As an 82 yo retired family doc with 4 high risk chronic medical problems, I have spent 4 years being a COVID nerd. In 2020, fearing a fatal infection, I totally avoided indoor spaces (but loved walking in the park) except to shop for groceries at 8am. I am gratified that my current masking protocol totally matches yours. It is practical for risk/benefit and allows a full life. Never be embarrassed to mask when you feel it is necessary.
Thanks for this, Dr. Gordon. I care for an 84-year-old parent with a similar chronic problem load. I am healthy, my husband and two teenagers are healthy, but we mask to keep Gpa, Gma (also at risk), and Asperger Syndrome 60-year-old brother safe. It’s a big ask of my own family, but if I go down, two households go down with me. Never mind long Covid risks. It’s hard to trust the decision making of us all when there’s memory issues beginning (folks), beginner independent decision making happening (college freshman), and autism spectrum complicating nuanced choices. We are tired of masking. We trudge on, and I’m not sure how much longer they all can bear up. I appreciate your seconding of Dr. Faust’s decision tree. It helps.
This is excellent, practical advice that doesn’t dictate what we should all be doing but instead gives us good information with which to make the best decisions for ourselves. I’m a healthy, 81-yr-old retired ER nurse and think similarly to you; I’ve instinctively been pretty much following the same guidelines as you and have yet to be infected with Covid. However, I’ve been wearing KN-95 masks, rather than the uncomfortable N-95’s. What are your thoughts on them vs N-95’s? Also, should I purchase a CO2 monitor? Thanks for all the useful and well-presented information you provide.
If the fit/seal is good and you're comfortable for the duration of wearing it, that sounds like the right mask for you. I've used KN95 all along. I keep on hand both the powecom flat fold for its ease, and the boat shaped breatheteq for its breathability and fit. My kid sings in choir with the breatheteq!
Same here: KN-95s (higher buy-in from the teens) and 3/4 of us are Novids ( oldest teen caught mask fatigue in the summer wave, and then Covid. There’s a price for every part of this).
Dr. Faust, Thanks for this essay. It is helpful and reinforces my own behavior and beliefs about continual masking. I appreciate that you are masking in your medical workplace. I wish all médical facilités and personnel masked when they are in the presence of patients. MGB’s facilities and personnel are better at this protocol than are other medical institutions.
My experience with both Dana Farber and MGB-Cooley Dickinson Hospital is that hardly any of the providers wear masks. Even in the ED (on my one recent trip there), some would mask up before approaching me (but not everyone), but mostly were not masked. The ambulance crew provided me with an N95 before delivering me, and I wore it throughout. -- The one phlebotomist who wore a mask on a recent blood-draw visit told me that she routinely is insulted and derided for doing so - not by everyone, but enough times that she's pretty fed up. No wonder health care providers are often finding other alternatives when they can.
That's my experience at the Brigham outpatient clinic--zero masks at the immune deficiency clinic on the providers--from early on. A few on the staff. Osterholm has cited MGB as being behind the science on masking. I would concur.
This is very helpful and practical. Thank you! I will be getting a portable CO2 monitor from Australia--Airspot, and am looking forward to it confirming or denying my "sense" of ventilation. Where I struggle is my "rule" to mask in healthcare settings when I'm the lone mask--as a patient. The desire to feel socially "normal" is a powerful thing.
