Scroll down to read the comic vertically. Click the icon links for endnotes.

In the foreground, a black person busses dishes while giving side-eye to two white adults talking as one of their kids sneezes. We see the air flow out and billow around them, splashing on a listening face and forming a miasma that fills the rest of the background. The busser has a button that says “service with a smile” even as their mouth is covered by a k100 mask. In large hand drawn lettering at the top of the page, the words “WHY WE MASK:” sit on a black background. And then out in the miasma and it says “IT’S NOT” and then in quotes “JUST A COLD”. In the bottom right, it says “Laurel Lynn Leake” above a large “2025”.
TITLE PAGE: ‘WHY WE MASK: IT’S NOT ‘JUST A COLD’’ in bubble letters with the subtitle underneath saying ‘A Handy Scientific Guide To Surviving COVID-19 Together’. At the bottom of the page, a cute drawing of a big headed person with cat’s eye glasses. She looks nervous and sweat is flying off her, filling the house shape she’s in. Outside, a large COVID-19 particle looms. Text below reads ‘featuring ME!’
Spiky viruses surround the text: ‘THE BASICS: COVID-19 is an illness caused by the virus SARS-CoV-2, and mainly spreads through the air.’ An endnote is shown here as e1. ‘ A single infection, even one that seems ‘mild’, can cause severe damage throughout your body. What’s worse, each new infection risks new damage to your brain, immune system, lungs, heart, and more, and can add up to permanent disabilities or death. e2 Right now, at least 75% of all adults e3 (and 30% of children e4) are at a high risk for catching severe infections that could hospitalize or even kill us. And if you have EVER had COVID-19, even once, YOU are now officially high risk too.’ It says ‘THE VIRUS’ and explains that SARS means ‘Severe Acute Respiratory Syndrome’, COV is ‘Corona Virus (crown-shaped, round with spikes)’, & 2 is ‘similar to 2002-2003 SARS-CoV outbreak’. It says ‘THE ILLNESS’ beside a curly-haired sniffly person. The word COVID-19 splits into ‘corona’, ‘virus’, ‘disease’, & ‘discovered in 2019’. P1
Large hand-drawn text reads ‘COVID-19 is an AIRBORNE ILLNESS e5’ over that same curly haired character from the last page sneezing with a big ‘KACHOO!’ It says ‘Respiratory Particles as we see a large billow of mist labeled ‘invisible aerosols’, goop labeled ‘snot &spit (too big to be particles)’, and falling circles labeled ‘visible droplets’. A measurement in meters is below, showing larger droplets dropping in the first couple meters and the more misty particles continuing to 6 meters. In a box below, text reads ‘ It spreads when infected people exhale clouds of mostly invisible RESPIRATORY PARTICLES carrying hidden viruses. RPs are the tiny drops of fluid that shoot out of our mouths whenever we cough, sneeze, talk, or even breathe. If you’re infected and contagious, you can breathe out enough virus to infect others in just 20 seconds! e6 And in places with no fresh air or ventilation, the tiniest RPs can float around like smoke for HOURS. e7,e8’ P2
A cloud of particles, with a large one labeled ‘DROPLETS…are barely visible globs that slowly drift to the ground. Too big to inhale.’ A small dot says ‘AEROSOLS...are blobs that are so light they can float. Mostly too small to see.’ Big text asks ‘What’s inside a respiratory particle?’ as a cute Laurel magnifies a speck to show SARS-COV-2 inside. The particle grows larger, revealing dots of ‘dust’ & squiggly ‘mucus’. Text explains ‘RPs form out of the fluids that naturally line your lungs, throat, & mouth, including sticky mucus. They also pick up junk like dust, bacteria, & viruses like SARS-CoV-2 e9. AEROSOLS, the smallest type of RPs, are actually the most dangerous. We all need to breathe, & they’re hiding in the air all around us! While heavy DROPLETS fall fast & smash into things in seconds, aerosols can drift invisibly for hours until inhaled by someone new. That means more of their viral passengers survive the trip through the air to infect you. e10, e11’ P3
‘SYMPTOMS: SARS-COV-2 symptoms start about 3-6 days after infection, & last about 12-14 days. e12 This initial or acute infection stage is more commonly called COVID-19. Symptoms and contagiousness differ by viral variant, but often include… e13’. Below, symptoms are illustrated by cartoony figures on a black background. ‘EXHAUSTION, DIZZINESS, HEADACHE’ is by a miserable face radiating lines suggesting confusion and pain. A person hacks into their hand for ‘COUGHING, SNEEZING, RUNNY NOSE’. A reclining figure saying ‘ow’ has little stars shooting out of their joints to show ‘SORENESS, FEVER, CHILLS’. A figure barely holding in vomit represents ‘NAUSEA, VOMITING, ABDOMINAL PAIN’, &’DIARRHEA’. And a confused head disgusted at the taste of an apple shows ‘LOSS OF SMELL AND/OR TASTE’. Below, text says ‘Then again, you could be one of the 32-50% of people with COVID-19 who are… e14, e15’ And then next to a silly drawing of a person frolicking and singing: ‘CONTAGIOUS WITH NO SYMPTOMS’ P4
SEVERE SYMPTOMS header over a distressed muscular person gasping for breath, with lungs labeled STRAINED AND/OR RAPID BREATHING, WHEEZING, heart with CHEST PAIN AND/OR PRESSURE, & darkened lung areas with PNEUMONIA (fluid in the lungs) Below reads: HYPOXEMIA: COVID-19 can impair O2 flow to your blood, even w/o obvious breathing issues. LOW BLOOD OXYGEN symptoms can cause organ failure and even death w/o treatment. Measure BLOOD OXYGEN LEVELS at home with a PULSE OXIMETER: There’s a drawing of a finger inside a pulse oximeter. ‘91-94% = concerning, 90% and under = emergency!! WARNING: Oximeters may give FALSELY HIGH READINGS to people with dark skin &/or painted nails. E16’ It then lists Hypoxemia symptoms, with a troubled face for CONFUSION AND/OR DISORIENTATION, a beating heart for RACING HEART & INABILITY TO WAKE UP OR STAY AWAKE’, & CYANOSIS has ‘PALE, GREY, or BLUE-TINTED TONGUE, LIPS, &/or NAILBEDS, depending on skintone.E17 Page ends: All these require emergency hospitalization! P5
‘HOW COVID SPREADS’ it says in large letters above the text Respiratory particles carrying SARS-CoV-2 usually enter our bodies in one of three ways: 1) INHALATION, 2) DIRECT CONTACT and 3) INDIRECT CONTACT’ The page underneath this text is filled with a splash image of a chubby, shadowy figure breathing in mist and particles as we see the particles descend down the trachea and into their lungs. Couples sit across from each other at tables in the background, letting off gusts of air. A bubble pointing to the inhaling mouth says ‘#1 INHALATION: The vast majority of COVID-19 infections begin by breathing in an infected person’s aerosols. e18 In crowded spaces with no air flow, you can inhale enough to get infected in seconds! And if you work or live in places like these, you’re in constant danger of catching repeated, severe infections. e19, e20’ P6
A black femme with close cut hair puts their arm over the shoulder of a person with a mop of curly hair, as they blow out air that flows all around them. An bubble pointing towards their visualized sinuses reads ‘#2 DIRECT CONTACT: Viral aerosols/droplets can also collide directly into your MUCOUS MEMBRANES. e21 These are the layers of soft, wet cells lining your nose, mouth, eyes, respiratory tract, etc.’ Another balloon points at a beer bottle being handed from one of the friends to the other, it reads ‘#3 INDIRECT CONTACT: Much less likely to infect, but still possible: You get respiratory particles on your hands, & then transfer them to your mouth, nose, or eyes. e22’ P7
‘When you breathe in...air (including any nearby respiratory particles) rushes into your nose or mouth, down your TRACHEA or windpipe, and then splits into the twin BRONCHI tubes of the LUNGS’ We see a trachea filled with respiratory particles, & branches filling transparent lungs. ‘This whole system is called the RESPIRATORY TRACT…and it’s protected by a special kind of MUCOUS MEMBRANE cell lining covered in tiny waving tentacles called CILIA. They’re coated with slippery MUCUS fluids.’ We see noodly cilia wrapped in stringy mucus dotted with SARS-CoV-2. ‘Cilia use their mucus to collect any dangerous PATHOGENS you inhale (ike dust, viruses, or bacteria). While they can catch a few virus-carrying RPs, cilia get overwhelmed by hundreds at once.’ A cartoony virus celebrates its escape as text says ‘RPs dissolve inside the warm, wet respiratory tract, & their viral passengers break free! SARS-CoV-2 attack nearby cells, in the ‘initial phase’ of a new COVID-19 infection. e23’ P8
‘SARS-CoV-2 uses SPIKE PROTEINS like lockpicks on cells’ outer membranes, tricking them into opening and letting the virus inside.’ A virus' knobby spikes connect with Y-shaped cell receptors to a cell membrane. ‘It then re-program the host cells to pump out new copies of SARS-CoV-2. The infected cells swell with copies until they burst, scattering the virus all over their healthy cell neighbors. e24’ A virus infects a cartoony cell, which sickens & barfs up SARS-CoV-2. ‘VACCINES: Most COVID-19 vaccines teach our immune systems to create defensive ANTIBODIES. These specialized proteins lock onto SARS-CoV-2’s lockpick spikes to make them useless.’ Y-shaped antibodies block the cell receptors. ‘While antibodies don’t block every single virus in your body, they help a lot: vaccinated people have far better chances of surviving initial infections. e25 But after 6 yrs of unchecked spread, we’re now dealing with dangerous VIRAL VARIANTS. These SARS-CoV-2 mutations (like Delta/Omicron/FLiRT/JN.1) have fancy spike proteins that old antibodies simply don’t fit! e26 So scientists race to keep up with yearly booster vaccines that can block the latest viral variants with new antibodies.’ P9
Overlapping branch shapes cover the top of the page, each branch splitting & narrowing into tiny twigs. A circle enhances the twigs to show bunches of grape-like forms labeled ‘Bronchioles’. Text underneath says ‘Once air reaches the lungs, it flows into the BRONCHIAL TREE, where the twin BRONCHI airways split into smaller & smaller twig-like BRONCHIOLES intertwined with BLOOD VESSELS, the ARTERIES & VEINS that carry blood cells to & from the heart.Each bronchiole is tipped with ALVEOLI, clusters of flexible ALVEOLAR SACS that look sort of like grapes. These clusters are wrapped in nets of CAPILLARIES, the tiniest, most delicate type of blood vessel.’ These details are labeled in the drawing, where veins & arteries wind around the branch-like bronchiole, splitting into smaller capillaries. A full bunch of grapes is labeled ‘alveoli’ with individual ‘alveolar sacs’. ‘Aerosols’ flow in through the bronchiole.
