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Jan 12
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Masks & PPE
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Testing & Diagnosis
Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
Real life data: Staff worn face shields+masks protected nursing home residents from COVID-19. Zero cases in 8 VA nursing homes over 6 months, 48 months (8x6) of observation. Great implementation effort led by @MGoto_Iowa and colleagues in VISN23 1/6 cambridge.org/core/services/…
ID doc & Epidemiologist | Prof @IntMedatIowa | Assoc Editor @JAMANetworkOpen | #HandHygiene #AntibioticResistance | #BLM | my opinions | he/him
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Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
Main figure highlights rates of infections in the region and other (non-VA) nursing homes over the same period. Dashed line was the 8 nursing homes with no cases. 2/6 pic.twitter.com/2pFDntvjto
Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
Caveats. (1) This was done without weekly testing of staff and nursing-home residents (in VA we call them community living centers - CLCs). This was not because we didn't believe in the value of frequent testing (we do!) but testing wasn't readily available during this period 3/6
Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
(2) Testing was done. In fact, VISN23 implemented five universal testing initiatives (one for the entire network and four for individual facilities)
(3) There was a higher incidence per capita in the upper-midwest region than the national average, so this result was not easy 4/6
Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
(4) None of this would have been possible without strong support from executive leadership teams, infection control professionals, hospital epidemiologists and all staff on the care units at all sites 5/6
Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
(5) In my opinion, this study highlights the benefits of adding face shields to masks for source control. Face shields provide an additional barrier and can overcome some limitations of cloth and medical masks (e.g. wearing below nose) 6/6
Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
Addendum: Big fan of @MackayIM Swiss Cheese Virus Pandemic Defense model. Think face shields could be added for eye protection and improved source control
Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
FYI - effective effort to prevent COVID-19 in eight VA CLCs within VISN23 cc @atkins_hsrd @vahsrd
Expert Quote Tweets:
Carolyn Cannuscio, ScD
@CarolynCannu
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Tue Jan 12
Universal face masks AND face shields for staff in nursing homes. ZERO cases of COVID identified in residents over 6 months. The case gets stronger for the addition of face shields. twitter.com/eliowa/status/…
Eli Perencevich, MD MS🧼 😷
@eliowa
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Tue Jan 12
@CarolynCannu Good example of the Swiss cheese model but applied to source control uses of PPE, I think. Impressive and challenging implementation led by @MGoto_Iowa and his team and a real-life example of the approach initially proposed by @mike_edmond @dan_diekema and others at UIHC
Carolyn Cannuscio, ScD
@CarolynCannu
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Tue Jan 12
@eliowa @MGoto_Iowa @mike_edmond @dan_diekema Such good work.
Interesting to see how widely masks have been adopted (thankfully), at least here in Philly, where 96% of ppl have been observed wearing masks in retail and almost 90% are wearing them correctly outside. What a success!
But face shields? Not at all common.
Brett Mitchell
@1healthau
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Tue Jan 12
Nice paper just published showing potential benefits of adding face shield to masks for source control COVID-19 twitter.com/eliowa/status/…
Peter Collignon
@CollignonPeter
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Tue Jan 12
We neglect eye protection at our peril. Face shields or other eye protection are essential when there is lots of community transmission or in high risk situations. Our eyes make us susceptible to lots of infections. And eyes are in direct communication with our nose via a duct. twitter.com/eliowa/status/…
