The Curbsiders' 'Hot Takes'

OK, So We Were Wrong About the Masks

Matthew F. Watto, MD; Paul N. Williams, MD


May 07, 2020

Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

This transcript has been edited for clarity.

Matthew F. Watto, MD: I'm Matt Watto. Joining me is my cohost, Dr Paul Williams. Can you tell us about this segment?

Paul N. Williams, MD: We talked about COVID-19 management about a month ago with internationally renowned infectious disease guru Dr Paul Sax. We're going to recap and revisit some of our favorite pearls from that conversation and see whether they are still relevant.

Watto: So much has changed. What was your favorite takeaway from that interview?

Mask Whiplash

Williams: At one point we were saying, "Please don't wear masks in public. Save those masks for your healthcare workers. We need them." Dr Sax talked about the mixed message we were possibly sending with that. And now we've transitioned to the CDC recommending face coverings for everyone who's going to be out in public.

We went from kind of shaming people who were wearing surgical masks in public to recommending masks for anyone who is going to be out without the chance to do really super-effective social distancing. That transition has been interesting to watch.

Watto: I have to admit, I feel totally guilty about this. I put this into the script for the podcast. It was an invented person we were talking about—someone who was wearing an N95 mask out to all the places she was going to hoard toilet paper. I thought that Paul Sax was going to lambaste her for wasting a mask.

But no, and here we are. Surgical or cloth masks—whatever patients have available to them—should be worn in public. The thought is that the mask prevents people from transmitting what they have to other people. It's not really protecting you—it's protecting other people from you.

Williams: It's been fun to watch the transition in things that I get angry about. I was angry at people for wearing a mask, and now I'm angry at people who don't wear a mask.

Promising and Not-so-Promising Therapies

Watto: The other thing we talked a lot about was drugs. At that time, the hydroxychloroquine and azithromycin combination was very popular. People were starting to hoard those medications. In the past month, the data on hydroxychloroquine means the drug has kind of fallen out of favor.

Another medication we talked about was tocilizumab. I haven't heard much about that one, but just this week there have been some preliminary reports on remdesivir, and another randomized trial in the Lancet talking about this medication. People began predicting that remdesivir would get emergency use authorization from the FDA, and that it might at least shorten the duration of illness.

Are you tracking any other therapies?

Williams: We touched briefly on the IL-6 antagonists as possible therapies. Dr Sax said there were some case reports that showed promise. I haven't heard much buzz about it in the popular news media, so I'll be curious to see if that shakes out.

Watto: More trials than anyone could possibly keep track of are going on right now. The other really hot topic is convalescent plasma, which relates to what everyone is wondering: "Do I have it? Have I been exposed? Do I have antibodies?" The antibody tests are just starting to come out.

A lot of exciting stuff. If this topic interests you, we are making COVID podcasts pretty regularly. Until next time, I'm Dr Matthew Watto.

Williams: And I'm Dr Paul Williams. Thank you and goodbye.

Click to hear the full episode of COVID-19 Update with Paul Sax, MD, or find the Curbsiders podcasts on iTunes.

The Curbsiders is a national network of students, residents, and clinician educators from across the country, representing 15 different institutions. They "curbside" experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge, and bad puns. Learn more about their contributors and follow them on Twitter.

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