The new COVID-19 variant Omicron has been a game changer in terms of how health-care professionals handle the pandemic. Omicron has spread quickly, leaving many people unsure about how to keep themselves and others safe.

Regina infectious diseases specialist Dr. Alex Wong took some time to speak to The Morning Edition host Stefani Langenegger and answer listener questions.

Is it better to wear a double mask or an N95? And if the N95 is better, why is that not a recommendation from the Saskatchewan Health Authority?

The SHA actually just recently changed guidelines, and are now recommending N95s, in the context of acknowledging that airborne transmission of COVID-19 is actually very real and relevant. In the last couple of weeks, N95s are now recommended for all health-care workers, who are interacting with any COVID positive patients, regardless of the type of interaction.

The bottom line here is that respirators, like N95s or KN95s, or KF94s are better than medical and surgical masks and cloth masks because they filter a lot of what is in the air and what we breathe much, much better, (filtering) 95 per cent plus, compared to medical masks, which are probably between 50 to 70 per cent, and cloth masks, which are even less.

If you have the financial means to do so, upgrading to a respirator for all indoor public interactions is recommended. If you can’t afford or can’t find a respirator mask, then you need to certainly upgrade your cloth mask, at least to some type of a medical or surgical grade mask to improve the amount that’s filtered. Double mask by placing a cloth mask over top of a medical or surgical mask to try to make that fit much tighter and to reduce the amount of leakage.

Especially with Omicron being as contagious and transmissible as it is, we really want to do the best that we can to upgrade masks as best as possible, both for yourself, as well as for all your family members, including your kids.



Written by Florence Hwang

The full impact of the COVID-19 pandemic on the environment will take years to fully understand, but a new study from the University of Portsmouth in the U.K. is giving a first look at just how much litter stemmed from the first wave.

Published Thursday in the journal Nature Sustainability, the study “Increased personal protective equipment litter as a result of COVID measures,” compared and analyzed data from the “COVID-19 Government Response Tracker” from Oxford University and the litter collection app “Litterati,” both open-source databases.

Researchers took data from 11 countries – Canada, France, Germany, Belgium, Spain, the U.K., the U.S., the Netherlands, Sweden, Australia and New Zealand – and mapped their policy responses to the pandemic, including things like lockdown severity and mask policies. They then created a “base line” of litter proportions in the 11 study countries from Sept. 2019 through the first six months of the pandemic.

The study found that face mask litter increased 9,000 per cent from March to October 2020, and there was a direct link between national legislation and discarded waste that included masks and other personal protective equipment (PPE).

“We found that littered masks had an exponential increase from March 2020, resulting in an 84-fold increase by October 2020,” lead researcher Keiron Roberts said in a release. “There is a clear need to ensure that requiring the use of these items is accompanied with education campaigns to limit their release into the environment.”

The U.K. showed the highest overall proportion of masks, gloves and wipes as litter, with masks accounting for five per cent of all litter from August to October 2020, and gloves and wipes accounting for 1.5 per cent.

The Netherlands, however, showed the proportion of masks, gloves and wipes did not exceed one per cent of the total examined litter, except for gloves which reached three per cent in April 2020.

Sweden had several months when no COVID-19 related litter was recorded.

Canada’s data showed an emergence of mask, glove and wipe litter around and after the announcement of the pandemic.

Germany and the U.S. had a similar pattern to Canada for masks, but the study notes that gloves and wipes were present as littler prior to the pandemic.

Through the course of the study, researchers established some patterns that affected the amount of litter being discarded. In January to March 2020, countries struggling to find enough PPE had guidance to physically distance.

In March to May 2020, the most severe lockdowns were observed, leading to mask litter being low, yet on the rise.

In June to October 2020, the WHO recommended the use of masks, following which many lockdown measures were relaxed, the study said, leading to a dramatic increase in mask litter as people exercised their increasing freedoms.

Glove litter increased in the initial stages of the pandemic, but fell after the introduction of mask policies, the study notes.

“In April 2020, it was beginning to appear that there were some small positives in the decrease in human activity caused by lockdown, with improvements in air quality and water quality. Reduced human activity also saw reports of animals coming back to towns and cities,” Roberts said in the release.

“At the same time, reports of masks and gloves appearing on beaches and streets, where they hadn’t been before, started to emerge. As COVID-19 spread, so did the news reports of this new type of litter,” he continued.

