Thanks @drsanjaygupta for the shoutout! Absolutely agree- high grade masks like N95s in all high risk settings can urgently curtail superspreading/ drastically slow spread- critical while we vaccinate. Hopeful @JoeBiden admin will operationalize #BetterMasks for #covid19 control
2/ @RanuDhillon @sri_srikrishna & I have a piece coming out shortly on this topic this week with more specific thoughts that raise the bar above double-masking, which is a backstop for the time being. #covid19 #BetterMasks
3/ not even clear that *supply* is the issue! Need to actually move existing supplies into healthcare and other high risk settings, & also continue to manufacture thereafter— but more than anything, need an organized strategy. #covid19 Image
4/ before Biden pushed double masking, Trump pushed cloth masks

Many of us pushed back for months

Next, we will get them to back #BetterMasks that are verified protection & which exist already but are difficult to find/verify for consumers. #covid19… Image

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More from @AbraarKaran

16 Feb
This is key

It’s been a long year, & I can sense hesitancy from the public health community about being too vocal on what is “safe”— but once you are fully vaccinated, you have excellent protection from severe disease!

When around those who aren’t yet vaccinated, wear a mask ⬇️
2/ I think part of the hesitancy is that “safe” and “unsafe” is a nonspecific framing.

Safe from what? From severe disease? Hospitalization? Death?

Yes, once vaccinated, the chance of this happening is extremely low. We have excellent trial data showing this.
3/ Is it possible to still get #covid19 after vaccinated? It’s possible- but it is much more likely to be *mild* disease

Can you transmit onwards? Yes, although vaccines likely ⬇️ this chance as well

This is why we say to wear a mask around those still waiting for their shots
Read 4 tweets
13 Feb
1/A mask mandate map of America. #covid19

But- this needs to be about more than mandates; needs to be about getting people to understand & implement masking when/where it is most important (often, not outdoors which is where mandates seem to be focused)…
2/This is not to say outdoor transmission doesn't happen.

But it is presumably much lower than indoors.

Indoors includes public spaces. But it also includes unregulated private spaces.

If people believe in masks as protection, they will use them.
3/ Understanding drivers of ongoing transmission- the where/when/why/how (@RanuDhillon) continues to be key.

Beyond frontline workers who are getting infected in the workplace (which should be a main focus of our interventions/support), where else and how else?
Read 9 tweets
13 Feb
Some of the framing around impoverished countries not getting adequate vaccine doses center on this being bad for wealthy countries because there will be ongoing reservoirs of disease/ more mutations etc

Why is the framing always relative to the effect on wealthy lives?
2/ Why is the focus not on equity?

Why are all lives not treated equally?

Why are impoverished countries seen as vectors of disease rather than places with human beings deserving of vaccines like everyone else? #covid19
3/ I ask these questions of course rhetorically.

This is always how it has been.

This is not surprising.

This has been every part of the pandemic, from testing, to treatment, to vaccines. #covid19
Read 6 tweets
10 Feb
1/ Here is official @CDCgov @CDCMMWR report out today

They assessed various modifications incl:

•wearing a cloth mask over a medical procedure mask (double masking)

•knotting the ear loops of a medical procedure mask & tucking in the sides

2/ Simulation set in a 10x10 foot chamber; aerosols generated simulating someone doing “light work” load and the receiving dummy doing “moderate work”

Pic below of some key mods as described:
3/ “Ten mask combinations, using various configurations of no mask, double masks, and unknotted or knotted and tucked medical procedure masks, were assessed”
Read 12 tweets
10 Feb
Short Thread
1/ Another must-read piece from Dr. Mike Klompas @BrighamWomens - lead author of the recent #covid19 outbreak study from our hospital in @AnnalsofIM- I've been lucky to call Mike a mentor this year & have learned a lot from him
What is an AGP?…
2/ "It has become clear that the traditional dichotomy b/w droplet vs aerosol-based transmission is overly simplistic. In practice, people routinely produce a profusion of respiratory particles in a range of sizes that incl both droplets & aerosols as well as particles in b/w"
3/ "Respiratory particles of all sizes can carry virus and all are potentially capable of transmitting infection. The amount of respiratory particles one emits varies by activity. Quiet breathing generates a small but steady flow of aerosols." #covid19
Read 9 tweets
9 Feb
1/ The major #covid19 outbreak from @BrighamWomens where I work is now published in @AnnalsofIM — definitely worth a read. Phenomenally detailed work here from many smart people.

The index patient tested negative twice, but soon became positive after.…
2/ “The virus was likely introduced into the facility by a symptomatic patient who tested negative twice on admission but in retrospect was contagious from at least hospital day 3 and infected staff and patients for at least a week before detection” #covid19
3/ The infection control team & overall program at our hospital is awesome. They are among the smartest people I know. And despite all of the protective measures in place, transmission & a serious #covid19 cluster still happened.
Read 19 tweets

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