Lazarus Long Profile picture
Jul 26, 2022 44 tweets 23 min read Twitter logo Read on Twitter
Speaking of the CDC - a thread on them NOT recommending masks - although an outbreak on a plane in 2021 was stopped by masks.

Per the actual monkeypox lead for the CDC.

And more - enjoy:

#MonkeypoxIsAirborne.

According to the CDC Travel department. Thank you, @jmcrookston .

"... Person to person spread is principally respiratory..."

Someone is going to try and squawk about respiratory droplets. Let's head that off at the pass.

wwwnc.cdc.gov/travel/yellowb… Image
The word is respiratory. Not respiratory droplets.

The word comes from respire.

Which comes from the Latin word "respirare."

To breathe in, and to breathe out.

I don't breathe in and out spittle. Neither do you.

We both breathe in and out aerosols. Airborne aerosols. Image
Expect that page to change now that I am notifying @CDCgov that their travel department has given the game away.

And relax. Breathe in clean air through your N95. Don't breathe in monkeypox.

(H/t @fitterhappierAJ ) Image
If there is asymptomatic transmission with a disease already suspected of airborne transmission? Odds go way up that it's airborne.

Because it moves airborne ahead of droplets. No symptoms means no coughing (no droplets).

Further tying asymptomatic transmission to monkeypox. It would be foolhardy to think this does not happen.

You might wonder why I am hammering down on this? #CoVidIsAirborne was SIGNIFICANTLY delayed due to authorities proclaiming not airborne since not asymptomatic.

Not this
time.

At the very least, even the most stubborn Benjamin Button type of science writer would concede that we should assume asymptomatic transmission is occurring.

Especially because they report what the authorities are reporting.

And the CDC as seen in an MMWR, used the
precautionary principle to euthanize those animals who might have asymptomatically transmitted monkeypox.

This was the 2003 outbreak:
cdc.gov/mmwr/preview/m… Image
This next one is an exercise in logic and an understanding of aerosols.

H/T @NjbBari3 !

Ok, noninvasive means ... See 👇

And here's the thing.

Those who were close to an animal? 80% experienced upper respiratory symptoms.

Using Occam's Razor, is it more likely the person touched the animal, then their mouth having just touched a prairie dog? Image
Or they were close enough for the concentrated cloud of near field aerosols surrounding the clustered cages, to be inhaled?

Keeping in mind, fomites, once thought to be one of the two main ways of infection of CoVid, are now relegated to the 1in 10,000 kitchen junk drawer.
Now, this is a HOT #MonkeypoxIsAirborne update.

You see, evidently they have been collaborating with Congo for a long time.

And it turns out it's airborne.

Per them.

H/t to @lavika and @sri_srikrishna .

Image
Of course, some will try to twist the above sneezing and coughing to mean droplet.

The key is "through the air" . And this is why you are glad that a #CoVidIsAirborne team member is now giving you the guided tour.

Because the phrase "through the air" has only one
meaning in CDC-landia.

For example, with TB. For sure known to be airborne by the CDC.

"Through the air."👇

cdc.gov/tb/publication… Image
Here is the Congo travel warning. Lots of backups to web archive.

wwwnc.cdc.gov/travel/notices…
Another #MonkeyPoxIsAirborne Update!

H/T @DrEricDing and the US DHS.

"Humans can be contagious
before a visible rash appears and can continue shedding the virus weeks after symptoms
have dissipated. "

No symptoms means no lesions. No coughing.
dhs.gov/sites/default/…
What does that leave?

Just like CoVid, breathing, talking, laughing, etc - because it is airborne via aerosols.

And look at that, @celinegounder @benryanwriter, DHS confirming airborne aerosols

"Sources of laboratory-acquired infections include exposure to aerosols..." Image
The CDC should just write this thread on #MonkeypoxIsAirborne .

"... Wear a well-fitting mask..."

You don't need a mask for lesions or fomites.

You don't need a well-fitting mask for droplets.

You only need a well-fitting mask for airborne.

Image
This is getting embarrassing.

How is a smaller Anon account just beating the daylights out of the @CDCgov with their own words, over and over?

BTW, @CDCgov, in the linked doc, why not just recommend N95s?

There is no shortage.

Hmm.. let me put it in terms you can
understand.

@3M, a multinational corporation, will make more money if you actually say "N95."

(No offense intended 3M... Love your products, but when you speak to 5 year olds, you have to use words they understand.)
Yet another source for #MonkeyPoxIsAirborne.

Dynamed. A point of care solution by physicians for physicians.
dynamed.com/condition/orth… Image
Another update for #MonkeyPoxIsAirborne.

H/t @citlanx.

@celinegounder along with Benjamin has been pointing to the mostly MSM network of transmission as proof positive that it's not airborne.

As I have pointed out, it's just in that network.
Eventually, it will branch out.
You know the phrase - if you don't know your history, you will be doomed to repeat it?

Back in 2008, everyone was reporting that the drug-resistant MRSA was relegated to the MSM network.

And it was. For example, the @nytimes itself reported that MRSA was isolated to gay men.
archive.ph/ZNjAc

"A separate part of the study found that gay men in San Francisco were about 13 times more likely to be infected than other people in the city."

I am grateful that @apoorva_nyc has been reporting the possibilities of airborne transmission
in the NYTimes - even in the face of pushback from the CDC Director.

This MSRA history might be handy, Ms. Mandavilli.
archive.ph/Ftkc2d

Because there is no more mention of MSM with MRSA.

Sometime in the near future, certain parties will take a
mayoclinic.org/diseases-condi…
a break from Twitter. The CDC's website (am I the only one who views the focus on MSM as homophobic?) will be quietly redacted.
Excellent thread disconnecting sexual activity from Monkeypox.

