To Mask or not to Mask, that is the Question: Spoiler alert, those who mask may not be criminals.

When the Mayor of New York city asked shoppers to remove their masks, it led to very worrisome conversations with many moving parts that need to be unpacked.

First, Mayor Eric Adams framed mask wearers as likely criminals by saying, “When you see these mask-wearing people, oftentimes it’s not about being fearful of the pandemic,” he said. “It’s fearful of the police catching them for their deeds.”

Second, it prompted many like Fernando Mateo of the United Bodega Workers of America, to weigh in with an assessment of the risks of COVID19 - despite having no expertise to do so - by saying, “COVID is over, let’s take the masks off.”

This conversation is being echoed in Canada as well, as can be seen from this quote by a guy who works in security with no expertise in COVID19, “We are seeing a lot of people who are up to no good keeping masks on, and I’m sure it’s to aid in their ability to do what they want to do.”

Let’s unpack the facts. If COVID19 is still a risk for hospitalizing and killing people, masks would be warranted and this makes the whole argument that only criminals wear masks a moot point. So, let’s start there.

Vaccines have helped reduce the harms of COVID19 but even those who have fully updated bivalent vaccines can still get infected. We are hoping for better vaccines that prevent infection but they are still in the works, so until the time they arrive, masking is crucial if COVID19 is still a risk and, indeed, it is.

In Canada, COVID19 is the second reason for hospitalization and the third cause of death.

So, the narrative that COVID19 is over and there isn’t a need to mask, simply doesn’t fit with the facts. When lives and health are at risk, facts matter.

In his statement, Mayor Adams suggests what he probably considers a compromise, by saying, “We are putting out a clear call to all of our shops: Do not allow people to enter the store without taking off their face mask… And then once they’re inside, they can continue to wear it if they so desire to do so."


This statement also misses the facts by a wide margin. COVID19 is an airborne virus and, in an area where many people removing their masks, the density of the virus would be significant, putting people at risk by breathing in enough virus to get infected.

When calling out inaccurate facts, I’d also like to call out bad takes, because Mayor Adams called people who wear masks as “being fearful of the pandemic.” and this is a call to remove masks and get infected when COVID19 is still a clear and present danger to the population.

There is a hidden bad take in all of this and it warrants some airtime: identifying who might be involved in criminal activity on first glance is fraught with biases. Much has been written about racial biases in policing and this call against masks puts those masking while not white at risk.

An article published in April 2023, presented findings showing that Indigenous, Latino, Pacific Islander and Black Americans all have significantly higher COVID-19 mortality rates than either white or Asian Americans when the data are adjusted to account for age distribution differences among racial and ethnic groups.

So, those more likely to be identified as criminals while wearing masks are also the same groups that are most in need of masking because they are most at risk.

Between inaccurate facts and bad takes, the conversation about masks and criminal activity is problematic. It may well be that criminals are using masks as a way to hide their identity but many are masking to protect themselves against an airborne virus that is still putting people in hospital and killing them. Conflating mask wearing and criminal activity is something I did not expect to be on our Bingo card for 2023, but here we are.

And let’s get personal – because it is for me – If my 6’ 3' mixed race son enters your store masked, do not tackle or taser him. He’s my child, trying to protect his parents – including his father who just had heart surgery – from COVID19.

What happens in Gatineau doesn't stay in Gatineau

"By day he worked for the Canadian government as an IT specialist.

By night, he worked as a drug trafficker and becomes a federal government employee  hacker, extorting companies and others around the world as a part of a criminal ransomware gang, amassing millions of dollars in bitcoin by threatening to expose the private digital information of victims who didn't pay up.”

For those who don’t know Gatineau, its a rather sleepy community in Quebec, so near the capital of Canada, Ottawa, that many federal civil servants live there because it’s lovely, nestled in nature, and much cheaper than Ottawa. Who would have thought that an international criminal in ransomware - masquerading as a 33-year-old simple bureaucrat - lived there? He has an addiction to making money and is very dangerous.

What is ransomware? It’s a form of malicious software that blocks access to a computer or computers until a ransom payment is made.  The ransomware criminals hold sensitive information on the locked computer and threaten to release the information publicly if the payment is not made. How much? Millions of dollars. In bitcoin that can’t be traced.

For those who aren’t familiar with the Fifth Estate, it’s an amazing CBC investigative journalism program. Here is the link: https://gem.cbc.ca/media/the-fifth-estate/s48e07

My summary:

The hacker, User ID 128, has a name: Vachon-Desjardins. He doesn’t live big, he lives in a small home in a sleepy community. He just wants more money. And then, even more.

