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COVID-19
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COVID-19

A plan of a call centre divided into three parallel rows with the seats of coronavirus cases marked. Most people on one side of the floor and only a handful on the other side were infected due to the area of stairs, elevators, and washrooms in between
From Park et al., “Coronavirus Disease Outbreak in Call Center, South Korea,” https://doi.org/10.3201/eid2608.201274 via https://www.erinbromage.com/post/the-risks-know-them-avoid-them figure 2

This is a commonplace book to organize the most important, useful, and long-term reliable information and data sources I have found. Because the situation is constantly changing, this is not the easiest read. Check out categories like:

and keywords like:

My commonplace book includes German, some Italian, and English resources and focuses on Austria and Canada which are the countries most important to me.

I have met many many thinky talky universitied people who as of early May 2020 do not know things about this virus which were easily available in English in March 2020 such as “if sufficient hospital resources are available, the fatality rate in a typical rich-country demographics is around 0.5%; if sufficient hospital resources are not available it is several percent.” These key facts do not seem to be controversial among experts in epidemic disease. Agnotology is a useful word; neither the old media nor the social media which replaced them are good at spreading the key facts and ways of thinking which let you make use of daily news.

I am not a medical doctor or a health scientist but annotated bibliographies are how I organize things I am learning! I believe I know more about COVID-19 than some people, but everyone likes their own opinions. So please, please do not take me as an authority, just as someone who is putting his notes on the Internet.

Data and Rigorous Analysis

a log chart of deaths from covid-19 over time by thirteen countries in the North Atlantic and West Pacific regions
If you want one figure which shows the massive failures of governments in the North Atlantic and western Europe, this will do it (from Our World in Data). In a global perspective, the difference between countries in this region which handled the pandemic better or worse than each other is far smaller than between them on average and countries in the west and south Pacific on average. These countries are so diverse that they burst through any attempts to special plead them away like a catapult bolt through a rotten plank.

On 18 December 2022 I decided to break this list down into categories with subjects in bold. Have a look at reproduction number,

If I had different skills, there would be some big philosophical things to say about different expectations of evidence (eg. is it good enough to have theoretical arguments that wearing a properly fitted CAN99 mask reduces your risk of spreading or becoming infected with COVID, or do we need studies of masks used by ordinary people in ordinary environments? Anyone who talks to sexual health advocates will know similar debates about birth control measures in theory v. birth control measures used by ordinary busy excited people).

Very early studies often focused on the reproduction number of COVID-19 (how many people the average infected person infected). There were also debates about the mechanism of transmission (by touch, or mainly through the air?)

  • Jinghua Li et al., “Estimation of the epidemic properties of the 2019 novel coronavirus: A mathematical modeling study,” medRxiv, 20 February 2020 https://doi.org/10.1101/2020.02.18.20024315 {estimates that in China, this virus has R0, the number of people each infected person infects, around 4 not 2-3 as many Anglos were still saying in March … epidemic flu is around 1.3-1.5, by 31 March 2020 after two weeks of shutting down nonessential business and three weeks of closing universities the government of Austria estimated a R0 of 1.7 (Beiglböck et al.)
  • Nishiura et al. (Mar 3, 2020). “Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19)” Pre-print released 28 February 2020 https://doi.org/10.1101/2020.02.28.20029272 {again, ignored well into May 2020 as busybodies shouted at people meeting outside}
  • Rothe et al., “Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany,” 5 March 2020 DOI: 10.1056/NEJMc2001468schol {another major warning bell: it is much easier to contain a disease if people get sick and stay in bed rather than continuing their lives}
  • Science for the People Coronavirus http://www.scienceforthepeople.ca/episodes/coronavirus {interview with a virologist on 15 March which contains most of the facts about this disease available to the public as of 24 March!}
  • van Doremalen et al., “Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1”, 17 March 2020 DOI: 10.1056/NEJMc2004973
  • Mathias Beiglböck, Philipp Grohs, Joachim Hermisson, Magnus Nordborg, Walter Schachermayer, Experten-Stellungnahme zur COVID19 Krise vom 30.3.2019 https://www.amz-gmbh.net/breaking-news-stellungnahme-zur-covid19-krise-30-3-2019/ (English executive summary v. 2 dated 31 March at https://www.oesterreich.gv.at/dam/jcr:43a9c348-38f5-4315-9dd0-6c98c7a2a85c/Executive_Summary_COVID-19_engl._2._Version_.pdf) {estimates that the reproduction number of the virus in Austria was still 1.7 after two weeks of closing all nonessential businesses and three weeks of limited closure}
  • Ramanan Laxminarayan et al., “Epidemiology and transmission dynamics of COVID-19 in two Indian states,” Science, 30 Sep 2020 DOI: 10.1126/science.abd7672 {“No positive contacts were identified for 70.7% of index cases for whom reliable contact-tracing data, including test results, were available.” In other words, 70% of known cases in two Indian provinces were not in contact with anyone else who was subsequently diagnosed}
  • SORA: COVID-19 Prävalenz (10 April 2020) https://www.sora.at/nc/news-presse/news/news-einzelansicht/news/covid-19-praevalenz-1006.html

