Guidance against wearing masks for the coronavirus is wrong – cover your face(bostonglobe.com)
bostonglobe.com
Guidance against wearing masks for the coronavirus is wrong – cover your face
https://www.bostonglobe.com/2020/03/19/opinion/guidance-against-wearing-masks-coronavirus-is-wrong-you-should-cover-your-face
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Anecdote: I talked with a doctor with regards to this subject and mentioned that there were no gloves or masks available in the market. Without blinking he immediately suggested I just wrap a scarf around my mouth and nose.
It boggles the mind how some people prefer to suggest to just not use anything at all.
It boggles the mind how some people prefer to suggest to just not use anything at all.
A few days ago I saw 2 women in a shop covering their nose and mouth with a scarf.
No problem you would say, except for the fact that they constantly had to keep their hand in front of their mouth to keep the scarf up.
I don't know about you, but in a shop where everybody touches everything, I keep my hands as far away from my face as possible, especially when some people like to breath in their hand and then touch everything.
So no, scarfs are really bad and counter productive.
No problem you would say, except for the fact that they constantly had to keep their hand in front of their mouth to keep the scarf up.
I don't know about you, but in a shop where everybody touches everything, I keep my hands as far away from my face as possible, especially when some people like to breath in their hand and then touch everything.
So no, scarfs are really bad and counter productive.
Being Scottish I learned at a young age how to tightly tie a football[1] scarf around my face to brace against the cold winter wind.
There's also products such as the buff scarf. Which are ideally suited to use as an impromptu mask[2].
It's not the scarf that is bad and counter productive, it's the haphazard application of it ;)
1: https://en.m.wikipedia.org/wiki/Association_football
2: https://youtu.be/IYNIzI3Hztk
There's also products such as the buff scarf. Which are ideally suited to use as an impromptu mask[2].
It's not the scarf that is bad and counter productive, it's the haphazard application of it ;)
1: https://en.m.wikipedia.org/wiki/Association_football
2: https://youtu.be/IYNIzI3Hztk
> No problem you would say, except for the fact that they constantly had to keep their hand in front of their mouth to keep the scarf up.
Given the choice, I pretty much prefer that over the scenario where they carry the virus and freely spread it into the environment by having zero filters between their airways and the world.
Scarves over the mouth and nose are not a panacea. They are a way to mitigate the problem.
Counterpoint: I've seen policemen wearing masks on their chin instead of their mouth and nose.
Given the choice, I pretty much prefer that over the scenario where they carry the virus and freely spread it into the environment by having zero filters between their airways and the world.
Scarves over the mouth and nose are not a panacea. They are a way to mitigate the problem.
Counterpoint: I've seen policemen wearing masks on their chin instead of their mouth and nose.
Ok, so, you think there is no way that we can cover our mouth with scarf and not touch it for, say, 1 hour?
Are you saying nobody can do that?
If you can't do that with scarf, then get a washable cotton mask.
Also, we should all stop touching our face, mask or not. It shouldn't be too hard to learn that.
Are you saying nobody can do that?
If you can't do that with scarf, then get a washable cotton mask.
Also, we should all stop touching our face, mask or not. It shouldn't be too hard to learn that.
The WHO rationale on masks includes not emboldening people to go out in less than effective masks. Isolation is better at stopping the spread than slightly slowing the spread with masks.
It’s also worth noting that there isn’t a straightforward way to map particle blocking ratio of a mask to probability of becoming infected.
It’s also worth noting that there isn’t a straightforward way to map particle blocking ratio of a mask to probability of becoming infected.
The article makes a good point about wearing masks being a reminder to people that "things are not normal". So I would say that saying "masks are not necessary" actually serves the reverse purpose of emboldening people to go out because it's not quite that serious yet.
> The WHO rationale on masks includes not emboldening people to go out in less than effective masks.
That logic is deeply flawed in my opinion. Sure, any sort of protective gear might give a false sense of security. However, people still need to get out, and odds are some of them already carry the virus. Getting a filter between them and the world is an effective way to contain the spread. After all, some efficiency is far better than completely unobstructed access, right?
That logic is deeply flawed in my opinion. Sure, any sort of protective gear might give a false sense of security. However, people still need to get out, and odds are some of them already carry the virus. Getting a filter between them and the world is an effective way to contain the spread. After all, some efficiency is far better than completely unobstructed access, right?
This whole "rationale" of feeding people noble lies so that some fleeting, temporary gain can be had for the next few days or weeks, comes at the expense of destroying their credibility in the public's eye and thereby making any expert advice they might offer in the future far less convincing and effective.
Yeah, when you say any kind of masks works, you will get someone comes in and say:
WHO says masks are not effective. Also, do you have source that says masks work?
I actually don't know how to reply to that.
Fortunately, Cambridge published a research about DIY mask against influenza.
Then, that person will say that's not covid. They aren't the same thing.
Science wins, I guess.
We cant say masks work without scientific research backing it up.
WHO says masks are not effective. Also, do you have source that says masks work?
I actually don't know how to reply to that.
Fortunately, Cambridge published a research about DIY mask against influenza.
Then, that person will say that's not covid. They aren't the same thing.
Science wins, I guess.
We cant say masks work without scientific research backing it up.
The message should be that simple, non-N95/FFP3 masks only have minor protective effect for the wearer, but can significantly reduce the spread of droplets by the wearer and protect others around them. Furthermore, wearing masks in populated public places should not be a recommendation, it should be enforced.
There is also reason to believe that enforcing wearing of masks in public spaces INCREASES social distancing, because people are less likely to slip into an illusion of normality in certain places.
