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Knock-knock... It’s mild!
C19.Life • 1 November 2025
“How mild can a cigarette be?”
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Learn Real Mildness... it’s easy
‘Just make your next pack Chesterfields, that’s all, and as quick as you can light up, you’ll learn the meaning of real mildness... and you will learn this too, Chesterfields are cooler and defintely better-tasting. You get all of the right answers to your smoking pleasure with Chesterfields... the busiest cigarette in America.’
Chesterfield – THEY SATISFY
1940 Liggett and Myers Tobacco Co.
Mildness is a Pleasure with Pall Mall
‘Don’t miss the fun of smoking...’
Outstanding... and they are Mild!
Pall Mall’s natural mildness is so good to your taste!
‘For flavor and enjoyment you just can’t beat Pall Mall’s natural mildness. It’s so good to your taste. Never too strong. Never too weak. Always just right! Enjoy satisfying flavor... so friendly to your taste.’
So smooth, so satisfying, so downright smokeable!
How mild can a cigarette be?
‘In a recent coast-to-coast test, hundreds of men and women smoked Camels – and only Camels – for 30 consecutive days. These people smoked on the average of one to two packs a day. Each week, during the entire test period, throat specialists examined those Camel smokers. A total of 2470 careful examinations were made. The doctors who made the throat examinations of these Camel smokers reported:
“NOT ONE SINGLE CASE OF THROAT IRRITATION due to smoking CAMELS!”
According to a Nationwide survey:
MORE DOCTORS SMOKE CAMELS than any other cigarette
Doctors smoke for pleasure, too! And when three leading independent research organizations asked 113,597 doctors what cigarettes they smoked, the brand named most was Camel!’
Money-Back Guarantee!
Rothmans SPECIAL
Extra Special. Extra Mild.
‘Enjoy the great taste of Rothmans in a special mild cigarette.’
Warning: Health and Welfare Canada advises the danger to health increases with amount smoked – avoid inhaling.
RALEIGH EXTRA MILDS
Mild. But not Meek.
‘Because Raleigh always starts with more full flavor than the ordinary cigarette, more flavor comes across in Raleigh Extra Milds. Mild, yes, because they’re lowered tar. But not meek, because they’re Raleigh.’
Warning: The Surgeon General Has Determined That Cigarette Smoking is Dangerous To Your Health.
GIVE YOUR THROAT A VACATION
‘Smoke a FRESH cigarette.’
CAMELS ~ Mild... No Cigaretty After-Taste
NEW! CAMEL MILD INTERNATIONAL
R.J. Reynolds Tobacco Company, Winston-Salem, N.C.
IT’S CHESTERFIELD
‘Up at dawn or to bed at dawn... fresh or fagged, more smokers every day are finding this out... for Real Smoking Pleasure it’s Chesterfield’s Milder, Better Taste every time.’
MILDNESS and BETTER TASTE
DANGER... Aunt Nellie’s UPSTAIRS!
‘The Zeros started to dive. “I was a pigeon,” Sharkey said later. Visibility unlimited... no cloud-cover to hide in. He could not try to shoot it out with the Nips, because the transport carries no guns for fighting back. It’s dive – or else! And transports aren’t meant for diving...’
COLORS OF THE DAY
Thanks to the Chemical Warfare Service, G.I. Joe now talks in a new battle language – in color.
‘Using colored smoke grenades in code combination, Charlie signals exact target location to air support above.
“No job for a color-blind guy. Hey! There comes one of our A-20’s down for a look!”
“Nice goin’ Charlie. You called those signals right on the nose!”’
The Service First ~ CAMELS ~ First in the Service
NOW... Scientific Evidence on Effects of Smoking!
“Believe me, folks, you’ll want to read this important new evidence on the effects of smoking. Then you’ll say, as I do... MUCH MILDER! CHESTERFIELD IS BEST FOR ME!”
‘A MEDICAL SPECIALIST is making regular bi-monthly examinations of a group of people from various walks of life. 45 percent of this group have smoked Chesterfield for an average of over ten years.
After ten months, the medical specialist reports that he observed... no adverse effects on the nose, throat and sinuses of the group from smoking Chesterfield.’
MUCH MILDER ~ CHESTERFIELD IS BEST FOR YOU
RAMESES Modern Mildness ~ New Light on Smoking Pleasure
‘Steady smokers who turn to Rameses find a milder, smoother, more downright refreshing tobacco flavor, day in and day out. Rameses Modern Mildness is today’s most pleasing cigarette quality.’
BLENDED BY STEPHANO BROTHERS ~ RAMESES 1895-1945
THE ARISTOCRAT OF CIGARETTES FOR HALF A CENTURY
MILLIONS MUST AGREE – BECAUSE CAMEL LEADS ALL OTHER BRANDS!
‘Smokers all over the country have made the sniff test, the puff test – and the thorough 30-day Camel test to find out the score on cigarette mildness.
Now, after all the mildness tests, the smoke has cleared and Camel has its biggest lead in popularity in 25 years! The latest published figures show that Camel leads all other brands by billions of cigarettes!
Joan Crawford made her own 30-day Camel test – and compared for mildness and flavor. So have many other smokers. Start your own sensible 30-day Camel test today. Enjoy Camel’s rich, full flavor – a flavor no other cigarette has. And see just how mild a cigarette can be – pack after pack, week after week!’
‘TV STAR PHIL SILVERS KNOWS: PLEASURE HELPS YOUR DISPOSITION – IT’S A PSYCHOLOGICAL FACT!’
No other cigarette tastes so rich, yet smokes so mild
Let your own TASTE and THROAT be the judge!
There’s never a rough puff in a Lucky...
“I always count on Luckies for a perfect performance!”
‘Correct, Mr. Evans... you can always count on Luckies to give you the real smoothness, mildness and deep-down smoking enjoyment you want. And, smokers, you can depend on Luckies because Lucky Strike means fine tobacco – fine, light, naturally mild tobacco that’s always smooth.
Yes, let your own taste and throat be the judge. Find out for yourselves – get a carton of Luckies today!’
Lucky Strike... so round, so firm, so fully packed – so free and easy on the draw
The TAREYTON Twosome
‘For better smoking, ask for Herbert Tareyton. You’ll enjoy the mild, rich-tasting blend of famous quality tobaccos and you’ll like the genuine cork tip that always stays firm and fresh... that adds so much to your smoking pleasure.
All the pleasure comes thru... the taste is great! Filter Tip Tareyton smokes milder, smokes smoother, draws easier. And Tareyton’s filter is pearl-gray because it contains Activated Charcoal for real filtration. It’s the best in filtered smoking!’
Only FILTER TIP TAREYTON gives you Activated Charcoal filtration
PRODUCTS OF THE AMERICAN TOBACCO COMPANY, AMERICA’S LEADING MANUFACTURER OF CIGARETTES
‘Estimated cumulative excess deaths during COVID-19, World.’
From 1 Jan 2020 to 10 June 2024:
❂ Lower bound, excess deaths: 19.24 million people.
❂ Central estimate, excess deaths: 27.27 million people.
❂ Upper bound, excess deaths: 36.29 million people.
Since 17 June 2024: Zero (0) excess deaths.
❂ Confirmed COVID-19 deaths: 7.05 million people.
Data source: The Economist (2024); World Health Organization (2025).
Accessed: 25 September 2025.
© 2025 OurWorldInData.org ➤ / Annotations by C19.Life.
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More... Smoke, mirrors and mild propaganda
“We’re going to need a bigger Greek alphabet.”
❦ “The reason why most people aren’t taking Covid-19 seriously is because they simply can’t imagine that their public health body would abandon protections and let an incredibly disabling and airborne virus spread wildly. They will be very angry when it becomes clear to them that that’s exactly what has happened.” ❂ © 2023 Dr. David Keegan ➲
❦ “If you’re puzzled as to why governments and public health departments almost never mention even the possibility of SARS-CoV-2-induced immune dysregulation, it’s because to do so would be to admit the greatest mistake made in the history of modern health policy.” ❂ © 2023 Conor Browne ➲
❦ ‘The emergence of [new SARS-CoV-2 Variant of Interest] BA.2.86 meant a decision was made to bring forward the autumn Covid booster to better protect the most vulnerable this winter. But the new jabs are only available to people over 65 years old – it was the over-50s last year – and those with certain health conditions. That is a tactical decision , says Dr. Adam Finn, Professor of Paediatrics at the University of Bristol. He explained: “When younger people who’ve already had infections and vaccines get Covid [again], they get a cold and a cough and might be off work for a few days. There’s no real value in investing a lot of time and effort immunising them again when there are so many other things for the Health Service to be doing.” [ ❦ Note : Can a 62-year-old be defined as a ‘ younger person ’? Yes, at a pinch, if Mr. Finn compares them to a 78-year-old. What age-group do these ‘ younger people ’ belong to who don’t need vaccinating, and who instead need to be continually reinfected with a highly pathogenic Biohazard-Level 3 virus? Could it be a 32-year-old man or woman hoping to have a baby ? Or the 0 to 19-year-olds , who are the academic professor’s strong suit? ] ‘The reality is then that most under-65s will now end up boosting their immunity not through vaccination , but through catching Covid many times . In general, Prof Finn says each new infection should feel milder with the length of time you are sick reduced [sic] . “Each time you catch it, your immunity gets stronger and broader ,” he adds. ’ ❂ [ Note : This is simply not true, and is staggeringly dangerous. ] ❂ 📖 (24 Sep 2023 ~ Jim Reed, Health Reporter / BBC online) What you need to know about Covid as new variant [BA.2.86] rises ➤ © 2023 BBC .
❦ Ten people who were wrong 1. The people who said it was the 'exit wave' in April 2020, October 2020, February 2021, July 2021, October 2021, January 2022, May 2022, September 2022, December 2022, January 2023, and March 2023 are also wrong when they say it's the exit wave in July 2023. 2. The people who said that kids don't catch it, they were wrong. 3. The people who said that everyone had already caught Covid in Spring 2020 and that we were all immune to it by June 2020, they were wrong. 4. The people who said Omicron was mild, they were wrong. 5. The people who said that Covid infection didn't harm kids, they were and are wrong. 6. The people who say that people are prone to illness now because of lockdowns three years ago, they're wrong. 7. The people who say that working from home is worse for your health than working in an office, they're wrong. 8. The people who said that the best way to stop the spread of Covid is to wash your hands, they were wrong. 9. The people who said that you can't get reinfected, they were wrong. 10. The people who said that there wouldn't be any reinfections, and then when there were reinfections said that the repercussions of them would be milder, they were wrong. 11. The people who said that Covid is over, they were wrong. 12. The people who said Covid was just a flu, they were wrong. 13. The people who said that everyone had to get it, they were wrong. 14. The people who said that variants would be rare, they're wrong. 15. The people who said that Covid was seasonal, they were wrong. 16. The people who said that long-term repercussions of Covid infections would be rare, they were wrong. 17. The people who said that vaccines would end the spread of Covid, they were wrong. 18. The people who said that it wasn't airborne, they were wrong. 19. The people who said that Covid infections don't damage your immune system, they were wrong. 20. The people who said that Omicron was nature's booster, they were wrong. The people who said that 5G was causing the pandemic, they were wrong. The people who said that the way to end the pandemic was to stop testing, they were wrong. The people who said that masks don't work were technically right if you're talking about masks that don't work, but if you're talking about respirators that do work when worn properly, they're wrong. The people who said that restaurants and cafés were safe, they were wrong. The people who say that Covid isn't causing heart disease, they're wrong. The people who said that it would only affect China and the Far East, they were wrong. The people who said that Western hospitals and healthcare would be able to cope with Covid, they were wrong. The people who said that we should just let it rip, they were wrong. The person who told us to eat out to help out, he was wrong. The people who said that Covid infections weren't causing the increased RSV waves, they were wrong. The people who said that Covid infection was safe for healthy people, they were wrong. The people who said that Long Covid was a psychological problem, they were wrong. The people who said that Long Covid was caused by deconditioning, they were wrong. The people who said that repeat Covid infections for kids would be harmless, they were wrong. The people who said that standing two metres apart meant that you were safe, they were wrong. The people who said that schools were not super-spreaders, they were wrong. The people who said that Covid was solely a respiratory infection, they were wrong. The people who said that we just have to get it over with, they were wrong. The people who said that Covid would attenuate, they were wrong. The people who said that we had to infect healthy children with Covid, they were wrong. The people who said that Covid infections were finite and did not persist inside you, they were wrong. The people who said that Covid was a hoax, they were wrong. The people who said that Covid did not cross the blood-brain barrier, they were wrong. The people who said that letting Covid spread would be good for the economy, they were wrong. The people who said that only people with pre-existing medical conditions would be at risk were technically right, except we all have pre-existing conditions, so they were wrong. The people who said that the vaccine was a greater risk for kids than the virus, they were wrong. The people who said that you should vax and relax, they were wrong. The people who said that frequent testing made people vulnerable to Strep A, they were wrong. The people who said that Long Covid doesn't exist, they were wrong. The people who said that Covid infection was unavoidable, they were wrong. The people who said that we're all in this together, they were wrong. The people who said that most of the effects of Covid were felt in the aging West and not in middle-income and developing countries, they were wrong. The people who said that Covid would not mutate to evade immunity, they were wrong. The people who said that we didn't need to lock down, they were wrong. The people who said that the best thing to do was to make Covid endemic, they were wrong. The people who said that HEPA air filtration doesn't help, they were wrong. The people who said that ventilation doesn't help, they were wrong. The people who said that it's safe to end isolation at five days, they were wrong. The people who said that it's safe to end isolation at three days if you're under 18, they were wrong. The people who said that there was no such thing as a Paxlovid rebound, they were wrong. The people who said that Molnupiravir wasn't triggering mutations, they were wrong. The people who said that Covid is no longer causing serious illness, they were wrong. The people who said that we need to learn to live with Covid were technically right, but they meant just catching it repeatedly forever, so they were wrong. The people who said that pathogenic infections are good for children, they were wrong. The people who said that the severity of on-going repercussions of a Covid infection depends on the severity of the initial infection, they were wrong. The people who said that Covid infections don't leave you vulnerable to other opportunistic infections, they were wrong. The people who said that Covid infections couldn't be chronic, they were wrong. The people who said that Covid couldn't damage your brain, they were wrong. The people who said that testing was pointless, they were wrong. The people who said that we overreacted in 2020, they were wrong. The people who said that there was no asymptomatic infection, they were wrong. The people who said that adults couldn't catch Covid from children, because adults are taller than children and stand above their coughs and sneezes, they were wrong. The people who said that Covid infections couldn't accelerate dementia progression, they were wrong. The people who said that Covid infections couldn't dysregulate the immune system, they were wrong. The people who said that Covid infections couldn't cause or trigger autoimmune disorders, they were wrong. The people who said that Covid infections couldn't cause permanent disruption to metabolic processes, they were wrong. The people who said that Covid infections were beneficial, they were wrong. The people who said that unvaccinated people generally have better outcomes from infections than vaccinated people, they were wrong. The people who said that Covid doesn't cause strokes, they were wrong. The people who said that Covid doesn't cause heart attacks, they were wrong. The people who said that Covid doesn't cause high blood pressure, they were wrong. The