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jimmy m
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20 Aug 2020, 6:55 pm

Here is another article about New York Nursing Home deaths. A follow on to what AsPartOfMe wrote.

Unlike the federal government and other states, New York is the only state to explicitly say it only counts residents who died on nursing home property from coronavirus in its count of nursing home deaths. Those who were transported to hospitals and died there are added to a separate count.

“If you die in the nursing home, it’s a nursing home death. If you die in the hospital, it’s called a hospital death,” the Democratic governor told Albany public radio station WAMC on Wednesday. “It doesn’t say where were you before.”

An Associated Press report last week found New York’s official care home death count of more than 6,620 is not just an undercount but likely an undercount by thousands of deaths. A separate federal count in May that included resident deaths in hospitals was 65 percent higher than the state count that didn’t.

Early on in the pandemic, a law enacted by Cuomo forced nursing homes to take back COVID-positive patients despite the health risk it posed to other residents. As a result, New York hospitals released more than 6,300 coronavirus patients to nursing homes, according to a state Health Department report. The goal was to free up hospital space.

Cuomo’s administration has taken intense criticism for the policy, and reversed it on May 10. The virus had already spread to more than 20,000 nursing home staffers, many of whom kept going to work and were unaware they had the virus.

Source: Cuomo shrugs off concerns over coronavirus nursing home death undercounting


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20 Aug 2020, 7:21 pm

AEROSOL TRANSMISSION OF THE CORONAVIRUS

Another research study supports aerosol transmission of the coronavirus. This one used guinea pigs.

Sending influenza virus-containing droplets into the air through coughing and sneezing may not be the only way to spread respiratory diseases, according to a new study involving guinea pigs.

Some viruses like influenza may also spread by attaching to dust particles, according to a new study published in Nature Communications.

The study suggests that dust particles and small fibers on contaminated surfaces can be kicked up into the air and create aerosolized fomites, germ-laden particles, which may spread certain respiratory viruses like influenza, according to new research from the University of California, Davis and the Icahn School of Medicine at Mt. Sinai. The findings discussed viruses like influenza but have obvious implications for coronavirus transmission, according to multiple reports.

“Surprisingly, we find that an uninfected, virus-immune guinea pig whose body is contaminated with influenza virus can transmit the virus through the air to a susceptible partner in a separate cage," lead author, Professor William Ristenpart of the UC Davis Department of Chemical Engineering, stated in the study.

Ristenpart stated in a report in Science Daily that "It's really shocking to most virologists and epidemiologists that airborne dust, rather than expiratory droplets, can carry influenza virus capable of infecting animals."

The professor also said in the report, "The implicit assumption is always that airborne transmission occurs because of respiratory droplets emitted by coughing, sneezing, or talking. Transmission via dust opens up whole new areas of investigation and has profound implications for how we interpret laboratory experiments as well as epidemiological investigations of outbreaks."

In the guinea pig study, the researchers investigated if tiny, non-respiratory particles or aerosolized fomites, could carry influenza virus between guinea pigs.

Using an automated machine to count airborne particles the researchers found uninfected guinea pigs moving around a cage can release spikes up to 1,000 particles per second, according to the report. The team of scientists also found guinea pigs immune to influenza with the virus painted on their fur transmitted the virus through the air to vulnerable guinea pigs. That revealed that the virus did not have to be expelled from the respiratory tract to be infectious, the report stated.

“We further demonstrate that aerosolized fomites can be generated from inanimate objects, such as by manually rubbing a paper tissue contaminated with influenza virus,” the researchers stated in another report.

Overall, the researchers stated that the data suggests aerosolized fomites may contribute to transmission of viruses like influenza in animal models, which could have important but understudied implications for public health in humans.

Source: Influenza virus spread by guinea pigs through dust particles, study shows


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22 Aug 2020, 8:43 am

The Complicated Ethics of Keeping a COVID-19 Patient Breathing

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At the height of the coronavirus pandemic in New York City, Dr. Brian Mitzman led the team at N.Y.U. Winthrop hospital, in Long Island, that oversees tracheostomies, meaning that it was his job to decide how to keep the sickest ventilated covid-19 patients breathing. All patients on a ventilator initially have air delivered to them via an endotracheal tube, which is inserted through the mouth and into the windpipe. The procedure usually requires patients to be unconscious—often, for two or three weeks. Many of these patients do not survive. For those that do, at around the three-week point, the protocol is to perform a tracheostomy. A trach, in medical argot, is a tube surgically inserted through the throat. Trachs allow most patients to wake up. Over time, this is better for the body, so much so that Mitzman and his colleagues at N.Y.U. believe that “traching” some of the hospital’s covid-19 patients as early as possible—up to sixteen days earlier than advised—has saved lives. Under normal conditions, a tracheostomy is a straightforward and uncontroversial procedure. During the pandemic, the question of whom to trach, and when, has presented doctors with one of their most difficult rationing decisions—how best to ration themselves.

The idea of traching covid-19 patients early is contentious. (During the sars outbreak, in 2003, doctors and nurses who performed tracheostomies increased their chances of infection by a factor of four.) The typical tracheostomy is a super-spreading event. While a patient is on a ventilator, a surgeon cuts a hole in the throat. As a result, air from the lungs sprays blood, mucus, and saliva through the incision, aerosolizing the virus. In late March, researchers in Israel conducted a simulation of a similar procedure, using fluorescent markers to represent viral droplets. The doctors and nurses who participated wore the personal protective equipment recommended by the Centers for Disease Control and Prevention and the World Health Organization: N95 respirators, eye protection, gowns, and gloves. Yet, after the procedure, when illuminated under a black light, their hair glowed with constellations of fluorescent particles. Their shoes lit up. Almost all of the participants, even those who wore face shields, exhibited direct skin contact—usually right below their jawlines.

n April, Mitzman’s hospital received two covid-19 patients with remarkably similar profiles, as though they were medical twins. Both were otherwise healthy men in their fifties, fathers from the local community. Both were put immediately on a ventilator, and, soon, an ecmo machine, an external device that mechanically pumps oxygen into the blood. “Their prognosis was very bad,” Mitzman said. “These were probably two of the sickest patients in the hospital, at certain points. When you have this disease, and you require a ventilator and ecmo, your chance at survival is likely less than ten per cent.” He faced a choice: traching the men early might help, but it would put those who were treating them at higher risk, which could then lead to its own cascading spread of the virus. “Would these trachs really be helping the patients? It seemed like it would,” Mitzman said. “Would the doctors really be safe? We didn’t know.” What was worth risking for two patients who were unlikely to survive, anyway?

