HEALTH

CDC Finally Admitted How Far The Coronavirus Actually Travels in Enclosed Spaces

HILARY BRUECK, BUSINESS INSIDER

5 OCTOBER 2020

Six feet of space is not always enough to protect you from catching someone else’s coronavirus.

“People who are physically near (within 6 feet [or 1.8 metres]) a person with COVID-19, or have direct contact with that person are at greatest risk of infection,” the CDC said in its new guidance, posted Monday afternoon.

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Some of the easiest ways to get COVID-19 from someone else, the agency stressed, are:

• Being around someone “with COVID-19” who might “cough, sneeze, sing, talk, or breathe.”

• Inhaling someone else’s virus through your nose and/or mouth.

• Having “close contact” with a person who is sick with the virus (as you might if you live or work with them).

In an emailed statement released along with its new guidance, the agency said its recommendations for coronavirus precautions “remain the same.”

“CDC continues to believe, based on current science, that people are more likely to become infected the longer and closer they are to a person with COVID-19,” the statement said.

“People can protect themselves from the virus that causes COVID-19 by staying at least 6 feet away from others, wearing a mask that covers their nose and mouth, washing their hands frequently, cleaning touched surfaces often, and staying home when sick.”

Why 6 feet isn’t always sufficient: The virus thrives in stuffy spaces

The agency also acknowledged, for the first time, that it’s possible to catch the coronavirus from another person, even if you’re further than six feet away from them – something the agency backtracked on last month.

“There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away,” the agency said.

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“These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising.”

This acknowledgement by the CDC that the virus can be airborne – floating in smaller particles, rather than dropping to the ground – is something many other public health experts have voiced concern about in recent months.

It came after the CDC, once considered the world’s finest public health response team, spent weeks revising a draft form of the same guidance, that the agency said was “posted in error” and ripped from its website last month.

Heavy breathing, shouting, and singing, without proper ventilation, are all thought to contribute to a “buildup” of virus-carrying particles, the CDC said, and these can more easily infect others nearby.

“The take-home is that it’s travelling through the air, and there is no bright line,” University of Maryland virologist Don Milton (who is not affiliated with the CDC) said during a press call shortly after the CDC updated its guidance Monday.

As we are moving towards tenth month of pandemic ,focus is shifting towards prevention of virus getting hold into body and thereby preventing inflammation . Few facts about this disease ( based on science and observation)

1a)there can be significant lung infiltration without development of hypoxia ( Spo2 less than 94 percent).( prehypoxic , low or non detectable inflammation markers )

1b)NETosis seems to be important path for development of localised lung inflammation ( CRP , IL6 may not represent as sign of lung inflammation )

2)waiting for saturation to drop less than 94 seems to be too late in course of disease .

3)too early use of immunomodulatory drugs ( first 5 days ) can be hazardous. Not only it can increase the mortality but also leads to late viral clearance.

4)Delayed viral clearance is linked with late cytokine storm ,MIS C ( now seen in adults also )and post covid syndromes.

5) Concept “ virus doesn’t kill but body reaction “ seems inappropriate and leading to delay the action required during first seven days ( Cold War time ). This important time ( early )if missed then we are left with only ( war)anti reactive ( anti inflammatory) medications.

6)we need to control the disease before patient reaches reactive stage .

7) efficacy of HCQ , IVERMECTIN (as prophylactic and treatment ) looks doubtful. ICMR should analyse real data .

8) Preventive strategy is required for (selective group )high risk patients as in 85 percent innate immunity is sufficient to clear virus effectively.

9) 62 percent of beds in hospitals are occupied by young people ( less than 50) . This evidence clearly indicates that being young doesn’t guarantees less complicated course .

10) recognising high risk patients during first seven days of disease process is the key to preventive treatment.

11) fifth to seventh day after onset of symptoms is the most important period . Persisting clinical features especially fever , fatigue , tiredness ( extreme) should alert patients/physicians about likely complicated course .

12) long lasting smart Chinese virus but poor quality chinese pulseox – led to poor interpretation of hypoxia ( which is being overemphasised ) . To prevent this ,base line oxygenation (at start of disease ) should be noted in sitting posture , after one minute of steady hand with demonstration of good waveform and simultaneously matching pulse rate . Thereafter measuring oxygenation during crucial phase ( 4 day onwards – same position , same hand and finger ).Any drop then becomes significant.

14) CT scan to define lung shadows is important tool . This should be used appropriately . It should be used in high risk situations where other markers are confusing ( for changing treatment gears ).Very early use ( during first 4 days ) leads to false assurance . Once saturation is less than 94 again it’s of no use as management plan is not going to be changed ). Best time is 5 th day to 10th day based on clinical features, risk stratification , inflammatory markers and used of immune modulatory medications .

15) closely chasing each and every patient on day to day basis is most important strategy and strength of management.

Dr Dhiren gupta

Sir Ganga ram hospital

After “trump “treatment published in public domain- use of antibodies early in the course seems to be talk of world .

Today NIH has announced its phase III TRIAL hypothesis—- “anti-coronavirus hIVIG at the onset of COVID-19 symptoms, before the body makes a protective immune response on its own, could augment the natural antibody response to SARS-CoV-2, thereby reducing the risk of more serious illness and death,” https://www.nih.gov/news-events/news-releases/nih-clinical-trial-testing-hyperimmune-intravenous-immunoglobulin-plus-remdesivir-treat-covid-19.

Dhiren gupta