‘Healthy Alveoli’ in big text, next to a cross-section of an alveolar sac. A translucent arrow fills the inner chamber labeled ‘air flow in’ over the honeycomb-like shape of different cells. ‘Blood cells full of waste CO2’ flow through a capillary and Co2 passes through a ‘thin fluid layer’ & ‘semi-porous membrane’ and O2 goes back out oxygenating the blood cells, in a ‘gas exchange, CO2 out, o2 in’. The cells burst forth from the cut capillary surrounded by fluid labeled ‘blood plasma’. Text explains ‘Your alveolar sacs are so small, in fact, that air molecules can squeeze through their outer SEMI-POROUS MEBRANES! Fresh O2 (oxygen molecules) from the air swap places with the waste CO2 (carbon dioxide) carried by capillaries on the surface, in a GAS EXCHANGE. That’s another reason why tiny aerosols are so dangerous...Their size allows them to shoot all the way through your lungs and into your alveoli. There, they take advantage of the gas exchange to slip inside your blood...! e27’ P11
‘Our body takes defensive action against SARS-CoV-2 with IMMUNE CELLS, but variants excel at turning our immune response against itself in escalating CYTOKINE STORMS. e28 Infected, dying cells release CYTOKINES, or chemical signals that summon immune cells...But then those cells get attacked too, so they summon even MORE immune cells, & on & on...! e29 Your inflamed alveoli try to flush the invaders out with protective fluids, until they’re swollen with pus. This causes a suffocating state called PNEUMONIA, where your infected alveolar sacs struggle to keep exchanging O2-CO2 through their damaged walls. Without treatment, this can end in death.’ Below, fluid fills a sac as SARS-CoV-2 infects the larger cells of the membrane. Healthy immune cells attack viruses, & infected ones send cytokines to tell other IC to weaken the cell membrane. Virus spills out into a capillary, swelling the cell lining, & coagulating blood cells e31. A neutrophil attacks cell lining, & blood cells lack O2. P12
In stylized handwriting: ‘Meanwhile…’ & text continues ‘...SARS-CoV-2 spreads into your CIRCULATORY SYSTEM, triggering your blood to form MICRO CLOTS while attacking the ENDOTHELIAL LINING. e32 That’s the thin layer of cells lining every artery, vein, and capillary that normally keeps all your blood and tissues functioning.’ To the left, we see blood with little SARS-COV-2 particles splashing out, and a clump of cells labeled ‘micro clot’. The vein connects to a brain & down through thicker & thicker blood vessels until it reaches the heart. Big text reads: ‘Vascular damage like this damages EVERY part of you.’ Regular text: ‘Even ‘mild’ initial COVID-19 infections travel through the bloodstream to injure your BRAIN, HEART, & other critical organs - whether you notice that damage or not. e33’ An arrow from the brain shows spindly neurons covered with tiny circles labeled SARS-COV-2, and another arrow from the heart shows fibrous stretched forms covered with more of the tiny circles. P13
LASTING EFFECTS: A graph of symptoms over 3 years, with a small infected person illustrating different phases of illness. Text: At least 10-30% of people who survive COVID-19 report symptoms reappearing months or even YEARS later. That’s 10-30% of ALL adults, of all ages and backgrounds. e36, e37, e38 Millions have had their lives changed for the worse, with no end in sight. Long COVID (aka POST-COVID SYNDROME or POST-ACUTE SEQUELAE OF SARS-COV-2) varies wildly from person to person, but common symptoms include difficult coughs, strokes, heart attacks, immune dysfunction, & debilitating exhaustion. We’re only just beginning to understand it as a POST-VIRAL ILLNESS, like Shingles (caused by the Chickenpox virus) & AIDS (caused by HIV). COVID vaccines lower the likelihood of long-term damage, but don’t prevent it entirely.39 Long COVID also hits marginalized people the hardest, and we often go undiagnosed and untreated due to systemic bigotry in healthcare. e40,e41,e42 A child sweats in bed with a sleep mask: can’t sit up…can’t talk…light & sound hurt…this sucks. P14
LONG COVID: This page shows a chubby person with an undercut & facial hair using a cane & holding their free hand aloft. Inside of them we can see various organs, muscles, & veins, & they're surrounded bubbles containing symptoms. Starting from the top, near the brain, the bubbles say ‘strokes and memory loss’, ‘migraines’, ‘new or worsening mental illness’, ‘debilitating exhaustion, (sleep doesn’t help and activity makes it worse)’, ‘brain fog’, ‘loss of taste/smell’, ‘hearing loss’, ‘vision loss’, ‘immune disorders’, ‘new or worsening cancers’, ‘joint pain’, ‘lung damage’, ‘rashes’, ‘heart attacks’, ‘digestive issues’, ‘new or worsening diabetes’, ‘kidney and liver failure’, ‘nerve pain’, & ‘bowel damage’. e43, e44, and e45. Text says: ‘As of 2025, we keep discovering new ways SARS-CoV-2 damages the body long-term, but we still don’t have a ‘cure’. There are many ways to treat the symptoms (primarily serious, extended REST e46, e47, e48), but no silver bullet to reverse damage.’ P15
‘THE DAMAGE GETS WORSE WITH EVERY NEW INFECTION: Most people don’t know that SARS-CoV-2 damage is CUMULATIVE. That means every new infection you get raises the odds you’ll be hit by horrible new health complications that may become permanent. e49, e50 Even infections that feel like just a cold or just allergies can cause your health trouble immediately or down the line. e51’ A chart shows each infection raising risk; blood, lung, etc. issues rising & hospitalizations soaring. e52 ‘An easy or entirely asymptomatic initial infection may even mean your immune system barely activated to fight off the virus. Long after you recover from the ‘mild’ symptoms, the inactive viral debris from the infection can remain hidden throughout your body. e53’ A FDG-PET shows clouds of spike proteins around organs & joints e54. ‘These are VIRAL RESERVOIRS: Leftover virus chunks & spike proteins that collect in your muscles, bones, & organs, ready to reinfect you whenever your immune system gets stressed.’ P16
‘IMMUNE SYSTEM DYSFUNCTION: COVID-19 infections can leave your immune system depleted & unable to fight off much of anything. e55 Exhausted immune cells called T-CELLS can miss invading pathogens like bacteria or other viruses. They might even ‘reset’ and forget how to handle infections they’ve fought off before. e56’ 2 T-cells mumble & snore as VIRUSES & BACTERIA laugh. ‘COVID-19 infections can also leave you with a fired up immune system in constant high alert against your own body (aka AUTOIMMUNITY). Your T-cells and NEUTROPHILS may attack healthy cells & cause systemic inflammation, especially when triggered by old viral debris. e57 Meanwhile, overactive PLATELETS in your bloodstream gather blood cells into unnecessary micro-clots. These trigger heart attacks, strokes, as well as many other Long COVID symptoms throughout the body. e58’ A t-cell signals & says ‘I KNOW there’s a virus around here somewhere!’ as happy platelets make a clot & an attacking neutrophil says ‘I’m helping!’ P17
‘STOPPING THE SPREAD: So obviously we want to stop getting sick, but how? We can’t end pandemics through individual action alone.’ Emphasized text says: ‘So we work together! And we combine many strategies, both individual and systemic.’ Regular size: ‘The SWISS CHEESE MODEL OF INFECTION PREVENTION is an easy, cheesy way to visualize this tactic. e59’. Billows of air carrying countless tiny particles coalesce at the front of a bunch of thin slices of Swiss cheese, each with unique holes. Slices are labeled: limiting exposure, well-fitting respirator masks, good air filtration, fast, accurate testing, quarantining after exposure, & vaccines & boosters. Each slice blocks more of the particles, ending with a baby sitting in clean air saying ‘I love not having COVID!’ Text below: Just like how each Swiss cheese slice has holes, no single protection method against SARS-CoV-2 works 100% perfectly. So we stack together methods until we’ve covered up all the holes, and maximized protection!’ P18
Protestors march with a WE KEEP US SAFE banner: a Native American in a wheelchair with a Land Back top, a trans teen, a Jew in a kippah & Palestine watermelon shirt, & a drag queen with the progress pride flag. Text: ‘COMMUNITY CARE: To survive this pandemic, we must follow the lead of Disability Justice & survive TOGETHER. That means all of us - the infants & toddlers too young to mask, the disabled & the neurodiverse, Black & Indigenous people, all POC, queer & trans people, sex workers, pregnant people, immunocompromised people, the undocumented, the unhoused, the incarcerated & institutionalized...People forced into constant exposure at home, work, & school until they’ve lost count of infections, people forced into indefinite isolation because 1 infection could kill them or permanently change their life for the worse, people who get fired when they run out of sick days & evicted when they run out of money...Everyone abused by our medical industry & abandoned by our govs. All of us.
In mid sized text it says ‘Just like how masks work better when more of us wear them, when we come together - locally & globally - we keep each other safe. We mask because we refuse to accept a world where any of us are disposable. We fight for a future with room for all of us.’ Below, a large drawing of those two from the bar on page 7, the Black femme and the curly haired friend. Here, the two walk by a scenic river arm in arm as a breeze blows the tassels of the femme’s hoodie, and the keffiyeh of the friend. They are both wearing respirator masks and looking at each other, and hearts appear between them.
‘This comic would not exist without my partner Kimball Anderson’s hard work and COVID know-how. Their editing kept the zine going during my RSI flare-ups, and their emotional support got me through it all. Thank you! I’m also grateful to everyone who gave me zine feedback, with an extra big thank you to Dupe & Caitlin for their copy edits. Finally, thank you to everyone who’s made SARS-CoV-2 research & resources more accessible online, and to everyone fighting to keep each other alive out there.’ A sketch of Laurel’s hair and glasses atop formless goo. ‘Laurel Lynn Leake...is a white, queer, and disabled artist & full-time lump. She’s taking care of herself even though it’s hard! You can find them at: LaurelLynnLeake.com LaurelLynnLeake.Storenvy.com laurel-lynn-leake.itch.io CounterIntuitiveComics.tumblr.com patreon.com/CounterIntuitive‘ Final note: THANK YOU FOR READING! If you’ve stopped masking, let this be the excuse to start again! And if you never stopped - thank you, thank you, thank you.’
BACK COVER: Aerosol droplets flow in a swooping line towards a brain and all of the veins that twist around it and lead down to the rest of the body. A cute little Laurel holds up a magnifying glass bigger than herself to show a SARS-COV-2 virus. Large text says: ‘A Handy Scientific Guide To Surviving COVID-19 Together’. Below, regular text continues ‘Why’s everyone sick all the time? Well, it’s not ‘just a cold’ & it’s definitely not ‘mild’... It’s SARS-COV-2 and it can change your life forever. This 26-pg zine uses simple, non-judgemental language to explain WHAT the virus does to your body, HOW it spreads through the air, and WHY we mask to protect ourselves and each other. PLUS: Science illustrations featuring fat, queer, trans & disabled people of color! Extra resources for surviving all these pandemics! Hopeful words to keep you going!’ At the bottom, a hand gives a wrapped up boat shaped mask to another hand while puffs of air float around. The mask says ‘NIOSH N95’ on it.

