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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
Feb 23
Great interview of Ed Yong - I am just covering the C0V1D part.

/1 The Interview Ed Yong Wants to Show You the Hidden Reality of the World Ed standing with his arms folded. His eyes tell you COVID is not over.
You've been clear in saying that C0V1D has not gone away. You ask people to wear masks at your events..... You’ve been clear in saying that Covid has not gone away. You ask people to wear masks at your events. But that attitude is not necessarily where the rest of the world is. How do you think about continuing to take precautions and advising others to do so when it feels as if society has moved on? I do it for a bunch of reasons. Firstly, I have learned that I enjoy not being sick. I know that the cost of long Covid is real and substantial, and I don’t want to run that risk lightly.
"I think it makes a huge difference to them to have the person at the front of the stage wear a mask. It tells them, It’s not weird." . I also know that I have many friends and people I’m close to who are immunocompromised. So for the sake of the people around me, I also don’t want to get sick. When I do events, I wear a mask for those reasons, and because I know that every time I do a talk, while the vast majority of people in the audience have probably moved on, there are going to be other people who haven’t. I think it makes a huge difference to them to have the person at the front of the stage wear a mask. It tells them, It’s not weird. So I do it for that reason, too. In terms of holding this line at a point when a l...
Read 5 tweets
Lazarus Long Profile picture
Feb 22
I am sorry if this will upset you. A lot of people depend on NASAL SPRAYS for C0V1D.

I have been iffy on them, but viewed them as "if they don't hurt, why not" but not for me.

There's an analysis
on Reddit that you should read in detail, and make up your own mind.
/1
Here is the link:


Here is a 4 tweet TLDR version.

Here is how it starts - the author goes HARD at the underlying studies. reddit.com/r/ZeroCovidCom…There is no convincing evidence that nasal sprays prevent COVID-19 There is a lot of misinformation out there about nasal sprays preventing COVID-19. Unfortunately, there are no convincing studies showing that nasal sprays prevent COVID-19. The published studies investigating whether or not nasal sprays prevent COVID-19 each have major issues, which I will detail here. I have a PhD in biochemistry and one of my PhD projects was on COVID-19. The main takeaway of this post is that there is no sound evidence that nasal sprays prevent COVID-19. Thus, nasal sprays should not be used for COVID-...
Some pretty harsh language, but to me the important thing is we still have clean air.

Which is good, because it boils down to only 2 studies saying that nasal sprays work, per them. 5. Summary/TLDR and final thoughts Unfortunately, many people including covid influencers have fallen for the grift of nasal sprays preventing COVID-19. Some such influencers have promoted these nasal sprays for free and helped spread the misinformation that they prevent COVID-19. Unlike with nasal sprays, there is ample, sound evidence that high-quality well-fitting respirators, ventilation and air purification prevent COVID-19. The human clinical trials testing whether or not nasal sprays prevent COVID-19 are garbage, and to my knowledge there are only two! Please don't lower your covid...
Read 7 tweets
Lazarus Long Profile picture
Feb 17
Guillain-Barre Syndrome linked to poultry eggs? H5N1?!

The BBC had a good article from February 3 that talks about how these Indian states' cases are linked to campylobacter jejuni, a bacteria. It IS the most common root-cause, globally.

And IT is commonly found in poultry. AVOID CHICKEN AND EGGS RIGHT NOW SIGN showing for the country of India in a tweet from @alwaysmadesh. Due to Guillain-Barre Syndrome.
"Campylobacter jejuni infection is the common associated microorganism (25–40%), followed by cytomegalovirus (6–15%), Mycoplasma pneumoniae (3–21%), and Haemophilus influenzae (1–9%)"

BTW - Cytomegalovirus is also an airborne virus - that just happens to cause brain cancer.
Mycoplasma pneumoniae - also airborne.

And...drum roll please...Campylobacter jejuni also airborne.

Don't get me wrong - jejuni most definitely is also fecal-oral, no question.

But it's also airborne.

Sampled from the air below. Figure 7. GCN/m3 results using microorganism-specific primers. These microorganisms were chosen for their pathogenic and opportunistic nature. Samples 1–12 indicate the WWC collections in House A, 1R–12R the WWC collections in House B and 1F–12F the filter collections in House A.
Read 11 tweets
Lazarus Long Profile picture
Feb 13
Just a little bit closer to acknowledging H5N1 is airborne.

