Reason that past clinical studies, focusing on health-care worker outcomes, are not the best indicator is that masks for *source-control* is not an individual level variable. It's like asking if filters on car exhausts lower air pollution by measuring the air ... inside each car.
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Replying to @zeynep @boriquagato
Not sure why you're dismissing lab studies because measuring the filter on that exhaust is one good way to figure out what's going on. But okay, this virus is less well understood than pollution. Look at SARS is best we can do probably.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322931/ …
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Replying to @zeynep @boriquagato
Strikingly from that study, there is a dose-response effect for the significant protection from masks. Dose-response is a pretty big signal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322931/ …pic.twitter.com/Zp9sfzzQ75
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Replying to @zeynep @boriquagato
We outline both the logic and previous existing studies for *source control* here. (Current as of few months ago).https://www.preprints.org/manuscript/202004.0203/v2 …
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Replying to @boriquagato
We didn't have many COVID specific studies at the population level at that paper (next update will include the natural experiment papers.) The reason I posted that is the source-control argument is important to acknowledge. Really changes what study is applicable to this.
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Replying to @zeynep @boriquagato
I mean you find a lot of this. …https://www-sciencedirect-com.libproxy.lib.unc.edu/science/article/pii/S0140673603131686 … Masks work to protect health-care workers. You find those across the board.
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Replying to @boriquagato @zeynep
thoughts?? https://aapsonline.org/mask-facts/
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Replying to @theltgovernor @boriquagato
None of those are for source-control. There is an asymmetry to the physics of this. Virus expelled in droplets, which are big and easier to block. As the droplet evaporates, the tinier particles can float and hang (more like a mist) and cannot be kept out without well-sealed N95.
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So consider trying to block big water drops coming out of a hose, just block it there and you can do a lot to keep them in. But keeping out a mist from your airways is really difficult! Plus, intubation etc. generate aerosols (mist!) so healthcare workers do need that seal+fit.
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