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
/1
@kprather88 summary:

Short and long-range inhalation of aerosols is the dominant route for transmission, with extensive & rigorous supportive data.

'Droplets don't shoot out and turn around back' - chorister event
'Droplets don't do bends' - ferret model proving airborne route
@kprather88 more:

Humans are aerosol generating people!

AGMPs release fewer aerosols [for transmission], yet WHO guidelines suggest HCWs only require N95 masks for AGMPs.

[ed: this dogma needs to die - it's responsible for the infection &/or death of 1000's of HCWs globally]
@kprather88 more:

WHO SARS-CoV-2 IPC Scientific Briefing July 2020 needs an urgent update in light of every aspect of [alleged] gaps in research being addressed.

[ed: our lives are on the line here 🙏]

#COVIDisAirborne @trishgreenhalgh @microlabdoc @mjb302 @Linzofm87
@kprather88: why it is important for @WHO to clearly acknowledge that SARS-CoV-2 is 'airborne'
@mvankerkhove @NjbBari3
@DFisman only had 5 minutes but shared his 'epiphanies'

'It's time to let the science speak'

'It's time to treat [SARS-CoV-2] as predominant airborne spread'

#COVIDisAirborne
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.

Check out the thread and you'll see why.
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".

I seem to recall similar statements from @angie_rasmussen and/or @SaskiaPopescu on this platform in recent weeks.

Is this a clear enough public health message?
More:

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.

No apology to HCWs for @WHO PPE policy.
Closing Qs: 10 mins.

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.'

#COVIDisAirborne @lisa_iannattone
END

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More from @DRTomlinsonEP

8 Apr
The Disinformation Playbook ucsusa.org/resources/disi… via @ucsusa
@Its_Airborne

Great read for all those wondering how anyone could argue against the fact that #COVIDisAirborne.

[IMO airborne transmission = dominant in nearly every setting...although I could be wrong!]
For a masterclass in medical disinformation tactics, try this [from 28 mins]:

I especially like this part. After discussing how important it is to ‘be careful and use your critical appraisal skills and common sense’...
Read 7 tweets
8 Apr
Q: Did your nation’s pandemic flu plan require N95/FFP3, or FRSM for HCW protection?

TOP SECRET: AEROSOL TRANSMISSION MESSAGE TO BE SUPPRESSED AT ALL COSTS

#COVIDisAirborne

/1
‘There is considerable support in the scientific literature for a contribution of aerosol transmission to the spread of influenza A, which has been reviewed elsewhere (Tellier 2006).’

/2
‘Briefly, supportive evidences include the prolonged persistence of infectivity in aerosolized influenza A virus at low humidity, the transmission to volunteers of influenza by aerosols, reproducing the full spectrum of disease, at doses much smaller than the doses required..’
Read 12 tweets
5 Mar
Evidence will be presented that:

• the relevant Government departments (PHE/DHSC) are seriously misleading healthcare workers by referring to surgical masks as ‘PPE’,
• this misinformation leads workers to a false belief that they are being adequately protected, and

• this seriously compromises the health and safety of these workers and endangers their lives @doctorsdilemma @DrPieterPeach @YouAreLobbyLud

👇
Read 8 tweets
3 Mar
May 2020.
A true gem: no bias.
#COVIDisAirborne
doi.org/10.1136/bmjope…
‘HMG PPE guidance on the indications for use of FFP3 respirator relies on two assumptions. First, that its list of AGPs & high-risk areas are exhaustive. Second, that the droplet theory of SARS-CoV-2 transmission is correct.’
@TheBMA @theRCN @KGadhok Image
‘If either of these two postulates are incorrect & the role of aerosolisation transmission is greater than currently thought, the current triaging system of respirators may result in HMG PPE guidance indicating a less effective form of RPE in a higher-than-expected risk setting.’
Read 8 tweets
3 Mar
'In summary, antibodies against N protein of SARS-CoV-2 WERE NOT DETECTED in 408 (56%) of health care workers of a major hospital for COVID-19 in southern Vietnam.'

A huge contrast with the UK position: why?
@mancunianmedic @microlabdoc @mjb302 @DrLindaDykes @chrismainey @theRCN Image
Contributing factors?

1. 'Early preparedness and experience gained from previous pandemics...safety training on COVID-19 patient management and laboratory safety for its designated staff in early January 2020'

When did you receive your COVID19 safety training?
@davidshukmanbbc Image
2. 'To further reduce the risk of nosocomial infection, wearing a medical mask is mandatory for all COVID-19 patients, while being hospitalized.'

Are all your patients required to wear a medical mask throughout their in-patient stay?
@LABailey @NHSProviders @NHSEngland Image
Read 4 tweets
16 Jan
From Dan Kahneman: Thinking, Fast and Slow

THE ILLUSION OF VALIDITY

p.221

SPEAKING OF ILLUSORY SKILL

“She is a hedgehog. She has a theory that explains everything, and it gives her the illusion that she understands the world.”
#FreshAirNHS #COVIDisAirborne Image
Transmission of SARS-CoV-2: implications for infection prevention precautions
'Scientific Brief' @WHO
who.int/news-room/comm…
Before 05:00AM today I hadn't read this.

Have you? 🤔
#FreshAirNHS #COVIDisAirborne Image
Read 72 tweets

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