By Jessica Corbett
As the number of confirmed Covid-19 cases in the United States surpassed 6.43 million and the nation's death toll topped 192,600, the federal government's top infectious disease expert warned Friday that life likely won't return to normal until sometime—perhaps late—in 2021.
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There are many different ways to get CBD into your body. While some prefer oils, others love gummies, topicals, edibles, and other methods. But what most cannabidiol enthusiasts are quickly learning is that the fastest way for the body to absorb CBD is through vaping.
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By Gudrun Heise
"Although I hadn't used the stove at all, I touched every ring to check that it was off. Finally I had to keep telling myself: 'Off! Off! Off!'" Michaela says (her name has been changed by the editor).
Even when Michaela was a child, there were rituals that she always had to observe and from which her mind would not permit her to deviate. There were things that were simply not "allowed."
OCD Is a Common Illness<p>Checking compulsions often begin at a young age, but can also develop in adulthood. "It is a common mental illness, but it is usually not obvious because it is often made a taboo and concealed," says Wahl-Kordon.</p><p>Sometimes sufferers and the people around them do not really take the somewhat strange behavior seriously. People with this form of <a href="https://www.dw.com/en/are-obsessive-compulsive-disorders-amid-coronavirus-pandemic-on-the-rise/a-54567173" target="_blank">obsessive-compulsive disorder (OCD)</a> must first become aware that their behavior is not normal and be prepared to start treatment.</p>
One Step Forward, Two Steps Back<p>To find out whether someone has OCD, therapists usually work with various screening questions, such as: "Do you clean or wash extremely often? Are you often concerned with symmetries? Are there thoughts that do not let go of you?"</p><p>Wahl-Kordon says that "what is most significant is the intensity at which such actions are carried out and the time the sufferer actually spends on them or thinks about them," he says.</p><p>"With many sufferers, we can achieve very good results through behavioral therapy. Exposure and confrontation exercises are core elements here," Wahl-Kordon says.</p><p>Michaela has also been taking part in these kinds of therapies, which force her to permit situations that she fears and would otherwise try to avoid. They are meant to help her deal with her compulsions and fears, which often have their roots in the past.</p>
'I Thought It Was My Fault'<p>When Michaela was 16, her sister-in-law died at the age of just 28. For Michaela, this was a traumatic experience and one that triggered severe feelings of self-blame.</p><p>"About a week before my sister-in-law died, I told a friend of mine that there was nothing to look forward to and that I dreamed that my sister-in-law was in the cemetery behind the cemetery wall and could not get out. When my sister-in-law died, I blamed myself a lot. I thought it was because of me, because I had moaned so much for no reason," she says.</p><p>She still has these feelings of self-blame and fears some kind of punishment if she complains about something without there being an obvious reason. And it is just one of many fears that she has developed.</p>
Trouble Leaving the Apartment<p>Michaela studied law; during her time at university, her checking compulsion continued to accompany her and became a never-ending ordeal.</p><p>"My apartment had a kitchenette within sight of the bed. In the evening I always had to start checking from left to right to make sure that all appliances were turned off: stove, coffee maker and kettle. Had I pulled out all the plugs? Then check the fridge door again to see that it was really closed. Then I'd start all over again," she says.</p><p>Sometimes the whole procedure lasted several hours, she says, and on occasion she would go and sit outside the front door at 4 o'clock in the morning in desperation because she had not managed to go to bed.</p>
Checking the Checks<p>During her studies, Michaela met her husband. She immediately got him involved, asking him to help her with her checking. "My husband was my salvation back then. I asked him to do a very last follow-up check after my check-ups. This gave me the feeling that he had taken the responsibility from me in case something started to burn because I had forgotten to check everything thoroughly," she says.</p><p>For about 20 years, Michaela checked every evening whether her husband had checked everything properly — checking the checker, so to speak. Thanks to the therapy, this, too, has now improved.</p>
'I Was Afraid of Doing Everything Wrong'<p>Michaela was a specialist lawyer for criminal law and social law. She was on committees, gave lectures and received requests from various associations to join their boards of directors. She was a successful lawyer, at least on the outside. But her constant self-doubt and her checking compulsion made her life so difficult that she finally had to give up her profession.</p><p>"I was always just afraid of not doing anything right, of not being able to do anything, of being too stupid for everything, and thought that it was just a matter of chance that I had a particular position. In my work, I never felt as though I had done enough preparation," she says. "If, for example, I had an appointment at 2 p.m. on one day, it was not possible for me to do anything else that day. I always thought I had to prepare myself more and more and more for this one thing."</p><p> At some point, her fears increased so dramatically that she was no longer able to go in to work at the law firm at all.</p><p>"At some point, compulsions determine their entire lives," Wahl-Kordon says. "Some sufferers withdraw completely, no longer eat properly and lose weight. Those are the most serious cases — when everything revolves around the compulsions."</p>
More Than One Compulsion<p>In addition to her constant drive to check things, Michaela developed other compulsions. Compulsive hoarding is a particular problem for her. People with this form of OCD collect all sorts of things without any necessity or good reason: small notes, old receipts, papers that are no longer valid. Michaela even finds it difficult to part with daily newspapers.</p><p>After one three-week vacation, the newspapers piled up in the apartment, but throwing them away was impossible for her. After all, something important could be hidden somewhere among the countless pages, and then she wouldn't be able to find it again.</p><p>"It is incredibly difficult for me to throw something away. It takes me a very long time to put things in order. I never finish. There is simply no end. I always think that maybe I could use the things again sometime," Michaela says.</p><p>Your partner doing the cleaning and throwing things away does not work either, says Wahl-Kordon. "That can mean that the world collapses for the sufferer, so it doesn't work at all. Hoarding often has to do with objects that I associate with certain events or experiences and which I simply can't get rid of for that reason alone."</p><p>Disposing of those objects thus becomes a difficult and confronting task that the patient must tackle with the support of a psychotherapist. Often the compulsive need to hoard affects older people in particular. In severe cases, they literally become buried in clutter because they simply cannot bring themselves to throw things away.</p>
