A mask may not protect the wearer, but it will help prevent the wearer from spreading the virus to other people.
Masks prevent respiratory droplets (produced by talking, coughing, and sneezing, for example) from spreading germs to other people. Some people find typical masks uncomfortable because they can trap moisture against the face and may opt for ones with one-way valves or vents. Unfortunately, this creates an effective channel for exhaled droplets to reach others, defeating the purpose of the masks. This is why the CDC recommends using masks without an exhalation valve or vent.
Masks alone are not enough.
You can reduce the spread of SARS-CoV-2 by wearing masks in addition to practicing other preventive measures, such as social distancing, frequent and effective handwashing, and cleaning and disinfecting frequently touched surfaces.
Surgical masks are ONE-WAY.
Let me repeat that one more time for emphasis. Surgical masks are ONE-WAY. The concept of flipping the mask based on situation is a MYTH. If you wear the mask inside out, it’s not going to help anyone.
If the mask has a blue or green side, this is the side that should face other people. If the mask is all white, put the softest side to your face.Surgical masks don’t work unless they completely cover your nose and mouth. Pinch around the bridge of your nose.
Why are they one-way? Surgical masks can’t be reversed because they have three specialized layers. In the name of science, I dissected one so I could show you.
Zoomed in view of the stitching that keeps the 3 layers of a surgical mask together.
Dissected surgical mask, side view.
These handy little forms of PPE (personal protective equipment) are specifically designed to protect a patient on the operating table from the respiratory droplets of a surgeon, who is breathing, talking, and potentially sneezing above a patient’s open abdomen/brain/etc. They do this by intercepting and diffusing those droplets and by minimizing lateral dispersion (sideways spread). First, droplets are captured by a water-loving absorbent layer, typically white. Anything that makes it beyond this layer is then filtered out (remember, these filters won’t trap viruses because they are really tiny). If a droplet isn’t caught by the filter, it hits the final, water-repellant exterior layer, often blue or green, which further helps to minimize the chance it will spread to those around the wearer. These masks are not intended to protect the wearer.
Mask Layers
Outside – water repellent
Middle – Filter
Inside – water absorbent
What happens if my mask is inside out?
If your mask is inside out, the moisture repellant side is up against your face. When you exhale, water vapor won’t be absorbed by the mask and it will become wet. The mask then loses its ability to efficiently filter and trap droplets and you will likely find the damp mask pretty uncomfortable. With the mask inside out, the absorbent layer now faces the environment and has become a droplet landing zone. If you touch the contaminated exterior of the mask and then touch your face, or re-use the mask instead of replacing it, you increase your chances of getting sick. This virus is already super effective at spreading; let’s not make it even easier!
Masks don’t work when:
dirty or wet
upside down/inside out
torn
not covering your nose or your mouth completely
Under any of the above conditions, the filtration efficiency and protective capability of the mask is compromised.
I’m a sucker for fun ways to remember things, so here you go! B is for blue and brrrr.
Didn’t the CDC say NOT to wear masks?
Yes, but here’s why. Previously, the CDC and the WHO recommended that only those with symptoms should wear masks. They’ve since modified this recommendation because:
SARS-CoV-2 can be spread by asymptomatic individuals or before symptoms appear
Surgical masks are prioritized for healthcare workers coming into contact with many patients
You should still prioritize surgical masks for healthcare workers. Cloth masks, however, are more effective than not wearing anything — although not a substitute for social distancing, not touching your face (cloth masks also provide a tactile reminder not to touch your face), and frequent hand washing.
Let’s Review!
Wear a mask that properly fits, and in the right orientation.
Don’t wear masks with exhalation valves/vents.
Always practice social distancing and hand hygiene. Wearing a mask is not a substitute for these behaviors.
Don’t touch your face!