Doctors risk their lives when performing many covid-19 interventions; they increase their risk of exposure by merely showing up at the hospital. Endotracheal intubations, for example, are also super-spreading events, but by the time a patient needs one the choice is clear: do it or let the patient die. The benefits of early tracheostomy, on the other hand, are more ambiguous. At the start of the pandemic, the American Academy of Otolaryngology—Head and Neck Surgery, a major professional group in the field, recommended waiting at least two to three weeks before inserting a trach. Patients tend to be less contagious at this point. It also eliminates useless exposures; after three weeks, the patients who are going to die will probably already be dead. In the spring, Robert Cerfolio, the chief of hospital operations for N.Y.U. Langone Health, was making surgical rounds when he encountered a patient whose mouth-inserted breathing tube was plugging with thick secretions, a common but life-threatening complication for intubated covid-19 patients. He asked the nurses and respiratory therapists why they hadn’t intervened. They told him that they were not allowed to; the patient could still be shedding the virus, and the procedure could spread it. Cerfolio made a decision: disregard the guidelines. He wanted his staff to behave as they would for any other, non-contagious patient.

Recently, Cerfolio told me that the situation reminded him of the aids epidemic, when some surgeons refused to operate on patients who were H.I.V.-positive. “Twenty years later, not many people got aids from operating on them, not unless you’re a real idiot,” he said. (Unlike covid-19, however, H.I.V. is not transmitted through the air.) Cerfolio was sitting in his office in Kips Bay, where a flat-screen showed live feeds of nine different operating rooms. The day he changed the hospital’s policy, he said, colleagues at other institutions called to accuse him of malpractice. Some of his own doctors refused to participate. They saw it as reckless. “We get paid a hell of a lot more money than firemen and policemen—a hell of a lot more with a couple of zeros after it—and part of that’s the responsibility of being a professional,” Cerfolio said. “So I draw the line that, if it can help the patient, it’s incumbent on us to do it.”

When I spoke with Cerfolio, Mitzman joined us, and Cerfolio, who is fifty-eight, asked Mitzman if he was a millennial. “Technically,” Mitzman said, shaking his head. “Unfortunately.” (He was born in 1985.)

“That’s O.K.,” Cerfolio said. “I love the millennials!” But he worries that doctors of that generation place too much of an emphasis on risk avoidance. “They draw the line in a very different place than I do,” he said.

Mitzman admitted that he needed to overcome his fear, both of the virus and of being needlessly reckless; he didn’t want to put his team at risk for nothing. He told Cerfolio that he had developed his own risk-assessment tool: if the patient was his own father, what would he do? The test naturally favored one course of action. It meant that, for the twin patients at his hospital, he proceeded with the trachs.

I first spoke to Mitzman this past spring, at the peak of the pandemic in New York. He has two children under the age of four, who were staying, along with his wife, at their grandparents’ house, in order to not expose themselves to him. His hours were long, and he and his colleagues were emotionally drained in ways that they’d never experienced. They were also scared. “We’re not volunteers,” he said. “People are doing this because it’s their job and they have to, and it is terrifying.”

In New York, the crisis in the intensive-care wards has subsided. Mitzman, who is a cancer surgeon in non-plague times, recently left for a new job at the University of Utah. But as New York prepares for future waves of the coronavirus, and as hospitals in California and Florida and across the Southwest have plunged fully into their own crises, doctors are reëvaluating the techniques that they have used to fight the virus thus far. One of the most fundamental questions—how to keep a patient breathing—has prompted a reassessment of the early tracheostomy. The emerging consensus is earlier intervention. “What we were told is basically the opposite of what we do now,” Benjamin Braslow, a chief of emergency surgery in the University of Pennsylvania Health System, told me.

Susannah Hills, an airway surgeon, is part of a tracheostomy team at Columbia University Irving Medical Center. The team, when it formed at the start of the pandemic, decided to avoid early trachs. As the coronavirus made its way to the United States, Hills studied data from early surges around the world. One report, out of a hospital in China, said that fourteen medical professionals who had provided care to a covid-19-positive patient undergoing sinus surgery had become infected, although it is not known whether they contracted the virus during the procedure. An ear-nose-and-throat surgeon in Italy gave a lecture about the alarming rates of covid-19 among the country’s doctors—and of resulting deaths. Nobody had great data, but the anecdotal reports that Hills’s team read indicated that a surgeon who did enough tracheostomies would almost certainly catch the virus. And one of the first papers out of Wuhan, based on a small group of patients, indicated that ninety-seven per cent of ventilated patients were dying, anyway. Hills’s team has conducted almost two hundred tracheostomies, but usually after at least two weeks. “We have to take care of the patients, and they are our priority, but you also have to be around to take care of the patients that keep coming,” Hills said. “We had no idea when this was going to stop.”

Hospitals around the world have been forced into wrenching decisions. Tom Routledge, a surgeon at Guy’s and St. Thomas’ Hospitals in London, told me that, in May, some surgical teams there decided to put off most procedures that could aerosolize the virus. Still, he said, “the risk to colleagues has been brutally and tragically borne out.” To protect staff members with comorbidities, the hospitals made another uncomfortable choice. “When a high-risk procedure needs to be done,” he said, “we try to put together a scratch team that is relatively safe—younger, whiter, fitter, and, best of all, nurses or doctors who have had the virus and who we hope have some sort of immunity.” Routledge himself tested positive for the virus in April; he is now regularly on call to replace more vulnerable colleagues.

