A few days ago I saw a post on Facebook about the devastation to businesses like wedding venues, caterers, bars and restaurants in Wisconsin. The post said we should have been open like Texas and Florida. The Texas Covid Tracking Project has detailed information on Texas Hospitalization rates. October 1 had 3,190 patients hospitalized with 1075 on ventilators. By January 9 there were 13,935 reported hospitalized with 3,478 on ventilators. That means nearly 14,000 Texas residents will remember the 2020 holidays, not for family gatherings, but for praying that your loved one would be there for the next Christmas Holiday. We need to help the person who wrote this post. I would like to see a more targeted Covid-19 relief package to help these folks. Activities that are super spreader events must be put on hold until 85% are vaccinated. Opening like Texas is not an option. I spoke with a friend in Atlanta who is a manager at a 150 bed hospital. They now have 81 beds designated for Covid-19. My friend in Atlanta is drained by double shifts, staff shortages, and seeing patients being diverted or not given a hospital bed as there are none left. A relative who has two pensions, social security and did not spend money during Covid-19 by staying home said, give the relief to those who need it.
Viruses do not live long outside a host. So every 10-14 days the virus needs its host to spread the virus to another host. On average someone infected with Covid-19 infects 3-4 other folks. This is called the Reproduction Rate. To control a virus the Reproduction Rate needs to be less than one. The results of this exponential rate of infection can be seen in the county where I live. Winnebago County went from 1300 cases on September 1 to over 15,000 today one day from the New year.
Last Summer Kansas’s Governor issued a state wide mask mandate that most counties opted out of. A Study by Kansas State University showed that the counties that opted out of the mask mandate had twice the rate of growth in Covid-19 cases than those that did not opt out. Berkeley California has a strict mandate with enforcement. Berkeley has a death rate of 8 per 100,000 on the same date Winnebago County had a death rate of 80 per 100,000. Wisconsin has a mask mandate that has no enforcement. Taiwan has had less than 10 deaths with a strict mask mandate and a weekly mask allocation program of high quality masks, either N95 or multi layer surgical masks. My last dental visit the dentist was wearing a N95 mask with a surgical mask over the N95. This is a virus that spreads easily through air. Dentist work in aerosol filled environments, so Dentist are especially careful. This virus can be controlled with a strict mask mandate that has enforcement. The Kansas study showed we can easily reduce the infection rate by half in counties with a mask mandate. Asian countries, with massive public transportation and crowded cities, that are perfect for viral spread, were able to control the virus with high end masking. This has kept their economies open.
If everyone would properly wear a high quality mask, or double mask with less effective masks we could lower the Reproduction Rate below 1. The further below 1 we lower it the faster the virus goes away. If we mainly rely on a vaccine that is 95% effective, we have to have 85% of folks vaccinated. A person who is an asymptomatic spreader, normally spreads the virus to 4 others, If 3 of the 4 folks are vaccinated those 3 do not get the virus, and now only one other person gets infected. Occasionally, all four of the folks are vaccinated, then the chain of spread is broken, the virus dies out. If we add strict masking to this equation once we hit 85%, with everyone wearing a mask, the spread is further cut in half or more, then the virus fails to find a new host a majority of the time, the virus dies out quickly. Until the United States has no new cases for several days, strict masking should be followed.
Kristen V Brown writes, that Researchers at Standford University and Northwestern University used data collected between March and May in cities across the US to map the movement of people. Their Study was published Tuesday in the journal “Nature”. They found that 10% of the locations examined accounted for 85% of predicted infections. Capping occupancy at 20% in Chicago Metro area cut infections by 80%.
Wisconsin has a restaurant occupancy limit of 25% back in effect after several court actions. Most restaurants cannot financially survive at this occupancy. I believe it is more important to provide financial assistance to these local businesses instead of sending more money to Foxconn whose buildings are being used for winter boat storage. To rebuild the Wisconsin economy, from the effects of the Pandemic, we need to redirect resources to training skilled trades to replace retiring Baby Boomers, make sure that 90% of folks get the Covid19 Vaccine so retirees feel safe in restaurants, and give aid to closed business until at least a 80% vaccination rate is reached. Since restaurants have been the source of many super spreader events, the Tavern League, Chamber of Commerce and Restaurant owners need to push vaccinations.
