Notices by A Concerned Scientist (be@qoto.org)

Big thank you to @EricCarroll for pointing out this new WHO document on SARS-CoV-2 transmission.

This document is pretty complex, in-depth, dense, and I still expect it to evolve as we learn along the way. They have some of the correct people to be working on this, for once. Hello Lidia Morawska signing off on it at the beginning of the forward.

First, a tldr. If you don't care about how it came to be, or the science, and just want to know the outcome, here it is:

https://partnersplatform.who.int/tools/aria

Go to the calculator, enter your data, and come out with a probability of infection in a given situation along with the number of expected secondary infections from that interaction.

Here's the document itself if you want to follow along:

https://iris.who.int/bitstream/handle/10665/376346/9789240090576-eng.pdf?sequence=1&isAllowed=y

Disclaimer - This is evolving science.

I'm going to split this up in a thread, because I took a lot of notes of what stood out to me on a first read, and I hope to come back to it, and use it as a general reference moving forward.

While not strictly the same document, the WHO this week released a related document bringing new clarity for a(hopefully) shared terminology of airborne infection going forward.

From the executive summary:

"Terminology used to describe the transmission of pathogens through the air varies across scientific disciplines, organizations and the general public. While this has been the case for decades, during the coronavirus disease (COVID-19) pandemic, the terms ‘airborne’, ‘airborne transmission’ and ‘aerosol transmission’ were used in different ways by stakeholders in different scientific disciplines, which may have contributed to misleading information and confusion about how pathogens are transmitted in human populations.

...

The scope of what type of pathogens were covered in this consultation and the resulting
descriptors used in this document are as follows:
• Pathogens, contained within a particle (known as ‘infectious particles’), that travel through the air, when these infectious particles are carried by expired airflow (they are known as ‘infectious respiratory particles’ or IRPs), and which enter the human
respiratory tract (or are deposited on the mucosa of the mouth, nose or eye of another person) and;

• Pathogens from any source (including human, animal, environment), that cause
predominantly respiratory infections (e.g., Tuberculosis [TB], influenza, severe acute
respiratory syndrome [SARS], Middle East respiratory syndrome [MERS]), but as
well as those causing infections involving the respiratory and other organ systems (e.g. COVID-19, measles).

The following descriptors and stages have been defined by this extensively discussed consultation to characterize the transmission of pathogens through the air (under typical circumstances):

• Individuals infected with a pathogen, during the infectious stage of the disease (the source), can generate particles containing the pathogen, along with water and respiratory secretions. Such particles are herein described as potentially ‘infectious
particles’.

• These potentially infectious particles are carried by expired airflow, exit the infec-
tious person’s mouth/nose through breathing, talking, singing, spitting, coughing or
sneezing and enter the surrounding air. From this point, these particles are known as ‘infectious respiratory particles’ or IRPs.

• IRPs exist in a wide range of sizes (from sub-microns to millimetres in diameter).
The emitted IRPs are exhaled as a puff cloud (travelling first independently from air
currents and then dispersed and diluted further by background air movement in the room).

• IRPs exist on a continuous spectrum of sizes, and no single cut off points should be
applied to distinguish smaller from larger particles, this allows to move away from
the dichotomy of previous terms known as ‘aerosols’ (generally smaller particles) and ‘droplets’ (generally larger particles).

• Many environmental factors influence the way IRPs travel through air, such as ambi-
ent air temperature, velocity, humidity, sunlight (ultraviolet radiation), airflow distri-
bution within a space, and many other factors, and whether they retain viability and infectivity upon reaching other individuals.

...

The descriptor ‘transmission through the air’ can be used to describe the mode of trans-
mission of IRPs through the air.
Under the umbrella of the ‘through the air’, two descriptors can be used:
•
‘Airborne transmission/inhalation’: Occurs when IRPs expelled into the air as described above and enter, through inhalation, the respiratory tract of another person and may potentially cause infection. This form of transmission can occur
when the IRPs have travelled either short or long distances from the infectious person. The portal of entry of an IRP with respiratory tract tissue during airborne transmission can theoretically occur at any point along the human respiratory tract, but preferred sites of entry may be pathogen specific. It should be noted that the dis-
tance travelled depends on multiple factors including particle size, mode of expul-
sion and environmental conditions (such as airflow, humidity, temperature, setting, ventilation).