In the U.S., at the start of the pandemic, decisions to perform early tracheostomies were affected by material shortages. (Hills told me that an initial lack of P.P.E. contributed to her team’s concerns about performing the procedure early on.) But tracheostomies have also been shown to reduce the amount of time that a patient needs to spend on a ventilator, freeing up scarce resources. “We had shortages of ventilators. We had shortages of medicines to put them to sleep,” Cerfolio recalled. “We didn’t run out of anything at N.Y.U., but we were friggin’ close a couple of times.”

Doctors were also operating in a type of fog. Reliable data was scarce. The first papers on health-care-provider safety have only recently begun to appear in medical journals. Mark Neuman, a doctor and researcher at the University of Pennsylvania, said that early reports have been encouraging. He is one of the leaders of intubatecovid, a worldwide data project that tracks intubations during the pandemic, and he is interested in how much of a risk such procedures pose to health-care providers. The project has found that P.P.E., in particular, has greatly reduced infections. “There’s no question this is extremely high-risk,” Neuman said. “But, with P.P.E., the early signals show that the actual risk may not be much more elevated above the usual population.” He also concluded that patient safety and doctor safety “is not a zero-sum game.” Doctors were finding techniques for treating covid-19 patients that were safer and just as effective.

One of these doctors is Luis Angel, N.Y.U. Langone’s director of lung transplantation, who has performed more than a thousand tracheostomies in his career. Last winter, he encountered a problem when inserting a trach tube into a patient’s windpipe. On the fly, Angel developed a new procedure, which involved pausing ventilation and creating a new route into the windpipe. When the pandemic hit, he realized that the new method could prevent most aerosolization.

When Mitzman’s twin patients were trached, his team used Angel’s technique. (The team has now performed more than two hundred tracheostomies using the method, and no health-care workers are known to have been infected during them. N.Y.U. has taught and advised dozens of hospitals worldwide on the technique.) The twin patients had a similar progression: they’d entered together and then began improving at the same time. Because intubated patients remain unconscious, the body experiences severe atrophy; for survivors, recovery is arduous and can take months. In the case of Mitzman’s patients, once they were trached, they could begin moving.

Within two weeks of the procedures, Mitzman’s team huddled to discuss whether it was time to take out their tubes. Decannulation, as doctors call it, is a milestone: patients taking their first breaths completely on their own, after weeks or months on ventilation. Timing is important. “Let’s take them out and give these guys a chance,” one of the senior surgeons said, and no one dissented. The procedure itself is easy; the teams performed them back to back. In less than ten minutes, the tubes were out and both patients were breathing normally.

Patients often cannot talk with a trach tube in their throats; after its removal Mitzman’s first task is to make sure that their vocal cords haven’t been damaged. He asks them to speak. Hearing from a patient for the first time can be surprising. Some patients, after so much time, are voluble, using their first words to demand ice cream or grabbing their phones to video-call their families. Mitzman’s two patients, twins to the end, were stoic. Minutes after the first procedure, Mitzman stood by the first patient, and asked him to try some words.

“Hello,” the man said.

Mitzman told him how wonderful it was to hear his voice. (“It was something that I really personally needed,” Mitzman later said.) The man, who, like the second patient, was soon released from the hospital, reached for his hand and thanked him. Mitzman was slightly embarrassed to tell me that it made him cry.


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jimmy m
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23 Aug 2020, 10:59 am

Coronavirus Transmission as a Function of Humidity

The airborne transmission of the coronavirus SARS-CoV-2 via aerosol particles in indoor environment seems to be strongly influenced by relative humidity. This is the conclusion drawn by researchers from the Leibniz Institute for Tropospheric Research (TROPOS) in Leipzig and the CSIR National Physical Laboratory in New Delhi from the analysis of 10 most relevant international studies on the subject. Therefore, they recommend controlling the indoor air in addition to the usual measures such as social distancing and masks. A relative humidity of 40 to 60 percent could reduce the spread of the viruses and their absorption through the nasal mucous membrane. To contain the COVID-19 pandemic, it is therefore extremely important to implement standards for indoor air humidity in rooms with many people, such as hospitals, open-plan offices or public transport, writes the research team in the scientific journal Aerosol and Air Quality Research.

According to the WHO, the coronavirus SARS-CoV-2 has led to at least 21 million infected persons and over 750,000 deaths worldwide in over half a year. The health and economic effects of the pandemic pose major social challenges for practically all countries. Worldwide, therefore, ways are being sought to stem the spread of the virus in order to avoid drastic measures such as lockdowns and contact restrictions. For a long time, the main transmission route of viral droplets was considered to be direct human-to-human contact, because of infected people sneezing or coughing and secreting the virus. Because these drops are relatively large and heavy, they fall very quickly to the ground and can only cover very short distances in the air. The recommendation to keep a minimum distance of 1.5m to 2m (social distancing) is based on this assumption.

Recently, however, COVID-19 outbreaks have also been recorded, which seem to be due to the simultaneous presence of many people in one room (choir rehearsals, slaughterhouses, etc.). A safety distance of 1.5m is apparently not sufficient when infected and healthy people are together in one room for a long time. For example, Dutch researchers have now been able to prove that tiny drops of 5 micrometers in diameter, such as those produced when speaking, can float in the air for up to 9 minutes. In July, 239 scientists from 32 countries—including the chemist Prof. Hartmut Herrmann from TROPOS—therefore appealed to the World Health Organization (WHO) to focus more closely on the long-lived infectious particles suspended in the air. In order to contain the spread via the aerosol particles floating in the air, the researchers recommend not only continuing to wear masks but also, and above all, good indoor ventilation.

