The title of this “post” comes after two things: The historical revision of David and Goliath by Malcolm Gladwell (below), and the article published at Medscape on July 30,2020:

COVID-19 Data Dives: Why Arguments Against SARS-CoV-2 Aerosol Transmission Don't Hold Water

The Medscape article showed the ignorance in the medical establishment after reviewing two articles related to the spread of coronavirus by José Luis Jiménez: one was written by the WHO, and the other one appeared in the Journal of the American Medical Association (JAMA). Both of them did not mention by ignorance or negligence, or because they did not want to mention, that the main route of Covid 19 spreading is through aerosol. These institutions looked like goliath-- following Gladwell analysis, they were unable to perform what the only raison d'être for both of them is: “the analysis and publication of the best research possible.” Our guidelines regarding training in the pandemic considers aerosol as the main route of infection:

21 avr. 2020

Triathlon and Team Oaxaca Coronavirus Guidelines

We started learning since the beginning of the pandemic about the virus, to face the situation. We have learned the following:

1) The virus is transmitted via aerosol in addition to saliva drops. Why? We have the story about the chorus rehearsing and apparently keeping the distance between two people. They said: “No one sneezed or coughed.” One-day rehearsal, 60 people practicing, 45 sick, two deaths. https://edition.cnn.com/2020/04/01/us/washington-choir-practice-coronavirus-deaths/index.html This is more anecdotal, if you wish, but we have other sources of information.

The article written by José Luis Jiménez made the mentioned above institutions looked like Goliath. José, like David, armed with his slingshot killed them. This situation is not to be cheerful about it; but on the contrary, we should be sad about what we are living. José’s article shows how the establishment deteriorated over the years: “compadres” were invited to do research or to peer reviewed research. Unfortunately, this is not only related to this subject but it is present in all our existence: “compadres” are invited to do things that they barely know. We have two good examples of how they do it: Trump and López Obrador. The International Unions are also a good example, look at the IAAF and FIFA, to mention two that currently are having what we have known for years, corruption and more corruption. Let go back into business. We will discuss José’s article.

“I am an aerosol scientist. I have spent a lot of time examining the arguments from some that aerosols play only a very minor role in the transmission of SARS-CoV-2 -- and presenting the evidence that rebuts this claim. A recent article in JAMA argues that aerosols are not an important transmission pathway for SARS-CoV-2. While the article raises good questions, the arguments against aerosols are not consistent with the best science. Here's why I say that:

Aerosol size. Most important, a good understanding of aerosol physics, airflow, and dilution is needed to interpret the behavior of potentially infectious aerosols in complex real-world situations… However, the actual size of droplets that fall to the ground that quickly correspond to sizes larger than 50 μm, so 10 times the size and 1000 (!) times the mass given in the article. This fundamental error has been repeated for decades in guidance from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) and in medical papers, despite the correct physics having been figured out by Wells in 1934 and the error having been pointed out many times by other scientists.

This video from Ryan Davis, PhD, gives a more accurate picture of the behavior of ~50 μm aerosols in the air. Even at this size, the aerosols do not fall very rapidly to the ground. For aerosols of 5 μm to fall to the ground quickly, as shown in a short animation from the WHO, gravity on Earth would have to be 100 times larger than it is. This happens...on some stars. A 5 μm aerosol can actually stay suspended in air for 30 minutes indoors.

If 5-μm aerosols fell to the ground as stated by the authors and as shown in the WHO's video, we would not have to worry about aerosol (particulate matter) pollution, because a large fraction of it would fall to the ground so quickly. We also would not have to worry about Saharan dust reaching Florida, because much of the dust mass is composed of aerosols in this size range.

