RE: Health Care / Public Health
There is confusion by the public on appropriate corona-virus control. Perhaps it was caused by much of the information in the media which came from Mayors, Governors, and other administrators. But then the medical experts from CDC, NIH and others seem to support that a six-foot distance was an appropriate isolation technique.
The six-foot social or rather physical distancing was based on a study that mapped the path of virus droplets in a single cough or sneeze. The cough droplets were ejected from the mouth in a conical fashion of approximately 60 degrees projecting to 6 feet (2 meters) on average. This was done in a research facility with no air currents.
Researchers from Florida Atlantic University’s College of Engineering and Computer Science conducted experiments using flow visualization to demonstrate how far a cough travels and how long it lingers in the air. Flow visualization is a method that enables flow patterns, such as a stream of particles from a cough, to become visible in fluids like air and water since they are transparent. Various techniques using flow visualization make these patterns visible to the naked eye. The researchers at FAU used LED and laser lights. Particles and droplets that result from a human cough or sneeze typically range in size from 5 to 500 microns. The larger particles fall to the ground within a short distance due to gravity, but smaller particles can be carried longer distances by prevailing breezes of air. The particulates making up the fog, used in the emulation of the cough-jet, ranged in size from 10 to 20 microns. The larger particles fall to the ground within a short distance due to gravity, but smaller particles can be carried longer distances by prevailing breezes of air. It only took the particles a couple of seconds to travel 3 feet; in about 12 seconds it reached 6 feet and in about 41 seconds it reached around 9 feet. For a heavy cough, the researchers found that particles can even travel up to 12 feet. Their preliminary conclusion was that six-feet may not be enough protection.
Lisa Maragakis, M.D., M.P.H. , senior director of infection prevention at Johns Hopkins states that there was a public health reason for these measures. She indicated that sporting events, cruises, festivals and other large gatherings place people at high risk should be completely avoided. She advised that when a six-foot distance could not be achieved at all times, a face covering or mask should be worn.
Other recent studies have shown a projection of a mild cough is less than 2 meters and a forceful cough or sneeze projects up to 7 meters.(21+ feet). Hence, there is no safe social or physical distancing that would prevent a corona-virus infected person from infecting another person. Since many rooms may be smaller than 21 feet, there may be no safe distance for a second person in the same room.The only way to stop the corona virus is at the source by covering the mouth and nose with a mask.
The initial incubation period was estimated to be 4-days with the infectious period begining 48 hours prior to clinical symptoms, which includes coughing or sneezing. Newer data now estimates that the incubation period is closer to 10-14 days. Hence, people who don’t think they are ill are spreading the virus for up to 10 days prior to illness. When CHINA, after months of unfortunate delays, and after arresting the doctor who initially made the diagnosis (who subsequently died of the virus) enforced the wearing of masks by everyone or be cited, there were no new cases after a period of approximately two weeks.
This indicates that everyone should always wear a mask when leaving the house or car if we want to stop the spread of the corona-virus. Otherwise we will have sporadic recurrences of this infection into the future.
The initial corona-virus infection in this country was on Jan 20, 2020. After three months we are still experiencing new cases nearly every day as evidence by an epidemic this week near Sacramento. We will continue to have progression of this pandemic until everyone wears a mask in public at all times until there are no new cases for at least two weeks.
Business closures should be limited to those where a mask would interfere such as restaurants, bars, salons, barber shops, etc. Many businesses could remain open with reduced traffic by having an employee or a security officer as a door monitor enforcing mask requirements, sanitation sprays at the door, and infra-red non-touching thermometers so no one with a fever over 100.4 be admitted. Unless businesses remain solvent so they can pay rent, salaries, supply lines and other expenses, we may proceed to another depression. Walmart understood this business reasoning and with 1.5 million employees, 150,000 on leave, hired 150,000 more at 5,000 per day integrating new workers in 24 hours instead of two-weeks, with a surge in sales of 20% in March.
School children would be unable to wear a mask at all times and schools should remain closed until the pandemic is over, which more likely than not, is the remainder of this school year[i]. However, there are now CDs, DVDs, CD-Roms available for essentially most subjects for K-12. Parents could have a rewarding experience with their own children as they maintain their learning experience.
Respectfully submitted,
Del Meyer
Delbert H. Meyer, MD
Pulmonologist
Sacramento.
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