Mike Hoerger, PhD MSCR MBA Profile picture
Dec 17, 2022 21 tweets 9 min read Read on X
THREAD: 19 Tips for a DIY mask fit test to reduce your risk of #COVID19.

H/t @amandalhu & @__philipn__

What did I miss? Assorted fit-testing pictures
Fit-testing Tip #1: Keep it Simple.

Get a nebulizer (usually $30-40) & some 3M FT-32 Bitrex solution ($24). The FT-32 fit-test solution (right) goes in the nebulizer. J
Fit-testing Tip #2: Taste the Failure.

Use the nebulizer to spray the bitrex solution (barely visible). Breathe through your mouth. If you taste it, there’s a mask leak.

"It’s not rocket science," as @CorsIAQ likes to say.
Fit-testing Tip #3: Spray at Problem Areas.

I use the nebulizer to spray bitrex fit-testing solution all around the nose bridge, by both cheeks, and under the chin.

You’ll quickly taste a leak. Spray all around the edge of the mask. Make a big loop. Focu
Fit-testing Tip #4: Go Hoodless.

Do what ya wanna, but for DIY fit testing, the method above works fine w/o the hood.

I bought a hood – overpriced! Plus, the goal is to get as many people as possible fit testing. Many would find them off-putting or feel claustrophobic. Me wearing a fit-testing hood. In my view, not needed for DI
Fit-testing Tip #5: Don’t Test around Maskless People/Animals.

After reinstalling a new filter on my Flo Mask, I did a fit test while my son was having a bath. He started coughing. For a moment, I worried he had COVID.

Put 2&2 together, cranked up the HEPA & gave him juice. Don't test around other people or animals. If too much bitre
Fit-testing Tip #6: Have a Beverage Handy.

You’re testing for leaks. You will find some. The bitrex tastes horrible, like licking a rubber band. Have some OJ or a soda ready for after you’re done.
Fit-testing Tip #7: Share the Wealth.

Supplies cost $60 total. It takes hardly any fit-testing solution to test, so offer the opportunity to friends, family, or co-workers. You’ll help protect their health & better cocoon yourself from illness too.

Wise investment. Protect those in your "pods" or "bubbles"
Fit-testing Tip #8: Wear and N95 or #BetterMask.

I tested all 3 of my favorite N95s: the Aegle flat-fold, 3M Aura, and 3M VFlex. I could pass a fit test with each, some caveats noted later. Aegle, 3M Aura, 3M VFlex
Fit-testing Tip #9: Select the Best N95 for YOUR Face.

If you have several masks, test and compare. Go with the winner.

For me, the 3M VFlex held up most robustly. The 3M Aura needs to be readjusted if I talk to much. The Aegle is harder to seal at the nose. The 3M VFlex passed a fit test most easily and robustly, whe
Fit-testing Tip #10: Get your best N95 to fit better.

Although the 3M VFlex most easily & robustly passed fit-testing, I realized I hadn’t been pulling it back far enough under the chin (@jasmith_yorku). I also learned how best to adjust the nose piece to get the best fit. Dr. James showing off how to wear the under-chin region of t
Fit-testing Tip #11: Elastomeric Masks beat N95s.

I tested 6 elastomeric masks. I hate the word “elastomeric.” It’s alienating.

They’re just non-disposable, reusable masks. Great seal. All outperformed my disposable N95s when testing the limits. I'm wearing the Flo Mask, my go-to elastomeric. It's the mos
Fit-testing Tip #12: Get your Elastomeric to Fit Better.

Straps can wear out or loosen over time! Filters also need to be reinstalled properly. Use fit testing periodically and when installing new filters to confirm no leaks. Flo Mask filter. I added a cancer ribbon (safe). Put the fil
Fit-testing Tip #13: Procedure Masks are a Joke.

Fit tested, fails in <0.5 sec. Air flows to the path of least resistance. Gaps poorly guard against inhaling/exhaling viral-laden aerosols.

Everybody should be using #BetterMasks, paid w/public funds.
Fit-testing Tip #14: Cloth Masks are ALSO a Joke.

Also tested a cloth mask. Fails in <0.5 sec. Viral-laden aerosols are too small. Not good enough for 2022.

Everybody should be using #BetterMasks, paid w/public funds.
Fit-testing Tip #15: Fit-test Ear-Loop Masks.

