Behind Closed Wards Profile picture
Feb 4 7 tweets 1 min read Read on X
🧵 THREAD: The quiet revolution in aerosol transmission (2017–2019)
In the years just before COVID, scientists were increasingly clear that “droplet vs airborne” was a false binary and that real-world transmission didn’t fit it. Image
Across epidemiology, virology, and aerosol science, researchers were synthesising evidence from influenza, SARS-1, measles, and TB that challenged droplet-based infection models.
Scientists including Linsey Marr, Lidia Morawska, Julian Tang, Tellier, and Zeynep Tufekci were making this case publicly in papers, commentaries, and outbreak analyses.
I’ll cover their work in individual profile tweets.
Their argument wasn’t new physics. It was failure of fit.
Droplet-based assumptions could not explain observed transmission patterns, especially in indoor settings.
Outbreak investigations increasingly pointed to shared air, ventilation, and exposure time as dominant risk factors where distance, brief contact, or surface cleaning could not account for spread.
By 2019, many scientists were explicit: the droplet–airborne distinction was a false binary.
Transmission existed on a continuum shaped by indoor air with direct implications for hospitals.
Sources include Morawska et al.; Marr et al.; Tellier et al.; Tang et al.; Tufekci commentaries (2017–2019).
Mini-profiles of each scientist to follow.

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More from @BehindWards

Jan 19
Aerosol transmission of SARS-CoV-1 was identified during the 2002–2003 SARS outbreak, including in hospital settings Image
This was recognised during the outbreak itself, not years later, when transmission patterns could not be explained by droplets or close contact alone.
Hospital investigations showed:
• infections across wards
• healthcare workers infected without prolonged bedside contact
• spread despite droplet precautions
Read 8 tweets
Jan 16
How do aerosol viruses like SARS-CoV-2 spread in hospital settings? 🧵
Understanding airborne transmission is essential to preventing hospital-acquired COVID. Image
Aerosols are tiny particles released when people breathe, speak, cough, or shout.
Unlike droplets, aerosols can remain suspended in the air, travel beyond close contact, and accumulate indoors.
In hospitals, risk increases when:
• ventilation is inadequate
• air changes are low
• spaces are crowded
• patients and staff share air for prolonged periods
This is especially true on wards.
Read 6 tweets

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