Top Tweets for #improveNPI
@VentiloAngel @sri_srikrishna Thank you, Natalie. Calling a spade a spade is needed if we want to #improveNPI. If Thomas Khun (dynamic of scientific revolutions) model has value, maybe we're at a point of incremental shifts, with possible massive shifts in sight. https://t.co/LNOPWIDlmC
@danaludwig Open qualitative exploration of what needs to be improved in the respirator space is extremely exciting. Thanks @sri_srikrishna and others. Species-level response for the win. https://t.co/FrEf8sRnTv
This is presented as a binary proposition: big stuff or not. For me it's more: the third prong of the PMI. Plus & Minus, sure, but also let's explore the Interesting and how to #improveNPI for 🌐 species-level response to the #covidstrategy & #h5n1badsoonscenario challenges. 👏🏻👏🏻
Are there BIG usability problems using N95-level masks for long periods of time (hours, days, weeks) or NOT?
e.g. gets too hot, breathing resistance, skin irritation, communication, eating/drinking, eyeglass fogging, making mistakes, degrading face seal, sweat, etc.
@sri_srikrishna Those problems are in turn solvable by improved masks and/or adding other components to #improveNPI. Societal mis-reaction makes those really hard too. "It's us" is really accurate on many levels.
This ABSOLUTELY* needs to go to https://t.co/60HaVaT8i5 so that there's an open compilation of all the aspects of this essential piece of the #improveNPI puzzle. For #h5n1badsoonscenario & #covidstrategy. *Who wants to help?
I use them (N95). However here are 7 BIG problems and limitations of N95-level masks:
#1 Breathing resistance
@AmeshAA #improveNPI =
1: effective protection of respiratory contacts
and
2: sustainable reduction of number of respiratory contacts if 1 is not enough
In a #H5N1BadSoonScenario, add
3: https://t.co/xUqAXl2vQX
Which countries can manufacture respirators & elastomerics for all?
@KrutikaKuppalli Within 4 months. Maybe, just maybe, there's need to put the spotlight on... 🥁🥁🥁 ... Non Pharmaceutical Interventions. #improveNPI
The USA govt says to improve local production of respirators.
What else?
Just in case #H5N1BadSoonScenario https://t.co/o5w3unPrvO
@lisawhelan @sri_srikrishna #improveNPI Upgrade, not fight. Better chances of being "contagious" (in a good way).
@Fla_Medic The actual mechanism is aerosols in shared enclosed spaces, I'm guessing?
Buses connect localities, etc.
Viruses multiply in cells, bodies, localities & beyond.
We can act in a few levels.
Would we try #zeroflu in a #H5N1BadSoonScenario?
#fluscim2 #improveNPI #covidstrategy
2/12 The design of the Zimi is modeled after the Japanese Shigematsu DD11V. This type of mask uses a semi rigid plastic frame with nose foam and an outer filter with a cloth-like soft seal. This is becoming a popular design in East Asia.

@HelenBranswell @CDCgov That's comparable to the flu vaccines.
Of course, the difference with the old "flu only" situation is that covid is worse and now we know about #improveNPI (respirators, CO2 guided ventilation, filtration, maybe Far UV), testing, apps, etc.
Oh, and the #H5N1BadSoonScenario.
@JadeKhalife Will definitely go to https://t.co/4Dootdgs6R and eventually Manufacture.
The subheadings would include materials, condensation, etc.
Maybe people who have worked with helmets...
@leashless
#fluscim2 #H5N1BadSoonScenario #ImproveNPI
This thread is gold but how are we going to do this?
#H5N1BadSoonScenario #fluscim2 #longcovid #covidstrategy #improveNPI this is not a #PandemicFluGame
Some quick answers:
IAQ (indoor air quality) measures, as a matter of public policy in the US, are largely shaped by ASHRAE's recommendations. ASHRAE’s recommendations are shaped by the needs of the HVAC industry, so they tend to favor interventions that require lucrative infrastructure upgrades and long-term service contracts- which in-room filtration and germicidal ultraviolet generally do not.
Ventilation is the most powerful mitigation tool we have, but few in North America are willing to tolerate even the minor changes in indoor temperature control that it causes. This results in far higher energy costs or the need to purchase and install expensive Heat Recovery Systems- that still do not recover all of the wasted energy.
Ventilation-based IAQ measures generally stop as soon as significantly higher power bills that require budget reallocation start coming in or when occupants are advised to wear a sweater or jacket indoors.
Commercial stand-alone air purifiers currently follow the razor blade & inkjet printer business model. The profit is made by selling poorly built but attractively designed machines with motors that burn out within two years and cannot be serviced and expensive proprietary filter medium that only fit that specific air purifier model.
There is little money to be made, and none of it recurring, in building durable, repairable air purifiers that accept non-proprietary, standard HVAC filters like a commercialized CR-Box would when there is almost no public demand.
While it’s everyone's first thought and seems intuitive, “UVC in a box” doesn’t work as air moving within the confines of a reasonably sized enclosure (even if convoluted), at a volume and velocity high enough to significantly reduce the viral load in a room, is not exposed for a long enough time to permit that viral inactivation.
Usually, it's just a low-cost gimmick that manufacturers add-in that does little or nothing to improve air quality.
In-duct GUV is effectively a far larger enclosure, is low cost, and offers some mitigation between rooms, but it does little to reduce the viral load within a room. Its inherent low cost makes it unpopular with contractors who often try to add ionizers and similar dubious proprietary technology to raise the installation cost.