I don't wear ear-loop masks (many KN95/KF94). My experience fit-testing makes me skeptical of cheek gaps.

Worrisome if spending much time in a poorly-ventilated space (car, plane, school, office).
Fit-testing Tip #16: Check for Counterfeits.

Many KN95/KF94 masks are counterfeits, especially on Amazon. Even the city of New Orleans distributed fakes “N95s” last winter. Use fit-testing to check whether a mask is legitimate.
thelensnola.org/2022/01/14/cit…
Fit-testing Tip #17: Facial Hair is a COVID Risk.

My disposable N95s start to fail fit-testing after about 2.5 days w/o shaving. My elastos make it about 3.5 days. If you’re clean-shavin, keep it clean.

If you prefer facial hair, use a mask-safe cut, or know the risk. Facial hair can create mask leaks, increasing COVID risk. Kn
Fit-testing Tip #18: DBAA.

No, fit-testing is not REQUIRED for masks to “work.”

It’s about improving safety on the margins (5-10%) and especially for the most dangerous prolonged contexts.
osha.gov/laws-regs/stan…. https://www.osha.gov/laws-regs/standardinterpretations/2018-
FYI, I have no conflicts of interest, such as investing in one of the companies mentioned.

I’m a psychologist just trying to help people understand COVID mitigation tips I didn’t know a year ago so maybe you can reduce your lifetime number of cumulative SARS-CoV-2 infections.

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More from @michael_hoerger

May 3
30 million excess deaths attributable to COVID is a tremendous underestimate because most analyses insufficiently account for mortality displacement.

In the U.S., it's about 50% worse than people realize.
Mortality displacement or "harvesting" is the idea that so many people died of COVID in the early pandemic that we should actually expect to see *fewer* deaths today if COVID were "over."
In fact, we see similar or slightly higher mortality relative to pre-pandemic levels. Despite the millions of people that have died, the mortality faucet keeps running strong. It should have slowed.
Read 9 tweets
Apr 22
🧵1 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

🌤️Only 1 in 5 days of the pandemic have seen transmission as low as today
🌤️1 in 196 actively infectious
⚡️BUT still 1.7 million weekly infections, resulting in >85,000 LC cases and up to 1,000 deaths

I'll walk you through it... Current Levels for Apr 21, 2025	 % of the Population Infectious	 0.5% (1 in 196)	 New Daily Infections	 244000	 New Weekly Infections	 1708000	 Resulting Weekly Long COVID Cases	 85,000 to 342,000	 Resulting Weekly Excess Deaths	 600 to 1,000	 	 Monthly Forecast	 Average % of the Population Infectious	 0.7% (1 in 147)	 Average New Daily Infections	 324800	 New Infections During the Next Month	 9744000	 Resulting Monthly Long COVID Cases	 487,000 to 1,949,000	 Resulting Monthly Excess Deaths	 3,500 to 5,800	 	 Running Totals	 Infections Nationwide in 2025	 62331000	 Average Number of Infecti...
🧵2 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

We're in the 6th year. See the small red line, bottom left. Notice how closely it tracks the median (gray), year 4 (yellow), & year 5 (orange).

Acknowledging caveats, those are plausible gist-level scenarios for months ahead. year over year graph, summarized in post
🧵3 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

Expect steady transmission bouncing up and down around the current national lull-level estimate the next several weeks. 200-350k daily infections nationally.

This is about as low as lulls bottom out anymore. Past 12 months and forecast, summarized in post
Read 8 tweets
Apr 14
🧵1/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

🔹2.2 million weekly infections
🔹1 in 149 actively infectious
🔹>100,000 LC cases resulting from the week's infections
🔹>800 deaths resulting from the week's infections
🔹"Lull" transmission steady/slightly decliningCurrent Levels for Apr 14, 2025	 % of the Population Infectious	 0.7% (1 in 149)	 New Daily Infections	 320000	 New Weekly Infections	 2240000	 Resulting Weekly Long COVID Cases	 112,000 to 448,000	 Resulting Weekly Excess Deaths	 800 to 1,300	 	 Monthly Forecast	 Average % of the Population Infectious	 0.7% (1 in 138)	 Average New Daily Infections	 345366.6667	 New Infections During the Next Month	 10361000	 Resulting Monthly Long COVID Cases	 518,000 to 2,072,000	 Resulting Monthly Excess Deaths	 3,700 to 6,200	 	 Running Totals	 Infections Nationwide in 2025	 60891000	 Average Number of ...
🧵2/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

Year-over-year transmission (red line, lower left) is tracking the median (grey), year 4 (yellow), and year 5 (orange) closely.