Keep in mind - when we engage in sexual activity, our respiration rate increases - which means we see an increase in intake of aerosols.

Masters and Johnson had some classic work embedded in this study - the whole thing was fascinating.
sci-hub.hkvisa.net/10.1016/s0002-…
I haven't found any studies actually documenting the production of aerosols during sex - would love to give a H/t and include you in the thread if you know of one.

Given that the Gesundheit 2 might be ergonomically difficult to work with during sexual activity? Image
Another #MonkeyPoxIsAirborne update.

I almost feel sorry for
@benryanwriter @celinegounder as the onslaught of non-MSM cases begins.

You two probably won't watch it all the way through, but yep.... she shared that it's also airborne.

tiktok.com/t/ZTRUfTThX/?k…
I've just deleted a tweet where I stated that Monkeypox is only handled at BSL4 labs - that was incorrect.

The law does state that:
law.cornell.edu/cfr/text/42/73…

But, there was a caveat not viewable on that page, but over here is citation #4.

selectagents.gov/sat/list.htm

My apologies! Image
#MonkeyPoxisAirborne - because we breathe it out through - even when there are NO lesions present.

If lesions are present, then it's even more airborne due to those nasty little skin flakes.

Mask up, folks.
#MonkeyPoxIsAirborne - via a saliva test that correctly predicted the infected.

Huh?

Please bear with me.

Excellent results for saliva test:
medrxiv.org/content/10.110…

This is huge for ring vaccination strategies.

Also, huge for airborne. 5 of 22 had no symptoms at the Image
time of test. 23%.

4 of the 5 did not have symptoms AT THE TIME. Which meant they went on to develop symptoms.

And yet they tested positive.

The authors nailed it as a concern.

Most likely - if you can test for it? You can spread it.

Mask it up! Image
#MonkeypoxIsAirborne because fomites are very rare.

"Only about 0.2% of people have caught the virus through contact with contaminated material, according to a recent report from the WHO."

Which suddenly make the sorts of reports in the next tweet?

statnews.com/2022/08/10/wha…
Make you realize it's airborne.

A Six Flags worker caught it just by walking by his coworker.

Image
#MonkeypoxIsAirborne - because NHS from the UK says its spread by coughing or sneezing. Which as we all know is accompanied by turbulent clouds of aerosols.

Which are airborne. This is for sneezing - coughing has the same basic mechanism.

nhs.uk/conditions/mon… Image
As always - there are many forms of transmission with monkeypox. Though as we saw above, thanks to the WHO, actual fomite-based infection is far below .5% of cases.

"A new airborne Ebola-like viral disease, referred to as ‘Monkeypox’ has hit the Niger Delta University Teaching Hospital."

"They said the symptoms of the disease include...cough.."

H/t @mdc_martinus for:
guardian.ng/news/monkey-po…

H/t @Iamgoingtosleep for the top qt and pic. Image
A mystery infection. How, oh how, could he have been infected?

#MonkeypoxIsAirborne. Second study this progression has been observed.

Enters respiratory. Then to lymph, the off to the races, and finally the lesions on the skin.

H/t @beansprouts_mom

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More from @LazarusLong13

May 25
Finally got a chance to thread this study on SARS-COV-2 and PRION disease. It's well-written, appropriately cautious.

And scary AF for an Opinion piece.

🧵 of highlights - I strongly encourage you to read this study as it is packed with info.
To be crystal clear, at this juncture, this appears to be association, not causal.

And this is an "OPINION" paper, albeit based on some very good studies.

So, take some small comfort from that - while you can.
Prion Disease (PrD) - 80-95% of which is Creutzfeldt-Jacob disease (CJD).

ACE2. The receptor is ACE2R

"ACE2R has been identified on every human host cell type so far analyzed except for enucleated red blood cells "

ACE2R is abundantly detected in all cell types of the brain.
Read 15 tweets
May 23
Wish Dr. Osterholm the best. And I wish you, the person going to be thinking about this Cov1d elevator thread, the best, too.

You will need it - unless you have boarded the elevator with an N95 or N100 on.
In this study, in hospital elevators, you'd think ventilation would be continuous.

No. Turns off after 1-2 minutes.

Next elevator you go in, look at the walls and imagine the ventilation off and you are sucking in that delivery person's Covid breath.

ncbi.nlm.nih.gov/pmc/articles/P… Image
They found it would take 28 minutes for aerosol particles to decrease 100 fold - after the infector had left, and the doors closed.

No biggie, right? Image
Read 9 tweets
May 23
I love all the house styles in Baja California. Building codes?

"Heck with building codes....I'm gonna make a camper tower." ImageImage
"Going to move into the trailer, and then add on as I have money."

(Very common thing to do, which really makes sense.) Image
"Doesn't rain here, so trailer it is!" Image
Read 6 tweets
May 22
This confirms the "age means more aerosols" from another study back in 2021.

Quick thread.
From 2021 - though this one found BMI was also related.

In any event, age is now a lock.

The older you get? The more of a supespreader you are.

Do me a favor? Google "nursing homes near me."

If we are lucky, that's where we end up.

Unventilated abattoirs is what I called nursing homes a couple of years ago.

I was not joking. I am not joking.

@BrooksLaSureCMS - this is squarely under your bailiwick. Any progress on improving ventilation?

Read 4 tweets
May 19
Mask mandates REDUCED the bioaerosols by 69%.

Air cleaners by 39%.

Masking is important - but both are necessary.

Air cleaners - the mask for the entire room when kids' masks slip. Image
The tweet above seems to have a bit of a rocket attached to it, so attaching a conversation that you SHOULD listen to while driving home from work....

A little more on this study...the number of positive Covid saliva samples:
No intervention: 11.1%
Air Cleaner: 7.7%
Mask: 5.7% Image
Read 6 tweets

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