From Massachusetts General Hospital (“the Massive Genital” to some of my physician friends), a 50-page summary of what is known regarding Covid-19 risks and mitigation in schools. A fwe excerpts:
Based on early data, schools do not appear to have played a major role in COVID-19 transmission. Based on data at this time, transmission from students to staff and from students to other students (especially younger students) appears to be rare, and will likely be even more rare with appropriate risk mitigation strategies.
(conclusion after reading the above: let’s keep schools closed anyway! #AbundanceOfCaution)
#MasksWork:
There are few data about mask use, specifically in schools. The available data about masks usually come from a combination of studies on COVID, SARS, and MERS. There are no data about the combined effectiveness of masks plus face shields plus physical distancing
HEPA filters like those mandated by Governor/Hero Cuomo will save us:
Low-efficiency filters (e.g., less than MERV 8 according to ASHRAE Standard 52.2 or less than ePM2.5 20% according to ISO 16890-1:2016) are very unlikely to make a difference. Of note, high-efficiency filters may be counter-productive since frequent filter changes are needed and a high-pressure drop filter can also diminish the amount of air supplied into the environment, making the filter less effective
I.e., American schools will never get organized to change the HEPA filters often enough.
Also.. don’t ride the bus and don’t sing on the bus!
And, in the ongoing debate about whether to follow advice from Dr. Donald J. Trump, M.D. … “Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19” (International Journal of Infectious Diseases):
According to a protocol-based treatment algorithm, among hospitalized patients, use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine.
How do experts characterize a falling death curve?
The United States is in an acceleration phase of the COVID-19 pandemic. Currently there is no known effective therapy or vaccine for treatment of SARS-CoV-2, highlighting urgency around identifying effective therapies.
Here’s the acceleration (nytimes):
Results?
Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4-10 days), median age was 64 years (IQR:53-76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3-53). Overall in-hospital mortality was 18.1% (95% CI:16.6%-19.7%); by treatment: hydroxychloroquine + azithromycin, 157/783 (20.1% [95% CI: 17.3%-23.0%]), hydroxychloroquine alone, 162/1202 (13.5% [95% CI: 11.6%-15.5%]), azithromycin alone, 33/147 (22.4% [95% CI: 16.0%-30.1%]), and neither drug, 108/409 (26.4% [95% CI: 22.2%-31.0%]). … Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p < 0.001).
Maybe we have to dig into the paper for adjustments, but it looks as though a higher percentage of those on hydroxychloroquine + azithromycin died (20.1 percent) compared to those only on hydroxychloroquine (13.5 percent).
What explains the regular weekly spikes and troughs in the NYT graph of reported deaths? It seems that every Tuesday there’s a significant high, and on Sat/Sun there’s a low. Is it simply that the weekend means that stat-gathers aren’t working, and by Tuesday they’ve caught up with the weekend’s numbers?
Anonymous: I think so. If you look at the WHO data at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports you’ll see that a lot of countries report zero deaths Saturday, Sunday, and Monday or at least Sunday and Monday (stats that would have had to be gathered on Saturday and Sunday). Sweden, for example, reported 13 additional new deaths today, but that’s after two days of reporting 0. So really it is a daily death rate of about 4 people (in a country of 10 million, i.e., a “raging epidemic” according to our media).
So, it looks like Dr Koch who claimed roughly the same at the end of April and reviled for that claim by the US/UK media, and by our gracious contributor Ryan, was vindicated by the MGH scientists ?
https://philip.greenspun.com/blog/2020/05/09/swiss-children-cant-transmit-coronavirus-but-teachers-shouldnt-rush-back-to-work/
To be fair to German non-speakers the BBC somewhat mistranslated Dr Koch’s original statement perhaps due to lack of German speakers at the BBC.
On a related note, Florida is planning to open schools in August.
Dr. Koch is quoted there as saying:
“Young children are not infected and do not transmit the virus.…They just don’t have the receptors to catch the disease.”
We know this is patently false because there have been numerous cases of kids getting seriously ill after contracting coronavirus:
https://www.statnews.com/2020/06/29/nejm-inflammation-children-covid19-misc/
I think how effective kids are as transmitters is still an open question. I suspect there’s an awful lot of wishful thinking going on with these claims that they definitely for sure won’t infect anyone, given how effective kids are at spreading pretty much every other infectious disease known to mankind except those typically transmitted by having sex or sharing needles.
Massachusetts is the state with the fourth-highest death rate per capita in one of the world-hit countries in the world, so one might wonder why we should be taking advice from doctors in Massachusetts. If we look at countries doing much better:
Taiwan gives kids masks and dividers:
https://www.cbc.ca/news/business/taiwan-covid-19-lessons-1.5505031
South Korea closed schools after a kindergartener tested positive:
https://www.forbes.com/sites/tommybeer/2020/05/25/6-year-old-tests-positive-for-coronavirus-complicating-south-koreas-school-reopening-plans/#6e241f6c6f63
Vietnam gives kids masks and keeps them from touching each other: https://www.reuters.com/article/us-health-coronavirus-vietnam-schools/vietnam-reopens-schools-after-easing-coronavirus-curbs-idUSKBN22N0QB
It seems it’s probably possible to send kids back to school while taking reasonable precautions, rather than making an assumption that kids can’t transmit the disease and throwing caution to the wind.
Ryan,
For the third time, Dr. Koch did not say that. I am not sure why you insist on the incorrect quote, but so be it.
Can you please forward the report to Harvard and MIT, preferably with highlights on the relevant paragraphs.
MIT’s President Reif letter published this morning: “[…] in planning for the Fall, we took a very MIT approach: broadly consultative, science-based and intensely analytic.”
Harvard’s Dean Rakesh Kuranna (according to his website “Not just a Dean, but a friend”) letter published Sunday July 5: “[…] The recent upturn in COVID-19 cases in certain states illustrates the difficulty of making predictions, even well-informed ones, about the evolution of this virus”
I think the expression “consultative, science-based and intensely analytic” should not be taken literally. It is a just a piece of managerial bel canto, a formulaic prayer. I like “intensely analytic” the most, it is better than “bad/good optics”.
“the difficulty of making predictions, even well-informed ones, about the evolution of this virus”
YB:
“It’s tough to make predictions, especially about the future”
@Ivan – Reif’s management speak is just the tip of the iceberg. In fairness to MIT, they at least offered a $5K tuition discount compared to Harvard which is standing firm on no price changes to their product.
Both MIT and Harvard talk unconvincingly about how great their online course offerings are going to be without presenting any sort of actual evidence.
It’s disappointing to see how weak is Harvard’s BS, considering their reputation for training future Masters of the Universe.