Post B6Sm2pYIaaAdtfHz4i by jmcrookston@mastodon.social
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(DIR) Post #B6Sm2C1fXxtfJAisIi by jmcrookston@mastodon.social
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A damning indictment of droplet theory (that pathogens spread by flying droplets out 'cha mouth) from as long ago as 1936.Written by Dr. Wells & Mr. Wells, a wife and husband team.Thread.[originally posted August 28, 2020]#COVIDIsAirborne #RespiratoryVirusesAreAirborne #EntericVirusesAreAirborne #History #InfectiousDisease #Aerobiology #Airborne
(DIR) Post #B6Sm2FJrInEHWSFwZM by jmcrookston@mastodon.social
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History. Before 1861 we didn't know there were organisms in the air. Just that we got sick. I've posted elsewhere that they knew fresh air was good, but not why.Some people believed just something about "bad air" (origin of word "malaria" is mala aria from medieval Italian).Others thought it was from excretions, maybe our sweat or breath.Wells & Wells (I'll just refer to both as Wells) noted in 1861 we discovered little organisms. Aha.
(DIR) Post #B6Sm2HC8KUEpL4eno0 by jmcrookston@mastodon.social
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Forward to the turn of the century, Chapin, a public health doctor, said let's stop cleaning cities and examine how diseases spread. He examined the various ways, but relevant to us he looked at close contact and long-range airborne (miasma). He liked close contact.Wells:
(DIR) Post #B6Sm2I8ynhJGHaBnWq by jmcrookston@mastodon.social
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At turn of century, close contact dominated.This article in 1936 notes that no real way to show until recently. Hence, they wrote this article.They note the two forms:1. Droplets flying through air and floating particles. (Wells prefers the latter. Chapin had preferred the former - although he didn't rule out the latter, as I've said elsewhere.)
(DIR) Post #B6Sm2J6XEGwrGI3MMC by jmcrookston@mastodon.social
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2. Small droplets that float. What we'd call small aerosols these days. What the epis call "airborne" except they often use that word to only mean "long-range".
(DIR) Post #B6Sm2KQmIUjdNMX2Y4 by jmcrookston@mastodon.social
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Wells noted that the droplets really couldn't infect. They didn't do anything but fly out and fall to the ground. Couldn't explain wide dissemination of pathogens.The little drops though, could float. That could explain it!
(DIR) Post #B6Sm2NAE8UHJqtoMfQ by jmcrookston@mastodon.social
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They tested. They aerosolized bacteria and lo and behold, it was found throughout a building.
(DIR) Post #B6Sm2PBibuey86WaGm by jmcrookston@mastodon.social
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Including to the upper floors!Aha! So these little aerosols can really get around.
(DIR) Post #B6Sm2R67VhN03Jv8oy by jmcrookston@mastodon.social
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This confirmed these things were airborne. Wells notes, this might change our understanding of things the way when we discovered cholera in our water we knew to treat it - hence his reference to drinking water.Ask epi friends about the pump handle story.
(DIR) Post #B6Sm2S55r08v6QRprM by jmcrookston@mastodon.social
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This, Wells thought, should answer things. Airborne it is!Airborne explained intensive outbreaks of measles and smallpox!No longer would airborne have this burden of proof to meet to show it was how things transmitted![Narrator: Little did Wells know how wrong they were]
(DIR) Post #B6Sm2UkHwoHdMljlLc by jmcrookston@mastodon.social
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Tests showed how readily people got reinfected, so it couldn't just be droplets.
(DIR) Post #B6Sm2WZNAMjx1Ue4bw by jmcrookston@mastodon.social
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But hold on, if it's in the air why don't we see disease everywhere?Because we only see the CLINICAL INFECTIONS. We don't see the people who don't get sick!(Lots of us have been saying this for a while. High R means infectious not that it alone travels in air.)
(DIR) Post #B6Sm2XrUMUpF1y83UG by jmcrookston@mastodon.social
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Many infections through the air don't lead to sickness. They fall like "seed on stony ground", quote below:
(DIR) Post #B6Sm2Yv4QfHiJMoQi0 by jmcrookston@mastodon.social
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And maybe the reason hospitals aren't chalk full of sick people is that they have better air, or maybe that people were most infectious before they went!
(DIR) Post #B6Sm2aLL8TtMj86vIG by jmcrookston@mastodon.social
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And just to reassure their readers, they pause to note they are not talking about miasma theory. This isn't just bad air randomly floating around.Nor are they really referring to infection over miles and miles, like pollen.[ed. this happens though, for animals for sure]
(DIR) Post #B6Sm2b2EZ0CesABB9U by jmcrookston@mastodon.social
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So, they turn to look at contact:Contact isn't a good explanation. Droplets fall to ground too quickly, too soon. Not enough time to infect.
(DIR) Post #B6Sm2brHVD2JQU3wie by jmcrookston@mastodon.social
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Chance of big outbreak with droplets would be small.BUT if it came out in sneezes that filled a room (aerosols), we'd see these explosive outbreaks, which we do!And if they could count the subclinical infections they could answer this. But no way to do that.