'But First I Have to Clean Up'<p>Michaela always tries to organize and prepare everything as perfectly as possible and have control over as many things as she can — even when she had suicidal thoughts because her condition was becoming too much for her.</p><p>"It was on a Sunday, and I had actually managed to organize replacements for my appointments for the entire coming week," she relates. After all, she was planning to not be alive the following week. But then, she says, her husband came home unexpectedly and thwarted her plans.</p><p>"Later, I always thought that I couldn't ever kill myself because I would have to clean up first. The thought of someone tampering with my things is simply unbearable for me!" she says.</p>
New Perspectives<p>Michaela has now taken up other forms of employment, including teaching social law to special education teachers. This is easier for her than her work as a lawyer. She can engage with it in a completely different way and sometimes even uses herself as an example.</p><p>After all, aspiring teachers must learn to deal with disabled people like her, she says. She says everyone in her environment knows about her obsessive-compulsive disorder — with the exception of her family.</p><p>In recent years, she has undergone trauma therapy, depression therapy and exposure therapy, which have helped. "I still check the stove and the refrigerator. I still have to do everything right. I'm still afraid that I am doing everything wrong. But compared to the way it used to be, everything is much, much better now."</p>
By Kathleen Schuster
In the weeks since Beirut's deadly chemical blast, residents have been sweeping up the broken glass and wiping down surfaces caked in dust. And it's this dust that some say poses a major threat to the city.
Side Effects of Ammonium Nitrate<p>What is known is that when heated, ammonium nitrate — commonly used in fertilizers and, due to its ability to speed up combustion, also in explosives — melts, releasing toxic gases like nitrogen oxides (NOx) and ammonia gas (NH3).</p><p>These gases, both harmful to the human respiratory system and the environment, in turn break down and react with other chemicals. Nitrogen oxides, for example, when combined with other pollutants and sunlight form "bad ozone," that is to say, <a href="https://www.epa.gov/ground-level-ozone-pollution/ground-level-ozone-basics" target="_blank">ozone at ground level</a>.</p><p>Not only would these gases mix with Beirut's already dangerous air pollution levels — a combination of fossil fuel combustion, <a href="https://acp.copernicus.org/articles/20/9281/2020/" target="_blank">sea salt, and mineral dust</a> — which were estimated at least 150% over the World Health Organization's (WHO) standards before the disaster, but also with demolition dust.</p><p>There's no up-to-date information on the level of air pollution at the moment: Beirut shut down its monitoring system to cut costs in 2019. In previous years, though, Lebanon has averaged roughly 30 micrograms of fine particulate matter (PM2.5) per cubic meter, far above the WHO recommendation of <a href="https://apps.who.int/iris/bitstream/handle/10665/69477/WHO_SDE_PHE_OEH_06.02_eng.pdf?sequence=1" target="_blank">10 micrograms per cubic meter</a>.</p>
Political Instability Holds Up Testing<p>One person familiar with those tests is Najat Saliba, a professor of chemistry at the American University of Beirut, where she also directs the Nature Conservation Center.</p><p>Her team has been taking air samples with their own sensors and expects results in about a month — double the wait of the usual procedure, she says, due to the economic collapse.</p><p>"We are really running very low on resources like quality standards and equipment to do the tests," Saliba says.</p>
Beirut's Epic Trash Problem<p>That message doesn't bode well for Beirut, which has been dealing with a <a href="https://www.dw.com/en/trash-crisis-forces-lebanons-environmental-awakening/a-36765579" target="_blank">recurring trash crisis</a> for several years, and is now facing a cleanup to the tune of up to $15 million (€12.6 million). In 2015, the government failed to react quickly enough after a major trash dump was closed, leaving streets and beaches covered in mounds of solid waste.</p><p>In fact, one of the city's main landfills reached capacity in late April, prompting the government to approve a vertical expansion that would hold for roughly three months – or until around the time of the blast.</p><p>The question of what to do with the solid waste has been on the mind of some, like Salam Kabboul, a local freelance journalist and co-founder of "The Tent," a volunteer initiative launched the day after the blast. The name refers to their first project of offering victims snacks and a place to rest with the only thing they had on hand: a tent.</p><p>Now, they repair buildings and homes so life can return to normal. They take precautions for the dust, but when it comes to dealing with trash, they're also in the dark about what to do.</p><p>"It's not clear what happens to the waste," says Kabboul, who, like everyone else is aware of another imminent trash crisis.</p><p>A new aspect of this problem is the type of debris in the cleanup. According to Seoud from UNDP, there's a lot of <a href="https://www.dw.com/en/5-things-you-need-to-know-about-e-waste/a-47210118" target="_blank">hard-to-dispose-of items</a> like air conditioners, compressors, electronics.</p><p>There's also medical waste from the COVID-19 pandemic, and the fear of chemical waste – both of which could cause problems for the city's water. As things stand, Beirut is waiting to find out if all of its pipes are still intact post-explosion, and researchers still aren't allowed to test the already contaminated coastal waters, which are roped off as the search for the missing continues.</p><p>Beirut is facing one pollution problem on top of another. Now, with the magnitude of dust and debris putting the city under even more strain, civilians and NGOs alike hope that this disaster could mark a turning point as it moves forward.</p>
A patient in the Netherlands and another in Belgium have been reinfected with the coronavirus, Dutch media reported Tuesday, following reports that scientists in Hong Kong had confirmed the first known reinfection.