Here's the website for AirSpot--https://airspothealth.com
I so appreciate your communication and even some re-communication on masking. Especially as that must have taken a lot of time. And I also appreciate macro to micro elucidation in detail. Many here are especially sensitive to masking issues (and yes, we see it as one of many approaches we use in combination to protect ourselves and others) because we, like myself, or our loved ones are highly immune compromised. I can't tell you how many of my doctors and nurses do NOT mask when treating me, and if they do, wear those thin paper masks. I'm talking about during my treatment for a return of Breast Cancer, Pulmonology treatment, infusions of powerful large doses for Progressive MS monoclonal anti-bodies that have brought my B and T cells down to close to zip. I also have CVID (Common Variable Immune Deficiency) and don't naturally manufacture enough IgG. It was the same for my sister who recently died from Inflammatory Breast Cancer. Some of them were doctor's who I really respected. In 2 different ER's recently the nurses who triaged me and other patients were NOT wearing any masks. I have many friends and family who are docs and nurses so I'm very empathetic to a healthcare system that fails them and the good work they want to do. I have sat in my wheelchair in the rain with nurses when MA had a proposed bill to increase the staff of ER nurses here. I saw what happened to them during COVID and fundraised for nurses and staff to find ways to show them the community supported them during the beginning of COVID. If you think it was hard as medical staff, consider how it has been for us. We were already isolated by our precarious health (as are our families by default) and especially when you use a wheelchair BEFORE COVID. Then it was a nightmare that still continues for us. We already had to worry that we could really get much sicker from flu or COVID, or die. But we also want people to see our faces, we want to participate in our community, work jobs, share in activities with our kids, to have society see us as valuable human beings, not obstacles and inconvenient. We are fallible too and want to be free to go out without a mask and just blend in with the crowd. None of this is easy for any of us, but communication, and ongoing, is absolutely key. And there's no avoiding that it will get challenging at times, but that is exactly why I and many others appreciate your consistent writing, evaluation, while maintaining your demanding job, and caring for your family. I ascertained a long time ago that you must be awfully good at your job and still could speak out so honestly on healthcare issues (although I'm sure it's still a concern). And because you are relentless about facts and data.
Not a doctor or scientist just someone doing the best I can. The thing I can't get past is if masking helps, why wouldn't I? I love hosting at my home - I've got Coways & Corsi-Rosenthals & an Aranet CO2 monitor & windows that open. The only thing I'm not doing is indoor restaurant dining. I keep hoping folks get on board with cleaner indoor air - positive in any instance. So much money but peace of mind is priceless.
Thank you for this. It is reaffirming to read in this "back to normal" world. I too am doing something very similar in my day to day. I always have one in my pocket or purse. And I am often the only one wearing a mask (N95), even in very crowded places. But I do feel it changes my interactions with others a bit. Jan I feel the same way - the desire to feel "normal" and fit in is alive and well in my psyche too. But I have yet to get Covid (or unknowingly give it to my high risk family or friends.)
I have found the sense of ventilation not that accurate when I have pulled out the monitor. Huge indoor spaces with high ceilings can still be poorly ventilated (maybe the type of HVAC system contributes?) And outdoor spaces also can be deceiving, especially if they are crowded or you are sitting next to the same people for hours, or talking at close distances.
I must admit that when I began reading your post, I was skeptical about whether I would agree with your perspectives on masking and COVID-19 risk management. However, by the time I reached the end, I was pleasantly surprised to find common ground on several important points.
Firstly, I’ve observed that many individuals in the “Still COVIDing” community strive to eliminate even the slightest risk, going to great lengths to avoid the last 0.5% of potential exposure. When challenged on this approach, they often accuse others of being COVID minimizers. It’s akin to the risks we accept when driving a car—we don’t all install three-point racing harnesses or equip our vehicles with roll cages to mitigate every possible danger. At some point, we have to balance risk reduction with practicality and quality of life.
Regarding your point about the linear relationship between exposure time and infection risk, particularly with influenza, it’s important to consider that at some point, one reaches an infectious dose. The relationship isn’t entirely linear because once that threshold is crossed, the likelihood of infection increases significantly.
I wholeheartedly agree with your views on outdoor settings. Masking outdoors is generally unnecessary, as the risk of transmission in well-ventilated, open-air environments is minimal. This aligns with both scientific evidence and common sense.
