We argue that the so-called "droplet precautions" do, to a good degree, overlap with "airborne protections" (because aerosols are also nearer) which is fine, but it's important to get the mechanism right, because it's not a complete overlap, and the implications aren't the same.
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This is the geekiest bit that I love and cannot wait for the longer papers to be public: I'm persuaded that the traditional droplet/aerosol boundary has a major scientific error (wrong by about 20x) that has led to much misunderstandings and errors. Ask
@jljcolorado about that!4 replies 36 retweets 392 likesShow this thread -
Fascinatingly, you search the scientific record high and low, but there really is little to no direct evidence for gravity-sprayed droplets being predominant mode of transmission for respiratory illnesses outside of coughing/sneezing. It's many... assumptions. Like a tradition.
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If you put it together, it's true that distancing and masks are key, but when you have the right predominant mechanism—aerosols—there are differences. Indoor and outdoor policies can differ, for example, and distance is good but not enough indoors and depends on ventilation.
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Airborne transmission unites three things crucial to recognize for effective COVID-19 mitigation: transmission without symptoms (thus aerosols), clusters driving the epidemic (also aerosols) and masks/ventilation indoors being key (hey, also aerosols). This framework is coherent.
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We had a word limit.
But the power of a coherent, empirically strong framework is that it's easier to make the case even in a short paper especially since one can dispense of the epicycles taking up useless space and just point out how it all fits together, the epi, labs, etc.4 replies 17 retweets 248 likesShow this thread -
There's good that can come out of this, including correcting our understanding or airborne transmission of other respiratory pathogens. See this letter in Science pointing out the correct aerosol/droplet boundary by
@kprather88@linseymarr et al. This is important for the future.pic.twitter.com/O8z0BqFvpE
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Anyway, it's been a true honor and pleasure to be included in this paper with my co-authors,
@trishgreenhalgh@kprather88@Rschooley@jljcolorado and@dfisman and, hey, I even liked the peer review process! The reviewers were sharp which is always good.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00869-2/fulltext …7 replies 41 retweets 366 likesShow this thread -
I want to add something. Recognizing SARS-CoV-2 as *predominantly* airborne isn’t an obstacle. It helps identify effective mitigations& chokepoints—like Japan did, for example. Airborne doesn’t mean it necessarily spreads like measles—a common error. TB is airborne but lower R0.
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Well their theory has been correct from the beginning and their numbers are better than most. I am not there so can’t testify to full practice.
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