The Pandemic Informer

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Children might be more vulnerable to Covid-19 than once believed, with new research suggesting that they are able to contract and spread the virus, especially if they don’t take precautions such as wearing a mask.

Several studies and reports published in recent weeks found coronavirus infections among children of all ages at places ranging from schools to camps to homes. Other research suggested that kids, especially older ones, can be a driving force behind transmission.

And some researchers found children carry high levels of Covid-19’s genetic material in their upper respiratory tract, which doesn’t mean they are transmitting the virus but that they potentially could. Most of the studies have limitations, and more research is needed, experts say. Yet the new studies, together with reports of outbreaks among children at some schools overseas and a summer camp in Georgia, have persuaded many researchers that children aren’t as immune to Covid-19 as initially thought.

ROME (AP) — With confirmed coronavirus cases in the U.S. hitting 5 million Sunday, by far the highest of any country, the failure of the most powerful nation in the world to contain the scourge has been met with astonishment and alarm in Europe. Perhaps nowhere outside the U.S. is America’s bungled virus response viewed with more consternation than in Italy, which was ground zero of Europe’s epidemic. Italians were unprepared when the outbreak exploded in February, and the country still has one of the world’s highest official death tolls at 35,000. But after a strict nationwide, 10-week lockdown, vigilant tracing of new clusters and general acceptance of mask mandates and social distancing, Italy has become a model of virus containment. “Don’t they care about their health?” a mask-clad Patrizia Antonini asked about people in the United States as she walked with friends along the banks of Lake Bracciano, north of Rome. “They need to take our precautions. … They need a real lockdown.”

Much of the incredulity in Europe stems from the fact that America had the benefit of time, European experience and medical know-how to treat the virus that the continent itself didn’t have when the first COVID-19 patients started filling intensive care units.

Yet, more than four months into a sustained outbreak, the U.S. reached the 5 million mark, according to the running count kept by Johns Hopkins University. Health officials believe the actual number is perhaps 10 times higher, or closer to 50 million, given testing limitations and the fact that as many as 40% of all those who are infected have no symptoms. With America’s world’s-highest death toll of more than 160,000, its politicized resistance to masks and its rising caseload, European nations have barred American tourists and visitors from other countries with growing cases from freely traveling to the bloc. The virus is still raging in some Balkan countries, and thousands of maskless protesters demanded an end to virus restrictions in Berlin earlier this month. Hard-hit Spain, France and Germany have seen infection rebounds with new cases topping 1,000 a day, and Italy’s cases inched up over 500 on Friday. Britain is still seeing an estimated 3,700 new infections daily, and some scientists say the country’s beloved pubs might have to close again if schools are to reopen in September without causing a new wave. In the U.S., new cases are running at about 54,000 a day — an immensely high number even when taking into account the country’s larger population. And while that’s down from a peak of well over 70,000 last month, cases are rising in nearly 20 states, and deaths are climbing in most. “Had the medical professionals been allowed to operate in the States, you would have belatedly gotten to a point of getting to grips with this back in March,” said Scott Lucas, professor of international studies at the University of Birmingham, England. “But of course, the medical and public health professionals were not allowed to proceed unchecked,” he said, referring to Trump’s frequent undercutting of his own experts.

When the virus first appeared in the United States, Trump and his supporters quickly dismissed it as either a “hoax” or a virus that would quickly disappear once warmer weather arrived. At one point, Trump suggested that ultraviolet light or injecting disinfectants would eradicate the virus.

Trump’s frequent complaints about Dr. Anthony Fauci have regularly made headlines in Europe, where the U.S. infectious-disease expert is a respected figure. Italy’s leading COVID-19 hospital offered Fauci a job if Trump fired him.

Trump has defended the U.S. response, blaming China, where the virus was first detected, for America’s problems and saying the U.S. numbers are so high because there is so much testing. Trump supporters and Americans who have refused to wear masks against all medical advice back that line. “There’s no national strategy, no national leadership, and there’s no urging for the public to act in unison and carry out the measures together,” he said. “That’s what it takes, and we have completely abandoned that as a nation.”

