Post #1521: COVID-19 trend to 5/25/2022, and a reason to stay out of the cardio room at the gym.

 

The U.S. is back up to 33 new COVID-19 cases per 100K population per day, up 8% over the past seven days.  It now looks as if the Northeast region — the leader for the Omicron-II wave — has peaked.  That suggests that the U.S. as a whole should not be far behind.  The current, stable rate of new cases in the U.S. is the result of continued increases in most of the country being offset by reductions in the Northeast and Midwest regions.

Data source for this and other graphs of new case counts:  Calculated from The New York Times. (2021). Coronavirus (Covid-19) Data in the United States. Retrieved 5/26/2022, from https://github.com/nytimes/covid-19-data.”  The NY Times U.S. tracking page may be found at https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

Here’s the Northeast by state, where the peak continues to shape up nicely.  As they were the leaders on the up-slope of this wave, they should be the bellwethers for the peak.


Extreme aerosol emissions from intense aerobic exercise

 

 

One of the earliest U.S. COVID-19 super-spreader events occurred at a church choir practice in Washington State.  More than 50 persons (of the roughly 60 in attendance) were infected, and two died.

The terrible thing about this event is that they did everything “right” according to then-current CDC guidance.  But this was still the period during which the CDC was in denial about aerosol (airborne) transmission of COVID-19.   At that time, the CDC was still telling people that COVID spread via large droplets that rapidly fell out of the air.  Accordingly, the official party line was that if people stayed 6′ apart, all would be well and there would be no transmission of COVID-19.  No need for masks, ventilation, or other measures.  If you read the CDC’s official write-up about that event, they are still in denial, and per the existing, absolutely implausible writeup, that an entire roomful of persons was sickened by one index case because they failed to stay 6′ apart.

Putting the CDC’s past intransigence behind us, it’s now well-established that COVID-19 spreads via aerosols (tiny droplets that can float through the air).  We know that certain people (“superemitters”) and certain activities greatly increase emission of those aerosol droplets.  And, in particular, we know that singing produces as much aerosol emissions as coughing.  This is why some countries (e.g., Germany) and many U.S. mainstream churches banned singing in church for the duration of the emergency phase of the pandemic (see e.g. Post #678, or search this site for “singing”).

In hindsight, then, it’s no mystery why this choral practice created a superspreader event, as did many similar situations around the world.  It as if nearly every first-world country had at least one major church-based super-spreader event, e.g. Post #679).

You can extend that to any situation with crowds and loud talking.  Plausibly, this is why going to a bar seems to have been the most dangerous activity possible for spread of COVID-19, and why bars were always the first sites to be shut down when COVID-19 restrictions were in place.  Followed by indoor dining.  As it turns out, sipping a drink and talking loudly is just about the worst thing you can do in terms of aerosol emissions (Post #723).

If talking loudly increases aerosol emissions (Post #585), and singing does the same, it should come as no great shock that breathing heavily likely increases aerosol emissions as well.  This is probably why many lists rated “working out at a gym” as a relatively high-risk activity during the pandemic (Post #811).

Based on reporting in yesterday’s NY Times, research now shows definitively just how much intense aerobic exercise increases aerosol emissions.  This research, published in the Proceedings of the National Academies of Science,found the aerosol emissions increased well over 100-fold at maximal exercise rate, compared to emissions at rest.  My recollection is that this is modestly higher than was found for singing or coughing.  Thus, I believe that working out at your maximum aerobic capacity — breathing as hard as you can breathe — increases your aerosol emissions more than any other activity measured so far.  The upshot is that high-intensity indoor group exercise is likely among the most dangerous activities for spread of COVID-19. 

The research explicitly notes that emissions during intense exercise are far higher than emissions during loud speech.  For a given density (persons per square yard), and given level of ventilation, from the standpoint of COVID-19 transmission, you’re safer in a bar than in an aerobics class.

The article shows that the biggest increase occurs when you push really hard.  Moderate aerobic exercise pushes up aerosols somewhat.  But the big increase occurs when you are pushing yourself as hard as you can.  More-or-less, emissions are a function of how hard you breathe.  And, interestingly, trained athletes — with higher aerobic capacity — are capable of emitting more aerosols.

Source:  Adapted from “Aerosol particle emission increases exponentially above moderate exercise intensity resulting in superemission during maximal exercise”, Benedikt Mutsch, Marie Heiber , Felix Grätz , Rainer Hain et al, PNAS May 23, 2022m https://doi.org/10.1073/pnas.2202521119

There’s a clear policy implication here for Virginia and likely many other states.  When mask mandates were imposed for indoor public spaces, Virginia made an exception for individuals using cardio equipment in a gym.  In the gym my wife and I (used to, and maybe will again) use, you had to wear a mask walking around, using the weights, and so on.  But you did not have to wear one while using the cardiovascular equipment or otherwise engaging in intense aerobic exercise.  (Though, to be clear, I continued to wear one in that situation for my own protection, because breathing deeply is also the best way to inhale aerosolized virus directly to the locations where it can take hold most effectively.)

