Thread by @UniversalMaski2

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei Here is a summary published in @ACPinternists on the Brigham Women’s hospital. @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ (1/

acpjournals.org/doi/full/10.73…

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ Here are some results:

First, the test to clear isolation failed. @michaelmina_lab @yaneerbaryam @noellejt

“The index case was a symptomatic patient in whom isolation was discontinued after 2 negative results on nasopharyngeal polymerase chain reaction testing.”

(2/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt Also, 8 of 9 roommates who shared rooms with potentially contagious patients were infected. Remember #dontsharetheair (3/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt The only limitation is that “Findings may not be generalizable.” Sadly, this statement could not be further from the truth. The findings in this cluster support transmission are not an anomaly because @covidisairborne. (4/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne “Staff noted that the patient was frequently coughing, did not tolerate a mask, and had indistinct speech that led many providers to come near to understand her.”

These are significant risk factors. @SherriDouville @citlanx (5/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx None of the staff members who got infected wore N95 respirators at all times. @JenLingeman @medpie1 @DvsBlack (6/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack Two technicians got infected. Was the failure from not wearing a gown, as the @WHO recommends @epireport? The failure was not wearing a N95 respirator. @BarryHunt008 (7/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack @WHO @epireport @BarryHunt008 By using SF6 concentrations, the index patients room was 35 PPM, nursing station was 11 PPM, and other rooms were 0.5 PPM. @KanakaMPH has noted nurses are concerned about negative pressure from a COVID unit at the other end of the floor in Texas. (8/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack @WHO @epireport @BarryHunt008 @KanakaMPH These are the proposed changes. Please remember talking is a very important aerosol generating procedure. #GetMePPE (9/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack @WHO @epireport @BarryHunt008 @KanakaMPH I posted a short thread on this back in late September of 2020 commenting that instead of using airborne precautions, @BrighamWomens was blaming a lack of compliance with droplet precautions. (10/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack @WHO @epireport @BarryHunt008 @KanakaMPH The denial that #COVIDisAirborne and the failure to #UseAirbornePrecautions is allowing COVID to spread. @akm5376 @healthyheating @cohnkaren @SprkJoy4BtrDays (11/

https://twitter.com/aaronrichterman/status/1309308729305772038?s=21

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack @WHO @epireport @BarryHunt008 @KanakaMPH @akm5376 @healthyheating @cohnkaren @SprkJoy4BtrDays We should not have been debating this @Cleavon_MD. A fit tested N95 is vitally important if you have to share indoor space with others. (12/12)

https://twitter.com/cleavon_md/status/1279910492140535808?s=21

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack @WHO @epireport @BarryHunt008 @KanakaMPH @akm5376 @healthyheating @cohnkaren @SprkJoy4BtrDays @Cleavon_MD Because of bad threading, I left a couple tweets off. @co2detective @eliowa @LastGreatAct. (13/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack @WHO @epireport @BarryHunt008 @KanakaMPH @akm5376 @healthyheating @cohnkaren @SprkJoy4BtrDays @Cleavon_MD @co2detective @eliowa @LastGreatAct If the person was not wearing a nebulizer, wouldn’t the air get out anyways, still spread in the room, and still allow aerosols to be inhalled? The nebulizer may make some of those aerosols smaller, but doesn’t the air make aerosols shrink in size? (14/

@danaparish @BhadeliaMD @BrighamWomens @DrKatrin_Rabiei @ACPinternists @jljcolorado @Iamgoingtosleep @kprather88 @busycactus @NjbBari3 @Don_Milton @j_g_allen @jmcrookston @meganranney @shikgupta @ShikhaJainMD @CorsIAQ @michaelmina_lab @yaneerbaryam @noellejt @covidisairborne @SherriDouville @citlanx @JenLingeman @medpie1 @DvsBlack @WHO @epireport @BarryHunt008 @KanakaMPH @akm5376 @healthyheating @cohnkaren @SprkJoy4BtrDays @Cleavon_MD @co2detective @eliowa @LastGreatAct On plexiglass, Dr. Prather has commented aerosols are not reduced by plexiglass. (15/

https://twitter.com/kprather88/status/1343211287531069441?s=21