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1/ This study looked at exhaled breaths in patients w/ confirmed respiratory infections, including seasonal coronavirus (not #SARSCov2), flu, and rhinoviruses.

They studied both droplets and aerosol in breaths w/ and w/o masks on the patient.
nature.com/articles/s4159…
2/ For seasonal coronaviruses, they found a significantly lower detectable viral shedding in both droplets and aerosols from exhaled breath when regular surgical face masks were worn v/ when they were not worn.
3/ Not that we need any more evidence to wear masks, but here is more evidence that masks can and do have a notable effect on source control, which is very important w/ pre symptomatic transmission in #covid19.
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Abraar Karan
@AbraarKaran
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1/ So as states are literally drowning, need to point out that the CDC- your favorite silenced gov org- has a full (actually strong) report out on when to "rebound" & move back phases, w/ public health metrics...

#covid19
cdc.gov/coronavirus/20… Image
2/ There are actual gating criteria, based on *public health* data, that guide when moving to a next phase is safe, & when that move has to be reversed (one example below).

The guidance has been out since May.

I share this to say-- it *did not* have to be this way. Image
3/ Many states are spiraling toward recurrent lockdowns.

This time around, *listen to public health expertise*-- reopening was never meant to be easy.

It was always going to be the hardest part.

And locking down initially was literally so that we could get systems in place.
Read 6 tweets
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Abraar Karan
@AbraarKaran
While masking is critical- there is nuance because masking *outdoors* will be largely offset if people then do not mask *indoors*, when transmission is highest. Need to ensure masking is happening in highest transmission risk situations; I am most worried about in the home.
2/ Clusters of home-based cases were significant in early Wuhan reports. I found the same to be true when I took care of #covid19 patients in April. Vast majority seemed to be infected by a family member in the home, often before symptoms had started.
3/ Tough problem without a clear solution.

Masking consistently outside the home will make one less likely to contract the virus; but if one gets sick, transmission indoors in the home while presymptomatic seems like a high-risk situation.
Read 7 tweets
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Abraar Karan
@AbraarKaran
We’ve been saying this since April. Most epidemiologists knew this was necessary even then. It’s a failure of political leadership; a failure of science communication; a failure of manufacturing; but, it is still more necessary than ever.
hbr.org/amp/2020/05/a-…
2/ This was our piece in @HarvardBiz published on on May 1st.

We had been writing this and iterating new versions since March.

And we kept landing on the same: better masks. ASAP.
3/ We followed with a second piece this past June— same message, another month lost—> better masks. Without a vaccine, better masks are the most achievable way to substantially slow transmission and get us back into society.

hbr.org/2020/06/we-nee…
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