Belgian Case 'Not Good News'<p>The Belgian patient displayed only mild symptoms, NOS reported, citing virologist Marc Van Ranst. "It's not good news," Ranst said.</p><p>The development shows that the antibodies the patient developed in the first case were not strong enough to fend off an infection from a slightly different variant of the virus, he said.</p><p>It is not clear if this is a rare phenomenon or if there are "many more people who could have a reinfection after six or seven months," he said.</p>
First Reinfection Confirmed in Hong Kong<p>The European developments follow Monday <a href="https://www.dw.com/en/hong-kong-researchers-report-first-known-covid-19-reinfection/a-54680268" target="_blank">reports of the first confirmed coronavirus reinfection</a>, a man in Hong Kong.</p><p>The 33-year-old, who was infected with the virus in March, returned in mid-August from a trip to Spain infected with a different strain.</p><p>"COVID-19 patients should not assume after they recover that they won't get infected again," said Kelvin Kai-Wang To, a microbiologist at the University of Hong Kong.</p><p>"It shows that some people do not have lifelong immunity" to the virus even if they've already been infected, To said.</p><p>Some experts see the news as a positive development. "If there is a reinfection, it suggests the possibility there was residual immunity ... that helped protect the patient" from getting sick again, said Jesse Goodman, a former U.S. Food and Drug Administration chief scientist, now at Georgetown University, responding to the Hong Kong case.</p><p>The Hong Kong patient did not display any symptoms during his most recent infection. </p>
Implications for Vaccine Development<p>The possibility of reinfection has implications for the global race to develop a vaccine and for key decisions on when people return to school and work.</p><p>Speaking on the Hong Kong case, London School of Hygiene and Tropical Medicine microbiologist Brendan Wren said the case was "a very rare example of reinfection and it should not negate the global drive to develop COVID-19 vaccines."</p>
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By Monica Gandhi
Masks slow the spread of SARS-CoV-2 by reducing how much infected people spray the virus into the environment around them when they cough or talk. Evidence from laboratory experiments, hospitals and whole countries show that masks work, and the Centers for Disease Control and Prevention recommends face coverings for the U.S. public. With all this evidence, mask wearing has become the norm in many places.
Exposure Dose Determines Severity of Disease<p>When you breathe in a respiratory virus, it immediately begins hijacking any cells it lands near to <a href="https://doi.org/10.1016/j.cell.2020.05.042" target="_blank">turn them into virus production machines</a>. The immune system tries to stop this process to halt the spread of the virus.</p><p>The amount of virus that you're exposed to – called the viral inoculum, or dose – <a href="https://doi.org/10.1038/nri2802" target="_blank">has a lot to do with how sick you get</a>. If the exposure dose is very high, the immune response can become overwhelmed. Between the virus taking over huge numbers of cells and the immune system's drastic efforts to contain the infection, a lot of damage is done to the body and a person can become very sick.</p><p>On the other hand, if the initial dose of the virus is small, the immune system is able to contain the virus with less drastic measures. If this happens, the person experiences fewer symptoms, if any.</p><p>This concept of viral dose being related to disease severity has been around for <a href="https://doi.org/10.1093/oxfordjournals.aje.a118408" target="_blank">almost a century</a>. Many animal studies have shown that the higher the dose of a virus you give an animal, the <a href="https://doi.org/10.1258%2Fla.2012.011157" target="_blank">more sick it becomes</a>. In 2015, researchers tested this concept in human volunteers using a nonlethal flu virus and found the same result. The higher the flu virus dose given to the volunteers, <a href="https://doi.org/10.1093/cid/ciu924" target="_blank">the sicker they became</a>.</p><p>In July, researchers published a paper showing that viral dose was related to disease severity in hamsters exposed to the coronavirus. Hamsters who were given a higher viral dose <a href="https://doi.org/10.1073/pnas.2009799117" target="_blank">got more sick than hamsters given a lower dose</a>.</p><p>Based on this body of research, it seems very likely that if you are exposed to SARS-CoV-2, the lower the dose, the less sick you will get.</p><p>So what can a person do to lower the exposure dose?</p>
