Thursday, May 4, 2023

Back to Basics: A Reminder of How It All Works

What Covid is and how it spreads:

It's a virus that mutates very quickly inside "host" bodies (that's us if we get it). It can seem respiratory, but it's actual vascular, causing micro-clots in the bloodstream that stick around and cause issues in many organs. Because it mutates so quickly, we can get it over and over again. It's airborne and can hang around in the air for hours after people leave a room, like cigarette smoke. You can smell smoke in the room even when it's been empty for hours, right? Unfortunately, Covid can't be seen or smelled, so it could be anywhere. 

Some estimate that up to 50% of cases are asymptomatic, and the symptoms change with each variant, sometimes presenting like allergies, so you really can't know for sure that you don't have it unless you've been isolating for the past two weeks! 

How prevalent it is:

We don't have big waves of cases anymore, but a high continuous level of hospitalizations that is less newsworthy yet unsustainable. There's evidence that over 70% of Canadians have had a case. It's causing ten times the fatalities as auto collisions, so if you still wear a seatbelt, consider also continuing to wear a mask. It can provoke Long Covid which can be permanently disabling (like, can't get to a bathroom without help, and can't sit up for more than a few minutes at a time for months or years, not just a foggy brain). The more infections a person gets, the higher the risks of Long Covid complications. In one study of people with Long Covid, 1/3 of people couldn't work after two years.

We're not testing or tracing or tracking cases anymore so any data on cases will be inaccurate, but we can look at hospitalization rates to see how prevalent it is (and wastewater where it's still being collected). Look at the rates of Covid hospitalization now compared to early 2020 because just looking over the past few weeks or months gives a skewed idea of how many are still getting sick enough to need hospitalization. It's not going away! Here are stats on Canada. So far about 1 in 1,000 have died, and over 1 in 10 are experiencing Long Covid. It's similar to how chicken pox hides in the body and later shows up as shingles, except we have no idea what Covid does to a body after a 10 or 20 year incubation period. For perspective, it's nowhere near as bad as the Spanish Flu, for sure, but it's way worse than a regular flu. The red line below is at current hospitalization levels of Covid patients in Canada to indicate how much worse it is now than when we had so many mitigations.

Focus on the amount under that red line. Just because there aren't the high peaks and low valleys doesn't mean we're in the clear; it means there's never a safer time to get together without mitigations. 

Long Covid can show up a few months after even just a mild or asymptomatic case. It can present as an autoimmune disease or lymphopenia from a depletion of T-cells that are responsible for killing infections, and/or brain damage from less blood flow to the brain and degeneration leading to strokes, and it increases the risk of cancerheart disease and heart attacksPOTS (Postural Orthostatic Tachycardia Syndrome), lung damage, and liver damage. It sometimes results in behavioural changes that favour viral survival, the way toxoplasmosis makes mice move towards cats! It might help to explain all the denial out there, particularly from people who are sick over and over but insist it can't possibly be Covid.

It's not a cold or the flu. We need to do everything possible to avoid getting it and spreading it.

How it can be prevented:

Vaccines don't significantly prevent infection but can help us stay out of the hospital, but they become less effective after just a few months, and we're not able to get more than 1 or 2 each year. Some people stopped at two shots a couple years back, which, at this point, is as if they never had a vaccine at all. Many researchers are still working on better, longer lasting vaccines, but low public uptake might stall the progress. There is no herd immunity with Covid because there are far too many mutations. Omicron is over 1,000 different variants, but public health organizations continuing to call them all one thing (and actively trying to stop any nicknames) is an attempt to get the public to think nothing's new or different. Public health is more concerned with avoiding panic than avoiding illness. 

Well fitting N95s can significantly reduce transmission to ourselves and to others, but they have to be worn all the time when inside public buildings. Taking them off just to eat something quickly is enough to transmit the virus. One-way masking has a risk of transmission of about 70% compared to 1% with two-way masking. Here's a 5 minute video of the difference between a surgical mask and an N95 respirator from the US Department of Labor sounding the alarm back with SARS-1. 

We just need masks until we can ensure clean air in buildings to the point that CO2 is below 700 ppm at all times, at least 6 air changes/hour, and air is being well-filtered (at least MERV13/ Filtrete 1900). Here are some guides for that from The Lancet, University of Toronto, the Ontario Society of Professional Engineers, and MIT. It would help if more businesses and public institutions look into upper room UVGI (some guides from Harvard and the CDC, and Joey Fox explains it all here). It's proven effective, silent, out of the way, and not too expensive (unlike far-UV, which is very pricey and less effective), and, once set up, it's just a matter of changing bulbs as needed, but it has to be set up by trained professionals. 

If we don't wear a mask indoors, we could be spreading a debilitating disease to other people. Most of us can do almost anything we typically do with a mask on provided we don't play a wind instrument! But we really do need to change the cultural norm of eating and drinking whenever we socialize. I have some friends I'd love to see, but their line in the sand is, "Once you're okay to come inside without a mask on." They won't tolerate my phobia. This is all a public health fiasco, so I can't really blame them. Sometimes I even start to think they're right, that it's all in my head, but a quick look at the current data and research reminds me it's all very real. 

I still wear a bike helmet too, despite it not being required by law.

Yesterday Conor Browne wrote,

Once again, I am incredulous at the inability of people to understand what, to me, is a very simple fact. So I feel like I need to spell this out very simply: SARS-CoV-2 continues to transmit at high levels globally. Children get sick from Covid-19. Children also get sick from all the other illnesses children got sick from before the pandemic. Children's immune systems get hit by Covid-19 and some go on to get sick from other infectious diseases following SARS-CoV-2 infection. Children also suffer long-term effects of infection. All of this adds up to an increased burden of morbidity on children, which, of course, leads to increased absences from school. This is not difficult stuff. It would be helpful if the media would actually acknowledge this. 

And a recent WHN Broadcast featured Ryan Gregory explaining why high global levels of SARS-CoV-2 infection are bad. It's so curious that we need to be told this! Then he was on ReSisters last night explaining that we don't have to accept so much illness as the new normal. We can choose the new normal to be cleaner air and masks. Lessons we should have learned include the importance of global vaccine equity, open access to data, wastewater surveillance, and clear, unambiguous, accurate information, because prevention and mitigation can lead to longer healthier lives. 

1 comment:

lungta said...

What's Yodas' last name?
Lay Hee Hoo