The COVID-19 Poll Results: Opinions and Comments

Masks, oculocentric factors Ivermectin, conspiracies, and binary thinking

The TSC COVID-19 poll is complete, a minority of readers have voted, and they are conflicted.

Similar to all polls, the numbers are representative of those motivated to spend time clicking and must be taken with a grain of salt. I’m sure there is a study out there somewhere that breaks down the differing characteristics of those who click versus those who don’t. Perhaps, before quoting such polls, we should insist on seeing this data.

Masks

With respect to masks, 74% think they work. About half of those feel, like me, if you really want efficacy, you should be wearing the higher quality N95 or KN95 masks.

I also agree with the 8% who felt that high-quality masks, worn properly, protect the individual. Their general efficacy has been hard to demonstrate. Thus, it makes sense that my employer has eliminated mask mandates in doctor’s offices and airlines have dropped them.

For those with impaired immunity, they make sense for situations where exposure is likely.

One reader wrote

The argument/discussion over masking is basically irrelevant in the real world. A trip to any mall in America reveals that nearly all mask wearers do not wear them in accordance with accepted protocols. Loose fit, worn under nose, handled continually, same mask worn for days or weeks, etc. Finally, I have read that recent studies show virus particles easily enter the nose via the eyes.

He is correct. There are studies suggesting the mucosa of the eyes represent a significant portal for the entry of SARS-Cov2. One study suggested we, the bespectacled, are therefore protected:

However, a peer-reviewed study of higher quality performed in Denmark and Sweden was inconclusive on whether eyeglasses help (1).

Eye entry of the virus would definitely contribute to the inefficacy of the face mask. A possibility that is quite depressing to ponder. However, I’m putting this possibility in the increasingly large buck of unanswered COVID-19 questions.

Ivermectin DOES NOT HELP!

The 62% of poll voters who chose to say no to the question “Is ivermectin effective at reducing the severity of COVID-19” were 100% correct!

This has been proven beyond a shadow of a doubt by numerous high-quality randomized controlled trials. As this JAMA article summarizes, even at higher doses and longer durations this drug is not beneficial for the treatment of COVID-19.

With masks, high-quality randomized controlled trials to prove or disprove efficacy are extremely hard to design and conduct but with drugs like ivermectin, hydroxychloroquine, and paxlovid they can be performed and yield valuable information.

It would be great to have these data on all pharmacologic and non-pharmacologic interventions before widespread application but resources are limited. In some cases involving grave danger public health organizations have to make recommendations with incomplete information.

Comments: Inappropriate and Appropriate

There were many thoughtful comments on my post on both sides of the COVID-19 spectrum which I appreciate.

One reader tagged a comment as inappropriate for these reasons:

"Devoid of any rational, or logical thoughts or ideas. This comment is purely designed to underscore this posters conspiracy theories without even a hint of supporting information."

I agreed and removed the comment. The poster suggested there was no pandemic and no COVID-19. He felt that we were being misled by “lies and propaganda.”

Some people believe this and others that the earth is flat. Some believe that America did not send astronauts to the moon. These are bizarre beliefs which border on delusions and often have associated conspiracy elements.

I know the earth is round, Neil Armstrong walked on the moon, and that the COVID-19 pandemic was real. There were 14.9 million excess deaths worldwide in 2020 and 2021 due to COVID-19. Early on, ICUs were filled to capacity and beyond with patients sick and dying from COVID-19. All healthcare workers from Italy to Taiwan to St. Louis who worked in hospital settings saw the devastation with their own eyes.

I leave you with poll results and observations submitted by a reader:

On March 15, 2023 mask mandates in the hospital and clinics were dropped by SSM and Mercy, two of the three largest healthcare systems in St. Louis and Missouri. Two days ago, the third system, BJC, dropped their mask mandates

I begin 2 months in St. Louis during which I will spend several weeks as the cardiology consult attending at St. Louis University Hospital, rounding daily with my team. I will likely wear my Kimberly-Clark N95 during those rounds and when I enter the outpatient clinic exam rooms.

I will also ask a known or suspected patient with TB or COVID-19 to wear a mask upon entering our waiting room and until they left the office. I see little downside to these actions.

Mandatorianly Yours,

-ACP

(1). Wearing glasses was inversely associated with COVID-19 infection in the Swedish cohort (odds ratio [OR], 0.61 [95% CI, 0.37-0.99]; P = .047; seroprevalence, 9.3%) but not in the Danish cohort (OR, 1.14 [95% CI, 0.53-2.45]; P = .73; seroprevalence, 2.4%). Adjusting for age, sex, job function, and number of workday contacts in Sweden, wearing glasses no longer was associated with COVID-19 infection (OR, 0.64 [95% CI, 0.37-1.11]; P = .11). When stratifying by job function, a large difference was observed among office staff (OR, 0.20 [95% CI, 0.06-0.70]; P = .01) but not ambulance staff (OR, 0.83 [95% CI, 0.41-1.67]; P = .60) nor health care staff (OR, 0.89 [95% CI, 0.35-2.30]; P = .81).

N.B. I’ll have more to say on long COVID-19 and cardiac risk when I get around to describing the relevant poll results.