Sharing in case this helps someone.

The last time someone in our household got Covid, we were able to keep it from spreading to anyone else. ♥️🙏🏿 This time we were not so lucky. My Covid high score streak is finally broken! Rona got me y'all!

Completely unscientific observations of how this thing looks to have beat our mitigations:

Day 0: Contagious. No symptoms. Negative tests.

Day 1: Contagious. Slight symptoms. Negative test.

Day 2: Contagious. More severe symptoms. Positive tests.

Our family doesn't eat indoors, doesn't go into buildings unmasked, wears masks in dense outdoor situations, wears a full elastomeric mask when flying.

For the past few weeks, even when outdoors, I've seen a few friends coughing, and I immediately put my mask on. They then say, "No dude, relax, it's not Covid, I tested this morning!" And I said, "🙅🏿‍♂️ Sure! That's what 'Rona *wants* me to think! 😷" 4 friends this happened with, and all 4 tested positive the day after their little coughs.

Mitigations that worked last time:

* Positive person moved to the remote room in our house with its own sliding door to the patio

* Masking tape and rolled up towel put around the door to seal them in.

* AC run on not heat, not cool, but "move air" through the hypoallergenic filter.

* Feed the infected person by wearing a mask and leaving trays of food on the patio, like feeding Hannibal lecter!

* Me spending a week outnumbered by my toddlers, while my wife watches SpongeBob and relaxes

At first I couldn't figure out why the same mitigations didn't work this time, but then I noticed the pattern of who was getting infected and when.

6 people drove back on a 4 hrs road trip after 4th of July. The front passenger had sniffles, but tested negative. They tested multiple times in a row to be sure.

A theory: front passenger caught Covid during the trip and were on their "day zero, negative results" day.

Driver and passenger directly behind them had their "day 0," two days later.

On the "day 0: no symptoms, negative test" day, and "day 1: slight symptoms, negative test" day, I tried out another theory, and it kind of worked.

My hypothesis was that if you're able to spread covid, but your test is showing negative, then you're either testing wrong, or you're testing right, but the right method is not showing the right result.

We usually do the nasal and cheek and tongue swab.

So we burned a bunch of tests on everyone testing everyone multiple ways.

We tested:

* Nasal only
* Nasal, and tongue and cheek swab
* Nasal, tongue and cheek, and hold swab in air near back of throat and cough
* Nasal, and cough
* Just cough

Adding the cough turned "day 0 negative" into a slight positive test, and "day 2 positive" into a super dark purple line positive test. Darker than we've ever seen. 😬

My totally unscientific understanding of this, is that this is a "throat Covid," not a "nose Covid." And that the false negative rate is higher for this wave.

🚨Talk to your doctor before doing any of what is implied by the following. Seriously. If you don't, you are exercising the exact same judgement as the Ivermectin sipping anti-vaxxers. Which is none. Don't do it. You are not smart if you take a drug based on a Mastodon thread written by some tech bro.🚨

* Long Covid sucks. Try to avoid it.
* There are well understood, relatively safe, relatively cheap drugs, that can reduce your chances of getting long Covid

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00299-2/fulltext

Oh, what we could have done differently, that may have yielded a different result:

* Treat road trips like airplanes. Super annoying, but we should have all masked on the 4 hr drive. 🤷🏿‍♂️

* Added coughing to our testing.

* Understood better (remembered) that a lot of transmission happens before a positive test. We should have all preemptively masked in the house, once one of us tested positive.

@mekkaokereke Also: I doubt your AC on its own reaches 6, much less 12, air changes per hour. Portable HEPA filters or Corsi-Rosenthal boxes very much recommended. See @joeyfox’s https://itsairborne.com/ blog, or just go straight to my favorite source: @cleanairkits

@DirkK @joeyfox @cleanairkits

Yeah, we have a Corsi Rosenthal box, and a real air purifier too.

And we have a powerful UV light on a timer that we put in the isolation room and program to light up for an hour when we're not in there.

On the level of caution, I'd say we're extreme for the USA, but par for the course for some parts of China and Korea.

@mekkaokereke @DirkK @joeyfox @cleanairkits excellent thread, matches my strategy al most exactly with exceptions. We didn't have a uv light. Pos person shared a bathroom. She took Paxlovid and wore an N95 when leaving her isolation room. The rest of us wore procedure masks at all times. Zero spread.

