This article is written by Joon Chan, and the views expressed here are his own.Â
Very frequently the most obvious of solutions is not seen although it is right in front of us, and that is the human expert condition after all. I’m Joon Chan, a semi-retired ex-startup founder.Â
I’d like to share with you on what i’ve learned regarding the transmission of COVID. It all started when my curious interest to learn more on the spread came to me looking at specific cases where clusters were overly infectious relative to the others.
1. There was our super spreader lawyer with an infection rate varying between 10% to 80%
2. A girl in Singapore that hosted her bridal lunch and infected all 3 of her friends present – 100%
3. The Tabliqh Jemaah Islam scandal which had an infectivity rate of 15% over 14,000 attendees
3. The Tabliqh Jemaah Islam scandal which had an infectivity rate of 15% over 14,000 attendees
4. A choir in Washington state that infected 45/70 present, although social distancing was practiced.
How can this be so? With this infection rate, even a ride on a crowded bus will cause thousands of cases daily, one infected in an office should take the whole department down. But is in fact NOT what we observe. It all comes down to how it spreads.
1. COVID virus spreads via droplets/aerosols released from our respiratory system, these are outputs from the nose and mouth.
2. Infection happens when sufficient viral loads are inhaled thus entering the respiratory system.
3. What the viral-load needed is still unknown, and and varies from host to host. Generally, the more the viral-load the higher chance of infection taking place.
4. Every authority says avoid “CLOSE CONTACT”, but what the hell does this mean. Is it touching? Is it breathing the air of an infected? is it catching a sneeze to my face? Is it being in the same room for long periods of time? Is it talking to someone close by?
5. The answer is sustained speaking. Speaking produces by far, in orders of magnitudes more (10,000x) respiratory particles than any other events such as breathing(exhalation), coughing, sneezing combined. Look at the chart below :
Do note that speech is SUSTAINED, we talk for 30 seconds or more at a time, at close distance to someone who is inhaling, or fill up a room very quickly with contaminated particles.
Exhalation in terms of total time in exhalation, and volume-size of particles, puts out orders of magnitudes less (1/10,000) . The same applies for coughing and sneezing, since it occurs sparingly relative to speaking. Contact transmission (fomite) outside the medical setting is also in orders of magnitude less (there wont be much if people don’t speak in the first place anyway)
I’ve not found any paper attributing exhalation or contact transmission to community spread of influenza, or even this virus. There are found to be statistically insignificantly small, might as well have been a sampling error because it’s so accidentally rare, and probably confounding because the proper attributed reason is being exposed to massive amounts of particles via sustained speech or a direct hit of cough/sneeze.
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6. What do the above super spread cases have in common? A lot of speaking, a lot of talking, a lot of chanting, a lot of singing.Â
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What do familial clusters have in common?
Speaking between family members at close range.
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Why did some lower level employee at Maybank fail to infect the whole office?
She does not speak much to many people.
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Why did the lawyer managed to infect first, 6 out of 8 meeting members, then 8 out of 10, then 10 of 15, then somehow 1 of 21?
Because some are meetings when he is actively speaking, and some are not.
7. Generally the advice given does not convey this obvious point. It is not hand-washing, or physical distancing that people need to know about. It is the act of sustained speaking in close distance, or in poorly ventilated areas. So it’s not social/physical distancing, it’s speaking distancing, it is in essence about particulate control.Â
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This SHOULD be the message the public is told. Especially in light where asymptomatic cases or phases go on speaking, symptomatic cases will likely self-isolate or socially-isolated.
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The message however being told to us now, does not highlight this. We see people in households, whether they are symptomatic or asymptomatic talking to grandma – lulled by the false sense of security social distancing from outsiders it provides them.
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People pulling down their masks when talking because of course it’s hard to be heard in a mask, people washing hands and doing all sorts of another non-significant measures that address vastly improbable spread pathways, all the loud speaking back and forth in the market that’s still going on during lock-down, the waste of time disinfection sprays done in big spaces, and many more improbables.
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8. Compliance with masks daily is immensely difficult, nor is supply adequate globally. Even Japan,China,Taiwan will not get full compliance.
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But honestly, we have a mask built into us. We just have to keep our mouths shut. Speak only when masked, or at an overly safe distance, note room conditions.
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We need to be aware, objectively, what needs to be tackled to solve the problem. Keeping silence is dead easy. Creating distance before speaking is easy. Reducing speech outside social circles is easy. Life can still go on relatively normally. There are voice-notes, whatsapp, emails, etc for communicating.
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We must recognize that compliance is directly correlated with difficulty, even more so sustained compliance.
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9. At this juncture I’m willing to even say that 90% or more of community spread is probably from an infected talking. Yes. Not sneezing or coughing, or breathing, or touching. Let’s see how long it takes for all the scientists to figure out some common sense.
To be fair most research do include speech, touch, sex etc lumped in everything you do as “close contact”, but my point on communication, and there after rational mitigation efforts remain.
10. I implore you to share this information, please do verify as you would like, with diligence. You have a wide audience, and are well respected. I hope this has been helpful. I want to see lives saved, health maintained, our country and world to prosper. I’ve lost my father last year to pneumonia, it was a most difficult experience, for him, and for the ones he left.
11. Thank you
Main sources :
Journal link (PDF attached)
Media: