America, Put Your Mask On – Before It Is Too Late

If all of us wore masks, we could bring the COVID-19 cases under control within a month or two (Centers for Disease Control and Prevention) and save the U.S. economy $1 trillion (https://www.forbes.com/sites/sarahhansen/2020/06/30/a-national-mask-mandate-could-save-the-us-economy-1-trillion-goldman-sachs-says/#4f3d5f5756f1). At the early onset, people were initially confused about the necessity of masks because we did not know how the infection rate would impact the U.S., and there was also a shortage of supplies. Now there is no excuse. Masks are a necessity for both our public health and our economy. How foolish and naïve that Americans are making masks a political issue! As a healthcare provider, I find the current behavior of Americans, who are mismanaging this pandemic, both disrespectful, dangerous and selfish, especially toward the health field.

 Masks work. You can choose cloth or surgical masks. Although bandanas are not as effective, it is better than nothing. It is not necessary for the general public to wear N95 masks. There are also many misconceptions about the subject. Here are the facts:

• Many people foolishly think that cloth masks cannot be effective because they can’t filter out the tiny viral particles. These particles expel from the mouth and nose in much larger droplets that become smaller as they move away from the body. Masks trap the droplets and therefore, fewer viral particles escape. “So, when all parties in a gathering are wearing well-constructed, well-fitting masks, it provides an extra layer of safety for everyone. If two people are wearing masks, the viral particles can travel about 5 feet away from each individual. When an infected person is not wearing a mask, those particles can float through the air 30 feet or more and stay alive for up to 30 hours.” Yes of course the transmission rate is also a consideration, but overall the infection risk increases when one person takes his/her mask off (https://med.stanford.edu/news/all-news/2020/06/stanford-scientists-contribute-to-who-mask-guidelines.html).    
• Some people think that if you wear a mask for long periods of time you will trap and breathe in excess amounts of carbon dioxide, which could lead to brain damage. That’s just not true. A properly constructed mask provides more than enough ventilation (Medscape, July 15, 2020).
• We know that people can spread the virus before they have symptoms. By using masks, we reduce the spread from these potentially infected people. It is called “source control” (Medscape, July 8, 2020)
• The CDC recommends all people 2 years of age and older to wear a cloth face covering in public settings and when around people who don’t live in your household, especially when physical distancing is difficult to maintain (https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html).
• In a recent study (published in Health Affairs) mask mandates led to a slowdown in daily COVID-19 growth rate. With 5 days of mandate, the daily growth rate slowed by 0.9 percentage and after three weeks, the daily growth rate slowed by 2 percentage points (https://www.ucsf.edu/news/2020/06/417906/still-confused-about-masks-heres-science-behind-how-face-masks-prevent)

In addition to masks the other two parts to the equation in protecting ourselves from the spread of the virus are physical distancing (in general 6 feet apart) and washing our hands. These three simple measures – 1. Wearing masks, 2. Physical Distancing, 3. Washing hands – have shown that the resurgence of the disease can be prevented (https://med.stanford.edu/news/all-news/2020/06/stanford-scientists-contribute-to-who-mask-guidelines.html).    

The pandemic is a crisis, and like other crises, denial does not work in managing it. We must see transformations in two areas: The federal government’s initiatives and the American public’s behavior.

1. Federal government: Why isn’t the federal government implementing an effective use of The Defense Production Act, so that we produce and distribute adequate supplies to our hospitals and other health facilities in order to control this pandemic?  The U.S is way behind in testing, tracking the virus, and we are ill prepared for the next wave. The blunders have already occurred (Read about “The US Paid Millions for Test Tubes – and Got Unusable Soda Bottles Instead.” – https://meteor.news/2020/06/18/the-trump-administration-paid-millions-for-test-tubes-and-got-unusable-mini-soda-bottles/). Why isn’t there an overall federal plan for the management of this health crisis? I find it astounding that we don’t have one. Would you accept having no plan from your physician if you were dealing with a diagnosis of heart disease, cancer or some other health trauma in your life?
2. The American Public: Why are Americans being so childish and irresponsible by not wearing masks?  If your doctor offered a solution to prevent you from getting sick or dying, would you go out in the streets and protest this, claiming it was taking away your freedom? It is a very simple solution; otherwise the result is a spread of the infection, more deaths and a worsening economy. We have already witnessed what happens when our hospitals and our healthcare providers are overwhelmed with the onslaught of this virus. The surges are happening all over the country and this fall we will be seeing the co-occurrence of COVID-19 and influenza (regular flu season). This means our healthcare system will be overextended even more than what we have already witnessed.

