CDC has added a new line about use of N95 masks for the general public now that “availability…has increased”

We should have used the Defense Production Act last year to overcome the supply issue

But more importantly- we must ensure we aren’t caught w our pants down next time
2/ In May 2020 we wrote our first piece about how we can get out of this epidemic— a key part of it was ensuring the general public had access to #bettermasks

This was well before vaccines. This was when the debate was focused on ‘virus vs economy’

hbr.org/2020/05/a-plan…
3/ As the epidemic pushed on, @RanuDhillon & I both continued seeing patients and we almost exclusively utilized N95 masks for most of last year

But hospitals are often much safer than community settings

Better ventilation & everyone was being tested on admission
4/ Thus began our push for #BetterMasks for the general public — an idea that has been pushed by all of us but especially efforts by @sri_srikrishna who has been compiling & testing masks throughout the year

hbr.org/2020/06/we-nee…
5/ One of those— elastomeric respirators— showed exceptional promise with reusable design for protecting essential workers.

We pushed for these. We knew it was needed because these were our patients— the very people who couldn’t WFH / “stay home”

hbr.org/2020/10/essent…
6/ Later in the year, @drsanjaygupta brought our idea to the national stage, even pressing @CDCDirector & Tony Fauci on this during a widely viewed CNN townhall #BetterMasks

cnn.com/2021/01/22/hea…
7/ When Biden won, we tried to push this on a national level as a Hifi mask initiative given vaccinations would take quite a while to reach everyone

statnews.com/2021/01/07/nat…
8/ It took this long for CDC to say that N95s were a supply issue

They are better masks; much better than the cloth masks many have been using. It didn’t have to be that way. Also they have incl more promotion of fitters— which, when used w surgical masks- are also excellent
9/ As we have said so many times— access to excellent respiratory protection will be an ongoing issue.

Future variants, future respiratory threats— vaccines will take time to update

Better masks can be available immediately.

But— even seeing this small advance makes me happy

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More from @AbraarKaran

11 Sep
1/ This week I have treated multiple cases of #covid19 that were fully vaccinated several months ago; all were elderly & mostly immunocompromised. A few became quite sick.

A short thread
2/ This is a reminder: if you have high risk folks at home who were vaccinated near the start of 2021, it is worth being extra careful around them.

Avoid high risk areas of transmission; & if you must, then please wear a surgical mask or higher grade if you have it. #covid19
3/ While spread from fully vaccinated folks to others is unlikely, it’s not impossible.

It happens. And risk higher if community transmission is high; also highest indoors, crowds, poor ventilation
Read 6 tweets
10 Sep
On Biden #covid19 update- yes to vaccine mandates + paid time off for workers; yes to increasing rapid tests— but we need more on masks than increasing fines. Cloth masks are better than nothing; but that’s too low of a bar now

Need: Surgical masks + fitters; or high filtration
2/ Risk is dependent on where you are & who is around you

That’s a given but that’s also hard to control

Esp important for those with children or unvaccinated / elderly / immune compromised in their homes
3/ Important not just for now but for future variants, future respiratory threats

Has to be about more than fines

Must be about access and the right communication about why #BetterMasks are key for a virus primarily spread via aerosols #covid19
Read 4 tweets
7 Sep
Almost 9 months ago, @RanuDhillon @sri_srikrishna & I called for exactly this — that the federal government should take this into their own hands & ensure every household had access to high filtration masks.

statnews.com/2021/01/07/nat…
2/ And this was right when vaccines were beginning to roll out— it’s astounding that for most of last year, the gov asked unvaccinated Americans to just wear whatever they could find— including folding up a t shirt.

“Do-it-yourself” during the worst pandemic of our life time…
3/ Our call for better masks was not just for #covid19 at that time— it was because of concern for future variants (this was well before Delta)

And it is still for future threats, be they variants or completely novel pathogens

There is no reason not to ensure this safety
Read 4 tweets
6 Sep
I am actually shocked that Fauci is still saying “any mask” is good enough— this is not what the science shows, both in the laboratory & in a real world randomized trial

High filtration masks or even surgical masks provide significantly better protection than cloth masks. Period
2/ Ultimately the point isn’t Fauci or any one person— & it’s not even that some people wear no masks (that’s a separate problem). @mehdirhasan specifically asked about indoor venues & the differences between masks; the response basically deflected the question
3/ This disregards both the serious efforts to get people better protection; & the research that has gone into figuring out what better protection looks like. The correct response would be - yes, surgical masks provide better protection; N95s even better.
Read 5 tweets
3 Sep
1/ Fully vaccinated people who tested positive from a recent #covid19 outbreak infected fully vaccinated family members afterwards in new CDC MMWR

None became v sick— but brings up a key point about the potential for disease transmission from mild or asymptomatic vaxx’d people
2/ I think this is most important if/when you have immunocompromised people in your close social circles or family

If you need to be in high risk settings (indoor crowds), you should definitely wear a high-filtration mask to minimize your exposure during #covid19 surges
3/ There is a lot we still don’t fully understand about disease transmission from those who are fully vaccinated in terms of their transmission potential after each new #SARSCoV2 exposure (presumably much less than in unvaxx but unclear beyond that) #covid19
Read 4 tweets
3 Sep
1/ A patient recently confided how they were confused about vaccines & #COVID19 because they heard some doctors say yes while others said no— & to be frank, they are completely right.

Because of certain media channels amplifying fringe ideas, some patients are getting confused.
2/ We spent time explaining the benefits & risks, & were able to help them understand vaccines better. And ultimately they decided to get vaccinated. Our job as doctors now is to dispel misinformation, some of it unfortunately coming from people within our field.
3/ But the media outlets that are amplifying these dangerous ideas are also to blame.

Misinformation during a health emergency is catastrophic— & those channels perpetuating its dissemination are equally responsible.
Read 5 tweets

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