An Indo-German research team is now pointing out another aspect that has received little attention so far and could become particularly important in the next flu season: Indoor humidity. Physicists at the Leibniz Institute for Tropospheric Research (TROPOS) in Leipzig and the CSIR National Physical Laboratory in New Delhi have been studying the physical properties of aerosol particles for years in order to better estimate their effects on air quality or cloud formation. "In aerosol research, it has long been known that air humidity plays a major role: The more humid the air is, the more water adheres to the particles and so they can grow faster. So, we were curious: what studies have already been conducted on this," explains Dr. Ajit Ahlawat from TROPOS.

Therefore, they evaluated a total of 10 most relevant international studies between 2007 and 2020 by other researchers who investigated the influence of humidity on survival, spread and infection with the pathogens of influenza and the corona viruses SARS-CoV-1, MERS and SARS-CoV-2. Result: Air humidity influences the spread of corona viruses indoors in three different ways: (a) the behavior of microorganisms within the virus droplets, (b) the survival or inactivation of the virus on the surfaces, and (c) the role of dry indoor air in the airborne transmission of viruses.

Although low humidity causes the droplets containing viruses to dry out more quickly, the survivability of the viruses still seems to remain high. The team concludes that other processes are more important for infection: "If the relative humidity of indoor air is below 40 percent, the particles emitted by infected people absorb less water, remain lighter, fly further through the room and are more likely to be inhaled by healthy people. In addition, dry air also makes the mucous membranes in our noses dry and more permeable to viruses," summarizes Dr. Ajit Ahlawat.

The new findings are particularly important for the upcoming winter season in the northern hemisphere, when millions of people will be staying in heated rooms. "Heating the fresh air also ensures that it dries. In cold and temperate climate zones, therefore, the indoor climate is usually very dry during the heating season. This could encourage the spread of corona viruses," warns Prof. Alfred Wiedensohler of TROPOS. The air humidity determines how much water a particle can bind. At higher air humidity, the surface of the particles changes considerably: a kind of water bubble forms—a miniature ecosystem with chemical reactions. The liquid water content of aerosols plays an important role in many processes in the atmosphere, as it influences the optical properties, leading for example to haze or altered effects of aerosols on the climate.

At a higher humidity, the droplets grow faster, fall to the ground earlier and can be inhaled less by healthy people. "A humidity level of at least 40 percent in public buildings and local transport would therefore not only reduce the effects of COVID-19, but also of other viral diseases such as seasonal flu. Authorities should include the humidity factor in future indoor guidelines," demands Dr. Sumit Kumar Mishra of CSIR—National Physical Laboratory in New Delhi. For countries in cool climates, the researchers recommend a minimum indoor humidity. Countries in tropical and hot climates, on the other hand, should take care that indoor rooms are not extremely undercooled by air conditioning systems. When air is extremely cooled, it dries out the air and the particles in it, making people inside the room feel comfortable. But the dry particles will remain in the air for longer duration.

Source: Coronavirus SARS-CoV-2 spreads more indoors at low humidity

So in preparation for the upcoming winter season, I purchased a small humidifier for my home.

I wonder if humidifiers will become the next item to disappear off the shelves due to the pandemic. In the news recently one of the items that became hard to find currently is laptops. The kids are returning back to school and many are doing distant learning. You can do distant learning without a laptop. So an instant shortage.


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24 Aug 2020, 12:47 pm

Coronavirus in Foods

A puzzling new cluster of coronavirus cases recently resurfaced in New Zealand, for instance, after more than 100 days free of local transmission. Several members of a household in Auckland tested positive earlier in August, though the source of the infections has since stumped officials. There was no history of overseas travel among the infected cluster, leaders had said. Some of those infected work at an Auckland refrigerated food facility, leading to speculation the virus could have survived from abroad on chilled or frozen food.

On Monday, New Zealand officials reported nine new cases of COVID-19, including one probable case, all of which were linked to the Auckland cluster. There are 123 active infections, and 151 people linked to the cluster have been moved into an Auckland quarantine facility, including 82 people who tested positive and their household contacts, officials wrote.

“To date, despite comprehensive testing at the border, comprehensive work within our isolation facilities, we have as yet not been able to find what occurred here. We continue to look,” Jacinda Ardern, New Zealand prime minister, said at a press conference on Monday.

Researchers from Singapore and Ireland published a study in bioRxiv last week, exploring the possibility of infectious virus lingering on imported foods as a plausible reason for the virus resurgence in Vietnam, New Zealand and parts of China. The study was not certified by peer review.

The team added SARS-CoV-2 to sliced cubes of salmon, chicken, and pork sourced from supermarkets in Singapore and stored the samples at three different temperatures (4˚C, –20˚C and –80˚C) and harvested at specified time points (1, 2, 5, 7, 14 and 21 days post-inoculation), study authors wrote.

Image

They found that the food was still contaminated with the virus three weeks later in both the refrigerated (4°C) and frozen (–20°C and –80°C) samples.

"When adding SARS-CoV-2 to chicken, salmon, and pork pieces there was no decline in infectious virus after 21 days at 4°C (standard refrigeration) and –20°C (standard freezing)," they wrote.

“We do know from studies overseas that actually, the virus can survive in some refrigerated environments for quite some time,” Ashley Bloomfield, New Zealand director-general of health, said in mid-August, per the Associated Press.

However, the World Health Organization (WHO) officials have previously said there’s no need to fear the possibility of contracting the virus from food or food packaging.

“People should not fear food, or food packaging or processing or delivery of food,” Mike Ryan, the executive director of the WHO Health Emergencies Programme, said this month, according to Reuters.

The researchers from Singapore and Ireland argued that though the risk of transmission is minimal, its potential to spur an outbreak still exists.

“While it can be confidently argued that transmission via contaminated food is not a major infection route, the potential for movement of contaminated items to a region with no COVID-19 and initiate an outbreak is an important hypothesis," they wrote.

“It is necessary to understand the risk of an item becoming contaminated and remaining so at the time of export, and of the virus surviving the transport and storage conditions,” they added.

