NYT: Biden Mandates Vaccines for Workers, Saying, ‘Our Patience Is Wearing Thin’

[FIPurpose]

Somewhat related, I got an email recently of travel nurses needed in Oregon and Mass. that were paying 7-10k per week. For the next 2 months. Part of me thinks I could've chosen a job where I can make an entire year's salary in 2 months. le sigh. I'll just stick it out in my home office pretending to work half the day. lol.

[MudPuppy]

Lots of staff are leaving to take these crisis contracts! Hospitals are complaining, but if they paid their real staff they wouldn’t have to pay through the nose for travelers!

[DadJokes]

Locally (and entirely anecdotal with a meaningless n) my younger cousin got offered $26 an hour as a new grad and my niece’s fiancé got a job at $19.50/hr as a forklift operator. Your point still stands to an extent that I’d rather make 26 that 19.50!

I don't work in the industry, but it's my understanding that healthcare workers typically have a lot more overtime opportunities.

[MudPuppy]

He seems to get a few every week, but I can’t speak for all. I am simply comparing entry wages for a  standard work week. Tossing OT in the mix wouldn’t be useful IMO since burnout adds a whole other can of worms.

[GuitarStv]

I think the problem here is you regard me as some anti-sunscreen person. I'm not.

I do have some anti-sunscreen people in my family . . . who also are big fans of tanning salons and was getting a similar vibe from your post.  Obviously I misread you, so please accept my apologies.

It would be nice to have products that were demonstrated to be reasonably safe and with reasonably good manufacturing standards rather than the mystery products on the shelves today. My point is that a reasonable person can minimize risk by avoiding some of the more exotic ingredients and still have protection from UV rays. Accepting whatever corporate America extrudes into a colorful bottle as good-enough is setting the bar quite low.

So, here I think you're misreading my position a bit.

I'm with you on the need for demonstrably safe products with good manufacturing standards.  There's some evidence that several chemicals commonly used in sunscreens may be damaging to you, so it makes sense to avoid those until we better know about them when possible.  If it's a choice of grabbing whatever sunscreen in on the rack or not using any for a day at the beach though, the balance of evidence suggests that the former is the better choice to make.

[GodlessCommie]

News went on to list vaccination rates at several hospitals in the metro area.  Big, shiny, newly relocated to downtown Children's hospital had 100%, but a satellite hospital site near my parents was only 46% (in a wealthy suburb).  WTH?

Commuters from farther-out (and, thus, conservative) places, I would suspect. Also, a lot depends on the leadership. A manager that wants to make it happen will, more often than not, make it happen - given cover from above, which they now have.

[the_fixer]

Well i work within an executive federal branch and have co-workers who are resistant to the mandate and adamant they won't get the vaccine.
   A supervisor in a different area, who has about 10 guys under him on a crew, says 8 are saying they'll leave rather than follow the mandate for federal employees. I feel it's mostly bluster and verbal diarrea, and several would comply if it meant their comfortable jobs+ paycheck would really be lost - not many of those 8 guys strike me as secret millionaires.

   But it seems the can will be kicked down the road....Covid test weekly checks were supposed to be starting this week for the unvaccinated, but the agency has put this on hold  "pending further guidance from DOD commands above us, pursuant to the new mandate". Rumor has it 50% of the local federal employee workforce is unvaccinated and managers are skittish about putting mass amounts of dissenters on 'admin leave' and not having their work metrics/jobs completed.

  One fellow is rather vocal about his resistance - the irony here is that he was in the military for about 12 years, and was deployed overseas, which i am sure they gave him a set of specific vaccinations for , not received by the ordinary US citizen or even the average soldier, due to his duty station location.  But now that he is out of the 'service' and is a federal employee, feels that his personal wishes and freedoms overrule his governments' directives. Meanwhile his wife got the shots months ago, since she also works at a federal agency, and deals directly with customers [close physical proximity to total strangers ] , so she is apparently getting mad at him.
   But he's dug himself into his resistance and comraderie with fellow - " it's unconstitutional, it's unproven, it's a fake news, its a way to control us for nefarious purposes " - likeminded co-workers.  2 other coworkers that we deal directly with , in person, have gotten [relatively mild] Covid in the last month, both were unvaxxed and antivax in mindset, one was sent home for 2 weeks, the other is nearing 20 days still with symptoms.
    Another in an adjacent work crew was in the hospital for a month, and now@ home on oxygen - that guy is about 36 years old and was in good health before covid struck him down. { he came from the crew that has 10 guys mentioned above - see they used to have 11 on the crew -but they don't know when he'll be able to physically come back and do the job }.
   
 And the 12 yr veteran guy has/had an ex-military buddy whom he stayed in touch with, " in good shape" , who went into hospital [ out of state] with covid and died after being there a week.
   I feel like just pulling him aside and saying "just get the shot already- and than continue on with your verbal bluster if you need to look cool to your 30-45yr old buddies".

   Unfortuately i see this dragging on within this federal agency as they try not to hurt the anti-vaxxers snowflake feelings, delay due to no-one buying or appropriating the 1000's of covid tests they'd need each week [ just for the site i work at] , and worry over lawsuits, costs of removing the recalcitrant employees, replacing workers with specific skill sets,  etc...

FYI my wife is a fed employee and they received an email yesterday clearly laying out the dates for each brand of shot to be started in time to meet the deadline and if not completed by that date a list of consequences including up to termination.


