Masks and thermometers: Paramount measures to stop the rapid spread of SARS-CoV-2 in the United States

Abstract

In the United States, there is currently an exponential growth for the COVID-19 cases. The US president's coronavirus guidelines for America “30 Days to Slow The Spread” are necessary. To effectively curb the rapid spread of SARS-CoV-2, two more control measures facemasks and thermometers are strongly suggested to be included in the Guidelines.

As of April 15, 2020, in the United States (US), the coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)¹ reached 579,005 including 22,252 deaths of this disease.² Since early March this year, there has been an exponential growth for the COVID-19 coronavirus in the US. All of the measures recommended by Centers for Disease Control and Prevention (CDC) and US president are needed. The current US president's coronavirus guidelines for America “15 Days to Slow The Spread”³ (Fig. 1) were issued on March 16, 2020. The CDC's guidelines are similar to the US president's coronavirus guidelines for America.⁴ Yet, 15 days have since passed, and we are still on an exponential growth curve with no end in sight. During this writing, President Trump announced on March 29, 2020 that the coronavirus guidelines for America “15 Days to Slow The Spread” (now “30 Days to Slow The Spread”) would remain in place until April 30, 2020.⁵ However, it is hard to say now that two more weeks of the same measures will likely effectively stop the spread of COVID-19 coronavirus if we do not modify the current guidelines. There are no approved drugs or vaccines for COVID-19 yet, although there are clinical trials going on.⁶ Thus, the prevention to mitigate the rapid spread of SARS-CoV-2 is the important step now.

Figure 1.

The President's Coronavirus Guidelines for America. Source: https://www.whitehouse.gov/wp-content/uploads/2020/03/03.16.20_coronavirus-guidance_8.5x11_315PM.pdf.

We believe that masks and thermometers are key measures to curb COVID-19 from rapidly spreading. These two measures are not highlighted in US president's coronavirus guidelines for America “15 Days to Slow The Spread” (Fig. 1). The official CDC guidance initially only recommends that people who feel or are sick, as well as for the health workers and caregivers who must interact with infected individuals on a regular basis should wear masks.^4,7, 8, 9, 10, 11 The thought from these guidelines is that masks do not necessarily protect healthy people from getting infected in a public setting. The official guidelines say that people should stick to frequent hand-washing and maintaining a social distance (>6 feet). Many of the US hospital staff do not wear masks in the working environment even now. However, the recent outbreak rage in US with far more confirmed cases than any other country¹² has put more people in this country now at risk of getting sick.

We strongly suggest that the healthy individuals, especially those engaged in essential business must wear masks regularly, especially in any situation involving more than two people in order to curb the spreading of the COVID-19 virus. This practice will help prevent spread, particularly asymptomatic transmission. We recommend that everyone in the healthcare setting be required to wear masks, including medical staff, support staff, research staff, patients, and visitors. We hope the officials will enforce or put this in the guidelines. According to the current evidence, COVID-19 virus is transmitted easily between people by droplets carried through sneezing and close contact through respiratory tract.¹³ Recent research shows that talking to people and airborne can transmit coronavirus.¹⁴ A very recent study published on April 3, 2020 demonstrated that surgical facemasks could prevent transmission of human coronaviruses from symptomatic individuals.¹⁵ Moreover, presymptomatic or asymptomatic coronavirus carriers could spread the COVID-19 coronaviruses.¹⁶ In addition, keeping social distancing (e.g., stay at least 6 feet away from other people) may not be enough when people are moving around. For example, one person may enter a place where another person has just stayed. As the COVID-19 coronavirus can cause the significant morbidity and mortality,^1,17 wearing a mask can protect health individual and sick people.

Another quick measure to mitigate COVID-19 rapid spreading is the non-contact handheld cutaneous infra-red thermometer for fever screening. Research shows that 98.6% of COVID-19 patients tested had a fever than normal.^18,19 Therefore, although it will not screen in every individual, a temperature check can be used as a quick screening tool that is cost-efficient and useful. When people enter public spaces, we must measure their body temperature to make sure that those identified with a fever get further confirmation by coronavirus test kits,²⁰ stay at home or obtain appropriate medical care if needed.

No single measure will work 100%, but if we use a variety of modalities, especially key measures such as wearing facemasks and temperature screenings are implemented, we can curb the rapid spreading of the COVID-19 virus. We cannot panic during this pandemic, but we all must take effective measures to stop the spread of COVID-19.

Conflict of interest

The authors declare no conflicts of interest.