McIlvaine Coronavirus Market Ale

Livestock Meat Packing Plants Responsible for 6-8% of COVID Cases in the U.S.

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Masks should be selected based on a CATE rating system which takes into account comfort, attractiveness, tight fit and efficiency. The rating can combine leakage percentage, inefficiency percentage, and resistance in mm H20 to produce a combined rating number. Attractiveness could be A for very attractive B for medium and C for not attractive.

Mask	Inefficiency %	Leaks %	Resistance mm H20	Total	Attractiveness
CATE mask 99	1	4	14	19	A
CAE mask 95	5	4	9	18	A
CATE mask 93	7	4	8	19	A
Cloth Mask	40	40	15	95	A
Surgical Mask	5	40	8	53	C
LF N95	5	30	14	49	C
TF N95	5	4	12	21	C

This rating system will make it much easier for people to select the best mask for their needs. For example the numerical difference between a 18A mask and a 95A mask is striking.

On a rough basis the wearer can determine the relative risk of one mask vs another. In a low load virus environment the risk with the 18A mask may be 1 in one thousand. The 95A mask would generate 5.3 times that risk which is still only 5.3 in one thousand. But in a super spreader situation where the odds jump to 200 in 1000 or 20% with the 95A mask they are only 3.8% for someone in a 18A mask

The inefficiency and leaks from various mask types have been documented in previous alerts. This includes loose fitting N95 masks worn by a number of people who do not realize the leak danger.

Testing firms such as Nelson Laboratories already provide reliable validation of efficiency and resistance

Fit testing for the public requires a different system than for healthcare workers. For someone in a hospital setting there are both qualitative and quantitative fit testing methods. But they require tests of individuals.

For masks used by the public the best approach is to use a panel of people of different sizes, provide appropriate masks for each and then test leakage under various conditions. One company has invested heavily in this approach.

Vogmask has Quantitatively Fit Tested human subjects to ensure the filtering efficiency is retained over a series of motions like walking, head movements, bending over, talking, etc. Here is a sample of the fit testing on Test Subjects.

The determination of a leakage rating is therefore more subjective and requires a different validation approach. An expert reviewing the Vogmask data would have confidence that the leakage range is within the 1-8% range. It is therefore recommended that a validation group be formed to provide impartial judgements on data submitted by mask makers.

This group can rely directly on leakage and efficiency data if provided by a qualified firm. It will need to spend more time reviewing the fit data supplied by the mask maker. If this fit testing is also done by approved vendors then this too should require little time from the validation group.

The validation group could charge for each mask reviewed. The cost would not be appreciable if the primary task is validation of the approach used by others.

Quantitative Fit Tests are Needed

Examinetics explains the distinction between qualitative and quantitative fit testing.

Qualitative fit testing is a pass/fail method used on half-masks that relies on senses - such as taste and smell - to detect air leakage from your respirator. The half masks being tested must have an overall fit factor (mask particle concentration divided by the ambient particle concentration) of 100 or less. The test relies on a harmless, yet bitter-tasting chemicals called Bitrex, which will determine whether you pass. Rather than measuring the amount of leakage into the facepiece, the qualitative fit test determines whether the facepiece is in working order. Unfortunately, if you taste a bitter substance, it is a fail.

Specifically, at Examinetics, they offer taste only tests. For those who cannot detect bitter taste, they offer saccharin, an artificial sweetener, as a replacement.

Workplace Quantitative fit testing is the process to measure the precise amount of leakage into any tight-fitting facepieces. Instead of relying on bitter-tasting chemicals and your senses, the test is performed by a machine calculating the measurements. Typically, the facepiece is attached to a probe, which is connected to the measuring machine by a hose. According to OSHA regulations, there are three acceptable quantitative fit test methods:

Upon completion of the test, each eligible employee has issued a card listing the make, model and sizes of the respirator they received a passed fit test.

Livestock Meat Packing Plants Responsible for 6-8% of COVID Cases in the U.S.

New research published by the National Academy of Sciences ties livestock meat packing plants to 6% to 8% of U.S. COVID-19 cases, and 3% to 4% of the deaths through late July.

The authors said the data show “a strong positive relationship” between meatpacking plants and “local community transmission,” suggesting the plants act as “transmission vectors” and “accelerate the spread of the virus.”

