Why admitting Covid is Airborne is so hard(theair.substack.com)
theair.substack.com
Why admitting Covid is Airborne is so hard
https://theair.substack.com/p/why-covid-is-airborne-history
87 comments
Medical doctors and scientists are happy to use pharmaceuticals for which the mechanism of action is unclear as long as experiments show a dose response curve. If we can see that the response increases with higher doses then we can be confident that there's a causal relationship rather than just a spurious correlation.
For example SSRIs are widely used and empirically seem to be effective for some patients with chronic depression, but there's still no firm consensus on why they work.
For example SSRIs are widely used and empirically seem to be effective for some patients with chronic depression, but there's still no firm consensus on why they work.
SSRIs, and anti-depressants in general, are subject to an unavoidable failure mode of evidence-based medicine's "gold standard", randomly-controlled trials (RCT): ambiguous diagnosis.
If you are unable to distinguish between a half-dozen causes for what appears to be the same illness, your RCT of even a perfect cure (for one of the causes) will show arbitrarily small positive effects, and possibly large negative effects, according to the prevalence of each actual cause represented in the sample population.
Thus, we see assertions in scurrilous publications that "anti-depressants don't work any better than placebo", despite that they make the difference for millions of real patients between 100% dysfunction and normal life. Psychiatrists are stuck with no better means to diagnose the different kinds of depression than to prescribe different anti-depressants, one after another, and see which, if any, help.
It is almost miraculous that the anti-depressants we have were approved. It is doubtful they would be approved today. That is a consequence of fetishizing RCTs as "the gold standard" to imply that no further thought is needed in evaluating its results.
The world economy has abandoned the actual gold standard, for reasons.
... But, yes, to your point, there are certain ad-hoc routes by which evidence can sometimes get through to medical practice despite typical epistemological roadblocks.
If you are unable to distinguish between a half-dozen causes for what appears to be the same illness, your RCT of even a perfect cure (for one of the causes) will show arbitrarily small positive effects, and possibly large negative effects, according to the prevalence of each actual cause represented in the sample population.
Thus, we see assertions in scurrilous publications that "anti-depressants don't work any better than placebo", despite that they make the difference for millions of real patients between 100% dysfunction and normal life. Psychiatrists are stuck with no better means to diagnose the different kinds of depression than to prescribe different anti-depressants, one after another, and see which, if any, help.
It is almost miraculous that the anti-depressants we have were approved. It is doubtful they would be approved today. That is a consequence of fetishizing RCTs as "the gold standard" to imply that no further thought is needed in evaluating its results.
The world economy has abandoned the actual gold standard, for reasons.
... But, yes, to your point, there are certain ad-hoc routes by which evidence can sometimes get through to medical practice despite typical epistemological roadblocks.
> Medical doctors and scientists are happy to use pharmaceuticals for which the mechanism of action is unclear as long as experiments show a dose response curve.
All medical doctors? Or many? Maybe just some? (Doctors over here in Europe certainly wouldn't do this commonly without recommendation of national institutes, as demonstrated by the Cov19 vaccines). I think the underlying question is strongly linked to the actual numbers. You could have 90% of doctors agree with the airborne idea (or admit they don't have the expertise) and with 10% rejecting the idea patients would still be in doubt or pick the thing they like more ("Energy crystals!").
All medical doctors? Or many? Maybe just some? (Doctors over here in Europe certainly wouldn't do this commonly without recommendation of national institutes, as demonstrated by the Cov19 vaccines). I think the underlying question is strongly linked to the actual numbers. You could have 90% of doctors agree with the airborne idea (or admit they don't have the expertise) and with 10% rejecting the idea patients would still be in doubt or pick the thing they like more ("Energy crystals!").
Is it true that nobody knows how acetaminophen works?
It's also true that a lot of trials show that it's only a couple percent more effective than a placebo.
That fact is even more true about anti-depressants. Tons get rejected because they are only 1-2% more effective than a placebo. Even worse, we make the anti-depressants and don't actually have any real idea about what causes depression in the first place nor what exactly the drugs are treating.
We're also really bad about long-term side effects.
Meridia was pulled after something like 15 years.
Permax after 20 years years due to causing birth defects and other things.
Cylert was an ADHD drug pulled after 30 years.
Accutane (for acne treatment) was pulled after around 30.
Pentylenetetrazol was pulled after 48 years because a whopping 42% of the people who took it got spinal fractures from the seizures it caused (not to mention all the other body damage to other bones and muscles).
Propoxyphene (pain killer) was supposed to be pulled in the 70s, but the FDA waited 55 YEARS until around a decade ago to pull it.
And if you look up lists of recalled drugs and their reason for recalls, there's hundreds with many having been in use multiple decades and sometimes like these, despite the high risk being well known.
That's just one problem with the FDA and big pharma having a revolving door policy.
That fact is even more true about anti-depressants. Tons get rejected because they are only 1-2% more effective than a placebo. Even worse, we make the anti-depressants and don't actually have any real idea about what causes depression in the first place nor what exactly the drugs are treating.
