Lazarus Long Profile picture
Jan 5, 2022 β€’ 10 tweets β€’ 5 min read β€’ Read on X
A quick thread on why elastomeric respirators are better than N95's.

In short? Like N95/N99 disposables are better than surgical/cloth masks?

Primarily, fit. Not that fit πŸ‘‡πŸ‘‡.

How it fits to your face.

For a number of different reasons that may surprise you.
First off, getting the respirator to actually fit to your face.

Not all facial geometries are the same.

The Fit Test Panels used to evaluate fit, I submit, do not have enough women or Asians.

Archived the pdf here:
web.archive.org/web/2022010510…

Study here:
tandfonline.com/doi/abs/10.108…
So, no surprise that with N95 disposables that πŸ‘‡πŸ‘‡

High - level:
web.archive.org/web/2021082422…

Direct Study Link:
web.archive.org/web/2021020313…
web.archive.org/web/2021082422… Image
Do elastomerics fit easier? Yes - because of the elastomeric material (another way of saying 'rubber-like', but usually made of medical grade silicone.

So when comparing the two, we find a huge difference:

With 60 subjects from the ASA, 98% of elastomerics passed fit testing Image
versus 57% of disposables.

And the single failed fit test for the elasto's? She switched from a medium to a small and passed.

web.archive.org/web/2021020313… Image
In this next study:
jamanetwork.com/journals/jama/…

87% of participants had experience with elastomerics or disposables.

Only 1.3% had experience with elastos.

So, they were largely experienced at wearing N95's.
Yet, after watching just a 9 minute video, 92% were able to successfully fit the elastos's vs 88.5% in the N95's that they were experienced at.

Let's move on.

Speaking of movement, elastomerics keep their fit much better during movement.

Do you move during your job? Cook?
Clean? Do things as manually involved as CPR?

Then you will want an elasto.

In jamanetwork.com/journals/jaman…

N95's performance during CPR was poor. (Filtering Face piece Respirator πŸ‘‡).

But elastomeric half-mask respirators' (EHMRs) performance was high.

This study confirmed Image
this next study, that CPR causes N95's to lose fit.

Their conclusion is stark and very real.

sciencedirect.com/science/articl… Image
Let's end on a light note.

Elastomeric respirators?

They let you keep fit and having fun!

With clean lungs!

β€’ β€’ β€’

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More from @LazarusLong13

Jun 10
Please explain how a study measuring physical improvement in a Cognitive and Behavioral study can have unmeasured Graded Exercise Therapy - and be considered as well-controlled. Not confounded.

So, I emailed Dr. Ebell and asked how that was nitpicking. Image
Image
I also agreed with the comments at the bottom of the study, linked below.

If you change analysis protocols post hoc? That's not nitpicking in my book. But maybe that is nitpicking?

jamanetwork.com/journals/jaman…
Science is ALL about nitpicking. You ARE SUPPOSED to be very detailed, so you can be replicated, right? Alan is funny.

Anyway, amusing to spot the lobbying group for the Lightning Process on their advisory board.

Tch tch. Or is that nitpicking. ;) ? Image
Read 7 tweets
Jun 1
A thread on airborne Ebola - the rest is accurate.

Let me emphasize that I agree far more than disagree with her, in general.

Declaring a thing debunked without actually debunking it, with facts, is not debunking.

So, let me debunk this. Image
Dr. Kuppila has excellent credentials, and has earned her laurels.

If we accepted the debunking of airborne Ebola on the basis of credentials, we would have given into the fallacy of appeal to authority.

:) not today.

She worked in an Ebola Treatment Unit in Sierra Leone,
coming back in December 2014, and now resides in Dallas per her very interesting StatNews article:



She did not get infected. We could have survivorship bias here - fortunately.

This is a reference to possible surgical mask usage by her.

You see, the web.archive.org/web/2026052103…Image
Read 22 tweets
May 28
Ebola - it's not all about respiratory aerosols.

DYK that you, and me, and everybody are Pig Pen from Charlie Brown?

We shed our entire outer layer of skin every 2-4 weeks, about 500 million cells daily.

Your corneocytes (outermost cells) lift off of your body with the
gentlest of micro-air currents. Like a leaf picked up off the ground for the briefest of moments in fall.

They act like 12 micron aerosols in float time, but 25% of total skin flakes are sub 5 microns...and you know what that means. Deep deposition - or shallow as
sub 5 likes to also deposit in the nose.

It's funny...I embrace push-back in debate. Tightens up my game.

Imagine if those skin flakes now have Ebola on them?

Two studies show that Ebola literally oozes through the skin - both ways. In and out.

Not shown in vivo, but
Read 10 tweets
May 23
The WHO forbids contact tracers from masking or gloving up.

"Do not conduct home visits wearing personal protective equipment like masks, gloves, or
gowns."

It gets worse. Do not conduct home visits wearing personal protective equipment like masks, gloves, or  gowns.
They have a handy how to reduce risk of catching ebola at home.

It even has 5 masks listed on it.

But not for the other family members.

"7. If the patient has vomit, diarrhoea or bleeding, a mask or a dry towel wrapped around the face can be used to protect the nose and mouth Image
7. If the patient has vomit, diarrhoea or bleeding, a mask or a dry towel wrapped around the face can be used to protect the nose and mouth when touching the patient or items soiled with blood or body fluids. A waterproof gown, eye protection, gloves and rubber boots should also be worn in these circumstances.
Here are the 5 face masks. Image
Read 9 tweets
May 22
The "epidemiology" of Ebola tells us that it's not airborne. You've heard this over and over.

What drives it? The questions on the contact tracing form.

Quick 🧡. Image
COVID - the WHO and CDC said it wasn't airborne via aerosols, right?

The CDC said it was spread person to person via close contact - within about 6 feet.



And you remember it took FOREVER to get changed.

The contact tracing form was web.archive.org/web/2020032817…Image
Image
arranged around close contact. These are the questions driving the stats of how many and how are infected.



So, the CDC will only hear back what it's asking. This was the epidemiology of COVID - until it wasn't. web.archive.org/web/2020052514…Image
Read 16 tweets
May 20
Speaking of silly, can we agree that the WHO has Ebola experts?

Let's talk about PPE, and a bias towards "less PPE is better." Image
The WHO EBOLA IPC guidance:


Foreshadow on PPE

"...due to the desirability of an off-
the-face design, and not for protection from aerosols, respirators may be used instead of medical masks"who.int/publications/i…
If you can stay 3 feet away while screening? No medical mask needed. Image
Image
Read 12 tweets

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