Mask mandates may be lifted, but now is not the time take them off, experts say

With restrictions lifting across Canada as a sixth COVID-19 wave hits parts of the country, individual responsibility and personal choice appear to be the default public health measure, leaving some asking: when will it be safe to stop wearing face masks?

Most provinces have already lifted mask mandates and other restrictions. Quebec, which is now allowing 100 per cent capacity in public spaces, is planning on removing most public mask requirements except on public transportation by mid-April. PEI is set to lift theirs this month too. In Ontario, requirements have already been removed except for public transit and a few other exceptions like health-care settings. All this comes as wastewater data from a number of provinces suggest a clear rise in COVID-19 and hospitalization figures that are also edging higher.

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With public health messaging that strongly recommends masking, but doesn’t make it a requirement, CTVNews.ca asked some health experts to weigh in on what they look when deciding when to stop wearing masks.

WHAT DO THE NUMBERS SAY?

With PCR testing very limited and a highly-transmissible BA.2 subvariant circulating, raw case numbers are no longer a reliable indicator of the COVID-19 situation, experts say.

“What is important to note right now is that based on wastewater and test positivity …we are just really seeing a resurgence. Numbers are going up,” Dr. Peter Juni, the head of Ontario’s COVID-19 Science Advisory Table said in a phone interview.

“Keep wearing your mask at least until two weeks after the resurge, after the peak … we don't want to be challenged again in our hospitals.”

Only about 10 per cent of cases are being diagnosed, he estimates, noting that infections are likely still higher than at any other point in the pandemic except during the Omicron wave. Under these circumstances, he recommends continuing to mask.

Juni points to the U.K., where hospitalization levels are near those reached during the Omicron wave, adding, “it shows you we are not out of the woods and we just need to try to be careful.”

“To interrupt the chain of transmission, I would wear it to protect myself and my family.”

Lisa Barrett, an infectious disease specialist with Dalhousie University in Halifax, also looks at the per cent positivity rate week over week, but adds it is only one of a combination of indicators used to gauge the situation.

“Most people don't know where they got it now. And that's a really good indicator that there's a lot of virus,” she said in a phone interview.

While hospitalizations and deaths are also metrics to consider, Barrett says they are also preventable at this point in the pandemic.

“I don’t know if it’s OK to watch those go up and as soon as they start to go down, again take away all these measures,” she said.

“I'd use [percent positivity] with caution and start waiting until the province seems to be seeing less community spread as one of those measures. So deaths, hospitalizations going down, percent positivity going down, and then – you switch over to managing your personal and surrounding risks with your community.”

Barrett also says that masks alone are not enough to cut community spread.

“For me, it's about vax-plus plan. So you do the vaccine part – that's the cornerstone. The pieces that hold the rest of that tabletop up are the moderate activities. It's the staying home when you're sick. It's the masking in public places, and testing if it's available.”

WHO, WHERE, AND WHEN

When it comes to “individual responsibility,” mask considerations will also depend on what you are doing, where you are, the people around you, and your own health situation, health experts say.

“If you're in a place and space where you're only around a few people and none of them are vulnerable and everybody is vaccinated within the last three months with their last dose, then the chances are that that's a safer environment than if you're in a place with a large group of people – some of whom are vulnerable – and you're out and about a fair bit and people are under vaccinated,” Barrett said.

The warmer weather around the corner may also be a factor in whether you need a mask or not. Juni, for example, says he would not wear a mask outdoors.

“If there’s no wave, numbers are low, I would just not wear it at all. I’m fully vaccinated, I have had three doses. And my risk of being admitted to hospital or the risk of my family … will be very low,” he said.

SEASONAL MASKING

But if there is a wave, like the current one we are in now, Juni would avoid staying in public indoor spaces longer than necessary. It is not just about protecting others, he says.

“We still are in a situation where we don't know – even if you're fully vaccinated with three doses and to get Omicron – it's too early to tell what the risks of long COVID is with Omicron in somebody that has two or three vaccines,” he added.

“If you want to protect yourself, even if you're fully vaccinated … You don't want to end up with long COVID. Omicron hasn't been around long enough that you actually are even able to tell what the risk is. Long COVID is a challenge.”

Medical experts also note there are instances even after the pandemic is over where they will put a mask back on, saying it is a tool they would continue to use during the fall, winter, and spring respiratory seasons.

“I’m going to be much more diligent about the mask thing if I'm inside around people I know are going to be vulnerable,” said Barrett.

“There’s still circulating viruses that we know are pretty damaging to vulnerable people.”

Juni added that, irrespective of COVID-19, he would also continue to wear a mask in late autumn, winter, and early spring when taking public transportation.

WHAT DOES PUBLIC HEALTH SAY?

Canada's top public health officials have previously said that continuing to wear a mask amid restrictions easing in many provinces is a "personal choice." Still, the Public Health Agency of Canada’s website continues to emphasize the importance of wearing one as an added layer of protection even when not required, particularly in private or indoor settings. A well-fitted mask will help contain potentially infected particles you breathe out and filter any virus lingering in the air that you might inhale, the agency says.

Masks have been used by health-care professionals long before the pandemic and should not be seen as an onerous chore or even a political symbol, medical experts add.

“It really doesn't make much of a difference for most of us…it's really not imposing anything on us,” Juni said.

Infectious disease specialist Dr. Isaac Bogoch says mask-wearing is a very simple protective measure that goes a long way.

“We know masks aren't perfect, but they still help. They help protect the individual. They help protect more vulnerable people among us, and it might help blunt some of the wave we’re experiencing,” he told CTV News Channel on Thursday.

“I know mandates have been lifted, but people can still choose to wear a mask.”

For Barrett, helping to prevent deaths, even just a few, is worth it.

“Five preventable deaths might be 0.01 per cent, but I don't really think that's OK,” she said.

“If I’m going to stay home when I'm sick, moderate my activity, test and wear a mask as my new normal for two more months? I don't think that's too big a deal to prevent five deaths in a community of a million.”