Photo courtesy Peter Karlin: Dr. Peter Karlin, from left, and Dr. Gloria Lowe, physicians at MultiCare Eatonville Clinic, stand outside the clinic while wearing face masks. They encourage all residents to wear masks to protect themselves and others during the COVID-19 pandemic.
Photo courtesy Peter Karlin: Dr. Peter Karlin, from left, and Dr. Gloria Lowe, physicians at MultiCare Eatonville Clinic, stand outside the clinic while wearing face masks. They encourage all residents to wear masks to protect themselves and others during the COVID-19 pandemic.
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As our community navigates the COVID-19 pandemic, how do we work together to protect each other and preserve our way of life? 

Regardless of how one feels about face masks, we all care about the health of our loved ones and those around us, value the freedom we have in this country, and want our small businesses to thrive and life to return to normal. While our approach may differ in these challenging times, we still share many more values with our neighbors than what the sometimes contentious debate around masks and COVID-19 would suggest.

On June 26, with a concern for ongoing community spread of COVID-19, face coverings in indoor public spaces became mandatory in Washington state. The order also required that we use these coverings in outdoor spaces when we cannot social distance. As medical providers at the MultiCare Eatonville Clinic, we felt compelled to respond when we became aware of a recent petition to make Eatonville a "Mask Sanctuary Town."

At the time of this article, the death toll from COVID-19 in the United States was 128,648 ("Coronavirus Disease 2019 (COVID-19)," CDC). When we first became aware COVID-19 was spreading in the United States, many felt that the risk of this virus was overblown. Some compared it to the influenza virus and suggested that our response to COVID-19 should be similar. 

It is important to realize that COVID-19 is a "novel" or new virus with key differences from the typical seasonal flu. Our immune systems have not seen this specific virus before. It has a much higher death rate than the flu, and we do not have a vaccine for COVID-19 at this time. These are just some of the differences from the flu that have led to this pandemic. 

The Centers for Disease Control reports that since 2010, the death toll in the United States for influenza ranged between 12,000 to 61,000 people ("Influenza (Flu) - Disease Burden of Influenza," CDC). We have already far surpassed the death toll from the worst flu season in the last decade despite all the measures taken to limit the spread of this virus. Acknowledging the unique threat of COVID-19 compared to other infectious diseases like the flu, is a critical first step our community and government must take to effectively combat this virus and save as many lives as possible.

As we have learned more about COVID-19, evidence has made it increasingly clear that face coverings are an effective tool to slow the spread of the virus. Our hope with this article is to address some of the misconceptions about face coverings. We will need as many people as possible in our country participating in this and other efforts like social distancing to gain control over this virus and reduce the number of infections and deaths.

Masks weren't recommended in the beginning, why should I wear one now?

• The short answer: To protect the vulnerable and ourselves.

• COVID-19 spreads by respiratory droplets when we talk, sing, sneeze and cough.

• People with minimal or no symptoms ("asymptomatic") can spread the virus.

• It is not good enough to only wear a mask or stay home when we are sick since we can expose others even when we feel well.

• This knowledge of asymptomatic spread has led to a change in the recommendations from the CDC, World Health Organization, the Surgeon General and other public health officials that people wear face coverings when in public and cannot maintain social distancing.

 

COVID-19 is so small, do masks really help?

• Yes: The virus is small, but the respiratory droplets it rides on are large enough for many to be caught in the face covering.

• The best evidence shows that wearing a mask reduces the number of respiratory droplets that enter the surrounding environment.

• Masks are most effective when worn by the infected person. They reduce the chance an infected person will pass the virus to those around them.

• Face coverings also provide some protection against the virus to the person wearing it.

• As COVID-19 resurges around the country, we see more states recognizing the importance of face coverings and as a result are implementing mandatory face coverings in public.

But there aren't that many vulnerable people around. No one I know has died

• Adults with hypertension, obesity, diabetes and other chronic health conditions are at increased risk of serious complications from COVID-19.

• Four in 10 Americans are obese, and six in 10 have a chronic health condition.

• When we pass a stranger on the street, we do not know all their risk factors.

• Chances are, we all have family members at increased risk, and they need our help to protect them.

 

Won't it hurt me to wear a mask?  

• For most people, wearing a mask while working in an office, at the post office, attending school or shopping at the store is safe.

• Those with severe lung disease and those under 2 years of age or who are unable to adjust their own mask should not wear a mask (the state mandate makes exceptions for these cases).

• The most common adverse reaction is skin irritation and worsening of acne, but proper use of the mask can reduce this.

 

But what about our economy, small businesses and my personal freedom?

• Until we have a vaccine and the majority of our population is immune to COVID-19, life will not return to normal.

• Ignoring our reality and deciding not to use masks or adhere to social distancing does not protect our small businesses; it hurts them as this pandemic is prolonged.

• Wearing masks is a personal sacrifice we can make to help our state open up sooner, avoiding more drastic measures like shelter-in-place orders that have a devastating impact on our local businesses.

 

OK, I'm convinced to wear a face covering. What should I do now?

• Find a mask that fits you comfortably.

• It should cover both your mouth and nose, fit under your chin and stay in place when you talk.

• Avoid touching the mask and your face.

• Keep you mask clean and launder if dirty.

• Do not share your mask with others.

• Wash your hands after touching or removing your mask.

• Wearing a face mask is not enough, please continue to wash hands frequently and practice social distancing.

— Gloria Lowe and Peter Karlin are family physicians at MultiCare Eatonville Clinic

This article was written in support by:

Howard Hull, PA

Trish Ellis, RN

Carla Toulouse, RN

MultiCare Eatonville Clinic

 

Peter W. McCahill, MD, FACEP

Medical program director, Lewis County Partner, Mt. Rainier Emergency Physicians Staff emergency physician, MultiCare Good Samaritan Hospital

Thomas M. Van Eaton, MD

Family physician

Kirk Heinz, RPh

Kirks Pharmacy

 

Robert Perras, PT

Mountain Physical Therapy

For more information, or to personally review the evidence to support this article, visit: 

Mayo Clinic

USFC Davis

University of Washington

CDC

WHO