If that trend continues, expect steady yet bumpy transmission the next couple months, until June/July.line graphs, described in tweet
🧵3/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

The heat map shows only 4 states in the CDC 'high' level and none in the 'very' high level.

Check local data. Those timing activities to lulls may see a clear opportunity.heat map, described in tweet
Read 6 tweets
Apr 9
The NIH Clinical Center drops universal masking after 5 months of protecting patients, family, & staff.

Wastewater-derived estimates indicate 2.79 million Americans are getting Covid per week AND top actuaries suggest an American dies of Covid every 3 minutes.

🧵1/5 Masks are optional beginning April 11. Staff will mask on request.
These are the current wastewater-derived estimates of transmission.

2.79 million Covid infections/week in the U.S. in the current high "lull."
🧵2/5
This thread with video explains in exquisite detail how every 3 minutes in 2025 an American dies of Covid.

🧵3/5
Read 5 tweets
Apr 7
1) PMC COVlD Dashboard, April 7, 2025 (U.S.)

🔹1 in 120 actively infectious
🔹1 in 3 chance of exposure in a room of 50
🔹2.8 million weekly infections
🔹>140,000 resulting LC cases from the week's infections
🔹>1,000 deaths resulting from the week's infections Current Levels for Apr 7, 2025	 % of the Population Infectious	 0.8% (1 in 120)	 New Daily Infections	 399000	 New Weekly Infections	 2793000	 Resulting Weekly Long COVID Cases	 140,000 to 559,000	 Resulting Weekly Excess Deaths	 1,000 to 1,700	 	 Monthly Forecast	 Average % of the Population Infectious	 1.0% (1 in 105)	 Average New Daily Infections	 455766.6667	 New Infections During the Next Month	 13673000	 Resulting Monthly Long COVID Cases	 684,000 to 2,735,000	 Resulting Monthly Excess Deaths	 4,900 to 8,100	 	 Running Totals	 Infections Nationwide in 2025	 55591000	 Average Number of...
2) Watch this video to understand how we use excess death data from one of the world's largest reinsurers to estimate how this week's infections will result in >1,000 deaths.
3) Transmission is steady or declining across much of the nation, but remains high in 11 states and DC, per the CDC.

Other sources, such as WastewaterSCAN, show a near doubling of transmission in the Northeast the past few weeks, so remain cautious.
Read 4 tweets
Mar 31
🧵1 of 5
PMC Dashboard, March 31, 2025 (U.S.)

🔹800-1,400 deaths expected to result from this week's infections (new stat, see video next Tweet)
🔹100,000+ Long Covid conditions to result from this week's infections
🔹1 in 142 actively infectious todayCurrent Levels for Mar 31, 2025	 % of the Population Infectious	 0.7% (1 in 142)	 New Daily Infections	 337000	 New Weekly Infections	 2359000	 Resulting Weekly Long COVID Cases	 118,000 to 472,000	 Resulting Weekly Excess Deaths	 800 to 1,400	 	 Monthly Forecast	 Average % of the Population Infectious	 0.8% (1 in 120)	 Average New Daily Infections	 397233.3333	 New Infections During the Next Month	 11917000	 Resulting Monthly Long COVID Cases	 596,000 to 2,383,000	 Resulting Monthly Excess Deaths	 4,300 to 7,100	 	 Running Totals	 Infections Nationwide in 2025	 52303000	 Average Number of ...
🧵2 of 5
PMC Dashboard, March 31, 2025 (U.S.)

This video explains U.S. COVID excess death statistics, which we have incorporated into the dashboard.

🧵3 of 5
PMC Dashboard, March 31, 2025 (U.S.)

The transmission forecast suggests 300-500k daily infections the next month. If the data get retroactively corrected downward, we could dip to 200k.

Check local dashboards, and time events accordingly.Forecast graph, described in post
Read 5 tweets

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