Based on this research, that’s entirely backwards.  It’s the people using the cardio equipment that pose the greatest threat to others, and for whom mandatory masking would generate the greatest public health benefit per person.

Given that we’ve all put this behind us, I don’t expect to see any changes in policy.  But if — as many expect — we have a winter COVID-19 wave, this research provides a reason for the cautious among you to skip the indoor aerobics when case counts are up.  A room full of people breathing heavily from intense cardio exercise is probably not a room you want to be in during an airborne pandemic.

Post #1516, COVID-19 trend, now 31/100K/day, rising 23%/week

 

At this point, I could probably just copy a post from any random day in the past month or so, and I doubt anyone would notice.  New cases continue to grow roughly 25 percent per week.  Today’s case count of 31/100K/day is there just a matter of arithmetic, plus or minus some random variation. Continue reading Post #1516, COVID-19 trend, now 31/100K/day, rising 23%/week

Post #1513: William and Mary, last COVID-19 update for the semester

 

The uptick in new COVID-19 cases at William and Mary that started a few weeks back appears to be ending.   But, because students have been/continue to leave the campus at the end of the semester, that’s not crystal clear.  But the current week continues the downward trend seen last week.

Source:  Calculated from William and Mary COVID-19 dashboard, accessed 5-16-2022.

You can see that the infection rate for the comparable (age 18-24) Virginia population rose last week, in line with the overall increase in the official count of new infections in Virginia.

For sure, this is the last usable reading for the semester. Everyone but the Seniors has gone home at this point.

In truth, this is likely to be my last update ever.  My daughter graduates this year, and I no longer have a reason to track after that.  Let’s hope that by that time fall semester rolls around, the new case rates are so low that nobody need to bother to track it.

Post #1511: COVID-19, finishing out the data week

 

The official count is still at 26 new cases per 100K population per day, an increase of 28% over the past seven days.  Rounded to the nearest whole number.  Same as yesterday.

Data source for this and other graphs of new case counts:  Calculated from The New York Times. (2021). Coronavirus (Covid-19) Data in the United States. Retrieved 5/13/2022, from https://github.com/nytimes/covid-19-data.”  The NY Times U.S. tracking page may be found at https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

I guess there are only a few things left to say.

First, nobody really knows what the actual new case count is.  That’s been true all along — at best, half of cases were captured by the official reporting — but there’s a nagging suspicion that the gap between the true and official case counts has been rising.  Can’t prove it, but between cheap and plentiful home testing, and a large degree of immunity in the population (suggesting that severe cases would become an increasingly small portion of all cases), it’s a good bet that it is. For sure, the last fix we got — via the CDC seroprevalence survey — suggested that the ratio of total infections to official infections was expanding.  It used to be a bit above 1:1, but as of the February 2022, cumulative for the entire pandemic, that had risen to 1.4:1.  Because that’s cumulative for the entire pandemic, that suggests a pretty large shift in the most recent months, in order to move the entire average up that much.

Source:  Post #1498, calculated from CDC seroprevalence survey data, COVID data tracker accessed 5/2/2022.

That said, deaths are still not rising  — they are still around 300/day — and hospitalizations still have not reached 3000 per day.  So there’s a lot of new cases, but not a lot of severe new cases.  As discussed in earlier posts, I’m pretty sure that’s a consequence of the change in the vaccinated/unvaccinated mix of new cases.  The vaccine and (particularly) booster still provide good protection against severe illness, even if they provide little protection against getting some COVID-19 infection after a few months.

Finally, this seems like it’s just getting started and/or there seems to be no hint that this is slowing down.  Note that the regions that started this the earliest (e.g., the Northeast, top line above) have had cases rising at a more-or-less steady rate since the end of March.  (That graphs as a straight line on the log chart at the top of this post).  Meanwhile, other regions — most of the middle of the country — are only now joining this wave.  Both of those suggest this has a lot longer to run.

Around here, informally at least, I think I’m seeing a turnaround in mask use, as Fairfax County, VA tops 40 new cases per 100K in the official stats.  Today, mask use was nearly uniform at both stores I briefly visited.  My wife perceives an age gap, as almost all older people are masked, and few younger people are.  That makes perfect sense from an every-man-for-himself personal protection standpoint.  Which is, I think, all we’re going to have in the U.S. moving forward.

Post #1510, COVID, now 26/100K

 

Now 26 new cases per 100K population per day, up 28% in the past week.   The BA.2.12.1 wave now looks well-organized in every region except the Mountain states, where Colorado still does not show a strong upward trend.

Data source for this and other graphs of new case counts:  Calculated from The New York Times. (2021). Coronavirus (Covid-19) Data in the United States. Retrieved 5/13/2022, from https://github.com/nytimes/covid-19-data.”  The NY Times U.S. tracking page may be found at https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

At this point, new cases are rising almost everywhere.  There were only five states where new cases did not increase in the past seven days.