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1/ Should we call it “Airborne” or “Aerosol” transmission?
Term “airborne” appears to be quite divisive. I’ve reached out to scientists on both sides of debate, asked for reasons why they think we should do one or the other. Many thoughtful responses, this thread summarizes it
Term “airborne” appears to be quite divisive. I’ve reached out to scientists on both sides of debate, asked for reasons why they think we should do one or the other. Many thoughtful responses, this thread summarizes it
2/ To be clear, till 6 months ago the closest use of "airborne" for me was for the experiments we do with @NASAAirborne & @NCAR_Science chasing eg wildfire smoke from an aircraft (some cool videos at https://photos.google.com/share/AF1QipOJ_lzwGPaVLehH3gxJhqVXwVLUc1gu0PmjZz7YCEQuTtq9HEjyyHrAgac9kzO0sw?key=RVYwcUJldVdheUxZemIwb3ZuM25oMXFrSktsYnh3)
3/ In the past I've used “airborne”as synonym of “aerosol” for SARS-CoV-2. But was told by some this was problematic, so stopped. Asked around, this summarizes it:
"Arg+" and "Arg -" mean arguments in favor and against using “airborne”
“Resp” are my responses to some arguments.
"Arg+" and "Arg -" mean arguments in favor and against using “airborne”
“Resp” are my responses to some arguments.
4/ (a) Arg +: “if it’s borne by air, then it is airborne”
Resp: yes, according to the dictionary. Like an aerosol, NASA DC8, or cow in a hurricane ;-)
But, there other ways to say it. No magical meaning of airborne, in the sense of borne by air, that can’t be said in other ways
Resp: yes, according to the dictionary. Like an aerosol, NASA DC8, or cow in a hurricane ;-)
But, there other ways to say it. No magical meaning of airborne, in the sense of borne by air, that can’t be said in other ways
5/ (b) Arg +: “it communicates better with the public”
Resp: this is a hard one. Maybe, although does not seem the case to me. Need focus group research? I think a physical description, some good videos, visual materials, would communicate fine. As someone in epid. put it:
Resp: this is a hard one. Maybe, although does not seem the case to me. Need focus group research? I think a physical description, some good videos, visual materials, would communicate fine. As someone in epid. put it:
6/ “the goal isn’t to “grab the public,” it’s to communicate practical guidance so the public can be empowered by information and reduce risk as much as possible”
7/ (c) Arg +: “cat is out of the bag, airborne been used a lot already, NYT, sci. papers etc”
Resp: True. But serious cacophony of terms and recs in last 5 months. Unfortunately have a lot of time left w/ pandemic. Other words used too, no reason to stick w/ airborne bc past use
Resp: True. But serious cacophony of terms and recs in last 5 months. Unfortunately have a lot of time left w/ pandemic. Other words used too, no reason to stick w/ airborne bc past use
8/ (d) Arg +: let’s explain nuance to public and health care workers (HCWs), not airborne like measles, use “opportunistic airborne”(Milton), “short-range airborne”(Cowling)
Resp: used to like it, used “opportunistic airb.”. But I am told that reasons (e-g) not lessened enough
Resp: used to like it, used “opportunistic airb.”. But I am told that reasons (e-g) not lessened enough
9/ (e) Arg -: “airborne” in health care means “extremely transmissible disease, like measles” “travels long distances, stays infective in a room a long time” and “it needs airborne PPE and precautions, or health care workers (HCWs) will get it in large numbers”. HCWs trained...
10/ for decades to recognize this, term scares them to the bone. Some steal N95s etc, lots of practical problems. WHO admitted limited PPE supply
Resp: legitimate debate about exactly which PPE is needed to prevent SARS-CoV-2. Aerosol & related scientists have a lot to...
Resp: legitimate debate about exactly which PPE is needed to prevent SARS-CoV-2. Aerosol & related scientists have a lot to...
11/ contribute to that debate (e.g. a hopefully useful contrib. at https://twitter.com/jljcolorado/status/1283678008398606342). Let’s not be a bull in a porcelain shop in this debate by repeating “it’s airborne”.
12/ (f) Arg -: corollary to (d). Due to these effects, many scientists in infectious dis. / epidem. / public health (ID-E-PH) get incredibly tense when they hear “it’s airborne.” Probably less likely to work with aerosol+ scientists towards a solution of the current conundrum.
13/ Actually multiple ID-E-PH scientists who are allies or are warming up to our proposals. But there are also powerful ppl in eg WHO comm who may “die defending their view” ( https://www.nytimes.com/2020/07/04/health/239-experts-with-one-big-claim-the-coronavirus-is-airborne.html).
14/ No time for a protracted fight. To overcome the current impasse, in which the evidence favors aerosol transmission (e.g https://twitter.com/jljcolorado/status/1288932022547656704) but the official guidance only timidly and contortedly acknowledges it, we need enough allies on ID-E-PH to turn the tide
15/ (g) Arg -: “aerosols” don’t have a very specific meaning in health care. When I mention the 5 micron error in WHO guidance, nobody in ID-E-PH reacts. Often they say the equivalent of “microns schmicrons”, doesn’t matter much to them. This is an opportunity! “Aerosols” is...
16/ new term, malleable in health care. “Aerosol PPE” perhaps can be intermediate in dichotomous EITHER droplet OR airborne PPE situation. Diseases span a continuum of transmission, no reason there should only be 2 options! Some prominent ppl in ID-E-PH would welcome opportunity
17/ Summary: while all arguments carry some weight, to me (e)-(f)-(g) appear overwhelmingly more important in current situation. If, as I think, calling it “aerosol” get us closer to WHO etc accepting “aerosol transmission plays a substantial role in community”, setting...
18/ clear guidelines to avoid it, communicating clearly (eg smoke analogy, better videos we all agree with, A CIViC DUTy-type slogans: https://twitter.com/jljcolorado/status/1289695523524374528) that would be a huge step forward. Imagine a world in which ID-E-PH and aerosol+ scientists agreed on...
19/ community guidelines, all support WHO, CDC guidance, stop arguing in press, work together to tackle critical interdisciplinary problems? I believe (perhaps naively) that would be a little closer if we all agree to about “aerosol transmission” & stop saying “it is airborne”
20/ Thoughts? Comments? Reasons that I missed or didn’t articulate well? Suggestions for way forward?
Thanks a lot if you made it to here!
Thanks a lot if you made it to here!