There is also reason to believe that enforcing wearing of masks in public spaces INCREASES social distancing, because people are less likely to slip into an illusion of normality in certain places.
Is there science behind that WHO rationale? Trying to use mass psychological tricks instead of direct communication also has a big cost because it reduces people's trust in authorities which can lead to more deaths.
Scott Alexander thinks it's because the WHO uses the phrase "not effective" to say masks haven't been scientifically proven to protect against COVID-19 specifically and beyond any reasonable doubt, while the media interprets this to mean that they're "not effective" as in there's evidence against the effectiveness of masks.
https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...
https://slatestarcodex.com/2020/03/23/face-masks-much-more-t...
This WHO rationale is bizarre.
I have to go out to buy stuff periodically. What do I do?
Should I wear any kind of mask or not?
According to WHO guideline, I should not wear masks....
I have to go out to buy stuff periodically. What do I do?
Should I wear any kind of mask or not?
According to WHO guideline, I should not wear masks....
> CDC, US, and WHO are just so incompetent around this matter. If they didn't want N95 shortage, they could've told people to wear cotton washable masks. It was such a simple and effective solution that they couldn't think of.
The behavior of the CDC, WHO, and FDA during this crisis has long since passed incompetence and entered the territory of active malevolence. They're institutions at their most corrupted, driven more by the bureaucratic impulse towards self-sustenance than any connection to their ostensible mission. I hope we burn them to ground after this is over (I mean that metaphorically: more literally, we should dramatically reform them).
The behavior of the CDC, WHO, and FDA during this crisis has long since passed incompetence and entered the territory of active malevolence. They're institutions at their most corrupted, driven more by the bureaucratic impulse towards self-sustenance than any connection to their ostensible mission. I hope we burn them to ground after this is over (I mean that metaphorically: more literally, we should dramatically reform them).
There’s and old Chinese proverb stating a fish rots from the head down. I think that applies quite well to this situation.
It's not clear that a scarf's effectiveness at blocking tiny particles makes it good at protecting the wearer from those particles.
Consider the case where you're on a flight with someone who's got COVID-19 and is coughing. The scarf blocks 50% of the particles a surgical mask would block. You then spend the rest of the flight breathing in and out through the scarf that blocked those particles. Does wearing the scarf lower your risk, leave it unchanged, or actually raise it?
Consider the case where you're on a flight with someone who's got COVID-19 and is coughing. The scarf blocks 50% of the particles a surgical mask would block. You then spend the rest of the flight breathing in and out through the scarf that blocked those particles. Does wearing the scarf lower your risk, leave it unchanged, or actually raise it?
I co-authored an evidence-based call to action for promoting simple DIY masks some time ago [1] and it got some good resonance from politicians.
Still, we don't see adoption of DIY masks in most countries so far, and I start to wonder what is holding back officials from promoting it. Maybe the variability in quality of DIY masks made by individuals might be too large, and officials just have too strong of a resilience against such DIY solutions as to ever promote them? Perhaps a standardized design for cotton masks, not made by individuals but local businesses would be more acceptable for officials?
[1] https://link.medium.com/LY7RRNr2X4 "Promoting simple do-it-yourself masks: an urgent intervention for COVID-19 mitigation", Svara et al. 2020
Still, we don't see adoption of DIY masks in most countries so far, and I start to wonder what is holding back officials from promoting it. Maybe the variability in quality of DIY masks made by individuals might be too large, and officials just have too strong of a resilience against such DIY solutions as to ever promote them? Perhaps a standardized design for cotton masks, not made by individuals but local businesses would be more acceptable for officials?
[1] https://link.medium.com/LY7RRNr2X4 "Promoting simple do-it-yourself masks: an urgent intervention for COVID-19 mitigation", Svara et al. 2020
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You could seal your mouth with duct tape -- it won't change the fact that you are more likely to aquire SARS-CoV-2 through your eyes than through your mouth. Are you covering your eyes?
>you are more likely to aquire SARS-CoV-2 through your eyes than through your mouth
What is the evidence supporting that claim?
What is the evidence supporting that claim?
Wouldn't get less particles of virus better than getting more?
Let's say I cough at you. 33% go to your eyes, 33% go to your nose, and 33% go to your mouth.
Are you saying that getting 33% is the same as getting 100%?
I'm fairly certain that your immune system works better if you are exposed to less amount of virus. This is true for bacteria and toxin as well.
Every measure reduces risk/amount. Nothing can guarantee 100% that you won't get covid.
But you do want to keep reducing risk.
Let's say I cough at you. 33% go to your eyes, 33% go to your nose, and 33% go to your mouth.
Are you saying that getting 33% is the same as getting 100%?
I'm fairly certain that your immune system works better if you are exposed to less amount of virus. This is true for bacteria and toxin as well.
Every measure reduces risk/amount. Nothing can guarantee 100% that you won't get covid.
But you do want to keep reducing risk.
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How do you correct misinformation when the guys at the top are wrong and social media's intent on shuting down information that disagrees with the guys at the top?
The amount of misinformation coming out of the WHO has been staggering and hard to account for, but I will stop short of suggesting any conspiracy.
* They held that there was no evidence of person-to-person transmission for far too long in the face of evidence out of China.
* They claimed for far to long that if you weren't showing symptoms you weren't contagious. This advice has been very widely used to not quarantine people who were exposed to a person who got sick shortly after interactions... to devastating effect around the world.
* They claimed it does not spread through atomized particles, only droplets. This has been demonstrated to be false by experiment.
* They said masks are not effective.
