Interesting Corona Virus Study

[emerydc8]

I'm no fan of CCTV, but since the Chinese had these on all long-distance busses anyway, they were able to reconstruct the process of one passenger infecting over a dozen others over a four-hour trip. I took vacation for the month of March and now I have some serious doubts whether I'll even be able to go back to work in April. If there is a total lockdown, I'm not sure the airlines will even be operating to get me to work. According to this study, the virus infected someone who boarded the bus 30 minutes after the infected person got off.  Plus, it traveled 14' through the air, from the back of the bus to the front.
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Coronavirus Can Stay In Air For 30 Minutes, Travel Twice 'Safe Distance' According To Study

by Tyler Durden
Mon, 03/09/2020 - 15:15

Aerosolized coronavirus can hang in the air for at least 30 minutes and travel up to 14 feet - approximately twice the "safe distance" recommended by health officials, according to SCMP.

The study, conducted by a team of Chinese government epidemiologists from Hunan province, also found that the virus can survive for days on a surface where respiratory droplets land.

The length of time it lasts on the surface depends on factors such as temperature and the type of surface, for example at around 37C (98F), it can survive for two to three days on glass, fabric, metal, plastic or paper.
These findings, from a group of official researchers from Hunan province investigating a cluster case, challenge the advice from health authorities around the world that people should remain apart at a "safe distance" of one to two metres (three to six and a half feet).

The researchers warned that the virus could survive over five days in human feces or bodily fluids, and that it could remain floating in the air after a carrier had left a public bus.

"It can be confirmed that in a closed environment with air-conditioning, the transmission distance of the new coronavirus will exceed the commonly recognised safe distance," the researchers wrote in their paper, published in peer-reviewed journal, Practical Preventive Medicine.

"Our advice is to wear a face mask all the way [through the bus ride]," the researchers recommended.
They said the study proves the importance of washing hands and wearing face masks in public places because the virus can linger in the air attached to fine droplet particles.
...
Their work was based on a local outbreak case on January 22 during the peak Lunar New Year travel season. A passenger, known as "A", boarded a fully booked long-distance coach and settled down on the second row from the back.

The passenger already felt sick at that point but it was before China had declared the coronavirus outbreak a national crisis, so "A" did not wear a mask, nor did most of the other passengers or the driver on the 48-seat bus.

Because China requires closed circuit television cameras to record all long-distance us rides, researchers were able to reconstruct the spread of the virus on the bus, which had no open windows.

Lead author Hu Shixiong said that the camera footage revealed patient "A" did not interact with anyone throughout the four-hour ride, yet the virus infected seven other passengers by the time the bus stopped at the next city. Infected passengers included not only those sitting relatively close to "patient zero," but people six rows away - or 4.5 meters (14.76 feet).

All seven tested positive, including one passenger who displayed no symptoms. Then, 30 minutes later, another group of passengers got on the bus - one of whom was sitting in the front seat when they also became infected. Patient "A" meanwhile, got on another minibus and infected two other passengers.

Hu said the patient, who was not wearing a mask, was likely to have inhaled aerosols, or tiny particles, breathed out by the infected passengers from the previous group. Aerosols are light-weighted particles that are formed from tiny droplets of bodily fluids.

"The possible reason is that in a completely enclosed space, the airflow is mainly driven by the hot air generated by the air conditioning. The rise of the hot air can transport the virus-laden droplets to a greater distance," the paper reads.

"When riding on more closed public transportation such as subways, cars, planes, etc, you should wear a mask all the time, and at the same time, minimise the contact between your hands and public areas, and avoid touching your face before cleaning."

In total, patient "A" is believed to have infected at least 13 people.

https://www.zerohedge.com/health/coronavirus-can-stay-air-30-minutes-travel-twice-safe-distance-according-study

[Will]

I would caution everyone to see these as preliminary findings, and wait for more data from more studies before considering this report actionable. The South China Morning Post, an English-language newspaper, has its bias (like every other media outlet), so it's interesting that the second bullet point in the headline is a defense of wearing masks, which is a cultural thing in Asia. As we all know, the ubiquitous face mask is something that Asian people take a lot of confidence in (just look at the incessant CCTV videos of patriotic Chinese wearing masks as they go about their daily business), whereas science, and most of the rest of the world, draw a distinction between airborne precautions needed for diseases like measles, and droplet precautions needed for diseases like influenza. Masks of the kind most people wear are not recommended for the general public for an illness spread by droplets. (Healthcare providers are a different story; they need different precautions.)

Most of the peer-reviewed scientific literature, including that from China, points toward a coronavirus illness that goes where the droplets go, and doesn't travel far or hang around in the air. This includes data from real-time sampling of the air from hospital rooms of infected patients.

