Know someone having a baby soon? CONGRATULATIONS! 🍼🍼🍼

As hospitals drop universal COVID protections, these are my top 7 tips for protecting unmaskable un-vaxable newborns from #nosocomial (hospital-acquired) COVID.

What did I miss?

THREAD of Top 7 Tips 🧵
Tip #1 – Determine your #mask rules. Some parents require staff to #N95. Compliance would vary by region/hospital. Prep for what you’ll say if staff don’t comply.

With our newborn twins, we supplied medical staff w/free N95s & tests. Nobody wanted N95s; 1 took a #RAT. 🤣
Tip #2 – U.S. hospitals SHOULD have excellent ventilation (air cleaning) by reg. But HVAC repair doesn’t have a CPT code. Many of my best & worst air quality readings are from hospitals.

Consider buying a #CO2monitor, read on that hashtag, & follow @joeyfox85 for basic tips.
Tip #3 – Bring 1-2 large #HEPA filters. Your GOAL is to keep them plugged in. When someone says they must unplug them, have a plan!

When told to unplug our HEPAs, I demanded to speak to the building engineer (too busy to ever show up) & …
Tip 3 (cont) – talk to the 'patient advocate' BEFORE letting anyone unplug the #HEPA.

If anyone unplugged my HEPAs, I would have kicked them off the care team, trashed the hospital on social media, called the news and a lawyer, and started picketing outside.

Have a plan.
Tip #4 – W/all the unmasked ppl roaming medical facilities, build a #PAPRbuggy/#HEPAbuggy to keep babies safer when leaving & for their many well visits.

I began testing designs in March. Read my empirical report (under review, see link to pre-print).
Tip #5 – Protect yourself. Get the bivalent #booster. Discuss nuance w/OBGYN/PCP. Mask well. Set vax & mask rules for any fam visitors.

I wore N95s >99% of the time in the hospital & my partner did except for meals (after a HEPA cleaning delay). Mask while sleeping.
Tip #6 – Develop testing protocols for fam who may visit in or after the hospital stay. I’ve administered hundreds of tests (RATs, PCR, antibody), talk about boogers, swab tactics, etc.

No family sees my babies w/o getting tested. Determine what’s right for your fam context.
Tip #7 – Give yourself grace. Health systems have little understanding that #COVIDisAirborne. The WH, CDC, and much of America are living in #delusion-ville while a 9/11 of ppl die each week. Whatever happens, you did the best you could.

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More from @michael_hoerger

Sep 13
Such a proliferation of useless #COVID "treatments," now nasal irrigation.

If a virus kills millions of people, a useful treatment would be published in a journal with impact factor >20, not 1.7.

journals.sagepub.com/doi/full/10.11…
The study gave people nasal irrigation and compared it to CDC data on hospitalization and death rates.

Not everything must be an RCT, but the purpose of an RCT is to compare two equivalent groups so that the observed differences can be attributed to the treatment.
Since this is not an RCT, the people in the nasal irrigation could have easily differed from people in the CDC normative sample.

Specifically, people who sign up for studies are often less ill. If they are less ill, they see better outcomes regardless of the "treatment"
Read 4 tweets
Sep 13
Do you know any #parents looking for better #masks for their kids this fall?

Check out all the helpful comments on this Tweet.

Best for many: @flo_mask & 3M Vflex 9105s
Popular: WellBefore, Powecom, Lutema, Vitacore

1/3
The child #MentalHealth clinic I was helping out ended up purchasing the WellBefore masks. Useful in this context b/c they needed disposables in plenty of different sizes.

The clinic runs somewhere between 12-18 ACH to help w/ imperfect mask fit.
2/3
When @vitacoreinc heard about this, they donated >200 CAN99/CAN99e masks to the child mental health clinic!

Very kind. Thanks for supporting child mental health in New Orleans!
3/3 masks for children
Read 4 tweets
Jul 19
Top 10 tips everyone should know about wearing #N95 & #elastomeric masks.

What did I miss?

THREAD! Image
Tip #1: Masks buy time. Context matters too: Ventilation (HVAC/outdoor air), filtration (HEPA), & ⬇️ people buy more time.

The longer you’ll be someplace or the worse the context, the better the mask you’ll need.

In a “typical” setting, you might expect this (per @akm5376): Image
Tip #2: If you’re going to be someplace a long time (home, office, hospital, wedding), open windows, add #HEPA, turn HVAC from ‘auto’ to ‘on' & do testing.

BOOM, you just improved your mask. Better context = less work for the mask.

Read 12 tweets
Jul 14
Kids <2 yrs old can’t mask.
Kids <6 months can’t vax.

Many parents are using strollers w/rain covers to try to get some protection during essential activities.

Does adding a #PAPR or #HEPA device help?

I tried 6 models: engrxiv.org/preprint/view/…

#PAPRbuggy #HEPAbuggy
1/10 Image
First off, thanks @RealSexyCyborg for the original design. Thanks to @ccwake1, @gjmf, @drgregkelly for ideas too. Happy to acknowledge!

My goal was to test 6 models & help relate them to non-engineers.

2/10

The PAPR & HEPA buggies I tested had an estimated 57-951 air changes per hour (ACH) in these TINY spaces. The worst design had about 3x the air cleaning of an OR.

You can make a #PAPRbuggy that’s super discrete for about $110 more than an existing stroller & rain cover.

3/10 Image
Read 10 tweets

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