People used ‘droplet’ and ‘aerosol’ as though they meant the same thing. They don’t. And when medical experts fight over words, millions die
By the time WHO conceded that the virus was airborne and spread through aerosols, 9 months had passed and 1.53 million people had died
Words matter, more than you could know. Someone gets rip-roaring drunk at a party but shrugs it off with, “I wasn’t drunk, silly, I was just a little inebriate.”
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Drunk or inebriate? Or merely tipsy as the hoi polloi sometimes get?
The Hutus were butchering millions of Tutsis in Rwanda. But Bill Clinton thought there was no need for US involvement because, he said, it was a massacre, not a genocide.
Massacre or genocide? Or perhaps a more sanitary cleansing?
Are the Uyghurs of China being brainwashed or re-educated?
Does Trump tell lies or is he being sarcastic?
Does coronavirus spread in aerosols or in droplets?
On April 3, 2020, not a month after SARS-Cov-2 struck this little planet, WHO tweeted: “FACT: #COVID19 is NOT airborne.” They explained that it was carried by large droplets which immediately sank to the ground or settled on surfaces. I learned a new word, fomites, meaning objects or materials that might carry infection.
WHO’s main safety guidelines, based on their conviction that the virus spread through droplets, were frequent hand washing and social distancing.
Except that they had it dead wrong. It was not till nine months later, on December 1, 2020, that they backed off, conceding that the virus was airborne, and spread through aerosols, not droplets. Social distancing does not protect anyone when the air you breathe is your nemesis. The guidance on COVID19 from the world’s largest health organisation had been lethally misinformed and wrong.
While WHO insisted it was droplets, dismissing scientists who told them repeatedly and urgently that it had to be aerosols, millions lost their lives, misguided by ineffective protocols.
So—droplets or aerosols? Thereby hangs a very scary forensic tale.
On the April Zoom call, 35 aerosol scientists tried to convince WHO that all evidence pointed to an airborne virus, citing mounting evidence from superspreading incidents in restaurants and other gatherings. A month earlier, 52 singers at a choir practice in Mt Vernon, Washington, had been infected by a single superspreader. Two died. It was proof that social distancing was just not enough.
But the world’s largest medical health body, alas, knew it all. In no mood to be corrected, they dismissed even the venerable atmospheric scientist Lidia Morawska, when she tried to explain how far infectious particles could really travel. WHO cut her off, saying the word airborne only applied to particles less than 5 microns in size.
A micron is a millionth of an inch.
Another aerosol scientist, Linsey Marr, asked them where they’d gotten the 5 micron number from. No one knew. It seemed the 5 micron size limit was accepted unquestioningly as an axiom by WHO and the worldwide medical fraternity.
What if the number was wrong? What if aerosols were much larger than 5 microns? What if they didn’t settle to the ground but stayed in the air and spread?
Marr began digging into old papers, searching for the origin of the 5-micron ‘fact’. She found a paper by Yuguo Li, a Hong Kong University researcher who had put together convincing evidence that coronavirus in the first SARS outbreak was airborne.
His mathematics showed that in a sneeze, heavy droplets were too few and the targets—mouth and nose—too small to account for much infection. The doctors had it ass backwards. Li concluded that colds, flus and respiratory illnesses must spread through aerosols.
Marr came to the same conclusion after analysing air samples from daycare centers and aeroplanes. She found the flu virus floating in the air, in aerosols. According to traditional science, influenza spread through droplets.
The trail finally led to a 1955 book, Airborne Contagion and Air Hygiene, by a Harvard engineer called William Firth Wells. He showed how whatever we spew out through sneezing, talking or coughing is pulled one way by gravity and another way by evaporation. He found that particles larger than 100 microns sank in seconds. Everything else stayed in the air.
The head of the US CDC then, Alexander Langmuir, believed health was about personal hygiene and dismissed Wells’ research. The ‘bad air’ hypothesis, Langmuir thought, was so yesterday.
However, he was impressed by another Wells study that showed that mice sprayed with mist containing TB particles smaller than 5 microns got infected by TB. Particles larger than 5 microns got filtered out by mucus in the nose and throat. In a 1962 speech, he cited Wells’ study, saying we should really worry about particles under 5 microns.
That number, taken out of context, somehow became gospel. It found its way into textbooks and medical ‘wisdom’—and finally WHO.
By November 30, 2020, when WHO finally swallowed spit and changed its guidance, admitting that coronavirus was not a droplet but an aerosol, 1.53 million people had died..
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Note: This article is inspired and informed by the article in WIRED,
The 60-year-old Scientific Screwup That Helped Covid Kill, published May 13, 2021.
Here, viewed from there. C Y Gopinath, in Bangkok, throws unique light and shadows on Mumbai, the city that raised him. You can reach him at cygopi@gmail.com
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The views expressed in this column are the individual’s and don’t represent those of the paper
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