There is a lot of misinformation and a lot of intentional disinformation about Herd Immunity. Sweden is conducting a national experiment in Herd Immunity. The Idea is that if enough people catch Covid-19 early, it will prevent a second wave. Sweden has had 5 times the per capital deaths of Denmark and 10 times the rate of Norway and Finland. Yesterday Sweden quietly changed directions allowing local lock-downs. The jury is still out on this approach. If Wisconsin had the same per capital deaths of Sweden 1900 more would have lost their lives. That means 1900 more times an ICU nurse would have zipped a body bag and informed families that their loved ones died. The infection rate is going up, but as medical communities develop better treatment, the death rate is declining. There are medications being tested that may be available in several months. We will not know the long term effects of Covid-19 for those with mild cases, but there appears to be lung, heart, and kidney damage in some patients. What is more troubling is there is a lot of disinformation being put out by Russian Trolls aimed at polarizing our great nation, and folks on the far right and left re-posting this disinformation. Please research your sources and do not support the efforts of the Russian Cyber Warfare division of the Russian Military.
Three Epidemiologist put out the “Great Barrington Declaration”. They are advocating in letting Covid-19 run its course in younger patients to achieve herd immunity. There are several issues with this. This herd immunity approach has been call a fallacy by a group of 80 researchers according Contagion Live publications. Some are claiming that herd immunity could be achieved with just 20% of the population being infected. Herd immunity for a virus with a reproduction rate of over 3 is more likely 70%. Since the long term effects of this virus on heart, lung and kidneys is not know, wearing masks avoiding indoor spaces with non-family members, until a vaccine is available seems prudent. Getting herd immunity where up to half of those with the virus have long term organ damage, goes beyond stupid. Too much is still unknown to advocate for this course of action.
Taiwan and New Zealand still remain the gold standard for controlling Covid-19. Taiwan has a weekly allocation of N-95 or 3-layer surgical masks. Taiwan has had less that 10 deaths in 7 months. In New Zealand President Jacinda Ardern won by a landslide in the October 18 election. Her motto for coronal virus of “Go Hard and Go Early” has controlled outbreaks with a hard early lock-down. New Zealand had gone for over 100 days without infections, before they had a new cluster outbreak, which they controlled. The most frustrating aspect of this virus is that we are seeing rural areas of Wisconsin and the Dakotas, which avoided the virus, now leading the country in outbreaks. These are areas where the president has great followings, and had plenty of time to put robust prevention protocols in place. However, they ignored the advise of the medical community as the president ridiculed many of the precautions that countries like Taiwan took. We know how to control this virus, just do it.
I watch a 90 minute panel discussion by 4 members of the American Association for the Advancement of Science. Three panel members had 35 years or more in viral vaccine and immunization research. The moderator had a strong background in viral science. This panel believes there are several promising paths to a vaccine and expect 2 or more to be successful. The panel emphasized that the critical aspect will be primary care physicians communicating the case for a vaccine so Americans buy into the vaccine need.
One dangerous and disturbing development is some conservative media is pushing the notion that we are close to herd immunity. This disinformation will prove to be deadly. Covid-19 has a reproduction rate of slightly over 3. This means herd immunity will require 70% of the population to be vaccinated or have a Covid-19 infection. Today we may be at 10% based on analyzing dialysis patients. The Red Cross checks blood for antibodies, and they are finding 2% to 3%, but this segment of the population is probably more cautious than the general population. In any event we are no where near 70%. Achieving herd immunity without a vaccine means a lot more would need to die.
Oshkosh is voting tonight on a mask ordinance. It is important to weigh in on it. The ordinance has a number of loopholes. It is not clear if someone can claim an exemption and enter a business that requires mask. This loophole needs to be closed. Two issues everyone needs to consider: how do small businesses make customers feel safe and how do we prevent a winter second wave.
A retirement investment seminar my wife watched predicted a slowdown in job recovery until people feel safe going to small businesses. It is important that all small businesses post signs requiring mask. I was in Door County last week and the grocery store Piggly Wiggly had signs on each side of the drive into the parking lot requiring masks, two signs on each side of each entrance and one banner sign between the two entrances. Our Oshkosh Piggly Wiggly has none of that. If every business had large posters stating masks required to protect our employees on every entrance folks would comply and feel safer. The Colorado sun said Amazon in Colorado is hiring 1900 more workers. That is not a good sign for small business.
A second issue is scientist do not know if there will be a second wave like 1918. From April through September 1918 there were 75,000 deaths, then in October there were estimates of 195,000 deaths for that one month. Do not relax precautions at this point.