We're also really bad about long-term side effects.
Meridia was pulled after something like 15 years.
Permax after 20 years years due to causing birth defects and other things.
Cylert was an ADHD drug pulled after 30 years.
Accutane (for acne treatment) was pulled after around 30.
Pentylenetetrazol was pulled after 48 years because a whopping 42% of the people who took it got spinal fractures from the seizures it caused (not to mention all the other body damage to other bones and muscles).
Propoxyphene (pain killer) was supposed to be pulled in the 70s, but the FDA waited 55 YEARS until around a decade ago to pull it.
And if you look up lists of recalled drugs and their reason for recalls, there's hundreds with many having been in use multiple decades and sometimes like these, despite the high risk being well known.
That's just one problem with the FDA and big pharma having a revolving door policy.
> Although its exact mechanism of action remains unclear [...]
Quote is from https://www.ncbi.nlm.nih.gov/books/NBK482369/ , which has last been updated this year (or so it says). The studies quoted are from 2016 and 2009, so any real insight would have to be very recent.
Quote is from https://www.ncbi.nlm.nih.gov/books/NBK482369/ , which has last been updated this year (or so it says). The studies quoted are from 2016 and 2009, so any real insight would have to be very recent.
Badly. Acetominophen works badly.
As I understand it, it makes you oblivious to suffering, incidentally including your own.
As I understand it, it makes you oblivious to suffering, incidentally including your own.
> makes you oblivious to suffering, incidentally including your own
Sounds like the definition of alcohol from "The Devil's Dictionary"!
Sounds like the definition of alcohol from "The Devil's Dictionary"!
I like the definition of "cabbage" best: A familiar kitchen-garden vegetable about as large and wise as a man's head.
Yes. It's called Applied science (https://en.wikipedia.org/wiki/Applied_science).
"Applied science is the use of the scientific method and knowledge obtained via conclusions from the method to attain practical goals. It includes a broad range of disciplines such as engineering and medicine."
It's different from experimental/research science. Nothing new.
> truth, to be believed, needs a theory
Science is not the pursuit of "truth".
"If it's truth you're looking for, Dr. Tyree's philosophy class is right down the hall." - Prof. Indiana Jones
"Applied science is the use of the scientific method and knowledge obtained via conclusions from the method to attain practical goals. It includes a broad range of disciplines such as engineering and medicine."
It's different from experimental/research science. Nothing new.
> truth, to be believed, needs a theory
Science is not the pursuit of "truth".
"If it's truth you're looking for, Dr. Tyree's philosophy class is right down the hall." - Prof. Indiana Jones
You are confused in exactly the same way as everyone at the CDC who insisted, and continues insisting, that airborne transmission of COVID-19 does not happen.
You are misrepresenting the CDC's position. They have acknowledged the "potential for airborne spread".
https://www.cdc.gov/media/releases/2020/s1005-how-spread-cov...
https://www.cdc.gov/media/releases/2020/s1005-how-spread-cov...
The CDC is sending fatally mixed messages. A few there have caught on, but apparently most have not.
No one is saying it cant transmit that way, just that it is likely not the predominant way.
Just because something can transmit via airborne particles doesnt make it an airborne virus.
This is partially because there is no strict definition for airborne virus.
humans have been known to eat other humans to survive. Cannibalism isnt the predominant mechanism for nutrition. Therefore we wouldnt generally call humans cannibals.
Just because something can transmit via airborne particles doesnt make it an airborne virus.
This is partially because there is no strict definition for airborne virus.
humans have been known to eat other humans to survive. Cannibalism isnt the predominant mechanism for nutrition. Therefore we wouldnt generally call humans cannibals.
Fine, except the statement is not true. All the cases we know about are consistent with airborne transmission.
About the only disease we know of that transmits only airborne is tuberculosis. We don't need another word for tuberculosis. We have that one.
About the only disease we know of that transmits only airborne is tuberculosis. We don't need another word for tuberculosis. We have that one.
> Science is not the pursuit of "truth".
"If it's truth you're looking for, Dr. Tyree's philosophy class is right down the hall." - Prof. Indiana Jones
Quite funny because Indiana Jones is an archaeologist.
And supposedly teaches history, which often is a form of social science.
One of these few sciences where it is commonly admitted that most evidence is tainted by biased as well as both personal and limited groups' interests.
Even taking aside the fact that it’s a fictional character invented by some people more interested in telling fun stories than anything else, using this as a call to authority to support a view on any science is quite hilarious.
Your view on science also reminds me of how, in med school, a professor once told us "medicine is not a science; it’s an art".
Which, to me, has since been a good way to know which health professionals to stay clear of.
Quite funny because Indiana Jones is an archaeologist.
And supposedly teaches history, which often is a form of social science.
One of these few sciences where it is commonly admitted that most evidence is tainted by biased as well as both personal and limited groups' interests.
Even taking aside the fact that it’s a fictional character invented by some people more interested in telling fun stories than anything else, using this as a call to authority to support a view on any science is quite hilarious.