WORKS CITED

PAGE 1: THE BASICS

1. Greenhalgh T, Jimenez JL, Prather KA, Tufekci Z, Fisman D, Schooley R. Ten scientific reasons in support of airborne transmission of SARS-CoV-2. The Lancet. 2021;0(0). DOI: https://doi.org/10.1016/S0140-6736(21)00869-2

2. Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nature Reviews Microbiology. 2023;21(3):1-14. DOI: https://doi.org/10.1038/s41579-022-00846-2

3. Ajufo E, Rao S, Navar AM, Pandey A, Ayers CR, Khera A. U.S. population at increased risk of severe illness from COVID-19. American Journal of Preventive Cardiology. 2021;6(14):100156. DOI: https://doi.org/10.1016/j.ajpc.2021.100156

4. Kompaniyets L, Agathis NT, Nelson JM, et al. Underlying Medical Conditions Associated With Severe COVID-19 Illness Among Children. JAMA Network Open. 2021;4(6):e2111182. doi: https://doi.org/10.1001/jamanetworkopen.2021.11182

PAGE 2: COVID-19 IS AN AIRBORNE ILLNESS

5. Zhang R, Li Y, Zhang AL, Wang Y, Molina MJ. Identifying airborne transmission as the dominant route for the spread of COVID-19. Proceedings of the National Academy of Sciences. 2020;117(26). doi: https://doi.org/10.1073/pnas.2009637117

6. Lane G, Zhou G, Hultquist JF, et al. Quantity of SARS-CoV-2 RNA copies exhaled per minute during natural breathing over the course of COVID-19 infection. eLife. 2024;13. DOI: https://doi.org/10.7554/eLife.91686.1

7. van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. New England Journal of Medicine. 2020;382(16):1564-1567. doi: https://doi.org/10.1056/nejmc2004973

8. Rosti ME, Olivieri S, Cavaiola M, Seminara A, Mazzino A. Fluid dynamics of COVID-19 airborne infection suggests urgent data for a scientific design of social distancing. Scientific Reports. 2020;10(1). DOI: https://doi.org/10.1038/s41598-020-80078-7

PAGE 3: WHAT’S INSIDE A RESPIRATORY PARTICLE?

