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Lazarus Long Profile picture
@LazarusLong13
Sep 20, 2021 • 12 tweets • 6 min read • Read on X
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Here's a true CoVid story from the Chicoutimi Hospital in Quebec, Canada. From catastrophe to redemption.

Huge outbreak of 400 employees over 2.5 months, directly linked to nosocomial infections. 70 HAI patients.
To be frank, at first the employees were blamed.

Because of overtime due to CoVid - but the employees were blamed.

lequotidien.com/actualites/dur…

Was that the end of the story?
No. The workers did not want to catch CoVid. They were careful.

See the quote below from Anne who caught CoVid below.

And the outbreak continued, until someone decided to test the ventilation.
Right now, you just raised an eyebrow.

"Why test the ventilation? It's not airborne!"

But, as you can see above, Anne was wearing her droplet protection.

So, here were the ventilation results as measured in CO2 (a decent aerosol stand-in).

Up to 1611 ppm. In a hospital!
So, what did they do?

Spent $200,000 to improve the ventilation (bring in exterior air) and bring in negative pressure rooms.
The ventilation improved, as expected. But it wasn't quite enough.

Why? Ventilation/ filtration solve far-field aerosols, but cannot act quick enough to remediate aerosols that are up close (near-field aerosols).

Those can only be remediated by airborne PPE.
In February, N95's were mandated.

ici.radio-canada.ca/premiere/emiss…
N95's are great - but they can be expensive if replacing them all the time, right?

N100 Elastomeric respirators, though - a little more expensive up front - but within a few days much, much cheaper.

Have these been deployed anywhere? Yes- at the Alleghany Health Network.
13 hospitals, 250 locations, 21,000+ employees.

Here is Dr. Chalikondra, CMO of AHN (ahn.org/about/leadersh…), talking about that roll-out:


Or here is a study that was done on that roll-out:
journalacs.org/article/S1072-…
Here's a cost-save calculator from MSA for elastomeric respirators over N95's:
webapps.msasafety.com/apr-calculator/

But besides the cost-save that will make you the hero of your administration?

You will be the hero to the HCW's under your charge. Why?
After the AHN roll-out, guess how many wanted to go back to N95's? 0.

facs.org/media/press-re…

N100's medical grade silicone is much more comfortable than scratchy N95 material.

And safer since they protect against 99.97% of particles vs. 95%.

cdc.gov/niosh/npptl/to…
What about the patients? Like anything new - it's just a matter of education.



My DM's are open for any questions that you might have - not just HCW's! Regular people wear N100 elastomeric respirators, too:

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More from @LazarusLong13

Lazarus Long Profile picture
Dec 20
Not sure what is going on with @HealthcareGlob1 - they sure seem to have it out for @NukitToBeSure.

They blocked me after I pointed out that they were incorrect. I could care less about being blocked.

I do care they did not address the issues I raised. 🧵
They retweeted this tweet from DisabledDoctor, which has numerous issues.

1. FARUVC has been safely
& extensively tested on the eyes. There are a rather large number of studies on the topic.

2. FARUVC will not cause AQ issues, besides a Yup. Not even considering the fact that she recommends using her far-UV devices in ways that are possibly unsafe (pointed at face as they are untested on eyes and in poorly ventilated indoor spaces where it is likely it will cause air quality issues leading to or exacerbating respiratory problems). She's harming vulnerable people while profiting off of them and she seems to give no fucks while somehow managing to get people to aggressively support her when she is (fairly) criticized. She's a master manipulator 8:08 AM 11 Sep 29, 2024 7,975 Views
negligible amount of ozone.

But that's not me saying that, but the studies. Two studies in well sealed rooms - about 5 parts per billion, 5 ppb.

If you are in a well sealed room, you would want that window cracked, anyway, right?

If not, and you are In summary, the two published measurements of far-UVC associated ozone in real-world settings, both around 5 ppb, are likely to be upper limits in terms of real-life far-UVC usage; this is both because of the far-UVC doses used in the studies, but also because both rooms were comparatively well sealed (respectively 0.4 and 1.4 ACH, see Table 1), whereas far-UVC will predominantly be used in public indoor spaces, which typically feature higher air-exchange rates.18 Overall it is reasonable to assume that far-UVC-associated ozone levels in real-life settings are extremely unlikely to exceed 1...
Read 13 tweets
Lazarus Long Profile picture
Dec 15
Got HEPAs and or a #CorsiRosenthalBox and still have VOC's?

(New furniture, left over smoke damage, odor, etc)

Welcome to @TheFandelier Quick VOC BUILD!

Goal below.
Slap filter on counter.
Slap fan on filter.
Slap USB adapter on fan.
Go.

/1 TruSens DuPont Odor & VOC Filter with True HEPA for Z-3000 TruSens Air Purifier with SilverStone fan.
THE FILTER.

TruSens DuPont Odor & VOC Filter with True HEPA for Z-3000 TruSens Air Purifier

This filter has more carbon than the others from this brand.

"The filter comes w/foam surrounds that make a seal w table and fan."

UPC is 038576802810

a.co/d/gcKIL5KBrandTruSens MaterialCarbon Fiber MERV Rating16 Compatible DevicesAir Purifier Item Weight1050 Grams UPC038576802810 ODOR & VOC DEFENSE : Activated carbon filter helps combat cooking and cleaning odors, and reduces airborne VOCs such as ammonia, acetone and formaldehyde. True HEPA filter captures common pollutants.
the Odor & VOC carbon drum has 3 layers of carbon
The link above will go dead eventually - that's why I am listing the full name above, so you can search for it.

THE FAN.

