Should masks be mandatory? It depends

Click to play video: 'Should masks be mandatory? Alberta doctor weighs in'
Should masks be mandatory? Alberta doctor weighs in
WATCH: Should masks be mandatory? Alberta doctor weighs in – Jun 15, 2020

Mayors across the Greater Toronto and Hamilton Area (GTHA) are urging the province to make masks or face coverings mandatory in public spaces as businesses reopen amid the novel coronavirus pandemic.

On Tuesday, Toronto Mayor John Tory announced that he supports a proposed bylaw that would make face coverings mandatory in indoor businesses and enclosed public spaces in an effort to prevent a “resurgence” of COVID-19 cases. The city already announced masks will be mandatory on public transit as of July 2.

If the proposed measure is approved by Toronto city council, it will come into effect one week from Tuesday.

In Canada, hot spots in Ontario and Quebec continue to report new cases of COVID-19, the disease caused by the coronavirus, every day. On Monday, Ontario reported 257 new coronavirus cases, including 177 from Windsor-Essex. On Tuesday, Windsor-Essex only reported 17 new cases.

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READ MORE: Ontario says provincial policy on mandatory masks ‘isn’t necessary’

Tory’s announcement comes after mayors across the GTHA released a statement on Monday asking Ontario Premier Doug Ford to make mask-wearing mandatory in large municipalities.

The mayors, including Tory, Markham Mayor Frank Scarpitti and Mississauga Mayor Bonnie Crombie, said people should be required to wear a face covering in indoor businesses, on transit and in other indoor spaces where people gather.

Peel Regional mayors and health officials also made moves to enact mandatory face mask use in indoor public spaces on Tuesday, and if the bylaw is passed, will become an official, mandated requirement as of next week.

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In Guelph and Wellington County, the local medical officer of health mandated in early June that residents wear masks or face coverings while in commercial businesses like stores to help curb the spread of COVID-19.

Efforts to make face coverings mandatory are also happening outside of Ontario.

READ MORE:Toronto makes face masks mandatory on TTC, Ontario recommends all riders wear them

The Quebec government announced on Tuesday that masks will soon be mandatory on public transit. Public transit authorities in the Greater Montreal area — the epicentre of the COVID-19 outbreak in Canada — have been handing out masks to commuters.

In early June, Montreal suburb Côte Saint-Luc passed a bylaw that makes wearing a mask mandatory in indoor public spaces such as stores and municipal buildings as of July 1.

Rules based on location

Creating mask regulations based on location and COVID-19 case count makes sense, says Dr. Andrew Morris, a professor of medicine at the University of Toronto and the medical director of the Sinai Health System-University Health Network Antimicrobial Stewardship Program.

If a city has few active cases of COVID-19, mandatory mask-wearing may not be necessary. But in environments with higher COVID-19 risk, masks — alongside other public health measures — can help.

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Click to play video: 'Coronavirus: Local reaction to changes to airlines, bars and long-term care facilities'
Coronavirus: Local reaction to changes to airlines, bars and long-term care facilities

Morris said that in his opinion, “we need masking in a few locations in Ontario at present and that it should be mandatory there,” but overall, mask-wearing should not be enforced equally across Canada.

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“There should be the weight of law imposed when a high threshold is met, and that threshold should be nimble — we do this with fire bans or water shortage advisories,” Morris, who also wrote a Twitter thread on the topic, told Global News.

“Public health is a municipal responsibility, primarily, and we are at a stage when the local public health units should be the ones to gauge what is necessary.”

READ MORE: Quebec health experts call on province to make masks mandatory

In places where masks are mandatory, Morris said free masks should be readily available to everyone.

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“Make it easy for people to comply,” he said. “A no-brainer.”

The federal government recommends Canadians wear non-medical masks or face coverings in the community “for periods of time when it is not possible to consistently maintain a two-metre physical distance from others, particularly in crowded public settings, such as stores, shopping areas and public transportation.”