9. Dommer A, Casalino L, Kearns F, et al. #COVIDisAirborne: AI-enabled multiscale computational microscopy of delta SARS-CoV-2 in a respiratory aerosol. The International Journal of High Performance Computing Applications. 2022;37(1):109434202211282. doi: https://doi.org/10.1177/10943420221128233

10. Liu K, Allahyari M, Salinas JS, Zgheib N, Balachandar S. Peering inside a cough or sneeze to explain enhanced airborne transmission under dry weather. Scientific Reports. 2021;11(1). DOI: https://doi.org/10.1038/s41598-021-89078-7

11. Wang CC, Prather KA, Sznitman J, et al. Airborne transmission of respiratory viruses. Science. 2021;373(6558). DOI: https://doi.org/10.1126/science.abd9149

PAGE 4: SYMPTOMS

12. Boucau J, Marino C, Regan J, et al. Duration of Shedding of Culturable Virus in SARS-CoV-2 Omicron (BA.1) Infection. New England Journal of Medicine. 2022;387(3):275-277. DOI: https://doi.org/10.1056/nejmc2202092

13. Marquez C, Kerkhoff AD, Schrom J, et al. COVID-19 Symptoms and Duration of Rapid Antigen Test Positivity at a Community Testing and Surveillance Site During Pre-Delta, Delta, and Omicron BA.1 Periods. JAMA Network Open. 2022;5(10):e2235844. DOI: https://doi.org/10.1001/jamanetworkopen.2022.35844

14. Boyton RJ, Altmann DM. The immunology of asymptomatic SARS-CoV-2 infection: what are the key questions? Nature Reviews Immunology. 2021;21. DOI: https://doi.org/10.1038/s41577-021-00631-x

15. Almadhi MA, Abdulrahman A, Sharaf SA, et al. The high prevalence of asymptomatic SARS-CoV-2 infection reveals the silent spread of COVID-19. International Journal of Infectious Diseases. 2021;105:656-661. DOI: https://doi.org/10.1016/j.ijid.2021.02.100

PAGE 5: SEVERE SYMPTOMS

16. Howard J. People with darker skin are 32% more likely to have pulse oximeter readings overestimate oxygen levels, report says. CNN. Published March 20, 2024. https://www.cnn.com/2024/03/20/health/pulse-oximeter-skin-tone/index.html

17. Pusey-Reid E, Quinn L, Samost ME, Reidy PA. Skin Assessment in Patients with Dark Skin Tone. AJN, American Journal of Nursing. 2023;123(3):36-43. DOI: https://doi.org/10.1097/01.naj.0000921800.61980.7e

PAGE 6: HOW COVID SPREADS (PT 1: INHALATION)

18. Malin Alsved, Nygren D, Thuresson S, Fraenkel CJ, Patrik Medstrand, Jakob Löndahl. Size distribution of exhaled aerosol particles containing SARS-CoV-2 RNA. Infectious Diseases. 2022;55(2):158-163. DOI: https://doi.org/10.1080/23744235.2022.2140822

19. Ehsanifar M. Airborne aerosols particles and COVID-19 transition. Environmental Research. 2021;200:111752. DOI: https://doi.org/10.1016/j.envres.2021.111752

20. Alsved M, Nyström K, Thuresson S, et al. Infectivity of exhaled SARS-CoV-2 aerosols is sufficient to transmit covid-19 within minutes. Scientific Reports. 2023;13(1):21245. DOI: https://doi.org/10.1038/s41598-023-47829-8

PAGE 7: HOW COVID SPREADS (PT 2: DIRECT & INDIRECT CONTACT)

21. Hu K, Patel J, Patel BC. Ophthalmic Manifestations Of Coronavirus (COVID-19). PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK556093/

22. Center N. Science Brief: SARS-CoV-2 and Surface (Fomite) Transmission for Indoor Community Environments. Nih.gov. Published April 5, 2021. https://www.ncbi.nlm.nih.gov/books/NBK570437/

PAGE 8: WHEN YOU BREATHE IN…(CILIA AND BRONCHIOLES)

23. Kuek LE, Lee RJ. First contact: the role of respiratory cilia in host-pathogen interactions in the airways. American Journal of Physiology-Lung Cellular and Molecular Physiology. 2020;319(4):L603-L619. DOI: https://doi.org/10.1152/ajplung.00283.2020

PAGE 9: VACCINES

24. Rajah MM, Bernier A, Buchrieser J, Schwartz O. The Mechanism and Consequences of SARS-CoV-2 Spike-Mediated Fusion and Syncytia Formation. Journal of Molecular Biology. 2021;434(6):167280. DOI: https://doi.org/10.1016/j.jmb.2021.167280

25. Rahmani K, Shavaleh R, Forouhi M, 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. 2022;10. DOI: https://doi.org/10.3389/fpubh.2022.873596

26. Tian D, Sun Y, Zhou J, Ye Q. The global epidemic of SARS‐CoV‐2 variants and their mutational immune escape. Journal of Medical Virology. Published online October 13, 2021. DOI: https://doi.org/10.1002/jmv.27376

PAGE 11: HEALTHY ALVEOLI

27. Thangavel P, Park D, Lee YC. Recent Insights into Particulate Matter (PM2.5)-Mediated Toxicity in Humans: An Overview. International Journal of Environmental Research and Public Health. 2022;19(12):7511.

PAGE 12: CYTOKINE STORM IN AN ALVEOLI

28. Fajgenbaum DC, June CH. Cytokine Storm. Longo DL, ed. New England Journal of Medicine. 2020;383(23):2255-2273. DOI: https://doi.org/10.1056/nejmra2026131

29. Otsuka R, Seino K. Macrophage activation syndrome and COVID-19. Inflammation and Regeneration. 2020;40. DOI: https://doi.org/10.1186/s41232-020-00131-w

30. Ackermann M, Anders HJ, Bilyy R, et al. Patients with COVID-19: in the dark-NETs of neutrophils. Cell Death and Differentiation. 2021;28(11):3125-3139. DOI: https://doi.org/10.1038/s41418-021-00805-z

31.O’Sullivan JM, Gonagle DM, Ward SE, Preston RJS, O’Donnell JS. Endothelial cells orchestrate COVID-19 coagulopathy. The Lancet Haematology. 2020;7(8):e553-e555. DOI: https://doi.org/10.1016/s2352-3026(20)30215-5

PAGE 13: VASCULAR DAMAGE DAMAGES EVERY PART OF YOU

32. Jing H, Wu X, Xiang M, Liu L, Novakovic VA, Shi J. Pathophysiological mechanisms of thrombosis in acute and long COVID-19. Front Immunol. 2022;13(13). DOI: https://doi.org/10.3389/fimmu.2022.992384

33. Magazine U. Bad Blood? The Uncertainty Around Microclots and Long Covid. Undark Magazine. Published May 20, 2024. https://undark.org/2024/05/20/bad-blood-microclots-long-covid/

34. Ramón Martínez-Mármol, Giordano-Santini R, Kaulich E, et al. SARS-CoV-2 infection and viral fusogens cause neuronal and glial fusion that compromises neuronal activity. Science Advances. 2023;9(23). https://doi.org/10.1126/sciadv.adg2248

35. Taschetta-Millane M, Fornell D. PHOTO GALLERY: How COVID-19 Appears on Medical Imaging. Imaging Technology News. Published March 22, 2022. Accessed March 25, 2022. https://www.itnonline.com/content/photo-gallery-how-covid-19-appears-medical-imaging

PAGE 14: LASTING EFFECTS (AKA LONG COVID)