* They said you didn't need to cover your eyes. Medical staff now wear full face shields.
* They said travel bans don't work. This defies basic logic.
* They delayed declaraing the pandemic to be a pandemic.
* They've been completely silent about ACE inhibitors and ARBs upregulating the expression of ACE2 receptors, and that available evidence strongly suggests that people on these medicines have much more severe reactions to the disease. WARNING: I cannot say whether these drugs are the cause -- it may well not be the case -- but shoudn't this have been seriously investigated by now?
The amount of misinformation coming out of the WHO has been staggering and hard to account for, but I will stop short of suggesting any conspiracy.
* They held that there was no evidence of person-to-person transmission for far too long in the face of evidence out of China.
* They claimed for far to long that if you weren't showing symptoms you weren't contagious. This advice has been very widely used to not quarantine people who were exposed to a person who got sick shortly after interactions... to devastating effect around the world.
* They claimed it does not spread through atomized particles, only droplets. This has been demonstrated to be false by experiment.
* They said masks are not effective.
* They said you didn't need to cover your eyes. Medical staff now wear full face shields.
* They said travel bans don't work. This defies basic logic.
* They delayed declaraing the pandemic to be a pandemic.
* They've been completely silent about ACE inhibitors and ARBs upregulating the expression of ACE2 receptors, and that available evidence strongly suggests that people on these medicines have much more severe reactions to the disease. WARNING: I cannot say whether these drugs are the cause -- it may well not be the case -- but shoudn't this have been seriously investigated by now?
> They said travel bans don't work. This defies basic logic.
> They delayed declaraing the pandemic to be a pandemic.
I have come to think that a major problem with the WHO might be that it is not independent enough from the political interests of major countries.
Banning non-essential travel from/to highly affected countries early would probably have helped to slow down global spread, but political opposition made that impossible.
> They delayed declaraing the pandemic to be a pandemic.
I have come to think that a major problem with the WHO might be that it is not independent enough from the political interests of major countries.
Banning non-essential travel from/to highly affected countries early would probably have helped to slow down global spread, but political opposition made that impossible.
I think they were trying to keep china on their side by not offending them. Politics intrudes into medicine. Perhaps they were even right to do so, they appeared to uncritically accept and repeat China's blatantly lying figures (though behind the scenes I think they knew exactly they were being lied to) and perhaps that was necessary - I'm not a politician so I can't say - but I don't like it at all. But I am not in a position to judge as I don;t have all the facts.
> Banning non-essential travel from/to highly affected countries early would probably have helped to slow down global spread
I think the point was that people tend to get round those travel bans - people instead of going from A to B (now banned) go A to C to B. But again, I don't know and would like to understand why they though that way.
> Banning non-essential travel from/to highly affected countries early would probably have helped to slow down global spread
I think the point was that people tend to get round those travel bans - people instead of going from A to B (now banned) go A to C to B. But again, I don't know and would like to understand why they though that way.
> I have come to think that a major problem with the WHO might be that it is not independent enough from the political interests of major countries.
Yeah unfortunately the WHO showed it lacked any credibility and is sounding like a major tool.
Yeah unfortunately the WHO showed it lacked any credibility and is sounding like a major tool.
> They claimed it does not spread through atomized particles, only droplets. This has been demonstrated to be false by experiment.
Do you have a link on this for further reading?
Do you have a link on this for further reading?
Here's a Reuters article about the experiment in question: https://www.reuters.com/article/uk-health-coronavirus-study-...
Unfortunately I never saw the papers on this and I'm looking for them now, so take this bullet with a grain of salt. Two lines of research were relayed to me verbally.
1. In one experiment in a hospital room detected virus on surfaces but not in the air, but it did so many (I vaguely recall it was 4) hours after the patient was in the room. I think I heard this in answer to a press question during a New Zealand official 1pm broadcast on COVID-19. They didn't categorically claim it can't be atomized, but suggested strongly that this wasn't expected to be a significant vector for transmission.
2. The other source was a paper someone linked to on Twitter. And I neglected to download it. But someone physically atomized material with the virus and then after some time period was able to detect the virus still atomized in the air. This proved it was possible to remain atomized, but not that sick people actually atomize the virus well. Again, perhaps not a significant mode of transmission.
I'll keep looking. I'll temporarily retract that bullet point.
1. In one experiment in a hospital room detected virus on surfaces but not in the air, but it did so many (I vaguely recall it was 4) hours after the patient was in the room. I think I heard this in answer to a press question during a New Zealand official 1pm broadcast on COVID-19. They didn't categorically claim it can't be atomized, but suggested strongly that this wasn't expected to be a significant vector for transmission.
2. The other source was a paper someone linked to on Twitter. And I neglected to download it. But someone physically atomized material with the virus and then after some time period was able to detect the virus still atomized in the air. This proved it was possible to remain atomized, but not that sick people actually atomize the virus well. Again, perhaps not a significant mode of transmission.
I'll keep looking. I'll temporarily retract that bullet point.
I believe the incident you're referring to was actually an apartment building outbreak, not a study. As an event it seemed to confirm the airborne/atomized/fecal-oral spread early on. Somebody got someone in another part of their building sick.
Cheers, yeah my reading on it tended to the conclusion that it could aerosolise, but that was a limited vector compared to droplets (but limited doesn't mean none).
It was only mid March when the WHO finally admitted that SARS-CoV-2 could potentially remain airborne for an extended period of time. They still go out of their way to deny that it's common for it to spread in the air, they're clearly skeptics (when it's the only great explanation for how it spreads so rapidly and effectively among large crowds of people).
