120 years we should have known this. Be generous say 80). We should have been prepared for it, but experts mangled the science so we aren't ventilating.
Short thread of threads.
Before 1850, miasma theory said disease came out of swamps and killed you. Nobody knew how.
~1850 Snow says cholera in the water (ppl thought in the air).
~ 1860 discovered bacteria. They didn't live long outside body.
By 1887, a Dr. Chapin knew diseases floated, like scarlet fever. Not as contagious as measles.
At the time there are studies showing spit up bacteria growing within 2.5 m/6ft or so. Any time infection found over longer, he says must be touch. (Same as modern IPAC, really.)
Interestingly, He acknowledged that people criticized him for being too pro-"close contact".
Interestingly, he also said don't over generalize and keep studying air transmission:
Then came Drs. Wells and Wells (husband and wife team), who studied air. They concluded its in air and asymptomatic spread keeps it going. UV in schools stopped measles dead.
They wrote a damned indictment of droplets. They were ignored, it seems.
We had the "droplet" vs "airborne" debate about measles. But when a few outbreaks happened that could not be explained by droplets, we grudgingly accepted "airborne".
Not really any proper parameters to declare something "airborne". We just do it.
You know, evidence-based medicine and all.
Then SARS, and we clung to droplet, and Amoy Gardens shows it can float to another building, and sewage engineers proved this matched their modelling, but still it is debated.
Nobody on ground floor caught it. Hmm.
And we now see apartment spread of SARS-CoV-2.
!!
Problem was, when people got sick outside of 2m, what do we do?
1. Well, when get sick at hospital we call it AGMP and say that it "aerosolizes" the droplets. No real proof these do that more than coughing:
I don't think they know you're big on aerosols and retweeted a bunch of @jljcolorado and @kprather88 stuff - both of whom I'm in close contact with and are air experts!
All of this fits together and is how we get out of this mess.
Cheers!
(By the way follow those two and I have an air expert list that people might be interested in flipping through.)
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I have a list of articles I never had a chance to pull. Old ones.
I just opened ONE. For fun.
The FIRST ONE.
It's from 1910.
Here is what the abstract said. Most is sprayed out, as found by Flugge. Within 2.5 meters (which is more than the 2m we are using now, interestingly).
Found bacteria on plates but not in air. Their collection methods were rudimentary, of course. That's probably why.
Mentions 7 colonies of bacteria in 140 litres of air. Concludes its safe, and mostly the spray.
We are not special, this is coming, and we need to pull out all the stops.
Vaccination is not a magic bullet nor coming soon.
Or HCW will die.
In the meantime please be safe in closed spaces. #COVIDisAirborne
We didn't do the work before so we have to now. #COVIDZero
@fordnation@JohnTory - to the social media people on these account: Mention it up the chain for these two to actually lead. Crack heads. Get going. Earn your keep.
This is a battle and we're on the sofa.
And get money out to people and businesses. This isn't their fault.
It's just an old talking point that keeps getting repeated. It comes from the PROCEDURE bringing MANY HCW into the room for intubation. Plus the idea of drops flying out of mouths when you intubate.
Once we finally solve this terminology, they're gonna have another problem, which is that all these viruses are "airborne" and we just see longer-range transmission amongst the more contagious/in odd situations.
So they're gonna have a chance to make up more words soon anyway.