Sunday, January 17, 2021

Just use maximum protection for your population - use filtration !

As indicated before, many governments act according the advice their OMTs or outbreak management teams give them regarding how to tackle the spread of SARS-CoV-2. Following the crisis via press reports, statements of politicians on Twitter, statements of virologists and epidemiologists on Twitter and not only the statistics of death toll, hospitalizations, number of patients on ICUs and those suffering from long-Covid gives a full picture what happens. It is also necessary to know what kind of 'official advice' national public health authorities provide to their citizens. To complete the picture it's also helpful to monitor the behavioral changes of national 'CDCs' in order to find out if there have been any adaptations regarding the severeness of the crisis or the virus itself. It's helpful to see if some to what degree national 'CDCs' changed their publications indicating a changed routine, if there is a change at all. Without naming any specific countries it has to be said that some of those are still busy with 'GAGA research'¹, thus things which should have been abandoned a year ago in order to put as many resources into the emerging new mega crisis we in Europe have been facing since the beginning of last year (2020). 

Gaga research still going on while hundreds or thousands of mostly, but not exclusively, elderly citizens are dying. Gaga¹ research of highly qualified and educated specialists in their field perhaps, but with a lack of vision what's the right thing to do in an existential crisis. Researchers employed for many years, perhaps decades without a challenge of having to act 'fast & brutal' and to use all techniques and resources which are currently available, and not using those methods learned from books which have been printed in the 1960s or 1970s. Kind of a similar problem with the faculty of economics where many 'orthodox' economists predominantly in countries like Germany, Austria or the Netherlands have been taught or are still learning from professors as well as from 'printed knowledge' that are still occupied with 'high inflation', which was indeed a major problem the last time in the 1970s and the 1920s in e.g. Germany after World War I. The latter event of extreme inflation destabilizing a country to the brink and the result was - Hitler-, the only problem is that the other event in the early 1930 was deflation which led to mass unemployment and ultimately to the reign of -Hitler. We have to consider all facts and not just pick those we know because of 'group think' or easier: exchange information who also favor one particular theory. It's perhaps OK to have a quite flat learning curve during a new economic crisis which cost the economy a few percent of GDP. Most likely it won't affect a country's death rate. 

It's not all right however to discuss the 'right way' of tackling a crisis while the physical existence of parts of the population is at stake. 'Business as usual' except that large parts of the population are demobilized without taking care of significant flaws like health care workers infecting colleagues or even worse: elderly patients. Being a scientist in fields which are a matter of life and (mass) death also comes along with a responsibility for human life and livelihoods. It's not exclusively about statistics of numbers of dead, hospital beds, ICU occupation, new infections, the 'R value' and some other indicators, or science as a matter of making one's living. Of course it's absolutely necessary to have such numbers as gauge how (fast) the virus is spreading. That's undisputed, but what comes next is significant: Do we tackle the virus the way the people in the 19th and beginning of the 20th Century have 'tackled' it and what is written in history books and presumably in many epidemiology books as well (have to admit did not read them at all) by using methods of 'avoiding' new infections by distancing. There are two major problems with that method of 'avoidance': 

A Avoiding works when the spread (by infecting other individuals) is caused by droplets with just a limited range. A wrong assumption missing the point that the spread is caused by the tiniest particles hovering in the air we all breathe would have disastrous consequences. 

B Avoiding the virus on a massive scale will disrupt the economy which is nowadays much more than 100 years ago depended on 'distributed manufacturing'

It's also helpful to know some facts about 'war history' and the way soldiers in the trenches and their commanding officers were since 1915 faced with several new threats released by the enemy forces. Initially chlorine gas and later mustard gas was released and soldiers didn't have the opportunity to 'avoid' the often lethal, but more often 'only' crippling chemical substances which attacked mainly their lungs, eyes, exposed skin and so forth. The most deadly effect was inhaling the airborne substances into the lungs where the lung tissue was destroyed and consequently the individuals blood could not get sufficient oxygen anymore and the patient suffocated. Sound familiar ? Most severe Covid-19 affecting patients' lungs and they often suffer from 'silent suffocation' and end up either in ICUs, get a cure or some of them don't make and end up in the morgue. 

