With the threat of VOCs looming, the question is what more can we do? A lot. And it all starts with 2 central concepts that haven't gotten the attention they deserve:
1. #COVIDisAirborne
2. Pre-symptomatic/asymptomatic transmission cause up to half of infections https://twitter.com/JenniferKShea/status/1353667250297962499

Lockdowns to decrease contacts get all the attention but there's also another very basic element to stopping covid: we need to decrease the chances of transmission between contacts that still occur. We can't beat covid if we can't effectively prevent transmission & outbreaks.

#1 here is the need to publicize that covid is airborne. Everyone needs to know. And we need to get to work on preventing transmission of an airborne virus. We need to get air quality experts into all of our hospitals/LTCs/schools/workplaces to improve ventilation and filtration.

(side note: that means engineers, air scientists, occupational hygienists... people who do this for a living, even pre-pandemic)

We need to protect our healthcare workers. This should go without saying. We can't fight a war without soldiers. There are thousands of HCWs in isolation right now bc they have or were exposed to covid. Thousands less to care for patients at a time when we need all hands on deck.

It's honestly unthinkable that in Canada in Jan 2021, after aerosol transmission has been widely recognized, that protocols have NOT been updated and HCWs still don't have access to respirators (N95 or other) in most institutions. Even on covid wards. Even during outbreaks.

HCWs and patients deserve to be safe in our hospitals. Good enough precautions haven't been good enough at all. The number of outbreaks is staggering. If there's more we can do to protect HCWs & patients, why aren't we doing it? There's no harm in doing too much in this scenario.

To prevent transmission, we also need to find silent transmitters. The resistance to using rapid tests needs to end. We don't need them to be perfect. Catching most cases is better than catching *zero* if we don't use them. In this situation, good enough is actually good enough.

We also need to think about households. A large chunk of transmission occurs at home. We need to educate on how to prevent household transmission and also provide safe places for people stay if they cannot effectively isolate from others at home. Cut all chains of transmission.

There's definitely more we can do but I'll leave it at that for tonight. The key message is that #COVIDisAirborne and vaccines won't help us in the short or medium term. Less mediocrity and preventable illness/death. More progress, collaboration, innovation and *ambition* please.