COMMENTARY

How Medicine Is Clearing Up Mixed Messages on Masks

Hansa Bhargava, MD, and Vineet Arora, MD

Disclosures

July 08, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

As health professionals, we will readily admit that there has been widespread confusion among the public about whether or not they should wear a mask to help stop the COVID-19 pandemic. 

Some of this confusion is due to a variety of forces at play early in the pandemic. First and foremost, we were worried about any hoarding that could result in shortages of critical personal protective equipment, and in particular N95 and surgical masks, that we so desperately needed to care for patients with COVID-19. In some cities, the ICUs and EDs were overwhelmed and it was essential for frontline workers to be adequately protected. 

Another reason we hesitated to tell the public to universally wear masks at the start of the pandemic was that data on the benefits of universal masking were still murky. Our public health leaders, including the Centers for Disease Control and Prevention and Anthony Fauci, MD, head of the White House Coronavirus Taskforce, said the public did not need to be masked, in part because they thought the rate of circulating virus was not high. Back in March, Surgeon General Jerome Adams, tweeted, "STOP BUYING MASKS!"

https://twitter.com/Surgeon_General/status/1233725785283932160

However, that has all changed. The data are clear now. 

We have considerable evidence that universal masking mandates with cloth masks or face coverings can reduce the spread of COVID-19. For example, studies show that talking releases hundreds of droplets into the air and a mask creates a barrier to help prevent those droplets from infecting others. Moreover, we also know that people can spread COVID-19 even before they have symptoms. This makes "source control", or reducing the spread by potentially infected persons before they know they are sick, critical. 

Now the challenge becomes: How best to communicate the importance of masking to the public? And how do we as medical professionals advocate this recommendation after the early mixed messaging? Fortunately, medical professionals on social media are rising to the occasion to help get the right information out. Using the might of "Med Twitter," doctors, nurses, and other healthcare professionals were able to influence over 45 subspecialty societies over the last month. 

Initially, gastroenterologist Amy Oxentenko, MD, a prominent social media influencer, encouraged GI society leaders over Twitter to advocate for masking.

https://twitter.com/AmyOxentenkoMD/status/1277582483882565632

 

Four of the societies quickly responded with a statement endorsing masking. This started a domino effect. 

https://twitter.com/MarkPochapin/status/1279459321634529282

Shortly thereafter, Shikha Jain, MD, a cofounder of the advocacy organization IMPACT and founder of the Women in Medicine Summit, helped sponsor a petition that has over 4000 signatures calling for a federal mask mandate. As this conversation gathered steam through retweets, likes, and comments, Helen Burstin, MD, chief executive officer of the Council of Medical Subspecialty Societies (CMSS), took notice. She tweeted out that she would look into this issue with the leaders of the 45 medical subspecialty societies representing 800,000 doctors. The following day, she shared CMSS's unequivocal statement advocating for the need to respect science and implement a national mandate for universal masking.  

https://twitter.com/HelenBurstin/status/1278702274081161216

Other healthcare professionals are also doing their part. Robin Cogan, a leader in nursing education and a "#NurseTwitter influencer", tweeted that she had contacted the executive director and president of the National Association of School Nurses and the American Public Health Association-Public Health Nursing to endorse wearing masks or face coverings. 

https://twitter.com/RobinCogan/status/1277580512564072449

And earlier this week, three powerful healthcare organizations followed suit supporting masks. The American Medical Association, the American Hospital Association, and the American Nurses Association released an open letter to the public strongly encouraging the use of cloth masks. 

https://twitter.com/FutureDocs/status/1280159897750048772

We are pleased that the medical, nursing, and public health communities are now a united chorus advocating for the adoption of universal masking. When urgent public health issues such as this must be elevated, doctors, nurses, and other healthcare professionals have stepped up on social media to advocate, to lead, and to present a unified message that masks work and can help make a difference.

We are letting the public know that the science is clear. Experts are communicating this with a single (if masked) voice. Now more than ever health professional voices do matter, especially in the noisy, crowded coronavirus conversation taking place on social media. 

Hansa Bhargava, MD, is a senior medical director at WebMD and Medscape. Follow her on Twitter here. Vineet Arora, MD, MAPP, is an academic hospitalist at the University of Chicago Medicine. Follow her on Twitter here.

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