Time to unmask?

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I'm sure many will disagree but my take is why did we ever work without masks? Outpatient clinics that aren't seeing acute illnesses, sure. But it's crazy to me that we used to let idiots and children with URI symptoms cough in our faces for 12 hour shifts before this. Hand washings, masks, hospital laundered scrubs, and no hand-shaking should be the norm for acute care settings.
 
DeadCactus said:
I'm sure many will disagree but my take is why did we ever work without masks? Outpatient clinics that aren't seeing acute illnesses, sure. But it's crazy to me that we used to let idiots and children with URI symptoms cough in our faces for 12 hour shifts before this. Hand washings, masks, hospital laundered scrubs, and no hand-shaking should be the norm for acute care settings.
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I hate wearing the mask but I think you may have a valid point.
 
DeadCactus said:
I'm sure many will disagree but my take is why did we ever work without masks? Outpatient clinics that aren't seeing acute illnesses, sure. But it's crazy to me that we used to let idiots and children with URI symptoms cough in our faces for 12 hour shifts before this. Hand washings, masks, hospital laundered scrubs, and no hand-shaking should be the norm for acute care settings.
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Technically infection control guidance always was that patients with respiratory sx should be masked and staff working with them also should until infectious etiology ruled out. It just wasn’t always followed well outside certain settings, & certain pathogen types.
 
BUT PATIENT SATISFACTION?????? Best part of COVID is no hand shaking. Ill wear a mask so I dont have to do that. Half my patients were fondling their balls or touching their herpes lesions before I walked in the room.
 
DeadCactus said:
I'm sure many will disagree but my take is why did we ever work without masks? Outpatient clinics that aren't seeing acute illnesses, sure. But it's crazy to me that we used to let idiots and children with URI symptoms cough in our faces for 12 hour shifts before this. Hand washings, masks, hospital laundered scrubs, and no hand-shaking should be the norm for acute care settings.
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It's realistically likely not that effective in practice. How many times do you have to adjust it during a shift? Fall off your nose during an encounter or often during a procedure. Patient's never keep them on. We always take them off in the doc box or nursing station. Set them on counters, etc. It'd probably N95 or bust if you really cared.
 
EctopicFetus said:
BUT PATIENT SATISFACTION?????? Best part of COVID is no hand shaking. Ill wear a mask so I dont have to do that. Half my patients were fondling their balls or touching their herpes lesions before I walked in the room.
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Yeah I never shook ER patients hands even before Covid. This ain’t no well heeled Ortho clinic. My average patients fingers were jammed firmly up their crack picking their dingus the moment before I walked in their exam room.
 
I'd be a fan of physician discretion

If someone came in for a leg lac I don't care

if someone has URI/cough/fever symptoms sure whatever
 
I love wearing a mask in the ED. I haven’t caught a cold at work in years (*knock on wood*). No one sees the spinach in my teeth. People complement my youth way more. Smells are knocked down a notch. I can stifle a yawn or scowl much more easily.

For the low cost of permanent skin discoloration on the bridge of my nose and intermittent acne at the mask-face interface! A worthy trade.
 
May I extoll the virtues of the KN-94? Comfort of a surgical mask, seems effective in preventing acquisition of COVID (n=1 not having caught COVID despite working 14-21 shifts a month throughout the pandemic). Comes in an array of stylish colors.
 
Arcan57 said:
May I extoll the virtues of the KN-94? Comfort of a surgical mask, seems effective in preventing acquisition of COVID (n=1 not having caught COVID despite working 14-21 shifts a month throughout the pandemic). Comes in an array of stylish colors.
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Do you mean KN95? Or KF94? As far as I'm aware, KN94 isn't a thing.

I agree that a KN95 is way more comfortable than an N95 and doesn't destroy my nose. The loops still hurt my ears after a few hours though. I still wear my envo for every patient encounter and then generally go maskless back at my desk.
 
BoardingDoc said:
Do you mean KN95? Or KF94? As far as I'm aware, KN94 isn't a thing.

I agree that a KN95 is way more comfortable than an N95 and doesn't destroy my nose. The loops still hurt my ears after a few hours though. I still wear my envo for every patient encounter and then generally go maskless back at my desk.
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Yeah, KF-94. Posting pre coffee is usually a mistake. I just keep the KF-94 on and toss on a face shield for anybody with respiratory complaints. I get some slight ear irritation but it doesn’t seem related to time in mask so I only take it off if I’m eating something.
 
