Boston COVID-19 positive rate is a “wildfire” close to becoming an “inferno”

Boston’s COVID-19 positive test rate is a “wildfire” that is close to becoming an “inferno” if officials fail to take more precautions, according to one expert.

The city’s positive test rate has doubled in a month and a half to 7.8%, and shows no sign of dropping.

And Boston is not alone. Last week, 121 of the state’s cities and towns — more than a third of the 351 total Massachusetts municipalities — are in the high-risk “red zone.”

“7.8 % is a wildfire. We’re getting close to an inferno,” said Dr. Todd Ellerin, director of infectious diseases at South Shore Health. “The time is now to take our foot completely off the accelerator and onto the brakes; otherwise the governor, his leadership team and the state Department of Public Health will be forced to put their foot on the emergency brake. It may already be too late to avoid that.”

Boston Health Chief Marty Martinez told reporters on Friday that the city is considering stopping indoor dining or rolling back other restrictions as coronavirus cases continue to mount.

The city shut down both indoor and outdoor dining, as well as a range of other businesses, at the start of the pandemic before gradually allowing them to reopen over the summer.

But stopping indoor dining will not be enough to reverse the infection rate, Ellerin said. Because 80% of the coronavirus clusters have been in people’s homes, he said, they should wear masks at home, as well as elsewhere, and everyone who can work from home should.

Because people need ventilation, they also should open windows about 6 inches when they’re in a room, Ellerin said, and they should think twice about having people with whom they don’t live over for Thanksgiving.

Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, said shutdowns or stay-at-home orders are not the solution.

“What you have to do is look at what’s driving the increase; is it restaurants, is it bars, is it sports activities?” Adalja said. “You can fix it. … It always boils down to testing, tracing and isolating.”

Dr. Jeffrey Singer, a Phoenix-based general surgeon and senior fellow at the Cato Institute, a libertarian think tank, agreed that lockdowns are not the answer, nor, he added is “micromanaging.”

“It’s a fool’s errand to think that if you lock down long enough, the virus is going to disappear,” Singer said. “We should give people who run businesses the freedom to come up with their own solutions, based on CDC (Centers for Disease Control and Prevention) guidelines. One size does not fit all. The more flexibility you have, the more compliance your’e going to get.”

But Ellerin said it’s unclear if individual behaviors will be enough to reverse the positivity rate.

“This virus can be unforgiving and relentless,” he said. “We have to act aggressively now because before we blink, the positive test rate could be 10 to 15%. Everything should be on the table because we are

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Coronavirus in the U.S. is spreading like ‘wildfire,’ epidemiologist says

Coronavirus cases are climbing at an alarming rate in the U.S., raising fears that parts of the country are in a third wave of Covid-19.

Nationwide, cases Friday were 79,303, the second day in a row of record-setting confirmed new cases of the coronavirus. Over the weekend, the U.S. added 79,059 cases on Saturday and 64,603 cases on Sunday according to an NBC News tally. According to the COVID Tracking Project, the 7-day average for new cases of the coronavirus is 69,692, the highest number to date. There are also nearly 43,000 Americans hospitalized with Covid-19, the highest number since August 19th.

Fewer than 10 states in the country are not experiencing increases of infection.

During an outbreak, a “wave” comes from the curve used to visualize the number of people infected. If more people get sick every day, the curve goes up. If fewer people get sick every day, the curve goes down. Even during the summer, experts say cases in the U.S. never got to a low-enough level of new cases to make it out of the first wave from the spring when cases rose astronomically.

“I look at it more as an elongated exacerbation of the original first wave,” Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, said Monday at an annual event for Yahoo Finance. “It’s kind of semantics. You want to call it the third wave or an extended first wave, no matter how you look at it, it’s not good news.”

Fauci and other experts are particularly concerned that the recent surge in cases is starting from a higher baseline of roughly 40,000 cases per day, compared with 20,000 cases per day during the summer surge.

“Each wave we start from a higher baseline and we start climbing,” Dr. Ashish Jha, dean of the Brown University School of Public Health said, noting that during the summer, infections were rising most in the South and Southwest. “This time, it’s all around the country and we’re heading into winter, where the virus becomes more efficient in spreading.”

Still, Jha said the terminology isn’t as important as Americans understanding that the growth of new cases can quickly become exponential.

“The metaphor of a wildfire is probably better,” said William Hanage, an associate professor of epidemiology at Harvard T.H. Chan School of Public Health. “It’s indisputable that the U.S. is now seeing a pretty widespread transmission across the board.”

Unlike a wave, which comes and passes through, wildfires can be patchy and more intense in areas, similar to the situation in the U.S., Hanage said. Community mitigation efforts such as masking and social distancing can stamp out the spread, but then infections tend to pop up in other areas with more relaxed measures.

Tara Smith, an infectious diseases epidemiologist at Kent State University in Ohio, is not a fan of the wave terminology. “That implies there’s a trough, and our cases have never really declined that significantly,” she said.

