The National Message Has Undergone a Massive Transformation

"We could save tens of thousands of lives if everyone would just wear a mask for the next few months. Not Democratic or Republican lives. American lives." 

"I implore you. Wear a mask. Do it for yourself. Do it for your neighbour. A mask is not a political statement."

"The goal is to get back to normal as fast as possible. And masks are critical in doing that. It won't be forever."

"But that's how we'll get out nation back up to speed economically, so we can go back to celebrating birthdays and holidays together, so we can attend sporting events together, so that we can get back to the lives and connections we shared before the pandemic."

"I hope it [Catholic hymn -- "On Eagle's Wings"] can provide some comfort and solace to the 230,000 Americans who have lost a loved one to this terrible virus this year. My heart goes out to each and every one of you."

U.S.President-Elect Joe Biden

"Given the fact that the statisticians have come to a conclusion at this stage, I think we get behind the new President."

"You're not going to change the nature of President Trump in these last days."

"He has a relatively relaxed relationship with the truth. And so he's going to keep on fighting until the very end, But I'm convinced that, once all remedies have been exhausted, if those are exhausted in a way that's not favorable to him, he will accept the inevitable."

"But don't expect him to go quietly in the night. That's not how he operates."

Mitt Romney, Utah Senator, former presidential aspirant 

"[I ask Americans to set aside their political differences and] give him a chance and lend him your support."

"When he walks into the White House in January, he'll face a series of extraordinary challenges no incoming President ever has -- a raging pandemic, an unequal economy and justice system, a democracy at risk, and a climate in peril."

"I know he'll do the job with the best interests of every American at heart, whether or not he had their vote. [The election results] at every level show that the country remains deeply and bitterly divided."

"It will be up to not just Joe and Kamala, but each of us, to do our part -- to reach out beyond our comfort zone, to listen to others, to lower the temperature and find some common ground from which to move forward." 

Former President Barack Obama 

 

"[I] WON THE ELECTION." 

"Bad things happened [during the election his poll observers were not permitted to view]."

"71,000,000 Legal Votes. The most EVER for a sitting President!" [Biden had won 74.5 million votes and Trump had won 70.4 million votes]."

"I will not rest until the American People have the honest vote count they deserve and that Democracy demands."

U.S.President Donald Trump

President Donald Trump has cast doubt on whether he will commit to a peaceful transfer of power.

Mr. Biden has gone into action, first things first; attending to the disastrous pandemic that has stricken over ten million Americans and taken the lives of a quarter million U.S. citizens in its sweep through the continent, striking the United States ferociously. A fact that the sitting administration should but would not admit to having had some hand in producing primarily through the off-hand attitude of its president who constantly and deliberately downplayed the nature of the threat that SARS-CoV-2 represented.

 

Jeering at the namby-panby individuals who followed science and wore masks and diligently social distanced, he did otherwise, setting an example for his avid followers, an example that bit back when he contracted the disease himself and with the considerable assistance of therapies not available to ordinary citizens, surmounted the disease, while members of his administration began succumbing to COVID-19 like dominoes falling in order, struck down in their turn. 

Millions of Americans are now unemployed as a result of the turmoil in the economy in overturning normal business, production and economies as they have been worldwide. Mr. Trump made no secret of the fact that he focused primarily on returning the economy back to a firm footing to restore losses in trade, the stock market, the country's employment figures. It was only the elderly that were really under threat, he shrugged, characterizing them as expendable in the larger interests at stake for the U.S. economy to get back to production and work and profitability.

The latest close Trump associate testing positive for COVID was Housing Secretary Ben Carson, following hard on the revelation that White House Chief of Staff Mark Meadows tested positive. Mr. Biden spoke of his team focus on rapid testing to be widely available and a corps of contact-tracers tracking and curbing the spread of the pathogen, prioritizing vulnerable populations such as the health-impaired and the elderly. Approved vaccines would be "distributed as quickly as possible to as many Americans as possible, free of charge".

Credit: Eva Marie Uzcategui/Bloomberg via Getty

Compelling scenarios allied with today's surprise revelation from Pfizer that they and their German collaborator BioNTech had succeeded in developing a promising vaccine -- that ongoing Third Stage human trials have proven 90 percent successful in a double-blind trial involving 44,000 volunteers. The vaccine producers are prepared to ask the U.S. Food and Drug Administration for immediate assent for use of the vaccine which they are prepared to produce 50 million doses of by the end of 2020, increasing to well over a billion doses next year.

