The rheumatologist, the third inning of COVID-19 and the importance of masks
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It’s summertime but the living ain’t easy. I have to share my reflections with you that after a sprinting start and glimpse of flattening the curve, we are still in the third inning of this astral baseball game of COVID-19. And right now, the home team isn’t winning.
It feels like any hope for a quick fix is gone, with half the country surging and no leadership (among elected officials) in sight. We are now confronting the reality that we have no policy that makes sense, and we are witnessing an inchoate anger surrounding how we should be conducting ourselves as we waddle through this pandemic.
I am sorry to be such a downer, but a recent appraisal of social happiness from a social media study conducted in the beginning of June described the 2 weeks surrounding the study as the 2 saddest weeks ever recorded. I believe the reality has hit that this pandemic — which the President of the United States makes fun of — is not going away and we need to come to peace with how we will both think about it and conduct ourselves. While we are all citizens, I want to focus on our roles as physicians and advanced practitioners to both support and influence our patients as they struggle to respond, as well.
Being an optimist by nature, this is particularly challenging and I want to say that I am optimistic that biomedical research is gaining ground in bunt singles and some soft line drives, but no extra bases or homeruns for now. I am happy about the success of dexamethasone (number needed to treat to save a life in ventilated patients = 8) and happy to put hydroxychloroquine back in our rheumatology patients’ pill bottles. I am even more optimistic about the potential for an early vaccine that may reduce morbidity and even prevent infections. I guess what I am most bummed about is the behavior of our community as we attempt to ‘re-enter’ a more normal life. I am talking about masks here.
Regardless of the imperfect science surrounding masks, there is no doubt they can be effective to a palpable degree. If you want to argue data, just email me at calabrl@ccf.org or message me through Twitter at @LCalabreseDO. There is also no doubt that there is no harm to wearing a mask except to the machismo of some, who I guess want to live free or die. Being a libertarian of sorts, this could sit with me OK if it were not for the fact that not wearing a mask is more about me than you. Without a mask you are putting me at increased risk from asymptomatic/paucisymptomatic spread — therefore, please wear a mask if you care about me (ie, the royal me or everyone). When I see the President and Vice President not wearing masks, encouraging mass gatherings without masks and making jokes about the pandemic, I am heartbroken and saddened.
So, what is a rheumatologist to do? First, wear a mask (as I know you are doing). Second, talk to your patients and their families about wearing masks in the same way we should be discussing vaccines. In our Rheumatology-Infectious Disease Clinic at the Cleveland Clinic, Cassandra Calabrese, DO, is the marshal on vaccine best practices, and our DNP partner, Betsy Kirchner, CNP, who did her doctoral work on vaccine utilization, are two people you don’t want to mess with over whether or not to be vaccinated.
In the vaccine space, we explain not only the facts, but also appeal to our patients’ (and their families’) humanity as they are protecting the lesser for the common good no matter how brave they want to be. The same goes for masks: wearing one shows you care about the ‘we’ more than the ‘me’. Wearing a mask shows empathy and humanity.
I saw a recent news clip of citizens lunging at city commissioners after they passed a mask mandate. They were screaming their civil rights were being violated — heartbreaking, indeed. I will close by telling you that these days I sometimes lose my Zen more than I would like. I want to appeal to our patients’ and their families’ humanity, but a voice inside me keeps saying: Don’t like the way a mask feels? Then try a ventilator. Namaste.
- For more information:
- Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.
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