The WHO has been an epic disaster this entire time, wrong several critical times and behind on everything. They should not be regarded as to have much credibility after their failures on this pandemic.
This tweet by the WHO on Jan 14 will go down in history for the 21st century as one of the dumbest things said by anyone prominent in the medical sphere (it's astounding they left it up):
https://twitter.com/WHO/status/1217043229427761152
The WHO has been an epic disaster this entire time, wrong several critical times and behind on everything. They should not be regarded as to have much credibility after their failures on this pandemic.
This tweet by the WHO on Jan 14 will go down in history for the 21st century as one of the dumbest things said by anyone prominent in the medical sphere (it's astounding they left it up):
https://twitter.com/WHO/status/1217043229427761152
Here's a recent article on the topic
https://www.npr.org/2020/03/28/823292062/who-reviews-availab...
https://www.npr.org/2020/03/28/823292062/who-reviews-availab...
The UK deputy chief medical officer was questioned on the UK deviating from WHO advice at a press conference.
She pointed out the W was for World and suggested they have a different focus. I thought it was a brilliant swerve. Accurate, but I suspect not the whole picture.
She pointed out the W was for World and suggested they have a different focus. I thought it was a brilliant swerve. Accurate, but I suspect not the whole picture.
To be fair, the UK started off with a long string of facepalm official policies towards the covid19 epidemic. I mean, they were famous for jumping enthusiastically into the "let everyone catch it in one go and get it over with" bandwagon.
> but I will stop short of suggesting any conspiracy
But that's what you're doing.
> They held that there was no evidence of person-to-person transmission for far too long in the face of evidence out of China
Possibly true. Any pointers to that?
> They claimed for far to long that if you weren't showing symptoms you weren't contagious
If you make these claims, provide refrences please. This is new to me.
> They've been completely silent about ACE inhibitors and ARBs upregulating the expression of ACE2 receptors, and that available evidence strongly suggests that people on these medicines have much more severe reactions to the disease
Provide a link. If you're going to post stuff that sounds relevant and important, post references to it.
But that's what you're doing.
> They held that there was no evidence of person-to-person transmission for far too long in the face of evidence out of China
Possibly true. Any pointers to that?
> They claimed for far to long that if you weren't showing symptoms you weren't contagious
If you make these claims, provide refrences please. This is new to me.
> They've been completely silent about ACE inhibitors and ARBs upregulating the expression of ACE2 receptors, and that available evidence strongly suggests that people on these medicines have much more severe reactions to the disease
Provide a link. If you're going to post stuff that sounds relevant and important, post references to it.
> But that's what you're doing.
I don't think the WHO is trying to get people sick, or that China is doing this to the USA, or anything like that. I do think that something doesn't smell right, but I'm unwilling to make any kind of conclusion on what it might be.
As for the person-to-person thing, I lived through the storm of data and information and distinctly remember them claiming there was no evidence of person-to-person transmission after I had seen multiple bits of evidence out of China. To prove that, I'd have to do a lot of wayback machine work.
People have been contagious before symptoms and also without showing any symptoms. I thought this knowledge was widespread at this point. The 3rd case and 5th case in NZ were a couple where the 5th case (wife) travelled to Iran. The man got sick after she returned. She was not sick. They tested her and she was positive and became the 5th case. https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&object... https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&object... Probably sexual transmission, so not too suprising. But there are many other reports which the CDC acknowledges on this page: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...
The question on ACE/ACE2 has references itself: https://www.thelancet.com/journals/lanres/article/PIIS2213-2...
I don't think the WHO is trying to get people sick, or that China is doing this to the USA, or anything like that. I do think that something doesn't smell right, but I'm unwilling to make any kind of conclusion on what it might be.
As for the person-to-person thing, I lived through the storm of data and information and distinctly remember them claiming there was no evidence of person-to-person transmission after I had seen multiple bits of evidence out of China. To prove that, I'd have to do a lot of wayback machine work.
People have been contagious before symptoms and also without showing any symptoms. I thought this knowledge was widespread at this point. The 3rd case and 5th case in NZ were a couple where the 5th case (wife) travelled to Iran. The man got sick after she returned. She was not sick. They tested her and she was positive and became the 5th case. https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&object... https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&object... Probably sexual transmission, so not too suprising. But there are many other reports which the CDC acknowledges on this page: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...
The question on ACE/ACE2 has references itself: https://www.thelancet.com/journals/lanres/article/PIIS2213-2...
I agree WRT china something stinks. My guess is it is just realpolitik. A lot of useful info was coming out of china (as well as lies) and maybe the WHO needed to bite its tongue to keep that channel open (China being... odd in its reactions to criticism).
I'll accept your point about no P2P transmission claim as I remember it too, and I suspect that was just parroted back from China early on - but they've not said that for a while.
The ACE stuff from your links just says 'we suspect'.
The WHO has indeed spoken on this recently (https://mobile.twitter.com/WHO/status/1240409217997189128):
"WHO is aware of concerns on the use of #ibuprofen for the treatment of fever for people with #COVID19. We are consulting with physicians treating the patients & are not aware of reports of any negative effects, beyond the usual ones that limit its use in certain populations"
You're being unfair here, they have spoken and it's clear they don't feel enough to recommend for or against at this point. Getting clean yes/no info out of a filthy cloud of murk like this covid situation - I'm glad I'm not them.
Nonetheless, thank you for a civil and informative reply
I'll accept your point about no P2P transmission claim as I remember it too, and I suspect that was just parroted back from China early on - but they've not said that for a while.
The ACE stuff from your links just says 'we suspect'.
