A dose of science April 15th

CDC: Most Kids Dying From Coronavirus Had Underlying Conditions — Enormous racial-ethnic disparities revealed as well https://www.medpagetoday.com/infectiousdisease/covid19/88630 COVID-19 in children with underlying chronic respiratory diseases: survey results from 174 centres. https://openres.ersjournals.com/content/6/4/00409-2020 https://www.health.harvard.edu/diseases-and-conditions/coronavirus-outbreak-and-kids https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html COVID-19 guidance for schools Kindergarten to Grade 12 https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/guidance-schools-childcare-programs.html Coronavirus disease (COVID-19): Prevention and risks https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks.html Coronavirus disease (COVID-19): Schools https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-schools#:~:text=Current%20evidence%20suggests%20that%20people,information%20is%20still%20needed. Coronavirus digest: British variant more dangerous for children Germany has warned the British variant spreading through Europe is more dangerous. Meanwhile, Hong Kong has suspended administering the BioNTech-Pfizer vaccine over a packaging issue. Follow DW for the latest. https://www.dw.com/en/coronavirus-digest-british-variant-more-dangerous-for-children/a-56966798 Merkel says British coronavirus variant more dangerous to children BERLIN (Reuters) - A variant of the coronavirus first detected in Britain, and now spreading in Germany, is more dangerous to young people, Chancellor Angela Merkel said on Wednesday. “The British mutant, and this is the difference with the spring, is proven to be more dangerous in children and young people so we need to put the protection of schools more front and centre than with the original virus,” she told lawmakers. https://www.reuters.com/article/uk-health-coronavirus-germany-merkel-idUKKBN2BG20J https://www.theguardian.com/world/2021/mar/23/merkel-germany-covid-british-variant-easter-lockdown Merkel says British variant more dangerous to children – latest updates https://www.trtworld.com/life/merkel-says-british-variant-more-dangerous-to-children-latest-updates-45266 https://www.npr.org/sections/coronavirus-live-updates/2021/02/11/966823691/germanys-merkel-warns-coronavirus-variants-could-destroy-gains-against-pandemic https://www.tribuneindia.com/news/world/merkel-says-british-coronavirus-variant-more-dangerous-to-children-229901 https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-in-babies-and-children/art-20484405 2020: Patients with underlying conditions were 12 times as likely to die of covid-19 as otherwise healthy people, CDC finds People with underlying medical conditions such as heart disease and diabetes were hospitalized six times as often as otherwise healthy individuals infected with the novel coronavirus during the first four months of the pandemic, and they died 12 times as often, according to a federal health report Monday. https://www.washingtonpost.com/health/2020/06/15/patients-with-underlying-conditions-were-12-times-more-likely-die-covid-19-than-otherwise-healthy-people-cdc-finds/ Updated Mar. 29, 2021: Underlying Medical Conditions Associated with High Risk for Severe COVID-19: Information for Healthcare Providers. Purpose: This webpage provides an evidence-based resource for healthcare providers caring for patients with underlying medical conditions who are at higher risk of developing severe outcomes of COVID-19. Severe outcomes are defined as hospitalization, admission to the intensive care unit (ICU), intubation or mechanical ventilation, or death. This page summarizes data from preprinted and published studies that were included in a literature review conducted by subject-matter experts. The summary of information reflects current evidence regarding underlying medical conditions and is intended to help healthcare providers make informed decisions about patient care and increasing the awareness of risk among their patients. This page is distinct from the People with Certain Medical Conditions webpage which is intended for the general public. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html 2021: COVID-19 is a new disease. Currently there are limited data and information about the impact of many underlying medical conditions on the risk for severe illness from COVID-19. Based on what we know at this time, adults of any age with the following conditions might be at an increased risk for severe illness from the virus that causes COVID-19: Asthma (moderate-to-severe) Cerebrovascular disease (affects blood vessels and blood supply to the brain) Cystic fibrosis Hypertension or high blood pressure Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines Neurologic conditions, such as dementia Liver disease Overweight (BMI > 25 kg/m2, but < 30 kg/m2) Pulmonary fibrosis (having damaged or scarred lung