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COVID-19 transmission patterns only seem explainable by aerosols. Drops could play a role but are not needed.

Kept thinking about the modes of transmission, reached conclusion above, from table below. Putting it out there for discussion
docs.google.com/document/d/1Kx… (Too long for Tw)
@linseymarr @kprather88 @Babak_Javid_Lab @eliowa @CathNoakes @ErinBromage @ShellyMBoulder @mauricedehond @SaskiaPopescu @angie_rasmussen @CorsIAQ @nataliexdean @jeremyphoward @epireport @j_g_allen @mvankerkhove @allegranzib @WHO @CDCgov @apoorva_nyc @RichReadReports @javisalas
Note that all the details are in the Google Doc, the table is not stand alone.
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More from @jljcolorado see all

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Jose-Luis Jimenez
@jljcolorado
1/ This article (jamanetwork.com/journals/jama/…) was recently published in JAMA, and argues against aerosols being an important transmission pathway for COVID-19. Although better than other similar articles, the arguments against aerosols are weak or incorrect. Here we go.
2/ Most important lack of understanding about aerosols. Seems very unlikely it was reviewed by someone with knowledge of aerosol physics or airflow

Most important property of aerosols is size. Bc mass increases with the diam^3, aerosol properties change dramatically w/ size
3/ “Droplets are classically described as larger entities (>5 μm) that rapidly drop to the ground by force of gravity, typically within 3 to 6 feet of the source person.”
But real size for droplets falling that quickly is > 50 μm, so 10 times the size and 1000 (!) times the mass
Read 40 tweets
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Jose-Luis Jimenez
@jljcolorado
1/ Thread on the relative importance of transmission modes

A very difficult question, everyone reluctant to guess. As evidence accumulates, I decided to venture a guess, hoping to start some discussion. Pls comment w/ flaws in my arguments, other arguments, give your guess.
2/ Three modes: fomites, ballistic drops & aerosols

a) Fomites (touching objects, then touching eyes, nose, mouth): increasing consensus that they are minor. WHO: “no specific evidence. CDC: “it may be possible - not thought to be the main way”.
3/ Lancet letter argues against it:
- thelancet.com/journals/lanin…
- Good news piece on topic with interviews: cbc.ca/news/health/co…

People should still wash hands etc. But appears unlikely to be MAJOR contributor to spread. If anyone disagrees, pls reply and explain why
Read 20 tweets
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Jose-Luis Jimenez
@jljcolorado
1/ Nature had a news piece on the COVID-19 aerosol letter.
nature.com/articles/d4158…

I read it trying to understand the resistance to aerosols. Shocking that the aerosol-resisting researchers do not seem to have any good arguments.

Some key points to understand the debate below:
2/ Nat: boundary of 5 um btw larger droplets that fall to the ground very quickly (in 1-2 m), and aerosols that stay suspended in air longer E.g. "These bigger droplets, more than 5 um [..] drop out of the air quickly because they are too heavy to ride on light air currents."
3/ This is a very stubborn error. Droplets need to be larger than ~ 50 um (not 5) to fall to the ground in 1-2 m. Smaller ones can stay afloat minutes to hours (see ).

Those can be inhaled, and can infect through the aerosol pathway.
Read 14 tweets

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