Small gatherings

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Wildfire smoke may help virus spread, mouthwash helps curb it

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Wildfire smoke likely helped to spread COVID-19

Large wildfires may be linked to increases in COVID-19 cases and deaths in the San Francisco area, according to a paper in the European Review for Medical and Pharmacological Sciences. Researchers found that between March and September, increases in smoke particles, other wildfire pollutants and carbon monoxide levels corresponded to increases in daily COVID-19 diagnoses and total COVID-19 deaths. While correlation does not necessarily mean causality, coauthor Sultan Ayoub Meo of King Saud University in Saudi Arabia said air pollution provides a means for viruses to move around the environment. These tiny pollution particles, along with the microorganisms they carry, “can easily be inhaled deep into the lungs and cause infections,” Meo said. “Carbon monoxide is a highly toxic gas which can damage our lungs, resulting as a triggering factor for an increase in COVID-19 cases and deaths in the wildfire region,” he told Reuters. (https://bit.ly/2FXvAh0)

Antiviral mouthwash could help curb coronavirus transmission

Mouthwashes with antiviral ingredients could help decrease COVID-19 transmission by reducing viral loads in the mouths of infected patients when they cough, sneeze or speak, according to a paper in the Journal of Dental Research published on Thursday. Studies have found that rinses containing cetylpyridinium chloride or povidone-iodine can reduce the oral coronavirus load; other promising compounds include hydrogen peroxide, chlorhexidine, cyclodextrin, Citrox, and certain essential oils. Coauthor Dr. Florence Carrouel of University Claude Bernard Lyon in France told Reuters everyone should be using these mouthwashes because people can be infected and not realize it. While more studies are needed to determine appropriate regimens, she suggests using three doses of antiviral mouthwash the day before a meeting, and one dose the morning of the event. COVID-19 patients should be using mouthwash regularly for seven to 10 days. (https://bit.ly/35r1efw)

Common-cold antibodies may hijack body’s COVID-19 response

A phenomenon called “antigenic sin” may explain why some COVID-19 patients become critically ill, researchers say. Because the new virus shares some features with coronaviruses that cause common colds, the body’s immune response can include antibodies that previously learned to recognize and attack those older viruses. This can in turn detract from the body’s ability to fight COVID-19, because the common cold antibodies do not reliably attack the new virus. In severely ill COVID-19 patients, the immune response directed at other coronaviruses is higher than in mildly ill patients, researchers reported on medRxiv ahead of peer review. This situation – when the body reacts to a new invader based on its “memory” of previous invaders – has been seen before and is called “original antigenic sin.” New vaccines must be able to prompt an immune response against this new virus, not merely boost immune responses toward common cold viruses, said coauthor Gijsbert van Nierop of Erasmus Medical

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Spiraling healthcare costs of wildfire smoke in California

The annual cost of smoke-related hospitalizations in the state may have quadrupled between 2012 and 2018, according to new research. The costs of this year’s wildfires are likely to be even higher.

According to the California Department of Forestry and Fire Protection, since the start of 2020, there have been more than 8,500 wildfires across the state, incinerating more than 4.1 million acres of land.

At the time of writing, 6 of the 20 largest wildfires in the state’s history have occurred in 2020, including the largest on record, known as the August Complex, which has been burning since the middle of August.

Wildfires release large amounts of particulate matter (PM) and toxic gases, such as carbon monoxide and nitrogen oxides.

Smoke particles that are 2.5 microns or smaller in size, known as PM2.5, are carried long distances by the wind. Their small size means that they are breathed deep into the lungs, where they have a wide range of effects on human health.

In addition to the severe harms to health and well-being, there are also financial costs.

Daniel Cullen, who recently gained his Ph.D. in health economics from the University of California Santa Barbara, has estimated the annual healthcare costs of wildfires in the state between 2012 and 2018 in terms of hospitalizations for respiratory and circulatory illnesses.

As part of research for his doctoral thesis, he calculated that the cost may have increased as much as fourfold over this period, from around $88 million in 2012 to $348 million in 2018.

This year is likely to be the worst on record, says Cullen, but given how extraordinary the 2020 wildfire season has been thus far, it is difficult to predict exactly how bad it will be. “When a big county like San Francisco is covered in smoke for 2 months, it is hard to say what is going to be the effect,” he says.

Cullen believes the costs of smoke exposure will continue to rise in coming decades as climate change increases the size, frequency, and intensity of wildfires.

“These healthcare costs need to be accounted for when we are thinking about the costs of climate change,” he says.

Cullen used data from California’s Office of Statewide Health Planning and Development regarding hospital admissions for respiratory and circulatory illnesses between 2012 and 2018.

To investigate possible relationships with smoke exposure, he correlated these admissions with satellite data from the National Oceanic and Atmospheric Administration’s Hazard Mapping System Fire and Smoke Product. This tracks wildfire smoke plumes across the United States.

To account for other variables that could affect admissions, Cullen compared each county with itself for the same month in different years. This allowed him to calculate the increased number of admissions that were directly caused by wildfire smoke.

“Using this year to year variation in whether a specific area was exposed to wildfire smoke at a specific point in time, I am able to identify the causal impact of wildfire smoke exposure,” he writes.

He estimates

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