3 vets asymptomatic, + for bird flu antibodies. Did not wear respiratory gear or glasses.

Did wear gloves and coveralls - so rules out fomites.

One practicing in states with NO H5N1.

Vets get very close to /1 No seropositive practitioner knew that they were working with dairy cattle with known or suspected HPAI A(H5) infection. None of the seropositive practitioners reported wearing respiratory or eye protection while providing veterinary care to cattle. Neither respiratory or eye protection is recommended when working with uninfected animals in regions without confirmed cases; however, safety goggles and a respirator are recommended when working with uninfected animals in regions where there are confirmed or potentially infected animals (4).
Among 150 bovine veterinary practitioners, three had evidence of recent infection with HPAI A(H5) virus, including one who only practiced in two states (Georgia and South Carolina) with no known HPAI A(H5) virus infection in cattle and no reported human cases (1,2); this practitioner reported no exposures to animals with known or suspected HPAI A(H5) virus infections. These findings suggest that there might be HPAI A(H5) virus–infected dairy cattle in states where infection in dairy cattle has not yet been identified, highlighting the importance of rapid identification of infected dairy cat...
aerosol sources. Aerosol orifices.

This lines up with previous studies.

"93% glove usage and 85% boot covers would have stopped transmission" 93% glove usage and 85% boot covers would have stopped transmission CDC PPE Study of Dairy Workers Infected. 11/7/2024 Dairy workers exposed to ill cows during the week after A(H5N1) virus detection reported higher use of gloves (93%), boots or boot covers (83%), head or hair covers (79%), and eye protection (76%) compared with those who reported exposure to ill cows in the week before detection of HPAI A(H5N1). Reported use of N95 FFRs or other respirators and other types of masks was low (9% and 27%, respectively) among workers exposed to ill cows the week before A(H5N1) outbreaks were d...
CDC PPE Study of Dairy Workers Infected. 11/7/2024 Dairy workers exposed to ill cows during the week after A(H5N1) virus detection reported higher use of gloves (93%), boots or boot covers (83%), head or hair covers (79%), and eye protection (76%) compared with those who reported exposure to ill cows in the week before detection of HPAI A(H5N1). Reported use of N95 FFRs or other respirators and other types of masks was low (9% and 27%, respectively) among workers exposed to ill cows the week before A(H5N1) outbreaks were detected, with higher usage reported among exposed workers in the week...
Veterinarians are one possible vector between infected and uninfected herds/ farms.
Read 4 tweets
Lazarus Long Profile picture
Feb 13
Latest Pew Poll.

Or an exercise on "How well did Biden disappear C0V1D?"

On one hand, 21% of Americans still view C0V1D as a major public threat 21% of Americans still view COVID as a major public threat.
On the other hand, still masking?

6% of Democrats
4% Americans
2% Republicans

Guess when Biden took over on the graph? On the other hand, still masking? 6% of Democrats 4% Americans 2% Republicans Guess when Biden took over on the graph?
Yes - pretty much as soon as Biden took over, he began disappearing C0V1D.

BTW, the last poll was by yougov - masking was at 12% last year. On the other hand, still masking? 6% of Democrats 4% Americans 2% Republicans Guess when Biden took over on the graph?
Read 12 tweets
Lazarus Long Profile picture
Feb 11
What do we need to do to make every healthcare worker in the world understand that flu is airborne?

Get IPC on board.

Let me introduce you to Dr. Zahir Hirji, President of @IPACCanada at #IPAC2023.

Where do we know him from?

That's a very interesting question.

/1 Image
In 2006, Dr. Tellier wrote an article in the CDC EID explaining that influenza was airborne via aerosols.

Quite nicely done.

pmc.ncbi.nlm.nih.gov/articles/PMC33…
Dr. Zahir Hirji and some other IPC doctors from the Canadian HUGE University Health Network disagreed.

Right back you, Tellier - in 2007.

wwwnc.cdc.gov/eid/article/13…Camille Lemieux*Comments to Author , Gabrielle Brankston*1, Leah Gitterman*, Zahir Hirji*, and Michael Gardam*† Author affiliations: *University Health Network, Toronto, Ontario, Canada; †University of Toronto, Toronto, Ontario, Canada;
Read 10 tweets

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