Unmasked

[booklady]

Lots of areas are now allowing both kids and adults to go maskless in public. What concerns you the most?

[doctork]

I'm not really worried about going maskless, as soon as there is the official State OK. Which I am not sure has happened yet - there have been so many changes and I know WA has/will loosened up but I am confused.

We may be wearing masks a lot longer in the clinic (hospitals and other healthcare sites also), until it is conclusive that we cannot transmit Covid to patients even though we vaccinated folks may have the infection but be asymptomatic.

BTW, most commercial Covid antibody tests are not very reliable, and even if the measured antibody level is low or absent, humoral immunity (T cells and B cells) is good through 9 months, per journal article I just read this morning.

And - since anybody 12 and older who wants the vaccine can get it, I am not worrying about protecting the unvaccinated.

[liriodendron]

I work in the Children's Department of a public library. The CDC has just made my department less safe for our primary patrons since children under 12 cannot get vaccinated. Personally, I am having severe COVID anxiety issues and this guidance has just made it less likely that I will venture inside of a store or other public place since I believe that many (not all) of the people who do not wish to be vaccinated are the same people who did not wish to wear masks and they will now simply be able to blend in with the folks who are vaccinated.

[doctork]

I think you are right about the people who don't get vaccinated are often the same as those who won't wear masks. I don't see any practical way to verify who is vaccinated in every day life - grocery store, etc.

FWIW, current statistics suggest that the possibility of a vaccinated individual getting Covid infection is about 1 in 10,000. Most of those will be asymptomatic; they are identified mainly through environments that have routine Covid screening (nursing home employment, travel requirements, etc) because they aren't ill.

Unvaccinated kids are an issue, particularly if you have to work indoors with them, though I think Covid vaccines will be approved for ages 5 - 12 fairly soon. Schools are already equipped to mandate vaccines for students.

Lirio, are you comfortable wearing an N-95 mask? They really do provide better protection to the wearer. Also keeping a small bottle of sanitizer on my ID lanyard reminds me to sanitize every time.

[booklady]

While I guess I shouldn't joke around about Covid, the near-universal availability of the vaccine within five miles of most everybody (that's what I heard somewhere) and the very low incidence of children getting/suffering greatly from/passing along the virus (I've been told and read that, too), turned me sort-of silly yesterday when I was getting ready to go to tutor some young children at a school. Hence, the chin hair question. But actually, I think at this stage that really is my main concern about removing my mask, which is to say, I'm not all that concerned. I'm relieved.

Lirio, your serious response is interesting and I'm sorry to have made light of what is a real concern for you. But all authorities tell us that vaccinated people are protected. Isn't that why people choose to be vaccinated? Last summer I gouged my little toe on a filthy rusty sheetrock nail in my basement. It took me about three tries and three hours of calling my doctor's office, waiting on hold for the answering service to pick up and forward my call to a nurse at whatever staffed location they had (not many employees were actually in the offices last summer) and arrange for an immediate tetanus shot. I don't know what my chances were of getting tetanus from that rusty nail injury (I've read about a man dying from tetanus, and I'd rather get Covid than that), but I trusted that a tetanus shot would protect me. It took literally hours to arrange to get one, but I was protected by it.

Watching the Sunday news talk shows a few days ago I was struck by the tone of the moderators, how nervous and anxious they were as they interviewed people about the repercussions of the CDC's new guidance (that's the guidance that finally convinced me to get vaccinated -- the hope of getting the damn mask off). We have been told for six months or so now that the vaccines are safe and effective. If they are safe and effective and we get them, we are protected. If a person chooses not to get vaccinated, it's like any other risk a person chooses to take, and that person has to accept the possible consequences. So Martha Radditz worried about two vaccinated people talking in a room without their masks on when an unvaccinated person comes in without his mask on -- that's on him. They are protected, as best as they can try to be in any case. Not 100 percent, not guaranteed, but that is true every time we get behind the wheel of a car or walk across a street or take a shower.

Yesterday, the school where I tutor announced that kids no longer have to wear their masks when they are outside for recess or gym. The school has been open since early September and has followed (and continues to follow) to the letter all state and CDC guidance. It's great news that the kids can play outside now maskless.

[booklady]

I just want to add that even though it took me a while to be convinced to get the vaccine, I am not opposed to vaccines and I have always complied with mask mandates, social distancing, and other Covid rules, precautions, and recommendations. I do not advocate for people to be rude or aggressive or confrontational towards each other about wearing or not wearing masks. Protect yourself and, as with driving around people obviously looking at and using their cell phones, try to stay the hell as far as possible from people you think might be endangering themselves and others.

