A lot of strong statements these days in support universal N95s, wearing 2+ masks. Models are great but can anyone point to a single epidemiological investigation consistent w numbers below (a 15-20% secondary attack rate when everyone is wearing surgical masks)?https://twitter.com/j_g_allen/status/1354382152830513154 …
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This is completely inconsistent w hospital experience of the last year, where transmission can be nearly eliminated w universal surgical masks, & virtually all residual transmission occurs in context of truly unmasked exposures
@mugecevik@EricMeyerowitzhttps://jamanetwork.com/journals/jama/fullarticle/2773128 …11 replies 13 retweets 50 likesShow this thread -
Anyway, please send best clinical studies suggesting otherwise!
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Replying to @AaronRichterman
I agree we don't have good epi data yet but what's driving it is partly the question mark around the new variants (more transmissible may behave different), and partly the emphasis on self-protection. Hospitals have good ventilation plus they can mandate universal masking.
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Replying to @zeynep @AaronRichterman
Many folks are working or interacting with people who are masked to varying degrees and wearing masks of varying quality/fit, and different levels of ventilation. Different patterns of showing up to work with symptoms, too. So hospital to community translation is a little messy.
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Replying to @zeynep
Fair points all around, though still seems the fundamental issue is ppl not wearing any mask at all, not that people aren't wearing N95s. Maybe the ship has mostly sailed on that one.
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Replying to @AaronRichterman @zeynep
Jury is out on new variants, but if transmissibility difference is viral load mediated Id be surprised to see meaningful clinical difference beyond surgical masks given basically no epi evidence of transmission w surgical masks & wild type.
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Replying to @AaronRichterman
Yeah, we're flying a little blind here. The problem is the interaction between that ship which has sailed, tragically, and the people who need to think about self-protection in this environment.
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Replying to @zeynep @AaronRichterman
Ideally, we'd have better contact tracing data to give us guidance, and with this, we could measure it since the intervention and measurement is the same person. But that's not us right now.
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Replying to @zeynep @AaronRichterman
Anectodally, I am seeing an uptick in the "I don't know where I got infected" stories. A real increase due to seasonality, community transmission and variants? I dunno. I think vaccination plus getting through the seasonal part will help, and most focus is on the next few months.
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(And this is yet another instance of why on earth do we not have better data? I mean, yes, cluster randomization for cloth masks for source control is hard, but I wish we had a randomized N95 study launched in Fall! We'd be on much firmer ground than this guessing game).
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Replying to @zeynep
Aaron Richterman, MD Retweeted Dr. Lynora Saxinger 🇨🇦 *answers DM not mentions
There is this ongoing. in hcw thohttps://twitter.com/AntibioticDoc/status/1354564477597835264 …
Aaron Richterman, MD added,
Dr. Lynora Saxinger 🇨🇦 *answers DM not mentionsVerified account @AntibioticDocReplying to @AaronRichtermanMark Loeb and colleagues have an RCT in HCW, updated November and still recruiting ...?no strong signal so far....https://clinicaltrials.gov/ct2/show/NCT04296643 …: I was wondering if there has been a bunch of new data I'd utterly missed somehow, as it has been very insistent messaging but seems not.0 replies 0 retweets 0 likesThanks. Twitter will use this to make your timeline better. UndoUndo
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