A new study on masks that measures the number of droplets emerging from the mouth during speech shows that properly fitted N95, surgical, and polypropylene masks are best, layered cotton masks are good, bandanas are not great, and neck gaiters may be worse than wearing no mask. Here’s a Washington Post article about the study.
I have some issues with this study — most masks were tested by only one speaker and mask materials were not identified precisely1 — but when combined with other studies about masks, it is clear that surgical masks or masks that are made with similar materials (polypropylene non-woven fabric) are what you want to shoot for, you want multiple layers for more protection (no single-layer microfiber gaiters), homemade cotton masks are pretty good (but would be better with a layer of polypropylene non-woven fabric), proper fit matters, and for god’s sake, stop wearing a bandana as a mask. Yes, bandanas are convenient, but you’re probably trading safety for that convenience, especially if you factor in the amount of time you’ll be wearing a mask over the next several months. A proper mask is going to protect you and your neighbors much more over the long haul — it’s just common sense at this point.
Re: the tested neck gaiter being worse than wearing no mask: the hypothesis is that the gaiter’s material splits large droplets into smaller ones, hence the higher count.
We noticed that speaking through some masks (particularly the neck fleece) seemed to disperse the largest droplets into a multitude of smaller droplets (see Supplementary Fig. S5), which explains the apparent increase in droplet count relative to no mask in that case. Considering that smaller particles are airborne longer than large droplets (larger droplets sink faster), the use of such a mask might be counterproductive.
Here’s what I’m taking away from this and other mask studies: wear the highest quality mask you can locate (multi-layered, incorporating surgical mask materials) that fits properly and, secondarily, is comfortable & convenient. For me, that’s a two-layer cotton mask (like these Vida masks) with an inserted layer of polypropylene non-woven fabric. An N95 would be much better in terms of efficacy, but it’s overkill in most situations (particularly here in VT, where rates continue to be low) and is difficult to fit properly and quickly. (via @EricTopol)
The purpose of the research was to establish that the testing method worked in principle-not to come up with meaningful or accurate verdicts about particular masks.
But she also concludes (correctly, in my mind):
Should you think twice about wearing just a gaiter inside, in close proximity to other people? Yeah, a fitted mask is probably better. But you didn’t need this study to tell you that.
Update: But interesting to note that in this test, scarves, bandanas, and microfiber neck gaiters came in last.
What is a “gaiter type neck fleece” made out of exactly? If you look at the photo, it doesn’t look like fleece so much as microfiber polyester, which is what my kids wear for skiing. This article says the neck gaiter was “made of polyester mixed with a little spandex”, which is definitely not fleece. My guess is they tested a one-layer microfiber gaiter and that higher quality gaiters would perform better (but still not as well as a surgical mask).↩
In the United States, amid high numbers of Covid-19 infections and thousands of weekly deaths, no national plan for testing & tracing, little support for working parents, and individual states and school districts left to their own devices to figure this all out for themselves, schools around the country are trying to “open” for the 2020-2021 school year. At McSweeney’s, Kara Baskin imagines Your School District’s Reopening Survey. Here’s what a hybrid learning model will look like:
This model will combine the key elements of in-person instruction (see above) with remote learning, which we hopefully perfected this spring. Your child will be divided into a cohort (A, B, AB, BC, CC, XVY, MCXLVII, and Depeche Mode) based on careful consideration of his or her learning style, social-emotional needs, friendships, and an algorithm our intern designed this summer. You will need a reliable Internet connection, a work schedule that follows no concrete pattern, a forgiving supervisor, independent wealth, or a Xanax prescription. Please contact our school nurse for the latter.
I sent this link to a friend who is currently evaluating several options for her child’s schooling that range from poor to dangerous, and she replied, “This may be too on the nose to be funny.”
Photographer Daniel Arnold and editor Dodai Stewart collaborated on a photoessay documenting the first five months of the pandemic in NYC. That image above is just…wow.
The Instagram account thefamilyvocab features videos of words & phrases in sign language that are not part of standard ASL.
Our aim is to play with sign language and expand my child’s visual vocabulary with signs that are not part of standard ASL. It’s only 200 years old and still thriving and evolving.
So I can understand that teachers are nervous about returning to school. But they should take a cue from their fellow essential workers and do their job. Even people who think there’s a fundamental difference between a nurse and a teacher in a pandemic must realize that there isn’t one between a grocery-store worker and a teacher, in terms of obligation. People who work at grocery stores in no way signed up to expose themselves to disease, but we expected them to go to work, and they did. If they had not, society would have collapsed. What do teachers think will happen if working parents cannot send their children to school? Life as we know it simply will not go on.
Oh yes, that is a totally awesome thing our brave grocery store workers did for us out of a sense of obligation and not because their choice was between risking their health and losing their job in a country with a terrible social safety net. But let’s leave that to one side for a second.
I think many more people would support (and indeed rapturously welcome) kids going back to school if a) there were many fewer cases of Covid-19 in the US, b) if the federal and state governments were doing more testing, tracing, and isolation & support of those who test positive, c) if there was more support for parents, and especially low-income folks, with other options around education and childcare (more on that below), and d) if the mask issue wasn’t so contentious in some parts of the country. Oh and don’t forget that even before any of this happened, teachers regularly used their own money and held online fundraisers to buy necessary school supplies for their classrooms.
Blaming teachers for not wanting to go back to work because their country and communities can’t or won’t do the hard work of making it safe is ridiculous. It’s not fair to ask them to do their part when others with greater responsibility to act are not. Someone has been watching too many war movies where soldiers dying due to the negligence, incompetence, or bad intentions of their superiors is played off as patriotic service & bravery instead of murder.
