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Statistics Issues

COVID-19 Test Reporting

• Growing use of home Covid-19 tests leaves health agencies in the dark about unreported cases 12/2021
• How Could the CDC Make That Mistake? The government's disease-fighting agency is conflating viral and antibody tests, compromising a few crucial metrics that governors depend on to reopen their economies. 5/2020
• How do death rates from COVID-19 differ between people who are vaccinated and those who are not? To understand how the pandemic is evolving, it’s crucial to know how death rates from COVID-19 are affected by vaccination status. 11/2021
• How the CDC compromised its coronavirus testing totals 5/2020
• States accused of fudging or bungling COVID-19 testing data 5/2020
• 'Just stupid stuff': Logistics and lack of testing stymied finding the Omicron variant in the U.S. 12/2021
• The CDC is lumping positive COVID-19 viral and antibody tests together. Here's why that's bad. 5/2020
• The C.D.C. Waited Its Entire Existence for This Moment. What Went Wrong? 5/2020
• The extraordinary success of Covid-19 vaccines, in two charts. Deaths tell one story of the pandemic. The lives saved tell another. 1/2022
• Where's the data on delta? Lack of testing, info makes it hard to see virus's full scope The CDC announced the creation of a disease forecasting center to assess emerging health threats and help guide public health decisions. 8/2021

COVID-19 Vaccination Reporting

• Alarming study on COVID-19 vaccine side effects withdrawn after authors recognize key mistake 10/2021
• New CDC dataset showing COVID vaccine-by-county numbers misses the entire state of Texas. Why? 6/2021
• RPT-Vaccine dose count caught up in data discrepancies, community health centers say 2/2021
• States want to vaccinate more people. But data on who has received a shot is lacking. One month into the vaccine rollout, some states have yet to publish data on who's gotten shots. 1/2021
• Uneven Reporting Raises Doubts About CDC Vaccination Numbers The agency has acted to address inconsistencies in its data tracker. But experts say the solution does little to correct reporting that has miscounted the vaccination status of millions. 12/2021

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Data Reporting

• As COVID Data Collection Moves From CDC to HHS, Questions Mount - Administration says new process will be more efficient; but public health community fears disruption, manipulation 7/2020
• As Schools Weigh Reopening, Dearth of Data on COVID in Kids; Age groupings vary by state, children under-tested: "It's a mess" 7/2020
• Assessment of the CDC's New COVID-19 Data Reporting Version 1.0, May 18, 2020
• Claiming confusion, Texas Medical Center changes how it reports ICU capacity amid COVID-19 6/2020
• Covid data disappearing in some states even as delta surges. As Covid case numbers rise nationwide, Georgia and some other states have restricted the case count data they share publicly. 8/2021
• Covid-19 in the US: We're not getting full value from our data 7/2020 BMJ opinion
• Does Green on COVID-19 Maps Mean What You Think? COVID-19 “heat maps” are intended to help the public evaluate health risks during the pandemic. But the guidelines the CDC and other institutions use to create these maps can lead to confusion. Two linguistic anthropologists help make sense of what these maps really mean. 3/2022
• Florida scientist says she was fired for refusing to change Covid-19 data to support reopen plan. 5/2020. Dr Rebekah Jones says she was fired from Department of Health by the governor after protesting order to censor information
• I'm looking for the truth: States face criticism for COVID-19 data cover-ups 5/2020
• Johns Hopkins's coronavirus tracker has become a gold standard, but its creators say many miss the real story 6/2020
• Many States Are Not Reporting The Latest COVID-19 Numbers 9/2021
• Nursing Homes Shocked at 'Insanely Wrong' CMS Data on COVID-19 6/2020 One facility supposedly had eight coronavirus deaths for each bed
• Omicron wave prompts media to rethink which data to report 1/2022
• States Pull Back on Covid Data Even Amid Delta Surge 8/2021 KHN.org
• Woman who designed Florida's COVID-19 dashboard has been removed from her position 5/2020

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Death Statistics Issues

Graphic source: https://www.nature.com/articles/d41586-022-01245-6

Graphic source: https://www.nature.com/articles/d41586-022-00104-8

Graphic source: https://www.nature.com/articles/d41586-022-00104-8

Graphic source: https://twitter.com/WHO/status/1522195970825535488/photo/1

Graphic source: https://twitter.com/WHO/status/1522210454113714176/photo/1

Graphic source: https://www.bbc.com/news/health-61327778

Graphic source: https://www.bbc.com/news/health-61327778

Graphic source: https://www.bbc.com/news/health-61327778

Figure 2Global distribution of estimated excess mortality rate due to the COVID-19 pandemic, for the cumulative period 2020–21

Map source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02796-3/fulltext

Figure 4Global distribution of the ratio between estimated excess mortality rate due to the COVID-19 pandemic and reported COVID-19 mortality rate, for the cumulative period 2020–21

Map source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02796-3/fulltext

Graphic source: https://twitter.com/MaxCRoser/status/1434228604666368007/photo/1

The Economist journalists updated their a model of the true death toll of the pandemic, corrected for underreporting. They come to the conclusion that 15.2 million have died, more than 3-times the official toll of 4.6m. This map shows the distribution of the death rate.

• 14.9 million excess deaths associated with the COVID-19 pandemic in 2020 and 2021 WHO.int 5/2022
• 15 million people have died in the pandemic, WHO says The World Health Organization’s long-awaited estimate of excess COVID deaths is in line with other studies. 5/2022
• A Coronavirus Mystery Explained: Moscow Has 1,700 Extra Deaths. Russia's government has boasted of a low coronavirus mortality rate, but figures from an obscure city agency cast doubt on those claims. 5/2020
• Assessing the Impact of the Covid-19 Pandemic on US Mortality: A County-Level Analysis 1/2021
• Autopsies and covid-19. America’s elected coroners are too often a public-health liability The politics of death 1/2022
• Challenges Estimating Total Lives Lost in COVID-19 Decisions 7/2020. Consideration of Mortality Related to Unemployment, Social Isolation, and Depression
• COVID's Global Death Toll May Be 3 Times Official Numbers 3/2022
• COVID mortality in India: National survey data and health facility deaths 1/2022
• COVID’s true death toll: much higher than official records. Modelling suggests that by the end of 2021, some 18 million people had died because of the pandemic. 3/2022
• Covid: World’s true pandemic death toll nearly 15 million, says WHO 5/2022
• Death Certificate-Based ICD-10 Diagnosis Codes for COVID-19 Mortality Surveillance - United States, January-December 2020 MMWR 3/2021
• Deaths in New York City Are More Than Double the Usual Total 4/2020
• Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21 3/2022
• Hospitalizations of Children Aged 5–11 Years with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 2020-February 2022 4/2022
• How Many Covid Deaths? Don't Ask President Trump. The president has expressed skepticism about the fatality figures reported to him by his own experts. 5/2020
• How many died? Different ways of counting make the COVID-19 tally elusive "It becomes fairly random, and we're basically at that point," N.Y. Gov. Andrew Cuomo said. 6/2020
• India Is Counting Thousands Of Daily COVID Deaths. How Many Is It Missing? 4/2021
• India Is Stalling the W.H.O.’s Efforts to Make Global Covid Death Toll Public. The agency has calculated that 15 million people have died as a result of the pandemic, far more than earlier estimates, but has yet to release those numbers. 4/2022
• In one Missouri county, coroner excludes COVID from death certificates if family asks 8/2021
• NIH study associates COVID-19 surges with mortality increases for patients 7/2021
• Nobody Accurately Tracks Health Care Workers Lost to COVID-19. So She Stays Up At Night Cataloging the Dead. 8/2020
• Op-Ed: Death Counts and Despair - Are we growing numb to the COVID carnage? 8/2020
• Peru says its true Covid death toll is almost triple its official count. 5/2021
• Russian statistics soar for virus-linked deaths in 2020 2/2021
• Study: 35 percent of excess deaths in pandemic's early months tied to causes other than COVID-19 7/2020
• Surprisingly low Shanghai COVID death count spurs questions 4/2022
• The Difficulty Of Counting the COVID-19 Pandemic's Full Death Toll 6/2020
• The lag between daily reported Covid-19 cases and deaths and its relationship to age 3/2021
• The pandemic’s true death toll: millions more than official counts Countries have reported some five million COVID-19 deaths in two years, but global excess deaths are estimated at double or even quadruple that figure. 1/2022
• Total Deaths Due to COVID-19 Underestimated by 20% in US Counties. Deaths caused by indirect effects of the pandemic emphasize the need for policy changes that address widening health and racial inequities. 5/2021 BU.edu
• Uncounted: Inaccurate death certificates across the country hide the true toll of COVID-19 Some counties, like Cape Girardeau, have seen a spike in deaths that aren’t attributed to COVID-19. Many of them, blamed on natural causes, are likely from the coronavirus 1/2022
• Undercounting of Covid-19 deaths is greatest in pro-Trump areas, analysis shows 1/2021
• U.S. deaths soared in early weeks of pandemic, far exceeding number attributed to covid-19 4/2020
• Virus deaths are probably two to three times more than official records, the W.H.O. says. 5/2021
• What to Say if Someone Wrongly Claims 99% of People Survive COVID
• Why Do Countries' COVID-19 Death Rates Vary So Much? Multiple factors at play: testing capacity, case definitions, age distribution, preparedness 5/2020
• Why we still don't know how deadly this new coronavirus is 2/2020. Without the mortality rate, it's hard to decide how to respond and prepare for a worsening outbreak.
• Why We Don't Know the True Death Rate for Covid-19 4/2020 Determining what percentage of those infected by the coronavirus will die is a key question for epidemiologists, but an elusive one during the pandemic.
• Worst-Case Estimates for U.S. Coronavirus Deaths 3/2020

Hospitalization Data Issues

• Biden officials trying to recalculate U.S. Covid-19 hospitalizations. The administration’s goal is to get a more accurate sense of Covid’s impact across the country. 2/2022
• COVID-19 Hospital Data System That Bypasses CDC Plagued By Delays, Inaccuracies 7/2020