As data collection in the field became increasingly difficult due to lockdowns, researchers turned to the online databases which allowed them to compare litter trends on a monthly basis, matching up WHO announcements and national policy and lockdown restrictions to see how those actions impacted litter proportions.

“It wasn’t a surprise to see mask litter appear, but what did surprise us was how national legislation had dramatically impacted the occurrence of mask litter,” Roberts said.

The two national policies examined by the study were introduction of lockdown travel restrictions and mask-wearing.

As countries legislating mask use increased, their appearance in litter also increased, the study notes.

Gloves showed a “significant increase in prevalence with the announcement of the pandemic,” which corresponds with most countries in the study implementing what the study calls “lockdown level 3.”

The study posits glove litter is due citizen’s personal actions to prevent surface cross contamination, but an increasing awareness and communication of the role of aerosols in the initials months of the pandemic may have shifted the use of PPE away from gloves towards masks in line with WHO advice.


Another researcher in the study and professor at the University of Portsmouth Steve Fletcher said in the release “despite millions of people being told to use face masks, little guidance was given on how to dispose of them or recycle them safely. Without better disposal practices, an environmental disaster is looming.”

Fletcher said the majority of masks are manufactured from long-lasting plastic materials and, if discarded carelessly, can stay in the environment for “decades to hundreds of years.”

The study outlined several ways the litter from the COVID-19 pandemic affects the environment. Short term, if masks and other PPE enter sewers they can cause potential blockages which affects infrastructure, plus the potential for litter to act as a viral vector to transmit the coronavirus within the first few hours or days if discarded by an infected person.

Medium-term, litter can get entangled and choke large animals, and if eaten can cause internal complications and even death. Wherever litter lands can smother smaller organisms and plant life.

Long-term, the researchers point out all the factors from short and medium-term concerns will compound, with the “addition of becoming a transmission route for other pollutants.” The researchers pointed out that if the litter is made from plastic, it will eventually break down into micro-plastics and have the potential to enter the food chain.

“As nations use masks to support social interactions, they need to support the safe disposal of this litter, and while they are at it, all other litter too,” Roberts said in the release. “We need to avoid this pandemic litter becoming a lasting legacy.”

The researchers are urging world governments to put in place policies and legislation for the proper disposal of face masks when making them mandatory.


Written by Christy Somos

Your cloth mask may not be as protective as you’d like, especially as we head indoors.

Now that the cold weather has hit and people are moving inside, many doctors and scientists are urging Canadians not only to resist getting complacent about wearing masks to protect against COVID-19 — but also to take a closer look at whether that cloth mask is keeping you and others as safe as possible.

“In general, while non-medical masks can help prevent the spread of COVID-19, medical masks and respirators provide better protection,” the Public Health Agency of Canada (PHAC) said on its COVID-19 mask information webpage, which was updated on Nov. 12.

The updated guidance also recommends medical masks or respirators for people “who are at risk of more severe disease or outcomes from COVID-19” and those “at higher risk of exposure to COVID-19 because of their living situation.”

Respirators (such as N-95 and KN-95 masks) are considered the highest level of mask protection and were previously recommended only for health-care workers coming into direct contact with infectious patients. In those high-risk areas, respirators require a “fit test.”

But in a nod to more general use, PHAC’s guidance now says: “A respirator worn in the community doesn’t need to have been formally fit tested as is required in some occupational settings.”

Responding to a CBC News inquiry about why PHAC’s recommendations have changed, the agency said in an email it was “based on the latest scientific evidence on SARS-CoV-2 virus variants of concern, increased understanding of the impacts of vaccination and immunity in the population, and new data available on mask types and their effectiveness.”

In addition to the updated online guidance, Dr. Theresa Tam, Canada’s chief public health officer, recently posted a series of tweets illustrating how COVID-19 could spread through the air, using the analogy of second-hand smoke.

Many doctors, scientists and engineers say this shift in messaging reflects a growing body of evidence suggesting that COVID-19 is largely spread through aerosols (tiny particles that can hang in the air), and not just through respiratory droplets (larger particles) transmitted by close contact with an infected person.

In turn, that means it’s important to re-evaluate the masks we’re using, they say.