Sent from my iPhone using Tapatalk

[GodlessCommie]

A lot of fascinating data on public opinion related to vaccines, masks, mandates, etc:

https://www.pewresearch.org/science/2021/09/15/majority-in-u-s-says-public-health-benefits-of-covid-19-restrictions-worth-the-costs-even-as-large-shares-also-see-downsides/

Fellow atheists, you can be proud of yourself! Highest vaccination rate. Also, very strong consensus on requiring vaccinations for air travel and on college campuses. No data on Biden's mandate, research was done before that.

[Wolfpack Mustachian]

Two anecdotes from my little social circle-

Sis-in-law is a traveling nurse and currently working in TX.  Firmly in the "don't trust this rushed vaccine, instead take vitamins and zinc to strengthen the immune system" camp. She got the Pfizer vaccine this week thanks to Biden's Medicare/Medicaid healthcare worker mandate. Guess what? She survived the jab. Way to go, Joe.

A lady friend of mine who is a nurse had resisted taking the vaccine for months, but also had to get it due to the healthcare worker mandate. Eight days after she took the vaccine she was short of breath and had pain in her leg so she went to the doc thinking it was vaccine related side effects. They didn't find anything related to the vaccine, but DID find a 4 inch tumor attached to her liver that they're going to surgically remove.

In summary, I'm sure some healthcare workers will resign, but most will get vaccinated like these two in order to save the high paying job that they invested thousands of hours of education and training into.

Excellent.  This is exactly what I think will happen.  End result - safer country, less strained hospital systems, and more people vaccinated.

I hope you are right. I will say that the high paying part of the job (from the previous post) is a bit of a stretch. Nurses with 4 year degrees are getting paid maybe a few bucks an hour more than the starting salary for an hourly person at a manufacturing plant with a lot less responsibility and dealing with a lot less crap. This is also not counting the people on burnout, who are retiring early, who would leave even without losing more nurses and making it worse.

End result could be safer country, less strained hospital systems, and more people vaccinated. It could also be much more strained hospital for a significant period of time, worst case having a hard time finding nursing staff for years to come. I hope your end result is what comes about.

In California, most registered nurses can pretty easily make $100k+ shortly after landing their first professional job. That is completely different than your average manufacturing job with no responsibility. Of course, maybe you are thinking of LVNs that don’t make as much money but also don’t have the same education requirements.

In my circle, the few registered nurses I know are much more likely to be vaccinated than the LVNs and CNAs that I know. The CNAs and LVNs are the most vocal about “stop the mandate”, while the one RN I know that’s not vaccinated is at least not advertising it nearly as much.

I think you've hit the nail on the head with your location. I believe that it is very location-specific and that's why we're all having different perspectives. I did a quick glassdoor search for RN's in my area, and their starting salary was literally 3 dollars more an hour than the starting salary of a manufacturing plant down the road.

I can't speak to the amount of RN's vs. CNA's or whatnot but there's a lot of people in direct patient care, and they don't seem to be backing down.

[Fireball]

Two anecdotes from my little social circle-

Sis-in-law is a traveling nurse and currently working in TX.  Firmly in the "don't trust this rushed vaccine, instead take vitamins and zinc to strengthen the immune system" camp. She got the Pfizer vaccine this week thanks to Biden's Medicare/Medicaid healthcare worker mandate. Guess what? She survived the jab. Way to go, Joe.

A lady friend of mine who is a nurse had resisted taking the vaccine for months, but also had to get it due to the healthcare worker mandate. Eight days after she took the vaccine she was short of breath and had pain in her leg so she went to the doc thinking it was vaccine related side effects. They didn't find anything related to the vaccine, but DID find a 4 inch tumor attached to her liver that they're going to surgically remove.

In summary, I'm sure some healthcare workers will resign, but most will get vaccinated like these two in order to save the high paying job that they invested thousands of hours of education and training into.

Excellent.  This is exactly what I think will happen.  End result - safer country, less strained hospital systems, and more people vaccinated.

I hope you are right. I will say that the high paying part of the job (from the previous post) is a bit of a stretch. Nurses with 4 year degrees are getting paid maybe a few bucks an hour more than the starting salary for an hourly person at a manufacturing plant with a lot less responsibility and dealing with a lot less crap. This is also not counting the people on burnout, who are retiring early, who would leave even without losing more nurses and making it worse.

End result could be safer country, less strained hospital systems, and more people vaccinated. It could also be much more strained hospital for a significant period of time, worst case having a hard time finding nursing staff for years to come. I hope your end result is what comes about.

In California, most registered nurses can pretty easily make $100k+ shortly after landing their first professional job. That is completely different than your average manufacturing job with no responsibility. Of course, maybe you are thinking of LVNs that don’t make as much money but also don’t have the same education requirements.

In my circle, the few registered nurses I know are much more likely to be vaccinated than the LVNs and CNAs that I know. The CNAs and LVNs are the most vocal about “stop the mandate”, while the one RN I know that’s not vaccinated is at least not advertising it nearly as much.

I think you've hit the nail on the head with your location. I believe that it is very location-specific and that's why we're all having different perspectives. I did a quick glassdoor search for RN's in my area, and their starting salary was literally 3 dollars more an hour than the starting salary of a manufacturing plant down the road.

I can't speak to the amount of RN's vs. CNA's or whatnot but there's a lot of people in direct patient care, and they don't seem to be backing down.

Agreed. My perspective is from a very rural area where a job at a hospital paying $25/hr is considered to be *excellent*.  You lose that job and you're only alternative is to drive 2-3 hours round trip each day or take something else locally making half that(if you can find it). 

My traveling nurse sis-in-law that got vaxxed recently due to Biden's order makes $9,000/wk right now.  She's not walking away from that even if there was a microchip in that shot. Subsequently, my brother and his 16yr old son are now getting the shot since sis-in-law got it.

