Lazarus Long Profile picture
Nov 3, 2023 24 tweets 7 min read Read on X
The HICPAC Public Comments threaded.

I tried to do a quick synopsis. I will add more tomorrow. Please tag folks you recognize.

I apologize in advance for some very butchered spelling of names and brevity.

The value is not in my words - but theirs. Image
Here is the HICPAC schedule, so keep in mind that we still need to comment on their draft after tomorrow.

And without further adieu.... Image
Mary Germanus, @PeoplesCDC

Many HCWs refuse to mask, and continue to expose people. Are HICPAC and CDC prioritizing profits over our health?

Dr. Rosalie A Bright, retired federal epidemiologist. Nails almost every single point that I personally would have made.

Maria Castro has been avoiding healthcare because of current practices. HICPAC and CDC should be serving the public. They are not . They should be educating about the risks of Covid. They are not.

No places are requiring masking for vaccinations.
Zenei Triunfo-Cortez, nurse, President (if I heard that correctly) of @NationalNurses.

The CDC did not have the draft available before this meeting so there was no perspective from: Frontline nurses, immunocompromised, aerosol scientists, engineers, etc.
Eric Berg, Deputy Chief of Health for Cal OSHA. Very interesting sharing of Aerosol Law that is more protective and trumps CDC's recommendations. But many employers use CDC to skirt the law.

Cal OSHA recommended elastomerics for the PPE shortage.

Don Ford - our brains are vulnerable to SARS2, and it is respirators that protect the most against it.

(My apologies, you spoke very quickly, and I am tired).
Chloe Humbert - why do HCP say they are following CDC's guidelines in not actually masking up? Is the high-faluting HICPAC simply about saving money for the corporations - and has no patient advocates?

The HICPAC is Koch's Brownstone Institute.

Naomi Baryam, @TheWHN

It's no longer 2007, with a pandemic 80 years ago. We are in the middle of a pandemic. HICPAC needs more diverse voices.

@joaquinlife- calling for respirators, improve ventilation, bring back reporting of hospital acquired infections. By def, every patient is vulnerable.

Pharmaceuticals are not enough.

Megan Cunningham, mother of an immunocompromised child. SC2 is not the last pandemic. More are coming.

Having to beg for HCWs to mask up, who still refuse.

Jay Herzmurg (sorry!) - nurse, registered Industrial Hygenist,

IPC tends to just listen to itself. But physics is physics, and the laws of physics apply to healthcare. But, it's like talking to a TV.

Dr. Sharif, (also sorry!) nephrologist and physician.partnering with National Nurses United. HICPAC did not discuss LongCovid at all. Surgical masks can be as low as 8% IPE, but is being recommended as part of the Standard Transmission.

Lisa Foreman, nurse practitioner.
Half of all HCWs go to work with symptomatic Covid. Overall, over half of all transmission is with no symptoms.

Massive amount of preventive healthcare has been missed due to no masking in healthcare.

Danielle Pack, patient from Michigan. Caught Covid at a Dr office while seeking postpartum care.

HICPAC should be strengthening IPC as we are in the middle of a pandemic.

She has a great demand list! Eg. A few minutes of public comment at the END?

And let me add - I appreciated EVERY SINGLE COMMENTER. THEY ALL brought their A-game..
Christine Braille. Her son is immunocompromised and has LongCovid. Infected by his home infusion nurse who refused to mask properly.

Covid is airborne, definitively, and without question.

"We got to see the disease transmitting smiles of the Drs..."

Wow ...that is a must listen. Just wow.

Last one coming up.....
Dr. Andrew Wang, doctorate and masters in public health, of @PeoplesCDC.

Showed graciousness towards the HICPAC members, and urged more protection than less.

@PeoplesCDC My final take-away - we cannot go quiet into the night.

The 1918 pandemic, and many other pandemics are noted for the silence afterwards.

We must make our mark. Loudly and proudly.

We are still here. We deserve better from the hospital corporations, and the droplet
@PeoplesCDC dogmatists that still run the bulk of IPC.

They are wrong, but revolutions in thought take time and effort.

In the meantime, contact your local representatives and ask them why an illegal committee is setting policy minus key input.

Tweet at them.
usa.gov/elected-offici…
@PeoplesCDC Call them the next day.

Email them the 3rd day.

You can have a much bigger impact than you think!
@PeoplesCDC This @DrJudyStone article is a great starting point that lays out the issue cogently.

forbes.com/sites/judyston…

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More from @LazarusLong13

Jul 17
So, I got curious.

Despite the pore sizes of the N95 filtration being so much larger than CO2 molecules, there is a greater concentration of CO2 in the N95, than outside.

Why?

