There are many who have argued against mask mandates, citing that we don’t need masks in every single situation, esp outdoors. While this is true, leaving it up to people to interpret when to mask has also not worked out so well— to no fault of theirs- our messaging has failed
2/ Our messaging hasn’t been nuanced enough to help people understand viral transmission well enough that they always know when to mask v when not to mask.

And that behavior change takes time; unfortunately, we are once again out of time.
3/ At this point, the benefits of masking consistently will outweigh the costs. And as we hit winter, we will mostly be indoors where masking is most important anyways.

The one place that we will get hit hard I predict is *home based* transmission, where people aren’t masked.
4/ I am hopeful that more consistent masking outside the home will prevent many cases inside the home, but it probably won’t prevent them all— and some level of viral spread within families and “social bubbles” has already been set in motion as our 70-80k daily cases makes clear

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More from @AbraarKaran

25 Oct
The coverage at the hospital is slim on the weekend meaning we have to double up shifts.

I spent the entire day caring for patients—just got home at 10 pm.

Watching Trump claim he can better determine the cause of death of patients that we actually watch die— vote him out.
2/ During #covid19 surges, many of us who were not supposed to even be on service at that time had been called back to the hospital bc that is where we needed to be. We put on whatever PPE we had access to, & we stuck by our oath to be there for our patients no matter what.
3/ We showed up & we’ll do it again if we need to. That’s not a question, or a hesitation— that’s a commitment. That’s a promise. Watching this man degrade us, accuse us of falsifying the causes of patient deaths— he has no respect for what doctors, nurses & patients went through
Read 8 tweets
24 Oct
Should we have a mask mandate? Yes. This should have happened a long time ago

Those arguing that outdoor transmission is far less than indoor as a reason against a mandate are often in my experience the same people who don’t wear masks in either location

cnn.com/world/live-new…
2/ For what it’s worth, I agree that outdoor transmission is far less than indoor— the data suggests this. Yet— I have encountered a number of people that happily mask outdoors to show others, but don’t when they are indoors at work etc— this is problematic.
3/ The least likely place to mask is probably inside one’s own home, yet we know that indoor transmission in households is relatively higher than in other locations. Ultimately, the safest bet is when you are outside your “bubble”, you stay masked unless completely alone outside
Read 4 tweets
22 Oct
1/ Probably the most common question I am asked by friends is whether or not it is "safe" to date during the pandemic.

While dating can be a high-risk activity, the cost of loneliness & missing social connection is also high.

@WebMD
webmd.com/lung/news/2020…
2/ Some may see it as ridiculous to even think about dating as we are headed into a third surge in this country; & while I get that sentiment, risk mitigation is still the name of the game. Otherwise, people may just do it anyway but without tools for safety, which hurts us all.
3/ The basics here are the same.

Outdoors over indoors. Minimizing number of contacts in your social circle. Using regular testing to minimize the chance that you are unknowingly infected/infectious. Trust, of course, is key.

And, throwing digital options in the mix as well.
Read 4 tweets
21 Oct
PROTECT FRONTLINE WORKERS
THREAD
1/ There is a lot of talk about protecting the vulnerable. Yet, unsurprisingly, that has yet to be a priority.

And for those in crowded indoor conditions where aerosol spread can happen, cloth masks aren’t always enough.

hbr.org/2020/10/essent…
2/ For months, @RanuDhillon @sri_srikrishna and I have been arguing for better masks. We did this because we knew that aerosol spread was likely, even if not the dominant mode of transmission, & that many situations would require this level of protection. hbr.org/2020/06/we-nee…
3/ As doctors, Ranu and I both know that we would not walk into a room w/ someone that has COVID19 without the proper PPE, which would be an N95 mask in the healthcare setting.

But what level of protection is needed outside the hospital in other crowded conditions is less clear.
Read 21 tweets
19 Oct
THREAD
1/ #Covid19 super-spreading event from a bar in Vietnam; this report is from a party for St Patrick's day in which one guest infected 12 others at a poorly ventilated crowded bar.

Genome sequencing analysis helped to confirm this.
wwwnc.cdc.gov/eid/article/27…
2/ They note that asymptomatic secondary spread occurred to people who were not at the bar as well.

Indoor, crowded, poorly ventilated spaces without masks are dangerous; these types of cluster spreading events are propagating this epidemic.
3/ While this may happen at bars, we have seen the same in others settings as well.

Sports games--> recent CDC report of an outbreak at a hockey game

Read 22 tweets
18 Oct
One of the most interesting parts of working on #covid19 has been as a contributor @npr @NPRGoatsandSoda helping with their weekly FAQs for the last several months. Some of the questions might seem strange or “obvious”, but I appreciate every one of them.

npr.org/sections/goats…
2/ As we say in medicine during our training, there is no such thing as a “stupid question”— I know this phrase gets thrown around but I really believe it. We need to create an atmosphere in which people aren’t meant to feel ridiculous or stigmatized for trying to learn.
3/ Elitism is, IMO, one of the reasons we are in this mess. As scientists, did we not do enough to connect w the public before COVID19? In creating that gap inadvertently, did we also create space for a demagogue President who people found more relatable; who they now listen to?
Read 6 tweets

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