Wonderful opportunity to hear the great and the good discussing evidence underlying SARS-CoV-2 transmission & optimal mitigation: the most immediately pressing topics for humanity. @kprather88@DFisman and Prof John Conly #COVIDisAirborne
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Prof John Conly. In case you've forgotten: he's a VIP with respect to global health policy.
So we'd better hope he's up to speed on the latest science & isn't trying to hold on to respiratory virus transmission concepts based on dogma, bad science and/or bias, right?
Confession: for me, his presentation started very badly as it was exactly the same opening slides & discussion as in his July 2020 talk.
Best summarised as a masterclass in medical misinformation.
Summary: Does anyone else think these two slides alone provide evidence indicating that Prof Conly is importantly biased against airborne transmission of SARS-CoV-2? He's omitted a vast body of data supporting airborne.
Does anyone have any idea what his true motivations are?
Amazingly, Prof John Conly admitted that airborne transmission of SARS-CoV-2 can occur, but that "it's situational".
Face touching getting a mention here: maybe SARS-CoV-2 neuronal infection creates disinhibition of face touching behaviour?
It's possible I guess. But direct aerosol-bound viral binding of alveolar type II pneumocyte ACE2 receptors with TMPRSS2 is so much easier, right?
Last slide: nice attempt to suggest the airborne transmission 'world of science' [my words] is lacking rigour.
This tactic is a great ploy for politicians campaigning or aggressive advertising against competitor brands but has absolutely NO ROLE in scientific discourse.
Notable absences from Prof Conly's talk:
No attempt to explain how superspreading occurs with his 'transmission model' limiting airborne spread to 'situational'.
Nothing to counter the animal models which prove airborne transmission.
JC: accepted airborne transmission can occur but that it is 'situational'.
JC: regarding aerosol transmission, 'I would like to see much higher levels of scientific evidence including some basic science.'
MUCH higher: what's his definition of 'much'?
Fantastic exchange on the Q of why in early 2020, WHO did not use the precautionary principle & treat SARS-CoV-2 as an airborne transmitted virus.
@DFisman 'It's time to treat as predominant airborne spread'
Conly: 'I couldn't disagree more'
Reasons given? Next tweet...
Conly: 'you need to consider the harms of N95 masks'
- Acne
- Eczema
- Conjunctivitis
- CO2 retention
- Low O2 saturations in pregnant women
In this order. Honest.
Q for HCWs: given the choice, would you risk death/long covid/onward transmissions with FRSM, or 🖕 with N95?
So there you have it.
In a nutshell:
@kprather88 'Once we acknowledge it is airborne we can fix it.' @DFisman 'It's time to treat as predominant airborne spread.'
Prof John Conly 'Airborne transmission can occur: it's situational.'
‘Healthcare leadership has lost its way. Its foundation should be in love, not lies. We are truly sorry for what we have done’
** ‘testimony’ 🙃
/🧵
‘We knew SARS2 transmission was airborne in Jan 2020, but instead of showing love to healthcare workers & being honest with them about the RPE shortages, we lied to them & kept on lying’
‘…we are truly sorry for what we have done’
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We knew AGP-only aerosol risk was a smokescreen - a thinly disguised rationing tool for RPE - but instead of being honest with HCWs, in love, we lied to them & kept on lying’
If you missed what Prof Sir Chris Whitty said on IPC & PPE, or just couldn't carry on watching after the amazing @Kevin_Fong [God bless you sir, & thank you for all you do 🙏]
TL/DR
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Sir Chris worked shifts on the wards in every wave
Wore FRSM mainly - as per IPC guidance, he said
HCID declassification had no bearing on IPC guidance
"I am not an expert on IPC'
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On national IPC guidance:
'quite a lot of people had partial responsibility'
Now we've seen IPC Cell minutes from 22/12/2020 & the plea from 'CB' for wider FFP3 use because:
'Our understanding of aerosol transmission has changed'
🚨Would you like to know whether very late 2020 was when *all* 🇬🇧Gov departments knew of the importance of aerosol risk?
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Obtained via FOI request
🚨From the Department of Business, Energy & Industrial Strategy
🦺Working safely during coronavirus (COVID-19)
10 July 2020 update
'You should ensure that steps are taken to avoid people needing to unduly raise their voices to each other...
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'This includes...refraining from playing music or broadcasts that may encourage shouting, including if played at a volume that makes normal conversation difficult. This is because of the potential for increased risk of transmission, particularly from aerosol transmission.’
Over the last 2 days at @covidinquiryuk the NHS has shown its dark & ugly side
There was never going to be an apology from IPC guidance authors whose guidance drove disproportionately high rates of death & COVID19 in non-ICU HCWs & huge rates of nosocomial SARS2, but…
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the level of obfuscation, evasion & incompetence on display from those tasked with keeping HCWs safe, is jaw dropping
I was one of the lucky ones: my NHS Trust ALWAYS provided HCWs with FFP3 when caring for those with COVID19 - my IPC remained precautionary
As a result…
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by Dec 2020 the number of consultant staff working on Covid wards testing positive was: 0
🚨The ONLY deviation from national guidance was universal FFP3!
The last & most vital line of defence - FFP3 - *is life saving* @SMHopkins
TL/DR in evidence to @covidinquiryuk, CH stated SARS2 transmission is via large droplet & fomites
But:
Following peer review triggered changes 6 Jul 2022, CH's own work stated that SARS2 transmission is via 'fine aerosols & respiratory droplets, & to a lesser extent...fomites'
Why omit the empirical truth that SARS2 transmission occurs importantly via the airborne [aerosol inhalation] route?
Why do this, particularly as David Heymann's 13th Oct 2023 evidence to the PI clarified the @WHO position:
WHO knew SARS2 transmission was via aerosols, Jan 2020
'Arguably the most fundamental misstep in the UK response was the presumption that covid would be an unstoppable flu-like wave'
This
underpinned the early (Chris Whitty) position on T&T, & the Vallance view on 'herd immunity' (later air-brushed)'
Aside
Early SAGE minutes clarify the UK rationale for stopping community SARS2 testing: it was deemed unnecessary because with rapidly increasing case numbers there was no point in testing, as there were insufficient personnel to contact trace
Good to know whose plan this was
'But there was an alternative'
'This led us to question...though we found ourselves quietly dismissed as not understanding the science'
'Ironically, the pride in our science & our capabilities, slowed our ability to learn lessons from other countries'