“This marks a transition in Canada toward a recognition of how important aerosol, airborne-based transmission is in transmission of this virus,” said Dr. Brooks Fallis, a critical care physician at the Toronto-area William Osler Health System.

Because aerosol particles are smaller and can accumulate in the air over time, Fallis said, the best-performing masks are critical if you’re going to be indoors with other people for a while.

“If you’re just, you know, popping into the grocery store to grab a couple of items, or you’re … walking along a crowded street and you want to wear a mask, then it’s fine [to wear a medical mask],” Fallis said.

“But if you’re in a closed space with lots of people, then we should be upgrading to higher-level masks, like the KN-95 masks or a respirator-type mask, which provides better fit and better filtration.”

Masks are important even when you’re fully vaccinated, both PHAC and doctors say, because although it’s much less likely, infection with the virus that causes COVID-19 — especially the highly transmissible delta variant — can still happen.



Written by Nicole Ireland

Layering protection of masks, ventilation and filtration can help fight airborne spread.

Canadians looking for guidance on how to reduce their risk of COVID-19 indoors this winter may be feeling left out in the cold.

The Public Health Agency of Canada (PHAC) now recommends opening windows to increase ventilation and using HEPA filters to clean indoor air, but it stops short of advocating for better-quality masks or saying outright that the virus is primarily airborne.

“From what I’ve seen, Canada is now an outlier in terms of not acknowledging transmission through the air,” said Linsey Marr, an expert on virus transmission at Virginia Tech in Blacksburg, Va. “I think the messaging could be more clear.”

Canada’s guidelines on masking also haven’t been updated in more than a year, with non-medical masks containing a filter still recommended — despite research showing cloth masks are less effective than surgical masks against the airborne spread of COVID-19.

“It sounds like they’re still talking like there’s a shortage of medical masks,” said Marr, a civil and environmental engineering professor. “We know any mask is better than no mask, but also some masks are better than other masks — and so if you haven’t already, you could consider upgrading your mask.”

Marr said Canada is “missing out” on the opportunity to promote better protection from medical masks with higher filtration levels, such as surgical masks or N95s, but also when it comes to explaining exactly why filtration, ventilation and masking are so important.

“That’s because the virus is in the air,” she said. “I think if people understand that, they will be much more likely and willing to take measures that are effective at reducing transmission.”

Aerosol transmission ‘changes the game’ on indoor risk

Almost two years into the pandemic, our understanding of the airborne spread of the virus has changed dramatically, with more infectious variants increasing risk and physical distancing alone not proven to be sufficient — especially indoors.

The virus can be transmitted through the air in two key ways: microscopic airborne particles called aerosols that linger in the air like smoke, or larger respiratory droplets that fall to the ground quickly (prompting the original two-metre physical-distancing guidelines).

But experts say Canada’s public health guidance has struggled to keep up with the evolving science, leading to contradictory advice, such as PHAC’s recommendation that physical distancing is the “best way to help prevent the spread of COVID-19.”

“If that’s the case, then you should be OK with being in a room with a COVID-infected person with your mask off if you are six feet apart,” said Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa.

“If that is not the case, then you accept aerosol transmission. But the problem is, we don’t have 100 per cent consensus amongst experts. So it might be confusing for people who get conflicting information.”

Toronto respirologist Dr. Samir Gupta says once we realized aerosol transmission was a primary driver of the spread of the virus through the air, public health guidelines for Canadians should have followed suit.

“This whole pandemic has turned aerosol science on its head,” he said. “It became clear that there were transmission events happening much further out than two metres, and so it couldn’t be just droplets.”

Gupta said the “pendulum swung” toward aerosol transmission being a major factor in how the virus is transmitted, and the practical implications of that are “huge” for the Canadian public when gathering indoors.

“You can be very far away from the infection source, but if you’re in there for long enough, you will catch it through aerosols,” he said. “And that changes the game in terms of how we control spread.”

Layering protections can ‘reduce the risk by a lot’

Other countries go far beyond Canada’s guidance: The U.S. Centers for Disease Control and Prevention now says N95s can be worn by the general public, and Britain recently launched an awareness campaign on preventing airborne transmission indoors.

Canada quietly updated its guidelines on the risk of airborne spread a year ago, adding the word “aerosols” for the first time, but it has stopped short of recommending medical masks for the general public or creating a similar campaign specifically around airborne spread.

