Discover and read the best of Twitter Threads about #BetterMasks

Most recents (24)

🧵1/ Sometimes when you push for an idea for long enough (#BetterMasks) & when the logic makes sense to you- but you are continuously told by other “experts” (CDC leadership) that it’s not needed; you begin to wonder if you yourself are missing something. #covid19
2/ But- the other factors at play- the political ones- make me think otherwise.

If CDC said “yes better masks are better; yes they protect you more”, they are now on the hook for getting these to people.

But- if they don’t have the bandwidth or political backing to do it...
3/ Then they can’t acknowledge it.

But- because we (many of us) pushed for #BetterMasks incessantly, they probably had to do something.

So they did a study with two masks, which worked better than one mask; two masks is easy bc it’s still on the public to figure it out.
Read 7 tweets
Another @CDCgov report today on #covid19 from unmasked exercise classes

The secondary attack rate of infection from instructors to class participants for classes taught within 1 day of symptom onset was 95% (20 of 21)!

And again here, we have CDC 🗣 about aerosol transmission Image
2/ Transmission despite 6 feet apart w/ instructors yelling during stationary cycling class #covid19 Image
3/ One of the instructors was teaching kickboxing & personal training - two of the infected participants wore masks and were *still infected*
#BetterMasks Image
Read 4 tweets

1/ New CDC report on #covid19 outbreak -55 cases in a week- among those attending an exercise facility in Chicago in August 2020...

22 people (40%) attended on or *after* the day their symptoms started

76% reported wearing masks *infrequently*…
2/ Right in the abstract here under "implications for public health practice", CDC says:

"To reduce SARS-CoV-2 transmission in fitness facilities, attendees should wear a mask, including during high-intensity activities when ≥6 ft apart."

So the 6 foot rule has limits...why?
3/ Because of smaller particles- aerosols- that spread farther than six feet, & hang around for more than 15 minutes.

And CDC acknowledges that; but is still hesitant to send people #BetterMasks (announced today they are sending cloth masks)? C'mon man. What is going on?
Read 8 tweets
A year ago, rhetoric was no mask

A few weeks after that, masks

Months later, finally started talking about #BetterMasks in mainstream #covid19 response

Then came double-masking as a backstop

Now- more pragmatic articles on how to get certified Hi-Fi masks ⬇️
2/ In @washingtonpost this week, we proposed how the Biden administration could actually operationalize a strategy to get #BetterMasks to the general public quickly. #covid19…
3/ As w/ most parts of the response, it’s not a lack of ideas but lack of actually doing them consistently, effectively, for long enough, with enough understanding of local public health & norms that determine the uptake of interventions. This isn’t new. It’s basic public health.
Read 4 tweets
This week there were some vital pandemic articles published in US newspapers.

They're from scientists and public health experts on *urgent* changes we need to make in US pandemic policy now.

Authors included 5 members of Biden's own transition team.

First, this one about the fact that COVID is airborne and how the CDC isn't really listening to the science on this yet.

Second, members of Biden's own COVID-19 transition team wrote an open letter saying the Biden admin needs to step up their response *now*.

Read 6 tweets
1/ Just saying #BetterMasks isn’t good enough. How do we actually do this?

We already have supply across a number of certified options incl
•surgical masks + mask fitters

Double masking can be good, but even here fit+filtration inconsistent
2/ Biden administration needs to have an Operation #BetterMasks.

People keep asking me where & how to get certified retail N95s or KF94– frankly, I’m not sure. Some are real, others are counterfeit.

Entire states are having issues with this at scale.…
3/ There would need to be some vetting by CDC/NIOSH & other private labs to quickly assess mask quality.

We need DPA/American manufacturing to help ensure a continuous supply of verified high filtration masks.

Priority for high risk &/or high exposure + unvaccinated folks
Read 8 tweets
There are a few challenges in talking about pandemic strategy in the US. First, the media hasn't given us the debate we deserve about which strategy we should use in 2021. Second, neither of our two major parties are talking about it. Third, b/c of #1 and #2 it can sound strange.
If you want to talk about changing our pandemic strategy in the US, and trying something other than the failed strategy that Trump started last year, you can do it in ways people will understand.

Start by talking about inequality in the United States.
The US has massive inequality. Even before the pandemic huge numbers of poor/low-income people struggling to stay housed and fed.

Shocking for the world's wealthiest country.

This inequality is exactly why our pandemic strategy hasn't worked. People can't afford to stay home.
Read 28 tweets
Thanks @drsanjaygupta for the shoutout! Absolutely agree- high grade masks like N95s in all high risk settings can urgently curtail superspreading/ drastically slow spread- critical while we vaccinate. Hopeful @JoeBiden admin will operationalize #BetterMasks for #covid19 control
2/ @RanuDhillon @sri_srikrishna & I have a piece coming out shortly on this topic this week with more specific thoughts that raise the bar above double-masking, which is a backstop for the time being. #covid19 #BetterMasks
3/ not even clear that *supply* is the issue! Need to actually move existing supplies into healthcare and other high risk settings, & also continue to manufacture thereafter— but more than anything, need an organized strategy. #covid19 Image
Read 4 tweets
1/x Just can't shake my disappointment in yesterday's #CDC school opening guidelines: "Operational Strategy for #K12 Schools through Phased Mitigation"

A 🧵 with other thoughts, links, practical tips wrt #school COVID airborne health, beyond CDC guidance.…
2/ First, here is the link to updated #K12 guidelines, as well as a few other key #CDC pages (w/ last update as of today).

