🧵 Parents of teens looking for N95/KN95/KF94 masks that your teens will wear without complaint, I feel your pain. We are 2 drs w/ 3 teens. We obviously believe in high-quality masks, & we’ve struggled to find masks that fit well & are comfy enough for kids to wear all day. 1/x
Let me start by saying we have no relationship with any mask company, no one gave us any free masks, & no one asked us to review or recommend any mask. Our views don’t represent any employers. Tweeting here as parents & your kids may be different. 2/x
My teens (14, 16, 17) are both sexes & pretty average sizes, especially their faces (unlike their mom…I have a small face & can wear some kids’ eyeglass frames). We started trying the masks that we liked or had ourselves. 3/x
For my small face, I have found the Respokare N95 (size M) to be a comfy mask that I can put on & not need to adjust, & it’s got antiviral coating. It was too tight on them. Size L fit them width-wise but was still too long top to bottom, so would be 👍 for a long/wide face. 4/x
The antiviral coating has kind of a vinegar smell. I don’t mind it. It kind of reminds me of salt & vinegar chips. But one of my kids who is sensitive to smells & textures etc found the smell to be a dealbreaker. May not be a good choice if your kid is the same. 5/x
It comes only in light blue & straps go around head.
We also tried the 3M Aura N95 mask, which seems to be avail all over. We bought it directly off the 3M website, but I know many have found it in the paint aisle of HD, hardware stores, etc. It comes only in white.
6/x
It fits all 5 of us well, despite a pretty dramatic range of face sizes, & we all get a good seal, so if you had to go grab N95 masks for a ✈️ or something & hope they fit, it’s a 👍 bet. The nose wire is covered by soft rubber inside, which makes it comfy. Straps go around head.
Our kids have worn it for higher risk things where I was very worried about aerosol, like singing, & it doesn’t muffle voice, but straps are tight. They wear it w/o complaint it for 2-3 hrs, but all agree they would find it tough to wear for a full school day, day after day.
8/x
My kid who hates anything too tight from clothes to masks finds it too tight & will only stay in it for 20-30 mins before insisting on changing it. Many HCWs wear the Aura at work, so it CAN be worn all day, but the efficacy of a 😷 that’s not worn is 0%. Know your kids.
9/x
Since our kids felt those masks were too short/long, tight, or vinegary, we tried the Kimberly-Clark Kimtech N95 pouch respirator 53358. It comes only in white & has straps around head, but they are a soft kind of fabric, not rubber, so they don’t pull hair whatsoever.
10/x
Because they are thin & have a lot of airspace in front of the mouth, they also get less hot/humid & don’t muffle the voice at all. I thought that made them a slam dunk for school. Alas the teens feel they make them look the most ridiculous of any mask we’ve tried. Sigh.
11/x
They’re still extremely comfortable & affordable. My teens agree you could wear it all day & forget it’s on. (Except for people pointing at them.) A good 😷 for a teen who just wants comfort & doesn’t care if they look different. A good 😷 in home isolation for same reason.
12/x
And finally we tried Powecom GB2626-2019 KN95 mask. It comes in white, black, or pink, & has both ear loop & strap around head style. We got the ear loop one, & all agreed it was very comfy on both their faces & ears. The mask is closer to the mouth than any other.
13/x
But they didn’t find it bothersome. No one found it too hot or humid. No one asked if we were done yet. It’s also pretty affordable at ~$1 each, & it has scratch-off w/ a unique code on each bag you check on their website to know it’s legit (KN95 counterfeits are an issue).
14/x
I suspect part of why they like it is that it’s very well-fitted to the face, but not nearly as tight as a true N95 w/ headstrap is designed to be. It’s the only non-N95 mask we tried with them, & the only one with ear loops. It’s possible they’d like any KN95 just as well.
15/x
Nonetheless all are happy with this one. Being less tight, it’s prob less protective than one of the true N95 masks we tried, but I have far greater confidence they’ll keep it on, which is its true test in the real world. One of them liked it enough to give some to friends.
16/x
Lots of these masks are available via the nonprofit @projectn95, where the people are available 365 days per yr & so helpful if you’re having trouble finding a good match for yourself or your family. They’re affordable too, even without buying a truckload.
17/x
We’ve seen others available via the US-based family-run @BonaFideMasks, which began selling 😷 in 2020 at request of a community org. If you are buying KN95 masks, you should know that up to half of these in the US have been found to be counterfeit. I would strongly suggest
18/x
That you buy these from a place w/ a reputation for vetting its products carefully. Read the About Us section of the website. Or buy a brand that includes a scratch off # or QR code on the bag to enable you to verify the KN95 authenticity on the manufacturer’s website.
19/x
This article is helpful to identify reputable sites: scientificamerican.com/article/why-we…. If you buy KN95 masks in a store, ask the manager where they source their products from. If it’s not the manufacturer directly, might be best to steer clear.
20/x
If you’re still with me, on tweet #21, I think, at midnight on a Friday, you get a 🍪. Parents of teens, drop recs for other high-protection masks your kids like. They may not love to #WearAMask, but #schools will NOT succeed during #omicron w/o them.
Finally, we didn’t try any KF94 masks (the South Korean equiv of our N95; KN95 is the Chinese equiv). We’ve heard of KF94 masks w/ same shape as the 3M Aura & adjustable ear loops that many people say offer a great fit & comfort, but never any in stock, eg Bluna Facefit.