Masks Reduce Viral Dose<p>Most infectious disease researchers and epidemiologists believe that the coronavirus is <a href="https://doi.org/doi:10.1001/jama.2020.12458" target="_blank">mostly spread by airborne droplets</a> and, to a lesser extent, tiny aerosols. Research shows that both cloth and surgical masks can <a href="https://dx.doi.org/10.7326%2FM20-2567" target="_blank">block the majority of particles that could contain SARS-CoV-2</a>. While no mask is perfect, the goal is not to block all of the virus, but simply reduce the amount that you might inhale. Almost any mask will successfully block some amount.</p><p>Laboratory experiments have shown that good cloth masks and surgical masks could block at least <a href="https://doi.org/10.1093/annhyg/meq044" target="_blank">80% of viral particles from entering your nose and mouth</a>. Those particles and other contaminants will get trapped in the fibers of the mask, so the CDC recommends <a href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-wash-cloth-face-coverings.html" target="_blank">washing your cloth mask after each use if possible</a>.</p><p>The final piece of experimental evidence showing that masks reduce viral dose comes from another hamster experiment. Hamsters were divided into an unmasked group and a masked group by placing surgical mask material over the pipes that brought air into the cages of the masked group. Hamsters infected with the coronavirus were placed in cages next to the masked and unmasked hamsters, and air was pumped from the infected cages into the cages with uninfected hamsters.</p><p>As expected, the masked hamsters were less likely to get infected with COVID-19. But when some of the masked hamsters did get infected, <a href="https://doi.org/10.1093/cid/ciaa644" target="_blank">they had more mild disease</a> than the unmasked hamsters.</p>
Masks Increase Rate of Asymptomatic Cases<p> In July, the CDC estimated that around <a href="https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html" target="_blank">40% of people infected with SARS-CoV-2 are asymptomatic</a>, and a <a href="https://doi.org/10.7326/M20-3012" target="_blank">number of other studies</a> have <a href="https://theconversation.com/can-people-spread-the-coronavirus-if-they-dont-have-symptoms-5-questions-answered-about-asymptomatic-covid-19-140531" target="_blank">confirmed this number</a>. </p><p> However, in places where everyone wears masks, the rate of asymptomatic infection seems to be much higher. In an <a href="https://www.msn.com/en-us/travel/news/greg-mortimer-passengers-to-be-evacuated-after-almost-60-test-positive-for-coronaviru/ar-BB12ie3v" target="_blank">outbreak on an Australian cruise ship</a> called the Greg Mortimer in late March, the passengers were all given surgical masks and the staff were given N95 masks after the first case of COVID-19 was identified. Mask usage was apparently very high, and even though 128 of the 217 passengers and staff eventually tested positive for the coronavirus, <a href="https://doi.org/10.1136/thoraxjnl-2020-215091" target="_blank">81% of the infected people remained asymptomatic</a>. </p><p> Further evidence has come from two more recent outbreaks, the first at a <a href="https://apnews.com/4b9d38f206db9ce5267a5898ac24f238" target="_blank">seafood processing plant in Oregon</a> and the second at a <a href="https://www.tysonfoods.com/news/news-releases/2020/6/tyson-foods-inc-releases-covid-19-test-results-northwest-arkansas" target="_blank">chicken processing plant in Arkansas</a>. In both places, the workers were provided masks and required to wear them at all times. In the outbreaks from both plants, nearly <a href="https://doi.org/10.1007/s11606-020-06067-8" target="_blank">95% of infected people were asymptomatic</a>. </p><p> There is no doubt that universal mask wearing slows the spread of the coronavirus. My colleagues and I believe that evidence from laboratory experiments, case studies like the cruise ship and food processing plant outbreaks and long-known biological principles make a strong case that masks protect the wearer too. </p><p> The goal of any tool to fight this pandemic is to slow the spread of the virus and save lives. Universal masking will do both. </p><p> <a href="https://theconversation.com/profiles/monica-gandhi-1080710" target="_blank">Monica Gandh</a> is a Professor of Medicine, Division of HIV, Infectious Diseases and Global Medicine at the University of California, San Francisco. </p><p> Disclosure statement: Monica Gandhi does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment. </p><p> <em>Reposted with permission from <a href="https://theconversation.com/cloth-masks-do-protect-the-wearer-breathing-in-less-coronavirus-means-you-get-less-sick-143726" target="_blank">The Conversation</a>.</em><em></em> </p>
By Luke Montrose
If I dare to give the coronavirus credit for anything, I would say it has made people more conscious of the air they breathe.
