Tag: SARS-CoV-2

Oral Antiviral COVID Treatments

Paxlovid and Molnupiravir are two new oral antiviral COVID treatments that were recently authorized.

As you are likely aware, a couple of new oral antiviral COVID treatments were recently authorized.

While that’s good news, especially if you have COVID and are at high risk for complications, it is important to understand that these still aren’t a quick cure for COVID.

Oral Antiviral COVID Treatments

So what do these treatments do then?

“Paxlovid consists of nirmatrelvir, which inhibits a SARS-CoV-2 protein to stop the virus from replicating, and ritonavir, which slows down nirmatrelvir’s breakdown to help it remain in the body for a longer period at higher concentrations.”

Coronavirus (COVID-19) Update: FDA Authorizes First Oral Antiviral for Treatment of COVID-19

If you have COVID, taking these medications will hopefully keep you out of the hospital or keep you from dying!

“In this analysis, 1,039 patients had received Paxlovid, and 1,046 patients had received placebo and among these patients, 0.8% who received Paxlovid were hospitalized or died during 28 days of follow-up compared to 6% of the patients who received placebo.”

Coronavirus (COVID-19) Update: FDA Authorizes First Oral Antiviral for Treatment of COVID-19

Paxlovid can be given to adults and children who are at least 12 years old with mild to moderate COVID-19 and who are at high risk of disease progression.

Each dose of Paxlovid consists of 2 pink tablets of nirmatrelvir with 1 white tablet of ritonavir. For each dose, you take all 3 pills at the same time. Paxlovid is given twice a day for 5 days.

Now, although ritonavir is included in Paxlovid to slow down the breakdown of nirmatrelvir, it can also affect other medications you might be taking.

That means Paxlovid is contraindicated if you are already taking any medication that is dependent on CYP3A for clearance or which induces CPY3A, including, but not limited to amiodarone, colchicine, clozapine, lovastatin, sildenafil, trazolam, carbamazepine, phenobarbital, phenytoin, rifamin, and St. John’s Wort. Ask your health care professional and pharmacist if you have any drug interactions before taking Paxlovid.

What about side effects?

In addition to liver problems and drug interactions, possible side effects of Paxlovid include dysgeusia (altered or impaired sense of taste), diarrhea, increased blood pressure, and myalgia (muscle aches).

There are also concerns about extra risks in those with uncontrolled or undiagnosed HIV-1 infection who take Paxlovid.

Where can you get Paxlovid?

As it was just authorized, Paxlovid is in limited supply in most pharmacies and will likely be hard to find.

Your health care professional can prescribe Paxlovid to those who meet the requirements of the EUA. And they have been distributed to many pharmacies, although you may have to call around to get your prescription filled.

Another oral medication, Molnupiravir, was also recently authorized and can be given twice a day for 5 days. Molnupiravir is a nucleoside analogue that inhibits SARS-CoV-2 replication by viral mutagenesis, targeting SARS-CoV-2 RNA-dependent RNA polymerase (RdRp).

“FDA has issued an EUA for the emergency use of the unapproved product molnupiravir for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progressing to severe COVID-19, including hospitalization or death, and for whom alternative COVID-19 treatment options authorized by FDA are not accessible or clinically appropriate.”

Frequently Asked Questions on the Emergency Use Authorization for Molnupiravir for Treatment of COVID-19

Unlike Paxlovid, Molnupiravir should only be prescribed when all other alternative COVID-19 treatment options authorized by FDA are not accessible
or clinically appropriate.

“Possible side effects of molnupiravir include diarrhea, nausea, and dizziness. Molnupiravir is not recommended for use during pregnancy because findings from animal reproduction studies showed that molnupiravir may cause fetal harm when administered to pregnant individuals.”

Frequently Asked Questions on the Emergency Use Authorization for Molnupiravir for Treatment of COVID-19

You should not take molnupiravir if you are pregnant or breastfeeding.

“Females of childbearing potential are advised to use a reliable method of contraception correctly and consistently, as applicable, for the duration of treatment and for four days after the last dose of molnupiravir.”

Frequently Asked Questions on the Emergency Use Authorization for Molnupiravir for Treatment of COVID-19

In addition to the warnings about pregnancy, you should not get pregnant while taking Molnupiravir. In fact, although the risk is thought to be low and studies are ongoing, to avoid pregnancy, sexually active males “with partners of childbearing potential are advised to use a reliable method of contraception correctly and consistently during treatment and for at least three months after the last dose of Molnupiravir.”

Your health care provider can prescribe Molnupiravir, but it will likely also be in short supply for a while.

What To Know About Oral Antiviral COVID Treatments

While it is great that we now have even more treatments available when folks get COVID, it is important to understand that these are still unapproved drugs that are authorized for use under Emergency Use Authorization.

More on COVID Treatments

The Latest on Masks to Keep Kids From Getting COVID

Face masks work to prevent the transmission of COVID and can help keep kids, many of whom are too young to be vaccinated, from getting COVID.