Your view on science also reminds me of how, in med school, a professor once told us "medicine is not a science; it’s an art".
Which, to me, has since been a good way to know which health professionals to stay clear of.
It is funny to say, but "Indy" is right, science more than anything else is the doctrine through which we find verifiable "facts", or maybe falsifyable? Hard to say, the philosophy of science is and endless pit for all these valiant enough to dive into it
But anyhow, Id agree with your call that Medics are not scientists on the specific usage of the term, they are medical professionals and applied science people, after their university education they can then pivot into more theoretical and research oriented sub-fields of medicine, which would indeed make them more "scienc-y" on my eyes
But anyhow, Id agree with your call that Medics are not scientists on the specific usage of the term, they are medical professionals and applied science people, after their university education they can then pivot into more theoretical and research oriented sub-fields of medicine, which would indeed make them more "scienc-y" on my eyes
> Quite funny / quite hilarious
I'm glad I made your day better by giving you some happiness. But yeah, science is not the pursuit of "truth".
> call to authority
Never intended to use it as a call to authority. I'm sorry you interpreted this way. Not everything I wrote is a dissertation about something.
> Your view on science
And what is my "view" on science? I wrote like 3 or 4 lines of text. Or are you thinking you "got me right"?
I'm glad I made your day better by giving you some happiness. But yeah, science is not the pursuit of "truth".
> call to authority
Never intended to use it as a call to authority. I'm sorry you interpreted this way. Not everything I wrote is a dissertation about something.
> Your view on science
And what is my "view" on science? I wrote like 3 or 4 lines of text. Or are you thinking you "got me right"?
Oh dear. This is quite a pleasant exchange. Thank you!
> And what is my "view" on science? I wrote like 3 or 4 lines of text.
That "science is not the pursuit of "truth"."
Now, you've got me wondering. Maybe we don't mean the same thing by "truth".
To me, in this context, it would be "the most accurate and comprehensive way of explaining and understanding how the world behaves". With a focus on different domains and behaviours depending on the area.
What do you mean by "truth", here?
> And what is my "view" on science? I wrote like 3 or 4 lines of text.
That "science is not the pursuit of "truth"."
Now, you've got me wondering. Maybe we don't mean the same thing by "truth".
To me, in this context, it would be "the most accurate and comprehensive way of explaining and understanding how the world behaves". With a focus on different domains and behaviours depending on the area.
What do you mean by "truth", here?
I would rather edit, but it’s too late for that.
So, just to be clear, in case there is any doubt. There is no sarcasm here.
I genuinely appreciate the response, and am genuinely curious.
That’s all.
So, just to be clear, in case there is any doubt. There is no sarcasm here.
I genuinely appreciate the response, and am genuinely curious.
That’s all.
Your professor was at least partly correct. Evidence based medicine is the gold standard for selecting treatments. But the reality is that today we still lack clear evidence to apply in many cases, so providers have to fall back on educated guesses based on what they have empirically found to work. Much of this is tacit knowledge that can only be gained through direct experience.
Thus, the need to "doctor-shop" until you get to one with the requisite direct experience.
sure, doctors are not scientists. they're not out there inventing or researching new things, but they still need to use logic to work things out, based on the scientific knowledge available.
of course bad things happen when they presume that the facts they read are 100% true, and we now know a lot of them are drip-fed false facts by big pharma, sales rep etc. with hidden agendas. also there is a tendency for experienced docs to get caught up in their own ego and start acting with their own bias, which happens in all professions.
of course bad things happen when they presume that the facts they read are 100% true, and we now know a lot of them are drip-fed false facts by big pharma, sales rep etc. with hidden agendas. also there is a tendency for experienced docs to get caught up in their own ego and start acting with their own bias, which happens in all professions.
Airborne has special meaning. Clearly covid spreads "through the air" that doesnt mean it is airborne.
One problem is there is no strict definition of airborne. There is no doubt that covid can spread via an airborne path, but it may not be the dominant path.
The original variant had about a .7% infection rate through casual contact. For people living in the same household it was something like 12%.
When people talk about airborne, one implication is that it floats in the air and is infectious for a long time. This generally means a much higher rate of transmission. One factor in this is the infectious dose. The lower the infectious dose, the more likely it is to be airborne. A TB infection can start from one bacterium. So even though they are huge, it is airborne.
Delta is 2X more infectious than the original, that means it likely needs a smaller infectious dose and is more likely to transmit via airborne particles.
Just because covid can transmit via an airborne path doesnt mean it is the main way it is transmitted. When we think of airborne we think of highly infectious viruses like the measles virus.
<<
Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected.
Measles virus can live for up to two hours in an airspace after an infected person leaves an area. >>
One problem is there is no strict definition of airborne. There is no doubt that covid can spread via an airborne path, but it may not be the dominant path.
The original variant had about a .7% infection rate through casual contact. For people living in the same household it was something like 12%.
