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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Replying to @zeynep @AaronRichterman
When we contact trace, nearly all infections happen during mask-less indoor contact. The variant is more transmissible but the physics have not changed, so masks still work. It makes more sense to get more people masked esp indoors, not adding more masks when you are masking.
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Replying to @mugecevik @AaronRichterman
At the population level, of course. But the question that’s coming up is not for source control but as PPE for individuals already wearing masks in environments they don’t control—others they encounter are unmasked, poor ventilation etc. So PPE considerations are in play as well.
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Replying to @zeynep @mugecevik
Aaron Richterman, MD Retweeted Anne Helen Petersen
Aaron Richterman, MD added,
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That’s why we need guidance. It doesn’t have to be one-size fits all. There are people in poorly ventilated places around people who don’t mask. There are high-risk people: indoors or around crowds. Plus, transmissibility increase is real so need to consider potential mechanisms.
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PPE (unlike source control) is well-studied so we’re not starting from scratch. As with all things in an evolving pandemic, different contexts need guidelines. (Aaron: what if the transmissibility increase is ID50 shift? Wouldn’t masks which filter at different levels matter?)
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Still a Tegnell Stan 😀 💉 💉 Retweeted David Dowdy
The 3 of you seen this? Before declaring "increases in transmisibility are real" perhaps...https://twitter.com/davidwdowdy/status/1354298137343647750?s=19 …
Still a Tegnell Stan 😀 💉 💉 added,
David DowdyVerified account @davidwdowdyA counterpoint to the alarm bells that are sounding over novel SARS-CoV-2 variants. Is it possible that we are misinterpreting differences in human behavior as differences in the biological fitness of viral variants? A thread to explain this hypothesis...Show this thread0 replies 0 retweets 2 likes
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