Of Course It's Airborne and We Should All Be in N95s

Just saving these here for posterity. 

Check out this whole thread of documents found on originsearch; there's tons more in the thread, but I have no idea why or how people suddenly have access. They're all over Twitter, though. That being said, it's entirely possible they're all fabricated; unlikely, but possible. 

The gist of these bits is that in February 2020, there was a lot of concern over public and international perception that affected the naming of the virus before it ever officially landed in the US, which isn't really surprising. Then by March it was clear that there was asymptomatic spread and more aerosol than the flu, and Fauci told his friends to wear N95s. Then in April it was clear they knew it was airborne, of course, that it was unknown how long inside a room the air remains infectious (and how long a room should remained closed off after someone infected was in it), and tons of concern with litigation if the message isn't exactly right. And a couple weeks after that, a disaster consultation firm advised strongly to get everyone in N95s or N100s, not homemade masks, specifically: "I don't see how it's defendable for an 'essential worker' working with the public in an enclosed space to work without PPE that is 'applicable and suitable for the purpose intended'. . . . It's not rocket science only for doctors." Then in May, the firm again pushed for N95s, clarifying the importance since it's transmitted just through just exhaling and talking and can spread up to 27' away - not just 6'. 

Remember when schools insisted just 3' of distance was perfectly safe the following September and made the kids eat together in classrooms??

I don't think any of it really matters. We all know they knew, it was in the news that it was airborne and can float a long distance in February 2020, and nobody important will every get in trouble for this ongoing risk to our health and wellbeing. They seem fine with children being bombed in Gaza, so a few dozen little ones dying of a preventable disease within our own borders is small potatoes. But it does kinda feel satisfying to see it all laid out in black and white. 

I transcribed the pertinent bits for easier reading followed by the document it came from. 

Nomenclature Matters

From Alexander Riccio:
February 23, 2020, emails between Dr. Maria Van Kerkhove, Covid technical lead at the WHO, and Bruce Aylward, Assistant Director General at the WHO, cc'd to Dale Fisher and Weigong Zhou 

MVK: I made some v minor edits to be consistent with our nomenclature (we don't use nCoV anymore and added influenza instead of flu).

BA: Yes but definitely do not use SARS-COV2 - I'm not signing anything with that in it. I prefer we use nCoV - intentional. I'm not going to be part of that mess. 

MVK: Agreed, and I'm revising--this is the Covid-19 virus, as has been agreed to by WHO...I'll make these changes throughout. China agrees with this as well. 

BA: I thought about nomenclature a bit more. given all the translation problems and deep history of this country with SARS, I want us to be really really clear. I'd like that we either use 'the novel Coronavirus' everywhere or 'the Covid virus' or - preferably - add a disclaimer footnote the 1st time we use nCoV that explains that while 'the Joint Mission understands that this nomenclature has been superseded by SARS-CoV2 however the term nCoV is used here to ensure absolute clarity given this country's unique history with both diseases and viruses. 

MVK: We are in complete agreement. We will NOT be using SARS-CoV-2 in this report and will use the Novel Coronavirus (Covid-19) throughput. I want us to be consistent with using Covid-19 throughout the mission report as this is consistent with all of WHO reporting - in WHO press, information products, technical guidance, letters to Ma, etc. We really should not introduce another term "nCoV" because there will be another novel Coronavirus ("nCoV") in the future. You can have a look when I send you the next version. I'm editing quite heavily. 

Likely a Bit More as Aerosol

And more:
March 1, 2020, from Fauci:

"Use an N95 if you have them available. Transmission is similar to influenza; respiratory droplets and likely a bit more as aerosol than with influenza. People can transmit even when they are asymptomatic. No approved therapies. . . . Vaccine going into phase 1 trial in about 6 weeks, but will not be ready for at least 1.5 years."

Message Carefully to Save Us from Litigation

From Maarten De Cock:
April 7, 2020 - an email exchange between two former White House Medical Unit Directors, William Lang and Richard Tubb, after the CDC suggests the possibility of airborne transmission. Highlighted bits include quoted pieces of correspondence followed by reactions in italics from Lang: 

I'm getting a number of questions from organizations about this section form CDC guidance on facility cleaning. Some parts seem internally inconsistent and others at odds with shat we have been telling people: 

• It is unknown how long the air inside a room occupied by someone with confirmed Covid-19 remains potentially infectious. . . . 
• Transmission via infectious aerosols is currently uncertain. . . . This sentence is generating significant concern in organization management. Would it not be more correct to say 'transmission via infectious aerosols may happen in limited circumstances'. . . . 
• Transmission of SARS-CoV-2 to persons from surfaces contaminated with the virus has not been documented. What??? . . .  
• It is unknown how long the air inside a room occupied by someone with confirmed Covid-19 remains potentially infectious. Managers are reading this and freaking out. We've been telling people that this virus is not infectiously airborne beyond 6' and this paragraph undercuts that concept.
• Messaging needs to be consistent. I understand that the writers are trying to cover their butts, but these blanket statements are confusing organizations that are trying to manage safety for their employees and, importantly, liability issues. Lawyer to employer: 'CDC said right here that the virus is airborne and potentially infectious for an unknown period of time and you did not put everyone in the space in N95 masks? Obviously you were negligent.'

