Mask Confusion, Mask Destruction?

This part at least is clear!

 

I’m just coming off a session of attempting to de-freakout someone about a misleading vaccine scare article. I’ve had it with the antivaxx disinformation crew, and then I’ve also had it with the “science-based” bunch who poo-poo everything that doesn’t fit their narrow field of vision, like the guy I was reading a few minutes ago who insists that chiropractors aren’t doctors. I’ve had it.

I bet you’ve had it too.

Let’s take a deep breath, get a cup of tea, and survey the current state of play in our pandemic reality.

 

Are you confused about where, when, and whether to wear a mask now, or whether they help at this point? Of course you are. The current guidance is about as confusing as anything in the past 15 months has been, though I don’t know how it could be stated much better under the circumstances. And some people are still getting vicious with each other over their decisions about masking and other precautions.

Emma Green wrote an article in The Atlantic that struck me as lacking in empathy at best, entitled “The Liberals Who Can’t Quit Lockdown.” She took jabs at people who, in her opinion, were refusing to follow science not by denying the need for precautions, but by keeping them in place too long. Yet, all too many times, loosening of restrictions has led to spikes in cases and restrictions being imposed again. Is it any wonder that a lot of people are taking their time in going back to “normal”?

Shayla Love responded to Green with “People Aren’t ‘Addicted’ to Wearing Masks, They’re Traumatized.” I found her thoughts compelling.
https://medium.com/vice/people-arent-addicted-to-wearing-masks-they-re-traumatized-2746308163cc

‘There are other reasons why people may be hanging onto COVID precautions. Some people have unvaccinated children who, though at low risk, don’t have zero risk. Others may be immunocompromised or worried about the uncertainty around variants. Individual risk tolerance varies, and since the pandemic is certainly not over, it’s understandable if people’s tolerances still rest at different levels.

‘But in general, there are two groups of people who are most likely to return to normal life more slowly — and their reasons have to do with mental health and trauma, said Steven Taylor, a psychiatrist at the University of British Columbia. They are people who had mental health concerns before the pandemic, like anxiety or OCD, and those who had highly stressful or traumatic experiences: people who had COVID themselves, have long COVID, or lost someone due to COVID. These groups deserve our compassion, and patience.’

She reminds us that much of the world is still in a far more precarious situation than we are, and a lot of us feel that acutely.
‘Frani also thinks it’s a bit obtuse to zero in on people being “overly cautious” when the pandemic is still causing so much loss around the world. “It’s obnoxious, the sort of glee and readiness of which we’re abandoning masks when we see what’s going on in India,” she said. “Of course we’re all happy that things are going well here. But it’s so cringey to me that in the same breath someone would have the audacity to say, ’You’re being too safe,’ when they [sic] are people praying for anything resembling this sort of safety that we have here in other parts of the world.”’
Frani speaks for me too.

Back at The Atlantic, the kind and gentle Ed Yong also took up the effects of our communal trauma in “What Happens When Americans Can Finally Exhale.”
https://www.theatlantic.com/health/archive/2021/05/pandemic-trauma-summer/618934/

‘But it is also reasonable for people to want to continue wearing masks, to feel anxious that others might now decide not to, or to be dubious that strangers will be honest about their vaccination status. People don’t make decisions about the present in a temporal vacuum. They integrate across their past experiences. They learn. Some have learned that the CDC can be slow in its assessment of evidence, or confusing in its proclamations. They watched their fellow citizens rail against steps that would protect one another from infections at a time when the U.S. had already weathered decades of eroding social trust. They internalized the lessons of a year in which they had to fend for themselves, absent support from a government that repeatedly downplayed a crisis that was evidently unfolding. “We had no other protections all year,” Gold said. “We had masks. No one else protected us. It’s understandable that people would be hesitant about taking them off.”’
…..
‘The pandemic hasn’t been a one-off disaster but “a slow, recurrent onslaught of worsening things,” adds Tamar Rodney, from the Johns Hopkins University School of Nursing, who studies trauma. “We can’t expect people to go through that and for everyone to come out the other side being fine. People suffered in between, and those effects must be addressed, even if we’re walking around maskless.”’

So, with all that, when and where do we wear our masks now, as of early June 2021? The CDC still says we should wear them in health care settings, and virtually all my patients are still preferring to keep them on in my office, even though nearly all are vaccinated and only one of them is in the building at a time. I’m still wearing mine, too. At this point our group opinion is that they aren’t bothering us and we would rather be cautious.

And I am obligated to keep my patients safe in every way I can, so legally and ethically I have to err on the side of caution. I can’t help worrying that I will inadvertently endanger someone.

On the other hand, I recently attended my first “unmasked ball” of the pandemic era, in a large space with plenty of ventilation and a small group of dancers in which all but one person had been fully vaccinated. I felt almost entirely comfortable there. Then I attended a largely-outdoor, mostly-unmasked event that included a lot of people I didn’t know, and felt on the verge of panic and almost bugged out. The fact that we were eating and drinking meant that simply keeping a mask on wasn’t going to be an option.

All the currently available evidence suggests that I was safe in those situations and that others were safe with me as well, but it’s going to take time to get used to throwing caution relatively to the winds. And I’m not naturally reckless, far from it. So, probably just like you, I’m trying to find the sensible happy medium.

No one can say anymore that masks and distancing don’t help prevent infection, though. In addition to all the other evidence built up over the past year, I submit this: We had essentially no flu season last winter. That’s huge. We may even want to do the same to some degree next winter— at least, keep up the hand-washing, and maybe even use masks in some situations.

Some time soon, we’ll likely be able to fling off those masks and forget about them. But don’t throw them away, because with all the unknowns about the viral variants and how long our natural or vaccinated immunity is going to last, we may well have to pull them out again.

Want to have less need to worry about a particularly nasty variant coming to get us? Then keep up sensible precautions. That’s the best advice I can give right now, vague as it is. Everything about this pandemic has been a matter of muddling along, doing our best to figure things out, building the airplane while trying to fly it. I don’t think that will stop anytime soon.