When people talk about airborne, one implication is that it floats in the air and is infectious for a long time. This generally means a much higher rate of transmission. One factor in this is the infectious dose. The lower the infectious dose, the more likely it is to be airborne. A TB infection can start from one bacterium. So even though they are huge, it is airborne.
Delta is 2X more infectious than the original, that means it likely needs a smaller infectious dose and is more likely to transmit via airborne particles.
Just because covid can transmit via an airborne path doesnt mean it is the main way it is transmitted. When we think of airborne we think of highly infectious viruses like the measles virus.
<<
Measles is so contagious that if one person has it, up to 90% of the people close to that person who are not immune will also become infected.
Measles virus can live for up to two hours in an airspace after an infected person leaves an area. >>
The answer is simple, you don't need an entire article on that. It's all politically motivated. Accepting it as airborne would force governments to accept the costs of fighting it.
Forget that "keep the 2m distance" nonsense. Airborne means you need N95 required everywhere. Public gatherings are out of question too.
And if you fight the narrative, you can easily be labeled as "anti-science", whatever that means. Did you all forget how the mask guidance was changed overnight around April/2020? All in the name of "new science information".
Take any information from the CDC or WHO with a large grain of salt.
Forget that "keep the 2m distance" nonsense. Airborne means you need N95 required everywhere. Public gatherings are out of question too.
And if you fight the narrative, you can easily be labeled as "anti-science", whatever that means. Did you all forget how the mask guidance was changed overnight around April/2020? All in the name of "new science information".
Take any information from the CDC or WHO with a large grain of salt.
> The answer is simple
Kiss of death right here. If you think any of this is simple then I have a bridge to sell you.
And why is there always the need to invoke conspiracy here lately? Don't trust the CDC or the WHO? Yikes!
Kiss of death right here. If you think any of this is simple then I have a bridge to sell you.
And why is there always the need to invoke conspiracy here lately? Don't trust the CDC or the WHO? Yikes!
>preliminary investigation
>local authority
>no clear evidence
This doesn't seem like a definite statement of something we know to be wrong in hindsight?
>local authority
>no clear evidence
This doesn't seem like a definite statement of something we know to be wrong in hindsight?
Regardless of whether the virus is airborne or not, there is no need to require N95 masks everywhere or prohibit public gatherings. All exposure control interventions are ultimately futile. They can perhaps slow the spread down slightly to reduce impact on the healthcare system but we'll all eventually be exposed no matter what we do. Fortunately the vaccines are very effective at preventing deaths.
https://www.businessinsider.com/delta-variant-made-herd-immu...
https://www.businessinsider.com/delta-variant-made-herd-immu...
Why are people so obsessed with death count? We still don't understand the long term effects of this virus. You don't know the "Long Covid" count for example. And there is very little evidence that vaccines are effective at preventing that.
Deaths can be counted with reasonable accuracy (although there are some edge cases where the primary cause of death is unclear). Whereas "long COVID" is just a vague term for a random collection of non-specific symptoms which seem to occur more commonly in recovered patients than in the general population. The science in this area is very preliminary and mostly low quality as studies have relied mainly on subjective patient reports rather than objective test results. For example, one recent widely cited study listed anxiety as a common "long COVID" symptom even though they didn't describe a plausible causative mechanism.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
In general any serious viral infection can potentially cause post-viral syndrome. That's not a valid reason for keeping pandemic control restrictions or mandates in place indefinitely. At some point we have to accept the risk and move on.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1710789/
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
In general any serious viral infection can potentially cause post-viral syndrome. That's not a valid reason for keeping pandemic control restrictions or mandates in place indefinitely. At some point we have to accept the risk and move on.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1710789/
Death count is relatively objective. There is some fudge factor for whether somebody died “from” COVID vs “with” COVID but other than that it’s cut and dry.
That is a big advantage over comparing case numbers, which depend heavily on testing, or long COVID which there’s not even a hard definition of.
That is a big advantage over comparing case numbers, which depend heavily on testing, or long COVID which there’s not even a hard definition of.
The lack of a definition for long Covid doesn't mean it's not happening. It just means we don't have good studies of it.
A study to prove/disprove long term COVID issues seems awfully difficult or impossible, especially for minor, objective things (fatigue, taste, “brain fog”, etc).
Are we relying on patients to self-report whether they had COVID, what they long term effects they noticed? If so, it seems like we’re testing mass hysteria as much as actual effects.
I was likely infected and noticed the taste/smell issue. Since I’ve recovered, so has my taste/smell but it was not an immediate recovery and I have no idea if I “lost” some amount of scent sensitivity.
It is probably the same as pre-COVID, but if I heard others were reporting this issue it would be very easy to convince myself that I did lose sensitivity and report that.
Are we relying on patients to self-report whether they had COVID, what they long term effects they noticed? If so, it seems like we’re testing mass hysteria as much as actual effects.
I was likely infected and noticed the taste/smell issue. Since I’ve recovered, so has my taste/smell but it was not an immediate recovery and I have no idea if I “lost” some amount of scent sensitivity.
