Desiree Sutton

A little bit of randomness. Ensnared in a gumption trap.

[Victor Lucas @Victor_Lucas]

When the string in your hoodie comes out in the dryer, nothing else matters until you work it back in.

[Dylan B. Raines @dylanbraines]

@penguinusa Also, support public libraries :) #freebooks

[Penguin Books USA @penguinusa]

Don't let anyone talk you out of buying that 1 book at the bookstore. Those 3 books could be the most life-changing 10 books you've ever gotten.

[Barry Hunt @BarryHunt008]

The elbow maneuver spread globally not because of evidence but because a hospital in Maine made a funny video in 2006

We can do better

Prevent > Cover > Protect

And for repeated symptoms: wear a respirator

Share if your IPC training never included any of this

[Barry Hunt @BarryHunt008]

3. REPEATED symptoms = wear a respirator

Before the cough or sneeze, not instead of covering

Protects you from your own triggers

Protects others from your unknowns

[Barry Hunt @BarryHunt008]

2. COVER for what gets through

Shirt > tissue > cupped hands

Never bare elbow alone

Two-handed elbow (pressing arm firmly to face) is mechanistically better but still inferior to shirt

[Barry Hunt @BarryHunt008]

So here's what the evidence actually supports:

1. PREVENT the sneeze

Philtrum pressure + tongue to hard palate the moment you feel it coming

Takes practice

Teachable to most people

Works ~70-80% of the time once learned.

Divers: use what you already know.

[Barry Hunt @BarryHunt008]

"I'm not sick, it's just allergies"

Wear a respirator

1. You will inhale less pollen → fewer sneezes, less misery (36% reduction in moderate-severe nasal symptoms in mask-wearers with pollen allergy)

2. Your repeated high-velocity sneezes are dispersing your respiratory microbiome to everyone around you

Wearing a respirator during allergy season protects YOU primarily

The protection of others is a co-benefit

📄 Pollen + mask evidence: https://t.co/g4NxfOdlOF

[Barry Hunt @BarryHunt008]

"I might be coughing or sneezing but I'm not sick - why would I need a respirator?"

6% of apparently healthy people are actively shedding respiratory virus at any given time

57-93% of positive respiratory virus samples come from asymptomatic individuals

Human bacterial pathogens (S. aureus, H. influenzae, MRSA) have been detected in exhaled breath of healthy carriers

Your respiratory microbiome is real

Whether it's pathogenic to the person next to you depends on THEIR immune status, not yours

📄 Asymptomatic shedding: https://t.co/nBP4fFCv02

📄 Exhaled breath pathogens: https://t.co/cfnZxFNcO9

[Barry Hunt @BarryHunt008]

Any condition causing REPEATED coughing or sneezing (cold, flu, COVID, allergies) should be a trigger to wear a respirator in shared spaces

Before the cough happens

This should be standard in healthcare

And become a cultural norm everywhere

[Barry Hunt @BarryHunt008]

A 2013 University of Alberta laser-diffraction study measured droplet size during cough etiquette maneuvers

97% of cough droplets <1 micron

Particles escaped regardless of maneuver - elbow, tissue, hands, surgical mask

📄 Zayas et al. 2013: https://t.co/wlP4J3RP3X

[Barry Hunt @BarryHunt008]

A 2025 University of Utah study compared cough maneuvers directly using slow-motion video

Elbow - 59.6% reduction

Surgical mask - 93.2% reduction

INTO THE SHIRT - 95.4% reduction

The shirt beat the elbow by 36 points

📄 Steimle et al. 2025: https://t.co/iO48SDTAKU

[Barry Hunt @BarryHunt008]

A 2020 study in Physics of Fluids used Schlieren imaging to visualize cough plumes under 9 different covering conditions

Finding: a BARE elbow cannot form a seal against the face

Aerosol leaks in multiple directions

📄 Simha & Rao 2020: https://t.co/kYTMvZOXiG

[Barry Hunt @BarryHunt008]

Here's what the evidence actually says 👇

📄 Zayas et al. 2013: https://t.co/wlP4J3RP3X

[Barry Hunt @BarryHunt008]

🧵 "Cough into your elbow" has no peer-reviewed origin

Researchers traced it to a 2006 hospital video

And a 1994 quote from a pediatrician who said she learned it from daycare

Neither CDC nor WHO can tell you who invented it

It's just folklore that gained a following

[Barry Hunt @BarryHunt008]

Tip: Try to PREVENT sneezes

1. Press firmly below your nose (philtrum) when you feel a sneeze coming (stimulates trigeminal nerve, can abort the reflex)

2. Press your tongue hard against your hard palate simultaneously

Competing touch signals interrupt irritant cascade upstream of the motor program (gate control theory)

📄 Mechanism: https://t.co/y2KUFy2o3G

[Barry Hunt @BarryHunt008]

Ranking:

1. N95 - 94-99% aerosol reduction

2. Into the SHIRT - 95.4%

3. Surgical mask - 93-94%

4. Multi-layer fabric / towel - ~77%

5. Tissue - large droplets

6. Cupped hands - some containment

7. Bare elbow - leaks in multiple directions

📄 Lindsley et al. 2021: https://t.co/hwllbhTZRL

[Barry Hunt @BarryHunt008]

TRUE

[Desiree Sutton @Desiree_Sutton]

@stats_feed Sorry, last one I promise. Couch co-op games. I have a kid and being able to play the same game on the same system on the same TV on the same couch is such a fun experience. Also great couple-fun once the kid is asleep. (Not taking anything away from other gaming, that's fun too)