Sunday, February 27, 2022

To mask or not to mask... that is the question

As you have probably read, the CDC has relaxed its mask guidance in response to the falling numbers of Covid cases and hospitalizations. What should you do?

There are several key points to consider.

The first is that being fully vaccinated is the most important thing you can do to protect yourself from serious illness. While the vaccines’ ability to prevent infection wanes, their protection against hospitalization and death has remained strong.

The second is that masks, while not a panacea, clearly reduce risk. If you are in close contact with an infected person and both of you are wearing masks, your likelihood of catching the virus is reduced by 50%.

Finally, life is inherently risky, and you can balance your tolerance for risk against other things that are important to you, as you do every time you get in a car.

There is little need for most people to wear masks outdoors unless packed together as in a stadium.

If you are healthy and fully vaccinated, and so are your family, it is reasonable to stop using a mask in most settings. I would still use one when you are indoors in crowded environments such as theatres and public transportation.

If you or a family member or close friend are immune compromised, masks are still a useful barrier to infection and should still be used in most indoor settings.

When gathering indoors with friends, if you are all vaccinated and have no symptoms, you can skip the masks. If someone in the group is immune compromised, you can add an extra layer of safety by all doing a self-test before the gathering.

One of the things that mask-wearing has done is markedly cut down both influenza and colds, which are spread the same way as Covid – the respiratory route. I may just keep wearing one in stores and such for a while longer!

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Thursday, February 17, 2022

Move it!

Just as with clothing, medicine has its fads. Coffee is good for you, then it is bad, Chocolate is harmful or perhaps it is helpful. Red wine prevents heart attacks, then it does not. Through all these ups and downs, the one thing that remains true is the value of exercise.

Regular aerobic exercise helps the joints, is one of the few activities shown to reduce the risk of dementia and can help elevate your mood. How much is necessary is unclear, and there does seem to be a point beyond which no extra benefit is seen.

Another feature that has been uncertain is whether the heart benefits of exercise require you to start young. A recent study from Italy tells us that exercise at older ages is very protective. The study looked at 3100 men and women 65 and older (60% female). Their baseline physical activity level was assessed when the study began and again 4 and 7 years later. “Active” seniors were those who engaged in at least 20 minutes of moderate or vigorous physical activity daily.

Those who exercised at 70-75 and kept it up had 50% fewer cardiovascular events than those who were sedentary throughout the study period. The benefit was greatest at preventing coronary disease, somewhat less at preventing congestive heart failure and least helpful at preventing strokes.

The benefits began at 20 minutes/day of exercise and seemed to plateau at 60 minutes. This agrees with other observations: you do not have to run marathons to gain the greatest reduction in heart disease. 40-60 minutes a day seems to get you “the most bang for the buck.”

It is also true that you do not have to push yourself beyond your safe limits. The study defined vigorous physical activity to include gardening, gym attendance, bicycling, dancing and swimming.

The take-home: it is never too late to start. If you find an activity (or several activities) you enjoy, get out there and do them every day. Your heart will thank you.

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