K12 update (2/12):…

How COVID spreads (10/28/20):…

Ventilation in buildings (2/9):…
3/ So many lines of thought to follow, but I will direct you to short thread yesterday by @CorsIAQ for a good summary. The gist is simply that the #CDC guidelines leave out some of the most important, obvious help b/c they ignore the airborne component.
Read 24 tweets
1/A mask mandate map of America. #covid19

But- this needs to be about more than mandates; needs to be about getting people to understand & implement masking when/where it is most important (often, not outdoors which is where mandates seem to be focused)…
2/This is not to say outdoor transmission doesn't happen.

But it is presumably much lower than indoors.

Indoors includes public spaces. But it also includes unregulated private spaces.

If people believe in masks as protection, they will use them.
3/ Understanding drivers of ongoing transmission- the where/when/why/how (@RanuDhillon) continues to be key.

Beyond frontline workers who are getting infected in the workplace (which should be a main focus of our interventions/support), where else and how else?
Read 9 tweets
1/ You've surely seen constant recent messaging & articles imploring you to improve quality of both #mask fit & filtration, in part b/c of worrying COVID variants.

Good news that the #CDC is catching up w/ those messaging efforts w/ updated guidance today.

Short 🧵 of links.
2/ Another good summary thread of the CDC changes; by @AbraarKaran, who has been among ardent supporters lobbying hard for #bettermasks:
3/ One good example summarizing the new #CDC guidance changes on masks, w/ helpful infographics, interviews, and short video w/ CDC chief Dr. Walensky.

By @bylenasun & @FenitN…
Read 5 tweets
1/ Here is official @CDCgov @CDCMMWR report out today

They assessed various modifications incl:

•wearing a cloth mask over a medical procedure mask (double masking)

•knotting the ear loops of a medical procedure mask & tucking in the sides

2/ Simulation set in a 10x10 foot chamber; aerosols generated simulating someone doing “light work” load and the receiving dummy doing “moderate work”

Pic below of some key mods as described:
3/ “Ten mask combinations, using various configurations of no mask, double masks, and unknotted or knotted and tucked medical procedure masks, were assessed”
Read 12 tweets
1/ On February 2, 2021 the National Personal Protective Technology Laboratory (NPPTL) published assessments for many foreign made masks, including KN95s. Some minimum #KN95 filtration results were < 26%! But others had >95%. @AbraarKaran @linseymarr @zeynep @CorsIAQ
2/ Before we get to the results at tweet 7, you should read the introduction. Excerpts: @nataliexdean

"[T]en respirators were submitted for evaluation. The samples were tested using a modified version of NIOSH Standard Test Procedure...
3/ "Only particulate filter efficiency was assessed. The results of these tests are for the sample tested and may or may not be representative of a larger lot or population of similar respirators.
Read 23 tweets
1/ The major #covid19 outbreak from @BrighamWomens where I work is now published in @AnnalsofIM — definitely worth a read. Phenomenally detailed work here from many smart people.

The index patient tested negative twice, but soon became positive after.…
2/ “The virus was likely introduced into the facility by a symptomatic patient who tested negative twice on admission but in retrospect was contagious from at least hospital day 3 and infected staff and patients for at least a week before detection” #covid19
3/ The infection control team & overall program at our hospital is awesome. They are among the smartest people I know. And despite all of the protective measures in place, transmission & a serious #covid19 cluster still happened.
Read 19 tweets
"And there’s another problem: too much filtration becomes unbreathable. “Are you breathing through the material, or are you breathing through the gaps in the material?” Zangmeister says.
2/ "If you’re breathing through the gaps in between the mask and your face, you’re not getting any filtration production at all."

#covid19 #BetterMasks
3/ "In lab settings, Zangmeister and his team have found these areas where air escapes tend to be behind the cheeks, or right above the bridge of the nose, which can look like a droplet exhalation geyser, he says. "
Read 5 tweets
TEACHERS. If you're heading back to the classroom soon, are concerned, and would like additional protections, I have 2 quick things you can do:

1⃣ Better masks

2⃣ Portable air cleaner w/ HEPA filter

Details and tips for you in this thread

Let's start w/ masks b/c these are the most important layer of defense. A typical cloth mask may only capture 25% of particles, but also could be as high as 75%. That's the problem. So, it's time to pick a #BetterMask. Here's my 'cheat sheet'


The power of masks comes when everyone wears one. If everyone in the room is wearing a blue surgical mask, which captures ~70%, respiratory particles have to go through 2 masks - mine, and yours. The *combined* impact is 91%!

And that's before distance or ventilation

Read 11 tweets
1/ In context of extra precautions against new COVID variants, some new questions pop up about #masks.

