With COVID-19 cases expected to rise, should you be wearing a mask again? Here's what experts say

We are in the “Omicron era” of the COVID-19 pandemic, as infectious disease specialist Isaac Bogoch puts it.

The newest sub-lineages of the Omicron variant, BQ.1/BQ1.11 and BA.2.75.2, are extremely transmissible and have been detected in other parts of the world. Bogoch believes the sub-lineages may drive future waves across Canada.

When it comes to efforts preventing the spread of the variant, some data suggests wearing a mask can reduce the rate of COVID-19 infections at the community level, Bogoch told CTVNews.ca in a phone interview.

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“But in the Omicron era, we're seeing some weakening of that data, meaning there's just not a lot of wiggle room in the Omicron era.”

By “wiggle room,” he means masks reduce the risk of getting infected, but don't eliminate it. 

With mandates dropping across the country, people make their own decisions on whether to mask. This, combined with what is already a highly transmissible variant, means more infections are likely, Bogoch said.

In the previous two years, cases of the quickly mutating disease have spiked during the fall months, and many required treatment in hospital.

This fall, experts say, will be different.

Case counts are still expected to rise, but most people who test positive for COVID-19 are no longer experiencing severe symptoms.

Recent data from the Government of Canada shows fewer patients are in intensive care units this fall than at the same time last year. Even fewer people now are on ventilators.

The reason for this, in large part, is due to some immunity derived from vaccination and recovery from infection, Bogoch explained.

Canada’s COVID-19 Immunity Task Force estimates, between Dec. 15 and July 15, at least 18.2 million Canadians were infected with COVID-19, but experts say it's hard to tell how accurate that estimate is.

“The actual number of newly infected (or reinfected) Canadians may have been higher because some people infected early in the Omicron phase of the pandemic may no longer have detectable anti-N antibodies,” the task force website reads.

Despite the anticipated rise in cases this fall, infectious disease specialist Sumon Chakrabarti said there's no cause for panic, or even for many protection measures.

“I don't think you have to do anything specifically this winter to avoid respiratory viruses,” Chakrabarti, who works at Trillium Health Partners in Mississauga, Ont., said in an interview with CTVNews.ca Tuesday. “If you're otherwise healthy, you have immunity, whether from the vaccine or previous COVID. You should do what you did back in 2018.”

Chakrabarti means that people should act as they would before the COVID-19 pandemic.

In the past, increased COVID-19 cases prompted strict lockdown orders and holiday gatherings over Zoom, but Chakrabarti said despite high transmission, the latest Omicron strain is weak and most people who get an infection don't get very sick.

“Omicron itself is much milder and in fact, if you look at it, it actually has a fatality rate of less than influenza,” Chakrabarti said.

Chakrabarti has been treating COVID-19 patients at Mississauga Hospital since April 2020, so he's seen what the situation was like at the start of the pandemic – when patients he described as "relatively healthy" and middle aged needed ventilators – compared to what it's been like in recent months, when few people are extremely sick.

“Even the oldest people, the average age of people coming in with COVID, they're generally all over 80,” he said. “And even they get better and go home.”

If someone is infected with COVID-19, Chakrabarti says, the symptoms they experience that are similar to that of a bad cold mean their immune system is “activated.”

“The symptoms that are you're getting (that) knock you on your butt, they're coming from your immune system it's not coming from the virus,” he said. “You feel like garbage for a couple of days, and then you can do better.”

Chakrabarti can appreciate there are people who are worried about being infected by COVID-19, especially those with certain health conditions.

For them, he recommends wearing a mask.

But he said he no longer recommends masks for most of his patients, as long as they've been vaccinated against COVID-19.

“These are all preventative things,” he said. “I think it's very important that this is not the advice that I give the general population. I think that if you're otherwise young and healthy…I don't think that during this winter, you’re going to do anything different than you did any other winter, excluding, of course, 2020 and 2021.”

Bogoch reinforced the risk of transmission is lower, even with the highly transmissible Omicron variant, when wearing a mask. He said this should be done for indoor settings in particular.

"Think about the three Cs: crowded, confined and closed settings are where most COVID is transmitted," Bogoch said. "I think people should be wearing masks in indoor settings to reduce their risk of infection. It is a personal choice in the current context of mandates being lifted, but wearing a mask in indoor settings, where the vast majority of COVID is transmitted, can help reduce the probability of infection."

The best masks, both experts agree, are KN95 masks. Bogoch says to remember the two Fs when finding an appropriate mask: fit and filtration.

Chakrabarti also highlighted what those who have COVID-19, or any other illness, should do.

“If you feel sick, then stay home,” he said. “Once you feel better, your fever is resolved or symptoms are improving, then you can go back. I think that's just general courtesy.”