“It is both troubling and tragic that our public health leaders have failed repeatedly to safeguard Canadians through simple, cost-effective and proven airborne protective measures,” said Mario Possamai, a forensic investigator and senior adviser on the 2007 SARS Commission.

“They should be held accountable for the deaths and infections their shameful negligence has caused.”

Experts say layering different levels of protection on top of each other, also known as the Swiss cheese model, can further prevent the spread of COVID-19 as colder weather pushes us more toward indoor activities in the coming weeks and months.

“None of them by itself is 100 per cent effective,” Marr of Virginia Tech said. “But when you combine them, you can reduce the risk by a lot.”

Deonandan said the use of proper masks, ventilation and filtration — combined with high vaccination rates and vaccine passports for indoor spaces — will help to keep transmission levels low and take care of the “lion’s share of the risk.”

“A year ago, there were so many mysteries about this disease … but now it’s not that mysterious how people get it — and because we know that, we know how to stop it,” he said.

“So we don’t have to have lockdowns, we don’t have to have economic pain anymore. All we’ve got to do is make some good choices on a daily basis.”

Lift measures cautiously, like ‘an on-off switch’

High vaccination rates, the rollout of third doses to vulnerable Canadians and the approval of vaccines for children in the coming weeks will make a big difference in our COVID-19 risk levels across Canada, but experts say we need to be patient.

“When cases are low, it doesn’t mean we should just remove these measures,” said Dr. David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health. “That’s like folding your umbrella in a rainstorm because you’re not wet yet.”

Ontario recently announced plans to lift all of its COVID-19 public health measure by March — including masks — but experts say that decision should be tied to data on transmission levels circulating at the time.

“If we’re going to lift the rules … we need to also be prepared to reinstate them if a new more transmissible variant comes along that escapes the vaccine,” Marr said.

“I think the U.S. got in trouble lifting mask rules in May, and we didn’t have a way to bring them back when we really needed them with the surge of [the delta variant] in late summer.”

Marr said keeping precautions in place and using a “data-driven mask policy” tied to transmission rates in the community “like an on-off switch” will help prevent a resurgence of COVID-19 in the future as we continue to learn to live with the virus.

“It’s important that people understand that the crisis is not over — but it will be,” Deonandan said. “And I know you’re tired of hearing this, but we can live our lives now, but live our lives responsibly.”


Written by Adam Miller

As provinces look at gradually lifting COVID-19 restrictions, masks should be among the last things to go, experts say, even with high vaccination rates.

That’s Ontario’s current plan – while it’s subject to change, the province anticipates lifting mask mandates in March 2022, after other measures like capacity limits and proof-of-vaccination requirements are already gone.

This is more gradual than the approach taken by B.C. and Alberta this summer. When they dropped their mask mandates – alongside a slew of other COVID-19 restrictions – cases went back up. Both provinces have since reimposed masks in most indoor settings.

“I think what happened in Alberta was predictable, but I think all of us really learnt from that experience, unfortunately, with the devastation that we’ve seen in our health-care system,” said Dr. Michelle Bailey, a pediatrician at the Alberta Children’s Hospital.

“Ending mask mandates is an absolutely horrible idea,” said Dr. Barry Pakes, an assistant professor at the University of Toronto’s school of public health.

Dr. Peter Juni, a professor at the University of Toronto and scientific director of the Ontario Science Table, agrees.

“We can’t let go of the masks and we can’t let go of the vaccine certificates,” he told Global News Friday after Ontario announced its plan to ease measures.

“If you want to have a proof of concept of what I just said, go to Denmark. Denmark has a lot of advantages over Ontario, structurally speaking, with a lot less problems with socioeconomic status, a lot less problems with living situations of people. But they lifted nearly all restrictions. And guess what? Case numbers are exploding again. We want to avoid that.”

The U.K., which also lifted masking requirements in July, has seen steadily high numbers of COVID-19 cases since then. Around 68 per cent of the U.K. population is fully vaccinated, according to Our World in Data, compared with about 77 per cent in Canada.

Mask science

Even if case numbers are falling, masks still serve a purpose, said Dr. Susy Hota, an infectious diseases specialist and director of infection prevention and control at Toronto’s University Health Network.

