Thread by @jljcolorado

1/ What are the REASONS for early DENIAL & continuing RESISTANCE & obfuscation by @WHO, @CDCGov & Other Public Health to the fact that #COVIDisAirborne?

We just published a paper on the contribution of history. Which is important, but NOT most important

onlinelibrary.wiley.com/doi/10.1111/in…

2/ Yesterday I wrote a 133 tweet thread explaining our recent paper and most of the history.

Some people think it is too long to read, and that it doesn't do justice to the main reason. So this (hopefully shorter) thread tries to address that.

https://twitter.com/jljcolorado/status/1562112453948755974

3/ IMHO, the reasons for the denial, resistance and obfuscation of #COVIDisAirborne by @WHO @CDCgov etc. are:

(a) Politics and economics. Droplets and surfaces are VERY convenient to those in power. All the responsibility is on the individual.

telegraph.co.uk/global-health/…

4/ #COVIDisAirborne is VERY inconvenient to those with POLITICAL POWER and to the larger ECONOMIC INTERESTS (e.g. large corporations) that have the most influence on them.

It scares ppl, who'd consume (e.g fly) less, and requires expensive measures.

telegraph.co.uk/global-health/…

5/ We know how political and economic power deals with INCONVENIENT SCIENCE. They deny, resists, obfuscate and delay as much as feasible.

Prime example is climate change. We have known for many decades, yet the fossil fuel industry and allies (~20% of World GDP) stalls progress

6/ But if it had been SCIENTIFICALLY CLEAR from the start that #COVIDwasAirborne, and it was WIDELY ACCEPTED by Public Health and Infectious Disease scientists...

those in power could not have resisted change as successfully as they have managed to do until now.

7/ So why wasn't it clear. These are the other key reasons:

(b) History set up a bad situation over a century

(c) When it became clearer and clearer that @COVIDwasAirborne, saving face by those in power in Public Health and Infectious Diseases became a critical driver too

8/ Some people were replying to yesterday's thread saying that PH and ID people KNEW early in the pandemic that it was airborne, and chose to hide it.

I disagree. I think the overwhelming majority of PH and ID were genuinely confused and thought airborne was totally wrong

9/ We met with the @WHO officials & IPC committee in Apr 2022. The Chairman of the @WHO IPC committee YELLED at us. They thought that suggesting that #COVIDwasAirborne was just crazy.

This (great) article in @WIRED recounts some of those discussions:

wired.com/story/the-teen…

10/ Months later, in July 2020, another @WHO IPC committee member (@metadoc) said in an interview that we didn't know what we were talking about, and hinted at us having an economic interest to promote airborne.

livescience.com/coronavirus-ai…

[An apology would be nice some day]

11/ Also in July 2020 (which is when we came out with the "letter of 239 scientists" about #COVIDisAirborne nature.com/articles/d4158…) the @WHO staff member in charge of IPC (@allegranzib) told @Nature that we didn't know what we were talking about (more politely, of course)

12/ So I do believe that they really were stuck in the scientific error that's #DropletDogma, and couldn't see past it.

But things started to change in late 2020, and faster and faster afterwards.

13/ As enormous scientific evidence for #COVIDisAirborne accumulates, those in charge at @WHO @CDCgov start to realize that #COVIDisAirborne.

E.g. @WHO officials start promoting ventilation without explaining the reason.

https://twitter.com/jljcolorado/status/1323279393725194240

14/ @WHO officials knew perfectly well that ventilation ONLY works for airborne transmission. Does NOTHING for droplets or surfaces.

They stated this to a journalist (@MeganMolteni) later!

wired.com/story/the-teen…

15/ @CDCgov Chief Medical Officer J. Brooks had given a talk to the US Nat. Acad. Sci @theNASEM in Summer 2020, describing:

- droplets as large / fall to the ground, limited by gravity
- aerosols as small / float in air, are inhaled

nationalacademies.org/event/08-26-20…

16/ @CDCgov even posted in their website that #COVIDisAirborne in Sep. 2020. But that was removed after 3 days, and replaced by big picture obfuscation (even if many sci. details are correct), which continues to date

I wrote this thread at the time:

https://twitter.com/jljcolorado/status/1307918933391933441

17/ Since, @CDCgov has resorted to describing the science more correctly, but calling aerosols "respiratory droplets". Which contradicts what they told @theNASEM months before, and the whole history of the field.

