1/ #Masks in Victorian hospitals- I hear many hospitals in Melb are masking all staff as per a DHHS directive last week. But, many aren't masking patients and visitors! This is a problem so obvious it doesn't warrant spelling out. Thoughts: #covid19aus #covid19vic 
3/ If we can't get a surgical mask/shield on every patient/visitor going into a metro melbourne hospital then should we consider cloth #masks? Cheap, reusable, people can supply their own. As effective? No. Contamination issues? Yes. But the aim is risk reduction, not elimination
4/ We could benefit from some guidelines on this, ideally from the national expert body AHPPC. But it will inevitably trigger discussions of role of masks in broader community as well. The gov would want to avoid these discussions because they are genuinely complex, nuanced:
5/ They'll deal with months of "why are you recommending masks in situation A, but not B?" and "why are cloth masks OK for me, but healthcare workers get surgical masks?"
6/ Masks pose many problems at a policy level. It's a trade off between known benefits +precautionary principle (N95s vs surgical masks) vs the opportunity cost of how they consume $, resources & literal bandwidth of public communication, distracting from more important messages.
7/ But if these trends of Victoria's #covid19 cases keep up, they won't be able to avoid the issue much longer. I do sympathise with them re: the shitshow of a discussion of masks we might end up with. Now...
8/ I know I'm going to hear the typical tropes about #masks again.
'Inappropriate use can cause harm' (contamination/face touching etc).
'Masks cause false-sense of security which makes them slack off other measures (risk-compensation)'. Thoughts:
'Inappropriate use can cause harm' (contamination/face touching etc).
'Masks cause false-sense of security which makes them slack off other measures (risk-compensation)'. Thoughts:
9/ I won't argue against these using data because I don't have it. I'd argue these points themselves have no/weak supporting data. Rather, I recognise their validity, and instead suggest that MANY health interventions share the same problems.
10/ Will the use of PrEP for HIV make people slacken with other safe sex practices? Will inappropriate use of prescribed medication cause adverse effects? Are drivers wearing seat belts more likely to tailgate? These points miss the main question which is:
11/ Will this health intervention (masks in hospitals for all) at a policy level confer NET benefit.
Will we be better overall, despite adverse effects/risk compensations? That's what matters most. If your position is 'we don't have the data so we can't say', that's fair but...
Will we be better overall, despite adverse effects/risk compensations? That's what matters most. If your position is 'we don't have the data so we can't say', that's fair but...
12/ I'd love to know which hospital in Melbourne you'd rather walk into today - one where everyone masks, or one where patients/visitors don't. To end:
12/ I went very off topic here , but my point is that having masks for hospital staff is a great start but only half the solution to the main. The other half is masking patients/visitors. We need a practical solution for this.#covid19aus
14/ I wrote 12 twice. the second 12 should be a 13. Apologies if that ruined your day