And this…this is just flat out false:
(And parents who want their children to stay home have that option, whether through homeschooling or continued remote learning.)
Rich people with reliable internet access and extra computers lying around have that option, and it’s a terrible option if those parents work (especially if they’re single parents). A huge chunk of America does not.1 If, by some miracle, the federal government started paying people to stay home from work to help their kids with school, gave everyone a laptop stipend (as well as enough money so that kids have access to meals that they might usually get through school programs), and ensured internet access to those who don’t have it, that statement would be closer to the truth. As long as we’re waving magic wands, I would like a chocolate pony and a peanut butter unicorn.
I would have been far more sympathetic to McConnell’s case had she made a convincing argument that school is so essential to children that it’s worth the risk to them, their teachers, and their families, that schools and governments are doing the right things to ensure the safety of their students and staff, and that Covid-19 is coming under control in the United States. But she did not.
The idea that remote work and home education don’t qualify as doing one’s part for society is so pernicious that it nearly distracts from McConnell’s core argument, which is both simple and widespread: If work is essential, it must also be sacrificial. That argument is worth examining, not least because it’s likely to reappear as parents cope with another semester at home. McConnell has taken a view expressed most commonly in the pandemic policies of certain large corporations and extended it to teachers. The same thread is visible both in Amazon’s failure to get enough masks to workers and to ensure social-distancing in warehouses and in the insistence that teachers should head back into classrooms, whatever the risk.
I also had a bunch of mail in my inbox this morning, both from teachers and healthcare professionals, poking holes in this poorly argued piece. The Atlantic’s coverage of the pandemic has been outstanding, but this article was just not very good — a rare misfire. (via @zidaya)
In the spring here in Vermont, where cell service and internet can be spotty, there was a steady stream of people asking on local message boards if anyone had extra computers to donate to their kids and where they could find free wifi that was accessible from the parking lot so their kids could sit in the car and do their schoolwork.↩
The Auralnauts, who have rejiggered the dialogue and sounds from your favorite movies with hilarious results (most notably Star Wars), have reimagined Bane from The Dark Knight Rises as a coronavirus mask advocate for their latest video.
Do I look like I live in fear of anything?! I’m wearing this mask for you, the people of Gotham, who, I can’t help but notice, are not social distancing!
A compilation of TV news clips of people saying “mask debate” (which sounds very much like another unrelated word when spoken — try saying it out loud right now to see what I mean), stitched together by the folks at Last Week Tonight with John Oliver. It feels good to laugh at infuriating things sometimes.
BTW, the actual debate over masks will continue to wane — science and then culture will win most people over and it’ll just become a normal thing that most people do in public all the time, like wearing shoes or carrying a bag.
We can virtually eliminate the virus any time we decide to. We can be back to a reasonably normal existence: schools, travel, job growth, safer nursing homes and other settings. And we could do it in a matter of weeks. If we want to.
Take New Zealand. With its fancy curve and life back to normal. Why can’t we? Not fair, you say. It’s an island nation. Okay. What about Germany? Not an island nation, large, growing diversity. Don’t like that comparison? What about countries that have been in big trouble? There’s Italy, France, and Spain. Those countries had it reasonably bad the same time we did. In fact, pick virtually any country you want.
But don’t tell me the United States can’t take action if we want to. And we can’t face the families of 150,000 people who didn’t have to die and tell them this had to happen. And I think it’s why our national political leaders won’t go near these families and the grieving process.
The good news — and it is good news — is we are always four to six weeks from being able to do what countries around the world have done.
I know this article is supposed to be hopeful and optimistic, but people have known what to do about Covid-19 since at least March. Instead the United States has not done it and indeed has done mostly the opposite. The “we” that are supposed to decide to lead this effort won’t because they don’t want to put in the work (it’s easier to blame the virus, Democrats, and China), they don’t want to just give money to people to stay home (a huge no-no for Republicans), and they don’t care that much about who is dying (urbanites, low-income, the elderly, Black & brown people).
As long as Republicans control the Senate and White House, the current scattershot approach of each state/county/city/person deciding what is best (or most in their self-interest) is what we’re stuck with. Treatments will improve, vaccines will be developed, many people will do the right thing and mostly stay home for many more months (sacrificing their mental health to do so), and Covid-19 will eventually come under control, but hundreds of thousands more people will die, many more will recover but carry chronic illnesses for years, vital years of the survivors’ lives will have been lost, and we will collectively grieve these losses for generations.
Biologically, a vaccine against the COVID-19 virus is unlikely to offer complete protection. Logistically, manufacturers will have to make hundreds of millions of doses while relying, perhaps, on technology never before used in vaccines and competing for basic supplies such as glass vials. Then the federal government will have to allocate doses, perhaps through a patchwork of state and local health departments with no existing infrastructure for vaccinating adults at scale. The Centers for Disease Control and Prevention, which has led vaccine distribution efforts in the past, has been strikingly absent in discussions so far — a worrying sign that the leadership failures that have characterized the American pandemic could also hamper this process. To complicate it all, 20 percent of Americans already say they will refuse to get a COVID-19 vaccine, and with another 31 percent unsure, reaching herd immunity could be that much more difficult.
I am the least anti-vaxxer person in the world, but I have to say that getting a vaccine for Covid-19 that was rushed through trials in time for the election (October surprise!) and signed off by a Trump administration that has completely politicized science does not sound like something I want to go near. Which, for me personally, is a really really depressing thing to even think.
