Friday Q&A: COVID, masks, boosters & testing

🦠 Here we go again 🦠

ICYMI

• 👉 YOUR GUIDE TO FALL/WINTER VIRUSES & VACCINES

• 👉 My conversation with Monica Gandhi, MD, MPH, public health and infectious diseases expert at UCSF

  Monica Gandhi on What's Next with COVID

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As always, question #1 (about masking) is free for everyone; questions #2-4 (about covid boosters; testing; and vaccine timing) are for paid subscribers only.

Click here to submit your questions (about anything) for future Q&A posts!

Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

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QUESTION #1: MASKING AGAIN?

I understand that no one wants to mask up again (sure … I get it), but what about the uptick in COVID cases? Shouldn’t we do everything we can to curtail the spread?

- Vanessa in Bethesda MD

Dear Vanessa,

Thanks for asking! I think this is actually two questions:

1. Do masks work to protect the individual?

2. Do mask mandates (i.e., policies that require groups of people to wear masks) work to protect populations?

As for #1, based on the available evidence, it seems clear that a high-grade, well-fitted, consistently-worn mask can help protect the wearer against infection, albeit imperfectly. In other words, a K9N5 or KF94 that isn’t hanging around your chin and that isn’t coming on and off for you to eat or drink, may help reduce your risk of infection.

As for #2, mask mandates seem not to have slowed the spread of COVID. The authors of the prestigious Cochrane review, published in January 2023, concluded that wearing masks “probably makes little or no difference” to COVID outcomes on a population level. This news, of course, only accelerated the culture wars around masks. One side shouted, Masks don’t work! The other side cheered, The Cochrane review is biased and wrong!

As always, the truth lives in the gray. 

My takeaway? Wear a mask if you want the potential for added personal protection against respiratory viruses. But there’s no role for mask mandates in 2023 given the absence of evidence to show they made a difference and when mask mandates aren’t a harm-free intervention.

But don’t take it from me! This week, various experts weighed in on masks here and here.

Photo by Daniel Schludi on Unsplash

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QUESTION #2: COVID BOOSTERS

Who should get the new Covid shot — and when?? How long after getting Covid or the last shot??? - Anonymous

Dear Anonymous,