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Lazarus Long Profile picture
@LazarusLong13
Jul 26, 2022 • 44 tweets • 23 min read • Read on X
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.
Welcome to the #MonkeypoxIsAirborne thread, @RougeMatisse

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

Lazarus Long Profile picture
Feb 23
Great interview of Ed Yong - I am just covering the C0V1D part.

/1 The Interview Ed Yong Wants to Show You the Hidden Reality of the World Ed standing with his arms folded. His eyes tell you COVID is not over.
You've been clear in saying that C0V1D has not gone away. You ask people to wear masks at your events..... You’ve been clear in saying that Covid has not gone away. You ask people to wear masks at your events. But that attitude is not necessarily where the rest of the world is. How do you think about continuing to take precautions and advising others to do so when it feels as if society has moved on? I do it for a bunch of reasons. Firstly, I have learned that I enjoy not being sick. I know that the cost of long Covid is real and substantial, and I don’t want to run that risk lightly.
"I think it makes a huge difference to them to have the person at the front of the stage wear a mask. It tells them, It’s not weird." . I also know that I have many friends and people I’m close to who are immunocompromised. So for the sake of the people around me, I also don’t want to get sick. When I do events, I wear a mask for those reasons, and because I know that every time I do a talk, while the vast majority of people in the audience have probably moved on, there are going to be other people who haven’t. I think it makes a huge difference to them to have the person at the front of the stage wear a mask. It tells them, It’s not weird. So I do it for that reason, too. In terms of holding this line at a point when a l...
Read 5 tweets
Lazarus Long Profile picture
Feb 22
I am sorry if this will upset you. A lot of people depend on NASAL SPRAYS for C0V1D.

I have been iffy on them, but viewed them as "if they don't hurt, why not" but not for me.

There's an analysis
on Reddit that you should read in detail, and make up your own mind.
/1
Here is the link:


Here is a 4 tweet TLDR version.

Here is how it starts - the author goes HARD at the underlying studies. reddit.com/r/ZeroCovidCom…There is no convincing evidence that nasal sprays prevent COVID-19 There is a lot of misinformation out there about nasal sprays preventing COVID-19. Unfortunately, there are no convincing studies showing that nasal sprays prevent COVID-19. The published studies investigating whether or not nasal sprays prevent COVID-19 each have major issues, which I will detail here. I have a PhD in biochemistry and one of my PhD projects was on COVID-19. The main takeaway of this post is that there is no sound evidence that nasal sprays prevent COVID-19. Thus, nasal sprays should not be used for COVID-...
Some pretty harsh language, but to me the important thing is we still have clean air.

Which is good, because it boils down to only 2 studies saying that nasal sprays work, per them. 5. Summary/TLDR and final thoughts Unfortunately, many people including covid influencers have fallen for the grift of nasal sprays preventing COVID-19. Some such influencers have promoted these nasal sprays for free and helped spread the misinformation that they prevent COVID-19. Unlike with nasal sprays, there is ample, sound evidence that high-quality well-fitting respirators, ventilation and air purification prevent COVID-19. The human clinical trials testing whether or not nasal sprays prevent COVID-19 are garbage, and to my knowledge there are only two! Please don't lower your covid...
Read 7 tweets
Lazarus Long Profile picture
Feb 17
Guillain-Barre Syndrome linked to poultry eggs? H5N1?!

The BBC had a good article from February 3 that talks about how these Indian states' cases are linked to campylobacter jejuni, a bacteria. It IS the most common root-cause, globally.

And IT is commonly found in poultry. AVOID CHICKEN AND EGGS RIGHT NOW SIGN showing for the country of India in a tweet from @alwaysmadesh. Due to Guillain-Barre Syndrome.
"Campylobacter jejuni infection is the common associated microorganism (25–40%), followed by cytomegalovirus (6–15%), Mycoplasma pneumoniae (3–21%), and Haemophilus influenzae (1–9%)"

BTW - Cytomegalovirus is also an airborne virus - that just happens to cause brain cancer.
Mycoplasma pneumoniae - also airborne.

And...drum roll please...Campylobacter jejuni also airborne.

Don't get me wrong - jejuni most definitely is also fecal-oral, no question.

But it's also airborne.

Sampled from the air below. Figure 7. GCN/m3 results using microorganism-specific primers. These microorganisms were chosen for their pathogenic and opportunistic nature. Samples 1–12 indicate the WWC collections in House A, 1R–12R the WWC collections in House B and 1F–12F the filter collections in House A.
Read 11 tweets
Lazarus Long Profile picture
Feb 13
Just a little bit closer to acknowledging H5N1 is airborne.

