You Can Isolate and Not Spread Covid-19

When you come down with covid-19, it is totally possible for you to isolate from others in your household and avoid spreading the disease to them.

Most people don’t know how to do this effectively, because proper, detailed advice has never been given. For example, this is all the CDC has to say about it:

“• Wear a high-quality mask if you must be around others at home and in public.
• Do not go places where you are unable to wear a mask. ...
• Do not travel.
• Stay home and separate from others as much as possible.
• Use a separate bathroom, if possible.
• Take steps to improve ventilation at home, if possible.
• Don’t share personal household items, like cups, towels, and utensils.
• Monitor your symptoms. If you have an emergency warning sign (like trouble breathing), seek emergency medical care immediately.”

If this is all you do, you will most likely spread it to others in your household. If you want to avoid spreading it, here are the best practices to achieve that end.

Step 1: Set up an isolation room where the sick person will remain, except for trips to the bathroom. This room will need to have an operable window to the outside.

Since the virus is almost totally spread through the air, the ONLY way a room actually counts as an isolation room is if it is completely cut off from the air in the rest of the dwelling. (See Note A.) To do this, see if there are any air registers in the isolation room. Make sure the HVAC system is running and blowing air. Isolation room registers that blow air INTO the room are OK. Any registers that draw air OUT OF the room must be closed off and completely sealed with materials such as cardboard and duct tape.

Set up a fan in the window to blow air out of the isolation room. There are window fans made for this purpose, or you can use any fan available. Block off any part of the window not filled up with the fan so the blown air does not “short circuit” but actually exhausts the room. The fan needs to run only at low speed. Its purpose is to be sure that any air leaking around the room’s door will be coming into the room, not out of the room and carrying virus to the rest of the dwelling.

fan in window

The isolation room will now be at “negative pressure”, and other members of the household need not wear masks, although those who want to do so certainly can. The rest of the dwelling should have good ventilation with a balance of fresh air and exhaust air, such that CO2 levels are below 800 ppm. Or “in the green” of a Safetulator Fresh Air Meter (See Note B.)

Step 2: Set up the bathroom that the sick person will use in the same fashion as the isolation room. As the CDC says, a separate bathroom is nice, but not required. If it’s a shared bathroom, wait 30 minutes after the sick person leaves, then disinfect surfaces before others use the room. The sick person should make direct trips to and from the bathroom, and not be in any other areas of the dwelling.

Step 3: Brief contact in the same room as the sick person is of course a necessity—delivering a tray of food, for example. But brief means something like ten seconds. In one documented case, the disease was passed on from one person to another with just five minutes of being in the same room! (See Note C.) Everyone involved in this brief contact needs to wear an N95 or KN95 mask—not a surgical mask, or a cloth mask, or any other kind of mask. Except of course if the non-infected person wears a Safetulator Mask, which will provide almost complete protection.

Step 4: Testing to end isolation should start on the third day. Use a home antigen test each morning. There is no magic number of days after which you can end isolation and not be contagious to other people. (See Note D.) The key to safely ending isolation is that a properly-administered negative antigen test shows that the person is no longer contagious. (If you want to be doubly safe, you could wait until you get another negative test on the second day, especially if you have any lingering symptoms.)

That’s It. Of course, this is a lonely life for the sick person, and it won’t be possible to follow this routine for children. Luckily, we have many computer-assisted ways to stay in frequent or continuous contact with the sick person, for their health and well-being is the primary focus.

- NOTES -

Note A - There are numerous documented cases where covid-19 was spread between people in separate, nearby rooms because the HVAC (Heating, Ventilation and Air Conditioning) registers were sending air into and out of the rooms, and the equipment mixed together air from multiple rooms and then blew it around to all the rooms again. This happened even in hospitals!

Note B - If you don’t have a meter, open a window a few inches in every room, and adjust the openings based on wind direction and whether each room’s door is open or closed.

Note C - In an extended study where all participants had location/proximity sensors, this transmission happened in a restaurant where the infected person was standing under an air conditioning unit blowing away from the person. It was 20 FEET AWAY where the person who contracted covid-19 was sitting!

Note D - The CDC’s five-day timing recommendation has no basis in science. Multiple studies have found that, after five days, anywhere from 31% to 80% of people will still be contagious. The point is, that there is wide individual variation, as one would expect with any medical matter.


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Here is my outlook on the three main covid-19 themes for 2023:

Covid-19 Is Here To Stay

I expect no big surges or declines in the amount of virus in circulation, nor in hospitalizations, nor in deaths, even as new variants come and go. The winter surge this year has not materialized nationally, even with new variant XBB.1.5. This is in stark contrast with the last two years, with peaks in deaths being in January 2021, September 2021 (Delta), and February 2022 (Omicron), as shown below from the Washington Post.

