Dr Greg Kelly Profile picture
Aug 15 17 tweets 4 min read
The 5 Fs of getting effective masks on the faces of your loved ones for #COVID19 protection in the real world

1 - Filtration
2 - Fit
3 - Feel
4 - Fashion
5 - Finances
1, Filtration

Refers to the % of potential covid containing particles (i.e aerosols) the mask material filters out. Cloth & surgical masks are unrated, untested & unpredictable but let’s be generous & say they filter 50%
But…because cloth and surgical masks are not designed or tested to filter reliably these numbers are highly variable - a well fitted surgical mask might be 80%, a poorly fitted cloth one 10%. There’s no real way to know
By contrast, N95, P2 & FFP2 are industrial products w long history of use that are designed, tested & certified to filter out a minimum of 95% covid containing particles even after a certain amount of time & use. <1/10 amount of virus

i.e they do EXACTLY what they say on the box
KF94 is Korean equivalent (us. well regulated) & KN95 is Chinese (unregulated but of course many good ones) + companies might also test to a standard and provide results but not be certifiable

nymag.com/strategist/art…
There’s an obvious opportunity to align certifications and make them understandable by people in the real world, even I have to look them up each time to avoid a typo
2, Fit

Even perfect filtration is ineffective if you have big leaks around your nose, cheeks & chin. I see tons of people wearing KN masks especially (good filtration) w big leaks around nose. We also know that many masks designed & tested by white men so fit others less well :(
Nose wire & cheek wings help masks fit. Do a visual fit check to see if there are obvious gaps and improve fit by bending nose wire around nose & tightening ear loops.

Everyone differs and you have to find something which fits you
Fit is an area where true N95s (which must have head bands) are likely to outperform ear loop masks (which other standards permit)

Note that any facial hair that sits under mask/face border is likely to be really harming fit

NB I’m not arguing for goatees to return en masse!
3, Feel

MASKS ONLY WORK IF THEY’RE OVER YOUR AIR HOLES (i.e mouth & nose, sorry chin wearers). But some are more comfortable than others, esp for long periods. Ear loops (esp if knotted) hurt my ears after a few hours & I’ve found some N95 head bands too tight. Comfort counts!
4, Fashion

Something we haven’t paid enough attention to & a HUGE opportunity for manufacturers. People care about how they look, even during a pandemic. I’ve got dozens of friends & family to wear Masklab KF masks because they look great, fit well & have huge choice (no COI)
Are here better masks they could wear? Yep, but these are the best masks that they WILL wear, for now, and are solid on filtration, fit, few and fashion so THEY GET WORN
5, Finances

We have thrown the poor (along w disabled, medically vulnerable, elders & kids under 5) under the bus (who’s even driving this thing now???) this pandemic in myriad ways. Avoiding covid takes privilege & is expensive. I’m really sorry this is the situation we’re in.
Having said that, masks are one of the cheapest personal measures you can take to avoid covid. You can get a good mask for $1-2, or places give them away. Most packets say “single use only” but that is for heavy industrial use. For daily covid-avoiding use they can last weeks
If you’re a privileged person, use it to help others get better masks. Buy an extra box or 20 & pass them on.

Shoutout to @VictorianCHO and Vic gov for recently announcing they are going to give away millions of better masks to the Victorian public
What do I actually do in my life?

I organise group buys of Masklab masks because my friends & family love them & actually wear them.

I have N95s which I can sometimes force on them for more high risk situations. Now I’ve found black N95s (by BNX) this will be easier
Obviously I haven’t even touched on N99s, elastomerics or PAPRs this thread, because focussing on what I can influence in my circles

Ps if Masklab wants to make a true N95 or someone else wants to make N95s that are that pretty I know some people who will buy 1000s

Just saying

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More from @drgregkelly

Jul 2
This should be a proper “oops” moment in our #COVID19 response, and quite possibly an “oh shit” one

Here is real world data confirming earlier predictions that the time between covid waves would progressively decrease

Why is this so concerning? 🧵
Briefly, waves grow when each infected person infects average > 1 person & end when each infects < 1 bc people got infected & either develop some immunity to that variant, die,or behaviour changes

Vax contribute to baseline immunity (that’s good) but prob too slow to affect wave
A new wave occurs when a new variant that is different enough from previous appears - which means that the average immunity is low enough (plus behaviour permits) each infected person to infect on average > 1 person, that wave ends as above
Read 8 tweets
Jun 30
It's dawning on me we're no longer fighting #COVID19 - we're fighting innumerable covids that are evolving along uncountable parallel evolutionary paths from original Wuhan strain

My non-viral-evolution-expert thoughts:🧵

Human time is meaningless to the virus - it's all about:
1) the number of generations since the original strain AND
2) each innumerable branch of SARS-CoV-2 phylogenetic tree evolving independently

Parallel processing - why our human-speed responses keep falling short
In addition, viral recombination events (not sure how common they are with this virus in particular but anything with a non zero likelihood will happen eventually with this many chances) could allow skipping 'ahead in time'
Read 7 tweets
Jun 18
Surely first time in history where 1-2% of such large, mobile, populations is getting infected with same virus EVERY WEEK

Given each infected person makes almost 1 trillion viral copies the opportunities for the virus to evolve are enormous & explain ongoing #COVID19 burden
Viral copy numbers here

ncbi.nlm.nih.gov/pmc/articles/P…
Such staggeringly large numbers mean that even the lowest probability worst case scenarios could eventually happen e.g SARS-CoV-2 combining with something with a much higher fatality rate like MERS.
Read 4 tweets
Jun 15
Thread on 2 months of use of a discreet home made portable HEPA filter aka "Pram-PAPR" using unmodified off-the-shelf equipment to put a layer of #COVID19 protection around our 6 month old baby
Despite some misinformed or misguided commentary earlier it is now apparent that #COVID19 is a potentially serious, even fatal, disease in all ages

Despite this, options to protect young children remain very limited
I'm aware of the enormous privilege that it takes to protect our baby from #COVID19 in this way and that this approach is neither equitable nor sustainable - it is FAR BETTER to reduce transmission & ensure a safe environment for all

Having said that - what were our options?
Read 18 tweets
May 27
We have genuinely tried "living with covid" in highly vaxed pop & is proving unsustainable for health system & economy

Time to try "living w less covid?"

NOTHING in "vax only" strategy game changer in near term. Boosters marginal at pop level, better (mucosal) vax uncertain 🧵
Our strategy in face of unsustainable situation seems to be:
1. Doubling down on what's not working (vax, necessary but not sufficient)
2. Hoping better versions of (1) come soon &
3. Changing testing / reporting & a PR campaign to convince everyone that things are actually fine
Of course, things substantially better than pre vaccines. Refrigerated trucks, mass graves & lockdowns are a thing of the past
Read 9 tweets
Apr 5
"Vaccines only" #COVID19 strategy w removal of other protections makes perfect if you hold 6 beliefs

Each belief WAS reasonable in 2020, yet proved wrong w time. Now, to maintain the idea that things are OK, each of these 6 beliefs must be defended with ever more vigor 🧵
I am completely serious that each belief was reasonable to hold at the start of the pandemic, and I myself held most of them. As we have learned more, I have changed my view, however many people have not and each of these beliefs has become a frontline in its own right - why?
I believe that cognitive dissonance explains a lot

...It is hard for us to admit we were wrong because this causes dissonance in our minds "I am a good person vs. I caused harm / I was wrong"

It is cognitively easier to change facts than to resolve the cognitive dissonance
Read 29 tweets

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