Update: I got a lot of flack for suggesting that I’d be skeptical of a Trump-approved vaccine rushed to market in time for the election (a very specific set of circumstances). But his buddy Putin is attempting something similar in Russia (skipping phase 3 trials), so if you don’t think Trump can try to bully the FDA and CDC into signing off on a vaccine that hasn’t been fully tested — perhaps made by a company whose CEO has donated millions to a Trump SuperPAC? — in order to salvage his reelection chances, I suggest that you haven’t paying proper attention over the past 4 years.
Update:A poll suggests that many Americans across the political spectrum are worried about a politicized FDA being forced to approve a Covid-19 vaccine before it’s adequately tested.
Seventy-eight percent of Americans worry the Covid-19 vaccine approval process is being driven more by politics than science, according to a new survey from STAT and the Harris Poll, a reflection of concern that the Trump administration may give the green light to a vaccine prematurely.
The response was largely bipartisan, with 72% of Republicans and 82% of Democrats expressing such worries, according to the poll, which was conducted last week and surveyed 2,067 American adults.
The sentiment underscores rising speculation that President Trump may pressure the Food and Drug Administration to approve or authorize emergency use of at least one Covid-19 vaccine prior to the Nov. 3 election, but before testing has been fully completed.
Eater food critic Ryan Sutton, who had Covid-19 back in March, isn’t dining out at restaurants right now and explains why.
What’s more is that local health regulations for dining out aren’t strong enough. Before every shift, restaurants have to screen employees with health based questions, but temperature checks aren’t mandatory for either staffers or employees. And even though patrons are encouraged to wear masks at tables while they’re not actively eating or drinking, few really do. Even if no one dies or is sent to intensive care under these conditions, the notion of being in a place where underpaid staffers are financially compelled to interact with unscreened and unprotected patrons seeking leisure is unacceptable to me on a very basic human level.
I miss dining out so SO much. I miss my friends in the industry and am furious that federal and state governments have pushed them back into unsafe working conditions in the idiotic & dangerous race to “open up the economy” before any reasonable system of test/trace/isolate + a mask mandate is put into place nationwide. But I haven’t been in a restaurant since early March and will not return to one, outside dining or no, until the pandemic is over.1 I’ve been ordering takeout as much as I can (and heavily tipping) to support local businesses that are operating safely. But the whole concept of dining out seems very irresponsible to me and should not even be an option right now.
If “over” actually has any meaning in the context of the pandemic. I keep saying “when this is over” and hearing others say it, but I have no idea what it means. Whatever “this” eventually is, I’m not sure it has an end, happy or otherwise.↩
In this video and accompanying infographic, scientist Dominic Walliman of Domain of Science explains what viruses are, how they infect cells, how they replicate, and what can be done to mitigate their effects on the human body.
At the beginning of this pandemic like everyone I was hearing lots about viruses, but realised I didn’t know that much about what they are. So I did a load of research and have summarised what I learned in these nine images. This video explains the key aspects of viruses: how big they are, how they infect and enter and exit cells, how viruses are classified, how they replicate, and subjects involving viral infections like how they spread from person to person, how our immune system detects and destroys them and how vaccines and anti-viral drugs work.
This is the day you start to turn. What we suck up from your lungs turns frothy pink and then the frank red of blood. We don’t know if your heart is finally failing or if the virus has destroyed so much tissue that this is necrosis, hemorrhaged in your lungs. There are tests, but no one willing to run them — you are too sick, and you have never cleared the virus. No one would ever want to be what you are now: a hazard, a threat, a frightening object on the edge of death. We try not to touch you. We construct our plans for saving you around staying as far away from you as possible.
I tell your husband about the blood. It’s true that nothing else has changed: your struggling lungs, with help, still take in air, your heart, with help, still brags along. “But she is stable,” he asks, barely a question. Why do I lie? “Yes,” I say, “for now.”
DeForest wrote this in early May as Covid-19 cases peaked at her hospital in New Haven. The country and its leaders ignored this and now cases are spiking in many hospitals all around the country now. Just some sniffles, though, nothing to bother anyone about.
If you’ve been wondering about the risk of contracting Covid-19 while performing common activities vs. the risk of doing stupid shit, XKCD has you covered. I feel like “getting a dental cleaning from a Tinder date” should have been much more high risk than its position on the chart.
On an Instagram account called Plague History, artist Genevieve Blais has been modifying the subjects of artworks to give them face masks. You know I couldn’t resist including her rendition of Vermeer’s Girl with a Pearl Earring.
Maybe climate chaos, a rising chorus of alarm signals from around the world, will simply become our new normal. Hell, maybe income inequality, political dysfunction, and successive waves of a deadly virus will become our new normal. Maybe we’ll just get used to [waves hands] all this.
Humans often don’t remember what we’ve lost or demand that it be restored. Rather, we adjust to what we’ve got.
The concept of shifting baselines was introduced in a 1995 paper by Daniel Pauly. Roberts explains:
So what are shifting baselines? Consider a species of fish that is fished to extinction in a region over, say, 100 years. A given generation of fishers becomes conscious of the fish at a particular level of abundance. When those fishers retire, the level is lower. To the generation that enters after them, that diminished level is the new normal, the new baseline. They rarely know the baseline used by the previous generation; it holds little emotional salience relative to their personal experience.
And so it goes, each new generation shifting the baseline downward. By the end, the fishers are operating in a radically degraded ecosystem, but it does not seem that way to them, because their baselines were set at an already low level.
Over time, the fish goes extinct — an enormous, tragic loss — but no fisher experiences the full transition from abundance to desolation. No generation experiences the totality of the loss. It is doled out in portions, over time, no portion quite large enough to spur preventative action. By the time the fish go extinct, the fishers barely notice, because they no longer valued the fish anyway.