He attacked universities and health institutions during COVID-19, their most vulnerable time, to extort millions. He threatened them with losing their valuable data and releasing personal information on patients. Why? For money. “He told me … he was having an addiction to money. He always wanted more and more and more. He [didn’t] know where to stop,”

Vachon was charged in Canada and, after the FBI got involved via the ransomware attacks in the United States, he was extradited and charged there too. “I think that a lot of individuals who commit these crimes don’t think that they’ll ever stand trial in the United States. I think that the 20-year sentence was a very good deterrence piece to prevent others who might consider committing this type of conduct, that maybe they should think twice.”

Vachon-Desjardins remains in Pinellas County Jail in Clearwater, Fla., as he awaits his next hearing set for January, when restitution for his victims will be decided. He will then be assigned to a federal prison.”

Does crime pay for those who need more and more money? At first, it sure looked like it, “When police raided Vachon-Desjardins’ Gatineau home and arrested him on Jan. 27, 2021, they seized $742,840 and 719 Bitcoin, valued at approximately $21,849,087 at the time and $14,463,993 as of today.”

Today, he’s in a federal prison in the United States, serving a 20 year sentence.

What happens in a small home, in a sleepy community like Gatineau Canada? A lot apparently. And what happens in Gatineau never stays in Gatineau. It isn’t Las Vegas. Thank goodness.

Threatening institutions in Canada and the United States during COVID-19 should have a price — 20 years seems hardly enough.

COVID-19 Mystery: Based on a True Story

The mystery: ten friends gathered for a weekend pre-wedding party. After spending the weekend together, only five of them got COVID-19.

Why did only half of the people get infected?

?

It is highly likely they were infected with the omicron variant – the dominant variant at this time – which is very contagious.

“The Omicron coronavirus variant was likely the fastest-spreading virus in human history. One person with the measles virus – a standout among infectious microbes – might infect 15 others within twelve days. But when Omicron suddenly arrived this past winter, it jumped from person to person so quickly that a single case could give rise to six cases after four days, 36 cases after eight days, and 216 cases after twelve days.”

So asked another way, how did five party goers avoid getting omicron?

Let’s set the stage with what we know of protections against omicron

First, all those at the party had three doses of the COVID-19 vaccine – so there was no difference in vaccinations between those who got infected wth COVID-19 and those who didn’t. However, they were all about 5 months past their third dose of vaccine and vaccines wane, making them vulnerable to be infected at this point in time. 

None were eligible for their fourth doses because they were all in their twenties – too young for fourth dose eligibility.  

However, they took a very important precaution: understanding they were vulnerable to infection they all did rapid antigen tests on Friday morning before meeting on Friday afternoon. All of them tested negative.

Did the rapid antigen tests miss an infection? How reliable are rapid antigen tests? Research suggests they aren't entirely accurate, “Medical experts continue to warn that a negative result on a rapid test doesn't necessarily mean you don't have COVID-19." New Swiss research, which is yet to be peer-reviewed, suggests some rapid tests have "significantly lower sensitivity" to Omicron than to the Delta variant.

So, could this have been a problem with one or more people being infected with COVID-19 but not testing positive on the rapid antigen test? Unlikely, because they all spent a weekend together, not wearing masks and doing what young people do – hugging, laughing, occasionally bursting into song and sharing bedrooms. Is it possible that half the people avoided infection given all this?

COVID19 is airborne, so a person gets infected “when infectious particles that pass through the air are inhaled at short range”, a process otherwise known as “short-range aerosol or short-range airborne transmission”… transmission can [also] occur through “long-range airborne transmission” in poorly ventilated or crowded indoor settings “because aerosols can remain suspended in the air or travel farther than conversational distance.”

If 10 young people share space with one or more infected persons, sharing the same air for an entire weekend, wouldn’t it be likely that more than half get infected? 

To answer this mystery, it’s helpful to fast forward to the end of the weekend. As all ten people were leaving, there were unmasked hugs, chats and laugher. Then 5 of the people piled into one car and 5 into the other. This is where the mystery becomes less baffling: all the people in one car got infected and none in the other car got infected.

Again – the question is why? What was in one car but not the other? What was in one car but not present all weekend long that infected everyone in the car only?

There are two important concepts to break down: the duration of safety with rapid antigen tests and the incubation period of omicron.

