Sunday, October 1, 2023

Should I mask on the subway?

Plus, why you can't find amoxicillin.

Hi folks, it's Kristen in increasingly sniffly NYC. A reader posed a question I have recently been asking myself, too. But before we get to that, the news:

Today's must-reads

Is it time to mask on the subway … again?

I take the subway to work every day. Should I wear a mask again since Covid is ticking up here in NYC? What are my chances of getting Covid on the subway? Does it matter how long my commute is? — Madison, New York, New York

After Covid-19 case numbers dropped, I vowed I would stick to masking on the subway, even as I found myself increasingly in the minority. I was tired of catching viruses from strangers on train cars and planes. Masking seemed like a no-brainer!

Then summer hit, and the NYC subway system again turned into a hot and sticky mess. Increasingly, I found myself "forgetting a mask." Now, I'm not even sure I own any. It's funny how fast attitudes can change and how easily comfort and convenience can replace steadfast vigilance. 

But recently, like our reader, as I have found myself scooting away from coughers and snifflers (and the occasional nose-picker) on the subway, I've wondered if it's time to stock up again on the ol' KN95. 

Katrine Wallace, an epidemiologist at University of Illinois at Chicago and regular adviser to the Q&A, confirms it's time to think about masking again. 

"Covid-19 is still around, and many people are still testing positive," she says. "While we do seem to be experiencing the downturn of the fall surge, rates are still a lot higher than they were over the summer."

The virus doesn't exactly follow seasonal patterns, but the truth of the matter is colder weather means more time indoors. That gives the disease more opportunities to spread. 
 
"Covid has, for the most part, shifted to the mild end of the spectrum for most, thanks to vaccines as well as immunity most of us have acquired through infection," Wallace says. "But in times when there is more Covid around (like now), it is definitely a good idea to mask in certain situations."

Riding public transit is definitely one of those times that call for a mask, especially on extended trips. The longer your ride, and the more crowded the transport, the more potential for viral exposure. (Just one more reason to feel intense surges of anger every time the train stops with no explanation for 20 minutes.) 
 
"Subway cars and buses are enclosed spaces with close contact and questionable ventilation," Wallace says. "A well-fitting N95 or KN95 mask can provide a layer of protection." 

They're also excellent places for viruses to spread because they're where groups that normally wouldn't interact are literally rubbing shoulders. 

Wallace points out that a mask won't just protect against Covid, but a host of other respiratory viruses your fellow commuters might be carrying, such RSV, the flu and parainfluenza.

Those at greater risk of severe Covid should especially consider masking, Wallace says, as should those with a recent Covid exposure. For all of us, donning a face covering is a good way to not only protect ourselves, but more vulnerable members of society. 

It's hard to imagine going back to daily mask-wearing. Personally, it's almost like I've developed an emotional resistance to it. But while for many of us concerns about Covid have disappeared, the virus unfortunately has not. — Kristen V. Brown

The Sunday read

A manufacturing plant nestled in the Appalachian Mountains once employed more than 500 workers and each year pumped out billions of pills containing the most commonly prescribed antibiotic: amoxicillin. It was enough to treat the entire country's strep throat.

But by late July, only 62 people were working there. Bloomberg's Ike Swetlitz has the scoop on what happened, and how that made it so hard to find amoxicillin. 

What we're reading

24 hours in an invisible epidemic. From the Pudding.

Dolly the Sheep's legacy lives on with CRISPR'd cattle and cloned camels, reports Nature. 

Another pig heart transplant, in Maryland. From the Baltimore Banner.

How fixing air pollution could address health disparities, reports Scientific American

How are you thinking about Covid?

Are you Covid fatigued or back to masking? Running to get your booster or can't be bothered? We want to know how your attitudes towards Covid have changed as the virus has become a part of daily life. So get in touch via AskPrognosis@bloomberg.net.

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