There were also many debates in 2020 about experimental treatments such as ivermectin and hydroxychloroquinine. These are too far from my areas of expertise and my social circles to collect (many enthusiasts were in the USA and very reluctant to wear a mask), but for example of how debunkers could be bunked:

As of December 2022, its my impression that most doctors have never recommended using hydroxychloroquinine to prevent or treat COVID, but this particular study used data which can not be verified. Even more than anything else on this page, listen to medical doctors and health scientists before undertaking any medical treatment!

The reliability of public health statistics for COVID is a sad topic, especially as governments in the North Atlantic began minimizing the pandemic from summer 2021 to spring 2022. A key concept has become excess deaths: the number of deaths in excess of the number that would have been expected before COVID arrived. This is counterfactual, and there are all kinds of ways to fudge it, like the Swedish government which just extrapolated from the average death rate before 2020 and did not address that death rates were falling until COVID arrived. Good statisticians work out expected rates of death by age and sex, and apply these rates to the demographics of the population in a new year.

  • Gilmour, S. et al. “A Bayesian estimate of the underreporting rate for COVID-19 based on the experience of the Diamond Princess cruise ship.” [Submitted]. Bull World Health Organ. E-pub: 12 March 2020. doi: http://dx.doi.org/10.2471/BLT.20.254565 {based on experience with the cruise ship Diamond Princess, argues that China is identifying and reporting about 10% of infected people}
  • Icelandic Ministry of Health, “Large scale testing of general population in Iceland underway,” 15 March 2020 {about 10% of people in Iceland tested through the health care system, and 0.86% of the population in a random sample, tested positive in the middle of March. This would imply that about 3000 people in Iceland were infected at that date, but as of 27 March only a thousand have been identified … false positives may explain part of the difference} https://www.government.is/news/article/2020/03/15/Large-scale-testing-of-general-population-in-Iceland-underway/
  • Ferguson et al., “Impact of Non-Pharmaceutical Interventions (NPIs) to Reduce COVID-19 Mortality and Healthcare Demand,” Imperial College London, 16 March 2020 DOI: https://doi.org/10.25561/77482
  • Claudio Cancelli, Luca Foresti, Coronavirus, studio su Nembro: «Il numero vero di morti è almeno 4 volte quello ufficiale» Corriere della Sera (Milan), 25 March 2020 (Italian version and English version) {“Nembro, one of the municipalities most affected by Covid-19, should have had – under normal conditions – about 35 deaths. 158 people were registered dead this year by the municipal offices. But the number of deaths officially attributed to Covid-19 is 31”}
  • Oriol Güell, “El coronavirus causa más muertes de las detectadas,” El País (Madrid), 28 March 2020 https://elpais.com/sociedad/2020-03-27/el-coronavirus-causa-mas-muertes-de-las-detectadas.html {official statistics show coronavirus doubling the normal death rate, but 3-5 times as many deaths from all causes are being registered as a year before}
  • “Coronavirus: Sechs von 1.161 Stichproben in Österreichs Schlüsselberufen positiv,” Oberösterriechisches Volksblatt, 2 April 2020 {of 1,161 workers in supermarkets, care homes and hospitals tested on 29/30 March, six tested positive on 29/30 March, a rate of 5 per 1000. At that date, about 1 person per 1000 population in Austria had been diagnosed with covid-10}
  • Bommer, C. and Vollmer, S. (2020) “Average detection rate of SARS-CoV-2 infections is estimated around six percent,” 2 April 2020 www.uni-goettingen.de/de/document/download/ff656163edb6e674fdbf1642416a3fa1.pdf/Bommer%20&%20Vollmer%20(2020)%20COVID-19%20detection%20April%202nd.pdf {uses the somewhat-reliable figures for deaths, and the somewhat-more-reliable data on death rates among infected people by age, to estimate what the number of deaths in a given country imply about the number of cases 14 days earlier: they estimate that 1% of the population of Austria was infected on 31 March 2020}
  • Adelina Comas-Herrera and Jose-Luis Fernandez, unpublished report summarized in The Guardian (May 2020) The rate of excess deaths in old-age homes in the UK from 13 March to 1 May is 2.5 times the Office of National Statistics figure for deaths in old-age homes due to coronavirus “from 13 March to 1 May, there were 19,938 “excess deaths” in care homes – that is above the average number of deaths for the same weeks in the previous five years. Only 8,310 of these were specifically linked to Covid-19 by the ONS”
    https://www.theguardian.com/world/2020/may/13/coronavirus-real-care-home-death-toll-double-official-figure-study-says
  • BC COVID-19 Modelling Group https://bccovid-19group.ca/ argues that BC continues to have a high rate of unexplained excess deaths since removing public health measures in spring and summer 2022; COVID causes damage to all parts of the body so its plausible that infection would lead to increased risk o of death in the months after recovery
  • Patrick Beane, “Insurance executive says death rates among working-age people up 40 percent,” WFYI PBS Indianapolis, 3 January 2022 https://www.wfyi.org/news/articles/insurance-death-rates-working-age-people-up-40-percent
  • “A province-by-province look at excess deaths in Canada during the pandemic” 30 May 2022 https://www.med.ubc.ca/news/a-province-by-province-look-at-excess-deaths-in-canada-during-the-pandemic/ summarizing Kimberlyn McGrail, “Excess mortality, COVID-19 and health care systems in Canada,” https://www.cmaj.ca/content/194/21/E741
  • BC CDC Mortality App https://bccdc.shinyapps.io/Mortality_Context_ShinyApp/ (‘conveniently’ moves COVID deaths from 6th to 10th most common)
  • “After N.B.’s deadliest year, COVID-related strokes and heart attacks are in the spotlight” CBC, 18 May 2023 https://www.cbc.ca/news/canada/new-brunswick/record-covid-deaths-heart-stroke-1.6847211 {after public health measures were abandoned in 2022, death rates in New Brunswick increased more than they have in any year since 1945}
  • Provisional Deaths and Excess Mortality in Canada Dashboard, Statistics Canada https://www150.statcan.gc.ca/n1/pub/71-607-x/71-607-x2021028-eng.htm {excess deaths were low and stable in 2021 except for the heat wave, then high and cyclic after the abandonment of public health measures in spring 2022}
  • Patti Sonntag, “COVID test supplier received billions in pandemic contracts after submitting edited results,” 21 December 2023 “Health Canada and the Public Health Agency of Canada bought 404 million tests from BTNX, which became ubiquitous during the pandemic. … Bàrbara Baro, a biomedical researcher at the Barcelona Institute for Global Health, studied the test on behalf of the Catalonian health system in early 2021. She found that it performed poorly at detecting the virus in people who were infectious but had no symptoms.”
  • “A clue to China’s true covid-19 death toll,” The Economist, 20 July 2023 https://www.economist.com/china/2023/07/20/a-clue-to-chinas-true-covid-19-death-toll (in one province of China, cremations in the first quarter of 2023 were twice as many as in the first quarter of 2020 and 50% higher than the first quarter of 2022; the statistics were removed shortly after people noticed them)
  • Du, Z., Wang, Y., Bai, Y., Wang, L., Cowling, B., & Meyers, L. (2023) “Estimate of COVID-19 Deaths, China, December 2022–February 2023.” Emerging Infectious Diseases, 29(10), 2121-2124. https://doi.org/10.3201/eid2910.230585 (estimates more than a million excess deaths in the first few months after China removed infection-control measures in October and November 2022)