Moreover, the concept of infectious dose is dynamic and can ebb and flow depending on factors such as how recently someone was boosted and how well that booster matches circulating variants. Immunity isn’t static, and our risk assessments should account for these fluctuations.
While N95 masks offer excellent protection, for most scenarios, a decently fitting KN95 mask suffices. People often underestimate the fit and filtration efficiency of many ear-loop masks. Having personally used a TSI PortaCount to test over 50 masks, I’ve found that most individuals can easily achieve over 97% filtration efficiency without a formal fit test.
I still have not dined indoors. I’ve found that every restaurant I’ve visited has >1,200ppm CO2. If there are any spots in the Boston area you feel comfortable with, I’d love your recommendations.
It would be great to see more public health messaging along these lines - encouraging masking in certain situations without making it all-or-nothing. We took our first family vacation last spring and I had the misfortune of sitting next to a woman and her husband who were coughing throughout the six hour flight to Hawaii. She had a bottle of Robitussin in the seat pocket in front of her. I was wearing an N95 and did not get sick. My family, sitting across the aisle in KN95s, did not get sick either. It was frustrating that in the course of travel I got second glances for masking, yet no one around us seemed fazed by this woman clearly being sick and spreading her germs in very close quarters. My husband teaches in a public school and wore an N95 for the first couple of years and then switched to a KN95 and has not caught anything at work. What great tools masks are! If only we could normalize their use.
I find this a useful discussion about mask use, thank you. One thing I sometimes consider is the social impact of wearing a mask. Some people have a harder time than I do in standing out and another person having a mask can help them feel comfortable.
The big thing for me though is: why not have clean air infrastructure? More outside air and effective filtration would greatly reduce the need for individuals to use masks. Let's start with schools! I don't want to have to disinfect and filter my water supply myself, I believe that it's better done for all. Seriously, at one point in history not that long ago cholera, dysentery, polio, and many more were common due to contaminated water. We got together and created a safe water supply. If we did this with air it would be beneficial not only for SARS-2 but for influenza and other respiratory diseases (e.g. note the low flu season in 2020-21).
Is there some reason this isn't even talked about? Yes, it will cost money. How many trillions of dollars have been spent on water and sewage treatment?
Dr. Faust, I really appreciate you for addressing this. When you say it’s not binary: ain’t that the truth. It’s not a line. It’s not even a circle. More like a universe of “if this/then that” decisions, and that’s only the stuff we CAN control. I am not 100% aligned with your points, nor am I completely against the case you’ve made. It’s hard out here in these Covid streets. Thanks for the discourse.
I can't afford to get LC, so I set a higher bar than Dr. Faust, but I appreciate his take.
The only way to prevent Long Cov*d is to prevent Cov*d. (I mean, no one can afford to get LC, they just don't know it until it's too late.)
I share living space with other people, and that space needs to remain free of SARS2, to the best of our ability. We mask as consistently as we can, which doesn't get in the way of living our lives, and use testing when we break protocol or expand our bubble. The protocol is an ideal, of course, but a necessary starting point. We know that unmasked sips in a social setting during low tide is very different from indoor dining twice a week during high community transmission.
We follow unmasked times with watchfulness and testing, so we can clamp down on onward transmission, which we've done successfully.
As a person with ME/CFS, I'm not going to FAFO w SARS2.
This is an important perspective. I am 68, higher risk, and I mask in many situations but not all. If I am on a plane I wear an N95. If I am in my local grocery store I wear an KN95. I go back and forth. Yesterday, a friend was coming over for dinner. She texted me to let me know she was exposed to Covid two days prior but had been wearing a mask (the patient was asymptomatic). She asked if she should still come over. I asked her to Covid test -- she was negative -- and we proceeded with dinner. I have an air purifier running and I felt okay about her status. (I could come to regret it!) Interestingly, she is a Novid and both her spouse and adult son had Covid a few weeks ago and she did not get it. She may be one of the lucky ones. As you say, Covid is not going away but I have to live a life.
