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Reply to: Non-respirator masks Posted July 30, 2020

This is a very good question that is not so straightforward to answer. A recent article in The Atlantic does a good job: https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/

Reply to: Non-respirator masks Posted July 12, 2020

Sort of… This JAMA article does a good job describing the advantages of face shields: https://jamanetwork.com/journals/jama/fullarticle/2765525 But the exact question of simple mask + faceshield compared head-to-head with N95 alone, I don’t know if anyone has a definitive answer. Ideally, it would be moot because everyone would have access to N95s and faceshields. When caring for COVID patients, I wear N95 + safety glasses + faceshield. When I wrote “non-healthcare settings” I was assuming a setting in which the main risks are droplet and contact (both of which a faceshield does a great job blocking) and that there are not a lot of aerosols being generated. A primary advantage of N95 compared to simple mask is aerosol protection. But the N95 depends on a tight seal to provide that protection. Many of the N95s worn out in public are non-fit-tested, and — given the shortage of N95s — also from a subprime manufacturer (e.g. not 3M). In my experience, these masks don’t make a very good seal.

Masking little kids

AdviceGear 4

14

Posted July 9, 2020

Reply to: What did covid-19 expose as a weakness in your preps? Posted July 8, 2020

Responding to the OP regrets about nitrile gloves: You can make a box of 100 last a long time if you reuse them. When you take off a pair, turn them inside out and save them in a paper bag. Periodically let a batch of used gloves sit for a week or two in the paper bag and in that time any virus on them will have died and they can be reused. Just make sure you save them in a warm, dry place so they dry out. Gently blowing into the glove will flip the fingertips right-side-out and make them easier to re-don. Reusing gloves in this way can also largely obviate the need for hand sanitizer.

Reply to: Non-respirator masks Posted July 7, 2020

If you don’t have access to a NIOSH-rated respirator, your best option to protect both yourself and others may be a simple cloth mask + plastic faceshield (assuming you don’t mind going out in public wearing a faceshield). In non-healthcare settings, this combo may even be more protective than wearing an N95 FFR alone.

Reply to: Do you think the media should be showing more visual imagery of the medical consequences of COVID? Posted July 7, 2020

Setting aside the patient privacy concerns for a moment, I agree that more vivid imagery is needed. The early videos from the Italian hospitals showing wards full of helmet CPAP were a wake-up for me before my own hospital became a COVID hotspot. Along similar lines, the impact on youngish/healthy people has been downplayed. Sure, elderly are hit the hardest, so the percentages of young/healthy deaths seem small in comparison. But by raw numbers, a lot of young people have been badly affected. Many of my sickest patients were in their 30s and 40s and had no serious medical problems before getting COVID.

Masking little kids

AdviceGear 4

14

Posted July 9, 2020

Reply to: Non-respirator masks Posted July 30, 2020

This is a very good question that is not so straightforward to answer. A recent article in The Atlantic does a good job: https://www.theatlantic.com/health/archive/2020/07/why-arent-we-talking-more-about-airborne-transmission/614737/

Reply to: Non-respirator masks Posted July 12, 2020

Sort of… This JAMA article does a good job describing the advantages of face shields: https://jamanetwork.com/journals/jama/fullarticle/2765525 But the exact question of simple mask + faceshield compared head-to-head with N95 alone, I don’t know if anyone has a definitive answer. Ideally, it would be moot because everyone would have access to N95s and faceshields. When caring for COVID patients, I wear N95 + safety glasses + faceshield. When I wrote “non-healthcare settings” I was assuming a setting in which the main risks are droplet and contact (both of which a faceshield does a great job blocking) and that there are not a lot of aerosols being generated. A primary advantage of N95 compared to simple mask is aerosol protection. But the N95 depends on a tight seal to provide that protection. Many of the N95s worn out in public are non-fit-tested, and — given the shortage of N95s — also from a subprime manufacturer (e.g. not 3M). In my experience, these masks don’t make a very good seal.

Reply to: What did covid-19 expose as a weakness in your preps? Posted July 8, 2020

Responding to the OP regrets about nitrile gloves: You can make a box of 100 last a long time if you reuse them. When you take off a pair, turn them inside out and save them in a paper bag. Periodically let a batch of used gloves sit for a week or two in the paper bag and in that time any virus on them will have died and they can be reused. Just make sure you save them in a warm, dry place so they dry out. Gently blowing into the glove will flip the fingertips right-side-out and make them easier to re-don. Reusing gloves in this way can also largely obviate the need for hand sanitizer.

Reply to: Non-respirator masks Posted July 7, 2020

If you don’t have access to a NIOSH-rated respirator, your best option to protect both yourself and others may be a simple cloth mask + plastic faceshield (assuming you don’t mind going out in public wearing a faceshield). In non-healthcare settings, this combo may even be more protective than wearing an N95 FFR alone.

Reply to: Do you think the media should be showing more visual imagery of the medical consequences of COVID? Posted July 7, 2020

Setting aside the patient privacy concerns for a moment, I agree that more vivid imagery is needed. The early videos from the Italian hospitals showing wards full of helmet CPAP were a wake-up for me before my own hospital became a COVID hotspot. Along similar lines, the impact on youngish/healthy people has been downplayed. Sure, elderly are hit the hardest, so the percentages of young/healthy deaths seem small in comparison. But by raw numbers, a lot of young people have been badly affected. Many of my sickest patients were in their 30s and 40s and had no serious medical problems before getting COVID.