Since the start of the pandemic, the CDC has failed to recognize the potential threat of airborne transmission of COVID-19. It seems pretty obvious at this point a year into the pandemic, so why can't they just say it?
The #COVIDisAirborne campaign continues to grow on Twitter as multiple studies show overwhelming evidence for aerosol transmission. To date, the CDC maintains that there is "no indication of a general community need to use special engineering controls, such as those required to protect against airborne transmission of infections, like measles or TB."  The message they continue to spread is that "airborne spread can only occur under special circumstances". Why?
Is COVID airborne or not?
A collaborative study published in Jan-2021 in the Journal of Hospital Infection "Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)" states, "There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to produce this review to consolidate the evidence for airborne transmission mechanisms, and offer justification for modern strategies for prevention and control of COVID-19 in health care and the community."
In addition, the National Nurses United (NNU) and 44 other organizations and unions delivered a petition with over 10,000 signatures to the CDC in February calling for President Biden to update the COVID-19 recommendations put out under former President Trump's administration. Because the Trump-era guidelines do not recognize that COVID-19 is transmitted through aerosols, the groups say, proper measures aren't being taken to protect key workers in such sectors as healthcare, grocery stores, meatpacking, warehousing and transportation. 
So why can't they just say it?
Even now, a year into the pandemic, Tuesday's tweet from @CDCemergency, states "Gaps can let air with respiratory droplets containing the virus leak in and out of the mask."
So droplets can "leak around" now? But wait...I thought droplets drop and aerosols float?
A Messy Timeline
The timeline of CDC messaging related to how the virus is transmitted is messy at best, but could be considered gravely dangerous and grossly negligent if more and more evidence keeps emerging suggesting COVID is transmitted primarily via the airborne route.
- February 3 — US Declares Public Health Emergency
- February 25 — CDC Says COVID-19 Is Heading Toward Pandemic Status
- July 6 — Scientists, Citing Airborne Transmission, Ask WHO to Revise Guidance
- July 9 — WHO Announces COVID-19 Can Be Airborne after more than 200 scientists sign a letter urging the agency to revise its recommendations
- September 18 — CDC Quietly Updates Guidance to COVID-19 Transmission Is Airborne
- September 21 — CDC Pulls Guidance Saying COVID-19 Transmission Is Airborne claiming the document was posted in error and the guidance was a “draft version of proposed changes”
By recommending that people avoid "confined and enclosed spaces with poor ventilation" and "and gather outdoors when possible", public health agencies like CDC and WHO seem to agree that there is a level of airborne transmission associated with COVID-19.
So why the reluctance?
Some of the reluctance to describe COVID-19 as an airborne disease may stem from concerns that the label would scare the public and may require hospitals to take "a whole new level of precautions," says Linsey Marr, an aerosol researcher at Virginia Tech, such as requiring an N95 mask, which blocks aerosols, to be worn around all potential COVID-19 patients.
To be frank, it seems the CDC knows that if they were to update their guidance, hospitals wouldn't be able to keep up with the requirements due to inadequate PPE, supply chain issues, and lack of funding for major engineering modifications to increase ventilation in every healthcare facility.
It begs the question, if these were addressable concerns and precautions could be revamped to introduce additional measures of safety needed to protect against airborne transmission, including better ventilation and perhaps, barrier protection devices like *eh hem* SCONE in hospitals, would they be changing their guidance?
Improving indoor air quality, ventilation, and active barrier protection must be prioritized and recognized as a better solution to stop the spread of COVID-19.
The SCONE is helping hospitals reduce the risk of airborne transmission using negative pressure barrier protection, a long-term cost-efficient solution for infection prevention.