Copyright © 2020 Albuquerque Journal
Welcome to the slow return to normalcy – pandemic-style.
And the new norm as of this weekend is all about covering your face in public places, state officials say.
If enough people do it, up to 1,800 people who might otherwise die of coronavirus infections over the next year may be saved, a top state official said. If New Mexicans don’t mask up, Gov. Michelle Lujan Grisham warns, the state will likely stumble on the road to a full reopening of its economy.
As of Saturday, the state had recorded 259 coronavirus-related deaths, the majority in senior care facilities and in northwestern New Mexico.
Beginning this weekend, there is a partial reopening of businesses that have been closed for weeks by the COVID-19 crisis. In the coming weeks, if people wear masks, more “high-risk” activity – such as dining in restaurants – could get the green light, the governor said last week.
But there’s a trade-off that could last until a vaccine is developed: a state mandate to keep your nose and mouth covered in public settings, except for eating, drinking, exercising and if a health provider advises otherwise.
“These are not political statements,” the governor said Friday of mask wearing. “I know it’s not popular in a way I wish it was.” Yet since the state offered to furnish masks to the public, about 8,000 requests have been received online at the state’s COVID-19 website, she said.
The state recommends masks for children ages 3 and older. New Mexicans aren’t expected to wear them in their cars, but masks are required in the workplace, along with social distancing, said Dr. David Scrase, secretary of the state Human Services Department.
“We know there’s some protective benefits. There’s evidence that wearing a mask can protect other people from you and from spreading the disease,” said Scrase, a top COVID-19 adviser to Lujan Grisham. “This is a very, very serious virus and a very infectious virus, and anything we can do (to prevent transmission) is probably worth the inconvenience.”
Critics question the timing and effectiveness of the order. The also question whether the mask mandate can be enforced.
New Mexico Republican Party Chairman Steve Pearce told the Journal that elsewhere around the country, requirements for face coverings in public “have been meeting a lot of resistance. ”
“That is just a foreshadowing of, I think, what you’re going to find in the state of New Mexico.” Moreover, he said, since the outbreak began, there have been mixed messages as to whether the public should wear masks.
“But this evolution,” he said, “people see through that and they say, ‘Wait, if it was unsafe to be outside without a mask, what have we been doing for the last six weeks? Why did they wait until now to tell us?’ ”
New Mexico has joined 38 other states, including Michigan and Hawaii, and entities such as Los Angeles County, that have issued mask mandates. Other countries have imposed mandates, and in Japan, the government is issuing masks to 50 million households.
After weeks of calling for only voluntary face coverings, Lujan Grisham announced the new public health order requiring the wearing of face coverings last week in conjunction with a gradual reopening of nonessential business.
She also announced an online competition, a takeoff on NCAA March Madness, called “Mask Madness” for the best homemade mask. Photos of face masks can be submitted at http:cv.nmhealth.org/mask-madness.
The governor said the masks are an extra precaution to slow the virus spread now that New Mexicans will likely be moving around more to go to reopened retail stores, parks and churches. The openings are limited to 25% of capacity, for the most part.
“If you want businesses to stay open, then you have to have face masks,” she said. “Because if I can’t get folks to do this, that’s the enforcement tool, then we can’t stay open, I can’t mitigate, I can’t stay the long course.”
A contemplated reopening in the coming weeks of “higher-risk” businesses, such as those with dine-in service where people congregate and social distancing is difficult, also would rely on people wearing masks, she said.
“So I need everyone to do it,” she said.
Scrase said: “Ultimately, your mask mainly protects other people from you, not you from other people.”
White House cases
Nationally, the White House held off requiring masks of staff until two employees tested positive for the virus last week. And Dr. Anthony Fauci, the nation’s leading infectious disease expert, is now recommending that people wear masks in public after telling the “60 Minutes” news show at the onset of the virus outbreak in March that there was no need to wear a face covering if you were healthy.
The U.S. Centers for Disease Control and Prevention now recommends wearing basic cloth masks in public.
“This is very different than what I said last week,” Lujan Grisham said in announcing the public health order requiring coverings on Wednesday. “I was really concerned about enforcement. I still am.”
She said the idea of citing violators is a waste of precious first responder time. Businesses won’t be expected to enforce the order when unmasked patrons enter the premises, but they can if they choose to do so.
The means of enforcement will be “positive peer pressure,” because, she said, fines and other legal action don’t seem to have worked elsewhere. She said she is counting on business and elected leaders in New Mexico to wear masks and become role models for the rest of the state.
“I implore New Mexicans to wear these face coverings, and it is foreign, and I will tell you that it feels awkward, and it’s difficult to speak with these on. It’s hard to hear.”
“But every day I wear it is an easier day, and the more we do this, the better prepared we are not to have to go backwards. We must live in a COVID-safe world pending a vaccine, and these are an incredible tool to that end.”
There’s not a lot of data on the effectiveness of wearing cloth face protections or masks to keep infections down, Scrase said.
“Part of the problem is the lack of scientific evidence about masks because really the issue only comes up in a pandemic, right? There’s no reason to think about what the effectiveness is of everyone wearing masks unless you’re in a situation where you’re trying to do something about a fairly desperate medical situation.”
But he points to two new studies backing the value of facial coverings in a respiratory pandemic:
• A study released May 1 in India showed masks were reported to be more effective in viruses that transmit easily from asymptomatic people. A significant percentage of COVID-19 cases are in asymptomatic people. There’s a significant benefit in preventing the spread of respiratory viruses, “but its utility is limited by inconsistent adherence to mask usage,” the study concluded.
• A mathematical assessment by a team of scientists from schools that included Arizona State University, Harvard Medical School, and the University of New South Wales concluded that 80% adoption of moderately effective masks could prevent 17% to 45% of projected deaths over two months in New York, while decreasing the peak daily death rate by 34% to 58%, absent other changes in pandemic dynamics.
In Washington state, 80% adoption could reduce mortality by 24% to 65%, the study said. The communitywide benefits are likely to be greatest when face masks are used along with other practices, such as social distancing, and when compliance is high.
Based on that modeling data, Scrase said New Mexico hypothetically could cut its projected 4,000 or so COVID-19 fatalities over the next 12 months by 1,800.
“But,” Scrase said, “even with people wearing masks, we will see more cases, and more hospitalizations. There’s just no question.”
Yet a 2010 study cited in a Journal guest column found that many fabric materials that could be used for masks were unlikely to be effective protection against virus-size aerosol particles.
“In sum, very poor filter and fit performance of cloth masks and very low effectiveness for cloth masks in health care settings led us to conclude that cloth masks offer no protection for health care workers inhaling infectious particles near an infected or confirmed patient,” wrote Dr. Lawrence Gernon, an attending physician at the Raymond G. Murphy VA Medical Center, emergency medicine department.
Scrase said he doesn’t believe the study applies to the general public because – unlike health care workers – most New Mexicans aren’t being exposed to the virus daily at work.
Health care workers also wear surgical masks and other medical protection to keep from contracting the disease.
But masks have to be worn correctly over the nose and mouth.
“I think we’re going to have to do a lot of public education on how to make a mask. It’s going to take instruction. It’s going to need a lot of role modeling from leaders,” Scrase said last week. “Our journey to whatever the maximum reopening can be while we’re waiting for a vaccine, whatever that journey is, it will take a lot longer and there will be a lot more detours if people don’t wear masks and don’t maintain six foot distancing.
“Every case can be the start of a new local epidemic,” he added. “One person can create over time over 1,000 cases potentially. I think we’re talking about interventions that will last until we have the vaccine.”