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Abraar Karan Profile picture
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6 Jan, 5 tweets, 4 min read
*MUST READ*
This August 2021 technical bulletin by 3M is a must read— it covers all the questions you would have about respirators for the public; the limits of surgical & cloth masks; fit, filtration & more

multimedia.3m.com/mws/media/1791…
They even mention that FDA had approved 3M respirators 8612F and 8670F for an airborne infectious disease outbreak; they were discontinued “following a long period of inactivity”

We need some answers folks
Cc @chasdanner @zeynep @drsanjaygupta @JeromeAdamsMD @RickABright @DrTomFrieden
They also discuss fit in more detail. Unlike those who argue that fit is impossible without formal fit testing in the hospital, this guidance is more reasonable for the public/ accounts for our emergency situation. They provide info on doing a user seal check with the product.
Cc @MikePHager @margbrennan @ScottGottliebMD @emilylmullin @KatherineJWu @apoorva_nyc

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More from @AbraarKaran

Abraar Karan Profile picture
6 Jan
New JAMA piece by @drdavidmichaels @ZekeEmanuel @RickABright calls for many things incl respirators for all

First, thank you

Second, can you *please push the administration* to move on this?

This is no longer feels like it’s public health— it’s starting to feel like politics ImageImage
2/ there’s no way the administration hasn’t heard about the request for public respirators. Many of us brought this up since spring 2020. @drsanjaygupta directly asked Dr. Fauci & Walensky about this on @CNN townhall early in 2021

Something here isn’t adding up at all
3/ Preparation around public respirators goes back at least to 2008 with the 3M 8612F and 8670F models.

There were products ready to be scaled up and mass distributed. There’s no way this was a cost issue for the federal government.
Read 5 tweets
Abraar Karan Profile picture
6 Jan
I know there are a lot of amazing journalists covering #covid19. Can someone please look into this— this is from the 3M technical briefing Aug 2021 on their public respirator models where they mention 2 models from 2008 made for a pandemic crisis that were discontinued
2/ what happened to these— why was there no effort to scale up respirators for the public, ESPECIALLY if they already existed and had been approved for this purpose in the past?
3/ I can understand if these weren’t ready to go in March 2020– we were caught off guard. But between then & vaccines in December 2020, there were months without any action. Also, all of 2021– knowing vaccines didn’t provide sterilizing immunity— what happened?
Read 4 tweets
Abraar Karan Profile picture
5 Jan
1/ Transmission & infection are very complex dynamic processes

To cause clinical infection, need adequate dose of inoculum

Adequate dose depends on many factors, including
-proximity
-duration
-infectiousness of host
-symptomatology
-use of mask & which type
-ventilation
2/ Some of those factors are modifiable, but that depends on what you are capable of doing

You cannot control the infectiousness of random people around you, what viral strain they have, or what type of masks they have on (if any)
3/ You cannot (always) control the ventilation of space you are in (esp for necessities like travel or grocery shopping etc)

You can sometimes modify duration of time in a place or proximity to others, but often you cannot (public transit)
Read 5 tweets
Abraar Karan Profile picture
5 Jan
1/ Important Aug 2020 commentary from @CDCDirector in @JAMA_current on N95 masks

Even with suboptimal fit, N95 significantly better than unfitted surgical masks (let alone cloth)

This was pre-Delta, pre-Omicron

jamanetwork.com/journals/jamai…
2/ later in the commentary, authors refer to pragmatism around mask use and cite that N95 masks are suffocating and uncomfortable

Here, I disagree bc as mentioned there are many models; users should be allowed to decide

And user seal check is a very teachable process
3/ additionally they cite cost issues for consumers

I agree— which is why these masks should be made free during times of crisis or surges.

You should not have to go out and find the right masks

Please @CDCDirector - incorporate better masks into this surge & the next
Read 4 tweets
Abraar Karan Profile picture
4 Jan
Prevention today matters exponentially more than prevention tomorrow, esp in the middle a surge

Hospitals should not be dragging their feet on preventing in-hospital transmission

Many are patients who despite vaccinations can get very sick. We would know — we are treating them
2/ Mandatory N95 mask use for patient care should be initiated.

For hospitals that do not have capacity to do so, this should at minimum be initiated for the care of immunocompromised patients.

We have documented cases of transmission despite surgical mask use
3/ There are likely many more cases of this that are completely undercounted because most hospitals would not track/trace & sequence to confirm this.

But where they have, they have found it.

With transmissibility of #Omicron, expect to see this even more.
Read 4 tweets
Abraar Karan Profile picture
4 Jan
1/ This was a public email sent to all of Stanford healthcare from our CMO last week

With the #Omicron surge, we have had more healthcare worker infections than at *any week* in the entire pandemic

And this is at an awesome hospital w/ excellent testing capacity!
2/ Just imagine what the numbers are like at other hospitals, esp ones in big crowded cities

I doubt most hospitals are doing as much staff testing as we are, which means many HCW infections are going undiagnosed

We saw this all of last year too

This is a real issue
#covid19
3/ Mandating N95 masks for all healthcare workers right now makes sense— it can stop occult transmission between patients & staff

This is literally a no-brainer policy with insane community incidence of #Omicron!

Every single hospital should be doing this, now.
Read 4 tweets

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