That kids wearing face masks to keep them from getting COVID is controversial is amazing to many people, especially pediatricians.

Why wouldn’t you want your kids to wear a mask if it could protect them?

The Latest on Masks to Keep Kids From Getting COVID

And yes, the data does show that wearing a mask is safe and protects kids from getting COVID…

Need some proof?

Let’s take a look at what’s happening in Texas.

A few weeks ago, there were 86 active staff and 708 active student cases in GISD.
A few weeks ago, there were 86 active staff and 708 active student cases in GISD.

In one north Texas school district that opened early, on August 2, they now have 67 active staff cases and 564 active student cases.

While that’s a lot, it is important to keep in mind that as cases are continuing to rise in most other school districts, leading to more than a few temporary school closures, they are actually dropping in GISD!

Why?

Staff and students in GISD are wearing masks and their active case counts are dropping!
Staff and students in GISD are wearing masks and their active case counts are dropping! They also limit the capacity for indoor and outdoor events once positivity rates get too high.

It is almost certainly because their staff and students are wearing masks!

Masks Save Lives

Wearing a mask can protect the person wearing the mask and the people around them.

Need more proof that masks work?

Wearing a mask is especially important to protect those who are too young to get vaccinated and those who have a true medical contraindication to getting vaccinated against COVID.

“When used in conjunction with widespread testing, contact tracing, quarantining of anyone that may be infected, hand washing, and physical distancing, face masks are a valuable tool to reduce community transmission.”

An evidence review of face masks against COVID-19

Wearing a mask is also important as COVID variants surge, some of which are more infectious, even to those who are fully vaccinated.

Masks save lives.

“Without interventions in place, the vast majority of susceptible students will become infected through the semester.”

COVID-19 Projections for K12 Schools in Fall 2021: Significant Transmission without Interventions

Parents should ignore the misinformation and disinformation about facemasks and COVID-19.

“To maximize protection from the Delta variant and prevent possibly spreading it to others, fully vaccinated people should wear a mask indoors in public if you are in an area of substantial or high transmission.”

Use Masks to Slow the Spread of COVID-19

In addition to social distancing, they should wear a mask and should encourage their kids who are at least two years old to wear masks in school and when in public around a lot of other people.

More on Masks Save Lives

Treating Kids with COVID Monoclonal Antibodies

While anti-SARS-CoV-2 monoclonal antibodies have an EUA for older, high risk children with COVID, they are not routinely recommended by most experts.

While you are likely used to hearing that there are no real cures or treatments for COVID, a few treatments do have emergency use authorization, including monoclonal antibody therapy.

“Monoclonal antibodies that target the spike protein have been shown to have a clinical benefit in treating SARS-CoV-2 infection. Preliminary data suggest that monoclonal antibodies may play a role in preventing SARS-CoV-2 infection in household contacts of infected patients and during skilled nursing and assisted living facility outbreaks.”

Anti-SARS-CoV-2 Monoclonal Antibodies

And they are available for use in kids who are at least 12 years old!

Treating Kids with COVID Monoclonal Antibodies

So why doesn’t everyone with COVID get treated with these monoclonal antibodies?

“Three anti-SARS-CoV-2 monoclonal antibody products currently have Emergency Use Authorizations (EUAs) from the Food and Drug Administration (FDA) for the treatment of mild to moderate COVID-19 in nonhospitalized patients with laboratory-confirmed SARS-CoV-2 infection who are at high risk for progressing to severe disease and/or hospitalization.”

Anti-SARS-CoV-2 Monoclonal Antibodies

In general, they are mainly used in those older children (at least 12 years of age) and adults who are at high risk for severe disease.

“When using monoclonal antibodies, treatment should be started as soon as possible after the patient receives a positive result on a SARS-CoV-2 antigen or nucleic acid amplification test (NAAT) and within 10 days of symptom onset.”

Anti-SARS-CoV-2 Monoclonal Antibodies

Also, ideally, treatment with monoclonal antibodies should be started very early, but even more importantly, it involves an IV infusion. So it is not something that your pediatrician will likely be able to give your child in their office.

So where can you get these monoclonal antibodies?

“The federal government controls the distribution of monoclonal antibodies, and the regional infusion centers in Austin, El Paso, Fort Worth, San Antonio and The Woodlands have exhausted their supply of sotrovimab, the monoclonal antibody effective against the COVID-19 Omicron variant, due to the national shortage from the federal government. They will not be able to offer it until federal authorities ship additional courses of sotrovimab to Texas in January. People who had appointments scheduled this week will be contacted directly and advised. Other monoclonal antibodies have not shown to be effective against the Omicron variant, which now accounts for more than 90 percent of new cases. The infusion centers will continue to offer those antibodies as prescribed by health care providers for people diagnosed with a non-Omicron case of COVID-19.”

Statement on Monoclonal Antibody Availability

Monoclonal antibody therapeutic treatments have been distributed to hospitals and infusion centers around the country. You can hopefully find a treatment location nearby if you need to get your high risk child treated, keeping in mind that you likely want sotrovimab if you have COVID during the Omicron surge.