We exhale 4–5% CO2 (40,000–50,000 ppm), much higher than the ~0.04% (400 ppm) in ambient air. Image
What is the the AVERAGE CO2 in the dead space below an N95? 1-3% - or 10,000 to 30,000 ppm.

Sounds scary high, right? It's the AVERAGE. Below you can see it rise and fall. See how at the end of the inhalation it's almost zero?

But what happens to that CO2? We inhaled it Image
all, so we must be poisoning ourselves!?

Nope, here is what is going on with our alveoli gas composition.

Not much of a change.

And that gets reflected in the amount of CO2 in our blood.

That is best measured by PaCO2 (arterial CO2 partial pressure). Image
Image
Image
Image
Read 17 tweets
Jul 15
Are you reading this thread because you said you were worried about CO2 in an N95?

Hypercapnia?

1. Don't worry - be happy. This thread explains why you should not be worried about those things.

2. If still worried? We'll get to what YOU can do about it.
In 1998, long before the mask controversy of 2020, the OSHA Respiratory Protection Standard was passed.


Cntrl F for
"carbon dioxide", "dead space", or "physiological burden".

Before they passed it, they consulted industry, unions, academic researchers. osha.gov/sites/default/…Image
Image
Image
Image
Dozens of studies addressing CO₂ buildup, dead space, and other tolerability issues in respirators.

Seriously, Cntrl F above.

But there is a long history they built upon within NIOSH AND OSHA - AND before.

Timeline
cdc.gov/niosh/about/ti…

Great video
youtu.be/qZEf-tzko0A?si…
Read 36 tweets
Jul 13
Tired: Infectious fecal and respiratory aerosols.
Wired: Infectious urine aerosols.

Do you know how many aerosols you generate at the urinal, standing up?

Do you know how many aerosols you generate on the toilet, sitting down?

Do you know you have a thermal plume lifting
both up to your breathing zone?

Do you know that you can get an N95 at Home Depot or Lowes - and you can wear it into their public restrooms?

Studies to come to avoid the Musk Masking algorithm.
Infectious, cultured urine from a patient:
tandfonline.com/doi/full/10.10…

standing thermal plume
link.springer.com/article/10.100…

sitting thermal plume
journals.sagepub.com/doi/abs/10.117…

flushing generating aerosols:
youtube.com/watch?v=elieor…

study on flushing generating aerosols
link.springer.com/article/10.100…
Read 5 tweets
Jun 8
"COVID IS OVER, YOU DON'T NEED THAT!"

Reason 4,657 on why I mask now that I understand aerosols and transmission. It's not all about COVID.

This is Chicago, but it's really Anytown, USA. Image
"The human DNA virome. Prevalences (%) of viral DNAs in the body (≥1 tissue positive for a virus) and in different organs as determined by qPCR or NGS"

researchgate.net/figure/The-hum…

x.com/AbundantLandUs… Image
.Why I mask in more details...

EV-D68. An enterovirus - many people think enteroviruses are strictly fecal-oral.

They think wrong ( this is not a subtweet at Dr. Johnson).

Read 6 tweets
Jun 7
How do we know TB is airborne?

71 guinea pigs gave their lives between 1956 and 1958 in the eponymous study by Riley et al, getting TB air piped in from some TB patients, to prove TB is airborne.

Influenza is kind of airborne per most doctors. But kind of not.

So....

/1 Image
We need some volunteers.

Will horses be those volunteers that finally lay it all out?

Yes - but none of them lost their lives.

Air samplers were deployed and tracked horses inoculated with Equine influenza virus (EIV).

From the very first day post inoculation (dpi), until the Image
12th day, EIV was found in the air, in this new study.

With no horses, or guinea pigs, hurt in the process.



But sure, influenza's not airborne - if you are the USDA, right, @nirav_maine?

Of course, yet another new study points an accusatorysciencedirect.com/science/articl…
Read 9 tweets
May 26
Thank you @BarryHunt008 for flagging this.

@ThailandMedicaX, retweeted by some because of their controversial takes (ahem, their lies?), is saying that FAR-UVC is dangerous because somehow the light will get into the lungs.

Lol.

They are just apparent supplement grifters.

🧵 Image
I noticed they were using @NukitToBeSure's excellent torches as their example picture.

Strange to be so selective of an example picture for someone purporting to be an independent news source on health.

Hmm. I helped defend Nukit against charges of Image
racism by a very nasty couple who it turned out just do not like UVC, personally. I wonder....

Yep, ThailandMedicalX has blocked me.

But, it's weird for a purported news source to block someone like me @gorskon
@doritmi @19joho.

And them blocking me, is probably because Image
Image
Read 21 tweets

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