Reference: https://jamanetwork.com/journals/jama/fullarticle/2762692

Still, the situation is evolving and more data will emerge with time.

[emerydc8]

So, health care workers get a different version of the virus than non-healthcare workers? Most people I know, including myself, have N95 masks. What are the health care workers using?
https://youtu.be/4InhmRCIpow?t=1158

[Will]

You have to take that video in context. The narrator is addressing the probability of catching the virus if you are in close, personal contact with an infected person. Most people are not in that situation, hence the CDC recommends against routine wearing of masks by healthy people.

The CDC does not recommend the general public wear masks when they go about their daily routine.

Reference: https://www.cdc.gov/coronavirus/2019-ncov/faq.html

CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. You should only wear a mask if a healthcare professional recommends it. A facemask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected.

The CDC does not recommend that anyone wear N95 respirators unless they are healthcare workers on the job.

Reference: https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirator-use-faq.html

[From guidance to healthcare workers] CDC does not recommend the routine use of respirators outside of workplace settings (in the community). Most often, spread of respiratory viruses from person-to-person happens among close contacts (within 6 feet). CDC recommends everyday preventive actions to prevent the spread of respiratory viruses, such as avoiding people who are sick, avoiding touching your eyes or nose, and covering your cough or sneeze with a tissue.

There's actually evidence that wearing a mask can increase your personal risk of infection, because people muck about with their masks, adjusting them all day long, and that means you're touching your face.

The best recommendations are: stay home if you're sick, wash your hands frequently, cover your cough, don't touch your face, and don't bother wearing a mask unless you are a healthcare worker tending to sick people or a person with the illness who for whatever reason has to be out in the community (e.g. on the way to visit their doctor).

[emerydc8]

The CDC does not recommend the general public wear masks when they go about their daily routine.

That's because there's a shortage. 

There's actually evidence that wearing a mask can increase your personal risk of infection, because people muck about with their masks, adjusting them all day long, and that means you're touching your face.

[Will]

Jon,

I believe the data presented in your video, but I also stand by what I posted above, and that's because they're not mutually exclusive.

Your video referenced a study that looked at family members living with person who has influenza. An analogy there would be a healthcare worker, nurse, or hospital food service employee (etc.) who comes into contact with a patient with influenza. In each case a mask would be effective. So we can agree on that!

The question is whether this specific scenario justifies healthy people wearing masks as they go about their business in the community, where the evidence does not suggest an advantage to healthy people wearing masks.  To extend the hospital analogy, that same nurse will wear a gown, gloves, mask, and face-shield when entering the room of a patient on isolation precautions, but will take the protective gear off when leaving the room and going back to the the nurses' station, break room, or the hospital Starbucks. The food service employee will wear a mask while delivering a food tray, but will take it off after leaving the room and won't wear one in the hospital kitchen. This has been the evidence-based standard of infection control for years, long before the nationwide shortage of N95 masks.

Let me also just say that the Aerowinx forum is enriched by people of many different professional backgrounds all united by an interest in aviation. (And hopefully friendship as well.)

My background is this: I flew for a regional airline for a while but I quit and went to medical school, and for the last 20 years I have been in healthcare; I am a physician, and a researcher, at an academic medical center in Chicago, where I attend to patients in the hospital and I am the Medical Director of a large outpatient clinic. I am on our senior COVID19 planning committee, and I help shape not only our patient care rules but also the recommendations for our employees, all of whom I want to keep as safe as possible because without healthy staff, we don't have a mission.

Where do I get my data? Not from the CDC, not from the government, and not from the media. The information that shapes my decision-making comes from the scientists, who work as hard as they can to generate data for the purposes of keeping you (and me!) informed, safe, and ahead of the knowledge curve.

You are entitled to your opinion, as everyone is. But in shaping your opinion, I respectfully and humbly submit that in this era of spin and politicization, the highest quality facts will come from the people who do the research - who perform experiments, who use the scientific method to test hypotheses, and who share their data openly for peers to review. As those facts get filtered through successive layers of interpretation and spin, those facts can get damaged.

You may choose to trust me about what I say about SARS-CoV-2 and infection control, or you may choose not to trust me. Either way is fine. I will only say that I would not mislead you or anyone else about the situation. Peace.

