COVID 19 SUSTAINED SPEAKING IN PROXIMITY SPREADS THE VIRUS EASILY - BY JOON CHAN

This was sent to me by Joon Chan (Chan Heng Joon)?  Joon Chan  says he is a semi-retired ex-startup founder/co-founder, who used to run EasyTaxi in the region, and briefly was running FoodPanda in Malaysia.

He has done some research on the spread of the Corona Virus and I hope our Health Ministry / DG of Health / doctors / households / businesses / offices will read this easy to understand article. It is brief.

Thank you Joon Chan. 

COVID-19 Transmission : Hubris over proper communication of authorities

Hi Mr. Syed

You're known for thinking outsyed the box, but 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'd like to share with you on what i've found regarding the transmission of COVID. It all started when my curiousity to learn more about the spread of COVID resulted in my looking at specific cases where clusters were overly infectious relative to the others. 

There was our 

• super spreader lawyer with an infection rate varying between 10% to 80%
  
• a girl in Singapore who hosted her bridal lunch and infected all 3 of her friends present - 100%
  
• the tabliqh which had an infection rate of 15%
  
• 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 person in an office should take the whole department down. 

But it 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, outputs from the nose and mouth.

2. Infection happens when sufficient viral loads are inhaled thus entering the respiratory system.

3. What is the viral-load needed is still unknown, and varies from host to host. Generally, the more the viral-load the higher chance of infection taking place.

4. Every authority says "CLOSE CONTACT", but what the hell does this mean. Is it touching? Is it breathing the air of an infected person? 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 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 breathing, or fill up a room very quickly with contaminated particles. 

Exhalation in terms of total time in exhalation, and volume of particles, puts out orders of magnitudes (1/10,000) factor less, same for coughing and sneezing, since it occurs sparingly relative to speaking. Contact transmission (fomite) outside the medical setting is also 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 the spread of influenza, or even this virus. There are all 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.

6. What to the above super spread cases have in common? A lot of speaking, a lot of talking, a lot of chanting, a lot of singing.

What do familial clusters have in common? Speaking between family members at close range, or just the volume of particles emitted.

Why some lower level employee at Maybank fail to infect the whole office?

She does not speak much to many people.

Why 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, as with any Malaysian meeting)

7. Generally the advice given skips 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 distancing, it's speaking distancing, or particulate control. 

This MUST be the message the public is told.

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. 

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 back and forth in the pasar, oh my god, i can go on forever and ever.. so could you!

8. Compliance with masks daily is immensely difficult. Even Japan and Taiwan will not get full compliance. But honestly, we have a mask built into us. We just have to keep our mouths shut.
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. We must recognize that compliance is directly correlated with difficulty, even more so sustained compliance.

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 common sense.

10. I implore you to share this information, verify as you would like. 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)

https://www.nature.com/articles/s41598-019-38808-z

Media:

http://kvi.com/news/local/church-choir-stricken-with-covid-19-in-mt-vernon