And yet, if you are caught in a superspreading event you are surely exposed to a higher risk of infection. And the persistence of the virus in the population suggests such events must be important 8/n
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The risk of transmission, and the risk by different routes varies over the course of infection. For most of the time I think it is probably pretty low 9/n
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However the existence of superspreading events show that for *enough* it has to be super high. And I find it hard to explain these without a short-lived capacity for airborne transmission 10/n
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And it is widely agreed that such superspreading events are essential components of the transmission dynamics so... ? 11/n
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I think that transmission risk is low other than at the point of peak viral loads, which usually happens earlier in infection. I *think* that airborne transmission may happen from at least a fraction of people at that stage. How many they infect depends on how many contacts 12/n
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What does this mean? Well first I want to be clear that this is an opinion based on what I see in the data. But I cannot find a way to get "overdispersed R0 driving things" into my head without a role for the mode of transmission that drives that over dispersion 13/n
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But for crying out loud, this indicates also the importance of freaking distancing. If you aint there, you're not gonna be the infected or infectee. So distance and find ways to maintain it! (
sorry I truly appreciate this is hard but it is also not my wheel house) 14/n1 reply 20 retweets 98 likesShow this thread -
in conclusion we are almost where we were, but hopefully recognizing the importance of an overdispersed reproductive number and what may well be driving it. Distancing, testing and tracing remain crucial. Take care of yourselves, and others x 15/end
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Replying to @BillHanage
I'd add is that overdispersion plus short-range aerosols do modify some recommendations (masks indoors no matter distance) and adds a few new ones (ventilate; speaker should remain masked etc.). These are not currently in guidelines. I wrote about it here:https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/ …
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You're very welcome! I've been trying to focus on what people should be aware of given all this. I think having the right mental model helps folk assess their own situations; avoid binary thinking (six feet as magic!); plus need for new/modified guidelines (outdoors, masks etc.)
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