying in Vietnam, more Americans and Vietnamese, including civilians, would die too.
The whole purpose of these drastic measures is to slow the spread so hospitals are not overwhelmed.
The Hope: We’ll know next week how effective new medical treatments are. Some look promising.
A recent report from experts:
“Data analysis by the University of Washington School of Medicine suggests over 81,000 people may die as a result of coronavirus in the U.S.
Some estimates put the death toll as low as 38,000 and as high as 160,000.
The number of hospitalized patients are expected to peak in mid-April, though this may change from state to state.”
Compare those numbers with the 2017-18 Flu Season where 81,000 died, and let us ask how many of those who die from the Coronavirus would have died from the Common Flu? We’ll only know in retrospect. Also most who die from the Coronavirus have pre-existing illnesses, so only in retrospect willwe know the Coronavirus’s impact on overall life expectancy.
Also remember annually in the U.S. we have about 36 million hospital admissions, and about 40% of those are for elective procedures, so as the AHA recommends postponing elective admissions will free up hospital beds.
Also remember, if in three weeks the Infectious rate peaks, and by that time we have a sufficient number of ventilators, we will still need a sufficient number of trained physicians and nurses who know how to operate those ventilators.
SO MANY FACTORS TO CONSIDER. IT IS ENDLESSLY FASCINATING.
Everyone should continue to investigate, ask questions and comment, for it is only through open discussions and the free flow of info that we will be able to make the best decisions.
And, in my humble opinion, American Ingenuity is the best hope for redressing and ameliorating this crisis.
Matt, like a good judge, I know you want to hear both sides of an issue.
Here’s an article about HOMEMADE MASKS, which summarizes data from the CDC and Minnesota Health Authorities:
“Are DIY cloth face masks effective against the coronavirus?
“In short, no. DIY masks are likely close to useless in protecting against the virus.”
“Homemade face masks are not considered personal protective equipment [what health-care professionals call PPEs], and should be an option only when there are absolutely no respirators or face masks left, and used with other protective equipment, such as face shields,” CDC spokesperson Arleen Porcell said in an email statement. “It’s important to note that this strategy is considered a last resort and does not adhere to the typical standards of care in the US, but acknowledges the hard realities on the ground.”
Of course, Arleen Porcell is talking about those caring for patients.
The article continues: “SARS-CoV-2 is so new that we don’t yet have direct studies to consult on the efficacy of different protective equipment. However, a 2015 study in Vietnam found that hospital health-care workers wearing cloth masks were far more likely to become infected with respiratory and flu-like illnesses than people wearing disposable surgical masks were. Cloth masks stopped just 3 percent of particles, and medical masks stopped 56 percent. A 2013 study (PDF) by Cambridge University, which studied how aerosolized bacteria and viruses passed through DIY mask materials inserted into a testing device, indicates that only vacuum cleaner bags came close to matching surgical masks’ ability to block one type of virus; among cloth masks, tea towels blocked the highest percentage of the virus.”
https://thewirecutter.com/blog/homemade-face-masks-coronavirus/
And the reality of running out of surgical masks is not a chimera. Billions of those masks will be needed by medical personnel over the next few months.
So, I’d conclude it’s best for now to follow CDC advice.
But who knows? The CDC, Governor Parker or Mayor Walsh may make masks mandatory. Look what Ralph Nader did with speed limits and seat belts.
William:
You are comparing apples and oranges. No one is suggesting that homemade masks be used by first responders or hospital workers. The CDC and Minnesota study said “Homemade face masks are not considered personal protective equipment” for health-care professionals. That’s elementary. Even then the CDC suggests they can be used as a last alternative. How many time do I have to say I am not talking about health care workers who come in close, intimate contact on a minute by minute basis with coronovirus stricken victims.
The woman you reference then cites a 2005 study of ” hospital health-care workers wearing cloth masks” were more likely to be infected than those using cloth masks. They didn’t need a study to tell them that but again you are in a hospital situation. I am aware of the Cambridge University study and that a mask made from a vacuum cleaner bag is almost as effective as a surgical mask. But I’m not talking of the protection needed by a surgical mask I’m talking of the protection needed by a person walking around in a store or some other similar place.
The Cambridge study states that a surgical mask gives 96.35% protection, a vacuum cleaner bag 94.35%, a tea towel that I recommended 83.24%, a cotton mix shirt 74.6%, and a 100% cotton shirt 69.42%. I’ve mentioned all these figures before. The question is do you want some protection or no protection. If you could not get the bullet proof vest that gave you 96.35% protection would you turn down one that gave you 83.24% protection. The CDC is plainly wrong. Homemade masks give good protection for people out in the public who are not in the more serious infectious locale of a hospital.
As an aside, the Trump administration is requesting underwear companies to make masks of three-ply cotton which it plans to distribute. The Cambridge study indicates that adding more layers to the the material adds very little more protection. Why is the Trump administration ordering masks that give 69.42% protection, or a slight bit above that, while at the same time the CDC is saying they should not be used?
Masks will save lives of the average citizen. They will prevent those infected from spreading the virus and those not infected from becoming so. Keep your research up and you’ll find I am 100% correct – read an article in the Globe telling people to wear masks. Yes, masks should be mandatory as our death toll from the virus is now over 2,000. As for Ralph Nader and seat belts, look up the statistics to see how many lives they save at a minimum of inconvenience. “According to the National Highway Traffic Safety Administration (NHTSA), more than 15,000 lives are saved each year in the United States because drivers and their passengers were wearing seat belts when they were in accidents.” Masks will save many more.