people who said that Covid mitigations were just delaying the inevitable, they were wrong. The people who said that Covid infections were only dangerous because the virus was novel, they were wrong. The people who said that it should be personal responsibility as to whether you use mitigations, they were wrong. The people who said that Covid wouldn't mutate past anti-viral treatments, they were wrong. The people who said that Covid would just go away, they were wrong. The people who said that you can only catch Covid from strangers, they were wrong. The people who said that herd immunity would end the pandemic, they were wrong. The people who said that hybrid immunity would end the pandemic, they were wrong. The people who said that super immunity would end the pandemic, they were wrong. The people who said that we had achieved herd immunity, they were wrong. The people who said that all the damage of Covid infections is evident at the time of the initial infection, they were wrong. The people who said that Covid infection doesn't affect developing foetuses, they were wrong. The people who said that Covid infections don't cause neurological issues, they were wrong. The people who said that Covid won't affect infants developmentally, they were wrong. The people who said that Covid infection doesn't affect cognitive function, they were wrong. The people who said that it takes fifteen minutes to get infected with Covid, they were wrong. The people who said that Covid particles couldn't hang in the air for hours and cause infections hours later, they were wrong. The people who said that singing, shouting, aerobic activity, breathing, coughing and sneezing are not aerosolising activities, they were wrong. The people who said that vaccine efficiency would not wane, they were wrong. The people who said that you can tell if you're infectious, they were wrong. The people who said that Covid infections do not increase your risk of death from other causes, they were wrong. The people who said that waves of Covid infection no longer put a strain on healthcare systems, they were wrong. The people who said that the cure for Long Covid was graded exercise, they were wrong. The people who said that a Covid infection guaranteed that you were safe from Covid for months, they were wrong. The people who said that people were just being hospitalised with Covid, they were wrong. The people who pretended that Covid didn't exist, they were wrong. The people who said that the cure for Covid was Ivermectin/Hydroxychloroquine/prayer, they were wrong. The people who said that Covid infections didn't cause blood-clots weeks and months after the initial infection was over, they were wrong. The people who said that it was impossible for Covid infections to cause or accelerate cancer, or that Covid infection couldn't damage the body's ability to fight cancer, they were wrong. The people who said that Covid infections couldn't reactivate latent viruses, they were wrong. The people who said that countries with x or y climates wouldn't experience waves of Covid infection, they were wrong. The people who said that Covid can't trigger, cause, or worsen epilepsy, they were wrong. The people who said that Covid infections couldn't cause appendicitis, they were wrong. The people who said that your pets couldn't catch or be harmed by Covid, they were wrong. The people who said that you had to catch Covid to strengthen your immune system, they were wrong. The people who said that Covid infections couldn't cause POTS, dysautonomia and tachycardia, they were wrong. The people who said that you couldn't be infected by two different variants at the same time, they were wrong. The people who said that your sense of smell always comes back if you lose it during a Covid infection, they were wrong. The people who said that Covid infections couldn't affect male or female fertility, they were wrong. The people who said that Covid infections couldn't cause erectile dysfunction, they were wrong. The people who said that Covid infections aren't causing massive excess deaths, they were wrong. The people who said that Covid infections wouldn't lower life expectancy, they were wrong. The people who said that there is no such thing as superspreader events, they were wrong. The people who said that you just need to have faith to not catch Covid, they were wrong. The people who said that talking about the pandemic makes the pandemic continue, they were wrong – except in the case where someone with Covid is talking to someone else without Covid about the pandemic, thereby giving them Covid. The people who said that Covid was evolving into a dead-end branch that would end the pandemic, so far they're wrong. The people who said that immunity by infection is better than immunity by vaccination, they were wrong. The people who said that Covid infections would not have a significant effect on the economy because only a small proportion of people become sick straight away, they were wrong. The people who said that Covid infections couldn't cause permanent damage to the immune system, they were wrong. The people who said that Covid infections couldn't present like a stomach bug, they were wrong. The people who said that Long Covid is caused by lockdowns or masks or anxiety or anything other than Covid infection, they were wrong. The people who said that Covid infections couldn't dysregulate your gut microbiome, they were wrong. The people who blamed other viruses for the damage done by Covid infections, they were wrong. The people who said that Long Covid doesn't cause fatigue, they were wrong. The people who said that Covid infections couldn't damage the autonomic nervous system, they were wrong. The people who said that Covid infections couldn't cause endothelial dysfunction, they were wrong. The person who told me that Covid particles couldn't travel across a room because they had to obey the laws of physics, they were wrong. The people who said that we should take it on the chin, they were wrong. The people who said that the mental health consequences of lockdown were worse than the consequences of Covid, they were wrong. The people who said that Covid variants couldn't spontaneously combine to form recombinant variants, they were wrong. The people who said that mask-wearing only protects the people around you, they were wrong. © 2023 Tern, a Priest in England . ➲
❦ “I am realizing more and more how unusual, unscientific, unmedical, and counterproductive it is for the World Health Organization (WHO) to select the name COVID-19 and reject SARS2 . In fact it would be most consistent with medical practice to just call it SARS . Here’s why. In 1981, cases of immunodeficiency emerged in San Francisco; in 1982 , the Centers for Disease Control and Prevention ( CDC ) named this disease acquired immunodeficiency syndrome ( AIDS ). No agent was known at the time... Compare : in 2002 , cases of atypical non-bacterial pneumonia appeared in Guandong; in 2003 the CDC named this severe acute respiratory syndrome ( SARS ). No agent was known at the time... In 1983 , the virus that causes AIDS was discovered by Françoise Barré-Sinoussi and Luc Montaignier. It was eventually named HIV in 1986 by the International Committee on the Taxonomy of Viruses ( ICTV ). Compare : in 2003 , the virus that causes SARS was isolated in Hong Kong, sequenced by the CDC and a Canadian consortium. It was named SARSCoV in 2004 by the ICTV. ➲ Taxon Details for Severe acute respiratory syndrome-related coronavirus ➤ In 1986 , a milder acquired immunodeficiency syndrome was discovered in West Africa, and the virus was quickly isolated by the Montaignier group. It had 50% sequence identity to HIV . The virus was named HIV-2 . The disease name ? Unchanged: AIDS . Compare : In 2019 , a severe acute respiratory distress syndrome was discovered in Wuhan and the virus was quickly isolated by Wuhan scientists. It had 79% sequence identity to SARSCoV . The virus was named SARSCoV-2 by the ICTV. The disease name ? Well, that’s when the WHO stepped in. To review: HIV-1 and HIV-2 are 50% identical , and both cause immunodeficiency . They result in different disease severities (you’re less likely to die from HIV-2) – but the diseases they cause are (or the disease they cause is) considered the same : AIDS . SARSCoV-1 and SARSCoV-2 are 79% identical , and both cause severe acute respiratory distress . They result in different disease severities (you’re less likely to die from SARSCoV-2), so by analogy to HIV-1/2→AIDS , the diseases they cause should be considered the same : SARS . However, the WHO stepped in (why does the CDC have to defer to them anyway?) and decided that the one requirement for the name was that it not mention SARS . Thus the terrible name COVID-19 was chosen. It stands for coronavirus disease , and thus has no useful medical information . It is an open suspicion that this was done to deflect criticism for a slow response to what is basically a second SARS epidemic . Because we already knew how to stop [the airborne] SARSCoV – and knew that it was bad – there was no excuse for not quickly addressing what is basically a strain of SARSCoV . The purposeful hiding of the identity of the COVID-19 virus – that it is a strain of SARS virus – has had severe negative consequences to world health . By not realizing that we are dealing with SARS, many political leaders have failed to address the epidemic forcefully enough. Also, the term COVID-19 hinders clinical education and communication . Let’s compare to AIDS again. Calling the disease(s) caused by HIV-1 and HIV-2 as AIDS in both cases has clinical utility . The signs and symptoms are similar enough that it helps to consider HIV-1/2 together . Considering HIV-1/2 together also reminds us that treatments and preventive steps we learn from one can be used on the other . Likewise, COVID-19 should have been called SARS , SARS2 , or – as a compromise – variably severe acute respiratory syndrome , vSARS . Li Wenliang , who warned about the new outbreak in Wuhan, had it exactly right : “Seven confirmed cases of SARS were reported... The latest news is, it has been confirmed that they are coronavirus infections , but the exact virus strain is being subtyped.” Disease names have always been guided by a desire to inform . The WHO has taken the opposite approach , to misinform . Not surprisingly, confusion has resulted. With millions dying , we are now seeing the tragic consequences of WHO’s placement of politics over medicine and science . Since some people seem to have already forgotten their history (or maybe were living under a rock when the WHO naming decision happened), here’s the quote from the WHO itself...” ✾ ❦ From Science , 12 Feb 2020 : “COVID-19. I’ll spell it: C-O-V-I-D hyphen one nine. COVID-19.” ‘That’s how Tedros Adhanom Ghebreyesus, head of the World Health Organization (WHO), introduced the agency’s official name for the new disease that’s paralyzing China and threatening the rest of the world. The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, the paper noted, had decided that the virus is a variant of the coronavirus that caused an outbreak of severe acute respiratory syndrome (SARS) in 2002–03. So, it named the new pathogen severe acute respiratory syndrome-related coronavirus 2 , or SARS-CoV-2 . But that’s not a name WHO is happy with , and the agency isn’t planning on adopting it. “From a risk communications perspective , using the name SARS can have unintended consequences in terms of creating unnecessary fear for some populations, especially in Asia which was worst affected by the SARS outbreak in 2003,” a WHO spokesperson wrote in an email to Science . “ For that reason and others , in public communications WHO will refer to ‘the virus responsible for COVID-19’ or ‘the COVID-19 virus , ’ but neither of these designations is intended as replacements for the official name of the virus” that the study group has picked. Misunderstandings about the virus and disease names began almost immediately ...’ 📖 (12 Feb 2020 ~ Science) Update: ‘A bit chaotic.’ Christening of new coronavirus and its disease name create confusion ➤ ✾ ❦ From the WHO Director-General’s mouth on 11 Feb 2020 : — “First of all, we now have a name for the disease: COVID-19. I’ll spell it: C-O-V-I-D hyphen one nine – COVID-19. Under agreed guidelines between WHO, the World Organisation for Animal Health and the Food and Agriculture Organization of the United Nations, we had to find a name that did not refer to a geographical location, an animal, an individual or group of people, and which is also pronounceable and related to the disease .” [Ed: So ‘ SARS ’ would’ve worked, then.] “Having a name matters to prevent the use of other names that can be inaccurate or stigmatizing. It also gives us a standard format to use for any future coronavirus outbreaks ...” 📖 (11 Feb 2020 ~ World Health Organization) WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020 ➤ ❂ © 2020 by Dr. Michael Lin, MD PhD ➲
‘Although COVID-19 was originally considered a respiratory illness, it is now well established that SARS-CoV-2 infection can have far-reaching impacts on the nervous system. Common neurological symptoms in Long COVID [PASC] include new-onset cognitive difficulties, dysautonomia, fatigue, and peripheral neuropathy.’ from ‘Neuroimmune pathophysiology of long COVID’ by Moen et al / Psychiatry and Clinical Neurosciences (2025).
“We’re going to need a bigger Greek alphabet.”
The Health and Safety Executive (HSE) has designated SARS-CoV-2, the virus that causes COVID-19, a Hazard Group 3 (HG3) pathogen that can cause severe human disease. The United Kingdom’s Health Security Agency (UKHSA) classifies SARS-CoV-2 as a notifiable organism, and COVID-19 as a notifiable disease (2025).
‘FRSMs [Surgical Masks] have never been considered either adequate or suitable equipment for protection against inhalable or respirable risks under COSHH.’
‘... SARS-CoV-2 infection causes prolonged disruptions in mitochondrial function, significantly altering cellular energy metabolism.’
‘Importantly, NB.1.8.1 shows a balanced profile of ACE2 binding and immune evasion, supporting its potential for future prevalence.’
‘Since late 2024, a potential third major evolutionary shift in SARS-CoV-2 evolution might be unfolding. In November 2024 and January 2025, a highly mutated descendant of the Omicron subvariant BA.3 was detected in South Africa.’
“There’s nothing radical about clean air and compassion.” Thoughts and essays by Dr. Lisa Iannattone.
“We are drunk-driving in healthcare... with a pathogen that has a 10% fatality rate in that setting.” Thoughts and essays by Dr. Noor Bari.
‘Vaccine effectiveness against SARS-CoV-2 [COVID-19] infection declines markedly with time and Omicron variants.’ from ‘Effectiveness of COVID-19 vaccines against SARS-CoV-2 infection and severe outcomes in adults’ by Zhou et al / European Respiratory Review (2024).
‘The arrival of the Omicron variant marked a major shift, introducing numerous extra mutations in the spike gene compared with earlier variants. Before Omicron, natural infection provided strong and durable protection against reinfection, with minimal waning over time. However, during the Omicron era, protection was robust only for those recently infected, declining rapidly over time and diminishing within a year.’
‘These findings have important implications for understanding the potential impact of COVID-19 on long-term immune function and susceptibility to pathogens.’
‘Patients admitted to hospital for COVID-19 showed higher rates of all-cause admissions to hospital and infectious illness-related hospitalisations, including sepsis and positive urine and blood cultures, compared with patients admitted to hospital for influenza. While previous research has primarily shown elevated rates of infection in patients with long-COVID, or in those requiring admission to hospital, this analysis demonstrates substantial increases in infection rates even in those with mild initial disease. ’
CBC Radio-Canada interview with long COVID [PASC] researcher David Putrino from the Icahn School of Medicine at Mount Sinai in New York.
‘For patients already battling Alzheimer’s disease, studies indicate that Covid can exacerbate brain inflammation, damage immune cells, and accelerate the disease. Even previously healthy older adults face an increased risk of cognitive impairment and new-onset dementia after infection. Mild Covid cases in younger adults have also been linked to brain issues affecting memory and thinking. ’
‘But even people who had not been hospitalized had increased risks of many conditions, ranging from an 8% increase in the rate of heart attacks to a 247% increase in the rate of heart inflammation.’ Nature (2 Aug 2022) ‘Either symptomatic or asymptomatic SARS-CoV-2 infection is associated with increased risk of late cardiovascular outcomes and has causal effect on all-cause mortality in a late post-COVID-19 period.’ The American Journal of Cardiology (15 Sep 2023)
‘The proportions of PACS [PASC/Long Covid] patients experiencing chest pain, palpitation, and hypertension as sequelae were 22%, 18%, and 19% respectively.’
