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Prof. Jose-Luis Jimenez Profile picture
@jljcolorado
Nov 23, 2021 • 18 tweets • 14 min read • Read on X
Scrolly
1/ HOW TO AVOID TRANSMISSION and have #CleanAirHolidays?

Most important: understand and explain clearly that we get infected by breathing infected air (aerosols) exhaled by SOME (not all) the infected

Mainly in close proximity, and in shared room air

journalofhospitalinfection.com/article/S0195-… Image
2/ Recognize that this is an INDOOR PANDEMIC

20 times more likely to get infected indoors than outdoors (can only be explained by airborne transmission)

DO EVERYTHING YOU CAN OUTDOORS (family and work meetings, schools etc.)

pubmed.ncbi.nlm.nih.gov/33249484/
nytimes.com/2020/07/17/nyr… Image
3/ If you have to go indoors, there is NO SILVER BULLET. You need to do multiple things to reduce risk.

I.e. the "SWISS CHEESE" model of @MackayIM

#CleanAirHolidays Image
4/ A mnemonic to remember what to do: "A CIVIC DUTY"

time.com/5883081/covid-…

#CleanAirHolidays Image
5/ Try to MINIMIZE time spent INDOORS, and with as few people as feasible. Understand that distance helps, but is not enough

#CleanAirHolidays

numeroteca.org/cat/en-el-aire/ Image
6/ Understand that PLEXIGLASS BARRIERS help in a cashier / teller situation. But they actually INCREASE TRANSMISSION when lateral, as they make ventilation more difficult.

dx.doi.org/10.1126/scienc… Image
7/ Understand that DISINFECTION OF SURFACES is an UTTER & COMPLETE WASTE OF TIME AND MONEY

(except perhaps in hospital COVID ward, per the @CDCgov)

nature.com/articles/d4158…
cdc.gov/mmwr/volumes/6…

#CleanAirHolidays Image
8/ Understand that LOUD VOCALIZATION (talking, yelling, singing) is STRONGLY associated with transmission.

Talking less loudly (or not talking when possible, e.g. public transportation) reduces transmission a lot.

arxiv.org/abs/2009.04060

#CleanAirHolidays Image
9/ MASKS are the most effective layer of protection indoors.

bmj.com/content/375/bm…

MASKS ARE NOT SIEVES, they can filter aerosols much smaller than the gaps in the mask through microscopic mechanisms.

medium.com/@asit.mishra76…


#CleanAirHolidays Image
10/ Any mask is better than no mask. But to work best, masks need to:

1) Be a good filter (aerosols stick to it when air goes through its cloth)
2) Let us breathe (low resistance)
3) NOT LEAVE GAPS between face & mask - BIGGEST PROBLEM IN THE REAL WORLD
Image
11/ Since #COVIDisAirborne and AIRBORNE IS THE DOMINANT mode of transmission (see our paper in @TheLancet, thelancet.com/article/S0140-…), we should recommend higher quality masks, especially for riskier situations when sharing indoor air

FFP2/3, N95, or elastomeric

#CleanAirHolidays Image
12/ How to GET RID OF VIRUS IN INDOOR AIR?

1) Get rid of air & floating virus: ventilation - BEST
2) Keep air, remove virus: filtration - GOOD
3) Keep air + floating virus, "kill" virus: disinfection - DANGEROUS, AVOID (except UV disinfection, does work)

#CleanAirHolidays Image
13/ How to know that VENTILATION IS GOOD ENOUGH?

Measure CO2 with an infrared meter (NDIR, ~$100). Keep it below 700-800 ppm (parts per million)

See section 9 of Bit.ly/FAQ-A

#CleanAirHolidays Image
14/ Install PUBLICLY-VIEWABLE CO2 meters everywhere where we share indoor air

(Can be done for low cost $200 or so per location -- much lower than pandemic economic losses)

See section 9 of Bit.ly/FAQ-A

#CleanAirHolidays Image
15/ If ventilation is not sufficient or practical, then go with FILTRATION.

- Commercial HEPA filters: work well, but they are expensive, huge variation in cost, quality, and noise (many companies selling substandard ones)

#CleanAirHolidays

Image
16/ But filters DO NOT NEED TO BE HEPA!! Cheaper filters built with a regular (Comfort) fan and HVAC filters work just as well and are much cheaper. E.g. #corsirosenthalbox

#CleanAirHolidays

en.wikipedia.org/wiki/Corsi-Ros… Image
17/ For more information on the science, the historical errors that have made it so difficult for @WHO and @CDCgov and other govs. to accept that #COVIDisAirborne etc., see this thread and the linked articles and threads:



#CleanAirHolidays
18/ Este mismo hilo en español / castellano:

