3 ms·

From that article: >The head of the CDC at the time, Tom Frieden, had initially recommended that health-care professionals not use respirators when taking care

From that article: >The head of the CDC at the time, Tom Frieden, had initially recommended that health-care professionals not use respirators when taking care of patients with Ebola. It took two health-care workers in Dallas contracting Ebola from a patient for the CDC to change its recommendations in October 2014. What the fuck? How is this a recurring pattern?

wahern 7y ago
The traditional classification system for disease transmission is "contact", "droplet", and "air borne". This is the system that has been taught for well over half a century to every doctor and epidemiologist in the world. But the system is overly simplistic.[1] And that's because the system is based on faulty models from the 1950s that were never revisited or questioned until relatively recently.[2] During the Ebola outbreak it was still medical heresy to question the droplet/air borne dichotomy. There were just a handful of scientists (one very loud one--Osterholm, I think) pressing the issue. Subsequent research after Ebola vindicated their arguments, but it can take a long time for good science to displace bad science, especially in the conservative medical community, and especially when the new science doesn't make for simple decision trees. The irony is that the old models made (and still make) typically conservative health professionals overly optimistic about the difficulty of transmission of various types of diseases. [1] See, e.g., Michael T. Osterholm, et al, "Transmission of Ebola Viruses: What We Know and What We Do Not Know", February 19, 2015, https://mbio.asm.org/content/6/2/e00137-15#sec-7 https://mbio.asm.org/content/6/2/e00137-15#sec-7 (links directly to the section "The Complexities of Aerosols and Droplets: A Changing Paradigm"). [2] "Medical and infection control professionals have relied for years on a paradigm for aerosol transmission of infectious diseases based on very outmoded research and an overly simplistic interpretation of the data. In the 1940s and 50s, William F. Wells and other 'aerobiologists' employed now significantly out-of-date sampling methods (eg, settling plates) and very blunt analytic approaches (eg, cell culturing) to understand the movement of bacterial aerosols in healthcare and other settings. Their work, though groundbreaking at the time, provides a very incomplete picture." Lisa M. Brosseau, Rachael Jones, "Health workers need optimal respiratory protection for Ebola", September 17, 2014, http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola http://www.cidrap.umn.edu/news-perspective/2014/09/commentar.... EDIT: And here's a 2019 paper about aerosol transmission of influenza, disputing the droplet orthodoxy, that suggests the continuing predominance of the old models: Timo Smieszek, Gianrocco Lazzari & Marcel Salathé, "Assessing the Dynamics and Control of Droplet- and Aerosol-Transmitted Influenza Using an Indoor Positioning System", February 18, 2019, https://www.nature.com/articles/s41598-019-38825-y https://www.nature.com/articles/s41598-019-38825-y ("virtually all studies assessing the dynamics and control of influenza assume that it is transmitted solely through direct contact and large droplets, requiring close physical proximity").
- nradov 7y ago
  Michael Osterholm was recently interviewed on Dr. Peter Attia's podcast. Worth listening, excellent information on viruses. https://peterattiamd.com/michaelosterholm/ https://peterattiamd.com/michaelosterholm/

wahern 7y ago

The traditional classification system for disease transmission is "contact", "droplet", and "air borne". This is the system that has been taught for well over half a century to every doctor and epidemiologist in the world. But the system is overly simplistic.[1] And that's because the system is based on faulty models from the 1950s that were never revisited or questioned until relatively recently.[2] During the Ebola outbreak it was still medical heresy to question the droplet/air borne dichotomy. There were just a handful of scientists (one very loud one--Osterholm, I think) pressing the issue. Subsequent research after Ebola vindicated their arguments, but it can take a long time for good science to displace bad science, especially in the conservative medical community, and especially when the new science doesn't make for simple decision trees. The irony is that the old models made (and still make) typically conservative health professionals overly optimistic about the difficulty of transmission of various types of diseases. [1] See, e.g., Michael T. Osterholm, et al, "Transmission of Ebola Viruses: What We Know and What We Do Not Know", February 19, 2015, https://mbio.asm.org/content/6/2/e00137-15#sec-7 https://mbio.asm.org/content/6/2/e00137-15#sec-7 (links directly to the section "The Complexities of Aerosols and Droplets: A Changing Paradigm"). [2] "Medical and infection control professionals have relied for years on a paradigm for aerosol transmission of infectious diseases based on very outmoded research and an overly simplistic interpretation of the data. In the 1940s and 50s, William F. Wells and other 'aerobiologists' employed now significantly out-of-date sampling methods (eg, settling plates) and very blunt analytic approaches (eg, cell culturing) to understand the movement of bacterial aerosols in healthcare and other settings. Their work, though groundbreaking at the time, provides a very incomplete picture." Lisa M. Brosseau, Rachael Jones, "Health workers need optimal respiratory protection for Ebola", September 17, 2014, http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola http://www.cidrap.umn.edu/news-perspective/2014/09/commentar.... EDIT: And here's a 2019 paper about aerosol transmission of influenza, disputing the droplet orthodoxy, that suggests the continuing predominance of the old models: Timo Smieszek, Gianrocco Lazzari & Marcel Salathé, "Assessing the Dynamics and Control of Droplet- and Aerosol-Transmitted Influenza Using an Indoor Positioning System", February 18, 2019, https://www.nature.com/articles/s41598-019-38825-y https://www.nature.com/articles/s41598-019-38825-y ("virtually all studies assessing the dynamics and control of influenza assume that it is transmitted solely through direct contact and large droplets, requiring close physical proximity").

nradov 7y ago
Michael Osterholm was recently interviewed on Dr. Peter Attia's podcast. Worth listening, excellent information on viruses. https://peterattiamd.com/michaelosterholm/ https://peterattiamd.com/michaelosterholm/