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Sunday, June 21, 2020

Kentuckians give varied reasons for wearing a mask or not

Gov. Andy Beshear wears a mask at his briefings when he isn't speaking. (US News & World Report photo)
By Melissa Patrick
Kentucky Health News

Research clearly shows that wearing a face mask when out in public can effectively curb the transmission of the novel coronavirus, for which there is no vaccine, but Americans and Kentuckians are divided on whether it's necessary.

"Recently, I started not to wear it because I feel like I'm young and healthy, so I feel like I probably wouldn't get it," Jay Cruz, 23, who moved to Lexington from San Diego, told Kentucky Health News. "I've also been at tons of gatherings where there are hundreds of people and nobody is wearing a mask, so I feel like if I get it, I get it."

What Cruz and others seem not to know is that health experts say wearing a mask is more about protecting others than about protecting yourself.

The U.S. Centers for Disease Control and Prevention, in recommending masks be worn in public, cited research showing that people can have the virus but no symptoms and still spread it. It has been estimated that one-fourth to one-half of people with the virus have no symptoms.

Some people know that, and act on it.

"I would rather wear one and not actually need it than to not wear one and risk spreading it to other people," said Morgan Hensley, 34, who moved to Lexington about 10 years ago from Hazard. "It can be inconvenient, but I would rather be slightly inconvenienced than cause harm to somebody else."

Cruz and Hensley were among 19 people who were willing to talk with Kentucky Health News about why they wear a mask or not during the pandemic, which through June 21 had infected nearly 14,000 Kentuckians and killed 526.

During the interviews in the parking lot of Walmart on Nicholasville Road in Lexington, several things became evident. Most who weren't wearing a mask also didn't want to be interviewed, and of the few who did, most didn't want to share their name. But every person who had a mask on and was asked for an interview agreed to it and all but one gave their name.

Further, most who were wearing a face covering of some sort gave a health-related reason for doing so, and some who weren't pushed back on the science that supports wearing them.

It appeared that about half of the shoppers in the lot wore a mask, but a count of those coming out of one door between noon and 12:30 p.m. on June 18 found 81 with a mask and 62 without.

Reasons for not wearing one

Two men from Fayette County, one 46 and one 37, said they don't wear masks in public places  because the original guidance said they weren't effective against the virus. The 37-year-old also suggested that sick people and those who are in high-risk categories should just stay home. Neither would provide their name.

"The way I look at it, if they are helpful, why didn't they require us to wear one to begin with?" the 46-year-old asked.

For more than five weeks after community spread of the virus was documented in the United States, the Centers for Disease Control and Prevention held firm that it was not necessary to wear a mask.

Following research, that guidance changed in early April, and the CDC now recommends that all Americans wear a face mask or covering in public places where practicing social distancing would be difficult, especially in areas of significant community-based transmission.

Another unmasked man at Walmart, who provided no personal information, said he didn't wear a mask because "The science is indicating that a mask is not effective." Asked about this, he said people who wear masks tend to touch their face more, making them ineffective. In addition, he said, "The science is now showing that for instance during the protest, nobody is spreading covid from that."

Experts say it's still too soon to gauge the effects of the protests, but masks have been proven effective at slowing the virus. That's because it is primarily spread in tiny droplets from infected people, not just from coughing and sneezing, but from talking and breathing. A mask can largely stop the spread of those droplets.

In New York, the daily rate of new infections dropped 3 percent after a policy requiring that people wear face masks or coverings in public took effect, according to a new study. It was among several reported by the Advisory Board, a health-care group that shares research. Some scientists say these new findings should be viewed with caution, largely because they are based on observational studies and not randomized controlled trials. That is the scientific gold standard, but a difficult one to meet in the midst of a pandemic.

Cruz also repeated an oft-repeated claim as a reason to not wear a mask: "And also, there are some negative effects from wearing it, like you are constantly breathing in your own CO2, which is not very good either."

That was among the myths about masks that USA Today fact checked. The CDC told the newspaper that because surgical masks are porous, and cloth masks are even more so, and the general public is not wearing masks for a prolonged period of time, "It is unlikely that wearing a mask will cause hypercapnia," too much carbon dioxide in the bloodstream, caused by re-breathing exhaled CO2.

