"What's Up With COVID and How to Protect Yourself: 2024 Edition" © 2024 by Hazel Newlevant is licensed under CC BY-NC-ND 4.0

Download a printable PDF of this zine here! Print on 4 sheets of paper, double-sided, short-edge binding. Fold it in half, then staple in the middle. Regular PDF here.

Traducción al castellano aquí.


1 Business interests in ignoring COVID

Cde. Dremmel. Let Them Eat Plague! The Red Clarion. 9 Jan. 2023

2 CDC's community levels was political minimization

The People's CDC. The CDC Is Beholden to Corporations and Lost Our Trust. We Need to Start Our Own. The Guardian, 3 Apr. 2022.

3 CDC wouldn't admit COVID is airborne

Doubleday, Julia. New CDC Guidelines: Work 'Til You Drop. The Gauntlet. 15 Feb. 2024.

4 People who masked spent less time shopping

Zhang, Shunyuan, et al. Frontiers: Unmasking Social Compliance Behavior during the Pandemic. Marketing Science. 42 (3): 44050. 2023.

5 Delta's CEO wanted shorter isolation guidelines

Shivaram, Deepta. Delta's CEO asked the CDC for a 5-day isolation. Some flight attendants feel at risk. NPR. 29 Dec. 2021.

6 COVID is airborne

Greenhalgh, Trisha, et al. Ten Scientific Reasons in Support of Airborne Transmission of SARS-CoV-2. The Lancet, vol. 397, no. 10285, 1 May 2021.

7 Aerosols stay suspended and maintain infectivity

Fears, Alyssa C., et al. Persistence of Severe Acute Respiratory Syndrome Coronavirus 2 in Aerosol Suspensions. Emerging Infectious Diseases, vol. 26, no. 9, Sept. 2020, pp. 216871.

8 Over half of spread is asymptomatic

Johansson, Michael A., et al. SARS-CoV-2 Transmission from People without COVID-19 Symptoms. JAMA Network Open, vol. 4, no. 1, Jan. 2021.

9 Forced to work while sick

Karlis, Nicole. Ill-Gotten Gains: Why Does American Society Coerce Us to Work While Sick? Salon, 15 Feb. 2024.

10 CDC stopped COVID tracking

---. The CDCs COVID Tracker Is about to Go Dark. Salon, 18 May 2023.

11 Wastewater Is the best we've got

Jacoby, Sarah. How to Use COVID-19 Wastewater Data to Make Safer Choices, according to Experts. TODAY.com, 14 Mar. 2024.

Wastewater correlation to actual cases is .94

Hoerger, Michael. PMC COVID-19 Forecasting Model (Nov 27, 2023).

Wastewater to cases conversion


Check local wastewater data


12 COVID damages the blood vessels

Kitscha, Phoebe. Is Coronavirus a Disease of the Blood Vessels? Bhf.org.uk, British Heart Foundation,, 18 Sept. 2020.

13 damages almost any organ

Anderegg, Nick. Long COVID and Post-COVID Conditions. Pandemic Patients, 12 Mar. 2024.

14 brain shrinkage

Douaud, Gwenaëlle, et al. SARS-CoV-2 Is Associated with Changes in Brain Structure in UK Biobank. Nature, vol. 604, no. 7907, Mar. 2022.

15 1 in 10 get LC

Hastie, Claire E., et al. True Prevalence of Long-COVID in a Nationwide, Population Cohort Study. Nature Communications, vol. 14, no. 1, Nov. 2023, p. 7892.

16 10%-20% of kids get LC

Rao, Suchitra, et al. Postacute Sequelae of SARS-CoV-2 in Children. Pediatrics, vol. 153, no. 3, American Academy of Pediatrics, Feb. 2024.

CDC reports 1 in 5 infections results in LC

Bull-Otterson, Lara. PostCOVID Conditions among Adult COVID-19 Survivors Aged 18-64 and ≥65 Years United States, March 2020 November 2021. MMWR. Morbidity and Mortality Weekly Report, vol. 71, no. 21, 2022.

