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Abraar Karan Profile picture
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28 Jan, 7 tweets, 5 min read
1/ One point of resistance from some is that we don't "need" #BetterMasks for the general public

Yet we still have people saying they took "all precautions" & got infected (while wearing a cloth or surgical mask)- many have reached out to me w/ this story
washingtonpost.com/outlook/2020/0…
2/ @RanuDhillon & I wrote this WaPo piece earlier in the epidemic to highlight that we still do not have a solid grasp on relative contributions of various modes of transmission (think droplets v aerosols as one over-simplified version of this)
3/ Part of the issue is that we have been falling behind on contact tracing since the very beginning of the epidemic & still are.

Moreover, if tracing is only looking for transmission within 6 feet/ 15 minutes, that is what it will find #covid19

4/ With more transmissible variants like #B117 & exponential spread, we need to employ at least the basic needed protection in high-risk transmission settings. This is without a doubt masks with better filtration & fit than your t-shirt or random unverified cloth/surgical ones
5/ If you talk to anyone in the industry, the quality of surgical masks that you are dealing w/ will vary greatly.

And the fit presents its own serious challenge that compromises the protection you are receiving

cc @KatherinePasem1 @larmbrust
6/ Frankly, whether @CDCgov wants to acknowledge it now or later, we will keep pushing forward for #BetterMasks for the general public- whether these are N95s w/ fit training; KF94s, KN95s, FFP2s, or high quality surgical masks w/ fitted braces.

No more avoidable infections.
7/ This @CNN #CNNTownHall tonight was particularly frustrating - watch it for yourself and tell me if any of the questions that @AC360 @drsanjaygupta asked Dr. Fauci & Dr Walensky were actually directly addressed...

@RanuDhillon @sri_srikrishna

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More from @AbraarKaran

Abraar Karan Profile picture
28 Jan
If any single intervention worked *perfectly*, it could feasibly stop the epidemic- whether test/trace/isolate; fully supported lockdowns until transmission is dead; 100% usage of high-filtration masks at all transmission points; 100% vaccination

Real world doesn't work that way
2/ Instead, we are trying to do a bit of everything. That can work, but it won't if everything is done below standard, which at times it has

This is why trying to improve every intervention we have is critical

More testing
Faster tracing
Safer isolating
Better masking
Vaccines
3/ Sometimes, it feels like new ideas to get us *better* are shot down bc not *perfect*- like #BetterMasks recently; response from @CDCDirector was that they are hard to breathe through- sure, but that doesn't mean they aren't needed, or that they won't help.
Read 5 tweets
Abraar Karan Profile picture
28 Jan
Short thread
1/ As much as we have been tweeting lately about #BetterMasks, & as much as wearing masks that offer higher source control & personal protection could quickly paralyze #covid19 transmission- even these are but one more tool in our playbook; they are not the only one.
2/ With that being said, the responses to our push for #BetterMasks from Drs. Fauci & Walensky last night on #CNNTownHall were frustrating- essentially "a mask is better than no mask" & "N95s are hard to tolerate for long periods of time"

??
cnn.com/videos/health/… Image
3/ To bring more nuance here, I have said many times this would not be as simple as "mass produce N95s"- you still need to make sure the fit is correct & that people are using them consistently during high transmission risk situations both outside AND sometimes inside the house
Read 5 tweets
Abraar Karan Profile picture
28 Jan
THREAD
1/ On #CNNTownHall today- @drsanjaygupta and @AC360 asked Dr. Fauci & @RWalensky @CDCDirector about #BetterMasks

They pressed them on key points- should people get access to #BetterMasks?

Will the federal government help get these masks to people (N95s as an example)?
2/ Fauci responded saying "the most important thing is that you wear a mask"

Yes- we agree

A mask > no mask

But a high filtration mask > "a mask"

That last point is not really a "debate"- N95 masks are #bettermasks than cloth & surgical masks bc of fit & regulation on quality
3/ He then says we must "get everybody to wear a mask"

Unfortunately, that's not going to happen

Thankfully it doesn't need to!

Need enough people wearing masks in high risk transmission scenarios to stop cluster based spread

In these scenarios, high filtration masks key
Read 11 tweets
Abraar Karan Profile picture
28 Jan
"France has issued a decree banning certain homemade masks from being worn in public, saying they do not offer sufficient protection from the newer, more contagious #Covid19 variants."

theguardian.com/world/2021/jan…
2/ "Last Friday, two associations – one of doctors & a second of victims of Covid-19 – lodged an official demand to the state council demanding the wearing of FFP2 masks be made obligatory in public transport, shops & universities. The council will consider the demand this week"
3/ Have spoken w/ colleagues about this point that is being pushed saying that cloth masks don't protect as well "against the new variants"

Even these variants travel the same way- droplets & aerosols- so the equation is still the same as before- need to block both.
Read 4 tweets
Abraar Karan Profile picture
27 Jan
"As a whistle-blower report would later reveal, in January [2020], Department of Health and Human Services officials effectively dismissed an offer from one of America’s few remaining N95 manufacturers, Prestige Ameritech, to expand its production lines"

nytimes.com/2020/11/17/mag…
2/ "Steve Francis, a special agent in an investigatory division of the D.H.S., told me that the illicit P.P.E. market was so profitable that some transnational criminal organizations turned from smuggling humans and narcotics to moving masks."

Wow. #Covid19 #BetterMasks
3/ "The mayor of Los Angeles described cutting a check for a shipment of masks, only to have FEMA swoop in at the last moment. The governor of Montana complained on a conference call to President Trump that his state lost 4 or 5 orders in the previous week to federal agencies"
Read 13 tweets
Abraar Karan Profile picture
26 Jan
1/ So #LACounty is resuming outdoor dining after #COVID19 stay-at-home order is canceled-- this article quotes California health experts who are concerned that people need to remain vigilant.

It's strange that **outdoor dining** was a target though...

latimes.com/california/sto…
2/ As many of us have said, a key to controlling transmission is for people to avoid high risk situations.

Most if not all of these are *indoors*

If safer outdoor options are shut down, people are likely to migrate indoors where socialization isn't regulated
3/ California has the benefit of tolerable outdoor weather year round

The game plan here should have been to convince people to modify activities in a way that mitigates risk but gives them safer options to continue life.

Outdoors w/ physical distancing is a good way

#covid19
Read 4 tweets

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