The vax/mask confusion


Let us first take politics and political correctness out of the current controversy about the safety of the vaccines against COVID-19 and its variants and the use of mask. Let us stick to medical science, since this is a medical issue.

As a cardiac surgeon, I am most familiar with the use and the value of   masking. I have been wearing them almost daily in the operating room for more than 30 years. A good mask mostly protects the people around the one wearing it, but it also protects the wearer to a significant degree from dust, allergens, and other particulate matters, including bacteria, mold, and viruses.

Who decides?

Does the decision to wear a mask during a pandemic for vaccinated or unvaccinated individuals rest on politicians, on the people themselves, or on epidemiologists?

In a democracy, in a free country, like the United States and The Philippines, yes, people have the right to do what they want, unless the action negatively impacts others or is immoral or illegal. In this case, it is clear that unvaccinated persons not wearing a mask, and even for those who already had the vaccines, could still expose the vaccinated ones to the more serious variants of COVID-19 (Delta, Brazilian, etc.) from unvaccinated carriers. As statistics showed, almost ball of those who were recently infected were unvaccinated individuals, and so with those who died. More than 50 percent of the current infection in the USA is caused by the Delta variant, which could still infect even those who had the vaccines. These are the so-called “breakthrough infections.” This is why vaccinated individuals, especially seniors, should still wear a mask in public to protect themselves from the unvaccinated (the most likely carriers and transmitters of the viruses). It behooves the unvaccinated to wear a mask to protect people around them, besides themselves. Innocently or unintentionally spreading COVID-19 thru negligence that results in deaths is technically  manslaughter.

Medically speaking, the decision for getting the vaccines or for wearing a mask in public should rest on evidence-based clinical data, on medical science, not on random, misguided, dangerous personal preference or bias. A great segment of the general public is not medically-oriented enough to know the subtleties and nuances of the true safety-efficacy of the vaccines and of the significant value of masking.  The 60 million individuals in the USA who refuse to get the vaccines seem not to realize that so far more than 4 million people around the world (about 624,000 in the USA) have died from COVID 19, and only a tiny fraction (less than half percent) died from the side-effects of the vaccines. Indeed, a simple arithmetic. If you and I could only make these medical facts clear to people, we would be saving millions of lives.

A grave waste

The reason countries around the world, foremost the USA, spend billions on medical research and development to achieve amazing advances in medicine and healthcare is to protect people from diseases and maintain a healthy society.

More than 1 billion people (of the 7.9 billion) have been vaccinated worldwide (more than 150 million of the 310 million population of the USA, more than 4 in The Philippines), proving the general safety and efficacy of the vaccines. Not to take advantage of what our state-of-the-art medical care has to offer is indeed unwise, foolhardy, unsafe, and a great waste of priceless resource, which third world countries would only love to have, as millions of them die because of lack of vaccines. And here we are, in the land of plenty, wasting this golden treasure.

Civil rights

In this land of the free and home of the brave, some of us sometimes inappropriately invoke our civil rights, our wonderful freedom in this great democracy, to do what we want, regardless of its negative impact on others. 

The question during this pandemic is whether the 60 million (20 percent of the US population) who refuse to get vaccinated have the right not to wear a mask when in public places and expose those who have been vaccinated to potential COVID-19 breakthrough infection, especially to the deadlier variants?  How about the civil rights of the vaccinated?  While the anti-vaccine individuals have the right to refuse the vaccines, don’t they have the moral obligation (self-imposed or mandated by law) to help protect their fellowmen? With civil liberties come responsibilities, fairness, and justice for all. 

The collateral issue, which is a great dilemma and risk, is how to tell or know who are vaccinated or not, in order to protect oneself from exposure to them, knowing the most likely carriers are the unvaccinated? After all, those who were more compliant who took the risk and got vaccinated also have the right to protect themselves and their family and the right to live. 

Behavior and discipline

As I have written in this column in early March of this year, behavior and discipline are vital during any pandemic or natural disaster. Irresponsible and reckless behavior, contempt and lack of caring for others, would result in new waves of COVID-19 infections and millions more deaths. This would also delay our ability to defeat the viruses and prolong this pandemic to, perhaps, COVID-22, 23….God forbid.

Pandemic of the unvaccinated

The current statistics showing a scary surge, rising wave of more than 30,000 cases of COVID-19 in one day, the 97 percent of the hospitalization, and new deaths were caused by the Delta variant involving mostly unvaccinated individuals. Indeed, this is now a pandemic of unvaccinated people. It is crystal clear that vaccines are safe and effective, compared to getting infected with the killer COVID-19 viruses.

One is too many

The best scenario is for those 60 million anti-vaxers to get vaccinated. This will protect them and society as a whole, allowing us to achieve herd immunity sooner and finally destroy the virus and its variants, disabling them to mutate further into more fatal strains. Otherwise, this 20 percent of the US population will serve as the giant reservoir, the hosts, of these viruses, which would rapidly and unceasingly mutate to become more efficient transmitters and deadlier variants. Without a host, viruses self-destruct.

As I have alluded to in a previous article, it took only one Typhoid Mary Mallon to spread killer Typhoid in New York in 1906 from her unclean hand-infected peach ice cream. The resurgence of measles in the USA in 2019 that killed 207,500 was transmitted by an unvaccinated American traveler who returned from abroad. Indeed, one carrier-spreader is enough. Imagine 60 million potential hosts-carriers-transmitters of the COVID-19 viruses!             

May wisdom and discipline prevail. And may God have mercy on us all.

Previous articleWould filing bankruptcy affect my applying for a job?
Next articleStreet Talk – How to fight the Infodemic
Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, a Health Public Advocate, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian and anti-graft foundation in the United States. Visit our websites: and Email: