Friday, April 3, 2020

COVID update April 3, 2020

As the pandemic progresses, we see more and more abundant evidence that very strict social distancing is effective.

2 metres (or 6 feet) of social distancing means that if both you and a person next to you have your arms extended, stretched out as far as you can reach, you should not be able to touch the other person's fingertips.

As expected, mask use is gaining more clear evidence.  Probably the greatest benefit of wearing a mask is to prevent the mask-wearing COVID-positive person (including the many people who are carrying the virus but not yet showing obvious symptoms) from spreading the virus to others.  Therefore, to be most useful, everybody should be wearing masks, particularly in crowded places such as grocery stores.

I have updated my idea about a voluntary inoculation technique:
The risk of this technique would be that some of the volunteers would face a risk of death or permanent injury.  But the benefit of the technique would be that a cohort of people would leave the technique in a proven immune state; and the technique would allow much more rapid research (done in the most perfectly rigorous blinded randomized-controlled manner) to establish clearly and in the quickest possible way whether proposed antiviral treatments work or not.  I suspect most antiviral treatments would be much more effective if given in the earliest stages of infection, rather than after severe symptoms have developed.  This is true of other antiviral treatments, such as acyclovir for HSV.  This technique would allow a guaranteed method of testing whether such antivirals would make a difference for people guaranteed to be infected but who are in the earliest pre-symptomatic stage.  In getting these answers quickly (saving weeks to months of time), tens of thousands of lives could be saved as we determine much more quickly which treatments actually work and which do not.  Not only could it identify effect sizes of effective treatments rapidly, it could also give us the information which would lead us to stop  offering putative treatments that may actually be harmful.

Meanwhile, I continue my advice to keep up social distancing.  Wash your hands very thoroughly and frequently, with an extra time whenever you have touched anything that anyone else might have touched.  Learn about good hand-washing technique.

Mask use has strong evidence.  But there is a shortage of masks for those who need them most.  So people will have to improvise their own home-made masks.

I encourage keeping some disinfecting cloths with you.  Clorox wipes are in short supply, but you can make your own by cutting up some old clothes into rags, and storing them in a glass jar containing a strong antiseptic such as Mr. Clean.

Avoid going out unless it is absolutely necessary.  I do consider daily exercise necessary, but if you do this, choose a time when fewest people are around, and a place where there is the least crowding.  I suggest sunrise or midnight.  Of course, be mindful about other safety risks.

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