Since the abandonment of public health measures in spring 2022, the least unreliable measure of COVID-19 prevalance is probably measuring the amount of virus in wastewater. There is some debate about how well viral load corresponds to number of people infected and obviously there is room for tricks around data collection and data processing:

Many public health authorities in the North Atlantic were slow to admit that COVID-19 mainly transmits through aerosols in the air. This turns out to date to a taboo which fixed during the 1919 flu pandemic.

  • Emanuel Goldman, “Exaggerated Risk of transmission of Covid-19 by fomites,” The Lancet Infectious Diseases 3 July 2020 https://doi.org/10.1016/S1473-3099(20)30561-2 {argues that there is very little evidence of transmission of the virus by patient to object to patient, while air transmission is well documented}
  • Randall, Katherine and Ewing, E. Thomas and Marr, Linsey and Jimenez, Jose and Bourouiba, Lydia, “How Did We Get Here: What Are Droplets and Aerosols and How Far Do They Go? A Historical Perspective on the Transmission of Respiratory Infectious Diseases” (15 April 2021) https://ssrn.com/abstract=3829873
  • Megan Molteni, “The 60-Year-Old Scientific Screwup That Helped Covid Kill.” Wired: Backchannel, 13 May 2021 https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill/ {on the research by Lindsey Marr, Katie Randall, Tom Ewing, Jose-Luis Jimenez, and Yuguo Li which convinced public health authorities to admit in May 2021 what had been proposed by January 2020 and known by May 2020 that the virus spreads through aerosols (ie. is airborne as public-health officials define it) so the rule ‘keep six feet apart whether indoors or outdoors’ which protects people from droplets does not protect people from infection}
  • Jose L. Jimenez et al., “What were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic?” Indoor Air, Vol. 32 Issue 8 (21 August 2023) https://doi.org/10.1111/ina.13070 {“Since the early 20th century, there has been resistance to accept that diseases transmit through the air, which was particularly damaging during the COVID-19 pandemic. A key reason for this resistance lies in the history of the scientific understanding of disease transmission: Transmission through the air was thought dominant during most of human history, but the pendulum swung too far in the early 20th century. For decades, no important disease was thought to be airborne. By clarifying this history and the errors rooted in it that still persist, we hope to facilitate progress in this field in the future.”}
  • Haddrell, A., Oswin, H., Otero-Fernandez, M. et al. “Ambient carbon dioxide concentration correlates with SARS-CoV-2 aerostability and infection risk.” Nature Communications 15, 3487 (2024). https://doi.org/10.1038/s41467-024-47777-5 CO2 is a good proxy for how much of other people’s breath you are breathing in, but higher CO2 makes COVID more transmissible!

