Tuesday, June 23, 2020

Always Wear Protection: A Quest to Convince People to Wear Masks

When you go to college in the middle of nowhere, you probably attend the programs in your residence hall, especially if you are a freshman, because there isn't really much else to do. So it was that I ended up at a program about AIDS awareness in the fall of my freshman year. The other freshmen on my floor and I barreled down to the lounge for the program that was being led by an iconic biology professor, Bill Laughner. He was the professor I met with when I toured the college as a high school senior and he was synonymous with the college itself. I was hoping someday to take his classes and was excited to hear him talk that night.

AIDS had been identified for years, but, by the fall of 1987, the virus and education about it were in full swing. According to HIV.gov, in October of 1987, 68% of people polled identified AIDS as "the most urgent health problem facing the world." October was designated as AIDS Awareness month that year; thinking back, the program in our hall was probably because of that. The purpose of the program was to raise awareness and talk about misconceptions. It wasn't a gay man's disease or a drug user's disease; AIDS was a disease any of us could get if we weren't careful. I have two very specific memories of this program. First, Bill told us that this disease would be the Vietnam of our generation, that eventually every one of us would know someone who died of AIDS just as his generation knew someone who died in Vietnam. This resonated specifically with me because my dad had served in Vietnam and my sister is named for someone who died there. Eventually, Bill talked about how using condoms could provide a great deal of protection, but only, he explained, if they were used properly. And this is the second very specific memory: Bill pulls out a banana, and a condom, and just matter-of-factly describes that there is no shame in buying these, as he opens the condom and demonstrates how to put it on - the banana - properly. He probably said there was no need to feel embarrassed, but I am certain I was. I had never had sex or seen a condom. I don't think I moved or breathed during that demonstration. Ah, college.

I've been thinking about this program, and its impact on me, a lot lately. There are a number of similarities between the AIDS epidemic and the COVID-19 pandemic. Both diseases started slowly and then took off, infecting and killing many people. Both disproportionately affected Black and Hispanic people. Both resulted in discrimination. Both were subject to slow governmental response and disagreement about how to proceed. Both could be slowed, or perhaps stopped, by wearing personal protective equipment.

I can't say for certain that it was the banana demonstration that has kept me from getting AIDS, but I can say a couple other things: Eventually, without shame, I bought condoms. I knew how to put one on from watching this demonstration. Whatever he said in the hour or so that proceeded the banana convinced me that using condoms correctly would keep me safe. Hearing a well-respected authority give common sense advice had a lasting effect on my sexual health. Now, as I look ahead to an unusual school year, I have been considering how to use a demonstration to convince students and staff members to properly wear masks, the personal protective equipment of our current urgent health problem.

Early in my teaching career, many biology teachers were using a demo to simulate the spread of a virus like HIV. Described in detail here, the demo has students "share bodily fluids" by pouring their cup of liquid (most have water; some have a baking soda solution) into another student's cup and then transferring half the mixture back into the first cup. After repeating this process two more times, an acid-base indicator is added to all the cups. The color of the resulting solution shows who has tested positive for the virus. Perhaps this demo could be altered by giving some people cups with lids to simulate wearing a mask. Like a mask, the lid prevents the sharing of fluids, so those people would be less likely to test positive for the virus. Maybe a demonstration like this, coupled with meaningful conversation by respected authority figures, could help everyone in a school embrace mask wearing.

At the height of the AIDS epidemic in the 1980s, around 130,000 new infections were reported in the US in a year, but that number dropped to around 50,000 by 2010. Certainly a combination of factors resulted in that strong decrease. During the 40-year AIDS epidemic, almost 700,000 people in the US have died (CDC Fact Sheet). Comparing this with COVID-19, over two million cases have been identified in the US; over 120,000 people have died (JHU COVID Dashboard). We know that a combination of factors - social distancing, masks, and education - can slow the spread of this disease. Masks work, but only if we all wear them. Let's develop some interesting ways to convince our students and colleagues that we must do that at school this year.