1/ A SHORT THREAD ON HOW THE UPCOMING INFECTION CONTROL CONFERENCE IN GENEVA EXPLAINS WHY WE CAN'T CONTROL COVID
Firstly, it is fair to observe that Prof Didier Pittet is what they like to call in those parts, "Le Patron", of this conference. ("Mr Big" en anglais.) 👇
2/ Mais, qui est Professor Pittet? Well, he is a staunch proponent of the importance of hand hygiene, an important intervention in infection control, as Dr Ignaz Semmelweiss would certainly attest. Professor Pittet's Twitter profile shows us how strongly he feels about it. 👇
3/ You can read more about Professor Pittet's signal achievements in relation to hand hygiene and his many, many, many, many honours at his Wikipedia page, which he links to on his profile. en.wikipedia.org/wiki/Didier_Pi…
4/ Washing your hands, like motherhood, apple pie and that blissful feeling of driving away from the hospital after a series of nights, is A Good Thing. However, as we have had confirmed in the last two years, it's not the only thing, or even the most important thing...
5/ ... when it comes to the transmission of respiratory viruses like COVID-19. Beyond any doubt, we know that airborne transmission is the most significant mode, as this excellent review by @kprather88@jljcolorado et al published this week details. 👇 science.sciencemag.org/content/373/65…
6/ So, let's see what a text search using the words "airborne" and "ventilation" comes up with on the programme of this infection control conference at the most critical time in a hundred years for infection control. This is the programme. 👇 conference.icpic.com/wp-content/upl…
7/ Searching for "airborne", we come up with one reference, not in a presentation, but in the title of the 145th scientific poster:
8/ Searching for "ventilation", we also come up with just one reference, also not in a presentation, but again in the title of a scientific poster, the 79th:
9/ And that's it. The world has been turned upside down by a deadly, highly transmissible airborne virus and the topic of airborne transmission and associated mitigations is essentially entirely absent from this supposedly world-leading IPC conference.
10/ Importantly, however, what does make it into the list of presentations is a reminder - lest we may have somehow forgotten (Quel horreur!) - that Professor Pittet was appointed BY NO LESSER A PERSON THAN PRESIDENT MACRON HIMSELF to lead a mission into COVID-19:
11/ The programme of this conference in Geneva, then, helps us understand why the world is in such desperate straits with regard to controlling this airborne-transmitted virus. You see, the @WHO is based in Geneva and Professor Pittet is "Un grand fromage" there ("A Big Cheese"):
12/ And that, children, demonstrates how a century old screw-up over infection control, a hitherto obscure controversy fought out in the dusty corridors of academia, has killed millions, brought the entire world to its knees and shows no signs of abating. wired.com/story/the-teen…
13/ Thank-you for reading. You may now turn your attention back to surveying the wreckage of your respective, devastated countries, their horrific catalogues of human suffering and economic ruin unthinkable less than two years ago.
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1/ WHEN HUMAN LIVES BECOME ECONOMIC UNITS
As doctors we go to extraordinary efforts to save a single human life. And when things go wrong - even when they're not our fault - we beat ourselves up about it, try to figure out what went wrong and try not to repeat it.
2/ Politicians are entirely relaxed about sacrificing (killing and maiming) large swathes of the population for the benefit of their political donors. There is no real accountability for this and through talking in generalities they normalise fascism and eugenics.
3/ That's it. That's the difference. To us doctors you are all humans with special lives and a unique, invaluable existence. To the politicians, you are numbers, economic units, and can be subject to acceptable levels of attrition for the sake of utility.
1/ WHY I'M ABOUT TO SPEND $3000 ON A PAPR (PPE)
I am going to buy one of these this week. It's a Cleanspace HALO lightweight PAPR. It delivers filtered, positive pressure air to a comfortably fitting mask for up to nine hours on a single charge.
2/ The 'fit factor' for this mask is usually around 5,000, compared to 100-200 for a disposable N95. In this study from Singapore it proved completely protective for HCWs. cleanspacetechnology.com/dr-swan-austra…
3/ A few hospital units in Australia are already using this Australian-made product, but it is still rare. Well, I have decided to spend $3000 and buy one and this is why:
1/ HOW TO LIVE WITHOUT COVID-19: A PRIMER
The maddening thing about our (the world's) situation is that the tools to live without COVID are all readily available and technologically simple to implement. Read on to see how we can (and must) LIVE WITHOUT COVID...
2/ VACCINES
These are incredibly effective at preventing the most severe illness and death, much less so at preventing infection and transmission. But look, we haven't even had them for a year. They are an extraordinary scientific and technological achievement.
3/ They will be refined and developed in years to come and there is no reason to believe we will not eventually develop sterilising vaccines that will reduce transmission and have the potential to lead to herd immunity.
1/ I'm offering this reflection to help people understand what's going on. Many think thusly: "It's not worth going to much effort if only 1% of people die of this. Normal population growth will fill that in an instant. Not even noticeable."
2/ "And anyway most of those deaths will be the old or those with comorbidities. Sure, there'll be a few younger, healthy people. Or kids. But there's always collateral damage. Shit happens, man. Got to put on big boy pants and deal with it."
3/ "And look, we are keeping too many people alive these days anyway, what with the welfare state and medicine. It's an expensive drag on society, which WEAKENS us. This is actually cleansing for society, like an enema: unpleasant during, but a relief after."
Italy's largest kids hospital.
400% INCREASE IN HOSPITALISATION OF CHILDREN with Delta compared to previous variants.
"The age of the sick varies from the very youngest of 10 months up to adolescents of 15 years. Villani: "Now children must be vaccinated." roma.repubblica.it/cronaca/2021/0…