To mask or not to mask?

By Michelle Price
Special to the UCBJ

COOKEVILLE – Five-plus months into living with the COVID-19 virus, there is still a great debate over the wearing of face masks. Misconceptions and rumors abound surrounding the topic. UCBJ asked Stephanie Etter, RN, CRMC infection prevention manager, questions surrounding mask wearing in hopes of clearing the air.

Explain the basics of masks:

“You’re trying to control the source,” said Etter. “We can all be a source of infection. Whether we know it or not, we could have COVID or be a carrier of COVID. We know that COVID is spread by respiratory droplets – our snot and our spit – and if we can cover the source of our snot and spit with a mask, it is very unlikely that we will spread COVID to anyone else. 

So, my mask is protecting you and yours protects me, speaking of cloth masks – in particular – for the public.” 

So, you wearing a mask protects others from you and not you from getting COVID?

“It really depends on the type of mask you wear,” Etter explained. “If you’re in the public and wearing a cloth mask, it will still protect you to some degree. It may not fully protect you from others, but you’re still controlling those secretions.

“When you have anything over your face, it controls droplets. Like when they tell you to sneeze or cough into your elbow – even that controls droplets during flu season. This is that same logic, instead of sneezing and coughing into open air or into your hand. 

“You have those droplets that come out when you laugh, when you talk, when you sing covered with a mask, it’s the same logic as coughing into your elbow – you’re containing all those droplets and keeping them from being out into the open air.”

So, the concern isn’t just somebody coughing? It could be somebody laughing or singing?

“Absolutely. And even when you are talking, some of us when we talk really fast or have a loud voice do actually spit a little when we talk. 

“Those secretions, that’s where respiratory diseases live, in your nose and mouth. So, anything that comes out can potentially infect another person if that virus is living in those secretions. Even if you don’t have signs of cough, fever and so on. We’re five-plus months into this now, so we (the CDC) have good data on how that happens, and we know that respiratory diseases spread that way.”

How long can somebody have COVID and not know?

“Some people will never show symptoms. Some people will have it, and are carriers of it, and never have any symptoms ever. 

“We (the CDC) think 48 hours, and this is the guideline we use from CDC when we are trying to figure out an exposure. If you are around someone 48 hours before they have symptoms, or before they test positive – because again not everyone will have symptoms – then you are considered potentially exposed. That’s also pretty typical of any respiratory illness, like flu, 24 to 48 hours before you have symptoms, that virus is already in your spit and snot, and you can transmit the virus. So, that same logic applies to COVID.

“I think a lot of people have just sort of given up on masking in general because they think that most people don’t get that sick and we’re all going to get it anyway, so why bother, let’s just get it over with. But if you look at the healthcare side of it, that has a great impact on us as a whole. 

“What that means is – if we all have that practice of getting out and going to the store or wherever else we have to go in public, and we aren’t masking and 50 of us get it at the same time, a handful might be in the hospital in the ICU or in the hospital period, and we will be overwhelmed with cases. We cannot take care of that many patients if a tremendous number get sick at one time. 

“So that’s why from the beginning, the White House and the CDC has asked people to help flatten the curve by avoiding large gatherings and later into this universal masking.”

How does CRMC protect themselves against people that have no symptoms?

“We have universal masking, just like we encourage the public to do. So, every day when we come in as employees, we are supposed to have a mask on before we enter the building. Then we have our temperature checked and we are asked if we have had any changes in symptoms and so on from the CDC guideline. 

“We mask all day long whenever we are taking care of patients or around our co-workers. We do allow people to take them off when they eat if they can maintain six feet of distance from others. But other than that, we universally mask all day long except when we are alone in our office. Any patients that come in for outpatient procedures, we mask also.

“Once a patient is in their room, they don’t have to keep a mask on, because we are coming in with our mask on. So again, we are controlling the source, in case we have it and don’t know it. We also wear a surgical type mask, or a medical face mask. So, we’re not wearing cloth mask, so it gives even more protection for us and from us to the patient.”

Because of the nationwide nursing shortage, do you take additional measures regarding COVID?

“We have to protect each other and our patients. When we are doing direct patient care – you’ll see all of our staff in the emergency room wearing medical grade or surgical grade masks, because you do have that unknown status of every patient that comes through the door. You haven’t evaluated them yet, whether they are a COVID suspect or not, so we treat them all as a suspect in that regard. We do wear a medical grade mask for all patient care.”

What about those masks that say they won’t protect against COVID?

“Overall, if you have a medical grade face mask, that’s been approved by the FDA, that’s what we try to use here. I think whatever you can buy is probably fine, to the best of your ability in the general public. 

“The point is not necessarily that you get a surgical or medical grade facemask, but that you have some type of mask on, because you are still helping to control the source. Which again is our secretions from our nose and mouth.” 

How often should you wash or change your mask?

“The CDC says often or frequently. In general, every couple of days. We don’t tell our staff you have to wash it every day. We focus on changing it out often or when soiled or wet. 

“Good hand washing or good hand hygiene, either soap and water or hand sanitizer. Every time you do touch the mask, if your hands aren’t clean, that’s a risk also. So, keeping your hands clean while you are wearing a mask is important.”

The conclusion:

The administration and staff of CRMC from the CEO to the nursing staff encourage social distancing and the use of a face mask.

“It is a proven statistic over and over again in any type of infection that masking helps reduce the spread,” CRMC CEO Paul Korth said. “I cannot over emphasize the fact that all of our citizens need to be wearing masks when they’re out in public. When they’re going to church, when they’re going shopping, wherever they’re at.”

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