tissues) Thalassemia (a type of blood disorder) Type 1 diabetes mellitus What we know about COVID-19 and the brain: Emerging data shows that people who have had a stroke are three times more likely to die from the virus than patients with no underlying conditions. Many of the risk factors associated with increased risk for stroke are also associated with increased risk of poorer outcomes with COVID-19, including age, high blood pressure and diabetes.5 Stroke survivors who experience swallowing difficulties are at increased risk of food going into the lungs and causing infection (aspiration pneumonia). These people are at higher risk of poorer outcomes with COVID-19. People living with stroke and vascular cognitive impairment (including dementia) may be especially challenged during this time as they often depend on others to help with their daily needs. People with vascular cognitive impairment are at increased risk of social isolation, and caregivers may also experience increased difficulties. What we know about COVID-19, smoking and vaping: If ever there was a time to quit smoking and vaping, it is now. Any kind of tobacco smoking is harmful to the cardiovascular and respiratory systems.16 People with COVID-19 who have pre-existing cardiovascular and respiratory issues due to tobacco use or otherwise have poorer outcomes. Smoking is most likely associated with a negative progression and adverse outcomes for COVID-19 patients. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html Why Some People Choose Not to Wear a Mask. From feeling uncool to believing masks are an exercise in compliance, there are many reasons why a minority of people oppose masks while a respiratory virus kills hundreds of thousands of people worldwide. (jumping down a bit) The third category of anti-mask arguments is a pernicious one: distorting the science. A common justification is that COVID-19 is simply no worse than the flu; this is clearly not true. Some anti-mask protesters have even said that masks impair breathing (a claim debunked by many physicians on social media) and that they breed illness, a bad argument that at least goes back to the 1918 San Francisco Anti-Mask League. A letter to the San Francisco Chronicle at the time complained that residents, who had to protect themselves from a pandemic strain of the flu, were being told “to wear masks and breathe foul air.” The solution often brought up, then as of now, is sunshine and nature, and while it is true that you are less likely to catch a respiratory virus while outside, immune systems don’t turn into magical fortresses when exposed to the Sun. Some anti-maskers even go so far as blaming people who got sick on their unhealthy behaviour, as if eating right and spending time outdoors are guarantees of a life free of viral infections. Many pseudoscientific arguments made to denounce the wearing of masks rely on motivated reasoning, this spell our brain falls under when it starts with a conclusion it likes and sorts through information to find supporting data. Reasoning can be motivated by the belief that personal freedom is paramount, the fourth category of arguments. Some people claim not to be against masks per se but against governments (and sometimes businesses) mandating their adoption. It’s always funny to me that these same people presumably stop at red lights and stick to the right lane when driving but a new, freedom-eroding mandate during their lifetime is their back-breaking straw. It may boil down to a concept known as “reactance,” which is a knee-jerk reaction we all have, to varying degrees, when we feel our freedom is being limited. Waving the flag for freedom has become very popular with another reactionary group, the anti-vaccination movement. Many conversations with anti-maskers as reported by journalists seem to devolve into the fifth and deepest category of arguments: that this is all part of a government conspiracy. Some outspoken anti-maskers believe this is just an exercise in compliance, with some erroneously claiming that Bill Gates is behind this entire pandemic. A recent French survey of 800 members of anti-mask Facebook groups conducted by Antoine Bristielle, a doctorate student at the French school Sciences Po Grenoble, is particularly alarming. He found that 52% of those surveyed said they believed in a global Zionist plot, an antisemitic conspiracy theory, compared to 22% of the general French population. These Facebook group members were also twice as likely as the general population to believe in the Great Replacement narrative, the far-right conspiracy theory that white people in Europe are being driven to extinction and replaced by immigrants. Grand conspiracy theories have always been with us but they tend to draw in more adherents in periods of great social anxiety, and a pandemic certainly qualifies as such. So how do we get mask resisters to cover their