As more #hospitals drop universal #masking requirements, I see many patients, family members, and medical staff who are rightly concerned.

🧵This thread has my best advice for protecting yourself from #COVID in high-risk settings.

1/10 Images from various threads...
Big Picture - Top 10 Tips if you're new to thinking about the importance of #mask quality, size, and fit in high-risk settings

2/10
#FitTesting is not always needed but becomes extremely valuable if the following apply:
▫️ Prolonged time period
▫️ Others are unmasked
▫️ Indoor air quality is bad or not tested personally

3/10
If fit-testing is something you or a loved one would never do, at least try a few different #mask types of varying sizes.

These are my recommendations in the U.S, though availability obviously varies geographically.

4/10
Once you get your own mask situation figured out, help others.

We've given away thousands of #masks locally, as have many other individuals and organizations around the globe.

Our empirical data show people love free masks!

5/10
This thread is designed to help people when at the #hospital for #labor, delivery, and recovery.

However, much of it applies to #inpatient stays generally.

6/10
There's a lot of talk about protecting "the vulnerable" in hospitals. However, there's almost no discussion about #children too young to mask or get vaccinated.

This is where the #PAPRbuggy and #HEPAbuggy could help.

7/10
Although these tips are geared toward patients and families, anyone in a position of #authority can take it upon themselves to do their best to keep others safer.

This is how I teach health students.

8/10
In fact, we have argued that #hospitals should use their authority to become leaders, rather than laggards, when promoting #COVID safety.

9/10
If you found any of these tips helpful, please share with others, especially offline + across other platforms.

I realize there are many limitations related to personal finances, the geographic availability of PPE, & procedures involved (ENT, dental, etc.).

10/10

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More from @michael_hoerger

Apr 19
Public Comments at the #CDC ACIP happening live now.

Absolutely heartbreaking. The first person, near in tears, talking of the lack of precautions for newborns. Now, a mother in 3rd trimester talking about lack of eligibility for recent booster.

video.ibm.com/channel/VWBXKB…
3rd speaker: Had to miss some work with mRNA vaccines. No issue with Novavax. Asking for greater flexibility on the frequency of vaccination and allowing anyone to get Novavax as a booster
4th speaker (lawyer): Calling for greater compassion in allowing international travelers to enter the U.S. Requests a testing requirement (or option) as opposed to vaccine requirement, which can create substantial delays.
Read 10 tweets
Jan 17
"Surviving the COVID-19 #Pandemic: Things I Have Learned (So Far)"

A pandemic mitigation primer geared toward my students.

Full video (40 mins):
vimeo.com/showcase/10115…

Refs in the PPT notes:
psychmike.com/Hoerger_pandem…

Video segments in thread🧵 Picture of video segments
1. Introduction

COVID cases and deaths were surging in New Orleans right when I launched a project working with people who are seriously ill.

Thus, I began studying COVID mitigation.
vimeo.com/789390581
2. COVID is NOT "A Cold or the Flu"

It is among the most serious illnesses.

COVID has caused life expectancy to plummet. Ppl are getting disabled. 1.5 million Americans can't work. Vascular dysregulation is concerning. Effects are cumulative.

vimeo.com/789392012
Read 11 tweets
Dec 23, 2022
In an Invited Editorial in @JAMAOnc today, my colleagues & I call for health systems to develop “Comprehensive #Pandemic Support Programs” for their most vulnerable patients.

These are our Top 10 Tips!

THREAD 🧵
jamanetwork.com/journals/jamao… JAMA Oncology article, "Variability in COVID-19 Vaccine
Tip #1: Health systems should explain to all patients that #COVIDisAirborne and is best avoided through multi-layered mitigation. Swiss Cheese model of COVID mitigation
Tip #2: Health systems should prioritize getting the most vulnerable patients vaccinated & boosted.

Offer #vaccines on-site w/the SAFEST options.

Vulnerable patients want highly-ventilated or outdoor options & high-quality (e.g., N95) masks for safety. Make it happen. Vaccination given while clinician wears an N95 outdoors
Read 15 tweets
Dec 17, 2022
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.
Read 21 tweets
Dec 15, 2022
Our #pandemic global strategy:
"If I paint a rosy picture, will you promise not to cry?"

ascopubs.org/doi/full/10.12…
1/5 Image
Written a decade ago, the article was about how clinicians too often falsely reassured patients w/terminal #cancer that treatment was working just fine.

There are many parallels b/w cancer cancer, the pandemic, & climate change.

Mortality salience elicits #denial.
2/5 ImageImage
Don't believe me?

Look back at the 1960s. Only 12% of patients were even told they had #cancer.

Society will tolerate BS for a long time to avoid immediate discomfort. So too w/the pandemic. Hardly a mask in sight & reinfections mount.

jamanetwork.com/journals/jama/…
3/5 Image
Read 5 tweets
Dec 2, 2022
If you're advocating for more cautious and compassionate COVID policies or generally "doing the right thing," please keep pushing.

I've had three extremely validating interactions in the past week I wish to share (details disguised)....
#1 - A vulnerable family member had a cable guy come to her home. The cable guy refused to mask, so she refused to let him in and called to complain to the cable company. One of those big, hated cable companies.

Know what they did? Fired him on the spot. 🔥
#2 - Met with a ped's specialist (just a follow up, all is well). The hospital is anti-mask, "wash your hands," full droplet dogma.

BUT she was wearing an N95, says she's never going back. Asked thoughtful questions about the #PAPRbuggy. Shared how scary the pandemic onset was.
Read 4 tweets

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