A message from the Clinic: Help me out here! Wear a mask!

June 19, 2020
By Olivia Cameron

BY DR LAUREN HANA, BGHC- With a recent and continuing spike in new cases of COVID 19 nationwide, it’s important to review what we do know about the virus’s transmission and spread so proper measures can be put in place. So, while realizing that information has been confusing, controversial and inconsistent, particularly regarding face covering usage by the general public, here’s some science to consider.
SARS-CoV-2, the virus that causes COVID 19 illness, spreads in the air via respiratory droplets, even from normal breathing and talking. These droplets then can be inhaled or land on surfaces and be picked up by touching contaminated objects. Touching our face transfers infectious droplets from our hands to portals of entry; our nose, mouth and eyes.
The virus spreads in places with poor air circulation and where people are in closer contact with one another in general, like indoors, areas of high population density and households. The data regarding “hot spots” confirms these observations. We have seen that States in colder climates where people are stuck indoors in the winter months had worse outbreaks (at least thus far).
Significant outbreaks have been noted in nursing homes, factories and meat packing plants were workers are in constant close contact with one another. These workers may also have a “double whammy” if they live in households that are multigenerational or made up of extended family, as is often the case, making even wider spread transmission possible.
We know that clean air helps reduce transmission and UV light inactivates this virus. UV light is being used to sanitize facilities and equipment like N95 masks so they can be reused. This may be one of the reasons that Florida has had less than the predicted number of cases.
There has been some research that suggests that air pollution and particulate matter may help propagate the spread of the virus and increase the likelihood of more severe disease. There are several ways that this could happen. Those with chronic exposure to air pollution are found to have pre-existing lung damage, predisposing them to more severe infection. Air pollution may increase more distant transmission by viral attachment to particles in the air. Attachment to particles may enhance the lifespan or infectivity of the virus. Conglomerates of particulate matter in the air with virus may lead to inhalation of a larger viral load and therefore more severe infection.
We do know that COVID 19 causes people to be most infectious two to three days prior to becoming ill and developing symptoms. This is called the pre-symptomatic stage. There have also been people found with confirmed infection with COVID1-9 that never develop symptoms. This would be considered A-symptomatic infection. These asymptomatic people are still infectious but likely carry a lower load of infectious virus and therefore are less effective in transmitting the infection to others. The risk of transmission by these asymptomatic people most likely is less, but it is not zero, and there is no way to know who is asymptomatic and who is pre-symptomatic until two to three days later when symptoms do develop.
How do we address these things that we do know? The answer is to continue taking all the precautions recommended by the CDC and other health organizations.
We need to continue to distance from others not in our household, especially indoors.
We need to continue to wash our hands, especially after using the restroom, prior to eating and on arriving home from public places.
We should stay outdoors when socializing as much as possible, but still continue to distance, cover our mouth and nose, wash our hands and avoid touching our face.
Everyone should wear a face covering that covers the mouth and nose in public, both indoors and outdoors and always if you are ill.
We should stay home and away from others, even in our own household, if we are ill.
There will, most likely, be someone that is infectious with COVID-19 that will unknowingly walk into your shop, eat at your restaurant or pay for their groceries just before you do. Public venues need to concentrate on increasing air circulation and filtration, regular disinfection and staff and patron distancing. Face coverings should be required by everyone. UV sanitation should be considered and liberal sick leave policies should be in place for staff.
COVID-19 will be with us indefinitely. It has taken over 20 years to find adequate treatment to suppress the viral load of other viral diseases like HIV. A vaccine is not a panacea, when and if one is developed. There will still be “anti-vaxers” and those who don’t respond to the vaccine even if given.
There may still be possibility of infection, albeit possibly milder, in those that are vaccinated, similar to how a flu shot isn’t a guarantee that you won’t get the flu, and even those with that mild infection will still be infectious to others. 
According to the National Center for Health Statistics, there are four million births in the US every year (130 million births yearly worldwide) and all will be susceptible to infection with COVID-19. A review of the most recent COVID-19 data, as of June 16, is below. The data is directly taken from the Florida Department of Health Website.
Florida: 80,109 total cases, 2993 total deaths
U.S.: 2,115,079 total cases, 116,250 total deaths
Florida weekly new cases over the last four weeks:
6/9-6/15/20 – 13,558
6/2-6/8/20 – 8324
5/26-6/1/20 – 5245
5/19-5/25/20 – 5154
Florida weekly testing over the last two weeks:
6/9-6/15/20 – 253,653
6/2-6/8/20 – 258,046
So, contrary to the reports that Florida’s increasing number of cases is due to increased testing, the actual data shows the testing to be stable to a little less, despite increasing new cases.
This has caused the percent positives to also increase to the currently reported rate of 7.46 percent positive.
Florida’s highest positivity percentage was 11 percent early on in the pandemic in March with the lowest being around three percent through April, May and even into the first of June. The increase corresponds to about four weeks after the stay at home orders for our state were lifted.
Closer to home, the current percent positive new cases for Charlotte County are 2 percent, for Lee County, 7 percent and for Manatee County (Sarasota), 4 percent.
Regardless of all these numbers, I know that in the last week there are 13,558 more infectious people in Florida to pass on their infection to me, or to anyone else.
Ever heard the saying, “Don’t put all of your eggs in one basket”? Think about your own investment portfolio. In these uncertain times, have you diversified your portfolio with stocks, commodities, fixed income options and alternative investments to safeguard against a volatile market or kept it more concentrated in one area? In order to get the highest return for the least risk, we need to apply this philosophy to our own behavior. Distancing and hand washing will not be as effective alone as if they are combined with face coverings and isolating if you are sick. If following all the recommended guidelines is universal, we will all have the best possible outcome.
Only WE can stop this virus. Not a treatment, not a vaccine, not a summer climate. Only WE, by adjusting our behavior, can make a difference.
So, help me out here and wear a mask! Wear one for your neighbor. Wear one for your grandma. Wear one for your friend that is undergoing cancer treatment. Wear one for me. I wear one for you.
NOTE: On Thursday, June 18, 3,207 new positive COVID-19 cases were reported in the state. It was a record day.
Dr. Lauren Hana is a physician with the Boca Grande Health Clinic.