How do you know if your child is high risk?

People aged 12 or older may be considered at high risk for developing more serious symptoms—making them eligible for mAb treatment—depending on their health history and how long they’ve had symptoms of COVID-19.
People aged 12 or older may be considered at high risk for developing more serious symptoms—making them eligible for mAb treatment—depending on their health history and how long they’ve had symptoms of COVID-19.

Does your child who is at least 12 years old have chronic kidney disease, diabetes, heart problems, chronic lung disease, including moderate to severe asthma and cystic fibrosis, etc., sickle cell disease, a neurodevelopmental disorder, including cerebral palsy, or have a medical device (tracheostomy, gastrostomy, or positive pressure ventilation, etc.)? Are they immunosuppressed? Are they overweight, with a BMI above the 85th percentile for their age?

Talk to your pediatrician if you aren’t sure if your child is high risk and if you need help finding COVID monoclonal antibodies for your child.

“One dose of Evusheld, administered as two separate consecutive intramuscular injections (one injection per monoclonal antibody, given in immediate succession), may be effective for pre-exposure prevention for six months.”

Coronavirus (COVID-19) Update: FDA Authorizes New Long-Acting Monoclonal Antibodies for Pre-exposure Prevention of COVID-19 in Certain Individuals

Another monoclonal antibody, Evusheld (Tixagevimab Plus Cilgavimab) is available for pre-exposure prophylaxis of adults and children who are at least 12 years old with moderate to severely compromised immune systems due to a medical condition or due to taking immunosuppressive medications or treatments.

Treating Kids with COVID Monoclonal Antibodies?

You may also want to ask if getting your child treated with monoclonal antibodies is something you really should do…

“Currently, there is insufficient evidence for utility, safety, or efficacy to recommend the routine use of monoclonal antibody therapy for children and adolescents with COVID-19, even those considered to be at higher risk of hospitalization or severe disease. At this time, neither bamlanivimab nor casirivimab plus imdevimab should be considered standard of care in any pediatric population, even in patients who meet high-risk criteria. There are no data supporting safety and efficacy in children or adolescents, and the evidence supporting use in the adult population (including young adults) is modest and/or unpublished and has limited applicability to pediatrics or to many specified risk groups.”

Initial Guidance on Use of Monoclonal Antibody Therapy for Treatment of Coronavirus Disease 2019 in Children and Adolescents

And know, that while monoclonal antibody treatments do have EUA for older children, a panel of pediatric experts has recommended against their routine use.

So get your kids vaccinated and boosted now and don’t think you can rely on monoclonal antibodies if they get sick…

More on COVID Treatments

Where is COVID-19 Spreading Now?

Since SARS-CoV-2 is spreading wherever a lot of people are getting together, you must adapt to life with COVID-19 now, so that you will still be around when COVID-19 is finally gone.

As cases start to surge again and countries are reentering lockdown, you might be asking yourself just who is spreading COVID-19 around now?

Is it political rallies, protestors, or kids going to school?

Where is COVID-19 Spreading Now?

In addition to very large gatherings, like political rallies, some folks might be surprised to learn that COVID-19 is now spreading:

  • after religious events and holidays
  • in daycare centers and schools
  • among recreational, high school, and college sports teams
  • at very large gatherings (>50 people), including funerals and weddings, some of which turn into superspreading events
  • at large gatherings (>10 people) of family and friends

Not surprisingly, SARS-CoV-2 is spreading wherever a lot of people are getting together.

Hopefully, understanding that can help us all avoid getting sick with COVID-19!

“Regardless of the origin of superspreading, we emphasize the particular fragility of a disease in which a major part of infections are caused by the minority. If this is the case, the disease is vulnerable to mitigation by reducing the number of different people that an individual meets within an infectious period. The significance is clear; Everybody can still be socially active, but generally only with relatively few – on the order of ten persons. Importantly, our study further demonstrates that repeated contact with interconnected groups (such as at a work-place or in friend groups) is comparatively less damaging than repeated contacts to independent people.”

Superspreaders provide essential clues for mitigation of COVID-19

Remember, the pandemic isn’t over yet.

If anything, we are heading into another big wave in most parts of the world.

And although COVID-19 vaccines are on the way, they won’t be hear quick enough to stop it.

A positive COVID-19 rapid test.
A positive COVID-19 rapid test.

Only you can stop it by social distancing from others as much as possible (stay at least 6 feet away), wearing a mask (yes, masks still work despite the new study some folks are talking about), and washing your hands regularly.

Most importantly, understand that:

  • someone can be contagious for up to two days before they develop symptoms of COVID-19 or they test positive and will continue to be contagious for at least 10 more days, their isolation period
  • if exposed to someone with COVID-19, you should avoid others and go into self-quarantine for at least 14 days after your last contact, as that is the incubation period (the time from exposure to when you might develop symptoms)
  • in addition to those who are sick before they develop symptoms (pre-symptomatic), some are contagious even though they never develop symptoms (asymptomatic transmission)
  • you can’t test out of your quarantine after being exposed
  • there are no good treatments and there is definitely no cure for COVID-19

And know that COVID-19 can be life-threatening, especially for folks who are in high risk groups, including those who are elderly and anyone with chronic health problems.

