Covid 19 Dos and Don'ts
Is it or Isn’t it
It is. Covid 19 is real. I know there are deniers that think this epidemic is fabricated, that either the infections are just a version of the flu or the entire last year has been a charade. Addressing this issue from a medical perspective compels me to be instructive and not divisive. Here are the facts; you do with it what you will. Hopefully, common sense will prevail. The Spanish Flu took 675,000 lives in America. By the end of this year, we will easily pass 500,000 deaths. Now for the shocker. People did not wear masks in the Spanish Flu pandemic; their quality was poor and compliance was sparse. With Covid 19, Americans have been wearing a mask—at least three quarters of us have—for the entire pandemic. Still, we have a shocking number of deaths. One can only imagine what that number would be if no one wore a mask. I’m certain the death toll would be closer to a million. Everyone pretty much knows someone who has been affected by this virus. Denying its existence is likely a combination of misinformation, political allegiance or some other kind of social pressure. There are no facts, citable publications from bodies of knowledge that we’ve come to rely on over the past many decades (CDC, FDA, etc.), that tell a different story.
Believe.
No mask
You can’t catch Covid 19 twenty feet from someone, or ten, or six. Less than six, well, that’s another matter. If you don’t want to wear a mask, simply stay six feet away from everyone in an outdoor setting; the same applies to indoors, but if the space is small enough, limit the amount of time you spend in any given room with others. If the others are not wearing a mask, spend even less time. I’ve heard some holding their breath on elevators if someone is not wearing a mask or if it’s too crowded. Probably better to just get off the elevator, but you get the idea.
Mask
Yes, wear one, but remember, a mask protects them, not you. That’s right. If you’re walking along and see someone coming and decide you want to protect yourself because they’re not wearing a mask, then putting on yours does nothing of significance. You need to get six feet away from them and the air trail behind them. If you’ve believed all along that a mask does nothing to protect you, then you are right, it doesn’t. It may filter the virus at a 30% success rate, but that’s nothing to write home about. It does, however, prevent your virus from spreading beyond a foot or so from your mouth and nose.
So, if your moral circle includes protecting other people, wear a mask but don’t stand within a foot or so of someone’s face. Also, because people wear handkerchiefs, gators and loose-fitting facial devices, I’d become an expert at what constitutes sufficient facial protection. Suffice it to say, doctor’s offices and hospitals will not allow admittance with anything but a surgical style mask. Handkerchiefs and gators don’t cut it. Neither do masks with valves or face shields without a mask underneath. Also, don’t stand directly behind someone wearing a mask. There is a backdraft as air escapes through side openings, directed back towards a person’s ears. If you’re standing close behind, you are in their backdraft. Give yourself room.
Finally, if you’re out on a walk and don’t intend to be face-to-face with anyone, then wearing a mask is optional. The same goes for riding or running. Carry one with you in case you need to provide assistance, or you meet a friend along the way. It is very unlikely, essentially unheard of, to get Covid while running or walking outdoors in uncrowded locations.
N95s
Many television journalists have them, and I’ve seen them in airport vending machines and for purchase online. N95s are supposed to be 99% effective in protecting you as well as others. There’s a catch. American hospital grade N95s are certified by American safety agencies to provide the 99% protection. These masks are also fitted to hospital workers, so we know exactly how to wear them. The N95s available elsewhere have varied certifications. My limited research showed some of these are made in China and certified in China but fail the American certification. Instead of being 99% protective they may come in somewhere around 70%. That is still better than the 30% protection from a surgical mask or the little to no protection from a handkerchief or gator. The problem is that these commercially available N95s have not been fitted to your face and you have not been educated on how to know if the fit is secure. Men, for example, cannot have any facial hair, not even stubble. If breathing is difficult, it may mean a good fit. If it is easy, it may mean the fibers are not doing their job well enough or there’s a leak. Suffice it to say, if you have one of these, be careful and use it more like a regular mask rather than a hospital N95; that is, don’t violate the six feet rule with other non-mask wearers and don’t get within a couple feet of a mask wearer.
Symptoms
If you get any respiratory, taste bud or appetite changes, or just feeling like you have an illness, get a PCR test. That’s the nose swab. If you’ve been exposed to someone who later tested positive, wait 72 hours after your last contact with them and then get tested with a nose swab. While you are waiting the 72 hours, assume you have Covid 19. Wear a mask at home everywhere, maybe isolate yourself and use your own bathroom. Also, eat your meals, which require a removal of your mask, in a separate room. Keep the house windows open if at all possible. Finally, consider taking aspirin daily, provided you have no allergies, while you wait on proof of Covid. There is a strong consideration that many of the non-respiratory symptoms of Covid that linger for weeks or months are related to blood clots in small vessels. Aspirin keeps the platelets from sticking and may keep your blood from clotting in these small vessels. Some countries are giving blood thinners to everyone that tests positive for Covid. The POTUS also received aspirin.
Vaccine
Get it. I can’t emphasize this enough. Trust the science. In the medical profession, we weigh the risk of benefits with the risk of complications before recommending a course of therapy. In this case, the chances of getting Covid 19 are pretty high for any American. Death or lingering complications are real concerns. The likelihood of an allergic reaction to the vaccine is infinitesimal, that is, it’s very small. In real terms, you are more likely to get very ill or die from Covid than you are to get sick from the vaccine. The fear for most is that getting Covid is still an uncertainty, getting the vaccine is real, so we focus more on the real side-effects of the vaccine rather than the real complications from Covid. This thinking is flawed and is the reason health care workers struggle to educate people to take protective measures.
The vaccine does not give you a Covid 19 infection. You are not given a real virus or even a real virus particle for the Pfizer and Moderna vaccine. Do not be concerned that you will give Covid to a loved one if you get the vaccine. That is a misunderstanding. You and they are safe. Everyone I know that got vaccinated with either Pfizer or Moderna had a sore arm for a day or so. One colleague of mine had a headache for a half day.
Once vaccinated, do not let your guard down. We are in a public health battle and we haven’t won yet. What this means is that the vaccines have a 90-95% efficacy of preventing us from getting Covid 19. If we get the virus anyway, the 5-10% failure rate, then we are, indeed, infectious. That means we can still spread the virus to others. Wearing a mask is still required until we see the viral spread diminish significantly. That may take a while. It will depend on how compliant we are with getting the vaccine and still wearing a mask.
Who should not get vaccinated? If you know you have an allergy to a chemical known to exist in the vaccine, then don’t get it. Rely on protective measure by staying six feet from others and socialize only with people wearing a mask. If you are pregnant or have allergies to the environment like pets, dander, bees, then you should still get the vaccine. You will be monitored for fifteen minutes to make sure you are safe, just like everyone else, but you will benefit greatly by being vaccinated.
P.S.: Wash your hands, often.
© Eric Clark, M.D.
Photo: tai-s-captures-0I52FCHNjoU-unsplash
