[Hac-announce] Fwd: The Checkup With Dr. Wen: Should mask mandates return?
Manny Sholem Ratafia
manny at ratafias.com
Thu Dec 15 17:03:25 EST 2022
I think this is a particularly helpful discussion by Leana Wen MD of
masking and other issues related to COVID/RSV/Flu.--Manny
"Fight for the things that you care about, but do it
in a way that will lead others to join you."
― Ruth Bader Ginsburg
-------- Forwarded Message --------
Subject: The Checkup With Dr. Wen: Should mask mandates return?
Date: Thu, 15 Dec 2022 21:34:16 +0000
From: The Washington Post <email at washingtonpost.com>
To: manny at ratafias.com
The Checkup With Dr. Wen: Should mask mandates return?
I think not. But people should consider masking in high-risk settings.
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Guidance on navigating the pandemic and other public health challenges
Leana S. Wen By Leana S. Wen
<mailto:checkupfeedback at washpost.com?subject=%20feedback>
/Opinions columnist/
Email <mailto:checkupfeedback at washpost.com?subject=%20feedback>
After a brief lull, coronavirus cases are again on the rise. At the same
time, hospitals are inundated with patients infected with RSV, influenza
and other viral infections. New York City health officials have strongly
recommended masking, and the Los Angeles area is considering a return to
mask mandates.
*I don’t think governments should implement mask requirements, but I
would urge people to consider masking in high-risk situations.*
I’ve written before about my apprehension toward government mask
mandates
<https://s2.washingtonpost.com/3692d97/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/11/58/639b922bef9bf67b23215551>*.
In short, I believe these should be reserved for dire situations —
five-alarm fires in which there are no other options.* Imposing such
mandates at lower levels of emergency would only further erode trust in
public health, especially if more effective and less controversial tools
exist to protect people.
I don’t want public health officials to become like the boy who cries
wolf: What happens in the future when a new, deadly virus for which we
have no vaccines or treatments emerges?
*That said, while I oppose a government-imposed mask mandate, I do
support increased masking, especially as this “tripledemic” is underway
and hospital capacity becomes limited.*
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Masks work to reduce your risk of contracting a respiratory illness. *If
you’re going to wear a mask to protect yourself, you should wear the
highest-quality one, and that’s the **N95*
<https://s2.washingtonpost.com/3894ce4/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/15/58/639b922bef9bf67b23215551>*(or
its equivalent, KN95 and KF94).*
A lot of people don’t mind wearing masks. But many people find them to
be uncomfortable and an impediment to social interactions. Those in the
latter category should consider that risk is cumulative. *Mask-wearing
doesn’t have to be all or nothing; the choice is not between wearing
them all the time and shedding them for good.*
Instead, consider which situations are highest-risk for virus
transmission. I’ve been traveling a lot for work recently, and I’ve been
surprised by how few people are wearing masks in the middle of crowded
airports and train stations where they’re standing shoulder to shoulder
with many other people. *Even if you have returned to all pre-pandemic
activities and normally don’t wear a mask, consider keeping one in your
purse or pocket and deciding, moment to moment, about whether to mask.*
You might decide, for example, not to wear a mask in an airport’s empty
security lines or while walking through spaces where people are spread
out, but then slip one on during boarding, when dozens of people are
packed together in an unventilated jet bridge. And you might keep the
mask on before takeoff and after landing, when airplane ventilation
often hasn’t kicked in, but then take it off during the flight, when
ventilation is running.
Maybe you put one on if the people around you are symptomatic. On my
last flight, I sat behind a parent with two young kids who both had
runny noses and were coughing. This family probably shouldn’t have been
traveling, but since they were, and I had no choice but to sit near
them, I made sure to mask during the entire flight.
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*What if you’re attending work or social functions where there is the
expectation of seeing one another’s facial expressions?* You could
unmask during settings that are of greatest benefit — for example, a
board meeting or presentation — and then keep it on in crowded elevators
and during transit.
Everyone should assess the covid-19 risk of their household. *If you or
someone you live with is still susceptible to severe illness from the
coronavirus, then you should all take additional precautions while
community virus levels are high. *Those visiting people who are
vulnerable should also take precautions for the three to five days
before the gathering, including wearing masks in all indoor crowded
settings.
*Masking has become a major source of controversy during covid, but it
shouldn’t be. A better approach would be to take mandatory masking out
of the equation and empower people to make reasonable decisions based on
individual circumstances.* There are other tools, too: It’s not too late
to get the flu vaccine and the coronavirus booster. And careful
handwashing and knowing how to access treatments can also help reduce
risk during this tripledemic.
My latest column
<https://s2.washingtonpost.com/3894ce5/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/19/58/639b922bef9bf67b23215551>
Opinion | It’s time the Pentagon ended its covid vaccine mandate
for the military
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By Leana S. Wen ● Read more »
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Ask Dr. Wen
*Submit your question*
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and I may answer it in a future edition of this newsletter.
