1/ As much as people push the “personal responsibility” narrative, so too should they remember when we were telling people to “stay home” when their very livelihoods depended on not staying home— the same low wage workers who ended up being the majority of patients we treated
2/ Personal responsibility to avoid getting infected with #covid19 - for many of my patients last year- ended when it meant they couldn’t get a living wage. For them, the decision was really health v health- w/ no good options.
3/ We are quick to view the lives & challenges of others through our own lens of responsibility- one that is often biased towards the privileges we have in our own lives. This is precisely how “stay home” became a social media movement early on by those who could stay home
4/ While they were well intentioned, my point is that we must be slow to blame, & more quick to understand for us to be able to solve complex societal issues. The idea of personal responsibility can quickly oversimplify the struggles & tradeoffs that face people in the real world

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More from @AbraarKaran

12 Sep
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
Read 9 tweets
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

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