What does all of this mean?

That you have to adapt to life with COVID-19 now, so that you will still be around when COVID-19 is finally gone.

More on the Spread of COVID-19

Mask Exemptions for Kids During the COVID-19 Pandemic

If your child doesn’t want to wear a face mask, your pediatric provider might be able to offer more help than just an exemption.

Some parents who don’t want their kids to wear a mask at school might think about asking their pediatrician to write a mask exemption for their kids.

You can easily spread what you don't know you have... Remember, you can be contagious a few days before you have symptoms of COVID-19, which is why mask exemptions for kids aren't a good idea unless they are medically necessary. #BeInformed
You can easily spread what you don’t know you have… Remember, you can be contagious a few days before you have symptoms of COVID-19, which is why mask exemptions for kids aren’t a good idea unless they are medically necessary. #BeInformed

Before they do, they might understand that there are very few real medical reasons for these types of exemptions for wearing a mask.

Masks Control the Spread of SARS-CoV-2

More and more, we are learning that masks can help prevent the spread of SARS-CoV-2, the virus that causes COVID-19, protecting both the person wearing the mask and the people around them.

“The prevention benefit of masking is derived from the combination of source control and personal protection for the mask wearer. The relationship between source control and personal protection is likely complementary and possibly synergistic, so that individual benefit increases with increasing community mask use.”

Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2

Still, that doesn’t mean that everyone has gotten used to wearing them…

Hopefully, most folks do now understand why they are important though.

Wait, why are they important, especially if you are healthy and the people around you don’t have COVID-19?

Mostly it is because people with COVID-19 can be contagious:

  • up to two days before they start to show symptoms
  • up to two days before they test positive, even if they don’t have any symptoms

So if you are waiting to put on a mask until people around you have symptoms, then you will eventually get exposed, probably without even knowing it, and you might get sick, ending up in isolation, not being able to go to school or work.

And if you wait to put on a mask until you start to show symptoms, then you will likely eventually expose other people to the SARS-CoV-2 virus.

The alternative, if you want to reduce your risk of getting sick, is to just wear a mask any time that you can’t social distance (stay at least six feet apart) from other people.

Mask Exemptions for Kids During the COVID-19 Pandemic

So what are the medical reasons that kids, like adults, can’t wear a mask all day while they are at school?

“The Department supports actions by the airline industry to have procedures in place requiring passengers to wear masks in accordance with the CDC Order, CDC guidance, and TSA SD. At the same time, the ACAA and Part 382, which are enforced by OACP, require airlines to make reasonable accommodations, based on individualized assessments, for passengers with disabilities who are unable to wear or safely wear a mask due to their disability.”

Notice of Enforcement Policy: Accommodation by Carriers of Persons With Disabilities Who Are Unable to Wear Or Safely Wear Masks While On Commercial Aircraft

In general, a child over age two years should wear a face mask unless:

  • they have a physical or intellectual condition that would keep them from being able to remove their face mask by themselves
  • they can’t tolerate wearing a face mask because they have a condition such as autism spectrum disorder, intellectual disability, or a mental health disorder
  • they have a physical or intellectual condition and wearing a cloth face mask gets in the way of their ability to communicate

But shouldn’t these kids just do virtual school if they can’t wear a mask, instead of getting an exemption?

While that might be an option for some kids, others need the extra services that they get at school, which they can’t get with at home schooling.

In addition to a face mask exemption, some things that might work in some situations when a child won’t wear a mask include:

  • a face shield
  • a transparent face mask
  • using different fabrics for the mask
  • trying a bandana or gaiter
  • try to desensitize your child to wearing a mask

What about asthma?

In general, most kids with well controlled asthma should be able to wear a face mask. If your child’s asthma is so severe that it is made worse by wearing a face mask, then they likely need an evaluation by a pulmonologist and it might be best to avoid being around others during the pandemic.

If your child can wear a face mask, but just doesn’t want to, then it might help to allow them to pick their own mask, with a comfortable fabric and fit, maybe even getting a mask with a favorite character on it.

“Model it! Make it familiar by wearing a mask too.”

Getting Your Child to Wear a Mask

And don’t expect your child to want to wear a mask at school if you don’t wear a mask when you go out or if you don’t believe that wearing a mask is necessary.

More on Mask Exemptions

Are Kids Spreading SARS-CoV-2 in School and Daycare Centers

If kids aren’t spreading SARS-CoV-2, then why are three percent of the students at a high school in Texas sick with COVID-19?

Why are people starting to think that kids are spreading SARS-CoV-2, the virus that causing COVID-19, in school and daycare centers?

There have been over 500,000 cases of COVID-19 in children in the United States.
There have been over 500,000 cases of COVID-19 in children in the United States.

