Covid-19 has redefined airborne transmission

“…Whilst the message from aerosol scientists that transmission of SARS-CoV-2 is predominantly airborne was ignored and dismissed within the medical and health policy mainstream during 2020, the heterodoxy did not die. On the contrary, by spring 2021 the dominance of airborne transmission was becoming more accepted even within medical circles -for example, in January 2021 the Journal of Hospital Infection published a paper entitled 'Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)' 87 , and in April 2021, the British Medical Journal commissioned an editorial from an overlapping team entitled 'Covid-19 has redefined airborne transmission' 14 , the Lancet published 'Ten scientific reasons in support of airborne transmission of SARS-CoV-2' 2 and the Journal of the American Medical Association published a review article on ventilation and filtration 88 . Whilst the WHO remained resistant to the phrase 'airborne transmission', it placed increasing emphasis on ventilation in late 2020 and into 2021 (source A17, Table 1 25 ).…”

Section: Emerging Challenges To Orthodoxymentioning

confidence: 99%

Orthodoxy, illusio, and playing the scientific game: a Bourdieusian analysis of infection control science in the COVID-19 pandemic

Greenhalgh¹,

Özbilgin²,

Contandriopoulos³

2021

Wellcome Open Res

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Background: Scientific and policy bodies’ failure to acknowledge and act on the evidence base for airborne transmission of SARS-CoV-2 in a timely way is both a mystery and a scandal. In this study, we applied theories from Bourdieu to address the question, “How was a partial and partisan scientific account of SARS-CoV-2 transmission constructed and maintained, leading to widespread imposition of infection control policies which de-emphasised airborne transmission?”. Methods: From one international case study (the World Health Organisation) and four national ones (UK, Canada, USA and Japan), we selected a purposive sample of publicly available texts including scientific evidence summaries, guidelines, policy documents, public announcements, and social media postings. To analyse these, we applied Bourdieusian concepts of field, doxa, scientific capital, illusio, and game-playing. We explored in particular the links between scientific capital, vested interests, and policy influence. Results: Three fields—political, state (policy and regulatory), and scientific—were particularly relevant to our analysis. Political and policy actors at international, national, and regional level aligned—predominantly though not invariably—with medical scientific orthodoxy which promoted the droplet theory of transmission and considered aerosol transmission unproven or of doubtful relevance. This dominant scientific sub-field centred around the clinical discipline of infectious disease control, in which leading actors were hospital clinicians aligned with the evidence-based medicine movement. Aerosol scientists—typically, chemists, and engineers—representing the heterodoxy were systematically excluded from key decision-making networks and committees. Dominant discourses defined these scientists’ ideas and methodologies as weak, their empirical findings as untrustworthy or insignificant, and their contributions to debate as unhelpful. Conclusion: The hegemonic grip of medical infection control discourse remains strong. Exit from the pandemic depends on science and policy finding a way to renegotiate what Bourdieu called the ‘rules of the scientific game’—what counts as evidence, quality, and rigour.

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“…Vaccines are a key to preventing further lockdowns, and vaccine passports may eventually play a role, if properly designed 11. But just as important are traditional public health measures to control transmission, especially preventing airborne spread 12…”

mentioning

confidence: 99%