The authors further instruct us that "[a]erosols are smaller particles (≤5 μm) that...are small enough and light enough to remain suspended in the air for hours (analogous to pollen)." This is curious, given that pollen ranges in size from 15 to 200 μm. If pollen aerosols, being larger than 5 μm, actually fell to the ground within 1-2 meters, pollen allergies would not be a problem either. But pollination for many plant species would be very difficult too. Relying on medical doctors for advice about aerosols is like relying on me, an aerosol scientist, for medical advice: not a good idea…

The conversation with a smoker is a qualitative example. But quantitative studies with very detailed physics have been published that estimate exposure to droplets and aerosols in a close proximity situation (often referred to as "close contact," although physical contact is typically not involved)…

Therefore, aerosols probably dominate "close contact" transmission when talking. And talking is the most relevant situation for SARS-CoV-2, which has a major fraction of transmission by asymptomatic and presymptomatic carriers who do not regularly cough. These are the conclusions of a modeling study — it was notably rigorous —using well-established inputs: Newton's laws of motion; the law of gravity; the well-known laws of air drag on moving aerosols; and well-established measurements on the sizes, amounts, and speeds of the expired aerosols. This is not difficult, uncertain physics, such as trying to quantify the expansion of the universe or the mass of neutrinos; it is very well established and tested. Like any scientific study, it has uncertainties, but those are unlikely to reach factors of 100-1000…

Some people argue that the clear effectiveness of limiting "close contact" through social distancing to reduce SARS-CoV-2 transmission demonstrates that droplets, which fall to the ground close to the person, are the dominant mode of transmission, and that the same observation disproves aerosols as an important source of infection. The reality is the opposite. That "close contact" is a major mode of transmission of SARS-CoV-2 does not disprove aerosols. Rather, it is some of the best evidence we have that aerosols are important and very likely major…

Given such a large fraction of spread through superspreading events, I have to agree with Prof. Donald Milton that these events could prove to be the Achilles' heel of SARS-CoV-2, and that we should focus on identifying their causes and preventing their occurrence. Definitely, the environmental conditions are key: indoor spaces, low ventilation, crowding, long duration, no masks, loud conversation or singing. Perhaps also there are unusual individuals who shed a lot more aerosolized virus than the majority of those infected, and for those individuals the contagiousness does approach that of measles?...

Nonaerosol transmission in superspreading events. The authors state that "it is difficult to determine in retrospect all the potential person-to-person interactions that may have happened before, during, and immediately following these events."

Yes, it is difficult. But for the Skagit choir case that we investigated, 53 out of 60 people were infected during a 2.5-hour rehearsal. The choir spokesperson told me, "It is not a highly social group. It is pretty seriously about the singing." Most of the time, choir members were singing in fixed positions, and there was no one within the 1- to 2-meter "landing area" of ballistic droplets in front of the index case.

Members were aware of COVID-19, and reportedly no physical contact between choir members took place. They used hand sanitizer. The index case did not touch the snacks or help distribute the chairs. The index case did visit the restroom, but many members who did not use the restroom were infected.

In any case, fomite transmission appears to be less likely per CDC guidance, while the WHO admits that they do not have direct evidence for it. There was a 15-minute break, during which members talked to "two to three people" on average. Talking between the index case and others "was minimal." Could droplet transmission explain this event? Per the CDC, it would have required “close contact” of at least 15 minutes with 53 people!

Could this choir be an outlier? Well, as we report on our paper, choir cases with high secondary attack rates have also been reported in at least the Netherlands, Austria, Canada, Germany, England, South Korea, and Spain. A similar case in France was just reported. Yet, events like these are being dismissed by what can only be referred to as "contortionist thinking." A scientist interviewed by the New York Times summed it up well: WHO staff members have yet to accept the importance of these case studies and instead have "dreamed up an alternative story" in which an infected person spat on his hands, wiped it on something and "magically" infected numerous other people.

I am high lining this paragraph because this is happening to our leaders when seeing reality. In Psychiatry this is called PSYCHOSIS! There is a “contortionist thinking” when approaching problems due to ignorance and lack of desire to do their job. Less and less people are trained to be responsible for what they do. I leave you with “Checo” Pérez and his knowledge about what a professional should do after a race (He flew to Mexico to see his mom and got coronavirus)