STENDEC

Based on the RCTs we would conclude that wearing facemasks can be very slightly protective against primary infection from casual community contact, and modestly protective against household infections when both infected and uninfected members wear facemasks. However, the RCTs often suffered from poor compliance and controls using facemasks. Across observational studies the evidence in favour of wearing facemasks was stronger. We expect RCTs to under-estimate the protective effect and observational studies to exaggerate it. The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19. Preprint Systemic Review Study

It looks like cloth face masks probably do almost nothing to prevent infection...reducing viral penetration only by about 3% The rates of all infection outcomes were highest in the cloth mask arm, with the rate of ILI statistically significantly higher in the cloth mask arm (relative risk (RR)=13.00, 95% CI 1.69 to 100.07) compared with the medical mask arm. Cloth masks also had significantly higher rates of ILI compared with the control arm. An analysis by mask use showed ILI (RR=6.64, 95% CI 1.45 to 28.65) and laboratory-confirmed virus (RR=1.72, 95% CI 1.01 to 2.94) were significantly higher in the cloth masks group compared with the medical masks group. Penetration of cloth masks by particles was almost 97% and medical masks 44%. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. BMJ Study

This is true. However, the first post in this thread had an article with a dozen or so references indicating that actual surgical face masks are generally of little value in preventing viral transmission even when used by professionals in medical settings...I have to believe that the cotton home-made masks worn by the general public are probably even less so. The second post contains an interview with a widely cited expert in respiratory protection on the utility of mask-wearing. Her conclusion, repeated here is: "I just want [people who are wearing masks] to understand that [masks] aren’t very much more protective than if they weren’t wearing them. And they’re really not doing a whole lot of good for the people around them." OSHA also provides the following guidance on surgical masks...note these are typically made of melt-blown, non-woven material that is electrostatically charged to improve the capacity to capture small particles....this is not talking about a homemade mask that someone sewed out of a cotton tshirt or a bandana. (emphasis mine) Surgical masks are used as a physical barrier to protect the user from hazards, such as splashes of large droplets of blood or body fluids. Surgical masks also protect other people against infection from the person wearing the surgical mask. Such masks trap large particles of body fluids that may contain bacteria or viruses expelled by the wearer. Surgical masks are not designed or certified to prevent the inhalation of small airborne contaminants. These particles are not visible to the naked eye but may still be capable of causing infection. Surgical masks are not designed to seal tightly against the user’s face. During inhalation, much of the potentially contaminated air can pass through gaps between the face and the surgical mask and not be pulled through the filter material of the mask. Their ability to filter small particles varies significantly based upon the type of material used to make the surgical mask, so they cannot be relied upon to protect workers against airborne infectious agents. source Data indicates that the virus that causes COVID19 is widely distributed in both droplets and airborne aerosols, even by patients wearing masks. Even the US CDC, the agency recommending "cloth face coverings" as a response to COVID19, has the following to say about surgical masks, which again, are presumably more effective than a single-ply cloth face covering : Surgical masks, on the other hand, are not specifically designed to protect the wearer from airborne hazards. These devices limit the spread of infectious particles expelled by the wearer. They are used to help protect a sterile field, such as the area surrounding the site of a surgical incision, from contamination by particles expelled by the wearer, such as those generated by coughs or sneezes. Surgical masks also help provide a physical barrier to protect the wearer from splashes, sprays, or contact with contaminated hands. The Food and Drug Administration (FDA) regulates surgical masks. The FDA regulations do not require surgical masks to form a seal against the user’s face or to have a level of filtration that provides the user protection from aerosol exposures. source So do masks make viral transmission more likely? Probably not. Do they catch large droplets expelled from someone sneezing or coughing? Almost certainly. Do they prevent people from touching their face with their hands? Maybe....some people seem to touch their faces more when wearing a mask in order to adjust the fit. Do they prevent an asymptomatic person from exhaling aerosolized viral particles into the air around him or other people from breathing in the same particles breathed out by others? Do they protect me from you or you from me if neither of us is coughing or sneezing? No. Do they make the average person, the one who has a very small chance of catching this virus in the first place, and an even smaller chance of becoming seriously ill from it, more confident about going back to work and going to Walmart and spending money? Absolutely. So masks are a very useful tool in the management of this pandemic...just not for the reasons most people think.

I didn't initially understand the broad recommendation to wear masks at first. As the articles above demonstrate, the science doesn't support their effectiveness in preventing transfer, specifically in the case of this virus. There are piles of other studies that confirm that surgical masks, nevermind a bandana or "cotton face covering" are generally ineffective at protecting against an airborne virus, and there is a concern that they might actually produce a false sense of confidence....and then BOOM I understood why we are all wearing masks... This is a form of security theater like the tamper seal on your vitamin bottle or the overworked, underpaid, unarmed TSA agent at the airport...the tamper seals were introduced in the wake of the 1982 Tylenol poisonings in order to restore public confidence in OTC medical products and the TSA was introduced to restore public confidence in air travel after the WTC attacks in 2001...both are apparently rather easy to defeat but they are part of what's known as "security theater" an elaborate Kabuki production intended to convey a sense of safety where one probably doesn't really exist. Mask wearing, in this case, is no different. The CDC and all of the state health agencies are recommending that we cover our face, not because any of them seriously think they are effective at reducing viral spread, but in order to restore our confidence in being out in society again with other people.

Find yourself a good CBT therapist Sam. I worked with a guy when I was having so much trouble with my hyper-arousal insomnia....most of it seems self-evident when you are sitting there listening to someone say it but until I was actually sitting there listening to someone say it, I didn't realize it....made a HYOOGE difference for me.

