Lazarus Long Profile picture
May 17, 2024 36 tweets 14 min read Read on X
This is a 🧵 that cuts through this CDC school guidance like the thread used in Netflix show "The Three Body Problem."

Their guidance will cut down the kids just like were cut down in the show.
Let's start with their tweet. It provides a framework to evaluate their actions against their words.

- preventing spread of infectious diseases.
-benefiting ALL students.
-maximize school attendance.

Let's start with preventing spread.

-Maximize school attendance
While preventing disease
Benefits all students is highlighted
The single most efficacious way to prevent the spread of infectious diseases is wearing respirators, as they stop both near and far field aerosols.

Are they mentioned in the intro page linked to? No. Masks are, but are buried.

People are logical.
cdc.gov/media/releases…

Teach and reinforce proper hand washing and respiratory etiquette. Take steps for cleaner air by improving ventilation in schools. Schools should consider ventilation enhancements and design when undergoing remodeling or when undertaking new building construction to optimize clean air. Clean, sanitize, and disinfect, when appropriate. Promote vaccinations for students and staff.
Long red arrow showing way down the page where masks are buried
They do the bullet points first.

Masking is not even in the bullet point sections.

PPE is in the 2nd group- for staff taking care of sick kids. Of course, this ignores the 58% presymptomatic transmission rate for SARS2, 38% for influenza.

Masks for kids are buried in the
"If illness activity is elevated, schools can consider implementing additional strategies"

section. Look at the action words...

Schools CAN CONSIDER implementing additional strategies.

Whoa! Your principal will be RUNNING to implement mask mandates. (Not mentioned). Image
"These additional strategies depend on several considerations, but include actions such as:"

What considerations? This is just such bad public health writing.

You don't say "there are several things" - and then not actually talk about those things. Image
Wearing masks are included with increasing space and distance between students and cohorts.

Really? The ONLY time that has been used in the US was during pandemics. (This does not include whole school closure for temporary outbreaks). Image
So, prima facie, the most effective NPI (NonPharmaceutical Intervention) is only listed in the pandemic section. And not even an effective version, masks, or the fact that mask mandates are necessary for wide uptake.

Especially in schools which are EVEN MORE subject to peer
pressure than adult society. (Mandates work by removing peer pressure).

But hey!

You can applaud the CDC because they actually mentioned the word masks.

✅ Everyone applaud the CDC for dropping the word into a page

You can. Not me.

Let's move on. Maybe it gets better? Image
Intro page here, but let's look at the quick (the fact) sheet



"Fact Sheet: Help Your Child’s School Prevent the Spread of Infections"



No masks found. Not in the pics.... cdc.gov/orr/school-pre…
cdc.gov/orr/school-pre…



Image
Image
Image
Image
Not in the words

Instead it is respiratory etiquette, which....

Image
Image
Image
does not work.

Do little fingers magically stop aerosols from spurting from between them?

No. Neither do elbows.

And we DO NOT USE RESPIRATORY ETIQUETTE when WE BREATHE.

The @CDCgov is being so STUPID on this point.

In between the coughs? We all

still breathe. And we breathe about 11,000 liters of air every day.

A cough is about 2.3 liters of air. That is 5,000 coughs per day for respiratory etiquette to be used - if it actually worked, which it doesn't.

RESPIRATORY ETIQUETTE DOES NOT PREVENT OR SLOW TRANSMISSION.
But it is part of their main page to prevent or control the spread of infection.

cdc.gov/orr/school-pre…

Everyday Actions for Schools to Prevent and Control the Spread of Infections
School Preparedness Everyday Actions for Schools to Prevent and Control the Spread of Infections PAGE 2 of 10 ‹View Table of Contents  This guidance is for general school settings. Healthcare workers in school-based health clinics or nursing offices should follow guidance for healthcare settings.  Everyday actions help keep students healthy by minimizing the spread of infections in school settings. Infections spread in schools because of shared objects, close contact with others, students playing closely together, lack of cleaning and disinfection routines and supplies, and lack of proper v...
As is Handwashing and Cleaning, Sanitizing.

Let me ask you a poll on this topic
Hand Washing Children washing hands at school Washing hands in school can help prevent the spread of respiratory and gastrointestinal diseases. Teaching and reinforcing proper handwashing can lower the risk of spreading diseases. Schools can set routines or scheduled opportunities for handwashing throughout the day. During times of increased illness spread or absenteeism, schools can evaluate hand hygiene routines and increase those opportunities. Schools could monitor and reinforce these behaviors, especially during key times in the day. Additionally, schools can provide adequate handwashi...
that are visibly soiled with blood or other body fluids. Use gloves and other personal protective equipment (PPE) as warranted to avoid contact with the fluid. Wipe or soak up the blood or bodily fluid, clean, and then disinfect the surface. For more detailed information, see Cleaning and Disinfecting Your Facility.  Rarely, a school might need specialized or enhanced cleaning and disinfection for a particular infectious disease. This can occur when a new pathogen emerges and an ill student has been in the school space or an outbreak occurs with a specific pathogen like norovirus. Schools s...
Do we magically ooze viruses through our skin?
WHERE DO PATHOGENS PRIMARILY COME FROM?