A final note
I don’t need to tell you that this pandemic has been difficult for so many people. Everything about our daily lives and how we provide for ourselves and our families has been affected. The disproportionate effect of COVID-19 on certain racial and ethnic minority groups has led to increased awareness of systemic racism and inequity, from housing to education and everything in between. If you don’t consider this virus a serious problem, I urge you to thoughtfully reflect on what privileges you may knowingly or unknowingly hold, and how no individual experience is reflective of our country as a whole. If you’re in a position to doubt whether or not this is a big deal, you may not recognize how fortunate you are to have some degree of financial stability or greater access to health care that others do not. I urge you to trust evidence-based science and to trust your public health officials. Please protect yourselves and others by observing the rules of masks, distance and hygiene.
Do you have questions, comments, or suggestions for my next experiment/dissection?
Email asktheoptimisticscientist@gmail.com or comment below!
There are 3 kinds of tests for SARS-CoV-2 under the FDA’s Emergency Use Authorization (EUA): Molecular, Antibody, and Antigen testing.
Molecular test — RT-PCR (Reverse transcription polymerase chain reaction): This is a molecular in vitro diagnostic test that identifies the presence of virus in the body through collection of nasopharyngeal, oropharyngeal, or other respiratory specimens by swabbing.
A false-negative result may occur if:
a specimen is improperly collected, transported or handled
inhibitors are present in the specimen
there are too few virus particles present in the specimen.
Detecting the presence of the virus doesn’t indicate whether or not someone is infectious.
A single negative result does not mean you can skip social distancing or stop wearing a mask.
A negative test result only means that you didn’t have COVID-19 at the time of testing. It’s possible your sample was collected too early in your infection.
You could also be exposed to COVID-19 after the test and then get infected and spread the virus to others.
If you develop symptoms later, you may need another test to determine if you are infected with the virus that causes COVID-19.
Antibody Test — Serology: Blood test with a turn-around time of typically same day, but sometimes can take a couple days. Serology is especially important because it may detect previous infections in people who had few or no symptoms.
Antibodies are proteins made by the immune system in response to a foreign substance (called an antigen). Each antibody recognizes a small portion of a single antigen (antibody specificity) so an antibody that recognizes the virus that causes chickenpox will not recognize the virus that causes measles.
There are 5 different types, or classes, of antibody: IgG, IgM, IgA, IgE, and IgD. Most rapid novel coronavirus tests look for IgG and IgM. After an infection, your body starts to produce IgM antibodies first, which can be detected after about a week and hang around for a couple weeks after your symptoms start. IgG antibodies are part of your immune system’s long-term arsenal, detected after 2 weeks from the start of symptoms, peaking around 30 days, and hang out for months or even years after you recover.
IgM antibodies: Produced first, detected ~ 1 week after start of symptoms. Because it is only detectable for a couple weeks, it is used to determine recent infection.
IgG antibodies: Produced later, detected ~ 2 weeks after start of symptoms. Because it can be detected for months or years after infection recovery , it is used to determine past infection.
In general, there are two kinds of antibody test methods: binding antibody or neutralizing antibody tests.
Binding antibody tests: These tests use purified proteins of SARS-CoV-2, not live virus, and can be performed in lower biosafety level laboratories (e.g., BSL-2).
Point-of-care (POC) tests usually use lateral flow to detect IgG, IgG and IgM, or total antibody in whole blood, serum, plasma, and/or saliva. A common example of a lateral flow device is a home pregnancy test. Some point-of-care tests can be performed on blood collected from a fingerstick rather than a blood draw.
Laboratory tests typically use ELISA (enzyme-linked immunosorbent assay) or CIA (chemiluminescent immunoassay) to detect IgG, IgM, and IgA antibodies, either individually or as total antibody.
Neutralizing antibody tests: As of July 2020, the FDA has not authorized the use of neutralization tests for SARS-CoV-2 yet. In this test, a serum or plasma sample is infected with live virus in a test tube to determine if the antibodies are functionally capable of preventing infection. Because this method involves the live virus, it requires a higher biosafety level (BSL-3 or BSL-2 laboratory).
Virus neutralization tests (VNT): Here, the SARS-CoV-2 virus comes from a clinical isolate or is modified for the assay. This testing must be done in a BSL-3 laboratory and can take up to 5 days.
