UCSF COVID expert Dr. Bob Wachter keeps his facemask at the ready

Outspoken UCSF COVID expert Dr. Bob Wachter on when he's still wearing a mask

SAN FRANCISCO -- Dr. Bob Wachter has amassed a large following on Twitter during the pandemic sharing his latest insights on COVID-19 and how he's trying to avoid catching the virus.

So when he tweeted recently he would wear a mask "forever" it got a lot of attention online, but he let KPIX follow him on a typical Saturday morning to show what he meant by continuing to mask in certain situations. 

"I virtually never wear it outside," he said.

Even with a little rain, the chair of UCSF's Department of Medicine prefers to walk to his favorite coffee and bagel spots in San Francisco's Noe Valley neighborhood before grabbing some fresh produce from the farmers market across the street.

 Each offering common examples of when to wear a mask and when he feels comfortable taking one off. 

"One of the virtues of San Francisco is that I think people don't look at me like I'm crazy," he said.

On this Saturday in February, with the door or windows open and not too large of a crowd, he still felt it best to keep the mask on while going inside the coffee and bagel shops. 

Overall, he explained that being outside is extraordinarily safe and case rates are low so that he doesn't worry about indoor dining.

But he does check out stores on a case-by-case situation. The main concern for him almost three years since the start of the pandemic is catching Long COVID as someone who has yet to get the virus. 

"I've been for a long time been telling people the way I am thinking about the pandemic and what I'm doing and at least some people seem to find that helpful," he said. 

Wachter says his audience on Twitter grew dramatically after COVID-19, reaching 275,000 followers. His tweets include long detailed threads where he explains his reasoning.

One thread with 25 tweets on Jan. 19 explained where his thoughts were on indoor and outdoor activities. In one of those tweets, he said for public transit, theaters, and other large gatherings he would wear a KN95 mask "likely forever." 

"I did not say I will always wear a mask forever in all circumstances," he said.

In another tweet he further explained his thinking that as a 65-year-old who hasn't had the virus and wants to live life as fully as he can, he will take reasonable steps to avoid the infection after being fully vaxed and getting a booster last September.

He also said he calculated the probability of getting Long COVID at around 5 percent per COVID case. 

"If outside, generally I won't wear a mask," he said.

But on this Saturday, he didn't see enough people at the farmers market to raise any concerns, so he put the mask away as he grabbed some lettuce to take home.

As the nation prepares to enter a fourth year since the start of the pandemic, he understands why the Biden administration will end the emergency declaration on COVID-19 in May. Lawmakers in Washington have expressed concerns about that decision on both sides, saying it is either too soon or should happen before then. 

"It does feel like this is a time where COVID now is probably what COVID is going to be a year from now, two years from now," Wachter said. "But I do think it's reasonable to begin moving to a different way of thinking about it."
In California, the governor announced the state's declaration will end in February. 

Here is Dr. Wachter's recent Twitter thread on masking: https://twitter.com/Bob_Wachter/status/1616158968883347456

Also, Wachter's risk calculations for COVID-19: https://twitter.com/Bob_Wachter/status/1607162086282645505

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