Incomplete/Missing Demographics and Variables, Reporting

Graphic source: https://www.covkidproject.org/state-report-card

• Agonizing Lag in Coronavirus Research Puts Pregnant Women and Babies at Risk 7/2020
• COVID-19 Data Miss A Lot Of People - Raising Questions 3/2021
• Covid-19: Male disadvantage highlights the importance of sex-disaggregated data 6/2020
• Finding COVID-19 Cases Among the Dead: 'It May Help the Living' Deaths with versus deaths from
• Florida's COVID-19 Data: What We Know, What's Wrong, and What's Missing
• Inside the detective-style hunt for missed COVID-19 cases 7/2020. A small group of doctors across the U.S. are reviewing tissue and blood samples preserved from autopsies in an effort to find the earliest COVID-19 cases.
• Staggering Surge Of NYers Dying In Their Homes Suggests City Is Undercounting Coronavirus Fatalities 4/2020
• States have stopped or slowed COVID-19 reporting amid Delta surge. Many states are updating data once or a few days a week, but seven-day averages are needed to accurately track the spread. 8/2021
• Why Don't We Know Who the Coronavirus Victims Are? 4/2020 The coronavirus is infecting and killing Americans of all races. But there's little public data on whether the virus is having a disproportionate impact on some communities.
• Understanding the State Data Quality Report Card

Manipulation of Data Reporting

Graphic source: https://www.miamiherald.com/news/coronavirus/article253796898.html

Graphic source: https://www.miamiherald.com/news/coronavirus/article253796898.html

• Behind the White House Effort to Pressure the C.D.C. on School Openings. Documents and interviews show how senior officials sought to play down the risks of sending children back to the classroom, alarming public health experts. 9/2020
• Emails show HHS official trying to muzzle Fauci. Emails obtained by POLITICO show a top aide at the department dictating what the nation's top infections disease expert should say during media interviews. 9/2020 Politico
• Florida changed its COVID-19 data, creating an 'artificial decline' in recent deaths 8/2021
• Internal Documents Reveal COVID-19 Hospitalization Data The Government Keeps Hidden 10/2020
• Political Appointees Meddled in C.D.C.'s "Holiest of the Holy" Health Reports 9/2020 NY Times
• Public Health Experts Worried About Possible COVID-19 Data Manipulation 9/2020
• Report: Trump Officials Altering CDC Scientific Reports To Fit Covid-19 Coronavirus Message 9/2020
• Trump officials interfered with CDC reports on Covid-19 The politically appointed HHS spokesperson and his team demanded and received the right to review CDC's scientific reports to health professionals. 9/2020 Politico

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Prevalence Data

• Coronavirus is spreading in schools, but the federal government isn't keeping count Researchers say the absence of a comprehensive accounting is hampering efforts to identify which safety practices can best protect students and teachers. 8/2020
• Coronavirus was in Italy already in December, sewage study shows 6/2020
• Estimating SARS-CoV-2 infections from deaths, confirmed cases, tests, and random surveys 8/2021
• Scientists model "true prevalence" of COVID-19 throughout pandemic 7/2021
• > The government still doesn't know how many nursing homes have coronavirus outbreaks. The lag in data collection is just one of a number of bottlenecks in the effort to slow the virus' deadly spread in nursing homes across the U.S. 5/2020

Probable Cases/Excess Deaths

Graphic source: https://www.nature.com/articles/d41586-022-00104-8

Graphic source: https://www.vox.com/future-perfect/21539483/covid-19-black-death-plagues-in-history

Visual Abstract. Impact of Population Growth and Aging on Excess U.S. Deaths During COVID-19
Estimates of excess mortality during the COVID-19 pandemic provide an important metric for quantifying deaths due to COVID-19 as well as those indirectly caused by it. This study updates recent estimates for excess mortality by accounting for the aging of the population.

Graphic source: https://www.acpjournals.org/doi/10.7326/M20-7385

Graphic source: https://www.kff.org/coronavirus-covid-19/slide/during-pandemic-higher-premature-excess-deaths-in-u-s-compared-to-peer-countries-partly-driven-by-racial-disparities/

Graphic source: https://www.healthsystemtracker.org/brief/covid-19-pandemic-related-excess-mortality-and-potential-years-of-life-lost-in-the-u-s-and-peer-countries/

Graphic source: https://www.healthsystemtracker.org/brief/covid-19-pandemic-related-excess-mortality-and-potential-years-of-life-lost-in-the-u-s-and-peer-countries/

Graphic source: https://www.healthsystemtracker.org/brief/covid-19-pandemic-related-excess-mortality-and-potential-years-of-life-lost-in-the-u-s-and-peer-countries/

Graphic source: https://jamanetwork.com/journals/jama/fullarticle/2778361

Graphic source: https://www.economist.com/graphic-detail/2020/07/15/tracking-covid-19-excess-deaths-across-countries

• COVID's Death Toll 3 Times Worse Than Official Counts - In U.S. alone, excess deaths were 300,000 higher than those attributed to virus 3/2022
• Covid-19 deaths in Africa: prospective systematic postmortem surveillance study 2/2021 BMJ
• Covid-19: Excess deaths point to hidden toll in South Africa as cases surge 7/2020 BMJ
• COVID-19 Pandemic-Related Excess Mortality and Potential Years of Life Lost in the U.S. and Peer Countries 4/2021
• During Pandemic, Higher Premature Excess Deaths in U.S. Compared to Peer Countries Partly Driven by Racial Disparities 4/2021
• Estimating the early death toll of COVID-19 in the United States
• Estimation of Excess Deaths Associated With the COVID-19 Pandemic in the United States, March to May 2020 7/2020 JAMA
• Excess Deaths From COVID-19 and Other Causes in the US, March 1, 2020, to January 2, 2021 4/2021 JAMA
• Getting to Accuracy: Measuring COVID-19 by Mortality Rates and Percentage Changes 4/2020
• How COVID-19 Deaths Are Counted. 5/2020. Assigning a cause of death is never straightforward, but data on excess deaths suggest coronavirus death tolls are likely an underestimate
• How coronavirus charts can mislead us
• How does the government count COVID-19 deaths? Medical conditions or injuries at an individual's time of death are not automatically official causes of death for the purpose of government statistics. That includes COVID-19. 10/2021
• How Many People Have Actually Died From Coronavirus in New York? 4/2020 The official statistics paint a partial picture and may understate the death toll. Here's why.
• Impact of Population Growth and Aging on Estimates of Excess U.S. Deaths During the COVID-19 Pandemic, March to August 2020 4/2020 AIM
• Just How Much Was 2020 an Outlier for Deaths? Setting cause aside, death numbers were "massive" compared with 2019 4/2021
• N.Y.C. Death Toll Soars Past 10,000 in Revised Virus Count 4/2020. The city has added more than 3,700 additional people who were presumed to have died of the coronavirus but had never tested positive.
• Pandemic death toll is far higher than 200,000 in the US 10/2020
• 'Probable' COVID-19 Death Reporting Varies by State 4/2020. Authorities wrestle with fatal cases that look like COVID but lack test confirmation
• Racial and Ethnic Disparities in Excess Deaths During the COVID-19 Pandemic, March to December 2020 10/2021. ACPjournals.org
• The Pandemic's Real Toll? 300,000 Deaths, and It's Not Just From the Coronavirus 10/2020
• Tracking covid-19 excess deaths across countries 7/2020
• Update on Excess Deaths Associated with the COVID-19 Pandemic - United States, January 26, 2020-February 27, 2021 4/2021 MMWR

Undercounting

Graphic source: https://www.bmj.com/content/372/bmj.n334

Graphic source: https://www.npr.org/sections/health-shots/2021/02/06/964527835/why-the-pandemic-is-10-times-worse-than-you-think

Graphic source: https://www.npr.org/sections/health-shots/2021/02/06/964527835/why-the-pandemic-is-10-times-worse-than-you-think

• Health Equity Tracker Investigating rates of COVID-19
• A Coronavirus Death in Early February Was Probably the Tip of an Iceberg 4/2020
• After Deaths At Home Spike In NYC, Officials Plan To Count Many As COVID-19 3/2020
• Africa COVID cases could be seven times higher than reported - WHO 2/2022
• As Covid sweeps India, experts say cases and deaths are going unreported 4/2021
• CDC Hasn't Updated COVID Vax Breakthrough Data - Agency doesn't report real-time breakthrough data, but states provide some answers 11/2021
• Coronavirus Death in California Came Weeks Before First Known U.S. Death 4/22/2020
• Covid: Does Tanzania have a hidden epidemic? 3/2021 BBC.com
• England and Wales coronavirus death toll 41% higher than UK government's daily figures 4/2020
• Impact of COVID-19 in Africa 'vastly underestimated', warn researchers. Study from Zambia shows many more deaths than official reports suggest 2/2021
• Impact of covid-19 in Africa "vastly underestimated" warn researchers 2/2021 BMJ
• India Is Counting Thousands Of Daily COVID Deaths. How Many Is It Missing? . 4/2021
• India's pandemic death toll could be in the millions 7/2021
• Millions Of People Are Missing From CDC COVID Data As States Fail To Report Cases 10/2021
• NIH study suggests COVID-19 prevalence far exceeded early pandemic cases. Researchers estimate nearly 17 million undiagnosed cases in the U.S. by mid-July 2020. 6/2021
• Non-stop cremations cast doubt on India's counting of COVID dead 4/2021
• Official coronavirus death tolls are only an estimate, and that is a problem 4/2020 NBC News takes a look at how some of the world's health authorities have tried, and often failed, to keep track of those who have died in the pandemic.
• Official U.S. coronavirus death toll may be missing many thousands. 5/2020 A confluence of testing shortages, inconsistent death reporting practices and a high concentration of nursing home deaths means the overall fatality number is likely higher.
• Russia adds record 10,000 coronavirus cases in dramatic turnaround as Putin's problems stack up 5/2020
• There's Been a Spike in People Dying at Home in Several Cities. That Suggests Coronavirus Deaths Are Higher Than Reported. 4/2020
• Trump's plan to limit the pandemic's death toll: Undercount the numbers. Experts say the official numbers are too low. The White House wants to make them lower. 5/2020
• U.S. Coronavirus Death Toll Is Far Higher Than Reported, C.D.C. Data Suggests 4/2020
• Why we don't know the real number of COVID-19 deaths in Africa 10/2020 Why the coronavirus may be killing more Americans than the government data says 4/2020
• Why The Pandemic Is 10 Times Worse Than You Think NPR.org 2/2021

Vaccination Reporting

• Accuracy of Federal Stats on Most-Unvaxxed Hospitals in Question - Information crucial in light of high court's decision upholding health worker vaccine mandate 1/2022

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COVID-19 Risk Factors

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Risk factors for severe COVID-19 among persons who completed a primary COVID-19 vaccination series - 465 health care facilities, United States, December 2020-October 2021 (MMWR)

Graphic source: https://www.cdc.gov/mmwr/volumes/71/wr/mm7101a4.htm

Risk Factors (Enlarged)

Graphic source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html

Graphic source: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html

Graphic source: https://informationisbeautiful.net/visualizations/covid-19-coronavirus-infographic-datapack/

