~ Submitted by Christina Kim, NP, Massachusetts General Hospital
“You cannot solve community problems with individual solutions.”
This quote encapsulates exactly why the town of Bedford should not yet lift its indoor mask mandate, particularly in schools.
In order to reduce the risk of spread of COVID-19 in our communities, we need to implement as many layers of mitigation as possible as described in the “Swiss cheese model” (1). The more layers of mitigation we utilize (masks, hand hygiene, distancing, vaccines, ventilation, testing, quarantine, isolation), the more successful we will be at mitigating spread.
Why is this important? We need to protect the vulnerable members of society – the elderly, immunocompromised, chronically ill, young children who are not yet eligible to be vaccinated – and to argue otherwise is shamefully ageist and ablest.
More importantly, we must do all we can to mitigate spread of COVID-19 so we can get on the other side of this pandemic more quickly. If we want to reduce the risk of new more concerning variants from emerging in the future, we must do all we can to limit its spread now.
New variants emerge because of mutations. Mutations occur during viral replication. Viral replication occurs in infected people (much less so in fully vaccinated people (2)). That means that every single new infection, no matter how “mild” the illness, is contributing to the risk of new variants emerging. It means that we must do all we can to NOT give this virus a new place to call home.
Regarding masking in schools, multiple studies have demonstrated that mask-wearing in the daycare (3), school (4,5) and college (6) settings reduced the risk of transmission and likelihood of COVID outbreaks.
Wearing a mask by those who oppose the mask mandate is often presented as an individual choice. “If you’re scared, then YOU wear your mask.” This mindset of individuality goes against the basic principles of weathering a public health crisis as a community. Every decision that each of us makes does and will have an impact on the greater situation.
So, to those of you who are against the mask mandate, who believe masking is an individual choice, I ask this: if you won’t wear a mask to help mitigate spread, what WILL you do? Will you get vaccinated and boosted? Will you limit crowded gatherings, especially indoor gatherings?
This is a community problem, and we cannot rely on individual solutions to get us through it.
Footnotes:
- https://www.nytimes.com/2020/12/05/health/coronavirus-swiss-cheese-infection-mackay.html
- https://www.nejm.org/doi/10.1056/NEJMc2102507
- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788457
- https://www.cdc.gov/mmwr/volumes/70/wr/mm7039e3.htm?s_cid=mm7039e3_w
- https://www.cdc.gov/mmwr/volumes/70/wr/mm7039e1.htm?s_cid=mm7039e1_w
- https://www.cdc.gov/mmwr/volumes/70/wr/mm7036a3.htm?s_cid=mm7036a3_w
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Your treatise here provides no comments at all on how and when to remove your preferred mitigation methods. Are you advocating doing this forever? How did we ever protect the vulnerable from other viruses, such as the annual flu viruses? Will you mandate that every person get every flu vaccine and wear masks in public for the 4-6 months flu is prevalent each year? Restricting the masses instead of the vulnerable has not been and is not now a viable long term strategy.
I completely agree with Ms. Kim. We need a community effort to control this disease.