[DaMa]

My niece has been holding out (she had COVID), but is getting one tomorrow due to a work mandate.  Her husband is going, too. 

[six-car-habit]

Well i work within an executive federal branch and have co-workers who are resistant to the mandate and adamant they won't get the vaccine.
   A supervisor in a different area, who has about 10 guys under him on a crew, says 8 are saying they'll leave rather than follow the mandate for federal employees.   

Just imagine the economic effects if all these easily-influenced-by-internet-propaganda people quit or were fired.

In the short term, the federal deficit would decrease and unemployment would be higher because agencies would have fewer redundant personnel on the payroll, and that would be a negative for the economy. In the long-term, there would be a scramble by people in lower-paying jobs to get promoted to the newly-vacated higher-paying jobs. I'm under no illusions that hiring in the federal or state contexts is 100% meritocratic, but the purging* of internet ideologues who are demonstrably unqualified to make health decisions for themselves would be specifically removing those less qualified to make decisions, lead people, cooperate on collective projects, and discern truth from falsehood.

When all the sorting is done, the replacements for these people will be more qualified and productive in all these ways. What does that mean for the effectiveness of government in general? It means better times are coming, if we can stand to listen to the grumblings of people who demoted themselves because they identified with an "influencer" on YouTube.

*To be clear, the purge I'm talking about is via death, disability, and finally vaccine mandates. It's not a political purge, it's an evolutionary event.

 Yes, one could hope this would bring about a wave of retirements as well.   I'd like to see the gov't offer a separation bonus of one or two months salary to get these folks out now, before the time and costs to get rid of them start to spiral upwards.  This assumes people actually lose their federal jobs, or federal contracting jobs before 2022, and i'm not so confident that will actually happen.

 As a note to TheFixer's comment - your spouse must work at a different branch , or have a more responsive command/management structure than the one i work for -- as of today, info is minimal and muted from management, and workers are having us-versus-them confrontations more often
  In fairness, an email was put out that had a non-direct link to a newssite website story put out by the -" federal news network / govexec sites" which seem to be privately owned businesses.  It was buried in a "daily email" that has info about training, recent promotions + new hires, barbeque safety. things of note that happened on this date in the past, etc.   And the non-linked story said the Safer Workplace Task Force has decided Nov 22nd is the cutoff date to be considered fully vaxxed , before discipline and pre-removal proccesses would begin. 

   Yes, I have found this info by looking for it, but the average blusterer who is convinced he'll give up his job for 'medical freedom' , or that this will all blow over, imo doesn't do much deep reading or investigation, and hasn't been informed of potential consequences directly by management - either verbally or by email.  But maybe they are working on refining their message to make it more palatable sounding ?

 Fixer - can i ask what the "consequences" that built up, prior to termination were ?

[GodlessCommie]

Meantime, at United Airlines, the number of resignations over a vaccine mandate is in single digits, and the workforce is already 90% vaccinated.

https://sports.yahoo.com/united-airlines-ceo-says-number-200755013.html

[PeteD01]

Another Facebook post of one of my former trainees. He is an old hand and certainly is at the top of his game. Not exactly the profile of someone caving under the pressure. There will be consequences for health care in states that failed to protect essential services from being overwhelmed.

"I think I ran out of empathy today. I never thought that would happen.
Our post partum patient on ecmo died. Never lost a mom with baby that young before. Had to turn down another new mom for ecmo, because we don’t have enough nurses. 17 ICU nurses turned in their notice. They are done. Totally done.
These days, there are more and more crazy, entitled A holes and I just don’t care about your feelings anymore.
If your husband or wife is unvaccinated and dying of covid, don’t blame me. It’s not my fault they didn’t take the shot.
I still do the best for my patients, but it’s cold now. I still care, but it’s removed. I have completed my transformation into Lieutenant Colonel Bill Kilgore. Welcome to the war, the napalm smells like death and victory.
Four of my uncles were drafted into WW2. Three came back. I heard about my hero, my Uncle Jesse , my whole life. When I was in college, my uncle S.L. let me interview him for a report. I never told his children about the bodies of his friends he had to crawl through. I never told him a about the day he learned Jesse died.
I never thought I would be in war. I went to med school. I couldn’t go through what Uncle S.L. went through. I never thought my number would be called, but it was. I was drafted last year in March.
I was terrified, but I did my duty as an American citizen. I truly thought I was going to die, but I found a purpose. In my mind, I put my life on the line, my families life on the line.  I did my duty and I saved American lives.
Unfortunately, this isn’t the Great Depression, it’s not WW2, it’s not even 911. Americans aren’t willing to stand up and defend this country anymore.
In my mind, we all got drafted. In order to save our fellow Americans lives, we have to make some sacrifices. Hell. Some may die. You can accept that or you can dodge that draft. I will serve my time, but I don’t have to care anymore.
I am done posting. I don’t have anything positive to say anymore. Don’t bother thanking me or commenting. I don’t care for thanks. I care for shots. Don’t thank me. Get shots.
I will always do the best I can, but don’t expect me to give a shit when you die anymore. Don’t expect me to call you back if you are an entitled B.
Ps. I take care of sick people. I am a critical care pulmonologist."

And to finish on a higher note, one of my favorites these days:

https://www.youtube.com/watch?v=ej7Lh9kEdhY

[Abe]

Another Facebook post of one of my former trainees. He is an old hand and certainly is at the top of his game. Not exactly the profile of someone caving under the pressure. There will be consequences for health care in states that failed to protect essential services from being overwhelmed.

