From Dr. Stuart Weiss, Intelligent Crowd Solutions 

Dr. Stuart Weiss, FACEP, FAAP, CBCP

July 7, 2020

Today's topics: CDC on school guidance, WHO on aerosol spread, Another Trump rally, Update on testing, Deadly Hand Sanitizer, Summer Camps.

Friday wrap-up call on for tomorrow at Noon Eastern. See info button below.

If you want to subscribe to the newsletter, click the Subscribe Button below

CDC on School guidelines

Yesterday I questioned whether we can continue to trust the CDC and its guidance for schools now that there is considerable political pressure on them.

Well today Dr. Robert Redfield gave me some hope. He said that there would no no changing of the overall guidance. The CDC would issue some additional reference documents to help schools implement needed changes.

Well done Dr. Redfield. The CDC needs to base its recommendations on science and not political outbursts that might occur. The CDC needs to be the one non-political place we can go to get science based practical guidance on best practices to fight CoViD-19.

WHO adds aerosol to its list of modes of spread

A second well done is deserved. This time to the WHO. As you may recall, over 200 scientists wrote to the WHO earlier this week stating that there was adequate evidence to support airborne spread through respiratory aerosols and urging the WHO to list aerosols as a mechanism of spread. A new scientific brief came out today that list aerosols as a possible mechanism of spread and lays out the pro's and con's for it. This brief on transmission of SARS-CoV-2 virus is well written and worth a read. The link is: https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions

The scientific brief also goes through everything that is known about modes of transmission and prevention strategies. As I said, it is well worth the read.

Another Trump rally

After causing a huge spike in Tulsa cases and having several members of the secret service come down with CoViD-19 after the Phoenix rally (hard to tell if it caused a huge spike in AZ since they are already seeing a huge spike already), there is another rally organized this weekend for New Hampshire. New Hampshire and Vermont are the only two states listed by the NY Times as having decreasing CoViD-19 numbers. All other states as either remaining the same or increasing. It would be so unfortunate if that event was allowed to go on without face coverings or social distancing and thereby ruining New Hampshire's great trend. At the Tulsa rally, there is video showing campaign folks removing the social distancing stickers that had been placed on seats in the arena to promote proper social distancing. Every other seat was to be unoccupied to keep people apart and reduce the crowd density.

I am eternally hopeful that folks in New Hampshire will demand that this be done so they can have a safer event. As I wrote to a reader who asked me, it shouldn't have to be a choice between enjoying a rally or your health. There is a way to have both the ability to go AND be safe. These are not mutually exclusive. It just requires advance planning and the will to implement plans to keep people safe.

If you are in New Hampshire, I can't recommend that you should attend the rally. There is no indication yet that it will be safe.

Testing, testing, one, two, three....

I've received many questions this week about testing so lets review that again.

Remember that there are two broad categories of testing: viral antigen (testing for the presence of virus) and viral antibodies (also called serology). The two types of tests are used for different purposes. The simplest way to remember this is that viral antigen is used to know if a person is infected now. They tell you if a person has virus in their body now. It is only a point in time that it looks at. You could have some virus incubating in your body now but not enough to measure so you would have a negative test. Tomorrow, you could have more so you would have a positive test.

The serology test measures antibodies to SARS-CoV-2 virus. This tells us if you had an infection previously and fought it. It is good for population studies to look at trends or hotspots but doesn't really help you make individual decisions.

So, if you want to know if you can let someone into Zone-A of a film shoot, you would want to do a viral antigen test (Zone-A is small inner circle where actors are performing without face coverings).

Within the viral antigen tests there are a couple types of tests. The original and "standard" test is something called Real Time - Polymerase Chain Reaction (RT-PCR). It is a complex test with a high sensitivity (detecting positive people when they are really positive) and high specificity (making sure a positive test is really showing positive for SARS-CoV-2 and not some other corona virus). These tests tend to run close to 99% in both sensitivity and specificity. They are hard to do and require a lab with the ability to do high complexity work. Generally not available outside a lab. There is something under development that may change all of that and bring RT-PCR into the field but its too early to talk about that yet.

The second type of test is a Fluorescent Antigen Immunoassay (FIA). This test is a portable field deployable test that has a sensitivity of 94% and a specificity of 99%. Its not quite as accurate as RT-PCR but it is the same sensitivity and specificity as an annual flu test.
The third type, which is also field deployable is an isothermic nucleic acid amplification test. This test was introduced first by ABBOTT and has run into some concerns related to its very low sensitivity, in the mid 80's. That means that it could miss 15% of positive people. This makes this type of test problematic.

Lastly Becton Dickenson (BD) received an Emergency Use Authorization just three days ago for a new immunoassay test. They list the sensitivity of the test at 84% and the specificity at 100%. That low sensitivity make this test problematic as well.

When you are thinking about implementing field testing for your production, it is important to speak with your medical advisor to discuss what type of testing should be used and how to integrate testing into your overall Entry Management program for your venue.
I

f you don't have a medical advisor, we have great ones working here at iCrowd and we'd be happy to help you formulate a plan to keep your crew and talent safe.

Deadly Hand Sanitizer

Most hand sanitizers on the market are alcohol based and that helps them kill corona virus. However, there are a growing number of these products that use a poisonous alcohol as its base. Ethanol or Isopropyl Alcohol is okay. If it is over 60% Ethanol or 70% isopropyl, it will kill SARS-CoV-2 just fine and not hurt you. However, if your products uses Methanol, that is a problem. The FDA just today identified another two dozen products that have methanol in them. Take a look at your products and make sure it doesn't use Methanol.

Summer Camps

New York Daily News is reporting an outbreak in 82 campers, staff and counselors in a summer camp in Missouri. There have been reports of outbreaks in summer camps across Texas, Georgia, North Carolina and Tennessee. Its important to remember that when your child comes home from summer camp, you should have them self isolate for 14 days and don't let them visit vulnerable people within that time frame. So no visits to grandma fro two weeks.

Be well and take care of yourself. There are storm clouds on the horizon.
--Dr. Stu

COVID-19 HEADLINES FOR TODAY

YouTube Channel