What’s in Wildfire Smoke?<p><a href="http://doi.org/10.1038/s41370-018-0064-7" target="_blank">What exactly is in a wildfire's smoke</a> depends on a few key things: what's burning – grass, brush or trees; the temperature – is it flaming or just smoldering; and the distance between the person breathing the smoke and the fire producing it.</p><p>The distance affects the ability of smoke to "age," meaning to be acted upon by the sun and other chemicals in the air as it travels. <a href="http://doi.org/10.1021/acs.est.9b01034" target="_blank">Aging can make it more toxic</a>. Importantly, large particles like what most people think of as ash do not typically travel that far from the fire, but small particles, or aerosols, can travel <a href="https://doi.org/10.1016/j.atmosenv.2018.06.006" target="_blank">across continents</a>.</p>
Smoke from wildfires obscures the California sky on Aug. 19, 2020. Lauren Dauphin/NASA Earth Observatory<p>Smoke from wildfires contains <a href="https://www3.epa.gov/airnow/wildfire-smoke/wildfire-smoke-guide-revised-2019.pdf" target="_blank">thousands of individual compounds</a>, including carbon monoxide, volatile organic compounds (VOCs), carbon dioxide, hydrocarbons and nitrogen oxides. The most prevalent pollutant by mass is particulate matter less than 2.5 micrometers in diameter, roughly 50 times smaller than a grain of sand. Its prevalence is one reason health authorities issue air quality warnings using PM2.5 as the metric.</p>
What Does That Smoke Do to Human Bodies?<p>There is another reason <a href="https://www.calhospital.org/sites/main/files/file-attachments/wildfire_smoke_considerations_for_californias_public_health_officials_august_2019.pdf" target="_blank">PM2.5 is used to make health recommendations</a>: It defines the cutoff for particles that can travel deep into the lungs and cause the most damage.</p><p>The human body is equipped with natural defense mechanisms against particles bigger than PM2.5. As I tell my students, if you have ever <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/mucociliary-clearance" target="_blank">coughed up phlegm</a> or blown your nose after being around a campfire and discovered black or brown mucus in the tissue, you have witnessed these mechanisms firsthand.</p><p>The really small particles bypass these defenses and disturb the air sacks where oxygen crosses over into the blood. Fortunately, we have specialized immune cells present in the air sacks called macrophages. It's their job to seek out foreign material and remove or destroy it. However, <a href="http://doi.org/10.2105/AJPH.2020.305744" target="_blank">studies</a> have shown that repeated exposure to elevated levels of wood smoke can suppress macrophages, leading to increases in lung inflammation.</p>
What Does That Mean for COVID-19 Symptoms?<p>Dose, frequency and duration are important when it comes to smoke exposure. Short-term exposure can irritate the eyes and throat. Long-term exposure to wildfire smoke over days or weeks, or breathing in heavy smoke, can raise the risk of <a href="https://www.calhospital.org/sites/main/files/file-attachments/wildfire_smoke_considerations_for_californias_public_health_officials_august_2019.pdf" target="_blank">lung damage</a> and may also contribute to <a href="https://health.ny.gov/environmental/outdoors/air/smoke_from_fire.htm" target="_blank">cardiovascular problems</a>. Considering that it is the macrophage's job to remove foreign material – including smoke particles and pathogens – it is reasonable to make a <a href="http://doi.org/10.3109/08958378.2012.756086" target="_blank">connection</a> between smoke exposure and risk of viral infection.</p><p>Recent evidence suggests that long-term exposure to PM2.5 may make the coronavirus more deadly. A nationwide study found that even a small increase in PM2.5 from one U.S. county to the next was associated with a <a href="https://doi.org/10.1101/2020.04.05.20054502" target="_blank">large increase in the death rate</a> from COVID-19.</p>
What Can You Do to Stay Healthy?<p>The advice I gave my friend who had been running while smoke was in the air applies to just about anyone downwind from a wildfire.</p><p>Stay informed about air quality by identifying local resources for air quality alerts, information about active fires, and recommendations for better health practices.</p><p>If possible, avoid being outside or doing strenuous activity, like running or cycling, when there is an air quality warning for your area.</p><p>Be aware that not all face masks protect against smoke particles. In the context of COVID-19, the best data currently suggests that a cloth mask benefits public health, especially for those around the mask wearer, but also to some extent <a href="https://theconversation.com/cloth-masks-do-protect-the-wearer-breathing-in-less-coronavirus-means-you-get-less-sick-143726" target="_blank">for the person wearing the mask</a>. However, most cloth masks will not capture small wood smoke particles. That requires an N95 mask in conjunction with fit testing for the mask and training in how to wear it. Without a proper fit, N95s do not work as well.</p><p>Establish a clean space. Some communities in western states have offered "clean spaces" programs that help people take refuge in buildings with clean air and air conditioning. However, during the pandemic, being in an enclosed space with others can create other health risks. At home, a person can create clean and cool spaces using a window air conditioner and a <a href="https://www.youtube.com/watch?v=kH5APw_SLUU" target="_blank">portable air purifier</a>.</p><p><span></span><a href="https://www.epa.gov/pm-pollution/how-smoke-fires-can-affect-your-health" target="_blank">The EPA also advises</a> people to avoid anything that contributes to indoor air pollutants. That includes vacuuming that can stir up pollutants, as well as burning candles, firing up gas stoves and smoking.</p>
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By Libby Richards
With the coronavirus still spreading widely, it's time to start thinking seriously about influenza, which typically spreads in fall and winter. A major flu outbreak would not only overwhelm hospitals this fall and winter, but also likely overwhelm a person who might contract both at once.