Chances of LC are worse with reinfection

Boufidou, Fotini, et al. SARS-CoV-2 Reinfections and Long COVID in the Post-Omicron Phase of the Pandemic. International Journal of Molecular Sciences, vol. 24, no. 16, Aug. 2023, p. 12962.

17 List of Post Covid conditions

Anderegg, Nick. Long COVID and Post-COVID Conditions. Pandemic Patients, 12 Mar. 2024.

18 COVID death count

World Health Organization processed by Our World in Data. Weekly Confirmed COVID-19 Deaths. Our World in Data

19 Increased heart attack risk

Yeo, Yee Hui, et al. Excess Risk for Acute Myocardial Infarction Mortality during the COVID19 Pandemic. Journal of Medical Virology, vol. 95, no. 1, Oct. 2022.

20 increased stroke risk

Knight, Rochelle, et al. Association of COVID-19 with Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales. Circulation, vol. 146, no. 12, Sept. 2022, pp. 892906.

21 COVID excess deaths

Faust, Jeremy Samuel, et al. Two Years of COVID-19: Excess Mortality by Age, Region, Gender, and Race/Ethnicity in the United States during the COVID-19 Pandemic, March 1, 2020, through February 28, 2022. medRxiv preprint, 26 Sep. 2022.


Jetelina, Katelyn, and Kristen Panthagani. COVID-19 Vaccines and Sudden Deaths: Separating Fact from Fiction. Your Local Epidemiologist, 17 Jan. 2023.

22 multiple reinfections increase adverse health impacts

Bowe, Benjamin, et al. Acute and Postacute Sequelae Associated with SARS-CoV-2 Reinfection. Nature Medicine, vol. 28, Nov. 2022, pp. 2398405.

23 summary of viral persistence

Chen, Benjamin, et al. Viral Persistence, Reactivation, and Mechanisms of Long COVID. eLife, vol. 12, May 2023.

24 COVID disregulates immune system for at least 6 months

Ryan, Feargal J., et al. Long-Term Perturbation of the Peripheral Immune System Months after SARS-CoV-2 Infection. BMC Medicine, vol. 20, no. 1, Jan. 2022.

25 tuberculosis rising globally

World Health Organization. Global Tuberculosis Report 2023 Global Tuberculosis Report, 7 Nov. 2023.

26 various outbreaks

Siderea. Possible Post-COVID Immune Dysregulation & Its Epidemiological Consequences [COVID-19, Sci/Bio/Med]. Sibylla Bostoniensis, 28 Sep. 2022.

27 Covid causing TB outbreaks is plausible

Dheda, Keertan, et al. The Intersecting Pandemics of Tuberculosis and COVID-19: Population-Level and Patient-Level Impact, Clinical Presentation, and Corrective Interventions. The Lancet Respiratory Medicine, vol. 10, Aug. 2022.

28 Vaccine has reduced death and hospitalization

Rahmani, Kazem, et al. The Effectiveness of COVID-19 Vaccines in Reducing the Incidence, Hospitalization, and Mortality from COVID-19: A Systematic Review and Meta-Analysis. Frontiers in Public Health, vol. 10, Aug. 2022.

29 antibody levels quickly decline

Morales-Núñez, José Javier, et al. Overview of Neutralizing Antibodies and Their Potential in COVID-19. Vaccines, vol. 9, no. 12, Nov. 2021, p. 1376.

30 vaccines don't stop getting and spreading COVID

Lane, Gregory, et al. Quantity of SARS-CoV-2 RNA Copies Exhaled per Minute during Natural Breathing over the Course of COVID-19 Infection. medRxiv preprint, 8 Sep. 2023.

31 long term damage (8% LC in vaccinated)

Maier, Hannah E., et al. Reduction in Long-COVID Symptoms and Symptom Severity in Vaccinated Compared to Unvaccinated Adults. Open Forum Infectious Diseases, vol. 11, no. 2, Oxford University Press, Jan. 2024.

32 mutations in spike protein cause immune escape

Tian, Dandan, et al. The Global Epidemic of SARSCoV2 Variants and Their Mutational Immune Escape. Journal of Medical Virology, vol. 94, no. 3, Oct. 2021.

33 COVID reinfection in as little as 19 days

Ren, Xiangying, et al. Reinfection in Patients with COVID-19: A Systematic Review. Global Health Research and Policy, vol. 7, no. 1, Apr. 2022.

34 Asymptomatic sensitivity 11.7%

Soni, Apurv, et al. Performance of Rapid Antigen Tests to Detect Symptomatic and Asymptomatic SARS-CoV-2 Infection. medRxiv preprint, 23 Jan. 2023.

35 FDA recommendations

Center for Devices and Radiological Health. At-Home COVID-19 Antigen Tests-Take Steps to Reduce Your Risk of False Negative Results: FDA Safety Communication. FDA, Dec. 2022.

36 Throat swabs improve accuracy

Todsen, Tobias, et al. COVID-19 Rapid Antigen Tests with Self-Collected vs Health Care Worker-Collected Nasal and Throat Swab Specimens. JAMA Network Open, vol. 6, no. 12, American Medical Association, Dec. 2023, pp. e234429595.

37 Instructions

Ontario Health. COVID-19 Rapid Antigen Tests: How to Collect a Sample. Publication?, 9 Feb. 2022.

38 How to swab tonsils

Public Health England. How to Take a Combined Throat and Nose Swab for COVID-19. YouTube, YouTube, 13 May 2020.

39 Head straps are better than ear loops

Yung, Chee Fu. Poor Performance of Masks Secured Using Ear Loops. JAMA Internal Medicine, vol. 181, no. 2, Nov. 2020.

40 Elastomerics seal better

Chiang, James, et al. Elastomeric Respirators Are Safer and More Sustainable Alternatives to Disposable N95 Masks during the Coronavirus Outbreak. International Journal of Emergency Medicine, vol. 13, no. 1, July 2020.

41 Assuming it fits your face

Collins, Aaron. Quarter Mask Elastomeric Review - Flo, Envo & Breathe. Youtube, 18 Dec. 2023.

42 How N95s are better

MinutePhysics, and Aatish Bhatia. The Astounding Physics of N95 Masks. YouTube, 18 June 2020.

43 seal check

Occupational Safety and Health Administration. How to Perform a User Seal Check with an N95 Respirator. YouTube, 18 June 2020.

44 DIY fit test

Provenzano, Destie, et al. Alternative Qualitative Fit Testing Method for N95 Equivalent Respirators in the Setting of Resource Scarcity at the George Washington University. medRxiv preprint, Apr. 2020.

44 DIY fit test instructions

pneustrom. How to do a DIY mask fit test. Youtube, 27 Jul. 2021.

45 source control is better

Ueki, Hiroshi, et al. Effectiveness of Face Masks in Preventing Airborne Transmission of SARS-CoV-2. MSphere, edited by Michael J. Imperiale, vol. 5, no. 5, Oct. 2020.

46 Aura is good

ResTestThePlanet. Best Picks. TestThePlanet.org, 12 Mar. 2024.

47 EnvoMask Pro is good

@FitTestMyPlanet. I Am *NOT* recommending the regular old Envomask quarter mask. The old one was one of the 10 worst consumer elastos. The 2023 Envo pro is possibly the best. Twitter, 1 Aug. 2023.

48 Flo Mask Pro is good

Brooke, Ethan. Flo Mask Review - the Best Everyday Mask? BreatheSafeAir, 17 Jan. 2024.

49 Laianzhi is good

ResTestThePlanet. Black Respirators Most Likely to Reduce Exposure for a Random Set of Adults, Assuming No Adjustment of Out-of-Package Default Tension, as of 2024. TestThePlanet.org, 2024.

50 Outdoor transmission much less likely

Bulfone, Tommaso Celeste, et al. Outdoor Transmission of SARS-CoV-2 and Other Respiratory Viruses: A Systematic Review. The Journal of Infectious Diseases, vol. 223, no. 4, Nov. 2020.

51 Clean air instructions

Centers for Disease Control and Prevention. Ventilation in Buildings. Centers for Disease Control and Prevention, 12 May 2023.

how to build

Clean Air Crew. DIY box fan filters Corsi-Rosenthal box Clean Air Crew.

52 DIY purifiers help with smoke

United States Environmental Protection Agency. Research on DIY Air Cleaners to Reduce Wildfire Smoke Indoors. EPA.gov, 19 Aug. 2021.

53 Why nasal sprays

Chavda, Vivek P., et al. Nasal Sprays for Treating COVID-19: A Scientific Note.Nasal Sprays for Treating COVID-19: A Scientific Note. or Nasal Sprays for Treating COVID-19: A Scientific Note.Nasal Sprays for Treating COVID-19: A Scientific Note. Pharmacological Reportsg, no. 75, Feb. 2023, pp. 24965.

54 Xylitol nasal spray risk reduction 62%

Balmforth, Damian et al. Evaluating the efficacy and safety of a novel prophylactic nasal spray in the prevention of SARS-CoV-2 infection: A multi-centre, double blind, placebo-controlled, randomised trial. Journal of Clinical Virology, 155, Oct. 2022, p. 105248.

Previous version: Colloidal silver spray risk reduction 84.4%

Almanza-Reyes, Horacio, et al. Evaluation of Silver Nanoparticles for the Prevention of SARS-CoV-2 Infection in Health Workers: In Vitro and in Vivo. PLOS ONE, edited by Daniela Flavia Hozbor, vol. 16, no. 8, Aug. 2021, p. e0256401.

55 iota-carrageenan spray risk reduction of 80%

Figueroa, Juan Manuel, et al. Efficacy of a Nasal Spray Containing Iota-Carrageenan in the Postexposure Prophylaxis of COVID-19 in Hospital Personnel Dedicated to Patients Care with COVID-19 Disease. International Journal of General Medicine, vol. 2021, no. 14, Oct. 2021, pp. 627786.

56 Nitric Oxide nasal spray PeP reduced risk by 75%

Miller, Chris, et al. Epidemiological Analysis of Nitric Oxide Nasal Spray (VirX™) Use in Students Exposed to COVID-19 Infected Individuals. Respiratory Therapy, vol. 18, no. 2, 2023.

57 mouthwash

Lin, S-Y., et al. Effectiveness of Mouth Rinses against COVID-19: A Systematic Review and Network Meta-Analysis. Journal of Hospital Infection, vol. 139, no. 139, Sept. 2023, pp. 17591.

58 S salivarius k12 (Bactoblis) reduced RTIs by 65%

Wang, Qiang, et al. Oropharyngeal Probiotic ENT-K12 Prevents Respiratory Tract Infections among Frontline Medical Staff Fighting against COVID-19: A Pilot Study. Frontiers in Bioengineering and Biotechnology, vol. 9, June 2021.

59 Infectious for at least 10 days

Adam, David. How Long Is COVID Infectious? What Scientists Know so Far. Nature, vol. 608, no. 7921, July 2022, pp. 1617.

60 In-person PCR helps get disability benefits

Métraux, Julia. Can You Apply for Disability with an At-Home Rapid COVID-19 Test? Verywell Health, 12 Jan. 2022.

61 Dehydration associated with LC

Hultström, Michael, et al. Dehydration Is Associated with Production of Organic Osmolytes and Predicts Physical Long-Term Symptoms after COVID-19: A Multicenter Cohort Study. Critical Care, vol. 26, no. 1, Oct. 2022.

62 You need rest

Ziauddeen, Nida, et al. Characteristics and Impact of Long Covid: Findings from an Online Survey. PLOS ONE, vol. 17, no. 3, 8 Mar. 2022, p. e0264331.

Ducharme, Jamie. Why You Should Rest a Lot If You Have COVID-19. Time, 23 Sept. 2022.

63 ME/CFS in 46% of LC patients

Mancini, Donna M., et al. Use of Cardiopulmonary Stress Testing for Patients with Unexplained Dyspnea Post-Coronavirus Disease. JACC: Heart Failure, vol. 9, no. 12, Dec. 2021, pp. 92737.

64 75% of US adults at increased risk of COVID

Ajufo, Ezimamaka, et al. U.S. Population at Increased Risk of Severe Illness from COVID-19. American Journal of Preventive Cardiology, vol. 6, June 2021, p. 100156.

65 Paxlovid lowers LC risk

Xie, Yan, et al. Nirmatrelvir and the Risk of Post-Acute Sequelae of COVID-19. medRxiv preprint, 5 Nov. 2022.

Where to get tests







Further resources

COVID monitoring

Pandemic Mitigation Collaborative - Weekly-updating estimates of how many people currently have COVID in the U.S., based on wastewater data.

Biobot.io - COVID wastewater data that can be filtered by state, giving a more local estimate of how many people currently have COVID. [Note: as of 5/17/24, Biobot no longer shares local wastewater data with the public. Now they share "Respiratory Risk Reports" divided into Northeast, Midwest, South, and West. These reports still contain SARS-CoV-2 copies/mL, which can be converted into regional "% Infectious" estimates via the chart in this zine.

NEW WastewaterSCAN - Reports from individual wastewater testing sites, which can give a local sense of where COVID is spiking.

People's CDC - COVID-19 weather reports.


PandemicPatients.org - Information about Long COVID and Post-COVID conditions, and advocacy for public policies that reduce spread, empower survivors, enhance the safety of shared spaces, and invest in public health.

NEW Long COVID and Fatiguing Illness Recovery Program ECHO - Webinar series about treating various Post-COVID Conditions, aimed at providers but very useful for patients who want to learn more and self-advocate.

NEW Patient Resources and Support Webinar - From the LC&FIRP ECHO series, a video lecture by lived experience expert Alison Sbrana, focused on how to get Long COVID accommodations. Alison walks viewers through her list of resource links.

NEW #MEAction - Learn more about myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a common presentation of Long COVID, and how to manage it through pacing.

NEW ME and more - "Long Covid Isn't Always MECFS : How to tell when it is." - Blog post by Samantha Lincroft about identifying the defining characteristic of ME/CFS: post-exertional malaise. MECFS one of the many conditions that can be triggered by Long COVID.

NEW Long COVID Physio - Pacing guide. Pacing is a strategy and rehabilitation approach that balances rest and activities in daily life, to manage symptoms such as fatigue and post-exertional malaise.

NEW CURE ID - Case reports of different repurposed drugs that have been used to treat Long COVID.

The Sick Times - News about COVID-19 and Long COVID.


r/Masks4All Wiki - A list of respirator recommendations and suppliers around the world.

ResTestThePlanet - Quantitative fit test results for various disposable respirators, and recommendations of the best-performing types.

Lola Germs - Fun and highly informative videos about masks and other COVID-related topics!

Lola's Elasto Guide - Info on elastomeric respirators, and reviews of various types.

MaskBloc.org - Lists active Mask Blocs around the world. Blocs provide masks, COVID-19 tests and other equipment to their communities for free.

Clean Air

CleanAirCrew - Information on clean air, masks, and instructions for building DIY air purifiers.

Clean Air Club - Lends out air purifiers for shows in the Chicago area. They have a map of other Clean Air Lending Library organizations!

COVID Action Map - A combined map of mask blocs, clean air orgs, advocacy orgs, community spaces, and more.

Nukit Open Air Purifier - Pattern to laser-cut your own air purifier frame—just add HVAC filters and PC fans! Or you can buy a similar metal frame from Nukit.

It's Airborne - Info on improving air quality, and purifier reviews.

Other prevention measures

NEW "Saline nasal irrigation and gargling in COVID-19: a multidisciplinary review of effects on viral load, mucosal dynamics, and patient outcomes" - Oral and nasal saline irrigation (meaning neti pot, nasal spray, gargling, or nebulization) "can be recommended for fastening viral clearance, symptom relief, and prophylaxis against respiratory infection, as has been increasingly proposed in (self-care) treatment or hygiene prevention guides for COVID-19."

NEW Hypochlorous Acid information and generator instructions compiled by Vivica - HOCI is a powerful and body-safe disinfectant with potential uses as a hand sanitizer, mouthwash, nasal rinse, and even air disinfection via humidifier. Inhaling nebulized HOCI reduced the risk of COVID-19 disease progression.

Nasal Sprays and Reducing the Risk of COVID Reinfection - Review of the evidence on various nasal sprays.

222nm Far-UVC Lights are a promising emerging technology.


Walgreens and CVS will order you at-home COVID tests and bill your insurance, so they're potentially free. 

FastLabTech will mail you free at-home tests if covered by insurance.

CDC No-Cost Testing Locator

"Find Covid-19 Medications" - Filter for "Test to Treat" sites to find locations that do COVID tests and give free consultations with providers to potentially prescribe Paxlovid if you test positive.

"What to Do if You Have COVID" (not medical advice)

People's CDC - COVID-19 weather reports and guides including "Safer In-person Gatherings" and "What to Do if You Have COVID."

Clean Air Club's "My Covid+ Plan" - Example list of supplies, symptom tracking, dose schedules, and bloodwork to get done post-infection.

RTHM Health - A list of potential treatments to reduce the risk of Long COVID, and the science behind them, from a Long COVID telehealth clinic.


NEW COVID-19 Drug Interactions Checker - Check for possible drug interactions with Paxlovid ("Nirmatrelvir/ritonavir (5 days)").

NYC Health + Hospitals Virtual ExpressCare - For those in New York State: telehealth visit to get assessed for Paxlovid, billed to insurance. If you do not have insurance or cannot afford to pay, Virtual ExpressCare will connect you to trained financial counselors who can help you enroll in health insurance or financial assistance through NYC Care, Medicaid, and Medicare, with visit fees as low as $0, depending on your income and family size. The standard self-pay charge for Virtual ExpressCare telehealth visits is $125.

"Find Covid-19 Medications" - Filter for "Test to Treat" sites to find locations that do COVID tests and give free consultations with providers to potentially prescribe Paxlovid if you test positive. Filter for "Paxlovid Patient Assistance Program" to find sites that fill Paxlovid prescriptions for free for qualifying patients.

Get a Paxlovid Prescription Online: Dr. B’s $15 Online Healthcare

PAXCESS - A program run by Paxlovid manufacturer Pfizer that gives discounts on Paxlovid. Enroll in the PAXCESS program before picking up your prescription! PAXCESS will not reimburse you for anything you've already paid.


NEW COVID-OUT Clinical Trial - Repurposing Metformin, a common diabetes drug, found that when taken within 4 days of symptom onset, metformin reduced Long COVID incidence by 63%. Handout to share with physicians.

NEW AgelessRX - Telehealth visit with a clinician to consult for a Metformin prescription, for $55.

Communicating about COVID

The John Snow Project - Simple and effective factsheet and informational videos about airborne transmission.

How to Talk to Your Loved Ones About Covid - Guide to explaining the dangers of COVID to your loved ones and moving them toward taking more precautions.

What Therapists Need to Know About COVID-19 in 2024 - Slide deck by Olivia Belknap and Erin Batali.


Covid Safe Providers
- A map of user-provided listings of COVID-safer medical providers and services in the U.S. and Canada.