One study's look at COVID-19 transmission, plus advice to stay healthy

Dr. Peter A. McCullough laid out an intriguing theory about the science behind COVID-19 and how to guard against infection in an article for The Hill. He examined five points regarding viral transmission and offered four principles to put into practice, especially as people emerge from lockdowns and other restrictions. Dr. McCullough is vice chairman of medicine at Baylor University Medical Center and a professor of medicine at Texas A&M College of Medicine in Dallas.

Among his suggestions: Fresh air is an ally in the fight against COVID-19. This is a point I also recently emphasized in a recent AccuWeather.com report, “Air circulation is key. It is healthy to air out your home.” It’s an idea supported by the Centers for Disease Control and Prevention (CDC), which recommends increasing a home’s ventilation by opening windows to keep your home safe at this time.

McCullough considered five explanations for viral transmission. 

• Severely ill patients passed large viral loads on to their families, close contacts and first responders, creating more severe cases. 

• Large viral load transmission on planes played a role in the spread of the virus.

• The converse of his first point is true, he says: Asymptomatic and minimally symptomatic people had lower numbers of viral particles spread to others, creating another asymptomatic or minimally symptomatic person, resulting in community spread without hospitalization.

• The virus spread even further because of the susceptibility to COVID-19 among some older people, those with pre-existing conditions and nursing home residents.

• Finally, there were a number of cases of repeated viral exposures and self-dosing, for example, exposures among individuals kept in close proximity, such as occurred on cruise ships and the USS Teddy Roosevelt aircraft carrier. 

“This could explain why enclosed high-rise apartments in New York, Milan and Wuhan were fostering severe cases as infected patients sheltered in place without access to fresh air. It may also explain why there were relatively few severe cases in rural areas of any country, or in places where moderate temperatures and open windows allowed aeration,” McCullough wrote. 

Experts warn, however, that while total COVID-19 cases are still much lower in rural areas compared to cities, the number of cases is growing at a faster rate, according to the Washington Post. In the two-week period between April 13 and 27, novel coronavirus cases increased 125 percent in non-metro counties, compared to 68 percent in metro counties, according to research by the Kaiser Family Foundation. Deaths from the virus increased 169 percent in non-metro counties and 113 percent in metro counties for the same time period.

I believe, however, an individual in a big city is more likely to be around more people and therefore possibly get more of a viral load compared to an individual in a rural area. For example, if you are in a subway car and you have three to five people with the virus in that same car – you are confined, you are breathing it in – it is possible your viral load would be much higher.

It’s a different experience for more rural communities. People live in houses that are more widely separated, there is more land around many of the houses, and some of the houses have just one to four people. So it is a whole different environment and the viral load is less. That is why different parts of the country can open up at different intervals.

McCullough explains how his principles can be put into practice for everyday life in the COVID-19 era. He recommends these four steps to reduce one’s own viral load: 

• Wash your hands, use hand sanitizer, and at every instance open windows and go outside for fresh air.

• Wear a mask of any type indoors when in close contact with others to avoid the “big blast” of viral particles in a sneeze or cough or a cloud of bioaerosol left in closed spaces such as a public restroom or elevator. 

• Understand that the most important form of social distancing is to stay away from a sick household member.

• “Unless an ill patient confirmed with COVID-19 is in close contact with others, I do not advise a mask for the patient,” McCullough said. “The mask will only facilitate rebreathing the bioaerosol and serve to potentially amplify the infection.”

He recommends, “Staying close to the window or out on the porch alone without a mask is the best way to self-quarantine and ride out the virus.”

I agree; the more ventilation there is, the more you disperse whatever virus there is in the air. The more you mix the air, the less the concentration. And it may be that the concentration is critical. 

AccuWeather put together a rundown of practical information involving coronavirus-related questions and has referenced health advice from Michael Osterholm, the director of the Center for Infectious Disease Research and Policy (CIDRAP) and Regents Professor, McKnight Presidential Endowed Chair in Public Health. Also, we’ve been examining the environmental and weather-related impacts of coronavirus since February. Here are some other suggestions. 

• Air out your home.

• Stay away from very dry conditions.

• Get out in the sunshine and get Vitamin D.

• Get adequate sleep.

• Eat healthy.

• Get regular exercise.

• Wear a mask when you’re outside.

• When it’s sunny, allow the maximum amount of sun to come in the windows.

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