36. Li J, Zhou Y, Ma J, et al. The long-term health outcomes, pathophysiological mechanisms and multidisciplinary management of long COVID. Signal Transduction and Targeted Therapy. 2023;8(1). DOI: https://doi.org/10.1038/s41392-023-01640-z

37. Wang C, Ramasamy A, Verduzco‐Gutierrez M, W. Michael Brode, Melamed E. Acute and post-acute sequelae of SARS-CoV-2 infection: a review of risk factors and social determinants. Virology Journal. 2023;20(1). DOI: https://doi.org/10.1186/s12985-023-02061-8

38. Cai M, Xie Y, Topol EJ, Al-Aly Z. Three-year outcomes of post-acute sequelae of COVID-19. Nature Medicine. Published online May 30, 2024:1-10. DOI: https://doi.org/10.1038/s41591-024-02987-8

39. Maier HE, Kowalski-Dobson T, Eckard A, et al. Reduction in long-COVID symptoms and symptom severity in vaccinated compared to unvaccinated adults. Open Forum Infectious Diseases. Published online January 23, 2024. DOI: https://doi.org/10.1093/ofid/ofae039

40. Khullar D, Zhang Y, Zang C, et al. Racial/Ethnic Disparities in Post-acute Sequelae of SARS-CoV-2 Infection in New York: an EHR-Based Cohort Study from the RECOVER Program. Journal of General Internal Medicine. Published online February 16, 2023. DOI: https://doi.org/10.1007/s11606-022-07997-1

41. Shelly E. We’ve only just begun to examine the racial disparities of long covid. MIT Technology Review. Published September 20, 2022. https://www.technologyreview.com/2022/09/20/1059679/racial-disparities-of-long-covid/ 
42. Burgess CM, Batchelder AW, Sloan CA, Ieong M, Streed CG. Impact of the COVID-19 pandemic on transgender and gender diverse health care. The Lancet Diabetes & Endocrinology. 2021;9(11):729-731. DOI: https://doi.org/10.1016/S2213-8587(21)00266-7

PAGE 15: LONG COVID SYMPTOMS THROUGHOUT THE BODY

43. Jiao T, Huang Y, Sun H, Yang L. Research progress of post-acute sequelae after SARS-CoV-2 infection. Cell Death & Disease. 2024;15(4):1-16. DOI: https://doi.org/10.1038/s41419-024-06642-5

44. Nicolai L, Kaiser R, Stark K. Thromboinflammation in long COVID—the elusive key to postinfection sequelae? Journal of Thrombosis and Haemostasis. Published online May 1, 2023. DOI: https://doi.org/10.1016/j.jtha.2023.04.039

45. Kogevinas M, Karachaliou M, Espinosa A, et al. Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia. BMC Medicine. 2025;23(1). doi: https://doi.org/10.1186/s12916-025-03974-7

46. Sherif ZA, Gomez CR, Connors TJ, Henrich TJ, Reeves WB. Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC). eLife. 2023;12. DOI: https://doi.org/10.7554/elife.86002

47. Wright J, Astill SL, Sivan M. The Relationship between Physical Activity and Long COVID: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2022;19(9):5093. DOI: https://doi.org/10.3390/ijerph19095093

48. Appelman B, Charlton BT, Goulding RP, et al. Muscle abnormalities worsen after post-exertional malaise in long COVID. Nature Communications. 2024;15(1):17. DOI: https://doi.org/10.1038/s41467-023-44432-3

PAGE 16: THE DAMAGE GETS WORSE WITH EVERY INFECTION

49. Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nature Medicine. 2022;28:1-8. DOI: https://doi.org/10.1038/s41591-022-02051-3

50. Boufidou F, Medić S, Lampropoulou V, Siafakas N, Tsakris A, Anastassopoulou C. SARS-CoV-2 Reinfections and Long COVID in the Post-Omicron Phase of the Pandemic. International Journal of Molecular Sciences. 2023;24(16):12962. DOI: https://doi.org/10.3390/ijms241612962

51. Glynne P, Tahmasebi N, Gant V, Gupta R. Long COVID following mild SARS-CoV-2 infection: characteristic T cell alterations and response to antihistamines. Journal of Investigative Medicine. 2022;70(1):61-67. DOI: https://doi.org/10.1136/jim-2021-002051

52. Cibis A. Infographic Sliders: Live. AngieCibis.com. Accessed July 1, 2024.  http://www.angiecibis.com/info

53. Zuo W, Zuo W, He D, et al. The persistence of SARS-CoV-2 in tissues and its association with long COVID symptoms: a cross-sectional cohort study in China. Lancet Infectious diseases/˜The œLancet Infectious diseases. Published online April 1, 2024. DOI: https://doi.org/10.1016/s1473-3099(24)00171-3

54. Sollini M, Morbelli S, Ciccarelli M, et al. Long COVID hallmarks on (18F) FDG-PET/CT: a case-control study. European Journal of Nuclear Medicine and Molecular Imaging. Published online March 7, 2021:1-11. DOI:10.1007/s00259-021-05294-3

PAGE 17: IMMUNE DYSREGULATION

55. Chang T, Yang J, Deng H, Chen D, Yang X, Tang ZH. Depletion and Dysfunction of Dendritic Cells: Understanding SARS-CoV-2 Infection. Frontiers in Immunology. 2022;13. DOI: https://doi.org/10.3389/fimmu.2022.843342

56. Winheim E, Rinke L, Lutz K, et al. Impaired function and delayed regeneration of dendritic cells in COVID-19. Suthar M, ed. PLOS Pathogens. 2021;17(10):e1009742. doi: https://doi.org/10.1371/journal.ppat.1009742

57. Yin K, Peluso MJ, Luo X, et al. Long COVID manifests with T cell dysregulation, inflammation and an uncoordinated adaptive immune response to SARS-CoV-2. Nature Immunology. Published online January 11, 2024:1-8. DOI: https://doi.org/10.1038/s41590-023-01724-6

58. Lechuga GC, Morel CM, De-Simone SG. Hematological alterations associated with long COVID-19. Frontiers in Physiology. 2023;14:1203472. DOI: https://doi.org/10.3389/fphys.2023.1203472

PAGE 18: STOPPING THE SPREAD (SWISS CHEESE MODEL)

59. Mackay AM, PhD. The Swiss cheese infographic that went viral. Virology Down Under. Published December 26, 2020. https://virologydownunder.com/the-swiss-cheese-infographic-that-went-viral/

TRANSCRIPT

Transcript

COVER: In the foreground, a black person busses dishes while giving side-eye to two white adults talking as one of their kids sneezes. We see the air flow out and billow around them, splashing on a listening face and forming a miasma that fills the rest of the background. The busser has a button that says ‘service with a smile’ even as their mouth is covered by a k100 mask. In large hand drawn lettering at the top of the page, the words ‘WHY WE MASK:’ sit on a black background. And then out in the miasma and it says ‘IT’S NOT’ and then in quotes ‘JUST A COLD’. In the bottom right, it says ‘Laurel Lynn Leake’ above a large ‘2025’.

TITLE PAGE: ‘WHY WE MASK: IT’S NOT ‘JUST A COLD’’ in bubble letters with the subtitle underneath saying ‘A Handy Scientific Guide To Surviving COVID-19 Together’. At the bottom of the page, a cute drawing of a big headed person with cat’s eye glasses. She looks nervous and sweat is flying off her, filling the house shape she’s in. Outside, a large COVID-19 particle looms. Text below reads ‘featuring ME!’

PAGE 1: Spiky viruses surround the text: ‘THE BASICS: COVID-19 is an illness caused by the virus SARS-CoV-2, and mainly spreads through the air.’ An endnote is shown here as e1. ‘ A single infection, even one that seems ‘mild’, can cause severe damage throughout your body. What’s worse, each new infection risks new damage to your brain, immune system, lungs, heart, and more, and can add up to permanent disabilities or death. e2 Right now, at least 75% of all adults e3 (and 30% of children e4) are at a high risk for catching severe infections that could hospitalize or even kill us. And if you have EVER had COVID-19, even once, YOU are now officially high risk too.’ It says ‘THE VIRUS’ and explains that SARS means ‘Severe Acute Respiratory Syndrome’, COV is ‘Corona Virus (crown-shaped, round with spikes)’, & 2 is ‘similar to 2002-2003 SARS-CoV outbreak’. It says ‘THE ILLNESS’ beside a curly-haired sniffly person. The word COVID-19 splits into ‘corona’, ‘virus’, ‘disease’, & ‘discovered in 2019’.