Probably because we are seeing more and more cases in kids, especially kids in daycare centers and schools in states with spiking cases.

SARS-CoV-2 in School and Daycare Centers

For example, let’s take a look at what’s going on in Texas…

“As of Friday, 410 total cases of coronavirus — 267 staff members and 143 children — had been reported at 318 licensed child care operations across the state, according to the Texas Health and Human Services Commission.”

Texas child care centers see sharp increase in coronavirus cases after months of relative calm

So far in Texas, 83% of child care centers (12,196 facilities are open) haven’t reported a COVID-19 case.

But 17% have…

Either in a child or adult.

Altogether, since March, there have been 1,271 cases in children and 2,416 cases in adults in 2,034 different daycare centers in Texas.

So far the largest cluster was in a Houston daycare, in which 17 adult staff members and 6 kids tested positive.

In another large cluster, in Pleasanton, 11 kids, but only 2 adult staff members tested positive.

COVID-19 has also already led to several school closures in Texas, just weeks after the start of the fall semester.

In one high school in East Texas, the number of active COVID-19 cases has already reached 3%. The school was only open for about three and a half weeks before having to move to online only education.

Are Kids Spreading SARS-CoV-2 in School and Daycare Centers?

A rise in cases in daycare centers doesn’t necessarily mean that it is the kids that are doing the spreading though.

Are staff members getting exposed and bringing SARS-CoV-2 to work with them, exposing the children? Or are the children acting as the spreaders?

A new study, Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities — Salt Lake City, Utah, April–July 2020, provides some answers.

Children who likely got COVID-19 at two Utah daycare centers spread it to other family members at home.

These outbreaks all started with an infected staff member, but quickly spread to other staff members and children.

“Analysis of contact tracing data in Salt Lake County, Utah, identified outbreaks of COVID-19 in three small to large child care facilities linked to index cases in adults and associated with transmission from children to household and nonhousehold contacts. In these three outbreaks, 54% of the cases linked to the facilities occurred in children. Transmission likely occurred from children with confirmed COVID-19 in a child care facility to 25% of their nonfacility contacts.”

Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities — Salt Lake City, Utah, April–July 2020

Not surprisingly, cases then spread outside the daycare centers, to some of the parents of these children and other family members at home.

Of course, that this study found evidence that children can spread SARS-CoV-2 isn’t surprising because it isn’t the first to make this claim.

“These findings demonstrate that SARS-CoV-2 spread efficiently in a youth-centric overnight setting, resulting in high attack rates among persons in all age groups, despite efforts by camp officials to implement most recommended strategies to prevent transmission. Asymptomatic infection was common and potentially contributed to undetected transmission, as has been previously reported.”

SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020.

There is also the report about children at the overnight camp in Georgia in June, which found an overall attack rate of 44% among the campers.

And the report about the Rhode Island COVID-19 daycare outbreaks.

“A total of 101 possible child care–associated COVID-19 cases were reported during June 1–July 31. Among them, 49 (49%) symptomatic persons were excluded after receiving negative laboratory test results, 33 persons (33%) had confirmed cases, and 19 (19%) were classified as having probable cases.”

Limited Secondary Transmission of SARS-CoV-2 in Child Care Programs — Rhode Island, June 1–July 31, 2020

Fortunately, community transmission of SARS-CoV-2 was lower in Rhode Island than many other states at the time, which is likely why “possible secondary transmission was identified in four of the 666 programs that had been allowed to reopen,” and not more.

Of course, these results stand in contrast to early reports in other countries which found that children didn’t seem to be spreading SARS-CoV-2.

“These data all suggest that children are not significant drivers of the COVID-19 pandemic. It is unclear why documented SARS-CoV-2 transmission from children to other children or adults is so infrequent.”

COVID-19 Transmission and Children: The Child Is Not to Blame

Early reports that were maybe flawed because children simply weren’t being exposed to SARS-CoV-2 at the time because of school closures and other factors.

“Here, we report that replication of SARS-CoV-2 in older children leads to similar levels of viral nucleic acid as adults, but significantly greater amounts of viral nucleic acid are detected in children younger than 5 years.”

Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in Patients With Mild to Moderate Coronavirus Disease 2019 (COVID-19)

So with conflicting reports, what are we to believe?

What to Know About Kids Spreading SARS-CoV-2

We will have to see more research, but with cases continuing to increase in daycare centers, schools, and colleges, it is very hard to believe that kids aren’t spreaders of SARS-CoV-2.

Not that they have to be…

There is an easy way to keep kids from spreading SARS-CoV-2 at daycare, school, and college.

Even easier than making them wear masks.

A recent study in Germany found that child-to-child transmission of SARS-CoV-2 in schools/childcare facilities appeared very uncommon, but this was at a time of very low rates of community transmission.
A recent study in Germany found that child-to-child transmission of SARS-CoV-2 in schools/childcare facilities appeared very uncommon, but this was at a time of very low rates of community transmission.

Yes, that’s keeping the COVID-19 case count down in your community!

