My biggest takeaways from your very good article were the need for healthcare workers to isolate and the general lack of care and concern exhibited by the public. It is frightening to go to a doctors office or hospital where masks aren’t in sight on patients or even any of the healthcare people. And it is rare to see masks in public places including essential indoor places, as you mention, like grocery stores. We need stronger medical education, more principled leadership and a more caring public. All, alas, seemingly all beyond reach. But thanks for your continuing efforts.
100% agree. Btw, I still throw a mask on in the grocery store. But one thing that CA's old guidance had (and likely still basically implies but nobody cares) is a distinction on crowdedness and room size. It turns out that huge spaces that are not jammed packed (like a grocery store) may be less risky than small ones with a few people. The volume of air:# of people ratio is probably really under appreciated as a risk. (And air ventilation and turnover is huge)
Agree with you on that. Will go into the public library with its high ceilings (early in the day when almost empty), but won't go into the small specialty shop which produces prepared fresh meals.
Thank you so much to taking this on--I was so glad to see your article in the Globe!-
Personally I find the dismantling of public health around Covid so discouraging--and California returned all of their government Paxlovid and is shutting down their treatment phone line:
1) although people are not testing/isolating--in an ideal world tests would be free/cheap/easily available and isolation would be based on testing and context (and there would be paid sick time), 2) "having the tools" and accessing the tools are 2 different things--interfacing with the healthcare system is difficult at best and now that Paxlovid may cost over 1500$ and people who would benefit can't obtain treatment easily--and vaccine update is very low, the tools are not being used or easily accessible.
The people who are aware that Covid is still out there and are attempting to reduce their risk of infection are the vast minority at this point and there is such stigma associated with masking or even admitting that I adjust my behavior to avoid infection.
Yes, we just experienced a very large surge and less people are dying or hospitalized, but still it's over 2000/week during this surge that so few are aware of.
You’ve seen the science. You shared it with me back in the beginning times. Nothing has substantially changed. The virus hasn’t substantially changed. You know this is Not based on science.
Excusing people’s abominable behavior, giving them permission to be even worse, helps no one. You know as well as I that thoughtless people will not wear a mask for 10 days upon their return to work. The CDC & State Health Departments are creating excuses for plague rats. Shame on them.
You & they know this virus is airborne. You & they know that indoor ventilation & filtration is substandard. Yet no one is calling for, demanding improved standards. Why? Because it would cost rich people money to protect us. And not only from Covid, it would protect us all of the airborne viruses. 👀ing @ ili & RSV. Tb, too, though it’s now a lesser problem.
I appreciate you addressing this thoughtfully and thoroughly. It shouldn't be so necessary for doctors and researchers to step up and keep the public informed, or to triage dangerous developments. Thank you for this work.
I can't refer to the ever loosening layers of care as harm reduction. A lack of appropriate guidance from PH has facilitated every surge.
Good faith harm reduction would be more rigorous. It shouldn't be a choice between mandates and low quality guidance. PH guidance could be tiered. It can start from a place of more caution, so that the public understands what that looks like, and it would also note ways to make-do under one's circumstances.
The ideal guidance is to isolate when positive.
Isolate. When. Positive.
PH can attach as many compromises as they like, after stating the ideal.
Every time PH decides to placate a small fraction of disgruntled people, they do a disservice to all. They fail to educate and guide us.
Thank you for showing up to help us stay informed.
You ask: "What can we reasonably expect from the public in year five of this pandemic?" Based on what I see in a semi-rural western Massachusetts town: Nothing much. There's general tolerance of people wearing masks (though a phlebotomist at our local hospital, an outpost of Mass General Brigham, told me she gets insults and nasty comments about her mask almost every day from patients - and her colleagues don't mask at all), but hardly anyone else besides my wife and me wears one, including most health-care professionals most of the time - and when they do, they wear blue surgical-type masks, not particularly effective. At least those I see in the general population who do mask are on the whole well-informed, and wear N95 masks - no doubt understanding, as we do, that the main function in this cultural climate is to protect the wearer. Given the general assault on public health over the past few years - physical as well as verbal - it's hard to see public attitudes changing very soon. I wonder how your colleagues - in emergency and in the hospital generally - view the situation?
Also, what seems to be missing in our society is the discussion of care for one another, which turns mask wearing into a compassionate action, rather than a burden. If I see my actions as having consequence to others and if I care about not harming others, then wearing a mask becomes a courtesy and a priority to care for others who may be more vulnerable. It takes individual “privilege” to not mask and de-centers it in favor of the health of the community (my neighbors) and at the same time benefits one’s own health. What might be seen as onerous then becomes one of caring responsibility.
I have several risk factors and care for an elderly parent with cancer. I continue to mask with an N95 and have been ridiculed, yelled at from cars, etc. I’m in Massachusetts and I’m at the point where I just DGAF anymore what people think about my masking habits. That said, I’ve had a hard time finding a dental office that will wear an N95, at the one time my family and I really need the other person to pull some weight. I know it’s year 5 and we are tired, but I would truly appreciate just a little compassion from those who choose not to mask toward those who do for any host of reasons. It hasn’t been an easy time for any of us.
10 days for healthcare workers, that's funny. Healthcare workers were the first people who could leave prescribed COVID isolation early to go to work, masked at least.