The WHO has indeed spoken on this recently (https://mobile.twitter.com/WHO/status/1240409217997189128):
"WHO is aware of concerns on the use of #ibuprofen for the treatment of fever for people with #COVID19. We are consulting with physicians treating the patients & are not aware of reports of any negative effects, beyond the usual ones that limit its use in certain populations"
You're being unfair here, they have spoken and it's clear they don't feel enough to recommend for or against at this point. Getting clean yes/no info out of a filthy cloud of murk like this covid situation - I'm glad I'm not them.
Nonetheless, thank you for a civil and informative reply
Ibuprofen is one thing. ACEI and ARBs are another. I'm prescribed the maximum dose of an ACE inhibitor and I really want to know whether or not the scarcity of Angiotensin II has caused the ACE2 receptors to upregulate in compensation. It seems like it would, and studies on animals show it does at least in some contexts (https://www.bmj.com/content/368/bmj.m810/rr-2). I completely understand it would be dangerous to suggest publicly as people might suddenly stop their blood pressure medicines and we'd have a spate of heart attacks and strokes. But it might be equally dangerous to not phase them off, at least for a few months, and onto something else in the meantime.
Other links I have on this topic that might be relevant:
https://www.healio.com/cardiology/vascular-medicine/news/onl...
https://www.nature.com/articles/s41421-020-0147-1
https://www.bmj.com/content/368/bmj.m810/rr-2
https://www.eshonline.org/spotlights/esh-statement-on-covid-...
https://pubmed.ncbi.nlm.nih.gov/32064853/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1829448/
Other links I have on this topic that might be relevant:
https://www.healio.com/cardiology/vascular-medicine/news/onl...
https://www.nature.com/articles/s41421-020-0147-1
https://www.bmj.com/content/368/bmj.m810/rr-2
https://www.eshonline.org/spotlights/esh-statement-on-covid-...
https://pubmed.ncbi.nlm.nih.gov/32064853/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1829448/
I understood ibuprofen was relevant: "ibuprofen could increase the expression of ACE2 receptors that the virus uses to bind to cells" (https://www.popsugar.co.uk/fitness/should-you-avoid-taking-i...)
And you originally said
> upregulating the expression of ACE2 receptors
So ibuprofen is relevant.
And your first link says
“This speculation about the safety of ACE inhibitor or angiotensin receptor blockers treatment in relation to COVID-19 does not have a sound scientific basis or evidence to support it,” de Simone wrote in the ESC statement. “Indeed, there is evidence from studies in animals suggesting that these medications might be rather protective against serious lung complications in patients with COVID-19 infection, but to date there are no data in humans. The Council on Hypertension strongly recommends that physicians and patients should continue treatment with their usual antihypertensive therapy because there is no clinical or scientific evidence to suggest that treatment with ACE inhibitors or angiotensin receptor blockers should be discontinued because of the COVID-19 infection.”
THEY DON'T HAVE THE INFO TO MAKE A DECISION ONE WAY OR ANOTHER.
STOP SPREADING YOUR NON-EXPERT OPINION AS IF IT WERE FACT.
WHO repeating CCP bullshit is one thing, but you are not being honest here. Stop this.
Now I'm going to stop because I have some work to do that is laterally related to covid and I need to get on with it.
And you originally said
> upregulating the expression of ACE2 receptors
So ibuprofen is relevant.
And your first link says
“This speculation about the safety of ACE inhibitor or angiotensin receptor blockers treatment in relation to COVID-19 does not have a sound scientific basis or evidence to support it,” de Simone wrote in the ESC statement. “Indeed, there is evidence from studies in animals suggesting that these medications might be rather protective against serious lung complications in patients with COVID-19 infection, but to date there are no data in humans. The Council on Hypertension strongly recommends that physicians and patients should continue treatment with their usual antihypertensive therapy because there is no clinical or scientific evidence to suggest that treatment with ACE inhibitors or angiotensin receptor blockers should be discontinued because of the COVID-19 infection.”
THEY DON'T HAVE THE INFO TO MAKE A DECISION ONE WAY OR ANOTHER.
STOP SPREADING YOUR NON-EXPERT OPINION AS IF IT WERE FACT.
WHO repeating CCP bullshit is one thing, but you are not being honest here. Stop this.
Now I'm going to stop because I have some work to do that is laterally related to covid and I need to get on with it.
A number of people have brought up ibuprofen in relation to the expression of ACE2 receptors. There was a long thread on reddit about it. My point is that any reliable information on ibuprofen does not necessarily allow us to make the same conclusions about ACE inhibitors and ARBs.
The bullet point about this topic was the final bullet point, and I put a clear warning in place on the bullet point (originally too, not as an edit). I did not pass off my opinion as if it were fact, nor did I claim to be an expert. I questioned why we still don't have better data on this, given how strong the coorelation is in people who have conditions that are treated with these medicines.
But I will concede one point: The list about the WHO was not the right place for me to bring up this topic, and putting it there was misleading.
The bullet point about this topic was the final bullet point, and I put a clear warning in place on the bullet point (originally too, not as an edit). I did not pass off my opinion as if it were fact, nor did I claim to be an expert. I questioned why we still don't have better data on this, given how strong the coorelation is in people who have conditions that are treated with these medicines.
But I will concede one point: The list about the WHO was not the right place for me to bring up this topic, and putting it there was misleading.
I appreciate the way you've taken my criticisms. You acknowledge you're not an expert which is much to your credit, and haven't amended your posts or done the usual wankers trick of just downvoting someone who disagrees. I like that.
I can't speak for ACEs and ARBs.