In the last nine months, U.S. covid-19 deaths have been fairly constant at 300-500 per day.

And hospitalizations have been in the range of 25,000 to 50,000 for the last eight months (the pink area to the right of the vertical line in the graph below).

Covid-19 was the third leading cause of death again last year, after heart attacks and cancer, with less than 300,000 deaths (https://www.cnn.com/2023/01/17/health/covid-death-reporting-2022/index.html ) and will drop to maybe half that number if the present levels continue.


Most People Will Get Reinfected Over and Over Again

Maybe you think you have never had it? You could be like half the people in the U.S. who have had it with such mild symptoms they didn’t realize it. Such is the conclusion of multiple studies, including two with links shown below.

https://www.npr.org/2022/08/19/1118402942/omicron-variant-unaware-covid-research-study

https://www.cidrap.umn.edu/covid-19/42-us-adults-likely-have-had-covid-almost-half-them-say-they-didnt

Overall, 9 in 10 Americans "have been infected with the COVID-19 virus at least once, according multiple studies of covid-19 antibodies in the blood.

https://www.montereyherald.com/2022/11/26/just-1-in-20-people-in-the-u-s-have-dodged-covid-infection-so-far/

https://www.ny1.com/nyc/all-boroughs/health/2022/12/16/cdc-estimates-90--of-u-s--kids-have-had-covid-19 )

As long as most people do not take practical precautions (including good fresh air ventilation, selective use of highly-effective masks, and smart use of antigen tests), the virus will not die out, and reinfections will become the norm.


“Long Covid” Is Affecting Millions

Long Covid is affecting millions of Americans. The precise number can’t be pinned down because definitions vary from study to study, but the CDC has pegged it at 15 million U.S. adults.

https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220622.htm

And even though you don’t have to have had a bad case of covid-19 to get it, the impacts can be profound. A large multi-country study "found that … 90% of people living with long COVID initially experienced only mild illness with COVID-19. After developing long COVID, however, the typical person experienced symptoms including fatigue, shortness of breath and cognitive problems such as brain fog – or a combination of these – that affected daily functioning."

https://theconversation.com/long-covid-stemmed-from-mild-cases-of-covid-19-in-most-people-according-to-a-new-multicountry-study-195707


The Good News …
is that readers of this blog know how to use the best available practices and technology to reduce the frequency and severity of their covid-19 infections. See our previous post, “Highlights of the 2022 Blogs”, for more details.


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Highlights of the 2022 Blogs

Here is a list of the 2022 blog posts most useful today [and today’s comments on them].

Jan. 4 - Videos that explain everything about masks—which masks are the best, how to use them, how to sterilize them for re-use. [These are just as useful today as a year ago.]

Jan. 11 - A complete guide to in-room air purifiers, which are efficient at removing virus from the air, and can be used in addition to fresh air when the fresh air isn’t enough. [Very popular in schools, and rightly so. The recommended models are still good choices.]

Feb. 2 - First reports of how long people are infectious: 95% of people in the study were no longer infectious after ten days. [Still good advice to follow, since a third of the people in the study were infectious after five days.]

Feb. 16 - Link to an excellent story in The Atlantic on the history of fresh air ventilation in the U.S.

Feb. 25 - U.S. excess deaths surpass one million. [Still a good read.]

Mar. 21 - Finally, the story of how the CDC and the medical community got it wrong in the early days of the pandemic. [Still a very important story.]

Mar. 29 - Stories from people’s euphoria of returning to noisy, crowded places.

Photo of large CO2 meter

Apr. 29 - Introduction of “The Big Meter” to let people know that a building has good, fresh air. [We have these for sale.]

June 10 - New study: 80% of people with Omicron were still contagious after five days. [I wish everyone knew this, and the CDC would promote it!]

July 21 - “Someone in the Room Has Covid-19” [An interesting post because the infection levels are still about the same today!]

Aug. 5 - Groundbreaking news that a negative antigen test was shown to mean that the person is not contagious TODAY. [We are using this fact to ensure that our workplace will NOT be spreading covid-19, since we have morning antigen testing for all workers.]

Sept. 2 - Safetulator products for sale - a HEPA filter mask, and a small fresh air meter, both used to fly cross country while staying healthy. [These products are still available.]

Oct. 14 - "Breathe fresh air - and be smarter." An update on the benefits of fresh air. [Also a handy half-page handout on the subject.]

