Effective July 3, 2020, Governor Abbott has mandated that individuals in counties with twenty or more coronavirus cases wear face coverings while they are in public.
We are not accommodating any exemptions to the mask mandate at this time
We understand that there is controversy surrounding the governor’s order. We also understand that wearing a mask or face covering is difficult or impossible for some people as a result of physical or mental health issues. Despite these considerations, we have decided that, at least until things become much more clear about how the SARS-Cov-2 virus is transmitted, we will err on the safe side and require all individuals to wear masks the entire time they are in our building, even when social distancing is possible.
We have made this determination because recent evidence suggests that the SARS-Cov-2 virus may be carried on micro droplets that are emitted when people who are not wearing face coverings breathe and talk. These micro droplets may remain suspended in the air and may travel distances in excess of six feet. Think of the way that your breath is visible when the temperature is below freezing — each time you exhale or speak you are emitting a cloud of tiny droplets into the environment. According to a growing body of evidence, this cloud of micro droplets may contain viral particles that remain suspended in the air for extended periods of time and can travel long distances.
Because patients and their attendants are spending an extended period of time in enclosed spaces in our clinic (and are breathing and talking while they are in those enclosed spaces), it is important that we do everything we can to minimize shedding of potentially infectious respiratory droplets. Face coverings are a very important means of accomplishing this goal. (Please note face masks with unfiltered one way valves will not be permitted.)
If you are not able to wear a mask
If you have a physical or mental health concern that makes wearing a face covering impossible for you, we regret that we will not be able to offer in-person/indoor services to you at this time. Please alert us as soon as possible so that we can convert your appointment to a telemedicine session. You will not be admitted to our building without a face covering.
Other steps we are taking to keep you safe
In addition to requiring that all individuals (staff, patients, and patient attendants) wear face covering at all times, we have also modified our HVAC system to increase outdoor air ventilation, are running high-power air purifiers (our filters employ HEPA filtration, UV-C, and bipolar ionization) in all rooms round the clock, and are maintaining indoor humidity in the optimal range of 40-60%. Although there is not yet widespread consensus that HEPA filtration, UV-C sanitization, bipolar ionization, and/or indoor humidity reduces the transmission of COVID-19, experience with other pathogens (including influenza and measles) suggests that these are prudent steps to take.
- Mouting evidence shows masks may help avoid severe illness, even if you get COVID-19
- Mounting evidence suggests that coronavirus is airborne — but health advice has not caught up
- How COVID-19 is transmitted completely upended — here’s what we need to reopen
- Air conditioning may be spreading COVID-19
- Humidity helps in the fight against COVID-19, virologists report
- Estimating the Nationwide Transmission Risk of Measles in US Schools and Impacts of Vaccination and Supplemental Infection Control Strategies
- Do NOT Use a Mask With a Filtered Valve (It Can Spread COVID-19)
According to the governor’s order, acceptable face coverings include the following:
- Surgical masks
- Homemade masks
Note that the mandate requires that the mask cover your nose and mouth.
Although the governor’s order deems scarves, bandanas, and handkerchiefs acceptable face coverings (and any face covering is helpful for reducing the shedding of respiratory droplets), many fabrics do not offer optimal protection (some sources suggest that 100% cotton bandanas filter only approximately 2% of micro particles, whereas surgical masks filter approximately 85%). For this reason, we recommend that you wear a disposable medical mask as opposed to a cloth mask. For individuals who do not have access to surgical masks, materials such as paper towels may be more effective than many fabrics at filtering the SARS-Cov-2 virus. Please see the video below for instructions for constructing a paper towel mask.
Having observed numerous individuals wearing homemade masks over the past several months, we also have concerns about whether ill-fitting homemade masks may, in fact, be giving people a false sense of security.
- The outer surface of your face covering is a contaminated surface. Each time you adjust your face covering in order to prevent it from falling down below your nose or riding up to cover your eyes, your hands are contaminated and need to be sanitized. Adequate hand hygiene becomes impractical/impossible if mask adjustments have to be made dozens of times an hour, as is often the case with homemade masks. Adjusting a mask also often requires touching the face, specifically around the eyes and nose, which represents a significant risk for viral infection.
- We have also observed that ill-fitted face coverings often end up interfering with vision and balance, which could be a particular concern for individuals at risk for falls.
Given this, we encourage you to select a face covering that fits well enough that it will not require frequent adjustments and does not interfere with your ability to see (both ahead of you and the ground at your feet).