Silveratone AP183 140cfm is the one you want. The Silverstone AP 180mm is a great choice for the Maxx Core. It comes in a few flavors with varying price and cfm. They are all very sturdy. AP181 100cfm AP182 167cfm AP183 140cfm AP184 143cfm The 181 is very much slower than the others/cheapest. Get 183 if poss best bang/$
Read 15 tweets
Lazarus Long Profile picture
Dec 14
The CDC decides if you, the other patients, and your HCWs wear surgical masks, N95s, or no masks in hospitals. Where you go to get better, not sicker.

They obey the HICPAC, who voted for NO MASKS - based primarily on one study to justify it.

A 🧵 of an inadvertent giant lie? N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial
I suspect it's not actually a lie - except it kind of is. You read and decide.

The study is Radonovitch (2019). It was done from 2011-2015.

Back then, most everyone, including the authors 👇, thought respiratory viruses were primarily transmitted by actual large droplets. Respiratory viruses are primarily transmitted by large droplets. Because a fraction of respi- ratory viruses may be transmitted by aerosol, N95 respirators have been presumed to pro- vide better protection than medical masks against viral respiratory infections in health care settings.2 However, definitive evidence of
Design and Oversight This cluster randomized, multicenter, prag- matic effectiveness trial 16 conducted between September 2011 and May 2015, with final fol- low-up on June 28, 2016, compared the effect of N95 respirators, used as recommended dur- ing the 2009 H1N1 pandemic, 13 and medical masks, used as recommended to prevent sea- sonal influenza 17,18 and other viral respiratory infections and illnesses, among HCP.17 The in-
Would N95s really be worth the extra cost, if that was true? (No.)

The study was a massive undertaking. It was done at 137 sites, spread over 7 healthcare systems, 5 states and Washington DC.

The investigators were blinded to who had N95s and who had surgical masks. year of participation. Study intervention sites included outpatient settings at the Children's Hospital Colorado (Aurora), Denver Health Medical Center (Denver, Colorado), Johns Hopkins Health System (Baltimore, Maryland), Michael E. DeBakey Veterans Affairs (VA) Medical Center (Houston, Texas), VA Eastern Colorado Healthcare System (Denver), Washington DC VA Medical Center, and VA New York Harbor Healthcare System (New York). Sample storage and data analysis sites
Read 30 tweets
Lazarus Long Profile picture
Dec 14
There's a version of the "Had a bit of a health scare last night..." going around with laughing faces.

This is not that.

He went on to die the next day.

Short🧵 https://nationalpost.com/news/canada/montreal-man-dies-er-hospital-wait Montreal man, 39, dies from aneurysm after giving up on six-hour wait at ER 'Had a bit of a health scare last night, but thankfully it wasn’t a heart attack,' Adam Burgoyne said in a Dec. 5 post on social media. He died the next day Author of the article:Chris Lambie
He had no compassion for others, but I am not looking for compassion for him. Look, people can try the whole "you're so selfish!" routine to try to get me to wear a mask or stay home, but I couldn't possibly care less. Yes, I do care about my own life more than your 90 year old grandmother. Wish her all the best, but she's not my responsibility. 8:06 AM · Aug 31, 2023 · 3,517 Views Ⓐ @big_figgot · Aug 31, 2023 Wear all the masks you like, get 56 boosters this year and show the world how compassionate and virtuous you are by wishing death on everyone who doesn't think like you. Hiss and shriek at those who violate your 2m distancing bubble at the grocery s...
No, I just want to point out the failure of public health messaging here.

He goes after the Bangladesh study. A @big_figgot. Aug 31, 2023 ... The best they could do was the Bangladeshi mask study that showed only a 11% decrease in cases and only for people over 65 (IIRC - been a while since I read it). No difference in younger people. That was their best and they ran with it lying that it proved "masks work". 1 1 182 A @big_figgot. Aug 31, 2023 ... So EVEN IF we accept the results of the study which I find suspect for many reasons, it still doesn't justify the kinds of measures they were pushing.
Read 7 tweets
Lazarus Long Profile picture
Dec 12
@naomirwolf - if you want to avoid inhaling shed vaccines, then you'd be wise to get an N95.

You might be tempted to ignore this thread, but I have 5 years of experience of helping people get into respirators that avoid the problems you have mentioned previously.

/1
To paraphrase you, wearing an N95 is better than a surgical or cloth masks for protection.

/2

You mentioned that wearing a respirator can have some problems.

And it can....but let me go to the original source and, more importantly, show solutions to those problems.

Read 9 tweets
Lazarus Long Profile picture
Dec 9
@propublica - opening the window is not the only solution for formaldehyde.

In fact, formaldehyde is the most abundant VOC from fires. Like wildfires and wood burning stoves.

It is also found in tobacco smoke and automobile exhaust.

/1

acp.copernicus.org/articles/21/18…. x.com/propublica/sta…Formaldehyde (HCHO) is one of the most abundant non-methane volatile organic compounds (VOCs) emitted by fires. HCHO also undergoes chemical production and loss as a fire plume ages, and it can be an important oxidant precursor. In this study, we
Formaldehyde is also a byproduct of combustion. When burning natural gas, kerosene, gasoline, wood, or tobacco, formaldehyde is produced. Automobile exhaust is a common source of formaldehyde in our environment. Tobacco smoking in the home is another source of the chemical in the indoor environment.
A good rule of thumb? Open the window and smell smoke or auto exhaust? Formaldehyde.

Also, windows are at the edges of a room.

What if you want to hurry the process along and clean the air in the middle of the room, too?
Portable Air Cleaners with activated carbon filters will remove formaldehyde.

Here is Smart Air providing a very easy to read demonstration of this.

smartairfilters.com/en/blog/activa…
Read 6 tweets

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