1/ Some arguments relevant to the aerosol transmission debate that people may have missed, and may be more convincing for infectious diseases - epi - public health folks. Extracted from my Medscape perspective:
medscape.com/viewarticle/93…
medscape.com/viewarticle/93…
2/ For many decades it was thought that tuberculosis was transmitted through droplets and fomites, because transmission seemed to be strongly favored by extended "close contact." It was later proven that tuberculosis can only be transmitted through aerosols, highlighting the...
3/ difficulty of concluding which route may dominate on the basis of an observation of favorable transmission under "close contact."
4/ We have to accept that talking, and especially singing or shouting, are "aerosol-generating procedures." They do not generate aerosols on the same scale as intubation. But they do so for much longer periods of time, in environments with much lower ventilation than most...
5/ hospitals, and often without masks. As has been shown for tuberculosis, respiratory aerosol generation in an office was 3000 times less than during intubation, and yet it led to an outbreak with two dozen new infections (ingentaconnect.com/content/iuatld…).
6/ Capturing viable pathogens from the air is extraordinarily difficult, owing to their low concentrations and their fragility when sampled by the instrumentation. In fact, viable pathogens have never been isolated from room air for either measles or tuberculosis (the latter...
7/ with many attempts spanning almost a century), two diseases with well-established aerosol transmission. For tuberculosis, only directly sampling patient coughs in an unventilated space 25 times smaller than a typical room has been successful.
8/ WHO admits that there is actually no direct evidence for fomite transmission of SARS-CoV-2 (who.int/publications/i…), and large droplet transmission has never been demonstrated directly for SARS-CoV-2 or **any other disease.** (sciencedirect.com/science/articl…)
9/ It appears that absence of (complete) evidence is being taken as evidence of absence, but only for aerosols. Century-old bias is rooted in the history of the field of medical infectious diseases, and in fact we are working with historians to document it
10/ Superspreading events could be the Achilles' heel of SARS-CoV-2, and that we should focus on identifying their causes and preventing their occurrence. Environ. conditions are key: indoor spaces, low ventilation, crowding, long duration, no masks, loud conversation or singing
