September 9, 2020

Getting to herd immunity by masking up

We have been at this for a few months and I know that many of you reading these dispatches are following my recommendations for staying safe from infection with Sars-CoV-2, the virus that causes COVID-19. In the beginning, we knew so little that we weren’t sure about masks, except for health care workers. Now, we know they work. This article from July 3 links to 70 studies looking at effectiveness from masks. We have known for a while and are getting more confirmation daily.

Alas, many people are resisting wearing masks despite the evidence. I wish we could convince them, because they protect the wearer too. The mask cuts down on the inoculum or dose of virus one is exposed to. This is a phenomenally good essay with graphics that shows that the more people who wear masks, the more protected everyone in that community is. Why, it is almost like having herd immunity! It helps me see why flying on airplanes with everyone masked and with only 50% of the seats filled is not a superspreader event. It is why the very large Black Lives Matter protests did not increase infections, even when protestors were teargassed. The majority were masked. Why the rally in Sturgis is spreading SARS-CoV-2 far and wide. And why I can go to work in a medical facility everyday wearing a mask, knowing my colleagues and patients are also wearing masks, so we all feel safe-patients and staff.

I wish I knew how to convince the doubters. I read advice today in one of my family medicine newsletters about helping people who are vaccine hesitant decide to get a flu vaccine. They advised distinguishing between people who are “chronic no’s” who you know you can’t change their mind and others who may potentially change their minds. Don’t waste your time on the first group, but a technique called Ask-Tell-Ask can be used for that second group, who you may be able to influence. ‘Ask’ them why they are reluctant, ‘Tell’- respond with a short and brief data and explanation, watching for non verbal cues and answer further questions, then ‘Ask’ again if they are willing to consider the request. Granted, this technique will be unlikely to work for those influenced politically, but may work for others. Some of them may have been confused remembering the early messaging about masks. The more we mask up the safer we all are. I can live with that for a few more months.

It means we can relax some of our fears about food being contaminated, supported by this article on CNN about food being an unlikely cause of COVID-19. There are other precautions that we can probably ease up on as well, no need to wear gloves while shopping or disinfect packages and mail. We can allow cleaning or repair people in our houses if they are masked. Good news too is that swimming in pools is probably OK due to chlorine, if you get in and out as quickly as possible and don’t linger indoors. These little changes can bring us a little more normalcy.

And remember to wash your hands, cover your nose, keep safe six, and stay sensible. No need to argue with someone not wearing a mask, that is a losing and risky proposition.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://aatishb.com/maskmath/

https://threader.app/thread/1279144399897866248

https://link.springer.com/article/10.1007/s11606-020-06067-8

https://www.usnews.com/news/national-news/articles/2020-09-08/sturgis-motorcycle-rally-may-have-caused-over-250-000-coronavirus-cases-report

https://www.aafp.org/journals/fpm/blogs/inpractice/entry/vaccine_reluctancy.html

https://www.cnn.com/2020/09/07/health/food-unlikely-covid-19-transmission-scn-wellness-trnd/index.html

https://www.mdlinx.com/news/these-6-coronavirus-precautions-probably-arent-worth-your-time-according-to-experts/1f6PhrEcKaHK1pK91FkkY7