COVID-19 and Common Sense: A Tale of 2 States

Governor Larry Hogan continues to be Maryland’s most popular Governor in recent years because of his deep seated commitment to the health and well being of the people he serves. Earlier this year and months before the COVID-19 crisis struck Maryland, Governor Hogan’s popularity rating was 75%! This is astonishingly high considering that he is a Republican in a very blue state. But what has distinguished this Governor has been a common sense approach in managing the COVID-19 crisis. First, he directly purchased 500,000 test kits from South Korea when it became abundantly clear that an insufficient testing supply would hamper U.S. efforts during the early weeks of the pandemic. Second, he assembled a task force of highly qualified experts to help guide the reopening of Maryland. Third, (and most importantly) he listened to them! He used a common sense approach that consisted of meeting specific milestones over a designated 14-day period (i.e., reduction/stabilization in hospitalization & ICU rates). Only when these milestones were met, would progression to the next phased reopening be permitted. As a result of this thoughtful, common sense approach, new COVID-19 cases have dropped (see 1st Figure) as the phased reopening continues. The percentage of positive tests (positivity rate) has declined from high levels (over 25%) to the recommended level of less than 5%, meaning that we have better control over the virus and can institute safeguards such as contact tracing to keep transmission rates low.

But progress will only be maintained if we follow recommendations to stay home when ill, practice social distancing and wear a face mask. While face masks are required on public transportation, inside retail shops/malls, restaurants and bars (currently limited to 50% capacity), the “Masks on Maryland!” initiative is making a strong case for masks to be worn until an effective vaccine is available.

By contrast, states that have not mandated the wearing of masks, such as Florida, are suffering dearly. As illustrated in the 2nd Figure, cases have been rising at an alarming rate. The high positivity rate (~18%) is deeply concerning and consistent with the virus being well out of control. When Governors of Florida (and other states) minimize the importance of wearing masks, this potentially deadly virus is simply not taken seriously. Rather, the message is perceived as: “if I don’t need to wear a mask, then what’s the problem?” AKA “if I don’t need to wear a mask, then why do I need to socially distance?” This is precisely what has been observed when outrageously high numbers of (predominantly young) people congregate in bars, nightclubs and other social gatherings without any regard to the welfare of others. Consequently, bars/nightclubs have now been forced to temporarily re-close in some states.

My healthcare colleagues agree that wearing a mask over upcoming months is a very small price to pay for some small degree of normalcy. But make no mistake, life will not return to normal until COVID-19 is no longer a health issue. In other words, until an effective vaccine becomes available or more tragically, herd immunity develops (due to continued disregard to wear masks/socially distance, with the inevitable consequence of continued countless and unnecessary deaths), why don’t other states adopt the common sense approach that Governor Hogan has used to lead Maryland …and reduce spread of this viral beast?

Michael Miller, MD is Professor of Medicine, Epidemiology & Public Health and a cardiologist at the University of Maryland School of Medicine in Baltimore, Maryland.  His recent book,  “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” is published by Penguin Random House, USA.