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I don't know how to write this without stepping on toes, so apologies in advance. Last week seemed to be a big moment of clarification in the medical community regarding airborne transmission, bringing a consensus of knowledge arrived at from other fields to the mainstream.
Three commentaries came out, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00869-2/fulltext, https://jamanetwork.com/journals/jama/fullarticle/2779062, and https://www.bmj.com/content/373/bmj.n913, each of which clearly lays out compelling reasons to take airborne transmission more seriously.
Not much new was said in these commentaries, but the fact that they were published in 3 of the most highly-regarded medical journals says a lot about the state of the science. Interdisciplinary teams working to solve complex problems - the future of science.
It's been frustrating watching the response of a small minority of experts to these works. Some experts who continually fought against taking airborne transmission seriously have shifted their efforts to espousing the need for faster vaccination. No acknowledgement of mistakes,
no admission or reflection that perhaps they played a role in getting to where we are. Others have been extremely upfront about past mistakes - like @EpiEllie who wrote a great piece about her experience https://www.washingtonpost.com/outlook/2021/04/20/epidemiology-covid-self-criticism/.
We need more @EpiEllie's. We need more @DrPieterPeach's. We need more people who can actually say, yes, we had this backwards, so let's fix it moving forward. At this point, if you aren't acknowledging past mistakes, I feel like you are part of the problem.
I am frustrated. We've got these amazing vaccines, but we're seemingly doing everything we can to a) create conditions allowing for more mutations that *may* reduce effectiveness ( https://twitter.com/dgurdasani1/status/1384480587549872130?s=21) and b) get as many people infected before they get vaccinated as possible.
Vaccines absolutely are going to help us. Clearly they are an absolute triumph of science and it's amazing that we have multiple vaccines that work so well just barely more than a year into this. But, we can also prevent infections in the first place as well, right?
We *have* to reevaluate things here in Canada in light of this appreciation for airborne transmission. I know there are several arguments that still remain about how aerosols can't be that important, because we just aren't seeing that much transmission.
These arguments are logically faulty - how much transmission would you actually expect for an airborne disease? We have airborne diseases that are very transmissible (measles), we have airborne diseases that are less so (TB). I've yet to see anyone propose what an acceptably
high amount of transmission would be for SARS-CoV-2 to be considered definitely airborne. Are you counting super spreading events? Those seem to have pretty darn high attack rates, and the only reasonable explanation for those is airborne transmission.
We've gone from debating the mode of transmission to now placing all our hopes on the vaccinations. Will vaccinations eventually get us out of this mess? Well, they'll definitely contribute to solving the problem, that's for sure.
But holy hell, we've got better tools (e.g. N95s) we can start using *right now* to help prevent people from getting infected in the first place. This is particularly important for essential workers from marginalized communities who don't have the luxury of working from home
and won't be vaccinated for a long time yet. This is particularly important for the nursing and cleaning staff who are continually exposed to COVID-19 patients, many of whom now carry these lovely variants of concern.
I'm sure we have experts who know logistics - get them involved. We definitely have experts who know ventilation, like @DavidElfstrom - get them involved. If we don't, we're allowing thousands more Canadians to get sick for no good reason. /f
You know what else sucks? When the institute @OBrien_IPH than hosted the debate involving WHO advisor Dr. John Conly that catalyzed much of the recent focus on the problem removes the recording from their website. https://twitter.com/DFisman/status/1385626221745213442. Unbelievable.