The Case for COVID Mask-Wearing

"SARS-CoV-2 has the protean ability to cause myriad clinical manifestations, ranging from a complete lack of symptoms to pneumonia, acute respiratory distress syndrome, and death. Recent virologic, epidemiologic, and ecologic data have led to the hypothesis that facial masking may also reduce the severity of disease among people who do become infected. This possibility is consistent with a long-standing theory of viral pathogenesis, which holds that the severity of disease is proportionate to the viral inoculum received. Since 1938, researchers have explored, primarily in animal models, the concept of the lethal dose of a virus — or the dose at which 50% of exposed hosts die (LD50). With viral infections in which host immune responses play a predominant role in viral pathogenesis, such as SARS-CoV-2, high doses of viral inoculum can overwhelm and dysregulate innate immune defenses, increasing the severity of disease. Indeed, down-regulating immunopathology is one mechanism by which dexamethasone improves outcomes in severe Covid-19 infection. As proof of concept of viral inocula influencing disease manifestations, higher doses of administered virus led to more severe manifestations of Covid-19 in a Syrian hamster model of SARS-CoV-2 infection."

Monica Gandhi, M.D., M.P.H., George W. Rutherford, M.D. The New England Journal of Medicine

Law enforcement trainees wearing protective face masks as they take notes while being trained on how to handle civil disputes during class at San Bernardino County Sheriff’s Frank Bland Regional Training Center in San Bernardino on Wednesday, July 29, 2020. (Photo by Watchara Phomicinda, The Press-Enterprise/SCNG)

"If facial coverings decrease the amount of virus a person is infected with, they can provide a way of tilting towards infections that result in minimal or no symptoms, yet induce some degree of immunity."

Dr. Amesh Adalja, infectious disease expert, senior scholar, Johns Hopkins Center for Health Security, Baltimore

 

"If this theory bears out, population-wide masking, with any type of mask that increases acceptability and adherence, might contribute to increasing the proportion of SARS-CoV-2 infections that are asymptomatic."

Dr. Monica Gandhi, Dr. George Rutherford, University of California, San Francisco

 

"Covering mouths and noses with filtering materials serves 2 purposes: personal protection against inhalation of harmful pathogens and particulates, and source control to prevent exposing others to infectious microbes that may be expelled during respiration. When asked to wear face coverings, many people think in terms of personal protection. But face coverings are also widely and routinely used as source control. For instance, if given the choice between having surgery performed by a team not wearing some covering over their mouths and noses vs a team that does, almost all patients would reject the former. This option seems absurd because it is known that use of face coverings under these circumstances reduces the risk of surgical site infection caused by microbes generated during the surgical team’s conversations or breathing. Face coverings do the same in blocking transmission of SARS-CoV-2."

John T.Brooks, M.D., Jay C.Butler, M.D., Robert R.Redfield, M.D. Jama 

Masks -- the public is informed by authorities urging the use of facial coverings in this time of SARS-
CoV-2 disease roiling the world order -- are essential to protect others in the event you harbour the virus and have not displayed symptoms of COVID-19. There is also, health experts inform us, a good measure of protection for the mask-wearer from contracting the virus. On the other hand, a recent paper reflecting research published in The New England Journal of Medicine posits that mask wearing may have another residual and very important outcome.

Within communities where infection is widespread and many have yet to be diagnosed while shedding infectious droplets, mask-wearing which cannot entirely prevent some degree of infection penetration, by allowing a small amount of the virus to infect in essence acts as a vaccine. Allowing one's immune system to respond to trace amounts of infection without becoming overwhelmed by a large dose of infection. This is called variolation and its effect on a broad scale is to produce a kind of community 'herd effect'.

Masks, by limiting the amount of viral particles reaching tissues of those newly infected are then serving to inoculate more than massively infecting. In virology, the authors of this new paper explain, there is a tradition called the "LD-50" of a virus; the amount of an infection scaled to body mass that will produce great harm to those exposed to a full load. Viral disease toxicity may be dependent on "dose"; the lesser the dose the lesser the damage, enhancing opportunity for the body's immune system to adapt and fight the intruder.

Verification through research and observation appears as indirect evidence that SARS-CoV-2 doses if moderated through the preventive use of masks could produce a far less harmful outcome. A Japanese-led study that found "higher doses of administered virus led to more severe manifestations of COVID-19 in a Syrian hamster model of SARS-CoV-2 infection", appears to bear out the two authors' contentions.

Mask-wearing is now the norm in South Korea.Photo: Wonseok Jang 

Countries practising high-masking compliance are seen to have considerably lower rates of severe COVID-19 and consequent death numbers while resulting in fewer hospital admissions. The authors suggest that since being taken up as a first line of defence, (social isolation and mask-wearing), the result has been a mass protocol of "mask variolation". The original method of vaccination where fluids from smallpox patients were collected, to expose the non-infected to harmless amounts of diseased matter to induce mild infection providing immunity; hence variolation.

Health authorities early in the first wave of COVID believed that non-symptomatic people would not significantly shed as an infection source, until experience proved otherwise and then there arose an urgency to cope with the reality that asymptomatic carriers of the virus were indeed shedding infectious particles to the same degree as those infected with the virus who exhibited a wide range of symptoms. 

