Vivekanandan, M.D., is chief of infectious diseases for the Creighton University School of Medicine and CHI Health. Penn, M.D., is medical director of epidemiology and infection prevention at Methodist Hospital. Nora, M.D., is medical director of infection prevention/infectious diseases for Bryan Health.
We, along with the directors of infectious diseases from all the major medical systems in across Nebraska and colleagues that include pulmonology and critical care chiefs, have joined together to inform all Nebraska citizens that we are united in our recommendations to limit the spread of this virus. We are at a crucial juncture. We are witnessing rates rise in states all around us, and last week brought the highest one-day totals in Nebraska since May. In a matter of weeks schools are planning to reopen, so we need to act now. To be truly effective we need to work together — not against each other but against this common enemy, SARS-CoV2, if we really want to be victorious in this battle.
Although early in the pandemic the CDC and others did not support the wearing of masks by the public, this was before the extent and ease of transmission, even when individuals are asymptomatic, was known. Months of experience and additional studies have confirmed that masks work. And social distancing works. However, it is the combination of mask-wearing and social distancing together that can truly decrease spread. Neither of these actions alone are as effective as when used jointly. If you add being outdoors, the efficacy jumps even higher.
Although masks provide protection to the wearer, they are even more effective as source control, that is, in preventing the asymptomatic or pre-symptomatic individual from spreading this virus to others. One of the most unusual aspects of this virus is that it can cause asymptomatic to mild disease in many but, at the same time, for those who do become ill, a higher mortality than any respiratory viral illness in this country since 1918.
Our leaders should support universal masking in environments where close contact will be unavoidable such as schools, many places of employment, gyms, restaurants and bars. They also need to do everything in their power to increase testing supply. The ability to detect positive cases, isolate and contact trace coupled with quarantine are the most effective interventions from the public health teams.
Lastly, we need as a community to understand that recommendations for reopenings need to be universal to be effective. One highly infectious individual who may very well be asymptomatic can spread virus to several others. The plans and the community also need to be flexible to the prevailing cases in a local community. Those local officials, be they school board officials or local health department leaders, should be able to respond to the changing number of cases in their jurisdictions. An option for online education would allow home learning to proceed alongside in-school learning for those who have high-risk conditions or have household members at high risk.
So, when folks ask you to wear a mask, they don’t want to take away your freedom; they want to protect you and your loved ones and themselves and their loved ones. We have accepted that limiting smoking to areas where others can’t be exposed is a way we protect others from harm we could unknowingly inflict. Wearing a mask is no different.
If everyone works together and we do this for each other, we can:
- Prevent a rise in rates seen in many other states.
- Keep the rates low enough that opening school can occur more safely.
- Allow businesses to be able to function more safely and effectively.
- Protect health care workers and first responders.
- Allow for enough beds in intensive COVID treatment units should you or a loved one need specialized care.
This is an invisible enemy. Until we have better treatments and preventive measures, we as a group strongly encourage all Nebraskans to help save lives by wearing a mask every day when they leave their homes, including all students in schools, and practicing social distancing. It is the right thing to do.
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