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13 It’s Up to Us
Francis V. Chisari, M.D. | Crest Road

I write this in support of the City Council’s recent decision to enforce the wearing of masks in public. Is it perfect? No. Are opposing arguments understandable? Yes. Is it necessary? Absolutely. Why? Because with it we can defeat this virus in a matter of months, even without a vaccine, if we all follow the rules to wear masks, practice social distancing, and avoid crowded spaces, especially indoors. But, to do so, all of us must do our part … yes, all of us, and we must do it uninterruptedly for a solid 3 to 4 months. Let me explain why this makes sense.
I’m a virologist. I’ve studied deadly virus infections for the past 50 years. If there is one thing all viruses have in common, it’s that they must spread from host to host in order to survive. Spread. That’s what viruses do. And this one will continue to spread unless everyone, yes everyone, does his or her part to shut it down. Unfortunately, given human nature, some of us will refuse. Viruses love that aspect of our species. They absolutely love it. They need it to survive.

So, how does the new coronavirus spread? Two ways. First, inside big water droplets that explode from your nose and mouth when you sneeze and cough, or that sputter out when you talk or sing. Second, inside tiny aerosol particles that gently puff out of your mouth like a cloud every time you exhale and hang in the air for a long time. The big droplets only travel a few feet before they fall harmlessly to the ground unless they hit you in the face first. The aerosols, however, drift along on air-currents like puffs of smoke that waft into the face of everyone in their path and start a new infection. Think of it like “second-hand cigarette smoke” that you can smell when you come into a room that was vacated by a smoker. You didn’t smoke that cigarette, but the carcinogens in that smoke can give you lung cancer. In this case, however, it’s “second-hand virus” you’re inhaling, and they can give you COVID-19.

But, if everyone follows the rules, after 3-4 months of following the rules the virus will have nowhere to go. The hitch is, we all have to follow the rules. If everyone does, we can defeat the virus. If some of us don’t, it will be with us for years, even if we have a vaccine.

Why won’t a vaccine be enough? One reason is that not everyone will agree to be vaccinated. Another is because there’s likely to be a segment of the population that, for genetic reasons, will not mount a protective immune response to the vaccine. Another is because we don’t know how long immune protection will last after vaccination. So, while a vaccine will be hugely beneficial for those who mount a protective response, it won’t protect everyone, and the virus will continue to spread in the unprotected population and be with us forever.

So, with or without a vaccine, we will need to wear masks, practice social distancing, and stay out of bars, restaurants, theaters, house parties, work, school, etc, to eradicate this virus. The bad news of course is this is devastating for us personally and for our economy. The good news is we can wipe out the infection right now, even without a vaccine, if all of us follow the rules. I know, I’m repeating myself, but that’s the message. That’s how we win this battle.

Why 3 to 4 months? That’s how long it takes for the virus to run its course in already infected patients and spread to new, susceptible, hosts so it can survive. If those new hosts are protected and protecting each other by wearing masks, social distancing, avoiding crowdes, especially indoors, there’s no place for the virus to go. Also,that’s how long it took to control the virus and allow economies to open in China, South Korea, New Zealand, Italy, and elsewhere. If they can do it there, we can do it here. But, it will be hard. And in today’s world, if something requires self-discipline, sacrifice and hard work, it also requires enforcement. That’s what our City Council’s enforcement decision is meant to do.



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