Upper-room GUV using 254nm UV or even 270nm LED UV is well-tested, low-cost legacy technology that is extremely safe and effective at cutting in-room viral load. There are open-source fixtures available that can be built in any country, but all Upper-Room GUV requires professional installation, UV measuring equipment, and appropriately trained HVAC technicians.
As above, HVAC contractors prefer interventions that require no additional training and ensure long-term service contracts.
The Bored-Ape fiasco in Hong Kong also makes any GUV using 254nm UVC- as powerful and safe a tool as it is properly installed, something of a non-starter for the foreseeable future.
222nm Far-UVC, if properly filtered and installed, is safe for skin and eyes and is one of the most effective potential interventions we have. Particularly in high-mixing, high-traffic, low-dwell time spaces like elevators, stairways, and bathrooms that can be thought of as "pump handle points" or central branching off sites in long infection chains.
One-fifth grader infects the other fifth-graders in the classroom, but those fifth-graders pass the infection to the second-grade in the bathrooms. All the in-classroom filtration in the world won't help you if they share bathrooms or climb the stairs together unmasked between classes.
A hospital patient may only be exposed to 5-8 HCW a day in their room. But each time one of those HCW enters an elevator, they are breathing in the suspended aerosols of the last two dozen occupants.
Properly installed 222nm Far-UVC can offer ACH values well over 100- addressing even near-field transmission in these tight quarters.
Even limited use of Far-UVC at these "pump handle points" would drastically limit propagation along infection chains.
Unfortunately, there are very few Far-UVC manufacturers, and they have formed an informal cartel- somewhat reminiscent of the Phoebus Cartel, to keep prices 3-4x what they actually need to be, approximately $3000+ for a small room.
They also fight any degree of transparency as to the safety and specifications of their products, so it is difficult to know what you are getting and how to use it appropriately.
Their preferred customers are enterprises and governments- who can afford the margins and professional installation.
Most consumers don't even have Far-UVC on their radar so have little interest in pressing manufacturers for better conduct- and manufacturers have no incentive to risk their presently generous margins by pursuing the currently tiny consumer market.
TLDR- All the most effective mitigations we have can be manufactured and operated at far lower cost than they presently are. There are significant financial incentives to profiteer from the pandemic- to keep costs high and suppress low-cost options, and absolutely no incentives to counter that.
This remains possible because the public still has relatively little interest in IAQ despite its importance- largely due to its being politicized and a near media blackout on the subject.
@HelenBranswell @WHO @mvankerkhove It also doesn't look like flu, this time.
Use the extra time to push for #ImproveNPI, for the whole 🌐 & effectively, just in case there's a #H5N1BadSoonScenario?
https://t.co/o5w3unPrvO (or better): tested plans for massive aerosol education + respirators for >15% world pop.
The intention is good. I haven't looked at the details but that's a useful way to look at these things.
#ImproveNPI
How much would it cost to install air purifiers in all french schools, middle schools and high schools ?
€ 200M the first year
€ 63M each following year

Bird flu makes you look at the world differently.
I had to write https://t.co/xUqAXl2vQX and https://t.co/DVc6SdnOet and soon #fluscim2 #improveNPI.
I wonder how it affects others.
Thanks. https://t.co/JsRWXlyWpj
Translation: "_All the cheese layers work by reducing dose_. In some cases to zero, but less-than-perfect reductions matter, no layer is perfect, and combining layers is demonstrably good."
#improveNPI #fluscim2
https://t.co/KFONE4yAww
CLOSENESS OF CONTACT MATTERS: Another “Haley’s comet” ☄️ study from Delta + Omicron period revealing how close distance and prolonged exposure in prison cell plays role in increasing risk of Covid infection 🦠 versus distant, less intense exposure in cell block. (1/4)
Should be part of https://t.co/fX6FeyoOSL if anyone is tempted to add it
#improveNPI was the hashtag in early 2020
EPA: How to “Improve DIY Air Cleaner Performance
#1 Increase # of filters
#2 Use thick 2” or 4” thick HVAC filter instead of 1”.
#3 Cover outside corners of front of box fan so air flows only through center part of the fan where blades are visible.” https://t.co/BFcSeCx9Hi
Ok. Some clarity. #longcovid is one of the big reasons to #improveNPI (a hashtag I used around march 2020) and now also for #H5N1BadSoonScenario.
What I mean is:
1) Part of what needs to happen is IDENTICAL.
2) The speed needed is also IDENTICAL.
Still 🧐 how to even see it.
This is a MUST WATCH - please share!
"I assumed having it again wouldn't be a problem as I'd been ok during my first infection and I couldn't have been more wrong. Now I have all these debilitating symptoms and there's no treatment and no cure"
#LongCovid
Elegir el enemigo equivocado es un error que pagamos todos.
#ElEnemigoEsElVirus
El segundo error es centrarnos en una herramienta.
#ImproveNPI (principio de 2020) me llevó a #ukecovid.
¿Qué más falla/falta?
I want everyone to be vaccinated & immune to this virus
I also agree w this letter in the Lancet
This is not a pandemic of the unvaccinated. It is a pandemic of a virus. I hope we don’t lose track of this & I urge policy leaders to stop saying this
https://t.co/rIeHU8epEG
Page renamed: https://t.co/Ttw8bxjE4l
I would now need the best links from @RanuDhillon @AbraarKaran @MonicaGandhi9 @jljcolorado @linseymarr @CoronavirusMak3 @sri_srikrishna @Somosrim #masks4all & others #More_better_PPE #ImproveNPI
Please help RT: @leashless @appropedia thx!
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