a Covid news digest
for the period October 24 – November 20, 2020 FINAL EDITION
FRONT PAGE
CovidGram is back now after a few weeks off. On the other hand, far from taking a break, the pandemic has only intensified.
This issue reviews several new Covid-related technologies, but as a general rule, CovidGram does not endorse any products. Readers are encouraged to conduct further research on any reviewed products.
Just last Friday, a crowded Mumbo Jumbo virtual town hall took stock of personal life ten months into the Covid era. All sorts of perspectives emerged from the discussion including the self-probing, sometimes emotional accounts from Kheprw community members directly touched by the virus. Kheprw is continuously looking for ways to engage the community in pandemic awareness and to combat the spread of Covid. Watch out for the next Mumbo Jumbo focused on Covid issues.
Contact tracing app. The ability of contact tracing to control viral spread is limited by the time it takes testing and tracing to notify people who have been exposed to the virus. That’s because a newly exposed person can become contagious as soon as two days after exposure, well before symptoms appear—if they appear at all—and well before contact tracing ordinarily makes a notification.
Michigan, New York, Alabama, New Jersey and a couple other states are using phone apps that notify users when they have been within 6 feet of a person infected with Covid. Indiana is not yet on board with the new technology.
Air cleaners that use negative ions to remove virus particles from indoor air are being considered by Kheprw to help reduce the potential for Covid infection while working in Kheprw facilities.
Mask effectiveness compared. In a sequel to his previous investigation of mask effectiveness, Alvin Sangsuwangul conducted a new search for the best mask on the market. His research singled out the Livinguard face mask for best virus protection.
Free testing. Reports of long delays in getting test results from Marion County Health Department. Consider getting tested at CVS Pharmacy or the Indiana State Department of Health A home test kit priced around $50 just received FDA approval and should be available soon.
FEATURE STORIES
I. Contract tracing app
Stopping virus spread. When the pandemic gets too large, the contact tracers turn to 21st century technology, at least in some states. NPR reported this week the rollout of MI COVID Alert, Michigan’s latest strategy to rein in a pandemic that is rapidly running out of control statewide. MI COVID Alert is a free smartphone app that notifies users after they come into close contact with a Covid-positive person so they know it’s time to quarantine to prevent spread of the virus.
Because it normally takes days to set up a test appointment and then longer to get a test result, conventional testing and quarantining is not fast enough to ensure containment of virus spread. Even with a rapid test result in a few minutes, if you include the time contact tracing takes before a person is aware of having been exposed, the virus could have already spread. In contrast, the automatic rapid-alert notification of close contacts can get quarantining started within one or two days of exposure. Considering that 280,000 residents of Michigan have chosen to download the app in the first 10 days since its release, this high-tech approach to contact tracing appears promising. During a 3-week pilot in one Michigan county and a college campus, nearly 50, 000 people installed the app, and the app generated 40 exposure notifications.
Too invasive to tolerate? In details reported by Michigan’s Department of Health and Human Services, the new app uses Bluetooth technology instead of GPS positioning to determine when a user comes into close contact with a Covid-positive person. According to the state, this technology makes all users—both Covid-positive and Covid-negative—anonymous through a system of codes, and the system does not track location or store any personal identities.
CovidGram questions the app’s limit of anonymity, however, considering that a Covid-negative user could conceivably approach a suspected Covid-positive person and then wait to see if an alert shows up for that particular close contact.
For the app to work, two users in close contact must have the app installed and have their phones within reach. Covid-positive users have the option to register voluntarily in the database using a code generated by the testing agency that gave them a positive test result. When a registered Covid-positive person comes into close contact with an uninfected app user, the database sends a notification to the uninfected person informing them that they were recently exposed and strongly recommending that they begin a quarantine and get tested.
While this system seems to have many good design features, it contains too many moving parts for CovidGram to confirm the app’s claims of anonymity within the scope of this article. Further research on this question is needed.
Too new to decide? Virginia, Arizona, New York, Alabama and New Jersey have implemented similar phone app programs, but Indiana has not yet pursued that approach. Shandy Dearth, principal investigator at IU Fairbanks School of Public Health, which conducts some of the contact tracing for our state, said she is “exploring options for automating” the contact tracing process, but she did not detail those options. Another local public health official suggests that it makes sense to wait and see how the new technology performs in other states before investing in the new smartphone app for Indiana.