More on Kids Spreading COVID-19

Fact Check – Did a Doctor Prove That Face Masks Don’t Work?

A recently uploaded video on YouTube by an anesthesiologist doesn’t prove that face masks don’t work to protect people against COVID-19.

Why do some people still think that face masks don’t work to protect them and others against COVID-19 infections?

Ted Noel did not prove that face masks don't work in his YouTube video.
Ted Noel did not prove that face masks don’t work in his YouTube video.

The usual suspects…

Did a Doctor Prove That Face Masks Don’t Work?

Of course, most people understand that face masks work well to protect us from the SARS-CoV-2 virus and COVID-19 infections.

“Face masks are a simple way to help decrease coronavirus transmission and save lives.”

Which type of face mask is most effective against COVID-19?

Sure, not all types of face coverings are created equal, but if you are wearing a face mask when you can’t social distance, then you will help to reduce the spread of SARS-CoV-2.

And no, despite his claims and video on YouTube, Dr. Ted Noel, a retired anesthesiologist, did not prove that face masks don’t work!

As an anesthesiologist with 36 years of experience, you would think he would understand how a surgical mask is supposed to fit...
As an anesthesiologist with 36 years of experience, you would think he would understand how a surgical mask is supposed to fit…

What did he prove?

If you are vaping and exhale through a poorly fit face mask, then, not surprisingly, the “vape smoke” is going to find a way around your mask!

Will it go through your face mask ?

Again, not surprisingly, it depends on the type of face mask.

This is probably a single layer cloth mask and not one made with a recommended two or three layers.
This is probably a single layer cloth mask and not one made with a recommended two or three layers.

In Ted Noel’s little experiment, you can see that his cloth mask didn’t perform very well.

Interestingly, someone else had already done this face mask experiment and got widely different results!

Doctors Who Proved That Face Masks Do Work

And these results that face masks work have been shown in much more sophisticated experiments using high tech equipment, including high speed cameras and laser light scattering.

How much protection your face mask offers depends on the type of mask, but you can clearly see that face masks work!
How much protection your face mask offers depends on the type of mask, but you can clearly see that face masks work!

These experiments confirm that face coverings can block aerosols and droplets when we cough, sneeze, and breath. And since viruses like COVID-19 are carried on these droplets, they prove that masks work.

Well most face masks…

To make sure your face mask works effectively, you should:

  • use a face covering made of at least two layers of a washable, breathable fabric
  • avoid face masks with valves
  • use a properly fitting face mask instead of a neck gaiter or bandanna
  • avoid face coverings made with fleece
  • wash your cloth face mask

And don’t listen to or share misinformation from folks pushing propaganda about COVID-19.

“Among 139 clients exposed to two symptomatic hair stylists with confirmed COVID-19 while both the stylists and the clients wore face masks, no symptomatic secondary cases were reported; among 67 clients tested for SARS-CoV-2, all test results were negative. Adherence to the community’s and company’s face-covering policy likely mitigated spread of SARS-CoV-2.”

Absence of Apparent Transmission of SARS-CoV-2 from Two Stylists After Exposure at a Hair Salon with a Universal Face Covering Policy — Springfield, Missouri, May 2020

Face masks work!

More on Fact Checking Face Masks Work

What to Know About Face Masks and COVID-19

Wearing a face mask is safe and may help slow the spread of COVID-19.

Why do some people still think they shouldn’t wear a mask to help control the COVID-19 pandemic?

A chain link fence won't keep out a mosquito, but it will keep out a dog covered in ticks...
A chain link fence won’t keep out a mosquito, but it will keep out a dog covered in ticks…

The usual suspects…

Confusion About Face Masks and COVID-19

Much of the confusion about face masks stems from the fact the initial guidance from the WHO and CDC said that wearing a mask wasn’t necessary for everyone.

“Wearing medical masks when not indicated may cause unnecessary cost, procurement burden and create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices. Furthermore, using a mask incorrectly may hamper its effectiveness to reduce the risk of transmission.”

Advice on the use of masks in the community, during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak – WHO Interim guidance January 2020

Using a mask incorrectly?

If you are going to wear your mask under your chin or with your nose or mouth exposed and think you are protected and not social distance, then wearing a mask might actually get more people sick. With little information that masks were helpful, this fear that they would create a false sense of security likely influenced initial guidance.

Experts were likely also concerned about a limited supply of medical masks at the time.

Of course, as we have gotten more information about the SARS-CoV-2 virus and how it spreads, that guidance about face masks changed.

“CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.”

Use of Cloth Face Coverings to Help Slow the Spread of COVID-19 (April 2020)

We know that the best way to avoid getting COVID-19, at least until we get a vaccine, is going to be trying make sure you are never exposed to the SARS-CoV-2 virus. In addition to social distancing and washing your hands, wearing a face mask correctly will help to decrease your risk of exposing others. And if those around you are wearing a face mask, then they won’t expose you!

What to Know About Face Masks and COVID-19

But what about the idea that the pore size of the masks are too big to stop the small size of the SARS-CoV-2 virus?