Nov. 11 - “Holiday Gathering Without Covid-19” [Includes a buyers’ guide to home antigen tests.]

Dec. 1 - An almost-secret way to reduce ALL kinds of diseases in the winter: proper indoor humidity. Backed up by historic and recent research. [Includes a make/model recommendation.]

Dec. 16 - A study showing that fresh air ventilation reduced covid-19 infections by 80%! [Also lists a USA antigen test that costs just $5.]


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Highlights From Past Blogs

To Slow the Surge, Pick Your Percentage

The Winter 2022-23 Surge is Here

The best continuing number to watch is the hospitalization rate, since most cases are never tabulated. Covid-19 hospitalizations have been climbing steadily, increasing by more than a third in the last four weeks.

Washington Post, Dec. 15, 2022

Washington Post, Dec. 15, 2022

Nationally, the surge is far from uniform, but at each location it’s either here now, or probably coming sooner or later. The latest variants are increasing nationwide, and seem to be very easily transmitted.

CDC, Dec. 12, 2022

CDC, Dec. 12, 2022

Slowing the Surge and Avoiding Infections

For your holiday gatherings, and in general, you can pick your percentage of risk reduction: three choices are

- Minus 25%

- Minus 80%

- Minus 100%

Minus 25%: Wear a traditional mask, N95, KN95, or cloth mask. The 25% reduction in the number of covid-19 cases is from a large, multi-school study we have mentioned before. Mask effectiveness can be better if you are careful, but the 25% number reflects how a large number of people wore their masks in the real world. Here is a blog post reference: March 10, 2022 Blog Post

Minus 80%: Another exciting confirmation of the effectiveness of fresh air ventilation was just published. "A recent study .. involving 316 classrooms and 205,347 students, found that [covid-19] infection rates decreased 80% with ventilation rates greater than … 21 cfm per student.” This amount of fresh air, or a little more, is what we have been advocating and engineering since the summer of 2020. When our Safetulator™ Fresh Air Meters are “in the green”, you are getting fresh air at this level. Here is the article on the recent study:

https://www.infectioncontroltoday.com/view/covid-19-how-to-reduce-spread-without-vaccines-monoclonal-treatments

Minus 100%: This one is great in that it involves nothing out of the ordinary once the day gets rolling. Each person gathering together simply takes an antigen test first thing, each day of being together. A negative result means you are not contagious for the day. (Probably nothing is really 100%—if you make a mistake doing the test, then your negative result is meaningless.) See our blog post describing antigen testing: Nov. 11, 2022 Blog Post

And there’s a new brand we can now recommend: InBios, made in the USA, easy to use, and about $5/per test from Amazon and elsewhere.

InBios

InBios

Have a healthy and joyous holiday season!


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Low-Tech Healthy Air - “Sweet Spot” Humidity

The Science of Humidity in the Air

As long promised (Jan. 21, 2022 blog post), here is a guide to an important and usually ignored aspect of healthy indoor air quality—humidity, the moisture in the air.

This is a well-known topic to engineers dealing with indoor air—I gave my first technical presentation on it in 1979!—but usually completely overlooked today.

Humidity is all the more important now because of two related conditions:

- As readers of this blog are aware, increasing the amount of fresh air ventilation is a key strategy for reducing the risk and amount of covid-19 transmission.

- However, this incoming, usually colder fresh air is also often drier than the air already in the building.

Have you ever wondered why it’s called “Relative Humidity”? It’s because the capacity of air to contain moisture is RELATIVE to the temperature of the air. The warmer the air, the more moisture it can hold. When there is dew on the grass in the morning, it’s because the air became cooler overnight, and moisture from the air “fell out” onto the grass.

Here in New England and other cold climates, when a lot of fresh air is brought into the building, as it should be for general health and covid-19 safety, the indoor air will become very dry—much drier than optimum levels.

The science is well-established as to what these levels are—about 40 to 60% Relative Humidity or RH. For example, a 2013 CDC study dealing with the flu virus said: "Maintaining indoor relative humidity greater than 40% will significantly reduce the infectivity of aerosolized virus."

https://www.cdc.gov/niosh/nioshtic-2/20042261.html

Now a new study from MIT has been in the news lately, promoting this “Sweet Spot” after finding that, worldwide, "an indoor relative humidity between 40 and 60 percent is associated with relatively lower rates of Covid-19 infections and deaths”.

https://news.mit.edu/2022/covid-humidity-spread-1116

And, quoting a humidifier manufacturer:

https://aircare.com/blog/fighting-covid-add-mist-to-your-list/

"For centuries, studies have shown a correlation between dry air and respiratory illnesses. Now, recent studies from Yale University, Harvard Medical School, and the National Academy of Sciences all agree that an indoor relative humidity (RH) of 40-60% not only slows the spread of coronavirus, it also helps your immune system fight off [other] respiratory illnesses.”