Graphic source: https://www.mckinsey.com/featured-insights/2020-year-in-review/a-tale-of-2020-in-20-mckinsey-charts

Graphic source: https://www.medscape.org/viewarticle/941521

Graphic source: https://www.statista.com/chart/22365/prevalence-of-underlying-conditions-in-us-adults/

Graphic source: Texas Medical Association

Graphic source: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html

Graphic source: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Graphic source: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Graphic source: https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID19-What-You-Can-Do-High-Risk.pdf

Graphic source: https://www.nejm.org/doi/full/10.1056/NEJMcp2009249

• Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform 5/2021 Lancet.com
• Medical Conditions
• Predicting Mortality With Risk Score Calculation 12/2020
• Risk Factors for Severe COVID-19 in Hospitalized Adults Differ by Age 4/2022
• Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19: Information for Healthcare Providers CDC.gov 10/2021
• Want to get omicron and just get it over with? Here's why that's a bad idea 1/2022
• Which Fully Vaccinated Adults Are Most at Risk of Severe COVID? 1/2022

Cardiovascular

• Aging heart cells offer clues to susceptibility of older people to severe COVID-19 8/2020
• A healthy heart can lower the risk of severe COVID-19 symptoms, new research confirms 6/2021
• Cardiac Conditions Still on the Forefront of COVID-19 Severity 4/2021
• Covid-19 Patients with Previous Coronary Artery By-Pass Graft have a Higher Mortality Risk 8/2021
• History of CABG associated with a higher risk of death from COVID-19 8/2021
• PAD patients more likely to die from COVID-19 10/2021
• People with heart defects may be at greater risk for severe COVID-19 illness HEart.org 3/2022
• Peripheral Artery Disease and COVID-19 Outcomes:Insights from the Yale DOM-CovX Registry 1/0/2021

Cancer

• Can Type of Cancer Affect COVID-19 Outcomes? 10/2020
• Cancer Immunotherapy Tied to Severe COVID-19 Outcomes; Nearly threefold increased risk of hospitalization, severe respiratory illness
• Coronavirus: What People with Cancer Should Know Cancer.gov
• COVID-19 More Deadly Than Cancer Itself? Highlights from the AACR conference on COVID-19 and cancer 7/2020
• COVID-19 Mortality Spikes in Patients With Lung, Blood Cancers. 4/2020. Those with metastatic disease also at special risk for poor outcomes
• Findings from Real-World Data Study Reveal Higher Risk of Hospitalization and Death Among Cancer Patients with COVID-19, Underscore Health Disparities 7/2020
• How Does Cancer History Affect Risk for COVID-19? 3/2021
• U.K. Study Pinpoints Older Age and Blood Cancers as Predictors of COVID-19 Risk, Mortality 9/2020

Demographics

Graphic source: https://www.cnn.com/2020/08/20/us/systemic-racism-coronavirus-pandemic-trnd/index.html"

Graphic source: https://www.apmresearchlab.org/covid/deaths-by-race

Graphic source: https://www.apmresearchlab.org/covid/deaths-by-race

• Risk Factors for Severe COVID-19 Outcomes Among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series - 465 Health Care Facilities, United States, December 2020-October 2021 1/2022 MMWR
• No Data Behind CDC's Testing Guideline Change; Absent any evidence, experts speculate that supply shortages, politics influenced agency's decision
• Black individuals at higher risk for contracting COVID-19, according to new research 7/2020
• Coronavirus targets homeless shelters in the US 4/2020
• COVID-19 Among American Indian and Alaska Native Persons -23 States, January 31-July 3, 2020 MMWR 8/2020
• COVID-19 Killing African Americans at Shocking Rates 5/2020. Wildly disproportionate mortality highlights need to address longstanding inequities
• COVID-19 crisis: Millions of US workers at risk of infections on the job 4/2020
• Crowded homes, poor neighborhoods linked to COVID-19 6/2020
• Male Sex Is Risk Factor for Increased Mortality in COVID-19 12/2020
• Study of 17 Million Identifies Crucial Risk Factors for Coronavirus Deaths 7/2020. The largest study yet confirms that race, ethnicity, age and sex can raise a person's chances of dying from Covid-19.
• COVID-19 deaths analyzed by race and ethnicity — APM Research Lab
• Factors Influencing Risk for COVID-19 Exposure Among Young Adults Aged 18-23 Years - Winnebago County, Wisconsin, March-July 2020. MMWR October 2020.
• Regardless of Age, Obesity and Hypertension Increase Risks With COVID-19 9/2020
• These variables affect whether you live, die or get help during the pandemic 8/2020
• Why Is COVID-19 Striking Men Harder Than Women? 5/2020
• Why Women Experience COVID and the Vaccines Differently Than Men - It's chromosomal and hormonal, and maybe sociocultural too 3/2021

Diabetes

Graphic source: https://link.springer.com/article/10.1007/s00125-021-05458-8

Graphic source: https://abcnews.go.com/Health/covid-19-virus-diabetes-studies-find/story

Graphic source: https://link.springer.com/article/10.1007/s00125-021-05458-8

• Clinical Outcomes in Young US Adults Hospitalized With COVID-19 9/2020
• The COVID-19 virus can cause diabetes, new studies find. "The virus actually destroys the cells in the pancreas that make insulin." ABC News 6/2021
• COVID-19 may trigger new diabetes, experts warn 6/2020
• COVID-19: Why Are People With Diabetes at Increased Risk? 5/2020
• Diabetes, hypertension may increase risk of COVID-19 brain complications 11/2020
• Hyperglycemia Better Predictor of Severe COVID-19 Than Diabetes 3/2021
• Impact of COVID-19 on diagnoses, monitoring, and mortality in people with type 2 diabetes in the UK 5/2021
• Long-term Blood Sugar History Predicts Risk of Severe COVID-19 Among Diabetics. Two- to three-year history offers more accurate prediction than shorter time period 11/2021
• Revealed: Why severe COVID-19 infections are more common in people with diabetes 9/2021
• Risk phenotypes of diabetes and association with COVID-19 severity and death: a living systematic review and meta-analysis 4/2021
• Who With Diabetes Are at Most Risk? 6/2020

Drugs

• Opioid use disorder and health service utilization among COVID-19 patients in the US: A nationwide cohort from the Cerner Real-World Data 6/2021 The Lancet
• People with substance use disorders may be at higher risk for SARS-CoV-2 breakthrough infections. Co-occurring health disorders appear to contribute to increased risk, NIH study suggests. 10/2021
• Statins reduce COVID-19 severity, likely by removing cholesterol that virus uses to infect 9/2020

Environmental Factors

• Wildfire smoke may have contributed to thousands of extra COVID-19 cases and deaths in western U.S. in 2020 8/2021
• Wildfire smoke may have contributed to thousands of extra COVID-19 cases and deaths in western U.S. in 2020 8/2021

Genetic Mutations

• Carriers of two genetic mutations at greater risk for illness and death from COVID-19 Researchers recommend population-wide screening for detecting mutation carriers 9/2020
• Genetic risk factor found for Covid-19 smell and taste loss, researchers say. Six months after contracting Covid, as many as 1.6 million people in the U.S. are still unable to smell or have experienced changes in their ability to smell. 1/2022

Health Behaviors

• Lack of exercise linked to increased risk of severe COVID-19 8/2021

Hypertension

• Clinical Outcomes in Young US Adults Hospitalized With COVID-19 9/2020

Liver Disease

• Liver Disease Tied to Increased Risk of Death From Severe COVID - French study of hospitalized patients also saw an increased risk of mechanical ventilation 6/2021

Maternal/Child Health Issues

• Coronavirus May Increase Premature Births, Studies Suggest 9/2020. New studies provide more evidence that pregnant women may get severe Covid-19 symptoms and have an increased risk of pregnancy loss.

Mental Illness

• Mental Health Disorders Tied to Higher COVID-19 Mortality 7/2021
• Schizophrenia Tied to Higher Risk of COVID-19 Death -Increased mortality risk not seen with mood and anxiety disorders 2/2021
• Why people with mental illness are at higher risk of COVID 11/2021

Metabolic Syndrome

• Metabolic syndrome increases risk of respiratory distress, death for hospitalized COVID-19 patients 12/2021

Nutrition

• Could Boosting Vitamin D Cut COVID-19 Risk? Observational study suggests there may be a link between the two 9/2020
• Diet may affect risk and severity of COVID-19 9/2021
• Does Vitamin D Improve Patient Outcomes? 12/2020
• Is There a Link Between Vitamin D and COVID Risk? 11/2020
• Link identified between dietary selenium and outcome of Covid-19 disease 4/2020
• Low plasma 25(OH) vitamin D level associated with increased risk of COVID-19 infection 7/2020
• Microbiomes Might Influence COVID-19 Severity 8/2021
• More Evidence on Vitamin D and COVID-19 Risk? 12/2020
• More Vitamin D, Lower Risk of Severe COVID-19? 5/2020
• Nutrition, Immunity, & the COVID-19 Pandemic 3/2021
• Op-Ed: Don't Let COVID-19 Patients Die With Vitamin D Deficiency-We can't wait for perfect evidence 1/2021
• Scientists link vitamin D deficiencies to higher COVID-19 mortality rates 4/2020
• Sorting Out Whether Vitamin D Deficiency Raises COVID-19 Risk 1/2021
• Vitamin D levels appear to play role in COVID-19 mortality rates. 5/2020. Patients with severe deficiency are twice as likely to experience major complications
• Vitamin D Might Help Fight COVID-19 1/2021

Obesity

Graphic source: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2770542

Graphic source: https://www.mayoclinicproceedings.org/article/S0025-6196(20)30477-8/fulltext

Clinical manifestations and mechanisms for COVID-19 risk in individuals with obesity

Graphic source: https://onlinelibrary.wiley.com/doi/10.1111/obr.13128

• Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study 4/2021 < /B>
• Body Mass Index and Risk for COVID-19-Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death - United States, March-December 2020 3/2021 MMWR
• Clinical Outcomes in Young US Adults Hospitalized With COVID-19 9/2020
• COVID-19 reveals how obesity harms the body in real time 11/2020
• Even With Mild COVID, Obesity May Mean Worse Symptoms 10/2021
• Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships 8/2020
• NYU scientists: Largest US study of COVID-19 finds obesity the single biggest 'chronic' factor in New York City's hospitalizations 4/2020 ZDNET.com
• Obese COVID Patients More Likely to Have Pulmonary Embolism, Even Outside the ICU 6/2020
• Obesity and Outcomes in COVID-19: When an Epidemic and Pandemic Collide 7/2020
• Obesity Linked to Severe Coronavirus Disease, Especially for Younger Patients 4/2020
• Obesity one of the biggest risk factors in COVID-19 hospitalizations, study suggests 4/2020
• Sex-specific impact of severe obesity in the outcomes of hospitalized patients with COVID-19: a large retrospective study from the Bronx, New York 5/2021
• Why Obesity May Stack the Deck for COVID-19 Risk 7/2020

