King Kong and Godzilla faced off above the city skyline. With his teeth, Godzilla rips a hunk from the skyscraper, flinging it in Kong’s direction. Kong bats it away, sending it spinning down onto the city streets below where mere humans, trapped in the drama, scurry helplessly. It’s been like that.
Keeping up with the news stories on the pandemic the past year and a half, you may have noticed there seemed to be two major threads. I’m not talking about “it’s the end of the world” vs. “it’s all a myth.” I’m talking about the droplet vs. aerosol transmission controversy, asking the question, how does the virus pass from one person to the next? Does it primarily pass via particles that quickly fall to the ground or to a nearby surface, or can it linger in the air, potentially travelling longer distances before infecting someone?
The CDC and WHO mostly represent the medical profession and the research generated by the medical profession. They have their turf. But there are other relevant professions out there, physics, engineering, etc., and those whose work span multiple disciplines. When one group doesn’t acknowledge the other, it’s more than just a turf war. It could be tens of thousands of seniors dying. It could be the seniors we loved and cared for who died.
Public health policy, coming from the CDC and WHO, camped on a historical view of the droplet transmission side with its hand washing and six foot social distancing. They only tended to consider aerosol transmission during certain specific medical procedures, such as intubation. But there were impressive studies showing that aerosol transmission was happening in other more normal settings. This is a serious difference. A life and death difference. Hand washing and a mere six foot distance wouldn’t be enough to prevent aerosol transmission. Ventilation has to be addressed. Maybe that’s why when COVID got into our facility, we were helpless to stop it. Our building was not designed to prevent aerosol transmission. While we were washing our hands, wearing non-N95 surgical masks and nagging the residents not to sit near each other, was the virus wafting slowly down the hallways behind us?
Wired magazine published an article by Megan Molteni, entitled The 60-Year-Old Scientific Screwup That Helped Covid Kill, on May 13, 2021. She documented some of the back and forth drama that was taking place over our heads. According to Molteni, the medical profession had taken some numbers that applied to tuberculosis and coal mine dust and, for the 60 years up until now, applied them incorrectly to almost all respiratory germs. Look up all the places where 5µ had been named as the particle size cutoff point for aerosols. Anything bigger was assumed to only travel through the air in droplet form. Now substitute the 100µ size that might actually go aerosol. Quite a difference. Unfortunately, the 5µ mistake had become so entrenched that it was like heresy to the medical profession to challenge it.
It was April 3, 2020, when a group of scientists arranged a Zoom meeting to formally challenge the WHO about droplet transmission. It was March of this year, when the the WHO issued ventilation guidelines. In June, the the CDC issued theirs. Both finally acknowledged that the other sciences might be right, that aerosol transmission might be a culprit in the spread of COVID outside of the intensive care unit. So, the question is at what point did the threads merge to produce coherent policy that would help us protect our residents? Answer: they haven’t yet. The vaccines arrived before Kong got on the same side as Godzilla.
©Donna Stuart, ADC July 20, 2021
https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill
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