1/ The Lancet COVID19 Commission recognizes the role of aerosol transmission

In addition to role as a Commissioner, I am Chair of Task Force on Safe Work, Safe School, and Safe Travel

I added this section to our first statement, released today, and approved by all Commissioners
2/ Full text of section 15:

Identifying the dominant modes of COVID-19 transmission is an urgent public health priority. There is growing consensus from the aerosol science and infectious disease communities that aerosol inhalation is a key contributor to COVID-19 transmission.
3/ The US Centers for Disease Control and Prevention (CDC) and WHO have widely communicated a narrowed scope of possible transmission routes, limited to large droplets expelled by coughs and sneezes, and contact with contaminated surfaces.
4/ However, this notion is based on an incorrect assumption that 5 μm particles settle out of the air within 2 m (6 ft). Basic aerosol physics shows that people shed an entire continuum of particles when they cough, sneeze, breathe, or talk.
5/ Some of these are very large particles that do settle out of the air quickly because of gravity (influencing the 2 m [6 ft] distancing rule), but the vast majority are smaller particles that stay aloft for between 30 min and several hours, and travel beyond 2 m (6 ft).
6/ Mitigating airborne transmission is especially crucial for reducing the risk of superspreader events. These events appear to occur mainly or exclusively indoors, although large outdoor events are often preceded or followed by indoor crowds at bars, pubs, and restaurants.
7/ Full text of The Lancet Covid19 Commission statement

thelancet.com/journals/lance…

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More from @j_g_allen

19 Sep
1/ Stay in your seat and remain calm.

This report is making the rounds.

I read it. (including appendix, which I'm guessing few read, b/c if you did....)

wwwnc.cdc.gov/eid/article/26…
2/ For background, flight was from early March, 10-hour flight, thorough attempt to contact all passengers. A massive lift, so nice work by the authors on that front.
3/ Index patient had active symptoms, actively coughing, no masks

First takeaways:

-airplanes are vectors of disease, moving people around countries and globe and spreading
-this person was irresponsible

*stay home when sick*
Read 22 tweets
18 Sep
1/ Want to buy schools time? Open the windows

In late August, FAUCI answered a question on whether he supported healthy building strategies:

"You’re telling me we have this big crisis, and you’re telling me to open up a window? Yes, I’m telling you to open up the window.”
2/ Can it really be as easy as Fauci suggests? Just open the windows? Yes.
3/ When someone coughs, sneezes or just breathes, he or she releases viral particles suspended in respiratory droplets into the air, ranging in size from infinitesimally small to large droplets that will settle out of the air due to gravity.
Read 25 tweets
16 Sep
1/ 🚨MAJOR NEW PREPRINT

Why are some more likely to get Covid19?

Why are some asymptomatic while others suffer?

Why are kids so different than adults?

Short thread of new paper by @HarvardChanSPH colleagues, led by Kris Sarosiek (@CellDeathLab), first author @zintisinde
2/ For background, ACE2 is the receptor that SARS-CoV-2 uses to get into our cells

Questions they sought to answer: are there differences in ACE2 expression by age and does this correlates with disease severity?
3/ Here’s what they did:

They measured ACE2 expression in human lung tissue specimens from over 100 donors from ~4months to 75 years of age.

The full preprint is here, but come back to it. Keep reading thread to end.

biorxiv.org/content/10.110…
Read 9 tweets
14 Sep
1/ Listen to the science and reopen schools

Adding months more to this toll will be an educational disaster that some children may never recover from

A thread...
2/ listen to the science, which says that schools can — and should — reopen for in-person learning with appropriate risk reduction strategies, while officials also implement aggressive steps to keep community transmission low.
3/ Listen to the American Academy of Pediatrics, which argued for focusing on science and not politics in supporting a return to in-person schooling with new investments in safety, describing in-person school as “fundamental” to the well-being of the nation’s children.
Read 29 tweets
13 Sep
1/ TIPS FOR REDUCING RISKS

✅schools
✅homes
✅offices
✅parks
✅airplanes
✅cars
✅bathrooms
✅elevators
✅grocery stores
✅Broadway theater
✅jury trials
✅MASKS

Thread pulling together our guidance since March

All avail at Harvard #HealthyBuildings: forhealth.org
2/ what to do in SCHOOLS

(w/ Harvard #HealthyBuildings team)

schools.forhealth.org/risk-reduction…
3/ what to do in HOMES

(w/ @mlipsitch)

usatoday.com/story/opinion/…
Read 15 tweets
8 Sep
1/ Sharing some example data on opening windows in schools (note the caveats/limitations on last slide)

If you're curious how we did this, we created a 'how to' that is available here: schools.forhealth.org

First, we need to start with the targets:
2/
3/
Read 13 tweets

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