I made a new graphic representing my current gist-level representation of the #SwissCheese Model of #COVID mitigation.

In your mind, how do you organize the categories differently? Is there something else you prioritize?
1/5 Swiss Cheese model of COVID...
My mental model of COVID mitigation differs from others in that it gives more weight to secondary and tertiary prevention.

The less the Western world focuses on the first 8 slices of cheese, the more we will need to focus on the final 2-3 slices.
2/5 Secondary and tertiary prev...
In my #SwissCheese model, I debated how many slices to devote to masking & clean indoor air. Huge weapons. Masking is simple but w/plenty of nuance (mask selection, distribution, fit, duration). Clean air includes ventilation, filtration (CR boxes, HEPA), UVC, fluid dynamics
3/5 Masks and IAQ. Bigger slice...
You'll note that I couldn't fit "hand washing" within the most important dozen slices of my #SwissCheese model of #COVID mitigation. Nor hand sanitizer. Nor plexiglass.

I find these to be distractions. Yes, wash your hands, but not to avoid breathing viral-laden aerosols.
4/5
My #SwissCheese graphic works well for a Twitter banner. Feel free to use it. I'm sure I'll update it a bit more based on smart comments on what I missed.
5/5 Swiss Cheese profile banner

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More from @michael_hoerger

Sep 26
Empowered communities want free #N95 masks!

Our new pre-print shows that people are excited to use N95s during COVID surges when given them for free w/helpful information on their evidence & how to use them.
1/
psyarxiv.com/f76vw Study abstract: People want...Project banner: Free N95 Qu...Aegle N95, given away in th...
You might remember when we posted about the study back in December!

I hope you find the results useful. We tried to make the figures relatable, even if you're not reading science articles every day. Please let me know if you have questions!
2/

We gave out 2,500 #N95 masks in 5 packs to our racially & socioeconomically diverse community. Many used N95s for the 1st time. People treated us like we were giving them kidneys. So grateful!

97% used at least 1 N95 & 40% used all 5 within 1-mo!

3/
Read 11 tweets
Sep 25
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.
Read 9 tweets
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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