COVID-19 airborne, policies need “urgent refinements” — expert

Government agencies are yet to adjust preventive COVID-19 measures to recent findings of its virus’ airborne spread, a disease transmission expert said.

In a two-day webinar on Feb. 3 and 8, Colorado University professor Jose-Luis Jimenez decried the World Health Organization’s (WHO) delayed reception to the airborne transmission of COVID’s virus SARS-CoV-2, despite the findings of aerosol scientists worldwide.

The Philippines, which has tallied over 3.6 million cases since the start of the COVID pandemic, is one of the few countries that advocate the use of face shields in addition to face masks, said WHO Representative to the Philippines Rabindra Abeyasinghe. In the webinar, Jimenez urged the government to revamp protective measures in light of the virus’ spread through the air.

Jimenez and other scientists worldwide are challenging earlier notions that the virus solely spreads through large droplets like saliva or through contaminated surfaces.

Initial evidence of the COVID virus’ aerial spread was published as early as Mar. 10, 2020 from studies of facilities in Wuhan, China. Still, WHO stood firm that the virus is only spread through contact and droplets from sneezing, coughing and talking. The global health agency even published a fact-check post on Mar. 29 that the airborne transmission of COVID is “misinformation.”

Five days after the post, Jimenez said that he and other scientists approached WHO officials to notify them of COVID’s airborne transmission but their suggestions were rejected. 

“That’s how certain [WHO] were [that COVID] is not airborne. We told them [their claims] aren’t correct and they didn’t listen,” Jimenez added.

The scientists’ early plea to the organization was backed by resounding findings from other experts in the months that followed. In June 2020, aerosol researchers from the U.S. claimed that airborne spread “is the dominant route” for COVID infections. A month after, 239 scientists penned an open letter to health experts and governments entitled “It Is Time to Address Airborne Transmission of [COVID-19].”

Jimenez and a team of researchers published an April 2021 study in medical journal The Lancet compiling 10 pieces of evidence supporting the airborne transmission of SARS-CoV-2. Presented in the three-page paper is proof of the virus’ long-range transmission, superspreading and the higher infection rate indoors than outdoors.

A month after, WHO budged and admitted the possibility of COVID’s airborne infection, but Jimenez said the organization avoided using the term because “it has a specific meaning in the medical community.”

It took until December 2021 for WHO to acknowledge the COVID virus’ aerosol transmission, ensuing a “paradigm shift” from the old droplet dogma

“[A] person can contract the virus when infectious particles that pass through the air are inhaled at short range (this is often called short-range airborne transmission) … [or] travel farther than conversational distance (this is often called long-range airborne transmission),” WHO posted in its website.

Rejecting airborne

Jimenez claimed WHO’s refusal to immediately acknowledge COVID’s airborne spread is rooted in long-standing disregard for aerosol transmission. 

In the past, scientists considered the aerial spread of diseases rare until tuberculosis was proven to be airborne in the 1960s. Initially, experts thought diseases were only transmitted through droplets and close contact.

Jimenez believes that this created a power dynamic among healthcare professionals, neglecting aerosol scientists like him.

“For example, the WHO committee that decided how [SARS-CoV-2] was transmitted had six handwashing experts and zero airborne experts because they were so certain that airborne was not important,” said Jimenez.

Jimenez also argued that national governments rejected the idea of aerosol transmission as existing policies made it easier to put responsibility and blame on people.

“For governments, it’s very convenient,” Jimenez said. “All [they] have to do is tell people what to do: wash your hands, keep your distance [and] maybe wear a mask or something. If you get infected, [then] it’s your fault.”

Revamping pandemic policies to factor in airborne spread would compel governments to introduce new and costly solutions like improving ventilation and purchasing air filtration systems.

“The government [will] have a responsibility to clean the air and that costs money, that costs effort. And they want to avoid that,” Jimenez added.

Jimenez emphasized that the droplet and surface transmission dogma led governments to implement ineffective and even harmful policies such as wearing face shields and installing plastic barriers. He said that these barriers impede proper ventilation which is essential in curbing airborne infections.

“Face shields are designed for hospitals. The idea is that if some patient coughs on your face, [the droplets will] hit the eyes and nostrils,” Jimenez said.

Despite warnings from medical professionals, the Inter-agency Task force for the Management of Emerging Infectious Diseases (IATF) required the use of face shields and transparent dividers in public transportation and workplaces nationwide in June and July 2020 respectively. By December that year, face shields were made mandatory outdoors.

The IATF only overturned the mandatory face shield policy in November 2021 except in areas under Alert Level 5 and in areas under granular lockdown.

Government bureaus received evidence of the COVID virus’ airborne transmission in varying ways. The Department of Transportation said in Oct. 29, 2021 that plastic barriers in public utility vehicles such as jeepneys were ineffective in containing the disease.

Despite reminders from the Department of Health to prioritize ventilation, some schools continue to set up acrylic barriers as they retrofit classrooms for the looming resumption of limited in-person classes.

READ: Can public schools pandemic-proof their classrooms before students’ in-person return?

In Jan. 26, Commission on Elections (Comelec) spokesperson James Jimenez said in an online media forum that voters are still required to wear face shields to enter voting precincts in the upcoming 2022 elections.

“On May 9, election day, ‘di kayo papayagang bumoto nang hindi kayo naka-facemask at unfortunately nang hindi kayo naka-face shield,” the Comelec spokesperson said.

Yesterday, Comelec reminded candidates for the 2022 polls that face shields are also required when attending in-person campaigns.

Prof. Jimenez then highlighted the importance of proper ventilation and air filtration mechanisms for indoor spaces. He also recommended carbon dioxide meters that could help monitor and regulate the amount of exhaled air.

Jimenez also recommended the public to use respirator-style masks such as N95, KF94 and KN95, as they fit well in the face and are efficient in filtering at least 95% of airborne particles. He cautioned against surgical masks due to its gaps in the sides and nose area, allowing the inhalation of aerosol particles.

Apart from making “urgent refinements” to medical policies, Jimenez called on the government to stop exploiting the pandemic through “lies, fraud and corruption.”

Last year, the Philippine government paid Pharmally approximately P12 billion for COVID supplies including face shields, masks and infrared thermometers, which were flagged by the Senate and Commission on Audit as overpriced and substandard.

Amid the height of the lockdown in August 2020, a former Philhealth official claimed that approximately P15 billion was stolen by state health insurance officials through anomalous transactions. Due to massive net loss, Philhealth executive Neri Santiago expects the insurance agency to collapse in 2027 as pandemic expenses continue to rise.

READ: Billions For Millions: How the P15B Philhealth Fund Could Have Helped Filipinos

“People who are politically-connected suddenly get the contract for [COVID equipment] and suddenly they are more expensive or worse than they should be,” said Jimenez.

Jimenez emphasized that COVID is not only a medical problem, and underscored the need for an interdisciplinary approach among clinical and aerophysical experts, as well as government institutions.

“Many governments [and companies] just openly lie,” said Jimenez. “They want to keep responsibility on the individuals. They don’t want to take responsibility. They don’t want to take costs.”