Arcan57 said:
May I extoll the virtues of the KN-94? Comfort of a surgical mask, seems effective in preventing acquisition of COVID (n=1 not having caught COVID despite working 14-21 shifts a month throughout the pandemic). Comes in an array of stylish colors.
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Oh I just can’t do ear-loops. After about 30-60 I am miserable. Painful, trigger headaches, then I turn into a 2+ Whiny man-child of a doctor. Can’t do it with surgical masks, can’t do it with KN95s. I find the various N95s MUCH more comfortable personally, and also MUCH less likely to fog my glasses.

But if they worked for my comfort I think the KN95s would be fine.

As far as unmasking at work to get loogies coughed at me and the standard 4-6 viral illnesses (minimum) per year I used to get? No thanks :-D

Also makes all these “turns out the patient had TB!” Emails from occ health WAY easier to respond to 😉
 
Janders said:
This is why I drink alcohol, to kill the weakest of my brain cells so only the strongest survive and I get smarter!
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Mothers should start early and binge drink while pregnant. Only the smart kids will survive.
 
Watch Vinay Prasad MD on youtube regarding masking. He's not a fan of universal masking indefinitely and even some hospitals in Europe have gone away with it. I approached this subject in the med school forum because they're all saying many med schools are still requiring it from first to fourth year. I don't think there's much evidence to support masking in a young healthy population of people that I'm sure near 100% in the classroom setting have been vaccinated and probably most unnecessarily boosted based on their age and health status. I almost got booted because of my take. I think it's fine if it's provider discretion and you want to wear a mask. Not in agreement that everyone should mask in every healthcare setting no matter what though.
 
DOswag said:
Watch Vinay Prasad MD on youtube regarding masking. He's not a fan of universal masking indefinitely and even some hospitals in Europe have gone away with it. I approached this subject in the med school forum because they're all saying many med schools are still requiring it from first to fourth year. I don't think there's much evidence to support masking in a young healthy population of people that I'm sure near 100% in the classroom setting have been vaccinated and probably most unnecessarily boosted based on their age and health status. I almost got booted because of my take. I think it's fine if it's provider discretion and you want to wear a mask. Not in agreement that everyone should mask in every healthcare setting no matter what though.
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I agree that masking forever isn’t an option.

I think the way a lot of Asian countries address this with the expectation that sick people wear a mask is the way to go. Catch a cold, wear a mask. Catch the flu, wear a mask.

I agree that outside of high risk areas that there isn’t a need for masking absent another outbreak. Thankfully the more recent strains of COVID seem to have much less morbidity and mortality when compared to Delta and the original strain.

I think higher risk areas like the ICU and ER, where there’s a high possibility of encountering respiratory infection, is the way to go.

I pretty much only wear a mask in the hospital now, and that’s when I’m in patient care areas.
 
Siggy said:
I agree that masking forever isn’t an option.

I think the way a lot of Asian countries address this with the expectation that sick people wear a mask is the way to go. Catch a cold, wear a mask. Catch the flu, wear a mask.

I agree that outside of high risk areas that there isn’t a need for masking absent another outbreak. Thankfully the more recent strains of COVID seem to have much less morbidity and mortality when compared to Delta and the original strain.

I think higher risk areas like the ICU and ER, where there’s a high possibility of encountering respiratory infection, is the way to go.

I pretty much only wear a mask in the hospital now, and that’s when I’m in patient care areas.
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Yep. Don't really have much to add except to increase the N of docs who fall into the camp of "Mask for essentially all patient contact in the ED, don't wear a mask basically anywhere else in life."

I will add the caveat that I don't personally care about having to wear one when in a private business/on an airplane/whatever and they require it.
 
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It's time to move forward in my opinion. In our region, masks are almost entirely absent in the general public. We are also no longer masking in non-patient care areas within our hospital/system.

I'm skeptical that there is any significant benefit in trying to selectively mask for certain patients. There are a decent number of patients presenting with atypical symptoms that are positive for various viral infections. For example, I've taken care of several vaccinated older adults that ended up being COVID positive who presented following a seemingly mechanical fall also endorsing fatigue and generalized weakness without URI symptoms. Good luck trying to pick out before seeing a patient if they may or may not have a viral infection.