Working conditions at meat processing plants have been attributed to virus transmission due to prolonged close contact between workers, poor ventilation, crowding, and shouting, as the researchers also noted. Operations were temporarily paused across meat processing facilities amid the pandemic in the U.S. as workers became infected.

Study authors hypothesized that "with a significant burden of virus present in infected workers and the environment, then contamination of meat with SARS-CoV-2 is possible during butchering and processing.”

Virus-infected chicken wings made headlines less than two weeks ago when a batch of frozen chicken wings exported from Brazil to China was positive for coronavirus. Several days prior, Chinese officials in the city of Yantai announced the virus was found on the packaging of frozen seafood shipped from Ecuador.

Officials sealed off the goods and those who handled the seafood were under quarantine and tested negative, the government said.

The researchers from Singapore and Ireland said their lab work shows the virus can endure the time and temperatures associated with transportation and storage conditions for international food trade.

“We believe it is possible that contaminated imported food can transfer virus to workers as well as the environment. An infected food handler has the potential to become an index case of a new outbreak,” study authors wrote.

As for the virus outbreak in New Zealand, some of the infections were reported among workers at the Auckland Americold facility, and surface testing was reportedly underway last week.

“Our findings, coupled with the reports from China of SARS-CoV-2 being detected on imported frozen chicken and frozen shrimp packaging material, should alert food safety competent authorities and the food industry of a 'new normal' environment where this virus is posing a non-traditional food safety risk,” study authors wrote.

Source: Live coronavirus found on meat, seafood weeks later, researchers say


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24 Aug 2020, 1:59 pm

Fry all the foods in hot oil and turn off the AC.


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24 Aug 2020, 3:29 pm

Well, if they can stop everyone living their lives because of this COVID then maybe they can stop everyone from eating too, see if that saves lives.


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25 Aug 2020, 5:06 pm

The Importance of Wearing Facemark

One of the common lines used by the World Health Organizations is that face mask prevent YOU from contaminating others. This is wrong. The primary reason why a person should wear a facemark is to protect yourself.

There was an article today that highlighted the importance of wearing facemask.


South Korea has since experienced a surge in virus cases, specifically in Seoul, the country’s capital, where officials for the first time on Monday mandated masks to be worn indoors and outdoors, Reuters reported.

An outbreak of the novel coronavirus at a Starbucks cafe in Paju, South Korea, infected dozens of customers — but at least four of the location’s employees were spared, with health officials crediting face masks as the reason.

Authorities say that the outbreak took place on Aug. 8 in the city of Paju, about 25 miles north of Seoul. Local reports identify the infected person as a woman in her 30s, who stayed for about two hours on the second floor of the cafe.

Image

Health officials said the outbreak originated from a person infected with the virus who sat in the cafe earlier this month next to the air-conditioning system, which dispersed contagious aerosol particles throughout the space, Arirang News reported.

"Many of the visitors didn't wear masks, and there seems to be no proper air ventilation at the store even though air conditioners were in operation due to humid weather," Jeong Eun-kyeong, the chief of the Korea Centers for Disease Control and Prevention, said of the outbreak, according to the Yonhap News Agency.

At least 56 coronavirus cases have been linked to this Starbucks outbreak in Paju, South Korea.

But four of the cafe’s employees — all of whom wore face masks during their shift — were spared. Officials said the patrons were likely more susceptible because they removed their masks to eat and drink, Gang Young-do, a spokesperson for the Paju government, told Bloomberg.

Sources:
Mask-wearing employees at Starbucks in South Korea avoid coronavirus infection following outbreak
56 coronavirus cases were linked to a Starbucks in South Korea. But employees who were wearing masks didn't get infected.
Dozens infected with coronavirus in S. Korea Starbucks but 4 masked employees tested negative

Mask can protect YOU from breathing in aerosolized particles of coronavirus, which is one of the main transmission routes for infection, especially in dry environments. In indoor environments with heater/air conditioning downdrafts. But there are various mask designs and some masks are more efficient than others. N95 mask provide some of the best protection.


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25 Aug 2020, 5:54 pm

College campuses face explosion of COVID-19 cases — and challenges to get students to follow safety protocols

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The exploding number of new COVID-19 cases on campuses across the country has left many colleges and universities grappling with the same vexing question: How do you get students to cooperate with new safety measures?

While many students appear to be following social distancing guidelines, all too many are breaking the rules and putting their classmates at greater risk.

The University of Alabama reported more than 550 people — the majority of them students — tested positive for the coronavirus since classes began one week ago.

Montclair State University in New Jersey, this week barred 11 students from student housing for two weeks after they were caught partying in the residence halls and at an off-campus bash.

“The vast majority of students are following the rules,” said Andrew Mees, a spokesman for the university. “We are disappointed that a small number chose to disregard these rules and by so doing, to create risk for our campus community.”

Other major universities like Notre Dame, the University of Connecticut, and the University of North Carolina-Chapel Hill have all faced outbreaks.

Fraternities and sororities have been identified as the hottest of hot spots, with dozens of students catching the bug and school officials scrambling to shut down their houses and quarantine those infected to keep it from spreading further.

Brian Higgins, an expert on crowd management security at the John Jay College of Criminal Justice in New York City, said the problem for universities is two-fold: The students don’t take the COVID-19 threat seriously and the enforcement measures universities are taking don’t have much bite.

“What they’re doing now is clearly not working,” said Higgins, who previously was chief of police in Bergen County, New Jersey. “In addition to stricter guidelines, I think they need tougher penalties to get the students’ attention. Like, give them a ticket for violating the rules and if they don’t pay they don’t get their grades or they can’t matriculate.”

College students, like the rest of the country, have been feeding on conflicting reports about the severity of the pandemic, Higgins added.

“The problem is college kids don’t take it seriously, they don’t think they’ll get it and if they do it won’t be so bad,” Higgins said.

The pandemic has added to the “incredible amount of complexity that college students have to manage, especially undergraduates living on their own, away from family for the first time,” said Northwestern University psychologist and family therapist Alexandra Solomon.

