General Wellness

Just to be clear, masks work and, next to distancing, are the most important disease mitigating measure you can take.

We keep hearing from our leaders how even Dr. Fauci said early on that we didn’t need them, but it has been many months since then and we know a lot more now.

They have been shown to reduce the spread of the virus as well as reducing the potential for contracting it. And regardless of how many people have mild cases, you DO NOT want to contract it. You’re playing Russian Roulette with your life. CDC chief Robert R. Redfield, MD stated recently that masks will be more effective than any flu vaccine that may be on the horizon.

ETIQUETTE. There are variations on this quote but the one attributed to Abraham Lincoln is the simplest. “My right to swing my fist ends where your nose begins”.

Think what you want about your own personal protection and your own personal rights, but the fact is that masks are more important to protect others from you than to protect you from others. It’s that simple. Please be courteous to others by wearing a mask when around them, especially indoors where there is much less ventilation. It shows you care.

Cover your nose since this is the main location of viral concentration in the upper airway.

If it has a piece of metal to mold over your nose, don’t wear it upside down!

Stop touching it! You are just contaminating yourself.

MISCONCEPTIONS. Masks WON’T cause CO2 poisoning or oxygen deprivation! The only people who should have any concerns are those who already have severe lung disease and even then, short periods of mask wearing pose virtual no threat. Asthma is not an excuse. There will be another longer post coming up on mask myths.

Yes they are uncomfortable, but so are hearing aids, glasses and taking the myriad of drugs most Americans are on. We use them because we need to use them. 

EFFICACY OF DIFFERENT MATERIALS.

In a nutshell, the harder it is to breathe through, the more effective it is at filtering out droplets and viral particles, in both directions. That having been said, we do not all need to be walking around in hazmat suits either. Below is a list of masks and materials and how effective they are.

Medical grade masks.

N95 – without a valve – These are the most effective at filtering in both directions assuming there is a nice, tight fit. There are more effective industrial masks (N100) and closed-loop respirators but we are not astronauts or Darth Vader and don’t need them outside of the operating room or in extremely dangerous situations like our front-line healthcare providers.

N95 – with a filter – Protects the wearer but does little for anyone else. When you breathe out, all the particles go out directly. If you sneeze and cough, some of the droplets get blocked, but most get out.

N95 masks are a little harder to get and there is something to be said for reserving them for higher risk people or healthcare workers.

Hospital/Medical masks (typically, light blue with ear loops). Also very effective and a lot easier to get.

Homemade or Commercial Masks

Fabrics like cotton are great, especially if multilayer. The more snugly they fit around your nose and chin, the better. Some have been shown to be even as effective as N95 masks, especially if they have an added filter inside.

Bandanas and handkerchief masks provide little if any protection because of how loose they often are. Again, just like the valved masks, if you sneeze or cough, some droplets get caught in the fabric, but a lot get around it as well.

Fabrics like spandex and anything thin and stretchy, although more comfortable to wear and breathe through, can be worse than wearing nothing. They take larger droplets an aerosolize them making them smaller and easier to inhale, in both directions. You may inadvertently be putting yourself and others at greater risk.

Shields. If worn alone, they also provide little to no protection. They protect your eyes from large, sneezed or coughed particles, and the same outwards, but that’s about it.

Medical masks cannot be washed but they can be worn a number of times. Keep a rotation, placing them on your dash in the sun. 2-3 days will  kill anything. The same goes for cloth masks. Also, there are some devices which use UVC light rays to kill all microbes. They can also be used to sterilize phones, wallets… Fabric masks can be washed at home every few days but doing so daily is not necessary unless you have a specific exposure concern.

TIP for ear-loop masks. There are a number of products available called “loop mask extenders”. Simple devices which pull the loops off the ears with a strap across the back of the head. This is really great if you wear them for a long time or wear a hearing aid. I have had patients lose hearing aids because they get caught in the loop and go flying. They are available online pretty inexpensively or make your own with cloth and buttons. You need about 6 inches between the buttons.

Back to the mantra.

1. DISTANCE. Physical, not social. #1 behavior to protect yourself.
2. MASK UP. Wear it correctly. Wear an effective one. Don’t fool yourself.
3. WASH YOUR HANDS. Reserve hand sanitizers, which are loaded with chemicals, for emergencies. If a chemical is on you, it is in you! More to come on this topic.
4. DON’T TOUCH YOUR FACE.
5. GET HEALTHY.
6. VENTILATE.
7. VACCINATE.

Stay SAfe and Be Well.

AC😎✌️🌱❤🐖🏃🏻🧘🏻‍♂️🌎😷

At the start of the pandemic, we did not know what to expect. Horrifying images of mass graves in China, middle aged people in Italy being turned away from overfilled hospitals and portable morgues on the streets of NYC led to a lock-down (at least on the East and West coasts) and paranoia which has led to some sad lingering effects.

Isolation.

We evolved as social beings, relying on each other to survive. As connected as we may feel through social media, this has made us less-connected. There is a direct correlation between social media screen time and depression. There are studies that show that physical and social isolation lead to diminished activity in parts of the brain. In one case study of someone who was in long term isolation in prison (it turns out  he was wrongly imprisoned to begin with), when he was released, he had extreme difficulty recognizing faces of familiar people. His difficulties improved but how his brain changed is an example of neuroplasticity. The brain can change in a negative direction and then change back in a positive one once stimulated properly. At ANY age. Even into our 90’s.

We see the same with food. If you consume a lot of sugar, an apple may taste sweet, but if you eat the same apple after a month of eliminating added sugars, the apple tastes much sweeter. The same neural adaptation occurs with salt and fat.

One of the behaviors promoted by the healthcare community, in addition to wearing a mask, washing your hands and not touching your face  was “social distancing”. Early on in this pandemic, I heard and adopted the philosophy of “physical distancing” and not “social distancing”. We NEED to be social. Our friends and family need us and we need them. Be together, just apart.

It’s important to ask for help if you need it, and we ALL need help, whether we think so or not.

Although video conferencing is certainly better than nothing, it’s actually not much better than a simple phone call. Studies show that parts of your brain light up to significantly greater degrees when you are in the physical presence of someone than on a video or phone call. A simple touch goes a really long way also. Be together, hug and touch, just do it sensibly. Physical contact leads to release of oxytocin, the “love hormone”, also known as the “cuddle hormone”. If someone has medical issues, maybe be a little more reserved but a hug, out in the open air, masked, facing away from each other is perfectly fine, will result in improved mood and may be the difference between an OK day and an amazing day. And we certainly need more amazing days since there are many more tough days ahead.

Have a great weekend and enjoy the early fall weather.

Stay safe and be well. 

AC 😎✌️🌱❤🐖🏃🏻🧘🏻‍♂️🌎😷