Let's agree to disagree on why we don't have better data on these. I trust doctors and the WHO on this. You maybe feel they can do more. I can't take the time to look into it, nor if I did, to interpret what I found.
I repeat I appreciate your constructive attitude and have upvoted several of your posts and this one, because it's done in the right spirit. Good luck.
I can't speak for ACEs and ARBs.
Let's agree to disagree on why we don't have better data on these. I trust doctors and the WHO on this. You maybe feel they can do more. I can't take the time to look into it, nor if I did, to interpret what I found.
I repeat I appreciate your constructive attitude and have upvoted several of your posts and this one, because it's done in the right spirit. Good luck.
On asymptomatic spread:
https://www.nejm.org/doi/full/10.1056/NEJMc2001468 A woman from Shanghai traveled to Germany for a business trip between January 19 and January 22. She had no symptoms of coronavirus during this time and only became sick on her flight back to China. She was diagnosed with COVID-19 on January 26. But on January 24, a businessman who met with the woman on January 20 and 21 developed symptoms of coronavirus. He went back to work on January 27 and later tested positive for COVID-19. “We discovered that shedding of potentially infectious virus may occur in persons who have no fever and no signs or only minor signs of infection,” the report’s authors concluded.
https://www.nejm.org/doi/full/10.1056/NEJMc2001899 two individuals who had recently returned to Germany from Wuhan, China, appeared to be asymptomatic, but tested positive for COVID-19 when they were given a throat swab. "We discovered that shedding of potentially infectious virus may occur in persons who have no fever and no signs or only minor signs of infection,"
https://science.sciencemag.org/content/early/2020/03/13/scie... A majority of cases in China were transmitted by “undocumented infections” in the period before the country placed travel restrictions on Hubei province on January 23. “This high proportion of undocumented infections, many of whom were likely not severely symptomatic, appears to have facilitated the rapid spread of the virus throughout China"
https://www.medrxiv.org/content/10.1101/2020.03.05.20031815v... a significant number of infections can be attributed to people who had not yet developed symptoms
https://www.nejm.org/doi/full/10.1056/NEJMp2003762 Bill Gates "COVID-19 is transmitted quite efficiently," he wrote. "There is also strong evidence that it can be transmitted by people who are just mildly ill or even pre-symptomatic. That means COVID-19 will be much harder to contain than the Middle East respiratory syndrome or severe acute respiratory syndrome (SARS), which were spread much less efficiently and only by symptomatic people."
https://www.nejm.org/doi/full/10.1056/NEJMc2001468 A woman from Shanghai traveled to Germany for a business trip between January 19 and January 22. She had no symptoms of coronavirus during this time and only became sick on her flight back to China. She was diagnosed with COVID-19 on January 26. But on January 24, a businessman who met with the woman on January 20 and 21 developed symptoms of coronavirus. He went back to work on January 27 and later tested positive for COVID-19. “We discovered that shedding of potentially infectious virus may occur in persons who have no fever and no signs or only minor signs of infection,” the report’s authors concluded.
https://www.nejm.org/doi/full/10.1056/NEJMc2001899 two individuals who had recently returned to Germany from Wuhan, China, appeared to be asymptomatic, but tested positive for COVID-19 when they were given a throat swab. "We discovered that shedding of potentially infectious virus may occur in persons who have no fever and no signs or only minor signs of infection,"
https://science.sciencemag.org/content/early/2020/03/13/scie... A majority of cases in China were transmitted by “undocumented infections” in the period before the country placed travel restrictions on Hubei province on January 23. “This high proportion of undocumented infections, many of whom were likely not severely symptomatic, appears to have facilitated the rapid spread of the virus throughout China"
https://www.medrxiv.org/content/10.1101/2020.03.05.20031815v... a significant number of infections can be attributed to people who had not yet developed symptoms
https://www.nejm.org/doi/full/10.1056/NEJMp2003762 Bill Gates "COVID-19 is transmitted quite efficiently," he wrote. "There is also strong evidence that it can be transmitted by people who are just mildly ill or even pre-symptomatic. That means COVID-19 will be much harder to contain than the Middle East respiratory syndrome or severe acute respiratory syndrome (SARS), which were spread much less efficiently and only by symptomatic people."
These - that I've scanned - don't back up your point. They say that P2P transmission is happening (no argument with that these days), but your claim was that the WHO was silent for too long on this. I don't know what 'too long' is.
However, quick dig in wikipedia: (https://en.wikipedia.org/wiki/2019%E2%80%9320_outbreak_of_no...)
<<< On 12 January, based on additional information from the Chinese National Health Commission, WHO stated that "at this stage, there is no infection among healthcare workers, and no clear evidence of human to human transmission." >>>
So, fuck.
(you provided references in good faith, which I really appreciate).
However, quick dig in wikipedia: (https://en.wikipedia.org/wiki/2019%E2%80%9320_outbreak_of_no...)
<<< On 12 January, based on additional information from the Chinese National Health Commission, WHO stated that "at this stage, there is no infection among healthcare workers, and no clear evidence of human to human transmission." >>>
So, fuck.
(you provided references in good faith, which I really appreciate).
After this huge list and today's farce of pretending to drop a call to avoid talking about China, I think we can safely ignore the WHO from here on out. They're either in China's pocket or don't know their head from a hole in the ground.
> today's farce of pretending to drop a call to avoid talking about China
Source?
Source?
At some point you have to put it down to enemy action, even if they don’t realize they’re acting on behalf of the enemy.
On a recent 9hr flight I gave a couple sitting near me my last two masks. I don't think they realised this was a selfish and not a selfless act.
