🧵It is now clear that we are going to have to get people to #MaskUp to get thru winter without US health care system collapse. #Omicron is way too contagious. #VaccinesWork & #GetBoosted, but they will not be enough on their own. So this thread is for people who hate masks:
2/X: If you hate masks because the ear loops make your ears sore, google "ear savers." That's the term I've seen used for various products that spare your ears w/ masks. Examples in pics, but if you can sew on a button, make some. What else are you gonna do in #quarantine?
3/X: You can get a beanie, headband, baseball cap, head scarf, whatever & attach button or hooks of any kind that you can get from any sewing store or online, & attach your mask loops to that. Ear pain solved! It's important to have a snug fit so try diff distances.
4/X: Not crafty? Etsy people have got you covered. If you don't like to wear hats/headbands indoors, there are tons of strap-like products that go around the back of your head to accomplish the same thing. Again just google "ear saver" or "mask extender" & you'll see a bunch.
5/X: If you just don't want to have a strap or anything around your head, putting some petroleum jelly behind your ears (& on your nose if you are wearing an N95 which can irritate it) will reduce chafing a lot & make it much more comfortable to #MaskUp.
6/X: If you don't like to #MaskUp because it shifts around too much, you probably have a poor fit. You want one you can keep on & keep your hands off of (remember: virus from air is on the outside of it, which is the point). Go to nonprofit @projectn95 & get a few to try.
7/X: If you don't like to #MaskUp because your face is small & everything has gaps, you are my people. I have had good luck w/ the 3M Aura N95 & the Respokare Antiviral N95 Respirator Plus, the latter being more expensive but having antiviral coating so I re-use it a lot longer.
8/X: (By the way, I have absolutely no financial conflict of interest or relationship with makers of any of these products. I'm just sharing what I've found to work on my small face after a ton of trial & error.)
9/X: If you don't like to #WearAMask because it makes you too hot, #thestruggleisreal. The best advice I can give is to get outside as frequently as possible & take some unmasked breaks. It's much safer outdoors anyway. #OmicronIsAirborne.
10/X: If you don't like to #WearAMask because it muffles your voice, an N95 mask that is thinner and/or that has a duck bill shape may help. We have used the Kimberly-Clark Kimtech N95 pouch respirator 53358, which is thin & has a duckbill shape. It makes me less hot too.
11/X: If you don't like to #WearAMask because it makes you look like a fool, well, here we are. #Pandemic, #wompwomp. But you can always choose to put a beautiful thin cloth mask, which really isn't protective enough on its own, OVER another mask. Magic! You're hip again!
12/X: If you don't like to #WearAMask because now you're trapped inside it with your bad breath, visit your dentist. It's important to keep up preventive health care like teeth cleaning & cancer screening. This #pandemic is gonna go on WAY too long to wait 'til it's over.
13/X: If you don't like to #WearAMask because it's creating a zillion tons of waste headed into landfills or the oceans or wherever, I feel you. Wearing a washable cloth mask over a surgical or N95/KN95/KF94 mask can help cut down on the # of disposable masks you use.
14/X: Tell me other reasons you hate to #WearAMask & I'll do my best to offer some solutions. I think we need a #MaskMandate. I have little confidence we'll get one & no delusions that it would be enforced or obeyed, so I think our best bet is to try to address people's concerns.
*I should add that the Respokare N95 comes in Medium or Large. The Medium is great for kid/small adult faces (I use that size as an adult. My face is petite enough I can wear some kid sized eye glass frames). The large fits most adults, but won't fit really big faces.
15/X: A last request: no fighting in my replies. If you think ppl should just #maskup, same. Trying to make it so. If you hate to #WearAMask & still don't want to, I feel you. No one is enjoying #COVID19. Certainly not #MedTwitter/#NurseTwitter. This is our ticket out. Get along.
*Note that this Kimtech N95 pouch respiratory 53358 would probably be a good choice for #teachertwitter. It's thinner & has a duckbill design, so it's less likely to muffle your voice (& less hot than some other N95 masks if you need to stay in it for hours at a time.)