And it’s not just groups of people that do this over generations:
It turns out that, over the course of their lives, individuals do just what generations do — periodically reset and readjust to new baselines.
“There is a tremendous amount of research showing that we tend to adapt to circumstances if they are constant over time, even if they are gradually worsening,” says George Loewenstein, a professor of economics and psychology at Carnegie Mellon. He cites the London Blitz (during World War II, when bombs were falling on London for months on end) and the intifada (the Palestinian terror campaign in Israel), during which people slowly adjusted to unthinkable circumstances.
“Fear tends to diminish over time when a risk remains constant,” he says, “You can only respond for so long. After a while, it recedes to the background, seemingly no matter how bad it is.”
Ok, I’ll let you just read the rest of it, but it’s not difficult to see how shifting baselines apply to all sorts of challenges facing the world today. I mean the lines “You can only respond for so long. After a while, it recedes to the background, seemingly no matter how bad it is.” seem like they were written specifically about the pandemic.
Some Americans obviously aren’t troubling themselves with this but many of us are constantly running risk calculations in our heads for every little thing we do and don’t do during the course of the week during the pandemic.
Is it ok to visit the grocery store more than once this week? Can my kid have a playdate with her friend? Has her friend’s family been careful about seeing other people and how do I even ask them about it without sounding judgmental? Should I order that thing online or go to the store for it? Is it safe to take a roadtrip to a neighboring state? (Where the hell are we supposed to stop to use the bathroom?) Can I get a haircut? Do I need to order that thing online or do I just want it? Should schools reopen in the fall? And if they do, should I send my kids? Is eating at a restaurant safe for the staff? Can a friend come over for dinner? Can my son safely play in a baseball league? Will there be too many people not wearing masks in the store that I need to visit to get this one thing? Should I keep going to my favorite coffee shop when the barista just can’t seem to keep his mask up over his nose?
It goes on and on and on and IT’S EXHAUSTING. Comic from XKCD.
From January to the end of June, over 500,000 people died of confirmed cases of Covid-19. In order to demonstrate the magnitude of the pandemic, James Beckwith made a time lapse map of each Covid-19 death.
Each country is represented by a tone and an expanding blip on the map when a death from Covid-19 is recorded. Each day is 4 seconds long, and at the top of the screen is the date and a counter showing the total numbers of deaths. Every country that has had a fatality is included.
As was the case with the pandemic, the video starts slow but soon enough the individual sounds and blips build to a crescendo, a cacophony of death. The only way this could be made more ominous & upsetting is by including the first song off of Cliff Martinez’s Contagion soundtrack as a backing track. As Beckwith notes in the description: “It is likely a sequel will need to be made.” (via open culture)
The director of the National Institute of Allergy and Infectious Diseases, Anthony Fauci, told a Senate committee today that the US could be heading towards 100,000 new reported cases of Covid-19 per day. 100,000 cases per day. Yesterday the US recorded about 40,000 new cases.
“It is going to be very disturbing, I will guarantee you that,” he said.
“What was thought to be unimaginable turns out to be the reality we’re facing right now,” Fauci said, adding that “outbreaks happen, and you have to deal with them in a very aggressive, proactive way.”
Fewer than 20 countries have recorded more than 100,000 cases in total. Canada, for instance, has confirmed about 106,000 Covid-19 cases since the outbreak began.
Public health and infectious diseases experts, who have been gravely concerned about the way the U.S. response has unfolded, concurred with Fauci’s assessment.
Bars and restaurants are reopening around the country without any serious effort to test/trace/isolate/support. In the absence of strident guidance from the federal government, people are worrying less about social distancing and wearing masks to protect others. As this guy says, it’s just a matter of math:
“It’s unfortunately just a simple consequence of math plus a lack of action,” said Marm Kilpatrick, an infectious diseases dynamics researcher at the University of California, Santa Cruz. “On the one hand it comes across as ‘Oh my God, 100,000 cases per day!’ But then if you actually look at the current case counts and trends, how would you not get that?”
Limiting person-to-person exposure and decreasing the probability of exposures becoming infections can have a huge effect on the total number of people infected because the growth is exponential. If large numbers of people start doing things like limiting travel, cancelling large gatherings, social distancing, and washing their hands frequently, the total number of infections could fall by several orders of magnitude, making the exponential work for us, not against us. Small efforts have huge results.
We’ve known for months (and epidemiologists and infectious disease experts have known for their entire careers) what works and yet the federal government and many state governments have not listened and, in some cases, have actively suppressed use of such measures. So the pandemic will continue to escalate in the United States until proper measures are put in place by governments and people follow them. The virus will not change, the mathematics will not change, so we must.
For his piece The 3 Weeks That Changed Everything in The Atlantic, James Fallows talked to many scientists, health experts, and government officials about the US government’s response to the pandemic. In the article, he compares the pandemic response to how the government manages air safety and imagines what it would look like if we investigated the pandemic catastrophe like the National Transportation Safety Board investigates plane crashes.
Consider a thought experiment: What if the NTSB were brought in to look at the Trump administration’s handling of the pandemic? What would its investigation conclude? I’ll jump to the answer before laying out the background: This was a journey straight into a mountainside, with countless missed opportunities to turn away. A system was in place to save lives and contain disaster. The people in charge of the system could not be bothered to avoid the doomed course.
And he continues:
What happened once the disease began spreading in this country was a federal disaster in its own right: Katrina on a national scale, Chernobyl minus the radiation. It involved the failure to test; the failure to trace; the shortage of equipment; the dismissal of masks; the silencing or sidelining of professional scientists; the stream of conflicting, misleading, callous, and recklessly ignorant statements by those who did speak on the national government’s behalf. As late as February 26, Donald Trump notoriously said of the infection rate, “You have 15 people, and the 15 within a couple of days is going to be down close to zero.” What happened after that — when those 15 cases became 15,000, and then more than 2 million, en route to a total no one can foretell — will be a central part of the history of our times.