Dr. Michael Warner, a Toronto-based physician and medical director of critical care at Michael Garron Hospital, posted a video to Twitter stressing the importance of mandatory face coverings.

Warner said masks, whether medical or non-medical, should be worn in all indoor workplaces, even in workplaces where only workers — not customers and workers — are interacting. He said mandating that people wear face coverings in public will help normalize the behaviour and encourage people to follow the rules.

“Wearing a face covering is vitally important,” he said in his video. “It reduces the spread of COVID-19.”

Click to play video: 'B.C. reports 26 new COVID-19 cases, no new deaths over 72-hour period'
B.C. reports 26 new COVID-19 cases, no new deaths over 72-hour period

Tom Koch, a professor of geography at the University of British Columbia whose research specializes in the mapping of disease, said he suspects that “mandating masks both inside and in crowd situations would serve two functions.”

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“First, it would tend to remind people of the wisdom of their use and give club, store and other (business) owners a way to say: ‘Hey, it’s the law.’ And masks will remind people to be safe, to accept the real possibility of transmission,” he said in an email to Global News.

“So I support an order that set mandatory masking until, say, Aug. 31 with an option to renew. But I also think that in general we’re doing pretty well — both businesses and people — in being proactive.”

Dr. Lynora Saxinger, a professor of infectious diseases at the University of Alberta, said more research on non-medical masks and their effectiveness on curbing the spread of COVID-19 is needed before broadly mandating them.

READ MORE: These Canadians say they suffered COVID-19 symptoms for months

Saxinger said the idea of mask recommendations based on local activity of disease “makes sense” but is a decision in which public health officials should be involved.

“Another issue is consistency; people would need to get clear messaging about why recommendations are different in different places and at different times,” she said.

While non-medical masks can be helpful when it comes to reducing the spread of COVID-19, other health measures like handwashing, physical distancing and testing are important, she stressed.

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Saxinger said it’s also vital people understand that non-medical masks are not all equal, and some do a better job of catching the respiratory droplets that transmit the virus than others.

“Mask cloths vary a lot. First of all, if they’re not getting close to your face, they’re useless anyway,” she said. “But then when you look at studies of fabric, some fabrics have (about a) three per cent filtration efficiency.”

Click to play video: 'Coronavirus R value in Alberta remains low after parts of economy reopened'
Coronavirus R value in Alberta remains low after parts of economy reopened

Bottom line

Masks, alongside other COVID-19 prevention measures like handwashing, physical distancing, testing and contact tracing, are important pieces to the prevention puzzle, experts say.

But masks should not be seen as the only tool to help stop virus transmission.

“When you look at the countries that have done well, they’ve had a whole bunch of different things going on at once, and masks were one part of that picture,” Saxinger said.

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Coronavirus: WHO director-general says ‘the worst is yet to come’ regarding pandemic, pleads to ‘quarantine COVID politics’

“So if we want to learn from that, we don’t just take one part of it. We say, ‘What else were they doing?’ Well, they had consistent public messaging. They had hand hygiene campaigns. There’s a lot of pieces of a bundle that might be important.”

Morris said government leaders need to have clear and consistent public health messaging if they want citizens to understand rules and follow them. Right now, it is “terrible overall,” he said.

“It goes from confusing (Gov. of Canada website), to clearer (Ontario), to clear (Toronto Public Health). It is inconsistent partly because the data quality is meh, but it is mostly inconsistent because of a lack of clear leadership,” Morris said.

READ MORE:Why does the coronavirus seem to cause so many different symptoms?

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“If the prime minister said, ‘Masks are clearly a small but important part of a bundle of protection to prevent transmission that starts with social distancing, limiting the number and variety of people you interact with, testing and isolating if you have symptoms or come into contact with someone with symptoms, and frequent washing of hands’ — and this were repeated by every premier and officer of health — we would be way ahead.”

Questions about COVID-19? Here are some things you need to know:

Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

For full COVID-19 coverage from Global News, click here.

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