P2: Large hand-drawn text reads ‘COVID-19 is an AIRBORNE ILLNESS e5’ over that same curly haired character from the last page sneezing with a big ‘KACHOO!’ It says ‘Respiratory Particles as we see a large billow of mist labeled ‘invisible aerosols’, goop labeled ‘snot &spit (too big to be particles)’, and falling circles labeled ‘visible droplets’. A measurement in meters is below, showing larger droplets dropping in the first couple meters and the more misty particles continuing to 6 meters. In a box below, text reads ‘ It spreads when infected people exhale clouds of mostly invisible RESPIRATORY PARTICLES carrying hidden viruses. RPs are the tiny drops of fluid that shoot out of our mouths whenever we cough, sneeze, talk, or even breathe. If you’re infected and contagious, you can breathe out enough virus to infect others in just 20 seconds! e6 And in places with no fresh air or ventilation, the tiniest RPs can float around like smoke for HOURS. e7,e8’

P3: A cloud of particles, with a large one labeled ‘DROPLETS…are barely visible globs that slowly drift to the ground. Too big to inhale.’ A small dot says ‘AEROSOLS…are blobs that are so light they can float. Mostly too small to see.’ Big text asks ‘What’s inside a respiratory particle?’ as a cute Laurel magnifies a speck to show SARS-COV-2 inside. The particle grows larger, revealing dots of ‘dust’ & squiggly ‘mucus’. Text explains ‘RPs form out of the fluids that naturally line your lungs, throat, & mouth, including sticky mucus. They also pick up junk like dust, bacteria, & viruses like SARS-CoV-2 e9. AEROSOLS, the smallest type of RPs, are actually the most dangerous. We all need to breathe, & they’re hiding in the air all around us! While heavy DROPLETS fall fast & smash into things in seconds, aerosols   can drift invisibly for hours until inhaled by someone new. That means more of their viral passengers survive the trip through the air to infect you. e10, e11’

P4: ‘SYMPTOMS: SARS-COV-2 symptoms start about 3-6 days after infection, & last about 12-14 days. e12 This initial or acute infection stage is more commonly called COVID-19.  Symptoms and contagiousness differ by viral variant, but often include… e13’. Below, symptoms are illustrated by cartoony figures on a black background. ‘EXHAUSTION, DIZZINESS, HEADACHE’ is by a miserable face radiating lines suggesting confusion and pain. A person hacks into their hand for ‘COUGHING, SNEEZING, RUNNY NOSE’. A reclining figure saying ‘ow’ has little stars shooting out of their joints to show ‘SORENESS, FEVER, CHILLS’. A figure barely holding in vomit represents ‘NAUSEA, VOMITING, ABDOMINAL PAIN’, &’DIARRHEA’. And a confused head disgusted at the taste of an apple shows ‘LOSS OF SMELL AND/OR TASTE’. Below, text says ‘Then again, you could be one of the 32-50% of people with COVID-19 who are… e14, e15’ And then next to a silly drawing of a person frolicking and singing: ‘CONTAGIOUS WITH NO SYMPTOMS’

P5: SEVERE SYMPTOMS header over a distressed muscular person gasping for breath, with lungs labeled STRAINED AND/OR RAPID BREATHING, WHEEZING, heart with CHEST PAIN AND/OR PRESSURE, & darkened lung areas with PNEUMONIA (fluid in the lungs) Below reads: HYPOXEMIA: COVID-19 can impair O2 flow to your blood, even w/o obvious breathing issues. LOW BLOOD OXYGEN symptoms can cause organ failure and even death w/o treatment. Measure BLOOD OXYGEN LEVELS at home with a PULSE OXIMETER: There’s a drawing of a finger inside a pulse oximeter. ‘91-94% = concerning, 90% and under = emergency!! WARNING: Oximeters may give FALSELY HIGH READINGS to people with dark skin &/or painted nails. E16’ It then lists Hypoxemia symptoms, with a troubled face for CONFUSION AND/OR DISORIENTATION, a beating heart for RACING HEART & INABILITY TO WAKE UP OR STAY AWAKE’, & CYANOSIS has ‘PALE, GREY, or BLUE-TINTED TONGUE, LIPS, &/or NAILBEDS, depending on skintone.E17 Page ends: All these require emergency hospitalization!

P6: ‘HOW COVID SPREADS’ it says in large letters above the text Respiratory particles carrying SARS-CoV-2 usually enter our bodies in one of three ways: 1) INHALATION, 2) DIRECT CONTACT and 3) INDIRECT CONTACT’ The page underneath this text is filled with a splash image of a chubby, shadowy figure breathing in mist and particles as we see the particles descend down the trachea and into their lungs. Couples sit across from each other at tables in the background, letting off gusts of air. A bubble pointing to the inhaling mouth says ‘#1 INHALATION: The vast majority of COVID-19 infections begin by breathing in an infected person’s aerosols. e18 In crowded spaces with no air flow, you can inhale enough to get infected in seconds! And if you work or live in places like these, you’re in constant danger of catching repeated, severe infections. e19, e20’

P7: A black femme with close cut hair puts their arm over the shoulder of a person with a mop of curly hair, as they blow out air that flows all around them. An bubble pointing towards their visualized sinuses reads ‘#2 DIRECT CONTACT: Viral aerosols/droplets can also collide directly into your MUCOUS MEMBRANES. e21 These are the layers of soft, wet cells lining your nose, mouth, eyes, respiratory tract, etc.’ Another balloon points at a beer bottle being handed from one of the friends to the other, it reads ‘#3 INDIRECT CONTACT: Much less likely to infect, but still possible: You get respiratory particles on your hands, & then transfer them to your mouth, nose, or eyes. e22’

P8: ‘When you breathe in…air (including any nearby respiratory particles) rushes into your nose or mouth, down your TRACHEA or windpipe, and then splits into the twin BRONCHI tubes of the LUNGS’ We see a trachea filled with respiratory particles, & branches filling transparent lungs. ‘This whole system is called the RESPIRATORY TRACT…and it’s protected by a special kind of MUCOUS MEMBRANE cell lining covered in tiny waving tentacles called CILIA. They’re coated with slippery MUCUS fluids.’ We see noodly cilia wrapped in stringy mucus dotted with SARS-CoV-2. ‘Cilia use their mucus to collect any dangerous PATHOGENS you inhale (ike dust, viruses, or bacteria). While they can catch a few virus-carrying RPs, cilia get overwhelmed by hundreds at once.’ A cartoony virus celebrates its escape as text says ‘RPs dissolve inside the warm, wet respiratory tract, & their viral passengers break free! SARS-CoV-2 attack nearby cells, in the ‘initial phase’ of a new COVID-19 infection. e23’

P9: ‘SARS-CoV-2 uses SPIKE PROTEINS like lockpicks on cells’ outer membranes, tricking them into opening and letting the virus inside.’ A virus’ knobby spikes connect with Y-shaped cell receptors to a cell membrane. ‘It then re-program the host cells to pump out new copies of SARS-CoV-2. The infected cells swell with copies until they burst, scattering the virus all over their healthy cell neighbors. e24’ A virus infects a cartoony cell, which sickens & barfs up SARS-CoV-2. ‘VACCINES: Most COVID-19 vaccines teach our immune systems to create defensive ANTIBODIES. These specialized proteins lock onto SARS-CoV-2’s lockpick spikes to make them useless.’ Y-shaped antibodies block the cell receptors. ‘While antibodies don’t block every single virus in your body, they help a lot: vaccinated people have far better chances of surviving initial infections. e25 But after 6 yrs of unchecked spread, we’re now dealing with dangerous VIRAL VARIANTS. These SARS-CoV-2 mutations (like Delta/Omicron/FLiRT/JN.1) have fancy spike proteins that old antibodies simply don’t fit! e26 So scientists race to keep up with yearly booster vaccines that can block the latest viral variants with new antibodies.’

