Thread by @_TheAncientOne_

The #mask argument has become a situation that's out of control. A thread 🧵

One side, people argue that they work and will bring the pandemic under control - just wear them! The other side, people argue they don't work - They're ridiculous for aerosols! (1/11)

Here's the problem, and why it is so polarizing - they're both right (and both wrong).

Confused? So is just about everyone (I even make these mistakes - guilty).

It is a false dichotomy. Arguing about masks will only continue to be divisive and is unproductive. (2/x)

You can amass an arsenal of many studies and experts in various fields stating they can and do work for mitigating transmission.

The same is also true of the argument against masks being effective for aerosolized virus. Many experts and many studies will say masks = bad. (3/11)

How do we resolve this? I propose we stop arguing, meet in the middle and discuss this as adults.

To that end, I will try to talk through what I see and understand by using an example near and dear to my heart - schools.

Masks in schools are the recent heated debate. (4/11)

Schools are a combination of great to very bad environments for preventing transmission. We won't fix the environments today or tomorrow or in the coming months in many places. So we must look at ways to mitigate risks. Doing nothing is accepting failure. (5/11)

If you put 20+ children in a crowded room without ventilation, wearing masks, that room will fill up with aerosolized virus over time & become an infectious environment. No doubt. Masks won't stop it, especially the #DeltaVariant. Pro-maskers hold tight. (6/11)

In this same scenario if you were to crack windows or, even better, clean the air with portable HEPA filtration units, the risk in that environment drops by orders of magnitude.

I can already hear the argument from the anti-maskers: "Then you need ventilation not masks." (7/11)

...Not so fast!

1 thing we know masks are effective at preventing is vapor (another major transmission route).

Change scenario: +Ventilation/-masks

1 infectious child coughing or talking loudly will make a 6 ft. localized, infectious environment wherever they are. (8/11)

...Add masks back and eureka! It is the combination that matters.

Masks by themselves do not work. Ventilation alone will not work. Both pro/anti-maskers are right (and wrong) depending on the nuances around how we communicate the use and where it is practical or not. (9/11)

There are of course, other layers that will help.

Distancing (not realistic in a crowded school)

Vaccinate 12 and +

Deploy daily rapid testing where outbreaks occur in schools (needs to be looked at ASAP IMO).

All of these things build on each other. They will protect (10/11)

So that's it. That simple. You're all wrong, and I'm wrong (and we're all right too). Let's stop arguing about this & solve this problem because our kids need us. Do you want to say you did everything you could to protect children in pandemic, or say you argued and failed (FIN)

For more on the false dichotomies of the pandemic, this is an excellent (pack a sandwich) read.

bmcinfectdis.biomedcentral.com/articles/10.11…

Pre-print - looks promising.

"Combined interventions (i.e., natural ventilation, masks, and HEPA
filtration) were the most effective (≥ 30-fold decrease)."

medrxiv.org/content/10.110…