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What do we mean by #UseAirbornePrecautions? There are clear guidelines in health care settings, but what do we mean by it for the public? A 
of (met-thread) on this. Strap in, this will be long 1/
of (met-thread) on this. Strap in, this will be long 1/
2) First, this is not the first #airborne problem we have faced, and it won't be the last. And not all of them are exotic pathogens. Some could be as mundane as dust, smoke, pollens, volatile/semi-volatile organic compounds. They are all around our living space
3) Not all #airborne troubles are created equal. For example, I am a lot more allergic to cigarette smoke than incense. This varies from person to person and trouble to trouble. Some do not have any smell and can still be a "headache".
4) And we try to deal with these problems as best as we can. Since most of our life is spent inside buildings, we try to design buildings that can minimize exposure of occupants to a myriad of #airborne troubles https://twitter.com/Orla_Hegarty/status/1377953548877631492
5) When there is trouble in the air, you try to focus on the air, not the surfaces, not the water https://twitter.com/akm5376/status/1333207401823051776
6) That is because your lungs are like over 3000 hands touching the surrounding air all the time... (h/t @Orla_Hegarty, @mdc_martinus) https://twitter.com/akm5376/status/1375883143698386946
7) So, there are some standard steps we would take to deal with something in the air:
Source elimination
Source control
Ventilation
Filtration/treatment
Source eliminationSource controlVentilationFiltration/treatment
8) Source elimination is age-old wisdom.
âIf there is a pile of manure in a space, do not try to remove the odor by ventilation. Remove the pile of manure.â Max von Pettenkofer, 1858
âIf there is a pile of manure in a space, do not try to remove the odor by ventilation. Remove the pile of manure.â Max von Pettenkofer, 1858
9) In this case, the source is an infectious person. Eliminate sounds kind of harsh, but the aim is that we try to not have infectious persons in enclosed spaces. This is difficult with the pre-/a-symptomatic spread
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774707 https://www.pnas.org/content/117/30/17513
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774707 https://www.pnas.org/content/117/30/17513
10) So, we need rapid testing and easy access to testing https://twitter.com/michaelmina_lab/status/1377454976885219330
11) And, people should not be insecure to stay home if they are not feeling well - not financially insecure for lost wages or socially insecure for stigmatization
12) Source control - masking and better masks are the best way to achieve this. https://twitter.com/AbraarKaran/status/1362744072247549959
13) Once the cat is out of the bag or the virus is out of the human, there is only so much we can do. So, if we can control at source, that is one of the most effective ways to manage it.
And here is a fancy animation showing how masks work https://www.nytimes.com/interactive/2020/10/30/science/wear-mask-covid-particles-ul.html
And here is a fancy animation showing how masks work https://www.nytimes.com/interactive/2020/10/30/science/wear-mask-covid-particles-ul.html
14) And for the last time, masks are not sieves. They have more than one way of filtering particles. https://twitter.com/akm5376/status/1304989805252468737
15) And because the darn thing is #airborne, mask fit and mask quality matters. You are not just trying to get rid of some fat a** droplets
16) Masks can be leaky, even nice surgical ones https://twitter.com/i/status/1358362296733626368
17) And so, mask fit matters https://twitter.com/CPita3/status/1359556028778614795
18) Well, once the cat is out of the bag, you would have to resort to handling it somehow. One of the manners is #ventilation and #dilution
19) Distancing works not just because all the good droplets know to drop off after 2 m as if there is an invisible barrier. It works because #aerosol concentration reduces with distance, quite quickly
20) It is obvious that concentration would be highest at the source. And farther you go from the source, concentration starts to fall. So, a distancing of 2 m can be way better than 1 m.
21) But indoors, in a space where you are sharing air with others, there is no way to entirely escape the exhaled breath of others - no distance makes you absolutely safe. Exhalation from people is going to gradually fill up the space, unless it is #ventilated
22) In case you are a more visual person than me, this is for you - https://english.elpais.com/society/2020-10-28/a-room-a-bar-and-a-class-how-the-coronavirus-is-spread-through-the-air.html
23) Ventilation is the introduction of "clean" air into the space. In this case, "clean" means it is devoid of virus containing particles.
24) #Ventilation could be as simple as opening a window, or a door, or both.
