'Droplet dogma': Experts pick apart WHO's new COVID-19 guidance

An epidemiologist in Washington, D.C., called the World Health Organization's new COVID-19 guideline "droplet dogma," and other experts said it promotes disproven ideas, CIDRAP reported Jan. 26. 

In late December, the WHO published an updated COVID-19 infection prevention and control guideline. David Michaels, PhD, an epidemiologist and professor at George Washington University School of Public Health, told CIDRAP he was disappointed by what he calls "droplet dogma," or the claim that SARS-CoV-2 spreads through droplets instead of aerosols. 

The guidance also equates N95 respirator masks to medical masks: The Guideline Development Group "considered the evidence for particular respirators versus medical masks and agreed that the strength of this evidence was insufficient to recommend one mask over another except in some specific conditions," the WHO guidance said. 

Respiratory protection expert Lisa Brosseau told CIDRAP the comparison is unfair. 

"Medical masks and respirators don't have the same filters, and medical masks leak through their filters a lot," she said. "They may be similar in capturing large particles, but in small particles, medical masks are very leaky, so it doesn't really matter how it fits on your face, many of the small particles are still going to exit through the filter and around the facepiece."

Contention points between infectious disease experts and the guidance also include its emphasis on symptoms and a lack of reasoning for its 1-meter distance recommendation. 

In the meantime, the CDC is seeking clarification on guidance drafted by its committee for healthcare infection control measures, which critics say weakens current practices and is too lax on masking recommendations.


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