This 2009 photograph captured a sneeze in progress, revealing the plume of salivary droplets as they are expelled in a large cone-shaped array from this man’s open mouth, thereby, dramatically illustrating the reason one needs to cover his/her mouth when coughing, or sneezing, in order to protect others from germ exposure. Photo courtesy CDC/James Gathany
A sneeze in progress, revealing the plume of salivary droplets as they are expelled in a large cone-shaped array from this man’s open mouth. Photo by James Gathany.

The thing is, the SARS-CoV-2 virus, while it is very small, isn’t just floating around in the air by itself! It gets carried in and on larger respiratory droplets.

And if the mask blocks those respiratory droplets, then it should keep you from exposing others to the SARS-CoV-2 virus.

What about the claim that face masks cause folks to breath their own carbon dioxide, even leading to breathing problems?

OSHA has issued guidance to protect workers from getting COVID-19, which includes that they wear face coverings.
OSHA has issued guidance to protect workers from getting COVID-19, which includes that they wear face coverings.

Most folks realize this isn’t a real problem, after all, health professionals wear face masks all of the time without any problems, right?

But just think about these arguments…

On the one hand, they are worried that the pore size of face masks won’t block out the SARS-CoV-2 virus, which is about 0.1 μm in diameter.

But then they think these very same face masks will block carbon dioxide? How big are carbon dioxide molecules???

They are about 1000 times smaller than the SARS-CoV-2 virus…

So a face mask is not going to affect your ability to breath well.

Who Should Not Wear a Face Mask

Not surprisingly, a face mask is even recommended for folks with asthma, as long as their asthma is well controlled.

“There is no evidence that wearing a face mask makes asthma worse.”

AAAI Recommendations on the use of face masks to reduce COVID-19 transmission

Infants and toddlers under age two years can skip wearing a face mask because of the risk of suffocation, as can “anyone who has trouble breathing, is unconscious, incapacitated or otherwise unable to remove the mask without assistance.”

If you have “trouble breathing” though, you likely have a severe respiratory condition and you aren’t simply someone who doesn’t want to wear a mask.

Flyers about the Americans with Disabilities Act (ADA) and the use of face masks due to the COVID-19 are fake.

And there are no face mask exemptions under the Americans with Disabilities Act (ADA).

People are selling fake face mask exemption cards.
People are selling fake face mask exemption cards.

Are you ready to put on a mask now?

Since we are seeing higher rates of COVID-19 in states that don’t have mask mandates, the only confusion should be over why anyone still won’t wear a mask when they are around other people.

More on Controlling COVID-19

The Experts Defending Anthony Fauci

Anthony Fauci is receiving a lot of support from doctors, scientists, and public health experts.

Not surprisingly, more and more experts are speaking out to defend Dr. Anthony Fauci.

Anthony Fauci is receiving a lot of support from doctors, scientists, and public health experts.
Anthony Fauci is receiving a lot of support from doctors, scientists, and public health experts.

These experts understand that Dr. Fauci “deserves our deepest gratitude and support” and is “our best hope in these challenging times.”

The Experts Defending Anthony Fauci

Harold Bauchner certainly wasn’t alone in stating his public support for Dr. Fauci.

“As 12,000 medical doctors, research scientists and public health experts on the front lines of COVID-19, the infectious diseases community will not be silenced nor sidelined amidst a global pandemic. Reports of a campaign to discredit and diminish the role of Dr. Fauci at this perilous moment are disturbing.”

IDSA Statement in Support of Anthony Fauci, M.D.

The Infectious Disease Society of America issued their own statement.

“If we have any hope of ending this crisis, all of America must support public health experts, including Dr. Fauci, and stand with science.”

IDSA Statement in Support of Anthony Fauci, M.D.

And so did the Association of American Medical Colleges, whose members comprise all 155 accredited U.S. and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 51 Department of Veterans Affairs medical centers; and more than 80 academic societies, with 173,000 faculty members, 89,000 medical students, 129,000 resident physicians, and more than 60,000 graduate students and postdoctoral researchers in the biomedical sciences.

“The AAMC is extremely concerned and alarmed by efforts to discredit Anthony Fauci, MD, our nation’s top infectious disease expert. Dr. Fauci has been an independent and outspoken voice for truth as the nation has struggled to fight the coronavirus pandemic….

Taking quotes from Dr. Fauci out of context to discredit his scientific knowledge and judgment will do tremendous harm to our nation’s efforts to get the virus under control, restore our economy, and return us to a more normal way of life.

America should be applauding Dr. Fauci for his service and following his advice, not undermining his credibility at this critical time.”

AAMC Statement in Support of Anthony Fauci, MD

Hopefully Dr. Fauci knows how much the majority of people value his work and trust his opinions.

“We have been very fortunate to have Dr. Anthony Fauci at the helm directing infectious diseases research at NIH for so many years. His leadership and support of a rigorous scientific process has been critical to transforming HIV from a death sentence to a chronic condition​, saving millions of lives worldwide. His voice and expertise need to be amplified not silenced if we are going to get control of the COVID-19 pandemic​, which has now taken the lives of more than 135,000 Americans and more than 570,000 people worldwide.”