It seems fairly clear that air movement within a room can spread COVID eg. an outbreak at a restaurant in Guangzhou, China where most of the people infected were down-wind of patient zero. People in China such as Naomi Wu also suspect that COVID spreads between rooms in Chinese apartment buildings with poor sealing around wastewater. As of April 2023 it has not been confirmed that centralized HVAC systems spread COVID between indoor spaces.

Air currents like those from a fan or AC unit from an infected individual to others nearby can be an important factor in transmission. Avoid directional air currents from person to person to reduce the spread of respiratory particles.

There are case reports of unfiltered, recirculated air in a space linked to COVID-19 transmission in indoor settings with low or inadequate ventilation. To date, no reports have been identified of SARS-CoV-2 spreading through centralized heating, ventilation and air-conditioning (HVAC) systems

  • Cotman ZJ, Bowden MJ, Richter BP, Phelps JH, Dibble CJ (2021) “Factors affecting aerosol SARS-CoV-2 transmission via HVAC systems; a modeling study.” PLoS Comput Biol 17(10): e1009474. https://doi.org/10.1371/journal.pcbi.1009474 {indecisive but can’t point to strong evidence of COVID transmission between indoor spaces via HVAC systems}

By mid-2020 it was known that the most effective ways of infection control are avoiding crowded indoor spaces, ventilating and filtering the air in those spaces, and having people wear properly fitted respirator masks over their nose and mouth in those spaces. Unfortunately, the vaccines which became available in 2021 were not effective at reducing transmission.

Q. Where’s the best place to put an air purifier?

A. The best place is any room that needs more ventilation—an air purifier is backup support for a space with not enough air flow. I would not push it up against a wall or in a place where airflow is obstructed. Try to put it as close to the middle of the room as possible.

  • Sun, K., Loria, V., Aparicio, A. et al. “Behavioral factors and SARS-CoV-2 transmission heterogeneity within a household cohort in Costa Rica.” Commun Med 3, 102 (2023). https://doi.org/10.1038/s43856-023-00325-6 {a result anyone can see from experience: if you don’t share a bed and wear a respirator mask in shared indoor spaces, you are less likely to spread COVID to your household}
  • Justus Benzler, “Contact-tracing app predicts risk of SARS-CoV-2 transmission,” Nature News and Views, 21 December 2023 https://doi.org/10.1038/d41586-023-04063-6
  • Stacey Leasca, “Why You Should Always Choose a Window Seat on a Plane During Flu Season,” Travel and Leisure https://www.travelandleisure.com/travel-tips/why-you-should-choose-window-seat-during-flu-season Not entirely convincing since one argument is “people in window seats get up less” and spending an entire intercontinental flight seated has other health risks
  • Gen Pei, et al., “A CFD study on the effect of portable air cleaner placement on airborne infection control in a classroom,” Environmental Science: Processes & Impacts, 4 July 2004 https://doi.org/10.1039/D4EM00114A Pure computer model rather than an empirical study
  • “Ventilation made easy: A simple ventilation system removes 90 percent of respiratory aerosols which potentially include coronavirus particles, from indoor air” 1 December 2020 https://www.mpg.de/16075350/1127-chem-ventilation-made-easy-152990 (vastly reducing COVID transmission is a straightforward technical problem, the hard problem is persuading decisionmakers to provide it for the plebs like they do for each other)
  • “Study: Air purifier use at daycare centres cut kids’ sick days by a third,” YLE News, 27 November 2023 https://yle.fi/a/74-20062381 Mentions the E3 Pandemic Response project https://www.pandemicresponse.fi/about

Since summer 2020 it is generally agreed that COVID rarely spreads by touching infected surfaces ie. fomites although it might sometimes (and other dangerous viruses such as cold and influenza often spread that way). People in China and neighbouring countries seem to be concerned about COVID spreading via chilled or frozen seafood.