[doctork]

There are many gray areas in vaccination. The Covid vaccine is extraordinarily effective, much better than the annual flu vaccine. Yet it is 95% effective - it fails to work/prevent infection 5% of the time, although at least when those breakthrough cases occur they are almost always mild.

Aside from vaccine failure, immune suppressed people are often unable to fully respond to the vaccine but they are also those who are most likely to get very ill if infected with Covid. Some people are seriously allergic to a vaccine component and cannot be safely immunized.

With anti-vaxxer parents I remind them that there may be an immune-suppressed classmate - chemotherapy, immune deficiency, on steroids for asthma - and although their own non-vaccinated kid probably will fully recover from measles or mumps, their classmate may die or be seriously and permanently damaged/disabled as a result of exposure to their child. That persuades a few.

Ultimately, everyone has a different situation and different level of risk tolerance. We all need to just get along.

[booklady]

I'm undoubtedly dense, but I still don't get the controversy.

How does the unvaccinated, unmasked person endanger anyone but himself? The latest mask guidance allows vaccinated people to *not* wear masks if they choose, but obviously does not *require* them to not wear them. Anyone -- the cautious, the immune-suppressed, the child who is not eligible for the vaccine, the not fully vaccinated, or other category -- can still wear their masks, socially distance, clean surfaces, and so on, if they wish, just as we all have been doing for 14 months. Those who are fully vaccinated are protected, from either getting the virus or getting a severe case, and wear one or not. The unvaccinated unmasked person essentially endangers only himself.

We have laws against drunk driving, drugged driving, texting while driving, and other impaired/distracted driving but it does not stop everyone from doing it. I see it every day. This person doesn't just endanger himself but everyone else around him. I'm A LOT more afraid, almost to the point of paranoia, of a texting driver than I am of an unmasked American, child or adult.

[liriodendron]

Hey, chin hairs are also a good reason to wear a mask! Not to mention that I can eat as many onions for lunch as I want and not be as concerned that someone will smell them on my breath from 6 feet away!

Bookie, I did not think you were making light of my concern. I actually laughed when I read the chin hairs choice. I have other anxiety issues, as well (being a passenger in a car, flying, heights). COVID is the first thing that has changed my life so drastically, though, and has made me feel that I have so little control over the situation. I mean, I don't have to let anyone else drive me to work, or fly in a plane to get there, plus, the Children's Department is on the lower level. But I work with the public and I can't hide behind my Zoom storytime forever. I've been forced to come back into the library before I felt comfortable (last summer). I've been forced to let unmasked patrons (those 2 and under and those with medical reasons not to wear a mask) come into the building. It's been difficult to look at the state map and see that most of my state was red (meaning high risk) and know that I had to be friendly and helpful to everyone when I feel like I am about to crawl out of my skin. It was only last week that my town finally went from red to orange to yellow. It's like every time that I think about trying to do something to get a tiny bit closer to normal, the goal posts keep getting moved (and not in a way that is helpful to someone with an anxiety disorder).

Just when I was thinking that maybe I could deal with having to do outdoor programs this summer the one thing that was making me feel safer - people wearing masks and social distancing - was pulled off the table. I haven't been to the grocery store in over a year. I haven't been to a restaurant. I haven't had a haircut (and believe me, I hadn't intended to ever go back to the longer curly hair that I had in high school, but here I am).

I have just added outdoor storytimes to our summer schedule because a number of our patrons were asking about them and I hate to disappoint people, but if I think too much about it, I get terrified. So I am planning to try to make it as safe as possible. I just ordered spray chalk to make a big circle on the grass so that people will keep their kids away from my sound system and props (and me). I just ordered a $220 portable speaker and a $90 bluetooth headset (thank you Friends of the Library). I have a supply of KN95 masks and I will be wearing one. My assistant has said she will come outside with me and do crowd control so that I can focus on my stories and songs and fingerplays. I am hoping that seeing all the kids again will help me to stay calm, but I am sad that I can't get out my bubble machine. Unfortunately, it turns into a preschool mosh pit when I do and I can't be in the middle of that right now or I will freak out.

As far as the unvaccinated people infecting other unvaccinated people, I am worried about mutations. As far as I understand, the more that the virus spreads, the more chances it has to mutate and the more it mutates, the more possibilities that it will turn into something more dangerous and/or more likely to not be stopped by our current vaccines. I'm also very concerned about texting drivers and such, but I am trying not to go there too much. At least right now I don't have a bunch of anxiety about my own driving. I don't need to add to the list of things that I worry about. Unless it's chin hairs. I should probably worry about chin hairs. Especially since I have a Zoom storytime coming up soon and that "touch up my appearance" setting can only go so far.