When President Donald Trump connected by phone last week with Republican megadonor Sheldon Adelson — perhaps the only person in the party who can cut a nine-figure check to aid his reelection — the phone call unexpectedly turned contentious. The 87-year-old casino mogul had reached out to Trump to talk about the coronavirus relief bill and the economy. But then Trump brought the conversation around to the campaign and confronted Adelson about why he wasn’t doing more to bolster his reelection, according to three people with direct knowledge of the call. One of the people said it was apparent the president had no idea how much Adelson, who’s donated tens of millions of dollars to pro-Trump efforts over the years, had helped him. Adelson chose not to come back at Trump. When word of the call circulated afterward, Republican Party officials grew alarmed the president had antagonized one of his biggest benefactors at a precarious moment in his campaign. They rushed to smooth things over with him, but the damage may have been done. Adelson’s allies say it’s unclear whether the episode will dissuade the Las Vegas mogul — long regarded as a financial linchpin for Trump’s reelection — from helping the president down the home stretch.

With Trump trailing badly, some donors are more interested in bankrolling efforts to save the GOP’s Senate majority. Among the contributors who’ve cut checks to the super PAC for Senate Republicans but not Trump’s are hedge fund manager Paul Singer, investor Charles Schwab, and real estate developer Mel Sembler.

Others say there is simply exhaustion with Trump and disgust at his handling of the coronavirus pandemic.

Elastomeric (P3 r cartage) respirators are safer and more
sustainable alternatives to disposable N95
masks during the coronavirus outbreak

International Journal of
Emergency Medicine

A study done in Wuhan where COVID-19 had its initial outbreak found that aerosolized viral particles were detectable in high concentrations
in rooms where providers were doffing PPE,
and the majority of these particles were 0.25 to 0.5 μm. Another study has found that aerosolized viral particles of COVID-19 are detectable in the air 3 h after aerosolization [11]. Based on this evidence, proper protective equipment against aerosols and the safe removal of PPE are crucial for prevention of coronavirus infection in the healthcare setting. Reusing disposable N95 masks potentially
exposes patients and workers to considerable infection

In this regard, respirator masks with particulate (P3 R Canister) filters can be used for an extremely long duration, at least 1 year, so long as
the filter is not damaged or soiled [15].

Evidence shows that coronavirus remains detectable and viable on varioussurfaces up to 3 days [11]. It can then be extrapolated that once these viral particles are trapped in the electrostatic filters, they will slowly die over several days,
negating the need to change viral filters frequently.
Given the current short supply of disposable N95 masks, this advantage can potentially allow one respirator mask to replace using hundreds to potentially thousands ofnew disposable N95 masks. Elastomeric respirators also differ from disposable N95 masks in that they have a separate exhale vent, and exhaled air does not travel through the contaminated filter and re-aerosolize trapped viral particles. This is in contrast
to disposable N95 masks, which when re-used may
carry an increased risk of transferring viral particles from one patient to another.

Better fit and seal National Institute for Occupational Safety and Health (NIOSH)-approved (P3 R masks) have nonpowered particulate filter efficiency class to 99.97% filtration of particulates down to 0.3 μm, respectively. There are three levels of oil-particle resistance, N for no resistance, R for some oil resistance, and P for being completely oil proof [16].

Each user needs to be fit-tested for these respirator masks to be effective [17]. However, several studies show that healthcare professionals that do not frequently use N95 masks or wear masks for an extended duration tend to have inadequate seal. Nearly half of healthcare professionals who repeat a fit test 3 months after passing a fit test end up failing the second fit test [18]. (PAPRs), elastomeric respirators are still superior and preferred options over disposable respirators, especially given the severe shortage and increasing cases of healthcare professional infected with coronavirus. Currently, the CDC recommends that health care providers that will be within 3 ft of a suspected or confirmed COVID-19 patient without a mask, or if providers are in the room for an aerosolizing procedure, the provider may voluntarily utilize higher level of protection than N95 masks, such as elastomeric respirators or PAPR. The American Academy of Emergency Physicians and American Association of Nurse Anesthetists have made official statements that
support healthcare providers using self-supplied
NIOSH-approved PPE to feel safe or if it is inadequately provided [23, 24]. Download the coplete study below

Electro resperators better then N95

Chiang et al. International Journal of Emergency Medicine (2020) 13:39
https://doi.org/10.1186/s12245-020-00296-8

