Letter from Bd of Health President Dr. Jeremy Grayson, MD, 4/02

April 2, 2020

Dear members of the Montgomery Community,

On Friday, March 27, 2020, the Surgeon General of the United States, Jerome Adams, M.D. issued a statement on CBS This Morning, stating that, “The virus and the local community are going to determine the timeline.  It’s not going to be from us, from Washington, D.C.  People need to follow their data, they need to make the right decisions based upon what their data is telling them.”

Since that statement, we have indeed seen the federal government adopt a more somber tone toward the COVID-19 outbreak.  However, as your local health department, we feel it is our responsibility to inform and protect our community to the best of our ability; to do otherwise, would be a dereliction of duty, and a violation of our community’s trust.  While we realize this information may cause panic and fear, we believe that a healthy amount of these emotions are essential in decreasing and stopping this pandemic from spreading.

Therefore, we would like to issue the following declarations and strong recommendations:

  1. COVID-19 is airborne and can be spread by simple breathing and talking; this has been known in the medical community since January’s Wuhan outbreak, but silenced, or denied.  As of Thursday, April 2, 2020, the federal government admits to this understanding.  Thus, we implore our residents to wear masks or nose/mouth covering at all times while in public.  Any covering for the general public is sufficient, and better than nothing for our community’s public health.  Scarves, bandannas, turtlenecks, etc. are all acceptable, as are home-sewn masks.  Please see below for the care and cleaning of these types of protection.  If you have “official” masks, you should wear them while out in enclosed public spaces due to the aerosolized spread mentioned above.
  2. Local business owners who continue to remain open must wear nose and mouth coverings at all times while at work, as must their in-business employees. They must clean surfaces often and provide a safe environment for their employees and customers.  Employees have the right to supplement as they see fit for their, their family’s, and their community’s safety.
  3. We are committed to the policy of “social distancing” and maintaining as much “sheltering in place” as one is able. We recognize trips to the market, etc. are essential, but designate one family member to be responsible for such activities.  Far too often in the past week, as this pandemic progresses, have we seen members of our community failing to adhere to these guidelines—children and adults alike.  Our local police will be patrolling for violations of this civic duty.
  4. There are many members of our community who continue to work outside the home as essential employees. This is understandable; but, because of this, and because Montgomery has one of the greatest number of physicians in any town in NJ, the need for “social distancing” and “sheltering in place” is even that much more important to prevent community spread.
  5. Children need to understand the gravity of this situation, insomuch that they are able to understand. While children are often not victims of COVID-19 infection, they still carry and shed the virus to others, who may develop overt illness.  Thus, we implore parents to pay extra attention to their children’s whereabouts and daytime activities.
  6. All human beings should be under the assumption that everyone else they come in contact with are potential sources of COVID-19, irrespective of current state of health. There is overwhelming evidence to suggest there are large numbers of asymptomatic carriers, as well as viral shedding in the days leading up to overt illness, as well as over 7-10 days after symptom resolution; in fact, studies have shown shedding for 50 days in carriers.
  7. While our community seems to have low numbers at the time of this corespondence (19 positive out of 28,000 residents), this is an underrepresentation due to testing shortcomings, the asymptomatic infected, and underreporting to county and state agencies. Therefore, we implore our residents to not take these small numbers lightly.  As written in point 4 above, there are large numbers of workers outside the home, and large numbers of health care professionals.
  8. This is a 12-18 month process at a minimum; there will be a second spike in infections and deaths. We implore our community to avoid complacency even when this initial wave abates.
  9. WASH YOUR HANDS as often as possible; when you think you have washed them enough, do it again. If you are ill, stay away from others.  If someone is ill, stay away from them.

We are a strong and supportive community, and together we can get through this; but that requires every resident to work together, look out for one another, and point out when breaches in safety are noted.  This should be done in a polite fashion; everyone has their own individual circumstances and we should be respectful, while speaking up to keep our community safe, just as our Surgeon General recommended.

Respectfully Yours, Stay Well and Vigilant,

Jeremy S. Grayson, MD
President, Montgomery Board of Health
Diplomat, American Board of Anesthesiology and Pediatric Anesthesiology
Associate Professor, Departments of Anesthesiology and Perioperative Medicine, and Pediatrics
Rutgers-Robert Wood Johnson Medical School
Fellow-Rutgers Leadership Academy