But he rightly pins much of the blame for the state we’re in on the Trump administration almost completely ignoring the plans put into place for a viral outbreak like this that were developed by past administrations, both Republican and Democratic alike.
In cases of disease outbreak, U.S. leadership and coordination of the international response was as well established and taken for granted as the role of air traffic controllers in directing flights through their sectors. Typically this would mean working with and through the World Health Organization — which, of course, Donald Trump has made a point of not doing. In the previous two decades of international public-health experience, starting with SARS and on through the rest of the acronym-heavy list, a standard procedure had emerged, and it had proved effective again and again. The U.S, with its combination of scientific and military-logistics might, would coordinate and support efforts by other countries. Subsequent stages would depend on the nature of the disease, but the fact that the U.S. would take the primary role was expected. When the new coronavirus threat suddenly materialized, American engagement was the signal all other participants were waiting for. But this time it did not come. It was as if air traffic controllers walked away from their stations and said, “The rest of you just work it out for yourselves.”
From the U.S. point of view, news of a virulent disease outbreak anywhere in the world is unwelcome. But in normal circumstances, its location in China would have been a plus. Whatever the ups and downs of political relations over the past two decades, Chinese and American scientists and public-health officials have worked together frequently, and positively, on health crises ranging from SARS during George W. Bush’s administration to the H1N1 and Ebola outbreaks during Barack Obama’s. As Peter Beinart extensively detailed in an Atlantic article, the U.S. helped build China’s public-health infrastructure, and China has cooperated in detecting and containing diseases within its borders and far afield. One U.S. official recalled the Predict program: “Getting Chinese agreement to American monitors throughout their territory — that was something.” But then the Trump administration zeroed out that program.
Americans, and indeed everyone in the world, should be absolutely furious about this, especially since the situation is actively getting worse after months (months!) of inactivity by the federal government.
My God, this aerial photo of dozens of recent graves in the Nossa Senhora Aparecida cemetery in Manaus, Brazil:
The photo is one of several from In Focus’s look at the Thousands of Burials Across Latin America. Brazil has 1.2 million confirmed Covid-19 cases, second most in the world (but only half the total of the US) and 55,000 confirmed deaths, though the number is likely much higher when you take excess mortality rates into account. Way back in April, when the reported death toll in Brazil was only (only!) ~3300, NPR reported on the mass graves and modified funeral procedures that were necessary due to Covid-19 and the Brazilian government’s disastrous response to it.
Yet the coronavirus has introduced a new kind of horror. The Nossa Senhora Aparecida cemetery has begun using backhoes to dig mass graves.
This has become “the only option” because it is “humanly impossible” to dig the required number of graves, says Viana, who runs a funeral company and is president of the Syndicate of Funeral Businesses in Amazonas.
According to Viana, the city’s daily average of deaths has risen from 30 to more than 100. The mayor’s office confirmed to NPR that there have been 340 burials just in the past three days. In most cases, the cause of death was listed as unknown, said a city hall spokeswoman.
City authorities are in little doubt that COVID-19 victims account for most of the spike. This means the virus is taking a far deadlier toll on Manaus than the official count of 172 virus-related deaths suggests. The reported death toll throughout Brazil is 3,313.
Video footage has appeared online showing the collapse of Manaus’ burial services and public hospitals. In one, corpses lie on beds in a hospital alongside live patients undergoing treatment. Another shows a line of vans waiting to deliver bodies for burial at the Nossa Senhora Aparecida cemetery.
The many layers of trauma from the pandemic are going to resonate for decades in places like Brazil and the US. Decades.
From Christie Aschwanden’s Scientific American article about How ‘Superspreading’ Events Drive Most COVID-19 Spread comes this speculation by a group of scientists that the way in which some people talk or breathe might spread many more potential coronavirus-carrying droplets than other people.
The scientists also have found intriguing evidence that a small subset of people may behave as “speech superemitters” — individuals who consistently broadcast an order of magnitude more respiratory particles than their peers. “It is very difficult to identify who is going to be a superemitter ahead of time,” he says. “One of the superemitters was a very petite young woman. And I was a bigger, bulkier guy and was not a superemitter.”
Unlike the airy, pristine emptiness of modernism, the space needed for quarantine is primarily defensive, with taped lines and plexiglass walls segmenting the outside world into zones of socially distanced safety. Wide-open spaces are best avoided. Barriers are our friends. Stores and offices will have to be reformatted in order to reopen, our spatial routines fundamentally changed. And, at home, we might find ourselves longing for a few more walls and dark corners.
The reimagining of our living spaces, where everyone is now eating, sleeping, working, and homeschooling, reminded me of this recent tweet:
I think we need to stop calling it ‘working from home’ and start calling it ‘living at work’
The result was “the 6 Feet Office.” Carpet tiles demarcate six-foot black circles around every desk in the open floor plan. Extra chairs, positioned outside of the circles, facilitate conversation among colleagues. Conference-room chairs have been thinned out, and closed spaces must be exited clockwise, in unison, so that co-workers don’t bump into each other. “Hotdesking,” or the sharing of one desk by multiple workers, is made possible with disposable paper desk pads, on which a worker sets her laptop or keyboard and mouse when she arrives.