•‘Direct deposition’: Occurs when IRPs expelled into the air following a short-range
semi-ballistic trajectory, then directly deposited on the exposed facial mucosal sur-
faces (mouth, nose or eyes) of another person, thus, enter the human respiratory tract
via these portals and potentially cause infection."

https://iris.who.int/bitstream/handle/10665/376496/9789240089181-eng.pdf

I have done you all a disfavor by putting these two documents in the same thread, but what's done is done. I'm going to try to make this clear.

These are NOT the same documents. One is about only COVID:

https://iris.who.int/bitstream/handle/10665/376346/9789240090576-eng.pdf

One mentions COVID, but is about ANY airborne pathogen:

https://iris.who.int/bitstream/handle/10665/376496/9789240089181-eng.pdf

All day every day I see people taking quotes from the second one and talking about how absurd it is to say that about COVID, and every time I look, the document's not actually talking about COVID where they quoted from.

I know this won't stop any of it. It's far from a perfect document and that could be discussed. There's plenty there to disagree with, but, I'd say 90% of the discussion about it that I've seen to date has been uninformed and/or disingenuous.

I think this article from Scientific American does a great job of laying out some of the reasons these documents are important.

https://www.scientificamerican.com/article/a-fight-about-viruses-in-the-air-is-finally-over-now-its-time-for-healthy/

"The operative phrase here is “through the air.” It’s plain language that anyone can understand, and this switch from jargon such as “airborne” and “aerosol” may finally clear the way for researchers to get funding to study better, real-life ways to protect people from a range of infectious diseases.

And just maybe governments, retailers, school authorities and others can now start to get solid information about ways they can clean indoor air. While it is going to take more than a wordy WHO statement to persuade gym owners that fogged-up windows mean too many people are huffing out potentially infectious air, the new wording does provide a better explanation of why it’s gross and unhealthy."

...

"This should clear the way for funding more and better research on the transmission of infectious diseases—not just COVID, but influenza, respiratory syncytial virus (RSV) and viruses that cause the common cold. That, in turn, should give managers of schools, retailers, airports and other public spaces the information they need to help keep air and surfacers cleaner. Because if people understand the physics of disease transmission, they can find ways to safely keep schools, shops and restaurants open during outbreaks and epidemics with better practices in ventilation, air and surface cleaning and foot traffic control."

...

"“It’s now respectable to do this research,” Jiménez said. “People can get funding to do some research about indoor air and engineering systems. They are stepping into fields that they really wouldn’t work on before. So you see some encouraging changes.”"

I have chosen to die on this hill, and so I will continue. I was going to ignore this new opinion piece in The Lancet, but, I can't help myself in the end.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00244-7/fulltext

The first time I read it I gave up on the first paragraph.

Read this carefully:

"The report proposes that use of the unqualified terms airborne and airborne transmission in the context of infectious disease transmission should be avoided."

Followed by:

"It introduces new terms matched to specific definitions, including “through-the-air transmission”, “infectious respiratory particles”, “airborne transmission/inhalation”, “direct deposition”, “semi-ballistic”, and “puff cloud”. "

What this, literally, says is that we should replace "airborne transmission" with "airborne transmission/inhalation." This is what everyone is fighting over.

After it came across my timeline for the 20th time I decided I'd give the rest a read.

Paragraph two. Two examples of airborne being used in papers in the last 127 years to show that there was no confusion regarding the term "airborne"?

Compare that to the extensive writing of Prof. Jimenez on the history of the droplet dogma and decide if you think everyone understands this.

https://www.researchgate.net/publication/354772435_Echoes_Through_Time_The_Historical_Origins_of_the_Droplet_Dogma_and_its_Role_in_the_Misidentification_of_Airborne_Respiratory_Infection_Transmission

https://royalsocietypublishing.org/doi/full/10.1098/rsfs.2021.0049

https://onlinelibrary.wiley.com/doi/full/10.1111/ina.13070

Paragraph 3. Finally something we agree on. The WHO botched the last 4 years horribly.

The next paragraph is where this falls off the rails for me.

"This new WHO report appears to assume that because some infectious disease experts believe that the SARS-CoV-2 virus is airborne only “situationally” (ie, under unusual conditions),1"

I, for one, read this and went directly to the report itself because I was appalled. Guess what? The quoted word, "situationally", never once appears in the document, which is cited. Nor does "under unusual conditions." So now it's just quoting things that don't exist and citing them.

To be clear, it's citing a document titled "Global technical consultation report
on proposed terminology
for pathogens that transmit
through the air" not the document actually about COVID(https://iris.who.int/bitstream/handle/10665/376346/9789240090576-eng.pdf), while complaining about COVID.

