My Coronavirus Notes & FAQ

Here I'm pulling together a few different bits of information on dealing with the COVID-19 pandemic that I believe to be correct. I've linked to sources and included publication dates to help with identification and trust.

Starting with: Should you wear a mask when out and about?

Yes. See this post from Daring Fireball's John Gruber. "We’re waiting for peer-reviewed studies. In the meantime, early studies and anecdotal evidence from countries with established mask-wearing social norms suggest quite strongly that mask wearing is effective." (May 21, 2020.)

See also "HAMSTER RESEARCH SHOWS MASKS EFFECTIVE IN PREVENTING COVID-19 TRANSMISSION" linked to and summarized by John Gruber. (May 21, 2020.)
 
John's not some conspiracy theorist. He's a respected tech blogger linking to various respectable sources of information.

Note that disposable surgical masks should always be worn with the colored side out. (USA Today, April 15, 2020.)
 
But I read that surgical masks don't help, as they clearly don't filter out COVID-19 particles.

Multiple sources explain why you should wear a surgical mask when out and about. Here's one: Nicole Hernandez from KREM-TV (May 19, 2020): "a surgical mask can protect surrounding people from the respiratory emissions of the person who wears it. [...] So even if the mask doesn't actually protect the person wearing it from coronavirus, it does help keep that person's droplets from their mouth and nose out of the air. Since that's how COVID-19 can spread, it is ultimately helping reduce the spread."

Johns Hopkins Department of Environmental Health and Engineering Faculty expert Ana Rule said on April 24 that "[surgical] mask[s] will stop those larger particles from depositing on surfaces and potentially being picked up by the next person that touches that surface, for example at the supermarket."

The implication here is that surgical mask may be an imperfect blocker, but that research is ongoing, and that some research is showing that it does help, and that even before that research, a lot of smart folks suggested it might help and cannot hurt. The data on the upside is growing and the downside is minimal. 

But I read CDC guidance that said you shouldn't wear a mask!

Guidance evolves over time, for multiple reasons. One of those primary reasons is that this is how science works. CDC initially did not suggest masks, but that guidance changed and now they do recommend masks. Why? "But as Ranney pointed out in an interview with CNBC, it’s “part of the process” that leading public health authorities would adapt their thinking based on new information." Christina Farr, CNBC. (May 23, 2020.) 

More from that same CNBC article: "In our culture, we often hold politicians, corporate executives and other leaders accountable for the consistency of their positions. In political debates, candidates will often point out on the debate stage that a rival swung to the left or right over a controversial issue. It suggests a lack of authenticity, or even careerism, and indicates that they can’t be trusted to do what’s right for their constituents.

"[But,] In the scientific world, it’s expected that even the highest-ranking academics will evolve their thinking — and many have done so during this Covid-19 pandemic."

Making me wear a mask is discrimination and I have freedoms and rights! The ADA says you have to accommodate me!

It's been sad to see some people misuse the Americans with Disabilities Act (ADA) to try to argue that they don't have to wear masks and see them claim that the ADA requires that they be let into stores anyway. The law clearly does not say or allow for what they claim. Insider: Anti-mask protesters are trying to commandeer US disability laws to get into stores without face coverings. (May 19, 2020.)

Snopes: Can People Without Disabilities Use an ADA ‘Mask Loophole’ in Stores? No. "For the record, Americans without disabilities are not protected by the federal Americans with Disabilities Act (ADA)."

Epstein Becker Green is a "national law firm with a primary focus on health care and life sciences; employment, labor, and workforce management; and litigation and business disputes." On legal content site JD Supra, they published "No Mask, No Service? ADA Considerations for Business Owners Requiring Face Masks in Retail Stores" on May 14, 2020. They explain that a reasonable accommodation under the ADA can be made without letting the person into the store:

"In limited circumstances, there could be a situation in which a customer cannot wear a face mask due to a legitimate health reason (e.g., a person with a respiratory condition who cannot have their breathing restricted).  In this case, pursuant to the considerations detailed above, a business may not need to alter their face-mask required policy, but in any event should attempt to accommodate that customer in an alternative manner that would continue to protect the store’s employees and other customers while also providing service to the customer (e.g., providing curb-side pick-up; no contact delivery; or assistance via online store services)." 

Should you take hydroxychloroquine?

Probably not. It may increase death risk, and COVID-19 benefits are not clear. (Reuters via Yahoo, Mary 22, 2020.)

I have friends who take hydroxychloroquine it for lupus, and it's serious stuff. They don't do so lightly, so please don't cause a run on this drug so that it becomes harder to get for people for whom it has actually been prescribed.

"But the president is taking it for COVID-19 prevention" (the president has actually stopped taking it, USA Today, May 24, 2020) as an argument falls down for too many reasons to cover here. Do better. 

"But Hannity says..." Watching Sean Hannity is dangerous and puts you at risk. I am not kidding. Vox: A disturbing new study suggests Sean Hannity’s show helped spread the coronavirus. (Apr 22, 2020.)

Is it safe to go back to bars and restaurants?

