Progress for tomorrow: Preparing for the next disaster
HEALY: And what about masks? That's a hot issue this week. I know HHS just asked the Institute of Medicine whether or not masks could be reusable, if they were good for longer than eight hours – the N95 masks that people wear and the ones that became famous in Canada and in Toronto. And we saw pictures of people wearing even designer masks that had N95 capability. What do you think about masks? Should people have them in their back pocket or in their office or at home?
INGLESBY: It's a complicated question –
HEALY: I'm being very practical here, in the trenches.
INGLESBY: Practically speaking.
HEALY: Do you have a mask at home?
INGLESBY: No, we don't have masks at home, and I think for a pandemic, the problem is that you would – for it to be useful or sensible to have masks, you'd have to be wearing – if you were just going to put on a mask and hope that it would prevent spread, you'd have to wear a mask for prolonged periods of time. A lot of the masks that are out there we don't think would do anything to prevent the spread. It would have to be particularly fit, tested masks, which takes some time, has to fit well on your face.
It makes complete sense and it would be irresponsible not to have those for healthcare workers in hospitals. They have to have them. But for everyone to walk around for months wearing masks in a community - first of all, the mask-makers in the world –
HEALY: Well, I don't think we're saying that.
INGLESBY: They don't have them. We don't have those kinds of -
HEALY: But I think we have to focus it.
INGLESBY: Like for a day or two –
HEALY: I mean, you know, on the other side of Washington we just heard that, you know, someone has come down with a transmissible form of H5N1. I mean, think about what Dr. Low said on our second panel. What did he say? It was barrier that made a difference.
INGLESBY: In the hospital, but community-wide use of masks, I think there's a lot of debate about whether it's been proven to be useful anywhere. I think some people –
HEALY: Although people were wearing them on the trains and – what do you think, Dr. Kellermann?
KELLERMAN: I think that, as was said earlier, anything that can slow down virus spread may be of some use. But it's interesting you brought up the issue of Toronto. One of the key sparks that started the SARS epidemic was a second index case - came into an emergency department that was crowded, spent the night with a patient parked on their right, a patient parked on their left and staff moving in between, with what was thought to be community-acquired pneumonia. They infected both patients, who subsequently died, multiple members of the medical staff, and sparked that epidemic.
So masks matter, but so does having a healthcare system that can take people in the door, get them into isolation, handle the most sick appropriately, and provide effective care, and we don't have that level of resources today.
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