Steve Manley, 48, a nurse from Lexington, said he wore a mask in public at first, but does not now because he thinks it is enough to take other precautions. For example, he said he doesn't come to the store when sick, doesn't touch his face, is always mindful of social distancing, limits his trips out in public, and keeps his hands washed. The person with him held similar views.

Reasons for wearing one

Noah Garcia, 36, from Kansas, said he wears a mask because "It makes you feel like you are doing your part. It offers you a level of control of a situation where you don't have much control." He later added,  "It's for other people, too. I might be carrying it and not know."

Shirley Nemetz, 48, of Lexington, said she wears a mask because "I just got done with chemo three months ago and my mother just had a kidney transplant so I'm just taking extra precautions for myself and my family."

Teresa Fillingim, 57, a southern Indianan working in Lexington as a lab tech, said she wears one because, "It is precautionary. I may be a little more lax than some. As long as I'm out in the fresh air I don't worry about it, but being inside, it doesn't hurt to be a little more cautious."

Jane Giffin, 66, Lexington, a license practical nurse, said she wears a mask to protect herself and others. She said she has tested negative twice for the virus, but that doesn't mean she won't get it.

"It is kind of discouraging when you see so many people without a mask on," she said. "It's not a time to be selfish. We've got to think of other people, elderly people and people with higher risk. We've got to think of those people."

A strong public message could matter

"I listen to my governor," said Skip McFarlan, 74, of Lexington, when asked why he wears a mask.

So did Kelli Shackelford, 52, of Lexington:  "Andy told us to, so nicely, and I don't want to be responsible for making someone else sick, because if 40% of people are asymptomatic, then I have no idea if I have it or not."

Beshear regularly asks Kentuckians to wear a mask. Last week, he stepped up his pleas and asked those who don't wear one to think again

"We need you to reconsider," he said. "It's not a test of your manhood, whether you wear a masks or not. I think it's a test of your compassion, maybe even your faith, if you're willing to wear one of these to protect a fellow human being. Remember, we all have a duty to each other, even folks we've never met."

A strong public policy seems to matter. After the CDC changed its recommendation on April 3, a Gallup poll done the week of April 7 showed the percentage of Americans who reported wearing a mask increased from 38% to 62 % in just one week.

But President Donald Trump has refused to wear a mask in public and has downplayed the pandemic, and that appears to have had an effect. Of those polled by Gallup, 75% of Democrats said they had worn a mask in public, while 58% of independents and 48% of Republicans said the same.

The Washington Post summed up this political divide: "Like so many issues rooted in science and medicine, the pandemic is now fully entangled with ideological tribalism. This has played out before: helmets for motorcyclists, seat belts in cars, smoking bans in restaurants. All of those measures provoked battles over personal liberty. Now it’s masks and the coronavirus, with face coverings emerging as an emblem for what cleaves the nation."

Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, told the Post, “We may have mayors and may have governors who are saying the right thing, but because of the individual spirit of our country, we don’t listen to authority. You go to Korea, you go to Japan, when the authorities say something, man, it gets done.”

Fauci said Americans' individualism can complicate public-health measures. “When you’re dealing with infectious diseases,” he said, “a small percentage of people who don’t comply can have an impact on the entire population.”

Paul Prather of Mount Sterling, a Pentecostal minister and former Lexington Herald-Leader religion reporter who still writes a column for the paper, started a discussion on his Facebook page, asking the question: "Are my wife and I alone in still taking precautions against covid-19? I'm beginning to feel as if we are. Are you wearing masks and practicing strict social distancing or have you returned to your pre-pandemic lifestyle? Either way, what's your rationale?"

Prather gave his own feelings: "I’ve never experienced what I feel now—that those around me could not care less whether they kill me. That the lives of those who are older or have chronic illnesses apparently mean nothing. Millions are at extreme risk: the immune-compromised (young or old), those over 60, the overweight, diabetics, minorities, those with hypertension or asthma. When these folks get infected, they have a 20 percent chance of dying a lingering, agonizing death on a ventilator. They have a greater than 50 percent chance of being hospitalized, which often means weeks in an ICU followed by permanent disabilities.

"As we all know, the only way to control this disease is by taking precautions. Wear a mask everywhere—which not only protects you (somewhat), but (more so) protects others. It's a practical way of loving your neighbor."

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