[doctork]

Bookie, unvaccinated people can have asymptomatic Covid infection, thus unknowingly spread it to others even though they themselves feel fine, run no fever and don't look sick. Those they may spread it to are people who are vulnerable even if already vaccinated,and at greater risk because they are:

--in the 5% in whom the vaccine fails,

--elderly

--have underlying risk factors

--immune suppressed due to cancer chemotherapy, or
--on chronic steroids for autoimmune disease
--allergic,
--children who are too young for the vaccine, etc

Of course those who don't get vaccinated are the greatest risk to themselves; as long as they don't endanger others, refusing vaccination is their problem.  But when they don't wear masks around other people indoors, they cause preventable infections that may harm those whom they infect.

Those who have already had Covid themselves likely have some immunity and are not likely to infect others.  Those who have "breakthrough infections" (they get Covid despite vaccination or prior Covid infection) seem to be less ill, less infectious and less danger to the vulnerable, probably because they have a smaller "viral load" in the nose and throat, which doesn't pass to those around them in sufficient quantity to transmit infection.

Lirio is right about the mutations - they occur during replication/reproduction as the genes rearrange themselves. So the more new infections, the greater the likelihood a mutation may occur. The mutant virus may become more transmissible, more lethal, more resistant to the vaccine. So far we are not seeing much of that, except the Indian variant appears somewhat more transmissible.

This morning I read a journal article demonstrating that the vaccine results in ongoing immunity for at least 9 months.  That is good news, and also the vaccines seem effective against the mutant viruses, at least so far.

The vaccine is incredibly effective and remarkably safe, but nothing in 100% safe and effective. And - this is a new disease and a new vaccine so we do not know very much about it yet, nor what to expect.

Bookie, your basic premise is true - those who are unvaccinated are a danger mainly to themselves, while those who have had the shot(s) are "safe."  But because it's not 100% we'd like to prevent as many infections, and as many mutations, as possible.

That's my Covid report as of 12:50 am on May 20, 2021. It's been several hours since I checked my Covid news feed, so things may have changed...

[booklady]

The stories of the pandemic's non-physical (non-actual-viral-illness) side effects are fascinating and so varied. Thanks for sharing yours, Lirio. I've posted elsewhere about the severe indecision and sort-of emotional paralysis it's induced in me. I'll say this to you, Lirio. about working with children. I very often feel like I really just do not want to go out, don't want to leave home. Once I have (usually because I must, for work or necessary errand), I am always glad I have. And every day when I am at school for an hour or a few hours tutoring (the combination of Covid, age (69), and a bit of a hearing loss that makes it difficult to communicate with people wearing masks caused me to decide to stop working full-time), I find such pleasure in being with kids. It ends up being a few minutes or hours where I forget my troubles and lethargy and apathy, and enjoy life, and other people. Being in community. Socializing. I hope you will be pleasantly surprised at how good you feel when you get the kiddos back in person.

P.S. Individual businesses and institutions call still require mask wearing in their buildings and around their grounds, right? Maybe you can prevail upon your library to require them for all present.

P.P.S. One of the weird phobias I developed as a result of Covid is touching doorknobs and handles. I will use a sleeve or shirttail if I can, handwashing if I can't.

[doctork]

Bookie, I had similar feelings about "getting out," and found that going to work daily made my whole life feel much more normal in the midst of the Covid pandemic. At first we had a combination of in-person and telehealth visits, but now most patients come to the office for in-person visits, though telehealth remains an option for those who prefer it.

I continued my work as usual throughout the pandemic except for a couple months April-May of 2020 when things were just too slow and the clinic didn't need me.

I quit my last job working on Whidbey Island in mid-April, and though I've enjoyed having some time off, I interviewed for a new position earlier this week and probably will take the job starting in early July. I miss patients when I'm not working.

As far as doorknobs etc, I keep a small bottle of hand sanitizer (from Bath & Body) on the lanyard around my neck and use it liberally.

[booklady]

Doc, can I impose upon you for one more vaccine-related question? I do appreciate your willingness to share your physician expertise with me (us).

I'm supposed to get my second (Moderna) shot on June 12. The days after are going to be relatively busy and challenging, and from what I've heard, many folks don't feel too good for a few days after the second Moderna shot. I want to push my appointment back to the 19. This is probably a really dumb question, but will it mess up the timing if I wait an extra week for the second dose of the vaccine?