I don't see a need to continue.

Mark my word. The CDC delayed their response to this document, whether or not they would go along and declare COVID airborne, because people are making it "controversial" and giving them cover to.

The WHO - COVID is not airborne.

Everyone for 4 years - Declare it airborne!

The WHO - Here's a 66 page document painstakingly detailing how COVID is airborne titled "Indoor airborne risk
assessment in the context of SARS-CoV-2" followed by a 33 page document bringing the droplet people and aerosol people under one umbrella explaining how droplets can go through the air and be deposited AND aerosols can fly long distances through the air. To make both happy we'll put transmission in two subcategories:

Airborne transmission/inhalation and direct deposition.

Everyone - No, not like that!

I follow a lot of people. 1,878 as of this morning. I also don't engage in any other social media. Never have, never intend to. Pretty much every other social media domain is blocked at our firewall level. I only looked at twitter(as it was called at the time) in December of 2019, for the first time in my life, to try to get fast breaking COVID news, and have access to scientists who would be ahead of the knowledge curve.

I'm only really here for one reason. To get good info, synthesize it, and redistribute it, often in different words, when I think it'll be helpful. Despite some truly "delightful" DMs I've received recently, I have no ulterior motive. No one's forcing you to believe that, and I take it as a badge of honor to be blocked, so, knock yourself out if you're so inclined.

I'm asking everyone, particularly scientists, to be careful with your words. There's been palatable rising tensions here in 2024. Some of it has to do with science(H5N1, WHO airborne) some of it doesn't(politics), but it's real.

I have seen some truly awful H5N1 takes as things ramp up. Particularly this morning. Nuance matters. If you want to be a prognosticator, be clear. "I think" or "I believe" instead of launching into what you want to say.

Here's a few things I've seen that should be discussed carefully:

- Pasteurization is completely effective against H5N1.

Here's what the FDA says about that:

The FDA believes the pasteurization process is “very likely” to inactivate H5N1, though they acknowledged that no studies have been done to test that.

Here's someone who knows better:

“Daniel Perez, an influenza researcher at the University of Georgia, is doing his own test tube study of pasteurization of milk spiked with a different avian influenza virus. The fragile lipid envelope surrounding influenza viruses should make them vulnerable, he says. Still, he wonders whether the commonly used “high temperature, short time” pasteurization, which heats milk to about 72°C for 15 or 20 seconds, is enough to inactivate all the virus in a sample.”

- It's already spreading person to person across the US.

The only reference I can find that would lead to that conclusion would be this:

"Only one human case linked to cattle has been confirmed to date, and symptoms were limited to conjunctivitis, also known as pink eye. But Russo and many other vets have heard anecdotes about workers who have pink eye and other symptoms—including fever, cough, and lethargy—and do not want to be tested or seen by doctors. James Lowe, a researcher who specializes in pig influenza viruses, says policies for monitoring exposed people vary greatly between states. “I believe there are probably lots of human cases,” he says, noting that most likely are asymptomatic."

Or, perhaps in conjunction with this:

"The genetic sequence from the human case, which occurred on an unidentified farm in Texas, is sufficiently different from the cattle sequences that it can’t be easily linked to them, he said. The differences suggest that the individual was either infected in a separate event — maybe not via a cow, but through contact with infected wild birds — or that there might have been another line of viruses in cattle early on and it has since died out."

I don't want to belabor the point, and I don't want to call out anyone. I just felt the need, after scrolling through my timeline this morning, to point out that language matters. Be careful. Don't spread misinformation. If you want to prognosticate, go ahead, but be clear it's your opinion. Your magic internet points don't matter.

Presented without further comment.

https://www.nature.com/articles/s41577-019-0143-6

"The adaptive immune response to influenza virus infection is multifaceted and complex, involving antibody and cellular responses at both systemic and mucosal levels. Immune responses to natural infection with influenza virus in humans are relatively broad and long-lived, but influenza viruses can escape from these responses over time owing to their high mutation rates and antigenic flexibility."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291154/

"In summary, herd effects are assumed with influenza vaccine programmes, but there are few studies that quantify the herd effect of vaccination. We found low-level evidence supporting a herd effect of vaccination on influenza virus infection in contacts of vaccinated persons. Further rigorous studies are needed in order to better understand under which circumstances vaccination may prevent influenza and its complications in contacts."

