Why are suits and substances used to sterilize surfaces (e.g., hydrogen peroxide, bleach) mentioned in relation stopping pandemics? Another post by one of the authors (ASB) of the current post mentioned a self-sterilizing suit regarding the same subject.
Suits and surface sterilization seems unnecessary, because that stuff does nothing to stop airborne transmission of viruses, which seems to be the only way that pandemics can ever arise.
Just want to note that there are, in fact, 2 ongoing pandemics, and the earlier one, AIDS, isn’t a respiratory virus. And those two obviously don’t comprise an exhaustive list of possible transmission vectors.
AIDS is considered to be an epidemic, not a pandemic, but can a sexually-transmitted disease similar to AIDS lead to a pandemic? I doubt it, because pandemics are dangerous (in part) due to rapid spread, a feature which a sexually-transmitted disease will never possess. I’d be a slightly more worried only if everyone was a lot more promiscuous.
Yes, respiratory diseases are far and away the most likely causes of GCBRs, but even there there is risk from other types of disease. But we’re discussing pandemics, and there you seem a bit misinformed.
First, the WHO has recently classified AIDS as an endemic disease, changing from its earlier classification as a pandemic. (Just like we’ll do with COVID-19 in a couple years.) But that didn’t make it not a pandemic until that point. And not only has AIDS killed 35m+ people—easily twice the total for COVID-19, but somewhere between 500k-1m more people were killed this year. And absent AI or a biotech solution to AIDS, that is likely to continue for several more decades. Making this even worse, unlike COVID-19, which skews towards killing people in poor health and the elderly, they were almost all people who would otherwise have lived far longer and healthy lives. If AIDS is not they type of thing we want to stop when we say we’re hoping to end pandemics, I don’t know what is.
Second, in the past, in addition to AIDS being a clear example of a STD pandemic, fecal-oral spread diseases have caused pandemics, as have vector borne diseases. (And not only that, but many weren’t viruses—and antibiotic resistance should worry us on that front. And outside of viruses and bacteria, Plasmodium kills millions a year.) So again, the general point was that it’s simply not the case that airborne transmission of viruses is the only way for pandemics to arise.
This discussion is about preventing and mitigating pandemics that could potentially end civilization, and stuff similar to AIDS (regardless of how you want to categorize it) is off topic because transmission would not be rapid enough to end civilization.
I don’t think accusations of off-topic-ness at this point are very helpful.
Youhave been making strong claims about “pandemics” in general, which others have responded to by pointing out examples of pandemics that don’t fit your claims. If by “pandemics” you meant “civilisation-ending pandemics” only, I think it was on you to make that clear.
In the context of this discussion (the post is about GCBRs), it should have been clear what I meant by that term.
Also, it can be claimed that a lot of things are “pandemics” like TB and antibiotic-resistant bacteria, but what is usually meant by the term is rapid, global spread (within weeks to a few months at most) of a deadly pathogen.
But obviously, there are transmission modes other than airborne and sexual, so I think you are missing my point about too-narrow thinking.
Because your claim is, effectively, a near-certainty that only airborne transmission could be threatening. And my response was, in effect, that this isn’t correct, and that even eliminating airborne disease transmission completely wouldn’t sufficiently address risks of future bioengineered pandemics, even if it would greatly reduce the number of viable such cases.
I think you’re once again focusing far too narrowly—foodborne illness, waterborne disease, intermediate animal hosts and parasites, vector borne diseases, fomites, and sexual transmission are all mechanisms that currently spread disease, and it seems very strange to say that we should only ever look at aerosol transmission. Yes, it’s the most worrying, but it’s not enough on its own to address all threats.
Unless you have a reason to think otherwise, those methods of transmission (except for aerosol transmission) don’t seem capable of spreading a contagion rapidly enough to end civilization. This has been discussed in other comments.
I think he was explicitly addressing your question of sexually-transmitted diseases being capable of triggering pandemics, not if they can end civilization.
Discussing the latter in detail would quickly get into infohazards—but I think we should spend some of our efforts (10%) on defending against non-respiratory viruses. But I haven’t thought about this in detail.
The AIDs epidemic is widely considered a pandemic (pandemics are a subset of epidemics). And one of the deadliest pandemics of the 20th century, at that.
In the 19th century, cholera, a faecal-oral pathogen, caused several pandemics, killing very many people. It doesn’t do that any more thanks to sanitation in rich countries, but it’s certainly not impossible for non-respiratory pathogens to achieve rapid global spread.
Everyone agrees with you that respiratory viruses are the biggest concern, and you’ve provided some good resources in this thread that I appreciate. But I do think you are being undernuanced and overconfident here.
In order for us to be safe from future pandemics, it’s really important we don’t overindex on the pandemics of the past (or the present).
SARS-CoV-2 doesn’t really spread through surfaces/fomites much, if at all.