“Masking can be one of the most powerful, and it’s also one of the most easily tolerated interventions we have,” she said.

Several studies have found that masks are an effective way of slowing the spread of COVID-19.

randomized trial from Bangladesh published in September that looked at mask promotion found that even in areas where fewer than half of people regularly wore masks, symptomatic COVID-19 infection was 11 per cent lower than in areas that didn’t have mask-promotion campaigns. Symptomatic infections among seniors were reduced by 35 per cent.

An evidence review published in January also found that masks helped reduce disease spread, and the more people wore them, the better it worked.

Vaccination doesn’t entirely change the game, Hota said.

“The good news is that people are vaccinated. The risk of acquiring the infection is reduced significantly, and their risk of transmitting it off to others is also reduced, but it’s not down to zero,” Hota said. “So that’s why we have to have all of these measures in place and be mindful of when you remove one, making sure you have other measures that can help to mitigate the risk.”

In many provinces, you may remove masks inside a restaurant or while exercising at a gym, but you need to show proof of vaccination to get in, as a way of mitigating risk.

But even as more and more people get vaccinated, Bailey cautions against relying on vaccines alone as the pandemic continues.

“The question that we don’t know is how high a vaccination rate is good enough to be a standalone measure, and I think we really need to have caution going forward that this is really a combination deal,” she said.

Provinces should look at vaccination rates, case numbers, physical distancing measures, and a number of other factors before lifting things like mask mandates, she said.

Wearing a mask in most indoor settings can help to keep case numbers low enough to allow people to take them off where they think it’s important – like at a restaurant with friends, said Dr. Catherine Clase, a professor of medicine and member of McMaster University’s Centre of Excellence in Protective Equipment and Materials.



Written by Leslie Young

A new joint study says that without mask wearing, a two-metre physical distancing guideline may not be enough to prevent the spread of COVID-19 indoors, however, wearing a mask can reduce the contamination range of airborne particles by approximately 67 per cent.

The study, published in the December volume of the journal Building and Environment, was conducted by researchers at McGill University, Universite de Sherbrooke, Texas A&M University, and Northern Illinois University. The research was based on models that examined the flow of liquids and gasses in indoor spaces using a computer program that accurately simulated coughing dynamics.

“Mask mandates and good ventilation are critically important to curb the spread of more contagious strains of COVID-19, especially during the flu season and winter months as more people socialize indoors,” said study author Saad Akhtar in a release.

Coughing is one of the main sources of spread of airborne viruses from symptomatic individuals, and currently, most public health guidelines recommend a distance of two metres for physical distancing between people who are not from the same household to address this.

However, the study found that when people are unmasked, more than 70 per cent of airborne particles pass the two-metre threshold within 30 seconds. By comparison, less than one per cent of particles cross the two-metres mark if masks are worn.

Coughing simulations run by the study found that particles can reach distances as far as five metres away or more if the person is unmasked and depending on ventilation and air conditioning.

Coughing simulation

The effect of mask wearing indoors on the spread of particles over a 30 second interval can be seen here in a coughing simulation run by the joint study. (McGill University/ Building and Environment Journal)

The study found that ventilation, a person’s posture, and mask-wearing impacted the spread of particles significantly, but age and gender had only marginal impacts.

“This study advances the understanding of how infectious particles can spread from a source to its surroundings and can help policymakers and governments make informed decisions about guidelines for masks and distancing in indoor settings,” Akhtar said.


Written by Christy Somos

Some voters who arrive to their polling station without a mask or who refuse to wear a mask will be turned away from the polls, Elections Canada warns.

In a statement, a spokesperson from Elections Canada said anyone who refuses to wear a mask “will be refused entry to the polling station” in the provinces and territories with an active indoor mask mandate.

Saskatchewan, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, Yukon and Nunavut do not currently require residents to wear a mask indoors.

In these provinces, mandatory masks will still be enforced at polling stations where “the landlord leasing the space to Elections Canada” requires mask wearing.

In the other provinces, those who refuse to wear a mask are encouraged to apply for a mail-in ballot. The deadline to apply is Sept. 14 at 6 p.m. local time.

Voters who cannot wear a mask for medical reasons are also encouraged to vote by mail, but will not be turned away from a polling station and will not required to show proof of medical exemption, with the exception of Alberta schools, where school boards require proof of an exemption.

