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Prof. Jose-Luis Jimenez Profile picture
@jljcolorado
Dec 19, 2021 • 38 tweets • 29 min read • Read on X
1/ Examples of GOOD PRACTICES worldwide to stop transmission, given that #COVIDisAirborne

There are many BAD examples in a separate thread (), that others should avoid.

Here I will try to compile some of the good examples that others should copy.
2G/ UK Government: "COVID is like smoke" with a clear visualization:

[Note that many countries have both good and bad examples. Such is the situation we are in, as @WHO et al. don't provide a strong message that would lead to the good mssgs prevailing]

3G/ FRANCE, government: good visualization of the behavior of airborne aerosols indoors, and the impact of ventilation.

4G/ CANADA, University of Toronto School of Public Health (UofT_dlsph):

The Dean @SteiniBrown says is openly: "IT IS AN AIRBORNE DISEASE, I think that's clear

5G/ NEW ZEALAND: Ministry of Education (@EducationGovtNZ) ordering air purifiers &CO2 monitors to help cut the risk of Covid transmission in schools

Importantly, CO2 readings will be VISIBLE to teachers so they can make adjustments to vent.

nzherald.co.nz/nz/covid-19-de…

HT @venessb
6G/ CANADA: The Chief Public Health Officer (@CPHO_Canada) confirms that "AEROSOL IS THE MAIN ROUTE OF SPREAD of COVID"

"Think of it like smoke in the room: those closest to the source will inhale more"

Masking and ventilation are "very important"

piquenewsmagazine.com/national-news/…
7G/ PORTUGAL: National Health Service (@SNS_Portugal) gives a clear message about airborne transmission indoors. Advises ventilation, physical distancing, and masks.



HT @Co2Marta Image
8G/ VIETNAM: IPC Guidelines of the Ministry of Health (@VNGovtPortal) recommend "controlled ventilation in examination and patient rooms", "to prevent AIRBORNE infections"

9G/ USA: CDC Environmental Health (@CDCEnvironment) has some good materials about improving ventilation, including upgrading HVAC filters, using HEPA filters, and running exhaust fans.

The main @CDCgov doesn't promote these, but at least they are there

10G/ FRANCE (Government, @gouvernementFR):

"COVID transmits essentially through aerosols"

"Emitted when breathing, more when talking. Ventilation helps reduce them"

gouvernement.fr/l-aeration-un-… Image
11G/ FRANCE (Government, 6 ministries):

Recommend ventilation if CO2 > 800 ppm

Recommend LEAVING THE INDOOR SPACE if CO2 > 1000 ppm

Image
12G/ CHILE: poster in schools from the Health Ministry (@ministeriosalud), stating "Open doors and windows! Ventilation removes COVID-19"

13G/ UK (National Health Service @NHSuk): another great ad showing the airborne nature of transmission very graphically

[Now, having good ads seems to be decoupled of having actually good policies in place. Perhaps ads are cheaper than policies?]

14/ SPAIN: @elpaisinenglish newspaper has done several spectacular articles with very clear graphics illustrating and quantifying transmission:

[Which have won awards from @aaas and others; authors @javisalas y @marianozafra]

elpais.com/especiales/cor…
15G/ JAPAN: Public display of CO2 in EACH movie in a movie theater.

Shows (in this case) low risk of transmission of COVID or other resp. diseases.

Can be done everywhere at low cost.

#covidCO2 (see section 9 of Bit.ly/FAQ-A for details)

16G/ BELGIUM: COVID Commissioner @PedroFacon:

"You can compare transmission best w/ cigarette smoke", can infect close by, also when sharing room

CO2 meters:
• Rec.: ALL indoor public spaces
• MANDATORY: hotels, restaurants, bars, banquet halls & gyms

17G/ ARGENTINA (Government): Science and Health ministries (@msalnacion, @ciencia_ar) recommend to ventilate when #CO2 exceeds 700ppm.

argentina.gob.ar/sites/default/…

HT @covidco2_map Image
18G/ JAPAN: AEON Mall Franchise (@aeonmall_japan) monitors and displays indoor #CO2 in 160 locations.