  
If the federal government does not change its approach to the management of this pandemic and the American public continues its infantile behavior, we will have absolute bedlam this fall, and into the winter. In addition to the resurgences of the virus occurring in an unpredictable manner, our economy will go in the opposite direction – a direct and predictable decline. We will likely see more violence, increased mental illness, conspiracy theories, panic and shortages in such necessities as food products, toiletries and medications.
  
How can we educate the public about the benefits of masks? Many healthcare providers are  becoming proactive on social media, as well as petitioning the government to develop a federal mask mandate. “As this conversation gathered steam through retweets, likes, and comments, Helen Burstin, MD, chief executive officer of the Council of Medical Subspecialty Societies (CMSS), took notice. She tweeted out that she would look into this issue with the leaders of the 45 medical subspecialty societies representing 800,000 doctors. The following day, she shared CMSS's unequivocal statement advocating for the need to respect science and implement a national mandate for universal masking” (https://www.medscape.com/viewarticle/933604?nlid=136389_785&src=WNL_mdplsfeat_200714_mscpedit_nurs&uac=64796DZ&spon=24&impID=2460461&faf=1). Recently, “three powerful healthcare organizations followed suit supporting masks: The American Medical Association, the American Hospital Association, and the American Nurses Association released an ‘official letter’ to the public strongly encouraging the use of cloth masks” – see this link for the actual letter (https://www.aha.org/lettercomment/2020-07-06-aha-ama-ana-open-letter-urging-public-wear-mask-stop-covid-19-spread).

Here is my personal message to my fellow Americans:

• Get over ourselves: Too bad that masks have not been part of our culture; it’s time to change in order to protect ourselves. Since two masks are better than one when we are in public, it doesn’t help to hear from the non-masked person, “Thank you.”
• Cease the whining: Today I walked out of a store and I listened to a woman complaining about having to wear a mask for minutes of her day while shopping. Yet our healthcare providers wear masks and other PPE for up to 24 hours at a time, and they are not shopping. They are saving our lives.
• Put an end to being misled: The governor of Georgia,  Brian Kemp, banned Georgia's cities and counties from ordering people to wear masks in public places. That is not only an ignorant action, it is an act of spite. This misguided behavior results in negligence and public endangerment (https://www.aol.com/article/news/2020/07/16/georgia-gov-explicitly-voids-mask-orders-in-15-localities/24563447/).  We have to ask ourselves, “How many more political traps are we going to fall into before it is too late?”    
• Start caring: We – fellow Americans – go running to the hospital with our heart attacks, cancer, appendicitis, our many injuries and traumas and expect immediate care. Yet, we are failing to carry out three simple tasks: wear a mask, distance ourselves and wash our hands, in return for the care we are given.
• “It’s not that hard.” That’s what a 5 y.o. said to a group of people not wearing masks (https://www.huffpost.com/entry/my-5-year-old-can-handle-wearing-a-mask-you-can-too_l_5ef11b7ec5b6be4e89870013).

  
In contrast to what the American public has to sacrifice (and for some individuals it is much more than others), few stories can compare to what healthcare providers are enduring:

1. I strongly recommend that everyone read the following: “A day-in-the-life of a nurse during the pandemic in taking care of you – America.” It might bring you to your knees – in tears (https://www.wamc.org/post/our-grief-nurses-experience-during-covid-19-pandemic?fbclid=IwAR38dDe-AJoR_exCc2ft-fuoBVMkOsQRRhzdgUiCepXSGxd7w1IBRLvzf6c).
   
2. Co-workers talk about what happened in NYC hospitals when the pandemic first hit: “It was terrifying not knowing whether we would have enough protective gear (Now we know that our healthcare workers do not get infected if they have the suitable PPE). We watched young and healthy co-workers get critically ill and die. My colleagues discussed drawing up wills (Medscape, June 18, 2020).
3. A physician's assistant “recalled her husband leaving food on the cellar stairs while she isolated herself for months for fear of infecting her family: ‘I felt like an animal,’ she said, her voice cracking” (Medscape, June 18, 2020).
4. “It is haunting to think it may all happen again… I feel like it's a calm before a second storm," said an emergency room physician who lost a relative to the virus” (Medscape, June 18, 2020).

Wake up America, before it is too late; put your masks on!
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Charlotte Michos is a clinical nurse specialist who values personal-centered care and serves as a Healthcare Consultant in helping others make informed decisions. For more information, email her or call (845) 548-5980.