Any mask will provide some source control, but given Delta's formidable transmissibility, it's time for #bettermasks to maximize protection for ourselves and others.
☑️FILTER
🟠GOOD: A 3 ply, tightly-woven, cloth mask with a polypropylene inner layer
🟡BETTER: ASTM rated surgical masks, Level 2 or 3
🟢BEST: KN95, KF94, N95, Elastomeric Respirators
But since COVID spreads in aerosols.. we also need to #mindthegaps with a good FIT...
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☑️FIT
🟠GOOD: Thin cloth mask over a surgical mask, or use ear-saver/hair clip.
🟡BETTER: KN95/KF94 respirator with user seal-check, or mask brace on surgical mask.
🟢BEST: N95/N99/Elastomeric Respirator with user seal-check. If high-risk worker: Fit-Tested Respirator
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☑️FUNCTION
🟢Make sure your mask is breathable and comfortable!
🟡Be careful when adding layers (eg. double-masking with 2 thick masks); this could limit breathability and cause you to breath around the mask rather than through it.
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With Wild-Type SARS-CoV-2, the GOOD options above were probably sufficient, especially when combined with decent ventilation.
Unfortunately, Delta is a new beast, so we need to be aiming for BETTER and BEST masks + layer with excellent ventilation/filtration.
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I use a KN95 earloop mask, or a N95/N99 full band mask, depending on the riskiness of the activity/environment.
High-risk workers should be wearing fit-tested respirators.
The @Telegraph released an article claiming "we're still not completely sure how coronavirus spreads or how to stop it", muddying the waters re. Airborne Transmission.
If I were a hostile foreign state, with a goal of prolonging the Pandemic in the West, I would write this.
🧵1/
I'm not surprised that the usual WHO IPC Consultant suspects, continued to preach the biased tenets of #DropletDogma via their interviews in this article.
What shocked me is the lack of scientific fact-checking from the so-called "Science Editor" @sarahknapton.
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Two egregious things stick out, which amount to journalistic malpractice.
1) Citing the interviewees biased, failed review as evidence that Airborne Transmission isn't occurring
2) Referencing year-old, obsolete comments from Dr. Klompas, without mentioning his recent work
There has been a multi-day debate occurring amongst @AntibioticDoc and many engineers and Aerosol scientists, regarding whether there is sufficient evidence to use HEPA filters to mitigate against Airborne Transmission of SARS2.
For those following this HEPA filter thread – this is a really important acknowledgement. It’s clear from the thread, and this particular tweet, that many Infectious Disease experts still doubt that aerosol transmission is an important/mitigable transmission route for SARS2🧵 1/
While they acknowledge aerosol transmission can occur, they believe it is a rare event occurring in special circumstances, and is therefor not worth the $ to mitigate.
Eg. re HEPAs: "We need to resource by best impact", "Changes need rigorous justification and business case".
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See my pinned tweet for a thread summarizing the overwhelming evidence that Aerosol Transmission is an important and mitigable route. At the end, I provided a reference list and posed a question to the ID holdouts - no responses yet. 3/
During Friday's debate with @kprather88 and @DFisman, Dr. Conly raised a fairly common counter-point for why he thinks COVID is NOT Airborne: the relatively low Secondary Attack Rate (SAR) and Reproduction Rate (R0).
Let's unpack this flawed argument in a 🧵
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Dr. Conly states the SAR is 3 to 10%, with a household mean of 18%.
He then correctly points out that there is significant heterogeneity within the data, which means some people transmit to no contacts, while others transmit to everyone.
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After admitting to the heterogeneity, he cautions we "have to be careful not to draw conclusions" from these superspreaders... eg. Chalet (73% SAR), Choir (53%), and Diamond Princess (58.9%). He suggests there were "extenuating circumstances", and seems to dismiss them. 🧐
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As Dr. Conly reminded us on Friday, when considering Airborne Transmission, "it's very important to take into consideration the very very complex environment".... "direction of airflow, the number of air changes, temperature, relative humidity... its veeery very complex"
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This is actually NOT "complex" for Aerosol scientists, mechanical engineers, building scientists, and other experts in fluid mechanics. Due to the Pandemic, these experts have diverted their brainpower to this problem. See summary of studies below.
Let's unpack Dr. Conly on the Precautionary Principle.
Q: Why weren't HCW provided N95s, given the advanced warning that SARS2 might be Airborne?
Conly: "I need to see a much higher level of evidence..."
(🤔 That's not how the Precautionary Principle works)
🧵 1/
He then makes a pretty bold claim:
"certainly from our experience in Alberta, in Phase 1" the HCWs wore "gowns, gloves, medical masks"... and "not a single HCW transmission"... despite "highly infectious, hot viral patients"
*Phase 1* is defined here: MARCH-APRIL 2020
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So why the "Phase 1" qualifier? Why is he using evidence from a 1 to 2 month period that was over a year ago, and extrapolating out to "8 months of continuous contact time", rather than just telling us what happened during the past year?