Feel better!

@mekkaokereke That last point is the tricky one. Hope the family comes through safely.

@mekkaokereke That’s a tough break. If you’re in a car with an infected person that long … masks could have alleviated but I think y’all would have gotten it anyway. Masking the infected would have helped most

IME, the rapid tests now aren’t showing positive until day 2 or 3 of the infection. It stinks

Rest, rest, rest, drink water. SpongeBob is hilarious. Best of luck 🙏

@mekkaokereke I hope it passes swiftly. Time for Paxlovid?
@mekkaokereke thank you so much for all this information. It’s so helpful and very much appreciated.
@mekkaokereke Yeah, the car, without opened windows is a crowded, confined space. For the home, these or similar are good ideas, if possible: https://www.consumerreports.org/products/air-purifiers-29549/room-air-purifier-29550/blueair-blue-pure-211i-max-409590/
Blueair Blue Pure 211i Max Air Purifier Review - Consumer Reports

We've tested and reviewed products since 1936. Read CR's review of the Blueair Blue Pure 211i Max air purifier to find out if it's worth it.

@wndlb @mekkaokereke
Cars have *tiny* internal volumes

@mekkaokereke Cars are, if anything, worse than airplanes for respiratory disease transmission. I carry a CO2 meter with me and in a standard size car with 2 people, AC on (air on recirculate), it regularly reaches dangerously high CO2 levels of 1800+ ppm. Ideally you want <600 to go unmasked.

Planes usually end up similarly ventilated but they at least have HEPA filters. Cars don't. Masks (N95+) stay on in the car if I'm seeing someone my household and the windows get rolled down too.

@ehashman @mekkaokereke But masks won't affect the CO2 level of the air you breathe?

I would be very happy if every car in the world vanished overnight.

@ehashman @mekkaokereke that seems reasonable if you set it to recirculate? It should allow a minimum of new air to enter so it's basically the "please infect me" setting these days
@Paxxi @mekkaokereke Most cars default to recirculate if you have the AC on. Pulling in outside air through the ventilation system helps a little but not as much as you'd think, and reduces the ability of the car to cool the interior.
@ehashman None of my cars have done that afaik.I don't want outside air for cooling, I want it to prevent co2 buildup and drowsiness but that's my personal opinion, not saying it's right 😀
@ehashman @mekkaokereke airplanes have a bunch of people in them though so for virus your chances of one of them being infected goes up. Also you're usually in there longer with more unmasked people. If your in a car, mask up, and require anyone outside your household to mask. If your on a plane, most ppl are t masking, so that again increases risks. HEPA alone isn't a solution in any place by itself. It's meant to compliment masking.
@mekkaokereke thank you for this, it may not pass as a scientific test, but you at least thought logically about it.

@EdSanders

🐶🧪🔬

Much more dangerous than no knowledge!

@mekkaokereke A good rule of thumb is that masking divides exposure by five so a 5 hour trip masked is equivalent to one hour unmasked. Worth the effort but no magic bullet.
@mekkaokereke this is hella interesting, and i'm sorry you got sick! do you have any links to how to appropriately use coughing while performing a covid test?

@tabletophotdish

I don't have official guidance on how to do this properly. But my dad (doctor) says that what I did was... probably not great.

His take: Improved test accuracy yes, but by intentionally coughing (with my mask off no less!), I aerosolized a bunch of Covid into the room!😬

He said they've known about the increased accuracy of coughing up phlegm method, but that they never asked people to intentionally cough at mass testing centers for this obvious reason.

@mekkaokereke I hope you all recover quickly, with no lingering effects!
@mekkaokereke thank you for being so clear about where you feel the holes were in your raft of protections, for the benefit of a bunch of strangers!

@mekkaokereke
One thing I discovered from doing CO2 concentration measurements in closed cars is that they have *terrible* ventilation. Even a car with the vents fully bringing in outside air has poor ventilation. CO2, with only 2 people in a Golf, goes up to around 2500ppm with just vents.

The only mitigation we found was to open a window a crack. The tilt on the moon roof is perfect. CO2 stays around 500. Also helps keep me from falling asleep due to the high CO2.
@hakamadare