Notices by Siderea, Sibylla Bostoniensis (siderea@universeodon.com), page 5

One of the things that I recommend you take from this is to note how certain kinds of bad science wind up being excellently congruent with certain powers that are motivated to in some sense *reduce access to medical care*.

One of the driving engines of bad medical science is the various institutional and governmental payers for medical care. In the US, it's the health insurance industry; in the UK, it's the NHS (or whoever is in charge of it).

The kind of emotionally motivated irrational bad science I am talking about isn't just a stochastic phenomenon. It constitutes an intellectual movement that is a *faction* in medicine. And that faction makes common cause with illiberal governments, grasping corporations, and any parties who consider themselves to have a vested interest in preventing access to healthcare.

End digression.)

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A lot of people have said a lot of unbelievably dumb shit about how the CDC's recommendations must have been to protect the health care system. "Surely."

But, no, the CDC was also making the same sort of awful recommendations to health care facilities, too.

It helps here if you understand what CDC recommendations are and how they work – politically, as much as anything.

As a practical matter, in healthcare, CDC recommendations are no more recommendations than an IETF RFC is an actual "request for comment": it's the medical equivalent of a specification. It establishes the minimum standard of care or practice.

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So as I was saying:

There we were, by the first week of March, 2020, there are reputable reports in three very prominent journals that we have reason to believe there is asymptomatic spread of COVID.

That's just the scientific literature. At the same time, the government of China is quite certain that there is asymptomatic spread, and is behaving accordingly – both in its own infection control measures, and in the warnings they are trying to pass on to other governments around the world, including the US's, as the Trump interview betrayed.)

At this point, all of the CDC's recommendations are predicated on the notion that one can tell who has COVID by the fact they have symptoms.

This includes their recommendations to healthcare facilities on using masks.

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Consequently, when the CDC issued guidance on COVID to health care facilities that said masking was unnecessary except in the case of symptomatic patients who had tested positive for COVID, or that surgical masks were sufficient and n95s unnecessary, what that meant was that hospital systems were free to not provide their staff with PPE. Because it was "unnecessary." The CDC said so.

Worse, they could even FORBID their staff to wear masks – either at all, or to wear N95s or KN95s. Even if they brought them from home themselves. Since they were "unnecessary", per the CDC.

And that is in fact a thing that happened:
https://siderea.dreamwidth.org/1618316.html

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Yall. I will probably never not be mad about this.

There was a big article in Wired magazine titled "The 60-Year-Old Scientific Screwup That Helped Covid Kill" ( https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill/ behind a paywall, but https://archive.ph/pzGCD ) abstracted "All pandemic long, scientists brawled over how the virus spreads. Droplets! No, aerosols! At the heart of the fight was a teensy error with huge consequences."

It's an okay article, and has many informative things to say, but doesn't go deep enough, and it chalks the controversy of how far viable infectious material travels through the air up to a basic physics mistake.

I'm sorry. This wasn't just a physics mistake.

This was a *psychological* mistake.

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The scientists used a model infectious organism, a bacterium – at the time, viruses were only a suspicion, but science knew about bacteria – Bacillus prodigiosus (which has since been renamed Serratia marcescens).

The test apparatus was a room set up with an array of petri dishes coated with agar, a material in which bacteria can grow. Each dish marked with its distance from the subject.

They squirted the bacteria into the mouths of research subjects and had them engage in various behaviors: talking, shouting, coughing, and so on. After each behavior, they slapped lids on all the dishes and took them away to incubate.

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This article in the Boston Globe during the height of the first wave of the Spanish Flu 1918 global pandemic in the US, alerting the populace of Boston that the previously promulgated social distancing guidelines were inadequate, was published mere days after the publication of a scientific research article in the Journal of American Medicine.

Two medical researchers working for the army decided to experimentally determine how far infectious material was dispersed by air.

It was a clever, simple, and elegant experiment.

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Quote:

"Keep out of 'spray range,'" is the warning given to residents of Boston by Health Commissioner Woodward [...]

In explaining his meaning of the phrase "spray range," the commissioner said that by the operation of coughing and sneezing a person suffering from the epidemic can send germs into the air for a distance of from eight to 15 feet. A well person standing within this rage can be readily infected by breathing in these germs. For this reason he urges the public to be on guard against getting into crowds or even conversing in the open air with persons who may be infected.

It isn't even necessary for the infected person to cough or sneeze, according to the commissioner, in order to infect well persons within "spray range." The mere pronunciation of such letters as t, d, p and many others will send germs into the air for a considerable distance."

Boston Globe, Oct 14, ⭐1918⭐ "Influenza Losing Ground in Boston"

They knew 101 years before COVID.

You know how?

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Quote:

Method and Technic

B. prodigiosus was selected as a suitable organism to introduce into the mouth for these experiments, because of its innocuous character* and because its pigment formation makes its recognition easy on agar plates.

For our experiments two small rooms were selected which were used for no other purpose during this time. Each of these rooms contained a metal topped table and a chair. The arrangement of furniture is shown in Figure 1. When the observer was seated in the chair, the tabletop was just below his ensiform. Agar plates exposed on the surface of the tables showed no B. prodigiosus circulating in the air and dust.

* I don't think it's considered innocuous today.

