COVID-19: The importance of viral load and partial solutions

Way back on May 5, 2020, we published a post titled,  “The surprisingly simple way to open America in 14 days and avoid a depression”

The essence of the post was: If everyone wore a mask, the transmission of the COVID-19 virus would be reduced to low levels approximating the effect of “herd immunity.”

Sadly, President Trump, being concerned about how wearing a mask made him look, discouraged mask-wearing. So, his followers did their best sheep imitations by not wearing masks.

The predictable result: Millions of Americans became infected and many thousands died.

Yesterday (8/15/20) we published excerpts from an article saying that men, far more often than women, refuse to wear masks because they feel the masks make them look weak. It is a macho thing.:

Performative masculinity is making American men sick,  American men are failing the pandemic.
By Alex Abad-Santosalex@vox.com, Aug 10, 2020

According to bias, behavior, and health experts, the reason is maddeningly simple: Masks aren’t manly.

The post belittled the lack of self-confidence exhibited by men, so frightened about not looking “manly,” they are willing to risk their lives and the lives of others, by not wearing masks.

In response to that post, I received a note from a reader who wrote, “Sneeze goes right through masks. Masks are useless except to keep from drooling into the surgical field.”

The reader is correct — and incorrect.Prevent the spread of COVID-19 with cough and sneeze shields ...

VIRAL LOAD
You will not become ill if just one COVID-19 virus enters your mouth.

All viral diseases, including COVID-19, rely on “viral load,” the number of viruses that are in your body at any one time.

“Viral load, also known as viral burden, viral titre or viral titer, is a numerical expression of the quantity of virus in a given volume of fluid; sputum and blood plasma being two bodily fluids.” Wikipedia

The key to preventing the spread and the severity of sickness from COVID-19 is to reduce the number of viruses transmitted from person to person, i.e. reduce the viral load.

The fewer viruses received, the more likely will a person’s immune system be able to respond effectively.

That is one reason why social distancing has a positive effect. The farther you are from a person, the fewer of the person’s viruses will make it to your mouth. At six feet distant, some viruses will be transmitted, though fewer than at two feet distant.

It also is why an outdoor setting is less conducive to transmission than is an indoor venue. Outdoors, the breeze dissipates the concentration of viruses far better than does indoor air circulation.

The above-mentioned reader is correct that viruses do penetrate masks. If there were zero penetration, a mask-wearer would not be able to breath.

But:

  1. Masks reduce the number of virus-containing droplets that penetrate the mask to be projected by an infected person.
  2. Masks reduce the distance of droplet projection by an infected person, reducing the number that reach another person.
  3. Masks reduce the number of droplets that penetrate the second person’s mask and are received by that person.

In total, the number of virus-containing droplets transmitted from infected people to non-infected people would be greatly reduced if everyone wore masks.

In this vein, here are excerpts from two informative articles:

SARS-CoV-2 viral load predicts risk of death

Determining the viral load of patients helps predict the risk of severe disease and death, allowing clinicians to implement more aggressive care.

The new study is the first to report on the SARS-CoV-2 viral load at diagnosis as an independent biomarker of the risk of death in a large cohort of hospitalized patients.

The team also noted that viral load in the COVID-19 disease may correlate with infectivity, disease phenotype, morbidity, and mortality.

The researchers discovered that a high viral load was tied to mortality or the risk of death among hospitalized patients with COVID-19.

Not only does viral load determine whether or not a person will become infected, but it also determines how serious the infection will be and the outcome, including the likelihood of death.

The more viruses you receive, the worse your outcome.

And then, there’s this:

TIMESOFINDIA.COM | Last updated on – Aug 11, 2020,
A study published recently in the Journal of Infectious Diseases makes a case for commonly used mouthwashes in fighting COVID-19.

According to the latest findings, gargling with mouthwash solutions may help inactivate the viral load of the SARS-COV-2 virus persisting in the mouth and throat and thereby, help lessen the spread of the infection.

The study, however, made it clear that using mouthwashes is no guaranteed treatment for the viral outbreak or protecting one from the infection; what it can possibly do is lower the chances of spread and transmission.

Researchers have based their evidence of using oral disinfecting solutions after studies based out of Ruhr University Bochum in Germany found out that high quantities of coronavirus exist within the upper respiratory tract, including the mouth and the throat.

It is also possible that the oral and throat cavities act as the ideal environments for the virus to settle in healthy individuals post-infection.

Since the spread of respiratory droplets, coughing, sneezing or talking are the likely causes of spread, a gargling solution like mouthwash could reduce the risk of transmission and subsequently lower the viral load or even stop it from multiplying.

Although the article wasn’t specific on this point, we assume it refers to alcohol-based mouthwashes (most are), since alcohol does inactivate viruses.

