Is Canada ready to lift mask mandates? Experts weigh in

“It’s a really difficult and polarizing space right now. The best available evidence does support masking as an important part of a bundle of protections, but the best available evidence isn’t high level enough to tell us how much protection masking adds right now, or what to expect if we take it away at this point of the game. One of the other problems that we have is that most of the supportive studies are theoretical, lab based or observational. Observational data on masking can be very different between places, at different times, with different variants and different background immunization. So it’s a very complex situation to try to analyze.

With that, I really don’t understand the rationale behind rushing to drop (mask mandates) when most everyone has adapted well to using them at this point. I think that there’s a risk in saying “we don’t need to do that anymore” too early while things are so uncertain, with possible increases in transmission and also risk of sending a message that (the pandemic) isn’t a big deal anymore. That is premature. I think there is additional value to taking things more slowly, assessing what happens with each reduction in measures, and really keeping an eye on the changes that could be coming because it really can be harder to put the genie back in the bottle.”

“There’s still a large, vulnerable population that includes unvaccinated children, like children under 5 who are not eligible, elderly people, immunocompromised people, people with transplants and people with comorbidities. That’s a huge portion of the population – 30 to 40 per cent. All of these people are left vulnerable in any indoor space where the virus can circulate freely in the air. Masks as a personal responsibility is a good thing but it’s unrealistic. One infected person in an enclosed room with poor ventilation will infect every single other person. We’ve seen it time and time again. You have people vulnerable going into grocery stores, schools, pharmacies, hospitals – all places they can’t realistically avoid. These are places they have to go, and then there’s really no protection for them if you remove mandates like this.”

“No. I don’t think it’s time. One reason is that I’m unconvinced that we’re at the end of the pandemic in Canada. We actually have – in most jurisdictions across the country – a fair amount of transmitting infection with fairly high numbers. We also continue to have a reasonably vulnerable population. The most benign yet reasonably effective intervention apart from vaccination that is actionable are masks. I think we should get rid of (the mandate) when the numbers are low, but we don’t really have much assurance that the numbers are low, nor that cases aren’t going to rebound. What we’re seeing in Europe right now and wastewater testing in the U.S. all point to a likely resurgence of cases. I would wait at least a few more weeks before we drop them. If we had really fantastic air ventilation and filtration in shared spaces across the country, we probably wouldn’t need to have mask mandates. But until we have, we’re likely going to need these mandates. It still amazes me how polarizing and political masking has been.”

“I’m very supportive of the lifting of mask mandates. As a top level piece, I believe that wearing an N95 or a K95 is effective. But I also think the evidence is increasingly clear that the use of the majority of masks that are used by folks day to day – and the way that they use them – is of limited utility. And it’s true that it’s not a huge burden to wear a mask. But it still burns a lot of (the public’s) energy, and I think it’ll actually be easier to engage with the public on higher yield interventions if we can get rid of the ones that we understand to be lower yield at this point.

I also think that people feel more comfortable being out and about (when they’re sick) when using masks. But a cloth mask versus a big sneeze is not very effective. It’d be better if we created systems, strategies and interventions to help people stay home, isolate and not have to go to work when they’re sick – and to engage in those things in good faith. I think that requires energy and resources on the system’s behalf. That’s where I’d like to invest my time and energy from a public health perspective.”

“I’m in the camp that says that in order to be cautious, we should continue to have mask mandates. If you look at the history of this pandemic, it’s wave after wave because they tend to remove most restrictions all at once and then case counts go back up. A much more prudent way of operating would be to lift one restriction at a time, evaluate, and then decide what to do next.

Especially now when the rates are still very high. In Ontario, they stopped doing PCR testing for everybody when Omicron hit, so the actual infection rates are estimated to be 10 times what’s been shown by PCR tests. The Ontario Science Table has estimated that we’re getting about 15,000 to 20,000 cases per day. That is much higher than it was when the mask mandates were first put in place. We also know that the Omicron BA2 variant is increasing, and it’s even more contagious than the original.

Since we now have a wider availability of very good masks, like N95 respirators, we should take advantage of that and use them. If we’re indoors where there are a lot of people whose status we don’t know – whether they’re infected, whether they’re vaccinated, when we don’t know what the ventilation is like – it’s wise to wear a good mask. It just seems like an especially bad time to lift the mask mandates.”

“There’s different strategies for controlling the risk. Canada has been following what we call the mitigation strategy, which means the curve doesn’t completely flatten before restrictions are removed. There’s a big risk in doing that. At the moment, Canada’s is kind of a yo-yo process. The curve never gets down to the bottom again when the restrictions are removed. Obviously when we remove restrictions while cases are going down, it’s going to go up again. That’s a no-brainer. We’re seeing an increase in infections overseas including Denmark, Hong Kong and even now in China. Canada will most likely follow but we still don’t know yet. Nevertheless, this is not the right time to drop the mask mandate.

If anything, I think people should be wearing better, well-fitted masks that form a better face seal, not lifting the mandate. It took us so long to acknowledge aerosol transmission in Canada. Even now, some people haven’t fully acknowledged that SARS-Cov-2 is airborne and you can breathe it in, and that’s been a really big problem. These very small inhalable particles containing the virus float around like smoke, meaning airborne precautions are very important.

I think the public should be better educated about the proper types of face masks. We need a selection of masks that people can choose that comfortably fits the face shape and size of each person and has a proper seal – and we need to shift away from the blue surgical masks. A blue or surgical mask might stop really large projectile droplets, but many of the really small particles will go straight through or go through the gaps around the face. We should encourage people to wear respirators (which are fit for purpose), like N95 and KN95 masks. If we go that way, I think we’ll see fewer infections.”