Article by @cwarzel @zeynep asks/answers some good questions to start. Other thoughts in a 🧵, e.g. N95s, fit (Tw7+ ⬇️), when to replace (Tw25 ⬇️), etc.…
2/ Countless recent articles w/ interviews from relevant experts imploring people to still take mask-wearing & overall airborne COVID health seriously.

One of many, here by @skbaer w/ broad contribution. (Tw33 below has link to a compilation of more).…
3/ Many good arguments recently towards motivating broader use of #bettermasks, i.e. #N95s. So if not using already, consider.

See e.g. this editorial by @j_g_allen:…

Or this opinion-piece by a group of excellent scientists:
Read 33 tweets
1/ Contrary to some media headlines, our proposal for #BetterMasks has not been to “just give everyone N95s”

If that was, I would be using #N95Masks

I think of masks the same way I think of any risk mitigation. Better is better. Unregulated cloth masks not the bar to settle on
2/ we even specifically asked CNN to change the headline (they initially chose N95 masks) bc the idea behind this movement was always to provide folks w/ a multitude of options- N95s are one of those. But so are high grade surgical masks w/ mask fitters…
3/ The arguments saying “just get more people to wear any mask”- guess what?

We should do both

& getting “anti-maskers” to wear a mask is actually IMO a harder problem than getting someone who already believes in masks a #BetterMask (which helps them around those who don’t)
Read 11 tweets

Huge push on the #BetterMasks front today!!

@RepAdamSchiff @BernieSanders @RoKhanna @brianschatz pen letter urging @POTUS to distribute high-grade masks via USPS + community locations & use DPA to scale up N95 & medical grade mask production!…
2/ We @RanuDhillon @sri_srikrishna have pushed for this for so damn long along w/ *many many others* — the momentum is seriously shifting. #covid19 #BetterMasks
Read 6 tweets
The key points from our recent op-ed @CNN pushing back (respectfully) against Dr. Fauci & @CDCDirector who earlier this week on #CNNTownHall were asked about #BetterMasks

Variants, precautionary principle, communication & more
cc @RanuDhillon @sri_srikrishna
-new more contagious #covid19 variants could mean infection w/ less exposure time - better viral transmission needs better protection; cloth masks better than no masks, surgical better than cloth, but the bar must be raised now

-still transmit by droplets & aerosols
3/ -aerosol transmission better stopped by N95 masks (or equivalents, KF94, KN95, FFP2) or some surgical masks; electrostatic charge traps small particles; cloth masks not designed to do this

-cloth mask market & surgical mask market is poorly regulated; quality highly variable
Read 11 tweets
As time goes on it’s starting to feel like the hesitancy around getting #bettermasks out to high risk or highly exposed people is less that this isn’t a good idea or isn’t needed- operationalization of this may be beyond capacity of what feds can/will do right now #covid19
2/ But- as with any interventions- if you believe in it, you must keep pushing for it. We believed #bettermasks were needed last year; we believe they will be needed for a long time to come. As @sri_srikrishna put it, they should be as common as fire extinguishers in your home.
3/ And I’ve seen some arguing about whether you may just use surgical masks & why N95 masks are needed. We actually don’t disagree with this IF you have a surgical mask that has been quality approved (@larmbrust has been tweeting about this) AND is fitted like w/ @FixTheMask
Read 6 tweets
Just want to clarify that it's likely the Mother was the Index case. Child tested negative at the hospital. Mother was asymptomatic but developed symptoms 2 days after discharge, tested positive on day 4. Child tested positive on day 6.
Another key quote:

"As some of the report's authors were taking part in the medical round and got infected, we can declare there was full compliance with PPE guidelines."
Read 6 tweets
If any single intervention worked *perfectly*, it could feasibly stop the epidemic- whether test/trace/isolate; fully supported lockdowns until transmission is dead; 100% usage of high-filtration masks at all transmission points; 100% vaccination

Real world doesn't work that way
2/ Instead, we are trying to do a bit of everything. That can work, but it won't if everything is done below standard, which at times it has

This is why trying to improve every intervention we have is critical

More testing
Faster tracing
Safer isolating
Better masking
3/ Sometimes, it feels like new ideas to get us *better* are shot down bc not *perfect*- like #BetterMasks recently; response from @CDCDirector was that they are hard to breathe through- sure, but that doesn't mean they aren't needed, or that they won't help.
Read 5 tweets
Short thread
1/ As much as we have been tweeting lately about #BetterMasks, & as much as wearing masks that offer higher source control & personal protection could quickly paralyze #covid19 transmission- even these are but one more tool in our playbook; they are not the only one.
2/ With that being said, the responses to our push for #BetterMasks from Drs. Fauci & Walensky last night on #CNNTownHall were frustrating- essentially "a mask is better than no mask" & "N95s are hard to tolerate for long periods of time"

3/ To bring more nuance here, I have said many times this would not be as simple as "mass produce N95s"- you still need to make sure the fit is correct & that people are using them consistently during high transmission risk situations both outside AND sometimes inside the house
Read 5 tweets

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