[doctork]

No, it won't make any difference to wait a week, as far as anyone knows. And many people do not have problems with the second dose, and I hope you are one of them! I had the Pfizer vaccine and received my second shot 3 weeks and 4 days after the first, because I didn't want to chance being ill on a day I was scheduled to see patients. Other than a slightly sore arm, I had no reaction to the second shot.

The clinical trials of the Pfizer and Moderna products were done using, respectively, 3 and 4 week intervals, so that is how they were FDA approved. However, in the trials, fairly high levels of immunity were observed 10 days after the first immunization (though not as high as full immunization), so in Canada where vaccine has been in short supply, the intervals have been lengthened to up to 12 weeks, with good results so far.

By lengthening the interval, more people get their first shot, then as supply rolls out, everyone gets their "catch up." Some other countries have also used that approach.

I'm happy to answer questions, especially those that pertain to general medical knowledge, as this one does. After all, "Doctor" comes from the Latin root "to teach," whereas "physician" comes from the Greek root "to heal." Imparting information is teaching.

When the query is specific to a particular individual's medical condition, I always have to note that "I have not taken your medical history and done a physical exam so any information I give is general, and you should still see your own personal physician for advice."

[booklady]

Thank you so much, lovely Doc. You are so generous with your teaching.

I love the linguistic distinction between "doctor" and "physician."

[doctork]

May 24, 2021 9:14:09 GMT -5 booklady said:

Thank you so much, lovely Doc. You are so generous with your teaching.

I love the linguistic distinction between "doctor" and "physician."

You're welcome!

I explain the distinction to most of my patients, because whatever ailment they have (typically high blood pressure or other chronic problems), they see me for 15 - 30 minutes but have to deal with their ailment 24/7/365.

They need to know about their illness and medications, and understand the treatment plan. Otherwise,why would they continue?

[slb2]

I'm starting to wade through all this. I need to go to bed, though.
My answer: I'm reluctant to take off my mask when going to an indoor event--like church or grocery shopping--close to other people because PRIMARILY I think it sets a precedent to those who should be wearing a mask.

I realize my thinking is off-base.

Also, my family--some of them--are so anxious about covid19 that my not wearing a mask upsets them. I know I'm not responsible for their feelings and thoughts, but I still take on the onus of making others comfortable and happy.

I have never felt anxious about contracting covid19. Maybe because I had it when the lockdowns all started, mid-March 2020. My nature is not one of anxiousness about these issues. Just don't talk about my kids or my marriage. THEN I'll show you anxiousness.

[BoatBabe]

Here in Ballard, officials are reporting that our community is 80% double vaxxed. That does not make me feel any more likely to suddenly throw away my mask and run around nilly-willy licking doorknobs and commercial business counter tops.

I am still immune compromised, conditions that can decrease the efficacy of the vaccinations. Our granddaughter will be 4 next month. She's got a ways to go before she's eligible for the vaccine. We will continue being careful so we can see her, with less potential of us hurting her, or her hurting us.

I never again want to go months without seeing her.

Yes, the Pandemic Brain and anxiety continue. I can't be completely unmasked.

[doctork]

As I said, when in doubt, wear a mask. There are many situations when it is still important.

And Susan, "setting a good example" is a very good reason to wear a mask! If only President Trump had been willing to do that, I suspect our death toll would be well under 100,000 instead of nearly 600,000.

Half a million lives lost due to greed, politics and hubris. And stupidity.

[joew]

It took me a few days to stop wearing a mask outdoors once the mandate was lifted on May 29. When I'm going into a store or bank, I check for a notice at the door. If I don't see one, or if something says masks are not required, I leave mine off. Being fully vaccinated and not at special risk, I'd actually feel funny being masked where most people are maskless, although I understand that there are good reasons for other people to stay masked..

You may recall that a year ago, I took it for granted that I'd catch the disease, despite taking precautions, and I just hoped my case would be fairly mild. Having that mindset, I wasn't very stringent about disinfecting surfaces at home, where I was the only one coming and going, and I slacked off on using hand sanitizer and washing hands, although when I went to the supermarket, I sanitized the handle and around the top of the shopping cart with with a wipe — in fact I still do and will probably continue to do so.

Now, I figure if I didn't get it yet, I'm unlikely to get it now that I'm fully vaccinated. Obviously, if they say we should get a "booster shot" from time to time, I'll do that.

[booklady]

I get my second shot on Saturday. Hoping I feel ok for picking the grandkids up at school Monday afternoon.