P10: Overlapping branch shapes cover the top of the page, each branch splitting & narrowing into tiny twigs. A circle enhances the twigs to show bunches of grape-like forms labeled ‘Bronchioles’. Text underneath says ‘Once air reaches the lungs, it flows into the BRONCHIAL TREE, where the twin BRONCHI airways split into smaller & smaller twig-like BRONCHIOLES intertwined with BLOOD VESSELS, the ARTERIES & VEINS that carry blood cells to & from the heart.Each bronchiole is tipped with ALVEOLI, clusters of flexible ALVEOLAR SACS that look sort of like grapes. These clusters are wrapped in nets of CAPILLARIES, the tiniest, most delicate type of blood vessel.’ These details are labeled in the drawing, where veins & arteries wind around the branch-like bronchiole, splitting into smaller capillaries. A full bunch of grapes is labeled ‘alveoli’ with individual ‘alveolar sacs’. ‘Aerosols’ flow in through the bronchiole.

P11: ‘Healthy Alveoli’ in big text, next to a cross-section of an alveolar sac. A translucent arrow fills the inner chamber labeled ‘air flow in’ over the honeycomb-like shape of different cells. ‘Blood cells full of waste CO2’ flow through a capillary and Co2 passes through a ‘thin fluid layer’ & ‘semi-porous membrane’ and O2 goes back out oxygenating the blood cells, in a ‘gas exchange, CO2 out, o2 in’. The cells burst forth from the cut capillary surrounded by fluid labeled ‘blood plasma’. Text explains ‘Your alveolar sacs are so small, in fact, that air molecules can squeeze through their outer SEMI-POROUS MEBRANES! Fresh O2 (oxygen molecules) from the air swap places with the waste CO2 (carbon dioxide) carried by capillaries on the surface, in a GAS EXCHANGE. That’s another reason why tiny aerosols are so dangerous…Their size allows them to shoot all the way through your lungs and into your alveoli. There, they take advantage of the gas exchange to slip inside your blood…! e27’

P12: ‘Our body takes defensive action against SARS-CoV-2 with IMMUNE CELLS, but variants excel at turning our immune response against itself in escalating CYTOKINE STORMS. e28 Infected, dying cells release CYTOKINES, or chemical signals that summon immune cells…But then those cells get attacked too, so they summon even MORE immune cells, & on & on…! e29 Your inflamed alveoli try to flush the invaders out with protective fluids, until they’re swollen with pus. This causes a suffocating state called PNEUMONIA, where your infected alveolar sacs struggle to keep exchanging O2-CO2 through their damaged walls. Without treatment, this can end in death.’ Below, fluid fills a sac as SARS-CoV-2 infects the larger cells of the membrane. Healthy immune cells attack viruses, & infected ones send cytokines to tell other IC to weaken the cell membrane. Virus spills out into a capillary, swelling the cell lining, & coagulating blood cells e31. A neutrophil attacks cell lining, & blood cells lack O2.

P13: In stylized handwriting: ‘Meanwhile…’ & text continues ‘…SARS-CoV-2 spreads into your CIRCULATORY SYSTEM, triggering your blood to form MICRO CLOTS while attacking the ENDOTHELIAL LINING. e32 That’s the thin layer of cells lining every artery, vein, and capillary that normally keeps all your blood and tissues functioning.’ To the left, we see blood with little SARS-COV-2 particles splashing out, and a clump of cells labeled ‘micro clot’. The vein connects to a brain & down through thicker & thicker blood vessels until it reaches the heart. Big text reads: ‘Vascular damage like this damages EVERY part of you.’ Regular text: ‘Even ‘mild’ initial COVID-19 infections travel through the bloodstream to injure your BRAIN, HEART, & other critical organs – whether you notice that damage or not. e33’ An arrow from the brain shows spindly neurons covered with tiny circles labeled SARS-COV-2, and another arrow from the heart shows fibrous stretched forms covered with more of the tiny circles.

P14: LASTING EFFECTS: A graph of symptoms over 3 years, with a small infected person illustrating different phases of illness. Text: At least 10-30% of people who survive COVID-19 report symptoms reappearing months or even YEARS later. That’s 10-30% of ALL adults, of all ages and backgrounds. e36, e37, e38 Millions have had their lives changed for the worse, with no end in sight. Long COVID (aka POST-COVID SYNDROME or POST-ACUTE SEQUELAE OF SARS-COV-2) varies wildly from person to person, but common symptoms include difficult coughs, strokes, heart attacks, immune dysfunction, & debilitating exhaustion. We’re only just beginning to understand it as a POST-VIRAL ILLNESS, like Shingles (caused by the Chickenpox virus) & AIDS (caused by HIV). COVID vaccines lower the likelihood of long-term damage, but don’t prevent it entirely.39 Long COVID also hits marginalized people the hardest, and we often go undiagnosed and untreated due to systemic bigotry in healthcare. e40,e41,e42 A child sweats in bed with a sleep mask: can’t sit up…can’t talk…light & sound hurt…this sucks.

P15: LONG COVID: This page shows a chubby person with an undercut & facial hair using a cane & holding their free hand aloft. Inside of them we can see various organs, muscles, & veins, & they’re surrounded bubbles containing symptoms. Starting from the top, near the brain, the bubbles say ‘strokes and memory loss’, ‘migraines’, ‘new or worsening mental illness’, ‘debilitating exhaustion, (sleep doesn’t help and activity makes it worse)’, ‘brain fog’, ‘loss of taste/smell’, ‘hearing loss’, ‘vision loss’, ‘immune disorders’, ‘new or worsening cancers’, ‘joint pain’, ‘lung damage’, ‘rashes’, ‘heart attacks’, ‘digestive issues’, ‘new or worsening diabetes’, ‘kidney and liver failure’, ‘nerve pain’,  & ‘bowel damage’. e43, e44, and e45. Text says: ‘As of 2025, we keep discovering new ways SARS-CoV-2 damages the body long-term, but we still don’t have a ‘cure’. There are many ways to treat the symptoms (primarily serious, extended REST e46, e47, e48), but no silver bullet to reverse damage.’

P16: ‘THE DAMAGE GETS WORSE WITH EVERY NEW INFECTION: Most people don’t know that SARS-CoV-2 damage is CUMULATIVE. That means every new infection you get raises the odds you’ll be hit by horrible new health complications that may become permanent. e49, e50 Even infections that feel like just a cold or just allergies can cause your health trouble immediately or down the line. e51’ A chart shows each infection raising risk; blood, lung, etc. issues rising & hospitalizations soaring. e52 ‘An easy or entirely asymptomatic initial infection may even mean your immune system barely activated to fight off the virus. Long after you recover from the ‘mild’ symptoms, the inactive viral debris from the infection can remain hidden throughout your body. e53’ A FDG-PET shows clouds of spike proteins around organs & joints e54. ‘These are VIRAL RESERVOIRS: Leftover virus chunks & spike proteins that collect in your muscles, bones, & organs, ready to reinfect you whenever your immune system gets stressed.’

P17: ‘IMMUNE SYSTEM DYSFUNCTION: COVID-19 infections can leave your immune system depleted & unable to fight off much of anything. e55 Exhausted immune cells called T-CELLS can miss invading pathogens like bacteria or other viruses. They might even ‘reset’ and forget how to handle infections they’ve fought off before. e56’ 2 T-cells mumble & snore as VIRUSES & BACTERIA laugh. ‘COVID-19 infections can also leave you with a fired up immune system in constant high alert against your own body (aka AUTOIMMUNITY). Your T-cells and NEUTROPHILS may attack healthy cells & cause systemic inflammation, especially when triggered by old viral debris. e57 Meanwhile, overactive PLATELETS in your bloodstream gather blood cells into unnecessary micro-clots. These trigger heart attacks, strokes, as well as many other Long COVID symptoms throughout the body. e58’ A t-cell signals & says ‘I KNOW there’s a virus around here somewhere!’ as happy platelets make a clot & an attacking neutrophil says ‘I’m helping!’