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More from @jljcolorado

Prof. Jose-Luis Jimenez Profile picture
May 19
1/ Las enfermedades pueden propagarse entre viviendas a través de los sistemas de ventilación compartidos EN ESPANA, según un estudio estadounidense

La nvestigacion analizó un brote de COVID-19 ocurrido en un edificio residencial de Santander al empezar la pandemia
2/ El articulo de la vanguardia q lo cuenta:



Investigacion de @ShellyMBoulder @D_Higuera_Ing et allavanguardia.com/magazine/biene…
@ShellyMBoulder @D_Higuera_Ing 3/ @ShellyMBoulder lidero la publicacion de nuestro estudio sobre la superpropagacion de COVID-19 en el coro de EEUU, que demostraba la transmision por el aire

doi.org/10.1111/ina.12…
Read 9 tweets
Prof. Jose-Luis Jimenez Profile picture
May 13
1) Something very clear from this Hantavirus outbreak is that @WHO is still quite confused about airborne transmission

Still confuse "close contact" (a setting) with a mechanism of transmission

Do not understand that ease of transmission in close proximity ==> likely airborne
2) Several colleagues have published this note in @bmj_latest summarizing this problem with @WHO:

bmj.com/content/393/bm…
@bmj_latest @WHO 3) I spent a couple of years of my life trying to make progress on this issue. This is how me and many colleagues felt during the pandemic.

Frustrating that @WHO is still very confused

Read 5 tweets
Prof. Jose-Luis Jimenez Profile picture
May 8
(1) Veo el lio que se ha montado con el hantavirus en el crucero y queria decir algunas cosas. La mas importante:

**Esto NO va a ser una pandemia**

Estoy de acuerdo con @mvankerkhove e incluso con Fernando Simon. Y nadie me puede acusar de estar siempre de acuerdo con ellos
(2) ¿Por que no vamos a tener una pandemia de hantavirus?

Porque es un virus q se conoce. La variante de los andes se puede transmitir de persona a persona. Casi seguro q se transmite por el aire, por aerosoles.

Pero con dificultad. NO es un virus muy contagioso.
(3) El hantavirus es menos contagioso que la tuberculosis pulmonar, que la causa una bacteria por transmision por el aire exclusivamente. Y que anda suelta por ahi, pero no causa una pandemia rapida como el SARS-CoV-2.
Read 19 tweets
Prof. Jose-Luis Jimenez Profile picture
May 26, 2024
1/ Survey of CO2 indoors during trip

CO2 (above ~400 ppm outdoors) indicates the amount of exhaled air (& virus) trapped in a space

Also per recent scientific results by @ukhadds, CO2 helps SARS-CoV stay infectious in air much longer

@united flight boarding, pretty terrible! Image
2/ This is the trip so far:

-Low outdoors
-Pretty high ~2000 in @RideRTD bus to airport
- ok ~800 at @DENAirport, except restroom ~1500. Not sure why restrooms at this airport are so often poorly ventilated
- Then boarding on @united, ventilation OFF, so huge increase till ON Image
3/ For details of the recent results on how and why CO2 makes SARS-CoV-2 stay infectious much longer in the air, see this recent thread by @ukhadds

Read 9 tweets
Prof. Jose-Luis Jimenez Profile picture
May 8, 2024
1/ "After four years of fighting about it, @WHO has finally proclaimed that viruses, including the SARS-CoV-2 virus that causes COVID, can be spread through the air"



By @maggiemfoxscientificamerican.com/article/a-figh…
2/ "It took four years to get here because some leaders in public health, medicine and science clung too tightly to precision and semantics"

"One particular moment of shame came on March 28, 2020, when WHO tweeted: “FACT: #COVID19 is NOT airborne.”

3/ "Words matter. When people heard that COVID might spread on surfaces, they wasted time wiping down groceries. People who misunderstood airborne spread needlessly wore masks on outdoor walks and veered off sidewalks to avoid their neighbors."
Read 7 tweets
Prof. Jose-Luis Jimenez Profile picture
Apr 18, 2024
1/ @WHO has published a report on updated terminology for disease transmission

I've seen some debate about it. My take:

- Terminology itself is ok. Big progress
- But no recommendations of how to protect!

Report:

Press release: who.int/publications/m…
who.int/news/item/18-0…
2/ The report was likely the result of intense pressure on @WHO during the pandemic:

- They denied that #COVIDIsAirborne on March 2020
- They finally accepted it 2 years later

nature.com/articles/d4158…
@WHO 3/ To their credit, @WHO did invite some of their critics to be part of the committee.

What was the terminology before. In medical circles:

- droplet transmission: if it happened in close proximity, or if particles were > 5 microns

- airborne transmission: if it happened far
Read 34 tweets

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