‘Before Omicron, natural infection provided strong and durable protection against reinfection, with minimal waning over time. However, during the Omicron era, protection was robust only for those recently infected, declining rapidly over time and diminishing within a year.’
‘Scientists discover that even mild COVID-19 can alter brain proteins linked to Alzheimer’s disease, potentially increasing dementia risk. COVID-19-positive individuals exhibited lower cognitive test performance compared to controls – equivalent to almost two years of age-related cognitive decline. ’
‘The predominant symptoms, often clustering together, remain fatigue, cognitive disturbance and chest symptoms, including breathlessness, with sleep disorder and anxiety as additional complaints. Many patients with persistent PCS [PASC/‘Long Covid’] show impaired executive functioning, reduced cognitive processing speed and reduced physical exercise capacity.’
❦ On that 700-day cough... It’s a new thing, but it’s only reserved for inside supermarkets and offices. And pharmacies and hospitals and care homes. Oh, and your living-room. But apart from that, it’s not exactly a deal-breaker. I mean, c’mon. They put up with way worse in the 1900s.
❦ “If you are letting yourself get infected and taking no precautions against passing it on, you are not a passive bystander for your next infection. You’ve participated in creating it.”
❦ ‘In this population of healthy young adult US Marines with mostly either asymptomatic or mild acute COVID-19, one fourth reported physical , cognitive , or psychiatric long-term sequelae of infection. The Marines affected with PASC [Post-Acute Sequelae of COVID-19 / Post-COVID-19 Complications / ‘Long Covid’] showed evidence of long-term decrease in functional performance suggesting that SARS-CoV-2 infection may negatively affect health for a significant proportion of young adults .’ ❂ ‘Among the 899 participants, 88.8% had a SARS-CoV-2 infection. Almost a quarter (24.7%) of these individuals had at least one COVID-19 symptom that lasted for at least 4 weeks meeting the a priori definition of PASC established for this study. Among those with PASC, 10 had no acute SARS-CoV-2 symptoms after PCR-confirmed infection suggesting that PASC can occur among asymptomatic individuals. Many participants reported that lingering symptoms impaired their productivity at work, caused them to miss work, and/or limited their ability to perform normal duty/activities. Marines with PASC had significantly decreased physical fitness test scores up to approximately one year post-infection with a three-mile run time that averaged in the 65th percentile of the reference cohort. [ PASC was associated with a significantly increased 3-mile run time on the standard Marine fitness test. PASC participants ran 25.1 seconds slower than a pre-pandemic reference cohort composed of 22,612 Marine recruits from 2016 to 2019. A three-mile run evaluates aerobic exercise , overhead lifting of an ammunition can and pull-ups evaluate strength , and shooting a rifle evaluates fine-motor skills .] Scores for events evaluating upper body (pull-ups, crunches, and ammo-can lift) were not significantly reduced by PASC; however, overall physical fitness scores were reduced. ‘The poorer run times and overall scores among PASC participants are indicative of on-going functional effects.’ Standardized health-based assessments for somatization, depression, and anxiety further highlighted the detrimental health effects of PASC. Almost 10% of participants with PASC had PHQ-8 scores ≥10. Increased somatization * has been associated with increased stress, depression, and problems with emotions. * [ Somatization / Somatisation = Medical symptoms caused by psychological stress.] Additionally, PASC participants had higher GAD-7 scores suggesting increased anxiety in a population with unique inherent occupational stressors associated with higher rates of anxiety, depression, and post-traumatic stress disorder. ‘Increased severity of anxiety among those with PASC, combined with greater rates of mental health disorders in general, could portend an ominous combination and should be closely followed.’ Like others, we identified cardiopulmonary symptoms as some of the most prevalent. The high prevalence of symptoms like shortness of breath, difficulty breathing, cough, and fatigue is particularly notable when combined with decreased objective measures of aerobic performance such as running. These results suggest pathology in the cardiopulmonary system. In contrast we observed no reduction in scores assessing strength and marksmanship suggesting the lack of detectable pathology in the neuro-musculoskeletal system. We have previously found in this same cohort that SARS-CoV-2 infection causes prolonged dysregulation of immune cell epigenetic patterns like auto-immune diseases. Based on the reported PASC symptoms, the potential current and future public health implications in this population could be substantial. ‘Chronic health complications from PASC, especially in a young and previously healthy population with a long life expectancy, could decrease work productivity and increase healthcare costs.’ Significant changes in the Years-of-Life lived with a disability can disproportionally increase disability-adjusted life-years, and should be considered when allocating resources and designing policy.’ ❂ 📖 (23 Oct 2024 ~ The Lancet: Regional Health/America) Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel study ➤ © 2024 The Lancet .
❦ If parents, and politicians and teachers, and healthcare workers and public health bodies wanted things to change, all they need do is read . It’s all there. But they don’t. They won’t. And they insist on their medical and scientific flat-earthing – hand-sanitiser for aerosol-transmitted disease – because they prefer the world to be flat. So let them walk off the edge of the world. [ Caveat: The earth is not flat, and doing nothing will not flatten the curve – but walk far enough, and you are likely to fall off a cliff.] © 2024 C19.Life
‘Fatigue, difficulty concentrating, insomnia, and anxiety or depression were the most common PCS symptoms. Baseline risk factors for reporting PCS included screening for common mental disorders, direct contact with COVID-19 patients, pre-existing respiratory illnesses, female sex and older age.’
❦ NHS nurse: — “Shit, I just got a needlestick injury.” ❦ 2024: — “Yeah, well, whatever. We all gotta die of something.”
‘In those school-rooms where ventilation is imperfect and the air impure, six sevenths of the money expended to educate a child is wasted.’ ❂ The Ventilation and Warming of School Buildings (1887) By Gilbert B. Morrison Published by D. Appleton and Company, New York. 1887. Accessed 10 Apr 2024 Preface (p.xxii) ❦ ‘I am fully convinced that people are prematurely dying by thousands simply from a lack of correct and positive convictions concerning impure air; for, when the true nature of a danger is fully appreciated, the requisite means to avert it will generally be found.’ ❂ Chapter II: The Effects Of Breathing Impure Air (pp.20-23) ❦ ‘Impure air is also believed by the best authorities to be one of the principal causes of epidemics. Dr. Carpenter, than whom there is no abler authority, says: “It is impossible for anyone who carefully examines the evidence to hesitate for a moment in the conclusion that the fatality of epidemics is almost invariably in precise proportion to the degree in which an impure atmosphere has been habitually respired.” The Board of Health of New York conclude that forty per cent of all deaths are caused by breathing impure air. In view of such alarming facts, this same board declares: “Viewing the causes of preventable diseases, and their fatal results, we unhesitatingly state that the first sanitary want in New York and Brooklyn is ventilation .” Direct experiment proves that the air in our school-rooms is impure in almost all cases, and in a majority of them to a degree far beyond the danger line. In view of these facts, and the results as proved by the authorities above cited, why is it regarded by the public with such indifference? When a school-house is blown down by a hurricane, killing and maiming a score of children, it is justly regarded as a great calamity; a vacation is given to quiet the excited fears of parents and children; investigating committees are appointed to locate the responsibility, and the faces of the whole populace are blanched with apprehension. Why is this? Why does the intelligent parent send his child to a school-room poorly ventilated and crowded with children, some of whom are breathing into a stagnant air the germs of disease and death, while others, from unwashed bodies, are delivering into it their deadly emanations, and all without a protest on the part of those even who provide proper hygienic conditions at home? It is because the effects of the one are immediate, occupy little time, the number killed can be actually counted, and the exact magnitude of the calamity estimated all at once. In the other case the process is slower, but of far greater extent; the actual results are by the general public less definitely known, and custom and attention to other matters divert the attention, and the deadly destruction of the innocents by impure air goes on silently, constantly, and powerfully. While noisy demonstrations like that of the cyclone attract attention, and inspire fear and terror, it is in the silent forces that the danger lies. Nature’s most destructive forces, as well as her strongest constructive ones, are silent in their operations; but when Science detects a silent, insidious enemy to human welfare, it is not only our duty to assume an attitude of self-defense and self-protection, but it should be regarded as folly not to do so.’ ❦ On high CO₂ levels connected to poor performance in schools: ‘The effects of breathing impure air thus far considered are pathological, but it has its pedagogical and economical aspects. Every observing teacher knows the immediate relation between the vitiated air in the school-room and the work he wishes the pupils to perform. Much of the disappointment of poor lessons and the tendency to disorder are due directly to this cause. The brain unsupplied with a proper amount of pure blood [oxygen] refuses to act, and the will is powerless to arouse the flagging energies; the general feeling of discomfort, dissatisfaction, and unrest which always accompanies a bad state of the blood. From an economical standpoint it would, of course, be impossible to estimate the financial waste of breathing impure air, but it can not but be enormous. In any discussion of the feasibility of incurring the additional expense of the most perfect ventilation, this loss occasioned by the want of such ventilation must not be ignored.’ ❂ Chapter III: The Air (pp.25-26) ❦ On ventilation, air filtration, and the super-spreading of diverse diseases in classrooms: ‘Wherever an unusual amount of unwholesome matter is being evolved, there especially should the purifying conditions be present; air in such places, to remain pure, must be changed in rapid succession, in order that dilution, diffusion, and oxidation may fulfill their legitimate functions. In a school-room the contaminating process can not but be rapid, and wherever ample provision is not made for rapidly changing the air of the room a dangerous condition of affairs is sure to exist. Bacteria of many forms, and spores of fungi, are also found in the air, and all these organisms are known to thrive in the organic impurities found in the air.’ ❂ Chapter IV: Examination Of The Air (p.33) ❦ On measuring CO₂ levels as a proxy to establishing content of (infectious) re-breathed air: ‘A complete analysis of impure air comprehends the quantitative and qualitative tests for carbonic [sic] dioxide, free ammonia, and other nitrogenous matter, oxidizable matters, nitrous and nitric acids, and hydrogen sulphide; but for ordinary practical purposes the determination of the CO₂ is by far the most important, and is ordinarily the only one which need be made. While the poisonous qualities of the air are not wholly due to the presence of the CO₂ per se, the amount of this gas found to be present is, in air made impure by respiration, generally a good measure for other impurities to which the poisonous quality is principally due. Owing to this fact, a careful test for the amount of CO₂ contained in a given atmosphere is generally the only one which need be made where air is tested merely to determine its respiratory purity.’ ❂ 📖 (Accessed 10 Apr 2024 ~ D. Appleton & Company / Google Books) The Ventilation and Warming of School Buildings ➤ ❂ My thanks to Maarten De Cock for alerting me to this gem of a book. ➲
❦ A comprehensive collection of review articles from 1987 to 2022 regarding airborne transmission of pathogens , curated by Jonathan Mesiano-Crookston. ❂ Accessed : 4 March 2024 . 📖 (November 2022 ~ Geoscience Frontiers) Aerosol Transmission of Human Pathogens: From Miasmata to Modern Viral Pandemics and Their Preservation Potential in the Anthropocene Record ➤ 📖 (21 Aug 2022 ~ Indoor Air) What were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic? ➤ 📖 (31 Jan 2022 ~ Indoor Air: Editorial) Hypothesis: All respiratory viruses (including SARS-CoV-2) are aerosol-transmitted ➤ 📖 (November 2021 ~ Interface Focus) How Did We Get Here: What Are Droplets and Aerosols and How Far Do They Go? A Historical Perspective on the Transmission of Respiratory Infectious Diseases➤ 📖 (27 Aug 2021 ~ Science ) Airborne Transmission of Respiratory Viruses ➤ 📖 (August 2021 ~ Nature Reviews: Microbiology) Transmissibility and Transmission of Respiratory Viruses ➤ 📖 (July 2021 ~ Annual Review of Biomedical Engineering) Fluid Dynamics of Respiratory Infectious Diseases ➤ 📖 (14 May 2021 ~ Science) A Paradigm Shift to Combat Indoor Respiratory Infection ➤ 📖 (1 May 2021 ~ The Lancet) Ten Scientific Reasons in Support of Airborne Transmission of SARS-CoV-2 ➤ 📖 (18 Jan 2021 ~ Clinical Infectious Diseases) Airborne Transmission of SARS-CoV-2: What We Know ➤ 📖 (12 Jan 2021 ~ The Journal of Hospital Infection) Dismantling Myths on the Airborne Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) ➤ 📖 (1 Jan 2021 ~ Canadian Medical Association Journal) Mitigating Airborne Transmission of SARS-CoV-2 ➤ 📖 (November 2020 ~ Environment International) Aerosol Transmission of SARS-CoV-2? Evidence, Prevention and Control➤ 📖 (16 Oct 2020 ~ Science) Airborne Transmission of SARS-CoV-2 ➤ 📖 (1 Sep 2020 ~ Environment International) How Can Airborne Transmission of COVID-19 Indoors Be Minimised? ➤ 📖 (August 2020 ~ Anaesthesia) Airborne Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 to Healthcare Workers: A Narrative Review ➤ 📖 (6 July 2020 ~ Clinical Infectious Diseases) It Is Time to Address Airborne Transmission of Coronavirus Disease 2019 (COVID-19) ➤ 📖 (June 2020 ~ Environment International) Airborne Transmission of SARS-CoV-2: The World Should Face the Reality➤ 📖 (May 2020 ~ Risk Analysis) Consideration of the Aerosol Transmission for COVID‐19 and Public Health➤ 📖 (16 April 2020 ~ The Journal of Infectious Diseases) Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019? ➤ 📖 (26 March 2020 ~ JAMA) Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19 ➤ 📖 (28 Aug 2019 ~ Encyclopedia of Microbiology) Airborne Infectious Microorganisms ➤ 📖 (31 Jan 2019 ~ BMC Infectious Diseases) Recognition of Aerosol Transmission of Infectious Agents: A Commentary➤ 📖 (September 2016 ~ American Journal of Infection Control) Generic Aspects of the Airborne Spread of Human Pathogens Indoors and Emerging Air Decontamination Technologies ➤ 📖 (15 Nov 2011 ~ Advances in Preventive Medicine) Preventing Airborne Disease Transmission: Review of Methods for Ventilation Design in Health Care Facilities ➤ 📖 (October 2006 ~ The Journal of Hospital Infection) Factors Involved in the Aerosol Transmission of Infection and Control of Ventilation in Healthcare Premises ➤ 📖 (January 1987 ~ Critical Reviews in Environmental Control) Spread of Viral Infections by Aerosols➤ ✾ © 2024 Jonathan Mesiano-Crookston ➤
❦ SARS-CoV-2 – the virus that causes COVID-19 – is airborne . In May 2021, the WHO officially recognised that SARS-CoV-2 is airborne via microscopic aerosols – meaning that the virus is transmissible through the air at both long and short range . ✾
‘ Reinfection , which is now the dominant type of SARS-CoV-2 infection , is not inconsequential ; it can trigger de novo Long Covid or exacerbate its severity . Each reinfection contributes additional risk of Long Covid: cumulatively , two infections yield a higher risk of Long Covid than one infection , and three infections yield a higher risk than two infections .’