They avoid saying airborne like the plague

18/ Why do @WHO @CDCgov and PH worldwide avoid admitting that #COVIDisAirborne (as much as feasible)?

Partially is again (a) politics and economics. Many US hospitals are for-profit and hold huge sway at @CDCgov. They HATE airborne with a passion, because it costs $$$$ to them

19/ For @WHO, there may be some of that, but they also worry about lower income countries.

I head from a colleague who works there that they fear those small budgets would be "Wasted" on ventilation, if they said loud & clear that #COVIDisAirborne.

20/ I.e. top @WHO Officials think other priorities are more important, but that pressure would be irresistible to spend on ventilation (& N95 etc.), if @WHO admitted publicly #COVIDisAirborne

You won't see "airborne" in their extensive Twitter feed:

twitter.com/search?q=airbo…

21/ Sorry, I have to take a break to take our kid to the dentist. He may need to get braces but he is not happy about it.

I will continue the thread later today I hopefully can keep it below 35 or 40 tweets

22/ So the MAIN reason we are stuck now with resistance and obfuscation, now that the science is clear to ALMOST ALL SCIENTISTS is...

that the protective measures needed to reduce transmission when #COVIDisAirborne are VERY UNDESIRABLE to political and economic power (cost $$ $)

23/ @WHO and @CDCgov and ministries of health (e.g. @sanidadgob) are first and foremost POLITICAL organizations.

If there is conflict between science and politics, POLITICS ALWAYS WINS. And those in power HATE the cost & impact of protective measures needed for #COVIDisAirborne

24/ But that's not the whole reason why @WHO @CDCgov obfuscate on #COVIDisAirborne

There is reason (c):

(c) When it became clearer and clearer that @COVIDwasAirborne, saving face by those in power in Public Health and Infectious Diseases became a critical driver too

25/ E.g. @WHO told us loud and clear in March 2020 (when we were ALL learning like sponges & willing to do anything to protect ourselves) that:

- UNPROVEN mechanisms (droplets & surfaces) were DOMINANT

- #COVIDisAirborne was MISINFORMATION

https://twitter.com/WHO/status/1243972193169616898

26/ That led to billions of people focusing on washing hands & disinfecting surfaces, which are actually useless (or close) for COVID

We were told by @WHO et al. that masks (a very effective measure) were not useful. No serious mention of ventilation by @WHO till Nov. 2020

27/ The ACTUAL MISINFORMATION spread by @WHO et al. in the early pandemic leds to the virus spreading everywhere fast, eventually mutating to be more transmissible.

Millions of people have been sick or died. Would CERTAINLY been less if @WHO et al. told us early #COVIDisAirborne

28/ Naturally, the scientists and officials at the top of @WHO, @CDCgov do NOT want to admit CLEARLY and DIRECTLY that their actions helped the virus spread and kill.

One Govt official told us privately: "You need to find a way to allow us to save face"

29/ So we have an UNHOLY ALLIANCE between those with POLITICAL & ECONOMIC POWER and those with PUBLIC HEALTH POWER.

PH officials are all too happy to avoid admitting their errors, which suits political power just fine, by keeping transmission confusing and unclear

30/ Note that those in PUBLIC HEALTH POWER tend to be all trained in the same way (PH & inf. diseases).

And they have SYSTEMATICALLY excluded airborne and aerosol experts from key positions. E.g. see this paper from @trishgreenhalgh:

wellcomeopenresearch.org/articles/6-126

31/ E.g. @CDCDirector @RWalensky has said recently that @CDCgov needs reform, because of poor pandemic response.

This is welcome and useful. BUT... to my knowledge, NO MENTION of including aerosol / airborne scientists at the highest levels.

nytimes.com/2022/08/17/us/…

32/ So:

(a) political and economic power find #COVIDisAirborne VERY INCONVENIENT

(c) Public Health officials want to save face

are major reasons NOW.

But (b) SCIENTIFIC / MEDICAL HISTORY set us up to make the grip of (a) + (c) overwhelming today

33/ So then back to (b), the impact of history.