Yeah, these anti-vax jokers (trying to differentiate between the zealots and vaccine-hesitant people) think this is bad? Wait until the next pandemic and see who shows up for work one month after vaccines are available. Many of my friends from med school & residency (scattered across the country now) report massive nurse and other resignations from burnout, vaccine refusal or switching to travelling. One (Ped Surg) has to take out trash from his office since the maintenance guys resigned en masse in a fit of Trumpism. Another Ped Surg is looking for places that don't have ECMO so she doesn't get drafted into COVID ecmo call. Another is Ped Crit Care and is being drafted to the COVID adult units while regular Peds is manning the non-cardiac Peds ICU. It's just madness. These are all well-known major academic hospitals.

Reminds me of trauma call - an endless parade of pointlessness with a bunch of drunk jerks, morgue bags and raided crash carts.

[MayDay]

Abe or others, question:

What happens if you are ped Surg or whatever (not adult ICU) and you just refuse to cover it?

[mm1970]

Another Facebook post of one of my former trainees. He is an old hand and certainly is at the top of his game. Not exactly the profile of someone caving under the pressure. There will be consequences for health care in states that failed to protect essential services from being overwhelmed.

"I think I ran out of empathy today. I never thought that would happen.
Our post partum patient on ecmo died. Never lost a mom with baby that young before. Had to turn down another new mom for ecmo, because we don’t have enough nurses. 17 ICU nurses turned in their notice. They are done. Totally done.
These days, there are more and more crazy, entitled A holes and I just don’t care about your feelings anymore.
If your husband or wife is unvaccinated and dying of covid, don’t blame me. It’s not my fault they didn’t take the shot.
I still do the best for my patients, but it’s cold now. I still care, but it’s removed. I have completed my transformation into Lieutenant Colonel Bill Kilgore. Welcome to the war, the napalm smells like death and victory.
Four of my uncles were drafted into WW2. Three came back. I heard about my hero, my Uncle Jesse , my whole life. When I was in college, my uncle S.L. let me interview him for a report. I never told his children about the bodies of his friends he had to crawl through. I never told him a about the day he learned Jesse died.
I never thought I would be in war. I went to med school. I couldn’t go through what Uncle S.L. went through. I never thought my number would be called, but it was. I was drafted last year in March.
I was terrified, but I did my duty as an American citizen. I truly thought I was going to die, but I found a purpose. In my mind, I put my life on the line, my families life on the line.  I did my duty and I saved American lives.
Unfortunately, this isn’t the Great Depression, it’s not WW2, it’s not even 911. Americans aren’t willing to stand up and defend this country anymore.
In my mind, we all got drafted. In order to save our fellow Americans lives, we have to make some sacrifices. Hell. Some may die. You can accept that or you can dodge that draft. I will serve my time, but I don’t have to care anymore.
I am done posting. I don’t have anything positive to say anymore. Don’t bother thanking me or commenting. I don’t care for thanks. I care for shots. Don’t thank me. Get shots.
I will always do the best I can, but don’t expect me to give a shit when you die anymore. Don’t expect me to call you back if you are an entitled B.
Ps. I take care of sick people. I am a critical care pulmonologist."

And to finish on a higher note, one of my favorites these days:

https://www.youtube.com/watch?v=ej7Lh9kEdhY

I wish everyone could read this.

[Abe]

Abe or others, question:

What happens if you are ped Surg or whatever (not adult ICU) and you just refuse to cover it?

On a hospital-level, it depends on your employment contract. In most cases, if you are professionally qualified to cover and refuse you can be suspended or fired. That has not been implemented to my knowledge as that hospital would probably not hire competent physicians for a generation. Word travels fast on what hospitals suck to work for, and that would be so egregious that I doubt any administrator would even consider this.

Instead, this leads to multiple emails from desperate rural hospitals trying to find ICU coverage for a few weeks at a time since their teams are burning out/retiring. We already have a lack of qualified healthcare workers of all types as older rural physicians & nurses retire, and younger ones have little interest in living in those areas. This has been amplified as these places also happen to be chock full of anti-vax people that overload the hospital. Though pre-vaccine availability I would’ve considered it for the money, now I delete those immediately (and my current position doesn’t allow working at other institutions, anyway). This is true for almost all my physician friends. Some have done it and would never consider again.

[BlueMR2]

I think the problem here is you regard me as some anti-sunscreen person. I'm not.

I do have some anti-sunscreen people in my family . . . who also are big fans of tanning salons and was getting a similar vibe from your post.  Obviously I misread you, so please accept my apologies.

A bit of a tangent, but among my Oncologist friends, they are what I'd call "mostly anti-sunscreen".  Saying only to use it when going to be outside for extended periods of time and then only if it's the last resort.  Recommendation is to prefer covering up/shade.  I'm told that the cancers they're seeing that are related to excessive use of sunscreen have become a real thing, exceeding the cancer rate from NOT using sunscreen.  I've seen none of the supporting data for this and am not qualified to interpret it, but it's interesting that it's consistent across the small pool of experts that I know in that area.

[iris lily]

I think the problem here is you regard me as some anti-sunscreen person. I'm not.

I do have some anti-sunscreen people in my family . . . who also are big fans of tanning salons and was getting a similar vibe from your post.  Obviously I misread you, so please accept my apologies.

A bit of a tangent, but among my Oncologist friends, they are what I'd call "mostly anti-sunscreen".  Saying only to use it when going to be outside for extended periods of time and then only if it's the last resort.  Recommendation is to prefer covering up/shade.  I'm told that the cancers they're seeing that are related to excessive use of sunscreen have become a real thing, exceeding the cancer rate from NOT using sunscreen.  I've seen none of the supporting data for this and am not qualified to interpret it, but it's interesting that it's consistent across the small pool of experts that I know in that area.

Ptf to mark,tangent.interesting.