Rationalization. Been seeing it since 2020. This is why you and you family have had their first cases of Covid. With half the cases being asymp..pos more now with some immunity masking symptoms..you are still spreading whatever you breathed in. Science replaced by "vibes". Fine..if only you are affected.
I hear you. It's a communicable disease! We should not add to the burden of people who are trying to hold onto their health. And the most vulnerable should not be asked to rely on one-way masking, given the consequences if their mask is gappy or they need dental work or a medical procedure, etc. Asymptomatic cases play a role in community transmission, and I don't see Drs. with platforms talking about it enough.
People with disability, people avoiding new or worsening chronic health issues - they ask us to mask up where they need to be: shopping, pharmacy, healthcare, transportation, work, school, recreation. Everywhere. But the public has been socialized to believe that some all-clear has been sounded, despite proof that our current immunization is not durable. It decreases transmission by a smidgeon. It decreases but does not eliminate LC. It does its job, but unless we employ NPI, we don't slow or stop transmission. I'm angry that we missed the chance to squash this, that we missed the chance to normalize masking when sick, and to normalize masking to avoid illness.
I hear you. The world looks like a dumpster fire of apathy. One of the reasons I continue to mask is to normalize it. I wear it for me, and I wear it for you.
If Dr. Faust is in a position to advocate for it, I'd love to see twice weekly testing in a workplace or school for a time, to explore the prevalence of asymptomatic cases. I think that needs to be part of the calculus of one's decisions about mask use.
Great essay Jeremy. What gets lost in the vitriolic all or nothing discussion is the nuance you just described. It's a lot better to do smart things than nothing at all, and that message gets lost in black or white approach. I think it's also so important to keep the vulnerables you might encounter in Healthcare in the equation, as you did.
As an 82 yo retired family doc with 4 high risk chronic medical problems, I have spent 4 years being a COVID nerd. In 2020, fearing a fatal infection, I totally avoided indoor spaces (but loved walking in the park) except to shop for groceries at 8am. I am gratified that my current masking protocol totally matches yours. It is practical for risk/benefit and allows a full life. Never be embarrassed to mask when you feel it is necessary.
Thanks for this, Dr. Gordon. I care for an 84-year-old parent with a similar chronic problem load. I am healthy, my husband and two teenagers are healthy, but we mask to keep Gpa, Gma (also at risk), and Asperger Syndrome 60-year-old brother safe. It’s a big ask of my own family, but if I go down, two households go down with me. Never mind long Covid risks. It’s hard to trust the decision making of us all when there’s memory issues beginning (folks), beginner independent decision making happening (college freshman), and autism spectrum complicating nuanced choices. We are tired of masking. We trudge on, and I’m not sure how much longer they all can bear up. I appreciate your seconding of Dr. Faust’s decision tree. It helps.
Glad to know you have found what works for you. Thank you!
This is excellent, practical advice that doesn’t dictate what we should all be doing but instead gives us good information with which to make the best decisions for ourselves. I’m a healthy, 81-yr-old retired ER nurse and think similarly to you; I’ve instinctively been pretty much following the same guidelines as you and have yet to be infected with Covid. However, I’ve been wearing KN-95 masks, rather than the uncomfortable N-95’s. What are your thoughts on them vs N-95’s? Also, should I purchase a CO2 monitor? Thanks for all the useful and well-presented information you provide.
If the fit/seal is good and you're comfortable for the duration of wearing it, that sounds like the right mask for you. I've used KN95 all along. I keep on hand both the powecom flat fold for its ease, and the boat shaped breatheteq for its breathability and fit. My kid sings in choir with the breatheteq!
I appreciate the testing from the Mask Nerd.
https://youtu.be/s3-Hf6wnPds?si=Aqm3zKCB7XqSTdlY&t=1
Same here: KN-95s (higher buy-in from the teens) and 3/4 of us are Novids ( oldest teen caught mask fatigue in the summer wave, and then Covid. There’s a price for every part of this).