The detailed version is on the paper and yesterday's thread:

onlinelibrary.wiley.com/doi/10.1111/in…

34/ IMPACT OF HISTORY in the denial and resistance of #COVIDisAirborne. The SHORT VERSION:

For 2 millenia 400 BCE (Hippocrates) to the 2nd half of 19th Century, Miasma theory (diseases come from the air) was DOMINANT

en.wikipedia.org/wiki/Miasma_th…

35/ Between 1847-1898 3 major diseases (cholera, malaria, puerperal fever) that were THOUGHT to be transmitted to the air, are demonstrated to be transmitted by water, mosquitos, dirty hands.

For more detail see tweets #26+ from yesterday:

https://twitter.com/jljcolorado/status/1562146386388271104

36/ This shakes the belief that most diseases go through the air. GERM THEORY revolutionizes the understanding of transmission, also ~1860-1880. All old ideas are questioned and re-examined in light of new knowledge.

More detail at:

https://twitter.com/jljcolorado/status/1562160958788685826

37/ Just as it is the case now, political / economic power hated airborne transmission, as it scared people and was harder to fight than other means of transmission. And doctors worried about the social impacts of airborne transmission:

https://twitter.com/jljcolorado/status/1562167827569602560

38/ A prominent American Public Health researcher, Charles Chapin works around 1910.

He was trying to promote his own theory (contact infection) and found the lingering miasma / airborne beliefs extremely inconvenient to the acceptance of his ideas.

https://twitter.com/jljcolorado/status/1562174359136923648

39/ Even tho Chapin had NO evidence, he states:

- ease of transmission in close proximity & decreased transmission with distance is due to sprayborne (large) droplets that fall due to GRAVITY near the person

- Airborne transmission is extremely unlikely

https://twitter.com/jljcolorado/status/1562175497345175553

40/ Chapin's theories conquer fields of Public Health and Infectious Diseases, and become the #DropletDogma, dominant for 110 yrs till @WHO at the start of COVID:

- I am sure helped by the advantages for economic activity if airborne transmission assumed as unlikely (a) above

41/ In particular, Chapin's theories conquer the @CDCgov and its epidemiology branch.

E.g. Its first and longtime director referred to Chapin as "the best American epidemiologist".

And Chapin's ideas remain dominant there.

https://twitter.com/jljcolorado/status/1562177914107400192

42/ @CDCgov was (and still is) the preeminent public health institution. Has many more scientists than @WHO.

From there, Chapin's ideas about droplet transmission explaining close proximity infection, and the unlikelihood of airborne trans. conquer the world.

43/ So even though East Asian cultures and Eastern European countries (the latter at least during the cold war) viewed airborne transmission are more likely than Chapin, the response of @WHO to COVID-19 seems dominated by the Western "Chapinista" tradition

44/ In 1962, Wells, Riley, and Mills demonstrate that tuberculosis is airborne. First major disease to be accepted as airborne in modern times

Complete denial of airborne transmission ends

https://twitter.com/jljcolorado/status/1562191416456986624

45/ But extreme resistance continues, and AS LITTLE AS POSSIBLE airborne transmission is accepted.

E.g. such obvious airborne diseases as extremely contagious measles and chickenpox are NOT accepted as airborne till 20+ yrs after TB!

https://twitter.com/jljcolorado/status/1562198327772340224

46/ That exact same "tooth & nail resistance to accepting airborne" continued for the flu (despite mounting evidence of its airborne trans.) after 1990, and was at its clearest at the start of the COVID-19 pandemic:

https://twitter.com/WHO/status/1243972193169616898

47/ And that resistance from PH & infectious diseases, I believe honest at the start, and rooted in the scientific traditions of those fields sets us up

We are all misinformed about transmission, making it easier for political and economic power (a) to continue their obfuscation

48/ The (in principle honest) resistance of PH orgs. like @WHO is followed by realizing the enormous error they have made, and the enormous cost in lifes & illness of denying & resisting #CovidIsAirborne

Leading to their attempts to save face (c), unholy alliance w/ power (a)

49/ So that's that. Obviously this is my take, but I've discussed it with lots of other scientists.

If you think anything is incorrect, incomplete, you have papers that contradict or add etc., pls send it my way.

50/ If this thread was too short for you😉 and you want more detail on the history (which is fascinating), here is the more detailed history thread:

https://twitter.com/jljcolorado/status/1562112453948755974