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L i s te n to T h e A B M P Po d c a s t a t a b m m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 29 "Mask fatigue" and "COVID fatigue" are in your mind. That doesn't mean they're not real. It means it's up to you to find the resilience to keep caring about and doing what you can to limit the risks that are as real as your fatigue. If you can't do that, it might be time to take a break from caring for people. To mask or not to mask has never been the question. Masks work. The US saw about 700 deaths from flu last year, compared with 22,000 in 2019 and 34,000 in 2018. 1 The flu didn't decide to take a year off. Its spread was stopped by masking and physical distancing. It's not about politics or freedom. It's about particles and science. The latest data shows that wearing a mask protects others, but new information shows that wearing a mask also protects the wearer, assuming the mask fits well, that light cannot be seen through it, and that you wear it correctly and consistently. 2 Don't allow yourself to become overwhelmed by the debate of which mask is best. Analysis paralysis is just another excuse to abdicate your responsibility to do no harm. Experts continue to agree the best mask is one you will wear and one that fits well, snugly covering your nose as well as your mouth. End of story. Some people may use rationalizations like "all of my clients are vaccinated" or "I don't work with people in high-risk demographics" or "the infection rates in my community are low" to avoid wearing a mask. But Delta doesn't care if you're vaccinated, if infection rates change daily, or if most risk factors are invisible. People who are at increased risk of infection, hospitalization, and death number in the hundreds of millions in the The Delta variant doesn't care if you're vaccinated, if infection rates change daily, or if most risk factors are invisible. US when you add them all up. The high- risk demographic includes people living with conditions like asthma, which gets downplayed because it can be managed with prescriptions. 3 People with chronic kidney disease are also at higher risk, but nine out of 10 of them don't know they are living with chronic kidney disease. 4 And if you think you know who does and does not have a weakened immune system, think again. We also must consider the people who live and work with the people who are on our tables. The Delta variant has an R0 (its production number) of 6. That means that six people, on average, are likely to become infected by any single person carrying the virus. 5 That's about three times more contagious than the flu and Ebola, and as contagious as chickenpox. 6 That means every time you spend more than 15 minutes in an enclosed space with another human, you are potentially infecting at least six others. Your clients have kids who are too young to be vaccinated, elderly relatives, people going through cancer treatment, or people with chronic obstructive pulmonary disease (COPD) in their lives. It's your responsibility to ensure you do your part to protect them. Notes 1. Katie Peek, "Flu has Disappeared for More Than a Year," Scientific American, April 29, 2021, article/flu-has-disappeared-worldwide- during-the-covid-pandemic1. 2. Elizabeth Segran, "The Delta Variant is Highly Contagious. Which Masks Offer the Best Protection?," Fast Company, August 2, 2021, the-delta-variant-is-highly-contagious- which-masks-offer-the-best-protection. 3. Mayo Clinic Staff, "COVID-19: Who's at Higher Risk of Serious Symptoms?," July 29, 2021, conditions/coronavirus/in-depth/ coronavirus-who-is-at-risk/art-20483301. 4. Centers for Disease Control and Prevention, "Chronic Kidney Disease in the United States, 2021," March 4, 2021, publications-resources/ckd-national-facts.html. 5. Anders Gunderson and Liana Woskie, Harvard Global Health Institute, "Understanding Predictions: What is R-Naught?," February 7, 2020, understanding-predictions-what-is-r-naught. 6. Kathy Katella, Yale Medicine, "5 Things to Know About the Delta Variant," August 13, 2021, things-to-know-delta-variant-covid. Cal Cates is an educator, writer, and speaker on topics ranging from massage therapy in the hospital setting to end- of-life care and massage therapy policy and regulation. A founding director of the Society for Oncology Massage from 2007–2014 and current executive director and founder of Healwell, Cates works within and beyond the massage therapy community to elevate the level of practice and integration of massage overall and in health care specifically. Cates also is the co- creator of the podcasts Massage Therapy Without Borders and Interdisciplinary.

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