Q&A: CGU epidemiologist Nicole M. Gatto talks COVID-19, masks and politics

A woman wearing a red shirt and black blazer stands in front of a white building.
Nicole M. Gatto is an epidemiologist and an associate professor of public health at Claremont Graduate University. (Courtesy: Nicole Gatto)

As the United States continues to report record numbers of new daily COVID-19 cases and hospitalizations, TSL sat down with Nicole M. Gatto, an associate professor of public health at Claremont Graduate University, to discuss the surge in cases and governmental response.

The interview has been lightly edited and condensed for clarity.

How important is mask-wearing?

Mask-wearing is critical. In my opinion, it is one of the most important things that we can be doing right now, as we don’t have a vaccine to both protect ourselves and others.

Do you think mask-wearing is foolproof? If you had five people all wearing masks in an enclosed space and one person had COVID-19, do you think that person could transmit the virus to other people?

It’s impossible to say yes or no to something like that, because there are other parameters involved. But there was a really interesting study in a Morbidity and Mortality Weekly Report published by the [Centers for Disease Control and Prevention]. One report contained two instances of mask-wearing hairstylists who were working while infected but did not transmit the virus to customers. 

That’s evidence that a mask can be extremely effective in preventing the spread. A mask’s effectiveness also depends on many other factors, like how well it fits or how well the room is ventilated. A majority of medical professionals who wear masks and other protective equipment while treating COVID-19 patients are not contracting the virus.

Why is it necessary to shut down some aspects of society if everybody could just wear masks?

Does everybody wear a mask? Even if that was the case, mask-wearing is not enough to protect our population. We can’t ignore the potential of transmission through touching contaminated surfaces. We need to think of a package of interventions. We should also be social distancing, keeping our hands clean and staying home when we’re sick.  

What more can the federal government do to address the recent increase in cases?

Sending the right messages, which are so critical to the public’s response. Asking people to change their behavior is a very difficult ask — think about anything that you’ve tried to change. But if we model those behaviors as leaders, the uptake in people would follow, so it’s key to provide clear information about how to stay safe.

Can you point to a specific example of our leaders not modeling the right behaviors?

The message about the mask was first delivered by President Trump, who stressed that it was voluntary and that he wasn’t going to do it. In other words, he said, ‘Science is helpful and will help protect us, but I’m not going to follow it.’ That caused Americans to question mask-wearing, an unfortunate reality because it’s so important that people hear helpful information. When I talk to people, I say we’re members of families, neighborhoods, towns, cities and communities. We have a responsibility to keep ourselves and our communities safe.

Can you point to any other weaknesses or flaws in the federal government’s response?

It is important that communication is transparent to educate our population. It doesn’t do any good to make things seem better than they really are. We need a trustworthy, empathetic spokesperson who speaks clearly and simply. 

There’s been a lot of inconsistent information, where the medical and scientific community says one thing and the [executive] administration turns around and says something else. It can be very confusing to hear contradictory information. I mean, it’s confusing to me, and I’m an epidemiologist.

For example, would you point to the conflicting messages between President Trump and Dr. [Anthony] Fauci?

Correct, correct. In some places, the epidemic is not going in the right direction, as evidenced by the increasing number of cases, hospitalizations or deaths. The [Trump] administration is saying it’s almost gone, which is not in line with what the data is suggesting.

California has a state mask mandate and it seems like Gov. [Gavin] Newsom has been taking this pretty seriously, but cases are still going up here. Is there only so much the government can do?

We need to lean on people. Mask requirements only get you so far, because people need to follow through with the policy. It’s unfeasible for police to enforce the policy on everyone because of our large population. 

Do you think COVID-19 conditions in the U.S. will change under a Biden administration?

Since being president-elect, there are some good indications that he’s making more progress. He has assembled a task force composed of some very reputable scientists and medical doctors. This approach is different from what we’ve been hearing from the Trump administration, which is that scientists are stupid or don’t know what they’re talking about

How do task forces help?

I serve on a couple of task forces related to COVID-19. Usually, we’re chosen because of our expertise. We report the best evidence from the literature and advise on topics such as messaging, education or funding.

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