[DaMa]

PTF.  Also interesting tangent.  What do the oncologist friends think of mineral sunscreen?

[Wolfpack Mustachian]

I think the problem here is you regard me as some anti-sunscreen person. I'm not.

I do have some anti-sunscreen people in my family . . . who also are big fans of tanning salons and was getting a similar vibe from your post.  Obviously I misread you, so please accept my apologies.

A bit of a tangent, but among my Oncologist friends, they are what I'd call "mostly anti-sunscreen".  Saying only to use it when going to be outside for extended periods of time and then only if it's the last resort.  Recommendation is to prefer covering up/shade.  I'm told that the cancers they're seeing that are related to excessive use of sunscreen have become a real thing, exceeding the cancer rate from NOT using sunscreen.  I've seen none of the supporting data for this and am not qualified to interpret it, but it's interesting that it's consistent across the small pool of experts that I know in that area.

I'd echo my curiosity on this. It pretty much is what I do - only use sunscreen when I'm going out to the beach or the like. I've heard from many - sunscreen every day you're going out for more than just a walk to the car and back. It seemed excessive to me.

[Abe]

I think the problem here is you regard me as some anti-sunscreen person. I'm not.

I do have some anti-sunscreen people in my family . . . who also are big fans of tanning salons and was getting a similar vibe from your post.  Obviously I misread you, so please accept my apologies.

A bit of a tangent, but among my Oncologist friends, they are what I'd call "mostly anti-sunscreen".  Saying only to use it when going to be outside for extended periods of time and then only if it's the last resort.  Recommendation is to prefer covering up/shade.  I'm told that the cancers they're seeing that are related to excessive use of sunscreen have become a real thing, exceeding the cancer rate from NOT using sunscreen.  I've seen none of the supporting data for this and am not qualified to interpret it, but it's interesting that it's consistent across the small pool of experts that I know in that area.

What type of oncologists are they and what evidence do they have to back that up? This is demonstrably false.
1) melanoma rates are rising in the US, not declining. We don’t closely track non-melanoma skin cancers, but rates of surgery for these are also increasing (smaller ones are usually just burned off, suggesting the rates of larger ones are increasing ) https://seer.cancer.gov/statfacts/html/melan.html
https://jamanetwork.com/journals/jamadermatology/fullarticle/209782

2) benzene exposure causes leukemia, which has been flat to slightly decreasing over time in the US despite the aging population.
https://seer.cancer.gov/statfacts/html/leuks.html

I am an oncologist, trained at and working at major cancer centers with extensive experience in melanoma treatment. There is absolutely no peer-reviewed data to support their claims about increased cancer incidence related to use of sunscreens. In fact there are two randomized trials showing no harm. If they have such data, I can put them in touch with researchers who would be very interested in following up. Please let me know.

As an oncologist, I am loathe to provide any data based on anecdotal experience in my clinic due to the special weight people place on our guidance, and the long history of anecdotes being disproven with good science.

I do agree that covering up with clothing is better for several reasons:
- clothing (non-sheer at least) has higher UV absorbance than even the best sunscreens.
- people commonly forget to re-apply sunscreen at recommended intervals
- it’s clear what is and isn’t being exposed to UV when you’re wearing clothing
 - sunscreen efficacy is unclear for prevention of skin cancer specifically. Though it reduces the risk of sunburn, which is strongly correlated with melanoma, there is little high-quality data proving or disproving it’s efficacy in directly preventing skin cancers. This is primarily because it would be unethical to randomize people to sunscreen or not, and people’s recollection of sunscreen use is very poor, so survey studies are weak at best. There are mixed conclusions for and against sunscreen efficacy from these studies.
- some sunscreens (non-mineral formulas) are toxic to certain species of corals.

My recommendation is to use clothing and mineral sunscreens to prevent sunburns. This is especially important if you have a family history of melanoma, as your risk is already elevated (independent of skin tone). If you have red hair, your risk is further elevated.

[Wolfpack Mustachian]

I think the problem here is you regard me as some anti-sunscreen person. I'm not.

I do have some anti-sunscreen people in my family . . . who also are big fans of tanning salons and was getting a similar vibe from your post.  Obviously I misread you, so please accept my apologies.

A bit of a tangent, but among my Oncologist friends, they are what I'd call "mostly anti-sunscreen".  Saying only to use it when going to be outside for extended periods of time and then only if it's the last resort.  Recommendation is to prefer covering up/shade.  I'm told that the cancers they're seeing that are related to excessive use of sunscreen have become a real thing, exceeding the cancer rate from NOT using sunscreen.  I've seen none of the supporting data for this and am not qualified to interpret it, but it's interesting that it's consistent across the small pool of experts that I know in that area.

What type of oncologists are they and what evidence do they have to back that up? This is demonstrably false.
1) melanoma rates are rising in the US, not declining. We don’t closely track non-melanoma skin cancers, but rates of surgery for these are also increasing (smaller ones are usually just burned off, suggesting the rates of larger ones are increasing ) https://seer.cancer.gov/statfacts/html/melan.html
https://jamanetwork.com/journals/jamadermatology/fullarticle/209782

2) benzene exposure causes leukemia, which has been flat to slightly decreasing over time in the US despite the aging population.
https://seer.cancer.gov/statfacts/html/leuks.html

I am an oncologist, trained at and working at major cancer centers with extensive experience in melanoma treatment. There is absolutely no peer-reviewed data to support their claims about increased cancer incidence related to use of sunscreens. In fact there are two randomized trials showing no harm. If they have such data, I can put them in touch with researchers who would be very interested in following up. Please let me know.

