The Case for Masks and some Patience

By Dr. Darrell Brimhall, Franklin County public health officer

I’ll get straight to it.  We need to start wearing masks when in public. Initially, I was against this for many reasons. If 80 percent of our communication is non-verbal and I’m in the office, I don’t want to be this faceless beady-eyed Brimhall looking at little kids or a patient who is reluctantly opening up about their depression. Masks make me think 1,000 times a day that I need to brush my teeth for 20 minutes 20 times a day rather than twice a day.  Sure, sometimes it is the mask, but sometimes it’s not. They can be annoying to breathe in, and I feel like I am always readjusting them every three seconds. You get the picture. But I will say, most of the frustration has worn off. Not all – but most of it.

As one who sees plenty of types of infections and knows masks have their utility with tuberculosis and even more common viruses, I actually thought, “Well, there is no evidence for them right now. I’ll social distance and wash my hands.” I would then mentally fold my arms and pout because I was doing enough.

Then the shut-down began and most aspects of normal life started to disappear. We became strangers in a way, suspicious of others getting too close. Learning how to clear one’s throat in a public space became challenging. We all know this, but what became harder and harder was seeing the short-term economic impacts (and imagining the long-term) and then the impact to individuals and families. It is not surprising. We were not meant for this. I don’t care if you sit on the “evolving” or “creating” end of the spectrum, it is not good for us to be apart.

For the sake of my sanity, I’ve stopped trying to imagine an end date. It will end like all pandemics do but it can’t come fast enough for any of us. So, what do we do in the meantime? We do not have a vaccine or miraculous drug to prevent it so what do we do? We have hand washing and social distancing. Basic tools – but pretty effective. Well now we have evidence of a third tool that drastically decreases the risk of spread. Reduces to zero? No, but possibly allows us to go back to the closest version of normal without having to implement the draconian, mind-numbing, soul-sinking shutdowns (and this is coming from an introvert).

The Franklin County Health Department is pursuing a course to implement this policy in the coming days and at the time of this writing learned the state will be imposing its own. I am grateful for that.

Now before we start thinking a bunch of fascists have taken over your local board of health—made up of very normal people with the same frustrations over the way COVID has hijacked our lives—let us make a few things clear:

  1. COVID19 is not a fake disease or some grand conspiracy. If you are one who truly believes this, I can’t help you. I won’t waste my time as I’ve also given up on convincing those few who think our earth is flat and the moon landings were faked. However, if you are not quite sure, conspiracies are by their nature carefully coordinated (as we all have seen in movies and TV which makes us experts at recognizing them) and as we can see whether you watch local news, “red” news outlets, or “blue” news outlets, it is a mess everywhere in the world. If you believe the chaos was also “planned” as part of the conspiracy, again, I can’t help you there.
  2. Pandemics happen and while fortunately not often on the scale we see now, the fact is that it gives us very little experience knowing exactly what to do. Issues like air travel, social media, 24/7 hashing and rehashing on television/internet/radio were irrelevant issues in 1918. Although there are core principles for the prevention and spread of infectious disease, situations can vary—not every virus/bacteria plays by the same rules. Now add variables of locality, population density, level of health of that population, etc., and quickly it becomes overwhelming to predict exactly what is going to happen and what needs done. With that being said, no wonder we feel like our heads are spinning…on what is happening here or there, or what this county, state, country did or didn’t do. It is overwhelming.  We have not experienced this before.
  3. COVID testing has been imperfect and frustrating at best. The first tests that came out only detected parts of the virus. This second test detected evidence the body’s immune system has processed it. Both are important. If you tested positive, results are pretty accurate. However, if you had a negative test result and had symptoms, upwards of 30 percent of those tests could be wrong, meaning the negative was a false one and you really did have the virus or exposure to it. Now here is the second rub, there have been lots of stories of results that never came back, people that tested negative, then positive or vice versa, or positive tests done on empty tubes, etc. What I would say on this is that when you ramp up doing thousands to millions of tests in a relatively short amount of time using testing sites thrown together in a rush, even with the very best of intentions there are going to be errors and mix-ups and corners cut. This must be overwhelming to labs and those gathering samples, so we need to cut some slack on this issue and give the benefit of the doubt. Testing is important and will get better in time.
  4. We understand that getting “infected” does not always translate into a death sentence or even any symptoms, so why the “panic” or the “intrusive” measures? Most people will be fine but who exactly are they going to be? Sure, we can categorize severity of disease based on certain health conditions, race and age but still it is only a likelihood, not a crystal ball. All ages can get “infected.” An infected person with symptoms is more contagious than an “infected” individual with no symptoms, but both are contagious and can contribute to spread.

So why the masks? Isn’t this an infringement on your personal liberty? Sure, if you want to make it so, but I would ask a few questions to this individual. Are you protesting stoplights or speed limits? Did you drill your own well because the public water utility won’t take out the chlorine? Are you protesting the government requiring food workers to wash their hands after they use a restroom? I could go on and on — laws made in the interest of the public—that violate the “liberty” of the individual. But does it? We can still drive down the middle of a double-yellow lines, ignore red lights, drive 70 mph through a school-zone, and/or choose not to wash our hands, etc.  The consequences vary but no one is making us.

This public health debate and the “loss” of liberty has been going on for literally hundreds of years. Read about small-pox in England in the 1700s. The arguments are not new. But as good ‘ole John Adams argued, “Facts are stubborn things.”

Sure, someone can accuse me of being an automaton and/or robot and/or employee of Conspiracy Incorporated. However, those should also need to start calling me a robot when I try to go the speed limit, pass others appropriately, stop at intersections, wear my seat belt, make my kids wear theirs, stop texting when driving, and on and on and on. Sure, some things are political, but this is not. There is lots to be frustrated about and this includes having to get used to masks if we choose to see the vision of this temporary tool to help us get back to normal.

Do we remember that? Normal? We all ache for it so let us do what we can to get back there and not feed this war of words.