I’m sure the linked post is right to say that this is also true of “several respiratory pathogens”.
However I’d be surprised if it were true of all respiratory pathogens, let alone other diseases. Gastric/diarrhoeal diseases such as norovirus, rotavirus, or, indeed, ebola can spread through fomite transmission.
In short, I disagree that airborne transmission of viruses is the only way that pandemics can ever arise.
Why would you be surprised if airborne transmission was the only way that any respiratory pathogen could cause a pandemic?
I haven’t seen any strong empirical evidence that fomite transmission is even a thing and mechanistic reasons to doubt that it could cause a pandemic even if it were a thing. My mechanistic reasoning is this: fomite transmission would be too convoluted (e.g., nose → hand → variable period of time → door knob → variable period of time → hand → variable period of time→ nose) to be compatible with the sustained and rapid spread necessary to cause a pandemic.
Gastric/diarrhoeal diseases don’t and can’t cause pandemics for mechanistic reasons: it’s hard to infect people with bodily fluids.
I can’t find the source anymore but I remember being fairly convinced (70%?) that rhinovirus is probably spread primarily via formites, fwiw.
The main thing is that snot can carry a lot more viruses than aerosols. It’s also suggestive to me that covid restrictions often had major effects on influenza and RSV, but probably much less so on rhinoviruses.
I also don’t think we should necessarily overindex on viral respiratory diseases/pandemics, even though I agree they’re the scariest.
rhinovirus is probably spread primarily via formites
Until the COVID19 pandemic, nearly everyone thought that most infectious respiratory diseases were transmitted via fomites and droplets, but unfortunately, this was based on shockingly poor evidence and assumptions. The material you’ve seen is based on this outdated consensus.
As I pointed out before, there are mechanistic reasons to doubt that pandemics can arise from fomite transmission.
However, if I squint hard enough, I can kinda, sorta see how young children in daycare might be infected by sharing toys and sticking their fingers up their noses. But stuff like that isn’t going to cause a pandemic.
In fact, the dominant (and most likely only) mode of transmission of rhinovirus is aerosols (at least in adults), not fomites. The same paper claims that fomites were unable to infect adults.
I also don’t think we should necessarily overindex on viral respiratory diseases/pandemics, even though I agree they’re the scariest.
Anything that’s capable of causing a civilization-ending pandemic must be able to rapidly replicate in humans and spread via airborne transmission, and the only thing that can do that is viruses (and perhaps virus-like particles in the future).
The bottom line for me about fomites and surface contamination is that it’s probably a non-issue, and even if there’s something to it (which doesn’t seem too likely), it’s pretty easy to deal with without fancy tech: just wash your hands, disinfect surfaces, and wear a face covering to prevent face-touching.
That Wired article is fantastic. I see this threshold of 5 microns all over the place and it turns out to be completely false and based on a historical accident. It’s crazy how once a couple authorities define the official knowledge (in this case, the first few scientists and public health bodies to look at Ward’s paper), it can last for generations with zero critical engagement and cause maybe thousands of deaths.
I’m confused about the distinction between fomite and droplet transmission. Is droplet transmission a term reserved for all non-inhalation respiratory pathogen transmission (like touching a droplet on a surface and then touching your face, or the droplet landing on your mouth), so it includes some forms of fomite transmission? I’m seeing conflicting sources and a lot that mention the >5 μm rule so don’t seem too trustworthy.
I’m confused about the distinction between fomite and droplet transmission.
From what I’ve read, fomite transmission must involve surface touching, whereas droplet transmission must involve droplets, which are expelled by coughing or sneezing, directly landing (like a bullet) in your mouth, nose, or eyes without any extra contact or touching.
These methods of transmission seem so implausible (how many people actually sneeze or cough directly in someone’s face?) to be major causes of spread that it’s hard to believe that no one seemed to have performed definitive experiments to test these ideas for many decades. On the other hand, even seemingly definitive experiments (like the rhinovirus study) don’t seem able to shift expert opinion. In the case of rhinovirus, maybe one experient isn’t enough, but then the question is why no one seems to have been interested in replicating it.
Yeah, there were two groups that studied how rhinovirus is transmitted. One group was from the University of Virginia and found evidence of only fomite transmission. The study you cited is theirs. The other group was from the University of Wisconsin and found evidence for only airborne transmission. The Wisconsin group ”...argued that the high rate of transmission via the hands in the Virginia experiments might be attributable to intensive contact with fresh wet secretions produced by volunteers who essentially blew their nose into their hand.”
Why are suits and substances used to sterilize surfaces (e.g., hydrogen peroxide, bleach) mentioned in relation stopping pandemics? Another post by one of the authors (ASB) of the current post mentioned a self-sterilizing suit regarding the same subject.
