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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Replying to @zeynep @BillHanage
"Speaker remaining masked" has a very high socal cost as it makes it much harder for many to understand.
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Replying to @IanStockport @BillHanage
Indeed. But once you identify what needs the happen, and the problem—the high social cost—we can think about what we need to do. Design proper face-shields (neck seal?)/transparent masks with sufficient filtration is one obvious step. May be expensive, but okay for only speaker.
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a plastic face shield with a neck seal would be suffocating but you can see a dr wearing a powered air purifying respirator with a neck seal here: https://www.nytimes.com/2020/07/04/us/coronavirus-houston-new-york.html …
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Not a full seal, obviously! A filter.
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