Covid is airborne, but the continuing insistence in pushing fomites as the major source of infections makes ‘the idea of fomites as the main infection route’ a large contributor to infections. In a certain twisted way, fomites are the problem.
This insistence in fomites as a mode of transmission is especially problematic with the more infectious variants. For example: Indoor contact with cases for any amount of time as long as wearing a mask is generally classified as low risk in this province.
This means that potentially infected individuals are not considered high risk, and in many situations, small clusters of cases (the majority of transmission events) may not be classified as outbreaks, for not meeting epidemiological link criteria.
When epidemiologically linked clusters are approached as independent introductions (coinciding in time, but missing the “high risk contact” criteria), it gives a false sense of security to the population. It is not helpful to individuals, and it is a serious public health issue.
Additionally, infection prevention strategies are less effective when they only address one mode of transmission. No amount of hand washing and surface disinfection will reduce the proportion of infections acquired through air.
Similarly, when indoors for prolonged periods with possibly infected individuals, distancing will not mitigate the increased risk of infections due to poor ventilation. Same goes for low quality masking or mask removal in such environments.
Questioning the airborne nature of this virus is hindering progress towards control of this pandemic. It’s the reason schools are unsafe, it’s the reason so many cases miss epi links and the reason the true dynamic of this pandemic is so poorly documented.
It confuses the population, it muddles public health response, and it is undermining public confidence in public health. But it makes the daily theatrical approach to this pandemic so much cheaper... 🤷🏻‍♂️
See this, same issue, major outbreak as a consequence:
And this example of misguided investment strategy, focusing on the least impactful piece of the puzzle:
Btw: tomorrow this will be debated (I wish it did not need to be...) - it should be good.
I could retweet @DavidElfstrom all day long. But here is the last one for today. He is really worth following.
Great piece about the gym super spreader event:

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More from @DGBassani

9 Apr
Interesting new pre-print from Italy looking at the changes in doubling time of infections after school reopening last September. It compares the growth rates of daily new confirmed cases before and after a switch into exponential growth. medrxiv.org/content/10.110…
Rates are smoothed using 7-day rolling averages and log-transformed. A series of regional plots as the one below are presented in which the yellow line is date of school reopening in the region and the blue line is the date when the slope switches. Image
The doubling time of the growth rate (number of daily cases) changed consistently to approximately 7 days (lowest 5 and highest 15 days) in all regions as can be seen in the last column (DT2) of the table below. Image
Read 8 tweets
7 Apr
Why are these voluntary samples of the asymptomatic testing programs biased? Voluntary samples are always biased. They tend to be healthier, wealthier, with more time to spare, have better self-care habits, among many, many other traits.
bmcpublichealth.biomedcentral.com/articles/10.11…
Even if you go to a hot spot, the population that shows up for voluntary testing is non-representative of the hot spot population. Sampling is the bread and butter of field epidemiology, but even the recent Santa Clara sampling fiasco was already forgotten the-scientist.com/news-opinion/h…
And it was really a fiasco, loudly discussed, everywhere:
statmodeling.stat.columbia.edu/2020/04/19/fat…
Read 15 tweets
7 Apr
As if we did not have big problems with child mental health issues... back in 2009 we estimated that ~ 570,000 children under 12 lived in households where the an adult met criteria for one or more mood, anxiety or substance use disorders in the previous 12 months...
That corresponded to 12% of Canadian children under the age of 12. Almost 3/4 of those children had parents that reported receiving no mental health care in the 12 months preceding the survey.
And for 17% of all Canadian children under age 12, the individual experiencing a psychiatric disorder was the only parent in the household. capmh.biomedcentral.com/articles/10.11…
Read 5 tweets
6 Apr
Now here are the real devastating mental health outcomes of this pandemic, and they’re consequences of the infection, not public health measures. Who would have thought? thelancet.com/journals/lanps…
Seems so much worse than the flu.
And very worrying long-term consequences even for those under 65 years of age. Brace up Ontario, this will cost a fortune. Much more expensive than testing, tracing and isolation, sick days, safe schools...
Read 6 tweets
31 Mar
New preprint from OAHPP, Sunnybrook and SickKids about Pediatric household transmission of SARS-CoV-2 infection in Ontario with data from individuals living in private households (N=132,232 cases in 89,191 households) between June 1 and Dec 31, 2020. medrxiv.org/content/10.110…
This covers 84% of all cases (157,087) recorded during this period. Age-to-age transmission suggests that frequency of transmission increases with age, with kids infecting other kids, as well as adult household members. No data on adult index cases shown.
Younger children (0-3 years) were more likely to transmit SARS-CoV-2 compared to older children, but after adjustments ORs of household transmission were similar for ages 4-8 and 0-3. Testing delays also increased the odds of household transmission considerably.
Read 8 tweets
18 Mar
In the news: In 3 of the 7 previous years the average monthly number of youth suicide attempts presenting to Emergency Dept in the City of Hamilton PHU has been higher than the variability in the 4 month observation from McMaster Children's Hospital.
In all three previous years in which the presentations to ED were higher than the Oct-Jan reported increase of 4.8 additional cases/month they were above 6.0 additional cases/month. And in some, they have been much lower than the previous year.
Using longer time-series before going to the media with a before and after comparison that ignores the much longer time-series available for anyone to see is not reasonable. The hospital certainly could have calculated the monthly rates for a much longer time-series.
Read 7 tweets

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