This week, Governor Steve Sisolak mandated that when you’re out in public, you have to wear a mask.
COVID-19 infections are rising quickly again in Nevada, two weeks after casinos and other businesses were given the go-ahead to open up.
The debate over the efficacy of masks is ongoing. Dr. Vit Kraushaar, a medical investigator with the Southern Nevada Health District, told KNPR's State of Nevada it is difficult to test whether masks really work using the normal scientific method of control groups because the virus is so potentially deadly.
“One thing that argues most in its favor is just that COVID-19 is spread through large droplets," he said, "It makes sense to have some sort of barrier to prevent you from shedding those droplets.”
Dr. Krushaar said there is a lot of anecdotal evidence that shows masks can stop the spread. He pointed to two hairdressers in Missouri who tested positive for coronavirus and went to work with symptoms. They came into contact with dozens of clients, none of whome became ill - likely because they wore masks.
“Quality of evidence for masks is not great but there is a lot of anecdotal and circumstantial evidence,” he said.
Health officials are looking at various statistics and data sets as they monitor the spread of the virus. One type of data they're looking at is called effective reproduction number.
Kraushaar said the number is an estimate of how many secondary cases one infected person can give rise to. For example, if the number is two that means one infected person can infect two other people.
Nevada's number stands at 1.52.
Kraushaar said it is difficult to say how accurate individual numbers are because there are several ways to calculate the number.
“But what concerns me is the overall trend," he said, "When we’ve calculated a similar statistic or calculated the same statistic, using different methods. We’ve seen the same trends where the number is going up and that is concerning.”
Kraushaar said more testing is finding more cases but that is only part of the picture.
“We’ve seen that the proportion of people testing positive has increased from about 3 percent to about 10 percent over the last few weeks and so that’s really alarming. It really tells you that there is more community spread,” he said.
He said people are not social distancing and not wearing masks, which is partly why the cases are going up.
“When you walk around you may see a group of individuals who don’t look like they’re living in the same household and they’re acting like it’s 2019," he said, "I really think that has to do a big part of why we’re seeing more cases.”
One of the biggest fears from the pandemic is that with more infections, hospital intensive care units will overflow. Then people who need help, might not be able to get it.
“We have seen a slight increase in hospitalization stays or the rate of hospitalizations over the last two or three weeks,” Kraushaar said.
However, he noted those numbers often lag. He said cases go up and then hospitalizations and then deaths.
“There is a long lag time between when you start to see new cases and when you start to see increases in deaths," he said, "It can take a couple of weeks between when you see increases in cases to when you see increases in hospitalizations. And it can take a couple of weeks after that before you start to see an increase in deaths.”
But there is a twist in all of this.
Numbers of ICU patients are rising, but they aren’t coming in with symptoms as serious as when the pandemic began.
“What we’re seeing is that the rates of infection are highest in younger age groups that are less at risk for severe outcomes from this disease,” he said.
With more young people coming down with the disease and with those patients seeing less severe outcomes, Dr. Kraushaar understands it can be tempting to have an attitude that getting the coronavirus is really nothing to worry about.
“One of the things that really makes me nervous about getting this disease is that we’re finding that it affects the body in ways that we still don’t completely understand,” he said.
Plus, even if someone younger doesn't get seriously ill, it is extremely likely that he or she can spread the disease to their family. Kraushaar said one of the most tragic parts of the pandemic is that whole families are being infected and the elderly and sick members of the family are more likely to die.
“That’s really tragic and I don’t think anyone wants to be responsible for having infected their loved one,” he said.
Dr. Vit Kraushaar, medical investigator, Southern Nevada Health District.