This mask thing is a strange phenomenon. I suppose it is similar to panic buying toilet paper - people just feel the need to do something and blame someone. In Australia, although there has been panic buying of toilet paper, nobody is talking much about masks, or the lack of strong recommendations to wear them. In the USA, this is apparently a major issue, and a source of suspicion and mistrust of the government and various healthcare bodies. I don't get the obsession with it.
As a public health intervention, social distancing is vastly more effective and deserving of emphasis than mask wearing. There aren't enough masks. Public health orgs were worried about running out of masks, which is exactly what has happened, and this is a huge problem for doctors and nurses who whinge about it a lot less than your random person on twitter decrying the apparent conspiracy to stop mask wearing.
The surgeon general's tweet (February 29) at the time was reasonable. On Feb 29 there were 66 cases in a country with 327 million people.
As a public health intervention, social distancing is vastly more effective and deserving of emphasis than mask wearing. There aren't enough masks. Public health orgs were worried about running out of masks, which is exactly what has happened, and this is a huge problem for doctors and nurses who whinge about it a lot less than your random person on twitter decrying the apparent conspiracy to stop mask wearing.
The surgeon general's tweet (February 29) at the time was reasonable. On Feb 29 there were 66 cases in a country with 327 million people.
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I always thought that was a simple fiction to stop selfish hoarders from giving themselves a (randomly chosen) 10% better chance of staying healthy as opposed to people who actually need a mask to have a 200% better chance of not developing life-threatening symptoms.
But of course, truth is more important than lives. Which will earn lots of anger from people who contributed to the mask shortage, but I don't care. I'm not saying I'm right about the previous paragraph, just that it's a simpler explanation based on basic human nature than some conspiracy theory.
But of course, truth is more important than lives. Which will earn lots of anger from people who contributed to the mask shortage, but I don't care. I'm not saying I'm right about the previous paragraph, just that it's a simpler explanation based on basic human nature than some conspiracy theory.
"Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus" - U.S. Surgeon General
A flat out lie from the leading spokesperson on matters of public health.
All of the hand-wringing about foreign misinformation. But what if the misinformation is coming from within the house?
A flat out lie from the leading spokesperson on matters of public health.
All of the hand-wringing about foreign misinformation. But what if the misinformation is coming from within the house?
I don't see any particular reason to trust the opinion section of the Boston Globe over the US Surgeon General or the WHO, but that's just me. I'm even more hesitant about calling that claim a "flat out lie". As far as I can tell, these are just two people with a point of view, who don't link to a single study on the matter.
Seriously though, do you have any evidence that the consensus of the medical profession is that getting the general, non-sick population to wear masks is useful in combating the crisis? I'm open to the possibility that it is, but remain rather skeptical.
Seriously though, do you have any evidence that the consensus of the medical profession is that getting the general, non-sick population to wear masks is useful in combating the crisis? I'm open to the possibility that it is, but remain rather skeptical.
> do you have any evidence that the consensus of the medical profession is that getting the general, non-sick population to wear masks is useful in combating the crisis?
Yes:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810906/
https://www.ijidonline.com/article/S1201-9712%2808%2901008-4...
"Wearing a face mask was a protective factor against influenza infection."
"The staff who wore surgical masks and N95 masks were significantly associated with non-infection."
"In compliant users, masks were highly efficacious."
Also common sense. If you wear a mask you reduce the probability that you transmit the virus. And, to a lesser extent, you reduce the probability that you are infected by the virus.
Claiming that "they are not effective" is simply false. Perhaps "lie" is too strong, but it was untrue and irresponsible considering the position he holds.
Yes:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810906/
https://www.ijidonline.com/article/S1201-9712%2808%2901008-4...
"Wearing a face mask was a protective factor against influenza infection."
"The staff who wore surgical masks and N95 masks were significantly associated with non-infection."
"In compliant users, masks were highly efficacious."
Also common sense. If you wear a mask you reduce the probability that you transmit the virus. And, to a lesser extent, you reduce the probability that you are infected by the virus.
Claiming that "they are not effective" is simply false. Perhaps "lie" is too strong, but it was untrue and irresponsible considering the position he holds.
"Wearing a face mask was a protective factor against influenza infection."
It's about the size of the particles (both COVID-19 and flu are 80–120 nm) not the type of virus.
Besides, the other links concern a SARS virus.
Besides, the other links concern a SARS virus.
It is the consensus of medical professionals and officials in those countries that have demonstrated that they can greatly reduce the spread (China, South Korea, Japan).
It is not the consensus in countries that currently still see an explosion in cases.
It is not the consensus in countries that currently still see an explosion in cases.
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Well the opinion section of the Boston Globe is also written by a person (in this case two people, with separate credentials listed at the bottom). The Surgeon General tweeting is also an "opinion section". And if you think that whatever the official government official says must be true, feel free to go browse the official POTUS twitter acount.
> if you think that whatever the official government official says must be true
This is something I definitely said.
This is something I definitely said.
I'm referring to your statement about trusting the surgeon general.
> I don't see any particular reason to trust the opinion section of the Boston Globe over the US Surgeon General or the WHO
> I don't see any particular reason to trust the opinion section of the Boston Globe over the US Surgeon General or the WHO
Me: I think the statements of the US Surgeon General are usually trustworthy, at least more so than the opinion section of the Boston Globe.
You: you think that whatever the official government official says must be true
Do you see the issue here?
You: you think that whatever the official government official says must be true
Do you see the issue here?
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If you were at home like you should be, you wouldn't need a mask.