As an oncologist, I am loathe to provide any data based on anecdotal experience in my clinic due to the special weight people place on our guidance, and the long history of anecdotes being disproven with good science.

I do agree that covering up with clothing is better for several reasons:
- clothing (non-sheer at least) has higher UV absorbance than even the best sunscreens.
- people commonly forget to re-apply sunscreen at recommended intervals
- it’s clear what is and isn’t being exposed to UV when you’re wearing clothing
 - sunscreen efficacy is unclear for prevention of skin cancer specifically. Though it reduces the risk of sunburn, which is strongly correlated with melanoma, there is little high-quality data proving or disproving it’s efficacy in directly preventing skin cancers. This is primarily because it would be unethical to randomize people to sunscreen or not, and people’s recollection of sunscreen use is very poor, so survey studies are weak at best. There are mixed conclusions for and against sunscreen efficacy from these studies.
- some sunscreens (non-mineral formulas) are toxic to certain species of corals.

My recommendation is to use clothing and mineral sunscreens to prevent sunburns. This is especially important if you have a family history of melanoma, as your risk is already elevated (independent of skin tone). If you have red hair, your risk is further elevated.

What would you personally recommend in terms of something basic such as going outside in a short sleeve shirt and shorts for an hour or two to play a sport or whatnot if doing so does not give you a sunburn? Not do it outside of being fully covered,  use sunscreen, or not worry about it for shorter durations?

[MudPuppy]

For anyone who would like a relatively inexpensive option for outdoor protection, I like these shirts by Hanes. They are long sleeved and have a UPF of 50, and the fabric is sweat wicking.

[Adventine]

This sun protection solution is much more popular in Asia than in the West: a foldable umbrella that you can easily stash in any bag.

Good for sunshine, good for rain, covers more skin than a hat, frees you up to wear whatever (especially if you're like me and associate long-sleeved clothing with cold weather), and depending on the umbrella size, can cover more than one person at a time.

Of course, umbrellas only work if you don't need both hands or if you're not playing sports. But for walks outside in the summer sunshine, I've never found anything better.

[Abe]

What would you personally recommend in terms of something basic such as going outside in a short sleeve shirt and shorts for an hour or two to play a sport or whatnot if doing so does not give you a sunburn? Not do it outside of being fully covered,  use sunscreen, or not worry about it for shorter durations?

Data isn’t good for the reasons I mentioned above, but melanoma is strongly linked to sunburns (probably as a marker of the intensity of UV radiation experienced). If you aren’t getting burned and are out for short period of time , sunscreen is probably not necessary. If you can get burned in that short period, covering up and sunscreen for uncovered areas is important. For non-melanoma skin cancers, there seems to be a risk related to cumulative sun exposure (age is a big determinant of risk). If you have very pale skin, sunscreen and covering up is probably worth it to avoid these lesions in the future. If you have dark skin, the risk is very low.

[Wolfpack Mustachian]

What would you personally recommend in terms of something basic such as going outside in a short sleeve shirt and shorts for an hour or two to play a sport or whatnot if doing so does not give you a sunburn? Not do it outside of being fully covered,  use sunscreen, or not worry about it for shorter durations?

Data isn’t good for the reasons I mentioned above, but melanoma is strongly linked to sunburns (probably as a marker of the intensity of UV radiation experienced). If you aren’t getting burned and are out for short period of time , sunscreen is probably not necessary. If you can get burned in that short period, covering up and sunscreen for uncovered areas is important. For non-melanoma skin cancers, there seems to be a risk related to cumulative sun exposure (age is a big determinant of risk). If you have very pale skin, sunscreen and covering up is probably worth it to avoid these lesions in the future. If you have dark skin, the risk is very low.

Thanks for the information. I had never had a good nuanced explanation from someone with experience.

[Abe]

For anyone who would like a relatively inexpensive option for outdoor protection, I like these shirts by Hanes. They are long sleeved and have a UPF of 50, and the fabric is sweat wicking.

Those are good shirts. I have relatively dark skin so am not prone to sunburns (but can get them!). I wear those when outdoors in the summer during mid-day. They have kid sizes too.

[GuitarStv]

I think the problem here is you regard me as some anti-sunscreen person. I'm not.

I do have some anti-sunscreen people in my family . . . who also are big fans of tanning salons and was getting a similar vibe from your post.  Obviously I misread you, so please accept my apologies.

A bit of a tangent, but among my Oncologist friends, they are what I'd call "mostly anti-sunscreen".  Saying only to use it when going to be outside for extended periods of time and then only if it's the last resort.  Recommendation is to prefer covering up/shade.  I'm told that the cancers they're seeing that are related to excessive use of sunscreen have become a real thing, exceeding the cancer rate from NOT using sunscreen.  I've seen none of the supporting data for this and am not qualified to interpret it, but it's interesting that it's consistent across the small pool of experts that I know in that area.

Well, I'm on-board with avoiding sunscreen use when it's unnecessary (ie, when you can cover up or avoid the direct sun).  Sunscreen objectively sucks.  It is gross and greasy, takes a while to put on, smells funny, and it's expensive (much more expensive than no sunscreen).

I'd be interested in seeing the evidence that use (or "excessive use") of sunscreen causes cancer though.  Everything that I've read indicates that there isn't evidence of sunscreen causing cancer . . . so the risk/reward tradeoff for using sunscreen vs being in the sun for several hours seems heavily tilted towards using sunscreen.