Phenotypes

• https://www.nytimes.com/2020/09/04/health/covid-vaping-smoking.html
  • COPD and smoking associated with higher COVID-19 mortality 5/2020
  • Coronavirus and Smoking WebMD
  • COVID-19 Is More Severe in Smokers 5/2020
  • COVID Risk Up to 7 Times Higher for Young Vapers 8/2020
  • COVID-19, Smoking, and Vaping
  • How smoking, vaping and drug use might increase risks from Covid-19 3/2020
  • Intensity of Past Smoking Linked to COVID-19 Severity - Dose-dependent relationship, independent of current smoking status 1/2021
  • Is there a smoker's paradox in COVID-19? 8/2020 BMJ
  • NIDA Director outlines potential risks to people who smoke and use drugs during COVID-19 pandemic 2/2020 NIH.gov
  • Smoking, Vaping and COVID-19: About the Connection and How to Quit Massgeneral.org
  • Study reveals how smoking worsens COVID-19 infection in the airways 11/2020
  • Stanford Medcast: COVID-19 Mini-Series – Vaping 3/2021
  • Vaping linked to COVID-19 risk in teens and young adults, study finds 8/2020
  • Vaping linked to COVID-19 risk in teens and young adults 8/2020
• Vaping Links to Covid Risk Are Becoming Clear 9/2020

Other Factors

• 10 Things That Increase Your Risk of Coronavirus Complications
• Alzheimer's Gene Linked to Severe COVID-19 Risk 5/2020
• Canadian study finds temperature, latitude not associated with COVID-19 spread 5/2020
• Can I Catch It Through My Eyes? Will Goggles Help? 5/2020
• CDC: Age Nothing But a Number for COVID-19 Risks; Underlying conditions for people at any age more important, agency says 6/2020
• Contracting COVID-19: lifestyle and social connections may play a role 7/2020
• Coronavirus and Pneumonia 4/2020
• COVID-19: High-Risk Groups and Special Populations 4/2020
• COVID-19 Risk 10-Fold Higher for Opioid Abusers 9/2020. Substance use disorders in general tied to higher coronavirus hospitalization rates
• COVID Risks Raised in Rheumatoid Arthritis - Patients had higher rates of infection and hospitalization/death, study showed 5/2021
• FAQs About COVID-19 4/2020
• Groups at Higher Risk for Severe Illness 4/2020
• Heartburn medication tied to higher COVID-19 risk — but don't panic 7/2020
• HIV and The New Coronavirus
• Insomnia, disrupted sleep, and burnout linked to higher odds of severe COVID-19. Each 1-hour increase in sleep associated with 12% lower odds of infection among clinicians 3/2021
• Is Taking Aspirin Good for Your Heart?
• Large Vessel Strokes in Younger Patients Tied to COVID-19, 4/2020. Presenting symptom of coronavirus infection for some
• Miscarriage and Maternal Mortality in Pregnant COVID-19 Patients; Risk is unknown but nonzero 5/2020
• New Research Shows Disproportionate Rate of Coronavirus Deaths in Polluted Areas 12/2020
• Older Adults CDC.gov
• People With O Blood Type Appear to Have a Lower Risk of Catching Coronavirus, Preliminary Study Says 6/2020
• People of Any Age with Underlying Medical Conditions 6/2020
• Poor Sleep, Burnout Tied to Higher COVID-19 Risk 3/2021
• Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019-United States, February 12-March 28, 2020 3/2020 MMWR
• Substance use disorders linked to COVID-19 susceptibility 9/2020
• The Catastrophic Cost of Uninsurance: COVID-19 Cases and Deaths Closely Tied to America's Health Coverage Gaps 3/2021
• The Covid-19 Riddle: Why Does the Virus Wallop Some Places and Spare Others? 5/2020
• This One Thing Could Make You More Likely to Die From Coronavirus 6/2020
• What Is Phantosmia? 3/2021
• What Is the Real Coronavirus Toll in Each State? 5/2020

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COVID-19 Incubation Period

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Nature: Estimated that the incubation period for COVID-19 before the onset of symptoms was 5.2 days. Viral loads for COVID-19 were highest shortly after the onset of symptoms and then gradually decreased toward the detection limit by day 21. Sex, age, and disease severity did not substantially affect these findings.

The authors estimated that infectiousness of COVID-19 began 2.3 days before the onset of symptoms and peaked at 0.7 days after symptom onset. They further estimated that up to 44% of cases of COVID-19 could be a result of viral transmission before the onset of symptoms. Source: https://www.medscape.org/viewarticle/932932 (6/2020)

Graphic source: https://www.nejm.org/doi/full/10.1056/NEJMcp2009575

• Coronavirus: Virological findings from patients treated in a Munich hospital 4/2020
• New developments suggest coronavirus incubation could be longer than 14 days, as global infections rise 2/2020
• The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application 3/2020

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COVID-19 Symptoms

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Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study

Graphic source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00327-0/fulltext

Graphic source: https://www.reuters.com/article/us-health-coronavirus-types/symptom-tracker-app-reveals-six-distinct-types-of-covid-19-infection-idUSKCN24I1YI

Graphic source; https://salud-america.org/coronavirus-case-rates-and-death-rates-for-latinos-in-the-united-states/

Odds ratios and 95% confidence intervals of previous or current SARS-CoV-2 infection, by individual symptoms among service members reporting at least one symptom (n = 284) — USS Theodore Roosevelt, April 2020 (June 2020)

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6923e4.htm

Graphic source: https://int.nyt.com/data/documenthelper/6926-mayhhsbriefing/af7319f4a55fd0ce5dc9/optimized/full.pdf#page=1

Updated CDC COVID-19 symptom list (4/27/2020)

Graphic source: https://heavy.com/news/2020/04/early-symptoms-coronavirus-covid-19/

General

• Are COVID Symptoms Different With Delta? As reports of milder cold-like illness surface, experts suggest testing to know for sure 8/2021
• Symptoms of COVID-19 CDC.gov
• COVID-19: How Long Do Symptoms Last? 8/2020
• Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study 4/2022

Dermatological Manifestations

• Dermatologic Issues and COVID-19 NYC.gov

Hearing Loss

• COVID-19 linked to sudden hearing loss 10/2020

Loss of Smell

Graphic source: https://pubs.acs.org/doi/full/10.1021/acschemneuro.0c00210#

• AAO-HNS: Anosmia, Hyposmia, and Dysgeusia Symptoms of Coronavirus Disease 3/2020
• About Half of COVID-19 Cases Show Digestive Signs 3/2020
• Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection 4/2020
• Anosmia Can Warn Us of More Than Just COVID - Sense of smell is deeply connected with cognitive function 8/2021
• Another Presenting Sign of COVID-19 - Findings support adding to the list of GI manifestations of the disease, researchers say 8/2020
• Chinese Study: Some Mild COVID-19 Cases Have Only GI Symptoms About 19% with digestive issues experienced diarrhea as the first symptom of COVID-19 4/2020
• Coronavirus symptoms: What are they and how do I protect myself? BBC.com 6/2020
• COVID-19 and a loss of smell: Why the virus may hinder this sense. A loss of smell can be caused by nasal congestion. But it happens in COVID-19 patients even without a stuffed-up nose. 8/2020
• Diarrhea is first sign of illness for some COVID-19 patients 3/2020
• Expression of the SARS-CoV-2 Entry Proteins, ACE2 and TMPRSS2, in Cells of the Olfactory Epithelium: Identification of Cell Types and Trends with Age 5/2020
• From Loss Of Smell To 'COVID Toes': What Experts Are Learning About Symptoms 5/2020
• GI and Hepatic Symptoms Call for COVID-19 Testing. Liver injury, in particular, could lead to poor clinical outcomes 5/2020
• How COVID-19 Causes Loss of Smell 7/2020
• Inflamed brains, toe rashes, strokes: Why COVID-19's weirdest symptoms are only emerging now 5/2020
• Little Known About COVID Patients' Loss of Smell 4/2020
• Lost Sense of Smell May Be Peculiar Clue to Coronavirus Infection 3/2020
• Mysteries of COVID Smell Loss Finally Yield Some Answers. Explanations begin to arise at the molecular level for this vexing but commonplace symptom 11/2020
• Skin Rashes: An Emerging Symptom of COVID-19: What clinicians need to know about cutaneous manifestations of COVID-19 4/2020
• Smell and taste changes provide early indication of COVID-19 community spread 11/2020
• Smell and Taste Issues Unlikely to Linger After COVID-19 7/2020
• Smell Diminishes by Day 3 of COVID-19, Study Says 5/2020
• Sniffing Out Where Virus First Strikes in COVID-19 - More context for why COVID-19 patients might lose sense of smell 8/2020
• Symptom tracker app reveals six distinct types of COVID-19 infection 7/2020
• What are COVID toes? Dermatologists, podiatrists share strange findings 3/2020
• What it's like to suffer from the coronavirus's weirdest symptom 4/2020
• What are the symptoms of COVID-19
• What Is Covid Toe? 5/2020 Maybe a Strange Sign of Coronavirus Infection Dermatologists say the lesions should prompt testing for the virus, even though many patients have no other symptoms

Psychiatric Symptoms

• Small Number of Covid Patients Develop Severe Psychotic Symptoms. Most had no history of mental illness and became psychotic weeks after contracting the virus. Cases are expected to remain rare but are being reported worldwide. 1/2021

Tooth Loss

• Their Teeth Fell Out. Was It Another Covid-19 Consequence? 11/2020

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COVID-19 Transmission

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Transmission Routes

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Video source: https://twitter.com/CDCgov/status/1484277054162055175

Graphic source: https://www.nature.com/articles/s41591-020-1092-0/figures/2

SARS-CoV-2 introductions to U.S. and Europe. Credit: Modified from Worobey M, Science, 2020.

