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COVID-19
PANDEMIC

Centers for Disease Control now support universal masking
when in public places to help control the COVID-19
pandemic. 10,11 From a medico-legal basis, both the Texas Med-
ical Association and Texas Medical Board agree. 12,13
In authoritarian countries such as China and Russia, manda-
tory mask usage is readily accomplished by fiat or threat of
punishment, if needed. Mandating in countries such as the
United States, where individual liberties are immensely valued,
is more problematic. For example, the reported failure to use
masks is less than 2% of Chinese people, while it is 60-70% in
the United States. 14 In summary, it is reasonable to think that
universal masking is necessary to prevent transmission of the
COVID-19 virus in the United States, but it will be very diffi-
cult to assure adequate public cooperation for it to succeed.

John Menchaca, MD is board certified in Pediatrics and in Pediatric
Nephology, and is a member of the Bexar County Medical Society.

References:
1 Zhou,P et.al.: Nature 2020 : 579 (7798) 270-273. A pneumonia
outbreak associated with a novel coronavirus of probable bat ori-
gin. EXERCISE
2 Zhang et.al. J Clin Virology 2020 vol 127 p104364. Clinical fea-
tures and short term outcomes of 221 patients with Covid-19 in
Wuhan, China.
3 JF-W Chan et. al. Lancet 2020; Feb. (10223) 514—523. A family Like Your Life
cluster of 2019 novel coronavirus indicating person-to-person
transmission – a study of a family cluster.
4 World Health Organization Public Advice April 6, 2020. Masks Depended On It
helpful for “source control “—prevents an infected person from
passing on the virus. By Jon Courand, MD and Ajeya Joshi, MD
5 Messonnier, N. Director of Center for the National Center for
Immunization and Respiratory Diseases January 30,2020 Press
Briefing. This article, about exercise as great medicine, is the first of
6 Bourouiba, L.: JAMA published online March 26, 2020. six articles planned for upcoming issues of San Antonio Medicine.
Doi:10.1001/JAMA.2020.4756. Turbulent Gas Clouds and Res- Each article focuses on a different foundational area of
piratory Pathogens Emissions Potential Implications for Reducing
Transmission of Covid –19. “Lifestyle as Medicine: Exercise, Diet, Sleep, Stress Manage-
7 Setti, L.: Int. J. Environ. Res. Public Health 2020 17, 2932. ment, Avoiding Risky Substances, and Connectedness.” They
8 Greenhalgh, T and Howard,J.: Downloaded from follow last month’s article ‘Swimming Lessons for the Greater
www..fast.AI/2020/04/13/Masks-summary. Masks for All? The Good’ which framed the need for self-care now more than ever.
science says Yes. For as long as I (JAC) can remember, I have enjoyed running.
9 Greenhalgh, T. et. al.: BMJ 2020 ;369: m1435. Face Masks for There is a certain aspect of running that is more a meditation
the public during the covid-19 crisis. in motion than exercise, and while I enjoy all the physical ben-
10 World Health Organization advisory dated 6 April 2020. Advice
on the use of masks in the context of Covid -9. efits, I think I value the mental aspects even more. As a trained
11 CDC Coronavirus Disease Covid-19 updated May 4, 2020. pediatric intensivist and now hospitalist, I know that during
12 Texas Medical Association website Covid -19 Resources, Queried those times of high stress in my life, I have always found relief
May 7, 2020. by lacing up my running shoes and heading over to my favorite
13 Texas Medical Board web site Coronavirus Disease (Covid-19) trail or track.
Response, Queried May7, 2020. I am not alone. In an article written in Runners World, ap-
14 Clements, JM: Downloaded from http:// proximately 50 percent of surveyed physicians under the age
preprints.JMIR.org/preprint/19161. Knowledge and Behavior of 40 said that they run, the most popular leisure activity for
toward Covid-19 among US Residents During the Early Days of
the Pandemic: Online Questionnaire. that age group. Even for those over 60, a quarter of respond-
continued on page 18
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