Q and A: Toronto Public Health’s latest advice on masks…


The issue of whether to wear a face mask to protect against COVID-19 has come a long way since the virus first took hold in Toronto in March.

Official advice moved from “you don’t really need a mask unless you have COVID-19, save them for front-line medical workers” to “please wear a mask in enclosed public spaces,” to “wearing a mask is the law in Toronto,” and then it was mandated across the province.

A new, more contagious variant of the virus is confirmed to be circulating locally — one that could undermine the recent progress made in bringing down the number of daily new cases.

Residents are being asked to wear masks outdoors in crowds. Several European countries are recommending surgical masks in public.

The local supply of masks for health care is not the problem it was in March: There are now more than 31 million Level 2 surgical masks for front line workers in inventory in Toronto and additional contracts are in place, according to the city.

Dr. David Williams, Ontario’s chief medical officer of health said Friday that provincial and federal medical experts are looking at whether the advice on masks needs to be updated.

The Star spoke to Toronto associate medical officer of health Dr. Vinita Dubey about whether residents should buy medical masks if they can.

What’s the difference between a medical mask and a surgical mask?

In general, a medical mask is the same as a surgical mask or procedural mask. Medical masks come in three grades. A Level 1 medical mask has different properties compared to a Level 3 medical mask, which is just under an N95 mask, for example. The Level 3 mask also protects against splashes, like splashes of blood, which is not necessarily something that we need for COVID. So usually when we talk about a medical mask, we’re talking about a Level 1 medical grade, which includes surgical and procedural masks.

How do people know that they are buying a proper surgical mask?

The best way is to check it against Health Canada’s list to see that it has been approved as a medical-grade mask.

Other countries are recommending medical masks in public. What is the current thinking at Toronto Public Health around medical masks?

I think it’s important to recognize that COVID has evolved and so has the evidence to protect against it. We follow the guidelines provincially and nationally. The Public Health Agency of Canada recommends a three-layer mask (which can be a two-layer mask with a filter). That is where we’re at right now. We will certainly update our guidelines as the science recommends.

Dr. Eileen de Villa has always been clear about this: If you’re out in public and you pass someone on the street, you’re very unlikely to get COVID. Is the new variant so transmissible that you can get infected that way?

I don’t think we know for sure. What we know is that the U.K. variant for example is 30-50 per cent more transmissible. What does that mean? I don’t have any answers to that. But when you think about increased transmissibility, we have to think about all the ways in which the virus spreads.

So I guess it’s fair to say you’re still grappling with what that increased transmissibility means and how to protect against it?

Yes, I think the one thing that is clear though, is that the measures that we do have in place, let’s do those properly. How many times have we seen that mask under the nose? Even before we start talking about medical masks, lets talk about wearing masks properly. There was some evidence that three layer masks — two layers and filter — might provide similar type protection as a medical grade mask, and if that’s more comfortable, if you can get it to fit without gaps, you’ll keep it on for longer. Well, maybe that’s the better way to go. Compliance is actually a really important piece here, not just the mask.

Should the public wear N95 masks?

N95 is a very particular medical mask. You need to be fitted for it, to ensure that ambient air doesn’t get into the mask. They are actually quite difficult to wear, because they are not breathable the way a medical mask is. It’s not even recommended for everyone in the hospital. I only wear the N95 if it’s a code blue and I’m intubating someone for example.

Source: https://www.thestar.com/news/gta/2021/01/29/q-and-a-toronto-public-healths-latest-advice-on-masks.html