Doctors address mask concerns

Pictured, from left, are State Bank employees Andrea Lesniak, branch manager Lacey Wild and Dalton Pait at the Waterloo wedge location on Tuesday. The bank team works in close quarters and wears masks to keep the workplace healthy.

As the number of coronavirus cases and the positivity rate of coronavirus cases jumps across America, wearing face coverings to help slow the spread of the virus has become the subject of a political firestorm. 

The Centers for Disease Control and Prevention recommends that practice along with maintaining social distancing and frequently washing your hands.

To help readers make decisions on wearing face masks, the Republic-Times asked two local doctors some frequently asked questions about face coverings. Their responses, edited for clarity and brevity, are below. 

How does a face covering help reduce the transmission of COVID-19?

Dr. Christopher Schenewerk, practitioner of family medicine with BJC Healthcare and who has offices at 200 Admiral Trost Road in Columbia and in Smithton: “With these respiratory viruses, per se, they connect on droplets. COVID can also come through droplets on the skin, too, like through sweat and also just like when you rub your nose and things like that. And the mask really captures those droplets. A regular cloth mask, even most masks like filtered masks, don’t have the material to stop the virus completely because it’s so small, but just by wearing something over the nose and the mouth captures those droplets. That’s the main thing. It decreases the transmission that way.”

Dr. Julie Kelley, Emergency Room Medical Director at Red Bud Regional Hospital: “Wearing a mask is mostly about protecting others from our own droplets. The virus is carried in the moisture that is in our mouths and noses, so trying to keep those secretions contained is why wearing a mask is effective. 

Is wearing a mask supposed to protect you or protect others? 

Schenewerk: “It’s both. The reason, even in some of the areas where it’s lacking right now, that I still wear a mask is mainly to protect other people, just in case I’ve been exposed. As we’ve seen with such a high percent of people that are positive, they don’t even have symptoms. So it’s really everybody protecting each other.”

Kelley: See previous answer. 

How is the effectiveness of wearing a mask researched or what evidence is there to show wearing a face covering is an effective way to reduce the spread of coronavirus? 

Schenewerk: “This is certainly the first time we’ve been exposed to this particular virus, so part of the thing is you don’t really know except for the areas that had it before us. So one of the things along those lines is we know that those countries that really did an incredible job of wearing masks and social distancing, they had the best outcomes as far as number of cases and, more importantly, hospitalizations and deaths.” 

“Let’s just say  I’m at the beach. I’m not going to wear a mask at the beach because you’re in the open and things are really nice and air movement’s good. But even if I’m in an uncrowded grocery store, I wear a mask. Because, again, in an enclosed area, those droplets can hang out for some time. You just have to use common sense.”

Kelley: “How do we know this? We have been wearing masks in the medical field for decades.” 

Does wearing a mask increase your chance of having health problems due to lack of oxygen?

Schenewerk: “No. Certainly, if somebody’s oxygen levels are decreasing because they put a mask on, they have other problems that probably should be addressed. I find it funny how (Gov. JB) Pritzker came out and said kids are going to wear masks at school in the fall, unless they have a lung condition that doesn’t allow them to wear a mask. Those are the kids that should be wearing a mask. There’s really not many conditions where a person is sick enough with something that they can’t breathe and wear a mask. And if a person is that sick with lung disease, they’re not probably out shopping or whatever anyway.”

Kelley: “Masks are hot and can feel somewhat claustrophobic for some people. Masks can press hard on our noses and ears and be uncomfortable. These are all minor inconveniences when we compare this to the overall protection that masks can provide.” 

“There are many circumstances when people feel short of breath while wearing a mask. This is typically more associated with anxiety, not lack of oxygen.” 

Does wearing a mask increase your chance of having health problems due to increased levels of carbon dioxide (CO2)? 

Schenewerk: “No, not at all. That would have to be a very restrictive mask. Oxygen and CO2 are even smaller than the virus that we’re talking about. So if the virus can get through those things, we can get enough oxygen and CO2 exchange through those. A lot of times people are uncomfortable with the masks, especially when they’re restrictive like the COVID-19 masks, but it’s not so much that they’re not getting enough oxygen. The ventilation is slowed down, so it’s like breathing through a straw. It’s not that you’re not getting enough, you’re just uncomfortable.”

Kelley: “Medical professionals continue to fulfill daily activities, not showing signs of lack of oxygen or becoming unconscious from increased carbon dioxide levels in their blood.”

Organizations like the CDC and World Health Organization initially advised people not to wear face coverings, but later they changed their recommendation. Does that make their advice less credible? 

Schenewerk: “I don’t think so. If you look at when this was first reported in China in December, and by the time we had the first case in February here, they were already gathering data. It seems that some of that is untrue, and we were going by what data we had. But when we saw what was going on, in northern Italy, mainly, immediately that was changed. I don’t mind when they change gears because that means they’re looking at the data in real time. I’d rather somebody be looking out for me and trying to give me suggestions than not.” 

Kelley: “The Centers for Disease Control, as well as medical professions in general, are learning more about this virus every day. In the beginning of the pandemic, the CDC recommended that masks be available to the health care workers first. Once the supply of masks increased, they extended their recommendations to the public. But as we’ve come to see, recommendations can change. This means that as research continues, something we thought might or might not have be true at one point, may change. We use this as an opportunity to develop our focus on keeping patients and the general community safe as we navigate new developments.” 

Some people have argued that wearing face coverings is just an opinion held by medical professionals, like National Institute of Allergy and Infectious Diseases Director Dr. Anthony Faucci, should not be given too much added weight. What do you think of that? 

Schenewerk: “If I take my car to a good mechanic and they give me their opinion on what’s wrong with it, I’m assuming they’re using their expertise and what they’ve seen before and their knowledge to make some kind of educated guess. I put my trust in what these guys come up with. It’s not just Fauci, he just happens to be the guy who goes up there on the podium. They have a whole slew of people, some of whom have crazy ideas on both ends, but at the end of the day they come up with pretty tight guidelines on what to follow.” 

Kelley: “Medicine has always relied on evidence based practices rather than anecdotal based practices, which are more about individual experiences rather than facts. That also applies to COVID-19.” 

Is there anything else you’d like to add? 

Schenewerk: “I think the important thing is just listen to the experts. I’m sick of wearing a mask, and I wear it for eight to nine hours a day, but every time I get sick of it I remember that we just had a person come in who we found out had COVID last week. So it reminds me that I’m doing it for a reason. We need to protect those who are weaker. Just be aware of your surroundings.” 

Kelley: “Even if you feel healthy, it is important to wear a mask when in public. A significant portion of COVID cases are asymptomatic, meaning you have the disease and can transmit it, but you have no symptoms.” 

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