That's what I wear the vast majority of the time too.
Me too.
Dr. Faust, Thanks for this essay. It is helpful and reinforces my own behavior and beliefs about continual masking. I appreciate that you are masking in your medical workplace. I wish all médical facilités and personnel masked when they are in the presence of patients. MGB’s facilities and personnel are better at this protocol than are other medical institutions.
My experience with both Dana Farber and MGB-Cooley Dickinson Hospital is that hardly any of the providers wear masks. Even in the ED (on my one recent trip there), some would mask up before approaching me (but not everyone), but mostly were not masked. The ambulance crew provided me with an N95 before delivering me, and I wore it throughout. -- The one phlebotomist who wore a mask on a recent blood-draw visit told me that she routinely is insulted and derided for doing so - not by everyone, but enough times that she's pretty fed up. No wonder health care providers are often finding other alternatives when they can.
That's my experience at the Brigham outpatient clinic--zero masks at the immune deficiency clinic on the providers--from early on. A few on the staff. Osterholm has cited MGB as being behind the science on masking. I would concur.
This is very helpful and practical. Thank you! I will be getting a portable CO2 monitor from Australia--Airspot, and am looking forward to it confirming or denying my "sense" of ventilation. Where I struggle is my "rule" to mask in healthcare settings when I'm the lone mask--as a patient. The desire to feel socially "normal" is a powerful thing.
Here's the website for AirSpot--https://airspothealth.com
Your conclusion is just so spot on.
I so appreciate your communication and even some re-communication on masking. Especially as that must have taken a lot of time. And I also appreciate macro to micro elucidation in detail. Many here are especially sensitive to masking issues (and yes, we see it as one of many approaches we use in combination to protect ourselves and others) because we, like myself, or our loved ones are highly immune compromised. I can't tell you how many of my doctors and nurses do NOT mask when treating me, and if they do, wear those thin paper masks. I'm talking about during my treatment for a return of Breast Cancer, Pulmonology treatment, infusions of powerful large doses for Progressive MS monoclonal anti-bodies that have brought my B and T cells down to close to zip. I also have CVID (Common Variable Immune Deficiency) and don't naturally manufacture enough IgG. It was the same for my sister who recently died from Inflammatory Breast Cancer. Some of them were doctor's who I really respected. In 2 different ER's recently the nurses who triaged me and other patients were NOT wearing any masks. I have many friends and family who are docs and nurses so I'm very empathetic to a healthcare system that fails them and the good work they want to do. I have sat in my wheelchair in the rain with nurses when MA had a proposed bill to increase the staff of ER nurses here. I saw what happened to them during COVID and fundraised for nurses and staff to find ways to show them the community supported them during the beginning of COVID. If you think it was hard as medical staff, consider how it has been for us. We were already isolated by our precarious health (as are our families by default) and especially when you use a wheelchair BEFORE COVID. Then it was a nightmare that still continues for us. We already had to worry that we could really get much sicker from flu or COVID, or die. But we also want people to see our faces, we want to participate in our community, work jobs, share in activities with our kids, to have society see us as valuable human beings, not obstacles and inconvenient. We are fallible too and want to be free to go out without a mask and just blend in with the crowd. None of this is easy for any of us, but communication, and ongoing, is absolutely key. And there's no avoiding that it will get challenging at times, but that is exactly why I and many others appreciate your consistent writing, evaluation, while maintaining your demanding job, and caring for your family. I ascertained a long time ago that you must be awfully good at your job and still could speak out so honestly on healthcare issues (although I'm sure it's still a concern). And because you are relentless about facts and data.
Not a doctor or scientist just someone doing the best I can. The thing I can't get past is if masking helps, why wouldn't I? I love hosting at my home - I've got Coways & Corsi-Rosenthals & an Aranet CO2 monitor & windows that open. The only thing I'm not doing is indoor restaurant dining. I keep hoping folks get on board with cleaner indoor air - positive in any instance. So much money but peace of mind is priceless.