Our mouth, nose, and anal orifices.

The anal orifice is covered by underwear and pants. A cloth mask.

The mouth and nose are not covered.

So, AFTER you wash and clean? Guess what gets dirty again from the uncovered mouth and nose?
Taking Steps for Cleaner Air leads off that page. Great. But masks should lead it off.

Oh SACRED BLEU! How dare I say that?

Ever hear of a hospital? Yeah, they have GREAT ventilation and filtration.

And they are still infecting lots of folks.

In fact, when you Take Steps for Cleaner Air Person opening window Improving air quality can reduce the number of germs in the air by increasing airflow, cleaning the air, or moving gatherings outdoors. Cleaner air can reduce the likelihood of spreading disease, particularly respiratory viruses. See CDC’s Ventilation in Buildings webpage for information on how to improve ventilation in a school.  Strategies that can be implemented to have cleaner air include:  Ensuring existing HVAC systems are providing the minimum outdoor air ventilation requirement in accordance with ventilation design codes. Considering ...
take the same hospital and put in place universal masking? Infection rates go down.

And this is part and parcel of what the CDC recommends for all of our hospitals.

But not for our schools, WHICH HAVE WORSE VENTILATION.

(Vaccinations also on this page...good ).
Let's jump to the actual page with masks. Sorry, the Additional Strategies page.

Mandates are not mentioned. Despite that being one of the CORE lessons we have all learned is crucial.

Back when Biden first began to demask America?

cdc.gov/orr/school-pre…
Image
Masks had 84% or so support. But 84% of America sure wasn't masking.

👇 Masks recommended - as only an antimasker could recommend them.

Kids don't wear N95s in general. So, next best- KN95s? The counterfeited KN95s from Amazon?

You would think the CDC would mention KF94s, Cloth masks generally offer lower levels of protection to wearers, surgical/disposable masks usually offer more protection, international filtering facepiece respirators (like KN95 respirators) offer even more, and the most protective respirators are NIOSH Approved® filtering facepiece respirators (like N95® respirators).
from Korea with their much better regulatory process.

And most of all ? Why not mention elastomeric respirators for kids?

DISPOSABLE RESPIRATORS (N95, KF94, KN95) LOSE FIT!

Sure, @flo_mask is the best game in town for elastos in town, but at least mention the genre.
I assume someone from the @CDCgov reads the NYTimes?

web.archive.org/web/2024012403…


Image
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The CDC goes on to recommend possibly adding masking to anti-bullying programs - acknowledging the issue with not having mask mandates. While not mentioning the word.

And a bit later, they point out that immunocompromised children should not be segregated...while ignoring the
Image
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fact that not having all in masks? Segregates those in masks.

These CDC guidelines are a touch better than what they had before, but it not only continues to hurt the kids? But the CDC and public health.

/Continued... Image
Which brings us to maximizing school attendance.

THE NEW CDC GUIDELINES WILL NOT MAXIMIZE ATTENDANCE, and hurt the public's view of the CDC.

That's right - the CDC is hurting public health. Hurting themselves. Hurting the kids. Hurting America.

With this guidance.

/Cont Image
I will say /fin when done.

Will infectious disease transmission be reduced by the new guidance?

Well, they already had handwashing, cleaning, sanitizing, formally before.

Ventilation was already there before, informally, thanks to Covid.

And infectious disease transmission
has only gone up since the end of public health emergency.

RSV, influenza, etc.

The Zeitgeist has Americans feeling constantly infected. Reddit, Facebook, x/Twitter, etc .

And this new guidance was already in place.

Let's take a simple example, "Jack and Diane".
They see the CDC guidelines. They think, "Yay! The CDC is stepping in to help keep Burt and Ernie from being sick nonstop."

But Burt and Ernie keep getting infected because nothing amhas actually changed since the end of the PHE.

Will Jack and Diane look favorably upon
public health? Or are they more likely to think, "Hey - maybe it IS the vaccines making our kids sick."

Because they already knew their kids school HVAC had been improved.

It is truly ironic that the CDC continues to hurt public health.

While trying to help public health.
I almost forgot to close out on the maximize attendance point.

The CDC is "trying" to maximize attendance. This ostensibly is to be done by preventing the spread of the flu, norovirus, strep throat.

Interestingly, covid not mentioned there.

And even more interesting?
Image
Image
All of those are airborne. But as Covid has shown, near field aerosol dominates transmission of airborne diseases.

The CDC is putting fomite and far field aerosol strategies at play.

MASKING is the THE near field aerosol NPI, and is shoved into the back of the closet.
(Note: far field improvements will result in small improvements in near field. Distancing as listed in Alternative strategies is also a near field aerosol NPI)
By ignoring the PRIMARY form of transmission in their HIGHLIGHTED NPIs?

The CDC WILL NOT MAXIMIZE ATTENDANCE.

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More from @LazarusLong13

May 10
Great article by @EmilyJoshu here.

Emily, there's another article in this that's even more shocking.

The aerosols from milking have long been discussed by many of us on X.

