Outdoors is better than indoors when considering the risk of infection by SARS-CoV-2.
Dilution of aerosols outdoors & their removal via wind occurs much more easily outdoors than in a closed room especially if that room has no air filtration or active air exchange.
*But* ...
2/
...that doesn't mean proximity to an infected person & time exposed to them aren't still really important.
We need to keep our distance from others who may be infected and not spend too long indoors or near those outside our "bubbles".
3/
Think about queues for lunch, ice cream or the shower.
Distance is a great habit to keep up. It'll also help reduce our risk of getting any of the other 200 respiratory viruses
/end
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"Get a test when sick, and isolate while you await your result"
There's something missing from this message and it's
"*stay* isolated, even if your SARS-CoV-2 test is negative because you're still sick with *something* infectious!"
I don't want it. Others don't want it.
1/
I really feel like this part of the message needs to be stressed otherwise I don't think we're going to learn from the benefits of adopting masks in traditionally mask-phobic countries.
If not, we're just going to stumble back into flu season (also RSV, MPV etc) deaths and
2/
hospitalizations because somehow they're..."okay" deaths? But that was a pandemic! Seasonal illness & death is just 'normal', silly.
..then we're all idiots!
We've shown we *can* reduce morbidity & mortality due to other viruses, not just SARS-CoV-2
/3
Some thoughts on wastewater (sewage) testing...
💩Usefulness?
Of most benefit when used in an area with no known cases. Lets us look for a signal that virus is somewhere in that region. Pop-up testing may then be deployed to get a better idea of the situation
💩Mature technology?
Methods/usefulness still being evaluated.
What does a positive mean? How often are false negative/positives likely? Which PCR-based tests are best? What processes in place to confirm wastewater positive result & what response will that trigger if confirmed?
💩Do all agree?
Full spectrum of responses to wastewater testing, from exuberance to dismissal. I think time and continued refinement of the methods will tell which was the best position. As with everything in this pandemic, we're learning many new things as we go.
COVID-19 epidemiology reports, Australia, 2020
-latest report with data up to 13SEPT2020
🦠"The global case fatality rate (CFR) is approximately 3.2% and is decreasing as case identification improves"
🦠674/26,753 detected cases (2.5%) were fatal www1.health.gov.au/internet/main/…
🦠44% of 12,636 cases (47% of all recorded COVID-19 cases in Australia) had fever, 63% had cough, 39% had sore throat, 25% had runny nose - all in a wide range of combinations
🦠Most of the past month's 36 sequenced genomes from New South Wales, Queensland and South Australia belong to B.1.1.25 lineage. Other different sporadically detected lineages likely represent travel-introduced variants
At #UNGA 75 @WHO has 3 messages to share:
1⃣ Need for equitable access to #COVID19 tools
2⃣ Maintain the momentum towards achieving the sustainable development goals
3⃣ Call to prepare for the next pandemic together, now
1⃣ At #UNGA , @WHO calls on 🌐 leaders to support the Access to #COVID19 Tools (ACT)-Accelerator, a unique international collaboration to fast-track the development, production & equitable access to tests, treatments, & vaccines globally, while strengthening health systems.
2⃣ #COVID19 risks unravelling decades of gains made in health & development. At #UNGA , @WHO stresses the need to invest in stronger health & data systems to achieve universal health coverage & to meet the health-related targets of the sustainable development goals
Just a few examples of to highlight that every country (also varies *within* countries) has it's own story when it comes to #COVID19
Most graphs from ourworldindata.org
Not everywhere has comprehensive contact tracing. Tracing means you can keep confirmed cases away from susceptible people & to track down and interrupt transmission chains.
Physical distance is the number 1 most useful way to starve a virus of its ability to spread.
Plenty of locations can't/don't test enough. Without testing-no idea how much virus is in your community or who has it. The, interrupting transmission then *needs* a hammer not a scalpel. With enough testing, a more surgical approach can be take (see recent egs-NZ & Aust)
I know the technical PCR nerdery is hard for the general public. I feel this whenever I read a hardcore immunology paper!
A few thoughts on the concerns about PCR...
PCR threshold cycles are test-/machine-/reagent-/kit-/lab-/handler-/sample site-/sample storage/sample handling/..
..cold chain-/extraction method-/primer pair-/probe-/disease stage-specific.
To compare one lab's results to another lab's results (or even another run within the same lab), needs both labs to be using the same PCR setup & to have the same controls or calibrators.
This is easier when using commercial kits because they all use the same reagents and they've been optimised and (hopefully) well validated. But that doesn't mean they've done the work to correlate result with infectiousness, disease severity etc-it would be helpful if they did.