The message that the latest published research is delivering is that the eventual agreement that mask-wearing represented an integral approach to prevention ended up making far more of an impression in avoidance than might have been anticipated. The wearing of masks has proven successful in shielding the wearer from heavy infection doses, while the small amount of viral infection that did penetrate the shields has proven to have far-reaching consequences in making the wider public less susceptible to serious infections requiring hospitalization, while serving to reduce the death rate.

 

A line of people on Montgomery Street in San Francisco waits to get masks during the 1918 flu pandemic. Failure to wear a mask was punishable by imprisonment or a fine. Photo courtesy of the California History Room, California State Library, Sacramento.

Physical Distancing First, Face Shields Next

"We label the evidence about eye protection as low certainty, meaning any effects are suggestions."
[It's] not yet clear the relative contribution of eyes, versus nose vs. mouth."
Derek Chu, clinician scientist, McMaster University

"If you happen to encounter the respiratory droplet right next to you, and it lands in your eye, that is a potential risk."
"If we want to protect, for example, the elderly themselves then covering the eyes is an important concept."
Dr.Theresa Tam, Chief Public Health Officer, Canada

"[There's a role for face shields if masks aren't available], but that's something that needs to be discussed on where and when [shields] can be best used."
"I should remind you that masks alone will not protect you. Face shields alone will not protect you from infection."
"[All measures, including physical distancing, remain] really paramount."
Dr.Maria Van Kerkhove, head, Emerging Diseases and Zoonosis Unit, World Health Organization

Students wear face shields and gloves at the “Faik Konica” primary school in Pristina , Kosovo, on June 9, 2020. Schools in Kosovo are gradually reopening after almost three months of restrictions due to the COVID-19 pandemic. ARMEND NIMANI/AFP via Getty Images

"They're far more comfortable to wear, there's no breathing issues with them, they're not uncomfortable on hot summer days."
"They definitely cover the eyes, the nose and the mouth. You're less likely to touch your face, because you've got a shield on."
"The other beautiful aspect of them is that there are no issues with verbal and non-verbal communication. You can see people's faces right through them. The psychological and social benefits are significant."
"I'm not here to tell people what to do. I'm here to help people make informed decisions for themselves. But I think we should at least be open-minded to it."
Dr.Isaac Bogoch, Infectious Diseases specialist, University Health Network,Toronto

University of Iowa researchers produced a study, whose conclusion is that wearing face shields is superior in many ways to wearing face masks to ward off the potential of contamination by the hugely infectious novel coronavirus. Writing in JAMA, the Iowa team suggested that face shields, readily put together with materials sourced from craft and office supply shops could help contain COVID-19 infections.

While simple face masks, layered to filter out most of the tiny virus-sized particles hovering in the air when people cough, sneeze, talk or breathe, face shields, according to the Iowa researchers, may represent a superior option. Soap and water is all that is needed to cleanse shields, the shields can be "reused indefinitely". They wear comfortably, block mouths, noses and eyes from being entered by the virus and "reduce the potential for autoinoculation".

Face shields, visors or goggles may reduce to a significant degree the opportunities for viral infections or transmission, from 15 percent with no eye covering, to six percent, according to another review, published in The Lancet.  This was a review commissioned by the World Health Organization with an eye to synthesizing all available evidence on physical distancing, mask-wearing and eye protection.

Most studies were initiated to report on SARS or MERS and not SARS-CoV-2, involving for the most part, health-care settings, leaving the study authors to admit they cannot be "overly certain in the precise quantitative estimates of effects". For the general public, physical distancing of over one metre is "highly effective", face masks protect against infection and provide eye protection; "typically under-considered" they can confer added benefits, even while nothing gives complete protection.

There is evidence the virus is capable of entering the body through mucous membranes, with the inclusion of the mucous membranes on the surface of the eye and inner eye lids. Conjunctivitis (pink eye) has been reported present as a sign of COVID-19. 38 people with COVID-19 were presented in a brief report out of Hubei province in China, where "Ocular abnormalities" consistent with conjunctivitis was found in a third of the patients.

"Although there is a low prevalence of SARS-CoV-2 in tears, it is possible to transmit the virus via the eyes", the researchers wrote in JAMA Ophthalmology. No randomized trial of face shields versus cloth masks have been undertaken, but one study suggested face shields can protect people from inhaling 96 percent of droplets laden with flu following a cough, standing within 18 inches of the cougher.

At the recommended six-feet of physical distancing, the shield blocked inhaled virus by 92 percent, "similar to distancing alone and reinforces the importance of physical distancing in preventing viral respiratory infections."

Emergency services nurses at Harborview Medical Center in Seattle demonstrate how they wear medical face shields.

Ted S. Warren/AP