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Cover Your Face: The Covid-19 Pandemic Isn’t Over

Kelly Hammargren, R.N.
Saturday June 13, 2020 - 11:12:00 AM

Wear your face covering, the Covid-19 Pandemic isn’t over. And in fact, no matter what the enthusiasts for reopening are saying, hold onto to your socks. We are not even through the first wave.

Do you know that on March 16, 2020, the day the order for shelter in place in the Bay Area was called, there were 131 new infections recorded that day in California? It would be weeks before we would learn that the first death in the US from Covid-19 was February 6, 2020: Patricia Dowd, 57, in Santa Clara County. [1]

The rate of transmission [2] was in an upward spike, meaning we were at the beginning, and even without knowing how this new virus was spreading something scary was happening for those who understand epidemiology and exponential growth. Taming a deadly new infectious disease where no one has immunity, there is no treatment other than supportive care, and no vaccine, requires informing the public and public cooperation to contain it.

As the epidemiologists were trying to figure just what this new infection is, the White House was in full propaganda mode with popular Fox host political commentators to dismiss SARS-CoV-2 as nothing to worry about: It will all go away over the summer. Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases has repeated the summer story over and over. With many believers and wishful thinkers in the summer story and impatience with sheltering in place, the attitude that the pandemic is over is spreading at about the same speed as the infection. 

Last Friday, California hit an all time high with 3,603 new infections only to be broken by yesterday’s June 11 count of 3662.[3] California is hovering around 28th in the nation for the number of tests performed per million population.[4] 

The incidence of new Covid-19 infections in New York is in the decline, but that is not the picture for other parts of the nation. California, Texas, North and South Carolina, Oregon, Arkansas, Mississippi, Utah and Arizona are showing increased new cases of infection and hospitalizations. Arizona is running out of ICU beds. 

The challenge with Covid-19 is the delay between exposure and visible infection, and a hefty percent of people infected with SARS-CoV-2 are asymptomatic or have symptoms so mild they don’t raise alarm. People who never perceive symptoms or are in that pre-symptomatic stage are still able to infect others. 

Troubling reporting is surfacing that some people who test positive for Covid-19 and report no symptoms still have abnormal lung findings. Radiologists are being alerted to suspect Covid-19 when what is described as “ground glass opacities” (scattered opaque spots) are seen in the lungs.[5] 

The reopening of businesses, even with restrictions, still gives the message that the pandemic is over. 

The young have been told over and over they really may not have any symptoms at all and need only to worry about transmitting an infection to their parents or grandparents. 

It is true, the young are less likely to have serious complications, but this is not an absolute free ride to throw away those inconvenient facial coverings and forego handwashing. There are formerly healthy children, teens and young adults becoming desperately sick from Covid-19 and having terrible complications. 

A woman in her 20’s who had no underlying medical conditions had so much lung damage from Covid-19 that she had a double lung transplant last Thursday.[6] Fourteen-year-old Jack McMorrow shared his experience with pediatric multi-system inflammatory syndrome (PMIS also MIS-C). He has some residual heart damage which all hope will resolve over time.[7] Another 14 year old was not so lucky and died. 

Some researchers are now describing Covid-19 as a blood vessel disease, not a respiratory disease.[8] That analysis connects the dots: the blood clotting disorder, strokes, heart attacks, kidney failure, diarrhea, the attack on the lungs, the brain, neuropsychiatric disorders. For the sickest patients the virus is everywhere.[9] 

In a few weeks we’ll see the risk and impact of large crowds outside. We know wearing masks, and even homemade facial coverings do help in reducing risk as long as both the nose and mouth are covered. The better the fit, the fewer leaks, the better the prevention and protection. Some materials are better than others and none are as effective as the N95.[10] 

There is still much to learn about Covid-19. Lack of a nationally coordinated approach, fudging on numbers of deaths and the whole approach to testing and reporting has made matters worse by interfering in the collection of data and analysis. 

The door to containment of SARS-CoV-2 is closing. Some might say it is slammed shut. Herd immunity is when so many people have had the infection and either recovered and developed immunity or died from it that the infection fades away. That is about 60% to 70% of the population. Are we ready for that? The death count so far is over 116,000; penetration of infection into the US population of 330,000,000 is a wild guess. Mine is maybe 4%. 

Our bodies are not machines. We do not respond exactly the same way every day or even every hour of the day, but there are things we can do. Wearing facial coverings, imperfect as they are, masks if you can find them, is not just for preventing spread if you are infected. It is also to reduce the viral dose you receive if you are exposed to someone who is infected. 

We can’t see if there is virus floating toward us from someone coughing, sneezing or even just talking, but we can keep the facial covering on, keep our distance, keep our hands off our face and wash our hands before and after applying or touching any facial covering. It shouldn’t be too much to ask of ourselves. Countries where wearing masks is accepted normal culture shine in containment of infection. 

Anyone working in healthcare or who has multiple exposures to large numbers of people in enclosed spaced like workers in grocery stores, bus drivers, clerks, etc. needs to be in a properly fitted N95 respirator mask and those masks need to be fresh with a good seal, not reused for days on end. 

And last pay attention to that phone in your hands and next to your face. It is probably the most contaminated object in your possession. 

[2] Rate of Transmission (RT) is the number of people each infected person will infect. Any number greater than 1 is an infection that is expanding. The bigger the number the more people who are getting infected from a single person. When the Transmission Rate is under 1 that is infections that are declining. The includes RT and offers multiple ways to look at incidence of infection, hospitalizations and deaths. Day to day (RT) can vary so looking at trends is better.