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Tag Archives: Endemicity

Mask Truths and Signals

26 Tuesday Oct 2021

Posted by pnoetx in Coronavirus, Public Health

≈ 6 Comments

Tags

Aerosols, Anne Wheeler, Cloth Masks, Comorbitities, Coronavirus, Covid-19, Delta Variant, Emotional Interference, Endemicity, Germaphobia, Influenza, Mask Mandates, Masks, Michael Levitt, OCD Therapy, Outdoor Infectiions, Precautionary Principle, Randomized Control Trials, Seasonality, Viral Interference, Viral Transmission

It’s been clear since the beginning of the pandemic that your chance of getting infected with COVID outside is close to zero. (Also see here). Yet I still see a few masked people on the beach, in the park, on balconies, and walking in the neighborhood. Given the negligible risk of contracting COVID outdoors, the marginal benefit of masking outdoors is infinitesimal. Likewise, the benefit of a mask to the sole occupant of a vehicle is about zilch. Okay, some individuals might forget to remove their masks after leaving a “high-risk” environment. Sure, maybe, but cloth masks really don’t stop the dispersion of fine aerosols anywhere, indoors or outdoors. Of course, the immune-compromised have a reasonable excuse to apply the precautionary principle, but generally not outside with good air quality.

The following link provides a list of mask studies, and meta-studies. Several describe randomized control trials (RCTs). They vary in context, but all of them reject the hypothesis that masks are protective. Positive evidence on mask efficacy is lacking in health care settings, in community settings, and in school settings, and the evidence shows that masks create “pronounced difficulties” for young children and “emotional interference” for school children of all ages. Here’s another article containing links to more studies demonstrating the inefficacy of masks. Also see here. And this article is not only an excellent summary of the research, but it also highlights the hypocrisy of the “follow the science” public health establishment with respect to RCTs. Compliance is not even at issue in many of these studies, though if you think masks matter, it is always an issue in practice. Even studies claiming that cloth masks of the type normally worn by the public are “effective” usually concede that a large percentage of fine aerosols get through the masks… containing millions of tiny particles. In indoor environments with poor ventilation, those aerosols remain suspended in the air for periods long enough to be inhaled by others. That, in fact, is why masks are ineffective at preventing transmission.

Another dubious claim is that masks are responsible for virtually eliminating cases of influenza in 2020 and 2021. Again, to be charitable, masks are of very limited effectiveness in stopping viral transmission. Moreover, compliance has been weak at best, and areas without mask mandates have experienced the same plunge in flu cases as areas with mandates. A far more compelling explanation is that viral interference caused the steep reduction in flu incidence. The chance of being infected with more than one virus at a time is almost nil. Simply put, COVID outcompeted the flu.

Again, I grant that there are studies (though only a single randomized control trial out of India of which I’m aware) that have demonstrated significant protective effects. Even then, however, the mixed nature of this body of research does not support intrusive masking requirements.

Nevertheless, masks are still mandated in some jurisdictions. Those mandates usually don’t apply outdoors, however, and not in your own damn car! Mask mandates contribute to the general climate of fear surrounding COVID, which is wholly unjustified for most children and healthy working-age people. Public health messaging should focus on high-risk individuals: the elderly, the obese, and those having so-called comorbidities and compromised immune systems. Those groups have obvious reasons to be concerned about the virus. They have excuses to be germaphobic! Still, they are at little risk outdoors, the value of masks is doubtful, and breathing deep of fresh air is good for you in any case!

The incidence of COVID has declined substantially in many areas since early September, but the virus is now almost certainly endemic and is likely to return in seasonal waves. However, the Delta wave was far less deadly than earlier variants, a favorable trend many believe will continue. These charts from the UK posted by Michael Levitt demonstrate the improvement vividly. Perhaps the mask craze will fade away as the evidence accumulates.

The pandemic has been a moment of redemption for germaphobes, but no reasonable assessment of risk mitigation relative to the cost, inconvenience, discomfort, and psychological debasement of face jackets can prove their worth outdoors. Their value indoors is nearly as questionable. Yet there remains a stubborn reluctance by public health authorities to lift mask mandates. There are far too many individuals masking outdoors, and to be nice, perhaps it’s mere ignorance. But there are still a few would-be tyrants on Twitter presuming to shame others into joining this pathetic bit of theatre. I believe Anne Wheeler nailed it with this recent tweet:

“This is one of the first things you learn in OCD therapy – you don’t get to make people participate in your compulsions in order to lesson your own anxiety. It’s bizarre that it’s been turned into a virtue.”

