For the past 20 months, experts in Aerosol transmission of respiratory viruses have been conducting studies that prove #COVIDisAirborne. These experts have called for Airborne mitigations (ventilation, filtration and respirators), but we have not heeded their calls. Why?
🧵1/13
The ID/PH Evidence-Based Medicine gatekeepers, driven by biased #DropletDogma groupthink, and sunk cost fallacy, smugly dismissed these studies. They threw rocks at the conclusions, and perpetually raised the bar of evidence to accept and mitigate Airborne Transmission.
2/13
The criticisms from these self-anointed gatekeepers were ripe with logical fallacies, and they never bothered to offer a plausible alternate explanation for the undeniable indoor superspreader events. Just baseless declarations that COVID is NOT Airborne.
3/13
See this excellent thread for the perspective and play-by-play from a prominent aerosol transmission expert, @drkristenkc
These dispassionate, aloof gatekeepers (which include @WHO IPC officials), had raised the bar of evidence for Aerosol transmission so high, that even Measles and TB (accepted Airborne pathogens) fail to meet it. See thread here.
Well, in the past *2 WEEKS* alone, 5 groundbreaking papers have been released, the totality of which leaps over the unreasonably high bar set to establish Airborne Transmission. Here's the summary. TLDR: #COVIDisAirborne
6/13
Let's go through the studies. First up, Coleman et al, released Aug 6, 2021.
Viral RNA was detected in respiratory aerosols. Fine aerosols (NOT DROPLETS) constituted 85% of the viral load detected in the study.
Next, Hawks et al (Preprint released Aug 10, 2021) cultured infectious virus in aerosols emitted by Syrian Hamsters. The majority of virus was found in Aerosols <8um. Ie. VIABLE virus was cultured in RESPIRABLE Aerosols.
Third... Adenaiye, Milton et al (preprint released Aug 13, 2021), detected viral RNA in aerosols emitted by humans, cultured VIABLE virus in fine Aerosols from 2 samples, and found SARS2 is evolving toward more efficient Airborne Transmission.
Next up... Port et al (released Aug 17, 2021) successfully infected Syrian Hamsters via the Airborne route, and found that Airborne Transmission was both more efficient and led to more severe disease than Fomite Transmission.
Finally, Santarpia et al (Aug 18, 2021), detected viral RNA in all air samples from patients' rooms. They also successfully cultured VIABLE virus from 3 sub-micron aerosol samples, including observation of an intact SARS2 virion in 1 sample.
This evidence likely won't be sufficient for some, but know that the only higher level of evidence would be human experimentation involving intentional Airborne infection. This is dangerous given the implications of Port et al (Airborne leads to more severe disease).
12/13
The jig is up. Intransigent ID/PH experts, who have resisted Airborne transmission, need to "follow the science" and own up to their past failures. If their egos won't allow this, they are welcome to fade away into obscurity, just as long as they get out of the way.
This week, @TorontoStar published 2 articles re. whether the public should upgrade their masks for the Delta wave.
That's good, except that they chose to interview ID experts steeped in #DropletDogma, who thoroughly muddied the waters on this critical, life-saving topic.
🧵1/
First is this story, which asks: Is it time to upgrade your mask? The obvious answer is YES!! But instead of giving this unequivocal advice, the article muddies the issue, providing reckless quotes from the Ministry of Health and biased IPAC officials.
The @Telegraph released an article claiming "we're still not completely sure how coronavirus spreads or how to stop it", muddying the waters re. Airborne Transmission.
If I were a hostile foreign state, with a goal of prolonging the Pandemic in the West, I would write this.
🧵1/
I'm not surprised that the usual WHO IPC Consultant suspects, continued to preach the biased tenets of #DropletDogma via their interviews in this article.
What shocked me is the lack of scientific fact-checking from the so-called "Science Editor" @sarahknapton.
2/
Two egregious things stick out, which amount to journalistic malpractice.
1) Citing the interviewees biased, failed review as evidence that Airborne Transmission isn't occurring
2) Referencing year-old, obsolete comments from Dr. Klompas, without mentioning his recent work
Any mask will provide some source control, but given Delta's formidable transmissibility, it's time for #bettermasks to maximize protection for ourselves and others.
☑️FILTER
🟠GOOD: A 3 ply, tightly-woven, cloth mask with a polypropylene inner layer
🟡BETTER: ASTM rated surgical masks, Level 2 or 3
🟢BEST: KN95, KF94, N95, Elastomeric Respirators
But since COVID spreads in aerosols.. we also need to #mindthegaps with a good FIT...
2/
☑️FIT
🟠GOOD: Thin cloth mask over a surgical mask, or use ear-saver/hair clip.
🟡BETTER: KN95/KF94 respirator with user seal-check, or mask brace on surgical mask.
🟢BEST: N95/N99/Elastomeric Respirator with user seal-check. If high-risk worker: Fit-Tested Respirator
There has been a multi-day debate occurring amongst @AntibioticDoc and many engineers and Aerosol scientists, regarding whether there is sufficient evidence to use HEPA filters to mitigate against Airborne Transmission of SARS2.
For those following this HEPA filter thread – this is a really important acknowledgement. It’s clear from the thread, and this particular tweet, that many Infectious Disease experts still doubt that aerosol transmission is an important/mitigable transmission route for SARS2🧵 1/
While they acknowledge aerosol transmission can occur, they believe it is a rare event occurring in special circumstances, and is therefor not worth the $ to mitigate.
Eg. re HEPAs: "We need to resource by best impact", "Changes need rigorous justification and business case".
2/
See my pinned tweet for a thread summarizing the overwhelming evidence that Aerosol Transmission is an important and mitigable route. At the end, I provided a reference list and posed a question to the ID holdouts - no responses yet. 3/
During Friday's debate with @kprather88 and @DFisman, Dr. Conly raised a fairly common counter-point for why he thinks COVID is NOT Airborne: the relatively low Secondary Attack Rate (SAR) and Reproduction Rate (R0).
Let's unpack this flawed argument in a 🧵
1/
Dr. Conly states the SAR is 3 to 10%, with a household mean of 18%.
He then correctly points out that there is significant heterogeneity within the data, which means some people transmit to no contacts, while others transmit to everyone.
2/
After admitting to the heterogeneity, he cautions we "have to be careful not to draw conclusions" from these superspreaders... eg. Chalet (73% SAR), Choir (53%), and Diamond Princess (58.9%). He suggests there were "extenuating circumstances", and seems to dismiss them. 🧐
3/