[Thread] Last night the Chief Medical Officer finally said #covid19 is spread “indoors in poor ventilation”
This is HUGELY SIGNIFICANT, & here’s why.. 1/ #Covid19
..Ireland’s public health message is not in step with international scientific community & has not kept pace with 9 months of research.. so no warnings have been given about ~airborne~ virus spread that happens ~beyond 2m~ 2/
..it’s now known this respiratory virus is caught from inhaling when breathing; risks from surfaces were over-stared so perspex screens & deep cleaning have distracted people from the most important prevention- ‘clean air’ (take 5 mins this is worth it) 3/
.. so if HSE/NPHET catch up quickly then nursing homes, schools, homes, workplaces & amenities can ~immediately~ take simple preventative measures to ‘air’ rooms regularly, filter & monitor high risk conditions; most of this is ~free~ or very low cost 4/ usatoday.com/in-depth/graph…
.. nursing homes & over-crowded housing (incl direct provision, housing for homeless people, travellers, work dorms etc) need targeted prevention & support to make an immediate difference to stop ‘super-spread’ conditions
Stop the superspreading to stop the pandemic 5/
.. & it doesn’t take a crowd.. high risk #covid19 conditions can happen in a family homes in a very short time..
this is recent monitoring of CO2 (above red line shows high risk conditions) by @citlanx 6/
..which may explain recent ‘clusters’ in homes in closed windows when weather got colder
Last Spring the high-risk hot-spots were in yellow zone, temperatures 5-11°C & they’re back in October (zone: Wuhan, NY, Seattle, cities in Italy, Spain, France, Germany, UK, Ireland etc) 7/
..so there is far more hard evidence that this second #Covid19 wave is due to environmental conditions & human comfort... not ‘bad behaviour’ as claimed
Which means policing, fines & warnings may not be effective.. whereas clear advice, support & science-based rules may be 8/
..change signalled by @CMOIreland means @President_MU needs to re-run model to incl other factors
Spring lockdown had tailwind (rising temps, open windows, outdoor activity, shut schools) ..but Autumn lockdown has strong headwinds (cold, shut windows, open schools & fatigue) 9/
..& NPHET are currently using ‘average R’
..but acc to Prof Pennington: ‘In a care home, R number is probably 10. For whole population, R number may be below 1’
‘[average R] is useful in epidemiology textbook. It is not in public health measures’ reaction.life/hugh-penningto… 10
..most of known high-risk (high R) places are unchanged at Level 5 (schools, homes, care homes, direct provision, meat plants) & many others were already shut (pubs, restaurants, universities, offices etc)
..so changes in low-risk places (shops, sports) may not have impact /11
..‘HSE to employ 500 contact-tracers to track future Covid-19 patients, asking where they went & who they met. But, how many people are employed to look at our houses & buildings to prevent tens of thousands of people becoming infected in first place?’ /12 irishtimes.com/opinion/why-go…
.. can better ventilation work?
Japan has advised ‘3 Cs’ since February & in a population of 126m has had fewer #Covid19 deaths than Ireland /13
& in this case in Taiwan:
‘Improving ventilation was associated with 97% decrease in risk for contacts to become new infections & helped to end TB outbreak in a university’ /14 onlinelibrary.wiley.com/doi/full/10.11…
..lessons from other #Covid19 case studies linked to ventilation can inform changes: meat plant recirculated air in Germany, call centre outbreak in Hong Kong, choir super-spread in USA, school air-con in Israel, a cruise ship, a bus in India..& this restaurant in China /15
FAQs on Protecting Yourself from COVID-19 Aerosol Transmission docs.google.com/document/u/1/d…
‘Rigid safe distancing rules are an oversimplification based on outdated science’
#NursingHomes important to know #Covid19 builds up & spreads like cigarette smoke; so closed windows in cold weather is making conditions high-risk for super spread- it can be easily mitigated by airing rooms (ventilation), air purefier fans (filtration) & checks with CO2 monitor
Contacts between people are not all high-risk, & research says that most people with #COVID19 only transmit to 1 other person or fewer.. ‘It’s often not very contagious’ 1/
..but a small number of people with covid (less than 20%) are likely infecting more than 80% of new cases... ‘preventing superspreader events could go a long way toward stopping COVID-19’ 2/
..Germany’s top doctor
‘Most people only pass it to one other.. occasionally, someone spreads more widely, creating a cluster of infections that drives the pandemic. To avoid another lockdown Germany must focus on identifying & preventing clusters’ bloomberg.com/news/features/… 3/
‘If you need to be right before you move you will never win’ @who Dr Mike Ryan
HPSC acknowledges airborne spread of #Covid19 virus beyond 2m in poor ventilation, but give no public health warning because its ‘still uncertain..no conclusive proof.. further research needed’
High-risk #covid19 indoor air conditions are ~immediately~ preventable with public health advice about clean air, #ventilation & free/low cost solutions, it’s basic environmental science cires1.colorado.edu/jimenez/COVID/…
Autumn conditions in Ireland (10-15° & high relative humidity) are high-risk (yellow zone)
If #Covid19 surge is the weather, not bad behaviour, then policing, road blocks & fines won’t be effective at #Level5
..but ‘crowded indoor spaces have been shown to be associated with increased transmission.. determining what is due to proximity & poor hygiene practices, & what is ~due to poor ventilation~ though, is difficult’
^so, risk of spread due to poor ventilation is accepted by HPSC 2/
..but, no rules from HSPC, just ‘suggestions, specifically for commercial & public buildings’ ..& only for mech ventilation, which is small % of all buildings ..but ‘residential & healthcare settings fall outside the scope of HPSC document’ ..& very limited advice for schools 3/
#Covid19 High risk (yellow) zone at temperatures 5-11°C (spring & autumn)
An urgent public health message about clean indoor air & #ventilation (not fines & roadblocks) can have immediate impact on virus spread & prevent cases
WHO: ‘we are very concerned about rise in cases in Europe as it heads into winter’
‘Colder weather leads to behaviours that favour transmission of a respiratory virus- people tend to crowd indoors to stay warm, more often in poorly ventilated spaces’ smh.com.au/politics/feder…
‘overwhelming evidence that *inhalation* represents a major transmission route’
‘we urge public health officials to add clear guidance about importance of moving activities outdoors, improving indoor air & improving protection for high-risk workers’ science.sciencemag.org/content/early/…