“In a March 2020 article, Yale researchers stated that dry air makes it easier for airborne viral particles of viruses, such as COVID-19, to travel. This is because airborne droplets containing viruses shrink by evaporation, so they are lighter and float longer. When indoor air is at 40-60% RH, these particles retain moisture, so they are heavier and fall out of the air.”

https://news.yale.edu/2020/03/30/hopes-pandemic-respite-spring-may-depend-upon-what-happens-indoors

But too much moisture in the air is also bad. It has long been known that levels above 60% RH provide an environment conducive to mold growth. Mold can be hidden, as on the back sides of toilet tanks, or even behind wallpaper. Many people have allergies or sensitivities to mold, so it should always be avoided, or removed when discovered.

How to Maintain Optimum Indoor Humidity

In cold climates, achieving the sweet spot humidity means having humidifier equipment add moisture to the air.

The exception is in commercial buildings, and some residences, where they have Energy Recovery Ventilators that capture most of the moisture of the exhaust air and transfer it to the incoming fresh air (without transferring viruses or pollutants).

Another common case in schools and other commercial buildings involves Air Handling Units or Unit Ventilators, where fresh air is heated and brought into the rooms without being humidified. Rooms served by this equipment can be very dry, as low as 10% RH, so these are perfect places for humidification.

We have a recommendation for a make and model of room humidifier, which was selected after testing multiple models, and has now been in use for more than a year: Aircare EA 1407. This is a medium-sized floor model on wheels, and is widely available at less than $200. It has a moisture output that may be enough for most applications, such as a classroom, office, apartment, small house, or part of a larger house. If this unit proves to be not big enough, it’s simple to add another one.

The Aircare unit has a digital humidity gauge, but our experience is that this reads too high because it’s too close to where the moist air is being discharged. To get an accurate reading, use a separate digital humidity gauge such as the ThermoPro TP49 Digital Hygrometer (less than $10).

Aircare EA 1407

Aircare EA 1407


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A Happy Healthy Thanksgiving

Holiday Gathering Without Covid-19

Our holiday tips from a year ago remain valid today: being outside if your climate allows, having a good amount of fresh air and using HEPA air purifiers if you are going to be inside, doing home antigen tests, and even isolating ahead of time if you have someone particularly at risk.

But now we have actual research evidence that you probably need to do only one of these things—the antigen tests. (See Aug. 5th, 2022 blog post.)

Although I would add that good fresh air ventilation is always a good thing—with a house full of more people than usual, having a few windows cracked open provides fresh air and prevents overheating if you’re in a cool climate.

For the antigen testing, all that is needed is for all participants (including children age 2 and older) do the testing on the same day, prior to gathering together.

And if the family event lasts more than one day, it’s important to re-test each morning. Each daily test, if done properly, means that the person is almost certainly not contagious for the day.


Buyers’ Guide to Home Antigen Tests

There are dozens of brands of covid-19 home antigen tests. A lot of them are made in China, which I don’t find palatable, so those are excluded from the following recommended brands.

Abbott BinaxNOW
This test was the one we recommended a year ago because of its good record of accuracy. Of all the ones we have tried, it is the easiest to use, as there is no open vial of liquid. Results in 15 minutes. Widely available at drug stores—Walmart has them for about $10 a test.

Abbott BinaxNOW Image

InteliSwab COVID-19 Rapid Test
This is another unique design in that the test card and the nose swab are all together. After swabbing both nostrils, the probe goes into an open vial, and that’s it—results in 30 minutes. Moderately available including now at Amazon for about $9 a test.

InteliSwab COVID-19 Rapid Test Image

All the Rest
Most of the rest of the test kits are of the most common original design, with an open vial of liquid, a test swab, and then a slightly more complicated procedure of:

- collecting the swab sample from each nostril,
- stirring the swab in the vial,
- carefully removing the swab while squeezing the sides of the plastic vial,
- putting a cap on the vial,
- and dispensing a few drops out through the cap onto the test card.

Most of these take 10-15 minutes to get results.

We have tried several of this type that are made in China (oops), are just as expensive as BinaxNOW, or make it very difficult to get the cap put on the vial (AccessBio CareStart). We haven’t yet found a good one at a good price, not made in China. If you know of any, please let us know!


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