New guidance from the CDC on surface contamination spread of the virus
Less concern about surfaces like cardboard, metal, plastic
This commentary contains specific steps you and others can take to avoid the virus and help bring the crisis to an end as well as links to the CDC. Note: this is a revised version of an earlier post.
Masks. Masks. Masks. Can they really save us from getting infected with the demon of this virus?
The answer is maybe, maybe not. There are other steps that need to be taken.
Epidemiologists have pointed out that the masks most of us wear are not good enough to really filter out the airborne particles set loose by talking, breathing and, in the worst case, sneezing or coughing. So, the mask is to protect other people from us and to discourage touching the face when out and about and before we get a chance to thoroughly wash our hands.
A mask is a communal decision and action, which might be one reason that the “freedom first” crowd doesn’t like them: communal action is frowned up unless there is an agreed upon exchange, a benefit for ME. The rather extreme concept of freedom for some people, especially in the far western states, seems to contain an intention to be apart from the influence of others as a cause, a life purpose. How can you be a “rugged individualist” if you are cooperating with others? Cooperation, in this case however, is a way to pursue broader freedom by ridding ourselves of this virus and disease.
When NY state got information from hospitals about infections that occurred during the partial shutdown, they found that 66% of the new infections occurred in the home. This finding should have set off alarm bells because it was a major indication that the shutdowns, while helping, were not getting the job done.
Mitigation of the disease impacts is one thing; stopping it in its tracks should be the goal, however. The fact that infections, and deaths, declined was important, that they continued was a warning of insufficiency.
As of Friday, 5.15, the CDC issued new guidelines in regard to the reopening. They included ventilation of indoor areas as a recommendation. No, this does not mean air condition, which is merely, in most cases, merely air circulation. Ventilation, in the context of Covid-19, means air passing through and out of confined spaces, something that is difficult to achieve in buildings that have been designed as closed systems to save money on heating and cooling.
Here’s my suggestion: if you go out to a restaurant to eat and there is no air passage in and out of the seating area, leave. In some cities, the need to be in the open air is being recognized and streets are being closed to allow the establishments to create outside dinning zones. Good. (more recommendations for restaurants coming up)
The same could apply if you go back to work in an office setting. Social distancing? How does that really help if you are sitting in a closed area where the air conditioning will simply recirculate the tiny droplets in the air? The system could actually act to spread the virus, as a study in China of people sitting in a cafe showed.
While we have concentrated on masks, the need for fresh air circulation has been largely overlooked. This needs to change. Being outside is one of the safest places you can be because, even with a modest breeze of a few miles per hour, aerosols and larger droplets will disperse rather quickly. No, you don’t want to be around anyone, even at 10 to 20 ft. away, who is actively sneezing, but otherwise the chances of infection outdoors are small.
SURFACES A MAJOR POINT OF INFECTION?
Just today, 5.21.20, the CDC issued new guidance saying that the virus on surfaces is not nearly so important as a means of transmission compared to viral droplets and aerosols in the air. What does this mean? The new guidelines say the disease does not spread easily by the virus on surfaces but that doesn't mean that surfaces are entirely safe. It puts the emphasis back on person to person transmission through the air and, presumably, direct contact, touching. (More on this as facts become available.)
The newest advice from the CDC is confusing because the agency is not abandoning the idea of disinfecting surfaces. This is especially true for the advice on reopening schools where it recommends regular cleaning and disinfecting and covering with plastic areas that are commonly touched, like computer keyboards. In the main, it seems to mean we can be less concerned with infections spread from surfaces but not entirely assured. How does that help?
PUBLIC TRANSIT AND INFECTIONS OCCURRING IN HOUSES AND APARTMENTS
The governor of New York, Andrew Cuomo, made a big deal at his daily news conferences about the fact that, for the first time in history, the transit authority in New York undertook to disinfect every subway car and bus every night. So? Clearly, the above information indicates that is not enough. You can’t safely ride a subway car in a city with widespread infection and then touch virtually anything. Latex gloves might help but they would need to be disposed of upon leaving and carefully thrown away, followed by hand washing as soon as possible.
RESTAURANTS WILL NEED TO CHANGE THEIR WAYS
In the best of times, eating out involves a trade off on safety versus good tasting food and fine service. The meal might look wonderful by the time it reaches you but there have been many encounters with germs along its trip to the table. The late Anthony Bourdain said if you don’t want to eat food that has been played with a lot, don’t eat in a restaurant. Now? Major adjustments in the way restaurants operate are required.
