EXPERT VIEW ON VIRUS TRANSMISSION
I spend hours going through all the available data on SARS-CoV-2, the virus that is causing current pandemic, I also communicate daily with front-line physicians and experts, who understand this disease better than all of us.
Many of these frontline physicians are not able to share their experiences publicly out of the fear of retaliation from their hospitals' administration and also out of concern about the reaction of the public. In the end, this important information needs to be shared so that the people can make educated decisions about how to protect themselves and how to help protect their healthcare providers:
Below is a letter from one of the doctors, whom I consider to be an expert :
A LETTER FROM AN EXPERT
"I have debated whether to post about my suspicions regarding airborne transmission of SARS-CoV-2 and COVID-19, whether I’d be causing unnecessary panic over something we can’t do a whole lot about. I think it’s time.
There is much I can’t say in public that’s scaring the crap out of me and keeping me up all night. Those of you who know me well, know that I research exhaustively and am very logical and data driven. The data is bad.
I am the lead author of several publications on aerosol deposition in the airway. So when I talk about aerosol inhalation, I have more in depth understanding of this than most physicians. Not all—some know a lot more than I do. But most.
Airborne vs droplet precautions are archaic.
Airborne precautions require healthcare workers to don previously fit tested N95 masks or PAPRs (powered air purifying respirators), in addition to eye protection, gown, and gloves. Fit testing, which must be done before a healthcare worker can safely use N95 masks, ensures no air can be inhaled through gaps between the wearer’s skin and the edge of the mask. This is critical. Droplet precautions require a regular surgical mask, gown, eye protection, and gloves.
Airborne transmission relates to an infectious agent’s ability to infect others at a significant distance through aerosols. Aerosols are small particles of potentially infectious material generated by coughs and sneezes.
Aerosols remain suspended in the air for some time. They don’t immediately fall and land on surfaces like the larger particles, droplets, do.
Aerosols suspended in the air can infect others in close proximity, even if a disease is not classified as “airborne.”
We know the coughs of a healthy person generate aerosols. not just droplets. We know viral infection (specifically influenza) can increase the percentage of small aerosols generated by a cough. We know small aerosols penetrate deep into the lungs. This is thought to be a mechanism by which influenza enhances its transmission from host to host. SARS-CoV-2 might be able to do the same. We just don’t know yet.
Small aerosols <= 5 micrometers reach the lung alveoli when inhaled. That means the deepest lung tissue, where gas exchange occurs.
SARS-CoV-2 remains viable in the air for hours, at a minimum, when aerosolized in vitro. And it is postulated that the method of transmission on cruise ships may include true airborne, through the ventilation systems.
A regular surgical mask doesn’t protect the wearer against aerosols. It only helps to protect against droplets, for those in close proximity to expelled airway secretions. It also helps to keep the wearer’s own droplets in, to protect others and to maintain sterility. But it won’t stop anyone from inhaling aerosols
Asymptomatic and mildly symptomatic people are contagious, as are their coughs. They probably don’t know they have COVID-19, and probably aren’t socially isolating. The cases we know about are just the tip of the iceberg. You’re probably breathing the virus in from someone’s cough, even if you don’t know it, as well as contracting it through contact with droplets, contaminated surfaces, and possibly the fecal-oral route. If people don’t start DRASTICALLY socially isolating, we have no hope of flattening the curve.
HEALTHCARE WORKERS NEED N95 OR PAPR DEVICES NOT TO DIE. Please help by contacting your local, state, and national representatives, as well as philanthropists, to make them aware of the urgency of our need. And please, please stay home and stay away from others. Your life, the lives of those in close proximity to you, the lives of those you meet in passing, the lives of healthcare workers who may treat you, and their families’ lives, depend on it. Thank you."
Anonymity preserved per doctor's request
Dr. Maria Danilychev, M.D., is a San Diego based medical doctor with 20 years of experience and board-certified in Internal Medicine, Geriatrics, Hospice/Palliative Medicine, and as a Hospice Medical Director. Dr. Danilychev also conducts clinical trials and was one of the first responders during 9/11.