Docs Must Stand Up for Public Health Officials

Across the U.S., public health officials have recently been threatened and harassed at their homes, to the point of forcing them to quit their jobs. Theodore Mazer, MD, former president of the California Medical Association and a delegate and California representative to the American Medical Association, discusses with MedPage Today the hostility of the protesters, the data behind the social distancing measures they are fighting, and what physicians can do about improving public adherence.

Following is a transcript of his remarks:

Greg Laub: We’re here with Dr. Ted Mazer, who was the President of the California Medical Association in 2018. He’s an otolaryngologist and a delegate and California representative to the American Medical Association. Welcome, Dr. Mazer.

Theodore Mazer, MD: Thank you for inviting me to speak my mind.

Laub: Across the country, there’s been a huge outpouring of hostility in some states, in particular California, against public health officers who have mandated that people wear masks in public, keep six feet apart from others, and avoid going outside. Social gatherings outside of one’s immediate household members have been banned. Dr. Mazer, explain how this hostility is manifesting itself, and how is this affecting public health officers?

Mazer: Well, first of all it’s not just in California, and it shouldn’t be anywhere. It’s completely unfounded and unfair. These are people who are trying to do their job to protect the public health, and they’re doing it to the best of their ability with the best available information. The attacks unfortunately have been personal. They’re not just going after policies. They’re going after individuals who are there to put those policies forward and work with the other community leadership to enforce them for the public good.

In California, we’ve had, I think now eight people in leadership positions resign. I think six of them were physicians as public health officers. Around the country, I think the number is approaching 30 people that have resigned from these very important public health positions. These are not new roles. These people have been doing this in healthcare for a long time now. This happens to be a crisis and they’re reacting appropriately to that crisis. To then go and protest them as individuals, threaten them, threaten their families. And in the worst cases, literally go in front of their homes and promote people coming to do things to these people who are trying to protect the public good, working 60 to 80 hours a week, doing things they never thought they’d have to do, is just the opposite of what the protesters are claiming. They’re claiming that all of this is being politicized. It is the protesters who are politicizing a great deal of this.

They’re really completely unfounded in their accusations. They can talk about constitutional rights. They can talk about whether or not somebody should tell them to do something, but let’s face it. Public health officers and governments in general have always done things that restrict some activities for the public good. And I don’t mean to get down too deep into that, but we have laws against defecating in the streets. Is that infringing on somebody’s rights or is it a recognition that that brings about things like hepatitis outbreaks? Like we experienced in San Diego. There’s really nothing different here. And I think the public needs to realize that — these protesters truly need to realize — that what they’re doing is potentially harmful to themselves, as well as the public at large.

Who are the protestors? In many cases, we’re seeing a parallel right now to the anti-vaxxers. People who are not looking at the science, they’re looking at emotion. They’re looking at false previous reports in the vaccine era or the vaccine realm, that have been discredited and retracted by the very authors. And yet we have the anti-vaxxers who are continuing the anti-vax campaigns. And God knows what they’re going to do when we come up, hopefully, with a COVID-19 vaccine. But now they’re somehow equating all of this to masking, which we know works.

Laub: What if things take a turn for the worse, and outbreaks get out of control — and suddenly public health officers have to order a re-closure of businesses or something beyond just basic social distancing. Is there anything physicians can do about this?

Mazer: Well, number one, we hope that those public health officers are still there and that this nonsense stops so they don’t feel threatened and maybe some people come back on board. If we get into further outbreaks, and we are seeing that across the country now in certain hotspots, we hope we don’t have to go backward and close down businesses, but that could become necessary again, or at least start focusing on what we have to close down. We need to enforce both on the public health side and within physician offices and communities. We need to enforce the three things that we know work to decrease your risk: washing, masking, and social distancing. And doctors have a huge role in that they have a role with their current patients. Even if they’re doing telehealth, every visit should involve reminding people of the safety things that we can do.

We can’t eliminate all risks, but we already know — contrary to what the protesters are saying — that masking absolutely reduces your risk. Not necessarily the PPE that physicians are using, or nurses are using, but even a bandana, it’s not as effective, but it is effective in lowering risk. So from the doctor’s perspective with their individual patients, they need to be very strong educators. Some doctors are uncomfortable doing public advocacy, but most doctors are pretty comfortable doing social media and they should be out there doing social media to remind their patients and the public at large, that what they’re hearing from public health officers, what they’re hearing in the media is important. They need to protect themselves. Recognize you’re not wearing a mask to protect you. You’re wearing a mask to protect those around you who are within that close proximity, if you can’t keep socially distanced. They’re wearing the mask to protect you. And as a society — we remind our patients, we remind the public — as a society our responsibility is to care for each other. That’s why we wear the mask. That’s why we should wear the masks. Some doctors like myself are comfortable doing regular media. The more we can do that, the more we can support our public health officers, the more we de-politicize what ultimately our politicians having to make decisions and look at it and projected as a public health, not a political agenda, the more we’re going to get cooperation in the public.

There’s also a responsibility to respond to what media is putting out. We have a television station here in San Diego that I have done a lot of reports with. And they have generally been balanced about reporting on masking and other measures. Last night [June 22], unfortunately they interviewed a cardiologist and a chiropractor who basically said, “No, masks don’t make any difference outside of the hospital,” completely missing the point and completely misstating the evidence. Even one of them said, just increase your vitamin D and vitamin A. And the final portion of that report was, “Well, you’ve heard it from the medical people.” We have to watch out for that. And the first thing I did last night was to contact a reporter at that station and say, that was a very dangerous report because what they said was not factual. And it was concluded by the reporter supporting what they said. That’s not the way you used to report it. And that’s not what you should. And this morning, the editor of the station called me, or actually emailed me. And we’re working on a rebuttal. We as professionals have a responsibility to respond to things like that. So that at least a balanced message gets out.

Laub: What do you think is causing all that lack of balance — it seems as though the science has evolved to the point where it just makes sense to wear a mask, but adherence nationally has been so difficult. Why is the public – and sometimes as you mention even physicians — confused about who or what to believe? Why haven’t people accepted this better?

Mazer: It’s a great question. So we have to look at this historically. When all of this broke out, we realized that we did not have the data to talk about what’s effective, what’s not effective in masking. We also had a tremendous shortage, a severe shortage of PPE, including masks. So if we look at that from what was announced by the White House, by Dr. Fauci, the initial thing was not that you shouldn’t ever mask, it was keep your distance, keep away from people and save the PPE for the hospital so that the people in the hospital setting could actually protect themselves and be there to serve the people who were needing hospital-based care. We have learned a lot since February and March, and we have learned through the New York experience, through Italy’s experience, that simple public masking combined with social distancing actually lowers your risk by some 40%.

And it doesn’t have to be PPE. It doesn’t have to be N95 masks. I think the confusion was not people being told: Don’t wear a mask. It was: Don’t take a mask that’s really important in the healthcare setting right now. And as we learn more, we can re-educate. Why are people confused? Because the data wasn’t there, the data was confusing. The supplies weren’t there. We are learning. And now it’s time for the public to stop being scared of doing at least a temporary safety thing for each other. And again, we know from the data, unlike some of the people who are protesting masks under constitutional grounds, we know that this decreases the risk of infection for you and everybody around you. If you can keep six feet plus apart, and you’re not coughing on anybody, okay. But you don’t know if you’re going to cough. You don’t know if you’re going to sneeze. Cover up. It’s not a big ask.

Cheryl Clark contributed to this report.