That depends. Do you want to be part of the problem and get sick or transmit the disease to somebody else who could die from it, assuming you yourself don't die from it? No? Then stay home. Why? Because this thing is not under control yet. Washington Post: Study estimates 24 states still have uncontrolled coronavirus spread. (May 22, 2020.)

Restaurants are not safe. National Public Radio: From Camping To Dining Out: Here's How Experts Rate The Risks Of 14 Summer Activities. (May 23, 2020.) "Indoor dining 'is still amongst the riskier things you can do,'" according to Dr. Emily Landon, a hospital epidemiologist and infectious diseases specialist at University of Chicago Medicine. 

Remember that whether or not your state is "open for business," this does not mean that restaurants are safe for dining in. This does not mean that bars are safe places to congregate. The data suggests otherwise. 
 
What things are risky / not risky to do outside of the home right now?

Andy Larsen from the Salt Lake Tribune excellently summarizes available data. (H/T Megan Carpentier)

I'm going to share the bullet points from the SLT article, but please click through and read the whole thing. These are all direct quotes from the SLT article:

Bars and clubs
    • Dance floors are probably incompatible with social distancing.
    • High-capacity bars and clubs are going to be potential locations of superspreading events.
Buffets
    • Self-serve buffets probably create an unmanageable amount of viral spread.
Buses
    • In closed, small environments, virus transmission can occur throughout a room.
    • Keeping outside ventilation high on buses seems to be a worthwhile goal.=
Choirs
    • Singing appears to significantly raise the likelihood of transmission.
Church
    • Churches can be the site of community-changing superspreading events.
    • High-risk activities like singing and buffets may make church gatherings more dangerous.
Family gatherings
    • Avoid hugging and sharing food, especially while sick.
Grocery stores
    • Constant movement in spacious buildings probably helps prevent exposure to coronavirus droplets.
Gyms
    • Gyms can quickly spread the coronavirus, especially when instructors become infected.
    • High-intensity workouts may be more dangerous than low-intensity workouts, though that’s unclear.
Malls
    • Thanks to high traffic numbers, one mall or large store can infect many people, even though the likelihood of any individual customer being infected is low.
Offices
    • The most dangerous method of transmission in an office is spending a long time near an infected person.
    • Using shared facilities like restrooms with an infected person appears to be less dangerous.
    • Spending a short amount of time with an infected person, like on an elevator ride, is not especially dangerous.
    • Jobs with frequent talking, like call centers, do appear to have elevated risk for superspreading.
Planes
    • Don’t go on a plane with a cough. Everyone should wear a mask.
    • If there is someone with a cough, those viral particles can likely travel more than 6 feet, but probably not throughout the plane.
    • The odds of an outbreak on any individual plane trip are low.
Polling places
    • In-person voting either has a small or neutral impact on coronavirus spread when precautions are taken.
Schools
    • Schools are a significant source of spread for other diseases like influenza, but so far, not the coronavirus. We don’t know why.
    • A individual who has contact with an infected child in a school is unlikely to be infected.
Sports venues and stadiums
    • Getting thousands or tens of thousands of people together in one building can result in community-changing “biological bombs."
    • Sports celebrations (singing, hugging, cheering) could potentially mean more spread.
Here's more on what's safe and not safe as compiled by National Public Radio on May 23rd:
  • A BYOB backyard gathering with one other household: low to medium risk (avoid sharing food, drinks or utensils)
  • Eating indoors at a restaurant: medium to high risk
  • Attending a religious service indoors: high risk
  • Spending the day at a popular beach or pool: low risk (Watch out for crowds at entry points and bathrooms. Maintain social distance both on land and in the water.)
  • An outdoor celebration such as a wedding with more than 10 guests: medium to high risk
  • Using a public restroom: low to medium risk (risk depends on the number of local COVID-19 cases and how clean the bathroom is)
  • Letting a friend use your bathroom: low risk
  • Going to a vacation house with another family: low risk
  • Staying at a hotel: low to medium risk
  • Getting a haircut: medium to high risk
  • Going shopping at a mall: risk varies
  • Going to a nightclub: high risk
  • Going camping: low risk
  • Exercising outdoors: low risk 

But most people who died from COVID-19 had other medical complications that contributed to their death, so those people were going to die anyway.

I find that awfully callous to say those other people were just going to die so OK let them die then. And that stance is probably based on bad science. Business Insider: A new analysis of COVID-19 deaths estimates the patients might otherwise have lived much longer — regardless of underlying condition. (May 10, 2020.)

And for those of you saying "but some people didn't really die of COVID, they're over counting!" Reality suggests otherwise. Washington Post: U.S. reports 66,000 more deaths than expected so far this year. (April 29, 2020) That means that by the end of April, 66,000 more people have died this year than expected. That's not accounting for cause of death, and it's not accounting for May. That means that if you look at year-over-year death numbers, a bunch more people died this year compared to last year. On April 27th, The Washington Post reported that from March 1 to April 4, the United States saw 15,400 excess deaths -- nearly double the total attributed to COVID-19 for that thirty-four day period. Again, same thing. More deaths than expected for the stated time frame, and it provides a strong implication that at some point COVID-19 was under reported as cause of death.

