THREAD

1/ Our new piece in @statnews — along with vaccine rollout, the US needs a high filtration mask initiative

Every American should have access to high filtration masks for use any time they have to be outside their home in indoor spaces #covid19
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https://www.statnews.com/2021/01/07/national-hi-fi-mask-initiative-needed-with-vaccine-rollouts/

2/ As the pandemic surges, most of the cases I am now seeing in the hospital do not know where or how they were infected

A number of them report wearing cloth masks regularly, & this is much better than no mask

But we know that not all masks are created equal

Cc @EricTopol

3/ N95 masks that healthcare workers like myself use in the hospital offer the best protection

We use these masks for *any* #covid19 patient we are treating, whether or not they are undergoing an “aerosol generating procedure”

Cc @DrTomFrieden https://twitter.com/abraarkaran/status/1337522585844785160

4/ Why? Because we know that even normal speaking emits aerosols. We know that both droplets & aerosols contribute to spread of #covid19

Earlier in the year, when masks were in short supply, we were told to either not even wear a mask or wear cloth masks

https://www.nature.com/articles/s41598-019-38808-z

4.5/ Now, 10 months in when we have consensus that better masks are a win-win- we are stuck in a place where people can’t get them

People have been trying to navigate this market on their own with basically no support & running into issues incl fake masks

cc @meganranney

5/ We are now in situations around the country where literally 1 in 5 residents are testing pos

And we know people transmit before they show symptoms

More than ever, we have invisible transmitters around us during anything we are doing outside our homes @skarlamangla #covid19 https://twitter.com/abraarkaran/status/1346339768704131078

6/ And the vast majority of us cannot afford to “stay home” no matter how much this phrase is repeated. We have to get groceries/other basic supplies; many work on the frontlines in diff jobs, healthcare or otherwise; others use public transport. #covid19 https://coronavirus.medium.com/messaging-about-covid-19-needs-to-account-for-privilege-aa48743f1f84

7/ So there are two major components to better masks

Source control- reducing the amount of droplets & aerosols emitted into the environment from an infected person (many whom won’t know they are sick!)

Personal protection- protecting healthy people from breathing these in

8/ Masks that can do both of these things well will have a sig effect on reducing growth

They essentially function as a temp vaccine in terms of stopping spread (possibly better, given we don’t know how well our current vaccines stop onward transmission) #covid19 @AdamJKucharski

8.5/ We outline in other pieces we have written what qualities those masks need to have

Filtration, fit, scalability, reusability, comfort, style #covid19

@RanuDhillon @sri_srikrishna

Cc @ASlavitt @ashishkjha @Bob_Wachter @Atul_Gawande @JeremyKonyndyk https://hbr.org/2020/06/we-need-better-masks

9/ From the beginning of this epidemic, if we all had high filtration masks at our disposal, we could have started reopening more safely

Many of us brought this up numerous times this entire year

We are now looking to @Transition46
@mtosterholm
#covid19 https://hbr.org/2020/05/a-plan-to-safely-reopen-the-u-s-despite-inadequate-testing

10/ Better masks balance competing interests- stopping #covid19 & protecting those of us that literally have to work

We have been pushing temporizing measures like elastomeric N95s, which are already available; but these have issues
cc @ScottGottliebMD https://hbr.org/2020/10/essential-workers-need-better-masks

11/ I was shocked to hear this week that *healthcare workers* in parts of this country still don’t have adequate supplies of N95 masks

Some said they were not even allowed to bring their own N95 masks in to work (!) & were only allowed work N95 masks for aerosol gen procedures https://twitter.com/abraarkaran/status/1346625021960216577

12/ While there is now continuous news about the new #B117 variant, & whether vaccines will hold equivalent efficacy against this strain (& others), here too we can rely on better masks

Because masks are focused on stopping *how* the virus transmits rather than the virus itself

13/ Many experts have called for the best way to slow the spread of new variants is to keep doubling down on transmission-halting interventions

Better masks should be a serious priority here

The Defense Production Act should be leveraged for this just as for vaccines #covid19

13.5/ Other private efforts have also been underway like @xprize awarded to @LuminosityLab @ASU which is a group of college/grad students that designed the “Floemask” which builds on existing surgical mask designs

@getusppe
#covid19

14/ As vaccines roll out over this year, we cannot afford continued spread as it is happening

We cannot rely on incremental policy changes with exponential viral growth

We need to do everything we can do urgently— better masks are central https://coronavirus.medium.com/incremental-policy-cant-keep-up-with-exponential-spread-c2635b31eba7