The Covid situation in Indiana is not yet as dire as Michigan’s, but it is quickly heading in that direction. During the week of November 7-13 alone, close to 40,000 people were referred to Michigan’s public health system for investigation and contact tracing, but the state was only able to fully investigate 23% of them. Michigan officials are hoping the new contact tracing app will help reach enough potentially new Covid cases to slow the spread.
References
NPR, November 18, 2020, Covid overwhelms Michigan health care system
Detroit Free Press, November 9, 2020, Michigan rolls out new app for Covid
II. Ionic air cleaners
Kheprw is considering the purchase of an ionic air cleaner to provide an extra measure of protection from indoor airborne virus particles in its Alkhemy facility or other locations. Various models are available for $250-800. Ionic air cleaners generate negative ions—in most cases, negatively charged oxygen ions—which will attach to airborne particles and remove them to the ground or another solid surface. While this option is being explored, we continue to not host any people from outside the Kheprw bubble inside any Kheprw facilities, and we do guest visits and volunteering via outdoor social distancing of 6 ft while wearing masks.
The scientific evidence on the effectiveness of negative ions in cleaning indoor air is mostly positive. Most studies confirm the ability of negative ions to attach to airborne particles, thereby improving air quality. However, one study was agnostic about the ability of portable units to effectively clear the air in a room.
A recent comprehensive review article published by the National Institutes of Health provides the latest and most convincing data in an in-depth survey of the scientific literature on negative ion generators. That report supports the effectiveness of commercially available ionic air cleaners and finds the only drawback to such units is that some of them can generate noticeable levels of ozone, a pollutant.
Kheprw is considering a commercial-grade iWave ionic air cleaner. Its manufacturer claims that the unit does not produce ozone. Alvin Sangsuwangul at Kheprw compiled the following information about the iWave unit.
- Overall I believe it will effectively reduce the risk of virus particles building up in an indoor space.
- I believe it would allow us to safely use indoor spaces (Alkhemy and campus spaces) for small groups under these conditions:
- 6 feet of social distance (though I think if people need to quickly walk past each other it’s not a big deal as long as people stay apart 99% of the time)
- Strict wearing of masks with proven effectiveness by everyone in the house. The only mask I can recommend for this job right now is Livinguard
- Never taking them off, no eating/drinking
- Leaving masks on for 30 minutes after guests leave
- Leave the hvac fan on the entire time and 30 minutes after guests leave
- iWave’s commercial model has been tested in a scenario similar to an airplane with Covid-19 aerosol particles. It was shown to kill 99.4% of covid 19 in 30 minutes, and estimated 84% after 10 minutes , 92% after 15 minutes. It also kills/removes other viruses, dust, allergens, mold and odors. They describe this test in this webinar https://youtu.be/FRkp2LXFZd4?t=1840
- The residential model uses the same technology, it is sized smaller for smaller spaces/HVAC systems. I would infer that the residential would also be effective though numbers might very depending on the size of the space. I have contacted iWave to try to get more comprehensive test results and asked if the residential model is also effective against Covid 19.
- This system produces ions and the HVAC system spreads them throughout the indoor space. The ions survive 1-2 minutes before they attach to contaminant or water molecule. This is positive because it doesn’t just clean air in the HVAC duct, but spreads air cleaning throughout the space, this is described in more depth in this webinar https://youtu.be/o-0kHj0aL4E?t=619
- No maintenance or bulbs/filters to replace, 3 year warranty. They say they’re able to install within 48 hours. They give an estimated unit life of 200,000 hours which is approximately 20 years
Reference
International Journal of Molecular Sciences (via NIH), September 28, 2018, Negative air ions and their effect on human health and air quality improvement.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213340/
III. Best in category: face masks
An intensive search by Alvin Sangsuwangul for the most protective face mask turned up the Livinguard mask. It sells for $30 and can be ordered at the company’s website. Alvin’s report highlighted the following advantages of this Swiss-made mask.