❦ “This study confirms everything that I have seen in the microscope over the last few years. The authors of the study use a technique called dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI ), an imaging technique that can measure the density , integrity , and leakiness of tissue vasculature. Comparing all individuals with previous COVID infection to unaffected controls revealed decreased general brain volume in patients with ‘brain fog’ – along with significantly reduced cerebral white matter volume in both hemispheres in the recovered and ‘brain fog’ cohorts . Covid-19 induces brain-volume loss and leaky blood-brain barrier in some patients. How can this be more clear?” © 2024 Dr. Danielle Beckman, Neuroscientist (PhD Biological Chemistry) ➲ ❂ 📖 (22 Feb 2024 ~ Nature: Neuroscience) Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment ➤ ‘ Our data suggest that sustained systemic inflammation and persistent localized blood-brain barrier (BBB) dysfunction is a key feature of long COVID-associated brain fog. Patients with long COVID had elevated levels of IL-8, GFAP and TGFβ, with TGFβ specifically increased in the cohort with brain fog. GFAP is a robust marker of cerebrovascular damage and is elevated after repetitive head trauma, reflecting BBB disruption, as seen in contact sport athletes and in individuals with self-reported neurological symptoms in long COVID. Interestingly, TGFβ was strongly associated with BBB disruption and structural brain changes. ’ [Layperson overview] 📖 (February 2024 ~ Genetic Engineering and Biotechnology News) Leaky Blood Vessels in the Brain Linked to Brain Fog in Long COVID Patients ➤ [Related] 📖 (7 Feb 2022 ~ Nature: Cardiovascular Research) Blood–brain barrier link to human cognitive impairment and Alzheimer’s disease ➤ ❂
‘The very first canon of nursing... the first essential to the patient... is this: to keep the air he breathes as pure as the external air, without chilling him .’ ❂ Notes on Nursing (1860 edition) By Florence Nightingale First Published 1859. Revised edition reprinted in 1860 by Harrison of Pall Mall Accessed 19 Feb 2024 ❦ Chapter I – Ventilation and Warming ‘The very first canon of nursing, the first and the last thing upon which a nurse’s attention must be fixed, the first essential to the patient, without which all the rest you can do for him is as nothing, with which I had almost said you may leave all the rest alone, is this: TO KEEP THE AIR HE BREATHES AS PURE AS THE EXTERNAL AIR, WITHOUT CHILLING HIM. Yet what is so little attended to? Even where it is thought of at all, the most extraordinary misconceptions reign about it. Even in admitting air into the patient’s room or ward, few people ever think where that air comes from. It may come from a corridor into which other wards are ventilated, from a hall, always unaired, always full of the fumes of gas, dinner, of various kinds of mustiness; from an underground kitchen, sink, wash-house, water-closet, or even, as I myself have had sorrowful experience, from open sewers loaded with filth; and with this the patient’s room or ward is aired, as it is called – poisoned, it should rather be said. Always air from the air without, and that, too, through those windows, through which the air comes freshest. From a closed court, especially if the wind do not blow that way, air may come as stagnant as any from a hall or corridor. I know an intelligent humane house surgeon who makes a practice of keeping the ward windows open. The physicians and surgeons invariably close them while going their rounds; and the house surgeon, very properly, as invariably opens them whenever the doctors have turned their backs. I have known a medical officer keep his ward windows hermetically closed, thus exposing the sick to all the dangers of an infected atmosphere, because he was afraid that, by admitting fresh air, the temperature of the ward would be too much lowered. This is a destructive fallacy. To attempt to keep a ward warm at the expense of making the sick repeatedly breathe their own hot, humid, putrescing atmosphere is a certain way to delay recovery or to destroy life.’ ❂ ‘I have known cases of hospital pyæmia quite as severe in handsome private houses as in any of the worst hospitals, and from the same cause, viz., foul air. Yet nobody learnt the lesson. Nobody learnt anything at all from it.’ ❂ ✪ C-19: On schools ‘Of all places, public or private schools, where a number of children or young persons sleep in the same dormitory * , require this test of freshness to be constantly applied.’ * [ C-19 Note: You might substitute ‘sleep’ and ‘dormitory’ with ‘study’ and ‘classroom’ in this section.] ‘If it be hazardous for two children to sleep together in an unventilated bedroom, it is more than doubly so to have four, and much more than trebly so to have six under the same circumstances. People rarely remember this; yet, if parents were as solicitous about the air of school bedrooms as they are about the food the children are to eat, and the kind of education they are to receive, at school, depend upon it due attention would be bestowed on this vitally important matter, and they would cease to have their children sent home either ill, or because scarlet fever or some other “current contagion” had broken out in the school. There are schools where attention is paid to these things, and where “children’s epidemics” are unknown.’ ❂ ✪ C-19: Offices, shops, factories, and other workplaces ‘How much sickness, death, and misery are produced by the present state of many factories, warehouses, workshops, and workrooms!’ ‘How much sickness, death, and misery are produced by the present state of many factories, warehouses, workshops, and workrooms! The places where poor dressmakers, tailors, letter-press printers, and other similar trades have to work for their living, are generally in a worse sanitary condition than any other portion of our worst towns. Many of these places of work were never constructed for such an object. They are badly adapted garrets, sitting-rooms, or bedrooms, generally of an inferior class of house. No attention is paid to cubic space or ventilation. The poor workers are crowded on the floor to a greater extent than occurs with any other kind of over-crowding. The constant breathing of foul air, saturated with moisture, and the action of such air upon the skin renders the inmates peculiarly susceptible of the impression of cold, which is an index indeed of the danger of pulmonary disease to which they are exposed. The result is, that they make bad worse, by over-heating the air and closing up every cranny through which ventilation could be obtained. In such places, and under such circumstances of constrained posture, want of exercise, hurried and insufficient meals, long exhausting labour and foul air – is it wonderful that a great majority of them die early of chest disease, generally of consumption? Intemperance is a common evil of these workshops. The men can only complete their work under the influence of stimulants, which help to undermine their health and destroy their morals, while hurrying them to premature graves. Employers rarely consider these things. Healthy workrooms are no part of the bond into which they enter with their work-people. They pay their money, which they reckon their part of the bargain. And for this wage the workman or workwoman has to give work, health, and life. Do men and women who employ fashionable tailors and milliners ever think of these things? And yet the master is no gainer. His goods are spoiled by foul air and gas fumes, his own health and that of his family suffers, and his work is not so well done as it would be, were his people in health. And the time will come when it will be found cheaper to supply shops, warehouses, and work-rooms with pure air than with foul air.’ ‘And the time will come when it will be found cheaper to supply shops, warehouses, and work-rooms with pure air than with foul air.’ ❂ ✪ C-19: On ‘air-tests’, and measuring CO₂ as a proxy for estimating prevalence of airborne disease indoors ‘Dr. Angus Smith’s air-test, if it could be made of simple application, would be invaluable to use in every sleeping and sick room. Just as without the use of a thermometer no nurse should ever put a patient into a bath, so, if this air-test were made in some equally simple form, should no nurse, or mother, or superintendent, be without it in any ward, nursery, or sleeping-room. But to be used, the air-test must be made as simple a little instrument as the thermometer, and both should be self-registering. ‘...the air-test must be made as simple a little instrument as the thermometer, and both should be self-registering.’ The senses of nurses and mothers become so dulled to foul air that they are perfectly unconscious of what an atmosphere they have let their children, patients, or charges sleep in. But if the tell-tale air-test were to exhibit in the morning, both to nurses and patient and to the superior officer going round, what the atmosphere has been during the night, I question if any greater security could be afforded against a recurrence of the misdemeanour.’ ❂ ✪ C-19: ... And back to the school-room, testing its air, and combatting airborne pathogens ‘And, oh! the crowded national school! where so many children’s epidemics have their origin; and the crowded, unventilated work-room, which sends so many consumptive men and women to the grave; what a tale its air-test would tell! We should have parents saying, and saying rightly, “I will not send my child to that school. I will not trust my son or my daughter in that tailor’s or milliner’s workshop, the air-test stands at ‘Horrid.’” ‘We should have parents saying, and saying rightly, “I will not send my child to that school... the air-test stands at Horrid .”’ And the dormitories of our great boarding schools! Scarlet fever would be no more ascribed to contagion but to its right cause, the air-test standing at “Foul.” We should hear no longer of “mysterious dispensations,” nor of “plague and pestilence” being “in God’s hands,” when, so far as we know, He has put them into our own. The little air-test would both betray the cause of these “mysterious pestilences,” and call upon us to remedy it.’ ❂ ❦ Chapter II – Health of Houses ‘There are five essential points in securing the health of houses:– Pure air. Pure water. Efficient drainage. Cleanliness. Light. Without these, no house can be healthy. And it will be unhealthy just in proportion as they are deficient. To have pure air, your house must be so constructed as that the outer atmosphere shall find its way with ease to every corner of it. ‘To have pure air, your house must be so constructed as that the outer atmosphere shall find its way with ease to every corner of it.’ House architects hardly ever consider this. The object in building a house is to obtain the largest interest for the money, not to save doctor’s bills to the tenants. But, if tenants should ever become so wise as to refuse to occupy unhealthily constructed houses, and if Insurance Companies should ever come to understand their interest so thoroughly as to pay a Sanitary Surveyor to look after the houses where their clients live, speculative architects would speedily be brought to their senses. As it is, they build what pays best. And there are always people foolish enough to take the houses they build. And if in the course of time the families die off, as is so often the case, nobody ever thinks of blaming any but Providence for the result. Ill-informed medical men aid in sustaining the delusion, by laying the blame on “current contagions”. Badly constructed houses do for the healthy what badly constructed hospitals do for the sick.’ ‘Badly constructed houses do for the healthy what badly constructed hospitals do for the sick.’ ❂ ❦ Conclusion ‘The whole of the preceding remarks apply even more to children and to puerperal women than to patients in general. They also apply to the nursing of surgical, quite as much as to that of medical cases. Indeed, if it be possible, cases of external injury require such care even more than sick. In surgical wards, one duty of every nurse certainly is prevention. Fever, or hospital gangrene, or pyæmia, or purulent discharge of some kind may else supervene. If she allows her ward to become filled with the peculiar close fœtid smell, so apt to be produced among surgical cases, especially where there is great suppuration and discharge, she may see a vigorous patient in the prime of life gradually sink and die where, according to all human probability, he ought to have recovered. The surgical nurse must be ever on the watch, ever on her guard, against want of cleanliness, foul air, want of light, and of warmth.’ ‘In surgical wards, one duty of every nurse certainly is prevention.’ ❂ 📖 (Accessed 19 Feb 2024 ~ Original text copied from FiftyWordsForSnow.com) Notes on Nursing (1860) ➤ 📖 (Accessed 19 Feb 2024 ~ Original scanned pages from Google Books) Notes on Nursing (1860) ➤ ❂
❦ LitCovid is the most comprehensive online resource on SARS-CoV-2 / COVID-19, providing access to 417,800+ relevant articles on PubMed. The library of scientific articles is updated daily, and categorised by different research topics (e.g. transmission), as well as geographic locations. ➲ Date accessed: 18 Feb 2024 . ❂ ❦ Useful Categories ✪ Transmission ➤ Characteristics and modes of SARS-CoV-2 transmission. ✪ Prevention ➤ Prevention, control, response and management strategies. ✪ Long Covid ➤ Post-COVID-19 Conditions/Complications (PCC) / Post-Acute Sequelae of COVID-19 (PASC). ✪ Case Reports ➤ Descriptions of specific patient cases. ✪ Treatments ➤ Treatment strategies, therapeutic procedures, and vaccine development. ✪ Forecasting ➤ Modelling, and estimating the trend of SARS-CoV-2 spread. ❂ ➲ LitCovid Online Library ➤ © 2024 National Institutes for Health (NIH) / National Center for Biotechnology Information (NCBI) / U.S. National Library of Medicine (NLM USA).
