1/ UPDATES TO COVID-19 AEROSOL TRANSMISSION ESTIMATOR

We have just implemented several updates:
- added increased risk of variants
- made clearer how to enter vaccinated people
- added calculation of infection risk parameters

tinyurl.com/covid-estimator
2/ The risk parameters allow quantitative decisions on which mitigations are needed to avoid outbreaks. See the thread from yesterday on that topic and paper:

3/ We also added a sheet with a quantitative version of the BMJ table (bmj.com/content/370/bm…). See sheet "Risk Table", where you can modify it for your conditions.
4/ Based on feedback @ZheP_AtmChem is about to add 2 new versions of the Table, to see which one people find more useful.
5/ We are going to make some additional updates. If you have suggestions, please enter them in this form:

forms.gle/DcYETdg1dFaV2V…
6/ Note that the estimator has a goal of making the calculations explicit ("open source") and to be easy to modify and adapt for people familiar with spreadsheets.

There are other estimators that do the same calculations but may be easier to use. E.g. …re-modeler-data-devils.cloud.duke.edu
7/ As part of the update I also wanted to link to all the other airborne transmission estimators out there. To my knowledge they all do the same thing, but vary on the details.

If you know of one that we are not linking to, please enter it at forms.gle/DcYETdg1dFaV2V…
8/ We've added two new versions of the Table today, discussed here. Poll asking for feedback on that thread.

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More from @jljcolorado

2 May
1/ A SIMPLE WAY TO ESTIMATE THE RISK OF INDOOR SUPERSPREADING

Our preprint using the airborne transmission model

Captures the literature outbreaks well. So we can use it to see whether an activity is at risk of superspreading

Also to compare diseases

medrxiv.org/content/10.110…
2/ It can be very confusing to estimate how risky different activities are, depending of size of space, duration, number of people, vocalization, intensity of breathing, ventilation, air cleaning, masks + their quality + fit.

We combine it all into a single parameter, rigorously
3/ We'll explain the parameter(s) later, but first let me convince you that it works.

The key is Fig. 1 b:

- X-axis is risk parameter in log. scale. MUCH riskier to right, MUCH less risky to left
- Y-axis is attack rate (% of people present infected in outbreaks)
Read 34 tweets
30 Apr
1/ Dental office visit

Small room, windows closed, no ventilation system. CO2 got to 1350 ppm. Probably ~3 ACH, given rise time

Both me and provider vaccinated. Provider wearing well-fit KN-95 and eye protection. I wore surgical mask over nose, breathed from there + eye prot.
2/ They had small air purifiers by Medify (relative size as in pic; medifyair.com/products/medif…).

Reception area: set at 1 of 3, could not feel any air. Turned to 3, made more noise, started to feel air.

Procedure room: set to 2, I asked to turn to 3, noisier
3/ Not impressed, despite some precautions. I was not too concerned due to vaccination. But there ar other respiratory diseases, they need to do better, I'll let them know.

Repeated problem: HEPA filters viewed as "talisman" by being there. Even if too small and at low setting!
Read 4 tweets
28 Apr
1/ COVID-19 has "anisotropic" infection:

Despite 100 times LOWER dose, monkeys infected by SARS-CoV-2 thru aerosols developed MORE SEVERE respiratory disease and lung pathology (vs. nose/trachea)

Preprint from US Army Infectious Diseases Research Inst: biorxiv.org/content/10.110…
2/ This further argues for the importance of aerosols over large droplets, adding an 11th reason to the 10 that we summarized in our recent @TheLancet paper (thelancet.com/journals/lance…)

A step-by-step explanation in this thread:
3/ Note that this has been demonstrated for other diseases such as the flu, for which the intranasal dose needs to be 100000 (one hundred thousand) times larger to lead to the same symptoms, compared to aerosol infection. See:
journals.sagepub.com/doi/abs/10.318…
onlinelibrary.wiley.com/doi/abs/10.100…
Read 11 tweets
22 Apr
1/ BUENAS NOTICIAS: DONACION DE 46 NEVOS MEDIDORES DE CO2 A LATINOAMERICA (Y COMUNIDAD HISPANA EN USA / CANADA)

Hasta ahora hemos donado 80, ~45 a Latinoamérica y ~35 a España.

Esos los hemos pagado con donaciones vuestras, de @AlejandroC_IQ, @citlanx, @EspanaAranet y mías
2/ @SAFTehnika, fabricante de los Aranet4, se ha enterado de nuestra campaña, y contribuye donando 51 Aranet4 más!

46 están en EEUU y pueden ir a Latinoamérica y comunidades hispanas (o de bajos recursos en Canadá y EEUU).

5 van a Europa, tratando de llegar a nuevos países
3/ Muchísimas gracias a @SAFTehnika por esta generosa contribución.

Y muchas gracias a @citlanx, distribuidor de Aranet 4 (naltic.com/aranet4-co2.ht…), que hace todo el trabajo de logística y los envíos voluntariamente sin coste.
Read 12 tweets
17 Apr
1/ TEN SCIENTIFIC REASONS IN SUPPORT OF AIRBORNE TRANSMISSION OF SARS-CoV-2

Peer-reviewed publication in @TheLancet

An honor to have collaborated in multidisciplinary team across medicine, infectious diseases, epidemiology, aerosol science, sociology

thelancet.com/journals/lance…
2/ The authors are:

- @trishgreenhalgh, Prof. of Medicine at Oxford Univ., pioneer of evidence-based medicine (EBM)
- @DFisman, Prof. at Univ. of Toronto, epidemiologist
- @chipatucsd, Prof. of Medicine at UC-San Diego, Chief Editor of journal "Clinical Infectious Diseases"
3/ The rest of the authors:

- @kprather, Prof. UC-San Diego, member of US National Academies of Science and of Engineering, aerosol scientist
- @zeynep, Prof. Univ. of North Carolina, sociologist
- Yours truly, Prof. Univ. of Colorado, Highly Cited Scientist, aerosol scientist
Read 46 tweets
17 Apr
1/ JOHN SNOW Y EL COLERA, Y LOS PARALELOS CON COVID Y LOS AEROSOLES

Traducción del hilo del epidemiólogo canadiense @DFisman (coautor de nuestro paper del Lancet)

2/ Brevemente:

- Hay epidemia de cólera en Londres
- Se piensa que se transmite por el aire
- John Snow investiga y se da cuenta que los casos se concentran alrededor de una bomba de agua
- Quita el asa de bomba de agua, y la epidemia de cólera se para

en.wikipedia.org/wiki/John_Snow
3/ @DFisman: "Es bueno recordar q prácticamente todos los expertos de salud pública pensaban q John Snow estaba equivocado cuando dijo q el cólera se transmitía por partículas en el agua demasiado pequeñas para verlas

Modelo dominante era q se transmitía por un gas, una miasma"
Read 27 tweets

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