Thank you for this. It is reaffirming to read in this "back to normal" world. I too am doing something very similar in my day to day. I always have one in my pocket or purse. And I am often the only one wearing a mask (N95), even in very crowded places. But I do feel it changes my interactions with others a bit. Jan I feel the same way - the desire to feel "normal" and fit in is alive and well in my psyche too. But I have yet to get Covid (or unknowingly give it to my high risk family or friends.)
I have found the sense of ventilation not that accurate when I have pulled out the monitor. Huge indoor spaces with high ceilings can still be poorly ventilated (maybe the type of HVAC system contributes?) And outdoor spaces also can be deceiving, especially if they are crowded or you are sitting next to the same people for hours, or talking at close distances.
Thanks for this nuance. Points taken, for sure.
I must admit that when I began reading your post, I was skeptical about whether I would agree with your perspectives on masking and COVID-19 risk management. However, by the time I reached the end, I was pleasantly surprised to find common ground on several important points.
Firstly, I’ve observed that many individuals in the “Still COVIDing” community strive to eliminate even the slightest risk, going to great lengths to avoid the last 0.5% of potential exposure. When challenged on this approach, they often accuse others of being COVID minimizers. It’s akin to the risks we accept when driving a car—we don’t all install three-point racing harnesses or equip our vehicles with roll cages to mitigate every possible danger. At some point, we have to balance risk reduction with practicality and quality of life.
Regarding your point about the linear relationship between exposure time and infection risk, particularly with influenza, it’s important to consider that at some point, one reaches an infectious dose. The relationship isn’t entirely linear because once that threshold is crossed, the likelihood of infection increases significantly.
I wholeheartedly agree with your views on outdoor settings. Masking outdoors is generally unnecessary, as the risk of transmission in well-ventilated, open-air environments is minimal. This aligns with both scientific evidence and common sense.
Moreover, the concept of infectious dose is dynamic and can ebb and flow depending on factors such as how recently someone was boosted and how well that booster matches circulating variants. Immunity isn’t static, and our risk assessments should account for these fluctuations.
While N95 masks offer excellent protection, for most scenarios, a decently fitting KN95 mask suffices. People often underestimate the fit and filtration efficiency of many ear-loop masks. Having personally used a TSI PortaCount to test over 50 masks, I’ve found that most individuals can easily achieve over 97% filtration efficiency without a formal fit test.
I still have not dined indoors. I’ve found that every restaurant I’ve visited has >1,200ppm CO2. If there are any spots in the Boston area you feel comfortable with, I’d love your recommendations.
It would be great to see more public health messaging along these lines - encouraging masking in certain situations without making it all-or-nothing. We took our first family vacation last spring and I had the misfortune of sitting next to a woman and her husband who were coughing throughout the six hour flight to Hawaii. She had a bottle of Robitussin in the seat pocket in front of her. I was wearing an N95 and did not get sick. My family, sitting across the aisle in KN95s, did not get sick either. It was frustrating that in the course of travel I got second glances for masking, yet no one around us seemed fazed by this woman clearly being sick and spreading her germs in very close quarters. My husband teaches in a public school and wore an N95 for the first couple of years and then switched to a KN95 and has not caught anything at work. What great tools masks are! If only we could normalize their use.
I find this a useful discussion about mask use, thank you. One thing I sometimes consider is the social impact of wearing a mask. Some people have a harder time than I do in standing out and another person having a mask can help them feel comfortable.
The big thing for me though is: why not have clean air infrastructure? More outside air and effective filtration would greatly reduce the need for individuals to use masks. Let's start with schools! I don't want to have to disinfect and filter my water supply myself, I believe that it's better done for all. Seriously, at one point in history not that long ago cholera, dysentery, polio, and many more were common due to contaminated water. We got together and created a safe water supply. If we did this with air it would be beneficial not only for SARS-2 but for influenza and other respiratory diseases (e.g. note the low flu season in 2020-21).
