This is why the terminology is important, though. This entire issue has been one of communication. Transmission by inhaled droplets/aerosols/particles has been presented to the public as if this is new information when it's not and people are confused about what this means.
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Replying to @angie_rasmussen @ShellyMBoulder and
I am genuinely confused by what you are saying. - WHO talking about ballistic droplets, see video. And "FACT: NOT AIRBORNE". And guidance consistent w/ that, eg STILL NOW masks indoors only if can't keep 1 m distance https://twitter.com/i/status/1244258441880797184 …pic.twitter.com/InVsWjBydp
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Replying to @jljcolorado @angie_rasmussen and
However you seem to say that "transmission by inhaled droplets" (i.e. aerosols) has been known for a while, not new info? - Perhaps internally among researchers? - Also at WHO? Is that why they rec ventilation w/o saying why? Recognize it is real but fear of saying "airborne"?
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Replying to @jljcolorado @angie_rasmussen and
Having worked with WHO on this, I concur that they are still only recommending masks indoors *if* one meter distance cannot be maintained in the official guidance, and only recently acknowledged the possibility of any droplet/aerosol may remain "airborne" but stubbornly insist +
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Replying to @zeynep @jljcolorado and
that cases like the choir practice and the Guangzhou restaurant etc. could still be fomite or droplet (which they do mean ballistic action but it's muddled). They also say no cases that demonstrate fomite transmission but they still consider it a key transmission mode. Confusing.
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Replying to @zeynep @jljcolorado and
I see the practical relevance of this confusion because, for example, colleges are preparing to open indoor spaces with masks, hand-sanitizers and distancing but not a lot of discussion, if any, about the importance of ventilation or recognition that 1-2m indoors isn't absolute.
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Replying to @zeynep @angie_rasmussen and
Agree on that situation. WHO has issued recs on ventilation, our group helped them with those. But ppl don't understand **WHY**, have not made effort to implement, bc it is not clear WHY one would need to do that, if "FACT: NOT AIRBORNE" Once ppl understand, they take seriously!
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Replying to @jljcolorado @angie_rasmussen and
The danger there is when people hear "AIRBORNE" many think of that scene in Outbreak when Dustin Hoffman looks up at the vent and realizes that this is going to spread to the whole hospital. This isn't that, nor is it measles, but also not just WHO's initial ballistic droplets.
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Replying to @zeynep @jljcolorado and
Agreed- which is why when people were using "airborne" to describe this, the ID folks raised the flag saying "hey...maybe let's not use that term because the public health and healthcare associations with it”.
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Replying to @SaskiaPopescu @zeynep and
Both an arrow and a balloon are airborne. Most epidemiology supports arrows and not balloons except rare exceptions. It has been pointed out, the restaurant/air-con example is more like an arrow. Not seeing many balloon examples
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The communicative challenge is "airborne" is associated with mist-like spread, and this isn't that. But WHO droplets only have ballistic trajectories, and this isn't just that either, because clearly, they can be pushed around *a bit* by air currents rather than always dropping.
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From my end, I'm focused on the confusing messaging. I don't doubt that the experts can sort it out among themselves, but regular people are confused and I do not have a single consistent guideline to recommend to people. WHO still considers 1m indoors as super strong protection.
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The problem communicating across disciplines bleeds over into the public. If experts from different fields aren't able to understand each other, it makes it tremendously difficult to convey useful and consistent guidance to the general public.
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