Graphic source: https://pubmed.ncbi.nlm.nih.gov/32912998/

Graphic source: https://www.nejm.org/doi/full/10.1056/NEJMcp2009249

Current Sites of COVID-19 cases

Graphic source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767010

Potential Sites for future COVID-19 cases

Graphic source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767010

• Study finds 1 in 10 people with COVID-19 remains infectious beyond 10 days 1/2022
• Five things to know about COVID-19 transmission WHO.int youtube.com
• Coronavirus Transmission in Queens Drove the First Wave of New York City's COVID-19 Pandemic. NYU Langone Investigation Analyzed More Than 800 Coronavirus Genetic Samples to Trace the Path of the Virus as It Traveled Across the City 5/2021
• COVID-19 transmission - learning how to protect yourself and others WHO.int
• COVID-19: What Is the Primary Route of Transmission? 8/2020
• COVID Sure Looks Seasonal Now 11/2021
• Recommendations for Demonstrators, Law Enforcement Agencies, and Public Health Agencies for Reducing SARS-CoV-2 Transmission During Civil Protests 2/2021
• The interplay of movement and spatiotemporal variation in transmission degrades pandemic control 11/2020
• UC Davis Live: Coronavirus Edition ~ Transmission youtube.com
• Q&A: How is COVID-19 transmitted? WHO.int 7/2020
• The emergence of SARS-CoV-2 in Europe and North America 9/2020
• The Risks - Know Them - Avoid Them
• Transmission Dynamics by Age Group in COVID-19 Hotspot Counties; United States, April-September 2020 MMWR 1/2020
• USDA, FDA Underscore Current Epidemiologic and Scientific Information Indicating No Transmission of COVID-19 Through Food or Food Packaging 2/2021

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Reproduction Number

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"To determine when an outbreak had been contained, scientists look at case counts and determine the reproduction number, a measurement that shows how many people will be infected by one infectious person. If the reproduction number drops below 1, scientists consider the outbreak contained." (Source: https://news.utexas.edu/2020/06/01/for-each-days-delay-in-social-distancing-a-covid-19-outbreak-lasts-days-longer/)

Graphic source: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/when-will-the-covid-19-pandemic-end?cid=other-eml-alt-mip-mck

Graphic source: https://www.visualcapitalist.com/history-of-pandemics-deadliest/

Graphic source: @fperrywilson

Graphic source: https://www.mckinsey.com/business-functions/risk/our-insights/covid-19-implications-for-business

R-naught - the theory	R-naught - the reality of superspreaders

Source: https://www.nytimes.com/2020/05/22/well/live/coronavirus-pandemic-memorial-day-picnics-bbqs.html

Graphic source: https://www.cnn.com/2020/10/06/health/flu-covid-19-deaths-comparison-trnd/index.html

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6926e1.htm

Graphic source: https://www.zdnet.com/article/google-researchers-show-how-covid-19-super-spreaders-are-a-big-part-of-the-problem/">

Reich and colleagues show that even for the same "R," transmission rate, on average, infections can rise faster with a higher "gamma," the measure of how many "degrees" of contacts a person in the society has -- the super-spreaders.

Graphic source: https://cosmosmagazine.com/biology/measuring-different-responses-to-covid-19

Graphic source; https://www.vox.com/2020/1/28/21079946/coronavirus-china-wuhan-deaths-pandemic

Graphic source: https://www.nationalgeographic.com/science/2020/05/coronavirus-how-to-measure-your-nation-response-cvd/"

• Aerosol emission and super-emission during human speech increase with voice loudness 2/2019
• How to measure your nation's response to coronavirus 5/2020 National Geographic reviews the lessons learned from national responses to the COVID-19 pandemic.
• How to model a pandemic 4/2020
• Measuring different responses to COVID-19
• More people have died from Covid-19 than in the past 5 flu seasons combined. And coronavirus is much more contagious 10/2020
• The Next Flu Pandemic: What to Expect 10/2008
• These 2 questions will determine if the coronavirus becomes a deadly pandemic 2/2020

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Asymptomatic/Pre-symptomatic (Silent Spreader/Stealth) Transmission

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Graphic source: https://www.nejm.org/doi/full/10.1056/NEJMc2001468

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6923e4.htm

• About 80% of Asymptomatic People With COVID-19 Develop Symptoms 9/2020
• An enduring coronavirus mystery: Why do only some get sick? 6/2020. Months into a pandemic that has killed nearly 500,000 people worldwide, scientists are still trying to answer crucial questions about the coronavirus.
• As many as 45% of people infected with COVID-19 have no symptoms, and they may play a major role in the spread of the virus, according to a new study. 6/2020
• Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020 MMWR 3/2020
• Asymptomatic coronavirus infections contribute to over 50% of spread, according to UChicago study 5/2021
• Asymptomatic COVID-19 cases may be more common than suspected The problem? Even without symptoms, people can still spread the virus. 5/2020
• Asymptomatic COVID: Silent, but Maybe Not Harmless 8/2020
• Asymptomatic COVID-19 Transmission in China Confirmed? 2/2020
• Asymptomatic spread makes testing key for COVID-19 fight 5/2020
• Asymptomatic people may be fueling the coronavirus spread 4/2020
• Capturing hidden data for asymptomatic COVID-19 cases provides a better pandemic picture. Measuring the disease spread poses a challenge when not all carriers show it 2/2022
• Clinical Course and Molecular Viral Shedding Among Asymptomatic and Symptomatic Patients With SARS-CoV-2 Infection in a Community Treatment Center in the Republic of Korea 8/2020
• Even Asymptomatic People Carry the Coronavirus in High Amounts. Researchers in South Korea found that roughly 30 percent of those infected never develop symptoms yet probably spread the virus. 8/2020
• Coronavirus disease 2019 (COVID-19) Situation Report 73 Pre-symptomatic and Presymptomatic transmission April 3, 2020 WHO.int
• Coronavirus may be most infectious when symptoms are mildest, small study finds 4/2020
• Coronavirus Spreads Quickly and Sometimes Before People Have Symptoms, Study Finds 3/2020
• Coronavirus spreads quickly and sometimes before people have symptoms, study finds 3/2020
• Covert coronavirus infections could be seeding new outbreaks 3/2020
• Covid-19: Four in 10 cases in Italian town that locked down early were asymptomatic 7/2020
• COVID-19: in the footsteps of Ernest Shackleton 5/2020 Cruise ship 81% asymptomatic!
• COVID-19 spread is fueled by 'stealth transmission'. Cases of COVID-19 that fly under the radar without being diagnosed appear to fuel the rapid spread of the disease. 3/2020
• Did you already have coronavirus in January or February? 4/2020
• Estimating the generation interval for coronavirus disease (COVID-19) based on symptom onset data, March 2020 4/2020
• Even children with no symptoms can spread Covid-19, CDC report shows 9/2020
• Half of Singapore's new COVID-19 cases are symptomless, taskforce head says 6/2020
• Hidden Outbreaks Spread Through U.S. Cities Far Earlier Than Americans Knew, Estimates Say 5/2020
• How COVID Silent Spreaders May Be Infecting Others 4/2020
• How does the new coronavirus spread? These new studies offer clues. 3/2020
• How many COVID-19 infections are asymptomatic? Research shows it may be a lot more than thought 7/2020
• How much is coronavirus spreading under the radar? 3/2020
• How Stealth transmission is fueling the rapid spread of Covid-19, according to experts 3/2020
• How the World Missed Covid-19's Silent Spread 6/2020
• How to identify factors affecting COVID-19 transmission 3/2020
• Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020 6/2020
• Infected but Feeling Fine: The Unwitting Coronavirus Spreaders 4/2020
• Infected people without symptoms might be driving the spread of coronavirus more than we realized 3/2020
• In four US prisons, thousands of inmates are testing positive and 96% are asymptomatic 4/2020
• In the W.H.O.'s Coronavirus Stumbles, Some Scientists See a Pattern 6/2020
• It's not just people with symptoms who can spread COVID-19 3/2020
• Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis 3/2021
• More Evidence Points to Kids Being COVID-19 'Silent Spreaders' Study: 93% of infections would have been missed if only symptomatic cases were tested 8/2020
• Most COVID-19 Cases Come from People Without Symptoms 1/2021
• Most COVID Transmission Is Still Asymptomatic — Some 60% of spread starts with those who have no symptoms, and that may be higher with Omicron 5/2022
• New Study Says Silent Spreaders May Be Responsible For Half Of U.S. COVID-19 Cases 7/2020
• Over 85% of COVID-19 Infections in China Went Undetected Early On 3/2020. Number of mild or asymptomatic infections emphasizes need for mitigation measures
• People might be most infectious with coronavirus before they show symptoms, study suggests 4/2020
• Presymptomatic Transmission of SARS-CoV-2 -Singapore, January 23-March 16, 2020 4/2020 MMWR
• Prevalence of Asymptomatic SARS-CoV-2 Infection A Narrative Review 6/2020
• Rapid spread of COVID-19 is fueled by 'stealth transmission' 3/2020
• SARS-CoV-2 Infections and Serologic Responses from a Sample of U.S. Navy Service Members, USS Theodore Roosevelt, April 2020 6/2020
• SARS-CoV-2 Transmission From People Without COVID-19 Symptoms 1/2021 JAMA
• South Korean Study Suggests Children Can Silently Spread COVID-19; Symptoms went unrecognized more often than not in infected kids 9/2020
• 'Stealth Transmission' Fuels Fast Spread of Coronavirus Outbreak 3/2020
• Study: 17.9% Of People With COVID-19 Coronavirus Had No Symptoms 3/2020
• Substantial Undocumented Infection Facilitates the Rapid Dissemination of Novel Coronavirus (SARS-CoV2) 3/2020
• The natural history and transmission potential of asymptomatic SARS-CoV-2 infection 6/2020
• The truth about COVID-19 and asymptomatic spread: It's common, so wear a mask and avoid large gatherings 11/2020
• Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany 3/2020 NEJM
• We Still Don't Fully Understand The Label 'Asymptomatic' 6/2020
• What Does Asymptomatic COVID-19 Look Like Under the Surface? Many individuals show subclinical abnormalities as well as differences from symptomatic patients 6/2020
• What We Know About The Silent Spreaders Of COVID-19 4/2020
• What We Need to Understand About Asymptomatic Carriers if We're Going to Beat Coronavirus 4/2020
• WHO Creates 'Confusion' About Asymptomatic Spread. Here's What We Know 6/2020
• WHO Says Asymptomatic Spread Of Coronavirus 'Very Rare,' But Experts Raise Questions 6/2020
• Wuhan woman with no symptoms infects five relatives with coronavirus: study 2/2020

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Superspreader Events (SSEs)

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Graphic source: https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e2.htm

Graphic source: https://www.mckinsey.com/featured-insights/coronavirus-leading-through-the-crisis/charting-the-path-to-the-next-normal/people-who-see-people-how-high-mixers-help-spread-covid-19

Graphic source: https://public.tableau.com/profile/betsy.ladyzhets#!/vizhome/superspreadingevents/DashSuperspreadingeventsmap

