[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
So..

😷 MASK
💨 AIR
↔️ DISTANCE
covidstraighttalk.org /16
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’

..there is no safe distance or safe duration in poor ventilation /17
@bmj_latest bmj.com/content/370/bm…
Finally, other threads:
👩‍🏫 Schools, practical steps

📚 Inadequate & inconsistent public health rules for buildings

📈Can Level 5 work?

/end
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More from @Orla_Hegarty

22 Oct
#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
Ventilation & air filtration usatoday.com/in-depth/graph…
#Nursinghomes -use air filtration fan units to ‘clean’ virus from a room for <€100 (& diy options also work)

#Nursinghomes -check poor ventilation with a CO2 (carbon dioxide) monitor for <€150 elemental.medium.com/air-purifiers-…
Read 5 tweets
19 Oct
[Thread] Will #Level5 work?

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/

[ @jljcolorado cires1.colorado.edu/jimenez/COVID/… ]
..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/

[ @svscarpino scientificamerican.com/article/how-su… ]
..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/

[
Read 14 tweets
18 Oct
‘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’

.. so no preventative action in homes, cars, nursing homes
hpsc.ie/a-z/respirator…
meanwhile high risk sectors have inconsistent, unsafe & out of date ‘rules of thumb’ & no warnings at all for homes, shops, cars & public transport
Read 4 tweets
18 Oct
#Covid19 prevention: CO2 monitors used as proxy for inadequate #ventilation in #schools #nursinghomes etc, it’s cheap & effective way of preventing high-risk super-spread #Covid19Ireland #Level5 @NormaFoleyTD1 @DonnellyStephen @CMOIreland @paulreiddublin @ronan_glynn @CcoHse
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
Read 6 tweets
14 Oct
[Thread] Clean air & Ireland’s inconsistent #Covid19 rules 1/

‘possibility of airborne transmission of SARS-CoV-2 through aerosols is still uncertain..no conclusive proof..further research needed’ HPSC, 22 Sept

^known very high risk & there’s evidence hpsc.ie/a-z/respirator…
..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/
Read 14 tweets
11 Oct
#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 Image
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/…
Read 7 tweets

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