Relatively safe levels in that instance (even more so if there is some filtration of recirculated air)

HT @covidco2_map Image
19G/ JAPAN; Business owners are advertising the fact that they monitor CO2 levels in-store (keeping levels below 1000ppm) to encourage customers to visit their stores.

They upload real-time store CO2 levels on Google Maps!

We need this EVERYWHERE

20G/ SPAIN (Seville Metro / Subway @_metrodesevilla):

"from now on, the levels of CO2 concentration, will be openly and continuously available through the website and the app of the subway"

europapress.es/esandalucia/se…

Image
21/ FRANCE Health Ministry (@Sante_Gouv):

Interviewing infectologist:

- About 90% of transmission is through aerosols, often without symptoms
- Ventilation is very important
- Well fit mask important
- Works for the flu and other resp. infections

22G/AUSTRALIA: Chief Health Officer of Victoria @VictorianCHO of @VicGovDH w/ clear message:

- COVID-19 is airborne
- Risk indoors much higher than outdoors
- Description of ventilation methods
- Recognizes occupational physicians & ventilation experts

23G/ @WHO: Chief Scientist @doctorsoumya finally today (22-Dec-2021) referred to SARS-CoV-2 as "THIS AIRBORNE VIRUS".

Also now respirators (N95/FFP2/Elastomeric) are finally recommended in health care


Image
24G/ CANADA (National Government and Chief Public Health Officer): a very clear video about the importance of ventilation and air cleaners:

[It is the provinces that are hopelessly lost, esp. @CDCofBC, @ArrudaHoracio; @adriandix; @AntibioticDoc etc.]

25G/ IRELAND: FFP masks (= N95 or better) to be worn by health care workers in ALL healthcare settings. Also for patients who can wear them.

Follows recommendation from @WHO ()

@WHO 26G/ USA (Arizona, @ASU_CGH): volunteering to build #CorsiRosenthalBox to distribute to schools, & remove the virus from the air

Just as effective as HEPA filters, a lot cheaper. More info at cleanaircrew.org/box-fan-filter…

#COVIDBestPractices
@CleanAirCrewOrg

27G/ SPAIN 🇪🇸 (@BilbaoAirport): signs stating that ventilation on the terminal has been improved

Unlike e.g. this airport in Florida, USA 🇺🇸() which is in the #COVIDHallofShame

#COVIDBestPractices

28G/ CANADA 🇨🇦 (Toronto, restaurant): serious plan to reduce transmission in indoor dining: reduced capacity, staff vaccinated, serious ventilation, filtering, masks

They have an analysis of the Guangzhou restaurant superspreading event & how to avoid it

Image
29G/ USA 🇺🇸: Some Universities (e.g. @LSUHealthNO @UMBaltimore) require KN95 or N95 masks

“With Omicron it appears that the contagion plus the aerosol aspect is very similar to measles and therefore requires this higher-level mask”

chronicle.com/blogs/live-cor… by @Oyin_Adedoyin_ Image
30G/ CANADA 🇨🇦 (@OslerHealth Hospital in Toronto):

The first hospital Canada to require all visitors to wear respirators (in addition to staff). This is how to fight an airborne virus

#COVIDBestPractices

31G/ JAPAN 🇯🇵 (Hidaka City): Free distribution of CO2 monitors to 900 offices. To monitor & reduce risk of (dominant) airborne transmission of COVID-19

@ToshiAkima: "This is why Japan's COVID case rates are under control"

#COVIDBestPractices
#COVIDCO2

32G/ GERMANY 🇩🇪 (Bavarian Schools):

- Mask mandate indoors
- PCR Pool-Test 2x per week + extra rapid test if delayed PCR
- Air cleaners subsidized for all classrooms (currently only 50% bf Christmas)
- or ventilating every 20 minutes

#COVIDBestPractices

33G/ SPAIN 🇪🇸 (Asturias @GobAsturias): Regional Government mandates CO2 meters in bars, restaurants, and gyms

Increase ventilation and reduce occupancy if CO2 > 800 ppm

Government will inspect to verify compliance.