I suspect as viral disease becomes endemic that unless you are frequently receiving booster vaccinations (probably not necessary) you will lose some immunity to viral disease without periodic exposure and mild infection potentially leading to more severe infection when eventually infected. I think learning to live with some element of viral disease is better than trying to aim for complete elimination.

I'm fine with physician discretion, but supportive of not blanket masking at this point. If you want to mask fine, if not though that should also be fine. Agree that those that are sick should be the ones isolating and potentially being the ones to mask. Not that anyone will follow those rules given they never did in the past.
 
Siggy said:
I agree that masking forever isn’t an option.

I think the way a lot of Asian countries address this with the expectation that sick people wear a mask is the way to go. Catch a cold, wear a mask. Catch the flu, wear a mask.

I agree that outside of high risk areas that there isn’t a need for masking absent another outbreak. Thankfully the more recent strains of COVID seem to have much less morbidity and mortality when compared to Delta and the original strain.

I think higher risk areas like the ICU and ER, where there’s a high possibility of encountering respiratory infection, is the way to go.

I pretty much only wear a mask in the hospital now, and that’s when I’m in patient care areas.
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I don't think Americans will ever be on board with the concept of wearing a mask to protect others. Freedom has been redefined as the right to mess with other people without repercussion and masking directly interferes with that principle.
 
Arcan57 said:
I don't think Americans will ever be on board with the concept of wearing a mask to protect others. Freedom has been redefined as the right to mess with other people without repercussion and masking directly interferes with that principle.
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What would be your suggestion?

I also am one that likes the mask in hospital environment but essentially never wear outside hospital.
 
johhnybgood said:
What would be your suggestion?

I also am one that likes the mask in hospital environment but essentially never wear outside hospital.
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My suggestion is that we reorient society around a feeling of social connection that would make people give a damn about their fellows but I don’t see that happening. As such I think you should wear a ksomething-9x were you perceive a higher than normal chance of infection and can’t be sick in the next 10 days.
 
DOswag said:
Watch Vinay Prasad MD
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A physician with a self branded website and large social media presence opining on topics outside of his specialty with thoughts that just happen appeal to the desires of the masses. No thanks. There are few red flags bigger than people who make their money as professional speakers.
 
n2b8me said:
When will we be able to work without masks again in the ER?
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Can such questions be asked? Will the heretics be released from the stocks? Can Veers come back?

I just fired my dentist because his office minion insisted I wear a mask for 20 minutes in the waiting room...before I was scheduled to go back to a non-negative pressure room and sit in a chair with my mouth open for a couple of hours breathing on everything and everyone.

Do you have to be an intelligent critical thinker to get through medical school? Or is it simply a matter of being able to memorize and regurgitate new knowledge rapidly?
 
Old_Mil said:
Can such questions be asked? Will the heretics be released from the stocks? Can Veers come back?

I just fired my dentist because his office minion insisted I wear a mask for 20 minutes in the waiting room...before I was scheduled to go back to a non-negative pressure room and sit in a chair with my mouth open for a couple of hours breathing on everything and everyone.

Do you have to be an intelligent critical thinker to get through medical school? Or is it simply a matter of being able to memorize and regurgitate new knowledge rapidly?
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Yeah, so much this.

Every shift, I listen as the windowlickers say amazingly myopic things like: "Hurr durr, my cousint (sic) was in my house without a MASK! and I says to them, I says: THAT'S HOW YOUSE GETS COVID."

They then proceed to do things like use their finger to wipe up a dollop of mayonnaise on the bare counter surface and place it directly into their mouth.
 
Old_Mil said:
Can such questions be asked? Will the heretics be released from the stocks? Can Veers come back?

I just fired my dentist because his office minion insisted I wear a mask for 20 minutes in the waiting room...before I was scheduled to go back to a non-negative pressure room and sit in a chair with my mouth open for a couple of hours breathing on everything and everyone.

Do you have to be an intelligent critical thinker to get through medical school? Or is it simply a matter of being able to memorize and regurgitate new knowledge rapidly?
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Your presence in this discussion on this forum is proof that, yes, such questions can be asked.
 