[Zapp]

In the last 10 years I have been working in close contact with physicians in an oncology department of a big Hospital in Italy. I do maths, study and model data, help with publishing activity, teach resident school and phd students.
These 10 years have taught me two things: how cautious you have to be when reading medical literature, which I do daily, but often reaching out for expert opinion.
The second is the amount of passion and dedication doctors put in their work. At this time, my friends and some of my students are hard at work at the hospital to help patients with cancer get through this hard time while continuing with their therapies, some of which hit hard on their immune system, thus making them an easy prey to any virus. I can't go there, but I wish I could help in some way.
Maybe the best thing I can do is to offer my testimony to the fact that most doctors are great, dedicated people, and that everyone needs to listen to a doctor when it's about health.
The Internet is a wonderful thing, but it's producing some nasty side effects, with people without a clue who reach conclusions by "simple logic" and do not listen to those who really know things.
Regarding the paper in question: I asked my students some advice on it: it's on a minor, low impact journal, and it has serious methodology shortcomings (I even wonder how it was accepted by the journal in the first place).

To sum it up, if we have to land a 747, I'd rather trust the experienced 747 pilot than the doctor. When it's about our health, I will listen to the doctor and nobody else.

Just my 2 (or 20, I wrote a lot) cents

A.

[emerydc8]

The question is whether this specific scenario justifies healthy people wearing masks as they go about their business in the community, where the evidence does not suggest an advantage to healthy people wearing masks.

In a few weeks my vacation will end and, presuming there are still commercial flights operating, I will be required to commercial to work to begin my trips. Let me ask you this: If you were going to put your family on a CRJ-200 for three hours and you had no control over who was sitting in front of them or beside them, are you saying that you wouldn't suggest they wear a mask or be concerned at all? For argument's sake, let's say these people were directly in front of and next to them, coughing, sneezing and blowing their noses the whole flight.

My being on a commercial flight like the one described above is in fact a healthy person "go[ing] about [my] business in the community."

[Will]

It'a common sense. The mask is a barrier, not a talisman. If the guy in front of me were to turn around, get in my face, and start coughing, I'd love to have a mask, and in the absence of one I'd use the seat-back information card to keep his spittle off of me. Or the barf bag. Or anything.

If the guy BEHIND me was coughing, I'd either tell him to cover it, or ask the (overworked, overburdened) F/A to make the same request. If the guy wouldn't quit coughing, then yeah, it would be reasonable to unfold a cocktail napkin and hold it over your mouth and nose. If you find yourself in that circumstance, I wouldn't hold it against you if you undertook makeshift droplet precautions or even pulled a mask out of your pocket and put it on. For that matter, if a guy isn't covering his cough when asked, then the captain SHOULD deplane him.

But I'm 51 years old, and I commute to and from work without a mask. I would fly tomorrow on a commuter plane without a mask, partly because I'm not in the age demographic that is most susceptible to COVID-19, but also because of what we know about how coronaviruses spread. I linked to a JAMA article in which researchers performed real-time air sampling in the room of a COVID-19 patient and failed to detect the virus. That's because, unlike illnesses such as the measles, coronaviruses are dependent on water droplets, which fall to earth via gravity pretty quickly. I will change my mind about this if new evidence comes in.

My dad is 88, and he's in the prime demographic for COVID-19 related mortality. So for him, I'd recommend he take whatever precautions necessary to not get coughed on by multiple people. If he wanted to delay air travel, I wouldn't try to push him out of his comfort zone. I would recommend he not go on a cruise right now.

But I have a spouse, and we have a mother-in-law living with us, and I have a 10-week old baby. I don't wear a mask on my commute, nor do I wear one when I'm walking the halls of my own hospital where we actually have several patients who have tested positive for the disease, nor do I wear a mask in the community. I didn't even wear one to my kid's last pediatrician visit, and we all know that kids are walking petri dishes of nastiness. None of the pediatricians or staff were wearing masks either. I'm comfortable following the science: frequent hand-washing, cover your cough, stay home if you are sick, and so on, are adequate protections against respiratory illness spread by droplets. If anyone in my household gets sick I openly promise you now that I will report it on this thread.

[Will]

By the way, have you had your N95 respirator fit-tested? The fit-test involves putting the mask on, and then putting a hood over your head, creating your own personal gas chamber, and spraying perfume into the hood. If you can smell the perfume, then your N95 is no more useful than holding up a barf bag to prevent spittle from landing on you.

If you're worried enough to wear an N95 respirator, then you should at least have a buddy spray cologne on your face or blow cigar smoke on you with your eyes closed. If you can smell it, then you'd also be inhaling whatever airborne pathogens are nearby. The fit-test isn't rocket science, but it does make the point (to people who do it for the first time) that the N95 is nothing more than a good luck charm until you know how to seat it properly on your face. (There are probably YouTube videos that help you seat the mask correctly.) We do the fit-test once a year, to make sure we know what size N95 respirator works best for us.