Not being a restaurant expert, here are a few starting suggestions:
Every table has to be disinfected after every diner, as well as high touch areas like arms on chairs, etc.
The front and back doors should be open if at all possible (air flow). Otherwise, the door handles should be constantly disinfected or, at the very least, the front door left open.
Every diner should sanitize their hands before eating.
Plates and knives/forks can no longer be left out waiting for customers. They should be placed upon arrival or covered with a cloth napkin or something similar.
Plates cannot be handled with bare hands by any staff.
Payment by card and as close to touch free should be practiced.
The way air flows in and out of the dinning area should be carefully considered. Rotating air condition air that flows up, down and around isn’t acceptable any more.
(There are other specific recommendations available, I have tried to highlight ones that might not have gotten great attention elsewhere.)
Here's a link to the CDC guidelines for opening restaurants and bars:
https://www.cdc.gov/coronavirus/2019-ncov/downloads/php/CDC-Activities-Initiatives-for-COVID-19-Response.pdf#page=53
The CDC is still recommending cleaning and disinfecting on its website:
Disinfection using EPA-approved disinfectants against COVID-19 external iconcan also help reduce the risk. Frequent disinfection of surfaces and objects touched by multiple people is important.
https://www.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html
The black hole of this disease is the period in which people have it, and can infect others, but have not yet developed symptoms.
This is where contact tracing becomes useful because people who have come into contact with the virus can be notified to avoid contact with others. The efforts to ramp up contact tracing have been robust, and various governors have made strong efforts to increase tracing, but most experts say we are nowhere near we need to be at this point. Even if we were, many people who have the virus test negative the first time they are tested.
The governor of Maryland, Larry Hogan, pulled off something of a medical coup by, with the help of his wife of Asian descent, getting 500,000 tracing kits delivered from South Korea to Maryland. Additionally, he directed the special flight carrying the kits to land at Baltimore/Washington International to avoid any possibility that the federal government would try to seize the kits if the plane were to land at Dulles Airport in Virginia, outside DC.
What we have not had is a true mobilization, an all-hands-on-deck effort across the nation. Instead, the governors do what they can and the federal government, by all indications, brings up the rear. Tracing inside a specific state is all well and good for that state but that does not give us a national picture of what is happening and what response might be called for as a result.
CONCLUSIONS
We are fighting a virus with enormous potential for killing people for many months to come. The goal ahead should be to devise a plan to stop the virus in its tracks, if at all possible, in advance of the development of a vaccine, which might, in fact, never come along. What seems more likely is that a cocktail of various existing medicines will be uncovered that can lessen the impact of the illness and, perhaps, reduce the danger by a great deal so that far fewer people are threatened with death.
Social distancing and wearing masks certainly appear to be very important but we don't why the disease continued to spread during the near total shutdown in places like New York and Washington, DC. Disinfecting surfaces frequently, washing hands often and avoiding placing unwashed hands on the face are most likely just as important, especially at a time when person to person contact has been greatly limited.
We need a complete reassessment of how this disease is being spread with particular attention to what to do about asymptomatic people who can spread the disease that they don’t even know they have. A crack team of investigators needs to be sent into hot zones to do an intense study and come up with new recommendations.
In all the hours of listening to governors, medical experts and reading news and direct information from the CDC and elsewhere, I have not seen nor heard anyone addressing the asymptomatic issue in a comprehensive way. Masks and social distancing appear to be the two main weapons against that situation but getting infections down to zero appears to be far out of reach, in which case the virus could be with us for years.
ZERO must be the goal. If a drastic reduction in infections and death are reached while seeking zero, so much the better. In an emergency you can never do enough until you reach victory, release from the torment. The experts advised America on a particular course but those decisions were based on limited knowledge of the virus and fell within the scope of what they imagined they could get people to do. Now that we know the full potential for death and destruction, we can clearly see the need for a better course.
Remember this: the protocols with are using to fight Covid-19 were not developed to fight this particular pandemic. They were developed during the administration of G.W. Bush, with much resistance from the bureaucracy, to fight a pandemic. Those protocols need to be reviewed top to bottom and new recommendations provided.
Additionally, the education of the public has been woefully inadequate. Government, public minded businesses, non-profits and the media have to step in and do a better job, much better, in fact. (My website, http://covidnews1.com, is an effort to provide better, more comprehensive information on which people can act to save lives.)