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Lazarus Long Profile picture
@LazarusLong13
Nov 12, 2021 • 16 tweets • 9 min read • Read on X
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A thread on ambulance ventilation.

And why you are going to see more staffing EMS staffing shortages - resulting in you laying forever next to your wrecked car.

Waiting to be picked up by CoVid+ EMT's in surgical masks.
Study is here - click the PDF button....or just ride along in this clown car.
researchgate.net/publication/33…

Looks like in the USA, there are no standards for ventilation in ambulances.

Used to be 30 ACH..which would be amazing.
In the UK, they recommend not using the recirculating air during AGP's, during pandemics.

assets.publishing.service.gov.uk/government/upl…

Currently, surgical masks as long as within 6 feet of the CoVid+. No recirculating.
gov.uk/government/pub…

All based on WHO guidance. (Foreshadow.)
The default ventilation of the ambulance is 5 ACH, IF the exhaust blower was on.

They replaced the default ventilation tho with the below HEPA filter, so they could get accurate measurements, avoiding external aerosols, and reset quickly.

Quite clever.
americanlaboratorytrading.com/lab-equipment-…
Here's the rest:

"For each test, four optical particle counters
(OPCs) were placed in locations representing possible positions for a seated EMS worker treating the
patient. OPCs were placed in the positions labeled OPC 1-4 when the cot was at 0° or 30°, and positions ..."
Before going on, let's touch on the 5 ACH that all of you will be hit with in surgical masks.

Even with surgical masks on, we have certainly seen a huge number of outbreaks in hospitals with 6 ACH (better) ventilation
and continuous surgical masking.

For example, Alberta Health Services, @AHS_media, which is the embodiment of the @WHO's IPC guidance.

Stands to reason as Dr. Conly rules over AHS AND the WHO with a very clean fist.

Back to our clown car, Lindsley (yep, the famous one) found that a single cough resulted at least some worker exposure.

Given that Delta is everywhere, and we now know it takes under 3 virii to successfully infect?

Not good.

Might not be a bad idea to buy a @FixTheMask brace
in case you have to go to the hospital or even ride in an ambulance.

Or make the 3 rubber band version and keep it in your wallet or purse:


Why would there still be exposure?

"Air circulation pattern in the ambulance patient compartment generated by...
the ventilation
system. The jet of air created by the air inlet causes a clockwise recirculation pattern to form which
circulates aerosol particles throughout the compartment. Even if the cough is directed toward the rear
of the ambulance, aerosol particles are carried
toward the front by the recirculation. Thus, a worker
anywhere in the ambulance is exposed to the cough aerosol particles."

Thus, you will be exposed to the same.

But does it have to be this way?

No. Or I should say, N100.

The same solution as in this thread that was
slightly viral about 25 years of no infection in the Texas TB hospital:


And the same solution being used today by NYC's EMS:
nydailynews.com/new-york/ny-fd…
But the story does not end there.
Did you know that someone tried putting a HEPA filter into an ambulance?

cdc.gov/niosh/hhe/repo…

"The effective
air change rates ranged from about 43 to 46 ACH in
the HEPA ambulance, and from 26 to 32 ACH in the
non–HEPA ambulance."

This provides further proof that
portable air cleaners such as the Corsi/Rosenthal Box are additive to any current air cleaning infrastructure.

And...they help remove aerosols much faster.

The message is the same because this is NOT rocket science.

Vax.
N100.
HEPA if you can afford it.
CR Box if you can't
A very cool simulation model study confirming what Dr. Noakes shared below. Thank you!

1 - An ambulance transport with a patient actively emitting a virus.
2 - A subsequent transport with an uninfected patient <- very interesting setup here.

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More from @LazarusLong13

Lazarus Long Profile picture
Sep 7
COVID is as transmissible as measles?!

"BUT, BUT, measles can infect up to 90% of people they are in contact with!"

So can COVID.

Time to wake up. The lecturer tried to promote sales of a flax oil product, and many elderly people were lured to attend by the promise of free eggs, Xinhua News Agency reported. He gave three lectures on Jan 10 and 11 in a Tonghua classroom while not wearing a mask, with each lecture lasting about 2.5 hours. A total of 97 people, most of them retirees, attended the lectures in a classroom whose doors and windows were closed, the China CDC report said. The lecturer went to a pharmacy at noon on Jan 10 due to muscle pain and other symptoms, indicating he was likely at an early stage of the disease then, it ...
weekly.chinacdc.cn/en/article/doi…

govt.chinadaily.com.cn/s/202102/20/WS… Image
So, some will be pushing back - always welcome, albeit this is anticipated.

Rnaught is just an estimate.

The famous measles 12-18 is shown below.

But the R0 of 6-8 has the most estimates.

Free
sci-hub.se/https://doi.or…

Pay
sciencedirect.com/science/articl… Image
Read 8 tweets
Lazarus Long Profile picture
Sep 6
Remember THAT scene from Outbreak with Dustin Hoffman - "It's Airborne." ?

SARS-COV-2 is airborne via HVAC. Just like TB is - but it is way more contagious.

Still no panic, right? We know how to be safe.

Motel 6, or AirBNB - no shared HVAC, is best.

But HOW do we know?

🧵
A recent study in South Africa used Syrian Hamsters to duplicate the study that finally convinced everyone that TB was airborne.

