I began feeling sick on Sunday, May 31st. I felt better on Sunday, June 7th. According to the CDC, I can be around others (including those outside of my household) when I have 3 days with no fever AND symptoms improved AND 10 days since symptoms first appeared, regardless of the date of my positive test. That means that on Wednesday, June 10th I was free to be around others per the CDC.
Guess what? I started feeling bad again on Thursday, June 11th. Would you have wanted to be around me? Let me answer that for you. No. Do I think this guidance is smart and applies to all? No. But this is the current guidance AND it’s what the Alabama Department of Public Health (ADPH or “the Health Department”) advises when they call you after you’ve tested positive.
I don’t fault the CDC or the ADPH. It’s the best information that we have right now. I have talked to doctor after doctor and had long conversations about this and right now, we have to work with what we know. This is the best guidance that’s being given.
Now that you know that, let’s pretend for a moment that it wasn’t in my nature to question all things scientifically. Let’s pretend that I didn’t have a moral compass and want to do the right thing. What if I followed these instructions and felt comfortable to leave my house on Wednesday, June 10th and I decided to run to the store for milk and bread? In the short time between my blessing of freedom using the CDC and ADPH guidance, I could have infected others until the following day when my symptoms returned.
Let’s look at another scenario. Using that same guidance, for asymptomatic patients such as my son, the CDC says that he’s good to go 10 days after the first positive test as long as he doesn’t show symptoms. My son was retested on day 9 and on day 13. Guess what? He’s still positive. Again, what if I didn’t question everything scientifically? What if I was missing a moral compass? What if I let him go to a park and play with other kids? What if I let him start youth sports in June as we had planned? By the way, I don’t have to tell you that any of us tested positive. There is no legal requirement that I identify my family during contact tracing. But I did and I am. And we did not allow my son do any of those things.
Obviously I’m doing what the ADPH has already told me is “above and beyond” and I will continue to do that. You will not see my family out and about until I’m 100 percent comfortable that there’s no risk to others. That is my promise to you and to my family. That decision will be made with extensive consultation with my doctor, another advising physician, and an antibody test that will show that my body is producing the antibodies which would indicate I am no longer spreading live virus.
But ya’ll, there are people who will follow this guidance to a tee – remember, it’s the best we’ve got – and they can STILL be infectious and STILL be out in public…with you at the grocery store…with you at sporting events or the gym…with you in a restaurant…with you at the park. Let that sink in.
Now that you know this information, let’s talk for a moment about risk mitigation. This is something I know a little bit about professionally (if you need my credentials or references supporting this claim, I’m happy to provide upon request). Let me walk you through this like I would at work.
Hazard: Coronavirus spread
Risks: Illness to self or others, ranging from asymptomatic to mild/moderate to severe to include fatality
Risk acceptance: This one is up to you. Are you willing to accept illness or death? For my family, we are not willing to accept high risk. Our risk acceptance is low. We want to lower the risk as much as possible. How do you lower the risk? Through risk mitigation (see below).
Risk Mitigation: Let’s talk for a moment about the National Institute of Occupational Safety and Health (NIOSH) Hierarchy of Controls (the photo attached to this post was published by the CDC, reference: https://www.cdc.gov/niosh/topics/hierarchy/default.html). This pyramid is gospel to any environmental or safety professional. I use it every day at work and to the groans of my family, I bring it home and use it here. I am CONSTANTLY mitigating risk in my head.
In the control pyramid, the top level is the best defense you can take to minimize risk. The bottom is the risk mitigation effort that you should be taking at minimum to reduce risk. So let’s walk through this scientifically:
Most effective: Elimination of the hazard (the virus). We know this isn’t going to happen any time soon.
Second most effective: Substitution or replacement of the hazard (the virus). This will happen when a vaccine is available. Again, we know that we are still many months out from this.
Third most effective: Engineering controls or isolating people from the hazard (the virus). We did this during “lockdown” or “shutdown.” It absolutely wrecked our economy and has adversely affected so many people’s lives. Sure it offered some protection from the virus, but it came with a very high price. Let’s move along from this.
Fourth most effective: Administrative controls or changing the way people work. Society is currently doing this. Business capacities are being limited and Plexiglas shields are up to protect cashiers. No contact delivery and curbside options are available. More people are working from home and we are social distancing. Most of these controls, however, are out of YOUR immediate control. You hope that businesses are complying and you hope they have your best interest at heart, but you cannot directly control all of these factors.
Fifth most effective: PPE including mask or fabric facial coverings. Unless you are willing to isolate yourself completely until the virus is either eradicated or an effective vaccine is found, this is the only risk mitigation effort that you have direct control over. And it’s one that requires the least effort by you.
By the way, if you do nothing, you are assuming the HIGHEST level of risk with the virus. Are you willing to accept this risk on behalf of your family? Seriously, look into their eyes and tell them you are willing to risk their life by not using any of these controls. I cannot do that (and I’m betting you can’t either).
Now, some of you are viewing this as, “Why should I wear a mask (PPE) if it’s the least effective measure I can take?” I’ll tell you why. Go back up to the top/beginning of this post and read the paragraphs about when the health department cleared me to be around other people. You can’t control what I do, but you can control how you protect yourself. I would personally rather do something than nothing.
If I were to write out a risk assessment on this scenario like I do at work, I would assign numerical values to the hazards and risks that quantify likelihood of occurrence, number of affected people, and severity of effects. Those numbers would be incredibly high with the use of no mitigation controls. But with the addition of PPE (i.e. wearing a mask) I could reduce those numbers significantly, if not dramatically.
It’s really this simple: please wear your mask. It’s the one thing you can control to protect yourself and protect others. It takes minimal effort. It is not political, so please do not make it that way.
I read a social media post from someone I knew from high school that said, “Only snowflake democrats wear masks.” Well, I assure you that I am no snowflake. I’m fighting very hard to win a war against a terrible virus that has infected my family. And you have no clue with which party I identify. If you think you know, you’d probably be surprised to learn what I actually believe. But politics have no place in what I’m telling you.
I’m asking you to wear a mask because you are STRONG and you’re not a snowflake. I’m asking you to wear a mask because it’s the RIGHT thing to do to protect others REGARDLESS of with which party you identify.
At the end of the day, it’s up to you to determine your level of risk acceptance. And what’s right for you may not be right for me. But read those paragraphs about the ADPH and CDC guidance again. Do you want me to do the lowest standard of what is considered right? Or do you want me to adhere to a higher standard and do what I know to be truly right? I’m going to err on the side of caution for YOUR safety. That includes the safety of the jerk who wrote the snowflake post. I hope that you will have the same respect for me and my family.
Much love to you all and stay safe! Thank you for all the love and prayers and support you have shown my family.