The mask materials filter >95% of particles down to .3 microns
- This is the low end of airborne aerosols and same standard as N95 masks, however N95s are designed to have an airtight fit around the sides and this mask while tight fitting is not airtight.
- Here is the link to the lab test results on filter effectiveness after 30+ washes (referred to in lab report as N95 mask): https://drive.google.com/file/d/1DvEx67QWtKvjEGj9Pn6LbEuszGx-deo5/view?usp=sharing
- The mask is super positively charged which both improves filtration (New York Times article on masks and electrostatic charge) and kills covid-19 virus, germs and other microbes/viruses that come in contact with the fabric.
- In a study by the Free University of Berlin researchers “were able to demonstrate that these new textiles can reduce high amounts of SARS-CoV-2 virus particles by up to 99.9% within a few hours”.
- This makes handling the mask less of a biohazard, allows you to rewear the same mask each day without washing it.
- Of all the other companies I looked at this mask seemed the furthest along in studies from actual universities and government certifications. I contacted them about this and they said:
- “In regards to the FDA, we have been approved under the EUA (Emergency Use Authorization). This has not approved us to market with health claims, but it does allow us to sell the masks. We are in the process of getting our N95 Respirator (Note: I believe they’re referring to their Safety Mask) approved by the FDA and we are expecting that approval to happen in January 2021.”
- They also have a CE certification which means they meet safety standards to sell the product in Europe as well as some certifications for quality control in their manufacturing.
- The mask retains >95% filtration effectiveness after 30 washes. They recommend you can wash it every 7-10 days, cold water, no soap, air dry. It should stay relatively fresh because of the anti-microbial fabric. The less you wash it the longer it will stay effective.
- It is designed to have a good tight fit to reduce leakage (which may vary by face). This is demonstrated in this youtube review of the mask. When she puts it on she talks about the fit and you can see that the cloth puffs out and in when breathing, which shows that less air is leaking from the sides: https://www.youtube.com/watch?v=3idL1mw_FA4
Sport and fitness mask. For those who want a more breathable protection from airborne coronavirus while outdoors and during exercise, Alvin reviewed the R-Shield, a neck scarf with a nanofiber filter priced at $41. This neck scarf does not provide as much protection as the Livinguard mask described above, but it does feature other benefits as listed below.
This model “filters 99.9% of virus and bacteria and particles smaller than .1 micron. I chose the other mask as the safest because the R-shield filter does not cover the whole interior of the scarf, only the face area, which could lead to leakage around the sides. I contacted them about this and have copied their answer below.
There are unique benefits to this mask:
- More convenient, can leave it around your neck so whenever you need it you can put it on.
- More breathable and lighter material, so may be better for outdoor exercise
- Keep you warm in the winter
- Doesn’t lose effectiveness with washing (that is stated on the website)
- May be a better option for children
I think this is still a good option (but maybe not the safest), but it may be better for some circumstances. I will probably order one of these for myself as a second mask option (particularly for outdoor use and exercise): https://www.respilon.com/products/products/r-shield/
An important note is that though these masks provide superior protection, masks are not fool-proof and are not a substitute for social distancing and gathering outdoors when possible. Taking greater risks because you feel more protected could in fact increase your risk. However using the safest mask will be beneficial particularly when you need to be indoors and/or cannot social distance (essential workers, doctors visits, etc.).
The makers of R-Shield supplied the following information:
You have to make sure that the nanofiber membrane covers your nose and mouth. To ensure a tight fit of the neck gaiter you have to adjust both the tightness of an elastic band at the back of your head and the shape of a nose clip on your nose. We recommend to slip the R-shield into your T-shirt because of eliminate the risk. You have to follow these instructions https://shop.respilon.com/user/documents/upload/How-to-care-about-R-shield_Light.pdf.
R-shield cannot be an equivalent substitute for respirators, which are designed to fit exactly on the face and there are no leak of air, etc., however, the R-shield is still the greatest protection when it comes to scarves. You can also check our Annual CSR Report for 2019. R-shield is commonly used by sick patients, works without problem and protects sick people efficiently. https://www.respilon.com/data/public/RESPILON_Annual_CSR_Report2019_EN_web.pdf