(DIR) Post #B6Sm2cs1jvE8Z5Q3WK by jmcrookston@mastodon.social
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This makes sense. If you have bacteria who get in through respiratory system you'd expect them to have been acclimatized to getting in and out through that system. They'd be used to life in the air.Other bacteria would travel in other ways, and might not be airborne.
(DIR) Post #B6Sm2elMhf5QR0JlPk by jmcrookston@mastodon.social
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Sexually transmitted diseases for example transmit by touch, not air.There are diverse routes, and air is one of them, esp. for respiratory diseases.
(DIR) Post #B6Sm2fiDAs9rNVql8a by jmcrookston@mastodon.social
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They conclude by noting that the diseases society could not control enter and exit the body through the respiratory system. Those include the most important: flu, pneumonia, tuberculosis.Ends w/ until the purity of our air can be established we cannot control these diseases.
(DIR) Post #B6Sm2hBfgpJjxAdnhA by jmcrookston@mastodon.social
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The article is here: https://jamanetwork.com/journals/jama/article-abstract/273913Mr. Wells passed away, having passed the torch to his protege Riley who continued to work on air matters. They along with Cretyl Mills, proved TB was transmitted by air in the 50s or 60s after 8 years of workDr. Wells, who wrote her own articles about airborne spread, sadly passed away in the 40s, which explains why she is not involved in the later writings.
(DIR) Post #B6Sm2lMSAgJotliT3Y by jmcrookston@mastodon.social
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Riley wrote a short retrospective https://www.atsjournals.org/doi/full/10.1164/ajrccm.163.1.hh11-00In short, after 8 years of being forced by medical doctors to repeat their experiments, they proved it. But Wells had gone mad, and Mills had caught TB. "By the time results were written up eight years later (Riley, Mills, O’Grady, Sultan, Willstadt, Shivpuri, Infectiousness of air from a tuberculosis ward. Am Rev Respir Dis 1962;85:511–525), Barnwell had retired, Wells lay dying, and Cretyl Mills had been infected with TB."
(DIR) Post #B6Sm2nBtMv3iZan3s8 by jmcrookston@mastodon.social
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I want people to understand the naysaying around airborne spread of pathogens has gone on for one hundred years.Once Wells had proven TB in the air, the establishment criticized. Maybe the pigs were infected by the feed, the water, the caretaker.THEY DID A SECOND TWO YEAR STUDY to disprove these flippant remarks by obnoxious doctors.
(DIR) Post #B6Sm2oIJGXmpzmnhVw by jmcrookston@mastodon.social
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In 1955, Wells published a textbook about airborne spread which modern doctors seem to never refer to. Public health doctors and infectious disease doctors should know it, but neither field is very curious (to put it politely).https://archive.org/details/airborne-contagion/page/3/mode/1up
(DIR) Post #B6Sm2pYIaaAdtfHz4i by jmcrookston@mastodon.social
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"From the tube counts and computations of the volume of room air we estimated that from 10,000 to 100,000 nasopharyngeal parasites were expelled in an average sneeze (L.S.A.1., 1936d). The presence of streptococci in most samples of 5 cubic feet of air in schoolrooms, hospitals, and other occupied indoor atmospheres during the winter also provides natural evidence of atomization by expiratory processes (L.S.A.I., 1935b, 1936d)."
(DIR) Post #B6Sm2sTRj54UxU2eQa by jmcrookston@mastodon.social
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"The presence in the air of organisms expelled in these smaller droplets was demonstrated with the air centrifuge. A quantity of “sneeze powder” used by practical jokers was dusted into an air-conditioner supplying an occupied experimental room. Large numbers of Streptococcus viridans and Micrococcus catarrhalis recovered on centrifuge tubes showed that these typical parasites of the nose and throat continued to be distributed throughout the air of a room for some time after it was vacated."
(DIR) Post #B6Sm2tVbsWOeAU3tRI by jmcrookston@mastodon.social
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"Jennison (1942) found that individual particles between 5 and 10 microns in diameter could be clearly resolved and measured. By careful comparison with photographs of particles of known dimensions, he calculated that “at least 40 per cent, and perhaps 80 per cent, have a true diameter less than 100 microns” and that “at least 20 per cent, and perhaps 40 per cent, are less than 50 microns in actual diameter.” ...
(DIR) Post #B6Sm2uWi5us3KBaHnE by jmcrookston@mastodon.social
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...If these final estimates are approximately correct,” he concluded, “they indicate that a large proportion of sneeze droplets, in spite of their physical characteristics of viscosity and particulate inclusions, evaporate in the air to a size which constitutes the smallest of airborne ‘droplet nuclei.’ In the most violent sneeze recorded, in which the droplets were so dispersed that they could be enumerated, an actual count made on a life-size enlargement showed over 40,000 separate particles.”