Want to tell a story about masks. This takes place in Ann Arbor, a very educated and left leaning place at a University hospital.

All patients admitted to the hospital have had a COVID PCR.

So, I'm the cardiology consult attdg. I see tons of pts each day with all manner of cardiac issues that happen to be on other services like surgery, obstetrics, etc.

I and all the staff wear masks (surgical type) all the time.

When I go into a room to examine a patient, about 60-70% of the time they aren't wearing a mask.

This is usually perfectly okay, because mostly they are alone. They spend most of the day in their rooms & can't be expected to wear a mask all the time when nobody else is nearby.

But I always ask the patients to wear their mask before I start my exam.

Many are surprised by this. They assume that because their COVID tests were negative, there is no need.

I usually will educate them about potential for false negatives, that I may have exposures to other staff and patients and may unknowingly be a carrier (masks definitely are not 100% protective).

But I thought a little more about this.

I'm almost never the first doc they see. For sure not the first HC provider (nurses usually are).

So this means it is very likely that all these HC providers are seeing the patients, often in close quarters, without having the patient wear a mask.

I found this interesting.

There is a big gulf between the mask virtue signalling and shaming on Twitter and the real world.

(You may have seen some tweets get deleted and reposted. Sorry. I was trying to fix the thread sequence and it is brutally hard but I think I finally got it)

But in the end, I just want to say, I always wear a mask. I always encourage people to wear a mask.

I'm not sure how effective they are. It's probably something more than 0% but far less than 100% effective. But they also cost very little and have essentially no downsides.

But if nurses and docs don't always remind patients in hospitals to wear them all the times they are around other people, why are we angry that the clerks at a big box stores aren't tasked with this?