DeadCactus said:
A physician with a self branded website and large social media presence opining on topics outside of his specialty with thoughts that just happen appeal to the desires of the masses. No thanks. There are few red flags bigger than people who make their money as professional speakers.
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Lol you clearly didn't look too hard into him. He's Hem/Onc who is also professor of epidemiology and biostats. His entire platform is built on review of data/studies and that what he does on his platform. Appeal to the desire of the masses? Not quite how I would categorize him. I'd recommend you actually read/watch some of his content before blindly replying.
 
DOswag said:
Lol you clearly didn't look too hard into him. He's Hem/Onc who is also professor of epidemiology and biostats. His entire platform is built on review of data/studies and that what he does on his platform. Appeal to the desire of the masses? Not quite how I would categorize him. I'd recommend you actually read/watch some of his content before blindly replying.
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Have you critically appraised him yourself?

Based on your recommendation, I looked into him a bit. Yes, he has impressive credentials, but he also appears to misrepresent the positions that he wants to criticize (i.e.: strawman arguements). He also draws unsupportable conclusions from negative studies by saying that when a 95% confidence interval crosses 1 this proves that the intervention does not work. That is not how it works - when a 95% CI crosses 1 the study has failed to prove benefit, that is not the same as proving futility. As Donald Rumsfeld said, "absence of evidence is not evidence of absence".

A big red flag to me is that he invokes Nazi Germany in his criticisms. This isn't proof of maleficence, of course, but it's strongly correlated with it.

He strikes me as someone looking to profit off his youtube channel, not a font of "uncomfortable truth".

That's my opinion, anyway.
 
DOswag said:
Lol you clearly didn't look too hard into him. He's Hem/Onc who is also professor of epidemiology and biostats. His entire platform is built on review of data/studies and that what he does on his platform. Appeal to the desire of the masses? Not quite how I would categorize him. I'd recommend you actually read/watch some of his content before blindly replying.
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A Professorship in a second College is common and does not mean you are suddenly an expert in everything related to that field.
 
DOswag said:
Lol you clearly didn't look too hard into him. He's Hem/Onc who is also professor of epidemiology and biostats. His entire platform is built on review of data/studies and that what he does on his platform. Appeal to the desire of the masses? Not quite how I would categorize him. I'd recommend you actually read/watch some of his content before blindly replying.
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As someone who has worked alongside him professionally, you are correct that he has impressive credentials. He is also a self-aggrandizing twit who's primary interest is his own fame.
 
gutonc said:
As someone who has worked alongside him professionally, you are correct that he has impressive credentials. He is also a self-aggrandizing twit who's primary interest is his own fame.
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Love it! LOL

I listened to him once and he spoke as if he had an agenda. I never listened to him again.
 
DOswag said:
Watch Vinay Prasad MD on youtube regarding masking. He's not a fan of universal masking indefinitely and even some hospitals in Europe have gone away with it. I approached this subject in the med school forum because they're all saying many med schools are still requiring it from first to fourth year. I don't think there's much evidence to support masking in a young healthy population of people that I'm sure near 100% in the classroom setting have been vaccinated and probably most unnecessarily boosted based on their age and health status. I almost got booted because of my take. I think it's fine if it's provider discretion and you want to wear a mask. Not in agreement that everyone should mask in every healthcare setting no matter what though.
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The political bias in academic institutions has never been more apparent. Have you seen the stories about DEI questions on the applications?
 
Janders said:
Also makes all these “turns out the patient had TB!” Emails from occ health WAY easier to respond to 😉
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Happened to me last week!
Bonus: I did my history in a curtained cove off the waiting room, and it took about 45 seconds
Plot twist: he was in the waiting room with a shifting cast of 35-50 other patients +/- family members for 18 hours 😬
 
Where I work even during the peek of covid, I wore a mask into the pts room and took it off right after. I will take the risk of getting covid rather than feeling suffocated for the whole day.

N95 masks are the worse. I dont know how anyone can wear it for more than 5 mintues.

Its time to move on. You have a better chance of catching covid at school, supermarket, on an airplane than in the ER. Its all show and tell, just like a sterile field in the ER when we sew someone up.
 
emergentmd said:
N95 masks are the worse. I dont know how anyone can wear it for more than 5 minutes.
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So much this. I simply can’t tolerate N-95s for very long, I don’t know how my colleagues did it. Absolutely suffocating, I pretty much stopped wearing those after getting vaccinated, even before was only wearing when intubating someone.

Concur with the sentiment it’s time to move on and do away with masking.
 
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