Newtown and Connecticut are seeing positivity rates slowly diminishing with statewide rates over the past week trending in the mid to high three percent range, although health officials are cautiously watching as the more aggressive UK variant takes hold statewide.

“Connecticut’s numbers are going in the right direction,” said Connecticut Public Health Acting Commissioner Deidre S. Gifford, MD, MPH, in a February 6 advisory.

However, that same memo added four more cases of the B.1.1.7. variant detected in the state, bringing Connecticut’s total number of known cases of the UK variant to 20. This variant spreads more easily, the advisory stated.

Locally, on February 10 Newtown had registered 1,433 positive coronavirus cases from the 38,265 tests administered to town residents, and the local death count held at 60 for the second week in a row.

That day, the total of COVID-19 cases reported among Connecticut residents was 265,496, including 249,245 laboratory-confirmed and 16,251 probable cases; 770 patients were hospitalized with laboratory-confirmed COVID-19 at that time, and the state had logged 7,326 COVID-19-associated deaths.

Also on Wednesday, the US Centers for Disease Control & Prevention (CDC) issued results of experiments to assess two ways of improving the fit of medical procedure masks: fitting a cloth mask over a medical procedure mask, and knotting the ear loops of a medical procedure mask and then tucking in and flattening the extra material close to the face.

Each modification substantially improved source control and reduced wearer exposure, according to the report.

These experiments highlight the importance of good fit to maximize mask performance. There are multiple simple ways to achieve better fit of masks to more effectively slow the spread of COVID-19.

Universal masking is one of the prevention strategies recommended by CDC to slow the spread of SARS-CoV-2, the virus that causes coronavirus disease.

Masks substantially reduce exhaled respiratory droplets and aerosols from infected wearers and reduce exposure of uninfected wearers to these particles. Cloth masks and medical procedure masks fit more loosely than do respirators, e.g., N95 face pieces.

The CDC found that the effectiveness of cloth and medical procedure masks can be improved by ensuring that they are well fitted to the contours of the face to prevent leakage of air around the masks’ edges.

Fitting It Right

During January 2021, the CDC conducted experimental simulations using pliable elastomeric source and receiver head forms to assess the extent to which two modifications to medical procedure masks — 1) wearing a cloth mask over a medical procedure mask (double masking) and 2) knotting the ear loops of a medical procedure mask where they attach to the mask’s edges and then tucking in and flattening the extra material close to the face (knotted and tucked masks) — could improve the fit of these masks and reduce the receiver’s exposure to an aerosol of simulated respiratory droplet particles of the size considered most important for transmitting SARS-CoV-2.

The receiver’s exposure was maximally reduced (over 95 percent) when the source and receiver were fitted with modified medical procedure masks. These laboratory-based experiments highlight the importance of good fit to optimize mask performance.

Until vaccine-induced population immunity is achieved, the CDC states that universal masking is a highly effective means to slow the spread of the virus when combined with other protective measures, such as physical distancing, avoiding crowds and poorly ventilated indoor spaces, and good hand hygiene.

Innovative efforts to improve the fit of cloth and medical procedure masks to enhance their performance merit attention.

At least two recent studies examined use of mask fitters to improve the fit of cloth and medical procedure masks. Fitters can be solid or elastic and are worn over the mask, secured with head ties or ear loops. The results indicated that when fitters are secured over a medical procedure mask, they can potentially increase the wearer’s protection by more than 90 percent for aerosols in the size range considered to be the most important for transmitting COVID-19 and its variants.

Other studies found that knotting and tucking a medical procedure mask or placing a sleeve made of sheer nylon hosiery material around the neck and pulling it up over either a cloth or medical procedure mask also significantly improved the wearer’s protection by fitting the mask more tightly to the wearer’s face and reducing edge gaps.

Race & Ethnicity Data

Tuesday, the Connecticut Department of Public Health released data showing how vaccines in Connecticut have been administered throughout the state across race and ethnicity as of February 3. The data, while limited, mirrors what states across the country have seen: that disparities exist in vaccine administration across racial lines, with Black populations lagging behind white and Hispanic populations.

The department cautioned that the data should be interpreted with several caveats:

*While reporting of race/ethnicity is required for all vaccine providers, there are some gaps, which is the case across all vaccines and not unique to COVID-19 vaccines.

*Providers and individuals have the option of selecting “other,” “multiple races,” or “not reported,” which makes analysis and comparisons across races difficult.

*Providers use multiple means to report data to the state, which then must be aggregated and analyzed, which can lead to missing or under-reported data.

The department also noted that data quality issues are not unique to Connecticut and are being seen across the country.

Recently, the CDC noted that 50 percent of the data reported by vaccine providers across the country did not contain race/ethnicity data. Despite these limitations, Dr Gifford noted that the data does suggest that disparities exist in the administration of vaccines to historically underserved communities, particularly Black populations.

“As we open up the vaccine program to individuals 65 and over, we are redoubling our efforts to ensure that vaccine is reaching the communities and populations who have been disproportionately impacted by COVID-19,” Gifford said. “We are re-allocating additional vaccine to communities with large minority populations, encouraging our vaccine providers to conduct outreach and implement other measures to ensure that individuals from underserved communities have equitable access to vaccinations.”

Due to a constrained supply that limits the number of vaccines administered weekly and the relatively unreliable nature of the race/ethnicity data, the Department of Public Health does not have plans at this time for a regular release of this data.

In the coming weeks, as the number of individuals receiving their first dose of the vaccine becomes more robust and data reporting more reliable, the department will announce a regular schedule for the release of the race/ethnicity data.