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A Lifesaver in Previous Years, but More So Now<p>Both COVID-19 and the flu are contagious respiratory illness that present with <a href="https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm" target="_blank">similar symptoms</a>. Both viruses can impact the<a href="https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm" target="_blank"> elderly and those with certain chronic conditions</a>, such as heart and lung disease, the hardest.</p><p>Data on flu vaccination rates from 2018-2019 show that only <a href="https://www.cdc.gov/flu/fluvaxview/reportshtml/reporti1819/reporti/index.html" target="_blank">49%</a> of Americans six months of age and older received the flu vaccine. The vaccine's effectiveness varies each season, with early data from the 2019-2020 flu season indicating a vaccine effectiveness rate of <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6907a1.htm" target="_blank">50%</a> overall, and <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6907a1.htm" target="_blank">55%</a> in youth.</p><p>While some may think this effectiveness rate is low, the flu vaccine remains the single best way to prevent the flu and related complications. For example, during the 2018-2019 flu season, flu vaccination was estimated to prevent <a href="https://www.cdc.gov/flu/about/burden-averted/2018-2019.htm" target="_blank">4.4 million flu illnesses, 58,000 flu hospitalizations and 3,500 deaths</a>. Early data from the 2019-2020 flu season estimates there were <a href="https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm" target="_blank">39-56 million flu illnesses, 18-26 million flu-related medical visits, 410-740,000 hospitalizations and up to 62,000 deaths</a>. Much of this disease burden is preventable from higher flu vaccination rates.</p><p>It is now quite apparent that COVID-19 will still be circulating during flu season, which makes getting a flu vaccine more important than ever. As schools, our communities and our economy continue to reopen, it is vital to get the flu vaccine for personal, family and community protection.</p>
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Worried about the overuse of antibiotics and the emerging trend of bacteria-resistant drugs, researchers recommend that honey should be tried first to treat upper respiratory tract infections (URTIs), according to a new review published by Oxford doctors in BMJ Evidence-Based Medicine.
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The chemical bisphenol A, or BPA, which is ubiquitous in plastic bottles, can linings and receipts, has been linked to numerous health issues because it disrupts hormone function. Besides being connected to low birthweight and brain disorders in babies and children, and obesity, heart disease and erectile dysfunction in adults, a new study has linked the chemical to a greater likelihood of premature death, Newsweek reported.
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By Allison Johnson
Most people who buy organic do it because they want to eat healthier. It's true – switching to an organic diet rapidly decreases exposure to a wide range of pesticides, including glyphosate (the main ingredient in Roundup). According to a new study published in Environmental Research, glyphosate levels in families' bodies dropped 70% in just one week on an organic diet. The researchers concluded that diet is a major source of glyphosate exposure and that eating organic reduces exposure.
Friends of the Earth / https://foe.org/the-study/<p>But the health benefits of organic agriculture extend far beyond our individual dinner plates. Organic farming offers a comprehensive alternative to chemical agriculture, and it protects our soil, air, water, wildlife, and critically – our farming communities – from toxic pesticides.</p><p>The purpose of pesticides is to kill. So it's not surprising that widespread use of these chemicals poses a serious public health threat. Diet alone exposes us to a frightening cocktail of pesticide residues, and toxic pesticides pose much <a href="https://law.ucla.edu/news/exposure-and-interaction-potential-health-impacts-using-multiple-pesticides" target="_blank">more severe</a> health threats to <a href="https://www.organic-center.org/organic-agriculture-reducing-occupational-pesticide-exposure-farmers-and-farmworkers-0" target="_blank">farming communities</a>.</p><p>Food system workers and their families and communities – who are <a href="http://www.pesticidereform.org/environmental-justice/" target="_blank">disproportionately Latinx and low-income</a> – bear the brunt of <a href="https://www.farmworkerjustice.org/sites/default/files/aExposed%20and%20Ignored%20by%20Farmworker%20Justice%20singles%20compressed.pdf" target="_blank">harm from toxic pesticide use in agriculture</a>. Farmworkers are at risk from direct exposure to harmful chemicals when mixing and applying pesticides, as well as while working in fields; as a result, they suffer <a href="http://www.farmworkerjustice.org/wp-content/uploads/2012/05/aExposed-and-Ignored-by-Farmworker-Justice-singles-compressed.pdf" target="_blank">more chemical-related injuries</a> than any other U.S. workforce. Exposure also extends beyond the workplace. Workers can carry pesticides home on clothes, shoes, and skin, inadvertently exposing their children and other family members, and pesticide drift can harm people living, working, and learning near farms.</p><p>These exposure routes add up. And weaning our agricultural system off its addiction to toxic chemicals is an uphill battle.</p><p>We've seen recent wins on pesticide issues in the <a href="https://www.nytimes.com/2020/06/24/business/roundup-settlement-lawsuits.html#:~:text=Just%20weeks%20after%20the%20deal,warn%20consumers%20of%20the%20risk." target="_blank">courts</a> and in <a href="https://www.nrdc.org/media/2019/191009" target="_blank">some</a> <a href="https://www.nrdc.org/media/2020/200320" target="_blank">states</a>, but it can take decades of fighting to end the use of a single pesticide. For example, NRDC petitioned the federal Environmental Protection Agency (EPA) to end use of the brain-toxic pesticide chlorpyrifos in 2007; thirteen years later, <a href="https://www.nrdc.org/experts/nrdc/nrdc-takes-epa-court-again-protect-childrens-health" target="_blank">we're still in court</a> demanding that EPA protect public health. Meanwhile numerous similar <a href="https://www.nrdc.org/media/2018/181024-0" target="_blank">organophosphate</a> chemicals also remain in our fields and our bodies.</p>
By Jessica Corbett
A sheriff in Florida is under fire for deciding Tuesday to ban his deputies from wearing face masks while on the job—ignoring the advice of public health experts about the safety measures that everyone should take during the coronavirus pandemic as well as the rising Covid-19 death toll in his county and state.
