Wednesday, August 5, 2020

Masking Morality 101

August, 4, 2020 BEAUMONT, Texas — A Southeast Texas doctor is talking about his recovery from COVID-19, and says he never expected to get it. 

Dr. Ray Callas says on July 27, he had symptoms he'd never felt before.

"I couldn't bend down to tie my shoes. All my muscles and my bones ached and that's never happened before," Callas said.

He tested positive for the coronavirus. 

"My temperature was normal but I had some of the worst chills you could possibly imagine," Callas said. 

He doesn't know where he got it.

"I wore a mask everywhere I went. I used hand sanitizer everywhere I went," Callas said. 

He wants to share his story, letting others know what to do if they test positive.

"They need go get treated right away," Callas said. 

Dr. Callas acknowledges there's no known treatment for COVID-19.

"I also took hydroxychloroquine, and that's very controversial. I just felt personally that I needed to throw the kitchen sink at it," Callas said. 

According to the FDA, doctors can make their own decisions about hydroxychloroquine. 

Dr. Callas also took an antibiotic cocktail that included Albuterol, vitamin C and zinc.

He believes the medications helped him recover.

"It gets rough very quickly and a couple of times last week I was concerned about going to the ER. The shortness of breath is very scary and you just letting it sit in your body, and you think it is going to go away is not the right away to approach," Callas said. 

The story brings up a point that has concerned me from the beginning of the restrictions: the effectiveness of the measures in preventing the spread of the virus to any given individual. If an individual has known comorbidity, the morality of the risk of exposure becomes subject to more scrutiny. Prudence in such circumstances requires a close examination of the true efficacy of the personal equipment one is using, not only for the protection of others, but for the protection of oneself, primarily. This is simply a very basic application of the principles of morality. One cannot knowingly expose oneself to the threat of deadly disease without a sufficient reason. This is a perplexing moral issue because there has been so much confusion coming from so-called experts. Indeed, from a moral point of view, some things we have heard have been wrong and accepting of the ignorance of the people to whom this is directed. This method of operation is not the stuff of moral action. Indeed, duress, ignorance, and fear all reduce the moral quality of an act. My impression is that many people are still of the opinion that by wearing a mask they are protecting themselves. In fact, however, the scientific literature up to this point disputes that point. There are different types of masks and the masks that we don are allegedly more effective at preventing the spread of the disease agent from the wearer to others than they are at preventing the wearer from becoming infected. According to the Mayo Clinic surgical masks and cloth masks "may" protect others by reducing exposure to the mask wearer's secretions. This is why it is often asserted that wearing a mask is an act of kindness or charity because by doing so one is preventing another person from being exposed to the virus. Of course, the mask may mean nothing at all as a disease preventative. Wearing a cloth mask only has a real pragmatic effect, to whatever degree, if the wearer is carrying the disease and is capable of spreading it. Moreover, there are many other factors that would suggest that one with comorbidity must exercise great caution. There are reasons that most of us are not permitted to visit our relatives in the hospital who have COVID-19. For those of us who are permitted to go in to a patient's room, the type of equipment is very specific. It is designed to prevent the wearer from contracting the disease and it is far more extensive than a mere mask. This is certainly our experience as priests. I would suggest that everyone in healthcare knows this. No professional would send one of us into a COVID patient's room with a homemade cloth mask.

Under the circumstances, the mask mandate gives concrete expression to two assumptions, one that is somewhat well-suited to the purpose while the other is a social control measure. The first assumption is that wearing a mask lessens the chance of expelling the contagion though the nose or mouth. This is a morally acceptable position though the degree to which such is effective is far from clear. The best the Mayo Clinic seems to muster here is by suggesting that it "may" be effective. The second assumption is that the only way to control the spread is to assume that everyone is contagious and should, on that basis, be required to wear the cloth mask. As I have said before, that is a social policy determination. It is not a medical or scientific conclusion. The degree to which a society should enforce the action based upon that assumption is a matter for public debate. There could be other factors that mitigate against it. This is the reason that there are health exemptions from the mandate. Without better scientific evidence, we simply trust the one with the authority to make such mandates. And while we might, for a time, concede that such authority exists, we still do not know why a particular individual should or should not be forced by political authority to wear a mask. Or, to put it another way, we do not know why it would be more dangerous for one individual to be permitted an exemption than to risk spreading the disease. How, exactly, is that calculation made? Does anyone know? Of course, not. It is a public policy estimation at this point.

We do not know the degree to which the social whole is protected by the universal wearing of cloth masks. We think it will help. As the experts say, it "may." The degree that it alleviates the spread of the contagion is completely unknown. 

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