Dear Etiquetteer: If I sneeze while wearing earphones, should I remove at least one bud to accept and show gratitude for a "bless you" or is it OK to keep listening to my NPR podcast?
Likewise, if I am on the opposite side of that scenario is it rude NOT to say "bless you" to the sneezer should they not shed a bud, assuming that they will not hear it anyway or should I throw it out there regardless?
If a sneeze is sneezed in the forest with no one to hear it, is it blessed?
It is one of etiquette's eccentricities that sneezing is the only Bodily Function acknowledged in public. One does not comment on, or even acknowledge, coughing, nose-blowing, yawning, belching, snoring, and especially flatulence - no matter how obvious any of those Bodily Functions might be. Etiquetteer has always understood that this began in Days of Yore ("when knighthood was in flower") because the soul was thought to leave the body with the sneeze; a blessing would protect or restore it.
To answer your second question first, a Perfectly Proper "God bless you!" can't go wrong, even if the sneezer is wearing earbuds or earphones. (Etiquetteer does prefer "God bless you" to "Bless you." The Fiercely Secular may always use "Gesundheit," which is the German for "health." Etiquetteer must caution you to avoid translating this into French. Answering a sneeze with "A votre santé!" will only lead people to wonder where the champagne is*.)
If you sneeze without sufficient power to dislodge your earbuds, Etiquetteer does not think it necessary for you to remove either or both of them to acknowledge a "God bless you." This does not, however, excuse you from acknowledging it. Make eye contact with your blesser and nod - kindly or briskly, depending on your degree of acquaintance - and then go about your business. If you're one of those people who are going along with the Medical Establishment and sneezing into your elbow instead of your hand, Etiquetteer hopes this won't involve removing, um, Nasal Effluvia from your sleeve. While hesitating to question the wisdom of the Medical Establishment, Etiquetteer continues to advocate the use of a Perfectly Proper handkerchief.
*Or whether or not you are Doris Day in Romance on the High Seas.