It is probably the same as pre-COVID, but if I heard others were reporting this issue it would be very easy to convince myself that I did lose sensitivity and report that.
I don't mean to imply that long COVID isn't happening. Just offering a reason why death counts get most of the attention when we try to assess whether a vaccine/treatment/policy measure is effective.
Because it's death and it's easy to understand over long covid.
And at the economic and government level, there exists a calculus for determining the "value" of a citizen to determine whether to address a situation.
There's a good Planet Money episode on this. [1]
"They say a human life is worth about $10 million."
It's a pretty messed up thing to try and determine, the dollar value of a person's life, but if you have to make tough policy decisions then it's a tool.
[1] https://www.npr.org/2020/04/15/835571843/episode-991-lives-v...
And at the economic and government level, there exists a calculus for determining the "value" of a citizen to determine whether to address a situation.
There's a good Planet Money episode on this. [1]
"They say a human life is worth about $10 million."
It's a pretty messed up thing to try and determine, the dollar value of a person's life, but if you have to make tough policy decisions then it's a tool.
[1] https://www.npr.org/2020/04/15/835571843/episode-991-lives-v...
"slow the spread down slightly to reduce impact on the healthcare system" is pretty important during these big waves.
Banning outdoor gatherings is probably overkill though, I believe the worst places still have maskless indoor activities.
A friend working in gov lab responsible for measuring covid airborne behavior said there's a lot of expenses, liabilities involved in formally labelling covid as airborne. The amount of resource intensive measures needed to make spaces not occupational hazards because covid is legally recognized as airborn is onerous.
I don't think it's necessarily political.
One of the issues is that airborne diseases have a totally different set of requirements for hospitals, and they're much harder and more expensive to comply with. Specifically, patients with contagious airborne diseases need to be kept in rooms with lower pressure than the rest of the hospital to prevent contagions leaking out. I would imagine we have even fewer of those than we have ventilators and ER beds.
Of course, we can free doctors of that restriction, but I don't know how much we stand to gain versus any losses that occur in the transition period as hospitals wonder what the guidelines are.
The other complication is that as I understand it (and I could be wrong), airborne vs droplet is not a hard and firm line, it's more of a spectrum. The distinction seems to be largely in how long a space will "carry" the disease. Things like the flu aren't typically considered airborne because they don't hang in the air for very long. If someone coughs on you, you might get infected. If you walk through a grocery store an hour after someone with the flu walked through, you're probably not going to get infected.
Measles is a classic airborne illness because the space is infections for ~2 hours after someone with measles walks through.
Some think the distinction is outdated, and anything that spreads via the air should be considered airborne. Others seem to think that larger particles should be considered airborne.
At any rate, I can see some validity to attempting to maintain the status quo. Several regions are in the midst of severe COVID outbreaks, and given the upheaval an airborne recognition would create, I think the CDCs stance of strongly hinting that it's airborne without declaring it such is reasonable. They don't seem to be denying it's airborne, just not officially declaring it so.
We can loop back and formalize the airborne status later, when hospitals aren't swamped. I don't want to stress already stressed hospitals, and I don't want to overly stress our healthcare workers. They have it hard enough, and we are having a hard time getting enough of them.
One of the issues is that airborne diseases have a totally different set of requirements for hospitals, and they're much harder and more expensive to comply with. Specifically, patients with contagious airborne diseases need to be kept in rooms with lower pressure than the rest of the hospital to prevent contagions leaking out. I would imagine we have even fewer of those than we have ventilators and ER beds.
Of course, we can free doctors of that restriction, but I don't know how much we stand to gain versus any losses that occur in the transition period as hospitals wonder what the guidelines are.
The other complication is that as I understand it (and I could be wrong), airborne vs droplet is not a hard and firm line, it's more of a spectrum. The distinction seems to be largely in how long a space will "carry" the disease. Things like the flu aren't typically considered airborne because they don't hang in the air for very long. If someone coughs on you, you might get infected. If you walk through a grocery store an hour after someone with the flu walked through, you're probably not going to get infected.
Measles is a classic airborne illness because the space is infections for ~2 hours after someone with measles walks through.
Some think the distinction is outdated, and anything that spreads via the air should be considered airborne. Others seem to think that larger particles should be considered airborne.
At any rate, I can see some validity to attempting to maintain the status quo. Several regions are in the midst of severe COVID outbreaks, and given the upheaval an airborne recognition would create, I think the CDCs stance of strongly hinting that it's airborne without declaring it such is reasonable. They don't seem to be denying it's airborne, just not officially declaring it so.
We can loop back and formalize the airborne status later, when hospitals aren't swamped. I don't want to stress already stressed hospitals, and I don't want to overly stress our healthcare workers. They have it hard enough, and we are having a hard time getting enough of them.
I do agree that airborne vs aerosol is a spectrum, but I do think not admitting it political. Admitting it would mean N95s should be used more widely.
As it stands we have "face covering" mandates in some places when it should be surgical or higher and should actually be enforced.
As it stands we have "face covering" mandates in some places when it should be surgical or higher and should actually be enforced.