Cushman & Wakefield is slowly testing the 6 Feet Office design at its Amsterdam office, which used to hold two hundred and seventy-five people but now only has seventy-five at a time. As the lockdown lifts, Lokerse expects to start with twenty-five per cent of employees back at the office, but as more workers come back they’ll have staggered start times to avoid overcrowding on public transportation, and thirty-per-cent fewer desks over all. Bruce Mosler, the chairman of global brokerage at Cushman & Wakefield, noted that office spaces were already feeling too crowded before the pandemic and had started to limit crowding, a trend that is now accelerating. “We got carried away in the over-all densification process, in the effort to be as efficient as possible,” he said. “We went a bit too far. This is going to change that.”
In The Price of Isolation for Rolling Stone, Alex Morris writes about how trends toward increasing social isolation in America left us ill-prepared to face weeks and months of time by ourselves during the pandemic. Studies have shown that humans in isolation are less healthy and less able to fight off disease than when other humans are around. This part in particular really really resonated with me:
Sometimes, though, the body can be tricked. When Cole and his colleagues started looking for ways to combat the physical effects of loneliness, they didn’t find that positive emotions made a difference at all. But one thing did: “It was something called eudaimonic well-being, which is a sense of purpose and meaning, a sense of a commitment to some kind of self-transcendent goal greater than your own immediate self-gratification. People who have a lot of connection to some life purpose? Their biology looked great.” Even when researchers compared lonely people with purpose to social butterflies without it, purpose came out on top. In other words, it’s possible when we’re doing things to better our society, the body assumes there’s a society there to better. We’re technically alone, but it doesn’t feel that way.
Which has profound implications in the moment in which we currently find ourselves, a moment when the physical isolation and disconnection the virus has inflicted is now layered over the clear divisions and systemic inequities that have always plagued our country. In the midst of our solitude, we’ve been confronted with the terrible knowledge that people of color are dying of the virus at the highest rates and that 40 percent of families making less than $40,000 a year have lost their livelihoods. We’ve been confronted with the killings of Ahmaud Arbery, Breonna Taylor, and George Floyd. We’ve been confronted with the lie that the virus is a great equalizer. We’ve witnessed the many ways it isn’t.
For its July 2020 issue, Scientific American has published A Visual Guide to the SARS-CoV-2 Coronavirus detailing what scientists have learned about this tiny menace that’s brought our world to a halt.
In the graphics that follow, Scientific American presents detailed explanations, current as of mid-May, into how SARS-CoV-2 sneaks inside human cells, makes copies of itself and bursts out to infiltrate many more cells, widening infection. We show how the immune system would normally attempt to neutralize virus particles and how CoV-2 can block that effort. We explain some of the virus’s surprising abilities, such as its capacity to proofread new virus copies as they are being made to prevent mutations that could destroy them. And we show how drugs and vaccines might still be able to overcome the intruders.
Several countries have been celebrated for their success in curtailing the Covid-19 pandemic — Iceland, New Zealand, Mongolia, Hong Kong, Taiwan — but Vietnam, a nation of 95 million people that borders China, has recorded only 334 total infections and 0 deaths. 0 deaths. They are currently on a 61-day streak without a single community transmission. (For reference, the US has recorded 2.1 million cases and more than 115,000 deaths with just 3.4 times the population of Vietnam.)
Experts say experience dealing with prior pandemics, early implementation of aggressive social distancing policies, strong action from political leaders and the muscle of a one-party authoritarian state have helped Vietnam.
“They had political commitment early on at the highest level,” says John MacArthur, the U.S. Centers for Disease Control and Prevention’s country representative in neighboring Thailand. “And that political commitment went from central level all the way down to the hamlet level.”
With experience gained from dealing with the 2003 SARS and 2009 H1N1 pandemics, Vietnam’s government started organizing its response in January — as soon as reports began trickling in from Wuhan, China, where the virus is believed to have originated. The country quickly came up with a variety of tactics, including widespread quarantining and aggressive contact tracing. It has also won praise from the World Health Organization and the CDC for its transparency in dealing with the crisis.
Vietnam enacted measures other countries would take months to move on, bringing in travel restrictions, closely monitoring and eventually closing the border with China and increasing health checks at borders and other vulnerable places.
Schools were closed for the Lunar New Year holiday at the end of January and remained closed until mid-May. A vast and labour intensive contact tracing operation got under way.
“This is a country that has dealt with a lot of outbreaks in the past,” says Prof Thwaites, from Sars in 2003 to avian influenza in 2010 and large outbreaks of measles and dengue.
“The government and population are very, very used to dealing with infectious diseases and are respectful of them, probably far more so than wealthier countries. They know how to respond to these things.”
By mid-March, Vietnam was sending everyone who entered the country - and anyone within the country who’d had contact with a confirmed case — to quarantine centres for 14 days.
Costs were mostly covered by the government, though accommodation was not necessarily luxurious. One woman who flew home from Australia — considering Vietnam a safer place to be - told BBC News Vietnamese that on their first night they had “only one mat, no pillows, no blankets” and one fan for the hot room.
Forced bussing to quarantine centers in the US, could you even imagine? Better that hundreds of thousands of people die, I guess.
Authorities rigorously traced down the contacts of confirmed coronavirus patients and placed them in a mandatory two-week quarantine.
“We have a very strong system: 63 provincial CDCs (centers for disease control), more than 700 district-level CDCs, and more than 11,000 commune health centers. All of them attribute to contact tracing,” said doctor Pham with the National Institute of Hygiene and Epidemiology.
A confirmed coronavirus patient has to give health authorities an exhaustive list of all the people he or she has met in the past 14 days. Announcements are placed in newspapers and aired on television to inform the public of where and when a coronavirus patient has been, calling on people to go to health authorities for testing if they have also been there at the same time, Pham said.