  • Matsui H, Sugamata M, Endo H, et al. (February 26, 2024) “SARS-CoV-2 Contamination on Healthy Individuals’ Hands in Community Settings During the COVID-19 Pandemic.” Cureus 16(2): e54919. doi:10.7759/cureus.54919 “The detection rate of SARS-CoV-2 RNA from the hands of healthy individuals was extremely low, and no viable viruses were detected. These results suggest that the risk of contact transmission via hands in a community setting is extremely rare.”
  • Kirsty R Short and Benjamin J Cowling, “Comment: Assessing the potential for fomite transmission of SARS-CoV-2,” The Lancet Microbe, Volume 4, Issue 6 (June 2023) https://doi.org/10.1016/S2666-5247(23)00099-X “Nevertheless, these data suggest that fomite transmission can occur in at least some cases, and we shouldn’t be too quick to rule out the possibility that hand hygiene could reduce SARS-CoV-2 transmission, particularly if other interventions are being implemented that target other modes of transmission.”
  • Han Dai et al., “It is time to acknowledge coronavirus transmission via frozen and chilled foods: Undeniable evidence from China and lessons for the world,” Sci Total Environ 2023 Apr 10:868:161388. doi: 10.1016/j.scitotenv.2023.161388. “new cases of infections were found in Xinfadi Market in Beijing on June 11, 2020. In the following series of re-emergent outbreaks, findings from epidemiological investigations suggested that more than twenty re-emergent outbreaks were caused by fomite transmission, predominantly via imported frozen and chilled foods contaminated by the SARS-CoV-2 virus. Seven of the eleven incidents involving frozen and chilled foods were identified by screening individuals with occupational exposure to imported cold-chain foods and associated individuals. Evidence showed that low temperatures and poor ventilation typically maintained through cold-chain logistics create amenable environments for the survival of SARS-CoV-2, making transnational cold chain logistics a congenial vehicle to spread the virus through global transport of consumer goods.”
  • Tina Chen, “Fomites and the COVID-19 pandemic: An evidence review on its role in viral transmission,” National Collaborating Center for Environmental Health (Canada), 23 March 2021 https://ncceh.ca/resources/evidence-reviews/fomites-and-covid-19-pandemic-evidence-review-its-role-viral

By summer 2020 it was clear that cleaning surfaces was not effective at containing COVID-19, although it is effective against other viruses such as influenza. A survey from the USA suggests that alcohol-based cleaners are effective against SARS-COV-2:

Among means of infection control, masks are especially difficult to understand. In theory, wearing a properly fitted N-95 or better mask should vastly decrease the amount of virus you breathe in or out, and the frequency with which you touch your eyes or mouth with virus-contaminated hands. Its hard to prove this in a randomized control trial because most people don’t wear properly fitted, high-quality masks for all indoor gatherings, and its not feasible to follow hundreds of subjects around for weeks and see their practices in high-risk situations. Watch out for people who use studies of people wearing surgical masks below their noses to argue that wearing a properly-fitted N-95 or better mask is not effective (or use policy requests to wear some kind of mask to test the effectiveness of specific mask policies)! There has been a concerted right-wing propaganda campaign against wearing masks, often framed in ‘scientific’ terms but motivated by a wish that public health and collective action were not necessary (a good tell is when someone on the Internet or in the news is down on masks but silent about air filters, ventilation, and moving events outdoors). We eliminated COVID outside Vienna in Austria with just cloth masks and rules against indoor gatherings. On the balance, the theoretical evidence, the weak studies, and my personal experience avoiding symptomatic COVID since the start of the pandemic suggest that its worth taking this low-cost, probably-high-benefit intervention.

The health risk of reinfection remains high and increases with each infection. People infected with COVID are more likely to die of many different health problems in the next six months, even if they were vaccinated. Strangely, in 2022 there was a concerted propaganda campaign by Anglo governments and and cranks against taking infection control measures or the idea that we have a collective responsibility not to infect each other. This coincided with a propaganda campaign against the government of China’s continued success in limiting infections and deaths (China’s handling of COVID had many problems but it did prevent mass infection until December 2022).

