Knowing that I am a triple alumnus of Georgia Tech, a friend recently tweeted me a picture from a Georgia Tech football game in 1918 showing the stands filled with dapper fans in suits sporting face masks. It was a picture Georgia Tech alumnus, Andy McNeil recently discovered from his grandfather and GT alum Thomas Carter, with a note written on the back that read “Georgia Tech during 1918 pandemic.”
My elders have always told me that there is nothing new under the sun, and that history repeats itself. Imagine that during the summer of 1917 in July, nearly 10,000 African-Americans marched down Fifth Avenue in New York City in silence to protest racial violence and white supremacy in the United States. In early 1918 the first wave of influenza hit the country, initiating the 1918 Influenza Pandemic. Newspapers provided daily updates on mortality rates of the pandemic while businesses, schools, churches and other places of public gathering were closed. Public services like mail delivery were interrupted and volunteers across the country assembled to make masks for possible prevention, as there was no vaccine for the influenza virus.
During the 1918 pandemic the only tools at their disposal were social distancing and societal behavior modifications, these are now known as non-pharmacological interventions. Even in the grainy photo from the Georgia Tech football game it even appeared that people attempted social distancing. In 1918, there was wide spread debates on the effectiveness of masks and whether there should be compulsory government orders demanding the public wear them.
Here we are in 2020, 102 years later and thousands of Americans of different hue, race, religion and creed are taking to the streets across America to protest racial violence and white supremacy. While simultaneously, the nation’s economy has been shuttered by the governmental lock down of businesses, schools, churches and public gatherings in an attempt to slow the transmission of the Covid-19 Pandemic. Since the novel coronavirus appeared in the U.S., there have been conflicting and widespread debates about the effectiveness of governmental shut-downs, stay-at-home mandates, social distancing and mask. Sounds like History is repeating herself!
The U.S. has begun reopening the economy even though we are seeing upswings in the coronavirus infections rates in many states. The rush to reopen the economy has many people overlooking the threats of the virus and returning to their daily routines. The only tool that will protect against a second wave of the virus is maintaining the behavior modifications of social distancing (6 ft), frequently washing your hands, avoid touching your face and wearing a mask. Yes, WEAR A MASK.
At the onset of the pandemic, like in 1918, there was very little scientific evidence regarding mask effectiveness in slowing the transmission of the disease; however, a recent study published in the “Proceedings of the Royal Society A” scientific journal concludes that widespread mask use by the general public could push COVID-19 transmission rates down to manageable levels across the nation.
A recent op ed by Dr. Markalain, DO, MPH, FACOI., an epidemiologist and medical director for infectious diseases at Access Health Louisana asserts that if there was universal masking for 28 days (two cycles of the incubation period of the virus) the risk of viral transmission would drive the R0 (the reproductive number) to levels that would be unsustainable by the virus. Dr. Déry writes, “masks are essential because they block respiratory droplets” he continues, “if masks are worn universally for 28 days, the virus can be eliminated far more rapidly than having to wait for herd immunity or a vaccine”.
It is becoming more clear that Covid-19 is spread from person-to-person contact through respiratory droplets between people in close contact, by the infected person sneezing, coughing or even talking. Due to their weight, the expelled droplets are so heavy, where they cannot travel no further than 3 – 6 feet. However, MIT research demonstrates coughing or sneezing may thrusts them up to 27 ft! The disease can be transmitted by a person inhaling the respiratory droplets containing the virus or exhaled droplets landing in another person’s mouth or eyes starting the incubation period of an infection.
Since the virus is spread by respiratory droplets, masks fully covering the mouth and nose can serve a barrier, preventing droplets from leaving one person’s mouth and blocking the droplets and entering the mouth or nose of another.
Wearing a mask won’t necessarily protect a person from catching the disease, but serves two purposes. The mask restricts an infected person’s ability to put droplets into the environment to infect others. Also, wearing a mask, limits two access points, the mouth and nose, for viral entry on another person. The mask is not a complete solution as it leaves the eyes unprotected; however, it is believed that wearing a mask, while following other recommended physical and social distancing behavior, will provide sufficient protection and help lower the transmission rate of the disease.
According to Dr. Eric Griggs, Research Assistant Professor at LSU School of Medicine and Community Medicine Director at Access Health Louisiana, the math is simple. “Wearing a mask reduces the community viral load. If there are less viral respiratory droplets in the air, there are less potentially-infected droplets for people to breathe in.”
Studies show regardless of the type of mask you decide to wear, you are reducing spread possibility. If you are in the healthcare profession working and or taking care of infected patients, it is imperative that you wear an N95 Respirator mask designed to block 95% of very small particles. All others can wear any type of mask, surgical or cloth mask, even a bandana or handkerchief. Based on the evolving research, the World Health Organization (WHO) now recommends that the public wear homemade or commercially available cloth or fabric masks in places where physical/social distancing (staying 6-feet apart, etc.) is not possible or is difficult. The following table gives you a description of what type of mask should be worn and when.
The ultimate goal of wearing a mask is creating a barrier to virus particle and droplet transmission. Simply wearing mask will save lives! Moreover, wearing a mask is a sign of respect for life and your fellow man. When you go into the public wearing a mask you are showing respect and concern for other people, doing whatever is deemed necessary to protect them from the virus, especially for those in our most vulnerable populations (the elders or those with compromised immune systems).
As we re-open and get back to some normality, think about the way things were for the last 90 days. If you want to prevent a second wave of inflections and society to stay open, continue to eat out, have friends and family over for a barbecue, or go to a bar, PLEASE WEAR YOUR MASK. It’s one of the few tools we have in this pandemic battle. But also remember, social distancing and wearing a mask works – we have the data to prove it. Stay Safe!