The TB study is interesting because the military vets in VA hospitals were getting infected disproportionately.

So, they used HVAC ducting to In 1956, tuberculosis was a major global killer, and it disproportionately affected military veterans hospitalized in the Veterans Administration hospital system. Then, as now with COVID-19, epidemiologists held that tuberculosis and other respiratory diseases were spread by large infected droplets through person-to-person contact or contaminated surfaces. But Richard L. Riley, an expert on lung physiology at the then Johns Hopkins School of Hygiene and Public Health, and his mentor, William F. Wells, had identified another possible mode of transmission.
connect a 6 room TB ward to 150 guinea pigs.

Of those 150, only 3 PER MONTH got infected.

Illustrating that TRANSMISSIBILITY is just a CLUE to if something is airborne.

Dr. Riley went on to patent UVC tech, and develop the Wells-Riley equation which is so important in airborne Atop the Baltimore VA Hospital, they constructed an air-tight closed ventilation system that connected a six-room tuberculosis ward to an exposure chamber with 150 guinea pigs. (Among rodent animal models, only guinea pigs could cough and sneeze, making them ideal for studying how respiratory diseases spread.) The guinea pigs were exposed to the infected air over a four-year period. A second group of 150 guinea pigs acted as controls: their air ducts were irradiated with UV-C lamps to kill TB bacilli.
In the test group, an average of three guinea pigs per month contracted TB, while no controls were infected. The experiment not only proved the airborne disease transmission of tuberculosis for the first time, but also quantified how many TB infections could be expected to result from exposure to a given number of patients over a defined interval.
The insights from the Baltimore VA Hospital studies were later used to develop the Wells-Riley equation, which quantifies infection risk and informs strategies to ensure staff and patient safety in contagious clinical environments. The model can also calculate the risks of transmission for airborne infections on planes and trains, in prisons, and in other public and institutional spaces. As chair of the Department of Environmental Medicine from 1960 to 1977, Riley warned that the danger of infection from airborne diseases was increasing as people spent more time indoors and air conditionin...
Read 8 tweets
Lazarus Long Profile picture
Sep 1
Plaque, Stephan's Curve (Imperative) mixed with breakfasts that you can brush immediately after.

It's actually best if you brush immediately up on waking up. This gets the overnight plaque.

It starts forming 4-6 hours after you sleep - your saliva is 20 millititers/hr Dental Plaque on the bristles of a used toothbrush. Yep, that came out of your mouth.
- during the day. At night? Just 3-6 ml.

Saliva washes away the bacteria, it contains bicarbonate, phosphate, and protein buffers that neutralize the acids being pooped out by the bacteria.

It also has the below ingredients. Who knew saliva was so cool?!

Or plaque? Antimicrobial Components Lysozyme: breaks down bacterial cell walls. Lactoferrin: binds iron, starving bacteria. Peroxidases: inhibit bacterial metabolism. Immunoglobulin A (IgA): prevents bacterial adhesion to teeth.
Plauque forming bacteria.
By brushing first thing, fluoridating, and then waiting a 1/2 hour before eating, you just prepped your teeth for their Acid Trip through the day.

Like if you like salsa on your breakfast burrito like I do.

But what is a good breakfast if you have NO TIME to wait for the 60 tripping the light fantastic.
Read 35 tweets
Lazarus Long Profile picture
Aug 27
Ah, it's that time of year again. The pitter patter of children's feet. The laughter of high school students as they flirt with each other.

The coughs of their parents.

Is a Portable Air Cleaner (PAC) on a desk aimed at the wee ones' faces going to protect them? Spicoli from Fast Times at Ridgemont High with a Levoit Air Cleaner pointing at his face braced up with a weight. In the middle of his pizza. Not cool, man, not cool.
TLDR? No. They need to be in a N95 or KF94 purchased from legit distributors, not from Amazon, and eat their food outdoors, spaced far enough away from their friends so as not get infected. Or use @sipmask and protein shakes at lunch in the cafetaria.

You need to teach them
about how it can take as little as one breath of uncleaned-air to get infected (100 virions study on my profile). How it can mess them up in terms of their entire body.

You need to have the "Birds and the Bees and Covid" talk, in other words.

But will a PAC aimed at their
Read 24 tweets
Lazarus Long Profile picture
Aug 23
People often underestimate the power of having someone with the reputation of Wolfgang Leitner, weighing in.

This is truly a significant development.

Personally, I prefer to let the studies do their own talking, but Voice Of Authority bears considerable weight in the real world
Just a few awards Image
An actual Conference Organizer. You underestimate the political savvy and pull this takes - and gives them. Image
Read 7 tweets
Lazarus Long Profile picture
Aug 21
Calley is lying from the very first sentence. The media is not cheering for MAHA to fail. They are cheering for antivaxxers to fail.

We all want to see better food, less chemicals.

But we are not idiots.

The single largest gain in American life expectancy was
between 1900 and 1940, primarily because of improved water & sewer sanitation. Adding 16 years of life expectancy.

And vaccines are a close second - adding 5-10 years a bit later - in the last half of the century.

If we get rid of vaccines? We lose 5 to 26 years, depending
if we lose smallpox and diptheria.

There's another thing. Calley wants us working on the below things.

The Red Arrows point to things that will not mean a thing because of the next tweet. Image
Read 15 tweets

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