I think of masks the same way I think of any risk mitigation. Better is better. Unregulated cloth masks not the bar to settle on
2/ we even specifically asked CNN to change the headline (they initially chose N95 masks) bc the idea behind this movement was always to provide folks w/ a multitude of options- N95s are one of those. But so are high grade surgical masks w/ mask fitters
3/ The arguments saying “just get more people to wear any mask”- guess what?
We should do both
& getting “anti-maskers” to wear a mask is actually IMO a harder problem than getting someone who already believes in masks a #BetterMask (which helps them around those who don’t)
4/ Those saying “where’s the data that better masks are needed”— let’s do this again just like we did for “where’s the data for masking at all”- & then let’s tell people they don’t need to mask (& then find out later we were wrong)
That worked out really well the first time
5/ Those using well ventilated hospitals w/ everyone masked & patients regularly tested & N95s used for Covid patients & COVID suspected patients as a comparison point for crowded poorly ventilated community settings where not everyone masks— yea, that’s not a good comparison
6/ Even in those clinical settings, we are at least using medical grade masks w/ 3 layers, one of which is meltblown nonwoven filter—NOT unregulated cloth—everyone is wearing it, & some, incl myself, are often wearing N95s. & even then we have had multiple hospital outbreaks
7/ Again- we are calling for smarter mask policies. Are #BetterMasks needed for every single setting? Alone or distanced outdoors? No.
We are specifically saying for high risk people, high exposure workers, or when regular risk people enter higher risk indoor crowded settings
8/ But notice that much resistance will come from w/in the establishment itself; this is par for the course
We don’t use the precautionary principle very well
If you’re not sure whether higher filtration better fitting masks will be better than poorly fitted cloth, they will
9/ Will they be a silver bullet? No. Will they alone stop the epidemic? No. Because we can’t do any intervention perfectly
And that’s the point. We need to do every intervention better. That includes getting more people to wear any mask; and to up the standard on our masks too
10/ And another point- contact tracing—which we know has fallen behind esp when places are surging with transmission well beyond our capabilities— is designed to find droplet based spread (within 6 feet, within 15 minutes); if that’s what you look for, that’s what you find
11/ Harder to trace for smaller particle spread in the community setting; but you’ll hear people say they have “no idea” where they got infected; “had a mask on” etc; masks w/ higher grade filtration & fit will reduce risk here. This has always been about reducing risk. #covid19
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1/ This story saying that a local health dept has changed their exposure time to any contact without masks ("1 second") doesn't mean that you will get infected in one second- but it does point out that 6 feet/15 min is not a hard/fast rule & never was.
2/ There are many possibilities for why new variants are "more transmissible"; but in the real world, figuring out the "why" takes time- and we don't have time. We must utilize the best protections we can right now- mitigation of risk is name of the game
3/ With vaccinations, it seems like our attention to other protection measures have fallen to the side- understandably bc there are only so many resources that public health departments have. Doing one often means not doing another (staff, funding etc)
THREAD
1//
The key points from our recent op-ed @CNN pushing back (respectfully) against Dr. Fauci & @CDCDirector who earlier this week on #CNNTownHall were asked about #BetterMasks
2/ -new more contagious #covid19 variants could mean infection w/ less exposure time - better viral transmission needs better protection; cloth masks better than no masks, surgical better than cloth, but the bar must be raised now
-still transmit by droplets & aerosols
3/ -aerosol transmission better stopped by N95 masks (or equivalents, KF94, KN95, FFP2) or some surgical masks; electrostatic charge traps small particles; cloth masks not designed to do this
As time goes on it’s starting to feel like the hesitancy around getting #bettermasks out to high risk or highly exposed people is less that this isn’t a good idea or isn’t needed- operationalization of this may be beyond capacity of what feds can/will do right now #covid19
2/ But- as with any interventions- if you believe in it, you must keep pushing for it. We believed #bettermasks were needed last year; we believe they will be needed for a long time to come. As @sri_srikrishna put it, they should be as common as fire extinguishers in your home.
3/ And I’ve seen some arguing about whether you may just use surgical masks & why N95 masks are needed. We actually don’t disagree with this IF you have a surgical mask that has been quality approved (@larmbrust has been tweeting about this) AND is fitted like w/ @FixTheMask
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.
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"
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