Chicago doctor, Emily Landon, an infectious disease specialist with the University of Chicago Medicine, spoke Thursday as a second surge of coronavirus cases climbs in Illinois.
Landon has periodically delivered speeches during the coronavirus pandemic in Illinois. Her first, at the start of the crisis, went viral on social media.
Read her full speech to Illinois Thursday below.
Thanks, Dr. Ezike and thank you, governor for inviting me to be here today. But this isn’t a happy occasion for me to be speaking.
Public health officials, epidemiologists and doctors, like myself, predicted this fall would bring more cases or hospitalizations, and more deaths. We hoped that knowing this would help us take steps to avoid it. And many of us did those things. We dutifully wear our masks even though we don’t really think we could be contagious. We keep distance from friends and neighbors, we wash our hands religiously. And now as the weather gets colder, and the cases still rise, we aren’t sure what more we can do.
You see, we are where we are today for a lot of reasons. But I’m really worried about the misinformation and fatigue slipping into and covering up our best intentions. I hear people say, ‘Sometimes people wear a mask and still get COVID. So why bother?’ Or sometimes people say that people like me are making a mountain out of a molehill, and we should just let everybody get sick and get over it.
I know many of you are hearing those same arguments from your friends on social media and even from the news. Sometimes people make these statements, dress them up with some some facts or graphs that look almost as convincing as the ones you saw today. They sometimes take experts’ comments out of context, and make you wonder what we really think. They make you question every inconsistency every change in guidance. So today, I want to set some facts straight. First of all, inconsistent recommendations are not evidence of a conspiracy, nor are inconsistent data. They’re evidence of a changing knowledge and epidemiology. In different situations, different metrics mean different things. For example, when testing rates are low or changing rapidly, the test positivity rate may not mean quite the same thing as when testing rates are stable, or when the testing rates aren’t increasing as much as the cases. Everyone is trying to use the best information available to make the best possible decisions. There are and will be disagreements about the details. There is no one measure or metric, but rather an understanding of the needs and the pain in the community, both from the virus as well as the consequences.
There are new data coming out every day. Science is learning. We change our guidance, because we learn something new. Changing advice should make you feel good that we’re making progress.
Disagreement is a normal part of every process and there’s no one right way to handle a new pandemic, but we’re all in the same boat and we should try and row in the same direction as much as possible if we want to get somewhere.
Some people are still skeptical of masks, because people like me didn’t know very much in March about how important they would be for curbing transmission in the community. Every single study now shows that masks reduce risk. Common sense says that masks reduce risk. Health care workers would all get COVID when they were caring for patients if masks didn’t prevent infection. And studies of health care worker antibodies showed that they have had COVID only slightly more than the regular population, despite having very close contact with patients that have COVID.
Still, no mask is perfect. But there is growing evidence that if you catch COVID, while wearing a mask, you may not get as sick. In fact, a lot of us think that this may be contributing to the lower mortality rate compared with earlier in the pandemic. Did you know there was a study done in Kansas that showed the areas with mask mandates had lower rates of COVID and lower mortality rates than the places that didn’t have a massive mandate? This gives us evidence that masks prevent COVID. But it also tells us that they may reduce the severity of illness, and that the mandate is important. Because in counties where there wasn’t a mandate, people could wear a mask if they wanted to and they were encouraged to do so, but when everyone wears a mask, it’s better for all of us.
So no matter what you hear, masks are important. And masks are safe. Construction workers, health care workers, artists, all kinds of people have been wearing masks for ages without complications. So stop your fussing and put your mask on – especially now that the weather is getting colder, which brings me to another point.
Warmer air is more humid, it has more moisture in it. You know this- that humidity keeps those droplets that are coming out of our mouth and our nose juicy, and when they’re wetter, they weigh more and they fall to the ground closer. But when air cools down, it doesn’t hold as much moisture. It’s drier and our HVAC systems are not awesome at putting moisture back into the air, even though they’re pretty good at heating it. This you know, because you have to buy more lotion, you complain about your dry skin all winter long, you may even buy a little humidifier that you put in the corner and realize it doesn’t actually solve the whole problem, because it’s a bigger problem than you can solve with a little humidifier. That drier air means that your droplets are drier and smaller too. And they can linger in the air, they’re lighter, they stay longer and they travel further. That’s that airborne transmission that you keep hearing about and it’s true. fall and winter weather literally make COVID more transmissible.
