2/ Earlier in the epidemic, @MonicaGandhi9 & Dr Rutherford from UCSF brought up variolation hypothesis as it relates to masking
Could masks have the benefit of reducing the viral load you are exposed to & could this potentially lessen severity of disease + prime immune system
3/ What is concerning now— if you pull back on mask mandates with high community incidence, especially in places with low vaccination / low booster rates
Lots more unmasked viral spread
Higher potential proportion of #LongCovid cases esp in these areas
More hospital-based spread of #covid19 during #Omicron than any prior waves. We knew this was a problem from prior waves— yet there is ongoing resistance to acknowledge it, to test for it, or do more to prevent it.
“The total # of people who contract Covid-19 while in the hospital remains unclear bc these figures only count patients who were in the hospital at least 14 consecutive days & don’t account for people who test positive after leaving.”
In our @JAMA_current piece, we lay out a few key reasons that hospital-based #covid19 transmission is likely underappreciated.
1/ few hospitals systematically test patients throughout and following their hospital stays. jamanetwork.com/journals/jama/…
2/ “Most hospitals only test patients for SARS-CoV-2 at the time of admission and therefore may miss some infections acquired after admission, especially because approximately 40% of SARS-CoV-2 infections are mild or asymptomatic and thus do not trigger repeat testing.”
3/ “Furthermore, hospital stays for many non–COVID-19–related conditions are short, so some infections will only develop after discharge and will be missed or misattributed to posthospital exposures”
1/ The biggest confounder in this study was the possibility that those who were more likely to mask in 2021 were more likely to only be doing lower risk indoor activities vs those without masks who were more likely to be doing higher risk ones.
2/ For example, it is possible that those who reported not wearing a mask indoors were also more likely to be eating indoors or drinking at bars indoors near others
while those reporting wearing masks indoor may have been shopping for essentials in less crowded settings
3/ Unfortunately, we don’t have that information (authors could run this analysis though)
We only know that those who reported always wearing a face mask were much less likely to test positive than those who reported never wearing a face mask
2/ The data in favor of using N95 respirators for shared air / public indoor spaces during surges will continue to grow. Those who are skeptics will eventually come around. But the time lag will result in many needless infections, hospitalizations and deaths. It already has.
3/ Limitations of studies are always important.
Authors mention: “First, this study did not account for other preventive behaviors that could influence risk for acquiring infection, including adherence to physical distancing recommendations”
Writing up a case report that makes clear that immunologic consequences of #covid19 even weeks after recovering can be devastating; it’s unbelievably frustrating how many people outside of medicine confidently assert that “you’ll be fine” when doctors cannot even assert this.
2/ Any doctor that has been regularly taking care of #covid19 cases over the past two years can tell you that what we have seen has surprised us. There is still so much we are learning. Ascribing to a strategy that allows for wide spread is irresponsible.
3/ I know that many folks are tired & over it. I am also tired as are many colleagues who still understand that reducing transmission and creating safer environments within which we work, learn & socialize is what we should be demanding of our leaders.