Our local Wisconsin State Representative Michael Schraa is using his Facebook page to get anti mask supporters out to Winnebago County legislative committee meetings, Winnebago County board meetings, and Oshkosh City Council meetings to speak against any form of a mask ordinance. He was joined by Donnie Herman who is running for an adjoining district representative seat. I watched citizen presentations for three hours at the July 2020 county board meeting. There were only 4 folks who spoke in favor of the ordinance. The four were Lois Gruetzmacher a retired public health nurse who was booed by the crowd. Dr. Eric Smiltneek, a practicing Oshkosh Physician who spoke early and was ignore, my wife Dr. Patricia Dwyer-Hallquist, and myself. My wife and myself spoke at the end of the meeting on zoom, when most folks had left. Most of the anti-mask talks were along three themes, it is our right not to wear masks, mask are not effective, we don’t want a public health officer who is not an elected official to have enforcement powers. Representative Schraa’s Facebook page is littered with disinformation posts about masks including fake CDC papers with questionable grammar. Representative Schraa is stating “we the people have rights and freedoms not to wear a mask”, never touching on the issue of protecting fellow Americans from contracting a virus that has long term unknown consequences. Donnie Herman and Representative Schraa are small business owners. Yet there was no mention of the the responsibility of an employer to protect their customers and employees. No concerns from the anti-mask crowd despite nearly 1000 American deaths per day. This spring’s Parameters the quarterly officers magazine published by the United States War College has a Special Commentary: “#FakeNews in #NarSec Handleing Misinformation.” This United States War College publication describes disinformation spreading like a viral pathogen through the internet via social media. This is just one of many publications on Russian disinformation cyber warfare against the United States on the US Army War College Website. Fake CDC papers with questionable grammar has the signature of Russian trolls working for the Russian military spreading disinformation by getting folks to re-post disinformation on Facebook. Representative Schraa needs to screen these disinformation posts. In most times this conduct could be ignored, but with a pandemic it is proving deadly. Taiwan with a weekly mask allotment had fewer deaths total since the Pandemic’s beginning than we average every 15 minutes in this country. Korea controlled a initial outbreak at an evangelical church with about 300 deaths total since the pandemic started. A person is 140 times more likely to get Covid-19 in Wisconsin than Korea with direct flights from Wuhan and crowded cities unlike any in Wisconsin. I listened to 3 hours of citizen statements telling us that masks don’t work despite the total deaths from the start of the outbreak in Vietnam, Korea and Taiwan is less than 400. I would like to review some of the presentations. The first major disinformation follows this reasoning. Since mask filter at .3 microns and viruses are .2 microns masks do not stop a virus. The speaker keeps saying this is only “common sense.” On this blog I show a picture of a mask with red dye stained saliva after coughing into it. The mask traps the Aerosol and droplets as seen by the dye splatter. A mask is not trying to stop the single virus, it is stopping a million viruses contained in a droplet. In other words the mask is not trying to stop an individual snow flake, but is stopping the fifty snow balls containing hundreds of thousand of snow flakes. Viruses travel in droplets and aerosols. A mask is stopping the droplet or aerosol leaving the mouth and preventing it from becoming airborne. Breathing in a half million viruses deep into the lungs and having a thousand attach to ACE2 receptors is the problem, not a single virus. Folks are re- posting posts about filtering, as true science. The disinformation army loves code words like “common sense” as that is a magical phrase that support their argument, so no research is needed. This virus does not care about your “common sense”. The original writer of the disinformation understands it is a blatant lie. Another post brings up a H1N1 study that showed no effectiveness for masks with H1N1. Apparently, they read a headline and failed to read the all the discussion about the H1N1 study. The study was based on Heath Care Workers. Health Care Workers get yearly vaccines which often included an earlier H1N1 flu virus. They also have been exposed more to H1N1 than non-Health Care Workers. This epidemic started in April and some got exposure to the virus before the study. They also get exposure to the virus outside of their work. H1N1 is the virus Health Care Workers may have partial immunity for. Discussions of this study cover these issued. Over all masks are 45% effective for flu. However, Covid-19 is a novel coronal virus and it is appropriate to look at studies of novel coronal viruses. A study of SARS which is a novel virus like Covid-19 had an 80% effectiveness rate. Unlike H1N1 Health Care Workers had no prior exposure to SARS, no prior vaccine and the only setting that they were exposed to in was the health care setting. Epidemiologist use SARS as a model because it is a novel Coronal Virus like Covid-19. The biggest flaw in using H1N1 effectiveness study as an argument is that they are not based on universal mask wearing which requires everyone to wear a mask. That Minimizes the infection at the source, namely the asymptomatic carrier. None of the studies cited by the disinformation posts were looking at having the source of the virus with a mask. Health Care Workers were in an environment where infected folks were coughing and sneezing and the virus was airborne. Today if you go into most medical facilities you are given a mask at the door so the aerosol from the cough or sneeze is minimized. Analysis of these studies show the importance of everyone wearing a mask, not just the Health Care Worker. Another argument is masks interfere with my immune system getting stronger by not being exposed to germs. Masks reduce the viral load, they do not eliminate it. You