Six Deadly COVID Transmission Myths

Flawed guidance comes from the CDC

On Jan 24 in Guangzhou, A1 infected 9 people at 3 tables because bad ventilation blew exhalations over the tables. Safer buildings suck virus particles out & bring in fresh outdoor air.

County officials claim, “We are too busy dealing with ICU under-capacity to worry about reducing ICU demand via improved public health orders.” This reflects practical realities. Flawed guidance comes from the CDC, thwarting efforts to improve County health orders. The six deadly myths:

  • Aerosols (small airborne particles) aren’t important

MYTH 1: Aerosols aren’t important

FACT: Indoor aerosols, small airborne virus particles traveling more than six feet, are the ONLY explanation for EVERY superspreading case study on CDC’s website, starting with 15-foot transmission on January 24 in a Guangzhou restaurant: [1]

The US has 448,000 public health workers and 3,400 epidemiologists, none of whom are primary COVID transmission researchers. Transmission research falls onto 20 Aerosol Scientists and their laboratory staff, who have concluded that superspreading is explained by aerosols. [2] On August 26, Doctor Fauci and CDC endorsed these findings by hosting the National Academies of Sciences, Engineering, and Medicine’s “Airborne Transmission of SARS-CoV-2 Workshop.” Featured were five top Aerosol Scientists. [3] SARS-CoV-2 aerosol research isn’t perfect, but the findings stand unchallenged.

MYTH 2: Cleaning surfaces should be a top priority.

FACT: Dr. Fauci admits it is very unlikely to contract COVID from doorknobs.

The CDC has admitted fomite (surface) transmission is rare: “It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this isn’t thought to be the main way the virus spreads.” WHO concurred in their July 9 scientific brief, “Despite consistent evidence as to SARS-CoV-2 contamination of surfaces and the survival of the virus on certain surfaces, there are no specific reports which have directly demonstrated fomite transmission.“ [4] Dr. Fauci said in an interview, “It is conceivable, but very unlikely that you could get it through fomites, meaning inanimate objects such as doorknobs, or computers. It can occur, but it’s a very minor component of transmission.” [5] Many experts now think that excessive disinfection of surfaces is an unnecessary use of resources. [6]

MYTH 3. CDC believes it’s own guidance

FACT: CDC adopted evidence-based guidance on Sept 18 but then reverted on Sept 21.

On Sept 18, CDC changed public health guidance to reflect evidence from their August 26 Transmission Workshop. Such guidance would have halved transmission. Alas, CDC reverted to flawed guidance on Sept 21:

  • “The CDC removed language that said the coronavirus spreads via airborne transmission, the latest example of the agency backtracking from its own guidance. Evidence that the virus floats in the air has mounted for months, with an increasingly loud chorus of aerosol biologists pointing to superspreading events in choirs, buses, bars, and other poorly ventilated spaces. Experts had said the language change had the power to shift policy and drive a MAJOR RETHINKING ON THE NEED TO BETTER VENTILATE INDOOR AIR.” [7]

Your county regurgitates state guidance that copies flawed CDC guidance that overemphasizes surface transmission while ignoring aerosol transmission. Ethically, Inauguration Day should result in CDC changing back to Sept 18’s evidence-based guidance. Practically, CDC faces three challenges:

  • Contradicting previous guidance reduces public trust, risking a reduction in vaccination uptake.

No County has stepped forward to challenge the CDC. One Santa Clara County (SCC) Supervisor’s office understandably provided an inaccurate response when pressed about the County’s CDC-based guidance, claiming SCC “Public Health Department bases their decisions on the latest scientific data about what is likely to spread disease and put people at risk.” One of the world’s top COVID transmission experts, Professor Shelly Miller, reached out to Santa Clara County:

  • “The evidence for how the SARS-CoV-2 virus transmits differs from the assumptions in California state and county guidance. Evidence shows that surface transmission is rare whereas aerosol (i.e. small airborne particle) transmission is the only explanation for every superspreading case study. Better transmission understanding will lead to improved guidance and better health outcomes.” Miller offered to help SCC but received no response. [1]

MYTH 4. Residents and workers can’t measure indoor air safety

FACT: Lifesaving handheld devices can detect dangerous, stagnant air

From a GHG standpoint, outdoor CO2 concentration is 400 ppm whereas 350 ppm is necessary to prevent climate dystopia.[8] Humans exhale CO2. Indoors, we breathe in molecules that others have exhaled, sometimes including SARS-CoV-2 particles. If indoor CO2 increases to a dangerous 700 ppm level, bring in fresh virus-free outdoor air. $130 NonDispersive Infrared Sensor (NDIR) CO2 meters should be used to measure indoor air safety. [9] [10]

Up to this point, some specific reopening guidance has not been grounded in science. For example, “Restaurants can open at 50% capacity,” ignores that each restaurant has different ventilation producing widely varying COVID safety. Such guidance should be replaced by “No matter how many patrons, restaurants must keep CO2 below 700 ppm indoors.” [11]

Measuring CO2 can be crowdsourced. As part of a pilot program to “Go Beyond CDC Guidance,” there are many civic-minded people who would readily volunteer 10 hours per week to help the County Health Department measure CO2 in restaurants, adult care facilities, meatpacking plants, prisons, offices, and other indoor spaces.

