ER doctor talks masks, COVID & how to stay safe during holidays

December 22, 2020

An emergency room physician with Hillcrest Medical Center in Tulsa, Dr. Joshua Gentges talked recently with local podcaster Scott Townsend of The Scott Townsend Show on steps we can all take to help reduce the spread of COVID-19. Townsend serves on City’s COVID-19 Public Information Campaign Advisory Committee. You can listen to this podcast in its entirety at

Why wear a mask?

The importance of wearing a mask is to help us mitigate the spread of the coronavirus that causes COVID-19. Every time you say anything or cough or sneeze or open your mouth, small droplets that you can’t normally see come out of your mouth or your nose, and if you are infected with the coronavirus they can then spread to others. A mask helps prevent those droplets from spreading to others. And even if some of them get past the mask, their velocity is slowed so they can’t go as far. For example, if you wear a standard, two-ply cotton mask, droplet penetration will lessen in distance from around six to ten feet down to just a few inches. So that protects people around you.

(Health care providers) wear them all day, every day, at the hospital. And when we go into patient rooms we will add an additional mask called an N-95 mask. Those aren’t necessary for the public for going to the grocery store or the pharmacy or whatever. We wear them all day long, and they don’t cause your oxygen levels to go down. They don’t cause your carbon dioxide levels to rise. They don’t increase the risk of infection with bacterial illnesses. All they do is protect us from the spread of respiratory viruses and other respiratory pathogens, and the one that we care about most right now is the coronavirus that causes COVID-19.

Tips on how to wear a mask

The take-home points on wearing your mask is that it should cover your nose and your mouth. If it does not cover both your nose and your mouth, then it’s ineffective. But if it does cover your nose and your mouth, it will be at least somewhat effective in preventing the transmission of the virus. And every layer of protection helps slow down the transmission and will reduce the number of people in your community that develop COVID-19, which will reduce the number of hospitalizations and help Jane Phillips Medical Center be under less stress, for example, and also reduce the number of deaths. The number of deaths in all of our communities across Oklahoma has been tragic, and Washington County is no exception to that.

What is the best mask to wear?

This is a great question, and the answer that we have settled on, from the CDC and from other public health entities that are talking about mask wearing, is a two-ply, cotton mask. That is what we suggest for the public. It should fit securely around your nose and your mouth and cover both of those things. Some of these two-ply, cotton masks also contain an inner pocket, in which you can put an addition filter if you want additional protection. Honestly, it’s probably not necessary. One thing I would say about mask wearing is that I will see people who are wearing a handkerchief as a mask; these are minimally effective, but one of the problems with (them) is because they’re open at the bottom, if you sneeze or cough respiratory droplets will escape out of the bottom of that mask so it won’t be quite as effective as one that fully covers your mouth.

Are these the blue, surgical-looking masks?

No, the surgical masks in general are less comfortable than a cotton mask and they don’t work any better. We use them because they’re disposable. That way if one gets contaminated, I don’t have to throw it in the wash. I can take it off and put a new one on. For the public, we recommend that if their mask is potentially contaminated, like if they’ve been out in the public or they’ve touched their mask, they really should wash it at the end of the day, every day. That way it will keep it clean and fresh.

Does that hold true for the clear face shields?

The face shield will protect you to some extent from droplets, but unless it’s completely enclosed — and then, with those plastic ones, you couldn’t breathe if that were the case — it won’t be effective in preventing you from transmitting the virus.

What about these masks I see with the little round disc on the side?

Those are ventilatory ports, and masks like that will protect you to some extent but do not protect other people because the vent ports are designed to let things come out of them, so droplets and aerosols can come out of them and transmit the virus.

Where should you wear a mask?

I think, and this is also the recommendation from the CDC, that you should wear a mask anytime you’re around people who are not in your immediate family. By “around,” I mean in an enclosed area or within six feet whenever you’re outside — really any distance if you’re inside. You should have a mask on whenever you’re around people not in your immediate family. That means if you’re around your parents or your cousins or you’ve gone to a holiday gathering or a wedding or something like that — if you have to be around others, you should wear a mask.

Is it safe to celebrate Christmas with loved ones?

I understand that people really want to see their families. I miss my family immeasurably. I haven’t seen my dad or my mom in six months, and that’s been hard on me. It’s been hard on everybody. I think that we should be careful if we’re going to gather in those ways. Certainly the best recommendation and the way to keep people the safest is to not gather in person. But if you have to, and there are reasons why some people have to gather in person during the holidays, if you have to do that I would implore people to wear a mask, stay socially distant from people who are not in their immediate family, and that means stay six feet apart, and to wash your hands frequently. So if you pick up a glass or something to eat, or if you’re going to the table where the Christmas spread is set up, wash your hands before or after you touch things. And certainly, when you take your mask off and on you should wash your hands when you do that. That’s the best way to keep everyone in your family safe, if you have to gather during the holidays.

You say you haven’t seen your mom or dad in six months. When will you see them?

I think it’s important for physicians and public health officials, and I’m both of those, to model good behavior, and the “right” behavior that will keep my parents the safest is not to see them until I’m vaccinated and they’re vaccinated and the risk of the virus has gone down.

When do we get the all-clear? When can we take off the mask?

That’s a really great question. I think that whenever enough of the population has been vaccinated that the coronavirus can no longer spread, what they call “exponentially,” where it can grow and grow and grow each week and where levels of community spread have fallen to the point that we’re able to appropriately contact trace and test small numbers of cases to prevent further outbreaks. That’s when we’ll be taking off the masks. If you’re asking for a timeline, I would say I would expect that somewhere in the late spring or early summer.

Dr Joshua Gentges, D.O., is the research director and an associate professor of emergency medicine for the Oklahoma University Department of Emergency Medicine.