Researchers at Columbia University’s School of International and Public Affairs and the University of Chicago’s Booth School of Business found that the risk of excess death primarily came from large meatpacking plants operated by industry giants. Communities that acted to shut down slaughterhouses reduced spread, according to the researchers.

In a statement, the North American Meat Institute said, "Meat and poultry companies continue to invest, more than $1 billion so far, in significant changes and improvements regarding COVID-19 prevention and control practices to protect the men and women who work in their facilities. By limiting the data examined to July 21, 2020, the article does not evaluate the complete timeline of information. The authors fail to capture the downward trend of positive cases associated with the meat and poultry industry into the summer and fall, especially in contrast to the positive cases reaching new highs around the nation.

"Significantly, even the authors suggest caution, saying 'The best we can do here is provide an unusually broad array of observational evidence' and that they do not want to 'overstate the hardness of our method.' The timeline limitations, coupled with those cautions, should give pause to drawing any conclusions."

The peer-reviewed study was published last week in the Proceedings of the National Academy of Sciences of the U.S.

The researchers called the COVID-19 pandemic a public health and economic crisis in which policymakers face tradeoffs between maintaining essential economic activities and mitigating disease spread. President Trump issued an executive order on April 28 directing meatpackers to reopen closed facilities.

“Our study suggests that, among essential industries, livestock processing poses a particular public health risk extending far beyond meatpacking companies and their employees,” the authors wrote.

The study estimated packing plants were associated with 236,000 to 310,000 COVID-19 cases and 4,300 to 5,200 deaths by July 21.

“The vast majority” of those cases were “likely related to community spread outside these plants,” the researchers wrote. The authors suggested an investigation into supply chains, operating procedures and labor relations within the meatpacking industry.

The researchers also found plants that received waivers from the U.S. Department of Agriculture to increase their production-line speeds had relatively more county-wide cases.

“Ensuring both public health and robust essential supply chains may require an increase in meatpacking oversight and potentially a shift toward more decentralized, smaller-scale meat production,” the study concluded.

Meat Processors Not Using CATE Masks

The following is the just revised guidelines for meat processing plants in the state of Kansas. they do not specify tight fitting efficient masks and even allow workers to wear cloth masks of their selection. They discourage the use of medical masks. Also since much of the transmission is within worker families the use of CATE masks by everyone would solve the problem

“Masks for everyone entering facility: Employees should wear a face mask/face covering at all times while in the workplace. Employers can issue facemasks or can approve employees’ supplied cloth face coverings in the event of shortages. At this time, we are discouraging the procurement of medical masks as they remain in extremely short supply and should be reserved for healthcare workers. All visitors to the facility should also wear a face mask. Plans and procedures should be in place to ensure 100% mask use while in the facility. Health education should be provided on the importance of masks”

Nursing homes workers who do not have COVID patients can be using CATE masks. Nursing home residents who do not have COVID should definitely be using comfortable CATE masks. Instead many residents are not wearing masks and workers are reusing N95 masks for more than one week. Here are some excerpts from an NBC News Report.

More than 1,300 nursing homes across the U.S. reported having three or more confirmed Covid-19 cases during the first week of November — the highest number ever reported in a single week, according to an NBC News analysis of federal data. The figure does not include outbreaks at assisted living facilities, which the federal government does not track.

Many of the new nursing home infections are emerging in the Midwestern states where the virus is besieging the broader community, including Illinois, Ohio, Missouri, Indiana, Wisconsin and Iowa, which reported some of the country's biggest weekly increases in suspected and confirmed cases among residents, the data showed. (Facilities report suspected cases when residents exhibit Covid-19 symptoms but have yet to receive positive test results.)

Nursing home case numbers have also been surging in rural areas, with spikes in the Great Plains. Facilities in South Dakota reported 253 new infections among residents during the week that ended Nov. 8 — three times the number reported a month earlier. And across the country, a large number of facilities are reporting staff shortages, and some are still struggling to acquire personal protective equipment and reliable testing.

"It's an out-of-control fire. You stamp it out in one place, then it pops up somewhere else," said Bill Sweeney, senior vice president of government affairs at AARP, which has urged Congress to pass more funding for testing, personal protective equipment and staffing for the country’s 15,000 nursing homes.

