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Dr Satoshi Akima FRACP 『秋間聰』 Profile picture
Dr Satoshi Akima FRACP 『秋間聰』
@ToshiAkima
Nephrology & Internal Medicine. Immunothrombosis incl DIC. @ISTH Member. No Conflicts of Interest. Views my own etc
KathKayH @KathKayH@mastodon.social Profile picture 💧Georgielandy 🇦🇺 Profile picture ME 🍿 Profile picture It's a Dystopian World Profile picture Henriette A. Haanes Profile picture 33 subscribed
Mar 10 • 4 tweets • 2 min read
Despite ancient origins, “contagionism” remained deeply unpopular because it implied the need for lockdowns to contain spread. Libertarian miasmatists claimed diseases weren't contagious. They regarded themselves as too modern for nasty Medieval lockdowns. That's why when Semmelweis came up with the contagionist concept of handwashing to reduce disease spread, the whole libertarian medical world gasped in abject horror.
Feb 23 • 6 tweets • 2 min read
This article on the outbreak of Cryptosporidium infections in Queensland is riddled with problems and contradictions. abc.net.au/news/2024-02-2… It states: “Health officials say the spread of the illness can be controlled by proper hygiene and hand washing.” Yet, it also says, “You don't need to get much water in your mouth to potentially get a case.” How does handwashing stop that?
Feb 21 • 7 tweets • 2 min read
Statements claiming that SARS-CoV-2 can't possibly be airborne because that would imply it is frightfully contagious, with an R0 more like measles, reminds us of how divisive a concept contagionism has been through the centuries. 🧵 Miasmatists held that miasmatism was more modern and libertarian, as opposed to contagionism, which had been used since the Middle Ages to justify quarantines and lockdowns to contain person-to-person transmission.
Feb 15 • 6 tweets • 3 min read
A nice photo illustrating why surgical mаsks don't work as respiratory protective equipment. You can see big gaps at the top, sides, and bottom. All the air you breathe in goes through the gaps and enters your lungs unfiltered. Photo from a respirator ad by Koken. Image But—you may object—surgical mаsks have excellent particle filtration efficiency (PFE). So they must work…right? A high PFE means nothing if the air you breathe in sneaks past unfiltered through these gaps rather than going through the filter. armbrustusa.com/pages/mask-tes…
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Feb 13 • 9 tweets • 3 min read
A bit of commentary on this @JAMANetworkOpen paper. It just means that HCWs should get a fresh respirator after they remove their respirators for a meal break mid-shift. Simple. 🧵 jamanetwork.com/journals/jaman…
Image The mechanism of fit failure is uncomplicated. It is strap fatigue. The reason trifolds didn't last as long is that they were Auras, which have super thin straps. This is not the case with Trident trifolds. It has nothing to do with the facepiece design (cup, duckbill, trifold).
Feb 3 • 11 tweets • 3 min read
This is a tale of two earloop respirators. The Q100 is from Canada, and its antipodean twin, the AMD T4, harks from Australia. They are almost identical in look, feel, and fit test results.🧵
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Image The CanadaMasq Q100 respirator has Canadian CA-N95 certification. The AMD T4 has Australian P2 and EU/UK CE 2233 FFP2 certification. Both were tested during certification to show that a small group of subjects passed fit tests in them according to the AU and CAN protocols. Image
Jan 31 • 9 tweets • 4 min read
Not bad. Wearing your respirator is about living fearlessly. If it's good enough, your trusted respie is a time machine that transports you back to 2019—as long as you wear it. But we need a few corrections.🧵 thespinoff.co.nz/society/31-01-… The technical OH&S terminology is that маsks are for droplets/splashes. Respirators are for the prevention of inhalation injury. Μаsks don't protect against viral aerosol inhalation. So make sure your respiratory protective equipment is a certified respirator.
Jan 19 • 12 tweets • 4 min read
We look upon the treatment of Semmelweis with horror, but there were political forces at work here that we do not appreciate. In particular, handwashing implied contagionism.🧵 If handwashing worked, that meant the removal from the hands of a contagious medium. In an age when contagionism was considered an archaic Medieval theory inconsistent with modern progress, this didn't go down well, especially without a sound germ theory mechanism to explain it.
Jan 14 • 7 tweets • 4 min read
A reminder that if you purchase 3M products from Amazon, make sure they are BOTH sold AND shipped by Amazon (a 3M authorised seller). NOT from a third party (unless you are CERTAIN they are an authorised seller). Shipped by Amazon is NOT good enough.

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Image If you want to hear this directly from 3M safety division vice president Dr Nikki McCullough, here is the relevant excerpt of this video interview.
Dec 19, 2023 • 11 tweets • 4 min read
This is a mаsk. It does not protect you against СОVΙD. because it has a fit factor and filtration efficacy of zero. Mаsks don't work.🧵 This is a mаsk. It doesn't protect you against CV19. It has a fit factor of near zero. It has good filtration efficacy, but none of the inspired air goes through the filter. Mаsks don't work. It's physically impossible for them to work. You might as well be wearing a batman mask.
Nov 16, 2023 • 4 tweets • 1 min read
This business of passing off SARS-CoV-2 infections as a more socially acceptable case of “just a bit of RSV” or “just the flu” is nothing new. 🧵 The same thing happened in the age of cholera, which was not a socially acceptable disease to polite Victorian society. Image
Nov 4, 2023 • 18 tweets • 3 min read
The Central Error of the Pandemic…

Is that of running pandemic management by laissez-faire socioeconomic principles.

