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<div class="moz-forward-container">I think this is a particularly
helpful discussion by Leana Wen MD of masking and other issues
related to COVID/RSV/Flu.--Manny<br>
<br>
<pre class="moz-signature" cols="72">"Fight for the things that you care about, but do it
in a way that will lead others to join you."
― Ruth Bader Ginsburg </pre>
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<td>The Checkup With Dr. Wen: Should mask mandates return?</td>
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<th valign="BASELINE" nowrap="nowrap" align="RIGHT">Date:
</th>
<td>Thu, 15 Dec 2022 21:34:16 +0000</td>
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<th valign="BASELINE" nowrap="nowrap" align="RIGHT">From:
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<td>The Washington Post <a class="moz-txt-link-rfc2396E"
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<td><a class="moz-txt-link-abbreviated"
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I think not. But people should consider masking in
high-risk settings.
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<p>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.</p>
<p><b>I don’t think governments
should implement mask
requirements, but I would
urge people to consider
masking in high-risk
situations.</b></p>
<p>I’ve written before about my
<a
href="https://s2.washingtonpost.com/3692d97/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/11/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true">apprehension
toward government mask
mandates</a><b>. In short, I
believe these should be
reserved for dire situations
— five-alarm fires in which
there are no other options.</b>
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.</p>
<p>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?</p>
<p><b>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.</b></p>
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<p>Masks work to reduce your
risk of contracting a
respiratory illness. <b>If
you’re going to wear a mask
to protect yourself, you
should wear the
highest-quality one, and
that’s the </b><a
href="https://s2.washingtonpost.com/3894ce4/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/15/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true"><b>N95</b></a><b>
(or its equivalent, KN95 and
KF94).</b></p>
<p>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. <b>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.</b></p>
<p>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. <b>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.</b></p>
<p>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.</p>
<p>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.</p>
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<p><b>What if you’re attending
work or social functions
where there is the
expectation of seeing one
another’s facial
expressions?</b> 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.</p>
<p>Everyone should assess the
covid-19 risk of their
household. <b>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. </b>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.</p>
<p><b>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.</b>
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.</p>
<h1>My latest column</h1>
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It’s time the
Pentagon ended its
covid vaccine
mandate for the
military </a></h3>
<p class="byline"
style="vertical-align:
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100%;"> <span
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Leana S. Wen <span
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<p><i><b>“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?” </b></i><i>–
Ken from New Mexico</i></p>
<p>Ken, I’m sorry this happened
to your wife. I am sure it’s
distressing to hear that you
received a vaccination in
error.</p>
<p>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 <a
href="https://s2.washingtonpost.com/3894ce8/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/26/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true">one
study</a> 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.</p>
<p>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.</p>
<p><i><b>“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.” –
</b></i><i>Gilbert from New
York</i></p>
<p>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.</p>
<p>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.</p>
<p><i><b>“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?”</b></i><i>
— Don from Florida</i></p>
<p>Many readers are asking this
question. I don’t know the
answer.</p>
<p>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 <a
href="https://s2.washingtonpost.com/3894ce8/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/27/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true">some
temporary protection</a>
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.</p>
<p>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.</p>
<p><i>The Post has also compiled
Q&As from my previous
newsletters. You can </i><a
href="https://s2.washingtonpost.com/35efe91/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/28/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true"><i>read
them here</i></a><i>.</i></p>
<h1>What I’m reading</h1>
<p><b>A new study in </b><a
href="https://s2.washingtonpost.com/3894ce9/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/29/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true"><b>JAMA
Network Open</b></a><b>
provides further evidence
that coronavirus vaccines
are essential for older
individuals.</b> 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, <a
href="https://s2.washingtonpost.com/3894cea/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/30/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true">only
45 percent of nursing home
residents</a> have received
the updated booster.</p>
<p><b>Data from the </b><a
href="https://s2.washingtonpost.com/3894ceb/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/31/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true"><b>National
Vital Statistics System</b></a><b>
indicate that deaths from
opioids among adults 65 and
older increased more than
threefold between 2000 and
2020.</b> 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.</p>
<p><b>Researchers from the Food
and Drug Administration
authored an article in the
journal </b><a
href="https://s2.washingtonpost.com/3894cec/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/32/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true"><b>Pediatrics</b></a><b>
that warns parents against
giving young children cough
suppressant medications.</b>
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 <a
href="https://s2.washingtonpost.com/3894ced/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/33/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true">issued
guidance</a> 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.</p>
<h2>More from The Post</h2>
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style="color:
#069;"
moz-do-not-send="true">
China prepares for
exit wave of
infections as it
relaxes covid
policies </a></h3>
<p class="byline"
style="vertical-align:
middle; line-height:
100%;"> <span
style="font:14px
'FranklinLight',
sans-serif;">By
Christian
Shepherd, Lyric Li
and Lisa Movius <span
style="font-size:10px;">●</span> </span> <span><a target="_blank"
style="color:
#069;
white-space:
nowrap; font:
bold 14px
'FranklinBold',
sans-serif;"
href="https://s2.washingtonpost.com/3894cee/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/36/58/639b922bef9bf67b23215551"
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<h3 class="headline"><a
href="https://s2.washingtonpost.com/3894cef/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/37/58/639b922bef9bf67b23215551"
style="color: #069;"
moz-do-not-send="true">FDA approves updated coronavirus shots for young
children </a></h3>
<p class="byline"
style="vertical-align:
middle; line-height:
100%;"> <span
style="font:14px
'FranklinLight',
sans-serif;">By
Laurie McGinley <span
style="font-size:10px;">●</span> </span> <span><a target="_blank"
style="color:
#069; white-space:
nowrap; font: bold
14px
'FranklinBold',
sans-serif;"
href="https://s2.washingtonpost.com/3894cef/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/38/58/639b922bef9bf67b23215551"
moz-do-not-send="true">Read more »</a></span> </p>
</td>
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solid #ccc;" height="20"> </td>
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target="_blank"
href="https://s2.washingtonpost.com/3894cf0/639b922bef9bf67b23215551/596ad5cfade4e24119a85e03/40/58/639b922bef9bf67b23215551"
style="color:
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moz-do-not-send="true">
Why is there a
children’s Tylenol
shortage? Here’s
what parents can
do. </a></h3>
<p class="byline"
style="vertical-align:
middle; line-height:
100%;"> <span
style="font:14px
'FranklinLight',
sans-serif;">By
Marlene Cimons <span
style="font-size:10px;">●</span> </span> <span><a target="_blank"
style="color:
#069;
white-space:
nowrap; font:
bold 14px
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