3 vets asymptomatic, + for bird flu antibodies. Did not wear respiratory gear or glasses.

Did wear gloves and coveralls - so rules out fomites.

One practicing in states with NO H5N1.

Vets get very close to /1 No seropositive practitioner knew that they were working with dairy cattle with known or suspected HPAI A(H5) infection. None of the seropositive practitioners reported wearing respiratory or eye protection while providing veterinary care to cattle. Neither respiratory or eye protection is recommended when working with uninfected animals in regions without confirmed cases; however, safety goggles and a respirator are recommended when working with uninfected animals in regions where there are confirmed or potentially infected animals (4).
Among 150 bovine veterinary practitioners, three had evidence of recent infection with HPAI A(H5) virus, including one who only practiced in two states (Georgia and South Carolina) with no known HPAI A(H5) virus infection in cattle and no reported human cases (1,2); this practitioner reported no exposures to animals with known or suspected HPAI A(H5) virus infections. These findings suggest that there might be HPAI A(H5) virus–infected dairy cattle in states where infection in dairy cattle has not yet been identified, highlighting the importance of rapid identification of infected dairy cat...
aerosol sources. Aerosol orifices.

This lines up with previous studies.

"93% glove usage and 85% boot covers would have stopped transmission" 93% glove usage and 85% boot covers would have stopped transmission CDC PPE Study of Dairy Workers Infected. 11/7/2024 Dairy workers exposed to ill cows during the week after A(H5N1) virus detection reported higher use of gloves (93%), boots or boot covers (83%), head or hair covers (79%), and eye protection (76%) compared with those who reported exposure to ill cows in the week before detection of HPAI A(H5N1). Reported use of N95 FFRs or other respirators and other types of masks was low (9% and 27%, respectively) among workers exposed to ill cows the week before A(H5N1) outbreaks were d...
CDC PPE Study of Dairy Workers Infected. 11/7/2024 Dairy workers exposed to ill cows during the week after A(H5N1) virus detection reported higher use of gloves (93%), boots or boot covers (83%), head or hair covers (79%), and eye protection (76%) compared with those who reported exposure to ill cows in the week before detection of HPAI A(H5N1). Reported use of N95 FFRs or other respirators and other types of masks was low (9% and 27%, respectively) among workers exposed to ill cows the week before A(H5N1) outbreaks were detected, with higher usage reported among exposed workers in the week...
Veterinarians are one possible vector between infected and uninfected herds/ farms.
Read 4 tweets
Lazarus Long Profile picture
Feb 13
Latest Pew Poll.

Or an exercise on "How well did Biden disappear C0V1D?"

On one hand, 21% of Americans still view C0V1D as a major public threat 21% of Americans still view COVID as a major public threat.
On the other hand, still masking?

6% of Democrats
4% Americans
2% Republicans

Guess when Biden took over on the graph? On the other hand, still masking? 6% of Democrats 4% Americans 2% Republicans Guess when Biden took over on the graph?
Yes - pretty much as soon as Biden took over, he began disappearing C0V1D.

BTW, the last poll was by yougov - masking was at 12% last year. On the other hand, still masking? 6% of Democrats 4% Americans 2% Republicans Guess when Biden took over on the graph?
Read 12 tweets
Lazarus Long Profile picture
Feb 11
What do we need to do to make every healthcare worker in the world understand that flu is airborne?

Get IPC on board.

Let me introduce you to Dr. Zahir Hirji, President of @IPACCanada at #IPAC2023.

Where do we know him from?

That's a very interesting question.

/1 Image
In 2006, Dr. Tellier wrote an article in the CDC EID explaining that influenza was airborne via aerosols.

Quite nicely done.

pmc.ncbi.nlm.nih.gov/articles/PMC33…
Dr. Zahir Hirji and some other IPC doctors from the Canadian HUGE University Health Network disagreed.

Right back you, Tellier - in 2007.

wwwnc.cdc.gov/eid/article/13…Camille Lemieux*Comments to Author , Gabrielle Brankston*1, Leah Gitterman*, Zahir Hirji*, and Michael Gardam*† Author affiliations: *University Health Network, Toronto, Ontario, Canada; †University of Toronto, Toronto, Ontario, Canada;
Read 10 tweets

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