My wife & daughter traveled to @sickkids @SickKidsNews today for an appointment.

Several lapses occurred at screening. Most egregious:
They were made to remove their CA-N95 respirators for the blue surgical mask, shown below.

Let's go through all of them: /1 Photo of left hand holding ...
Your policy is to protect everyone, especially those at higher risk of COVID-19. How is downgrading masks consistent with that? What is the "right" amount of protection, anyway?
My wife and daughter were NOT offered the option of masking overtop. /2 Several extracts from unive...
Health Canada:
"If you're at higher risk, it's even more important to consider wearing a respirator if one is available to you"
"Respirators are designed to fit snugly on the face, which may allow for a better fit than a medical mask" /3
canada.ca/en/public-heal…
Contrary to your policy, after being made to remove their respirators, my wife and daughter were NOT given instructions for how to put the mask on properly. They were also not asked to clean their hands a second time. /4 Where will I get a mask whe...
So, they are asked to remove their well-fitting respirators (Health Canada advice) and instead wear a mask that has inherent gaps, without explanation on how to wear it or fit it in accordance with your instructions: /5 How can I be sure a mask fi...
Have you considered the benefits of sourcing Canadian-made kid's respirators and providing them at screening entrance, @SickKidsNews? That would be amazing. There's even a new CSA Standard for respirators! It includes a breathability label! /6 csagroup.org/store/product/…
Omicron is barreling towards us.
Sick Kids has young patients, many have had only one vaccine dose, or none, and potentially higher risk. The Universal Making policy is weak for its stated purpose, and enforced in a way that makes it worse. You can do better! Will you lead? /7
There's been many replies about being assertive. Our daughter has an intellectual disability. It was a great success when she finally accepted CA-N95 over cloth. The hospital visit is stressful enough; disagreement would cause her to shut down and is counterproductive. /8
Perhaps this masking policy application issue should be brought to the attention of Risk Management department @SickKidsNews. /9
@SickKidsNews Be more like Trillium Health Partners. Visits there have been both safer and less stressful because of a reasonable more equitable, and inclusive policy change. /10

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More from @DavidElfstrom

9 Dec
Swiss study finds SIX TIMES the cases in poorly ventilated classrooms (those with over 2000 ppm CO₂) compared to better-ventilated ones. #COVIDCO2
#Ventilate2Educate #COVIDisAirborne
H/T @SamJCauston
swissinfo.ch/eng/society/st…
More details on the Swiss CO₂ classroom study here: empa.ch/web/s604/covid…
For those school administrators who say “we have a ventilation system, it meets or exceeds ASHRAE standards”—That's not enough. You MUST monitor #COVIDCO2. My daughter's fully ventilated classroom, from her backpack monitor, yesterday vs today:
Read 7 tweets
9 Dec
While #Ventilate2Educate is geared towards schools, we can #Educate2Ventilate with simple directives for small businesses & organizations. Simple low-cost changes can make for an enormous indoor air quality improvement. Low-rise small commercial buildings are everywhere. Simplified schematic of small business rooftop unit: Maximiz
These simple ventilation actions and more are described on the CDC's Ventilation in Buildings Page: cdc.gov/coronavirus/20…
Idea for a local Business Improvement Area #Educate2Ventilate campaign: Team up with a local HVAC contractor and visit all the storefronts with a CO2 meter to promote simple changes to improve indoor air quality. Add energy efficiency measures too.
Read 5 tweets
7 Dec
Uh oh @GEDSB. My daughter's classroom was doing well in the fall with CO₂ levels below 800 ppm, so I stopped sending the logger. After my presentation last night with @DFisman, I decided to check it again. #COVIDCO2 /1 Levels below 900 ppm until ...
This is a school with full mechanical ventilation. This room is centrally provided so air is shared with other classrooms.
Filters have NOT been upgraded to MERV-13 or better.
HEPA is only in the rooms required by the province. Not in this classroom. /2
The relative humidity is low.
The entire school day it was 25%–28%. WHO & CDC recommend 40%-60% for SARS-CoV-2, Health Canada recommends 30%–50% on account of our climate & buildings. /3
Read 8 tweets
25 Nov
Genome sequencing analysis shows spread of new variant in HK in hotel quarantine between suites across from each other when the air flowed to the corridor. Here we go again—no amount of positive pressure in the suite is acceptable. /1
h/t @nzm8qs news.gov.hk/eng/2021/11/20…
If there is a 5 Pa positive pressure difference between the suite and the corridor, air will shoot out under the door continuously at an average velocity of 2.1 m/s (higher in the centre). No open door required. For a 10 mm bottom door gap, that's 19 L/s (40 CFM) of flow /2 Graph of average velocity (...
I verified the calculations with measurements in an earlier thread, illustrating why NSW Australia's IPAC guidance for quarantine hotels allowing up to +5 Pa was ridiculous and ignorant of physics: /3
Read 4 tweets
7 Nov
#corsirosenthalbox flow tests for Lasko 3733 and 3M Filtrete 1900 20x20x1 filters.
Shroud optimization: 20 cm radius (15.75" diameter) /1
Effect of shroud size on outlet flow. Having a shroud is important, but don't stress over it. Without it, air flows backwards at the corners instead of through the filters. /2
The supply voltage makes a difference! Fan speed changes linearly with voltage. Here's the flow range for the accepted 110-125V variation of the nominal 120 V North American distribution supply: /3
Read 10 tweets
5 Sep
Canadian Aerosol Transmission Coalition calls on federal party leaders for stronger, consistent COVID-19 protections:
1⃣Messaging on aerosol transmission and airborne protection,
2⃣clean air ventilation standard,
3⃣HEPA filtration, and
4⃣respiratory PPE. /1
Remember the prescient quote by the late Justice Archie Campbell, head of the 2003 SARS Commission:
📢“If we do not learn from SARS and we do not make the government fix the problems that remain, we will pay a terrible price in the next pandemic” /2
The Canadian Coalition on Airborne Transmission is a multi-disciplinary group includes physicians, health scientists, ventilation engineers, respiratory protection specialists and occupational health professionals. 6-minute video: /3
Read 13 tweets

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