*/Not subscribed yet?/ Questions to Dr. Wen from Washington Post
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/*“My 70-year-old wife just received what we thought was booster No. 3
at our primary-care clinic. However, there was an error at the clinic
pharmacy, and what she really received was the original vaccine. We were
notified of this error and told that the effectiveness against omicron
should be good for about two months. Is that an accurate assessment? And
if so, should she get the real booster after that? If it is not
accurate, what would you recommend we do?” *//– Ken from New Mexico/
Ken, I’m sorry this happened to your wife. I am sure it’s distressing to
hear that you received a vaccination in error.
Here’s what I hope is reassuring news: It’s not entirely clear yet that
the bivalent booster is necessarily better than the original monovalent
booster. There are some studies showing that the new booster will give a
better antibody response, suggesting that it might have an edge over the
original one. And one study
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reported an enhanced temporary response against symptomatic infection in
individuals who got the new booster. But we also know that the original
vaccine also works as a booster. It will give excellent protection
against severe illness and offer some protection against symptomatic
disease, at least for a short period.
The Centers for Disease Control and Prevention states that someone is
eligible for the new bivalent booster if it has been at least two months
since their last coronavirus vaccine. Your wife could get the updated
booster in two months. She could also wait three or four months, as the
vaccine she received, even in error, is still likely doing its job to
protect against severe disease.
/*“I am a physician and starting a new in-person job. It may require me
to commute on the New York City subway during rush hour. With an N95
mask, how safe is it to ride a crowded subway of maskless people? I
still haven’t had covid and prefer to avoid it. I’m fully vaccinated and
boosted.” – *//Gilbert from New York/
A well-fitting N95 mask, when worn during the entire time you are in
public settings, is extremely protective. It has been effective in
keeping health-care workers who are treating covid patients from getting
the virus, so it should do its job for you in the subway.
If your goal is to continue avoiding covid, I’d also urge you to keep
masking in your in-person job and to be aware that you could contract
the virus in indoor, unmasked social settings, too.
/*“I am up-to-date with covid vaccinations, having received the new
booster early in September. This was my fifth covid shot. I am elderly
(73) and therefore at risk. My question: When will it be appropriate to
receive the next booster?”*//— Don from Florida/
Many readers are asking this question. I don’t know the answer.
At the moment, people who received the new bivalent booster are
considered up-to-date with their covid shots. The updated booster
provides at least some temporary protection
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against infection, but this effect probably wanes within several months.
The protection against severe illness should be longer-lasting, but we
don’t yet know for how long.
The Biden administration has said that most Americans should expect the
coronavirus shot to become an annual one. It’s possible that those at
greater risk — people who are immunocompromised, the elderly and people
with chronic medical conditions — might benefit from more frequent
boosters. But there’s no such recommendation at this time.
/The Post has also compiled Q&As from my previous newsletters. You can
//read them here/
<https://s2.washingtonpost.com/35efe91/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/28/58/639b922bef9bf67b23215551>/./
What I’m reading
*A new study in **JAMA Network Open*
<https://s2.washingtonpost.com/3894ce9/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/29/58/639b922bef9bf67b23215551>*provides
further evidence that coronavirus vaccines are essential for older
individuals.* Researchers found that the original booster lowered
hospitalization or death by 80 percent and 64 percent across two
multistate nursing home systems. This underscores the importance of
older folks and vulnerable people in congregate settings to follow
federal health recommendations and keep up-to-date with vaccines.
Unfortunately, according to the Kaiser Family Foundation, only 45
percent of nursing home residents
<https://s2.washingtonpost.com/3894cea/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/30/58/639b922bef9bf67b23215551>
have received the updated booster.
*Data from the **National Vital Statistics System*
<https://s2.washingtonpost.com/3894ceb/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/31/58/639b922bef9bf67b23215551>*indicate
that deaths from opioids among adults 65 and older increased more than
threefold between 2000 and 2020.* There was a marked jump from 2019 and
2020 — 53 percent in that one-year period alone. Overdose rates in this
age group are lower than in some younger ones, but the alarming trend
points to the need for targeted intervention among older adults.
*Researchers from the Food and Drug Administration authored an article
in the journal **Pediatrics*
<https://s2.washingtonpost.com/3894cec/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/32/58/639b922bef9bf67b23215551>*that
warns parents against giving young children cough suppressant
medications.* One such drug, benzonatate (known by its trade name,
Tessalon Perles), is commonly prescribed for adults. Children 10 and
older are able to take it, but only at prescribed doses. The FDA had
previously issued guidance
<https://s2.washingtonpost.com/3894ced/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/33/58/639b922bef9bf67b23215551>
that children younger than 2 have died from ingesting as little as one
or two capsules. This article found that between 2010 and 2018, there
were 3,590 cases of unintentional benzonatate ingestion resulting in
calls to poison control centers, with most of them in children younger
than 5, highlighting the need for more medication safety education.
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China prepares for exit wave of infections as it relaxes covid
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