Harm reduction, as so clearly described by our guest Monica Gandhi on this podcast, began as a public health approach that guided management of HIV. Harm reduction represented an alternative to an abstinence-only approach, which clearly did not work. In the harm reduction model, you acknowledge that people will take some risks, and that the goal is to decrease risk, not eliminate it.

And yet, here we are with a fear-not-facts approach to the COVID-19 pandemic. Some are advocating for the use of masks in schools, hospitals, and nursing homes in perpetuity. As in, forever. Sounds eerily like an abstinence-only approach, right? Science would dictate that now that we have vaccines, which Monica describes as “the solution,” we don’t need to engage in masking (with a few exceptions).

Monica Gandhi, an infectious disease doctor at UCSF, has advocated strongly for a fact-based approach to school opening, early masking and now dropping masking, and global access to vaccinations (and temporarily dropping vaccine patents), among other things. You can and should follow her: @MonicaGandhi9

And from Ashwin Kotwal, geriatrician and palliative care doc-researcher, we hear about experiences caring for patients who are afraid to return to normal after a year of masking and forced isolation, despite the toll these experiences have taken on them (documented in his recent paper in the Journal of the American Geriatrics Society).

It’s time to get back where we once belonged. (song choice hint)

-@AlexSmithMD

Return to Normal Hesitancy: Podcast with Monica Gandhi and Ashwin Kotwal

GeriPal - A Geriatrics and Palliative Medicine Podcast