Discover and read the best of Twitter Threads about #bettermasks

Most recents (24)

A year ago I wrote in @PostOpinions on masks:

"The debate is over. You should be wearing a mask when you go out."

Didn't call it as as early as @zeynep, but early enough that there was still hesitancy on this, but momentum was building. Then...

...this was immediately undercut by the administration.

(yes, back in the early days I did TV from the car so I didn't disturb the fam in the house. @ratemyskyperoom, how's my car?)


Wasn't just Trump. Birx seeded doubt by the (false) claim that people wearing masks might let their guard down...


Read 9 tweets
1/ Treated multiple #covid19 cases today.

Only when you hear actual stories of the struggles people are going through does it make it clear how problematic it is when we blame those who got sick because of what externally seems like “irresponsible” behavior.
2/ Caregivers of disabled family members who did not have the luxury to stay home; those working in factories where outbreaks are prevalent; we are still seeing these cases and treating them. This isn’t about lockdowns or no lockdowns- this is about creating better public health.
3/ This is about creating systems that can protect us during crises.

The false choice of lockdowns v no lockdowns has been birthed from politics, not public health.

Why is the idea of an actual public health strategy not being brought up in these debates? #covid19
Read 6 tweets

Important paper from @BrighamWomens Dr. Klompas et al in @IDSAInfo — transmission of SARSCoV2 despite medical masks & eye protection (this is from our hospital); whole genome sequencing confirmation thanks to @MassDPH @lmadoff
2/ “We describe 3 instances of SARS-CoV-2 transmission despite medical masks and eye protection, including transmission despite the source person being masked, transmission despite the exposed person being masked, and transmission despite both parties being masked.” #covid19
3/ Again— what does this imply for poorly ventilated, crowded community settings where vulnerable frontline non-medical workers have been getting infected, are wearing *poorly fitting cloth masks* and are NOT yet vaccinated?? #covid19
Read 5 tweets
We've never meaningfully addressed spread in high-risk workplaces despite this likely being a major driver of the pandemic

In communities like mine, workplace spread seeded transmission in crowded multi-gen homes with at-risk elderly & others working in similar settings

Most of our 'standard' strategies -- cloth masks, "stay-at-home", distance -- do nothing to address this cycle of transmission

In my community, anecdotally, hospitalizations from this cycle of spread has only declined with rising vaccinations

It should never take waiting for a vaccine - & allowing thousands to suffer & die in the interim - to stop one of the main drivers of this pandemic

Read 6 tweets
🧵🧵1/ When people ask which mask is “good enough”, I often try to reframe it as better protection is better protection; everything we are doing is to reduce risk.

Is an N95 better than a cloth mask? Yea, it is

Is a cloth mask better than no mask? Yea, it is

2/ If there was a good reason to not wear an N95 or equivalent mask during indoor crowded activities, then we wouldn’t be pushing for it.

But frankly, most of the reasons presented have been weak.
3/ The CDC Director on CNN once said it was bc they are hard to breathe through.

I don’t think so

I have worn them for hours at a time in the hospital

We are calling for people to wear them when in higher risk indoor settings. This likely won’t be for hours most of the time
Read 11 tweets
The good news is that my beloved grandmother got vaccinated today! Thank you science (and all the scientists that contributed to this modern miracle) 🙌

The bad news is that the CO2 level at the vaccination center was nearly 1200 which is way too high to be safe. @cdube_sante
At 1200ppm, 2% of the air we breathed for that hour came out of other people’s lungs — it’s the air version of drinking backwash. 🤢 The recommended fraction is <1% or CO2 <800ppm. (This is also why #bettermasks are important!)
I asked to keep the doors open to let fresh air in — easy fix and would’ve also helped with the heat in there — but no luck. A simple (free) safety intervention was declined because of the lack of public education on airborne transmission safety measures and ventilation.
Read 9 tweets
🧵1/ The #CDC update today (2/26) on "Ventilation in Schools and Child Care Programs" looks like good progress.

Details on #ventilation, #filtration, #bettermasks, w/ helpful links. Seems they're listening to @kprather88 @j_g_allen @CorsIAQ and others?…
2/ The relatively short #CDC page seems to have more succinct, yet clear #K12 guidance & connection to other pages of support.

Though I admit, I haven't digested yet fully. What are your takes? (also e.g. @jljcolorado @linseymarr @ProfCharlesHaas @Don_Milton @ShellyMBoulder)
3/ I was pleased to see early mention that "Wearing a well-fitting, multi-layer mask helps prevent virus particles from entering the air or being breathed in by the person wearing the mask."

(BTW, need for good fit implies aerosols)

Links (twice) here:…
Read 17 tweets
Your school opening back up?

Worried about your kids?

Contact your school district manager about this!
Another great resource fro. The great @CorsIAQ:

HT: @cohnkaren - thank you!
A really good presentation by the EPA on school ventilation.

HT: @citlanx - thank you!

Read 8 tweets
🧵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
2/ Transmission despite 6 feet apart w/ instructors yelling during stationary cycling class #covid19
3/ One of the instructors was teaching kickboxing & personal training - two of the infected participants wore masks and were *still infected*
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
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
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

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