Suits and surface sterilization seems unnecessary, because that stuff does nothing to stop airborne transmission of viruses, which seems to be the only way that pandemics can ever arise.
Airborne transmission of respiratory viruses
https://doi.org/10.1126/science.abd9149
Just want to note that there are, in fact, 2 ongoing pandemics, and the earlier one, AIDS, isn’t a respiratory virus. And those two obviously don’t comprise an exhaustive list of possible transmission vectors.
AIDS is considered to be an epidemic, not a pandemic, but can a sexually-transmitted disease similar to AIDS lead to a pandemic? I doubt it, because pandemics are dangerous (in part) due to rapid spread, a feature which a sexually-transmitted disease will never possess. I’d be a slightly more worried only if everyone was a lot more promiscuous.
Yes, respiratory diseases are far and away the most likely causes of GCBRs, but even there there is risk from other types of disease. But we’re discussing pandemics, and there you seem a bit misinformed.
First, the WHO has recently classified AIDS as an endemic disease, changing from its earlier classification as a pandemic. (Just like we’ll do with COVID-19 in a couple years.) But that didn’t make it not a pandemic until that point. And not only has AIDS killed 35m+ people—easily twice the total for COVID-19, but somewhere between 500k-1m more people were killed this year. And absent AI or a biotech solution to AIDS, that is likely to continue for several more decades. Making this even worse, unlike COVID-19, which skews towards killing people in poor health and the elderly, they were almost all people who would otherwise have lived far longer and healthy lives. If AIDS is not they type of thing we want to stop when we say we’re hoping to end pandemics, I don’t know what is.
Second, in the past, in addition to AIDS being a clear example of a STD pandemic, fecal-oral spread diseases have caused pandemics, as have vector borne diseases. (And not only that, but many weren’t viruses—and antibiotic resistance should worry us on that front. And outside of viruses and bacteria, Plasmodium kills millions a year.) So again, the general point was that it’s simply not the case that airborne transmission of viruses is the only way for pandemics to arise.
This discussion is about preventing and mitigating pandemics that could potentially end civilization, and stuff similar to AIDS (regardless of how you want to categorize it) is off topic because transmission would not be rapid enough to end civilization.
I don’t think accusations of off-topic-ness at this point are very helpful.
You have been making strong claims about “pandemics” in general, which others have responded to by pointing out examples of pandemics that don’t fit your claims. If by “pandemics” you meant “civilisation-ending pandemics” only, I think it was on you to make that clear.
In the context of this discussion (the post is about GCBRs), it should have been clear what I meant by that term.
Also, it can be claimed that a lot of things are “pandemics” like TB and antibiotic-resistant bacteria, but what is usually meant by the term is rapid, global spread (within weeks to a few months at most) of a deadly pathogen.
It wasn’t obvious to me, and apparently also not to others, that your statements about “pandemics” were not meant to apply to pandemics in general.
In general, when you realise you have been communicating unclearly, it’s a bad idea to blame the people you confused.
I don’t think you’re being reasonable here. So, we’ll just have to agree to disagree.
But obviously, there are transmission modes other than airborne and sexual, so I think you are missing my point about too-narrow thinking.
Because your claim is, effectively, a near-certainty that only airborne transmission could be threatening. And my response was, in effect, that this isn’t correct, and that even eliminating airborne disease transmission completely wouldn’t sufficiently address risks of future bioengineered pandemics, even if it would greatly reduce the number of viable such cases.
Why do you think fomite transmission is still worth considering?
I think you’re once again focusing far too narrowly—foodborne illness, waterborne disease, intermediate animal hosts and parasites, vector borne diseases, fomites, and sexual transmission are all mechanisms that currently spread disease, and it seems very strange to say that we should only ever look at aerosol transmission. Yes, it’s the most worrying, but it’s not enough on its own to address all threats.
Unless you have a reason to think otherwise, those methods of transmission (except for aerosol transmission) don’t seem capable of spreading a contagion rapidly enough to end civilization. This has been discussed in other comments.
I don’t necessarily agree but don’t want to say more.
I would say the same.
I think he was explicitly addressing your question of sexually-transmitted diseases being capable of triggering pandemics, not if they can end civilization.
Discussing the latter in detail would quickly get into infohazards—but I think we should spend some of our efforts (10%) on defending against non-respiratory viruses. But I haven’t thought about this in detail.
The AIDs epidemic is widely considered a pandemic (pandemics are a subset of epidemics). And one of the deadliest pandemics of the 20th century, at that.
In the 19th century, cholera, a faecal-oral pathogen, caused several pandemics, killing very many people. It doesn’t do that any more thanks to sanitation in rich countries, but it’s certainly not impossible for non-respiratory pathogens to achieve rapid global spread.
Everyone agrees with you that respiratory viruses are the biggest concern, and you’ve provided some good resources in this thread that I appreciate. But I do think you are being undernuanced and overconfident here.