Pseudovirus neutralization tests (pVNT): This test uses a non-SARS-CoV-2 modified virus (e.g. vesicular stomatitis virus, VSV) that has a piece of protein from SARS-CoV-2 attached to it. This testing can be performed in a BSL-2 laboratory, depending on the particular strain.
Unfortunately, just because we can detect them doesn’t automatically mean that they can provide immunity/protection from reinfection.
Antibody testing results shouldn’t be used to decide if someone can return to work. It also shouldn’t be used to group people together in settings such as schools, dormitories, and correctional facilities that increase the risk of transmission.
Antigen test — Rapid: Rapid diagnostic test with a turn-around time of less than one hour. Antigen tests look for specific proteins on the surface of the virus and can diagnose an active infection.
Unlike antibody tests that detect your immune system’s response to the virus, antigen tests detect viral proteins directly. The two major antigenic targets of of the SARS-CoV-2 virus are the spike glycoprotein (S) and the nucleocapsid phosphoprotein (N).
Depending on the complexity of the method, these tests can be performed in <30 minutes or may take a couple of hours.
Have general questions? Comments?
Email asktheoptimisticscientist@gmail.com or comment below!
Resources/Further Reading
Interim Guidelines for COVID-19 Antibody Testing (CDC, updated 8/1/2020)
Great Video Explanation of Antibodies & Serology Tests (Beckman Coulter, 5/22/2020)
Incubation Period: The time from when someone is infected to when symptoms develop. Based on existing evidence-based research, the incubation period of SARS-CoV-2 and other coronaviruses (e.g. MERS-CoV, SARS-CoV) ranges from 2–14 days. 50% of people will become ill 5 days after infection.
Infectious Period: The time when an infected person, who may not be showing symptoms, can transmit the virus to others. While it varies from person to person, it is typically ~ 7 days.
Begins:
2 days before the start of signs/symptoms
Ends:
10+ days after illness onset and
symptoms are improving and
there has been no fever within the past 24 hours (without anti-pyretic medications).
Some immunocompromised individuals or those with severe COVID-19 may shed the virus for 20 days.
For asymptomatic individuals, it is more difficult to define their infectious period.
Yesterday, the CDC updated their recommendations regarding when someone can end their isolation. The following changes have been made to the guidance with regards to the duration that a person should be fever-freebefore they may leave isolation:
Prior guidance:
An infected person must isolate for at least 10 days after onset of symptoms, and may be released from isolation if their symptoms have improved AND they have had no fever, without the use of medicines, for at least 3 days.
New guidance:
An infected person must isolate for at least 10 days after onset of symptoms, and may be released from isolation if their symptoms have improved AND they have had no fever, without the use of medicines for at least 24 hours.
Seriously, how long can this thing survive on surfaces?
In an earlier post, I referenced some preliminary research suggesting that SARS-CoV-2, the virus that causes COVID-19, can live in the air and on surfaces between several hours and several days. This work, originally released as a pre-print and recently finalized and published in the New England Journal of Medicine, found the virus is viable for up to 4 hours on copper, 24 hours on cardboard, 48 hours on stainless steel, 72 hours on plastics, and is also detectable in the air for 3 hours.
A lot of posts present this information out of context and headlines can make it sound frightening, “SARS-CoV-2 Lives on Plastic for 72 Hours!!!” However, what’s more important is the amount of virus that’s still alive. It’s <0.1% of what the investigators started with. So, infection is theoretically possible but extremely unlikely at the levels they saw after a few days.
Another important thing to mention lies in the experimental design of the aerosol component of the study. It has some caveats. They found that the virus can be detected in the air for 3 hours in the lab. However, in nature, respiratory droplets fall to the ground at a faster speed than the aerosols generated in their experiments. This is because the lab-generated aerosols are smaller (<5 μm) than what is produced from a cough or sneeze, so they remain in the air at face-height longer than the natural, heavier particles. It’s not a perfect comparison (though science rarely is, we just do our best). The size of these particles can affect how they move through the air and how they impact a surface.
