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Let the World Know to Increase Airflow v. COVID-19

April 11, 2020

Attached is a letter you may use (and personalize and modify as needed) to alert hospitals, grocery stores, and any other places where people are at risk, to the need for increased airflow, ventilation, and filtering:

Download PDF:     open-letter-airborne-transmission-protections-11april2020.pdf

Download Word Doc:     open-letter-airborne-transmission-protections-11april2020.docx

In this time of global pandemic, do you worry about your local grocery workers? Those who shop there? Surely you worry about our front lines workers such as nurses, doctors, and EMTs in direct contact with people dying from the disease? Like me you may have close family and friends who are taking terrible risks as they work to save others’ lives.

DO NOT ASSUME THAT THEY HAVE TAKEN THESE MEASURES.

Please let them know!

You can use the attached letter with references.

world-map-of-cases-npr-10april2020Source: NPR (accessed April 11, 2020)

As the spread grows to every country, many of which are even less prepared than the United States, what can we do to minimize the damage? Isolation is essential, but where people must take risks, the air we breathe needs to be as clean as possible. Even opening doors or windows and using a small fan can make a measurable difference.

UPDATE (April 20, 2020): The New York Times reports today on a field research finding from China that it appears two families at nearby tables were infected by one person at another table due to the direction of air from an air conditioner.

#COVID19 #microparticles #coronavirus #pandemic #globalhealth

UPDATE (May 29, 2020): Almost 7 weeks later, News is finally catching up:
https://www.8newsnow.com/news/local-news/study-covid-19-can-stay-airborne-for-hours-cdc-recommends-increasing-air-flow/

 


Meggs holds a Master’s in Public Health (Environmental Health Sciences Division) from the University of California at Berkeley.

 

Protect Workers with Airflow – COVID-19

April 10, 2020

Essential businesses and services remain open during the coronavirus, putting workers at heightened risk along with customers.

Protect workers by increasing airflow and filtration.

The Occupational Health and Safety Administration (OSHA) has released guidelines in support of this measure which advises:

Engineering Controls
Engineering controls involve isolating employees from work-related hazards. In workplaces where they are appropriate, these types of controls reduce exposure to hazards without relying on worker behavior and can be the most cost-effective solution to implement. Engineering controls for SARS-CoV-2 include:
■Installing high-efficiency air filters.
■Increasing ventilation rates in the work environment.
■Installing physical barriers, such as clear plastic sneeze guards.
■Installing a drive-through window for customer service.
■Specialized negative pressure ventilation in some settings, such as for aerosol generating procedures (e.g., airborne infection isolation rooms in healthcare settings and specialized autopsy suites in mortuary settings).

Source: Pages 12-13, Guidance on Preparing Workplaces for COVID-19, OSHA 3990-03 2020, https://www.osha.gov/Publications/OSHA3990.pdf

My last blog article (Turn up the HVAC v. COVID-19) discussed how small businesses can reduce risk simply by keeping doors and windows open and using fans if available.

Essential businesses are a weak link in the effort to flatten the curve and prevent new cases. Do not assume that your local grocery store, market, bicycle shop, or even hospital is doing what it can to keep the infectious particles containing the virus from moving out of our breathing space. Without airflow they can persist for three hours or more.

Help get the word out to reduce the spread of virus by increasing airflow!

#COVID19 #microparticles #coronavirus #pandemic #globalhealth


Meggs holds a Master’s in Public Health (Environmental Health Sciences Division) from the University of California at Berkeley.

 

 

Turn up the HVAC v. COVID-19

April 8, 2020

All essential services need to take actions to move, filter, and avoid contaminated air.

Turn up the HVAC to reduce the risk of coronavirus infection.

Open doors, open windows, use fans, and be careful of where people are or have been breathing.

People who have the virus breathe it out in clouds of microparticles – blow those particles away, filter them out, destroy them with heat, and stay away from breath clouds – anything helps reduce the risk.

  • Open the doors and windows if you can. Microparticles will disperse faster (see this video).
  • Increase HVAC fan speed and percent of outside air coming  – heat may also help.
  • Blowing air with a fan should be helpful (be careful of direction)
  • Add a HEPA filter if you can (HEPA will filter particles much smaller than the virus).

Any kind of air movement should help disperse concentrations of particles and make them agglomerate into larger particles faster. Larger particles are more likely to fall out of the air and less likely to reach the deep lung when we breathe them in.