Using census data (which she acknowledges can be imperfect in capturing the full range of people’s identities), data scientist/artist Mona Chalabi created a drawing of 100 people who are representative of NYC’s population for a NY Times opinion piece on inequality and coronavirus.
When you think about who is most affected by Covid-19, you need to consider inequalities in housing, in access to healthcare, in wealth. And so much of that ends up consistently affecting people of color. You could think of it as overlapping circles in a Venn diagram. Or, you could look at these 100 people.
We conclude that facemask use by the public, when used in combination with physical distancing or periods of lock-down, may provide an acceptable way of managing the COVID-19 pandemic and re-opening economic activity. These results are relevant to the developed as well as the developing world, where large numbers of people are resource poor, but fabrication of home-made, effective facemasks is possible. A key message from our analyses to aid the widespread adoption of facemasks would be: ‘my mask protects you, your mask protects me’.
The research, led by scientists at the Britain’s Cambridge and Greenwich Universities, suggests lockdowns alone will not stop the resurgence of the new SARS-CoV-2 coronavirus, but that even homemade masks can dramatically reduce transmission rates if enough people wear them in public.
“Our analyses support the immediate and universal adoption of face masks by the public,” said Richard Stutt, who co-led the study at Cambridge.
We use the synthetic control method to analyze the effect of face masks on the spread of Covid-19 in Germany. Our identification approach exploits regional variation in the point in time when face masks became compulsory. Depending on the region we analyse, we find that face masks reduced the cumulative number of registered Covid-19 cases between 2.3% and 13% over a period of 10 days after they became compulsory. Assessing the credibility of the various estimates, we conclude that face masks reduce the daily growth rate of reported infections by around 40%.
We use anonymised GPS data from Google’s Location History feature to measure daily mobility in public spaces (groceries and pharmacies, transport hubs and workplaces). We find no evidence that compulsory face mask policies affect community mobility in public spaces in Germany. The evidence provided in this paper makes a crucial contribution to ongoing debates about how to best manage the COVID-19 pandemic.
And these are just from the last few days. Why WHY WHY!!!! are we still talking about this? There’s no credible evidence that wearing a mask is harmful, so at worse it’s harmless. If there’s like a 1-in-10 chance that masks are somewhat helpful — and the growing amount of research suggests that both 1-in-10 and “somewhat helpful” are both understatements — isn’t it worth the tiny bit of effort to wear one and help keep our neighbors safe from potential fucking death? Just in case?
I mean, look at where we are as a country right now. Most of the US is reopening while the number of infections continue to rise. Testing is still not where it needs to be in many areas. Tracing and isolation are mostly not happening. According to epidemiologists, those are the minimum things you need to do to properly contain a pandemic like this. Maybe if you’re Iceland you can pooh pooh the efficacy of masks because you test/trace/isolated to near-perfection, but if you’re going to half-ass it like the US has chosen to do, then wearing masks under semi-lockdown conditions is all we have left! Can we do the bare minimum that is asked of us?
Update: And some anecdotal evidence from Missouri: two hairstylists saw 140 clients while symptomatic last month and it resulted in zero infections. Both the hairstylists and their clients wore masks and took other precautions (staggered appointments, chairs spaced apart).
Update: I deleted a reference to this paper that many epidemiologists et al. have flagged as problematic (see here, here, and here for instance). (via @harrislapiroff)
“Libertarians” (in brackets) are resisting mask wearing on grounds that it constrains their freedom. Yet the entire concept of liberty lies in the Non-Aggression Principle, the equivalent of the Silver Rule: do not harm others; they in turn should not harm you. Even more insulting is the demand by pseudolibertarians that Costco should banned from forcing customers to wear mask — but libertarianism allows you to set the rules on your own property. Costco should be able to force visitors to wear pink shirts and purple glasses if they wished.
Note that by infecting another person you are not infecting just another person. You are infecting many many more and causing systemic risk.
Wear a mask. For the Sake of Others.
And finally, obviously, if wearing a mask is not advisable for you — for a genuine medical reason or if it makes you look dangerous to a racist policing system for instance — then you shouldn’t wear one! But the vast majority of us should be able to manage it.
Update:A study in Health Affairs analyzing the infection rates in US states with face mask mandates versus those without finds that a mandate was associated with a decline in the Covid-19 growth rate (italics mine).
Mandating face mask use in public is associated with a decline in the daily COVID-19 growth rate by 0.9, 1.1, 1.4, 1.7, and 2.0 percentage points in 1-5, 6-10, 11-15, 16-20, and 21+ days after signing, respectively. Estimates suggest as many as 230,000-450,000 COVID-19 cases possibly averted By May 22, 2020 by these mandates. The findings suggest that requiring face mask use in public might help in mitigating COVID-19 spread.
In a comparison among countries, those where people wore masks early fared much better than those where people didn’t. This is a pretty stark difference:
And this study noted that Google search volume of people searching for masks in various countries correlated with the infection rate — in general, the earlier the search volume increased in a given country, the fewer infections recorded in that country.
Update:A list of 70 scientific studies, dating all the way back to 2003, that support the wearing of face masks to prevent disease spread.
Bill Nye recently did a quick mask demonstration featuring a candle to show how effective homemade cloth masks are at blocking exhaled breath. He calls wearing a mask in public to protect other people “literally a matter of life and death”.
Stewart Reynolds shares some reasons to not wear a face mask, including selfish syndrome and chronic dickishness.
And this is a sad and all-too-typical American story in four parts. April: I’m not buying a mask; June: crowded pool party; July: complaining about being sick followed by an obituary. We need to fix this, now. People should not be dying like this — this is a 100% preventable death.
