Lazarus Long Profile picture
May 17 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…



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Not in the words

Instead it is respiratory etiquette, which....

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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…
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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…


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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
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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
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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 19
"Why You'll be Wearing Masks Again"

from TIME magazine (May 18, 2009)."

You can zoom in and read it, but quick 🧵 of lessons NOT learned.

NOT🤬 LEARNED


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Surgical mask for an airborne disease?

Lesson learned?

✅ CDC is recommending N95s for H5N1. But has no jurisdiction, so an easy recommend.

❌ CDC is not recommending masks, but handwashing to maximize attendance in schools and prevent transmission.

❌ But per their own document school closures pre-Covid were made up of 59% respiratory, 20% gastrointestinal. Why focus on the results from a study from the 2011-2013 period of time when Covid is by FAR the disease still in excess?

The study.
journals.plos.org/plosone/articl…


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Read 10 tweets
May 19
Not included in the below evisceration of the CDC?

This. The beginning of the Everyday Action document to protect the kids.

The BASIS of everything after.

A 🧵 of analysis you will not have read before. No studies.

Infections spread because of ....

cdc.gov/orr/school-pre…

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❌ shared objects? Do the objects spontaneously get dirty?

❌ Close contact with each other? If children stand next to each other, they are in close contact. Do they infect each other?

❌ Students playing close to each other, but not breathing each other's air, do they
infect each other?

Fortunately the CDC has spelled out the HOW of kids infecting each other.

Contact, spray & splashes, and inhalation👇.

Ah, @kprather88
@jljcolorado, you'll be pleased to see that droplets have now been renamed as spray and splashes.

cdc.gov/orr/school-pre…
Image
Read 12 tweets
May 18
A two week puke cruise from South Hampton to the Canary Islands with 3,077 other guests, 1,205 crew members, and 1 apparently greedy cruise ship company (?) -@pandocruises.

How does a 5 HOUR WAIT to call the ship doc sound?

H/t @FriedmanJas

pocruises.com/find-a-cruise/…

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The situation on the ship with capacity for 3,192 passengers was described as ‘terrible’ and ‘serious outbreak.’  The bug has allegedly plagued Ventura for more than a month, with staff thinking it was gone after each cruise before the bug returned to wreak more havoc among guests and some crew.  Guests allegedly face a five-hour wait to call the ship’s medical centre because of ‘so many cases.’
The norovirus outbreak has been going on for 5-6 WEEKS.

How does people throwing up in the public spaces sound?

How does 250, most def an undercount, infected passengers sound?

Ah, @pandocruises? Besides doing the deep cleaning? Image
Norovirus is airborne.

Why not offer your passengers and crew FFP2s/N95s, and suggest they eat outside - until the outbreak is over?

Or....bring in a bunch of HEPAs for the dining room? In between the tables? Plus the N95s.

Read 4 tweets
May 18
Dr. Marr wrote this. I respect her immensely, but completely disagree on this topic.

- She does not know the ventilation/filtration of every airport. She does not know who was just sitting in that spot moments before you found it. Aerosol stability, physics of aerosols, Image
speed of ventilation/filtration all agree with me on this. The Australian Church study of 45 feet transmission facing away agrees.

- On airplanes - the Harvard Aviation Public Health Initiative (APHI) disagrees with her, indicating masks are necessary

abcnews.go.com/Politics/covid…
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- On coughing, she might not be aware of the 58% presymptomatic transmission.

-Overall, she might not be aware of the:
✅ 38% LongCovid risk after 3 infections.
✅ It only takes one virion to start a covid infection (tight transmission bottleneck).

We can disagree, but still
Read 4 tweets
May 15
These folks refuse to give good real-life advice on how to clean up Hantavirus droppings.

And here we go - a shed with pressed board flooring and mouse droppings.

If I mop? Floor gets ruined.

If I blow it out with safety goggles and an N95 on?

Safely clean. And I
/1


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didn't have to pull everything out to get it done.

Real world aerosol-based solution versus a laboratory fomite-based solution.

@WADeptHealth - join us in the real world where viruses are airborne via aerosols - THROUGH THE AIR.

Or don't and let me gain followers by pointing
out your many many mistakes.

I would prefer to have no followers, and you putting out aerosol-based solutions.

But until then...thank you for being yet another useful tool to let me "gain clout."
Read 11 tweets
May 14
CDC Influenza A monitoring is up.



They compare to last year's influenza season, and if up 80%? Begin investigating.

There are some latency problems with this, but let's ignore that.

Let's look at the geographic location problem. cdc.gov/flu/avianflu/h…

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The thing is? While it's great to have this effort beginning, it is only covering 600 sites.

For Texas, it is Randall and Potter Counties. And there may be more than one wastewater treatment site in those counties.
Mdp showing Randall and Potter County as wastewater location for Texas panhandle.
Pic showing Randall and Potter County as popup context for map
I walked through every chicken and dairy outbreak from a preprint study that yielded county names.

(Only read if curious, can be skipped).
Read 8 tweets

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