22/x
And finally, a surgical mask that you tie & tuck per this CDC demo () w/ a 😎 cloth mask over top is far better than either alone if your teen just won’t do an N95/KN95/KF94. Most important msg: we’re SO much safer w/ #Omicron when we all #MaskUp. 👇
#MedTwitter
There is a widespread outbreak of #norovirus, a GI virus that causes projectile vomiting & profuse diarrhea usually lasting 24-48 hrs. Wastewater levels nationwide are high. It’s miserable & incredibly contagious. So many friends are texting us SOS, so here’s a 🧵. /1
Norovirus spreads when as few as 10 viral particles get in the mouth. This happens via direct contact (eg, kissing), contaminated food/water, or touching contaminated surfaces (countertop, toy, soiled clothes) then mouth (eg, toddler toys in mouth, eating by hand, nailbiting). /2
#MedTwitter
Given how contagious #norovirus is & how it spreads, it is like a brushfire in close quarters and/or where common items are handled by many. Cruise ships are famous for outbreaks, but also daycares/schools, dorms, dining hall/salad bars, nursing homes, jails, etc. /3
🧵 #MedTwitter IMPORTANT
The case of this 🇨🇦 adolescent with #H5N1 #BirdFlu is terrifying. Her only medical history was mild asthma, & symptoms started w/ fever and conjunctivitis. On d5 from symptom onset, she was admitted in respiratory failure, kidney failure, in shock … /1
Despite 3 antivirals (oseltamivir, amantadine, & baloxavir) to which her virus appeared to be susceptible & plasma exchange (three times !!), she spent 2 wks on ECMO and almost 3 wks on a ventilator and was dialysis-dependent. She survived. Let her be a warning, #MedTwitter /2
In an H5N1 outbreak, if even a small % of people get so sick, hospitals are in trouble. If a #H5N1 virus gains ability to spread btwn humans & enters widespread circulation, humanity is in trouble. No amount of #publichealth effort or cost to prep for #BirdFlu is too great. /3
#MedTwitter
NEW Analysis of 641K hospital admissions in 3.5y finds ending universal masking & #COVID19 testing was assoc w/ a 25% ⬆️ in hospital-onset resp viral infections (w/ longer stay & ⬆️ mortality) & resumption of universal hospital masking with a 33% ⬇️. #WearAMask /1
#MedTwitter
The ⬇️ in respiratory viral infections w/ universal masking included #COVID19, #influenza, & #RSV: .
We need universal masking in hospitals, especially now when #SARSCoV2, #flu, & #RSV levels are high nationwide based on wastewater testing. /2 ja.ma/3Z5fdn7
#MedTwitter
The study didn’t assess #longCovid (LC) risk but given that preventing #COVID19 is the only reliable way to prevent LC, universal masking in hospital would likely also ⬇️ LC risk. In my opinion, lack of universal masking should be a hospital quality measure. /3
President Jimmy Carter died today at age 100, having lived w/ melanoma that had spread to his brain & liver for >9y. I grew up in GA admiring him, so as an oncologist, I’d like to honor his life by teaching you a bit. #melsm #MedTwitter
First, the ⚠️ signs (ABCDE 👇) & pics
/1
It’s important to know who’s at ⬆️ risk for #melanoma (see 📸 ).
UV exposure (☀️ or tanning bed) is the major risk.
Having 5 sunburns doubles your lifetime risk of melanoma. Age matters. Even ONE blistering sunburn as a kid/teen doubles lifetime risk!
🔑 AVOID BURNS! /2
People with dark skin can also get melanoma (though they are at much lower risk than people with fair skin).
And #melanoma can appear in unusual places including some you might not expect like your nails or even areas that get little or no sun exposure. /3
NEW 📣 Nat’l study in #Sweden: 86% of people on sick leave due to #COVID19 in wave 1 of #pandemic still had symptoms 18m later, esp fatigue, cognition, sleep, movement. Risks higher if hospitalized or female. Vax didn’t exist then.
#MedTwitter #LongCovid
The study also found nearly half of respondents also had problems w/ functioning in daily life 18 mos after they were infected w/ #COVID19. That is #LongCovid. This is a stunning number.
Sweden never had a full lockdown or mask mandate in wave 1. /2
#MedTwitter
With this approach, #COVID19 deaths were noticeably higher in #Sweden than in neighboring countries with more precautions. For example, see this graph from ABC based on a Johns Hopkins analysis of the region. The King said: “I think we have failed.” /3 au.news.yahoo.com/leaders-tragic…
NEW Longest prospective study of #LongCovidKids: 1.3K kids who tested pos for #COVID19 were followed up to 3y. Of note, 89% of cases were “mild” & 9% had no symptoms, & 80% had zero doses of vaccine. Mix of variants, but most were Omicron then Delta. /1 thelancet.com/action/showPdf…
Sadly, 23% of kids had #LongCovid at 3 mos. While #s fell over time, 13% at 6 mos, 8% at 1 yr, 6% at 18 mos, & 7% at 2 yrs still had #LongCovid. This is tragic, both because it means that 1 in 12 kids are still suffering a year later, & most of those remain ill longer term. /2
Adolescents/teens were at MUCH greater risk than age <12, as were those infected by earlier variants. Females & those w/ comorbidities were also at slightly increased risk. Infection w/ orig variant resulted in ⬆️ autoimmune disease. Vaccination reduced risk of #LongCovid. /3