Update: The most recent version of an ongoing review of scientific studies about face mask efficacy was recently published online. From the abstract:
We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation.
At its core, the argument being leveled against public-health experts is that the reason for the protests shouldn’t matter. The coronavirus doesn’t care whether it’s attending an anti-lockdown protest or an anti-racism one. But these two kinds of protests are not equivalent from a public-health perspective. Some critics might argue that the anti-lockdown protests promoted economic activity, which can help stave off the health implications of poverty. (On this count, public-health experts were ahead of the curve: Many — including one of us — were advocating for a massive infusion of assistance to individual Americans as early as March.) But these protests were organized by pro-gun groups that believe the National Rifle Association is too compromising on gun safety. Egged on by the president to “save your great 2nd Amendment,” anti-lockdown protesters stormed government buildings with assault rifles and signs reading COVID-19 IS A LIE. The anti-lockdown demonstrations were explicitly at odds with public health, and experts had a duty to oppose them. The current protests, in contrast, are a grassroots uprising against systemic racism, a pervasive and long-standing public-health crisis that leads to more than 80,000 excess deaths among black Americans every year.
If “conservative commentators” cared at all about keeping people safe from Covid-19 infection, they would have denounced the I-Need-A-Haircut protests as reckless and they didn’t. Instead, they engage in these bad faith arguments that are just designed to stir up outrage.
Gonsalves wrote a thread on Twitter a few days ago that’s relevant here as well.
The risk to all of us was inflamed by an absolute decision at the highest levels that this epidemic was not worth an all-out, coordinated, comprehensive national mobilization. It took weeks for the President to even agree that the epidemic wouldn’t go away on its own.
The US, the richest nation in the world, then couldn’t get it together to scale-up the number of tests we needed to understand what was going on in our communities with SARS-COV-2, and in the end said it was up to the states to figure it all out.
And then this is the last word as far as I’m concerned:
We’ve all been put at far more jeopardy during this pandemic by our political leaders than by the people on the streets over the past week or so.
One of the countries with the best response to Covid-19 has been Iceland. The country didn’t lockdown nor do many people wear masks, but they have virtually eliminated the virus through a vigorous program of test, trace, and isolate that was coordinated by public-health authorities. Iceland’s numbers were high in the beginning (the virus was carried into the country from people returning from vacation) but they acted quickly and aggressively — Elizabeth Kolbert has the story for the New Yorker.
Möller pulled up a series of graphs and charts on her laptop. These showed that, per capita, Iceland had had more COVID-19 cases than any other Scandinavian country, and more than even Italy or Britain. There was an outbreak in a nursing home in the town of Bolungarvík, in northwestern Iceland, and one in the Westman Islands, an archipelago off the southern coast, which seemed to have started at a handball game. (In Europe, handball is a team sport that’s sort of a cross between basketball and soccer.)
“The numbers in the beginning were terrible,” Möller said. She attributed the country’s success in bringing the caseload down in part to having got an early start. The “trio,” along with officials from Iceland’s university hospital, had begun meeting back in January. “We saw what was going on in China,” she recalled. “We saw the pictures of people lying dead in emergency departments, even on the street. So it was obvious that something terrible was happening. And, of course, we didn’t know if it would spread to other countries. But we didn’t dare take the chance. So we started preparing.” For example, it was discovered that the country didn’t have enough protective gear for its health-care workers, so hospital officials immediately set about buying more.
The Atlantic’s Ed Yong interviewed several people who, like thousands of others around the world, have been experiencing symptoms of Covid-19 for months now, indicating that the disease is chronic for some. Thousands Who Got COVID-19 in March Are Still Sick:
I interviewed nine of them for this story, all of whom share commonalities. Most have never been admitted to an ICU or gone on a ventilator, so their cases technically count as “mild.” But their lives have nonetheless been flattened by relentless and rolling waves of symptoms that make it hard to concentrate, exercise, or perform simple physical tasks. Most are young. Most were previously fit and healthy. “It is mild relative to dying in a hospital, but this virus has ruined my life,” LeClerc said. “Even reading a book is challenging and exhausting. What small joys other people are experiencing in lockdown-yoga, bread baking-are beyond the realms of possibility for me.”
One of those who has been sick for months is Paul Garner, a professor of infectious diseases:
It “has been like nothing else on Earth,” said Paul Garner, who has previously endured dengue fever and malaria, and is currently on day 77 of COVID-19. Garner, an infectious-diseases professor at the Liverpool School of Tropical Medicine, leads a renowned organization that reviews scientific evidence on preventing and treating infections. He tested negative on day 63. He had waited to get a COVID-19 test partly to preserve them for health-care workers, and partly because, at one point, he thought he was going to die. “I knew I had the disease; it couldn’t have been anything else,” he told me. I asked him why he thought his symptoms had persisted. “I honestly don’t know,” he said. “I don’t understand what’s happening in my body.”
The illness went on and on. The symptoms changed, it was like an advent calendar, every day there was a surprise, something new. A muggy head; acutely painful calf; upset stomach; tinnitus; pins and needles; aching all over; breathlessness; dizziness; arthritis in my hands; weird sensation in the skin with synthetic materials. Gentle exercise or walking made me worse — I would feel absolutely dreadful the next day. I started talking to others. I found a marathon runner who had tried 8 km in her second week, which caused her to collapse with rigors and sleep for 24 hours. I spoke to others experiencing weird symptoms, which were often discounted by those around them as anxiety, making them doubt themselves.
We still have no idea what the long-term effects of this disease are going to be. But it is definitely not the flu. And I remain unwilling to risk myself or my family getting it.
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