MYTH 5. We can’t halve transmission

FACT: “If the aerosol mechanism of infection is not mentioned, people don’t understand safety recommendations, and have a hard time following them or adapting them to new situations. Once people understand ‘IT’S LIKE SMOKE, AND YOU WANT TO BREATHE AS LITTLE SMOKE AS POSSIBLE,’ they very quickly figure out what they need to do in their specific situations.” [12]

Social media has spread misinformation about transmission. Arbitrary reopening guidance has further muddied the water. New public health orders should mandate brief, high-quality transmission education for every building manager and entrant. It is criminally negligent that every American cannot yet visualize January 24’s Guangzhou superspreading. A three-minute YouTube transmission explainer can suffice. [13]

For building managers, current public health guidance is vague and impractical, creating a labor-wasting COVID learning curve for each manager. Learning is further complicated by the less-than-perfectly-scrupulous HVAC industry. [14] For example, without assistance from higher levels of government, two heroic Palo Alto Unified School District staff members traversed the curve, picked solid vendors, cornered the market on quiet air purifiers, and documented the safety upgrade of every classroom. Their example is being copied by other school districts. [15]

Moving forward, a more practical approach will collect best practice case studies of specific building safety measures, specifying:

  • building information including square footage and room layouts

Short case study YouTubes and web pages will provide more-practical guidance.

MYTH 6. Leaders shouldn’t challenge the CDC’s flawed guidance

FACT: Leaders have an ethical obligation to reduce unnecessary deaths

Let’s start with UC Berkeley Epidemiology Professor Arthur Reingold, who chairs the California State COVID-19 Scientific Safety Review Workgroup and who was an August 26 Transmission Workshop speaker. He has an ethical obligation to bring the findings from the Workshop to his state Safety Workgroup, but taking an ethical stand against CDC is likely a Quixotic quest. Ethics also dictates that Prof. Reingold enlist SCC Liason Michelle Moskowitz of Berkeley’s Government Relations Office into the battle.

In contrast, eleven Aerosol Scientists HAVE taken a principled stand. [2] Prof. Jose Jimenez indicated that

  • “We are all working at different levels, some talking directly to CDC and WHO, others to state / local authorities. We are definitely having an impact, but it is kind of like a landslide model. We do a lot and not much changes, and then suddenly something gives and there is some motion and so on. We’ll keep at it.”

MY OWN COVID LEARNING CURVE

Since March I have undertaken secondary COVID research, accessing national and local experts {Professors Michael Osterholm (part of Biden’s COVID team), Shelly Miller, Jose-Luis Jimenez, and Erin Bromage; ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers); Santa Clara County Public Health’s Dr. Rudman; a scrupulous local HVAC professional; a local HVAC technology investor; four commercial property managers managing over 30M square feet; public transit safety staff}. I led a national webinar with 180 attendees on “COVID-safe Return-to-Office.” [16] I do not claim relevant scientific expertise. These views are my own, not the views of Palo Alto Transportation Management Association.

REFERENCES:

[1] Prof. Shelly Miller’s Dec 9 message to Santa Clara County

[2] FAQs on Protecting Yourself from COVID-19 Aerosol Transmission

[3] Airborne Transmission of SARS-CoV-2: A NASEM Virtual Workshop, Aug 26–27

[4] WHO scientific brief

[5] Anthony Fauci said in an interview

[6] Unnecessary use of resources spent cleaning surfaces

[7] Sept 21, WaPo: “No matter what the CDC says, the coronavirus is airborne

[8] IPCC’s 2018 Special Report on 1.5C

[9] FAQ Sections 8 & 9

[10] https://twitter.com/Cities21/status/1333272157883756544

[11] FAQ Section 9.6

[12] FAQ Section 3.7

[13] “Office Safety: Prevent COVID-19 Airborne Transmission,” three-minute youtube

[14] Prof. Erin Bromage, regarding unscrupulous, overblown claims about HVAC products such as bipolar ionization air purifiers, “HVAC is a mess.”

[15] October 27: Palo Alto Unified School District ventilation guidance

[16] COVID-safe Return To Office Webinar (with BART & AC Transit)

Medium people tags: Alexandra Sifferlin , Jose-Luis Jimenez, Sarah Collins, Felix Gussone, MD, Kim Prather, Andy Slavitt, Yasmin Tayag.

Executive Director at Palo Alto Transportation Mgmt Assoc.

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