The Infection That’s Silently Killing Coronavirus Patients [NYTimes, April 20 2020]

Soldiers in those trenches in e.g. Belgium had no choice but to stay where they are and put on their respirators , or those who weren't equipped properly often used a piece of cloth 'treated' with their own urine in put it on their face and covered mouths and noses as efficiently as possible. A gas mask is of course the preferred and most effective 'defensive weapon of choice' and the soldiers back in the days of trench warfare didn't give a rat's ass about how stupid they look while wearing a life saving respirator. 'Do or die' was the simple choice those poor souls had. Getting court martial and probably shot when deserting their lines, put on their gas mask or the gas will dissolve their lungs. A terrible choice during a terrible time of man made misery (war). Pretty sure that not many of those left to 'choices' thought about about 'not looking fancy. Nowadays respirators are still used in environments where toxic substances do some harm to humans inhaling those airborne substances. Even in the DIY sector it's common to use filtering face pieces when creating a lot of airborne dust during removing paint, smoothing wooden materials with sand paper or painting objects in rooms with insufficient ventilation. Inhaling those substances can make you feel dizzy, damage your lungs or will give you cancer much later. If more of those scientists involved in virology and epidemiology would do some serious 'do it yourself' at home they would know that it isn't a big deal to wear a FFP (filtering face piece) or even a somewhat more professional respirator with attachable separate filters. 

Filtering face piece exhalation valve (valve not good for protecting others from getting infected)



By dronepicr - Corona Face mask FFP3, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=95752756

more professional:

         By Ryssby at English Wikipedia, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=9402223


Although those respirators can use a variety of filter units for different substances (e.g. for chemicals emitted from fresh paint during 'drying') only the ones capable of filtering particles are now of interest regarding the current pandemic.(and future ones for that matter)

 We used a cough aerosol simulator with a pliable skin headform to propel small aerosol particles (0 to 7 µm) into different face coverings. An N95 respirator blocked 99% (standard deviation (SD) 0.3%) of the cough aerosol, a medical grade procedure mask blocked 59% (SD 6.9%), a 3-ply cotton cloth face mask blocked 51% (SD 7.7%), and a polyester neck gaiter blocked 47% (SD 7.5%) as a single layer and 60% (SD 7.2%) when folded into a double layer. In contrast, the face shield blocked 2% (SD 15.3%) of the cough aerosol. 

          source:Efficacy of face masks, neck gaiters and face shields for reducing the expulsion of simulated cough-generated aerosols [Taylor & Francis online, Jan 7 2021]

 

The point is: When there is a substance in the air we can't avoid, we better mask up with the appropriate mask or use the proper attachable filter. Why using a simple piece of cloth which is just a miserable substitute when nothing else is at hand ? It was somewhat alright to use lockdowns of a modern industrial society when the virus struck 'unexpectedly' for those who don't have 'historic memories' , but it is not to be tolerated when ten(!) months later the industrial production for those simple filtering pieces hasn't been increased sufficiently or when the best engineers haven't been called by government and ordered to make a 'super mask' which is much better suitable for every day use than those FFPs used for a couple of minutes during DIY and professional construction. Are states like France, Italy, Germany or the Netherlands just agricultural nations or do they have different industries with a global reputation ? Do we leave the fate of nations to statisticians capable of correctly collecting numbers or do we follow the German example of offering the most vulnerable parts of the population the maximum available protection ? Now the Bavarian state of Germany is demanding that all citizens using public transport or visiting vital shops( other ones currently closed) to put on a FFP2 (N95 like) mask.