Want to know some hacks for #AirHygiene? Here are few easy to use ones - https://covidstraighttalk.org/hacks
Want to know some hacks for #AirHygiene? Here are few easy to use ones - https://covidstraighttalk.org/hacks
25) How do you know if you have enough ventilation? A simple indicator - and it has its flaws but for now, it is possibly the best we have - is measuring carbon dioxide levels in the space https://twitter.com/citlanx/status/1326789192182063104
26) Unfortunately, poor ventilation is an old foe that plagued many of our buildings from before the pandemic, and it has made matters worse during this pandemic. Here is Prof. Corsi explaining it for classrooms https://twitter.com/CorsIAQ/status/1290117989006577664
27) And again, Prof. Corsi has an elegant explanation of how simple and how profitable it could be to improve ventilation in classrooms https://twitter.com/CorsIAQ/status/1365733529007493124
28) And here is a global collection of messaging telling you to let #FreshAir in https://twitter.com/DrPieterPeach/status/1345254794886144001
29) Sometimes though, due to system limitations, outdoor weather, outdoor pollution, #FreshAir may not be a possibility
That is when we turn to air cleaning/treatment
That is when we turn to air cleaning/treatment
30) A thread from Prof. Jimenez, exploring all aspects of air cleaning https://twitter.com/jljcolorado/status/1291758303089852417
31) A thread from Prof. Corsi proving the point that equipping every classroom with a HEPA based air cleaner is just a good long term investment https://twitter.com/CorsIAQ/status/1362618407066030083
32) And beware of snake oil salespersons when it comes to air cleaners. Go for simple HEPA/filtration based air cleaners instead of fancy sounding "air purifiers" https://twitter.com/marwa_zaatari/status/1358625462889627653
33) By the way, just because unscrupulous people will try to sell snake oil and take advantage of the situation is no reason for us not to admit the thing is #airborne and nothing is stopping s from trying to educate the public.
34) And here are some guides that compile and complement all the steps mentioned so far for mitigating risks in real life situations -
Prof. Huffman on gatherings https://twitter.com/HuffmanLabDU/status/1328732644629049345
Prof. Huffman on gatherings https://twitter.com/HuffmanLabDU/status/1328732644629049345
35) @healthyheating on creating a temporary isolation room at home for infected persons, intended to keep other family members safer
http://www.healthyheating.com/2021.COVID.Residential.Isolation.Rooms/2021.Residential.Isolation.Room.htm
http://www.healthyheating.com/2021.COVID.Residential.Isolation.Rooms/2021.Residential.Isolation.Room.htm
36) Some hacks for improving your mask fit
https://www.fixthemask.com/ https://making.engr.wisc.edu/mask-fitter/
https://www.fixthemask.com/ https://making.engr.wisc.edu/mask-fitter/
37) And hacks for making your own air cleaners - The Corsi-Rosenthal box https://www.texairfilters.com/a-variation-on-the-box-fan-with-merv-13-filter-air-cleaner/
38) A thread on ventilation and air cleaning advice from the @WHO itself.
38) To conclude, it is a patently fixable problem once we admit to the kind of problem we have. Admitting it is #airborne is not scary, it is not alarming. It is just living in the reality we already are.
39) And the fixes are not necessarily costly or complicated.
We need to educate people, not try to pretend to "protect" them. And admission will be the first step towards the goal of #ZeroCovid
\\to be supplemented as needed
\\not ending
We need to educate people, not try to pretend to "protect" them. And admission will be the first step towards the goal of #ZeroCovid
\\to be supplemented as needed
\\not ending
40) In case you encounter folks touting situational #Airborne, advise them on the difference between situational and normal https://twitter.com/akm5376/status/1380945578360774656
41) #Airborne precautions - a visual flow path for you. https://twitter.com/SergioCoscolin/status/1381806449416929280
42) An excellent summarization from Dr. @ashishkjha on the implications and what we need to pay attention to 
https://twitter.com/ashishkjha/status/1383393271284518913
https://twitter.com/ashishkjha/status/1383393271284518913
43) My attempt at graphically summarizing the points of the excellent @TheLancet article which seems to have triggered the break of a dam! https://twitter.com/akm5376/status/1383035186355527684
44) A trying to summarize the @WHO roadmap for ventilation https://twitter.com/akm5376/status/1366711856690319365
trying to summarize the @WHO roadmap for ventilation https://twitter.com/akm5376/status/1366711856690319365
