Thread by @jljcolorado

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

https://twitter.com/EdselSalvana/status/1487912289772576769

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)

https://twitter.com/Bob_Wachter/status/1315385513528844289

@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

@Bob_Wachter @UCSFHospitals 4/ I.e. there are MANY things we need to know to manage the pandemic that one does NOT learn by treating patients

Be it running mathematical epi models, doing experiments with antibodies in the lab, or studying transmission in many ways

Here 1 example:

https://twitter.com/jljcolorado/status/1479250147330637825

5/ However, we have seen this "MEDICAL SUPREMACIST" behavior many times in this pandemic, including from @WHO (from where it emanates to ppl like Dr. Salvaña)

Logical Fallacies are very COMMON on Twitter (&elsewhere)

I wrote a thread listing some:

https://twitter.com/jljcolorado/status/1476710048839708675

7/ In this particular case @EdselSalvana is using 2 logical fallacies:

- "Appeal to Authority" (his own as clinician)

- "Courtier's Reply" (dismissing my expertise & of other physical scientists such as @JoshuaCAgar, which he blocked, as irrelevant)

https://twitter.com/jljcolorado/status/1476709395711119360

8/ @jbriand has summarized it better than I could:

https://twitter.com/jbriand/status/1488179468950773767

9/ Have we encountered this before? Oh yes. @WHO and its IPC committee members (in our emergency meeting on 3-Apr-2020, where we warned them virus was airborne) basically told us that our only relevant expertise was on ventilation (but NOT transmission)

wired.com/story/the-teen…

10/ Here is another example from @WHO IPC committee member @Metadoc:

- Courtier's reply (en.wikipedia.org/wiki/Courtier%…) dismissing our expertise as relevant (livescience.com/coronavirus-ai…

- adding "Appeal to motive" (en.wikipedia.org/wiki/Appeal_to…) implying we must have financial interests

11/ And here is @WHO staff @allegranzib calling us ignorant (in a slightly more subtle way than @Metadoc):

nature.com/articles/d4158…

12/ This is not the way to make progress. Disciplines need to work together

The Philippines has excellent physical scientists like @JoshuaCAgar that can contribute to the response

But the medical establishment is stuck in the stone age and blocks them!

https://twitter.com/EdselSalvana/status/1487956224880840706

13/ Really medical doctors are epistemologically TRESPASSING (philpapers.org/go.pl?id=BALET…) into aerosol science when they think they can give advice on N95 etc

But they have been trespassing for so long, they think aerosol scientists are the ones trespassing

14/ Here is a thread I wrote a year and a half ago on this topic.

Pointing out that medical experts were making ERRORS the SIZE of GODZILLA on the aerosol aspects of transmission

And that we needed to work together:

https://twitter.com/jljcolorado/status/1295518786951319552

15/ This is an example of the key error: defining transmission based on DISTANCE, NOT based on MECHANISM.

But protections dictated by mechanism, not distance. Inhalation near the infected needs N95 EVEN MORE than at a distance, not less.

https://twitter.com/EdselSalvana/status/1487629851691712513

16/ Everyone needs to switch to the updated @CDCgov, which were proposed by Prof. Yuguo Li of Univ. of Hong Kong (@WHO advisor and member of our group-of-36 scientists): onlinelibrary.wiley.com/doi/10.1111/in…

cdc.gov/coronavirus/20…

- Aerosol inhalation, large droplet spray, & surface touch

17/ This is not to say that surgical masks are not useful, if one doesn't have anything else (putting those words on our mouth is a "straw man" logical fallacy. Any mask is better than no mask.

https://twitter.com/EdselSalvana/status/1487941641038012418

18/ Understood that N95 are more expensive

But we have known for a long time that transmission occurs in hospitals despite surgical masks and eye protection, e.g. this study from @harvard:

academic.oup.com/cid/article/73…

(There are more e.g. dx.doi.org/10.7326/M20-75…)

19/ If only surgical masks are available, they can be made A LOT safer w/ inexpensive brace like @FixTheMask (probably cheaper than the often mandated face shields that are probably wasting $$ in Philippines). Helps a lot in leak tests

Can make your own: fixthemask.com/products/v2-di…

20/ But one has to understand and explain airborne transmission

@WHO clearly says is important for COVID-19, BOTH in close proximity ("short-range airborne", erroneously referred to as "droplet" by @EdselSalvana)

& in shared room air ("long-range A")

who.int/news-room/ques…

21/ @EdselSalvana is also repeating the debunked thinking that N95 are uncomfortable etc. (Though at least he didn't say they cause acne and that's a major reason not to wear them, like John Conly of @WHO IPC)

https://twitter.com/EdselSalvana/status/1487892993780576256

22/ Many healthcare workers and others have been wearing them for 8+ hrs a day for most of the pandemic, see e.g. this Australian doctor:

[But very careful w/ the very common FAKE KN95, those CAN be very hard to breathe through]

https://twitter.com/DrPieterPeach/status/1488031081479938048

23/ Coming back to the MEDICAL SUPREMACY and dismissal of aerosol science as irrelevant for transmission

@EdselSalvana will be glad to know that paper has already been written on his attitude, but the great @UniofOxford medical doctor @trishgreenhalgh

wellcomeopenresearch.org/articles/6-126

24/ "Political and policy actors at international, national, and regional level aligned—predominantly though not invariably—with medical scientific orthodoxy which promoted the droplet theory of transmission and considered aerosol transmission unproven or of doubtful relevance."

25/ "This dominant scientific sub-field centred around the clinical discipline of infectious disease control, in which leading actors were hospital clinicians aligned with the evidence-based medicine movement. Aerosol scientists—typically, chemists, & engineers—representing..."

26/ "...heterodoxy were systematically excluded from key decision-making networks & committees. Dominant discourses defined these scientists’ ideas and methodologies as weak, their empirical findings as untrustworthy or insignificant, & their contributions to debate as unhelpful"

27/ So @trishgreenhalgh has already analyzed thoroughly the attitude being still displayed by @EdselSalvana & other PH government advisors.

Much like @teddybird before. At this rate Trish can write the next paper only with examples from the Philippines!

https://twitter.com/trishgreenhalgh/status/1480223807709274112

28/ I've said before that @WHO ends up working as an INTELLECTUAL DICTATORSHIP on these matters of transmission

Not in US or Germany (tho has influence). But yes in most of the world, especially developing countries such as Philippines & Latin America

https://twitter.com/jljcolorado/status/1373663429463056385

@WHO 29/ I've talked to @WHO top officials who bristle at the notion that they become an intellectual dictatorship, point out how they want debate & ask many experts etc.

May be that way AT THE TOP, although as @trishgreenhalgh made clear, some experts are systematically ignored

30/ But that's the way the world works.

Which politician or medical advisor in the Philippines, Ecuador, or El Salvador is going to say publicly that @WHO is wrong, and push for different mitigations?

And if they did, how successful would they be?

31/ For anyone who is curious about this debate and wants to know more, you can listen to this webinar at the Univ. of the Philippines (also sponsored by their School of Medicine) on Thursday PH (Wednesday in the US)

https://twitter.com/UPOpenU/status/1485836967460098049