While COVID-19 is busy finding the unvaccinated and the undervaccinated in order to keep spreading, we are left with COVID-19 infection and its sequelae being one more disease of social and physical marginalisation and of povertyAFTER masking up to pay for petrol last week, I waited for cyclists to pass, before joining traffic on a busy six-lane road. One of the peloton yelled at me as he sped past: “take your f***ing mask off!”
It shocks me: the vehemence with which people respond to masks, a simple measure to reduce the transmission of COVID-19. We have very clear evidence that masking is effective in reducing transmission. Professor Trish Greenhalgh, Professor of Primary Care at the University of Oxford, speaking on Twitter, delivered one of the best arguments for mask wearing as a strategy for reducing the transmission of COVID-19 I’ve seen. It’s a long thread, but full of gems, including research from the American Journal of Tropical Medicine and Hygiene, JAMA Network Open, a demolition of the “risk compensation” argument against wearing a mask, PLOS Medicine, and her own work in the BMJ and the Journal of Evaluation in Clinical Practice.
My colleagues mask all day at work, whether in the operating theatre, in the consultation room or in meetings. Yet, on the train home, I am often one of very few wearing a mask, let alone a high grade one. There have been 9.5 million (reported) cases of COVID-19 in Australia, yet we’ve had messaging such as the “smiles are back” campaign from the Queensland Premier.
In posting a response to interjectors in federal Parliament recently, Dr Monique Ryan noted that “We all have a duty to look after each other. Here and everywhere”. Yet the Prime Minister received his booster shot while not wearing a mask.
While none of this will be unfamiliar to many readers, many others see COVID-19 as no more of a threat than this winter’s next cold, while they see mask wearing as a deeply offensive infringement on their lives. So, what is this COVID-19 denial? Where does it come from? I find it completely bewildering. Perhaps part of the answer can be found in the way we talk about the pandemic. The public discourse seems to be “live with it”, “return to normal”, “Freedom Day”, “we can’t live like this forever”. The doctors I read and those I speak with are concerned but are often not sure what to do. I feel as if they are not used to the idea of being activists. The doctors who say COVID-19 is all over seem to be regarded by their colleagues as foolhardy, and yet, frustratingly, they continue to be courted by the mainstream media.
Dr Thomas Finch, a psychiatrist in the US, commented on Twitter on the public statement released by President Biden’s office that the President “will continue to carry out all of his duties fully” while COVID-19-positive, taking antiviral medication and isolating. He tweeted that this represented:
“ … a complex organizing belief system about what it means to be strong and virtuous and that we must adopt a certain attitude toward a pathogen … To survive despite COVID is more virtuous than to avoid COVID. … To work when sick, to ‘live with a disease’. Rather than to rest, or to eliminate a disease.”This is the first time I have some sort of hold on this thinking. It is an echo of long-touted employment policies that insist one must not “abuse the sick days … and only miss work when … genuinely too ill to perform their job”. You cannot simply need time out to recover, to spend time with family, friends. To “soldier on” is virtuous. To “avoid” COVID-19 is to be a wimp, to not stand and face it.
On Twitter @FinchTH
On Twitter, the vocabulary has a negative tone: to evade, dodge, elude, escape COVID-19. It’s not that you’ve been clever, careful or conscientious. Instead, you’ve been cowardly and sheltered behind that mask.
For his sake, I hope President Biden doesn’t get long COVID. The post-COVID-19 persistence of symptoms is well described. The personal impact of persistent symptoms is high – Professor Chris Goodnow, an immunologist from the Garvan Institute of Medical Research, has written about his own experience of a post-COVID-19 heart complication, which occurs in 2% of infected people. Will the US President be expected to carry out his high level executive functions despite any post-COVID-19 repercussions?
I feel a deep despair now. It is wild that we have walked back such a simple measure as wearing a mask in this way. As I see it now, COVID-19 is expert at exposing the inequities of health care (and here). While COVID-19 is busy finding the unvaccinated and the undervaccinated in order to keep spreading, we are left with COVID-19 infection and its sequelae being one more disease of social and physical marginalisation and of poverty.
It joins an already overlong list.
Dr Lilon Bandler is a Sydney-based GP, medical educator, and Associate Professor with the Leaders in Indigenous Medical Education Network at the University of Melbourne. She is Medical Director of health services at The Wayside Chapel.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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