I don't really have time today to do a deep dive write-up on these, as I often do for articles. However, if you're interested in the possibility of airborne transmission, where the science has been on this, and how far off the possibility has been(spoiler alert, 5 amino acid substitutions) these articles are a good starting point. I'm also putting them here so I can refer back to them in the future if needed.

"Influenza A viruses are transmitted via the air from the nasal respiratory epithelium of ferrets"

https://www.nature.com/articles/s41467-020-14626-0

"Airborne Transmission of Influenza A/H5N1 Virus Between Ferrets"

https://www.science.org/doi/10.1126/science.1213362

"The Potential for Respiratory Droplet–Transmissible A/H5N1 Influenza Virus to Evolve in a Mammalian Host"

https://www.science.org/doi/10.1126/science.1222526

"A comprehensive review of highly pathogenic avian influenza (HPAI) H5N1: An imminent threat at doorstep"

https://www.sciencedirect.com/science/article/pii/S1477893923000984

"The Role of Airborne Particles in the Epidemiology of Clade 2.3.4.4b H5N1 High Pathogenicity Avian Influenza Virus in Commercial Poultry Production Units"

https://www.mdpi.com/1999-4915/15/4/1002

"Influenza: Five questions on H5N1"(which I admittedly mostly found interesting because it extensively quotes Jeremy Farrar 11 years before he became the head of the WHO in 2023)

https://www.nature.com/articles/486456a

@SRLevine @StillIRise1963 @WarnerCrocker

https://www.pnas.org/doi/10.1073/pnas.2321170121

@SRLevine @StillIRise1963 @WarnerCrocker

After having spent too much time on it, I think the paper might not be released yet. One write up I read said it's dated April 19th.

https://www.eurekalert.org/news-releases/1041168

@WarnerCrocker

Interesting write up, but the link to the actual paper in the article goes to a not found page, and searching pnas.org I can't find the paper by author name either. All of the write ups on it go to the same not found page.

If anyone finds a valid link to this paper, could you please post it?

Title is apparently:

Live-attenuated virus vaccine defective in RNAi suppression induces rapid protection in neonatal and adult mice lacking mature B and T cells

Thank you!

I'm hoping someone can ease my mind here and tell me if I'm being a paranoid weirdo, or if this is legitimately strange.

My wife works from home with a company issued laptop. She's a teacher and she's on Zoom with students for hours a day. We've never had any issues with our network over the last three years that she's been a virtual teacher.

There's a new tech support guy at her company who's issued new rules. She had a "tech check up" with him yesterday in which he said he's going to need:

Pictures of our cable modem and routers including serial numbers and MAC addresses.

Pictures of any hardware between the cable modem and routers, including serial numbers and MAC addresses.

Pictures of any hardware between router and company issued laptop, including serial numbers and MAC addresses. This is to include any other personal computers that may be on the same segment of the network.

Is this just good, preemptive tech support and I'm overthinking it?

My first thought was that I am not sending him the info on my own, personally owned cable modem, routers and hardware firewall, so he's getting photos of the old Spectrum equipment they dropped off that's been sitting in the closet for a decade, and we'll just tell him it's a VLAN all to itself(which it is). But after sleeping on it I thought that maybe I'm overreacting.

#CyberSecurity #WorkFromHome

My wife's company had a mandatory conference for all of their over 2,000 employees last week. She did not attend, thankfully. Even though it was mandatory she rolled the dice on a Telehealth appointment and the doctor she got thought it was wonderful that she hasn't gotten COVID yet, and wrote her a note suggesting that she be exempt from all in-person meetings for the next 365 days. Surprisingly, to us, HR at her company accepted it. We went camping while everyone else went to a packed, zero COVID precautions considered, conference.

No surprise at all, she's covering for many people out sick today, including the person she works most closely with who texted her to say she's "down with the worst bout of COVID yet."

She just got off of a zoom meeting with her boss, who also has COVID today, and is suddenly COVID cautious curious, let's say. She said it's her 7th(yes, seventh) known COVID infection, she has a "bizarre autoimmune disorder" that her doctors have spent a year trying to help her figure out, and she's come to believe that it *might* just be COVID related.

She asked how my wife has managed to stay COVID free, and my wife went ahead and listed out all of our precautions, and here's where watching this secretly from across the room blew my mind....The hangup was restaurants. She kept coming back to "You haven't been inside of a restaurant in 4 years?" Over and over. At least 4 times in the next 20 minutes she repeated that. Like it was some Herculean feat that couldn't be accomplished by the average human being.

I just don't get it...

Anyway, it was a bridge too far, and so she will continue getting COVID.