So, at the end of the day you’re more likely to become infected through the air if you’re next to an infected person versus a contaminated surface. Make sure you clean surfaces with disinfectant or soap – they work because they disturb the oily external layer of the virus keeping it from infecting your cells.
If your home/residence becomes unsafe, you are permitted/urged to leave and stay at a safe alternate location (e.g. victims of domestic violence).
Doesn’t Apply If:
If you are an individual experiencing homelessness, but you are urged to obtain shelter, and governmental and other entities are strongly encouraged to do as much as they can to increase their capacity to help as many people as possible.
What Does This Mean for Gatherings?
Effective midnight on March 25, 2020 until midnight April 6, 2020 (unless extended beyond that date)
No public and private gatherings
Regardless of the number of people involved
doesn’t apply to people who are part of a single household or residential living unit.
What Does This Mean for Businesses?
All non-essential businesses in shall cease operations by midnight March 25, 2020 except for performing basic minimum operations.
Solidarity Trial – International Study Being Organized
The first vaccine trial has begun just 60 days after the genetic sequence of the virus was shared by China. To ensure clear evidence of which treatments are most effective, WHO and its partners are organizing a large international study, called the Solidarity Trial, in many countries to compare different treatments.
WHO Health Alerts via WhatsApp
To increase access to reliable information, WHO has partnered with WhatsApp and Facebook to launch a WHO Health Alert messaging service. This service will provide the latest news and information on COVID-19, including details on symptoms and how people can protect themselves. The Health Alert service is now available in English and will be introduced in other languages next week.
To access it, send the word “hi” to the following number on WhatsApp: +41 798 931 892.
Virtual Concert Series
WHO and Global Citizen launched #TogetherAtHome, a virtual, no-contact concert series to promote physical distancing and action for global health. Chris Martin, lead singer of Coldplay, kicked it off earlier this week with a performance from his home. More Solidarity Sessions are planned to promote health, show support for people who are staying at home to protect themselves and others from COVID-19, and encourage donations to the COVID-19 Solidarity Response Fund.
What to do, what not to do, what various levels of government are instructing us to do, and what you shouldn’t do just because you see other people doing it…
Bars/Restaurants
Governor Inslee’s Emergency Proclamation
Mandatory and immediate 2-week closure of all:
Restaurants
Bars
Entertainment facilities
Recreational facilities
Restaurants can still provide:
✓ Takeout
✓ Delivery
Dental Offices
All elective procedures are to be put on hold.
Offices should still see patients for dental emergencies or urgent dental care.
The American Dental Association (ADA) has called upon dentists to do their part to mitigate the spread of COVID-19 by postponing elective procedures for the next three weeks. For the ADA’s guidelines on what constitutes a dental emergency, please refer to this document.
Groceries/Household Supplies
Grocery stores and pharmacies are still open and there is no need to hoard supplies. Seattle’s supply chain is strong according to governor Inslee[edit: This was confirmed 3/19/20 by Greg Ferrara, President of the National Grocers Association], so please, be considerate of your neighbors and community and do not contribute to shortages – buy what you need right now.
Health Officer Order (Dr. Jeff Duchin, Department of Public Health – Seattle & King County)
All events with > 50 people are prohibited until further notice
All events with < 50 people are discouraged and prohibited unless organizers observe COVID-19 prevention measure requirements.
All bars, dance clubs, fitness and health clubs, movie theaters, nightclubs, and other social and recreational establishments shall be closed until at least March 31.
All other retail – including banks, grocery stores, hardware stores and pharmacies – should and may remain open, provided they observe COVID-19 prevention measures.
Lyft is pausing Shared rides across all markets. The health and safety of the Lyft community is our top priority, and we’re dedicated to doing what we can to slow the spread of COVID-19. We will continue to monitor the situation closely and base our actions on official guidance.
In order to adhere to social distancing guidelines, until further notice, fare enforcement inspectors will not ask for proof of payment on board Link light rail or Sounder trains.
Buses and the Lightrail are increasing efforts to sanitize and keep cars/buses clean.