❦ Mitigation = ‘Lessening the force or intensity of something unpleasant; the act of making a condition or consequence less severe.’ 1. Clean indoor air . The priority should be air filters in schools and hospitals . New ventilation and air filtration standards for all public spaces . Grants made available to businesses to upgrade ventilation and air filtration . 2. FFP2/3 [N95/N99] respirators (masks) in all healthcare settings . 3. Free Covid vaccines available to everyone. 4. Wider access to Covid anti-viral treatments . 5. Free LFT/PCR testing . 6. Improved Covid surveillance , including wastewater monitoring and Long Covid prevalence . 7. Paid sick-leave , so that people don’t go to work when ill. 8. Respirators (masks) on public transport , including flights . 9. Better support and treatments for Long Covid patients . ... and last, but by no means least: 10. A public education campaign on the long-term risks of Covid – and why people should do more to protect themselves. ❦ Addendum : Allocate adequate research funding for a sterilising vaccine as well as treatments/cure for Long Covid . ❂ © 2024 Cat in the Hat . ➲
❦ ‘The occurrences of respiratory disorders among patients who survived for 30 days after the COVID-19 diagnosis continued to rise consistently, including asthma , bronchiectasis , COPD , ILD , PVD * , and lung cancer . * COPD = Chronic obstructive pulmonary disease . ILD = Interstitial lung disease . PVD = Peripheral vascular disease . With the severity of the acute phase of COVID-19, the risk of all respiratory diseases increases progressively. Besides, during the 24-months follow-up, we observed an increasing trend in the risks of asthma and bronchiectasis over time, which indicates that long-term monitoring and meticulous follow-up of these patients is essential. These findings contribute to a more complete understanding of the impact of COVID-19 on the respiratory system and highlight the importance of prevention and early intervention of these respiratory sequelae of COVID-19. In this study, several key findings have been further identified. Firstly, our research demonstrates a significant association between COVID-19 and an increased long-term risk of developing various respiratory diseases. Secondly, we found that the risk of respiratory disease increases with severity in patients with COVID-19, indicating that it is necessary to pay attention to respiratory COVID-19 sequelae in patients, especially those hospitalized during the acute stage of infection. This is consistent with the findings of Lam et al., who found that the risk of some respiratory diseases (including chronic pulmonary disease, acute respiratory distress syndrome and ILD) increased with the severity of COVID-19. Notably, however, our study found that asthma and COPD remained evident even in the non-hospitalized population. This emphasizes that even in cases of mild COVID-19, the healthcare system should remain vigilant. Thirdly, we investigated differences in risk across time periods, as well as the long-term effects of COVID-19 on respiratory disease. During the 2-years follow-up period, the risks of COPD, ILD, PVD and lung cancer decreased, while risks of asthma and bronchiectasis increased. Fourthly, our study showed a significant increase of the long-term risk of developing asthma, COPD, ILD, and lung cancer diseases among individuals who suffered SARS-CoV-2 reinfection. This finding emphasizes the importance of preventing reinfection of COVID-19 in order to protect public health and reduce the potential burden of SARS-CoV-2 reinfection. Interestingly, vaccination appears to have a potentially worsening effect on asthma morbidity compared with other outcomes. This observation aligns with some previous studies that have suggested a possible induction of asthma onset or exacerbation by COVID-19 vaccination. It suggests that more care may be necessary for patients with asthma on taking the COVID vaccines. The underlying mechanisms associated with COVID and respiratory outcomes are not fully understood, but several hypotheses have been proposed. First, SARS-CoV-2 can persist in tissues (including the respiratory tract), as well as the circulating system for an extended period of time after the initial infection. This prolonged presence of the virus could directly contribute to long-term damage of the respiratory tissues, consequently leading to the development of various respiratory diseases. Second, it has been observed that SARS-CoV-2 infection can lead to prolonged immunological dysfunctions, including highly activated innate immune cells, a deficiency in naive T and B cells, and increased expression of interferons and other pro-inflammatory cytokines. These immune system abnormalities are closely associated with common chronic respiratory diseases – asthma, bronchiectasis, COPD, as well as the development of lung cancer. Next, SARS-CoV-2 itself has been shown to drive cross-reactive antibody responses, and a range of autoantibodies were found in patients with COVID-19. In conclusion, our research adds to the existing knowledge regarding the effects of COVID-19 on the respiratory system. Specifically, it shows that the risk of respiratory illness increases with the severity of infection and reinfection. Our findings emphasize the importance of providing extended care and attention to patients previously infected with SARS-CoV-2.’ ❂ 📖 (17 Feb 2024 ~ The Lancet: eClinical Medicine) Long-term risks of respiratory diseases in patients infected with SARS-CoV-2: a longitudinal, population-based cohort study ➤ © 2024 The Lancet: eClinical Medicine .
❦ “Chronic disease is like the perfect medical crime. The cause is usually long gone by the time the disease manifests, and nobody links the two until it’s much too late for most.” ❂ © 2024 Henry Madison . ➲
❦ “It’s really not in the interest of the virus to kill us quickly. That’s why it has mutated to immune escape. That way it enters silently, and then eats you slowly whilst you’re still a spreading vector. Refrigerator trucks are long gone. That’s all the political class wanted. The unseen costs of CVD [cardiovascular disease] , DM [diabetes mellitus] , and both dementia and Parkinson’s Disease are the train coming down the tunnel. The economists are catching up. The actuaries are already there. Politicians and most people? Not yet...” ❂ © 2024 Dr. David Joffe PhD / FRACP (Respiratory Physician) ➲
❦ “I was in hospital for tests this morning. A nurse asked me: — “How come so many people are wearing masks? Is there something I don’t know?” I almost lost the power of speech.”
❦ Genomic epidemiology of SARS-CoV-2 with subsampling focused globally since pandemic start. All data and data visualisation by © 2025 NextStrain.org / GISAID.org
❦ “Every single case in which a person with COVID-19 infects another person in a healthcare setting – patient, relative, or hospital staff member – is a significant failure of hospital procedures. Every single instance .”
❦ Mike Honey’s Variant Visualiser (COVID-19 Genomic Sequence Analysis). The region of ‘Oceania/Australia’ is set by default, as the visualiser was created by Mike Honey , a Data Visualisation and Data Integration specialist in Melbourne, Australia. ➲ Choose your country by clicking on the ‘ Continent, Country, Location ’ dropdown menu in the top-right-hand corner . The variant visualiser is free to use, and is automatically updated every time you open the link. ❂ © 2024 Mike Honey .
❦ ‘Although some studies have shown neuroimaging and neuropsychological alterations in post-COVID-19 patients, fewer combined neuroimaging and neuropsychology evaluations of individuals who presented a mild acute infection. Here we investigated cognitive dysfunction and brain changes in a group of mildly infected individuals. We conducted a cross-sectional study of 97 consecutive subjects ( median age of 41 years ) without current or history of psychiatric symptoms (including anxiety and depression) after a mild infection , with a median of 79 days (and mean of 97 days ) after diagnosis of COVID-19. We performed semi-structured interviews, neurological examinations, 3T-MRI scans, and neuropsychological assessments. The patients reported memory loss ( 36% ), fatigue ( 31% ) and headache ( 29% ). The quantitative analyses confirmed symptoms of fatigue ( 83% of participants), excessive somnolence ( 35% ), impaired phonemic verbal fluency ( 21% ), impaired verbal categorical fluency ( 13% ) and impaired logical memory immediate recall ( 16% ). Our group… presented higher rates of impairments in processing speed ( 11.7% in FDT- Reading and 10% in FDT- Counting ). The white matter (WM) analyses with DTI * revealed higher axial diffusivity values in post-infected patients compared to controls. * Diffusion tensor imaging tractography , or DTI tractography, is an MRI (magnetic resonance imaging) technique most commonly used to provide imaging of the brain. Our results suggest persistent cognitive impairment and subtle white matter abnormalities in individuals mildly infected , without anxiety or depression symptoms. One intriguing fact is that we observed a high proportion of low average performance in our sample of patients (which has a high average level of education ), including immediate and late verbal episodic memory, phonological and semantic verbal fluency, immediate visuospatial episodic memory, processing speed, and inhibitory control . Although most subjects did not present significant impaired scores compared with the normative data, we speculate that the low average performance affecting different domains may result in a negative impact in everyday life , especially in individuals with high levels of education and cognitive demands .’ ❂ ❦ Note how these findings might negatively affect daily activities that demand sustained cognitive attention and fast reaction times – such as driving a car or motorbike, or piloting a plane. Consider air-traffic control. Consider the impact on healthcare workers whose occupations combine long periods of intense concentration with a need for critical precision. ❂ 📖 (19 Jan 2024 ~ Nature: Scientific Reports) Microstructural brain abnormalities, fatigue, and cognitive dysfunction after mild COVID-19 ➤ © 2024 Nature .
‘ Clinical evidence suggests that SARS-CoV-2 may lead to hypocalcemia, altered bone turnover markers, and a high prevalence of vertebral fractures. ’
❦ “We cannot individually assess the risk of infection from poor indoor air quality (IAQ). Just as we cannot individually assess food safety in restaurants, or fire safety in cinemas, or aviation safety on flights. These are in the control of others, and are regulated for our health and safety.”
❦ ‘Acute infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause a respiratory illness that can be associated with systemic immune cell activation and inflammation , widespread multi-organ dysfunction , and thrombosis . Not everyone fully recovers from COVID-19, leading to Long Covid, the treatment of which is a major unmet clinical need. Long Covid can affect people of all ages , follows severe as well as mild disease , and involves multiple organs . Patients with Long Covid display signs of immune dysfunction and exhaustion , persistent immune cell activation , and autoimmune antibody production , which are also pathological features of acute COVID-19. The complement system is crucial for innate immune defense by effecting lytic destruction of invading micro-organisms, but when uncontrolled, it causes cell and vascular damage . The complement cascade is activated by antigen–antibody complexes in the classical pathways or in the lectin pathway by multimeric proteins (lectins) that recognize specific carbohydrate structures, which are also found on the SARS-CoV-2 spike protein that facilitates host cell entry. Both pathways may contribute to the pronounced complement activation in acute COVID-19. Long Covid symptoms include a postexertional exhaustion reminiscent of other post-viral illnesses , such as myalgic encephalomyelitis ( ME ) – chronic fatigue syndrome ( MECFS ) with suspected latent viral reactivation . Antibody titer changes in Long Covid patients indicate an association of fatigue with reactivation of latent Epstein-Barr virus ( EBV ) infections , and Cervia-Hasler et al found that the severity of Long Covid symptoms is associated with cytomegalovirus ( CMV ) reactivation . A better understanding of the connections between viral reactivation, persistent interferon signaling, and autoimmune pathologies promises to yield new insights into the thromboinflammation associated with Long Covid. Although therapeutic interventions with coagulation and complement inhibitors in acute COVID-19 produced mixed results, the pathological features specific for Long Covid suggest potential interventions for clinical testing. Microclots are also observed in ME-CFS patients , indicating crucial interactions between complement, vWF, and coagulation-mediated fibrin formation in post-viral syndromes. A better definition of these interactions in preclinical and clinical settings will be crucial for the translation of new therapeutic concepts in chronic thromboinflammatory diseases .’ ❂ 📖 (18 Jan 2024 ~ Science) Immune damage in Long Covid ➤ © 2024 Wolfram Ruf / Science .
“I would argue that COVID-19 is not a disease of the lungs at all. It seems most likely that it is what we call a vascular and neurologic infection, affecting both nerve endings and our cardiovascular system.”
❦ “I met a nice lady – a ward patient – yesterday who, seeing my [ FFP3 ] respirator [ high-filtration ‘mask’ ] , promptly put on her surgical mask. So instead of diving straight in to asking what was most concerning her and how I could help, I opened up a bit about infection control in hospitals. I explained how, because of a lack of respirators, March 2020 saw NHS leaders downgrade PPE for all non-ICU staff. ❂ PPE : Personal Protective Equipment. I then reminded her of the amazing DHSC 2020 and 2021 campaigns on airborne transmission of SARS2 (the green-and-black smoke ones) – and I had to point out that every IPC Lead Nurse had since had to switch off their brain and forget what they knew – and while at work, to only protect ICU staff. ❂ DHSC : Department of Health and Social Care (UK). ❂ IPC : Infection Prevention and Control. I explained that the individuals responsible for the original IPC downgrade were now authors of the national manual on IPC (NIPCM), which sets the standard for infection control in hospitals, and this manual states that airborne transmission is ‘not a thing’ for SARS2 (AGP only). ❂ NIPCM : The UK’s National Infection Prevention and Control Manual. ❂ AGP : Aerosol-Generating Procedure, ie. intubation. So hospitals are destined to be unsafe spaces thanks to the NIPCM, and the surgical mask that she was wearing was OK (ish) to help protect me – but did very little to reduce her risk of SARS2 inhalation. However, she was in a single room (an extra, and not meant as a ward-bed space – but you know, >100% occupancy forever means that you need to use your imagination) – and she already had the window open. She was appalled at what healthcare workers were being put through. She was appalled at the on-going lies. She was appalled at the possible level of harm to patients and staff from such lies. She then went on to tell me how a weekend visitor of hers had just tested positive for Covid. She was worried that they had hugged and chatted, and that she might have got infected. She’s a switched on lady, too. Lives with a medic who has the windows open all the time (“It’s freezing at home”). So I explained about the CleanAirStars.com site. About HEPA filtration being a low energy and low-cost way to remove all airborne pathogens , and to make home a safer place for... • Covid • Flu • RSV • Norovirus • Fungi, etc. etc. The list goes on and on. — “Wow, that’s like magic!” We had a very nice chat. And then we talked about her heart. I just wish I could have this same conversation with each and every NHS CEO and IPC Lead Nurse. I’d ask some questions. I’d want to know why they aren’t protecting staff as they should. I’d want to know why they aren’t protecting patients as they should. I’d want them to know that they are in breach of UK legislation . And I’d want to look them in the eye and ask them to show compassion to the powerless: to staff, and patients. Help us please. Do whatever you can to counter the lies, and to help protect the NHS. Thank-you.” ✾ © 2024 Dr. David Tomlinson (NHS Consultant Cardiologist) ➤
‘[COVID-19’s] ability to invade the central nervous system through the hematogenous and neural routes, besides attacking the respiratory system, has the potential to worsen cognitive decline in Alzheimer’s disease patients. The severity of this issue must be highlighted.’
❦ Q . Why is it important for me to know if I have a COVID-19 infection? ❦ A . If you don’t recover well, it can help your doctor to know if you’ve had a COVID-19 infection – so that they can more effectively treat any of your on-going symptoms. It also helps you to be conscious of the fact that contact with other people might hurt, permanently damage, or kill them.
Post-exertional malaise (PEM) is a marked physical or mental fatigue and deterioration of symptoms occurring after physical , cognitive , social or emotional exertion that would have been tolerated previously. Symptoms typically worsen 12 to 48 hours after such activities , and can last for days , weeks or months , making it difficult to manage or predict. PEM is a hallmark symptom of myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS), and is commonly reported by people with Post-COVID-19 Syndrome (PCS/‘Long Covid’). PEM can be mitigated by activity management , or ‘ pacing ’.
C-19: Archives
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‘Although COVID-19 was originally considered a respiratory illness, it is now well established that SARS-CoV-2 infection can have far-reaching impacts on the nervous system. Common neurological symptoms in Long COVID [PASC] include new-onset cognitive difficulties, dysautonomia, fatigue, and peripheral neuropathy.’ from ‘Neuroimmune pathophysiology of long COVID’ by Moen et al / Psychiatry and Clinical Neurosciences (2025).
“We’re going to need a bigger Greek alphabet.”
The Health and Safety Executive (HSE) has designated SARS-CoV-2, the virus that causes COVID-19, a Hazard Group 3 (HG3) pathogen that can cause severe human disease. The United Kingdom’s Health Security Agency (UKHSA) classifies SARS-CoV-2 as a notifiable organism, and COVID-19 as a notifiable disease (2025).
‘FRSMs [Surgical Masks] have never been considered either adequate or suitable equipment for protection against inhalable or respirable risks under COSHH.’
‘... SARS-CoV-2 infection causes prolonged disruptions in mitochondrial function, significantly altering cellular energy metabolism.’
‘Importantly, NB.1.8.1 shows a balanced profile of ACE2 binding and immune evasion, supporting its potential for future prevalence.’
‘Since late 2024, a potential third major evolutionary shift in SARS-CoV-2 evolution might be unfolding. In November 2024 and January 2025, a highly mutated descendant of the Omicron subvariant BA.3 was detected in South Africa.’