There’s also no question that masks are still in vogue as a virtue signal in some circles, but a mask outdoors, especially, is increasingly viewed as a stupid-signal, and for good reason. I’ll continue to marvel at the irrationality of these masked alarmists, who just don’t understand how foolish they look. Give yourself permission to get some fresh air!

Herd Immunity To Public Health Bullshitters and To COVID

16 Monday Aug 2021

Posted by pnoetx in Coronavirus, Herd Immunity, Uncategorized

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Tags

Acquired Immunity, Aerosols, AstraZeneca, Border Control, Breakthrough Infections, Case Counts, Covid-19, Delta Variant, Endemicity, Herd Immunity, Hospitalizations, Immunity, Lockdowns, Mask Mandates, Oxford University, Paul Hunter, PCR Tests, School Closings, ScienceAlert, Sir Andrew Pollard, T-Cell Immunity, Transmissability, University of East Anglia, Vaccinations, Vaccine Hesitancy

My last post had a simple message about the meaning of immunity: you won’t get very sick or die from an infection to which you are immune, including COVID-19. Like any other airborne virus, that does NOT mean you won’t get it lodged in your eyeballs, sinuses, throat, or lungs. If you do, you are likely to test positive, though your immunity means the “case” is likely to be inconsequential.

As noted in that last post, we’ve seen increasing COVID case counts with the so-called Delta variant, which is more highly transmissible than earlier variants. (This has been abetted by an uncontrolled southern border as well.) However, as we’d expect with a higher level of immunity in the population, the average severity of these cases is low relative to last year’s COVID waves. But then I saw this article in ScienceAlert quoting Sir Andrew Pollard, a scientist affiliated AstraZeneca and the University of Oxford. He says with Delta, herd immunity “is not a possibility” — everyone will get it.

Maybe everyone will, but that doesn’t mean everyone will get sick. His statement raises an obvious question about the meaning of herd immunity. If our working definition of the term is that the virus simply disappears, then Pollard is correct: we know that COVID is endemic. But the only virus that we’ve ever completely eradicated is polio. Would Pollard say we’ve failed to achieve herd immunity against all other viruses? I doubt it. Endemicity and herd immunity are not mutually exclusive. The key to herd immunity is whether a virus does or does not remain a threat to the health of the population generally.

Active COVID infections will be relatively short-lived in individuals with “immunity”. Moreover, viral loads tend to be lower in immune individuals who happen to get infected. Therefore, the “infected immune” have less time and less virus with which to infect others. That creates resistance to further contagion and contributes to what we know as herd immunity. While immune individuals can “catch” the virus, they won’t get sick. Likewise, a large proportion of the herd can be immune and still catch the virus without getting sick. That is herd immunity.

One open and controversial question is whether uninfected individuals will require frequent revaccination to maintain their immunity. A further qualification has to do with asymptomatic breakthrough infections. Those individuals won’t see any reason to quarantine, and they may unwittingly transmit the virus.

I also acknowledge that the concept of herd immunity is often discussed strictly in terms of transmission, or rather its failure. The more contagious a new virus, like the Delta variant, the more difficult it is to achieve herd immunity. Models predicting low herd immunity thresholds due to heterogeneity in the population are predicated on a given level of transmissibility. Those thresholds would be correspondingly higher given greater transmissibility.

A prominent scientist quoted in this article is Paul Hunter of the University of East Anglia. After backing-up Pollard’s dubious take on herd immunity, Hunter drops this bit of real wisdom:

“We need to move away from reporting infections to actually reporting the number of people who are ill. Otherwise we are going to be frightening ourselves with very high numbers that don’t translate into disease burden.”

Here, here! Ultimately, immunity has to do with the ability of our immune systems to fight infections. Vaccinations, acquired immunity from infections, and pre-existing immunity all reduce the severity of later infections. They are associated with reductions in transmission, but those immune responses are more basic to herd immunity than transmissability alone. Herd immunity does not mean that severe cases will never occur. In fact, more muted seasonal waves will come and go, inflicting illness on a limited number of vulnerables, but most people can live their lives normally while viral reproduction is contained. Herd immunity!

Sadly, we’re getting accustomed to hearing misstatements and bad information from public health officials on everything from mask mandates, lockdowns, and school closings to hospital capacity and vaccine hesitancy. Dr. Pollard’s latest musing is not unique in that respect. It’s almost as if these “experts” have become victims of their own flawed risk assessments insofar as their waning appeal to “the herd” is concerned. Professor Hunter’s follow-up is refreshing, however. Public health agencies should quit reporting case counts and instead report only patients who present serious symptoms, COVID ER visits, or hospitalizations.

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