Here, the mouthwash acts as a kind of “mask” in that it reduces both the projection and the reception of the virus. You give fewer and you kill some of what you receive.

IN SUMMARY

For most problems in life, including diseases, partial solutions are all we have, and they are better than no solutions.

Herd immunity is one such partial solution. Herd immunity does not provide total immunity. Not everyone benefits. But it reduces the incidence and the effect of diseases.

With regard to COVID-19, we may never find an absolute prevention or cure. Even if a vaccine is developed, it may not be 100% effective. Partial solutions are all we ever may have.

One excellent partial solution is universal mask-wearing. Masks reduce the projection and the reception of the virus.

Additionally, it now is suspected that gargling with mouthwash will reduce the virus load in your mouth and throat, where most of the virus begins to do its damage.

And these reductions, by reducing overall virus load, will reduce sickness and death.

So I say to my readers, never demean any solution because of it not being 100% effective. Our lives rely on partial solutions.

Wear a mask. Gargle. Help yourself and help your neighbor.

Rodger Malcolm Mitchell

Monetary Sovereignty Twitter: @rodgermitchell Search #monetarysovereignty Facebook: Rodger Malcolm Mitchell …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..

THE SOLE PURPOSE OF GOVERNMENT IS TO IMPROVE AND PROTECT THE LIVES OF THE PEOPLE.

The most important problems in economics involve:

  1. Monetary Sovereignty describes money creation and destruction.
  2. Gap Psychology describes the common desire to distance oneself from those “below” in any socio-economic ranking, and to come nearer those “above.” The socio-economic distance is referred to as “The Gap.”

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics. Implementation of Monetary Sovereignty and The Ten Steps To Prosperity can grow the economy and narrow the Gaps:

Ten Steps To Prosperity:

1. Eliminate FICA

2. Federally funded Medicare — parts A, B & D, plus long-term care — for everyone

3. Social Security for all or a reverse income tax

4. Free education (including post-grad) for everyone

5. Salary for attending school

6. Eliminate federal taxes on business

7. Increase the standard income tax deduction, annually. 

8. Tax the very rich (the “.1%”) more, with higher progressive tax rates on all forms of income.

9. Federal ownership of all banks

10.Increase federal spending on the myriad initiatives that benefit America’s 99.9% 

The Ten Steps will grow the economy and narrow the income/wealth/power Gap between the rich and the rest.

MONETARY SOVEREIGNTY

7 thoughts on “COVID-19: The importance of viral load and partial solutions

  1. I generally agree with you here, Rodger. Very well-written article overall.

    But my question to you is, when does it all end? Will we all still have to be wearing masks in 2021? 2022? 2025? 2030? The rest of our lives? Already in Victoria, Australia there is a push to make masks mandatory every flu season even long after COVID-19 is gone! And that’s not satire either. (Ironically, they are SOOOO close to actually getting the point.)

    Meanwhile, none of the Nordic countries (including Sweden) have ever seen the need to mandate masks, nor do the Netherlands. And yet they seem to be doing no worse in terms of cumulative per capita death rates than the countries that do require them. In fact, they seem to be virtually virus-free now. And Hawaii’s very broad mask mandate has not seemed to have done them a lick of good (cases exploded well afterwards) as did their hubris of actually thinking they could seal themselves off from the world like New Zealand, annihilating their tourism-based economy for nothing, basically.

    At the same time, the East Asian success stories did involve widespread mask wearing, so the book has really not be written on it yet. There is likely *some* degree of effectiveness.

    Make no mistake, I am not trying to spread FUD (fear, uncertainty, and doubt) about masks, as I for the past few months have supported them as an alternative to lockdowns (which are far, far worse). But neither really seems to age very well in the long run.

    And as we approach herd immunity, if not already there, the case for prolonged mask mandates (i.e. more than a few months) becomes as threadbare as the poorest quality masks. That “two weeks” thing really seemed to be merely a polite fiction, of course.

    Thus, we need to start talking about how long these mandates shall last before they are ultimately phased out. Such a rational and nuanced discussion should honestly weigh the pros and cons, and define and delineate exactly what metrics shall be used to determine when they will no longer be needed and in which situations. For example, the number of cases, the number of deaths, the virus positivity rate (VPR), the R value, the Z statistic, the currenty situation at hospitals, and so on can all be used to determine when the pros outweigh the cons or vice-versa. After all, when the prevalence of the virus is at a very low baseline level (i.e. green zones), the effect size of universal mask wearing becomes practically negligible, while in areas with high and widespread community transmission of the virus (i.e. red zones), the effect size can become quite significant in the short run, even if only in slowing the virus down a bit.

