Understanding is coming. But slowly-slowly

The top infectious-disease expert, Dr. Anthony Fauci said to Harvard Medical School some clever things and some less clever ones. We reprint what was clever.

Coronavirus Is "Much More" Aerosolized Than Thought

Ill man wearing grey sweater, yellow hat and spectacles, blowing nose and sneeze into tissue

Theories on the extent to which coronavirus is transmitted through respiratory droplets (the stuff produced by coughing, sneezing and breathing, which quickly drops to the ground) versus aerosols (smaller particles that can linger in the air) are changing. "There was some real misunderstanding about respiratory droplets and so-called aerosolized particles," he said. "The aerosol and particle physicists that have approached us now have told us that we really have gotten it wrong over many, many years. Bottom line is, this is much more aerosol than we thought."

Transmission From Surfaces Isn't Understood

"Infected surfaces clearly occurred," said Fauci. "The degree to which they contribute to transmission is unclear."

The Virus Isn't Just In Respiratory Droplets

"The virus is in multiple body fluids," said Fauci. "Again, what the role in transmission is unknown."

Animals Can Be Infected

"Animals, both domesticated and zoo animals can be infected," said Fauci. "And yet again, we do not know and doubt whether this is a major source of human infection."

Events, Not One Person, Are Super-Spreaders

"They're really much more super-spread at events than super-spread of people," said Fauci. "We used to think that a single person may be particularly prone to spreading it a lot. It is much more likely it's the circumstance in which that person is, as opposed to anything specific about the specific person."

Asymptomatic Transmission Is Higher Than Previously Thought

"The thing about this outbreak that is very perplexing in being able to track and get our arms around is the fact that about 40 to 50% of the infections are asymptomatic," says Fauci. "If that's not bad enough, we know that now—and there was some doubt about this until it was really clarified—it is likely that up to about 50% of transmissions off of individuals who do not have symptoms."

What's "Most Perplexing" About COVID

"The thing that's most perplexing to me as a physician is the extraordinary range and spectrum of disease severity," said Fauci. The case fatality rate varies greatly on age and underlying condition."

Error

There's been some who feel that one of the approaches may be just protect the people in the nursing home, because they are the ones that are susceptible to severe disease. If the others get infected, there may not be a problem. Well, we know that's not the case, because there are enough people who have underlying conditions who are not in nursing homes, who clearly have a predisposition to severe disease.

It's Time to "Hunker Down"

I just think we need to hunker down and get through this fall and winter, because it's not going to be easy.

What He's Learned From COVID

Don't ever underestimate as it evolves. And don't try and look at the rosy side of things. The idea of throwing everything to somebody, because it's desperate, doesn't work. It's gotten us into trouble with other diseases. As for yourself, do everything you can to prevent getting—and spreading—COVID-19 in the first place: Mask up, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest.

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