VIRUS IS AIRBORNE. Repeat, the #SARSCoV2 coronavirus is airborne. Epidemiologists & aerosol Scientists have been saying it for months. Now 239 scientists have penned a letter to @WHO, coming out next week, demanding WHO acknowledgement. Implications? https://www.nytimes.com/2020/07/04/health/239-experts-with-1-big-claim-the-coronavirus-is-airborne.html

2) “coronavirus is finding victims worldwide, in bars & restaurants, offices, markets & casinos, giving rise to frightening clusters of infection that increasingly confirm what many scientists have been saying for months: virus lingers in the air indoors, infecting those nearby.”

3) “If airborne transmission is a significant factor in the pandemic, especially in crowded spaces with poor ventilation, the consequences for containment will be significant. Masks may be needed indoors, even in socially distant settings...”

4) “Health care workers may need N95 masks that filter out even the smallest respiratory droplets as they care for coronavirus patients.

Ventilation systems in schools, nursing homes, residences and businesses may need to minimize recirculating air and add powerful new filters.”

5) “Ultraviolet lights may be needed to kill viral particles floating in tiny droplets indoors.”

6) “in open letter to @WHO, 239 scientists in 32 countries have outlined the evidence showing that smaller particles can infect people, and are calling for the agency to revise its recommendations. The researchers plan to publish their letter in a scientific journal next week.”

7) “Even in its latest update on the coronavirus, released June 29, the W.H.O. said airborne transmission of the virus is possible only after medical procedures that produce aerosols, or droplets smaller than 5 microns. (A micron is equal to one millionth of a meter.)”

8) “Instead, WHO has heavily promoted the importance of handwashing as a primary prevention strategy, even though there is limited evidence for transmission of the virus from surfaces. (The CDC now says surfaces are likely to play only a minor role.)”

9) “But interviews with nearly 20 scientists — including a dozen W.H.O. consultants and several members of the committee that crafted the guidance — and internal emails paint a picture of an organization that, despite good intentions, is out of step with science.”

10) “Whether carried aloft by large droplets that zoom through the air after a sneeze, or by much smaller exhaled droplets that may glide the length of a room, these experts said, the coronavirus is borne through air and can infect people when inhaled.”

11) “Most of these experts sympathized with the W.H.O.’s growing portfolio and shrinking budget, and noted the tricky political relationships it has to manage. They praised W.H.O. staff for holding daily briefings and tirelessly answering questions about the pandemic.”

12) “But the infection prevention and control committee in particular, experts said, is bound by a rigid and overly medicalized view of scientific evidence, is slow and risk-averse in updating its guidance and allows a few conservative voices to shout down dissent.”

13) ““They’ll die defending their view,” said A WHO consultant, who did not wish to be identified. Even its staunchest supporters said the committee should diversify its expertise and relax its criteria for proof, especially in a fast-moving outbreak.”

14) ““If we started revisiting airflow, we would have to be prepared to change a lot of what we do,” she said. “I think it’s a good idea, a very good idea, but it will cause an enormous shudder through the infection control society.”

15) Scientist “point to several incidents that indicate airborne transmission of the virus, particularly in poorly ventilated & crowded indoor spaces. The WHO was making artificial distinction between tiny aerosols and larger droplets, even though infected people produce both.”

16) “Scientists have not been able to grow the coronavirus from aerosols in the lab. But that doesn’t mean aerosols are not infective, Dr. Marr said: Most of the samples in those experiments have come from hospital rooms with good air flow that would dilute viral levels...” but:

17) “In most buildings, she said, “the air-exchange rate is usually much lower, allowing virus to accumulate in the air and pose a greater risk.”

The W.H.O. also is relying on a dated definition of airborne transmission, Dr. Marr said.”

18) “People generally “think & talk about airborne transmission profoundly stupidly,” said @BillHanage. “We have this notion airborne transmission means droplets hanging in the air capable of infecting you many hours later, drifting down streets, thru letter boxes & into homes”

19) “Experts all agree that the coronavirus does not behave that way. virus seemed to be most infectious when people were in prolonged contact at close range, especially indoors, & more so in superspreader events — exactly what scientists would expect from aerosol transmission”

20) ““At the country level, a lot of (local) W.H.O. technical staff are scratching their heads,” said a consultant at a regional office in Southeast Asia, who did not wish to be identified because he was worried about losing his contract. “This is not giving us credibility.”

21) “The consultant recalled that the W.H.O. staff members in his country were the only ones to go without masks after the government there endorsed them.”

22) “Many experts said @WHO should embrace what some call “precautionary principle” & others call “needs and values” — the idea that even without definitive evidence, the agency should assume the worst of the virus, apply common sense and recommend the best protection possible”

23) “Even cloth masks, if worn by everyone, can significantly reduce transmission, and the W.H.O. should say so clearly, he added.

Several experts criticized the W.H.O.’s messaging throughout the pandemic, saying the staff seems to prize scientific perspective over clarity.”

24) “”What you say is designed to help people understand the nature of a public health problem,” said Dr. William Aldis, a longtime W.H.O. collaborator based in Thailand. “That’s different than just scientifically describing a disease or a virus.”

25) “The W.H.O. tends to describe “an absence of evidence as evidence of absence,” Dr. Aldis added. In April, for example, the W.H.O. said, “There is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection.”

26) “The statement was intended to indicate uncertainty, but the phrasing stoked unease among the public and earned rebukes from several experts and journalists. The W.H.O. later walked back its comments.”

27) Also “WHI said there was “no evidence to suggest” that people w/ HIV were at increased risk from the coronavirus. After Joseph Amon, director of global health at Drexel pointed out that the phrasing was misleading, the @WHO changed it to say the level of risk was “unknown.”

P.s. Good thread also by the reporter of the great piece: @apoorva_nyc https://twitter.com/apoorva_nyc/status/1279565795635408897?s=21 https://twitter.com/apoorva_nyc/status/1279565795635408897

Finally, for what it is worth, @DrTedros actually did warn about the new coronavirus being airborne months ago. I suspect the internal politics that @apoorva_nyc discussed likely prevented it becoming formal guidance.

30) Here is another simulation from scientists in Japan of transmission via micro-droplets: notice how microdroplets can float around for 20 minutes. https://twitter.com/alinouriphd/status/1279771317366112256?s=21 https://twitter.com/alinouriphd/status/1279771317366112256