Covid Fatigue and Leadership

When Covid-19 burst onto the scene three months ago, the jail administrators and the medical teams in my jails initiated several common sense practices to reduce the possibility of Covid infiltrating the jails.  These included screening and quarantining new inmates before allowing them into the dorms, screening jail employees daily, doing lots of Covid tests and, perhaps most importantly, having deputies wear masks at work.   The good news is that, so far, there have been no cases of Covid-19 in any of my jails (knock on wood here).

However, there seems to be growing evidence of “Covid Fatigue” in my community.  When I go out in public, I am one of the very few still wearing a mask.  And this is unfortunately spilling over to the correctional facilities.  I did a clinic at one of my smaller jails this week and was surprised and dismayed to see that the deputies were no longer wearing masks.  In the meantime, Community Covid cases are climbing, so the risk of transmitting Covid to the jail is actually greater than it was, say, a month ago.

What remains constant is that the greatest risk to the jail inmates is not new inmates with Covid, but deputies or other jail employees catching Covid in the community and bringing it to the jail with them before they know they have it.  One of those jail personnel is me! I have a responsibility myself not to be a potential Covid vector.  That means wearing a mask at the jail but it also means I have a responsibility to practice Covid safety in the community.

Think of it this way:  Of the next 1000 people I meet in my community (most of whom I don’t even know), at least one of them is statistically likely to have Covid.  The best way to prevent transmission from that person to me is for that person to be wearing a mask.  This is unlikely where I live, though.   

The next best way to prevent transmission from that person to me is for me to wear a mask, practice social distancing and clean my hands often. These actions will lessen the likelihood that I myself catch Covid and transmit it myself into the jail.  My job is to keep the inmates in my jails healthy.  In the time of Covid, my actions when I am not at work impact my primary goal of keeping inmates healthy.  If I am not practicing Covid safety in the community, I am abrogating my duty just as assuredly as if I failed to provide necessary medical care.

I also have a powerful leadership role whether I want to or not.  If a jail deputy sees me at the store without a mask, that will reinforce their perception that “this Covid thing is not that big of a deal.” Same thing with many of my friends who get their medical information about masks from political sources. They know that I am a physician, so when they see me wear a mask, it reinforces the concept that wearing a mask in public is an important medical practice.

So, keep yourself safe!  Keep your inmates safe! Exercise a positive leadership role in your community through leading by example!  Do all of these by practicing Covid safety at work and in the community.

As always, what I have written here is my opinion, based on my training, experience and research. I could be wrong! If you think I am wrong, please say why in comments.

A version of this post was previously published in CorrDocs, the Journal of the American College of Correctional Physicians.

8 thoughts on “Covid Fatigue and Leadership

  1. Dr. Keller:

    There is no question that these mitigation strategies (distancing, masking, fomite cleansing, and hand washing) are all necessary steps to slow Covid spread. At least the first two have been practiced in the middle ages for some or all bacterial or viral pandemics.

    The main reason, IMHO, that adherence to mitigation strategies vary in different environments is that the (non-linearity) of the geometric R parameter of infectivity is poorly understood by the general public.

    If R is < 1 there is a tendency amongst the general population to ignore these mitigation strategies as people see that Covid spread is VASTLY improved over the case when the spread (R) is significantly greater than 1.

    Dr. Goldberg

  2. “keep yourself safe! Keep your inmates safe! Exercise a positive leadership role in your community through leading by example! Do all of these by practicing Covid safety at work and in the community.”
    I’m a jail doctor here in the Philippines, this publication/journal is a big help in my decision making amid this pandemic.

  3. The policies in our facilities seem inconsistent and like you said this leaves people wondering if this is even a big deal. We are going through sentinel testing across our whole state but it leaves me wondering what good it will do knowing I could test negative this week but contract it next week and still be asymptomatic so no one is going to know. Many of the medical staff believe we actually had this virus run its course in late December 2019 through the end of January 2020. We had 1-2 pass away, a few get hospitalized, and many many with fevers and many with coughs they couldn’t shake. I myself thought I had TB I was coughing for so long. One of our older nurses ended up in the hospital but never on a respirator. Our local school had 40% of the kids out sick and all we knew is that people kept coming up negative for flu. I agree we need to focus on prevention and setting the example as medical personnel in public. to at least reinforce the best practice with the community at large. I also saw a MEME that said if you are having getting some of your politically minded friends to follow through then tell them it makes it difficult for the facial recognition software to identify you. Just a little humor to end on.

  4. Thanks for your timely advise Jeff.
    I’m wondering what other medical directors of jails and detention centers are doing to monitor and reduce the risk of spreading COVID in their facilities. I know, it’s probably already there, but we have to try and minimize the spread!.
    We first tried reducing the numbers of inmates, but now the jail is starting to fill up again. We screen everyone who comes in (employees too) and isolate those that have symptoms or recent exposures (we too are finding inmates that think that being “COVID +” is a ticket to special treatment, but soon find being in isolation is very bring). We are not doing any testing at this time due to safety issues of getting them to a testing sight and cost. We just isolate. We offer masks to any inmate who wants one but few do and those that get them seldom wear them. Staff and deputies are wearing when in close contact with inmates. My biggest concern is sending an infected inmate back out into the community where we cannot enforce self isolation.
    Anyone else doing anything different or have further suggestions?

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  6. My take on this — we are up against a cultural divide — the mask resistance effort — I have had security say there are other kinds of science — mine is the science that got us to the moon six times and the same science for which Dr Fauci was vilified during the HIV epidemic.
    Underlying this is a failure of the American educational system.
    Does life have to become the hoax and death the reality before an acceptance of Covid sinks in?

    • Thanks for the comment, Banes! I also prefer to get my medical information from medical sources rather than political sources.

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