P18: ‘STOPPING THE SPREAD: So obviously we want to stop getting sick, but how? We can’t end pandemics through individual action alone.’ Emphasized text says: ‘So we work together! And we combine many strategies, both individual and systemic.’ Regular size: ‘The SWISS CHEESE MODEL OF INFECTION PREVENTION is an easy, cheesy way to visualize this tactic. e59’. Billows of air carrying countless tiny particles coalesce at the front of a bunch of thin slices of Swiss cheese, each with unique holes. Slices are labeled: limiting exposure, well-fitting respirator masks, good air filtration, fast, accurate testing, quarantining after exposure, & vaccines & boosters. Each slice blocks more of the particles, ending with a baby sitting in clean air saying ‘I love not having COVID!’ Text below: Just like how each Swiss cheese slice has holes, no single protection method against SARS-CoV-2 works 100% perfectly. So we stack together methods until we’ve covered up all the holes, and maximized protection!’

P19: Protestors march with a WE KEEP US SAFE banner: a Native American in a wheelchair with a Land Back top, a trans teen, a Jew in a kippah & Palestine watermelon shirt, & a drag queen with the progress pride flag. Text: ‘COMMUNITY CARE: To survive this pandemic, we must follow the lead of Disability Justice & survive TOGETHER. That means all of us – the infants & toddlers too young to mask, the disabled & the neurodiverse, Black & Indigenous people, all POC, queer & trans people, sex workers, pregnant people, immunocompromised people, the undocumented, the unhoused, the incarcerated & institutionalized…People forced into constant exposure at home, work, & school until they’ve lost count of infections, people forced into indefinite isolation because 1 infection could kill them or permanently change their life for the worse, people who get fired when they run out of sick days & evicted when they run out of money…Everyone abused by our medical industry & abandoned by our govs. All of us.

P20: In mid sized text it says ‘Just like how masks work better when more of us wear them, when we come together – locally & globally – we keep each other safe. We mask because we refuse to accept a world where any of us are disposable. We fight for a future with room for all of us.’ Below, a large drawing of those two from the bar on page 7, the Black femme and the curly haired friend. Here, the two walk by a scenic river arm in arm as a breeze blows the tassels of the femme’s hoodie, and the keffiyeh of the friend. They are both wearing respirator masks and looking at each other, and hearts appear between them. 


At this point there are the ‘Works Cited’, ‘Guides and Tools’ and ‘Trackers’ pages, which have the citations listed above and the information listed below. On the ‘Guides and Tools’ page there are two people airing out a classroom and setting up a CR box. On the ‘Trackers’ page there’s a graph showing ‘official # of cases’ & ‘wastewater viral count’ over time. Both are the same ‘during the pandemic’ before diverging ‘post-pandemic’ where the wastewater is far above official cases. Below, it says ‘Source: Santa Clara County Public Health Dept, inspired by Lee Altenberg, PhD.’ And on a page that leads you to this website, there are drawings of a variety of different types of respirator masks.

INSIDE BACK COVER: ‘This comic would not exist without my partner Kimball Anderson’s hard work and COVID know-how. Their editing kept the zine going during my RSI flare-ups, and their emotional support got me through it all. Thank you! I’m also grateful to everyone who gave me zine feedback, with an extra big thank you to Dupe & Caitlin for their copy edits. Finally, thank you to everyone who’s made SARS-CoV-2 research & resources more accessible online, and to everyone fighting to keep each other alive out there.’

A sketch of Laurel’s hair and glasses atop formless goo. ‘Laurel Lynn Leake…is a white, queer, and disabled artist & full-time lump. She’s taking care of herself even though it’s hard! You can find them at: LaurelLynnLeake.com LaurelLynnLeake.Storenvy.com laurel-lynn-leake.itch.io CounterIntuitiveComics.tumblr.com patreon.com/CounterIntuitive

Final note: THANK YOU FOR READING! If you’ve stopped masking, let this be the excuse to start again! And if you never stopped – thank you, thank you, thank you.’

BACK COVER: Aerosol droplets flow in a swooping line towards a brain and all of the veins that twist around it and lead down to the rest of the body. A cute little Laurel holds up a magnifying glass bigger than herself to show a SARS-COV-2 virus. Large text says: ‘A Handy Scientific Guide To Surviving COVID-19 Together’. Below, regular text continues ‘Why’s everyone sick all the time? Well, it’s not ‘just a cold’ & it’s definitely not ‘mild’… It’s SARS-COV-2 and it can change your life forever. This 26-pg zine uses simple, non-judgemental language to explain WHAT the virus does to your body, HOW it spreads through the air, and WHY we mask to protect ourselves and each other. PLUS: Science illustrations featuring fat, queer, trans & disabled people of color! Extra resources for surviving all these pandemics! Hopeful words to keep you going!’ At the bottom, a hand gives a wrapped up boat shaped mask to another hand while puffs of air float around. The mask says ‘NIOSH N95’ on it.

Four different respirator masks (two trifolds & two cup shaped ones) floating through the orange background full of SARS-CoV-2 virons.

RESOURCES

GUIDES & TOOLS

Resources for people who are currently sick:

Resources for long-term disability & chronic illness:

  • Long COVID Physio – https://LongCovid.physio/pacing/
  • Long COVID Justice – https://longcovidjustice.org/ (English/Español)
  • How to Get On by Lily Silver https://HowToGetOn.wordpress.com/ 
    • Lily Silver’s life’s work: A self-advocacy guide for anyone who is homebound or bedbound in the US, focusing on Myalgic Encephalomyelitis aka “Chronic Fatigue Syndrome” but helpful to anyone with disabilities. No longer updates after the creator’s passing but contains vital resources for getting financial aid, affordable housing, medical care, mobility devices, etc, plus years worth of advice from people who have succeeded in “getting on” those resources.

Resources for buying & adjusting masks to suit your face shape:

Protections that aren’t masks:

    Two people wearing respirators clean the air in a room together. One in a beanie and vest sets up a CR box filter fan, and the other balances with a can as they open a window and let fresh air in.

    Combating misinformation with research:

    Expanding global databases of active mutual aid groups (Turtle Island, “Europe”, & “Australia” are most documented):

    Virtual events, support groups, online communities:

    COVID TRACKERS

    A graph showing ‘official # of cases’ & ‘wastewater viral count’ over time. Both are the same ‘during the pandemic’ before diverging ‘post-pandemic’ where the wastewater is far above official cases. Below, it says ‘Source: Santa Clara County Public Health Dept, inspired by Lee Altenberg, PhD.’

    Wastewater trackers monitor sewage plant samples for viral debris (like SARS-CoV-2, H5N1, RSV, influenza, etc) and then visualize that data by location. They’re far more accurate than the deliberately under-counted government and corporate numbers on COVID-19 cases, hospitalizations, and deaths.

    However, wastewater numbers do SKEW LOW & have a 2 week delay. Also, since they depend on gov access, most have been forced into removing public data & ignoring all developing pandemics. Air Quality Index (AQI) trackers don’t report viruses, but they’re a useful tool for flagging dangerous air conditions that require respirator masks, like wildfires & chemical leaks.

    TURTLE ISLAND:

    GLOBAL:

    SUPPORT THE COMIC

    Help us make and release more comics like this one!

    Help us get WHY WE MASK out to more people!
    Print and distribute the comic yourself!
    You can contact us at laurellynnleake@gmail.com if you’re interested in distributing WHY WE MASK at your local mask bloc, mutual aid group, shop, booth at a show, library, local meet-up, etc. and we’ll give you physical copies if we have them!

    Also, if you’re wondering where the original version of this comic went, you can still read the 2024 edition here.