Responses from British Columbia officials are part of a damning analysis on the reluctance by public health to acknowledge the airborne transmission of COVID-19 despite scientific consensus on the matter.
The new study, spearheaded by an influential and widely-respected Oxford professor, includes case studies in B.C. and Quebec, where responses were in line with a rejection and grudging acceptance by public health officials elsewhere.
The piece is titled “Orthodoxy, illusio, and playing the scientific game: a Bourdieusian analysis of infection control science in the COVID-19 pandemic.” In simple terms, they conclude that rigid thinking stemming from traditional medical education along with political influence, led health officials to reject evidence of airborne COVID-19 transmission for months.
“Covid is airborne, this has been proven, and so the focus of our paper is ‘why is it that public health authorities refuse to acknowledge this?’” said study co-author and University of Victoria professor of public health, Damien Contandriopoulos. “What we’ve seen is that medical doctors trained in infectious diseases realized they were outdated, outpaced and wrong — and instead of saying ‘oh, whoops’ what they’re saying is ‘oh, it can’t be true ‘ and the reaction was just ‘let’s pretend this does not exist’ and we see a lot of this in every public health authority.”
The research was organized by Oxford’s Trisha Greenhalgh, a professor of primary health sciences, who is influential in her field. She approached Contandriopoulos and another British professor to collaborate on the analysis. https://twitter.com/trishgreenhalgh
“Scientific and policy bodies’ failure to acknowledge and act on the evidence base for airborne transmission of SARS-CoV-2 in a timely way is both a mystery and a scandal,” reads the first line of the study, which has yet to be peer reviewed. "Measures to counter aerosol transmission are more difficult, more costly in the short term, and (therefore) politically less popular.”
B.C. researchers had advocated for a change in public messaging to reflect the evolution in understanding of the virus, but the province’s top doctor instead offered a convoluted response that only acknowledged airborne transmission indoors with poor ventilation — but that’s precisely what researchers warn is the most dangerous setting and needs emphasis.
“There’s a great alignment between public health authorities that were reluctant to change their view, and from the fact of political actors were quite happy with not doing anything different,” said Contandriopoulos. “Accepting recognition of the virus is in the air would mean one has to address what’s going on in schools — are the protocols still good ones? What’s going on in hospitals? What’s the plan for coming back to campus in the fall in universities? Plenty of tough questions like this.”
Experts and union leadership alike have raised those exact concerns for months with little result.
A culture of rejection in B.C.
While Contandriopoulos described Dr. Bonnie Henry in particular as “stubborn, reluctant to accept rapidly-evolving facts”, he said the attitude is widespread among health officials.
From the early days when in February of 2020, when the BCCDC tweeted a video of Dr. Eleni Galanis insisting “this is not an airborne virus,” to the deputy provincial health officer, few officials in public health acknowledged the results of engineering and airborne researchers.
"There is absolutely no evidence that this disease is airborne, and we know that if it were airborne, then the measures that we took to control COVID-19 would not have worked," Dr. Reka Gustafson, B.C.'s deputy provincial health officer, told CTV Morning Live in June of 2020, when hundreds of scientists were joining forces to say just that. "We are very confident that the majority of transmission of this virus is through the droplet and contact route.”
The World Health Organization was equally slow and resistant to changing its guidance, despite the evidence, and the study’s authors say orthodox public health officials seized on that as justification for their own skepticism.
When CTV News raised the issue with the health minister in April, pointing out that the US CDC and Public Health Agency of Canada had updated their messaging while B.C.’s public health authorities downplayed or rejected the idea of airborne spread, he was defensive.
“The BCCDC has been, I think, a national leader and a world leader,” claimed Adrian Dix, despite that being demonstrably false in this instance.
The following day, Vancouver Coastal Health quietly changed its website to remove a sentence saying there was no evidence of airborne transmission, and two weeks later the BCCDC updated its website to include discussion or aerosol spread.
Politics at play despite claims of independence
Contandriopoulos said while the third wave couldn’t have been avoided with airborne prevention methods, he and his colleagues believe it could’ve been mitigated.
They insist that the public health experts at the head of the government bureaucracy are appointed by politicians and it’s unrealistic to expect they’re making all their own calls.
“There is absolutely no way for a public health officer to say ‘I’m going to be disconnected from whatever the government wants me to say and I’m going to run my own show,’ they have to work together,” he said. “It’s not so much about individuals, it’s not so much about Dr. Henry or Dr. (Horacio) Arruda in Quebec, or any other jurisdictions. What our paper shows is that there is a pattern — a pattern that is way more fundamental and important than the people.”
The authors are urging governments to learn from their mistakes, fully accept airborne transmission, and accept that a multi-disciplinary approach to public health from a variety of experts is the best way forward as variants and vaccine hesitancy could draw out the COVID-19 pandemic for much longer than anyone would like.
“But given that transmission is predominantly airborne, different measures are needed,” they wrote. “Including ventilation, air filtration, reducing crowding and time spent indoors, greater attention to the quality and fit of masks, more widespread masking when indoors, and extensive higher-grade protection for healthcare and other at-risk staff.