HIV Medicine Association Stands with Science and Anthony Fauci, MD

And we know that the only way out of the COVID-19 pandemic is with our public health experts, like Anthony Fauci, leading the way.

“In his role as Director of the National Institute of Allergy and Infectious Diseases (NIAID), Dr. Fauci has fostered a longstanding and productive collaboration with the ATS. He has faithfully served the American people through six presidential administrations, always providing sound, science‐based guidance to threats large and small. As we move forward to combat COVID‐19, his scientific knowledge, expertise, and counsel will continue to be of critical importance.”

Statement by the ATS Executive Committee supporting Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases

As cases of COVID-19 once again surge, one thing is becoming clear:

“Science, not politics, must guide COVID-19 response“

AIBS Supports Dr. Fauci

We can’t wish the SARS-CoV-2 virus away…

I am a pediatrician and #IStandWithFauci.

We need health experts like Anthony Fauci to help guide us through this. And we need people to listen to his advice.

More on Anthony Fauci

Who Are the Real COVID-19 Experts?

Don’t be confused by fake COVID-19 experts pushing their own agendas that are opposite the guidance of the real experts.

Why are you still confused about who you should listen to for advice about COVID-19 and who the real experts are?

Why is an oral surgeon treating people with COVID-19?
Why is an oral surgeon treating people with COVID-19?

The usual suspects…

Who Are the Real COVID-19 Experts?

Consider that in Texas, where COVID-19 cases are once again surging, Texas Senator Bob Hall is telling folks that they should no longer be afraid and is touting his very own COVID-19 “experts,” including:

  • Dennis Spence DDS, MD – an oral surgeon
  • Robin Armstrong, MD – an internal medicine doctor, he gave hydroxychloroquine to dozens of elderly patients in nursing homes without informed consent in his own “observational study.”
  • Brian C. Procter, MD – a family medicine doctor who has become one of Collin County’s leading Botox and Juvederm providers, and has made claims about successfully treating COVID-19 patients using “hydroxychloroquine, azithromycin, losartan, aspirin, zinc, and CBD [Cannabidiol oil] as an anti-inflammatory.” Proctor has also come out against wearing masks!
  • Richard P. Bartlett, MD – a family practice doctor, he is pushing the idea that budesonide, an inhaled steroid, is a silver bullet cure for COVID-19. Of course, that wouldn’t explain why people with asthma, who already take these drugs daily, die with COVID-19…
  • Stella Immanuel, MD – a pediatrician who continues to push the use of hydroxychloroquine.
  • Richard Urso, MD – an opthalmologist who seems to think that hydroxychloroquine should be available over the counter..

With so many docs writing scripts for their patients, it’s kind of like it is already…

Hydroxychloroquine should not be available over the counter!
Why is an ophthalmologist an expert on COVID-19?

So are any of these folks experts on COVID-19?

There is no evidence that Urso's COVID-19 cocktail will stop the SARS-CoV-2 virus.
There is no evidence that Urso’s COVID-19 cocktail will stop the SARS-CoV-2 virus.

While they are physicians, none seem to have any extra training in public health, virology, or infectious diseases.

Just as I wouldn’t go to Dr. Fauci if I had a cataract, I wouldn’t go to an ophthalmologist if I needed help dealing with a novel viral pandemic…

These folks do not seem to be experts and should likely not be making any treatment or policy recommendations that are outside their areas of expertise.

Listen to the real experts. #IStandWithFauci
Listen to the real experts. #IStandWithFauci

You should not be listening to them, especially when their recommendations go against the guidance of the real experts on COVID-19, such as:

You certainly shouldn’t be listening to politicians touting so-called experts pushing unproven and dangerous cures and treatments, as they have one goal – to make you think the COVID-19 pandemic isn’t that bad…

A naturopathic doctor had a lot to say about COVID-19 at this City Council meeting that voted to allow 4th of July activities in the city...
A naturopathic doctor had a lot to say about COVID-19 at this City Council meeting that voted to allow 4th of July activities in the city…

But how do you explain their “success” they are having with their COVID-19 patients?

The success they think they are having is built on anecdotal evidence.

“The overall cumulative hospitalization rate was 107.2 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged ≥ 65, followed by adults aged 50-64 years and adults aged 18-49 years.”

COVIDView Weekly Summary

And misses the fact that most folks don’t end up in the hospital when they have COVID-19…

They also do a lot of cherry picking, ignoring any studies or evidence that show what they are doing might not be right.

“Hydroxychloroquine and chloroquine, with or without azithromycin or clarithromycin, offer no benefit in treating patients with COVID-19 and, instead, are associated with ventricular arrhythmias and higher rates of mortality, according to a major new international study.”

More Evidence Hydroxychloroquine Is Ineffective, Harmful in COVID-19

Still confused?

More on COVID-19 Experts