My biggest takeaways from your very good article were the need for healthcare workers to isolate and the general lack of care and concern exhibited by the public. It is frightening to go to a doctors office or hospital where masks aren’t in sight on patients or even any of the healthcare people. And it is rare to see masks in public places including essential indoor places, as you mention, like grocery stores. We need stronger medical education, more principled leadership and a more caring public. All, alas, seemingly all beyond reach. But thanks for your continuing efforts.
100% agree. Btw, I still throw a mask on in the grocery store. But one thing that CA's old guidance had (and likely still basically implies but nobody cares) is a distinction on crowdedness and room size. It turns out that huge spaces that are not jammed packed (like a grocery store) may be less risky than small ones with a few people. The volume of air:# of people ratio is probably really under appreciated as a risk. (And air ventilation and turnover is huge)
Agree with you on that. Will go into the public library with its high ceilings (early in the day when almost empty), but won't go into the small specialty shop which produces prepared fresh meals.
You nailed it!
Thank you so much to taking this on--I was so glad to see your article in the Globe!-
Personally I find the dismantling of public health around Covid so discouraging--and California returned all of their government Paxlovid and is shutting down their treatment phone line:
1) although people are not testing/isolating--in an ideal world tests would be free/cheap/easily available and isolation would be based on testing and context (and there would be paid sick time), 2) "having the tools" and accessing the tools are 2 different things--interfacing with the healthcare system is difficult at best and now that Paxlovid may cost over 1500$ and people who would benefit can't obtain treatment easily--and vaccine update is very low, the tools are not being used or easily accessible.
The people who are aware that Covid is still out there and are attempting to reduce their risk of infection are the vast minority at this point and there is such stigma associated with masking or even admitting that I adjust my behavior to avoid infection.
Yes, we just experienced a very large surge and less people are dying or hospitalized, but still it's over 2000/week during this surge that so few are aware of.
You’ve seen the science. You shared it with me back in the beginning times. Nothing has substantially changed. The virus hasn’t substantially changed. You know this is Not based on science.
Excusing people’s abominable behavior, giving them permission to be even worse, helps no one. You know as well as I that thoughtless people will not wear a mask for 10 days upon their return to work. The CDC & State Health Departments are creating excuses for plague rats. Shame on them.
You & they know this virus is airborne. You & they know that indoor ventilation & filtration is substandard. Yet no one is calling for, demanding improved standards. Why? Because it would cost rich people money to protect us. And not only from Covid, it would protect us all of the airborne viruses. 👀ing @ ili & RSV. Tb, too, though it’s now a lesser problem.
What do I think? This is a sham.
I appreciate you addressing this thoughtfully and thoroughly. It shouldn't be so necessary for doctors and researchers to step up and keep the public informed, or to triage dangerous developments. Thank you for this work.
I can't refer to the ever loosening layers of care as harm reduction. A lack of appropriate guidance from PH has facilitated every surge.
Good faith harm reduction would be more rigorous. It shouldn't be a choice between mandates and low quality guidance. PH guidance could be tiered. It can start from a place of more caution, so that the public understands what that looks like, and it would also note ways to make-do under one's circumstances.
The ideal guidance is to isolate when positive.
Isolate. When. Positive.
PH can attach as many compromises as they like, after stating the ideal.
Every time PH decides to placate a small fraction of disgruntled people, they do a disservice to all. They fail to educate and guide us.
Thank you for showing up to help us stay informed.
You ask: "What can we reasonably expect from the public in year five of this pandemic?" Based on what I see in a semi-rural western Massachusetts town: Nothing much. There's general tolerance of people wearing masks (though a phlebotomist at our local hospital, an outpost of Mass General Brigham, told me she gets insults and nasty comments about her mask almost every day from patients - and her colleagues don't mask at all), but hardly anyone else besides my wife and me wears one, including most health-care professionals most of the time - and when they do, they wear blue surgical-type masks, not particularly effective. At least those I see in the general population who do mask are on the whole well-informed, and wear N95 masks - no doubt understanding, as we do, that the main function in this cultural climate is to protect the wearer. Given the general assault on public health over the past few years - physical as well as verbal - it's hard to see public attitudes changing very soon. I wonder how your colleagues - in emergency and in the hospital generally - view the situation?
This article by Nate Bear is an important read: https://open.substack.com/pub/donotpanic/p/the-forgotten-lessons-of-infectious?r=nmpma&utm_medium=ios&utm_campaign=post
Also, what seems to be missing in our society is the discussion of care for one another, which turns mask wearing into a compassionate action, rather than a burden. If I see my actions as having consequence to others and if I care about not harming others, then wearing a mask becomes a courtesy and a priority to care for others who may be more vulnerable. It takes individual “privilege” to not mask and de-centers it in favor of the health of the community (my neighbors) and at the same time benefits one’s own health. What might be seen as onerous then becomes one of caring responsibility.
I have several risk factors and care for an elderly parent with cancer. I continue to mask with an N95 and have been ridiculed, yelled at from cars, etc. I’m in Massachusetts and I’m at the point where I just DGAF anymore what people think about my masking habits. That said, I’ve had a hard time finding a dental office that will wear an N95, at the one time my family and I really need the other person to pull some weight. I know it’s year 5 and we are tired, but I would truly appreciate just a little compassion from those who choose not to mask toward those who do for any host of reasons. It hasn’t been an easy time for any of us.
10 days for healthcare workers, that's funny. Healthcare workers were the first people who could leave prescribed COVID isolation early to go to work, masked at least.