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6947e1.htm

Distribution of COVID-19 cases (N = 177) linked to a rural wedding reception, by date of onset or test - Maine, August 7–September 14, 2020

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a5.htm

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a5.htm

Graphic source: https://news.mit.edu/2020/super-spreading-covid-transmission-1102

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6941a4.htm

Transmission chains and attack rates in three COVID-19 child care facility outbreaks, Salt Lake County, Utah, April 1-July 10, 2020

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6937e3.htm

Graphic source: https://www.dailymail.co.uk/news/article-8094933/How-one-man-spread-coronavirus-NINE-people-bus.html

Graphic source: https://www.nytimes.com/2020/04/20/health/airflow-coronavirus-restaurants.html

Chinese Restaurant transmission

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e1.htm

Funeral community transmission

CDC - Korean Call Center - Blue = infected with COVID-19

Graphic source: https://www.vox.com/21262268/coronavirus-tips-covid-social-distancing-harm-reduction

Graphic source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6920e2.htm

Graphic source: https://www.statista.com/chart/21699/coronavirus-outbreak-in-ischgl/"

Graphic source: https://www.statista.com/chart/21697/contact-tracing-response-seoul-south-korea-covid-19/

Graphic source: https://www.zdnet.com/article/google-researchers-show-how-covid-19-super-spreaders-are-a-big-part-of-the-problem/

Reich and colleagues construct graphs of people in their various states of infection and the like among people, to simulate how COVID-19 spreads. Caption from the article: "Contact tracing. Some share of the neighbors of a node which tests positive are traced and tested themselves." Reich et al. 2020

Graphic source: https://cosmosmagazine.com/biology/how-social-distancing-flattens-the-curve-of-coronavirus

This graph shows how an epidemic might spread across a network over time. Blue dots are susceptible individuals, while red dots are infected people. Two dots are connected by a line if they are in contact with each other, and the more contacts a person has, the bigger their dot is on the network. Author provided

Infected people are red nodes, and susceptible people are blue. The large node in the middle of the diagram is a super-spreader, a person who connects with many others, and thus has more potential to spread the disease.

Graphic source: https://quillette.com/2020/04/23/covid-19-superspreader-events-in-28-countries-critical-patterns-and-lessons/

Timeline of events and symptom onsets, by day of investigation, in a cluster of COVID-19 likely transmitted at two family gatherings - Chicago, Illinois, February-March 2020

Video source: https://www.nytimes.com/2020/04/14/us/coronavirus-updates.html
The farther the better

• After Lavish Nights of Clubbing in Bangkok, a Covid Outbreak. Thailand went for months without a single confirmed case of local transmission, but the epidemic has now radiated from nightclubs to areas where social distancing is all but impossible. 6/2021
• A large COVID-19 outbreak in a high school 10 days after schools' reopening, Israel, May 2020 7/2020
• An Outbreak of COVID-19 Associated with a Recreational Hockey Game - Florida, June 2020 MMWR 10/2020
• A person who was Covid-19 positive attended a church service and exposed 180 people 5/2020
• Bars, Strip Clubs and Churches: U.S. Virus Outbreaks Enter Unwieldy Phase 6/2020
• Clustering and superspreading potential of SARS-CoV-2 infections in Hong Kong 10/2020
• Clusters of Coronavirus Disease in Communities, Japan, January-April 2020 6/2020
• College towns fear super-spreader semester as students descend 8/2020
• Community Transmission of SARS-CoV-2 at Two Family Gatherings Chicago, Illinois, February-March 2020 4/2020
• Coronavirus Cluster on Cape Cod: 10 Test Positive After Attending Large Party 7/2020
• Coronavirus outbreak at USC's fraternity row leaves at least 40 people infected 7/2020
• Coronavirus Ravaged a Choir. But Isolation Helped Contain It. 5/2020
• Coronavirus Testing In Boston's Homeless Community Shows Shelter Size And Density Matter 5/2020
• COVID-19 Outbreak Among a University's Men's and Women's Soccer Teams - Chicago, Illinois, July-August 2020 MMWR 10/2020
• COVID-19 Outbreak Among College Students After a Spring Break Trip to Mexico Austin, Texas, March 26-April 5, 2020 MMWR 7/2020
• COVID-19 Outbreak Associated with a 10-Day Motorcycle Rally in a Neighboring State - Minnesota, August-September 2020 MMWR 11/2020
• Covid-19 superspreader events emerge as focus of concern. The White House cluster is the kind of incident that infectious disease experts are focusing on as a crucial way to understand how the coronavirus spreads. 10/2020
• COVID-19 Superspreader Events in 28 Countries: Critical Patterns and Lessons 4/2020
• Covid-19 "super-spreading" events play outsized role in overall disease transmission 11/2020
• Days After a Funeral in a Georgia Town, Coronavirus Hit Like a Bomb 6/2020. A mourner came to Albany, Ga., to attend the funeral of a retired janitor. After a pause while the infections incubated, the virus swept through the community.
• Dozens of persons in Shinjuku's sex industry infected with coronavirus 4/2020
• Epidemiologically Linked COVID-19 Outbreaks at a Youth Camp and Men's Conference - Illinois, June-July 2021 8/2021 MMWR
• Epidemiology and transmission dynamics of COVID-19 in two Indian states 9/2020
• Ford temporarily closed its Chicago Assembly Plant after two employees test positive for COVID-19 a day after reopening 5/2020
• Google researchers: COVID-19 super-spreaders are a big part of the problem 5/2020
• Greenwich & Darien Deal With Coronavirus 'Party Zero'-Type Cases 8/2020
• High COVID-19 Attack Rate Among Attendees at Events at a Church, Arkansas, March 2020 5/2020
• High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice — Skagit County, Washington, March 2020 5/2020 MMWR
• Hospital Traces COVID Cluster to Break Room - 15 employees of Holyoke Medical Center fall ill after eating together 10/2020
• How a Bus Ride Turned Into a Coronavirus Superspreader Event. One-third of passengers aboard a bus were infected by a fellow passenger, scientists reported. 9/2020
• How a Premier U.S. Drug Company Became a Virus Super Spreader Biogen employees unwittingly spread the coronavirus from Massachusetts to Indiana, Tennessee and North Carolina. 4/2020 NYT
• How a superspreader at choir practice sickened 52 people with COVID-19 5/2020
• How Coronavirus Infected Some, but Not All, in a Restaurant, A limited study by Chinese researchers suggests the role played by air currents in spreading the illness in enclosed spaces. 4/2020
• How Ischgl Set Off A Coronavirus Avalanche 5/2020
• How large superspreader events turned into coronavirus hot spots. This is why large gatherings should be the last normal activity to come back after Covid-19 is contained. 5/2020
• How one man spread coronavirus to NINE other people on his bus in China: Scientists find the deadly virus can travel four times the 'safe' distance and linger in the air for over 30 minutes in confined places 3/2020
• How Superspreading Events Drive Most COVID-19 Spread. 6/2020, As few as 10 percent of infected people may drive a whopping 80 percent of cases, in specific types of situations
• Intense fitness classes can lead to rapid spread of COVID-19, report shows 5/2020
• Lamont Warns Of Possible Coronavirus Spread At Parties. The parties mainly took place in Fairfield County. One involved people sharing a vape pen, Lamont said. 7/2020
• Maine CDC Investigates COVID-19 Outbreak Associated with Wedding Reception in Millinocket 8/2020
• More Than 6,600 Coronavirus Cases Have Been Linked to U.S. Colleges 7/2020
• Most People With Coronavirus Won't Spread It. Why Do a Few Infect Many? 6/2020
• Multiple COVID-19 Outbreaks Linked to a Wedding Reception in Rural Maine - August 7-September 14, 2020 MMWR 11/2020
• One Infected Clubgoer Triggers Massive Response 5/2020
• Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School - Marin County, California, May-June 2021 8/2021 MMWR
• Party with 400 people shut down during students' first weekend back at ECU, cops say 8/2020
• Party Zero: How a Soiree in Connecticut Became a Super Spreader 3/2020 NYT
• People who see people: How high mixers help spread COVID-19 4/2021
• Police Tactics Are Putting Protesters at Higher COVID Transmission Risk. 6/2020. Cops are forgoing masks and other PPE, and violating protesters' boundaries by pulling masks down, forcing them into crowded spaces, and more.
• Protests Pose Particular Risks for COVID-19 Transmission. 6/2020. Not just lack of social distancing, but increased droplet contact, tear gas could be factors
• Rose Garden announcement of Supreme Court nominee potential 'super spreader' event, with Trump plus six others getting COVID 10/2020
• SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp - Georgia, June 2020 MMWR 7/2020
• Spring Breaker Who Vowed To Party Despite Coronavirus Concerns Has Apologized 3/2020
• Superspreading and the effect of individual variation on disease emergence 11/2005
• The Coronavirus Infected Hundreds at a Georgia Summer Camp 7/2020
• The Coronavirus's Rampage Through a Suburban Nursing Home 3/2020 NYT
• The Effects of Large Group Meetings on the Spread of COVID-19: The Case of Trump Rallies 10/2020 Abstract
• The Effects of Large Group Meetings on the Spread of COVID-19: The Case of Trump Rallies 10/2020 Article
• Tracking Covid-19 infections among President Trump's contacts. What we know about the Covid-19 status of those who have been around the president recently. 10/2020
• Tracing Trump's movements: A timeline of the days leading up to his COVID diagnosis. A review of his public schedule shows several possible "super-spreader" events. 10/2020
• Two churches reclose after faith leaders and congregants get coronavirus 5/2020
• What's A 'Super-Spreading Event'? And Has It Happened With COVID-19? 2/2020
• What counts as a 'superspreader' event? 1o/2020
• With the holidays coming, Covid cases likely to surge during 'six weeks of superspreader events' 10/2020
• Why Are Some People So Much More Infectious Than Others? 4/2020
• Why COVID-19 Flare-Ups Will Keep Happening 5/2020
• Why understanding superspreaders is key to controlling COVID-19 PBS.org
• Younger adults are biggest spreaders of Covid-19, study suggests 2/2021

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Transmission Factors

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Graphic source: https://www.bmj.com/content/375/bmj-2021-065312

Graphic source: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1442/5910315

Graphic source: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1442/5910315

Graphic source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767010

Graphic source: https://www.nature.com/articles/s41591-020-0869-5

a, Schematic of the relation between different time periods in the transmission of infectious disease. b, Human-to-human transmission pairs of SAR-CoV-2 virus (N=77). We assumed a maximum exposure window of 21 days prior to symptom onset of the secondary cases. Detailed information on the transmission pairs and the source of information is summarized in Supplementary Tables 2 and 3. c, Estimated serial interval distribution (top), inferred infectiousness profile (middle) and assumed incubation period (bottom) of COVID-19.

