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A9(1). The most important change is that we have to pay attention to the FIT of the mask. No gaps between mask and face.
- Fit doesn't matter for ballistic droplets, only need a parapet
- Fit critical for aerosols (like smoke), since can go through gaps

#LeapsChat @leapsmag
A9(2) Quality of the mask also matters. Good cloth masks that fit well are very useful in community

COVID-19 also transmitted through the eyes. Face shields only help for ballistic droplets, not for aerosols



#LeapsChat @leapsmag
A9(3) Trans. thru eyes thought less common than inhalation. One study below said 1%. Some think that's too low, so maybe 10% of inhalation?

Suggest eye protection (closed glasses) for jobs w/ contact w/ lots of ppl (supermarket etc)



#LeapsChat @leapsmag
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A5(1) It is clear that ventilation reduces transmission
- Ballistic droplets & close proximity aerosols not affected by vent.
- Only shared-room-air aerosol transmission impacted by ventilation. This is a major pathway of transmission

#LeapsChat @leapsmag
A5(2) "ventilation" here = remove virus from the air
- A fan that moves air around is not ventilation

- 2 things:
(a) expel indoor air outdoors, bring clean air indoors (open windows, or through mechanical HVAC systems)

(Details: sciencedirect.com/science/articl…)

#LeapsChat @leapsmag
A5(3) Second thing to do:

(b) Filtration: either through HVAC systems (MERV 13 if possible), or through portable HEPA filters, or through cheaper fan-filters.

Extensive details: tinyurl.com/FAQ-aerosols

#LeapsChat @leapsmag Image
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A3(1). @CDCgov and @who guidance is ALL useful. Distance, masks, handwashing all useful.

But not enough. Need to defend against aerosols too, like smoke (which is an aerosol).

#LeapsChat @leapsmag
A3(2). Unfortunately clear aerosol guidance only from scientists: tinyurl.com/faqs-aerosol

@WHO and @CDCgov rec. e.g. ventilation. But very unclear, because they don't say why. Ppl don't understand, don't want to spend $$ if unclear.
#LeapsChat @leapsmag

A3(3) @c_drosten (leading German virologist) said it extremely clearly: it is not enough to give guidance that people don't understand. We need to explain WHY guidance works. IMHO, explanation is the MOST important part of guidance



#LeapsChat @leapsmag
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A2.(1) Major historical error in 1910 became paradigm:
+ correct observation (ease of infection in close proximity) was misinterpreted as being due to ballistic droplets
+ Stated that aerosol infection was nearly impossible

Details:

#LeapsChat @leapsmag
A2(2) Unfortunately paradigm has reigned till today

For COVID-19, and other diseases, droplets are accepted w/o evidence. But aerosol evidence is NEVER enough

As stated by Chapin in 1910: aerosols very unlikely, the burden of proof is on their proponents

#LeapsChat @leapsmag
A2(3) The unquestioning proclamation of droplets as the main mode of transmission by @WHO and @CDCgov
is especially troubling, given that they have never been demonstrated to transmit any disease in the history of medicine



#LeapsChat @leapsmag
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A1. Droplets are ballistic projectiles, they infect by impacting on eyes, nostrils or mouth. They are > 100 um

Aerosols float in the air from tens of sec to hours, and they infect by inhalation. They are < 100 um

(5 um boundary is a long-standing error)

#LeapsChat @leapsmag
A1(2): Some debate on twitter about what droplets exactly are. But clearly defined as ballistic projectiles that infect by impact. See this thread where I explained it in detail, or this image from a recent presentation of Deputy Director of ID at CDC
#LeapsChat @leapsmag
A1(3). And the thread that has all the gory details about the history and definition of droplets and aerosols is at:



#LeapsChat @leapsmag
Read 3 tweets

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