A Head Full of Coronavirus Research, Part 28

A bit in catch up mode here as I return.  I want to emphasize to people that notwithstanding what I post about the issues with testing and false positives, I do perceive that there is a swell in cases, including some serious cases, in the upper Midwest, and some mountain states.  It is not easy with the data we are given to do the kind of cohort analysis that is most meaningful, but the percent of serious cases and deaths is clearly down and this swell has a lower rate of those than the earlier one in mid to late spring, but that is partly influenced by testing levels.  I don’t have a significant factual basis for believing this, but I think Minnesota has participated at a lower level in the current swell than some neighboring states because of our international hub airport and level of international travel.  I also believe that this swell is unlikely to be long-lasting. For whatever reason, in most places CV-19 outbreaks seem to have a curve that goes for a few weeks before diminishing to a longer right tail.  But my caution would be that we have not been through a fall or early winter season any where with CV-19

People keep doing modeling studies supposedly showing that masks or mask mandates reduce cases.  Every one of them is worthless, completely unable to disentangle confounding factors, and all making the usual mistake of telling the model that masks will reduce transmission.  The studies that are useful, are the ones that attempt to ascertain the physical effects of a mask on potential particles carrying virus.  Here is the latest in that type of study.  (Medrxiv Paper)   Masks and face shields are designed to both protect the wearer from infecting others and from being infected.  This study focused on their utility for preventing transmission from the wearer.  The researchers had a physical model that simulated coughs, which disperse the most particles, and they covered the model head with various face coverings.  They were particularly interested in the effect on small aerosol particles.  An N95 respirator blocked 99% of such particles, a surgical mask blocked 59%, a three ply cloth mask blocked 51% and a polyester neck gaiter blocked only 47% at a single layer and 60% at a double layer.  A face shield only blocked 2%.  Not mentioned by the study was other work showing that masks tend to atomize or break up larger droplets into smaller aerosols, which pass more easily through face coverings.  Now you know why masks simply aren’t that effective at a macro level.  Imagine multiple encounters during a day with infected persons wearing any of the face masks other than an N95.  The odds aren’t great against preventing replication-competent virus escape from an infected person.   And if you are wearing a face covering, that may reduce some of the aerosols entering your respiratory system, but again, the actual effectiveness over a number of encounters isn’t enough to prevent transmission.

A paper in the British Medical Journal examines the models used initially to justify lockdowns and finds that what they really suggest is that lockdowns cause more deaths in the long run.  (BMJ Article)   The authors took the Imperial College code and ran their own set of simulations which found that depending on the type of mitigation efforts, lockdowns could cause more total deaths over the course of the epidemic.   In particular they found that school closings led to more deaths.  The implication is that once you start down the lockdown path, if you get off it you are still going to see the deaths you would have seen without the lockdown, and potentially more deaths.

This study is a meta-meta analysis on the effect of social distancing and isolation on mental and physical health.  (Medrxiv Paper)   They included 15 meta-reviews on mental health and 10 on physical health.  Over 3 million people were covered by the studies.  Here are the money quotes:  “The results suggest that social isolation is associated with chronic physical symptoms, frailty, coronary heart disease, malnutrition, hospital readmission, reduced vaccine uptake, early mortality, depression, social anxiety, psychosis, cognitive impairment in later life, and suicidal ideation.”   The authors make the obvious recommendation that this should be taken into account when designing mitigation of spread measures.  They harm to anyone other than a CV-19 patient hasn’t been considered at all so far, and there are no signs they will be in the future.  These harms are just as real and lead to more deaths.

Even the whackos in California are acknowledging that they have seen no spike in cases related to the opening of schools, including in-person education.  (Cal. Story)

Sweden not only didn’t disrupt its society much for the epidemic, its economy is in much better shape than those of other European countries.  (Telegraph Story)  The country’s economy is expected to fall by 3.3% versus 8.3% for Europe as a whole.