“There’s nothing radical about clean air and compassion.” Thoughts and essays by Dr. Lisa Iannattone.
“We are drunk-driving in healthcare... with a pathogen that has a 10% fatality rate in that setting.” Thoughts and essays by Dr. Noor Bari.
‘Vaccine effectiveness against SARS-CoV-2 [COVID-19] infection declines markedly with time and Omicron variants.’ from ‘Effectiveness of COVID-19 vaccines against SARS-CoV-2 infection and severe outcomes in adults’ by Zhou et al / European Respiratory Review (2024).
‘The arrival of the Omicron variant marked a major shift, introducing numerous extra mutations in the spike gene compared with earlier variants. Before Omicron, natural infection provided strong and durable protection against reinfection, with minimal waning over time. However, during the Omicron era, protection was robust only for those recently infected, declining rapidly over time and diminishing within a year.’
‘These findings have important implications for understanding the potential impact of COVID-19 on long-term immune function and susceptibility to pathogens.’
‘Patients admitted to hospital for COVID-19 showed higher rates of all-cause admissions to hospital and infectious illness-related hospitalisations, including sepsis and positive urine and blood cultures, compared with patients admitted to hospital for influenza. While previous research has primarily shown elevated rates of infection in patients with long-COVID, or in those requiring admission to hospital, this analysis demonstrates substantial increases in infection rates even in those with mild initial disease. ’
CBC Radio-Canada interview with long COVID [PASC] researcher David Putrino from the Icahn School of Medicine at Mount Sinai in New York.
‘For patients already battling Alzheimer’s disease, studies indicate that Covid can exacerbate brain inflammation, damage immune cells, and accelerate the disease. Even previously healthy older adults face an increased risk of cognitive impairment and new-onset dementia after infection. Mild Covid cases in younger adults have also been linked to brain issues affecting memory and thinking. ’
‘But even people who had not been hospitalized had increased risks of many conditions, ranging from an 8% increase in the rate of heart attacks to a 247% increase in the rate of heart inflammation.’ Nature (2 Aug 2022) ‘Either symptomatic or asymptomatic SARS-CoV-2 infection is associated with increased risk of late cardiovascular outcomes and has causal effect on all-cause mortality in a late post-COVID-19 period.’ The American Journal of Cardiology (15 Sep 2023)
‘The proportions of PACS [PASC/Long Covid] patients experiencing chest pain, palpitation, and hypertension as sequelae were 22%, 18%, and 19% respectively.’
‘Before Omicron, natural infection provided strong and durable protection against reinfection, with minimal waning over time. However, during the Omicron era, protection was robust only for those recently infected, declining rapidly over time and diminishing within a year.’
‘Scientists discover that even mild COVID-19 can alter brain proteins linked to Alzheimer’s disease, potentially increasing dementia risk. COVID-19-positive individuals exhibited lower cognitive test performance compared to controls – equivalent to almost two years of age-related cognitive decline. ’
‘The predominant symptoms, often clustering together, remain fatigue, cognitive disturbance and chest symptoms, including breathlessness, with sleep disorder and anxiety as additional complaints. Many patients with persistent PCS [PASC/‘Long Covid’] show impaired executive functioning, reduced cognitive processing speed and reduced physical exercise capacity.’
❦ On that 700-day cough... It’s a new thing, but it’s only reserved for inside supermarkets and offices. And pharmacies and hospitals and care homes. Oh, and your living-room. But apart from that, it’s not exactly a deal-breaker. I mean, c’mon. They put up with way worse in the 1900s.
❦ “If you are letting yourself get infected and taking no precautions against passing it on, you are not a passive bystander for your next infection. You’ve participated in creating it.”
❦ ‘In this population of healthy young adult US Marines with mostly either asymptomatic or mild acute COVID-19, one fourth reported physical , cognitive , or psychiatric long-term sequelae of infection. The Marines affected with PASC [Post-Acute Sequelae of COVID-19 / Post-COVID-19 Complications / ‘Long Covid’] showed evidence of long-term decrease in functional performance suggesting that SARS-CoV-2 infection may negatively affect health for a significant proportion of young adults .’ ❂ ‘Among the 899 participants, 88.8% had a SARS-CoV-2 infection. Almost a quarter (24.7%) of these individuals had at least one COVID-19 symptom that lasted for at least 4 weeks meeting the a priori definition of PASC established for this study. Among those with PASC, 10 had no acute SARS-CoV-2 symptoms after PCR-confirmed infection suggesting that PASC can occur among asymptomatic individuals. Many participants reported that lingering symptoms impaired their productivity at work, caused them to miss work, and/or limited their ability to perform normal duty/activities. Marines with PASC had significantly decreased physical fitness test scores up to approximately one year post-infection with a three-mile run time that averaged in the 65th percentile of the reference cohort. [ PASC was associated with a significantly increased 3-mile run time on the standard Marine fitness test. PASC participants ran 25.1 seconds slower than a pre-pandemic reference cohort composed of 22,612 Marine recruits from 2016 to 2019. A three-mile run evaluates aerobic exercise , overhead lifting of an ammunition can and pull-ups evaluate strength , and shooting a rifle evaluates fine-motor skills .] Scores for events evaluating upper body (pull-ups, crunches, and ammo-can lift) were not significantly reduced by PASC; however, overall physical fitness scores were reduced. ‘The poorer run times and overall scores among PASC participants are indicative of on-going functional effects.’ Standardized health-based assessments for somatization, depression, and anxiety further highlighted the detrimental health effects of PASC. Almost 10% of participants with PASC had PHQ-8 scores ≥10. Increased somatization * has been associated with increased stress, depression, and problems with emotions. * [ Somatization / Somatisation = Medical symptoms caused by psychological stress.] Additionally, PASC participants had higher GAD-7 scores suggesting increased anxiety in a population with unique inherent occupational stressors associated with higher rates of anxiety, depression, and post-traumatic stress disorder. ‘Increased severity of anxiety among those with PASC, combined with greater rates of mental health disorders in general, could portend an ominous combination and should be closely followed.’ Like others, we identified cardiopulmonary symptoms as some of the most prevalent. The high prevalence of symptoms like shortness of breath, difficulty breathing, cough, and fatigue is particularly notable when combined with decreased objective measures of aerobic performance such as running. These results suggest pathology in the cardiopulmonary system. In contrast we observed no reduction in scores assessing strength and marksmanship suggesting the lack of detectable pathology in the neuro-musculoskeletal system. We have previously found in this same cohort that SARS-CoV-2 infection causes prolonged dysregulation of immune cell epigenetic patterns like auto-immune diseases. Based on the reported PASC symptoms, the potential current and future public health implications in this population could be substantial. ‘Chronic health complications from PASC, especially in a young and previously healthy population with a long life expectancy, could decrease work productivity and increase healthcare costs.’ Significant changes in the Years-of-Life lived with a disability can disproportionally increase disability-adjusted life-years, and should be considered when allocating resources and designing policy.’ ❂ 📖 (23 Oct 2024 ~ The Lancet: Regional Health/America) Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel study ➤ © 2024 The Lancet .
❦ If parents, and politicians and teachers, and healthcare workers and public health bodies wanted things to change, all they need do is read . It’s all there. But they don’t. They won’t. And they insist on their medical and scientific flat-earthing – hand-sanitiser for aerosol-transmitted disease – because they prefer the world to be flat. So let them walk off the edge of the world. [ Caveat: The earth is not flat, and doing nothing will not flatten the curve – but walk far enough, and you are likely to fall off a cliff.] © 2024 C19.Life
‘Fatigue, difficulty concentrating, insomnia, and anxiety or depression were the most common PCS symptoms. Baseline risk factors for reporting PCS included screening for common mental disorders, direct contact with COVID-19 patients, pre-existing respiratory illnesses, female sex and older age.’
❦ NHS nurse: — “Shit, I just got a needlestick injury.” ❦ 2024: — “Yeah, well, whatever. We all gotta die of something.”
‘In those school-rooms where ventilation is imperfect and the air impure, six sevenths of the money expended to educate a child is wasted.’ ❂ The Ventilation and Warming of School Buildings (1887) By Gilbert B. Morrison Published by D. Appleton and Company, New York. 1887. Accessed 10 Apr 2024 Preface (p.xxii) ❦ ‘I am fully convinced that people are prematurely dying by thousands simply from a lack of correct and positive convictions concerning impure air; for, when the true nature of a danger is fully appreciated, the requisite means to avert it will generally be found.’ ❂ Chapter II: The Effects Of Breathing Impure Air (pp.20-23) ❦ ‘Impure air is also believed by the best authorities to be one of the principal causes of epidemics. Dr. Carpenter, than whom there is no abler authority, says: “It is impossible for anyone who carefully examines the evidence to hesitate for a moment in the conclusion that the fatality of epidemics is almost invariably in precise proportion to the degree in which an impure atmosphere has been habitually respired.” The Board of Health of New York conclude that forty per cent of all deaths are caused by breathing impure air. In view of such alarming facts, this same board declares: “Viewing the causes of preventable diseases, and their fatal results, we unhesitatingly state that the first sanitary want in New York and Brooklyn is ventilation .” Direct experiment proves that the air in our school-rooms is impure in almost all cases, and in a majority of them to a degree far beyond the danger line. In view of these facts, and the results as proved by the authorities above cited, why is it regarded by the public with such indifference? When a school-house is blown down by a hurricane, killing and maiming a score of children, it is justly regarded as a great calamity; a vacation is given to quiet the excited fears of parents and children; investigating committees are appointed to locate the responsibility, and the faces of the whole populace are blanched with apprehension. Why is this? Why does the intelligent parent send his child to a school-room poorly ventilated and crowded with children, some of whom are breathing into a stagnant air the germs of disease and death, while others, from unwashed bodies, are delivering into it their deadly emanations, and all without a protest on the part of those even who provide proper hygienic conditions at home? It is because the effects of the one are immediate, occupy little time, the number killed can be actually counted, and the exact magnitude of the calamity estimated all at once. In the other case the process is slower, but of far greater extent; the actual results are by the general public less definitely known, and custom and attention to other matters divert the attention, and the deadly destruction of the innocents by impure air goes on silently, constantly, and powerfully. While noisy demonstrations like that of the cyclone attract attention, and inspire fear and terror, it is in the silent forces that the danger lies. Nature’s most destructive forces, as well as her strongest constructive ones, are silent in their operations; but when Science detects a silent, insidious enemy to human welfare, it is not only our duty to assume an attitude of self-defense and self-protection, but it should be regarded as folly not to do so.’ ❦ On high CO₂ levels connected to poor performance in schools: ‘The effects of breathing impure air thus far considered are pathological, but it has its pedagogical and economical aspects. Every observing teacher knows the immediate relation between the vitiated air in the school-room and the work he wishes the pupils to perform. Much of the disappointment of poor lessons and the tendency to disorder are due directly to this cause. The brain unsupplied with a proper amount of pure blood [oxygen] refuses to act, and the will is powerless to arouse the flagging energies; the general feeling of discomfort, dissatisfaction, and unrest which always accompanies a bad state of the blood. From an economical standpoint it would, of course, be impossible to estimate the financial waste of breathing impure air, but it can not but be enormous. In any discussion of the feasibility of incurring the additional expense of the most perfect ventilation, this loss occasioned by the want of such ventilation must not be ignored.’ ❂ Chapter III: The Air (pp.25-26) ❦ On ventilation, air filtration, and the super-spreading of diverse diseases in classrooms: ‘Wherever an unusual amount of unwholesome matter is being evolved, there especially should the purifying conditions be present; air in such places, to remain pure, must be changed in rapid succession, in order that dilution, diffusion, and oxidation may fulfill their legitimate functions. In a school-room the contaminating process can not but be rapid, and wherever ample provision is not made for rapidly changing the air of the room a dangerous condition of affairs is sure to exist. Bacteria of many forms, and spores of fungi, are also found in the air, and all these organisms are known to thrive in the organic impurities found in the air.’ ❂ Chapter IV: Examination Of The Air (p.33) ❦ On measuring CO₂ levels as a proxy to establishing content of (infectious) re-breathed air: ‘A complete analysis of impure air comprehends the quantitative and qualitative tests for carbonic [sic] dioxide, free ammonia, and other nitrogenous matter, oxidizable matters, nitrous and nitric acids, and hydrogen sulphide; but for ordinary practical purposes the determination of the CO₂ is by far the most important, and is ordinarily the only one which need be made. While the poisonous qualities of the air are not wholly due to the presence of the CO₂ per se, the amount of this gas found to be present is, in air made impure by respiration, generally a good measure for other impurities to which the poisonous quality is principally due. Owing to this fact, a careful test for the amount of CO₂ contained in a given atmosphere is generally the only one which need be made where air is tested merely to determine its respiratory purity.’ ❂ 📖 (Accessed 10 Apr 2024 ~ D. Appleton & Company / Google Books) The Ventilation and Warming of School Buildings ➤ ❂ My thanks to Maarten De Cock for alerting me to this gem of a book. ➲
❦ A comprehensive collection of review articles from 1987 to 2022 regarding airborne transmission of pathogens , curated by Jonathan Mesiano-Crookston. ❂ Accessed : 4 March 2024 . 📖 (November 2022 ~ Geoscience Frontiers) Aerosol Transmission of Human Pathogens: From Miasmata to Modern Viral Pandemics and Their Preservation Potential in the Anthropocene Record ➤ 📖 (21 Aug 2022 ~ Indoor Air) What were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic? ➤ 📖 (31 Jan 2022 ~ Indoor Air: Editorial) Hypothesis: All respiratory viruses (including SARS-CoV-2) are aerosol-transmitted ➤ 📖 (November 2021 ~ Interface Focus) How Did We Get Here: What Are Droplets and Aerosols and How Far Do They Go? A Historical Perspective on the Transmission of Respiratory Infectious Diseases➤ 📖 (27 Aug 2021 ~ Science ) Airborne Transmission of Respiratory Viruses ➤ 📖 (August 2021 ~ Nature Reviews: Microbiology) Transmissibility and Transmission of Respiratory Viruses ➤ 📖 (July 2021 ~ Annual Review of Biomedical Engineering) Fluid Dynamics of Respiratory Infectious Diseases ➤ 📖 (14 May 2021 ~ Science) A Paradigm Shift to Combat Indoor Respiratory Infection ➤ 📖 (1 May 2021 ~ The Lancet) Ten Scientific Reasons in Support of Airborne Transmission of SARS-CoV-2 ➤ 📖 (18 Jan 2021 ~ Clinical Infectious Diseases) Airborne Transmission of SARS-CoV-2: What We Know ➤ 📖 (12 Jan 2021 ~ The Journal of Hospital Infection) Dismantling Myths on the Airborne Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) ➤ 📖 (1 Jan 2021 ~ Canadian Medical Association Journal) Mitigating Airborne Transmission of SARS-CoV-2 ➤ 📖 (November 2020 ~ Environment International) Aerosol Transmission of SARS-CoV-2? Evidence, Prevention and Control➤ 📖 (16 Oct 2020 ~ Science) Airborne Transmission of SARS-CoV-2 ➤ 📖 (1 Sep 2020 ~ Environment International) How Can Airborne Transmission of COVID-19 Indoors Be Minimised? ➤ 📖 (August 2020 ~ Anaesthesia) Airborne Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 to Healthcare Workers: A Narrative Review ➤ 📖 (6 July 2020 ~ Clinical Infectious Diseases) It Is Time to Address Airborne Transmission of Coronavirus Disease 2019 (COVID-19) ➤ 📖 (June 2020 ~ Environment International) Airborne Transmission of SARS-CoV-2: The World Should Face the Reality➤ 📖 (May 2020 ~ Risk Analysis) Consideration of the Aerosol Transmission for COVID‐19 and Public Health➤ 📖 (16 April 2020 ~ The Journal of Infectious Diseases) Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019? ➤ 📖 (26 March 2020 ~ JAMA) Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19 ➤ 📖 (28 Aug 2019 ~ Encyclopedia of Microbiology) Airborne Infectious Microorganisms ➤ 📖 (31 Jan 2019 ~ BMC Infectious Diseases) Recognition of Aerosol Transmission of Infectious Agents: A Commentary➤ 📖 (September 2016 ~ American Journal of Infection Control) Generic Aspects of the Airborne Spread of Human Pathogens Indoors and Emerging Air Decontamination Technologies ➤ 📖 (15 Nov 2011 ~ Advances in Preventive Medicine) Preventing Airborne Disease Transmission: Review of Methods for Ventilation Design in Health Care Facilities ➤ 📖 (October 2006 ~ The Journal of Hospital Infection) Factors Involved in the Aerosol Transmission of Infection and Control of Ventilation in Healthcare Premises ➤ 📖 (January 1987 ~ Critical Reviews in Environmental Control) Spread of Viral Infections by Aerosols➤ ✾ © 2024 Jonathan Mesiano-Crookston ➤
❦ SARS-CoV-2 – the virus that causes COVID-19 – is airborne . In May 2021, the WHO officially recognised that SARS-CoV-2 is airborne via microscopic aerosols – meaning that the virus is transmissible through the air at both long and short range . ✾
‘ Reinfection , which is now the dominant type of SARS-CoV-2 infection , is not inconsequential ; it can trigger de novo Long Covid or exacerbate its severity . Each reinfection contributes additional risk of Long Covid: cumulatively , two infections yield a higher risk of Long Covid than one infection , and three infections yield a higher risk than two infections .’
