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CDC and the Great Face Mask Dithering

The Carlat Psychiatry Blog, Volume , Number ,
https://www.thecarlatreport.com///

Daniel Carlat, MD

This morning, my COVID news feed is filled with articles about how CDC is considering recommending that everybody wear face masks (eg., “C.D.C. Weighs Advising Everyone to Wear a Mask,” New York Times.) It’s about time. 

We’ve known that those countries that have required universal masking (like China, South Korea, and Singapore) have been the most successful at limiting the scope of the pandemic. The director general of the Chinese CDC, Dr. George Gao (also a top COVID researcher) was recently asked in an interview why the U.S. and Europe have not been able to stem the COVID tide. His answer: “The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks … Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.” 

Now, CDC officials are trying to save face by claiming that there is “new data” showing that many COVID positive people are asymptomatic. But the data’s not new: CDC has known about asymptomatic transmission of COVID for several weeks. On March 6, Chinese researchers reported that up to 59% of COVID positive patients in Wuhan were either asymptomatic or mildly symptomatic. Also on March 6, researchers reported that an analysis of the Princess Cruise ship, a large cruise ship that had been quarantined from Feb 5 – 21, showed that of the 634 people infected, close to 20% had been asymptomatic. 

CDC either ignored such data or dithered over what to do about it. They continue, to this day, to publish recommendations on their website that are at best confusing and at worst simply wrong. For example, “You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.” (Source). Actually, given the high rate of asymptomatic shedding, you need to do everything you can to protect yourself against seemingly healthy people—social distancing, hand washing, and yes, wearing a facemask.  

For health care personnel, CDC continues to recommend use of surgical masks only in limited circumstances: “A surgical mask or fit-tested respirator should be worn by healthcare personnel who are within 6 feet of a suspected or laboratory-confirmed influenza patient” (Source). Actually, surgical masks should be worn by all health care providers in all health care contexts in order to reduce their chances of both infecting others or becoming infected. Our major academic teaching hospitals, such as Mass General Hospital, UCSF, University of Michigan and others, are simply ignoring CDC guidelines and are now requiring all staff to wear face masks—including administrative and custodial staff. 

As CDC officials have meetings, exercise caution, wait for more data, and delay decisions, people are dying. Even a week or two of delay in starting preventive measures can lead to catastrophe. For example, in New Rochelle, a single attorney “super spreader” infected at least 100 other people in 10 days.

So mask up, my friends. Please don’t go into any public place, such as grocery stores, pharmacies, or your workplace, without one. It doesn’t matter if you feel embarrassed, or get strange looks from others. None of us can afford to wait to protect ourselves and others in our community. And we definitely can’t wait until the CDC has made up its mind, because that may never happen. 


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