In many young people, the impulse-control part of the brain isn’t fully developed until around age 25, making students far more susceptible to “risky behavior” and peer pressure, Solomon said.

Additionally, Solomon said, many of the students enter college with “no first-hand experience with people being sick and dying."

“So to them all of this is very abstract,” she said.

To get students to cooperate and follow the safety protocols, universities need to come up with “a blend of carrots and sticks,” Solomon said.

“Yes, there need to be consequences,” Solomon said, but colleges also need to get students to understand that their behavior can affect the health of their friends.

To stem the coronavirus tide, many of the 5,000 or so colleges and universities in the U.S. are limiting the number of students allowed in dorms and classrooms, requiring testing or proof of a recent test for all arriving students, insisting on mask-wearing in all public areas, and canceling social activities where the virus is more likely to spread.

“Two-year colleges, for instance, are much more likely than four-year colleges to be planning an online fall,” the Chronicle of Higher Education reported.

Some schools are also insisting the students sign codes of conduct. But those are just words on a page to many students who have been getting around the restrictions by partying off-campus and at local watering holes, according to numerous published reports.

The situation is so dire in Tuscaloosa, Alabama, home of the University of Alabama, that the city’s mayor shut down bars and bar service in restaurants for two weeks.

“The truth is, fall in Tuscaloosa is in serious jeopardy,” Mayor Walt Maddox said this week.

Texas A&M University on Tuesday reported on its dashboard that 407 students have tested positive for COVID-19 since August 2.

Then there is the problem of who enforces the rules. Campus police can only do so much, so as The New York Times reported, “day-to-day policing is often falling to teaching assistants and residential advisers who have mixed feelings about confronting scofflaw undergraduates.”

The newspaper highlighted the plight of Jason Chang, a 24-year-old doctoral student at Cornell University, who oversees the undergrads in the dorm where he lives and caught a student who was supposed to be in quarantine sneaking out of her room three times.

“Constant insanity and madness,” Chang told the newspaper.

There was no focus on the spreading COVID-19 campus crisis when the virtual Republican National Convention kicked off Monday, but there was plenty of praise for President Donald Trump’s handling of a pandemic that has, as of Tuesday morning, killed more than 178,000 people in the U.S., the most in the world, according to the latest NBC News tally.


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25 Aug 2020, 6:39 pm

For 10 days so far my mom has been in strict quarantine (and will maintain it for 23 days as per Spains findings earlier that it can take 23 days fr symptoms to show up not 14)

but today she told me (as Nurse M suspected abd had asked me to ask my mom.and tell her what she said)..
That they didnt check her temperature anywhere in airport the agent was very relaxed and mild (she quoted him).. She was to download an App which she did..
She thought at the very least thé app would hqve u sign in daily to acknowledge u were still maintaining a quarantine..

She said nope the App turned out to just hace a list of guidelines that the govts website already had ..
Basically I read that quarantine will soon no longer be in effect for new arrivals/travellers..

And my mom told me her friend's daughter is in Australia under much stricter quarantine.. N she said it is way tooo relaxed and trusting here..
Because anyone can lie or just not follow it..


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27 Aug 2020, 5:16 pm

... just some shameless patriotic promotion of my home country of Denmark 8) :

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Source: https://www.pewresearch.org/global/2020 ... economies/



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27 Aug 2020, 8:27 pm

AEROSOL TRANSMISSION OF THE CORONAVIRUS

Many months into the COVID-19 pandemic, the coronavirus is still spreading uncontrolled through the U.S. Public health authorities including the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) tell us to remain six feet apart, wash our hands, disinfect frequently touched surfaces, and wear masks. But compliance with these measures—especially masks—is mixed, and daily we hear of cases where people do not know how they were infected. We hear about superspreading events, where one person infects many, happening in crowded bars and family gatherings, but not at outdoor demonstrations. Beaches in cities like Chicago are closed, but gyms and indoor dining at restaurants have reopened. It is no wonder the public is confused.

It is critical to have a clear physical description of the ways in which COVID-19 is transmitted, so that individuals and institutions are able to visualize it and will understand how to protect themselves. Contrary to public health messaging, I, together with many other scientists, believe that a substantial share of COVID-19 cases are the result of transmission through aerosols. The evidence in favor of aerosols is stronger than that for any other pathway, and officials need to be more aggressive in expressing this reality if we want to get the pandemic under control.

There are three possible ways the virus is transmitted, of which two have been emphasized by the WHO and the CDC. The first is through “fomites,” objects that are contaminated with the virus (which could include someone else’s skin). Early in the pandemic, concern over fomite transmission drove some people to bleach groceries and packages. The CDC now says fomites are a possible means of transmission, but likely not one that is major. For example, an intensive handwashing program in the UK led to only a 16% reduction in transmission. Significantly, other viruses that, like SARS-CoV-2 (the one that causes COVID-19), have a lipid envelope, do not survive long on human hands. That means someone would need to touch their eyes, nostrils, or mouth a short time after touching a contaminated surface in order to contract the novel coronavirus.

The second possibility for how COVID-19 spreads is through droplets, small bits of saliva or respiratory fluid that infected individuals expel when they cough, sneeze, or talk. Droplets—which the WHO and CDC maintain is the primary means of transmission of COVID-19—are propelled through the air, but fall to the ground after traveling 3-6 feet. However, published research, which has been replicated, shows that droplets are only important when coughing and sneezing. But when it comes to talking in close proximity, which appears to play a major role in COVID-19 transmission, droplets are less important than the third potential pathway: aerosols. Many diseases, including COVID-19, infect most effectively at close proximity. Since droplets are visible and fall to the ground between 3-6 feet, we can readily see and understand this route of infection. In fact, it was thought for decades that tuberculosis was transmitted by droplets and fomites, based on ease of infection at close proximity, but research eventually proved that tuberculosis can only be transmitted through aerosols. I believe that we have been making a similar mistake for COVID-19.