  • Phetsouphanh, C., Darley, D.R., Wilson, D.B. et al., “Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection,” Nature Immunology Letter, vol. 23 no. 210-216 (13 January 2022) https://www.nature.com/articles/s41590-021-01113-x
  • Benjamin Bowe, Yan Xie, Ziyad Al-Aly (2022) “Acute and postacute sequelae associated with SARS-CoV-2 reinfection.” Nat Med 2022 Nov; 28(11) : 2398-2405. doi: 10.1038/s41591-022-02051-3. https://pubmed.ncbi.nlm.nih.gov/36357676/

First infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with increased risk of acute and postacute death and sequelae in various organ systems. Whether reinfection adds to risks incurred after first infection is unclear. Here we used the US Department of Veterans Affairs’ national healthcare database to build a cohort of individuals with one SARS-CoV-2 infection (n = 443,588), reinfection (two or more infections, n = 40,947) and a noninfected control (n = 5,334,729). We used inverse probability-weighted survival models to estimate risks and 6-month burdens of death, hospitalization and incident sequelae. Compared to no reinfection, reinfection contributed additional risks of death (hazard ratio (HR) = 2.17, 95% confidence intervals (CI) 1.93-2.45), hospitalization (HR = 3.32, 95% CI 3.13-3.51) and sequelae including pulmonary, cardiovascular, hematological, diabetes, gastrointestinal, kidney, mental health, musculoskeletal and neurological disorders. The risks were evident regardless of vaccination status. The risks were most pronounced in the acute phase but persisted in the postacute phase at 6 months. Compared to noninfected controls, cumulative risks and burdens of repeat infection increased according to the number of infections. Limitations included a cohort of mostly white males. The evidence shows that reinfection further increases risks of death, hospitalization and sequelae in multiple organ systems in the acute and postacute phase. Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention.

  • “COVID-19 was third leading cause of death in the United States in both 2020 and 2021,” National Institutes of Health (USA), 5 July 2022 https://www.nih.gov/news-events/news-releases/covid-19-was-third-leading-cause-death-united-states-both-2020-2021 {“in 2020, COVID-19 was the fourth and fifth leading cause of death among people ages 45–54 and 35–44, respectively. But in 2021, COVID-19 became the first and second leading cause of death in these age groups. Among those 85 and older, COVID-19 was the second leading cause of death in 2020, but dropped to third in 2021, likely because of targeted vaccination efforts in this age group.”}
  • Robert Jones, “After N.B.’s deadliest year, COVID-related strokes and heart attacks are in the spotlight,” CBC News, 18 May 2023 https://www.cbc.ca/news/canada/new-brunswick/record-covid-deaths-heart-stroke-1.6847211 “Statistics Canada last week published what are called “provisional” mortality counts for New Brunswick, which estimated 9,288 people died in the province through 2022. If confirmed, the number will be a record for the province, obliterating the previous high set in 2021 by a stunning 1,179 deaths.”
  • Kim et al., “Long-Term Autoimmune Inflammatory Rheumatic Outcomes of COVID-19: A Binational Cohort Study,” Annals of Internal Medicine, 5 March 2024 https://doi.org/10.7326/M23-1831 (“patients with COVID-19 were at increased risk for incident AIRD compared with uninfected patients (adjusted hazard ratio, 1.25 [95% CI, 1.18 to 1.31]) and influenza-infected control patients (adjusted hazard ratio, 1.30 [CI, 1.02 to 1.59]). The risk for incident AIRD was higher with more severe acute COVID-19. Similar patterns were observed in the Japanese cohort.”) Press release on Kim et al. 2024 here
  • Yan Xie, Taeyoung Choi, Ziyad Al-Aly, “Long-term outcomes following hospital admission for COVID-19 versus seasonal influenza: a cohort study,” The Lancet Infectious Diseases, 14 December 2023 https://doi.org/10.1016/S1473-3099(23)00684-9 (another analysis of US Department of Veterans’ Affairs data, “Although rates of death and adverse health outcomes following hospital admission for either seasonal influenza or COVID-19 are high, this comparative analysis shows that hospital admission for COVID-19 was associated with higher long-term risks of death and adverse health outcomes in nearly every organ system (except for the pulmonary system) and significant cumulative excess DALYs than hospital admission for seasonal influenza.”)
  • Bernhard Kratzer et al., “Differential decline of SARS-CoV-2-specific antibody levels, innate and adaptive immune cells, and shift of Th1/inflammatory to Th2 serum cytokine levels long after first COVID-19,” Allergy 2024 Jul 14. https://doi.org/10.1111/all.16210 Austrian content! “COVID-19 causes long-term reduction of innate and adaptive immune cells which is associated with a Th2 serum cytokine profile. This may provide an immunological mechanism for long-term sequelae after COVID-19.”

About 10-30% of the time, infection with COVID causes debilitating Long COVID. This seems to belong to a class of post-viral syndromes which were poorly understood before 2020. ME/CFS is a useful keyword. Long COVID includes both total disability and minor consequences such as fatigue, but even minor consequences affect quality of life.