<div id="7a571" class="rm-shortcode" data-rm-shortcode-id="aad9dcf60e7385e6553ff23ffc1ae75d"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1293527664389693447" data-partner="rebelmouse"><div style="margin:1em 0">Deaths hit a record in Florida yesterday. This guy's jail system is rife with COVID. And he's banned masks in his s… https://t.co/Cbp2wR32o1</div> — Michael McAuliff (@Michael McAuliff)<a href="https://twitter.com/mmcauliff/statuses/1293527664389693447">1597236002.0</a></blockquote></div>
<div id="79024" class="rm-shortcode" data-rm-shortcode-id="4ac086eab58b9713f2ad777c40938252"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1293578984148606977" data-partner="rebelmouse"><div style="margin:1em 0">This actively puts peoples' lives at risk. https://t.co/GKF0Xgjyex</div> — CAP Action (@CAP Action)<a href="https://twitter.com/CAPAction/statuses/1293578984148606977">1597248238.0</a></blockquote></div>
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By Shelly Miller
The vast majority of SARS-CoV-2 transmission occurs indoors, most of it from the inhalation of airborne particles that contain the coronavirus. The best way to prevent the virus from spreading in a home or business would be to simply keep infected people away. But this is hard to do when an estimated 40% of cases are asymptomatic and asymptomatic people can still spread the coronavirus to others.
It’s All About Fresh, Outside Air<p>The safest indoor space is one that constantly has lots of <a href="https://www.epa.gov/indoor-air-quality-iaq/how-does-outdoor-air-enter-building" target="_blank">outside air</a> replacing the stale air inside.</p><p>In commercial buildings, <a href="https://www.ncbi.nlm.nih.gov/books/NBK143277/" target="_blank">outside air is usually pumped in</a> through heating, ventilating and air-conditioning (HVAC) systems. In <a href="https://www.epa.gov/indoor-air-quality-iaq/how-does-outdoor-air-enter-building" target="_blank">homes, outside air gets in</a> through open windows and doors, in addition to seeping in through various nooks and crannies.</p><p>Simply put, the more fresh, outside air inside a building, the better. Bringing in this air dilutes any contaminant in a building, whether a virus or a something else, and <a href="https://doi.org/10.1111/j.1600-0668.2010.00703.x" target="_blank">reduces the exposure of anyone inside</a>. Environmental engineers like me quantify how much outside air is getting into a building using a measure called the <a href="https://doi.org/10.1038/jes.2013.30" target="_blank">air exchange rate</a>. This number quantifies the number of times the air inside a building gets replaced with air from outside in an hour.</p><p>While the exact rate depends on the number of people and size of the room, most experts consider roughly <a href="https://doi.org/10.1034/j.1600-0668.2002.01145.x" target="_blank">six air changes an hour</a> to be good for a 10-foot-by-10-foot room with three to four people in it. In a pandemic this should be higher, with one study from 2016 suggesting that an exchange rate of nine times per hour <a href="https://doi.org/10.1177%2F1420326X16631596" target="_blank">reduced the spread of SARS, MERS and H1N1</a> in a Hong Kong hospital.</p><p>Many buildings in the U.S., <a href="https://doi.org/10.1111/ina.12403" target="_blank">especially schools</a>, do not meet recommended ventilation rates. Thankfully, it can be pretty easy to get more outside air into a building. Keeping <a href="https://doi.org/10.1016/S0960-1481(99)00012-9" target="_blank">windows and doors open</a> is a good start. Putting a box fan in a window blowing out can greatly increase air exchange too. In buildings that don't have operable windows, you can change the mechanical ventilation system to increase how much air it is pumping. But in any room, the more people inside, the faster the air should be replaced.</p>
Using CO2 to Measure Air Circulation<p>So how do you know if the room you're in has enough air exchange? It's actually a pretty hard number to calculate. But there's an easy-to-measure proxy that can help. Every time you exhale, you <a href="https://doi.org/10.1111/ina.12383" target="_blank">release CO2</a> into the air. Since the coronavirus is most often spread by breathing, coughing or talking, you can use <a href="https://pdfs.semanticscholar.org/dd7e/b2870c38f70e5285e5118ed6f158c091f7cf.pdf" target="_blank">CO2 levels</a> to see if the room is filling up with potentially infectious exhalations. The CO2 level lets you estimate if enough fresh outside air is getting in.</p><p>Outdoors, CO2 levels are just above 400 parts per million (ppm). A well ventilated room will have around <a href="https://doi.org/10.1111/j.1600-0668.1999.00003.x" target="_blank">800 ppm of CO2</a>. Any higher than that and it is a sign the room might need more ventilation.