More than 60 critical care physicians from across Tennessee expressed their frustration Monday over increasing COVID-19 cases and hospitalizations, calling on Gov. Bill Lee to issue a statewide face mask mandate, enforce safety guidelines and allow mayors to make public health decisions in their cities.
Dr. Aaron Milstone, a pulmonologist now treating COVID-19 patients, said science — not politics — should drive decision making during a health crisis. For example, research shows that face masks or coverings can help reduce the spread of infected respiratory droplets that transmit the coronavirus.
"We must issue a state mask requirement. When people refuse to wear masks, it does not protect their liberty. This selfishness is a threat to the liberty of everyone else," Milstone said. "When people ignore speed limits and drive recklessly, they are fined, because they are endangering others. When people drunk drive, they are fined as well, because they are endangering others. In this health crisis, not wearing a mask and not staying apart endangers the lives of countless others and prolongs the health crisis."
A report from June found that Tennesseans are among the least likely people in the United States to wear face coverings, with only 10% to 20% of citizens reporting that they always wore a face cover in public.
Milstone also said the "Tennessee Pledge," which outlines voluntary safety guidelines for businesses, should require that employers adhere to social distancing and masking protocols or face consequences.
"If an employer is endangering the public, the public needs a way to hold them accountable. At the very least, the state's administration should investigate businesses where employees or the public have expressed safety concerns," he said.
Finally, Milstone said, cities should be able to implement public health policies that go beyond policies of the state or county if the mayor believes they're needed to protect citizens. Lee's most recent executive order puts that responsibility on county mayors only.
Chattanooga Mayor Andy Berke has for weeks wanted to require face masks in public places, but only Hamilton County Mayor Jim Coppinger could make that call. Although Coppinger on Monday said face coverings in public will be required starting Friday, Milstone said COVID-19 in the state has worsened as Chattanooga went without a mask requirement.
"In June, Tennessee COVID-19 hospitalizations soared by 70% and ICU bed use has increased by 56%," he said.
One of 39 physicians who participated in a livestreamed videoconference appealing to the governor, Chattanooga-based pulmonologist Dr. Jigme Sethi, said Hamilton County so far has avoided a COVID-19 patient surge, but admissions increased "significantly" over the weekend.
"I've been a practicing clinician for 35 years, and I want to say that as a critical care physician, I have not come across a disease like this," Sethi said.
Not only is COVID-19 difficult to treat medically, the grief and sorrow of the deaths are "devastating" for everyone involved, he said.
"The patient dies alone, without families present, no one holding their hands, perhaps connecting through Zoom or Facetime as a poor substitute. The worst is to think that these deaths were entirely preventable, if the patients had worn masks or socially distanced or if those around them had cared enough to protect them by doing so," Sethi said. "This is a medical problem and the solutions, even for the economy, must put medical fundamentals first."
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