People like myself, @sri_srikrishna, @AbraarKaran have long advocated for comfortable aerosol
protective gear like PAPRs. But, have been ignored by the USDA who, of course, thought it was only contaminated milking gear like the claw.

But there is one more source of aerosols besides cow breath.

The wastewater. When you spray anything you generate huge amounts of Image
aerosols. And that farm wastewater, filled with milk dumped from being full of H5N1, gets reclaimed and reused.

Those milk and wastewater lagoons are on most dairy farms (my grandfather owned a dairy farm).

And there's something you should know.

Image
Read 15 tweets
May 7
Humanity's hubris vs the precautionary principle.

The virus, ANDV, will do what it will do. Pandemic? History tells us "NO." But history is in the past.

Let me show you what the studies tell us - and why I am livid that the WHO is insisting that surgical masks are ok.

🧵
Incubation time, or how long until symptoms show up?

The high risk time frame is 14–32 days. Not to put too fine a point on that, but that can mean a full month later

pmc.ncbi.nlm.nih.gov/articles/PMC32…

There have been some out to 8 weeks, but let's ignore those

gov.uk/guidance/andes… Image
Clinical features The most important complication of ANDV infection is HCPS, which is associated with a high mortality rate. Milder illness without significant cardio-respiratory compromise may also be seen. Illness usually develops 2 to 4 weeks following exposure, but incubation periods as early as 4 days and up to 8 weeks have been described.
But, what receptor does the ANDV attach to?

PCDH1 (protocadherin-1) is primarily expressed in the airway epithelium of the respiratory system, especially in the bronchial and nasal epithelial cells, and in pulmonary endothelial cells.

So, that means in the URT and the LRT.
Read 41 tweets
May 6
@mvankerkhove - a follow-up question on today's press conference.

In this bit, you were thanked for being very clear.

But, you said that the medical personnel taking care of those sick would be wearing PPE.

N95s are not PPE. They are Respiratory Protective Equipment. /1
Surgical masks are PPE.

So, is the WHO advising them to wear surgical masks or N95s/FFP2/KF94/KN95 (respirators)?

Second followup, @mvankerkhove, you referred to "really close contacts"

Close contacts are defined by the WHO as within 3 feet.
Cases 1 & 2 were close contacts.

How did the other cases get it? I realize you cannot possibly have an answer...but you are labeling this as "really close contact" for those cases - as well.

Staterooms are typical 2 person rooms.

It doesn't add up. Image
Image
Read 12 tweets
Mar 26
I've become a bit of a Dental Nerd after just getting savaged by avoiding the dentist due to COVID.

But, now, I have a Dental Nasal PAPR, know all about Stephan's Curve, use a waterpik, Oral-B iO Series 10, chew 8 pieces of xylitol gum - and the dentist just said that.....
He has never seen anyone reverse course so perfectly before.

"Immaculate."

And bonus...I ran into a fellow masker in his lobby!!

She had never heard of Readimask, so I was super happy to share the Good Word with her.

Sharing the Good Word - not COVID!
Read 4 tweets
Mar 16
Now, this is a very interesting PREPRINT.

We've all heard that shingles vaccination reduces risk of Alzheimer's.

And we all know that Covid increases the risk of Alzheimer's by 50-80%.

What happens when you mix them? Will the vaccination offset a different disease?

/1 Opposing effects of SARS-CoV-2/COVID-19 infection and recombinant zoster vaccination on the risk of late-onset Alzheimer disease  View ORCID ProfileCarly M. Rose, Shiying Liu,  View ORCID ProfileWilliam S. Bush, Jonathan L. Haines, Scott M. Williams,  View ORCID ProfileDana C. Crawford N3C Consortium doi: https://doi.org/10.64898/2026.01.21.26344555 This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
Yes.

But by how much? Conclusions and Relevance SARS-CoV-2/COVID-19 infection and recombinant zoster vaccination are modifiable risk factors for LOAD among older individuals, with a modestly significant interaction between the two. Recombinant zoster vaccination reduced LOAD risk regardless of sex and race, though the protection is greater in those without documented COVID-19 infection. Recombinant zoster vaccination and reduced exposure to COVID-19 infection in the later decades of life reduce the risk of developing Alzheimer disease over at least a five-year period.
Useful for below - "Late-onset Alzheimer disease (LOAD; onset age ≥65)"

"odds of LOAD are 16% higher among those with at least one reported COVID-19 infection" Image
Read 7 tweets
Mar 3
A doctor complaining about wearing N95s? Thread foreshadow in the gif 👇.

Dr. Sax, you should read this.

The arrogance of medical doctors thinking they know better than the CDC NIOSH and OSHA?

This comes as no surprise.
Imagine if an asbestos worker, or a tech working in BioSafety Lab was complaining about this.

But somehow, doctors making over $200,000 get carte blanche and and a piece in the @NEJM Voices.

And he does have a loud voice.
This is Dr. Sax, Clinical Director, Division of Infectious Diseases (ID), at THE Harvard hospital. In 2014, he wrote about how ID docs only make $174,000.

He probably makes northwards of $269,000.

This is very, very relevant.

You see, he is put out by the inconvenience Image
Read 23 tweets

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