“Aerosol” (sometimes referred to as “airborne”) transmission is similar to droplet transmission, except that the bits of fluid are so small that they can linger in the air for minutes to hours. To understand the scale of aerosols, the diameter of a human hair is about 80 microns, and aerosols smaller than about 50 microns can float in the air long enough to be inhaled. SARS-CoV-2 is only 0.1 microns in diameter, so there is room for plenty of viruses in aerosols.

Fomites and droplets have dominated our everyday understanding of COVID-19 transmission. While the WHO and CDC both state that aerosols could lead to transmission under highly specific situations, both organizations maintain that they are less important. I believe this is a significant mistake and on July 6 I, along with 239 scientists, appealed to the WHO to reevaluate their stance. WHO updated its position in response, but the agency’s language continues to express skepticism of the importance of this pathway.

When it comes to COVID-19, the evidence overwhelmingly supports aerosol transmission, and there are no strong arguments against it. For example, contact tracing has found that much COVID-19 transmission occurs in close proximity, but that many people who share the same home with an infected person do not get the disease. To understand why, it is useful to use cigarette or vaping smoke (which is also an aerosol) as an analog. Imagine sharing a home with a smoker: if you stood close to the smoker while talking, you would inhale a great deal of smoke. Replace the smoke with virus-containing aerosols, which behave very similarly, and the impact is similar: the closer you are to someone releasing virus-carrying aerosols, the more likely you are to breathe in larger amounts of virus. We know from detailed, rigorous studies that when individuals talk in close proximity, aerosols dominate transmission and droplets are nearly negligible.

Source: COVID-19 Is Transmitted Through Aerosols. We Have Enough Evidence, Now It Is Time to Act


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28 Aug 2020, 1:32 pm

87 coronavirus cases now linked to indoor wedding reception in Maine

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An indoor wedding and reception in Maine earlier this month has now been linked to at least 87 coronavirus cases. The Maine Centers for Disease Control and Prevention (Maine CDC) said the wedding has led to COVID-19 outbreaks at both a jail and a nursing home.

Dr. Nirav Shah, the director of the Maine CDC, said during a news conference Thursday that 59 of the 87 confirmed positive cases — about 85% — experienced symptoms of coronavirus. Thirty of the cases are primary, meaning people who attended the wedding, 35 are secondary, or people who had close contact with attendees and 22 are tertiary, people who had close contact with a secondary case.

The wedding is also responsible for one death last week from the virus.

The August 7 wedding and reception at Big Moose Inn in Millinocket has been connected to a virus outbreak at the York County Jail in Alfred. Shah said that a staff member at the jail attended the wedding, leading to 18 total positive cases — 7 inmates, 9 jail staff and 2 other York County government employees who work in the same building.

Shah said the jail was fully cleaned between Wednesday and Thursday of this week.

The wedding also led to an outbreak at the Maplecrest Rehabilitation Center in Madison, where nine people have now tested positive, including five residents and four staff members. An attendee of the wedding infected their parent, who then infected another one of their children, who works at the center and infected eight other people — all in the span of three weeks.

According to CBS affiliate WGME, the Big Moose Inn failed to take proper safety precautions.

Sixty-five people attended the wedding, exceeding the state's 50-person gathering limit. The state Health Inspection Program received complaints that guests were not wearing masks during the crowded event, where tables were not spaced 6 feet apart.

However, Maine CDC reported that guests had their temperatures taken and out-of-state visitors provided negative COVID-19 tests ahead of the event.

The inn failed to collect proper contact tracing information from attendees, WGME reports. State officials said they suspended the inn's license earlier this week after it failed to address problems and update safety precautions.


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29 Aug 2020, 12:29 pm

Aerosol Transmission of the Coronavirus

The British Medical Journal (BMJ) just published an article titled: Airborne transmission of COVID-19

In July, 239 scientists signed an open letter “appealing to the medical community and relevant national and international bodies to recognise the potential for airborne spread of COVID-19.” Although the World Health Organization conceded that “airborne transmission cannot be ruled out,” the response was reserved and arguably mistaken in continuing to suggest that airborne and droplet transmission are discrete categories and that airborne transmission occurs only during medical “aerosol generating procedures.”

WHO defines droplets as ≥ 5-10 μm diameter and aerosols as <5 μm. However, both can be generated as a continuum of particle sizes during numerous respiratory activities and their behaviours are not distinct. This has important practical implications for infection control, the prevention of outbreaks and superspreading events, and for the new social behaviours that are being implemented in an effort to control the pandemic.

Aerosols are generated when the surface tension of fluid lining the respiratory tract is overcome by force. The required forces can be created by rapid shearing air flows, vocal cord movement, and the open and closing of terminal airways—all of which are influenced by the type and force of respiratory activity. Heavy breathing, coughing, talking, and singing all generate aerosols, causing an exhalation plume of respiratory particles of varying sizes, containing potentially infective viral material. The high viral loads present in the pharynx early in the course of COVID-19 make these aerosols a plausible cause of both pre-symptomatic and asymptomatic transmission, which is so effective in fuelling outbreaks and yet difficult to control.

The arbitrary 5-10 µm threshold commonly used to dichotomise airborne and droplet transmission has never been supported theoretically or experimentally. Studies in both humans and airflow models show that particles as large as 50 µm can remain suspended and travel considerable distances. Furthermore, airborne range is influenced by the force and volume of exhalation as well as the local humidity, temperature, and airflow.

It is wrong to assume that droplets land only on exposed mucosal surfaces such as the eyes and mouth. Particles up to 50 µm can be captured by inspiratory airflows and are deposited along the much more extensive surface area of the respiratory tract; particles below 10 µm can penetrate as far as alveoli. The site of deposition may determine the viral dose required and severity of respiratory infection, as observed in influenza.

Inhalational risk may be reduced by social distancing, limiting interaction indoors, avoiding air recirculation, improved natural and artificial ventilation, and innovative engineering solutions which collect and neutralise aerosols to provide clean air in personal and community spaces. The infection risk associated with deep breathing, talking, and singing indoors is underappreciated and urgently needs attention.

