22 Comments

Dr. Faust, This essay is the sanest analysis of the masking issue that I’ve read anyplace. And FYI, I’m considered a zealot by my associates for my masking behaviors which mirror your’s, and I read a lot of Covid material. Thus, clearly why I totally agree with your explanation. “Harm reduction,” is the perfect two word answer when someone scornfully comments, “You know the pandemic is over, don’t you?” Rather than spending five minutes explaining why I have made the decisions that I have made and respect why other folks have made their decisions because of their children, grandchildren, family, friendships etc., now, I will simply use your “harm reduction.” Perfect.

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Agreed!

Tennis professionals with “a flu like thing” probably have Covid. Sad not to test and endanger everyone else around you. Reminds me of that time when the president of the United States went on a debate stage knowing full well he had covid, and would have been happy if his opponent came down with a case, too, which at that point was even higher risk of death as most treatments were not yet approved. The more sinister question is how many players DID test, came back positive, and played anyway?

I share your techniques and philosophy, and was one of the only people wearing an N95 on a flight back from Barcelona today, full of coughing people. We’ll see if the mask holds the line as it has situationally these 3+ years. Like you I haven’t had Covid yet, but might as we speak!

And finally I think “dosage” of virus matters. I don’t mask outside, even in crowded situations, because a breath of covid is different than 30 minutes’ worth of shared air.

Viruses are like colonists in a hostile new world - send a few and the settlement probably won’t last. Send an armada full of colonists and you have problems.

Good luck with keeping your streak alive, I’ll need it too!

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Thank you: as we all navigate the "new normal"=flying blind, it really helps to get practical, sensible advice. I'm handling things very similar to you, and working hard not to feel weird when I'm the only mask in some environments. I'd rather get Covid from a loved one or a meaningful encounter.

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I also take a harm reduction approach to COVID-19 and have not, to the best of knowledge, had COVID-19. Nor have I had any of the "ordinary" upper respiratory symptoms that I took for granted before 2020.

My wife and I have resumed normal life in nearly all respects; we've flown on airliners, we've eaten meals at restaurants, we go to church on Sunday, etc., etc. But we try to minimize risk whenever that can be done without preventing us from doing something important to us. If the weather is nice, we'll have a social meal outdoor. If we're doing something indoors away from home that doesn't include eating or drinking then we'll wear good masks. And so forth. I was on a Jury last week, wearing a mask. Nearly everybody else there wasn't masked.

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Dr. Faust, at 6-something AM, your piece is pre-coffee and the first thing I've read today, and it still makes perfect sense. The gentle blend of scientific knowledge with understanding of Americans’ cowboy instincts yields helpful perspective for those willing to be informed. Thank you, and please keep it up.

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My minister just had Covid and reported on her symptoms each day. She has not been a mask wearer for a while now but once was cautious. After a week she began having heart rhythm issues and went to the ER where she had an elevated d dimer test but no obvious clots. She is now wearing a heart monitor for the next two weeks. She and so many others I know (all women) are the reason I continue to wear a mask and don’t take as many risks as many do. She is not even 35. My elderly aunt has had 2 strokes after each round of Covid - another aunt’s a-fib is worse - I truly understand wanting to live like normal but for me there is not much that is worth giving up my heart health. Good luck to everyone, we all need it.

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Pls tell us what you are doing after returning home , being around your family , colleagues and patients

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I just want to thank you once again for the bravery of holding a point of view popular neither among my conservative nor (oddly) my liberal friends. That point of view, which seems increasingly rare, is the rational middle ground. I am one of the only people in my large friend circle who still masks, but I don't always. I constantly weigh environmental factors like population density and free airflow. I think most people are just too tired of it all to care. Rather than being honest about their exhaustion, they prefer to loudly bend the truth in convenient ways. But, folks like you give strength to those of us who are still engaging with the struggle to find a sane balance between caution and normalcy. I think you're doing a great service in that regard.

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Sep 4, 2023·edited Sep 4, 2023

Thank you for this sharing. It's very similar to my mask use. I've also not had covid. Stay safe, i so appreciate you

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Thanks for writing. My practice is very similar.

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I don’t go anywhere without my N95! Could care less what others do regarding masking. I take great pride remaining covid-19 free and I am exposed a lot! All the students or staff who come to the health office not feeling well, all test positive for covid-19 with the rapid antigen test. I learned April 2022 that being outdoors among over 80,000 individuals at Stagecoach, outside is safe. I still tested daily to make sure I remained negative and also did a PCR test before leaving for the festival. My friends also did the same testing. Went to Stagecoach again April 2023 and again remained covid-19 negative. Like you, I am cautious. When dining in a restaurant I still dine outside. But have also dinned inside usually closet to the door or near better ventilation such as huge windows being open. I don’t make dinning inside a habit. When I flew last February to Washington D.C. wore my N95. Thanks for sharing! Another great article! As for the Open, whoever didn’t feel well, more than likely caught covid-19. N95er4Life

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Sensible behavior

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Thank you for the post. This is pretty much what I do. I try to eat outside but not always possible. I caught my first (known) case of Covid while traveling in Vienna in June. We had to eat indoors due to rain and pretty much no one masks in Europe. While I wish I was still a Novid, it was worth the risk. I just flew back from the Bay Area and I was totally masked in the airport and on the plane (except for eating some pretzels!) and feel a little weird doing so but hey, I want to stay healthy.

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Thank You. Between flu and COVID, can be difficult to navigate. Very helpful information.

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I added some nose sprays that seem to be evidence based: Xlear and the betadine cold defense product with iota carrageenan --only sold in Canada (purchased on eBay.) Makes me feel better and helps with allergic rhinitis.

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I have my arsenal of nasal sprays. Flo, Covixyl, Xclear and most recently Enovid. Flying to London and using public transportation , all high risk . Will be wearing a mask . Will use nasal sprays in these high risk situations My strategy is similar to Dr Faust’s . Harm reduction with a side of enjoying myself

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I have also used nasal sprays. Not sure they work but I am willing to do anything to mitigate risk.

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My dermatologist swears by Enovid, I read a twitter thread comparing the sprays and the betadine was comparable to Enovid- 80% reduction, Xlear is 62, wish Covixyl had solid data. I feel more confident when I use them and they’re harmless. There’s a U.S. brand of the iota carrageenan that was slapped by the FDA for saying it reduces COVID transmission— out of washington state.

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Enovid is expensive , don’t buy it from on Amazon it’s surge pricing. Bought two then realized I need another one as my son hasn’t had Covid. Anyhow ordered it, paid $15 shipping hoping I would get it in time (it came from Israel) and DHL delivered it in 3 business days!!!

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My sister buys it from Israel— thanks.

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founding

Hear you and makes perfect sense. I just tested positive for strep. Was negative for COVID and Flu- multiple home tests then urgent care...hello strep. Totally different symptoms than I thought- long story short, isolated, tested and kept testing because I don’t want others to get sick. The sad part is most people don’t and it makes me sad! Thanks for sharing your smart and sane messaging.

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