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Quote, continued:

Experiment 1 – To determine the limits of projection of B. prodigiosus from the mouth by ordinary speech, loud speech, and coughing. – The observer first thoroughly rinsed his mouth and gargled his throat with a suspension of B. prodigiosus in 0.85 per cent. sodium chlorid[e?] solution, the viability of which was proved by subcultures at suitable intervals. The observer then entered the room and seated himself in the chair, facing down the length of the table. In line with the observer's mouth, agar plates were exposed from 1 to 6 feet distant, except in some of the coughing experiments, when plates were exposed up to a distance of 10 feet.

The observer then proceeded: (1) to talk in an ordinary conversational tone for five minutes; or (2) talk in a loud tone for five minutes; or (3) cough as much as he could for five minutes.

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Quote, continued:

In one instance conversational speech was maintained for a period of thirty minutes*. At the conclusion of his speaking or coughing, the observer left the room. In order to allow the droplets in the air, if present, to settle on the surface of the plates, the plates remained exposed an additional ten minutes after the period of speaking or coughing. The colonies appearing on the plates were counted and recorded after seventy-two hours' incubation at room temperature.

Agar plates were exposed for one hour in the room between different stages of this experiment. By this means we found that an eight hour interval between periods of talking or coughing was sufficient to ensure the absence of B. prodigiosus in the circulating air.

* Oops. #overlyHonestMethods

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Quote, continued:

The results of projection of B. prodigiosus from the uncovered mouth during ordinary conversational speech, loud speech, and coughing, are shown in Table 1. The experiments were paralleled by two observers working in separate rooms.

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Quote, from further on down the article:

From our own work, however, we judge that the infected zone has a considerably greater radius. Our data indicate that during ordinary or loud speech, droplets are rarely projected more than 4 feet, irrespective of the duration of the experiment. In talking for thirty minutes there was no greater projection of bacteria than in talking for five minutes, though during the longer time there may be a heavier seeding of a plate within the effective range.

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As predicted by droplet theory, they found that speaking dispersed the bacterium 1 to 4 ft.

But they found they hadn't placed the plates far enough to account for coughing. I assume they stopped at 10 ft because they ran out of room, because they certainly hadn't run out of reach of B. prodigiosus expelled when the researchers coughed.

It is worth noting that bacteria are very many times the size of viruses. This experiment was conducted with an organism that is vastly heavier than any virus, whether influenza, coronavirus, or any other.

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1918, yall. This experiment was conducted and published in 1918. It made the front page of the Boston Globe in 1918.

For the record, the Spanish Flu pandemic landed in the US in Boston, MA, on August 28th, 1918. It jumped to the civilian population (having first appeared among service members) and became headline news two weeks later.

This paper? Was published October 12th. Not even 8 weeks later.

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During coughing, however, the danger zone is immensely widened. We were surprised at the distance we could project the organisms during a hard spell of coughing. At first we exposed plates only to a distance of 6 feet. Subsequently we exposed plates up to a distance of 10 feet, on which we recovered B. prodigiosus in sufficient numbers to suggest the possibility of even greater projection. We found that the chances of recovering B. prodigiosus from the more distant plates were increased if the observer renewed the organisms in his mouth during the period of coughing. From our work it would seem that the danger zone about a coughing patient has at least a 10-foot radius.

End quote.

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The research paper is

Doust, BC & Lyon AB (1918) Face Masks in Infections of the Respiratory Tract. Journal of American Medicine. October 12, 1918, p. 1216 - 1219.

It is available here as images: https://quod.lib.umich.edu/f/flu/7350flu.0016.537/1/--face-masks-in-infections-of-the-respiratory-tract?rgn=full+text;view=image

Or this permalink:
http://hdl.handle.net/2027/spo.7350flu.0016.537

Compliments of the Influenza Encyclopedia ( http://www.influenzaarchive.org )

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The paper in question, by the way, did not primarily set out to find out how far was the "safe zone", as telegraphed by their describing this experiment as assessing the dispersal of B prodigiosus from the *uncovered* mouth.

They were doing this to get a baseline, to evaluate the efficacy of masks.

Quote:

Abstract

The use of face masks to prevent infection is now generally accepted, but the type of face masks worn remains variable; experimented with commonly used mask material to prove their efficacy or lack of efficacy in preventing infection; experiments show a 10-foot danger zone for speaking; experiments demonstrate the effectiveness of three layer buttercloth masks.

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This was a painful example of motivated reasoning and a whole bunch of other psychological nonsense that leads people, people who should be in some sense scientific and rational, to glom onto a paradigm and not let go in the face of evidence.

At the point that aerosol physicists are telling you, *No, really, what you believe doesn't make any sense*, and you are telling the aerosol physicists, *You're not medical professionals, what could you possibly know?* you are at the point – if not long, long past it – to notice something has gone COMPLETELY off the epistemological rails.

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But that going off the rails didn't just happen during our pandemic. It's been going on for decades.

And it's not limited to rigidly clung to, fiercely defended wrong beliefs about the range of dispersal of exhaled infectious agents.

My on-ramp to the pandemic – the point at which that which was going on in Wuhan came to my attention – was a point in January 2020, where all of a sudden people were talking about social distancing in terms of *the flu*.

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