[emerydc8]

Thanks, Will, for the advice on properly fitting them. My last trip was February 14 and I hadn't used the masks as of that time. As we get closer to my having to return, I'll definitely revisit this subject. Honestly, I have some serious doubts as to whether domestic flights will even be operating by then. Not only from a virus perspective, but if the credit market seizes up, it's going to cause collateral damage to the entire industry. So, from an economic perspective, who knows what will happen between now and then. Several of my coworkers and I believe that the airline industry, as we know it, may undergo a change even more drastic than after 911 if there's an economic crisis. The Fed has been bailing everyone out and propping everything up since at least Lehman in 2008, but there may be a point where no amount of money-printing or interest rate cuts is going to do anything. And the amount of debt carried by the airlines right now compared to the past is shocking. I just got off the phone with a buddy at JetBlue. His A321 flight to SEA tonight had a grand total of 60 passengers. We both agree this will not go on long before the furloughs start.

The Singapore study of March 4, which you cited above, was eye-opening to me. If the virus was present in the air exhaust vents in the room of a patient' who only showed mild symptoms (cough), how far a reach is it to expect that it could work its way into the water separator of an aircraft which is usually a petri dish to begin with, and almost never changed when it should be?

https://www.channelnewsasia.com/news/singapore/coronavirus-rooms-toilets-disinfectants-kill-virus-covid19-study-12503522

I linked to a JAMA article in which researchers performed real-time air sampling in the room of a COVID-19 patient and failed to detect the virus. That's because, unlike illnesses such as the measles, coronaviruses are dependent on water droplets, which fall to earth via gravity pretty quickly. I will change my mind about this if new evidence comes in.

So we're reading the same study and getting completely different interpretations.

You say they failed to detect the virus yet, the virus "contaminated 13 of 15 room sites testing [sic], including their chair, bed rail, the glass window of their room, the floor, light switches."

The SIN study, for whatever reason (maybe on purpose), failed to describe where these "air exhaust vents" were located, but I'll assume they weren't directly under the patient's feet and I think you'd have to agree. It would require more than just gravity to get the virus to collect in them. And I would bet the air flow in an aircraft is much stronger than whatever airflow existed in this patient's hospital room. 

China, South Korea and Italy didn't just decide to shut down their factories and completely destroy their economies in the process if this was just a nothingburger or a common flu.

[Jason M Tutwiler]

I was on Diamond Princess (all over Asia) 1 month prior to this breaking out. I got sick with some funky ear issue. My wife got sick and had a bad cough for a 1 day.   Corona is very much over-hyped by the media.  It's only harmful to those who are immunodeficiency.  It shouldn't be worried about.  These studies are hyperbole.

Regards,
Jason Tutwiler

[Martin Baker]

I agree - I am effectively out of work because of the (over)reaction to this. M

[Hessel Oosten]

It shouldn't be worried about.
Over reaction to this

Italy today:

Nearly 13000 cases.
1016  death

https://github.com/pcm-dpc/COVID-19/blob/master/dati-andamento-nazionale/dpc-covid19-ita-andamento-nazionale.csv

H.

[Hardy Heinlin]

Wonderful project, dedicated to Wuhan, found on Jack's web site: https://youtu.be/2pOteL3SZE0

[emerydc8]

Great work, Conductor Jack!
Jon

[Jason M Tutwiler]

wow, I just clicked on that link.  Really good orchestration and the record / mix engineering is well done.  I'm not feeling any one instrument trying to take over.

Regards,
Jason Tutwiler

[Will]

Very nice project. Well done, Jack.

[b744erf]

Oh thank you so much for watching my YouTube. Yes, we have stopped everything's in China for almosy two months. It is terrible and I believed economic has been hit hard, especially service, catering and, of course, aviation. Three of my very important friends are doctors. They once played at my orchestra. They all went to WuHan as volunteer doctors. I can't do anything to help them. So I did make some orchestral music videos for them with my orchestra. I may have more later.
I, as a classical musician and university teacher, still don't know when will be the day we work again. We are lucky here that the virus is almost gone and things seems go back to normal slowly. Of course we payed a lot for that. All industry in China completely stoped for a month! Hope things will be better soon.

[emerydc8]

Hope your friends in WuHan are okay, Jack. I guess the airlines here are just going to continue to operate until they're told not to, or they don't have any passengers who are even willing to fly for $19. Just as they had to be forced to stop flying the 737 Max, they can't be counted on to do the right thing now. They'll just spread it all over the country and wonder in a few weeks why it hit us so hard. Best of luck to all of us.

Jon