#COVIDBestPractices
#COVIDCO2

lne.es/asturias/2021/…
34G/ GERMANY 🇩🇪 (Hamburg schools):

- Mask mandate. Schools can get FFP2 from authorities
- 90% of all class rooms with air cleaners AND ventilating every 20 minutes
- Test 3x / wk
- mass vaccinations - opportunities in every school

#COVIDBestPractices

35G/@WHO🇺🇳: finally admitted clearly on webpage: transmission in close proximity is SHORT-RANGE AIRBORNE (not just "droplet") & long-range airborne is important

[But if webpage is updated quietly in the forest & nobody hears about it, does it help?]

who.int/news-room/ques… Image
36G/ USA🇺🇸(Santa Clara County, CA @HealthySCC): the Public Health team does not remove their masks when speaking indoors.

@WHO: when are you going to emulate them?

ImageImage
37/ FRANCE🇫🇷: MP @M_Orphelin brought a CO2 monitor to Parliament today:

- Pointed out CO2 > 800 ppm in parliament, until some MPs left after a vote
- Recommended that the government massively installs them in each classroom

#covidCO2
#COVIDBestPractices

38/ SINGAPORE🇸🇬: Ventilation improv. ongoing for more than a year

- >= MERV14 filters
- CO2 monitoring
- Good guidelines on air cleaners: recommends filters, UV
- Does NOT recommend chemical sprays and electronic ones (ions etc.)

nea.gov.sg/our-services/p…

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More from @jljcolorado

Prof. Jose-Luis Jimenez Profile picture
May 26
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
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
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
Prof. Jose-Luis Jimenez Profile picture
Mar 28
1/ New paper in @ScienceMagazine: "Mandating Indoor Air Quality for Public Buildings"

Explaining current status of indoor air quality standards (in short: bad or non-existent), the huge health benefits that would arise from them & proposing a path forward
science.org/doi/10.1126/sc…
Image
2/ "People living in urban & industrialized societies, which are expanding globally, spend more than 90% of time indoors, breathing indoor air (IA)."

"Most countries do NOT have legislated indoor air quality (IAQ) performance standards for public spaces"

science.org/doi/10.1126/sc…
3/ "Few building codes address operation, maintenance, and retrofitting, and most do NOT focus on airborne disease transmission."

"We propose that Indoor Air Quality (IAQ) standards be mandatory for public spaces"

science.org/doi/10.1126/sc…
Read 14 tweets
Prof. Jose-Luis Jimenez Profile picture
Oct 4, 2023
1/ Checking the ventilation by measuring CO2 as I travel to the #AAAR2023 conference

@RideRTD bus to Denver airport. Bus route had started 3 min before I got in, already 1500 ppm

Typical of these @RideRTD buses, poor ventilation Image
2/ Not getting any better as time passes in the @rideRTD bus to the airport...

7% of the air is being re-breathed, it has already been in someone else lungs when each of us breathe it. Image
@RideRTD 3/ Given the often poor-to-mediocre ventilation in US transportation systems, I wear N95 masks (not KN95, less good)

In this case @3M VFlex, which I tested at 99.99% filtration for myself

It also stays sealed when I talk, doesn't distort my speech (& add to my Spanish accent) Image
Read 14 tweets
Prof. Jose-Luis Jimenez Profile picture
Oct 2, 2023
1/ Video de mi presentación sobre "Transmisión de enfermedades por el aire: cómo funciona, por qué se malentendió, y cómo reducirla"

como parte de la presentación del libro de ventilación de @aireamos

2/ Las diapositivas se pueden bajar de este enlace.

(Son de una charla más larga así que tienen más detalles, pero están todas las de la presentación de @Aireamos)

drive.google.com/file/d/1Bs0RRG…
@aireamos 3/ Miguel Ángel Campano @MA_Campano y @Aireamos han sido los motores del libro de ventilación:

Read 4 tweets

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