Rapid antigen tests, even if they accurately detect infections, are only useful for that moment in time. So, one can be accurately negative today and accurately positive tomorrow.

How?

Here we need to look at the incubation period of omicron. An incubation period – for this mystery – is best seen as the time from the moment a person is infected to the time they are infectious. That time varies from three to five days.

So lets’s backtrack to the week before the get together. Someone got infected with omicron that previous week. They were asymptomatic when the weekend began and – very importantly – it was too early in the infection for the rapid antigen test to detect this early infection. As the weekend wore on, this person still remained infected but not infectious.

However, on the 2 hour long car ride home, this person went from infected to infectious and – with COVID19 being airborne and no one wearing masks – everyone in that car became infected.

We often say in medicine, timing is everything. It turns out, with rapid antigen tests and COVID-19, this still remains true.

Writing Mysteries in the Age of COVID-19

As always, I’m curious on how to plot a murder mystery and have been peeking at how death investigations have changed.

Since COVID-19, mystery writers attempting to hide a murder have a different landscape to deal with. If a person is COVID-19 positive, even if they wouldn’t die from the disease - this is far more possible with the Omicron variant - a murder via poison at home would be easier to conceal.

Recently, our jurisdiction changed the rules stating, “Autopsies will no longer be performed on someone who is suspected to have died from COVID-19 unless there is another factor of great significance, such as a homicide.”

So, without evidence of blunt force trauma or anything obviously untoward, a murder via poison in a COVID-19 positive person can be more easily hidden.

Is this true in other jurisdictions?

“During the pandemic, many sick people have stayed at home and died there rather than seeking help at hospitals overwhelmed with coronavirus patients.

“In April in New York City, for example, a reported 200 residents died at home each day, compared with 20 such deaths before the pandemic…If family or friends say the person had symptoms consistent with COVID-19, the coroner's office will typically do a nasal swab to test for the virus, he says. If the test is positive and the office can determine the cause of death without an autopsy, one will generally not be performed.”

A review of the literature shows, “The literature is dominated by appeals for more autopsies to be performed…The main reason for the great reluctance worldwide to perform autopsies seems to be concerns about infectivity emanating from deceased persons.”

In the United States, there’s the added problem of cost, availability of specialists and the vast number COVID-19 deaths.

“Hospitals are not required to provide autopsy services, and in those that do perform them, the procedure’s costs are not directly covered by most private insurance or by Medicare…Added into the mix: The number of experts who can actually perform autopsies is critically low. Estimates suggest the U.S. has only a few hundred forensic pathologists but could use several thousand — and less than one in 100 graduating medical school students enters the profession each year.”

Add to this the fact that there are almost 860k COVID-19 deaths to date, the volume of detailed death investigations, let alone autopsies, of those who die out of hospital would overwhelm the system. So they are not done.

In hospital deaths are also not autopsied but with COVID-19 restrictions on visitors it would be hard to write a plausible mystery involving a murder in hospital.

So if autopsies aren’t done for most COVID-19 deaths, is toxicology conducted?

“How are forensic toxicology tests done? At the time of the autopsy, collection of blood, urine, and tissue samples is done in preparation for the toxicology tests, says Barbarajean Magnani, PhD, MD, chairwoman of the Toxicology Resource committee for the College of American Pathologists.”

So, given the concerns about infection from COVID-19 would collection of samples occur? I have not found evidence to suggest it is done.

While this certainly makes for intriguing options for writing mysteries, it’s a huge loss to science. Fulsome and numerous autopsies are the one crucial way to obtain information about a disease. For scientific purposes, more rather than fewer autopsies should be conducted. However, the limitations of time, personnel, well-ventilated facilities and PPE have limited autopsies and we have lost a great deal of data. Because of this, there’s been a pushback from many to perform more autopsies.

“The results from the analyzed studies show that autopsies are essential in the COVID-19 pandemic. They enable a more differentiated assessment of mortality. More important than the determination of the cause of death, however, is the fact that only the autopsy (including histological and virological examinations) opens up the possibility of investigating the spread of the virus in the body, the involvement of various organ systems, but also the late effects of the disease…

There are few valid reasons not to perform autopsies in COVID-19 deceased if the technical equipment meets certain minimum standards. It is easy to protect oneself against infection during the autopsy. Both clinical and forensic pathologists – preferably in cooperation – play an important role in gaining knowledge about the new disease as a basis for therapeutic measures and global pandemic control.”

I do wonder how mysteries written in the age of COVID-19 will be different because of the new landscape of death investigations.