When I worked one summer in Washington D.C. for Georgia Senator Johnny Isakson, his Chief of Staff who served as my boss, would often tell me ‘you can’t take the politics out of politics.’ Having spent time in New York and Alabama over the past month and seeing the increasingly partisan divide around whether to wear or not wear a mask indoors takes me back to those days on The Hill.
It seems that the decision to wear or not wear a mask while indoors is less rooted in science, but more so in which set of ‘facts’ you choose to believe. Knowing that I will never be able to ‘take the politics out of politics,’ I am certain that no matter what arguments I set forth below won’t change some people’s opinions. But, I still feel obligated to try.
I don’t want to get caught up in the statistics or whether we’re subjectively in the 1st wave or 2nd wave or whether the case fatality rate is 1.2%, 2.2% or 0.8%. Rather, I’d like to focus on facts that I know are closer to indisputable because I’ve seen them with my own eyes.
The first fact I saw with my own eyes in caring for COVID-19 patients is that it kills people. Again, I don’t know the specific case fatality rate but I can say with 100% certainty that people of all ages from 49 to 89 were previously walking, talking, and functional before COVID-19 and were subsequently dead 20-40 days later. I know these folks were functional adults (even the 89 year old with 5 comorbidities) because it was me having to call their adult children and relay the daily report and hear them tell me how “Dad was doing so well, playing tennis with his grandkids two weeks ago” that I know many of my patients who died were previously functional prior to COVID-19 even if they were in their 70’s or 80’s.
The second fact that I saw with my own eyes was the tremendous resource effort it takes the healthcare system to care for these patients. As we all know, COVID-19 requires specific isolation precautions for everyone who interacts with the patient. This includes a wide range of stakeholders such as doctors, nurses, respiratory therapists, physical therapists, housekeeping just to name a few who all require special protective equipment to carry out their basic duties. Specifically, every one of us must don and doff personal protective equipment (PPE) every time we go in and out of the room. If you think wearing a cloth mask intermittently throughout the day is exhausting, try putting on and removing full PPE 15 times per day.
The third fact I saw was the emotional and mental burden caring for these patients takes out of healthcare workers. Yes, we have all seen patients die before. Yes, we have all seen life taken unexpectedly or too soon. But, we’ve never had to watch people die alone or be the only conduit between the patient and their loved ones. And while hospital policies may be relaxing to some extent, the burden still primarily rests on the nurses, doctors, and care team to play intermediary between the patient and their families.
Taking all of the above together, what makes COVID-19 different than all the other medical conditions that lead to death, disability, and tragedy. Why is COVID-19 different than strokes, heart attacks, sepsis, and cancer all of which lead to similar tragic outcomes? The difference is there are things we can do to prevent someone else from succumbing to this fate. What if there was a way to help reduce the risk of someone else developing a heart attack or stroke? That by your actions, you can directly impact the fate of others. Put another way, what if there was something you could do that affected your neighbor’s risk of developing cancer?
That is the position we’ve found ourselves in with COVID-19. We know that of all the things we can do, wearing masks is one of the most protective actions we can take to protect ourselves and those around us. And while it’s annoying, inconvenient, and uncomfortable it is critical to controlling the spread of virus.
Now, I know wearing masks indoors has taken a life of its own in declaring your political stripes, hence the title of the blog. Somehow wearing or not wearing a mask has become more of a political statement than a common sense public health measure. Further, I know that some folks feel that being ‘forced’ to wear a mask indoors violates their constitutional rights. I look to other ‘public health’ laws for comparison.
In many parts of the country, it is illegal to text and drive. Why? Because enough data showed that when people text and drive it not only puts the individual at risk but could severely injure or kill those around them. 48 states have laws that ban texting while driving. Clearly, both red and blue states see value in restricting this constitutional right. According to the National Highway Traffic Safety Administration there were 2,841 deaths in 2018 due to texting and driving. Based on data from the CDC, there were 2,148 deaths last week from COVID-19 and over 100,000 deaths since March 2020.
I know that many folks out there may not know anyone personally who has died of COVID-19. I recognize that without the personal experience it may feel blown out of proportion by the media, doctors, or public health experts. Again, I think back to the texting while driving analogy. Do you need to know someone directly who has died from texting and driving to stop doing it? Does it take having an accident or having a family member involved in an accident from texting while driving to make it real? I am fortunate that I do not know any of the 2,841 people who died from this in 2018, but it doesn’t change my commitment to not texting while driving. Can we apply the same rationale to mask wearing even for those fortunate enough to not have been directly affected by the virus?
I rarely hear folks say that not texting while driving is a sign of a political affiliation, but rather as a common sense safety measure to protect others. Wearing masks in public is no different. It’s not about you, it’s about those around you and reducing transmission throughout the community.
I am not asking to go into lockdowns or shut down the economy. I am not saying you should never go out to eat which may temporarily require lowering your mask while you consume food and beverage. We did the same thing in the hospital cafeteria. We would get our food, go sit a reasonable distance from each other and eat. I am not asking to keep schools closed or live in fear. Quite the contrary, I would say wearing a mask when in public enables us to go back to living normally and safely.
I am realistic enough to know that despite everything I’ve written, I am unlikely to change many people’s minds. Masks may very well continue to be seen as a political statement rather than a common sense public health act no different than texting while driving. But, I’m hopeful that all of us recognize that if our collective goal is to keep the economy open, keep our hospitals from overcrowding, and limit unnecessary death and suffering to the lowest level possible, we will all do our part and normalize the act of wearing masks in our communities.
I will be back in the next week or so with a mailbag with common questions I’ve been getting the past few weeks but until then be well and stay safe,
Harry