I am curious, in a non-mask effectiveness doubted sort of way, if it's known that surgical masks perform better than a well-fit cloth mask, at protecting the wearer?
Protecting the wearer is absolutely not the point of masking. The point is to protect everybody else from sick or asymptomatic infectious people.
Your mask has a fair chance to also, incidentally, protect you. Enough so to motivate wearing it even if you hate everybody else and wish they would die.
Your mask has a fair chance to also, incidentally, protect you. Enough so to motivate wearing it even if you hate everybody else and wish they would die.
I also think that part of the resistance to calling Covid transmission "airborne" has to do with containing mass hysteria. Droplets are "things," matter we can wipe away, dodge like bullets in The Matrix. A virus being airborne instills an even greater level of fear then is already apparent, because "airborne" takes the control out of it. "How can we clean the air?" Air isn't a "thing." Even the arguments for the airborne theory (which I'm partial to believe) are basically trying to make manageable a concept that seems impossible to manage--the cleaning of the air, the idea that airborne does not necessarily mean "out of our control."
>A virus being airborne instills an even greater level of fear then is already apparent, because "airborne" takes the control out of it. "How can we clean the air?" Air isn't a "thing."
What about air filters? IIRC at the start of the pandemic various transit authorities and airlines were assuring the public that travel was safe-ish because their vehicles ran HEPA filters.
What about air filters? IIRC at the start of the pandemic various transit authorities and airlines were assuring the public that travel was safe-ish because their vehicles ran HEPA filters.
If the airflow rate is sufficiently high than that would be true.
Would COVID being airborne mean that one should wear an N95 mask rather than just surgical masks? Analogous to when doctors perform procedures on patients that may produce aerosols?
Nothing in this is binary, there are few 100% protections, there is only risk reduction.
Surgical masks reduce risk. N95 or FFP2 masks reduce risks more. So, prefer N95 masks. This does not mean that surgical masks or cloth masks are useless, or that N95 masks are perfect.
Surgical masks reduce risk. N95 or FFP2 masks reduce risks more. So, prefer N95 masks. This does not mean that surgical masks or cloth masks are useless, or that N95 masks are perfect.
A recent study found that in large populations, cloth masks were useless and surgical masks were only marginally effective.
https://www.poverty-action.org/publication/impact-community-...
But even with masks, over a long period the risk that everyone will eventually be exposed is close to 100%. That's why instead of obsessing over masks we should focus on vaccinating as many vulnerable people as possible.
https://www.businessinsider.com/delta-variant-made-herd-immu...
https://www.poverty-action.org/publication/impact-community-...
But even with masks, over a long period the risk that everyone will eventually be exposed is close to 100%. That's why instead of obsessing over masks we should focus on vaccinating as many vulnerable people as possible.
https://www.businessinsider.com/delta-variant-made-herd-immu...
We need both. Delta is infectious enough that vaccine alone isn't going to stop it. Vaccine + masks can stop it, though, without infecting everyone.
Unfortunately that's simply wrong and there is no scientific basis for your claim. See the article linked I linked above, including the video testimony from Prof. Pollard. Vaccines are effective at preventing most deaths but vaccines and masks will not be sufficient to eradicate the virus. All of us can expect to be exposed multiple times. That is our reality.
But we need not expect to all get sick. Many, maybe most, vaccinated will get infected, and over it in a day or three, and likely not notice.
The empirical results of mandating masks is that virus spread is reduced substantially. But most masks people wear are not N95 type masks and shouldn't be as effective as the empirical results indicate. One article I read suggests that the effectiveness of masks comes not primarily from the filtering out of the virus but from increasing the humidity in the respiratory tract which in turn affects the ability of the virus to transmit disease.
Do you have any sources for that empirical result? I saw a big study result from Africa that came out last week, and it showed that surgical masks were helpful in reducing spread but the p-values were surprisingly weak except in the over-65 group. And cloth masks were very statistically weak in helping anyone.
>increasing the humidity in the respiratory tract which in turn affects the ability of the virus to transmit disease.
Consistent with early studies on mask sterilization techniques, which found that adding moisture to heat accelerated decay of virus particles.
Consistent with early studies on mask sterilization techniques, which found that adding moisture to heat accelerated decay of virus particles.
> Would COVID being airborne mean that one should wear an N95 mask rather than just surgical masks?
Yes.
>Studies that have been done show that if an individual might get infected within 15 minutes in a room, by time and concentration of the virus in the room, add a face cloth covering you only get about five more minutes of protection.
On the other hand if you use the n95 respirators and fit them tight to your face, you can actually spend 25 hours in that same room and still be protected.
https://www.pbs.org/wnet/amanpour-and-company/video/do-masks...
Yes.
>Studies that have been done show that if an individual might get infected within 15 minutes in a room, by time and concentration of the virus in the room, add a face cloth covering you only get about five more minutes of protection.
On the other hand if you use the n95 respirators and fit them tight to your face, you can actually spend 25 hours in that same room and still be protected.
https://www.pbs.org/wnet/amanpour-and-company/video/do-masks...
