The return of Masking: what have we learned?

New Musings in 2024

It has been months since I have posted anything on this site. I hope that my readers will forgive me. It is fascinating to me that the medical community in particular has learned so little about SARS-CoV2. The evolution of the virus via spontaneous mutations called variants has become quite clear. After major mutations from the original alpha strain, for the last two years we have noted with the help of nimble virologists and epidemiologists that new variants all seem to be variations of the omicron variant, which showed up about two years ago.

The result of the new variants are easily summarized in the following;

• quite contagious causing infections in those with either natural immunity and vaccine-conferred immunity.

• low virulence meaning that there have been no reports of marked spikes in mortality of any at risk group (elderly, immunocompromised, morbidly obese) or in ICU admissions.

• New vaccine boosters have been rolled out and blindly endorsed by the CDC without studies showing any measurable impact on morbidity or morality.

These new variants are emerging on a population that has a presumed partial immunity to SARS-CoV2 based on studies of both natural and vaccine-conferred immunity.

Nonetheless, some of our fellow citizens continue to choose to wear masks. Some are wearing masks for which there has NEVER been any evidence that masking outside in open air has any impact on spreading respiratory viruses. My observation is that African Americans and Asians are the most likely groups to wear masks. I presume that African Americans do not have a trust in the medical establishment and Asians have a cultural history of mask-wearing that goes back decades particularly in East Asian societies.

However, I am most concerned and distressed by the spotty practice of mask-wearing by my fellow physicians. I have a number of physicians due to the emergence of a variety of health issues. In the last six months, I have seen several of these physicians, all in the Texas Medical Center in Houston. There has been no explanation and no consistency of use among my physician in terms of mask wearing. Frankly, outside the clinics and hospitals, it is rare to see Houstonians wearing masks. I have seen my physicians in clinics where there are no acutely ill patients. I am really miffed when my physician chooses to hide her face from me, which obviously interferes with the nuances of communication, which include smiles, frowns, and other expressive facial expressions. There are NO Texas Medical Center wide policies requiring mask wearing. It thus must be confusing when patients encounter their own physicians enter the exam room and choose to wear a mask. What is the message they are sending? Is it “you may look and feel healthy but there is a good chance that you are carrying the virus and putting my health at risk? Is it despite the freely available vaccine boosters, I do not trust them myself and choose to wear a mask (of deeply questionable efficacy) to protest myself.

Overall, I am deeply skeptical of the majority of my fellow physicians, who have largely refused to consider the deep issues raised during the pandemic. I would love to hear from my readers.