Controlling this pandemic is difficult when the fundamental science determining the response is misunderstood. Accepting the importance of airborne transmission may prove a crucial breakthrough and should not be delayed further.


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30 Aug 2020, 10:25 am

Over 1,000 students have tested positive for Covid-19 at University of Alabama since classes resumed

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More than 1,000 students at the University of Alabama have tested positive for Covid-19 since classes resumed on the Tuscaloosa campus less than two weeks ago, according to the University of Alabama System.

The UA System coronavirus dashboard notes another 158 cases were recorded on campus over the course of the year prior to August 18, bringing the total to 1,201 cases. Classes resumed August 19.
UA in Tuscaloosa has by far the most students who have tested positive for Covid-19 among the three campuses that make up the University of Alabama System. The University of Alabama at Birmingham (UAB) has confirmed 157 cases among students this year, and the University of Alabama in Huntsville (UAH) has reported 10, per the dashboard

No positive students have been hospitalized as a result of Covid-19, the UA System said in a news release Friday.

Our exposure notification efforts have revealed no evidence of virus transmission due to in-person class instruction," said Dr. Ricky Friend, dean of the College of Community Health Sciences at UA.
"We remain satisfied that the precautions implemented prior to the resumption of classes -- including masking, distancing, and a blend of in-person and remote instruction -- are appropriate and effective," he said.
To help prevent the spread of coronavirus, UA President Stuart Bell urged the community in a Wednesday letter to wear masks and social distance, both on and off campus.

"At this critical time, we must be united and fully committed in our fight against COVID-19," Bell said. "I believe we will be successful this semester, and we all want to remain on campus throughout this fall, but we can only do so with your daily assistance."

Bell had previously called the rise in cases "unacceptable" and told students and faculty that university police and Tuscaloosa police will monitor restaurants, off-campus residences and Greek housing to ensure patrons and residents follow coronavirus safety guidelines. Tuscaloosa Mayor Walt Maddox on Monday also ordered all bars in the city to close for two weeks due to the rise in cases.


There are around 37,500 UA students.

Coronavirus outbreaks identified at 4 sororities at Kansas State University
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Coronavirus outbreaks have been identified at four sororities at Kansas State University.

Residents of those Greek houses have been told to quarantine for 14 days from the day the outbreak was declared. Alpha Delta Pi and Alpha Xi Delta have six cases each, while Chi Omega and Kappa Delta have five cases apiece, the Riley County Health Department said Friday.

More than 60 US universities and colleges in at least 36 states have reported positive cases of Covid-19, and some have returned to remote learning to try to stem the spread. More than 8,700 infections among American college students and staff were reported through Friday, as the nation approaches 6 million confirmed cases.
At Kansas State, event permits associated with fraternity and sorority organizations through September 10 have been canceled or revoked.

"It is no longer deemed safe to hold these events in person and they may not take place," the county said in a statement.


The sorority/fraternity rush parties seem to be a big problem. That is what apparently what happened at my alma matter. Out of 3,000 students there are 105 positives. As per New York State this triggers an automatic suspension of in class learning for at least two weeks. Five students and three organizations have been suspended for hosting parties.



Off topic:
Blame my class of ‘79 :cry: . On my campus when I arrived there were no Greek organizations, they were considered a relic of the past. Then ‘Animal House’ came out in ‘78, the first fraternity in 10 years formed and from what I understand the school is mostly Greek today. We undid the work of previous baby boomer classes. :skull:


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30 Aug 2020, 7:20 pm

Global coronavirus cases top 25 million as India sets single-day infections record

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The number of reported coronavirus cases topped 25 million worldwide on Sunday, according to Johns Hopkins University data, as India registered a record 78,761 new cases in the past 24 hours — the highest single-day spike in the world since the pandemic began.

The world’s second-most populous country exceeded the 77,299 recorded in the United States on July 16, a tally of official data by Reuters showed. With around 3.54 million recorded infections, the nation of around 1.3 billion people is only behind the U.S. and Brazil in the total number of cases and it now has the fastest-growing daily coronavirus caseload of any country in the world.

Globally, the somber milestone of 25,009,250 cases was reached Sunday, according to the Johns Hopkins data. More than 840,000 people worldwide have died from the virus.

But despite surging case numbers in India, the government has been pushing for a return to normalcy to lessen the economic pain of the pandemic after a strict lockdown imposed in March.

The county will reopen underground train networks, and allow sports and religious events in a limited manner from next month.

Meanwhile in South Korea, which was praised for its early handling of the pandemic, a country-wide lockdown is back on the cards as infections continue to spike.

On Sunday, it reported its 17th consecutive day of triple-digit rises in coronavirus infections, but the 299 new infections recorded was the lowest number of new daily cases seen in four days since the spike of 441 cases on Aug. 27.

To stave off the outbreak, the country has strengthened its social distancing rules until at least Sept. 8, after which the government will re-evaluate to decide whether it needs to ramp up the measures even further.

Health minister Park Neung Hoo said Saturday elevating restrictions to level 3, the highest level of social distancing, would be the country’s “last card” as it would result in “tremendous damage” to the livelihoods of South Koreans.

Jeong Eun Kyung, the head of the country’s centers for disease control, has also warned that failing to curb and control the virus spreading will lead to a “massive scale pandemic” in South Korea.

As the pandemic continues in Europe, France is also dealing with what its health ministry described as “exponential" dynamic of the epidemic's progression, following a spike on Friday when the country registered its highest number of cases since March.

On Saturday, the ministry reported 5,453 new cases, a significant drop from 7,379 it reported the day before.

The spike came as the world's greatest cycling race, Tour de France, kicked off in Nice on Saturday.

Under new rules, entire teams can be excluded from the race if two riders from the same outfit test positive within a seven-day period. Fans have also been told not to approach riders for selfies and to always wear masks.

A day earlier, authorities in Paris mandated that face coverings must be worn in all public places in the city.


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