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More from @tmprowell

20 Dec
🧵I have to say it: Christmas break is going to be bad. I'm watching confirmed #COVID19 cases⬆️ exponentially at our highly-#vaccinated school w/ a #MaskMandate & HEPA filters in every class. Make a plan now for how you'll handle Xmas & #quarantine when someone gets #Omicron.
2/ Think about how you can create a separate space for the person(s) infected. Remember #OmicronIsAirborne. Pick a rm w/ windows to open & its own door if your home allows. Today put a fan there that can be used to improve air exchange. Put a 🌡️, an O2 sat monitor, good masks.
3/ Go get a MERV13 filter for your HVAC at Home Depot or Lowe's or online. While here, get the stuff to build a simple, inexpensive, highly-effective Corsi-Rosenthal box. You can see what this is here. Build it now so it's ready.
Read 11 tweets
20 Dec
I’ve been contacted 2x just this wk—1 IRL acquaintance & 1 person I know only via Twitter—after they got imaging results in portal before their dr. They DM’d w/ screenshots, panicked, asking for help. I’m 💯 for pt access to #EHR, but #CuresAct implementation needs a MAJOR reboot
Whenever I have expressed concern about #CuresAct, #advocacy often tells me it’s still better. But it def was not better for these folks, nor for me dropping everything to help ppl who aren’t my pts, whose records I lack, & whose drs I don’t even know, i.e., it’s bad care. 😔
And I’m always happy to help patients, genuinely. I actually started using Twitter to be able to report out from #SABCS17 (I think) for #advocacy. But I don’t like providing bad medical care, & this is a set-up for doing so. We need a systems fix so pts aren’t left hanging…
Read 4 tweets
19 Dec
I know personally 3 people receiving monoclonal antibodies this evening. All have had 3 doses of #COVID19 #vaccine or prior infection + 2 doses of vaccine. All are careful. They all have risk factors, but all are pretty symptomatic. Jan is gonna be…rough. #MaskUp. #Omicron
Tweet 2: A lot of people seem to be panicking based on this anecdote. Panic is NOT productive. Instead you need to calmly plan & act to reduce your risk. These are some effective things you can do right now:
👉Upgrade your masks. No more cloth alone. Best is N95/KN95/KF94...
Tweet 3: As an alternative to N95/KN95/KF94, if you can't tolerate those or don't have them, I rec a surgical mask (ASTM level 3, 3-ply is great) w/ cloth mask over it. Read this: scientificamerican.com/article/why-we…. The non-profit @projectn95 has vetted, affordable PPE including masks.
Read 13 tweets
18 Dec
📢#HCWvsHunger Team #Feedalizumab! We know it takes a village in #MedTwitter, & it's time to make a move on the leaderboard. Announcing #MultiDFoodBoard merging #Feedalizumab, #BadBlood, #HopeAtTheScope, #RadsForFood, #HeartAttacksHunger, & #AmoxiChilin! 😎hcwvshunger.org/how-to-donate/
Your move, #KidVengers & #BladesNBougies. I told you not to count out #Feedalizumab. No one knows better than #OncTwitter how much it takes a village to care for complex patients. Heme/Onc/Path/Rads/ID/Cards--we need them all. Boom! GO merged team #MultiDFoodBoard😎♟️#HCWvsHunger
My only question is how far away people will be able to hear @kari_jerge, @MSharifpourMD, & @DrJenChen4kids when they see this tweet announcing the merger?🤔Go #MultiDFoodBoard. #HCWvsHunger
Read 5 tweets
16 Dec
📣#HCWvsHunger, the AMAZING Exec Chef at the Lord #Baltimore (& prev Ritz-Carlton), @chefdini, will be making homemade 🍩 at your Balt/DC worksite for 50 ppl (outdoors & brings minifryers) if you’re the next donor to give $1K+ to food bank for #Feedalizumab! Holiday party ✅! Image
Tweet 2/2: We’ll use the earliest official Google form time stamp on any $1000 or more donation following my tweet to determine the winner. Donate to any food bank first then log it here in 30sec for #HCWvsHunger #Feedalizumab. Must be Balt/DC area to win! hcwvshunger.org/how-to-donate/
Wondering what this is all about? Read more about Health Care Workers Vs. Hunger here. We’re taking care of you all during this #pandemic & we’ve raised > $550K since Dec 2020 to make sure people don’t go to bed hungry on our watch. #HCWvsHunger

Read 4 tweets
15 Dec
If you're confused about why #omicron is suddenly a crisis, it's exponential growth. Even if fewer people get seriously ill w/ this #covidvariant than priors (not clear, but hopeful data from #SouthAfrica), so many people abruptly ill with anything can grind the world to a halt.
With so many sick at once, you may lack school bus drivers, teachers, truck drivers to move supplies, grocery store shelf stockers, doctors & nurses, & so on. The world isn't set up for everyone to be sick simultaneously w/ #omicron. There's not enough redundancy in the system.
So even if NO ONE got seriously ill, but a large # of ppl were sick enough to be unable to work for a few days, it would be tough. Now add in that some % will get hospitalized, or die, of #Omicron. Even a small % of a very large # of cases is a big #. That's why we are worried.
Read 6 tweets

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