For most of human history, the dominant paradigm was that many diseases were carried by the air [… the] miasmatic paradigm was challenged in the mid to late 19th century with the rise of germ theory, and as diseases such as cholera, puerperal fever, and malaria were found to actually transmit in other ways. Motivated by his views on the importance of contact/droplet infection, and the resistance he encountered from the remaining influence of miasma theory, prominent public health official Charles Chapin in 1910 helped initiate a successful paradigm shift, deeming airborne transmission most unlikely. This new paradigm became dominant. However, the lack of understanding of aerosols led to systematic errors in the interpretation of research evidence on transmission pathways. For the next five decades, airborne transmission was considered of negligible or minor importance for all major respiratory diseases, until a demonstration of airborne transmission of tuberculosis (which had been mistakenly thought to be transmitted by droplets) in 1962. The contact/droplet paradigm remained dominant, and only a few diseases were widely accepted as airborne before COVID-19. Airborne transmission is a major mode of transmission for this disease, and is likely to be significant for many respiratory infectious diseases.
[COVID] recommendations have been based on four tenets: (i) respiratory disease transmission routes can be viewed mostly in a binary manner of ‘droplets’ versus ‘aerosols’; (ii) this dichotomy depends on droplet size alone; (iii) the cut-off size between these routes of transmission is 5 µm; and (iv) there is a dichotomy in the distance at which transmission by each route is relevant. Yet, a relationship between these assertions is not supported by current scientific knowledge.
I’d strongly encourage reading the full article; this is a case where reality has a surprising amount of detail and those details really matter. Many details are disease-specific, differing both between and within viral and bacterial infections, but were later assumed to generalize. Some are about measurement: researchers often used agar plates as a proxy for infected organisms without allowing sufficient time for airborne spread across a room (potentially hours) or with non-representative airflow, or imaging techniques which are inherently focussed on short distances and do not show the smallest particles. Others include conflation of particle transport through the air and particle deposition in the lungs, misattribution of the effect of spacing rules to distance (via droplets) rather than room occupancy, neglect of size change due to de- and re-hydration, and many more.
Ultimately, I think the question should not be “What’s wrong with the virologists” but with the field of virology, and it seems basically normal to me: researchers thought they understood what was going on, disconfirming experiments were nontrivial to conduct and older research was generally ignored, and nobody influential wanted to listen to outsiders with awkward questions.
I think ‘which interest groups benefited’ is the wrong question; scientists and public health officials sincerely and incorrectly believed that they understood what was going on, and were attempting to and largely succeeding in controlling infectious disease and saving many, many lives.
Remember that over this same period, this field controlled malaria in most developed countries (and we’re making good progress on the rest), banished the scourge of Polio (also close to eradication!), and eradicated smallpox worldwide.
https://onlinelibrary.wiley.com/doi/full/10.1111/ina.13070
https://royalsocietypublishing.org/doi/10.1098/rsfs.2021.0049 gives an excellent overview of the scientific consensus regarding disease transmission pathways over the last ~150 years.
I’d strongly encourage reading the full article; this is a case where reality has a surprising amount of detail and those details really matter. Many details are disease-specific, differing both between and within viral and bacterial infections, but were later assumed to generalize. Some are about measurement: researchers often used agar plates as a proxy for infected organisms without allowing sufficient time for airborne spread across a room (potentially hours) or with non-representative airflow, or imaging techniques which are inherently focussed on short distances and do not show the smallest particles. Others include conflation of particle transport through the air and particle deposition in the lungs, misattribution of the effect of spacing rules to distance (via droplets) rather than room occupancy, neglect of size change due to de- and re-hydration, and many more.
Ultimately, I think the question should not be “What’s wrong with the virologists” but with the field of virology, and it seems basically normal to me: researchers thought they understood what was going on, disconfirming experiments were nontrivial to conduct and older research was generally ignored, and nobody influential wanted to listen to outsiders with awkward questions.
See also: https://slimemoldtimemold.com/2022/01/11/reality-is-very-weird-and-you-need-to-be-prepared-for-that/
It can’t possibly be 100%, which interest groups specifically benefited from this?
I think ‘which interest groups benefited’ is the wrong question; scientists and public health officials sincerely and incorrectly believed that they understood what was going on, and were attempting to and largely succeeding in controlling infectious disease and saving many, many lives.
Remember that over this same period, this field controlled malaria in most developed countries (and we’re making good progress on the rest), banished the scourge of Polio (also close to eradication!), and eradicated smallpox worldwide.
I appreciate the elaboration on the quoted point, it still seems like it can’t possibly be 100%.