Elections Canada added that all election workers, candidates and candidates’ representatives “will be required to wear masks to lead by example and maintain the safest environment possible for electors and workers.”

At the polling station, physical distancing requirements will be enforced. There will be single-use pencils and hand sanitizer.

Workers will be regularly wiping down the voting stations, so Elections Canada warns there may be “very minor” delays to vote.



Written by Ben Cousins

Newfoundland and Labrador has only just lifted its mask mandate, but public health officials are still strongly recommending wearing one.

Some places, such as hospitals, long-term care homes and courthouses still require people to cover up, but many private businesses are giving customers an option.

Infectious diseases specialist Dr. Lisa Barrett says one good reason to wear a mask is to help those who have not or cannot be vaccinated yet.

“There are a lot of factors that go into whether masks are essential at the moment, but certainly it would not be unreasonable to consider wearing them in large spaces with lots of travelers and lots of people still waiting to be vaccinated,” said Barrett, who works at Dalhousie University in Halifax.

Barrett said Atlantic Canadians have been lucky that COVID-19 is fairly under control in their region, but she says it’s still important to protect vulnerable populations.

Children under 12, for example, are still unable to receive a vaccination.

“There’s a good chunk of people, including children, who do not get vaccinated at the moment because they can’t, and we have to keep that in mind as we go forward,” said Barrett, who is originally from Old Perlican, N.L.

“Especially while we’re still learning more about this virus and what the long-term side effects might be.”


Ottawa’s medical officer of health says she wants to see mask mandates remain in effect across Ontario even after the province moves out of Step 3 of its reopening plan.

Speaking to reporters Thursday, Dr. Vera Etches said she has spoken with Ontario’s chief medical officer of health. Dr. Kieran Moore, about maintaining a province-wide mask mandate come fall.

“What I expect, going into the fall, is that (Ottawa) will continue to operate under provincial regulations and I’m speaking with our chief medical officer of health about continuing to include mask requirements for crowds,” she said.

“My recommendation would be to have a province-wide approach,” she added. “We’re all connected and travel is increasing as people have that protection (from vaccines). It’s one of those things that is under active conversation and consideration for the next step.”

On Thursday, Ontario hit one of its benchmarks for moving beyond Step 3, but Health Minister Christine Elliott said there is still work to be done. The earliest Ontario can move past Step 3 is Aug. 6.

Ottawa has a local mandatory mask bylaw that covers mask use in public places, but city staff say it will expire on Aug. 26, as local authorities have been following the provincial guidelines. The temporary mandatory mask bylaw was first enacted when there were no provincial regulations regarding mask use as a public health measure.

Etches says that although the Public Health Agency of Canada says small groups of fully vaccinated people do not require masks, they are still a helpful tool in larger groups or when the vaccination status of others is unknown.

“Often, we don’t know the vaccination status of others in the workplace or others in a crowd,” she said. “Masks, in particular, are a very useful tool to continue to keep transmission lower when you’re indoors and in crowded places.”

Aside from masks, however, Etches was unsure about what other restrictions she would want to see continue.

“I think this is part of what we need to monitor and assess: which of the measures are going to be the most effective and strike the right balance as we go into the fall,” she said. “I’m not part of the public health measures table, but I know they have been looking at the evidence and the international experience around what is worth maintaining and, clearly, masks stand out as one of the practices that is helpful.”

Etches said she is confident vaccine uptake combined with continued public health measures will help keep the worst effects of a possible fall resurgence in cases at bay. Moore has previously said he expects a rise in cases in the fall but Etches said she believes schools can remain open.

“Our way of handling exposure to COVID-19 in schools is changing because of vaccination. If you’re vaccinated, even if you’re exposed to somebody who is positive in the school environment, you won’t have to go home to isolate for two weeks,” she said. “I hope that can encourage people to head out this week, if you haven’t already had your first dose or haven’t had your second dose. You can walk in to any clinic.”

Etches said Ottawa Public Health is also piloting a project that would allow someone who develops symptoms at school to return home with a take-home COVID-19 test if accessing testing is a challenge.

A full back-to-school plan from the provincial government is expected to be announced next week.



Written by: Ted Raymond

The CDC advised Americans on Tuesday to wear masks in public indoor settings, even if fully immunized, just two months after recommending that vaccinated people can avoid donning masks indoors, and only weeks after four Canadian provinces relaxed their own rules around mask wearing.

The reversal by the Centers for Disease Control and Prevention was prompted by the spread of the highly transmissible Delta variant and rising COVID-19 case numbers across the country.

British Columbia, Alberta, Saskatchewan and PEI stopped requiring masks in most indoor settings earlier this month in response to a surge in Canadian vaccination rates. Those provinces say they have no plans to tighten indoor mask mandates, despite the urging of health experts who say mask wearing will help curb the spread of the Delta variant. New Brunswick is set to remove its mask mandate on Friday.

Meanwhile, case numbers in Canada are rising. Chief Public Health Officer Theresa Tam said in a statement Tuesday that Canada saw a 36-per-cent increase in pandemic cases between July 20-26 compared with the previous week, while severe illness resulting from COVID-19 has continued to decline.

She said the Delta variant, which has infected vaccinated people on rare occasions, is one of the most prevalent strands in the country. The spread of Delta forced Israel to reimplement a mask mandate in late June, just 10 days after lifting it, when daily cases rose from zero to triple digits.

Dr. Tam encouraged people to continue wearing masks to help reduce the spread. Public Health Agency of Canada spokeswoman Tammy Jarbeau said in an e-mail that the agency does not expect that guidance to change any time soon.

However, Alberta Health spokeswoman Lisa Glover said in an e-mail that the province’s mask mandate will remain lifted for most public indoor settings, as it has been since July 1, but that the province will continue to monitor and adapt its approach as needed. Masking is now only compulsory for those who work or visit continuing-care facilities, hospitals and other acute-care facilities; and when using public transit or rideshares and taxis.

“While masking is currently required in certain settings, we encourage all Albertans to assess their individual situation and risk factors when making decisions about whether they wish to wear a mask in other locations,” Ms. Glover said in the e-mail.

B.C. Provincial Health Officer Bonnie Henry said Tuesday that although the province lifted its mask mandate, residents are still encouraged to wear masks to protect themselves and others.

“We are getting there, but we’re not yet at the place where we can let up these measures and our recommendations to everybody will continue to be wearing masks in indoor public spaces, particularly when they’re crowded spaces,” Dr. Henry said.

PEI Chief Public Health Officer Heather Morrison said that the province, which only has two active cases, plans to continue living mask-free. Dr. Morrison attributes PEI’s success to strong vaccination rates and testing of most who enter PEI’s boundaries.

“Masking is an additional layer of protection but not our first layer of protection,” Dr. Morrison said. “If we need to change things at any point, we will.”

Like PEI, Saskatchewan also plans to continue to do without masks, and to rely on vaccines to keep case numbers low.

“Vaccination continues to offer residents the best protection against COVID-19 and its variants, and the province continues to focus on increasing vaccination rates,” said Colleen Book, director of communications at the Saskatchewan Ministry of Health.

Guidelines around mask wearing have evolved since the start of the pandemic. After being deemed unnecessary for healthy individuals by some Canadian public-health officials in March, 2020, Dr. Tam soon recommended their use in light of new research.

Shannon Majowicz, an epidemiologist and associate professor at the University of Waterloo, said she expects provincial mask mandates to come back into place, given the virality of the Delta variant. She thinks it would be the right move.

“I’m not in a rush to see masking lifted because I do think it is one of the things that will let us have a lot more of activities possible,” she said. “Vaccines work best when they have less work to do, and masking is the way to do that.”

Dr. Majowicz said Canada’s high inoculation rate made it possible to consider removing mask mandates. According to recent data, almost 65 per cent of residents older than 12 were fully vaccinated.

Prime Minister Justin Trudeau said on Tuesday that Canada has enough doses to fully inoculate everybody eligible, a milestone hit two months ahead of schedule. Dr. Majowicz said, however, that it could take a vaccination percentage in the high nineties to really get rid of masks without fear of seeing more case surges.

For that to happen, she said, children 12 and under must receive their doses. That age group is still waiting for vaccines to become available. Until that happens, she calls it a no-brainer to continue wearing masks.

“Why wouldn’t you put a protective measure over your face? It’s a relatively easy measure we can take that really does make a substantial difference,” Dr. Majowicz said. “We are so close to near normalcy.”