  • Hannah E. Davis et al., “Long COVID: major findings, mechanisms and recommendations,” Nature Reviews Microbiology, 21, 133-146, 13 January 2023 https://www.nature.com/articles/s41579-022-00846-2
  • Phetsouphanh, C., Jacka, B., Ballouz, S. et al. “Improvement of immune dysregulation in individuals with long COVID at 24-months following SARS-CoV-2 infection.” Nat Commun 15, 3315 (2024). https://doi.org/10.1038/s41467-024-47720-8 (unvaccinated people who had mild to moderate COVID-19 often have persistent symptoms for the next year or two, note that they updated the study to emphasize that this shows the effects of early COVID variants in an unvaccinated population)
  • MyGuide: Long COVID https://www.longcovidbc.ca/ “a customizable guide for individuals who experience post-COVID symptoms, or those wanting to learn about recovering from lingering symptoms after COVID-19 infection.”
  • NIH Media Advisory: “Study suggests reinfections from the virus that causes COVID-19 likely have similar severity as original infection” 11 June 2024 https://www.nih.gov/news-events/news-releases/study-suggests-reinfections-virus-causes-covid-19-likely-have-similar-severity-original-infection
  • Yan Xie et al., “Postacute Sequelae of SARS-CoV-2 Infection in the Pre-Delta, Delta, and Omicron Eras,” The New England Journal of Medicine, 17 July 2024 DOI: 10.1056/NEJMoa2403211 (lingering effects in 8 to 10 per 100 unvaccinated patients and 4 to 5 per 100 vaccinated patients with acute COVID-19 infections from 2020 to 2022, because Long COVID means different things to different people others estimate higher rates of long-term consequences; as of 2023/2024 Zeynep Tufekci seemed frustrated that public-health advocates use ‘broad’ statistics and anecdotes about the worst cases)
  • Sara Talpos, “Looking for Long Covid: A Clash of Definition and Study Design,” Undark 25 July 2024 https://undark.org/2024/07/25/long-covid-clash-of-definition-study-design/

Public health messaging is a particularly depressing topic.

  • Bruce Y. Lee, “#COVIDIsAirborne Trend, Questioning CDC Director’s Tweet on Covid-19 Precautions,” Forbes, 29 October 2022 forbes website (script blockers recommended) {over the course of 2022, Anglo public health services started minimizing any public health measures against COVID except handwashing and voluntary vaccination and presented practices such as wearing an effective mask in shared spaces as a personal choice rather than a choice that affects others’ health}
  • Brishti Basu, “Most BC residents think pandemic was not managed well: independent review. Less than 20% of survey respondents trusted COVID-19 information shared by the government.” Capital Daily, 2 December 2022 https://www.capitaldaily.ca/news/most-bc-residents-think-pandemic-not-managed-well-independent-review

Lucky Tran, PhD, an organizer for the March for Science and a science communicator at Columbia University, pointed out that Walensky’s tweet didn’t even mention two key precautions against airborne viruses: face mask use and air ventilation/filtration. While getting an updated Covid-19 vaccine will help decrease your risk of more severe Covid-19 outcomes, it’s not going to prevent the virus from entering your nose or mouth. The only way the Covid-19 vaccine could possibly block the virus from entering your nose is if you were to shove multiple vaccine syringes up your nostrils, which you shouldn’t do for both safety and aesthetic reasons.

CO2 monitors or detectors use the fact that when people breathe out virus, they also breathe out carbon dioxide. CO2 is not a perfect proxy for your exposure to viruses (eg. fires also cause high CO2, and air can be filtered or sterilized to remove viruses but not CO2) but it is relatively simple to measure. High CO2 causes headaches and impacts cognitive function, so it is dangerous per se (every so often someone used to leaky housing suffocates in CO2). As of December 2022, two models which are often talked about are Aranet 4 (CAD 325 on Amazon) and Vitalight Mini (CAD 50 on Amazon). I can’t find any reviews which test them in an artificial atmosphere with known concentration of CO2, but two journalistic reviews are:

Germicidal ultraviolet lights / ultraviolet-C irradiation / Far-UVC has been used since the 1930s and offers the possibility of sterilizing air without exchanging it. People in China have been especially active in experimenting with them because many Chinese live in crowded buildings where air moves easily between apartments. Two optimistic articles about this technology are:

A problem is that indoor air today is full of fossil fuel based chemicals and germicidal ultraviolet breaks them down into smog which also causes serious health problems. Prof. Jose-Luis Jimenez has some back-of-the-envelope calculations of the risk at https://jljcolorado.substack.com/p/germicidal-uv-a-tradeoff-between

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Policy Advocacy

This week, Ontario’s Chief Medical Officer, Dr. Kieran Moore, urged the public to wear masks amidst the crushing pressure on the province’s ERs and children’s hospitals. Just days later, he was spotted maskless at a party: he was being honored at a “Most Influential People” gathering. He earned his place on the list for, yes really, “keeping COVID under control.” 

