just a selkie in the sea

(I also go by Liz)

avatar by @PotechiPon on twitter


NoelBWrites
@NoelBWrites

Do you have or know of a similar document? Do you have a good resource or research you can share?

Since we're in the US, our public health guidelines are, basically: "lol. lmao." We have to do this ourselves and I'm looking for examples or other guidance.

I know the basic is requiring respirators (and we have KN95s to give out if needed). We also want to require up-to-date vaccination, but that is spottier because what even counts as "up to date" in the US, not to mention not everyone has the same access.

Also what happens when someone does get COVID? How do we best handle it? Rapid tests are bullshit, do we require a negative PCR that may be expensive and onerous for a sick person to get? Do we just wait it out? For how long? How do we do contact tracing, how long is someone infectious?

I have a lot of questions and I want to know how other COVID-conscious orgs deal with this


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in reply to @NoelBWrites's post:

also like, I don't want to waste our time, energy and resources on security theater

we know screening for symptoms is a waste of time at best and provides false security at worst, so I'm not going to get us a thermometer to check for fevers and stuff, but like half the guidelines out there still recommend that

Oh hi!

The things I post are generally focused on activism and awareness moreso than specific strategies or data.

But also, I'd be happy to share some thoughts and links that could be helpful! As an individual, I generally approach this stuff under the philosophy of a Swiss Cheese Model + precautionary principle to stack together as many protective measures as I reasonably can (no matter how small the plausible benefit is).
But I read that you're working with limited resources for a shared space here, and I think that necessitates a more strategic focus.

The current SARS-2 vaccines don't prevent infection or transmission. They reduce the risk of mortality and poor outcomes from an infection, which is very important!! But they'll contribute little to office biohazard control.

The current tests for SARS-2 continue to become less reliable, less accessible, and more expensive. Asymptomatic and Pre-symptomatic infections have been estimated to be a major (or primary, in some studies) cause of transmission. Current rapid tests are known to mostly fail to detect the virus in samples from those who aren't experiencing symptoms. Honestly, I think it's difficult to justify any negative test result being authoritative unless multiple are used over the course of a week. Which gets pretty pricey really quick.

So if you take ^^ those things ^^ into account, that means people can be infectious without knowing AND there aren't accessible/affordable tests that could reliably detect an infectious period. Well, fuck! That's really challenging to confront.

And thus, I'd focus primarily on cleaning the air. Two effective approaches for this that work great together are using respirators for source control (no exhalation valves) and running supplemental air filtration units.

Firstly, the respirators. You say you have a supply of KN95s to distribute, which is a good place to start! Unfortunately, if it's a KN95, that means it probably has ear loops. And if it has ear loops, then it won't actually do a consistent job of filtering the virus out of the air.
So, if you can, I really do think it's worth it to try acquiring better respirators that actually provide respiratory protection. The 3m Aura is my top pick. But if you can't source anything better, there are some mask hacks that can improve those KN95s somewhat.
Regardless of what masks you're working with, it is incredibly important to ensure that these tools are being worn properly at all times within shared spaces.
This can be a pretty big ask for some people, and inaccessibly impossible for others. So there needs to be a shared understanding that any moments lifting a mask must be minimized as much as reasonably possible. One consideration for this is that acting calmly & quietly can reduce the amount of air that's inhaled & exhaled.

Secondly, the filtration units. I saw you commented about CR Boxes, and fuck yea!!! They are awesome devices that are very cost-effective for moving clean air around. Ideally, determining how many you want requires measuring the dimensions of your space and crunching some numbers.
But unless you have many of the boxes, this will likely work out such that you'll want to be running them on maximum power when people are in the space. Joey Fox has many good posts up on medium about sorting out the technical details if you want to dive deeper.

As for your last question, what to do in the event of confirmed COVID? Isolation for a minimum of 10 days & until all symptoms have subsided. Support those who are recovering however you can. Do whatever is needed to get 2 courses of Paxlovid & 1 course of Metformin started as soon as possible.

I'm happy to hear that my response has some helpful words!

Comment here again if other questions come up, and I can add links to more words from others.

To put my own words into perspective: I spent nearly a year handling COVID testing & procedures for a live performance venue, and also pushed for everything I could to make the space safer + more accessible. I had only limited input on the company's COVID policy document, and I don't think it's something worth referencing. Eventually, the company got tired of my efforts, and pushed me out.

I read a lot about this big scary virus, and want to help others where I can.

For testing, would the burden be on the individual or does the group have funding to help? There are certain at-home tests (Lucira, Cue, Metrix) that are more accurate than antibody tests (much closer to PCR).

But rapid tests are still helpful, depending on circumstances. A negative doesn't mean much, but obviously a positive does. And testing multiple days can help increase their helpfulness.

What's the purpose of testing? Is it as an extra layer of precaution before meetings, for symptomatic folks, for figuring out when people with confirmed cases are no longer transmitting? I don't really have answers on how best to handle any of those (sorry!), but answering those questions might help with finding resources.

We do not have any external funding at all, it's all whatever each of us can pitch in at any given time

From what I've found, the FDA recommends testing two or three times with 48hs in between with rapid tests for a negative to be even a little bit trustworthy

And a positive is still helpful, you're right. Ideally testing would not be just to make sure we're not spreading plague, but also to start treatment/recovery/help as soon as possible when someone is positive

As I understand it, although rapid tests aren't very effective for determining whether you actually have COVID, they're somewhat more effective for determining whether you're infectious. I haven't found great data on this for Omicron, but at least in earlier days there was a very high correlation between rapid test results and contagion.

Otherwise, meeting remotely when you can is the absolute best protection you can provide. When you have to meet in person, I think if you're masked, outdoors, and everyone's had a negative rapid you're probably looking at 99%+ protection even with pretty high ambient COVID prevalence.

Unfortunately the purpose of this org is specific and requires in-person stuff, but whenever we can do remote (like for meetings and planning) we do that. We're also getting CR boxes for the indoor space we'll be using and are fundraising for an air quality monitor, air filters, etc.

From what I've read, the rapid tests respond specifically to the spike protein (they have specific antibodies on the test strip that attach to it and cause the positive result to show up), which means they're less effective with newer variants that have a different protein "shape." They do have an easier time detecting the virus if it's present in larger quantities (like when you're infectious). The PCR tests look for genetic material, which is why they're more accurate (but also take longer and usually require a lab)

yeah, it's the "large quantities of spike protein" thing you'd be betting on. it's almost certainly the case that a rapid test is better at picking up infectious Omicron cases than uninfectious ones, the question is just "by how much" which I'm still searching for an answer to