Maui Health Interview: “Masking is our Social Conscience”

(Scroll down to view the transcript).

A radio segment featuring executives and doctors with Maui Health runs Thursdays at 7:19 a.m. on KPOA 93.5 FM.  The series provides updates and answers questions related to the COVID-19 pandemic.

Today’s guest is Dr. Lee Weiss, Regional Director of Emergency Medical Services.  In his interview, with KPOA’s Shane Kahalehau, Dr. Weiss discussed the logic behind proper masking, the cause of the recent uptick in cases, and why deaths from COVID-19 are not attributed to preexisting conditions.

The feature runs daily at 7:19 a.m. on KPOA 93.5 FM.

Q: What is causing the recent uptick in cases; How did we get to the spike so quickly and all of a sudden; and where can we find all of the statistics?

A: “Number one, the uptick in Hawaiʻi cases is no different than the uptick in cases all over the world.  It’s really related to large gatherings and people who are not wearing masks and socially distancing. There’s more testing being done as well; but testing alone doesn’t explain the number of increased positives.  The number of increased positives are people that are gathering in large congregations, not masking and not distancing pure and simple.  In terms of where to look for the data, I think it’s very easy.  You go to  That’s the Department of Health’s official COVID-19 website.  Look at the COVID-19 dashboard.  All of the information is there. But again, socially distance, wear masks (and) wash hands.”

Q: Is the recent spike in cases due to increased testing?

A: “There’s a little bit of that, but the number of positives far outweigh the number of increased tests.  So, yes, we’re testing more, and yes when you test more you will find more disease.  But the amount of disease is out of proportion to the tests. That tells us there’s a spike.”

Q: Did most of the people who passed away of COVID-19 have preexisting conditions, and why then do we attribute their death to COVID-19 and not their preexisting condition?

A: “Yes, the vast majority of people who die from COVID-19 have preexisting conditions, age over 65, obesity, diabetes, hypertension, heart disease–those kinds of things.  These preexisting conditions makes their ability to respond immunologically different.  It makes their ability to recover from large viral infections like COVID-19 more difficult, and it leads to more death.

“COVID-19 as you know is a pandemic that we’re still trying to understand.  We don’t have a vaccine. We have little in the way of therapeutics, but there’s new stuff coming, new medications, new monoclonal antibodies.  There’s hope for a vaccine soon, but again, if 90 percent of the people would do three things 90 percent of the time we’d be a lot better off than we are now… We can do this… hand wash every 20 minutes, wear a mask religiously (don’t leave home without it)… and socially distance and we will get ahead of this.”

Q: Why are we more concerned about COVID-19 than any other cause of death like chronic disease, accidents and other types of infections?

A: “Because, number one, it’s the rapidity with which it spreads, and it’s how rapid the disease progresses even when we’re doing everything we can to treat it.  You see someone who develops heart disease, which is a chronic condition, diabetes or hypertension–chronic conditions–it may impact their lives, but it doesn’t kill them in weeks or a month or so.  When we see COVID-19, we see a group of people who do very, very well.

“The vast majority, young, get over it, and seem to do quite well–though we’re starting to learn about their illness too.  But as we get older, and as we have underlying conditions, we become susceptible to this disease and we don’t do as well and we can succumb to and die from the disease; and so it becomes a far greater burden for us as we see it and don’t know what to do about it because we don’t have any solutions right now–with the exception of washing our hands, masking, socially distancing.  And then, when we get into trouble, the hospital is our source to do everything we can for people.

The vast majority of people do well. Some don’t.  This is what makes this different.  But we do have weapons in our quiver.. that we can something about this. And we know again, the 90 and 90 rule.  Ninety percent of us 90 percent of the time wear masks, socially distance and wash our hands, we’re going to beat this.”

Q: Is it safe to say COVID-19 on it’s own is not as effective as it is when it has underlying conditions that a patient might have?

A: “Very well said.”

Q: How does the prevention of the spread of COVID-19 work by wearing your mask over your nose?

A: “If you don’t wear your mask over your nose, you’re spreading the disease because the virus kind of attacks and lives in the upper respiratory tract, especially the nose and the oropharynx.  So you want to cover your mouth and your nose all of the time.  When we wear masks, we’re doing it for one another… one hand lifting up another resident.  When I wear a mask and you wear a mask, what are we saying to one another? We’re saying ʻohana, we’re saying mālama, we’re saying we want to take care of one another… That’s what Maui and Hawaiʻi are all about… When we wear masks, we prevent each other from spreading the virus not only to each other, but to everybody around us.

“The virus is spread in small droplets that remain aerosolized in the air for seconds, if not minutes. When we wear masks, it blocks that from happening. It block the exhale of our water vapor and those droplets that may contain virus if we’re infected and don’t know it.  We know a lot of people have this asymptomatic illness.  They don’t have symptoms.  They don’t even know they have the virus.  This is especially true in younger people.  The mask prevents them from shedding the virus out in public.

“And if I’m wearing a mask and you’re wearing a mask, and everybody in the supermarket is wearing a mask; or (everyone) on an airplane is wearing a mask, then we decrease dramatically… the presence of the virus in small droplets that are in the air from coughing or sneezing or even talking.  And so masking is our social conscience.  It’s what we do for one another.  It’s how we prevent the illness from spiraling out of control, over burdening the health care system, and leading to people unnecessarily expiring.  And so it’s the civically correct thing to do.  It’s showing care for one another.”

Previous interviews:

  • Thursday, July 2: Dr. Jennifer Mathieu, an OBGYN with Maui Lani Physicians and Surgeons and OB Department Chair for Maui Health
  • Thursday, July 9: Dr. Michael Shea, Intensivist and Immediate Past Chief of Staff at Maui Health.
  • Thursday, July 16: Michael Rembis, Chief Executive Officer, Maui Health: “We Have Not Had a COVID-19 Positive Patient Admitted to the Hospital for Over 70 Days”
  • Thursday, July 23: Dr. Lee Weiss, Regional Director of Emergency Medical Services: Highly Virulent and Rapid Spread Makes COVID-19 a “Perfect Storm”

*Note: KPOA 93.5 FM is part of the Pacific Media Group family of radio stations.  Pacific Media Group is the parent company of Maui Now.

Video Interview Maui Health July 30, 2020

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