My sister has Covid right now. She did not get vaccinated but wore a mask where it was/is required, but while traveling through Nevada, Utah, and Idaho, did not. She got the virus a couple of weeks ago in Idaho. She's ok -- very tired and lethargic and says she just feels "strange -- hard to describe." Her philosophy was that she preferred to acquire immunity through surviving, if she could, and building antibodies, but now says if she knew then what she knows now, she's not so sure she'd decline the vaccine. She also says a variety of the flu we both got in the 1973 was worse than Covid. I have not had Covid, but I remember that flu very well.

[slb2]

I think Covid-19 could have long-term effects that only time will tell.

[doctork]

Not much data available on this, but I think that older adults can also have asymptomatic cases of Covid, despite the propensity for the disease to be more serious in alder adults. And as Susan says, there are many possible long-term effects that we do not yet understand; some of these may be in people who weren't very sick, or maybe even asymptomatic.

Joe, I was never all that enthusiastic about sanitizing everything because Covid is a respiratory virus, not GI like, say, norovirus. So I was never much worried about touching a door handle and then "catching" Covid from it. But because I spent all day in small rooms with sick people, the better part of valor was lots of hand sanitization, and then especially, wearing a mask. Since all patients and all staff wore masks, we minimized risk of respiratory transmission.

Bookie, I had only minimal reaction to my second shot - arm a little sore, but no limitation of activities.

Stay calm and carry on.

[booklady]

Jun 7, 2021 20:28:33 GMT -5 doctork said:

Bookie, I had only minimal reaction to my second shot - arm a little sore, but no limitation of activities.

Stay calm and carry on.

Glad to hear it! Two of my kids who got the vaccine and some of the teachers I know felt pretty bad after the second Moderna, which is what I am getting. My other son wants to get the J&J. He doesn't trust the rna technology, or something.

[BoatBabe]

Shilshole Bay Marina is a Port of Seattle property. It's just like we live at SeaTac. All must be masked, so when I get off the boat to fill our water tanks, I must put on a mask.

The American Spirit Cruise Line has returned to our public pier, and even though it features cruises for fully vaxxed patrons, with fully vaxxed crew, they all must also wear masks while outside of the ship while here, which is about 20 feet away from our front door at high tide.

We don't get to so easily slip back into "normal."

I do have pre-existing immune compromises, so I'm okay with that.

[booklady]

Today I went into the Home Depot and then the grocery store without a mask. It's the first time I've been in a store without a mask since March 2020. I had the mask in the car, because the two-week-period since my second shot won't be until Saturday, but at the last minute I decided to go maskless and just try to stay distanced from people. It was very nice.

But I wonder how many chin hairs my old eyes missed before leaving home?

[slb2]

I'm curious how many of you are still wearing masks to any degree?

As a Federal Gov't worker, I am required to wear a mask when I am out in public and not able to distance a minimum of 6 feet and when I enter a Federal bldg, which I never do except the post office.

I also wear masks in stores generally speaking but not all the time. No more masks at church unless I see it's a preference by others.

[liriodendron]

I always wear a mask when I am in any building (other than at home). I sometimes wear a mask outdoors if in an area with a lot of people or if I think someone will come up to talk to me. The only places I go are the library (grab books and go), the grocery store (grab groceries and go), medical offices (for appointments), the hair salon (twice now since March 2020), and the occasional store, post office, etc., where I do not linger (I mostly shop online). I do not go anywhere indoors for entertainment or non-essential reasons. I insist that workmen wear a mask when they come to the house. I am seriously dreading flying home this week knowing that basically no one will be masking. I only wear N95 or KN95 masks.

[jspnrvr]

Jun 13, 2022 1:42:05 GMT -5 slb2 said:

I'm curious how many of you are still wearing masks to any degree?

As a Federal Gov't worker, I am required to wear a mask when I am out in public and not able to distance a minimum of 6 feet and when I enter a Federal bldg, which I never do except the post office.

I also wear masks in stores generally speaking but not all the time. No more masks at church unless I see it's a preference by others.

Occasionally, in a doc's office. Otherwise, no.

[liriodendron]

Those of you who do not mask, I am curious to know if you've had COVID or are likely to have a poor outcome if you got it. I understand that it is not necessarily as severe as it was earlier in the pandemic, but do you test if you get cold/flu-like symptoms and isolate if you test positive? I am convinced that one of the reasons that it is spreading so much is not only because this variant is more contagious but also because people are ignoring symptoms (or are asymptomatic) and are just going about their daily life and are spreading it because few people are taking any precautions not to spread it these days. I mean, someone posted on Facebook that they had symptoms but were purposely not testing because they were supposed to fly to Europe the next day and they were flying come hell or high water. People like this do no favors for people like my 92 year old mother-in-law.