Graphic source: https://www.nature.com/articles/s41591-020-0869-5

Viral load (threshold cycle (Ct) values) detected by RT-PCR (PCR with reverse transcription) in throat swabs from patients infected with SARS-CoV-2 (N=94), overall and stratified by disease severity, sex, age group and link to Hubei province. The detection limit was Ct40, which was used to indicate negative samples. The thick lines show the trend in viral load, using smoothing splines. We added some noise to the data points to avoid overlaps.

• 5 Things All Health Care Personnel Should Know About Infection Control, Viruses and Respiratory Droplets 8/2021
• Can SARS-CoV-2 Infection Be Acquired In Utero? More Definitive Evidence Is Needed 3/2020
• Coronavirus appears to thrive in dry air. Australian study adds weight to hypothesis. 8/2020
• COVID-19's problem of confounding variables 6/2020
• Covid-19: Viral Shedding Lasts Weeks in Some Children 10/2020
• How COVID-19 Spreads 10/2020 CDC.gov
• How are people being infected with COVID-19?
• How coronavirus spreads outdoors vs. indoors 5/2020 YouTube
• How COVID-19 Spreads CDC.gov
• Humidity is a consistent climatic factor contributing to SARS-CoV-2 transmission 8/2020
• Low humidity increases COVID-19 risk: Another reason to wear a mask Dry air could prompt further disease spread 8/2020
• NIH hamster study evaluates airborne and fomite transmission of SARS-CoV-2 Findings support efforts to reduce SARS-CoV-2 indoor airborne transmission. 8/2021 NIH.gov
• One in ten people may still be infectious for COVID after ten days, new research indicates 1/2022
• Persistence of clinically relevant levels of SARS-CoV2 envelope gene subgenomic RNAs in non-immunocompromised individuals 12/2021
• Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission Dynamics Should Inform Policy 9/2020
• Summer Is Coming, but the Virus Won't Be Going 5/2020
• Surfaces? Sneezes? Sex? How the Coronavirus Can and Cannot Spread. What you need to know about how the virus is transmitted. 3/2020
• Temperature, Humidity, and Latitude Analysis to Estimate Potential Spread and Seasonality of Coronavirus Disease 2019 (COVID-19) 6/2020 JAMA
• Temporal dynamics in viral shedding and transmissibility of COVID-19 4/2020
• Virus Likely to Keep Coming Back Each Year, Say Top Chinese Scientists 4/2020
• Visualising SARS-CoV-2 transmission routes and mitigations 12/2021 BMJ
• Weather impact on airborne coronavirus survival 8/2020
• What Don't We Know About COVID-19 Severity, Seasonality 4/2020

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Air (Airborne)Transmission

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Infected after 5 minutes, from 20 feet away: South Korea study shows coronavirus’ spread indoors

Evolution of a Cough

Graphic source: https://www.mcgill.ca/newsroom/channels/news/covid-19-without-masks-two-metres-distancing-not-enough-333819

Evolution of a cough with mask

Graphic source: https://www.mcgill.ca/newsroom/channels/news/covid-19-without-masks-two-metres-distancing-not-enough-333819

Graphic source: https://www.youtube.com/watch?v=i7e8t-Rzv0I

Graphic source: https://wwwnc.cdc.gov/eid/article/27/6/21-0465-f2

Graphic source: https://www.latimes.com/world-nation/story/2020-12-09/five-minutes-from-20-feet-away-south-korean-study-shows-perils-of-indoor-dining-for-covid-19

Graphic source: @ncdhhs

Graphic source: https://www.nationalgeographic.com/science/2020/08/how-to-measure-risk-airborne-coronavirus-your-office-classroom-bus-ride-cvd/

Graphic source: https://www.nationalgeographic.com/science/2020/08/how-to-measure-risk-airborne-coronavirus-your-office-classroom-bus-ride-cvd/

Graphic source: https://twitter.com/tukkerloo/status/1237078414416281605

Graphic source: https://www.sciencedirect.com/science/article/pii/S016041202031254X?via%3Dihub

Graphic source: https://cosmosmagazine.com/science/physics/heres-why-you-should-close-the-toilet-lid/

Left: Vortex caused by common annular flushing. Right: Large-scale spread of virus particles after flushing. Credit: J-X Wang

Graphic source: https://boston.cbslocal.com/2020/05/12/coronavirus-spread-restaurant-airflow-erin-bromage/

Graphic shows how coronavirus spreads through air (Image credit University of Oregon)

Graphic source: https://api.nationalgeographic.com/distribution/public/amp/science/2020/01/how-coronavirus-spreads-on-a-plane

• Let’s Clear The Air On COVID 3/23/2022 The White House
• US, WHO officials and experts agree (sort of) on how COVID-19 spreads 4/2022
• A case study of extended in-flight transmission of SARS-CoV-2 en route to Aotearoa New Zealand 11/2020
• Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 3/2020 ,/B>
• Identifying airborne transmission as the dominant route for the spread of COVID-19 6/2020
• It Is Time to Address Airborne Transmission of Coronavirus Disease 2019 (COVID-19) 6/2020
• Mounting evidence suggests coronavirus is airborne — but health advice has not caught up 7/2020
• Outbreak of Coronavirus Disease 2019 (COVID-19) in a Nursing Home Associated With Aerosol Transmission as a Result of Inadequate Ventilation 8/2020
• SARS-CoV-2 transmission on planes 4/2022
• Scientific Brief: SARS-CoV-2 Transmission CDC.gov 5/2021
• Ways COVID-19 Spreads CDC.gov 5/2021
• The virus is an airborne threat, the C.D.C. acknowledges. 5/2021
• Updated CDC guidance acknowledges coronavirus can spread through the air 9/2020
• CDC finally acknowledges airborne COVID-19 spread, for real this time 10/2020
• COVID-19: Without masks, two metres distancing is not enough 10/2021
• COVID-19: Without masks, two meters distancing is not enough, research finds. Simulations track the spread of coughs and safe physical distancing indoors 10/2021
• COVID Spread More Indoors by Talking Than Coughing, Study Suggests 1/2021
• COVID-19 Is Transmitted Through Aerosols. We Have Enough Evidence, Now It Is Time to Act 8/2020
• Droplets vs Aerosols: What's More Important in COVID-19 Spread? CDC finally acknowledged aerosol transmission, but contribution to case counts remains unclear 5/2021
• Efforts to stop spread of COVID-19 should focus on preventing airborne transmission, experts say 4/2021
• Epidemiologic Evidence for Airborne Transmission of SARS-CoV-2 during Church Singing, Australia, 2020 6/2021
• Fate and Transport of Indoor Microbiological Aerosols (FaTIMA) Web tool
• Excel fatima-csv-template Fate and Transport of Indoor Microbiological Aerosols (FaTIMA)
• Flushing a public toilet? Don't linger, because aerosolized droplets do. Study explores flushing power to test risk of COVID-19 transmission 4/2021
• Simple safety measures reduce musical COVID-19 transmission 8/2021
• 6 feet may not be enough to avoid infectious aerosols indoors 9/2021
• Transmission of Viruses in Droplets and Aerosols (part 1)
• Transmission of Viruses in Droplets and Aerosols (part 2)
• Transmission of Viruses in Droplets and Aerosols (part 3)
• Transmission of Viruses in Droplets and Aerosols (Part 4)Youtube
• 239 Experts With One Big Claim: The Coronavirus Is Airborne 7/2020
• Aboard the Diamond Princess, a Case Study in Aerosol Transmission. A computer model of the cruise-ship outbreak found that the virus spread most readily in microscopic droplets light enough to linger in the air. 7/2020

• Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals 4/2020
• Aerosol and Surface Distribution of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospital Wards, Wuhan, China, 2020 4/2020
• Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1 3/2020
• Aerosol Scientist: COVID-19 Is Likely Airborne 6/2020
• Airborne Coronavirus Detected in Wuhan Hospitals 5/2020
• Airborne Spread of SARS-CoV-2 and a Potential Role for Air Disinfection 6/2020 JAMA
• Airborne Transmission of SARS-CoV-2. Theoretical Considerations and Available Evidence 7/2020 JAMA
• Airborne transmission of SARS-CoV-2: The world should face the reality 6/2020
• Airborne Coronavirus: What You Should Do Now 7/2020
• Airborne viruses can spread on dust, non-respiratory particles 8/2020
• Can the coronavirus spread through speech? 4/2020
• CDC: COVID-19 Can Spread 13 Feet, Travel on Shoes; 4/2020
• Coronavirus can travel twice as far as official safe distance and stay in air for 30 minutes, Chinese study finds 3/2020 SCMP.com
• Coronavirus Lingers in Air of Crowded Spaces, New Study Finds 4/2020
• Coughs and sneezes travel farther than you think via @YouTube
• COVID-19 may spread through breathing and talking but we don't know how much. 4/2020 Speech-related spread could help explain why people can spread the virus before they develop a cough.
• COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020 7/2020 (Released 4/2020)
• Covid-19 spreads through the air. That is a big challenge for reopening 6/2020
• Covid Is Airborne, Scientists Say. Now Authorities Think So, Too 5/2021
• Everything You Wanted to Know About Air Purifiers and Coronavirus 11/2020
• Here's how coronavirus spreads on a plane and the safest place to sit. Global travel opens new roads for outbreaks, like coronavirus and the flu but which is more dangerous, and how can you stay safe? 3/2020 NATGEO
• How airflow inside your car affects COVID-19 risk 12/2020
• How Coronavirus Infected Some, but Not All, in a Restaurant A limited study by Chinese researchers suggests the role played by air currents in spreading the illness in enclosed spaces. 4/2020
• How Did We Get Here: What Are Droplets and Aerosols and How Far Do They Go? A Historical Perspective on the Transmission of Respiratory Infectious Diseases 5/2021
• How far can SARS-CoV-2 travel into the airways? A mathematical model shows it reaches deep into our lungs, and more to the right than the left. 6/2021
• How Important Is Speech in Transmitting Coronavirus? 3/2020 ucdavis.edu
• How important is speech in transmitting coronavirus? 4/2020
• How To Protect Yourself From Coronavirus That Can Linger In The Air 9/2020
• Infected after 5 minutes, from 20 feet away: South Korea study shows coronavirus’ spread indoors 12/2020
• It is Time to Address Airborne Transmission of COVID-19 7/2020
• Is COVID-19 spread through the air? 7/2020. Scientists say there's mounting evidence it can be.
• Measure the risk of airborne COVID-19 in your office, classroom, or bus ride 8/2020
• Model: Face Masks Prevented Thousands of COVID-19 Cases. Researchers argue airborne transmission "dominant route for infection" 6/2020
• Mounting Evidence Suggests Coronavirus Is Airborne but Health Advice Has Not Caught Up 7/2020
• People are getting sick from coronavirus spreading through the air – and that's a big challenge for reopening 6/2020
• Playing wind instruments generates less aerosol than vocalization, COVID-19 study finds 6/2021
• Researchers link 'heavy wildfire smoke' in Reno to increased risk of contracting COVID-19 7/2021
• Scientists Urge WHO To Update Guidance On Airborne Transmission Of The Coronavirus 7/2020 NPR
• 6 feet may not keep musicians safe during the pandemic 10/2020
• Stay 6 Feet Apart, We're Told. But How Far Can Air Carry Coronavirus? Most of the big droplets travel a mere six feet. The role of tiny aerosols is the trillion-dollar question. 4/2020
• Talking Can Generate Coronavirus Droplets That Linger Up to 14 Minutes 5/2020
• The Coronavirus Is Airborne Indoors. Why Are We Still Scrubbing Surfaces? 11/2020
• The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmission 5/2020
• The Coronavirus Can Be Airborne Indoors, W.H.O. Says 7/2020
• The Coronavirus May Be Adrift in Indoor Air, C.D.C. Acknowledges 10/2020
• The Flu May Linger in the Air, Just Like the Coronavirus 7/2020
• The Scientist, the Air and the Virus 6/2020
• The Shifting Paradigm of COVID-19 Airborne Transmission; Expert panel points to "circumstantial evidence," though research is evolving 8/2020
• The 60-Year-Old Scientific Screwup That Helped Covid Kill. All pandemic long, scientists brawled over how the virus spreads. Droplets! No, aerosols! At the heart of the fight was a teensy error with huge consequences. 5/2021
• Tree pollen carries SARS-CoV-2 particles farther, facilitates virus spread, study finds 6/2021
• Turbulent Gas Clouds and Respiratory Pathogen Emissions - Potential Implications for Reducing Transmission of COVID-19 3/2020
• Two meters distance might not be enough to avoid the spread of COVID-19 Social distance is important but also sneeze and cough etiquette 4/2020
• Using a public restroom? Mask up! Flushing public restroom toilets or urinals can spew clouds of particles carrying viruses, including COVID-19 8/2020
• Violent expiratory events: on coughing and sneezing 2/2014
• Viral Load of SARS-CoV-2 in Respiratory Aerosols Emitted by COVID-19 Patients while Breathing, Talking, and Singing 8/2021
• We Know Crowding Affects the Spread. It May Affect the Death Rate. Densely populated areas can have nearly twice the rate of transmission, and can make Covid-19 more deadly. Other areas can open more quickly. 4/2020
• What airborne coronavirus means, and how to protect yourself The COVID-19 pandemic has revived a decades-old debate about how respiratory diseases travel which affects the safety practices experts recommend. 8/2020
• What is airborne transmission? WHO adds guidance on aerosols in coronavirus spread 7/2020
• What We Know About Your Chances of Catching the Virus Outdoors 5/2020
• When you cough, how far can it go? Physics suggests we should be distancing further. 5/2020
• WHO Finally Admits Coronavirus Is Airborne. It’s Too Late 5/2020
• Why the WHO took two years to say COVID is airborne 4/2022 Nature.com
• Why you should close the toilet lid. Study shows flushing creates clouds that can carry viruses 6/2020
• WHO: The coronavirus may be airborne and could float beyond 6 feet in restaurants, bars, and other indoor locations 7/2020

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Hand Dryer Concerns

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• Are Bathroom Hand Dryers Sanitary? A New Study Found They May Spray You With More Bacteria Than You'd Think 4/2018
• Assessment of the bacterial contamination of hand air dryer in washrooms 3/2016
• Deposition of Bacteria and Bacterial Spores by Bathroom Hot-Air Hand Dryers 4/2018
• Grosser than ever, hot-air hand dryers spread fecal matter throughout buildings 4/2018
• The Dirty Truth About Hand Dryers 10/2019
• Using a Dyson hand dryer is like setting off a viral bomb in a bathroom [Updated] 4/2016
• Why hand dryers are public enemy No. 1 for holiday shoppers 12/2018

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Fecal-Oral Transmission

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• Can COVID-19 spread through fecal matter? Studies indicate genetic material of virus showing up in stool 5/2020
• Flushing the Toilet May Fling Coronavirus Aerosols All Over. 6/2020 A new study shows how turbulence from a toilet bowl can create a large plume that is potentially infectious to a bathroom's next visitor.
• How safe is it to use public bathrooms right now? It's complicated. 5/2020
• New coronavirus may spread through poop. Wash your hands after using the bathroom. 2/2020
• SARS-CoV-2-Positive Sputum and Feces After Conversion of Pharyngeal Samples in Patients With COVID-19 3/2020 Annals.org
• Sewage From Toilet in Chinese City Infected Six People with Coronavirus in First Known Case of Its Kind 10/2020
• Sewage as a Possible Transmission Vehicle During a Coronavirus Disease 2019 Outbreak in a Densely populated Community: Guangzhou, China, April 2020 10/2020

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Fomite (Contact) Transmission

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Graphic source: https://twitter.com/WebMD/status/1249276076146282496

Graphic source: https://www.newyorker.com/science/elements/from-bats-to-human-lungs-the-evolution-of-a-coronavirus

According to researchers at Rocky Mountain Laboratories, some viral particles remain viable up to four hours on copper, twenty-four hours on cardboard, and seventy-two hours on plastic and stainless steel, though the number of viable particles begins to decrease within minutes.

• Can Frozen Food Spread The Coronavirus? 2/2021
• Can PAP Therapy Machines Increase the Risk of Spreading the Coronavirus?
• CDC Now Says Coronavirus is Not Easily Spread by Surface Contact 5/2020
• Chicken wings test positive for Covid-19 in China, but there's no evidence of food transmission, experts say 8/2020
• Coronavirus lurks and lingers in nursing home patients' rooms, study finds. Rigorous surface cleaning needed to reduce chance of spread to unvaccinated and vaccinated-but-vulnerable patients, staff and visitors 11/2021
• Coronavirus: pathogen could have been spreading in humans for years, study says 3/2020 SCMP.com
• COVID-19: What Do We Know About Transmission Routes and Surface Survival? 3/2020 Medscape.com
• How long does the new coronavirus last on surfaces 3/2020
• New coronavirus stable for hours on surfaces SARS-CoV-2 stability similar to original SARS virus. 3/2020
• Novel coronavirus can last 28 days on glass, currency, Australian study finds. "It really reinforces the importance of washing hands and sanitizing where possible," said the study's lead researcher Shane Riddell. 10/2020
• Study confirms the low likelihood that SARS-CoV-2 on hospital surfaces is infectious 6/2021
• The New Coronavirus Can Live On Surfaces For 2-3 Days — Here's How To Clean Them 3/2020

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Household Transmission

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Graphic source: https://www.cdc.gov/mmwr/volumes/71/wr/mm7109e1.htm

• Are Young Children Super Spreaders of SARS-CoV-2 in Families? 9/2021
• CDC: Vaccination Curbed, but Didn't Halt, Omicron in Households - Attack rates still highest among unvaccinated index cases 2/2022
• Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study 10/2021 Lancet.com
• Coronavirus spreads quickly among household members, CDC report finds The report noted that the age of the index patient didn't matter — adults, children and teens all spread the virus to others in their households. 10/2020
• Household Transmission of SARS-CoV-2 from Children and Adolescents 7/2021 NEJM
• If You Love Your Family, Stay the Hell Away From Them/ People are letting their guards down while visiting loved ones, and it's putting them and everyone else around them at risk. 8/2020
• Kids sick with Covid are filling up children's hospitals in areas seeing spikes Absolutely household infections are the beginning of this pandemic, that is a major driving force in the spread of infections. We see it often within households, parents to children a pediatrician said. 8/2021
• SARS-CoV-2 B.1.1.529 (Omicron) Variant Transmission Within Households - Four U.S. Jurisdictions, November 2021–February 2022 2/2022 MMWR
• Transmission of SARS-COV-2 Infections in Households -Tennessee and Wisconsin, April-September 2020 10/2020

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Person to Person (Droplet/Respiratory; Saliva) Transmission

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Graphic source: https://cosmosmagazine.com/physics/when-you-cough-how-far-can-it-go

Graphic source: https://www.gao.gov/products/GAO-20-545SP

Graphic source: https://www.gao.gov/products/GAO-20-545SP

Determining the necessary spacing for effective social distancing, such as for riders in a subway car, can affect the extent of disease transmission. The shaded circle (top) shows the number of people who could be directly infected by droplets from a sick person.

• Deciding How Much Distance You Should Keep 3/2020
• SARS-CoV-2 infection of the oral cavity and saliva 4/2021
• Social Distancing During Pandemics 5/2020 GAO.gov
• Violent expiratory events: on coughing and sneezing 4/2020

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Sexual Transmission (Being investigated)

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• Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019 5/2020 JAMANetwork
• Coronavirus found in infected men's semen 5/2020
• Coronavirus May Lurk in Semen, Researchers Report 5/2020
• Coronavirus is not an STD: Semen from COVID-19 positive men doesn't contain the virus 4/2020
• Does coronavirus linger in the body? 8/2020
• Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis 11/2020

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Vertical Transmission

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• COVID-19 can be transmitted in the womb, reports pediatric infectious disease journal 7/2020. Case study provides evidence of intrauterine transmission of SARS-CoV-2 from mother to infant
• Mother-to-Baby COVID-19 Transmission Likely Rare - Vertical transmission linked to severe maternal infection, postnatal diagnosis 3/2022
• Report: COVID-19 Transmitted to Babies in Utero 7/2020. Italian researchers confirm two infections at birth

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Zoonotic Transmission

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Graphic source: https://www.biorxiv.org/content/10.1101/2022.02.22.481551v1

• Highly divergent white-tailed deer SARS-CoV-2 with potential deer-to-human transmission Pre-print 2/2022

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Other Forms of Reported Transmission

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• COVID-19 in the Ear: Have You Heard About the Risk for HCPs? "The jury is now in" on potential for transmission during otolaryngology procedures 7/2020
• Young people are infecting older family members in shared homes 7/2020

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PUBLISHED ON THE WEB: March 30, 2020
Updated: 5/16/2022 R13,491
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