Bavaria orders compulsory FFP2 masks on public transport and in shops 

[The Local Germany, Jan 12 2021]

Austria has just announced to open 'business for personal service' like hairdressers , massage salons , nail studios and so on under the condition that service provider and client wear a FFP2 mask. That's sufficient for the time being , but we should aim higher and develop those 'super masks' as well and produce them in millions. Even if that will cost a few billion euros when 100 million mass produced fancy looking respirators with full communication ability costs 50 euro a piece, only 5 billion have to be paid (plus costs for distribution) in exchange for opening up the economies even before a vaccine is availabe for 60 or more percent of the population.  Realistically it will take at least until Summer, probably until Winter to have achieved that goal of 'herd immunity' by using vaccines. We shouldn't leave those inoculated exposed to the virus immediately also because it's hard to differentiate between those who are immune by now and those who aren't. Wear a mask even when you got the vaccine is also the massage from Public Health England:

It's important to know that 'between' the science of virology (which studies the 'creatures' who cause that much of disease and economic pain) and the moment it enters the human body and starts infecting human cells in order to replicate itself in those cells and get emitted again for their next 'victim', there is their often neglected 'journey' on other particles. Those SARS-CoV-2 travel not on their own, they can't propel themselves, but they are occupying tiny particles of basically water and perhaps also human (dead) cells originating from lungs or other parts of a human respiratory tract all the way to mouth and nose. They are like passengers on a hot air balloon depending on wind and weather conditions determining journey until they decide (or being forced to) land. Those particles of very different small sizes hover through the air and just like those balloons can either move up by losing weight, the mass of those particles determine how long they can stay in the air once the exited a human's mouzth or nose. Like the balloon they also depend on the 'weather', so if there isn't any 'wind' they will drop to the floor in the vicinity of the human if bigger and heavier, or if it's 'windy' they will land some meters away from the infected human. It's more complicated once the 'virus factory'(human) is walking through a room when he/she is dragging a cloud of virus laden particles behind and next his/her head. It's getting even more complicated once the room has windows, doors or a fan attached to the ceiling or an AC(air conditioning system). The journey's destination becomes completely unpredictable even for virologists or medical experts dealing with the aftermath once the virus infected a patient o agree that he/she get's sick after some minor symptoms. Those 'journeys' can be modeled though by people who study airflow, particles and aerosols. Harmful particles can also be other substances, not just virus laden bodily fluids and unfortunately many other groups of people initially assumed that SARS-CoV-2 was 'riding' on droplets only. Droplets they are called because of their size and weight and therefore the likelihood to drop down to the floor very near the infected person in a very short time. It's a very different ball game once this assumption is wrong though. 

Once this very very small virus is riding on particles much smaller than so called droplets they take much longer to fall down to the ground and they can travel much further away from their 'hosting human'. If there weren't such things like filters we humans would indeed be as in big big trouble as animals like those mink in their cages are once SARS-CoV-2 entered their building and starts infecting the first of their caged buddies. The difference between human and mink is however that we can invent/build/craft things that protect our heads from weather: hats or our feet from getting cold and/or wet: shoes, or our hands: gloves. We can make and wear stuff that protect us while in dangerous conditions like hard hats at a construction site, shoes with steel protected soles and steel caps, goggles for eye protection and - respirators for protecting our lungs. Humans don't have toi wait for the evolution to protect us almost immediately when we find ourselves in lethal danger, we can goi to stores and buy protection when they are in stock, mink can't ! Governments can get information from industry whether or not there are sufficient stockpiles produced or how many they can produce in a given time frame. Engineers and industry can be tasked to build something according to specifications provided by the government. They do it all the time for e.g. defense departments when they need a new naval vessel or a new tank or a new plane. It's not even rocket science as when they are demanding a new kind of missile capable of flying through air for thousands of miles and hit a target with an accuracy of a 3 Feet or so. A respirator isn't a satellite which needs perhaps years to develop and construct before it can get launched into orbit. 