…

It might shock a liberal in 2020 that two years after mocking such behavior, they would, themselves, resort to anti-mask propaganda in service of our “back to normal” COVID non-response. At the start of COVID, headlines in prominent papers patiently explained, for the slow and right-wing among us, that no, masks can’t harm your immune system. But that was two years ago! Two years and two eugenicist administrations (in the USA) later, maybe masks DO harm your immune system!

  • Smriti Mallapaty, “China COVID wave could kill one million people, models predict: Boosting vaccination rates, widespread mask use and reimposing some restrictions on movement could reduce the number of deaths.” Nature NEWS, 19 December 2022 https://www.nature.com/articles/d41586-022-04502-w {lots of handwaving, if China starts handling the pandemic as badly as the USA and UK have handled it we would expect 5 to 10 million deaths by the end of 2023; more Canadians have officially died of COVID in 2022 than 2021 despite the arrival of vaccines}
  • Christina Pagel, “Covid is not ‘just a regular winter bug’: Three points against a recent BBC article framing Covid as ‘just a regular winter bug’ ” 16 October 2023 https://christinapagel.substack.com/p/covid-is-not-just-a-regular-winter {flu already causes serious harm to populations, COVID does not yet have a seasonal cycle, and long COVID and post-COVID are even more serious than other post-viral syndromes, especially since COVID infections are still more common than influenza}
  • John Snow Project, ‘Endemic’ SARS-CoV-2 and the death of public health, 6 November 2023 https://johnsnowproject.org/insights/endemic-sars-cov-2-and-the-death-of-public-health/ {choosing to control the public’s access to information rather than the spread of COVID-19 will make it tempting to try the same for the next pandemic, and has undermined the basic principle of public health which has massively improved wellness and life expectancy since the 19th century}
  • Rachel Thomas, “Your Immune System is Not a Muscle,” 13 August 2024 https://rachel.fast.ai/posts/2024-08-13-crowds-vs-friends/ By a Master’s student in immunology with a Machine Learning and Data Science background. “Our ‘old friends’ parasitic worms and beneficial microbes are associated with a reduced risk of allergies and autoimmune diseases. No such relationship exists for crowd diseases. In fact, the opposite is true. Crowd diseases contribute to allergies and autoimmune diseases. Comparing the immune system to a muscle that gets stronger with use is overly simplistic and, in many cases, inaccurate.”
  • https://teamshuman.substack.com/p/moral-sabotage “The US has ‘learned to live with covid’ not by effectively addressing the problem, but through a broad deliberate effort to erode empathy, break solidarity, desensitize the public to mass illness and mass death, and inculcate a sense of hopelessness and futility.” I would prefer to counter this.”
  • Nate Bear, “How Covid Broke Reality,” ¡Do Not Panic! 11 October 2024 https://www.donotpanic.news/p/how-covid-broke-reality
  • Meredith Farkas, “It’s not about information literacy: Why people’s risk calculus around COVID has changed,” 3 December 2024 https://meredith.wolfwater.com/wordpress/2024/12/03/its-not-about-information-literacy-why-peoples-risk-calculus-around-covid-has-changed/

I don’t think information literacy is the issue here. Most people I know are quite smart, well-read, and adept at research. I don’t know if they read things about COVID anymore, but if they’re not, it’s not because they don’t know how to find it. I think a lot more is happening with people who avoid COVID information and ignore risks and I think it’s a mix of personal psychological factors, privilege, the absolute disaster that was public health messaging around COVID, and social pressure to align with the dominant narrative that COVID is over. … Many of us are dealing with pandemic fatigue, which is a lot like burnout and leads to a “demotivation to engage in protection behaviors and seek COVID-19 related information.” … Instead of vilifying folks who experience pandemic fatigue and decrease their precautions, the WHO portrays it as “a natural and expected reaction to sustained and unresolved adversity in people’s lives,” (7), an approach which I personally appreciate. Shame is not a motivator and these are very normal psychological responses.

Groups include Protect our Province British Columbia, Canadian Aerosol Transmission Coalition https://www.aerosoltransmissioncoalition.ca/ COVID-19 Resources Canada https://covid19resources.ca/ and Do Not Harm https://donoharmbc.ca/

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Status Reports

I do not recommend Wikipedia, people familiar with statistics from different countries say that theirs do not agree.

Preparation

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Hygene

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Humour

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Sadness

Devi Sridhar, “Why can’t some scientists just admit they were wrong about Covid?” The Guardian, 24 March 2022 https://www.theguardian.com/commentisfree/2022/mar/24/scientists-wrong-covid-virus-experts

Unsorted

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