1/ The error conflating short-range airborne transmission (aerosol inhalation) with large droplet (sprayborne) transmission is alive an well in this Facebook post from a Philippines Government advisor:

[Can't reply there, so I will here]
2/ He is strangely defining airborne as ONLY long range. That makes no sense.

The protection measures depend on the mechanism, NOT ON THE DISTANCE.

3 key mechanisms per @CDCgov
(1) Aerosol inhalation
(2) Large droplet spray
(3) Surface touch

cdc.gov/coronavirus/20…
3/ It is clear that aerosol inhalation, i.e. airborne transmission (at ALL DISTANCES) is the dominant mode of transmission. There is overwhelming evidence of this, e.g.:

4/ Here we have some Harvard infection prevention doctors telling us the same thing, but with a focus on transmission in hospitals

Note that the REAL "aerosol generating procedures" are talking, singing, exercise... and for the most part NOT the AGMPs

dx.doi.org/10.7326/M21-27…
5/ Aerosol inhalation can happen at 3 distances:

(a) close proximity, important (low dilution of exhaled virus-containing aerosols)
(b) shared-room air, more dilution but more time + people (ALL superspreading, as we have shown recently, see thread)

6/ (c) Longer-range, when people not sharing room air at the same time. This also happens, there are many documented cases (see see case in quarantine hotel linked). But thought to be a smaller fraction of transmission, because of high dilution.

7/ To protect from inhalation need GOOD FITTING & FILTERING MASKS (e.g. N95) at ALL DISTANCES

Makes no sense to say that if transmission happens close to the person, i'ts droplet transmission & surgical masks ok

How can we have superspread w/o high aerosols in close proximity?
8/ I was talking to a Filipino colleague who lamented "the Philippines is really unfortunate to have these people providing erroneous public health messages"

Unfortunately they are not alone by a long shot!

That's why we have #COVIDHallofShame (> 120)

9/ In fact I'd say that the Filipino situation is better than others. Those experts present erroneous information very clearly. So one can point out errors & debate

But others (#BonnieHenry comes to mind, but many more) present unintelligible word salads & alternative facts

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More from @jljcolorado

Jan 31
1/ Yesterday I debated a Philippines govt. expert, @EdselSalvana

Reasonable debate, although he REFUSED to debate in person

But he ended it with this LOGICAL FALLACY: an appeal to authority

This has been SO common in this pandemic, that I'll explain it in a thread
2/ The pandemic is a really complex problem, which needs input from many disciplines. NOT only from clinical researchers / practitioners.

Other medical doctors are more open minded, see from @Bob_Wachter, prominent expert from @UCSFHospitals (>1 yr ago)

@Bob_Wachter @UCSFHospitals 3/ Among the disciplines @Bob_Wachter cites, MANY are non-medical. Clinical medicine is 1 of them. So is AEROSOL SCIENCE

Clinicians treat ppl w/ virus INSIDE body. Aerosol sci. studies virus OUTSIDE body

Need to work together, NOT claim supremacy of 1, ignore the other Image
Read 30 tweets
Jan 28
1/ @Nature: "COVID-10: endémico NO significa inofensivo"

"La palabra 'endémica' se ha convertido en una de las peor utilizadas de la pandemia. Y muchas de las suposiciones erróneas fomentan una complacencia fuera de lugar"

Por virólogo @ArisKatzourakis

www-nature-com.translate.goog/articles/d4158…
2/ "Una enfermedad puede ser endémica, generalizada y mortal. La malaria mató a más de 600.000 personas en 2020. 10 M enfermaron de tuberculosis ese mismo año y 1,5 M murieron. Endémico ciertamente no significa que la evolución haya domesticado de alguna manera un patógeno"
3/ Existe una idea errónea generalizada y optimista de que los virus evolucionan con el tiempo para volverse más benignos. Este no es el caso: no existe un resultado evolutivo predestinado para que un virus se vuelva más benigno..."
Read 8 tweets
Jan 24
1/ A big COVID outbreak takes 2 ingredients:

- someone highly infective (most infected people don't seem to be infective or little; the highly infective are so during a short period)

- The right indoor conditions for accumulating and breathing in the virus.
2/ In this paper we showed that the outbreaks that have complete data for analysis are explained by airborne transmission in shared indoor air

[Detailed explanation on that thread]

3/ The level of virus in the air is analogous to the level of water in a sink, depends on:

- faucet: emission rate of virus

- size of sink: volume of room

- size of drains: ventilation, filtration etc.

[Analogy not perfect but good for illustration]

Read 13 tweets
Jan 24
1/ @Nature: "COVID-19: endemic doesn’t mean harmless"

"The word ‘endemic’ has become one of the most misused of the pandemic. And many of the errant assumptions made encourage a misplaced complacency."

By @ArisKatzourakis

nature.com/articles/d4158…
2/ "A disease can be endemic and both widespread & deadly. Malaria killed more than 600,000 ppl in 2020. 10M fell ill with tuberculosis that same year & 1.5M died. Endemic certainly does not mean that evolution has somehow tamed a pathogen so that life simply returns to ‘normal’"
3/ "There is a widespread, rosy misconception that viruses evolve to become more benign. This is not the case: there is no predestined evolutionary outcome for virus to become more benign, especially ones, such as SARS-CoV-2, in which most transmission happens bf severe disease"
Read 6 tweets
Jan 23
Of course it is neurotropic, see e.g.: pubmed.ncbi.nlm.nih.gov/34189535/

70 years ago this fellow would have told us that polio was not neurotropic, because only 1% of the cases have serious complications of that type...
Read 5 tweets
Jan 23
Of course children need masks. COVID is not a cold. It is a neurotropic virus, can go into the brain and lots of other organs. 1000 children dead in US, millions of kids w/ #LongCovidKids, millions have lost parents.

Wearing mask is not hard for kids, they forget about it.
And this person is a doctor? And @BBCNews gives a platform to an someone with this level of ignorance?
Read 20 tweets

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