The Principal Scientific Adviser, Govt. of India
@PrinSciAdvGoI came out with guidelines on mitigation yesterday. A short 🧵delving further into them 1/

2) This is not the first mention of ventilation related guidance from Govt. of India
mohfw.gov.in/pdf/SOPonpreve… Image
3) #Ventilation related guides have been there since past year.
However, they were not highlighted as much.
And people were not told why to ventilate.
timesofindia.indiatimes.com/world/fresh-ai…
4) A really nice aspect of the recent guidance is that it is prominent, and it tells why people need to ventilate
Also, provides several scenarios to help people think.
5) A small quibble here - the guidance is a bit verbose. Maybe next version will go for more imagery, and more languages.
But, it is a great first start. And it is quite useful as instruction material to volunteers and HCWs
6) So, let us start:
- it can recur and quickly spread, important things to highlight
- asymptomatic spread - also a good point to stress Image
7) Key routes of spread. Good imagery and good numbering highlighting #Airborne spread. Image
8) Once more, asymptomatic/presymptomatic spreads very much possible. Keep masks on even if no symptoms shown. Verbose but good messaging. Image
9) Highlight outdoors less risky and why - because of dilution, as relevant to #airborne nature of this infection Image
10) Talks about dilution and why it is effective to ventilate.
I do not favour the smell analogy too much. You can smell things through masks. So far, the best is smoke. But analogies are not meant to be perfect. Maybe we can brainstorm on this. Image
11) Nice contrast between droplets and aerosols.
The only thing I would add is in a confined space, aerosols will eventually go everywhere, unless ventilated. Forget 10 m, they will make it across the whole house. Image
12) This is really important to depict the nature of masks as a community step. We protect each other. Just me or just you wearing a mask is not enough. Safest is for all of us to wear it and wear it right. Image
13) I would prefer the messaging be a 3 layer, snugly fitting mask rather than double layer.
I love the part emphasizing to wear masks when away from home and at home if you have guests. Also consider wearing masks if someone at home tested positive, unfortunately. Image
14) Like the part about sun exposure to masks. And also double masking, of course. Also highlighted that the outer mask is to make the fit better. Image
15) Scenario based examples for bad/good/ideal ventilation. Love these pieces and I hope they include more scenarios/settings in upcoming communications. Image
16) I like the stress on properly directing air flow (from cleaner to more infectious spaces) though the above image is a bit confusing.
Also, the stress on accumulating viral load in closed spaces - which necessitates ventialtion Image
17) This is good to have - turn a normal pedestal or desk fan into acting as an exhaust fan by proper orientation. Useful tip for many families. Again, could have used better visuals though the above imagery does have it. Image
18) Again a useful scenario for hutments - villages.
It would be helpful to have similar scenarios for urban villages as well.
But the imagery is nice, emphasizing directional flow and need for cross ventilation. Could be useful in long term too - cooking pollution Image
19) Good point bringing in what the authorities can be responsible for. People need to be given guidance and means. Government need not be an idle bystander after instructing. Image
20) Good point for offices employing wall/cassette units of AC
I would say use of exhaust fans, opening windows a few inches if not completely, use of normal fans to get more air in through window, use of fans for comfort instead of AC with windows/doors open also useful points. Image
21) For central systems, the building managers need to play an active role in terms of maintenance, upgrading capacity etc. Also, you cannot keep window/doors open with such systems; that will cause balancing issues. So, better filters centrally plus local air cleaners Image
22) I do like the point above that if you have less than HEPA filters, mark them so. It is good not to lie to your occupants. Explain to them that we want maximum clean air delivery. Sometimes, filters other than HEPA can also do a decent job with delivering lots of #SafeAir
23) Again filters are mentioned. Good to have them in transportation that uses air conditioning. You cannot be sure of directional flow in public transport so let us get as much dilution as possible. Not every window needs to be full-open. Moving vehicle = more air in Image
24) Really important point for ventilating vaccination and test centers Image
25) Providing masks to people - need wider mask distribution - distribution of good quality masks. Image
26) Overall, a really good start. I hope they keep up the trend and repeat this messaging.
I have modified some of the positioning of the images as per my sensibilities. Please find the original document here - static.pib.gov.in/WriteReadData/… \end

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More from @akm5376

23 May
The word Swaraj is a sacred word, a Vedic word, meaning self-rule and self-restraint, and not freedom from all restraint... - M K Gandhi
"Freedom" should mean freedom to wear a mask to protect the society you are part of
"Freedom" should mean the self-restraint to stay indoors if you do not need to go out
"Freedom" should mean avoiding crowding to protect yourself and others
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23 May
I will tell you the story of an open #window which did not work, from personal experience. Short 🧵on prescriptive vs performance based guidance 1/
2) Over the past 8-10 months, I have force-fed family members and close friends my opinion on how #COVID19 is #Airborne and so irrespective of govt. or public health bodies guidance, they are more or less aware of preventive measures that could work.
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Read 16 tweets
16 Apr
A quick 🧵 highlighting some points from the brilliant @TheLancet article authored by @trishgreenhalgh @jljcolorado @kprather88 @zeynep @DFisman @chipatucsd 1/
2) This will be biased since I admire and respect the authors - so that is my admission.
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thelancet.com/journals/lance…
Authors provide arguments in favour of their position and detractors are free to come after these points, if they can
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10 Apr
Situational #Airborne is not a real thing if the so-called situations are the norm! A 🧵 of these situations, likely to contain many places or situations you too frequent 1/
2) In a long bus journey - quite normal for many people commuting between home and work places

jamanetwork.com/journals/jamai…
3) From an inflatable costume at a party - unless you lack a friend group, you will be going to some parties/gatherings?
nytimes.com/2021/01/03/us/…
Read 23 tweets
8 Apr
#COVID19 and a tale of two gyms in a 🧵
Gyms are high risk situations since you are exerting and breathing in a lot more than you would usually do. Everything else remaining same, a gym could be 5 times more risky than a classroom 1/
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globalnews.ca/news/7744065/q…
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Final result 419 cases and counting
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2 Apr
What do we mean by #UseAirbornePrecautions? There are clear guidelines in health care settings, but what do we mean by it for the public? A 🧵 of 🧵(met-thread) on this. Strap in, this will be long 1/
2) First, this is not the first #airborne problem we have faced, and it won't be the last. And not all of them are exotic pathogens. Some could be as mundane as dust, smoke, pollens, volatile/semi-volatile organic compounds. They are all around our living space
3) Not all #airborne troubles are created equal. For example, I am a lot more allergic to cigarette smoke than incense. This varies from person to person and trouble to trouble. Some do not have any smell and can still be a "headache".
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