On top of that the cold weather makes us spend our time inside in our energy efficient homes that keep the heat inside and the COVID.
There have been numerous reports of super spreader events related to these kinds of situations. And they can be described with the three C’s: it’s unmasked contact with people in a closed space, that’s crowded because the more people you have, the more likely one of them has COVID.
Many modelers have shown the indoor ventilation in most buildings is not sufficient to prevent the transmission of COVID when people aren’t wearing masks. So it seems that limiting indoor gatherings where people don’t wear masks is a key part of preventing COVID transmission. And it is.
You see, bars and restaurants are one of the few places where people congregate and they can’t really wear a mask and eat and drink. Unfortunately, their employees and the restaurants and the businesses are the casualties here. But there’s no way around it. It’s not just models. Early on data from long show showed that recirculated air from an HVAC spread COVID from one family to multiple other families right in the flow of air. A quarter of cases in Louisiana in August, were related to bars and restaurants. And that’s when it was warm out. Over 100 cases were linked to one bar in Michigan in a week. And over the summer in Minnesota, 29 bars and restaurants started clusters that spread throughout the community. Shutting down bars and restaurants and putting in mask mandates changed the trajectory of the pandemic in Arizona, Texas, Florida, San Diego, Washington, D.C., Illinois – I could go on.
This isn’t the fault of any particular restaurant. In fact, the proprietors of these places do everything they can to prevent this from happening. But the reality is, that restaurant can be perfectly safe from 6 to 8 p.m. and become a super spreader event from 8 to 10 p.m. It all depends on whether or not someone with COVID walks in the door. And you have to remember that people with COVID are contagious before they even feel sick. Some will never even feel sick, spreading COVID to their close contacts while honestly believing that they’re fine.
Testing enough to identify all of the asymptomatic cases is still out of reach, even in this state with some of the best testing in the country.
And all the contact tracing in the world won’t tell you if you’ve been exposed to the source person if they were never tested.
As much as we don’t want to admit it, we can’t possibly know when we’re a risk to other people.
The likelihood of anyone, including me, having COVID goes up every time the case count goes up in a community. And we’re heading the wrong direction in every metric. Today is higher risk than yesterday. And unfortunately tomorrow will probably be higher risk than today.
And these facts about indoors without masks are not just true for bars and restaurants. Unfortunately, it’s true for any contact we have, including small gatherings in our own homes. As our cases go up, our bubble needs to get smaller. It’s the only way to stop the spread.
COVID thrives on this unmasked contact indoors. And so that’s what we’ve got to stop. We flattened the curve in March because everyone heeded the warnings and kept close contacts to a low number. Just your household, masked encounters with a barista, going to see your doctor, going to the library aren’t going to spread COVID, but eating with your coworkers in the cramped break room will. And that in-person book club with wine and appetizers when you’re going to try and be 6 feet apart will be a lot safer over Zoom.
Unfortunately, a Halloween party this weekend could become a super spreader event. And Thanksgiving could be a prologue to a tragedy for your family.
We’ve already had more than enough tragedies already.
I know you miss your family and your friends. And some days you probably don’t even care if you get COVID.
But you do care.
We all care.
So it’s time to start planning your risk the same way you planned your vote. You did plan your vote, right?
So go to these places. The IDPH website has all of the information that you saw here today that the governor showed you. It also has a lot of tools that you can use to help find out what’s risky and what’s not risky. You can also use the Chicago Department of Public Health website. And there’s a great free online tool from Brown University called My COVID Risk App. I strongly recommend it. It uses EPI data from your local ZIP code to help you assess the risk of going to the grocery store, or getting together with friends, and helps you find ways to lower your risk so you are empowered to make your own decisions.
Lastly, I just want to say a little bit to all of you out there who don’t believe a word I say.
You may never understand why the rest of us are still worried about COVID. Why we still wear our masks and wash our hands, why we’ll skip the Halloween parties and make alternate plans for Thanksgiving, why we eat alone in the break room or scarf down a sandwich outside…
It’s because we have the grit and the compassion to make sacrifices for the good of our community, for people we don’t even know. We pay taxes and stop at stop signs just like you do. But we know why we do it.
And we don’t mind. It may be hard, but we’ll keep doing it. Because we know real freedom isn’t about masks.
And you who don’t believe me are welcome to join us anytime.