"We included 29 studies (25 case-control, two cohort, one cross-sectional, and one controlled trial) involving 313,717 participants (10,670 cases). The overall meta-analysis did not show a significant association between skin cancer and sunscreen use (odds ratio (OR) = 1.08; 95% CI: 0.91-1.28, I2 = 89.4%). Neither melanoma (25 studies; 9,813 cases) nor non-melanoma skin cancer (five studies; 857 cases) were associated with sunscreen use, with a pooled OR (95% CI) of 1.10 (0.92-1.33) and 0.99 (0.62-1.57), respectively." - https://pubmed.ncbi.nlm.nih.gov/29620003/

"There is no scientific evidence that using sunscreen causes cancer. Both the American Academy of Dermatology and the Canadian Dermatology Association recommend that people use sunscreens to protect themselves from exposure to UV rays, which cause 80-90 percent of skin cancers."
 - https://www.healthline.com/health/skin-cancer/does-sunscreen-cause-cancer

"There is no medical evidence that sunscreen causes cancer. There is a lot of medical evidence that UV rays from the sun and tanning beds do." - MD Anderson Cancer Center - https://www.mdanderson.org/publications/focused-on-health/6-sunscreen-myths-debunked.h26-1592202.html

. . . etc.

[wenchsenior]

What would you personally recommend in terms of something basic such as going outside in a short sleeve shirt and shorts for an hour or two to play a sport or whatnot if doing so does not give you a sunburn? Not do it outside of being fully covered,  use sunscreen, or not worry about it for shorter durations?

Data isn’t good for the reasons I mentioned above, but melanoma is strongly linked to sunburns (probably as a marker of the intensity of UV radiation experienced). If you aren’t getting burned and are out for short period of time , sunscreen is probably not necessary. If you can get burned in that short period, covering up and sunscreen for uncovered areas is important. For non-melanoma skin cancers, there seems to be a risk related to cumulative sun exposure (age is a big determinant of risk). If you have very pale skin, sunscreen and covering up is probably worth it to avoid these lesions in the future. If you have dark skin, the risk is very low.

Thanks for the information. I had never had a good nuanced explanation from someone with experience.

Heh, I sure hope sunscreen doesn't cause cancer.  I live easily half my days absolutely covered with the stuff and have for decades.  As a pale 'blue' person who has lived in the South/Southwest most of my life, I slather it all over any time I'm going to be out in the sun for more than 10 minutes.

Even given these precautions, I still have a LOT of sun damage all over my arms and legs (pigmentless spots, mostly), though my face has held up well with the added protection of hats. 

[CodingHare]

Well, I'm on-board with avoiding sunscreen use when it's unnecessary (ie, when you can cover up or avoid the direct sun).  Sunscreen objectively sucks.  It is gross and greasy, takes a while to put on, smells funny, and it's expensive (much more expensive than no sunscreen).
<snip>

I highly recommend Asian sunscreens if you hate the greasy ones in most markets.  Biore, Etude House, Missha.  They feel much more like moisturizers than sunscreen and typically have higher SPF.  I used to hate wearing sunscreen.  Now I don't mind (although in Seattle, I basically skip it for half the year due to cloud cover.)

[PDXTabs]

- sunscreen efficacy is unclear for prevention of skin cancer specifically. Though it reduces the risk of sunburn, which is strongly correlated with melanoma, there is little high-quality data proving or disproving it’s efficacy in directly preventing skin cancers. This is primarily because it would be unethical to randomize people to sunscreen or not, and people’s recollection of sunscreen use is very poor, so survey studies are weak at best. There are mixed conclusions for and against sunscreen efficacy from these studies.
...
My recommendation is to use clothing and mineral sunscreens to prevent sunburns. This is especially important if you have a family history of melanoma, as your risk is already elevated (independent of skin tone). If you have red hair, your risk is further elevated.

I'm just a avid hiker, but I learned this recently and transitioned to more clothing and less sunscreen. Even if sunscreen doesn't cause cancer chemically it might "cause" it by me thinking that it works as well as clothing, right?

[Phenix]

For anyone who would like a relatively inexpensive option for outdoor protection, I like these shirts by Hanes. They are long sleeved and have a UPF of 50, and the fabric is sweat wicking.

Those are good shirts. I have relatively dark skin so am not prone to sunburns (but can get them!). I wear those when outdoors in the summer during mid-day. They have kid sizes too.

I use those Hanes shirts as well and had zero sunburn over the course of a week at the beach and two weeks on the lake.  I also bought a couple Speedo brand sun shirts.  Much more expensive, but I preferred the feel of the Speedo shirts vs the Hanes.  Both delivered the sun protection I was aiming for though.

[GreenToTheCore]

Heh, I sure hope sunscreen doesn't cause cancer.  I live easily half my days absolutely covered with the stuff and have for decades.  As a pale 'blue' person who has lived in the South/Southwest most of my life, I slather it all over any time I'm going to be out in the sun for more than 10 minutes.

Even given these precautions, I still have a LOT of sun damage all over my arms and legs (pigmentless spots, mostly), though my face has held up well with the added protection of hats.

We could be twins.

Being a Pale Blue Person, I'm the hiker out in the summer heat with long pants, long sleeves, and a hat. I get quite a few comments about how hot it must be and how they just could not imagine being so covered up. Honestly, I feel cooler and no longer have to put mental energy into How long has it been? Do I need to reapply early for this high rub location? Am I getting pink already?  And I just very strongly dislike the feeling of sunscreen, too.

tl;dr: I appreciate the discussion on sun protection.

[habanero]

I'd echo my curiosity on this. It pretty much is what I do - only use sunscreen when I'm going out to the beach or the like. I've heard from many - sunscreen every day you're going out for more than just a walk to the car and back. It seemed excessive to me.