Stay out of others’ breath clouds as much as possible. Especially if either of you are breathing hard. Example: you’re walking down the sidewalk, someone runs past you, breathing hard – they are leaving a trail of breath cloud. Don’t let a mask give you a false sense of security. Step out of and avoid that trail of breathcloud.

Masks help in both directions but have only limited effectiveness.

Even N95 masks when worn correctly only reduce the risk by about two-thirds versus normal breathing, one-half versus surgical masks (according to one large study of airborne transmission of flu virus to medical personnel). You may eliminate the protective effect and may even increase risk with heavy breathing and/or mouth breathing. The masks were not designed for athletics.

Nose breathing is less dangerous than mouth breathing – the nose and nasal passages make a natural filter which helps limit the reach of small particles.

Get this information to your local grocery stores and markets and hospitals – help protect people vulnerable on the front lines.

Arista_05.10_Facebook

The public has not been adequately warned about the risk of airborne transmission and how to best reduce risk, which should have started months ago and may have been able to greatly limit the pandemic.

This article to be updated with more of the scientific basis.

#COVID19 #microparticles #coronavirus

Photo source: https://aristair.com/blog/healthcare-hvac-quality-maintenance-reduces-risks/


Meggs holds a Master’s in Public Health (Environmental Health Sciences Division) from the University of California at Berkeley.

Avoid Coughing to Save Lives (COVID-19)

March 15, 2020

UPDATES:

  1. Simply breathing can transmit the virus, and 6′ distance is inadequate in many cases. See for example what happened to a choir in the Seattle area:
    https://www.seattletimes.com/nation-world/a-mount-vernon-choir-went-ahead-with-rehearsal-now-dozens-have-coronavirus-and-2-are-dead/
    And even more strongly, this:
    https://thehill.com/changing-america/well-being/prevention-cures/490831-coronavirus-could-spread-through-talking-and
    The science still supports this and increasingly supports this.

  2. Even if one covers a cough, or wears a mask, small particles can get through (in both directions), so physical (not social) distancing is key EVEN WITH NO SYMPTOMS
  3. Grocery store workers and others who interface closely with the public are at great risk and may also infect many people. The public health directives have largely failed to provide a safe way for grocery stores to operate.

Original article:

We are inundated with messages to wash hands as if it were the most important measure we can take — yet little is said about the risks of coughing.

The Centers for Disease Control (CDC) makes clear that the novel corona virus (SARS-CoV-2 or coronavirus, the virus causing COVID-19) is transmitted “mainly from person-to-person…through respiratory droplets when somebody coughs or sneezes.” (Source: https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html)

CDC-still-learning-COVID-19-spread-by-coughing-15March2020-blackborder

In addition a recently submitted paper (March 8, 2020) from Wuhan University and other scientists in China found the COVID-19 virus in the air in hospitals. (Source: https://www.biorxiv.org/content/10.1101/2020.03.08.982637v1). We already known flu virus is found in the air.

Hand-to-face contact may or may not cause infection. CDC further states “It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Source: https://www.cdc.gov/coronavir…/2019-ncov/…/transmission.html

Yet the world is being told to wash our hands and rarely told the importance of covering our coughs and of avoiding areas where people are or have been coughing.

The primary receptors are in the deep lung (ACE2) and our fingers don’t go there — how does the virus get there? Small particles get there all the time, however — whenever we breathe. Many particles are emitted when people cough, including tiny particles.

Moreover, it is coughing and sneezing that most likely deposits the particles we are trying to wash off. Don’t give up on washing hands – it’s important for many reasons – but it’s long past time to emphasize people COVER THEIR COUGH so those particles don’t get all over and onto our hands and into our bodies in the first place.

SELF-QUARANTINE if you are coughing and AVOID people who are coughing. Unfortunately, covering a cough is at best partially effective.

Yes we should already be isolating – but many are partially isolating at most — or people are isolating in groups, some of whom may be infected or are not entirely isolating and may become infected – and we don’t know yet how infectious people with few or no symptoms can be.

I have a family of friends (including two small children) who have been washing their hands so much that their hands are cracking and bleeding. For all we know this could be another source of infection by the virus, theoretically it could be even more dangerous than touching the face – we don’t know yet. Blood-based path of infection could help explain why some people get diarrhea along with COVID-19 (two major areas for the receptor cells are in the deep lung and the intestines, so the bowels could get sick as well from the same virus — for example if the virus enters the cuts in the hands, spreads through the blood, and then somehow enters the receptor cells).

