Coronavirus

Masks 101: Who Needs Them and How to Wear Them, From a Frontline NYC Doctor

NYC ER doctor Craig Spencer has become one of social media's top voices on the COVID-19 crisis

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New York City ER doctor Craig Spencer, who survived Ebola in 2014 and is now on the frontlines of the city's COVID-19 fight, has become a social media star in the last month for his frank takes on the pandemic.

But now that the CDC and NYC Mayor Bill de Blasio have recommended wearing some kind of face covering when out in public, Spencer took to Twitter on Sunday with a comprehensive thread on who should wear masks, what kind, and how they can make the problem worse if used incorrectly.

For Spencer's full thread in its native format, click here. A text version of the thread follows:

A Soliloquy on Masks - Personal Guidance from Someone that Trusts Them with My Life

A month ago people yelled at you for wearing masks in public. Now they yell at you if you don’t!? What’s a confused & concerned citizen to do? Let me share some thoughts & guidance...

THREAD If you read no further, here's the takeaway:

Masks alone DO NOT protect you.
They only help if you use them CORRECTLY.
And even then, the best mask is ALWAYS less effective than social distancing.
Want more? Read on.

BEST PRACTICES
BY AREAS OF TRANSMISSION
MASK MATERIALS 

BEST PRACTICES:
🔹When using a mask, touch it as little as possible. Every you time you touch & readjust, you risk infecting yourself.
🔹If you touch it with dirty hands, its dirty. So wash or sanitize your hands BEFORE AND AFTER putting on & taking off your mask. Every time. 

BEST PRACTICES:
🔹Remove the mask by using the loops, not by grabbing the front.
🔹You don’t need to wear a mask at home. Unless you’re sick and can’t isolate. Or others are.
🔹Wash your mask frequently or get a new one.
🔹Obviously, don’t share masks. Ever. Seriously. 

BEST PRACTICES:
🔹Is your family member/friend/worst enemy wearing their mask wrong? Tell them. It could save a life.
🔹Wearing a mask doesn’t mean you can change your behavior. Remember, a perfect mask used perfectly is much less effective than social distancing. 

BEST PRACTICES:
Main takeaway:
🔹Wearing a mask will give you a false sense of security.
🔹You will do things with it on that you wouldn’t do otherwise.
🔹Wear it religiously, but operate as if you don’t have one on.
🔹So no BBQs. No beers with friends. Stay home. Stay safe. 

BY AREAS OF TRANSMISSION:
If you're in an area of HIGH Coronavirus transmission:
🔹If you don’t have to go out, don’t. Even with a mask.
🔹If you have to go out (thank you essential workers!), wear a mask. Even if it’s a bandana or scarf. 
🔹Your mask is most helpful in stopping YOU from infecting others. You may be infectious even if you don’t feel sick. Wear a mask.
🔹A mask MAY help prevent you from getting infected by others. But only if used correctly. Most people don’t use it correctly. Even then, it’s way less effective than staying home

So...
How about in areas with LOW Coronavirus transmission?
🔹Assume these don’t exist. Follow guidance above. 

MASK MATERIAL:
🔹Medical masks should be reserved for healthcare workers. If you are hoarding them, hospitals need them. Consider donating them.
🔹You can make a mask out of a lot of fabrics. Want to make your own? Try this:

How to Sew a Face MaskA tutorial on how to make your own fabric face mask from common household materials. https://nyti.ms/2x3XcfS

MASK MATERIAL:
🔹Remember. Any mask is better than nothing. But no mask is better than social distancing.
🔹What about N95s??? Those are the thicker masks that filter viruses and provide the highest protection. Do you need one? Are you required to intubate a rapidly decompensating patient at a moment’s notice? No? Then you don’t need a N95. Because providers that are required to intubate rapidly decompensating patients at a moment’s notice are low on N95s because you’re wearing one. If you’re wearing a N95, you better be a healthcare worker.

If you’re a healthcare worker, you better be wearing a N95.

If you read this far and are still confused, here's the takeaway:
 🔹Masks alone DO NOT protect you.
🔹They only help if you use them CORRECTLY (see above).
🔹And even then, the best mask is ALWAYS less effective than social distancing. Always.
🔹 So stay home. Stay safe. And we will get through this. 

New York City remains the U.S. epicenter of the pandemic, with about 20 percent of all domestic cases and more than 25 percent of all deaths. Mayor Bill de Blasio said Sunday night that while there were early signs of optimism, the city still only had enough ventilators to get to Tuesday or Wednesday.

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