Friendship Haven, which runs a nursing home and assisted living facility in Fort Dodge, Iowa, had a few isolated Covid-19 cases over the summer, but amid the state’s record surge, 12 staff members and 14 residents recently tested positive.

"Masks are still not acceptable here, and that is very frustrating. The community is not really understanding," said Julie Thorson, the president and CEO of Friendship Haven. "You are worried about the inconvenience of a mask, and my staff has been sweating and crying through their masks since March."

New outbreaks are also emerging in facilities that were pummeled by the first wave of the pandemic — which killed tens of thousands of residents in the Northeast and other early hot spots — only for the virus to return.

Jewish Senior Services, a nursing home in Bridgeport, Connecticut, had 22 residents die from Covid-19 during the spring; about 10 percent of the staff became infected, said Andrew Banoff, its president and CEO. Personal protective equipment was so scarce that the facility resorted to purchasing supplies directly from a company in China, he said.

Within a few months, cases finally subsided at the facility and within the broader region. In mid-June, Connecticut began requiring weekly Covid-19 tests for all nursing home staff members and residents and funded all the testing. Other states have implemented similar testing requirements, although not all are paying for the tests.

Staff members with a resident of Jewish Senior Services in Bridgeport, CN. Jewish Senior Services

The nursing home was virus-free throughout the summer and early fall. Then, in mid-October, as case numbers began rising once again in Connecticut, the first staff member tested positive. Nineteen more staff members and eight residents have become infected, as well, Banoff said. Two of the residents died from Covid-19 last week.

"We knew we were on borrowed time," Banoff said. "But it was devastating when we all had to go in and call the families — not just of the residents that tested positive, but those exposed through staff. We had to make 84 phone calls."

Jewish Senior Services and other long-term care facilities have better access to testing and personal protective equipment compared to the spring. The federal government has also distributed billions of dollars in Covid-19 relief funding to nursing homes, along with rapid testing machines, although they are less accurate than lab-based tests.

But nursing homes across the country are still reporting shortages of protective equipment and testing delays. As of the first week of November 1 in 10 facilities said they did not have a week's supply of N95 masks, according to the federal data. Nearly a third of all nursing homes said they had to wait three to seven days to receive Covid-19 test results.

Providers worry that access to both protective equipment and testing will become more difficult as case numbers continue to rise. The federal government unveiled new testing guidelines in late August, requiring staff members to be tested monthly, weekly or twice a week, depending on a county's overall positivity rate. But nursing homes are still facing difficulty getting access to tests, freeing up staff members to administer them and covering the cost, according to LeadingAge, an industry group that represents nonprofit long-term care facilities.

“Our pleas are being ignored. The support we have received has been insufficient and is running out quickly,” Katie Sloan Smith, president and CEO of LeadingAge, said Monday on a press call. “The virus is raging, infection rates are skyrocketing, and the pool of financial support is running low.”

The national stockpile — intended to be a backstop for health care facilities that have exhausted their supplies — is also facing shortfalls. In July, the federal government said it wanted to have a 90-day supply of critical personal protective equipment on hand. As of last week, however, the Strategic National Stockpile had only about half of the 300 million N95 masks needed and less than 1 percent of the gloves needed to meet the target, according to figures from the Department of Health and Human Services.

Victoria Richardson, who earns $14 an hour as a certified nursing assistant at a Chicago-area nursing home has been struggling to pay her bills since her husband died of cancer in September, and she now fears losing her home. She also still worries about contracting the virus, which has killed 18 residents at Forest View since the beginning of the pandemic. Even now, she said, staff members struggle to get proper protective equipment. On Monday, Richardson and nearly 700 other Infinity nursing home workers went on strike to demand higher pay and proper protective equipment.

"I have to reuse the same mask for a week, and I don't get an N95 unless I insist on having it," Richardson said.

The Centers for Medicare and Medicaid Services pointed to efforts to provide long-term care facilities with testing, supplies, training and technical assistance, but said that some nursing home staff members were not following basic Covid-19 protocols, like washing their hands and wearing personal protective equipment properly.

“Based on our inspections and as the field reports from our strike teams, we have found that nursing home staff continue to fail to consistently implement proper infection control practices,” the agency said in a statement.