Thread by @LinnJarte

My thoughts on wider masking… 🧵

Many, including those who are covid-aware, are of the opinion that we’ll never be able to get masking to become widely adopted in society. Perhaps unsurprisingly, some of us who invariably mask in shared air tend to hold a different view. 1/21

Despite healthcare workers largely not masking (with the intention of reducing airborne transmission), there is still a higher use of surgical masks nowadays than pre-covid.
2/21

Boxes can be found in places they didn’t use to exist. Staff on occasion put them on around coughing patients, or rarely if they themselves are ill or if a pt asks. The use is inconsistent and scientifically incorrect to address airborne transmission, but the use is there.
3/21

Now imagine if all these boxes of surgical masks were replaced with earloop FFP2s. I strongly believe that people would just grab that instead and not give it much thought. Perhaps briefly curiously comment on them being a bit different.
4/21

Imagine adding some more of these boxes, providing enough stock that patients could be offered them - and a message encouraging this to happen.
5/21

No rules, no forcing, just encouraging caring gestures. Very far from everyone would, but I have no doubt some would. It already rarely happens, just with the wrong mask and very infrequently.
6/21

Imagine also adding a box by each hospital entrance, with a kind sign asking visitors to protect vulnerable patients. Ignored by many, I’m sure, but not by all. Especially if further encouraged by a public health campaign or two encouraging masking to protect inpatients.
7/21

I have no doubt this would wholly fail at achieving universal masking in healthcare (but that’s not the aim here) - but I do believe that it would lead to a somewhat increased mask use.
8/21

It would also introduce the (somewhat) right mask for the right task.

And it would increasingly normalise masking around vulnerable people.
9/21

My friends and I already ask tradespeople entering our homes if they wouldn’t mind putting on a mask (FFP2 or 3) - they almost invariably don’t hesitate to do it. A few years ago we were in a very different place, with much more hostile reactions to masks…
10/21

…the cultural shift has already started to happen, despite dis- and misinformation working hard against it. Just imagine if it’s given a boost by healthcare establishing masking as a symbol for protecting others.
11/21

Once we’re here, imagine introducing one or two IPC modules to healthcare workers around airborne transmission and the use of RPE and IAQ as infection prevention tools.
12/21

There’ll no doubt be lightbulb moments as to why we wear a surgical mask when doing a sterile procedure but an FFP2 when caring for a vulnerable patient or are around pts with airborne infections (and maybe it’s time to introduce headband RPE here-“even higher protection”)
13/21

This would all be a very gradual shift in the culture, not a sudden change - I don’t believe the latter to be possible.
14/21

If masks would become associated with protection of vulnerable people in hospital, it would likely positively affect how others view those who mask out and about. Ableism aside, it would make masking in public easier.
15/21

And from here, it’s not a big leap to being more ok with protecting others (at minimal hassle to themselves*) if they ask for it - because hospitals have already normalised this behaviour. So for example being asked to do a pluslife isn’t a big deal.

*I think this is key!
16/21

This isn’t asking people to start masking more widely, and especially not masking everywhere like I and others do - and I don’t think this step is possible nor something to strive for.

The wider focus should be on clean air infrastructure.
17/21

But I do believe this would lead to a culture change where it becomes easier for covid aware and vulnerable people to carve out safer spaces.

And gradually increase the public awareness of principles around airborne transmission prevention.
18/21

And all this actually needs in terms of resources is:

1. Replacing the incorrectly used surgical masks with boxes of FFP2 masks

2. Positively encourage hospital visitors to wear the right mask
19/21

3. Run a few public health campaigns to help encourage this message

4. Create an IPC module or two about airborne transmission and the use of RPE and IAQ as infection prevention tools
20/21

My humble opinion is that this would work.

The sole reason this for now remains unachievable is that the steps above require a top-down approach, and our leaders will not take the step.
21/21