My hunch at this point given everything is that small particles are a significant source of COVID-19 infection, possibly the major source. Small particles by their nature typically stay airborne for long periods of time. In this case presumably the small particles would be emitted primarily by coughing, and also by sneezing.

Please alert anyone suggesting that hand washing is the answer, especially organizations doing outreach, to start emphasizing the key source of the particles. Teach people to avoid exposing themselves and others to coughing as if lives depend on it – they do.


Meggs holds a Master’s in Public Health (Environmental Health Sciences Division) from the University of California at Berkeley.

Cover your Cough to Save Lives (COVID-19)

March 15, 2020

UPDATE: all my recent posts are out of date and inadequate, the most recent with an update to reflect the latest is:
https://meggsreport.wordpress.com/2020/03/15/avoid-coughing-to-save-lives-covid-19/
This is a necessary result of the urgency of giving out better information as it arrived.

Original article:

We are inundated with messages to wash hands as if it were the most important measure we can take — yet little is said about the risks of coughing.

The Centers for Disease Control (CDC) makes clear that the novel corona virus (COVID-19) is transmitted “mainly from person-to-person…through respiratory droplets when somebody coughs or sneezes.” (Source: https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html)

CDC-still-learning-COVID-19-spread-by-coughing-15March2020-blackborder

In addition a recently submitted paper (March 8, 2020) from Wuhan University and other scientists in China found the COVID-19 virus in the air in hospitals. (Source: https://www.biorxiv.org/content/10.1101/2020.03.08.982637v1). We already known flu virus is found in the air.

CDC further states “It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Source: https://www.cdc.gov/coronavir…/2019-ncov/…/transmission.html

Yet the world is being told to wash our hands and rarely told the importance of covering our coughs and of avoiding areas where people are or have been coughing.

What’s more there is evidently no proof yet the virus can be passed by hand-to-face contact. The primary receptors are in the deep lung (ACE2) and our fingers don’t go there — how does the virus get there? Small particles get there all the time, however — whenever we breathe. Many particles are emitted when people cough.

Moreover, it is coughing and sneezing that most likely deposits the particles we are trying to wash off. Don’t give up on washing hands – it’s important for many reasons – but it’s long past time to emphasize people COVER THEIR COUGH so those particles don’t get all over and onto our hands and bodies in the first place.

SELF-QUARANTINE if you are coughing and AVOID people who are coughing. Unfortunately, covering a cough is at best partially effective.

I have family friends who have been washing their hands so much that their hands are cracking and bleeding. For all we know this could be another source of infection by the virus, theoretically it could be even more dangerous than touching the face – we don’t know yet. It could help explain why some people get diarrhea along with COVID-19 (two major areas for the receptor cells are in the deep lung and the intestines, so the bowels could get sick as well from the same virus — for example if the virus enters the cuts in the hands, spreads through the blood, and then somehow enters the receptor cells).

My hunch at this point given everything is that small particles are a significant source of COVID-19 infection, possibly the major source. Small particles by their nature typically stay airborne for long periods of time. In this case presumably they would be emitted primarily by coughing, then by sneezing.

Please alert anyone suggesting that hand washing is the answer, especially organizations doing outreach, to start emphasizing the key source of the virus. Teach people to cover their coughs as if lives depend on it – they do.


Meggs holds a Master’s in Public Health (Environmental Health Sciences Division) from the University of California at Berkeley.

HAND WASHING IS NOT GOING TO PREVENT THE PANDEMIC

March 13, 2020

UPDATE: all my recent posts are out of date and inadequate, the most recent with an update to reflect the latest is:
https://meggsreport.wordpress.com/2020/03/15/avoid-coughing-to-save-lives-covid-19/
This is a necessary result of the urgency of giving out better information as it arrived.

Original article:

HAND WASHING IS NOT GOING TO PREVENT THE PANDEMIC.

The Centers for Disease Control (CDC) makes clear that the novel corona virus (COVID-19) is transmitted “mainly from person-to-person…through respiratory droplets when somebody coughs or sneezes.” (Source: https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html)

In addition a recently submitted paper (March 8, 2020) from Wuhan found COVID-19 virus in the air in hospitals. (Source: https://www.biorxiv.org/content/10.1101/2020.03.08.982637v1). We already known flu virus is found in the air.