❦ “This study confirms everything that I have seen in the microscope over the last few years. The authors of the study use a technique called dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI ), an imaging technique that can measure the density , integrity , and leakiness of tissue vasculature. Comparing all individuals with previous COVID infection to unaffected controls revealed decreased general brain volume in patients with ‘brain fog’ – along with significantly reduced cerebral white matter volume in both hemispheres in the recovered and ‘brain fog’ cohorts . Covid-19 induces brain-volume loss and leaky blood-brain barrier in some patients. How can this be more clear?” © 2024 Dr. Danielle Beckman, Neuroscientist (PhD Biological Chemistry) ➲ ❂ 📖 (22 Feb 2024 ~ Nature: Neuroscience) Blood–brain barrier disruption and sustained systemic inflammation in individuals with long COVID-associated cognitive impairment ➤ ‘ Our data suggest that sustained systemic inflammation and persistent localized blood-brain barrier (BBB) dysfunction is a key feature of long COVID-associated brain fog. Patients with long COVID had elevated levels of IL-8, GFAP and TGFβ, with TGFβ specifically increased in the cohort with brain fog. GFAP is a robust marker of cerebrovascular damage and is elevated after repetitive head trauma, reflecting BBB disruption, as seen in contact sport athletes and in individuals with self-reported neurological symptoms in long COVID. Interestingly, TGFβ was strongly associated with BBB disruption and structural brain changes. ’ [Layperson overview] 📖 (February 2024 ~ Genetic Engineering and Biotechnology News) Leaky Blood Vessels in the Brain Linked to Brain Fog in Long COVID Patients ➤ [Related] 📖 (7 Feb 2022 ~ Nature: Cardiovascular Research) Blood–brain barrier link to human cognitive impairment and Alzheimer’s disease ➤ ❂
‘The very first canon of nursing... the first essential to the patient... is this: to keep the air he breathes as pure as the external air, without chilling him .’ ❂ Notes on Nursing (1860 edition) By Florence Nightingale First Published 1859. Revised edition reprinted in 1860 by Harrison of Pall Mall Accessed 19 Feb 2024 ❦ Chapter I – Ventilation and Warming ‘The very first canon of nursing, the first and the last thing upon which a nurse’s attention must be fixed, the first essential to the patient, without which all the rest you can do for him is as nothing, with which I had almost said you may leave all the rest alone, is this: TO KEEP THE AIR HE BREATHES AS PURE AS THE EXTERNAL AIR, WITHOUT CHILLING HIM. Yet what is so little attended to? Even where it is thought of at all, the most extraordinary misconceptions reign about it. Even in admitting air into the patient’s room or ward, few people ever think where that air comes from. It may come from a corridor into which other wards are ventilated, from a hall, always unaired, always full of the fumes of gas, dinner, of various kinds of mustiness; from an underground kitchen, sink, wash-house, water-closet, or even, as I myself have had sorrowful experience, from open sewers loaded with filth; and with this the patient’s room or ward is aired, as it is called – poisoned, it should rather be said. Always air from the air without, and that, too, through those windows, through which the air comes freshest. From a closed court, especially if the wind do not blow that way, air may come as stagnant as any from a hall or corridor. I know an intelligent humane house surgeon who makes a practice of keeping the ward windows open. The physicians and surgeons invariably close them while going their rounds; and the house surgeon, very properly, as invariably opens them whenever the doctors have turned their backs. I have known a medical officer keep his ward windows hermetically closed, thus exposing the sick to all the dangers of an infected atmosphere, because he was afraid that, by admitting fresh air, the temperature of the ward would be too much lowered. This is a destructive fallacy. To attempt to keep a ward warm at the expense of making the sick repeatedly breathe their own hot, humid, putrescing atmosphere is a certain way to delay recovery or to destroy life.’ ❂ ‘I have known cases of hospital pyæmia quite as severe in handsome private houses as in any of the worst hospitals, and from the same cause, viz., foul air. Yet nobody learnt the lesson. Nobody learnt anything at all from it.’ ❂ ✪ C-19: On schools ‘Of all places, public or private schools, where a number of children or young persons sleep in the same dormitory * , require this test of freshness to be constantly applied.’ * [ C-19 Note: You might substitute ‘sleep’ and ‘dormitory’ with ‘study’ and ‘classroom’ in this section.] ‘If it be hazardous for two children to sleep together in an unventilated bedroom, it is more than doubly so to have four, and much more than trebly so to have six under the same circumstances. People rarely remember this; yet, if parents were as solicitous about the air of school bedrooms as they are about the food the children are to eat, and the kind of education they are to receive, at school, depend upon it due attention would be bestowed on this vitally important matter, and they would cease to have their children sent home either ill, or because scarlet fever or some other “current contagion” had broken out in the school. There are schools where attention is paid to these things, and where “children’s epidemics” are unknown.’ ❂ ✪ C-19: Offices, shops, factories, and other workplaces ‘How much sickness, death, and misery are produced by the present state of many factories, warehouses, workshops, and workrooms!’ ‘How much sickness, death, and misery are produced by the present state of many factories, warehouses, workshops, and workrooms! The places where poor dressmakers, tailors, letter-press printers, and other similar trades have to work for their living, are generally in a worse sanitary condition than any other portion of our worst towns. Many of these places of work were never constructed for such an object. They are badly adapted garrets, sitting-rooms, or bedrooms, generally of an inferior class of house. No attention is paid to cubic space or ventilation. The poor workers are crowded on the floor to a greater extent than occurs with any other kind of over-crowding. The constant breathing of foul air, saturated with moisture, and the action of such air upon the skin renders the inmates peculiarly susceptible of the impression of cold, which is an index indeed of the danger of pulmonary disease to which they are exposed. The result is, that they make bad worse, by over-heating the air and closing up every cranny through which ventilation could be obtained. In such places, and under such circumstances of constrained posture, want of exercise, hurried and insufficient meals, long exhausting labour and foul air – is it wonderful that a great majority of them die early of chest disease, generally of consumption? Intemperance is a common evil of these workshops. The men can only complete their work under the influence of stimulants, which help to undermine their health and destroy their morals, while hurrying them to premature graves. Employers rarely consider these things. Healthy workrooms are no part of the bond into which they enter with their work-people. They pay their money, which they reckon their part of the bargain. And for this wage the workman or workwoman has to give work, health, and life. Do men and women who employ fashionable tailors and milliners ever think of these things? And yet the master is no gainer. His goods are spoiled by foul air and gas fumes, his own health and that of his family suffers, and his work is not so well done as it would be, were his people in health. And the time will come when it will be found cheaper to supply shops, warehouses, and work-rooms with pure air than with foul air.’ ‘And the time will come when it will be found cheaper to supply shops, warehouses, and work-rooms with pure air than with foul air.’ ❂ ✪ C-19: On ‘air-tests’, and measuring CO₂ as a proxy for estimating prevalence of airborne disease indoors ‘Dr. Angus Smith’s air-test, if it could be made of simple application, would be invaluable to use in every sleeping and sick room. Just as without the use of a thermometer no nurse should ever put a patient into a bath, so, if this air-test were made in some equally simple form, should no nurse, or mother, or superintendent, be without it in any ward, nursery, or sleeping-room. But to be used, the air-test must be made as simple a little instrument as the thermometer, and both should be self-registering. ‘...the air-test must be made as simple a little instrument as the thermometer, and both should be self-registering.’ The senses of nurses and mothers become so dulled to foul air that they are perfectly unconscious of what an atmosphere they have let their children, patients, or charges sleep in. But if the tell-tale air-test were to exhibit in the morning, both to nurses and patient and to the superior officer going round, what the atmosphere has been during the night, I question if any greater security could be afforded against a recurrence of the misdemeanour.’ ❂ ✪ C-19: ... And back to the school-room, testing its air, and combatting airborne pathogens ‘And, oh! the crowded national school! where so many children’s epidemics have their origin; and the crowded, unventilated work-room, which sends so many consumptive men and women to the grave; what a tale its air-test would tell! We should have parents saying, and saying rightly, “I will not send my child to that school. I will not trust my son or my daughter in that tailor’s or milliner’s workshop, the air-test stands at ‘Horrid.’” ‘We should have parents saying, and saying rightly, “I will not send my child to that school... the air-test stands at Horrid .”’ And the dormitories of our great boarding schools! Scarlet fever would be no more ascribed to contagion but to its right cause, the air-test standing at “Foul.” We should hear no longer of “mysterious dispensations,” nor of “plague and pestilence” being “in God’s hands,” when, so far as we know, He has put them into our own. The little air-test would both betray the cause of these “mysterious pestilences,” and call upon us to remedy it.’ ❂ ❦ Chapter II – Health of Houses ‘There are five essential points in securing the health of houses:– Pure air. Pure water. Efficient drainage. Cleanliness. Light. Without these, no house can be healthy. And it will be unhealthy just in proportion as they are deficient. To have pure air, your house must be so constructed as that the outer atmosphere shall find its way with ease to every corner of it. ‘To have pure air, your house must be so constructed as that the outer atmosphere shall find its way with ease to every corner of it.’ House architects hardly ever consider this. The object in building a house is to obtain the largest interest for the money, not to save doctor’s bills to the tenants. But, if tenants should ever become so wise as to refuse to occupy unhealthily constructed houses, and if Insurance Companies should ever come to understand their interest so thoroughly as to pay a Sanitary Surveyor to look after the houses where their clients live, speculative architects would speedily be brought to their senses. As it is, they build what pays best. And there are always people foolish enough to take the houses they build. And if in the course of time the families die off, as is so often the case, nobody ever thinks of blaming any but Providence for the result. Ill-informed medical men aid in sustaining the delusion, by laying the blame on “current contagions”. Badly constructed houses do for the healthy what badly constructed hospitals do for the sick.’ ‘Badly constructed houses do for the healthy what badly constructed hospitals do for the sick.’ ❂ ❦ Conclusion ‘The whole of the preceding remarks apply even more to children and to puerperal women than to patients in general. They also apply to the nursing of surgical, quite as much as to that of medical cases. Indeed, if it be possible, cases of external injury require such care even more than sick. In surgical wards, one duty of every nurse certainly is prevention. Fever, or hospital gangrene, or pyæmia, or purulent discharge of some kind may else supervene. If she allows her ward to become filled with the peculiar close fœtid smell, so apt to be produced among surgical cases, especially where there is great suppuration and discharge, she may see a vigorous patient in the prime of life gradually sink and die where, according to all human probability, he ought to have recovered. The surgical nurse must be ever on the watch, ever on her guard, against want of cleanliness, foul air, want of light, and of warmth.’ ‘In surgical wards, one duty of every nurse certainly is prevention.’ ❂ 📖 (Accessed 19 Feb 2024 ~ Original text copied from FiftyWordsForSnow.com) Notes on Nursing (1860) ➤ 📖 (Accessed 19 Feb 2024 ~ Original scanned pages from Google Books) Notes on Nursing (1860) ➤ ❂
❦ LitCovid is the most comprehensive online resource on SARS-CoV-2 / COVID-19, providing access to 417,800+ relevant articles on PubMed. The library of scientific articles is updated daily, and categorised by different research topics (e.g. transmission), as well as geographic locations. ➲ Date accessed: 18 Feb 2024 . ❂ ❦ Useful Categories ✪ Transmission ➤ Characteristics and modes of SARS-CoV-2 transmission. ✪ Prevention ➤ Prevention, control, response and management strategies. ✪ Long Covid ➤ Post-COVID-19 Conditions/Complications (PCC) / Post-Acute Sequelae of COVID-19 (PASC). ✪ Case Reports ➤ Descriptions of specific patient cases. ✪ Treatments ➤ Treatment strategies, therapeutic procedures, and vaccine development. ✪ Forecasting ➤ Modelling, and estimating the trend of SARS-CoV-2 spread. ❂ ➲ LitCovid Online Library ➤ © 2024 National Institutes for Health (NIH) / National Center for Biotechnology Information (NCBI) / U.S. National Library of Medicine (NLM USA).
