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Abraar Karan Profile picture
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15 Jan, 16 tweets, 12 min read
1/ #BetterMasks - why and how

First, why do we even need high-filtration masks right now?

Increasingly, we are going to be (or already are) in crowded, poorly ventilated spaces- groceries, public transit, work, school etc
#covid19

2/ If can agree that we need these...what qualities should these masks have?

We talk about that in our @HarvardBiz piece on #BetterMasks

Fit
Filtration
Comfort
Affordability
Scalability
Style

#covid19

hbr.org/2020/06/we-nee…
3/ Given huge delays in getting any of this done...what options are available right now, off the shelf?

One of these - elastomeric (eN95s) which are used in different industries and were used by some hospitals can get job done

#covid19
hbr.org/2020/10/essent…
4/ Many have pointed to the issue of the exhale valves-- actually, even this issue has been studied by CDC/NIOSH, report below

Apparently source control can still be better than surgical masks or cloth masks even w/ these
#covid19

5/ Additionally, many have rightfully mentioned KF94 and KN95s

There have been some issues around counterfeits

CDC has a list of some that have definitely run into these issues (check the list if you have any of these, may need to contact company)
6/ Many are aware that higher filtration masks are the best personal protection we can get at this time, including President @JoeBiden

No silver bullets, but these are critical in addition to vaccines, T/T/I, ventilation etc #covid19

7/ Some home-made options exist & many smart people have studied these & have been trying to MacGyver their own

I commend these people- but it shouldn't have to be this way.

We are 11 months into this pandemic.

We have known this is an issue.

8/ Some places, like Bavaria in Germany, have actually started to make FFP2 (their N95 equivalent) *mandatory* when using transit or in grocery stores

This is key- using HiFi masks in places w/ highest risk of transmission from both droplets + aerosols

9/ But- just saying you need to wear #BetterMasks or even mandating them without helping people get access to these- ideally for free-- is unacceptable & will worsen health inequities. #covid19

10/ Some governments, like Austria's, are actually sending these hi-fi masks for free to their highest risk citizens- those 65+ year of age

Even if we can get better masks to high risk folks + those in frontline jobs, that would be huge

But ideally more
11/ Hong Kong got a 6 layer re-usable mask out to people; free w/ national ID card; ability to insert better filters for when you're in crowded spaces; distributed from post offices

#covid19
12/ Singapore has something similar, given out through vending machines

It's a mask kit- 2 reusable masks, 3 reusable filters

They have distributed this 3 times now (maybe more since that article was written, not sure)

#covid19

13/ Our latest piece in @statnews talks about what the @JoeBiden team needs to do

Ideally, you would be able to pick up your mask kit in convenient places or have it shipped right to you

More soon from @sri_srikrishna @RanuDhillon & me
#BetterMasks
statnews.com/2021/01/07/nat…
14/ As expected, over time, more transmissible variants such as #B117 will outcompete older ones; and at a later time, some variants may do better at evading our immune response.

When that happens, having a #bettermask on will be key.
#covid19
washingtonpost.com/health/coronav…
Cc @V2019N @InfectiousDz @RanuDhillon @sri_srikrishna
Cc @CarolineYLChen @B_resnick @sciencecohen @CaroMT @matthewherper @lisalsong @getusppe @MikeMadden @cshea4

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Abraar Karan Profile picture
15 Jan
Interesting albeit limited report here
7 infected #covid19 patients asked to wear:

-no mask
-surgical mask
-KF94
-N95

and asked to cough 5 times into petri dishes

Swabs taken from inside + outside of masks and measured growth on dishes

What did they find?
#covid19 Image
2/ In 3 out of 7 cases, virus was detected in the petri dish when wearing no mask or wearing a surgical mask

When wearing the Hi-Fi mask, no virus was detected.

Both inside + outside of surgical masks w/ detectable virus

Only the inside of Hi-Fi masks w/ detectable virus
3/ This attempts to get at *source control*

We will have more and more people walking around not even knowing they are sick or contagious

The better masks these people have, presumably lower chance they spread this #covid19
Read 5 tweets
Abraar Karan Profile picture
15 Jan
Short🧵
1/
So @CDCgov on their “Your Guide to Masks” has a section saying don’t use N95s or surgical masks for the general public bc they are reserved for healthcare workers. That is their reason. They invoke a *shortage of supply* as their main rationale
cdc.gov/coronavirus/20…
2/ On a separate page, they talk about the presumption that most transmission of #covid19 is happening via droplets but in *special circumstances* transmission happens via aerosols as well

What are those?

Enclosed spaces w/ poor ventilation

cdc.gov/coronavirus/20…
3/ In those situations, N95 & other high filtration masks are key. @cdcgov if there’s a supply issue then *fix* it

Bc being in enclosed crowded spaces is not a *special circumstance*

Many Americans find themselves in these situations every single day, from transit to groceries
Read 8 tweets
Abraar Karan Profile picture
14 Jan
Southern German state of Bavaria makes N95 masks *mandatory* (their version called FFP2) when using public transport or entering retail stores.

#covid19 h/t @sri_srikrishna
dw.com/en/covid-germa…
Agree w/ this— need to make sure these masks are free to the public! #covid19 #betterMasks #Bavaria

spiegel.de/international/…
Cc @carlzimmer @zeynep @jeremyphoward @KatherineJWu @apoorva_nyc @linseymarr @jljcolorado @MonicaGandhi9 @kakape @j_g_allen
Read 4 tweets
Abraar Karan Profile picture
14 Jan
Short thread
1/ One of the weirdest things about our quarantine policies in this country is that they were never actually enforced

We’ve been functioning on scout’s honor for 11 months & it doesn’t seem to be working? #covid19
2/ I personally know a number of people that traveled south for the holidays & did not quarantine upon arrival to Massachusetts- hell some even went to bars when they got back (@marty_walsh - one reason why these should be *temporarily closed*- not limited capacity)
3/ And for those that are staying home to quarantine, unclear what % are actually full on in quarantine in the house (essentially pretending you’re infectious, masking if you leave the room, eating/sleeping separately etc) #covid19
Read 4 tweets
Abraar Karan Profile picture
13 Jan
1//
Let's break down the new US federal policy requiring a negative #covid19 test before boarding announced today because it covers a few important concepts

It requires that people flying into the US have a negative test within 3 days of flying

nytimes.com/live/2021/01/1…
2/ First, this reminds me of the recent outbreak from September on the Dubai-NZ flight.

The index case tested negative 4 days before the flight.

In theory, had they tested within 3 days, infection may have been picked up, but possibly not

3/ This highlights the "one test is one test" point: all that test is saying is that you are negative when you got it

That is not a reason to not test-- but it is a reason to want a neg result as close to whatever event it is (flight or otherwise) that you can #covid19
Read 10 tweets
Abraar Karan Profile picture
11 Jan
THREAD
1// Have been saying this for months— and have actually have been doing this for the entire year any time I went back to LA to see family, even with a negative test.

High risk workers should mask at home if they have regular exposure. Every layer matters. #covid19
2// Increasingly colleagues of mine are incidentally testing positive without known exposure- takes 1-2 days to get PCR result back; end up exposing whole family in that time.

Nothing inherently safe about the home unfortunately.
3// In fact, may end up being most dangerous given less likely to mask here; very close prolonged exposure; crowding; ventilation variable

Now I’m going to accept that pragmatically speaking, most people are not going to mask at home BUT here are some personal recommendations...
Read 5 tweets

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