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David R Tomlinson 💙 Profile picture
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5 May, 7 tweets, 6 min read
SARS-CoV-2 routes of transmission & recommendations for preventing acquisition: joint @biainfection, @HIS_infection, @IPS_Infection & @RCPath guidance.
@loveebhc @dr_jas_islam @microlabdoc @trishgreenhalgh @kprather88 @DFisman @zeynep @jljcolorado
journalofhospitalinfection.com/article/S0195-…
I am sorry I can only copy two lead authors directly, but I would like to thank all authors for acting on their high sense of responsibility towards improving public health.

I am also sorry I could not reply within the 7-day window you provided for 'stakeholder feedback'.
I hope you don't mind a Q?
Given:
- Epidemiological studies support airborne transmission
- Presence of virus RNA in the air, air vents/exhausts/ducts/filters
- Presence of virus RNA in exhaled breath
- Airborne viability up to 16 hours
- Presence of live virus in the air
...
I hope you don't mind me suggesting that you are being 'obtuse' in stating:

'Overall decision for likelihood of transmission
Droplet: probable
Airborne: possible (in some circumstances, especially AGPs)'

Surely these data provide proof of airborne SARS-CoV-2 transmission?
Furthermore, I am staggered that you remain anchored on the preeminent importance of AGPs towards airborne transmission. Have you not seen these data (Oct 2020) indicating far greater aerosol release during coughing? @ShellyMBoulder @linseymarr
Lastly, stating that "SARS-CoV-2 appears to spread via the routes commonly implicated in transmission of other respiratory viruses" highlights the success of those with vested interests in suppressing the message that respiratory viral transmission is airborne!
Pic @Don_Milton
Last Q: why is it so important for you & other 'experts' to suppress the message that for SARS-CoV-2 (& other respiratory viruses, like influenza), human-to-human transmission occurs *predominantly* via the airborne route?
I hope you can help me understand

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More from @DRTomlinsonEP

David R Tomlinson 💙 Profile picture
9 Apr
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]
Read 18 tweets
David R Tomlinson 💙 Profile picture
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
David R Tomlinson 💙 Profile picture
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
David R Tomlinson 💙 Profile picture
5 Mar
Truth. 💙
@FreshAirNHS @theRCN @TheBMA @mancunianmedic @DrLindaDykes @Chakladar_A @KGadhok
tridenthse.co.uk/covid-report.p…
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
David R Tomlinson 💙 Profile picture
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
David R Tomlinson 💙 Profile picture
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

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