I recently shared the video on Twitter and provided some comments in a series of tweets which I’ve shared below.
Reducing Risk and Anxiety During Coronavirus (Tweets)
Some places that are opened are still risky: Just because a salon or restaurant is open (or because others are doing it) doesn’t mean it’s safe.
Consider making decisions with risk management in mind for #COVID-19 in the following manner:
- What is More Safe?
- What is Less Safe?
- How can I do whatever is safest to reduce my overall risk of contracting or spreading #covid?
Factor in how much virus is spreading in your community
It’s safer if #COVID infections in your state aren’t at an all-time high. If #Covid19 infections are relatively high think twice before going out!
Taking part in an activity
Activities are safer when there is more space available so activities outdoor are safer than indoor activities
Eating in a restaurant
Eating in a restaurant is less safe than eating outdoors with others, which is less safe than eating alone. But that doesn’t mean that you should eat alone. This is because it’s safer to be in places where you have more control than places with people you can’t control. Even when you are vigilant in a restaurant by wearing a mask, there is no telling what others will do.
Keep your distance
More physical distance is better than less physical distance. 6-feet is a guide based on how far a droplet might travel but there are times when the droplet & #covid can travel farther.
Strenuous Activity
Activities that might contribute to farther droplet & #covid spread might include: strenuous exercise with rapid, more frequent or louder breathing or going to #Church or other services with singing, chanting or loud recitation of prayers might propel droplets and #covid further.
When things get crowded
If you are indoors it is safer to be in a space that isn’t crowded. If it’s getting crowded…get out!
Limit your time around others or in confined space
If you are around others it’s safer to keep that time limited. That is what makes things like going to a hair dresser less safe–your time of exposure is prolonged. Confined spaces like airplanes might result in a crowded space, without distance and an inability to stay in control or to limit your time of exposure.
Stay away from Sick People
It’s safer (but not risk free) to be around someone who doesn’t have symptoms. Up to 40% of #COVID19 may be spread from asymptomatic individuals. That means 60+% is from symptomatic spread & these individuals are likely to be spreading even higher amounts of virus
Facemasks are a great but you don’t always have to wear one
Err on the side of caution & wear a #facemask but there are times that you can probably take it off safely like when you are alone outdoors (like going out for a jog) and there aren’t many people around. You might also be OK taking off the #facemask when you are with others in your household when
- you are already in close contact
- you are all healthy and not showing symptoms
- you don’t have #covid
It’s probably fine to go outdoors with your spouse and children who you live with, when everyone is healthy. On the other hand, it’s always a good idea to keep in mind whether COVID-19 is currently spreading in your community even when you are spending time with those in your household.
]]>This is an initial draft which is a work in progress. The plan is to have the draft reviewed by several colleagues along with some supporting literature. They can then be modified based on their collective feedback. The recommendations are meant to address 2 pertinent issues.
- The first is when to wear a mask. Unlike other guidelines, it relies on masks as much as other guidelines rely on social isolation and hand washing. In fact, it is very hard to accurately quantify the effect of each intervention, but research suggests that when you add additional interventions they tend to have a synergistic effect.
- The second is to try to establish priority for health care workers to address the shortage of masks, which is increasingly becoming a problem not only for the public but for healthcare workers. As Bloomberg news reports, hospitals are now making Face Masks from office supplies. At the same time it explains the rationale.
As masks become scarce, it is increasingly important to analyze exactly, what masks we need, why we need them, when we need them etc. Also, to ask questions. Do we need surgical masks? Are they better than other DIY versions? Why are they better? What alternatives are there?
I’m happy to see that others have been writing about the face mask topic and asking important questions. There is a growing amount of media coverage lately. Recently, an article on Time Online explained Why Wearing a Face Mask Is Encouraged in Asia, but Shunned in the U.S. which was good at exploring different recommendations. But I was rather hoping for an article similar to one published today by the NY Times in an Opinion piece titled: Why Telling People They Don’t Need Masks Backfired which goes into why being clearer with public health messaging is important and why it makes sense that masks are protective against Coronavirus.
These recommendation attempts to be as honest as possible, by letting individuals know that Face Masks do work, but that at the same time it is important that we reserve surgical masks for health care workers. The same would apply within a hospital where not everyone really needs to use those masks.
Many DIY masks, like those being made from office supplies, can achieve a similar level of protection from Coronavirus to surgical masks. They can also achieve comparable levels of source control–preventing spread from infected individuals. For purposes of Coronavirus, we need to stop large droplets, and most barriers will work to stop infecting droplets from a wearer. Even an elbow works. But it’s not as reliable as a mask that is always there to catch the droplets. The real advantage of surgical masks/ medical masks over home-made masks is that surgical masks have a slight advantage in their resistance to larger amounts of fluids. They are sort of water-proof. That is useful in an operating room where you can have splashes of fluid (usually blood). On the other hand, home made masks can be more comfortable and are probably sufficient to stop most large droplets.
Hopefully, we can get our recommendations out to the public as soon as possible. We want to have a social media peer review to see what other physicians think about the topic, but I’m fairly confident in them and that they can help to protect people including health care workers. By defining the appropriate times to wear a mask and the appropriate mask to use in a given situation, these recommendations address the need for the public to wear face masks for protection in the setting of a face mask shortage. Relying on science, these recommendations should enable more individuals to confidently use alternative face masks without depleting resources.
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This poster was just created and advises individuals to wear masks in public. It is based on a similar poster that the Cleveland Clinic posted yesterday but that stops short of recommending that everyone wear a mask in public. A few weeks ago, even the Cleveland Clinics poster would have seemed strange. Recently, there has been a growing amount of media coverage asking questions about why individuals in the USA aren’t wearing masks in public. The truth is we should be wearing them in public and I have provided several reasons in other posts. We need to do this before it’s too late! There are countries that are doing better than others in containing Coronavirus. For example, Italy is not doing particularly well. Singapore is doing relatively well. You will observe that in most countries that are doing a good job containing Coronavirus, there has been a difference in public health messaging and in the behavior of the populations as it relates to wearing masks.
In Asia, almost everyone wears a mask in public because they know, from experience, that it works. They realize it makes sense to wear a mask to prevent infected droplets from getting everywhere–including into your our own mouth. Even if public health officials in their county say it isn’t required that every person wears a mask in every situation, most people still wear one in public. In contrast, in the USA we think that the people wearing masks are hypochondriacs. If you wear a mask in the street you get looked at like you are insane. The messaging being provided by the CDC and WHO appears to have left out any mention of wearing masks in public and has even led some people to wonder whether masks are really effective in any situation.
If you look at the populations of the countries with the lowest rates of infections and deaths around the world, you will notice it is in countries where the populations generally wear masks in public. After having been through this twice before they have learned from the past. We need to mirror what those countries are doing. I can tell you after reviewing vast amounts of scientific literature that I have come across no convincing evidence suggesting that masks or any face covering won’t work to contain the Coronavirus. On the country, there is some evidence that the masks will help stop infection. In consideration of these facts, I have concluded that common sense trumps any lack of evidence. As I have written before, a lack of evidence is not proof that something works. It only proves that we don’t have enough evidence yet. By relying on the current science but also by observing and relying on countries that have experienced similar pandemics for expertise, we can have a more effective response.