Thursday, July 9, 2020

As masks are mandated in Kentucky, Louisville doctor talks about why they're important, and others debunk myths about masks

Beshear dressed up and went to the Capitol rotunda
to make the announcement. (Courier Journal photo)
By Melissa Patrick

Kentucky Health News

In an effort to get ahead of the rising number of cases of coronavirus in Kentucky, Gov. Andy Beshear issued a statewide mask requirement Thursday that will be in place for at least 30 days.

"It's no longer voluntary, it's mandatory," Beshear said. "I'd hoped that we'd all be willing to do the right thing, but I think that the amount of time that we've dealt with this, plus our anxiety, cabin fever, all of it has added up. But it's time to get serious. It's time to stop our escalation now."

Beshear and his top health officials have spent months begging Kentuckians to voluntarily wear masks, to little avail. Today, he stopped begging and made it a requirement.  He said 22 other states now have some form of a mask mandate.

"It's no longer a question," he said. "I understand that the CDC and the federal government told us different things. Right. But that doesn't get in the way of what the science absolutely shows now. . . . A mask helps to stop the spread of covid. It protects other people from getting it from you and now, there are studies showing that it can protect you from getting this virus in the first place."

Beshear was referring to a new study at the University of California-Davis Children's Hospital that found wearing a mask decreases the risk of covid-19 infection in the person wearing it by 65 percent.

"Everyone should wear a mask," Dr. Dean Blumberg, chief of pediatric infectious diseases at the hospital, said during a July 2 livestream. "People who say 'I don't believe masks work' are ignoring scientific evidence. It's not a belief system. It's like saying, 'I don't believe in gravity'."

Why wear a mask? 

Dr. Monalisa Tailor, an internal-medicine physician at Norton Community Medical Associates in Louisville, strongly recommended wearing a mask during an online press conference Thursday. She said many people have the virus -- but don't have symptoms -- and can easily spread it when they sneeze, cough, or spit while talking.

She said wearing a mask that covers both the nose and mouth helps to prevent the spread of those infected droplets to others, adding later that such aerosols can linger in the air up to three hours.

"It is something that we can do to protect ourselves, protect our family members and protect our neighbors," she said.

Beshear's executive order has a long list of exemptions, including people with physical impairments that keep them from safely wearing a mask. That said, Tailor encouraged almost everyone to wear a mask in public, including those with asthma or mild lung conditions, largely because of the risk the virus poses to their lungs if they get it.

"There are very few people that I would recommend should not wear one, and those would be folks that might suffer from claustrophobia or severe anxiety or panic attacks because they have some trauma related to feeling smothered, and that's going to be a very select group of people," she said. "Overall, looking at the general population, I would encourage everyone to wear a mask."

Tailor encouraged those who can't wear a mask to stay at home as much as possible, and if they do go out, to avoid closed indoor spaces, stay six feet away from others and keep their hands clean.

She said that social distancing is still "very important" even with a mask; that surgical masks should be thrown away after a trip out in public; and that cloth masks should be washed after each outing. She also reminded Kentuckians to remove masks by using the ear loops.

"That way you are less likely to touch the front," she said. "That would be another way that you could spread the virus."

Some fear a mask will make them breathe too much of their exhaled carbon dioxide, but Tailor said that that should not be a concern, since carbon dioxide and oxygen molecules are small enough to pass through masks.

She said Norton employees have worn pulse oximeters at work to measure oxygen levels while wearing masks and found that "It does not affect your oxygen capability or your ability to lose the carbon dioxide."

What she would say to people who refuse to wear a mask? "This is something that we are doing to protect ourselves and those around us. I don't want my family members getting sick, I don't want my patients getting sick, I don't want my friends getting sick. And if this is one way that I can help prevent the spread of the virus, I want to do that -- for myself and for others."

Debunking the myths

Infectious-disease physician Dr. Catharine Paules and pediatric allergist-immunologist Dr. Tracy Fausnight of Penn State debunked a list of common myths about masks in a university news release.

Myth: We didn’t need masks early in the pandemic, so we don’t need them now.
Fact:  Mask recommendations have evolved with the data around covid-19. Early on, very little data existed about the virus, and the nation was short of masks. "Recently it has become clear that asymptomatic people can transmit covid-19 from speaking, coughing or sneezing," they write. "This led to public health officials strongly recommending masks to prevent COVID-19 spread from individuals who do not know they are infected.

Myth: No studies exist about the effectiveness of masks.
Fact: “Several observational studies published since the covid-19 pandemic began show emerging data that masks coupled with other distancing measures help to prevent the transmission of covid-19,” Paules said.

Myth: Masks trap in bacteria and fungi, making people more susceptible to bacterial or fungal pneumonia.
Fact: “There is no data to support this statement,” Paules said. The release notes that health-care providers ask people at high risk for fungal infections, such as cancer patients, to wear masks for protection.

Myth: Masks won’t keep me from getting sick.
Fact: Masks do help keep a person from getting sick, and are even more effective at preventing somebody else from getting sick, the doctors write.

Myth: Masks weaken the immune system.
Fact: The immune system is exposed to germs all the time, they write, and wearing a mask doesn’t prevent it from “remembering” all of those prior exposures and staying strong.

Myth: We don’t need masks. We need herd immunity, to protect almost all the population.
Fact: Herd immunity works only if about 70 percent of the population has antibodies from an infection or a vaccine, and achieving that with the coronavirus would come at the cost of "a catastrophic number of deaths due to covid-19," so we must prevent the spread of the virus until a treatment or vaccine is found, the doctors write.

One “myth” that has some truth, they write, is that wearing a mask can cause some people anxiety and a sense of claustrophobia. To overcome that, “Try wearing a mask at home for short periods of time,” Paules said. “Then you can gradually build up to wearing it for a whole trip to the grocery store, for example.”

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