Absolute 🔥 from the inimitable @edyong209! So much insight, so succinctly written, with input from scientists with deep expertise (from well before 2020) on viruses. Excerpts with my thoughts follow... /1
Their movements through the air have been poorly studied, too. “There’s this very entrenched idea,” says Linsey Marr at Virginia Tech, that viruses mostly spread through droplets (short-range globs of snot and spit)... /2
rather than aerosols (smaller, dustlike flecks that travel farther). That idea dates back to the 1930s, when scientists were upending outdated notions that disease was caused by “bad air,” or miasma. /3
But the evidence that SARS‑CoV‑2 can spread through aerosols “is now overwhelming,” says Marr, one of the few scientists who, before the pandemic, studied how viruses spread through air. /4
“I’ve seen more acceptance in the last six months than over the 12 years I’ve been working on this.” [about which I am joyous] /5
Other epistemic trespassers spent their time reinventing the wheel. One new study, published in NEJM, used lasers to show that when people speak, they release aerosols. But as the authors themselves note, the same result—sans lasers—was published in 1946, Marr says. /6
I asked her whether any papers from the 2020 batch had taught her something new. After an uncomfortably long pause, she mentioned just one. /7
[It was the finding of infectious SARS-CoV-2 in air at non-negligible levels, although this group also successfully cultured flu virus from air a few years ago.] ijidonline.com/article/S1201-… /8
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We started studying cloth masks in March. Preprint now at medrxiv.org/content/10.110… Take-home: Cloth masks are not an N95, but they work reasonably well for aerosols 1-2 microns and larger, which is the size that we think mostly mediates transmission. See thread. /1
.@jinpan@charbeleharb & Leng tested vacuum bag, microfiber, coffee filter, MERV 12 filter, cotton, acrylic, bandana, CDC sewn & non-sewn designs, surgical mask, face shield for material filtration efficiency in a filter holder and inward and outward protection on a manikin /2
For submicron particles, vacuum bag, microfiber, and surgical mask filtered out >50% of aerosols. Other materials were way below 50%. /3
CDC's new guidance is out: "COVID-19 can sometimes be spread by airborne transmission" cdc.gov/coronavirus/20… /1
"Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours. These viruses may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left...." /2
"This kind of spread is referred to as airborne transmission and is an important way that infections like tuberculosis, measles, and chicken pox are spread." /3
Nearly tears of joy seeing new paper in medical journal with correct analysis and interpretation of aerosol transmission: thelancet.com/journals/lanre… See thread for summary of main points. /1
Where we have been: "Current infection control policies are based on the premise that most respiratory infections are transmitted by large respiratory droplets—ie, larger than 5 μm— produced by coughing and sneezing, then deposited
onto exposed fomite or mucosal surfaces." /2
Pathogens (e.g., M. tuberculosis, influenza, RSV, rhinovirus, many more) are consistently found in small aerosols <5 microns and if size-resolved data available, in much higher amounts than you would expect based on aerosol or droplet volume. /2
WHO's updated scientific brief on transmission of COVID-19 is a step in the right direction because they now acknowledge that airborne transmission may be occurring outside of specialized medical procedures, although they remain fixated on medical procedures as... /1
the main source of aerosols when we know they are generated by normal respiratory activities such as breathing, talking, singing, laughing, etc. /2
Exhaled breath is a significant source of SARS-CoV-2 emission medrxiv.org/content/10.110… Emission rate in exhaled breath of 1000-100,000 RNA copies/minute in 5/24 patients (<14 days). HT @TundraDesert /1
The 5 patients' hands all negative, only 2/22 phones positive, 0/26 swabs of handles positive, discounting direct contact. Other surfaces positive, prob by fecal or aerosol/droplet settling. /2
Previously, I estimated an emission rate of 10,000 copies/min from air measurements in hospitals in Nebraska and Singapore. We may be heading toward a robust number for those who emit virus into air. /3
Flushing the Toilet May Fling Coronavirus Aerosols All Over nytimes.com/2020/06/16/hea… Part 2: everything old is new again. See thread for prior work on this topic. /1