So here I go into turbulent waters. I do so because I have had several requests to weigh in on the matter of #Masks. I would like to qualify my statements first. I am not an infectious disease specialist. I would refer you to @AntibioticDoc for a higher level of expertise.
I do believe that non medical masks play an integral part in the mitigation and management of the spread of #COVID19. I use the word believe specifically because despite the recent proliferation of studies around masking, they are mostly of poor quality and applicability.
If you follow me you know that I despise oversimplifications. My concerns about masks from the very beginning has been the need to portray it as a solution to the pandemic, as way to get kids back in school, and people back to work. In a sense, a magic bullet.
There has been a growing call to mandate general masking. This has come from many levels. It concerns me. It took me a while to sort out why.
My first concern is that masks are not nearly as good at preventing spread as we tout them to be. They are a package deal, and quite honestly the last resort after distancing, hand washing and hygiene behaviours. You only need to look at outbreak data to see that.
Where masking has its true power is from the intent that it is derived. Those who choose to wear a mask do so because they are already onboard with the measures to reduce its spread. In general they value civility over inalienable personal freedom. They are good citizens.
To force people to wear masks when they do not share those values, to me is the equivalent of putting a bib on a toddler in a white shirt and then giving them a chocolate ice cream cone.
Where else have we seen this behaviour? Pediatrician’s have been threading this needle for years when the topic of mandatory vaccinations come up. For this topic I would direct you to @Kidsdoc1Rick. However the consensus has been, no matter how tempting it is to legislate ...
Building relationships and trust with your patients far outweighs mandating behaviour. Noteable exceptions do apply, especially when the greater good is in peril, and pandemics often fit into that category.
My second greatest fear, is that those who will be forced into masking to avoid fines and penalties, will be the camouflaged super spreaders amoungst us. The ones who blow off their symptoms, go about their shopping with unwashed hands, and throw parties with no safeguards.
My greatest fear is that we alienate those who are impressionable and teachable. Then we try to use the same ruberic with the role out of a vaccine. We, as healthcare professionals, have only so much “expertise capital”.
In the end, how best to go about this? Be a good role model. Reinforce and reward good behaviour. Incentivize good habits. Avoid ostracism and scapegoating, but most importantly, wash your hands, maintain your distance, stay home if your sick, get tested if you’re unwell.
And wear a mask. Properly. 🙂