Face shields as well. There was an Indian study showing that they reduced infections to nothing in social workers visiting unmasked people. Note that this also means that surgical masks should still prevent infecting others.
There was a Swedish study showing face shields WITHOUT mask don't do anything. Also a study showing people with eyeglasses get infected less, i.e. it's possible that one can get infected thru eyes, although, I thing, it's pretty rare. Let's not forget that tear ducts drain in your nose!
Do you mean face shield only? That seems like it would be much worse than mask only, if covid is airborne as the article suggests. Mask plus face shield should be even better than mask only.
No, they were using face shields as well as mask.
Citation for the study? The Indians also used ivermectin to great effect to reduce their wave 2 months ago.
himinlomax(4)
Sure. That almost became the mandatory policy where I live.
It was the mandatory policy in Bavaria from about January to this week. At this point, I’m so used to the FFP2 mask I found that fits best that I’m still wearing those instead of the surgical masks we can (for) now wear instead - hooking behind the head is key.
My impression is that there are rapidly rising and then diminishing returns on investment.
Going from cloth to any mask with a high filtration layer is a huge improvement. Cloth is <30% of small particles. High filtration layer is >90%. Beyond that, the benefits are questionable.
Some surgical masks include a non-woven layer, and those already do pretty well (but how would you find those? pre-COVID it was easy). From there, genuine (non-counterfeit) KN95 and nanofiber masks are a big step up, and incredibly effective. At least pre-delta, if everyone used those, combined with modest social distancing, there was very little spread.
N95 masks are a modest improvement from there in terms of filtration, but by that point, mask quality (at least pre-delta) no longer appeared to be the dominant risk factor. COVID19 can spread through other mucous membranes (e.g. eyes). While combined with a face shield, used correctly, etc. I'm sure N95 make a difference over KN95, in practical public health use, I doubt there's any difference.
This is a good summary of data:
https://docs.google.com/spreadsheets/d/1M0mdNLpTWEGcluK6hh5L...
https://docs.google.com/spreadsheets/d/1i06OAItoOwIUaMjElr8m...
I don't really distinguish between things with >90% filtration. Unless you've got an excellent seal and are otherwise protected, it doesn't matter much. Note that the measurements are performed at 300nm. There isn't much spread at 300nm (a single virus particle is unlikely to make you sick). A 90% mask at 300nm will have >>>90% at e.g. a micron. A micron particle is unlikely to have more than one or two COVID particles (a micron is 5 COVIDs wide).
I do distinguish based on pressure drop. Lower means more air goes through the mask, rather than around.
I also do distinguish based on technology. The nanofiber ones don't degrade the same way as N95. The N95 nonblown layer will theoretically beat nanofiber for the first couple of hours of use, but once it's moist from your breath, nanofiber beats it. Personally, I use a disposable nanofiber mask, and I consider it a better (e.g. safer) option. I'm not in a controlled cleanroom/hospital setting, and life happens. Masks do get reused, abused, rained on, and generally exposed to life. Nanofiber have much better durability.
I also supply chain. Amazon and eBay are rife with counterfeits. I like masks where I can order direct. Especially 3M tends to be mostly fakes, unless ordered through authorized distributors.
I distinguish on fit. In addition, a well-fitting 90% masks beats a poor-fitting 99% mask, since with a good fit, all the air goes through the mask. Order yourself a variety pack and see what's comfortable and fits.
The biggest thing you can do is limit yourself to settings where everyone uses reasonable precautions. All parties wearing KN95 masks, having reasonable social distancing, favoring outdoors, vaccinated if >12, etc. is pretty safe. If you have a mixture of extreme precautions and no precautions, everyone is at risk.
Going from cloth to any mask with a high filtration layer is a huge improvement. Cloth is <30% of small particles. High filtration layer is >90%. Beyond that, the benefits are questionable.
Some surgical masks include a non-woven layer, and those already do pretty well (but how would you find those? pre-COVID it was easy). From there, genuine (non-counterfeit) KN95 and nanofiber masks are a big step up, and incredibly effective. At least pre-delta, if everyone used those, combined with modest social distancing, there was very little spread.
N95 masks are a modest improvement from there in terms of filtration, but by that point, mask quality (at least pre-delta) no longer appeared to be the dominant risk factor. COVID19 can spread through other mucous membranes (e.g. eyes). While combined with a face shield, used correctly, etc. I'm sure N95 make a difference over KN95, in practical public health use, I doubt there's any difference.
This is a good summary of data:
https://docs.google.com/spreadsheets/d/1M0mdNLpTWEGcluK6hh5L...
https://docs.google.com/spreadsheets/d/1i06OAItoOwIUaMjElr8m...
I don't really distinguish between things with >90% filtration. Unless you've got an excellent seal and are otherwise protected, it doesn't matter much. Note that the measurements are performed at 300nm. There isn't much spread at 300nm (a single virus particle is unlikely to make you sick). A 90% mask at 300nm will have >>>90% at e.g. a micron. A micron particle is unlikely to have more than one or two COVID particles (a micron is 5 COVIDs wide).