</p><p>Last year, researchers in Taiwan reported on the <a href="https://doi.org/10.1111/ina.12639" target="_blank">effect of ventilation on a tuberculosis outbreak</a> at Taipei University. Many of the rooms in the school were underventilated and had CO2 levels above 3,000 ppm. When engineers improved air circulation and got CO2 levels under 600 ppm, <a href="https://doi.org/10.1111/ina.12639" target="_blank">the outbreak completely stopped</a>. According to the research, the increase in ventilation was responsible for 97% of the decrease in transmission.</p><p>Since the coronavirus is spread through the air, higher CO2 levels in a room likely mean there is a <a href="https://doi.org/10.1111/ina.12639" target="_blank">higher chance of transmission</a> if an infected person is inside. Based on the study above, I recommend trying to keep the CO2 levels below 600 ppm. You can buy <a href="https://doi.org/10.5194/amt-7-3325-2014" target="_blank">good CO2 meters</a> for around $100 online; just make sure that they are accurate to within 50 ppm.</p>
Air Cleaners<p>If you are in a room that can't get enough outside air for dilution, consider an air cleaner, also commonly called air purifiers. These machines remove particles from the air, usually using <a href="https://doi.org/10.1016/j.cap.2005.07.013" target="_blank">a filter</a> made of tightly woven fibers. They can <a href="https://shellym80304.files.wordpress.com/2020/06/miller-leiden-et-al-1996.pdf" target="_blank">capture particles containing bacteria and viruses</a> and can help reduce disease transmission.</p><p>The U.S. Environmental Protection Agency says that <a href="https://www.epa.gov/coronavirus/air-cleaners-hvac-filters-and-coronavirus-covid-19" target="_blank">air cleaners can do this for the coronavirus</a>, but not all air cleaners are equal. Before you go out and buy one, there are few things to keep in mind.</p><p>The first thing to consider is <a href="https://shellym80304.files.wordpress.com/2020/06/air-cleaner-report.pdf" target="_blank">how effective an air cleaner's filter is</a>. Your best option is a cleaner that uses a high-efficiency particulate air (<a href="https://doi.org/10.1016/S0021-8502(05)80214-9" target="_blank">HEPA</a>) filter, as these remove more than <a href="https://doi.org/10.1063/1.2771421" target="_blank">99.97% of all particle sizes</a>.</p><p>The second thing to consider is how powerful the cleaner is. The bigger the room – or the more people in it – the more air needs to be cleaned. I worked with some colleagues at Harvard to put together a tool to help teachers and schools determine <a href="https://docs.google.com/spreadsheets/d/1NEhk1IEdbEi_b3wa6gI_zNs8uBJjlSS-86d4b7bW098/edit#gid=1275403500" target="_blank">how powerful of an air cleaner you need for different classroom sizes</a>.</p><p>The last thing to consider is the validity of the claims made by the company producing the air cleaner.</p><p>The Association of Home Appliance Manufacturers certifies air cleaners, so the AHAM Verifide seal is a good place to start. Additionally, the California Air Resources Board has a <a href="https://ww2.arb.ca.gov/our-work/programs/air-cleaners-ozone-products/california-certified-air-cleaning-devices" target="_blank">list of air cleaners</a> that are certified as safe and effective, though not all of them use HEPA filters.</p>
Keep Air Fresh or Get Outside<p>Both the <a href="https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions" target="_blank">World Health Organization</a> and <a href="https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/deciding-to-go-out.html" target="_blank">U.S. Centers for Disease Control and Prevention</a> say that poor ventilation increases the risk of transmitting the coronavirus.</p><p>If you are in control of your indoor environment, make sure you are getting enough fresh air from outside circulating into the building. A CO2 monitor can help give you a clue if there is enough ventilation, and if CO2 levels start going up, open some windows and <a href="https://www.advisory.com/daily-briefing/2020/07/17/outdoor-gathering" target="_blank">take a break outside</a>. If you can't get enough fresh air into a room, an air cleaner might be a good idea. If you do get an air cleaner, be aware that they don't remove CO2, so even though the air might be safer, CO2 levels could still be high in the room.</p><p>If you walk into a building and it feels hot, stuffy and crowded, chances are that there is not enough ventilation. Turn around and leave.</p><p>By paying attention to air circulation and filtration, improving them where you can and staying away from places where you can't, you can add another powerful tool to your anti-coronavirus toolkit.</p>
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