As I watch the ramping up of institutional #covid19 #outbreak #notifications in #Ontario, it is yet another wave's reminder that, at least in Canada, #IPAC is mostly a cargo cult science.

"The form is perfect. ... But it doesn't work. No airplanes land. So I call these things cargo cult science, because they follow all the apparent precepts and forms of scientific investigation, but they're missing something essential, because the planes don't land." - Richard Feynman https://en.m.wikipedia.org/wiki/Cargo_cult_science

We deeply need an IPAC discipline that takes #aerosol #airborne transmission mitigation very seriously. We need an airborne revolution to get to #CleanAir, to #SafeAir

I know a few counterpoints to this view like Dr Victor Leung from BC who is a true practice leader in the field, but they are rare and rather quiet due to discipline pressure to conform to approved #DropletDogma

If you are in IPAC, please help drive your discipline from a handwashing, droplet & contacts precaution compliance mindset to one that truely embraces airborne risk mitigation, if not elimination. Don't just transfer the risk to the patient, and wash your hands of it.

It might be my life you save. It certainly could have been both my parents.

You have a choice.

Accept the minimalist strategy we decided to pay for. You have accepted the path of increased societal risk. Stop complaining about PFAS

Or take action

1. Mitigate your risk with #SafeAir #IAQ Clean the air you manage: #HEPA , central filtration & ventilation

2. Defend yourself from unsafe air you don't control with high filtration #N95 or better respirator worn properly

3. Advocate to drive society to reduce the risk. Let your elected officials know this is not ok

The other day I posted to praise my optician. Today I post to bury my dentist.

Ontario dentistry led the way in #safeAir - it was classified as AGMP.

I discovered today my dentist has removed almost all the protections they had in place.

Let's understand this. They did work, spent money & staff time to downgrade previously existing precautions.

Thus placed my wife at risk today. Her only mistake - trusting medical professionals would not place her at risk.

We start daily RATs tomorrow...

@steven @dgbassani @scarpino

Thus a #DefenceInDepth approach is now *mandatory* to get R0<1 from a modelling perspective. No single NPI will do the job.

You need airborne mitigations #N95, #HEPA, #SafeAir, etc to get Rt<1 to stop the pandemic.

The issue is that as #sarscov2 evolves, it is increasing its transmissivity & immune evasion.

As we delay doing the NPIs, the NPI cost is actually INCREASING in time.

There is an NPI cross-over curve that is changing over time, & its getting worse.

@broadwaybabyto

tl;dr Yes

The risk is that #SARS2 is immunosuppressive

If hospitalized #COVID19 is immunosuppressive➡️ medium impact

If "mild" is immunosuppresive, combined with #LetItRip➡️everyone impacted

I assessed probability low initially but it has dramatically increased, with increasing confidence

What is the mitigation? Avoid #infection

How? #SafeAir - Personal & central filtration aka respirator & hepa

COVID19 is probably the most transmissive virus we know, now exceeding measles