I do distinguish based on pressure drop. Lower means more air goes through the mask, rather than around.
I also do distinguish based on technology. The nanofiber ones don't degrade the same way as N95. The N95 nonblown layer will theoretically beat nanofiber for the first couple of hours of use, but once it's moist from your breath, nanofiber beats it. Personally, I use a disposable nanofiber mask, and I consider it a better (e.g. safer) option. I'm not in a controlled cleanroom/hospital setting, and life happens. Masks do get reused, abused, rained on, and generally exposed to life. Nanofiber have much better durability.
I also supply chain. Amazon and eBay are rife with counterfeits. I like masks where I can order direct. Especially 3M tends to be mostly fakes, unless ordered through authorized distributors.
I distinguish on fit. In addition, a well-fitting 90% masks beats a poor-fitting 99% mask, since with a good fit, all the air goes through the mask. Order yourself a variety pack and see what's comfortable and fits.
The biggest thing you can do is limit yourself to settings where everyone uses reasonable precautions. All parties wearing KN95 masks, having reasonable social distancing, favoring outdoors, vaccinated if >12, etc. is pretty safe. If you have a mixture of extreme precautions and no precautions, everyone is at risk.
I’ve been wearing N95s since Day 1 and most clueful people who could get them were doing the same.
It means that cloth fabric does nothing against aerosol. Even N95 masks don’t filter out all virons which can be as small as 1nm and escape the electrostatic charge of the N95. Security theater.
No, this is misinterpretation and too absolute a conclusion. The truth is not found in extremes. Protection is about reducing viral load -- it is useful even without fully eliminating viral load. A cloth facemask does get damp when you breathe through it, ergo some of your exhaled water (= infection carrier) got caught. An N95 mask catches a lot more. You need a bit of viral load to get infected, so whatever reduces viral load will help.
It is dangerous to immediately conclude that aerosol transmission makes masks security theater. They do not, they do help a lot.
It is dangerous to immediately conclude that aerosol transmission makes masks security theater. They do not, they do help a lot.
I had a hair on my phone, and I tried to blow it off while wearing an N95. Nothing. Even air itself is substantially slowed through an N95. It's the difference between sucking a viral load at full speed into your lungs, and having it crawl through a barrier at extremely low speed.
The evidence that sars 1.0 was airborne was already in medical journals. I am not a scientist or a doctor, but I found it on pubmed in feb of 2020.
While the history of science aspect to the denial is important, we cannot discount good old fashioned greed. If Airborne Covid is the messaging, then people don't want to shop, fly, or do lots of things where they spend their money. If however we have messaging about 6 feet apart, wash your hands, etc., then folks will still spend money.
While the history of science aspect to the denial is important, we cannot discount good old fashioned greed. If Airborne Covid is the messaging, then people don't want to shop, fly, or do lots of things where they spend their money. If however we have messaging about 6 feet apart, wash your hands, etc., then folks will still spend money.
I am surprised nearly all measures around the globe ignore the fact that the main method of infection is the aerosol one. People still damage their lungs inhaling alcohol vapors and other toxic disinfectants, still waste resources wiping stuff up, and washing frantically their hands, wear masks that do little, instead of focusing PPE on protecting the eyes and wearing aerosol-filtering masks like KN95, N95, KF94, FFP2, and higher grades!
Covid-19 is the disease which one can get from the virus.
The actual virus which is spread around is SARS-CoV-2.
I would only hope that those speaking about this would understand it by now.
The actual virus which is spread around is SARS-CoV-2.
I would only hope that those speaking about this would understand it by now.
even scientists often times use the disease name interchangeably with the virus.
The article mentions masks only once. What is the point of a mask but to suppress airborn transmission?
Prevent droplet spread.
I don't think anybody expects a mask will fully protect them. But they help. And they provide an important psychological benefit: They make people aware that the virus is still amongst us. They put social pressure on other people to conform and wear a mask like everybody.
Instead, doctors are obliged to memorize a great deal of what they are told are facts. Probably most of what they are told really are facts. But there is nothing systematic distinguishing facts with a great deal of support from those that are just repeated lore, like the business about airborne disease transmission.
Doctors have rejected evidence for airborne transmission because it contradicts what they were taught are facts, with no warning about how shaky any asserted fact is.
Another source of resistance is that facts, to be believed, need a theory. A fact without a theoretical mechanism by which it must operate is rejected. We saw that for cholera before germ theory made sense of it.
For a current example, in doi:10.1093/gerona/glab115, it turns out that having had a recent TDAP vaccine (which you can ask for at any pharmacy) turns out to predict, very robustly, a 40% decrease in onset of dementia among patients at an age where they are at risk for it. A 40% effect size is enormous! At this point, nobody knows why. Is it the tetanus, the diphtheria, the pertussis antigens? Or something else mixed in? Nobody knows. But without a demonstrated mechanism, nobody can allow anyone to see them to take it seriously.