Sam have you tried cognitive behavioral therapy? Its got a really good track record for managing anxiety/phobia/panic disorders.

No. Western Maine. We are up at our camp for the weekend.

Split and stacked a couple cord of wood today along with some other yardio tasks. No KB for me today Very hard to be unhappy with the world when you wake up to this view...

Are you still in Germany?

Seems plausible. I have to imagine someone living on the streets in LA county is probably replete with vitamin D from sun exposure.

It may be simpler to just spend more time standing up.

Impossible to say unfortunately...although, with ubiquitous use of sunscreen, I'm not sure how strong the association between D status and outdoor activity is anymore in the developed world.

COVID-19 is a major pandemic that has killed more than 196,000 people. The COVID-19 disease course is strikingly divergent. Approximately 80-85% of patients experience mild or no symptoms, while the remainder develop severe disease. The mechanisms underlying these divergent outcomes are unclear. Emerging health disparities data regarding African American and homeless populations suggest that vitamin D insufficiency (VDI) may be an underlying driver of COVID-19 severity. To better define the VDI-COVID-19 link, we determined the prevalence of VDI among our COVID-19 intensive care unit (ICU) patients. Methods: In an Institutional Review Board approved study performed at a single, tertiary care academic medical center, the medical records of COVID-19 patients were retrospectively reviewed. Subjects were included for whom serum 25-hydroxycholecalcifoerol (25OHD) levels were determined. COVID-19-relevant data were compiled and analyzed. We determined the frequency of VDI among COVID-19 patients to evaluate the likelihood of a VDI-COVID-19 relationship. Results: Twenty COVID-19 patients with serum 25OHD levels were identified; 65.0% required ICU admission.The VDI prevalence in ICU patients was 84.6%, vs. 57.1% in floor patients. Strikingly, 100% of ICU patients less than 75 years old had VDI. Coagulopathy was present in 62.5% of ICU COVID-19 patients, and 92.3% were lymphocytopenic. Conclusions: VDI is highly prevalent in severe COVID-19 patients. VDI and severe COVID-19 share numerous associations including hypertension, obesity, male sex, advanced age, concentration in northern climates, coagulopathy, and immune dysfunction. Thus, we suggest that prospective, randomized controlled studies of VDI in COVID-19 patients are warranted. Preprint Article

New research presented at this year’s Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain (September 16-20, 2019) reveals that vitamin D deficiency is strongly linked to increased mortality, especially in younger and middle-aged people, and is particularly associated with diabetes-related deaths. The study found that vitamin D levels of 10 nmol/L or less were associated with a 2-3 fold increase in risk of death, with the largest effect being observed in patients aged 45 to 60 years (2.9 times increased risk). Levels of 90 nmol/L or greater were associated with a reduction in all-cause mortality of 30-40%, again with the largest effect being found in the 45 to 60-years-old age group (a 40% reduction in risk). No statistically significant associations between vitamin D levels and mortality were observed in patients over the age of 75 Full Article

Reduced obesity for weighted-vest wearers Science News, April 30, 2020 Scientists from the University of Gothenburg, Sweden, have found a new method of reducing human body weight and fat mass using weighted vests. The new study indicates that there is something comparable to built-in bathroom scales that contributes to keeping our body weight and, by the same token, fat mass constant. The researchers hypothesized that loading the vests with weights would result in a compensatory body-weight decrease. Sixty-nine people with a body mass index (BMI) of 30-35, the lowest obesity category, took part in the clinical study. Their instructions were to wear a weighted vest eight hours a day for three weeks, and otherwise live as usual. All the study participants wore weighted vests but, by drawing of lots, they were assigned to one of two groups. The control group wore only light vests weighing 1 kg, while the treatment group wore heavy vests weighing some 11 kg. When the three weeks had passed, the experimental subjects who wore the heavier vests had lost 1.6 kg in weight, while those wearing the light vests had lost 0.3 kg. "We think it's very interesting that the treatment with the heavier weighted vests reduced fat mass while muscle mass simultaneously remained intact," says Professor Claes Ohlsson of Sahlgrenska Academy, University of Gothenburg. "The effect on fat mass we found, from this short experiment, exceeded what's usually observed after various forms of physical training. But we weren't able to determine whether the reduction was in subcutaneous fat (just under the skin) or the dangerous visceral kind (belly fat) in the abdominal cavity that's most strongly associated with cardiovascular diseases and diabetes," says Professor John-Olov Jansson of Sahlgrenska Academy, University of Gothenburg. In previous animal studies published in 2018, the scientists showed that there is an energy balance system that endeavors to keep body weight constant: the "gravitostat," as they have dubbed it. In mice, this regulation takes place partly by influencing appetite. To work, the system must contain a kind of personal weighing machine. The researchers' new clinical study shows that similar built-in scales exists in humans as well. If people do a lot of sitting, what seems to happen is that the reading on our personal scales falls too low. This may explain why sitting is so clearly associated with obesity and ill-health. Weighted vests can raise the reading on the scales, resulting in weight loss. Many questions about how the gravitostat works remain for the researchers to answer. Aspects they want to study include whether, in wearers of weighted vests, changed energy expenditure, appetite and mobility help them to lose weight. The scientists also want to see whether the weight reduction continues for the vest wearers over periods longer than three weeks, and whether the dangerous visceral fat is reduced by the treatment. Journal Reference: Claes Ohlsson, Edwin Gidestrand, Jacob Bellman, Christel Larsson, Vilborg Palsdottir, Daniel Hägg, Per-Anders Jansson, John-Olov Jansson. Increased weight loading reduces body weight and body fat in obese subjects – A proof of concept randomized clinical trial. EClinicalMedicine, 2020