❦ Mitigation = ‘Lessening the force or intensity of something unpleasant; the act of making a condition or consequence less severe.’ 1. Clean indoor air . The priority should be air filters in schools and hospitals . New ventilation and air filtration standards for all public spaces . Grants made available to businesses to upgrade ventilation and air filtration . 2. FFP2/3 [N95/N99] respirators (masks) in all healthcare settings . 3. Free Covid vaccines available to everyone. 4. Wider access to Covid anti-viral treatments . 5. Free LFT/PCR testing . 6. Improved Covid surveillance , including wastewater monitoring and Long Covid prevalence . 7. Paid sick-leave , so that people don’t go to work when ill. 8. Respirators (masks) on public transport , including flights . 9. Better support and treatments for Long Covid patients . ... and last, but by no means least: 10. A public education campaign on the long-term risks of Covid – and why people should do more to protect themselves. ❦ Addendum : Allocate adequate research funding for a sterilising vaccine as well as treatments/cure for Long Covid . ❂ © 2024 Cat in the Hat . ➲
❦ ‘The occurrences of respiratory disorders among patients who survived for 30 days after the COVID-19 diagnosis continued to rise consistently, including asthma , bronchiectasis , COPD , ILD , PVD * , and lung cancer . * COPD = Chronic obstructive pulmonary disease . ILD = Interstitial lung disease . PVD = Peripheral vascular disease . With the severity of the acute phase of COVID-19, the risk of all respiratory diseases increases progressively. Besides, during the 24-months follow-up, we observed an increasing trend in the risks of asthma and bronchiectasis over time, which indicates that long-term monitoring and meticulous follow-up of these patients is essential. These findings contribute to a more complete understanding of the impact of COVID-19 on the respiratory system and highlight the importance of prevention and early intervention of these respiratory sequelae of COVID-19. In this study, several key findings have been further identified. Firstly, our research demonstrates a significant association between COVID-19 and an increased long-term risk of developing various respiratory diseases. Secondly, we found that the risk of respiratory disease increases with severity in patients with COVID-19, indicating that it is necessary to pay attention to respiratory COVID-19 sequelae in patients, especially those hospitalized during the acute stage of infection. This is consistent with the findings of Lam et al., who found that the risk of some respiratory diseases (including chronic pulmonary disease, acute respiratory distress syndrome and ILD) increased with the severity of COVID-19. Notably, however, our study found that asthma and COPD remained evident even in the non-hospitalized population. This emphasizes that even in cases of mild COVID-19, the healthcare system should remain vigilant. Thirdly, we investigated differences in risk across time periods, as well as the long-term effects of COVID-19 on respiratory disease. During the 2-years follow-up period, the risks of COPD, ILD, PVD and lung cancer decreased, while risks of asthma and bronchiectasis increased. Fourthly, our study showed a significant increase of the long-term risk of developing asthma, COPD, ILD, and lung cancer diseases among individuals who suffered SARS-CoV-2 reinfection. This finding emphasizes the importance of preventing reinfection of COVID-19 in order to protect public health and reduce the potential burden of SARS-CoV-2 reinfection. Interestingly, vaccination appears to have a potentially worsening effect on asthma morbidity compared with other outcomes. This observation aligns with some previous studies that have suggested a possible induction of asthma onset or exacerbation by COVID-19 vaccination. It suggests that more care may be necessary for patients with asthma on taking the COVID vaccines. The underlying mechanisms associated with COVID and respiratory outcomes are not fully understood, but several hypotheses have been proposed. First, SARS-CoV-2 can persist in tissues (including the respiratory tract), as well as the circulating system for an extended period of time after the initial infection. This prolonged presence of the virus could directly contribute to long-term damage of the respiratory tissues, consequently leading to the development of various respiratory diseases. Second, it has been observed that SARS-CoV-2 infection can lead to prolonged immunological dysfunctions, including highly activated innate immune cells, a deficiency in naive T and B cells, and increased expression of interferons and other pro-inflammatory cytokines. These immune system abnormalities are closely associated with common chronic respiratory diseases – asthma, bronchiectasis, COPD, as well as the development of lung cancer. Next, SARS-CoV-2 itself has been shown to drive cross-reactive antibody responses, and a range of autoantibodies were found in patients with COVID-19. In conclusion, our research adds to the existing knowledge regarding the effects of COVID-19 on the respiratory system. Specifically, it shows that the risk of respiratory illness increases with the severity of infection and reinfection. Our findings emphasize the importance of providing extended care and attention to patients previously infected with SARS-CoV-2.’ ❂ 📖 (17 Feb 2024 ~ The Lancet: eClinical Medicine) Long-term risks of respiratory diseases in patients infected with SARS-CoV-2: a longitudinal, population-based cohort study ➤ © 2024 The Lancet: eClinical Medicine .
❦ “Chronic disease is like the perfect medical crime. The cause is usually long gone by the time the disease manifests, and nobody links the two until it’s much too late for most.” ❂ © 2024 Henry Madison . ➲
❦ “It’s really not in the interest of the virus to kill us quickly. That’s why it has mutated to immune escape. That way it enters silently, and then eats you slowly whilst you’re still a spreading vector. Refrigerator trucks are long gone. That’s all the political class wanted. The unseen costs of CVD [cardiovascular disease] , DM [diabetes mellitus] , and both dementia and Parkinson’s Disease are the train coming down the tunnel. The economists are catching up. The actuaries are already there. Politicians and most people? Not yet...” ❂ © 2024 Dr. David Joffe PhD / FRACP (Respiratory Physician) ➲
❦ “I was in hospital for tests this morning. A nurse asked me: — “How come so many people are wearing masks? Is there something I don’t know?” I almost lost the power of speech.”
❦ Genomic epidemiology of SARS-CoV-2 with subsampling focused globally since pandemic start. All data and data visualisation by © 2025 NextStrain.org / GISAID.org
❦ “Every single case in which a person with COVID-19 infects another person in a healthcare setting – patient, relative, or hospital staff member – is a significant failure of hospital procedures. Every single instance .”
❦ Mike Honey’s Variant Visualiser (COVID-19 Genomic Sequence Analysis). The region of ‘Oceania/Australia’ is set by default, as the visualiser was created by Mike Honey , a Data Visualisation and Data Integration specialist in Melbourne, Australia. ➲ Choose your country by clicking on the ‘ Continent, Country, Location ’ dropdown menu in the top-right-hand corner . The variant visualiser is free to use, and is automatically updated every time you open the link. ❂ © 2024 Mike Honey .
❦ ‘Although some studies have shown neuroimaging and neuropsychological alterations in post-COVID-19 patients, fewer combined neuroimaging and neuropsychology evaluations of individuals who presented a mild acute infection. Here we investigated cognitive dysfunction and brain changes in a group of mildly infected individuals. We conducted a cross-sectional study of 97 consecutive subjects ( median age of 41 years ) without current or history of psychiatric symptoms (including anxiety and depression) after a mild infection , with a median of 79 days (and mean of 97 days ) after diagnosis of COVID-19. We performed semi-structured interviews, neurological examinations, 3T-MRI scans, and neuropsychological assessments. The patients reported memory loss ( 36% ), fatigue ( 31% ) and headache ( 29% ). The quantitative analyses confirmed symptoms of fatigue ( 83% of participants), excessive somnolence ( 35% ), impaired phonemic verbal fluency ( 21% ), impaired verbal categorical fluency ( 13% ) and impaired logical memory immediate recall ( 16% ). Our group… presented higher rates of impairments in processing speed ( 11.7% in FDT- Reading and 10% in FDT- Counting ). The white matter (WM) analyses with DTI * revealed higher axial diffusivity values in post-infected patients compared to controls. * Diffusion tensor imaging tractography , or DTI tractography, is an MRI (magnetic resonance imaging) technique most commonly used to provide imaging of the brain. Our results suggest persistent cognitive impairment and subtle white matter abnormalities in individuals mildly infected , without anxiety or depression symptoms. One intriguing fact is that we observed a high proportion of low average performance in our sample of patients (which has a high average level of education ), including immediate and late verbal episodic memory, phonological and semantic verbal fluency, immediate visuospatial episodic memory, processing speed, and inhibitory control . Although most subjects did not present significant impaired scores compared with the normative data, we speculate that the low average performance affecting different domains may result in a negative impact in everyday life , especially in individuals with high levels of education and cognitive demands .’ ❂ ❦ Note how these findings might negatively affect daily activities that demand sustained cognitive attention and fast reaction times – such as driving a car or motorbike, or piloting a plane. Consider air-traffic control. Consider the impact on healthcare workers whose occupations combine long periods of intense concentration with a need for critical precision. ❂ 📖 (19 Jan 2024 ~ Nature: Scientific Reports) Microstructural brain abnormalities, fatigue, and cognitive dysfunction after mild COVID-19 ➤ © 2024 Nature .
‘ Clinical evidence suggests that SARS-CoV-2 may lead to hypocalcemia, altered bone turnover markers, and a high prevalence of vertebral fractures. ’
❦ “We cannot individually assess the risk of infection from poor indoor air quality (IAQ). Just as we cannot individually assess food safety in restaurants, or fire safety in cinemas, or aviation safety on flights. These are in the control of others, and are regulated for our health and safety.”
❦ ‘Acute infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause a respiratory illness that can be associated with systemic immune cell activation and inflammation , widespread multi-organ dysfunction , and thrombosis . Not everyone fully recovers from COVID-19, leading to Long Covid, the treatment of which is a major unmet clinical need. Long Covid can affect people of all ages , follows severe as well as mild disease , and involves multiple organs . Patients with Long Covid display signs of immune dysfunction and exhaustion , persistent immune cell activation , and autoimmune antibody production , which are also pathological features of acute COVID-19. The complement system is crucial for innate immune defense by effecting lytic destruction of invading micro-organisms, but when uncontrolled, it causes cell and vascular damage . The complement cascade is activated by antigen–antibody complexes in the classical pathways or in the lectin pathway by multimeric proteins (lectins) that recognize specific carbohydrate structures, which are also found on the SARS-CoV-2 spike protein that facilitates host cell entry. Both pathways may contribute to the pronounced complement activation in acute COVID-19. Long Covid symptoms include a postexertional exhaustion reminiscent of other post-viral illnesses , such as myalgic encephalomyelitis ( ME ) – chronic fatigue syndrome ( MECFS ) with suspected latent viral reactivation . Antibody titer changes in Long Covid patients indicate an association of fatigue with reactivation of latent Epstein-Barr virus ( EBV ) infections , and Cervia-Hasler et al found that the severity of Long Covid symptoms is associated with cytomegalovirus ( CMV ) reactivation . A better understanding of the connections between viral reactivation, persistent interferon signaling, and autoimmune pathologies promises to yield new insights into the thromboinflammation associated with Long Covid. Although therapeutic interventions with coagulation and complement inhibitors in acute COVID-19 produced mixed results, the pathological features specific for Long Covid suggest potential interventions for clinical testing. Microclots are also observed in ME-CFS patients , indicating crucial interactions between complement, vWF, and coagulation-mediated fibrin formation in post-viral syndromes. A better definition of these interactions in preclinical and clinical settings will be crucial for the translation of new therapeutic concepts in chronic thromboinflammatory diseases .’ ❂ 📖 (18 Jan 2024 ~ Science) Immune damage in Long Covid ➤ © 2024 Wolfram Ruf / Science .
“I would argue that COVID-19 is not a disease of the lungs at all. It seems most likely that it is what we call a vascular and neurologic infection, affecting both nerve endings and our cardiovascular system.”
❦ “I met a nice lady – a ward patient – yesterday who, seeing my [ FFP3 ] respirator [ high-filtration ‘mask’ ] , promptly put on her surgical mask. So instead of diving straight in to asking what was most concerning her and how I could help, I opened up a bit about infection control in hospitals. I explained how, because of a lack of respirators, March 2020 saw NHS leaders downgrade PPE for all non-ICU staff. ❂ PPE : Personal Protective Equipment. I then reminded her of the amazing DHSC 2020 and 2021 campaigns on airborne transmission of SARS2 (the green-and-black smoke ones) – and I had to point out that every IPC Lead Nurse had since had to switch off their brain and forget what they knew – and while at work, to only protect ICU staff. ❂ DHSC : Department of Health and Social Care (UK). ❂ IPC : Infection Prevention and Control. I explained that the individuals responsible for the original IPC downgrade were now authors of the national manual on IPC (NIPCM), which sets the standard for infection control in hospitals, and this manual states that airborne transmission is ‘not a thing’ for SARS2 (AGP only). ❂ NIPCM : The UK’s National Infection Prevention and Control Manual. ❂ AGP : Aerosol-Generating Procedure, ie. intubation. So hospitals are destined to be unsafe spaces thanks to the NIPCM, and the surgical mask that she was wearing was OK (ish) to help protect me – but did very little to reduce her risk of SARS2 inhalation. However, she was in a single room (an extra, and not meant as a ward-bed space – but you know, >100% occupancy forever means that you need to use your imagination) – and she already had the window open. She was appalled at what healthcare workers were being put through. She was appalled at the on-going lies. She was appalled at the possible level of harm to patients and staff from such lies. She then went on to tell me how a weekend visitor of hers had just tested positive for Covid. She was worried that they had hugged and chatted, and that she might have got infected. She’s a switched on lady, too. Lives with a medic who has the windows open all the time (“It’s freezing at home”). So I explained about the CleanAirStars.com site. About HEPA filtration being a low energy and low-cost way to remove all airborne pathogens , and to make home a safer place for... • Covid • Flu • RSV • Norovirus • Fungi, etc. etc. The list goes on and on. — “Wow, that’s like magic!” We had a very nice chat. And then we talked about her heart. I just wish I could have this same conversation with each and every NHS CEO and IPC Lead Nurse. I’d ask some questions. I’d want to know why they aren’t protecting staff as they should. I’d want to know why they aren’t protecting patients as they should. I’d want them to know that they are in breach of UK legislation . And I’d want to look them in the eye and ask them to show compassion to the powerless: to staff, and patients. Help us please. Do whatever you can to counter the lies, and to help protect the NHS. Thank-you.” ✾ © 2024 Dr. David Tomlinson (NHS Consultant Cardiologist) ➤
‘[COVID-19’s] ability to invade the central nervous system through the hematogenous and neural routes, besides attacking the respiratory system, has the potential to worsen cognitive decline in Alzheimer’s disease patients. The severity of this issue must be highlighted.’