Here's more data and analysis that suggests that COVID-19 deaths are actually being under reported. From Forbes: "There's also the case of excess deaths in many countries. The Times reported that the overall average number of deaths in many countries—not just including coronavirus cases—has been higher than normal, illustrating that potentially tens of thousands of fatalities are not being counted in the coronavirus death toll due to lack of information." (May 10, 2020.) The New York Times report that Forbes mentioned can be found here. The NY Times data analysis as of May 25th clearly shows a higher-than-average death rate in 2020 in many places in the world. 

Isn't this just like the flu, isn't all the concern here overblown?

Healthline: Here’s Why COVID-19 Is Much Worse Than the Flu, (May, 2020): "Faust concludes that COVID-19 deaths are actually anywhere from 10 times to 44 times the number of influenza fatalities."

OK, what if that's not true? It isn't false, but setting it aside, Google for examples of peoples' experiences. Shortness of breath, so tired they can't move for days, having to sleep on their stomach, fever, headache, vomiting, and more. Pretend that's flu if you want, but it's the worst flu you've ever gotten. Do you really want to experience something that's like the flu dialed up to 11? And then add back in that increased mortality rate when compared to the flu.

And then there's a chance that COVID-19 will cause lasting heart damage. The Harvard Gazette's Ekaterina Pesheva wrote on April 14th that "heart damage has recently emerged as yet another grim outcome in the virus's repertoire of possible complications." Also from the article: "'[COVID-19 is] like one big stress test for the heart,' said [Paul] Ridker, the Eugene Braunwald Professor of Medicine at Brigham and Women’s Hospital."

And then there's Multisystem Inflammatory Syndrome in Children (MIS-C), something that COVID-19 can seemingly trigger in the young. The CDC explains: "[MIS-C] is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. We do not yet know what causes MIS-C. However, we know that many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19." (Page reviewed by me on May 25, 2020.)

Dr. Cynthia Wachtell wrote about MIS-C in an op-ed for the New York Times on May 21, 2020"MIS-C is thought to be a delayed overreaction of the immune system to Covid-19 that can cause a deadly heart inflammation and a kind of toxic shock." She goes on to explain that her son was afflicted with MIS-C long after recovering from COVID-19. "Eight weeks after he was exposed to someone with Covid-19, he was hospitalized. During his first day in the hospital, we received a steady stream of reassuring news. Then on the second evening, his blood pressure suddenly began to drop." This is a mild case. MIS-C can kill.

But the protests and discussion on chatter make it clear: Americans overwhelmingly want America to reopen NOW.

Some reports would make you think there's a strong grassroots movement around this, but when you dig into it, it seems as though this may not really be the case.
 
First: Nearly half of Twitter accounts pushing to reopen America may be bots, according to Carnegie Mellon researchers. (MIT Technology Review, May 21, 2020.) Here's a quick summary of that from John Gruber of Daring Fireball from May 23rd.

Next, respected security researcher Brian Krebs traced a number of “Operation Gridlock” protest organization websites to a right wing group "so extreme in their stance they make the National Rifle Association look like a liberal group by comparison." They seem to be behind top "reopen" Facebook groups, too. (NBC News, April 20, 2020.)

The right-wing DeVos family (you may know of Betsy DeVos, Trump’s education secretary) seem to have some connection to this as well. From the Guardian: Why the DeVos family's backing of the Michigan protests is no surprise. (April 26, 2020.) 

In short, this isn't a grassroots, organic upswell of people who really believe that the shutdown is bad. These are opportunistic very far-right extremists and a big money group looking to stir the shit. That's called astroturfing. You're being played.

And you're putting yourself at risk. Aat least 72 people in Madison, Wisconsin recently caught COVID-19 after being at a "large event." The state Department of Health Services didn't track which event, but there was just the one big one recently -- the April 24th "operation Gridlock" protest. Meaning that there's a good chance that a bunch of people who attended the "anti-lockdown" rally caught COVID-19 for their efforts. (Channel 3000/Associated Press, May 8, 2020.) 

As far as what people actually think, data is available. Washington Post: Americans widely oppose reopening most businesses, despite easing of restrictions in some states, Post-U. Md. poll finds. (May 5, 2020.) 

You're crazy. We live in a small town and it's not like the big city. Everything here is fine.

I live in Chicago and my wife and I have many friends who live in New York. What's happening in NY I surely would not wish on anyone. It's serious business here in Chicago, too. But people in rural areas not taking this thing seriously means that it will affect them eventually. See: Washington post: A deadly ‘checkerboard’: Covid-19’s new surge across rural America. (May 24, 2020.)

I hope none of y'all small town folks know anybody who works in a meat packing plant: Wired: Why Meatpacking Plants Have Become Covid-19 Hot Spots. (May 7, 2020.) Hopefully you don't share any of the same stores, churches, bars, restaurants or hair salons with any of them either. 

This is all overblown and I'm going to start having dinner parties again.

I truly hope you're smarter than that. But if not, I hope I don't end up reading about you on the "Coronavirus Regret" subreddit or on the front page of the NY Times.