    Thanks for adding that bit about the mouthwash, by the way. I was not aware of that, and I need to step up my use of it more. Peroxide should be good as well. I already knew anecdotally that whenever I get a cold or sore throat, gargling with mouthwash and/or peroxide seems to shorten the duration of the cold a bit. Have a nice day 🙂

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    1. It’s not exactly as it may seem: See:

      Coronavirus (COVID-19) in the Nordics – Statistics & Facts
      Sweden experienced the highest number of confirmed coronavirus cases among the Nordic countries in 2020.

      Compared to its neighboring countries, Sweden has taken less drastic measures to prevent the spread of the coronavirus. While the other Nordic countries were closing down, Sweden kept its borders open for other members of the European Union.

      Schools for younger children, restaurants, shops, and bars remained open while the other Nordic countries applied lockdowns. The cumulative number of cases in the country had reached around 84.3 thousand as of August 13, while in Denmark, the Nordic country with the second highest number of cases, had around 15.4 thousand as of this date.

      Finland, Norway and Iceland had case numbers below ten thousand at the end of July.

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      1. Interesting. And yet none of the Nordic countries required masks, and even the ones not named Sweden all reopened fairly quickly. And Iceland was only modestly stricter than Sweden, by the way.

        Sweden did indeed do significantly worse than their Nordic neighbors (for now), I will grant you that. While doing significantly better than the UK, Spain, Belgium, Italy, and a good chunk of the USA as well, and only slightly worse than France. But unlike their neighbors, they also kept their borders wide open with no hard restrictions (not even Japan or Belarus did that), and unfortunately like so many non-Nordic countries, initially failed to protect their nursing homes (which are also larger and more understaffed than those in Denmark and Norway) as well.

        The Swedish city of Malmo, who unlike Stockholm, did manage to protect their nursing homes in time, hence the fact that they still boast a lower death rate than even Copenhagen, Denmark across the Oresund strait.

        So yes there is indeed a lot of nuance here. But much of that nuance actually makes Sweden appear to be the real winner of the lockdown debate. Please see the following below:

        http://inproportion2.talkigy.com/nordic_comparison_4jul.html

        https://www.telegraph.co.uk/news/2020/06/14/inside-swedish-city-may-prove-countrys-strategy-right-along/

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        1. The point being?

          Masks help? Masks don’t help?
          Social distancing (lockdowns) help or don’t help?
          Doing nothing is better because people keep working?
          Doing nothing is worse because people keep dying?
          It doesn’t matter what you do, because white people don’t die of COVID but black people do?
          Trump’s response was wrong? Trump’s response was right?

          I, for one, of am the opinion that if everyone wore a mask whenever near someone with whom they did not live, the virus would have found insufficient victims to sustain, i.e. quasi herd immunity.

          What is the counter opinion?

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          1. I must admit I digressed a little bit and started going off-topic. The point I am trying to make that while full lockdowns (not to be confused with moderate social distancing measures, as “doing nothing” is a false dichotomy that not even Sweden did) generally do more harm than good overall, the issue of masks is more nuanced and the jury is basically still out how effective they are at a population level in the long run. Again, they probably do help, but their effectiveness has likely been a bit overstated, and any quasi- herd immunity that results is likely transitory. The debate on masks is actually over a century old, and we will probably still be debating this another century from now.

            Thus, I see mask mandates as a short to medium term measure, when it makes sense, not a permanent solution. Albeit far better than lockdown.

            Eventually, after these mandates serve their purpose, we will have to phase them out like we ulitmately did in 1919, and thus went over a century without such mandates in the USA and practically every other country. There had to be a reason why such policies were abandoned sice 1919, after all. I don’t want masks to become the new seatbelts or the new condoms, in other words.

            (Which reminds me of an old Seinfeld-esque joke I adapted for 2020: sex with a mask on is like skydiving with a helmet–it’s more like it’s wearing YOU for protection. LOL, I just couldn’t resist that one!)

            And finally, I believe that Trump screwed up BIGLY. I am certainly no fan of his. And where did I say anything about race? But now that you mention it, it’s true that while all races are susceptible to dying from COVID, the risk does indeed appear to be higher among Black, Latino, and South Asian people compared to whites for whatever reasons. (Per your logic, just think how many lives would have been saved if all of the BLM protestors wore masks while protesting.) But racial disparities aside, antibody survey studies show the overall infection fatality rate (IFR) is far, far lower than it was originally believed to be, by a factor of 10, 20, or more, which really bodes well for herd immunity (with a lower threshold than originally believed as well) and thus a true end to this horrible nightmare for good.

            But overall, we actually agree more than we disagree, Rodger. Keep up the great work.

            Cheers!

            Like

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