Five former directors of the Centers for Disease Control and Prevention who came together to speak about the coronavirus on Thursday said repeatedly that the United States is still struggling to deal with the pandemic because of one thing: mixed messages from leadership. “This is the first public health response where the ground rules weren’t set up that we would be driven by the best available public health science,” said Dr. Richard Besser, who served as acting director of the CDC in 2009. “So, when you have political leaders and public health leaders coming at this with very different messaging, [and] when you don’t see the political leadership supporting public health science, you lose trust. And the people question whether things are being done because they’re the right thing to do scientifically or whether they’re being done for political reasons, and that leads to an undermining of the efforts to control something that is truly controllable,” he added. Besser, who was also the former chief medical correspondent for ABC News, was joined by Drs. Julie Gerberding, Tom Frieden, Jeffrey Koplan and David Satcher to speak with ABC News’ Linsey Davis. The former CDC directors, who worked under both Democratic and Republican administrations, also spoke about preventing the next pandemic and about the challenges Americans will face even once a vaccine is approved. They said the country’s best chance at stopping the virus is by working together. “Right now, one person a minute is getting killed by this virus in the U.S., and we need to focus on what the virus is doing and what we as a community are doing to stop it,” said Frieden, who was the CDC director from 2009 to 2017. “Because all of us can do things to make it less severe, whether that’s wearing a mask, washing our hands, watching our distance or supporting public health so that they can box in virus… and protect the most vulnerable. There’s a lot we can do,” he continued. “Progress is in our hands, but when it’s undermined, it makes it very difficult to make progress.” “This pandemic is not something that’s going to end abruptly,” said Satcher, who was the CDC director from 1993 to 1998. “The problem is going to be with us for a while in terms of COVID, so the question becomes: When are we going to get on top of it? When people take seriously the challenge.” The U.S. death toll from COVID-19 is higher than anywhere else in the world with at least 159,000 deaths. Nearly 5 million Americans have been diagnosed with the virus. As 31 states see a rising number of daily deaths and 25 states see increasing rates of positive cases, President Donald Trump in recent weeks claimed the U.S. has the virus “under control” and that the country is in “really good shape.” “Every one of those falsehoods drives away our opportunity to improve our mitigation efforts… and it causes confusion in everyone’s mind,” said Koplan, who directed the CDC from 1998 to 2002.

Continue reading “What went wrong in the pandemic response”

 

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• President Donald Trump’s interview with Axios on Monday evening tackled many issues, from the rising coronavirus death toll to the Black Lives Matter protests.
• Snippets of the 37-minute interview that originally aired on HBO have been trending on Twitter.
• Many have been praising reporter Jonathan Swan for his unflinching interviewing of the president.

Axios reporter Jonathan Swan cornered President Donald Trump on multiple issues in a wide-ranging interview aired on HBO on Monday evening. Clips of the interview have been circulating online and trending on Twitter. They show Swan pressing the president on the coronavirus crisis, the 2020 elections, foreign policy, and the anti-racism protests, among other topics. Many users have created memes of Swan reacting to Trump’s answers and applauded the reporter for his unwavering questioning of the president.

• On the coronavirus crisis taking 1,000 lives a day (7:20):

Trump: Right now, I think it’s under control.

Swan: How? 1,000 Americans are dying a day.

Trump: They are dying. That’s true. It is what it is. But that doesn’t mean we aren’t doing everything we can. It’s under control as much as you can control it. This is a horrible plague that beset us.

Swan: You really think this is as much as we can control — 1,000 deaths a day?

Trump: First of all, we have done a great job. We’ve gotten the governors everything they needed. They didn’t do their job. Many of them didn’t and some of them did. … But the governors do it. We gave them massive amounts of material.

—Josh Jordan (@NumbersMuncher) August 4, 2020

• On the seriousness of the virus (8:35):

Swan: Even some of your own aides wonder whether you will stick to that message until Election Day. Whether in a week or two, you won’t say, ‘Right, we got to reopen again. We can’t do this stuff anymore.’ That you’ll get bored of talking about the virus and go back to that sort of cheerleading.

Trump: No, I never get bored. I never get bored of talking about this. It’s too big of a thing.