nose and mouth in the middle of a serious public health crisis? There is no magic bullet. Shaming, as much as it can make us feel righteous, can backfire. Mask mandates seem to work well. Leading by example can be powerful. If I’m a conservative man who feels foolish wearing a mask, seeing other conservative men putting on a mask may encourage me to do so as well, which is why Trump publicly tweeting that masks have been called “patriotic” can be compelling to his followers. Making a variety of masks easily available can also help with uptake by removing one barrier to adoption. As for public figures and organizations spreading anti-mask propaganda, they must be publicly criticized, their statistics shown to be misleading and their bad logic exposed. Their harmful deception must be unmasked. https://www.mcgill.ca/oss/article/covid-19-health/why-some-people-choose-not-wear-mask COVID-19 Surge Triggers Demand for Personal, Wearable Air-Purifying Systems. Public looks beyond face masks for personal respiratory protection.. SAN FRANCISCO--(BUSINESS WIRE)--Expect to see more people walking around with tubes dangling from their faces and heads, and it won’t be because it’s Halloween. These are people who have turned to PAPR systems (Powered Air-Purifying Respirators) to protect themselves from COVID-19 and other viruses, as well as smoke and other airborne particulate matter. Personal PAPRs are new. Industrial PAPRs, many featuring complete suits with helmets, are typically used for protection in hazardous environments. They are designed to protect the wearers, allowing them to breathe highly-filtered air; they are not, however, designed to protect those around them. Further, they’re priced for commercial settings, and consumers are also likely to resist walking around in “spacesuits” or helmets. The JustAir personal PAPR provides the same type of personal protection but without the suit or the helmet. It instead features a soft, cloth mask that protects the user and exceeds the level of protection provided by commonly-used face masks in preventing the spread of viruses. The system provides a continuous supply of filtered air to the user, minimizing the accumulation of carbon dioxide from exhaled breath, which can cause headaches. The growing interest in personal PAPRs might have to do with the upcoming holiday travel season and kids returning home from college. “Planes have HEPA filters that work great, but you can’t control who’s sitting close to you. Unless people sitting next to you are wearing personal protective equipment such as N95s, you remain at risk since people can be contagious while being asymptomatic,” says Dan Burnett, M.D., CEO of Theranova, the biomedical device company that developed the JustAir system. “The JustAir system will help keep people safe and give them back the ability to move around freely.” “My husband, two daughters, and I flew from Houston to Cancun for a family vacation. We each wore a JustAir system from the time we arrived at the airport until we arrived at the resort,” says Teresa Scott, a dentist that specializes in treating sleep-disordered breathing and airway inadequacy. “For ten continuous hours, we breathed comfortably. No headaches, no lightheadedness, or panic attacks.” The JustAir system is equipped with a mask, air tube, and a rechargeable blower pack with a 12-hour battery life; the system also features medical-grade HEPA and carbon filters. The blower can be carried in a backpack, fanny pack, or clipped to a belt to supply purified air to the cloth mask. The incoming airflow creates positive pressure to push out contaminated air through an electrostatic filter that traps 99.9% of viruses that might be exhaled. According to Burnett, surgical and cloth masks may protect others, but they provide little protection for wearers. “It’s why the CDC recommends social distancing in addition to mask-wearing, especially in indoor settings,” he says. “N95 masks are the exception. When fitted properly, they protect users by blocking 95% of particulate, including viruses around them, but they become very uncomfortable within minutes.” https://www.businesswire.com/news/home/20201030005203/en/COVID-19-Surge-Triggers-Demand-for-Personal-Wearable-Air-Purifying-Systems CleanSpace PAPRs for industrial and healthcare settings CleanSpace is lead by a world-class engineering team with a vision to make respiratory protection comfortable, reliable and easy to use. CleanSpace powered air-purifying respirators (PAPRs) are NIOSH-approved and deliver significant safety and compliance benefits over traditional masks. https://www.levitt-safety.com/products/respiratory-protection/powered-air-purifying-respirators-paprs/cleanspace-air-purifying-respirator-papr/ https://www.gasdetectorshop.com/CleanSpace2-PAPR-Respirator-Low-Profile-PAF-2034-p/paf-2034.htm https://cleanspacetechnology.com/health/cleanspace2-healthcare/