While true, the disease was being spread weeks or a full month ago by asymptomatic people who didn’t know they had it before quarantines were in place. And that’s when we had every major news source, including the NYT, telling people that masks aren’t effective and not to buy or wear them.
It should be a common sense to cover your face during pandemic. It is 3 centuries old wisdom: https://en.m.wikipedia.org/wiki/Plague_doctor_costume
It is amazing how people naively believe in politician’s bullshit. The same is with “don’t hoard the food” with appearing articles about shortage of cheap workers in agricultural sector.
Next week a dude is coming to each flat in a complex with hundreds of flats to inspect pipes. There is pandemic outside, but it’s best time to inspect pieces. Politicians scream every day about pandemic and how one should stay at home. Maybe this pipe inspection might wait couple months!?
It is amazing how people naively believe in politician’s bullshit. The same is with “don’t hoard the food” with appearing articles about shortage of cheap workers in agricultural sector.
Next week a dude is coming to each flat in a complex with hundreds of flats to inspect pipes. There is pandemic outside, but it’s best time to inspect pieces. Politicians scream every day about pandemic and how one should stay at home. Maybe this pipe inspection might wait couple months!?
They're asking people not to hoard the food because of the impact it has on people who can't afford to buy a month's worth of groceries in advance.
If those privileged enough to be able to afford to hoard have cleaned out the supermarkets to an extent that the supermarkets' supply chain isn't designed for, the person shopping weekly is screwed.
Seems pretty straightforward to me.
If those privileged enough to be able to afford to hoard have cleaned out the supermarkets to an extent that the supermarkets' supply chain isn't designed for, the person shopping weekly is screwed.
Seems pretty straightforward to me.
I and some friends (older people) have always food at home for couple weeks. Older flats in Germany have designated rooms in a flat for storing food. In my flat it’s in the corridor, but in friend’s flat it’s directly in the kitchen.
On the other hand I saw the hoarders in action: throwing 2 shopping carts with cans to the car’s trunk. Really disgusting. Especially knowing, that this canned food does not taste well and will end in a landfill afterwards.
On the other hand I saw the hoarders in action: throwing 2 shopping carts with cans to the car’s trunk. Really disgusting. Especially knowing, that this canned food does not taste well and will end in a landfill afterwards.
> The same is with “don’t hoard the food” with appearing articles about shortage of cheap workers in agricultural sector.
Hoarding food increases demand, thus exacerbates potential food shortages.
Hoarding food increases demand, thus exacerbates potential food shortages.
I made a video precisely about this and other misinformation: https://www.youtube.com/watch?v=NGh9yNpEhQM
You talk a lot about boosting your immune system. This is very hard to study because immune function is broad and complex so it's hard to measure and test any such claims. Therefore claims like these are widespread but often not backed up with good science.
The best way to boost your immune function is to be exposed to a pathogen. Then you will develop antibodies. Those antibodies boost your ability to avoid that pathogen. Vaccines work in a similar way. Of course this advice is currently useless in the context of COVID-19.
Specific foods and supplements might help here and there, but most of the evidence is that they are antimicrobial (antibiotic/antiviral/antifungal) in vitro. There's much less research in vivo. That's not to say that some foods won't help, but just not to rely on them having a significant effect in your body. The effect, if any, is probably very slight.
There is stronger evidence for a healthy lifestyle: regular exercise, maintaining a healthy weight, getting adequate sleep, avoiding infection, not smoking, minimizing stress. Some good evidence for sun exposure too.
Back on the foods though, you didn't mention black elderberry syrup (sambucus nigra). A 2004 study (randomized, double blinded, placebo controlled) showed efficacy against influenza.https://www.ncbi.nlm.nih.gov/pubmed/15080016 and a 2016 study (randomized, double blinded, placebo controlled) showing it reduced the duration of the common cold (often a coronavirus): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848651/ And it's quite safe -- Europeans traditionally use it for pancake syrup.
The best way to boost your immune function is to be exposed to a pathogen. Then you will develop antibodies. Those antibodies boost your ability to avoid that pathogen. Vaccines work in a similar way. Of course this advice is currently useless in the context of COVID-19.
Specific foods and supplements might help here and there, but most of the evidence is that they are antimicrobial (antibiotic/antiviral/antifungal) in vitro. There's much less research in vivo. That's not to say that some foods won't help, but just not to rely on them having a significant effect in your body. The effect, if any, is probably very slight.
There is stronger evidence for a healthy lifestyle: regular exercise, maintaining a healthy weight, getting adequate sleep, avoiding infection, not smoking, minimizing stress. Some good evidence for sun exposure too.
Back on the foods though, you didn't mention black elderberry syrup (sambucus nigra). A 2004 study (randomized, double blinded, placebo controlled) showed efficacy against influenza.https://www.ncbi.nlm.nih.gov/pubmed/15080016 and a 2016 study (randomized, double blinded, placebo controlled) showing it reduced the duration of the common cold (often a coronavirus): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848651/ And it's quite safe -- Europeans traditionally use it for pancake syrup.
According to physics and common sense, anything you put between you and the cough-er is going to reduce the number of cough particles to reach you.
Anything will work with different effectiveness.
N95 > Surgical > Handkerchief > Covering your mouth with your hand.
CDC, US, and WHO are just so incompetent around this matter. If they didn't want N95 shortage, they could've told people to wear cotton washable masks. It was such a simple and effective solution that they couldn't think of.
Source: https://twitter.com/CMichaelGibson/status/123971835157384397... Scarf is ~50% effective relative to surgical masks. Though this is tested against influenza, it's still applicable to COVID