We are talking about some filters of class P2 or P3 attached to some kind of airtight mask. Made of simple plastics, fabric, silicone or other simple materials , not nano stuff requiring high tech science or complicated production environments just like computer chips made of silicon ! It's relatively simple, but nonetheless essential stuff for saving millions from death or severe illness ! Are members of governments the kind of DIY people who decide to paint a large object in a very poorly ventilated room without a proper respirator, because it might 'look bad' for a limited time once exposed to airborne solvents which will cause unconsciousness or lung damage ? Are they the kind of people who hope they will be found in time by next of kin who will then call the ambulance in time, or a they smart and just wear their f* mask ? If governments can't or won't see that we need to do more than just hope that sufficient amounts of vaccines will do the job, they are well worth to be called mass murderers. Unfortunately happens more often than we would like to think during other disasters where humans which happen to be at the wrong moment at the wrong place (the government) decide to sit idly by while others in danger require their action! It's not a choice between 'do nothing' and having millions of vaccine doses. We (our governments!) can also do something very useful right now ! 'There is no alternative'(TINA) is often used by either stupid or unwilling people ...  

When industry is not capable or willing to deliver sufficient quantities of 'products against the virus' it's possible to force also competitors to join the 'war effort', just as the United States did back in the 1950s or to threaten to use it as recently as in 2020: Defense Production Act of 1950 [Wikipedia]

There should have been sufficient stockpiles of PPE in the first place, there was a 'surprise' situation and a shortage of supply of PPE stuff because the whole world tried to purchase that stuff in Spring 2020, but just waiting for some vaccine to arrive is clearly irresponsible negligence. Switzerland (as well as The Netherlands early on) is even going further:"The use of FFP masks is not recommended for private use." source:Coronavirus: Masks [BAG.admin,ch] 

Ireland: Instructructions for care homes , source:HPSC

At least Germany and Austria are trying to provide help by mandating the use of FFP2 masks in either the whole country(Austria) or some states(Bavaria). Both countries also started to distribute free of charge FFP2 respirators for the elderly and vulnerable people. Just now the Austrian government has announced the reopening of parts of the locked down economy under the condition of the obligation to wear such a mask capable of protecting oneself and others. 

Austria: FFP2 masks to be mandatory in public transport and shops [The Local Austria, Jan 17 2021]

Besides the existing, and often annoying and unpractical masks (made of fabric, filtering face pieces) it would be good for society and economy to mass produce much better designed respirators of highest filtration class:

Razer has created a concept N95 mask with RGB and voice projection [The Verge, Jan 12 2021]

and the much more professional concept of a maximum security and usable respirator:

The ‘overcoming pandemic device’ EZRsecurity, Jan 5 2021, including research articles re how good N95 masks are compared with e.g. surgical masks]

The other so far neglected field of a save indoors environment for humans (without masks) is this:

ROOM AIR CLEANER: TAC V+ HIGH-PERFORMANCE AIR PURIFIER FROM TROTEC [Trotec, commercial] (mobile and fixed versions for rooms/buildings)

Some states have begun providing financial incentives for retrofitting/replacing old HVAC systems for buildings: Subsidies for technical solutions against SARS-CoV2[EZRsecurity]

All kinds of technical solutions against the virus as a compilation here:technical solutions


Examples of: "We have to discuss this or that next countermeasure" or "let's wait until Summer", "Don't worry - the vaccines are coming"

- stricter lockdown ("stop the economy for 2-6 weeks)

- close all schools an universities for as long as it takes 

- we have to reach the goal of 7, 25, 50 new infections per 100000 inhabitants (no details how to achieve that goal) 

some examples:


Baselland bietet nun ab diesem Wochenende dem Heimpersonal wöchentlich Corona-Tests an. Dabei handelt es sich um Speicheltests auf PCR-Basis. Das Ganze bleibt für das Heimpersonal jedoch freiwillig.

                   English:  just voluntary saliva tests for care home staff 

                source:Baselland geht neue Wege: Massentests in Altersheimen ]SRF, Jan 16 2021]

¹ meaning ongoing research and public relations campaigns of 'usual projects' and repeating the exact same research done and published in other countries. Maybe for verification purposes but often coming to the same conclusions. Regarding children's' ability to infect others many mistakes have been repeated by several countries for instance. Politics ignoring research contradicting their policy goals and so on. 

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