Yet the world is being told to wash its hands and rarely told the importance of covering their cough and of avoiding areas where people are or have been coughing.

What’s more it’s possible that the virus is not passed by hand-to-face contact, possibly making the widespread fear of touching the material world an unnecessary limitation on movement and action, an unnecessary stressor at a time that we need our bodies’ defenses to be optimal.

If anyone can demonstrate any evidence that the virus passes by hand to face contact and can explain how it then arrives in the deep lung please do. Until then it appears the hand washing mania is a dangerous misinformation which imparts a false sense of security (and misplaced stress and fear) on top of the failure of leadership, from Berkeley to the White House, to emphasize the danger of this pandemic. People should be isolating and anyone coughing even the slightest should be completely covering their mouth.

Some ideas (questions) for how the virus could possibly get from the face to the deep lung where ACE2 receptors are located in case anyone has any knowledge to share:

Could it be that:

1. There are cells with virus receptors in the oronasopharynx? The virus replicates in those cells, is released and makes its way into the bloodstream, and is carried to the alveolar region where it somehow connects with alveolar receptor cells?

2. There is a small amount of fluid in the throat that regularly makes it way past the glottis into the trachea, and somehow virus in the trachea makes it way down to the alveolar region?

3. There are macrophages in the oronasopharynx that pick up the virus, either because they have virus receptors or simply scavenge, and these macrophages migrate down to the alveolar region?

4. Given that a single virus is a nanoparticle, a virus physically navigates through a capillary wall in a mucous membrane in the oronasopharynx, enters the bloodstream, and is is carried to the alveolar region where it somehow connects with receptor cells? (I believe that at least some nanoparticles can pass through capillary walls.)

5. Particles with the virus attach to the face by contact or deposition from people coughing, and are then somehow released to the air and aspirated to the deep lung? (Added 3/14)

???

Thus far to my knowledge no biological explanation has been given for why hand washing would help. POINT IS HAND WASHING IS NOT GOING TO PREVENT THE PANDEMIC. STOP EMPHASIZING THAT OVER PROTECTION FROM COUGHING!

To be absolutely clear, of course hand washing is still important, if only to prevent other illnesses when health care services may be overwhelmed, so those with COVID-19 have more chance of living. Slowing the infection rate so health care resources are available to those who are sick makes a huge difference in the death rate. Also to be clear, yes it is certainly possible that hand-to-face contact might cause COVID-19 infection in at least some cases, evidently we don’t know yet. But ignoring the respiratory transmission is a deadly mistake.

My hunch at this point given everything is that small particles are a significant source of COVID-19 infection. Small particles might stay airborne for long periods of time. They are emitted primarily by coughing.

CDC-still-learning-COVID-19-spread-by-coughing-15March2020-blackborder

CDC is admitting they don’t know enough yet and again that the virus is thought to be passed “mainly from person-to-person…through respiratory droplets when somebody coughs or sneezes.”

CDC further states “It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

Source: https://www.cdc.gov/coronavir…/2019-ncov/…/transmission.html

Please alert anyone suggesting that hand washing is the answer, especially organizations doing outreach, to stop giving a false sense of security and misplaced fear. Teach people to cover their coughs as if lives depend on it – they do.


Meggs holds a Master’s in Public Health (Environmental Health Sciences Division) from the University of California at Berkeley.

Bicycle Safety: Recommendation to Uber (dooring)

November 1, 2019

Recently I was struck by an Uber door in Washington, D.C. It sent me spinning not only across the asphalt and into a parked car, but on an odyssey to consider what Uber and other automobile-based rideshare services can do to eliminate dooring.

Attached is the policy recommendation document I sent to Uber today: memo-to-uber-bicycle-safety-passenger-doors-jason-meggs-01november2019

right-leg-injuries-caused-by-uber-door.png

More details of my injury, how to avoid dooring, why dooring is never the bicyclist’s fault, and what to do if you are hit by a car door, may be forthcoming but for now the focus is on changing the big players who have greatly increased injuries to bicyclists with unmarked cars making frequent passenger pick-ups and drop-offs.

I want to be clear that this advice is important for any rideshare company, not just Uber and not just in D.C. – and much of it is applicable to any passenger vehicle including personal/private vehicles, vans and taxis. Moreover certain issues are NEW to rideshare and as of Jan. 22, 2020 Uber and Lyft have NOT replied.
Please share.

THESE HARMS CAN AND MUST STOP NOW.