Swan: So will you stick to that message?

Trump: It should’ve been stopped by China. It should’ve been stopped by China, and it wasn’t.

Swan: But now it’s here and you’re the president.

Trump: I think I’m very consistent. No, this is a very serious thing. We have 140,000 people at this moment. This is a very, very serious situation, and what you have to do is handle it the best it can be handled. And again, I’m working with the governors.

• On addressing inadequate coronavirus testing (10:00):

Trump: There are those that say you can test too much. You do know that.

Swan: Who says that?

Trump: Just read the manuals. Read the books. Read the books.

Swan: Manuals? What manuals? What books?

Trump: Let me explain. What testing does is it shows cases, it shows where there may be cases. Other countries test, you know when they test? They test when somebody’s sick. That’s when they test. And I’m not saying they’re right or wrong. Nobody’s done it like we’ve done it. We’ve gotten absolutely no credit for it but we’ve come up with so many different tests. The only thing that we have now is some people have to wait longer than we’d like them to.

Swan: It’s a big problem. … When, do you think, you’ll have it for everyone? What day?

Trump: I think you’ll have that relatively soon.

Swan: What does that mean?

Trump: I would much rather get back to you because I don’t want to have you write ‘in one month,’ I didn’t make it, I missed it by a day and it’s a headline.

Swan: OK. That’s fine.

• On the US’s coronavirus death toll versus the rest of the world’s (13:14):

Swan: You’re doing death as a proportion of cases. I’m talking about death as a proportion of population. That’s where the US is really bad. Much worse than South Korea, Germany, et cetera.

Trump: You can’t do that.

Swan: Why can’t I do that?

Trump: You have to go by the cases.

Swan: … Well look at South Korea, for example: 51 million population. 300 deaths. It’s crazy.

Trump: You don’t know that. You don’t know that.

Swan: You think they’re faking their statistics? South Korea? An advanced country?

Trump: I won’t get into that because I have a very good relationship with the country. But you don’t know that.

• On intelligence reports of Russia paying bounties to the Taliban to kill American soldiers (16:27):

Swan: You had a phone call with Vladimir Putin on July 23. Did you bring up this issue?

Trump: No, that was a phone call to discuss other things. And frankly, that’s an issue that many people said was fake news. … But we had a call talking about nuclear proliferation, which is a very big subject. … We did not discuss that, no.

Swan: It’s because you don’t believe the intelligence, is that why?

Trump: … If it reached my desk, I would’ve done something about it. It never reached my desk. … I have so many briefings on so many different countries. But this one didn’t reach my desk.

Swan: Even if you don’t believe this particular piece of intelligence, and there is dispute in the intelligence community about it, your former head of forces in Afghanistan said, and this was when he was working for you, that Russia is supplying weapons to the Taliban. Isn’t that enough to challenge Putin over the killings of US soldiers?

Trump: Well, we supplied weapons when they were fighting Russia, too.

Swan: But that’s a different era.

Trump: I’m just saying we did that too. … I have heard that, but, again, it’s never reached my desk.

• On uncertainty around accepting the results of the 2020 election and mail-in voting (22:22):

Swan: What does that actually look like as the sitting president? I mean, it’s unprecedented.

Trump: Hillary Clinton never accepted them. She still doesn’t accept them.

Swan: She conceded on election night. She grumbled about it.

Trump: Grumbled? Grumbled? She wrote books about it. Don’t use the word “grumbled.”

Swan: … What does that look like, not accepting?

Trump: We have a new phenomena, called mail-in voting.

Swan: New? It’s been here since the Civil War. … It’ll be bigger this year because of the pandemic.

Trump: Bigger? Not bigger, massively bigger. So they’re going to send tens of millions of ballots to California, all over the place … You got millions of ballots going, nobody even knows where they’re going. You look at some of the corruption having to do with universal mail-in voting. Absentee voting is OK.

Swan: It’s the same thing.

Trump: … You could have a case where this election won’t be decided on the evening of November 3. This election could be decided two months later.

Swan: Absolutely. What’s wrong with that? What’s wrong with the proper mailing count?

Trump: Lots of things will happen during that period of time, especially when you have tight margins. … Right now we have to live with it, but we’re challenging it in many courts