This is a false dichotomy.
Once you accept the possibility of aerosolized transmission/transmission by inhalation, you must strive for the highest grade of respiratory protection 1/
How to achieve that is a valid question considering we had been leaving in a droplet dogma world for long and respiratory protection has not seen as much innovation as it should have. 2/
That is not a reason to settle for leaky surgical masks, though. Wearing respirators for a long time can be difficult, but it is not a binary choice 3/
This is your actual field of choice - non-exhaustive.
Once you accept you need well fitting masks with good filtration, that opens up a whole world of options 4/
Use of a specific kind may be case specific. But leaky, ill-fitting masks for HCWs is not an option we should be accepting. 5/

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More from @akm5376

10 Sep
A quiet inclusion that #Covid19 is #airborne and trying to move on is not enough. It is okay to admit you were wrong if you want people to trust you ever again. Not doing so leads to unfair situations 1/
I am focusing on one such situation here that I shall refer to as droplet masking vs aerosol masking 2/
Masks under your nose - breathing, in itself also generates aerosols. It does not have to be big drops expelled from your mouth. So, cover both mouth and nose 3/ Image
Read 11 tweets
9 Sep
A short thread explaining #airborne precautions for a #layered approach of mitigation against #COVID19
Keep in mind that multiple layers is a key need. The more layers, the lower your risk 1/
2) Source elimination is always the first step we think of when dealing with an #airborne problem - no risk without an actual source in the space.
Again, these steps need not be perfect, but they reduce the chances of an infectious person being in the room.
3) Source control - when we cannot eliminate the source, we try to control it. It could be direct - like masks, use packed lunches, and it could be indirect like keeping a control on community levels using vaccination and surveillance like waste water testing
Read 6 tweets
17 Aug
Dose makes the risk - more the inhaled dose, more the risk of infection. These are screenshots of a slide deck made with pointers from @CorsIAQ and @ayushumd
A 🧵 1/
2) Risk of infection can be related to the inhaled dose. This helps to understand mitigation measures at a very simple and basic level. The slides were intended for high school students
3) Start with a dessert - in this case, an Indian dessert. If you are a bigger sweet tooth than me, you must want lots of spoons of sugar, right?
Read 16 tweets
10 Aug
A few days back, I posted this graphic that created quite some interest and confusion too. So, trying to put it together in more than 240 characters now - 🧵 1/ Image
2) The original idea came from ACGIH, trying to stress the point that essential worker, beyond healthcare, also need better masks, better respiratory protection.

acgih.org/covid-19-fact-… Image
3) Their assumption was that if without masks, it takes 15 minutes for a vulnerable person to inhale enough virus loaded particles to get infected, under the same conditions, how much can masks delay this time needed to reach infectious dose.
Read 12 tweets
30 Jun
Oh, thank you for disillusioning us. I thought modern medicine already had solved the problem of immortality and all of us were just too smug to consider it 1/
The problem with statements like this is they want to reduce medicine into disease care and forget about health care. 2/
If small measures like living in well ventilated spaces, wearing a mask when not feeling well, filtering air when there are pollutants can help keep people healthy, they are worth investing in, pandemic or not 3/
Read 4 tweets
30 Jun
Few days back, came across the thought that future generations will be surprised that we could manage a vaccine for a pandemic so quickly and yet could not manage equitable distribution for the vaccine. A 🧵 on potentially what else about the pandemic would surprise 1/
2) That it took so long for public health bodies to accept the fact that a respiratory tract infection, that can be exhaled by infected individuals, can also be inhaled by vulnerable individuals.
3) That the idea of #filtering the air we breathe (#masking) could be so controversial
Read 12 tweets

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