If you grasp this, all the other errors fall into place as the inevitable consequence of following that line of thought. 🧵 1/x Economics is the final bastion of Social Darwinism. Its laissez-faire principles dictate that all Keynesian central government-instituted intervention, even in a crisis, only makes things worse. A crisis should be allowed to run its natural course.
Oct 19, 2023 • 7 tweets • 3 min read
CAUTION. If you don't tighten the straps on the GVS N31000 Segre Folded, you WILL fail a fit test in this respirator.🧵
Image I fail unless the straps are tightened. This is a well-used respirator. I have two twists on top and three at the bottom. I make the top strap much longer. The bottom strap forms the seal. The top strap assists with the seal while stopping the facepiece from sliding down. Image
Jun 11, 2023 • 4 tweets • 2 min read
None of this is original. Anti-contagionists opposed us drinking cholera-free clean water and pulled similar crazy stunts back in the 19th century to gaslight us. Once cleanwater systems were in place, they found it had other health benefits beyond cholera. Pettenkofer ordered Vibrio cholerae culture from Robert Koch’s lab and proceeded to drink it before witnesses to “prove” it was not a contagious germ-spread disease. Vinay is our modern Pettenkofer.
Jun 11, 2023 • 13 tweets • 8 min read
A review of the @readimask N95. Unless you consistently pass a fit test in it, as many do, I recommend taking care with using the Readimask as your standard everyday respirator, but hands up everyone who goes to the hairdresser.🙋‍♀️🙋‍♂️ The @readimask is metal-free, making it ideal for MRI scans. Other respirators with aluminium nose-wires may be MRI-safe, but the metal degrades the image quality of brain scans and should be avoided. ncbi.nlm.nih.gov/pmc/articles/P…
Jun 10, 2023 • 8 tweets • 3 min read
More caveats about the COVID-OUT of Metformin for #longСОVΙD. The benefits of Metformin were diminished by vaccination but it was only taken for 14 days (“500 mg on day one, 500 mg twice daily on days 2–5, then 500 mg in the morning and 1000 mg in the evening up to day 14”).🧵 Image There are plenty of studies of viral persistence, showing the ongoing presence of replication-competent virus for many months after the acute illness. In chronic hepatitis C, we treat with antivirals not for 2 weeks but for 12 to 24 weeks!
Jun 8, 2023 • 4 tweets • 2 min read
You could argue that there are no cluster RCTs randomising districts to fire station vs no fire station. Firefighting is, you could proclaim, pointless, as it has never been “proven” by RCT to reduce the adverse impacts of fires. Disband the fire service now! 🧵 Image And when the firefighters do come rushing to put out the fire, guess what they will be wearing? Firefighting respiratory protective equipment. Not tested by RCT.
Jun 7, 2023 • 14 tweets • 4 min read
This article takes a step in the right direction by admitting RCTs are not a universal scientific method suitable for every question, e.g. “Is the earth round?” But clinicians need to go even further beyond their training to study broader questions in the philosophy of science.🧵 We must look at applied physics and engineering to ask ourselves why medicine failed to develop normatively as a science by creating models with high predictive power. We know that models like the rotundity of the earth and the heliocentric solar system work without RCTs.
Jun 4, 2023 • 6 tweets • 2 min read
I think these Tour de France safety protocols can be improved. They are too 2020. I'd get all riders and support staff fit-tested by QNFT to FFP2/3+ RPE. I'd allow autograph signing with riders wearing fitted RPE outdoors. 🧵 reuters.com/sports/cycling… “Do not get too close to the spectators—social distancing, no selfies, no autographs.” This is archaic stuff. It’s pointless if the RPE is of sufficiently high grade and it is outdoors. If you think FFP2/3s aren’t enough, move them to fit tested P3/P100 elastomerics. Image
May 28, 2023 • 7 tweets • 3 min read
The feedback to this thread has been overwhelmingly positive but some just wanted to shoot the messenger. A thought. I have never heard of a hospital in AU that purchases earloop respirators for their staff, even though AU (unlike NIOSH) certifies earloop respirators. Why? This excerpt of an interview with 3M division vice-president Nikki McCullough gives us a hint. Companies that brought earloop respirators like KN95 and KF94s find they have a low fit test pass rate (~8-13%). They end up with a lot of unusable inventory.
May 27, 2023 • 15 tweets • 7 min read
1. When headstrap Ν95s are converted to an earloop strap system (ELSS), the Fit Factor drops by 1/2 – 2/3rds. The result will be a massive increase in injury and death. Even if you pass in earloops, you'll > DOUBLE your fit test scores with headstraps. academic.oup.com/annweh/article… Image 2. NFS = Novel Faceseal System (not currently for sale AFAIK). It allows earloops to approach or surpass the performance of headstraps. If you added it to headstrap Ν95s, it would likely improve the fit factor further. Image