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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Replying to @AaronRichterman @mugecevik
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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Replying to @zeynep @mugecevik
Plausibly, sure. But it would be surprising if we went from a pathogen w little to no (to my knowledge) epi evidence of transmission in context of surgical masks to one in which an upgrade beyond standard surgical mask made more than a small difference.
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Admittedly I am biased by my hospital experience, with 100s of personal exposures using a surgical mask +/- face shield and this being standard practice, with patients +/- on masking and occupational health contact tracing finding single digit patient to hcw transmissions
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In the end im an empiricist. If someone is particularly vulnerable & in high exposure setting of course perfectly reasonable to upgrade if they wish, tho still seems to me simple guideline of 1 surgical mask most justifiable, esp w comfort/fit issues
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766070 …2 replies 0 retweets 0 likes -
Replying to @AaronRichterman @mugecevik
I agree for hospital setting! But there, you have aggressive ventilation standards plus universal masking. The question is often coming from individuals who are forced to interact with people who don’t mask or do badly, and in poorly ventilated areas. PPE, not source control.
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zeynep tufekci Retweeted Aaron Richterman, MD
So that’s exactly the point! These people need some guidance. So we are in agreement. Hospitals are doing great. Universal masking of patients with surgical masks plus good ventilation works. But high-risk folks/situations in community are looking for self-protection.https://twitter.com/AaronRichterman/status/1354652892075077632 …
zeynep tufekci added,
Aaron Richterman, MD @AaronRichtermanReplying to @AaronRichterman @zeynep @mugecevikIn the end im an empiricist. If someone is particularly vulnerable & in high exposure setting of course perfectly reasonable to upgrade if they wish, tho still seems to me simple guideline of 1 surgical mask most justifiable, esp w comfort/fit issues
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766070 …1 reply 0 retweets 3 likes
I’m volunteering at a vaccination clinic in the community. Right now it’s elderly people who we know are more prone to transmitting. It’s not a hospital setting so unsure about ventilation. Lots of people passing through, many hours. So an N95 for me. Maybe overkill but why not?
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Thanks for your service!!!!!
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