To Mask Or Not To Mask: Local Doctors Weigh In

The United States has more COVID-19 infections than any other country. At the same time our country and county are at a point in this pandemic where people have “COVID fatigue” — we are tired of thinking of the constant risk, we are less patient with the uncertainty of the future, and some question the value of public health interventions like masks.

Wearing a mask is a powerful, personal action you can do that will directly affect the number of infections and resulting deaths from COVID-19. As doctors, we look at the data and scientific studies to guide us. We see that other countries that adopted widespread use of mask wearing are able to control the spread of COVID-19 and save lives much better than we have done here in the U.S.

An article published just last week in the Health Affairs journal looked at the effect of mandating masks in public spaces in 15 states and the District of Columbia over a seven-week period. The study measured the decline in the daily COVID-19 case rate, and estimated that as many as 230,000 to 450,000 cases were likely prevented during that time by citizens complying with mask wearing in public spaces. That is lifesaving!

There is plenty of evidence for why wearing a mask is effective. We know the virus lives in the nasal passages and lungs, and can spread in the air in two ways:

1. When someone with COVID-19 coughs or sneezes, a “cloud” of respiratory particles is produced and can travel more than six feet ( though the majority of particles fall to the ground or surface before six feet) and can linger in the air before landing on a surface. This is why you wear your mask to protect other people from you — and your germs.

2. When someone with COVID-19 talks or laughs, an aerosol mist is formed — not visible to the naked eye — which can linger in the room’s air for hours, creating an invisible fog of “infectivity”. This is why you wear your mask to protect yourself from other people — so you don’t get their germs.

COVID-19 is a complex disease because so many of those carrying it are not initially (or ever) symptomatic — so you may not know if yourself or anyone around you are infected and thus “infectious.”

Many of us continue to watch national and international reports of how deadly this virus is, and consider it a civic duty to wear a mask and make the uncomfortable sacrifice for the greater good of the public’s health.

Some who were initially alarmed and cautious about the threat of COVID-19 are now more mobile and loosened their social distancing behaviors.

A few view masks as a symbol of government overreach and a violation of personal liberties regardless of impacts to others.

Our society is special in that it allows some latitude for all these viewpoints. Dr. Fauci recently pointed this out, stating “We may have mayors and may have governors who are saying the right thing, but because of the individual spirit of our country, we don’t listen to authority. You go to Korea, you go to Japan, when the authorities say something, man, it gets done.” This probably explains why infection rates have declined in those countries.

In essence, the fierce independent American spirit that makes us special can also complicate a public health response.

Dr. Fauci noted, “When you’re dealing with infectious diseases, a small percentage of people who don’t comply can have an impact on the entire population.”

One reason that public opinions vary so widely on the appropriate response to this virus is that there is still so much uncertainty understanding a new virus and for a while the unknowns of this virus outweighed the knowns. However, that balance is changing by the day, and as it does, the guidance on how to control this COVID-19 virus and prevent infections becomes more clear and concrete.

Chautauqua County has so far been spared a large outbreak — in part due to our low population density and the diligence of our citizens to “not let their guard down” when it comes to preventing the spread of this disease. As we move into the next phase of opening our society, we ask that you continue keep a six-foot distance from others (you can still be social — just at a distance and outdoors!), wash hands often, and always wear a mask when in public and interacting with others where you can’t maintain that important physical distance

Which mask should you use? Any mask is better than no mask. N95 masks are the most effective — but we tend to save these for the medical professionals if there is low supply. Surgical masks (now readily available in grocery stores) and cloth masks that fit your face well (you can make them yourself or perhaps hit up a crafty relative!) will give you substantial protection from others, and will give others protection from you.

So when you feel yourself getting frustrated with the “physical distancing” lifestyle and the imposition of wearing a mask everywhere, we ask you to remember that COVID-19 is here in Chautauqua County and waiting for a susceptible host.

Until we have good treatments and a safe and effective vaccine, we must take care of ourselves, our families, our neighbors and our community by doing what we have control over, which means following the recommendations that we all know well, and of course, by wearing a mask!

The Chautauqua Health Network Medical Leadership Group includes Wolf-Dieter Krahn, MD; Robert Berke, MD; G. Jay Bishop, MD, FACP, FSVM, RPVI; Patrick Collins, MD; Lynn M. Dunham, MD, FAAP; William A. Geary MD, PhD; Tariq Khan, MD, FAAP; Elizabeth (Betsy) Kidder, MD, PhD, MPH; John LaMancuso, MD, FACP; Tat-Sum Lee, MD, FACP, FACEP; Lillian Vitanza Ney, MD, FACP, FACC; James M. Sherry, MD, PhD; and James E. Wild, MD, FAAFP.


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