#COVIDisAirborne. It always has been.

120 years we should have known this. Be generous say 80). We should have been prepared for it, but experts mangled the science so we aren't ventilating.

Short thread of threads.
Before 1850, miasma theory said disease came out of swamps and killed you. Nobody knew how.

~1850 Snow says cholera in the water (ppl thought in the air).

~ 1860 discovered bacteria. They didn't live long outside body.
By 1887, a Dr. Chapin knew diseases floated, like scarlet fever. Not as contagious as measles. https://twitter.com/jmcrookston/status/1311410475784175617
In 1910 Dr. Chapin writes a famous book. Says what if we just carry disease around and infect each other. He's right.

BUT he also noted most transmission found when people close, and little evidence air, so so said probably droplet to him.
So ack'd measles airborne but over short range
https://twitter.com/jmcrookston/status/1297690281551200256

At the time there are studies showing spit up bacteria growing within 2.5 m/6ft or so. Any time infection found over longer, he says must be touch. (Same as modern IPAC, really.)
Interestingly, He acknowledged that people criticized him for being too pro-"close contact".

Interestingly, he also said don't over generalize and keep studying air transmission:
https://twitter.com/jmcrookston/status/1297690283233234945

Interestingly, he disliked fomites as a mode of transmission.
Here's a talk he gave at Harvard in 1917: https://twitter.com/jmcrookston/status/1309657599164514304
Then came Drs. Wells and Wells (husband and wife team), who studied air. They concluded its in air and asymptomatic spread keeps it going. UV in schools stopped measles dead.

They wrote a damned indictment of droplets. They were ignored, it seems. https://twitter.com/jmcrookston/status/1299386110070620165
Measles:

We had the "droplet" vs "airborne" debate about measles. But when a few outbreaks happened that could not be explained by droplets, we grudgingly accepted "airborne".

Airborne won. https://twitter.com/jmcrookston/status/1297250473448222720
Remember, measles was "droplet" in 1938 before it was "airborne" in ~ the late 80s, say. https://twitter.com/jmcrookston/status/1302258437993226242
TB:

We had the "dropet" vs "air" debate about TB.

But when Wells put guinea pigs on the roofs of cubicles housing TB patients, and the pigs caught TB, it was undeniable.

Air won. https://twitter.com/jmcrookston/status/1302772100860702724
Smallpox:

We had the same debate about smallpox.

(Although as I noted, Chapin back in 1887 already said they knew it could infect at a distance.)

Airborne won. https://twitter.com/jmcrookston/status/1311410475784175617
Chickenpox is also commonly accepted to be airborne.

But the reality is many others are. See this CDC book:
https://twitter.com/jmcrookston/status/1314688030171594752

Not really any proper parameters to declare something "airborne". We just do it.

You know, evidence-based medicine and all.
Then SARS, and we clung to droplet, and Amoy Gardens shows it can float to another building, and sewage engineers proved this matched their modelling, but still it is debated.

Nobody on ground floor caught it. Hmm.

And we now see apartment spread of SARS-CoV-2.

!!
Problem was, when people got sick outside of 2m, what do we do?

1. Well, when get sick at hospital we call it AGMP and say that it "aerosolizes" the droplets. No real proof these do that more than coughing:

https://twitter.com/jmcrookston/status/1345591596138557443

(Or blame HCW for bad practices, w/o proof.)
When it happens in community we blame people for not washing, although fomites have never been proven to do a lot.

https://twitter.com/jmcrookston/status/1334851435444531200

CDC says minor. Chapin never even liked them.
On planes we see infection transmit further than 2m. But instead of revising droplet thinking they say, fomites from seat backs.

SARS sure looks like TB on a plane.

https://twitter.com/jmcrookston/status/1301217115396022274

Anyway 2m rule on planes now under attack.
In past 20 years in hospital, or air, or vet journals you have article after article saying aerosol.

But many doctors don't read those. They aren't the Lancet.
And 2m distance for general citizens is a policy choice anyway. https://twitter.com/jmcrookston/status/1304784615039696899
And drawing 2m circles on the ground ain't gonna work if it's airborne. https://twitter.com/jmcrookston/status/1303080485602693121
So here we are with SARS-CoV-2. People said, well, its the same as SARS, which is droplet (incorrect).

But the whole notion of droplet is misconstrued anyway.
So the world is falling one country at a time to airborne.

We'll get there, but we need to do it faster. https://twitter.com/jmcrookston/status/1323813784377581568
You can follow @jmcrookston.
Tip: mention @twtextapp on a Twitter thread with the keyword “unroll” to get a link to it.

Latest Threads Unrolled:
Those who think consciousness raising & movement building are disconnected, or even a distraction from electoral politics have not paid attention to the history of social change.In this thread, we
Read more
The 2020s will be known as the Remote Work decadeA few predictions of what is likely to emerge[ a thread ] Third Space: Office and Working from Home will
Read more
1/29: Have you ever had a concept explained to you that helps frame complex issues you’ve been wrestling with and opens your eyes to new possibilities? A concept that I
Read more
By continuing to use the site, you are consenting to the use of cookies as explained in our Cookie Policy to improve your experience.