1/ Controlling the epidemic such that we don’t have surges & keep infection levels low doesn’t hinge on any one solution but the combination of many, done right
We have pushed for #BetterMasks with the expectation that only some people will wear them. But that this still matters
2/ No intervention will have 100% uptake
And every intervention has benefits and costs to the individual (diff for everyone)
Rapid tests, HiFi masks, vaccinations, air filtering products, avoiding social gatherings etc etc
Goal is to avoid surges, not elimination of virus
3/ When we have infection surges, the benefits of each intervention grow even more, relative to their costs
The combination of these tools applied at the right time by enough people can stun epidemic growth
But they require coordinated leadership & public buy in
4/ They also require adequate supply & ease of use to minimize disruptions/costs & maximize user uptake
As I’ve said many times, US epidemic response failure is largely a matter of weak uncoordinated implementation in a very culturally complex country
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"Our results also suggest that the use of FFP2 masks should be preferred to surgical masks, as even loosely worn FFP2 masks can reduce the risk of infection by a factor of 2.5 compared with well-fitted surgical masks."
2/ "IN CONTINENTAL EUROPE few people now wear cloth masks as protection against covid-19. Instead, they don surgical or, increasingly, FFP2 masks, a highly efficient medical grade. Meanwhile, in Britain and America, FFP2 coverings are less common." economist.com/the-economist-…
3/ "And rather than hoping your cloth mask will have you covered, come prepared with surgical masks and N95s as well. For example, you need N95s,KN95s or FFP2 to ride public transport in Germany."
The single best way at an individual level- even once vaccinated- to prevent infection is to upgrade the mask you have and make sure it is on when you are near others in public, esp indoors
Tight fit, high filtration. We can’t wait for the government on this
There are a number of folks who have done extensive research into different brands of masks tagged here: please share on this thread
2/ For those new to the #BetterMasks push, it has been something we have been yelling for a long time
Last year we argued for Biden administration sending high filtration masks to people’s homes or make them way more accessible & free statnews.com/2021/01/07/nat…
One thing we learn as doctors early on is that being able to place your health as your number one priority in life is a privilege afforded to very few of the patients that end up hospitalized
If we approached #covid19 policies w this in mind, we could meet people where they are
2/ Put another way— do not assume that people that got sick were being careless
For many, the need to feed themselves & their families will come above avoiding infection
Failing to help them is a failure of the system, not the individual
3/ We saw this early on in the epidemic.
The people that could work & tweet from home did so.
Many of the people that ended up in the emergency room didn’t have that luxury. #covid19
1/ "Masks reduce transmission risk by decreasing the quantity and velocity of respiratory emissions and increasing their dispersion. They do not eliminate trans- mission risk, however, because pathogen-laden aerosols can enter or exit the gaps between masks and faces"
2/ Again-- why *fit* is so critically important
The fit on N95 masks is better than ear loop masks. The latter can be augmented using mask braces @FixTheMask
In the hospital, we undergo fit testing for N95. Can approximate this in the community too
3/ Not completely fool-proof but one quick measure could be to check on how much glasses are fogging as a very general estimate of how much you are exhaling (& potentially inhaling)
In hospital, I use this to re-adjust my own fit as well
It’s a lot of the same excuses we have heard in global health for decades…
When it’s really about profits
We have to recognize that all the noise is gaslighting by pharmaceutical companies & everyone they own
2/ “People are hesitant anyways”
“other companies can’t make these vaccines”
“Tech transfers are too complicated”
“Supply chain is too difficult”
The list is endless but I don’t think any of it is true
If the money was there, it would be done …like two years ago
3/ Honestly— it would be easier if the Bancels and Bourlas of the world just said “yes we are going to sell to the highest bidders— we don’t care about anything else”
Then we could start realigning the system; &/or finding other ways to hold big pharma accountable