Where I lived a good decade ago we had a plastic surgeon two floors below. I returned from holiday and we met in the stairway

He: "Where have you been?"
Me: "Greece"
He: "What? you are barely tanned"
Me: "No, I prefer to stay in the shade at the beach"
He: "very, very smart. I know where it ends"

[sonofsven]

Heh, I sure hope sunscreen doesn't cause cancer.  I live easily half my days absolutely covered with the stuff and have for decades.  As a pale 'blue' person who has lived in the South/Southwest most of my life, I slather it all over any time I'm going to be out in the sun for more than 10 minutes.

Even given these precautions, I still have a LOT of sun damage all over my arms and legs (pigmentless spots, mostly), though my face has held up well with the added protection of hats.

We could be twins.

Being a Pale Blue Person, I'm the hiker out in the summer heat with long pants, long sleeves, and a hat. I get quite a few comments about how hot it must be and how they just could not imagine being so covered up. Honestly, I feel cooler and no longer have to put mental energy into How long has it been? Do I need to reapply early for this high rub location? Am I getting pink already?  And I just very strongly dislike the feeling of sunscreen, too.

tl;dr: I appreciate the discussion on sun protection.

I work outside in the sun a lot, and I dress like you. Long pants, t shirt, light weight long sleeve collared shirt, and hat, and I get the same comments.
I always reply "You must be so hot, with all that skin exposed to the sun". It's a joke, but the cooling effect of this outfit is real.
The other comment I make is along the lines of the people who have lived in the desert for ages generally cover themselves head to toe.
I put SS on my hands and face.

[Wolfpack Mustachian]

I'd echo my curiosity on this. It pretty much is what I do - only use sunscreen when I'm going out to the beach or the like. I've heard from many - sunscreen every day you're going out for more than just a walk to the car and back. It seemed excessive to me.

Where I lived a good decade ago we had a plastic surgeon two floors below. I returned from holiday and we met in the stairway

He: "Where have you been?"
Me: "Greece"
He: "What? you are barely tanned"
Me: "No, I prefer to stay in the shade at the beach"
He: "very, very smart. I know where it ends"

That's a good point and something I rarely do (stay in the shade on the beach). When at the beach (which isn't that often), I tend to apply sunscreen once at the beginning of the day and not reapply. I admit I have been lulled into this perspective by only getting burnt one time in the last decade or more when I worked outside at home without a shirt and without sunscreen on (for some idiotic reason) and got a little burnt. Since I rarely get burnt, I rarely think about it unless I'm in a situation like being on the beach and know that I will need some sunscreen. It's probably something I should look at improving on.

[Abe]

The other comment I make is along the lines of the people who have lived in the desert for ages generally cover themselves head to toe.
I put SS on my hands and face.

Good point. Most high-sun intensity areas have a culture of covering up extensively when outdoors, even when people most have dark skin.

[lost_in_the_endless_aisle]

I think the problem here is you regard me as some anti-sunscreen person. I'm not.

I do have some anti-sunscreen people in my family . . . who also are big fans of tanning salons and was getting a similar vibe from your post.  Obviously I misread you, so please accept my apologies.

A bit of a tangent, but among my Oncologist friends, they are what I'd call "mostly anti-sunscreen".  Saying only to use it when going to be outside for extended periods of time and then only if it's the last resort.  Recommendation is to prefer covering up/shade.  I'm told that the cancers they're seeing that are related to excessive use of sunscreen have become a real thing, exceeding the cancer rate from NOT using sunscreen.  I've seen none of the supporting data for this and am not qualified to interpret it, but it's interesting that it's consistent across the small pool of experts that I know in that area.

Well, I'm on-board with avoiding sunscreen use when it's unnecessary (ie, when you can cover up or avoid the direct sun).  Sunscreen objectively sucks.  It is gross and greasy, takes a while to put on, smells funny, and it's expensive (much more expensive than no sunscreen).

I'd be interested in seeing the evidence that use (or "excessive use") of sunscreen causes cancer though.  Everything that I've read indicates that there isn't evidence of sunscreen causing cancer . . . so the risk/reward tradeoff for using sunscreen vs being in the sun for several hours seems heavily tilted towards using sunscreen.

"We included 29 studies (25 case-control, two cohort, one cross-sectional, and one controlled trial) involving 313,717 participants (10,670 cases). The overall meta-analysis did not show a significant association between skin cancer and sunscreen use (odds ratio (OR) = 1.08; 95% CI: 0.91-1.28, I2 = 89.4%). Neither melanoma (25 studies; 9,813 cases) nor non-melanoma skin cancer (five studies; 857 cases) were associated with sunscreen use, with a pooled OR (95% CI) of 1.10 (0.92-1.33) and 0.99 (0.62-1.57), respectively." - https://pubmed.ncbi.nlm.nih.gov/29620003/

"There is no scientific evidence that using sunscreen causes cancer. Both the American Academy of Dermatology and the Canadian Dermatology Association recommend that people use sunscreens to protect themselves from exposure to UV rays, which cause 80-90 percent of skin cancers."
 - https://www.healthline.com/health/skin-cancer/does-sunscreen-cause-cancer

"There is no medical evidence that sunscreen causes cancer. There is a lot of medical evidence that UV rays from the sun and tanning beds do." - MD Anderson Cancer Center - https://www.mdanderson.org/publications/focused-on-health/6-sunscreen-myths-debunked.h26-1592202.html

. . . etc.

To be clear, I find the specific claim that sunscreen contributes to cancer risk to be low probability of being true. I am less certain that chemical sunscreens in particular don't have other adverse effects. Also, sun exposure below the level of being burned likely has offsetting positive effects from nominal increase in cancer risk, so for any short sun exposure durations I don't bother with it. I really only wear it above treeline on long hikes & trail runs. Haven't had a sunburn in decades.