Yes, Mr. President, health care workers actually need all those masks

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By Barbara M. Ostfeld

"Before you judge someone," goes the idiom, "walk a mile in his shoes." With that in mind, I urge President Trump to don a mask, if he can find one, and spend a day shadowing physicians, nurses and other healthcare providers in a hospital overrun with COVID-19 cases.

Word has it he is a germaphobe. But wouldn't we all be these days -- if given the choice? Unfortunately, anyone involved in healthcare today does not have that luxury.

At a White House news conference last weekend, the president invited leaders of industry to report on how their businesses were ramping up production and delivery of protective equipment, such as masks. However, before any comfort could be felt, he expressed disbelief that so many masks are actually needed and urged reporters to investigate the matter. Were health care workers who are risking their lives daily and witnessing their colleagues fall ill and, in mounting numbers, die, now having their character attacked as well? And by the president? One wonders what exactly he thinks people were doing with the masks, if not the obvious.

So, let’s look at the obvious. Were he to visit a hospital facing the unrelenting surge of cases, he would find that masks and other protective equipment are all that stand between healthcare providers and the invisible and formidable enemy, COVID-19. Remove them at your own peril. And peril to the healthcare worker means peril to the patients in need of their care. Without adequate testing, it is impossible to know who is carrying the virus. So, protective equipment is necessary at all times. And that equipment must be changed constantly as one moves from patient to patient, lest it becomes a source of spread. Even with them, safety is a fragile concept.

Dramatic changes to hospital protocols further reflect the lengths our healthcare systems are going to in order to protect patients, especially since those promised tests are not yet readily available to identify silent carriers, and personal protective equipment is in such short supply. As he walks through hospital halls, the president is likely to find that pediatric units no longer permit unrestricted family visitation.

Intensive care nurseries, where preterm infants may stay for weeks, cannot safely accommodate unrestricted parental involvement. These necessary changes are returning us to policies so many of us worked hard to put to rest some 50 years ago of separating families from patients at their most vulnerable time. We do not yet have the bandwidth to contemplate or deal with the emotional aftermath of this pandemic on all of us. That time will come.

On his hospital visit, the president would see health care providers stand in close proximity to very sick patients. Social distancing is not possible when you are administering care or when you are holding the hand of a dying patient. He might gain a deeper appreciation for the role that masks and other protective equipment play in protecting health care providers and for the incredible frequency with which they must be changed. Any suggestion that masks are a frivolous request would fall away against the reality of what life is like in hospitals these days.

He might even find that what seemed like an overly large request was actually modest given the power of the enemy. Spend a little while in any health care facility today and you may begin to feel naked without one.

It has been said that play is the work of childhood. Children re-enact what they experience as a tool for learning about their world and learning to exercise some control over it. As we watch them, we get a better sense of what they are feeling. COVID-19 has now entered the arena of play. Children are putting masks on their dolls. For the dolls they assign to be physicians and nurses, they are fashioning protective gowns from paper napkins. They place them apart for social distancing.

Clearly, even young children understand that these steps are “protecting” their dolls from the virus that is keeping them in the house and away from friends. Would that at the federal level all who have control over our destinies understand this as well.

Barbara M. Ostfeld, Ph.D. is a professor in the Department of Pediatrics at Rutgers Robert Wood Johnson Medical School and program director of the SIDS Center of New Jersey.

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