Coronavirus Masks versus Sneezes and Coughs

There has been an update to this blog: Guidance has continued to shift on whether it is advisable for people to wear protective masks during the coronavirus pandemic.  A notable addition is that wearing a mask may decrease portential for transmission rate by 10%.  Read here: https://www.wsj.com/articles/is-it-time-to-wear-a-face-mask-11585855788

The Coronavirus (COVID-19, or SARS-CoV2) pandemic has thrust our community into unknown territory. We recognize this is a frightening time and that many of our patients have faced both health and economic impacts. This post is a devloping idea that we will add to which hopefully will provide a service to you.

Much is recently developing regarding wearing masks in public, and whether “everyone should” (as in “must”) wear a mask.   In a professional forum I had recently discussed a New England Journal of Medicine article describing a study where they had generated a mist with a nebulizer (a mist sprayer), and managed to keep it floating and detectable “in the air”. Truth was, this air was inside a test container about the size of a garbage can – and it floated for three hours – before the virus settled out.  This created a concern and a potential suggestion that the CDC is still considering about recommending masks.

You may want to read this, but the bottom line is, that this WHO study right here quite specifically opines that the prior study –  using the nebulizer, etc. –  does not realistically simulate a real-world situation where human coughing produces an aerosol mist.

They are sticking with the coughing and sneezing produces “droplets which fall to the ground or land on surfaces” strategy. At the same time, they do concede the rationale for requiring masks to avoid aerosolization in a medical environment. where COVID -19 is being specifically treated.

That then is specifcially for the “Covid-19 aerosol as in an invisible mist like a gas” strategy. It does not address the “someone may cough or sneeze in your face” strategy.  It also does not address the “with a mask, you will not touch your mouth and nose” strategy.  Both of those, I think, are perfectly reasonable strategies for wearing a mask in public.

The Public Health initiative that masks are to be limited for medical providers is a real idea, although they are currently “finding” millions of masks that were being hoarded or diverted. Stay tuned; that situation may be getting better.  The other suggestion that masks are “scary and off-putting”, may not be real these days,as  I think everyone may already be freaked out and this does not much matter.   I think they have seen a lot worse than one of these masks.

We are going to do the mask thing in our clinic environment at Blue Heron Chiropractic, because we are assuming that some of the people we are treating might actually be asymptomatic positive, even though we are not treating coronavirus at this clinic. But these “Potential Positives” are the same as anybody that we come in contact with during the day, as in, the gas-station-attendant, the postal delivery person, or the cashier at the market.

Now, having said that – just like this picture above – if you see one laying about, these masks are potentially contaminated and contagious. Don’t pick one up unless you are ready to sanitize your hands. Definitely don’t lick the blue side.  Masks need to be discarded once they are dirty, and if they get wet, they are compromised. And – if you are not dealing with a “MEDICAL” N95 mask… not a “woodworking” N95, or a dust mask or an off-brand with a valve in it… we are probably not going to block the aerosols anyway.  Do wash your hands, avoid your nose and mouth, and maintain a 6 foot separation.

I would not fault anyone wearing a mask inside my clinic, for sure. In my opinion, it is fine if it makes you comfortable at this time. When the lights come back on, we will most likely be able to do away with the masks.

Just another one of these developing ideas.