Wear a Mask! Its Not That Hard- You Can Still Save a Life!

A Review of the Most Recent Coronavirus Prevention Data and the Importance of Wearing A Mask:

After months of admitting patients to my hospital with Coronavirus (Covid-19) I felt obligated to just make this statement:   It is not to late to Please Wear a Mask, Socially Distance and Wash your Hands.  I also felt obligated as a physician to simply review some of the current data about the Coronavirus and hopefully summarize our current situation.

 Why does this matter?  Isn’t this just another form of the seasonal flu?  And no one ever makes any big deal of that illness except for the yearly reminder to get a flu shot.  

The answer is YES-  this does matter and it is different.  And the bottom line is your own illness, or the illness of your loved one CAN be prevented.

Lets start with some stories:

Early in the pandemic, the nurses on one of the floors of my hospital had to take on the motto- “No one dies Alone”.    A 60 year old motorcycle rider from Minnesota was listed as the first fatality from the Sturgis Motorcycle Rally in August 2020.   Herman Cain- a previous presidential candidate tested positive for Covid-19 and died of complications within weeks of attending the Tulsa Trump rally after posting pictures of himself not wearing a mask.  He tested positive 9 days after attending the June 20th, 2020 rally and died one month later.   Missouri governor Mike Parson who has been an opponent of mandatory masks has now also tested positive for Covid-19.

As of Wed September 25th-  the US has reported 203,000 deaths from Coronavirus.  While this is such a huge number, many of us have a hard time relating, the sad fact is many of these deaths were avoidable and new deaths can still be avoided.

It would be easy to say this is all just fate if were not for our ability to compare real data to other countries.

As you can see by the following graph extracted from data at Johns Hopkins Univeristy of Medicine,  the United States is in the top 15 club for most deaths per 100,000 population.  I use  this comparison because it truly compares apples to apples to the success or failures of other countries. 

Deaths per 100,000 population:

What do you notice about this graph?  Do you notice that countries such as Canada, Germany, Denmark, Japan, South Korea are not on this list?  That is because those countries are not in the top 15 countries for Deaths per 100,000 population.  The Unites States is ranked 11th highest for deaths per 100k population.

While as of September 25, 2020 the US Death Rate per 100,000 is 61.99,  Canada is 25.09 per 100k population and South Korea is 0.76 per population.

Why is there such a big difference?

Compared to our own response, Canada’s response has been largely coordinated and swift and started lockdowns weeks prior to the United States, while South Korea recognized the necessity of early testing and the importance of isolating new patients.    It is estimated that if the United States had started universal lockdowns just one week earlier, 36,000 deaths could have been prevented. 

What is important is that it is NOT too late.   We don’t have to give up.  We can stop the spread even without a vaccine (which will not be a magic cure by itself).

Lets look at some real science on prevention:

Mask Wearing:

Wearing masks in healthcare workers makes a difference:  A study published in the Journal of the American Medical Association (JAMA) simply showed universal mask wearing for both Healthcare workers AND patients significantly decreased the infection rate of the healthcare workers.  This was just a simple study looking at infection rate early in the pandemic prior to patient’s wearing masks and then comparing all healthcare workers wearing masks as well as patients.

Eye shields and Eye Protection:

Consider eye protection when in crowded spaces.  This study out of India also cited in JAMA shows health care workers visiting known Covid-19 patients in their homes wearing only masks (and clothes) got infected 19% of the time.  When they simply added face shields to protect their eyes- there were NO further infections acquired by the Health care workers.

Glasses as Protection:

What about just wearing glasses?  This observational study from China showed simply wearing glasses decreases your chance of contracting Coronavirus 5 fold- in other words 5 times less chance of getting the virus if you always wear some eye protection when in crowded areas.

So again- why does all this matter?   Because like any other disease that you do NOT want to get-  why not take the steps to NOT get this disease?

The Mayo Clinic gives a nice review of the difference between the yearly flu and Coronavirus.   They are both spread through droplets (wear a mask) but that is where the similarities stop.  Covid-19 is more deadly, has longer lasting illness and spreads easier.

Death Rate:

Lets talk about that death rate.   When comparing the actual Infection Fatality Rate– which is the death rate of anyone who gets the disease (with our without symptoms),  the death rate is 0.1% for the seasonal flu, and 0.65% for Coronavirus- which means Coronavirus has a 6.5 times higher death rate.  Yes- even the Coronavirus has less than a 1% chance of killing you, but do you really want to be part of that less than 1% death club?

Contagion Rate:

Even if you want to challenge this death rate-  you still have the issue of how Contagious is this Coronavirus?   Coronavirus has been shown to be more contagious as it has a reproductive number (R-naught) of 2.5.  That means everyone who gets the disease will infect 2.5 other people.  The seasonal flu reproductive number is 1.3- again which means folks with the flu only infect 1.3 others.  This seems like a small difference, but lets give each of these diseases 10 rounds of infection.   10 rounds of Covid-19 results in greater than 2000 infections spread, compared with 10 rounds of the seasonal flu resulting in only 56 infections.

Real Experience, Seasonal Flu Deaths vs Coronavirus Deaths US:

OK- lets say you don’t like all these numbers and just want something more simple for comparison.

Start with Seasonal Flu deaths-  with our usual US approach of NO masks,  personal freedoms and a flu vaccine that is usually only about 50% effective, we average 12,000-  61,000 seasonal flu deaths per year for the past 10 years.

At the time I am writing this as of September 25, 2020, we have 203,000 Coronavirus deaths.  Simple math-  that means without any vaccine and a poorly coordinated approach, the US has already proven the Coronavirus is easily 3-16 times more deadly than the flu.

What if we compared the Canada numbers?  With the previously stated death rate of 25/100,000 in Canada-  if we had done as well as Canada in prevention,  the US would only have 82,750 deaths to date. (120,250 lives saved!)

We have now had our own experiment but that does not mean this experiment with our own lives and other’s lives needs to continue.  No, we don’t need a lock down- but we do need to wear masks, socially distance and wash our hands!  

As an Emergency Physician, why have I not gotten this virus even though I potentially see positive patients everyday at work?  Because I am careful- and that’s all anyone else needs to do.

Do you have a small chance of getting this virus? -Yes.  Do you have a small chance of becoming ill and dying from this virus? – Yes.   But unlike many Cancers and fluke Automobile Accidents, you actually have the power to prevent this illness for yourself and others.  Even though your chance is very small for yourself or your loved ones- if you do get it and happen to be the unlucky one to get extremely ill or give it to a loved one and they die- as they say “Sucks for You”.

So Please- Wear a mask- it’s not that hard!

-Mark Elliott, MD, MBA

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