Not Providing N95s to All is Indefensible

And more from Alexander Riccio:

April 16, 2020, from Mark Keim, MD, Chief Executive Officer of DisasterDoc LLC to Dr. Eva Lee and many others pushed for N95s. Emphasis (bold, italics) is all his:

"This is an important issue. I think that we should think seriously about expanding the N95 market for the general public, starting with high risk groups and essential workers. Realistically, I don't see how it's defendable for an 'essential worker' working with the public in an enclosed space to work without PPE that is 'applicable and suitable for the purpose intended'. (See OSHA 1910.134 below). I propose that the 'new normal' should be standard PPE that is 'applicable and suitable for the purpose intended', not t-shirts and home-made craft items. The US already regulates the use of respiratory protection in multiple sectors (not merely health--it's not rocket science only for doctors) and there are many worker that already routinely use PPE including N95/100, APRs and SCBA. How are workers safe from these hazards (including pathogens) but not safe form SARS-CoV-2 in the workplace? 

Of course I'm aware of the current market conditions under these circumstances of crisis. But as we discuss the 'new normal' before a Covid-19 vaccine, perhaps we should take a deeper look into the feasibility, effectiveness and efficiency of public masking with 'applicable and suitable' devices that allow for the occupational regulations and standards to be upheld. What is the cost-benefit analysis when it also includes worker and customer willingness to remobilize or the litiginy [sic] that may follow (e.g. WTC responders/FEMA trailers). Has anyone seen this analysis yet?

OSHA 1910.134(a) Permissible practice.1910.134(a)(1)

In the control of those occupational disease caused by breathing air contaminated with harmful dusts, fogs, fumes, mists, gases, smokes, sprays, or vapors, the primary objective shall be to prevent atmospheric contamination. This shall be accomplished as far as feasible by accepted engineering control measures (for example, enclosure  or confinement of the operation, general and local ventilation, and substitution of less toxic materials). When effective engineering controls are not feasible, or while they are bing instituted, appropriate respirators shall be used pursuant to this section. 

1910.134(a)(2)

A respirator shall be provided to each employee when such equipment is necessary to protect the health of such employee. The employer shall provide the respirators which are applicable and suitable for the purpose intended. The employer shall be responsible for the establishment and maintenance of a respiratory protection program, which shall include the requirements outlined in paragraph (c) of this section. The program shall cover each employee required by this section to use a respirator. 

N95s are Gold Standard

And, finally, May 1, 2020, from Mark Keim, MD to many people again imploring the widespread use of N95s.

"As you may recall, when the first early cases were being reported in the US, our SG told Americans that 'masks are not effective', then later showed them how to make this life-protecting device from a a t-shirt based upon 'new' data. If I may first offer a little insight into mask use. . . . The guiding principle for selection of respiratory protection among civilians is to begin with the highest level of protection for unidentified substances/risk and then to reduce protective levels as more becomes known about the threat agent. . . . Studies have described exhalation and conversation alone as a source of 'turbulent clouds' of microdroplets less than 10nm in size. Other studies indicate the potential for viral contamination well beyond 6 feet (up to 23-27 feet) and in hallways outside of patient rooms. . . . In other words consistent with airborne spread, where APRs like N95s would be required instead. Other reports of occupational illness among healthcare workers give some credence to the theory that the viral load dose of the infective dose may influence not only the probability of infection, but also the perhaps the severity, as well. For this reason, we have seen the administration reverse itself--from initially refuting the need for masks - to promotion of a sub-standard substitution that while being better than nothing, is less effective than an N95. Why so?

Then he explained how N95s work by imparting an electrostatic charge and why t-shirts are crap. 

I propose to you that our gold standard as a nation should be an effective population-based respiratory protection task force, strategy and program, with separate guidelines for workers and the public. Our immediate emergency goals should be as follows (in order of priority): 1. All healthcare workers have adequate respiratory protection 2. All essential workers have access to N95 masks 3 The general public has access to N95 masks through a stable market 4. Wearing of N95 masks is required in all public venues. 5. Studies are funded to evaluate low-cost, highly effective options for the next wave. 

So it goes.