Incredible week. First the WHO, now the CDC. It'll take work to have all this be heard, and correctly. Just today, I saw Canada is planning to close beaches "to protect against variants." It takes more than a few website updates to fix a year of messaging.https://twitter.com/nytimes/status/1390750809005203462 …
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The central statement of the group is: “The transmission of the SARS-CoV-2 viruses takes place almost without exception indoors.” ht
@BernieCornfeldhttps://www.thelocal.de/20210412/danger-lurks-inside-german-aerosol-experts-say-covid-restrictions-should-target-indoor-areas/ …Show this thread -
This isn’t exactly true though, for this. Once aerosol transmission is correctly understood, it actually *unlocks* effective mitigations, especially since SARS-CoV-2 is overdispersed (either superspreadering OR low transmission). Aerosol recognition shows us its chokepoints.https://twitter.com/tyschalter/status/1391386430572797957 …
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I just want to keep highlighting that there are very few confirmed outdoor transmission cases at all, and they are mostly in the context of prolonged *and* really close contact AND that the science of aerosol transmission makes it very clear why outdoors is so so much safer.https://twitter.com/JoannaTeglund/status/1390681712682749952 …
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My piece on the history and the context of the debate over aerosol transmission is out in print today in the New York Times. (Online is longer and linked below, print is shorter!): https://www.nytimes.com/2021/05/07/opinion/coronavirus-airborne-transmission.html …https://twitter.com/EricTopol/status/1391642044167196675 …
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So much gratitude to
@avizvizenilman and@isaacscher who provided incredible research assistance. The piece was fact-checked within an inch of its life over many days, and it's the tip of an iceberg in terms of the research and documentation that went into it.Show this thread -
Look at this incredible thread by
@jljcolorado on the history of aerosol denial/misunderstandings/errors. I put (what I could fit) to highlight this. There's something to say about individual conduct during all this—but also that this is a longer history.https://twitter.com/jljcolorado/status/1391111720526024708 …Show this thread -
The history matters. Top medical journals still publish errors about aerosol size and biomechanics. Not individual malfeasance. The errors are in the textbooks. Medical doctors are not biophysicists or aerosol engineers. Dismissing relevant expertise has been, sadly, very costly.
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The other part is how causal inference differs by field. Clinical practice rightly uses randomized trials (crucial for drugs and vaccines) but the clear point that the droplet theory didn't do a good job explaining the world as we observed it didn't get the attention it deserved.
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Overlooked but key. Nothing about transmission in this pandemic makes sense except in the light of overdispersion. It alternates between contagious clusters and little to no transmission. This makes causal inference difficult. It fries our assumptions. https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/ …pic.twitter.com/nygPqC3yzn
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Yes, around the world, to this day. And the constant overuse of bleach etc. is not just a waste of time and resources, it's genuinely unhealthy. "Stop over-disinfecting and start ventilating" has to be a loud campaign, led by WHO & public health agencies.https://twitter.com/Calamitatis/status/1391733545270497282?s=20 …
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Yes. Some of what we can do is easy/free. Some of it is not, and requires resources and trade-offs (sealed building are energy efficient). Filtering can be an option when dilution is not. Challenge is very real, but still should start from the right place.https://twitter.com/SeeTedTalk/status/1391739250291486727 …
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Yep. Overdispersed things can't be studied with methods not suitable for them. Example: information provided by non-events is asymmetric compared to info from events. Cluster-randomized trials—say for source control—can't easily get statistical power. Etc.https://twitter.com/DrPieterPeach/status/1391741852852756486 …
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Let me highlight that excellent work has been happening all year, as well. Resistance to relevant expertise was a problem, but many key papers from this year are co-authored by people across disciplines. One interesting interdisciplinary panel today.https://twitter.com/VirusesImmunity/status/1391751814840717316 …
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Excellent, rapid progress from the CDC, clarifying the tables that came with the aerosol update.https://twitter.com/linseymarr/status/1391863551132897285 …
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I recently went through the same chasing down of known outdoor case percentage. Same conclusion. As
@mugecevik explains, "less than 10%" is misleading. Reported numbers of confirmed cases are around 0.1% so way lower than 10% even assuming undercounting. https://www.nytimes.com/2021/05/11/briefing/outdoor-covid-transmission-cdc-number.html …pic.twitter.com/1Zr5Iuqj54
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Seeing so many wondering if confirmed outdoor transmission can really be that low, compared with indoors. Yes. This confusion is another loss of being so late to acknowledge the key role of aerosols: the epidemiological record shows exactly what acknowledging aerosols predicts.
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Yep, the problem with gyms — enclosed spaces where people engage in activities that we know greatly increase aerosol production — is that we aren't sufficiently good at spraying the weights with disinfectants. (ht
@slowphotograph2)https://twitter.com/thehill/status/1392909521819996165 …
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This is why the whole lack of clear communication and understanding around aerosol transmission—and the ensuing dominant visualization of COVID-19 mitigation as disinfecting, and its breach as people outdoors/beaches—matters. It makes things worse. https://twitter.com/dankrutka/status/1392913606522646538 …
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