I can’t think of a plausible, non-science fictional way in which this would not be impossible.
If you can but prefer not the mention it publically due to infohazard concerns, please send me a PM.
In order for us to be safe from future pandemics, it’s really important we don’t overindex on the pandemics of the past (or the present).
SARS-CoV-2 doesn’t really spread through surfaces/fomites much, if at all.
I’m sure the linked post is right to say that this is also true of “several respiratory pathogens”.
However I’d be surprised if it were true of all respiratory pathogens, let alone other diseases. Gastric/diarrhoeal diseases such as norovirus, rotavirus, or, indeed, ebola can spread through fomite transmission.
In short, I disagree that airborne transmission of viruses is the only way that pandemics can ever arise.
Why would you be surprised if airborne transmission was the only way that any respiratory pathogen could cause a pandemic?
I haven’t seen any strong empirical evidence that fomite transmission is even a thing and mechanistic reasons to doubt that it could cause a pandemic even if it were a thing. My mechanistic reasoning is this: fomite transmission would be too convoluted (e.g., nose → hand → variable period of time → door knob → variable period of time → hand → variable period of time→ nose) to be compatible with the sustained and rapid spread necessary to cause a pandemic.
Gastric/diarrhoeal diseases don’t and can’t cause pandemics for mechanistic reasons: it’s hard to infect people with bodily fluids.
I can’t find the source anymore but I remember being fairly convinced (70%?) that rhinovirus is probably spread primarily via formites, fwiw.
The main thing is that snot can carry a lot more viruses than aerosols. It’s also suggestive to me that covid restrictions often had major effects on influenza and RSV, but probably much less so on rhinoviruses.
I also don’t think we should necessarily overindex on viral respiratory diseases/pandemics, even though I agree they’re the scariest.
Until the COVID19 pandemic, nearly everyone thought that most infectious respiratory diseases were transmitted via fomites and droplets, but unfortunately, this was based on shockingly poor evidence and assumptions. The material you’ve seen is based on this outdated consensus.
As I pointed out before, there are mechanistic reasons to doubt that pandemics can arise from fomite transmission.
However, if I squint hard enough, I can kinda, sorta see how young children in daycare might be infected by sharing toys and sticking their fingers up their noses. But stuff like that isn’t going to cause a pandemic.
In fact, the dominant (and most likely only) mode of transmission of rhinovirus is aerosols (at least in adults), not fomites. The same paper claims that fomites were unable to infect adults.
Anything that’s capable of causing a civilization-ending pandemic must be able to rapidly replicate in humans and spread via airborne transmission, and the only thing that can do that is viruses (and perhaps virus-like particles in the future).
The bottom line for me about fomites and surface contamination is that it’s probably a non-issue, and even if there’s something to it (which doesn’t seem too likely), it’s pretty easy to deal with without fancy tech: just wash your hands, disinfect surfaces, and wear a face covering to prevent face-touching.
That Wired article is fantastic. I see this threshold of 5 microns all over the place and it turns out to be completely false and based on a historical accident. It’s crazy how once a couple authorities define the official knowledge (in this case, the first few scientists and public health bodies to look at Ward’s paper), it can last for generations with zero critical engagement and cause maybe thousands of deaths.
I’m confused about the distinction between fomite and droplet transmission. Is droplet transmission a term reserved for all non-inhalation respiratory pathogen transmission (like touching a droplet on a surface and then touching your face, or the droplet landing on your mouth), so it includes some forms of fomite transmission? I’m seeing conflicting sources and a lot that mention the >5 μm rule so don’t seem too trustworthy.
Don’t you mean millions of deaths?
From what I’ve read, fomite transmission must involve surface touching, whereas droplet transmission must involve droplets, which are expelled by coughing or sneezing, directly landing (like a bullet) in your mouth, nose, or eyes without any extra contact or touching.
These methods of transmission seem so implausible (how many people actually sneeze or cough directly in someone’s face?) to be major causes of spread that it’s hard to believe that no one seemed to have performed definitive experiments to test these ideas for many decades. On the other hand, even seemingly definitive experiments (like the rhinovirus study) don’t seem able to shift expert opinion. In the case of rhinovirus, maybe one experient isn’t enough, but then the question is why no one seems to have been interested in replicating it.
Here’s the study FYI.
Yeah, there were two groups that studied how rhinovirus is transmitted. One group was from the University of Virginia and found evidence of only fomite transmission. The study you cited is theirs. The other group was from the University of Wisconsin and found evidence for only airborne transmission. The Wisconsin group ”...argued that the high rate of transmission via the hands in the Virginia experiments might be attributable to intensive contact with fresh wet secretions produced by volunteers who essentially blew their nose into their hand.”
Oh this is really interesting, thanks!