Utilities (Gas, Electricity, Water)
Residential Evictions in Seattle have been Halted During this Outbreak
Seattle Public Utilities (SPU) , Seattle City Light (SCL), and Puget Sound Energy (PSE) will keep utility services on during the COVID-19 Civil Emergency in Seattle.
SPU and SCL customers who have been financially impacted by COVID-19, regardless of background or immigration status, can request a deferred payment plan that includes reversed late fees.
From the site: “This list is specifically designed to serve freelance artists, and those interested in supporting the independent artist community. This includes, but is not limited to, actors, designers, producers, technicians, stage managers, musicians, composers, choreographers, visual artists, filmmakers, craft artists, teaching artists, dancers, writers & playwrights, photographers, etc.” Visit covid19freelanceartistresource.wordpress.com to see the full list of regularly updated resources.
Financial Support for Seattle Artists Impacted by COVID-19
Seattle-based author and artist Ijeoma Oluo and others have organized this fundraiser on behalf of Artists Relief Fund. From the website: “This fund is aimed at helping those in the greater Seattle arts community who have been financially impacted by cancellations due to COVID-19, with priority given to BIPOC artists, transgender & nonbinary artists, and disabled artists – but we will try to help as many artists with need in Seattle as we can.” To donate to the fund, go here: gofundme.com/f/for-artists. To apply for funding, visit: surveymonkey.com/r/LHJNLQV.
Both Seattle’s Paid Sick and Safe Time (PSST) Ordinance and Washington Initiative 1433 establish local and statewide paid sick leave for hourly employees working in Washington state. In Seattle, the law requires employers to provide all employees with paid sick and safe time. This includes full-time, part-time, temporary, exempt, and non-exempt employees. Please call the Seattle Office of Labor Standards at (206) 256-5297 or visit Office of Labor Standards PSST page here.
State Unemployment Benefits for Workers
The Washington State Employment Security Department has programs designed to help individuals and employers impacted by the COVID-19 outbreak. They have an easy-to-read comparison guide listing some of the most common scenarios that may occur and benefits that may apply. More information for workers and businesses here: esd.wa.gov/newsroom/covid-19.
Washington Small Business Development Center Business Resiliency Toolkit
The Business Resiliency Guide is a tool to help small business owners assess risks and make contingency plans that will enable businesses to recover from the immediate threat of COVID-19 as well as the disruptions that could continue over weeks or months. You can download the business resiliency guide and supporting materials here: wsbdc.org/protect-your-business/business-resiliency/.
OLS has compiled a comprehensive list of resources and FAQs for both workers and employers affected by COVID-19: seattle.gov/laborstandards.
Small Business/Non-Profit Help
City of Seattle B&O Tax Deferment Information
Effective immediately, the City of Seattle Department of Finance and Administrative Services (FAS) will defer business and occupation (B&O) tax collections for businesses that have annual taxable incomes of $5 million or less and that pay city taxes quarterly. This will allow small business owners increased flexibility during a period of financial duress caused by the COVID-19 outbreak. If you have questions, please call (206) 684-8484 or email: tax@seattle.gov.
Financial Resources for Washington Residents Impacted by COVID-19
The Washington State Department of Financial Institutions has developed a list of financial resources for Washington consumers impacted by the Coronavirus. You can find more information about how to manage your mortgage, rent, and personal finances at their website: dfi.wa.gov/coronavirus-financial-resources
Financial Support for Non-Profit Organizations Impacted by COVID-19
Hosted by Seattle Foundation, the COVID-19 Response Fund will provide flexible resources to organizations in our region working with communities who are disproportionately impacted by coronavirus and the economic consequences of this outbreak. The Fund is designed to complement the work of public health officials and expand local capacity to address all aspects of the outbreak as efficiently as possible. To donate to the fund, go here: seattlefoundation.org/communityimpact/civic-leadership/covid-19-response-fund.
Resources for Unemployed Workers from United Way of King County
The Washington State Employment Security Department has programs designed to help individuals and employers impacted by the COVID-19 outbreak. They have an easy-to-read comparison guide listing some of the most common scenarios that may occur and benefits that may apply. More information for workers and businesses here: esd.wa.gov/newsroom/covid-19.
Small Business Adminstration Economic Injury Disaster Loans
In addition, small businesses in Seattle and King County are now eligible to apply for up to $2 million in low‑interest Small Business Administration (SBA) Economic Injury Disaster Loans (EIDL) to offset economic losses because of reduced revenues caused by the impact of the Coronavirus (COVID-19) pandemic. With currently $1 billion in loan subsidies available from the federal government, the City’s Office of Economic Development (OED) will be offering technical assistance and launching resources to help small businesses apply for SBA loans.
Eligible small businesses can receive loans of up to $2 million to pay fixed debts, payroll, accounts payable and other bills that can’t be paid because of the impact of COVID-19. Small businesses, private nonprofit organizations of any size, small agricultural cooperatives and small aquaculture enterprises that have been financially impacted as a direct result of COVID-19 are eligible to apply.
Applicants for the federal SBA may apply online, receive additional disaster assistance information and download applications at https://disasterloan.sba.gov/ela
Have general questions? Comments?
Email asktheoptimisticscientist@gmail.com or comment below!
How does SARS-CoV-2 spread? How long does it last on surfaces?
SARS-CoV-2 can spread between infected or non-infected people and infected people may or may not appear sick. The disease can spread between people from small droplets when someone coughs or exhales but they can also spread when these droplets land on any surface.
Recent preliminary research suggests that the novel coronavirus can survive on some surfaces for up to 3 days. This new research has not been peer-reviewed or published and is incomplete, therefore its conclusions cannot be treated as fact. This study has now been published in the New England Journal of Medicine, see my comments here.
What are the symptoms?
High fever (fever > 100.4ºF, a high fever is > 101.5ºF)
Dry cough
Shortness of breath
What if I think I may have COVID-19?
Call your primary care provider and discuss your symptoms with them over the phone. If they determine you should be tested, they’ll order the test and work with local and state health departments to coordinate the testing. Follow the Washington State Department of Health’s steps to help prevent the disease from spreading to people in your home and community found here.
How is my insurance coverage affected by the novel coronavirus?
The state of Washington has provided a page with a lot of information on how different types of insurance coverage may be affected, click here for that information.
If you have a state-regulated health plan (individual health plans, small employer health plans and some large employer plans) testing for SARS-CoV-2 and the associated office visit and lab testing is covered without copays or deductibles.
What if I don’t have health insurance?
If you do not have health insurance, the Washington Health Benefits Exchange has opened a limited-time enrollment period through April 8, 2020.
Until April 8, individuals seeking a special enrollment must contact the Customer Support Center between 7:30 a.m. to 5:30 p.m. Monday-Friday at 1-855-923-4633; TTY: 1-855-627-9604, or a local certified broker or navigator, request the SEP, and select a plan by April 8 for coverage start date beginning April 1, 2020. Language assistance and disability accommodations are provided at no cost.
Okay, I’m working from home / out of work / etc – what now?
Physicians and mental health experts emphasize how critical it is to maintain your normal routine. That means following your typical sleep and meal schedules and getting exercise. This certainly has the potential to be very isolating, so please do what you can to reach out to family, friends and colleagues and virtually check-in frequently.
I’m a parent, how do I help my child/teen cope with anxiety or fear about COVID-19?
Here’s a great article from Seattle Children’s that offers some really great information for how to help your kids (and it’s wise information for yourselves as well!). My biggest takeaway, and the impetus for writing this document, is to limit your information seeking to a fewcredible sources. This will help you stay informed without feeling overwhelmed. Summary points below, but you can read the whole article here.
Get the facts
Check-in and ask what questions they have
Watch for changes in behavior
Help them face anxiety and stick to routines
Limit media coverage
Take care of yourself
There’s also a great resource created by NPR and it’s a comic for kids about coronavirus. Check it out here.
I’ve heard the rumors, is it true there’s a quarantine/national lockdown coming?
Governor Inslee confirmed yesterday (3/16/20) that to his knowledge, there is currently no plan for a quarantine or forced lockdown.
The Optimistic Scientist 