Dear Jessica (Jess):

So glad once again to read from you here, and to read such an intelligent and well written post. Regarding masks, yes, we should all wear masks or cloth face coverings all the time when in enclosed/ indoor areas, and outdoors where we are not distanced enough from others. The virus is way more infectious indoors than outdoors.

www. cdc.  gov/ coronavirus: “We now know from recent studies that a significant portion of individuals with coronavirus lack symptoms (‘asymptomatic’) and that even those who eventually develop symptoms (‘pre-symptomatic’) can transmit the virus to others… In light of this new evidence, CDC recommends wearing cloth face coverings in public settings .. e.g., grocery stores and pharmacies.. It is critical to emphasize that maintaining 6- feet social distancing remains important to slowing the spread of the virus… The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders”.

www. who. int/.. when and how to use masks: “If you are healthy, you only need to wear a mask if you are taking care of a person with Covid-19”- the reason WHO has a different instruction in regard to wearing masks is the same concern as the CDC’s, which is that if everyone wears a mask, there won’t be enough for health care workers, a concern that is more acute in poor countries with fewer masks available. (I didn’t read a mention of cloth face coverings by WHO).

WHO provides these instructions regarding wearing masks: “Before putting on a mask, clean hands with alcohol-based hand rub or soap and water. Cover mouth and nose with mask and make sure there are no gaps between your face and the mask. Avoid touching the mask while using it; if you do, clean your  hands .. Replace the mask with a new one as soon as it is damp and do not re-use single use masks. To remove the mask: remove it from behind (do not touch the front of mask); discard immediately in a closed bin; clean hands with alcohol-based rub or soap and water”.

* You wrote: “It would seem that the bulk of Covid-19 cases are asymptomatic”- in the CDC quote above there is a distinction between asymptomatic and pre-symptomatic. Asymptomatic means people who .. never develop symptoms, and pre-symptomatic are people who develop symptoms later. If the bulk of people who are infected are also asymptomatic, this means that if you and I are infected (and if we are younger and with no pre-existing conditions) to be asymptomatic as well and never develop symptoms.

But of course, we should wear masks or cloth face coverings because we don’t want to risk getting infected and we don’t want to spread the infection to people who are older and/ or with pre-existing conditions.

Regarding a new wave of infections in the fall, in Wikipedia‘s entries on the pandemic in different countries, it states a number of waves. For example, in its entry on Singapore, it lists: “Wave 1: Imported cases from China (January 2020)… a total 13 confirmed cases, all of whom were visitors to Singapore from China.. Wave 2: Early local clusters (February to March 2020)… More clusters emerged at various locations, where there were large scale gatherings.. Wave 3: Returning Singaporeans and permanent residents from overseas (March 2020).. Wave 4: Spread among migrant worker population (April 2020 to Present) In April, the bulk of cases began to shift from imported cases to migrant workers living in dormitories”-

– so appearing in waves is the natural behavior of an infectious epidemic or pandemic, it goes up in one area, then down, then up in another area, down.. etc., like waves in an ocean. The talk about a second wave refers to a big wave in the fall and winter of this year, a coronavirus wave that will coincide with the flu season.

www. health. com/… cdc warns second wave coronavirus (April 23): “The second wave? Think of it as literally a second wave, it  comes behind the first, doesn’t get that high, but ebbs and flows.. Those ‘ebbs and flows’ depend on the success of protective and preventive measures”, and an example of these ebbs and flows is given regarding China: the outbreak in Hubei (the epicenter of the original outbreak) was the first wave, then it was controlled, “After reporting near-zero local transmissions over several weeks, a new batch of Covid-19 cases in the city of Harbin, at the border with Russia”- that’s a second wave which “resulted in fresh lockdowns”.

“It’s still too early to  identify Covid-19 patterns, though Dr. Adalja believes the biggest thread of a second wave appears to be during fall, which is the start of flu season… ‘A second wave starting in the fall could occur mixed with the flu and prove to be especially challenging for hospital systems to cope with,’ he says…

Urvish Patel, MD, MPH, a public health professional in the neurology department at Mount Sinai Hospital, New York.. points out that other SARS and MERS viruses have not shown a second wave, but says we should be ready for any possible condition. He advises that ‘prevention and precaution’ is always the best approach.”

* You wrote: My hope is that as it mutates through the months, it becomes less potent and less contagious”- which is what happened with the first SARS and MERS mentioned in the paragraph above, resulting in no additional waves of SARS (it was declared contained in 2003 by WHO), and no significant waves in the case of MERS.

– thank you for your thought provoking post, Jessica (or do you prefer Jess?) I hope to read from you again, anytime you are up to posting here.

anita

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