Face Mask
As of Saturday 6/20/2020, it will be mandatory to wear a face mask or covering in public in Orange County and City of Orlando . We know that the main mode of transmission is through particles in the air. We know that some of these particles can live suspended in the air indoors even hours after they were released. The best way to decrease the amount of particles in the air is to have the nose and mouth covered.
Covid infection rates are on the rise. Most people are eager to get back to “normal”. Florida is one of the states that is unfortunately on the uptick to the point that it is concerning. Being a small business owner myself, I can sympathize with wanting to re-open the economy. However, the reopening was supposed to be done with proper protocols of social distancing and facial coverings in place. I have personally seen less and less precautions being taken out in public. Most are not wearing facial coverings or they are wearing them incorrectly (ie nose out or mask below chin). As a physician, I urge you to educate yourself as much as possible with factual information from the right sources.
The past few months have been filled with contradicting information, conspiracy theories, and alot of anxiety for the majority of the population. The Covid-19 pandemic is unprecedented in our lifetimes. One thing I can say for sure is we need to follow the science and the facts. I know it is difficult to know what’s what when there’s conflicting information from the news, from our leaders, and on social media.
Everything in medicine and health is related to risk. For example, as a physician we can never tell you if you will have a heart attack, stroke, or if you will develop diabetes. However, we can use facts such as testing and history to tell you how to reduce your risk. We can recommend interventions to reduce your risk of these outcomes, such as certain medications, treatments, and lifestyle interventions. We know for a fact that there are certain measures that reduce your risk of certain illnesses. We cannot guarantee that you will never become ill. Even for certain illnesses and diseases that do have treatments, we cannot guarantee or say 100% that the treatment will work, and you will not have any other possible complications. Everything we do as a physician is based on statistics. When we analyze research and journal articles, we are looking at the statistics. We are reading about things like confidence intervals, relative risk reduction, absolute risk reduction, Number needed to treat, etc.
Facts- Covid-19 is very contagious. Covid-19 is not the flu. Compared to the influenza virus, Covid-19 is more contagious. Although, statistically speaking the vast majority of people with Covid-19 have recovered there has been a vast range of symptoms, and severity. We are still learning about this novel virus but we know alot more than we did in January. Severity of this virus has ranged from completely asymptomatic, mild symptoms, severe symptoms, severe enough to lead to hospitalization, severe enough to lead to ICU admission with ventilation, and severe enough to cause death. Statistically speaking being older in age, and having co-morbidities increases the risk of severe disease. But, it does not mean that the younger population could not develop severe disease. There is a smaller risk of severe disease in younger populations but the risk is not zero. You may only have mild symptoms and pass it on to a friend or loved one that has severe symptoms.
There was some recent conflicting information from WHO about asymptomatic people and if they can spread the disease. It is very difficult to study “asymptomatic” people. The person would have to be 100% symptom free (not even a mild runny nose), be honest about it, have tested positive, and monitored for a period long enough to know for sure that they are an asymptomatic person. But, the people that they did study that fit all of this criteria rarely were spreading the disease as far as they could trace. Again, not zero, but a very small risk. `
It is very difficult to determine if someone is truly “asymptomatic” vs “pre-symptomatic”. Pre-symptomatic is much more common. This means the person has not yet developed symptoms but most likely will develop some kind of symptoms. During the “pre-symptomatic” period the person can spread the disease. It has been shown that a person begins to be the most contagious about 3 days prior to developing symptoms. But, can potentially spread the virus earlier then that but this is a rough estimate. You see how that can be confusing?
We can reduce our risk significantly by following simple precautions:
Always properly wear a face covering while out in public (covering nose and mouth)
There are not any medical reasons, other than a child <2 years old, that would contraindicate a mask. Some materials are more difficult to breathe with so if you do have breathing issues you may need a more breathable material.
Wash hands often with soap and water for at least 20 seconds
Use an alcohol based hand sanitizer and rub vigorously for at least 30 seconds
Practice social distancing. This means keeping at least a 6 ft distance.
Risk:
High- Indoor activities especially if for prolonged periods of time (ie sitting in a restaurant indoors without a face covering, gatherings inside of homes with people that do not live in your home, Public gyms)
Medium/High Risk- Sitting indoors in close proximity for a long period of time (ie. Hair salon, nail salon)
Low risk- Outdoor activities with social distancing and/or proper face coverings
PROPER mask procedures:
Cover both your nose and mouth (Leaving your nose out will not protect you or anyone around you. Wearing it on your chin will not protect you or anyone around you).
Do not touch the outside of the mask. Wash your hands if you do.
Remove the mask by gently pulling from the ear straps or head tie. Do not touch the front/outside part of the mask. Wash your hands after removing the mask.
Have a paper bag, small cardboard box, or other storage container to safely store your mask if you will be reusing it. Do not touch the front/outside part of the mask. Do not contaminate the area that will be on your face. Wash/sanitize your hands prior to putting it back on and after it is on.
Cloth masks should ideally be washed daily after use.
Gloves- Should only be worn for a specific task. Do NOT touch your face, phone, keys, or anything else with used gloves (wipe down these things if you have). Once you have finished the task, properly throw away your gloves in a garbage can. Wash your hands.
Washing Hands- Do it. Do it a-lot. If you touch any common surface outside of your home such as door knobs, pens, shopping carts, etc. Wash/sanitize your hands. If you wonder if you should wash your hands after touching something, then you should probably wash your hands.
I know the past few months have sucked. I would love to be pre-pandemic myself. The more you arm yourself with knowledge and not media hyped hysteria and conspiracy theories, the more rational educated decisions you can make. I know it can be scary. I know we are feeling the social isolation and limitations. I know it is anxiety provoking. I know many are having major financial hits with being furloughed or laid off. Everything good accomplished in this world came when people joined together. Humans are a force of nature. When we band together and unite for the greater good we can move mountains. So, let’s do this for ourselves, for our families, for fellow humans that are strangers. This virus does not have to continue its spread and destruction. We actually have the power to stop it. But, it takes every single one of us to think as a whole and do right by others.
Let’s preserve and strengthen the human race.