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Dr. Albert Rizzo, Chief Medical Officer at the American Lung Association, speaks to News-Medical about the importance of wearing masks to help control the spread of COVID-19.
What prompted your research on COVID-19 and the use of masks?
There have been some debates over the months since the pandemic began about how the COVID-19 virus was transmitted. Surfaces or fomites are perhaps less important than originally thought, the virus can still be found for different periods of time on surfaces, depending on the type of surface and surrounding temperature, but it appears that infectivity by the virus is low and is likely to fade quickly over time.
The mask recommendations were derived from the fact that the aerial nature of the spread is more evident now, especially when we realized that these droplets or aerosols were being vomited up by individuals who were minimally symptomatic or not at all symptomatic, but had the infection.
Masks were initially recommended to protect others from these droplets and aerosols that were generated by the wearer, but there is now also growing evidence that masks can actually help prevent the wearer from being exposed to infection. and may actually decrease the inoculum or the amount of virus that could be inhaled, thus leading to a less severe infection.
The droplets themselves are usually between 10 and 15 microns in diameter and are generated by people when they cough or sneeze. They usually drop to the ground quickly and represent the six-foot social distance measure that has been recommended from the start.
More importantly, aerosols, which are smaller than droplets (10 to 15 microns), are generated simply by speaking, breathing, smoking, singing, exercising and screaming. These particles tend not to fall to the ground very quickly and remain suspended in the air for hours depending on the surrounding ventilation. That’s why outdoor meetings carry a lower risk of spread. This mode of transmission has often been cited as the reason for some of the super spread epidemics that occur at functions such as weddings, parties and sporting events.
We have actually developed a research protocol for COVID-19, not specifically for masks, but we know that masks are being examined by researchers who ask us for funding.
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What is the importance of wearing masks to help control the spread of COVID-19?
Everyone should wear masks to reduce the spread of COVID-19 from infected and / or asymptomatic carriers and help protect the wearer from inhaling infectious droplets from others.
The masks are playing a much more important role in keeping the pandemic in check than was initially thought.
Can you describe the correct way to wear a mask?
Masks will work best if they cover the nose and mouth. When we breathe, talk or sneeze, these droplets come out of both the nose and mouth, so covering both of them helps prevent exposure to others from your droplets.
The same thing helps protect you. If you breathe in through your nose or mouth, if it’s not covered by the mask, it won’t be able to protect you. So, there are definitely places where people, because they feel more comfortable, won’t cover their nose and only cover their mouth. We recommend covering both of them.
The other important thing is to try to fit it perfectly to the face, especially through the bridge of the nose. Many of these masks have a little more stiffness or sometimes even a metal bar on the bridge to fit the mask more securely. But many patients have to balance the snug fit with the comfort of breathing through a mask, and this mainly goes to many of the patients I see who already have underlying chronic diseases.
These individuals can get by well for 10-15 minutes at a time, but the longer they have to be in a mask, they feel like their breathing is too labored. So, they have to take a break, get away from the areas where they have to wear the mask for long periods of time, but covering their nose and mouth is especially important.
What other security protocols should people follow to limit the spread of COVID-19?
We certainly do not want to forget the importance of frequent hand washing with soap and water, or at least the use of alcoholic disinfectants with a solution of at least 60%. Wear a mask we’ve already talked about, especially outside the home, and practice social distancing measures as much as possible. Avoid being around sick people as much as possible, and try not to enter workplaces if you feel bad because you may actually be exposing others.
Another recommendation is to simply avoid crowds, especially indoors where we know ventilation may not be optimal, especially for long periods of time. We want to make sure that you avoid places where wearing the mask is not practiced by everyone.
Be truly aware of your surroundings and institute all those measures of hand washing, social distancing and wearing the mask.
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How will the coming winter months affect the severity of COVID-19 and what could people do to reduce their chances of spreading this virus?
The colder months will likely drive activities that could have been handled outdoors indoors where there is less than optimal ventilation, and this will be an issue regarding increased spread. The same recommendations apply here as mentioned above, but we also know that the winter months bring with them some holidays that are certainly covered here in the US and around the world.
This will unfortunately attract people, who have likely lost many family members for months, possibly let their guard down and gather in homes where there are more people than there should be, where social distancing cannot take place and where ventilation can. not be optimal. I think we all realize that these winter months could very well be a worsening of the already present increase that is occurring around the world.
In your latest statement, you encouraged all children over 6 months of age to get vaccinated against the flu. Why is this?
In the United States, it has been recommended for a period of time now that the Center for Disease Control believes immunization best practices include anyone over the age of six months receiving the vaccine.
The more individuals we immunize against seasonal flu, the more herd immunity is achieved and outbreaks and hot spots where local epidemics can be prevented. This is particularly important this year in view of the coexisting COVID pandemic that may already extend the resources of the healthcare community.
We are also emphasizing the importance of the flu vaccine for the elderly and those with concomitant illnesses because we know they are at increased risk of developing flu complications.
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Do you believe that if everyone followed the guidelines correctly, we could potentially reduce the number of people catching COVID-19?
Yes, and I believe this is supported by past experience with other infectious diseases and pandemics. Even last year alone, with the establishment of social distancing measures in the Southern Hemisphere, there has been a decline in the flu rate.
Influenza, just like COVID, is a disease transmitted from person to person via airborne transmission, and if we can follow measures like this, it should decrease the spread of the COVID-19 virus.
What are the next steps in your research on masks and COVID-19?
As part of our COVID-19 action initiative launched earlier this spring, we have already funded new COVID researchers in the areas of immune response, prevention, risk factors and therapies at a level of $ 3 million.
We are planning another funding round later this year. At the same time, we are using our other mission tools to educate the public and health care workers and to support state and federal legislation that will help eliminate many of the injustices in the social determinants of health that we have noted.
The COVID-19 pandemic has certainly shed light on the fact that communities of color and those who are socioeconomically disadvantaged suffer the most from this disease and we must do everything possible to pass legislation to help people have access to care across the country. world. table.
Where can readers find more information?
About Dr. Albert Rizzo
Dr. Albert A. Rizzo is the Chief Medical Officer for the American Lung Association and practices pulmonary / sleep medicine at the Christiana Care Health System in Newark, Delaware as a member of Christiana Care Pulmonary Associates.
He is certified in internal medicine, pulmonary, intensive care, and sleep medicine and is a clinical assistant professor of medicine at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia where he received his medical degree (1978) and completed his residency in Internal Medicine (1978-1981).
He received his specialist training at Georgetown University Hospital in Wash DC (1981-1983). He is a member of the American Thoracic Society, a member of the American College of Chest Physicians and of the American College of Physicians and of the American Association of Sleep Medicine, and a diplomat of the American Board of Sleep Medicine.
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