Is there some reason this isn't even talked about? Yes, it will cost money. How many trillions of dollars have been spent on water and sewage treatment?
Dr. Faust, I really appreciate you for addressing this. When you say it’s not binary: ain’t that the truth. It’s not a line. It’s not even a circle. More like a universe of “if this/then that” decisions, and that’s only the stuff we CAN control. I am not 100% aligned with your points, nor am I completely against the case you’ve made. It’s hard out here in these Covid streets. Thanks for the discourse.
I can't afford to get LC, so I set a higher bar than Dr. Faust, but I appreciate his take.
The only way to prevent Long Cov*d is to prevent Cov*d. (I mean, no one can afford to get LC, they just don't know it until it's too late.)
I share living space with other people, and that space needs to remain free of SARS2, to the best of our ability. We mask as consistently as we can, which doesn't get in the way of living our lives, and use testing when we break protocol or expand our bubble. The protocol is an ideal, of course, but a necessary starting point. We know that unmasked sips in a social setting during low tide is very different from indoor dining twice a week during high community transmission.
We follow unmasked times with watchfulness and testing, so we can clamp down on onward transmission, which we've done successfully.
As a person with ME/CFS, I'm not going to FAFO w SARS2.
This is an important perspective. I am 68, higher risk, and I mask in many situations but not all. If I am on a plane I wear an N95. If I am in my local grocery store I wear an KN95. I go back and forth. Yesterday, a friend was coming over for dinner. She texted me to let me know she was exposed to Covid two days prior but had been wearing a mask (the patient was asymptomatic). She asked if she should still come over. I asked her to Covid test -- she was negative -- and we proceeded with dinner. I have an air purifier running and I felt okay about her status. (I could come to regret it!) Interestingly, she is a Novid and both her spouse and adult son had Covid a few weeks ago and she did not get it. She may be one of the lucky ones. As you say, Covid is not going away but I have to live a life.
Rationalization. Been seeing it since 2020. This is why you and you family have had their first cases of Covid. With half the cases being asymp..pos more now with some immunity masking symptoms..you are still spreading whatever you breathed in. Science replaced by "vibes". Fine..if only you are affected.
I hear you. It's a communicable disease! We should not add to the burden of people who are trying to hold onto their health. And the most vulnerable should not be asked to rely on one-way masking, given the consequences if their mask is gappy or they need dental work or a medical procedure, etc. Asymptomatic cases play a role in community transmission, and I don't see Drs. with platforms talking about it enough.
People with disability, people avoiding new or worsening chronic health issues - they ask us to mask up where they need to be: shopping, pharmacy, healthcare, transportation, work, school, recreation. Everywhere. But the public has been socialized to believe that some all-clear has been sounded, despite proof that our current immunization is not durable. It decreases transmission by a smidgeon. It decreases but does not eliminate LC. It does its job, but unless we employ NPI, we don't slow or stop transmission. I'm angry that we missed the chance to squash this, that we missed the chance to normalize masking when sick, and to normalize masking to avoid illness.
I hear you. The world looks like a dumpster fire of apathy. One of the reasons I continue to mask is to normalize it. I wear it for me, and I wear it for you.
If Dr. Faust is in a position to advocate for it, I'd love to see twice weekly testing in a workplace or school for a time, to explore the prevalence of asymptomatic cases. I think that needs to be part of the calculus of one's decisions about mask use.
Great essay Jeremy. What gets lost in the vitriolic all or nothing discussion is the nuance you just described. It's a lot better to do smart things than nothing at all, and that message gets lost in black or white approach. I think it's also so important to keep the vulnerables you might encounter in Healthcare in the equation, as you did.