will have plenty exposure. What it mainly reduces is the viral load leaving the infected person. Another reported masks trap CO2. CO2 is a three atom molecule. A virus is a 90,000 atom structure which has a diameter that is 1000 times larger than CO2. CO2 travels very well through a .3 micron mask. To say masks are not effective you have to ignore the outcomes in three major countries that have strict mask requirements, ignore that overall Covid-19 infections have gone down in states with mask requirements, but overall have gone up in states without them. These folks will find one or two states with exception to those trends, post that, then ignore the 48 states which follow the trend. That is disinformation. These folks often cite websites devoted to promoting conspiracy theories. When it comes to conspiracy theories that call everything a Hoax, it is best to refer to papers on the US Army War College website under publications. They have paper that detail our military’s counter intelligence along with dozens of publications on the US Army War College about Russian disinformation. One of the most upsetting posts is a paper that Representative Schraa posted from an attorney author criticizing the worst case models from last March Epidemiologist only had two novel coronal viruses to model from, SARS with a 9% mortality rate and MERS with a 30% rate. I checked this author, and this was the first publication on models. Monday back quarterbacking 4 months after the game ended, not nice or fair. It is easy to look back and say what we got wrong, which was a lot, but we also need to acknowledge what countries like Taiwan got right which was universal masking and the anti-mask folks still get it wrong. At the time of the first models, epidemiologist said we don’t know a lot about this virus, but they hoped is would not be deadly, like the other two coronal viruses, but they had to plan for the worst case outcome based on The most important thing about this virus we won’t know for several years, what is the long term effects of lung, heart and kidney damage that physicians find in many asymptomatic patients. One person did ask me why we should mask against a virus that may eventually infect us all. That is a good question. Physicians will find better treatments, better drugs, and possible a vaccine. The longer you avoid getting the virus, the better the chance that there will be a treatment that keeps you from having long term heart or lung damage that may show up as COPD when you enter retirement. Lets see the outcome of Sweden’s experiment before we rush into herd immunity. To me too many elderly died in Sweden. Korea and Taiwan did keep their economy open. That seems to be a better model, universal masking and keep the economy open.
I placed a letter in the Oshkosh Herald as several hundred business folks showed up at a meeting of the Winnebago County legislative committee opposing a public health ordinance. The posts on Wisconsin State Representative Michael Schraa talked about winning, protecting their rights and freedom. I think these business owners are not aware of their disastrous messaging. This isn’t about winning, freedom or rights. It is about taking responsibility to stop an airborne virus from spreading in your business. It is about taking responsibility to protect your customers and employees. Every right has several responsibilities. So does every freedom. The Pizza industry has a message about con-tactless pizza delivery keeping you safe. That started in Korea, one company applied it to all 40 countries that they have stores in. Then every major pizza place adopted this concept. What a powerful message to their customers. Contrast the message on Representative Schraa’s Facebook page. Little mention of specific language they objected too. No messaging about what they are doing to protect you and me in their business. If this doesn’t scare most senior citizens from entering small businesses, I don’t know what will. If we all wear a mask starting now, the chances of an outbreak in a school in fall is fairly low. If we all wear a mask the virus dies out as (R) is less than one. If we don’t then 60,000 projected deaths will come true.
Dr Duffy made an YouTube video urging everyone to wear a mask. He is an Internal Medical Specialist who recently retired. This is worth watching and posting. Thank you Dr. Duffy.
Three successful approaches to controlling this virus: New Zealand after a “hard shutdown” and strict protocols has gone 17 days without a new case of Covid-19 and now reopened the economy fully without restrictions. They are a unique in that they are an Island and can quarantine travelers coming into their country. Korea where everyone wears a mask, has had under 300 deaths and never shut down their economy. They employ extensive testing, tracking and tracing. Taiwan has a weekly mask ration that you can purchase from a pharmacy or convenience store. Three slightly different approaches, but all work. In China before the outbreak folks wore masks in crowded areas. In the USA we need leadership that recognizes that Covid-19 is serious as the virus attaches to ACE2 receptors found in the heart and kidneys. Mayo’s put out a podcast that they are finding elevated Troponin levels associated with a heart attack from a blockage. Normally these people would be taken to the Cath Lab. Now they advise Covid-19 patients not go to the Cath Lab unless they have symptoms of a heart attack.
June 6 World Health Organization update included wearing mask in public reversing a previous recommendation for healthy individuals. Since then several observational studies also back wearing masks for healthy individuals in public.
June 17 The World Health Organization is no longer including Hydroxychloroquine in its trails of Covid-19 drugs.
June 18 Taiwan has had 7 deaths and 446 cases. Taiwan has very crowed cities, but has a weekly mask ration that can be picked up at a convenience stop or pharmacy. They started this early in their response to the Covid-19 outbreak.
June 16 Article in the Wall Street Journal: “Exactly how do you catch Covid-19? There is a growing consensus” This article details the biggest danger is poorly ventilated indoor spaces and close contact. It emphasizes the importance of wearing a mask.