Canada is preparing to reopen. But mask wearing must not be abandoned, experts warn.

As chefs add the final touch to their post-pandemic restaurant menus and designer shop assistants polish off their exclusive brands, across this country, businesses are getting ready to re-open.

As provinces and previously hard-hit regions in Canada see lower case counts, millions of Canadians are preparing to go back to working in office buildings, attending school in-person and gathering with family and friends. And a return to indoor dining, live entertainment, sporting events, working out in gyms, shopping at brick-and-mortar stores and getting primped-up in salons, barber shops and spas, will all likely be part of daily life again soon. 

But our infectious diseases experts say there are some crucial precautions that need to be taken care of first before any of this can unfold safely. In a recent CBC interview with journalist Lauren Pelley, a professor in the infectious-diseases division at the University of Alberta’s department of medicine and the university’s director of infection prevention and control, Dr. Stephanie Smith, said: “Yes, things are opening up, but we can’t just abandon all the measures that we’ve put in place. That means maintaining public health precautions such as mask-wearing, physical distancing and basic hand hygiene—and, in the case of some workplaces, upgrading their ventilation—during this transition period back to normal life, since many Canadians remain vulnerable and unvaccinated.

“We have to recognize that although our case numbers are going down … there still is some COVID circulating in the community,” Smith said.

Why ventilation and mask-wearing will be key

Infectious diseases specialist Dr. Srinivas Murthy, an assistant professor of medicine at the University of British Columbia, who was interviewed by Pelley for the CBC interview, said that Canadians need to approach transmission risk based on what we know about transmission of the virus. “In an ideal world, we would have clear public health guidance from each of our respective authorities,” he said. “What you should and shouldn’t do in this context. The 3 Cs approach developed in Japan—avoiding closed spaces, crowded places, and close-contact settings—sums up the best lessons we’ve learned so far about how to curb transmission,” Murthy said.

Reviewing case studies in a report entitled: “COVID-19 Transmission Through Large Respiratory Droplets and Aerosols… What We Know So Far” released by Public Health Ontario, some epidemiological studies reported that virus transmission took place beyond a few metres in a variety of indoor settings, including churches, restaurants, concert halls and office buildings and Public Health Ontario signals the need to boost airflow indoors.

The report’s key findings suggest that “viral respiratory transmission is most frequently and easily at short range through exposure to respiratory particles that range in size from large droplets which fall quickly to the ground to smaller droplets, known as aerosols, which can remain suspended in the air. But there is evidence to suggest long-range transmission can also occur under the right set of favourable conditions, implicating aerosols in transmission.” After an exhaustive review of case studies, and citing the recurring issue of ventilation, the Public Health Ontario report suggests the need to boost airflow indoors or stay outside whenever possible.

Regina infectious diseases physician Dr. Alex Wong, who was also consulted in the in the Pelley CBC interview, stated that mask-wearing should not be abandoned and that wearing a 3-layer mask will likely be in place in Canada for some time longer, even as vaccination rates increase.

Canada’s Chief Medical Officer of Health Dr. Theresa Tam recommends that Canadians wear a three-layer mask. And this type is now available at MedPPE Canada. Click on this convenient link to find out more about a 3-ply MedPPE Canada surgical mask: https://medppecan.com/product/3-ply-masks-50-box/

Although the 3-ply masks are a good everyday standard, Canadians perhaps should think of opting for masks that offer better protection when needed for venturing among crowds. 

If you’re able to opt for KN95s, which are actually “respirators,” you should do so. MedPPE Canada’s KN95 respirator masks are recommended by Health Canada, the CDC, approved by the FDA and are an essential resource for keeping healthcare workers and the public safe. With almost identical specifications, these masks have similar filter performance, flow rate, inhalation and exhalation metrics resistance and KN95 masks are manufactured from a non-woven fabric which helps keep users safe from smog, dust, air pollution, bacteria and more. Click on this link for your reliable Canadian source of masks:  https://medppecan.com/product/kn95-respirator-5-pack/

Furthermore, Dr. Wong stressed, “Improving ventilation is generally helpful,“ but he also stressed that mask-wearing will “likely be a staple of daily life for months to come until more Canadians get vaccinated.”

In the U.S., the CDC recently eased indoor mask-waring regulations  for the fully vaccinated. But Regina doctor Alex Wong said “since Canada’s rate of fully vaccinated individuals still lags behind the U.S., we’re not quite at that point yet, meaning face coverings remain a crucial tool to protect vulnerable individuals as more people start mingling and returning to workplaces. Masking continues to make a huge amount of sense in indoor, public spaces.” 

And is handwashing still important? “Yes, it still is.” 

Experts have continuously recommended effective handwashing as a precaution to prevent people from becoming infected after touching their face or mouth.

As more Canadians are fully vaccinated, there’s hope we can start to lift even the most stringent restrictions in the months ahead. “If you’re gathering in a group with people who are fully vaccinated, certainly the risk is much less,” Dr. Stephanie Smith said.

“Several resources exist for community guidance on how to reduce the risk of transmission through a layered approach of multiple public health measures designed to mitigate short-range and long-range transmission. In general these involve avoiding the ‘3 C’s’: closed spaces, crowded places, and close contact.” 

The Public Health Ontario report states that the degree to which various mitigation layers will be necessary to avoid future transmission will depend on the setting and risk context. Their recommendations (quoted from the report) on how that transmission can be mitigated are as follows: 

• Getting vaccinated (higher vaccine coverage in the population can reduce risk for individuals unable to receive a vaccine). 

• Staying home when sick. 

• Limiting the number and duration of contacts with individuals outside your household. 

• Physical distancing and avoiding crowded spaces. 

• Consistently and appropriately using a well-fitted, well-constructed (3-layer) mask for source control and personal protective equipment. 

• Ensuring that ventilation systems are well-maintained and optimized.

• Performing hand hygiene, respiratory etiquette, and environmental.

For those who are concerned about air quality and ventilation in their home, office, or other indoor spaces, obtaining an air purifier that quickly and effectively removes 99.99% of aerosols carrying harmful viruses, bacteria, mold and smoke from the indoor air might be a wise precaution to prevent transmission. For more information go to: https://medppecan.com/product/purashield-500-cabinet/

Once the pandemic is mostly contained, there is likely to be sporadic outbreaks for years to come, particularly in areas with low vaccination rates or when novel variants appear. In those cases, we must be willing to temporarily mask up once again, to keep our communities safe until the outbreak can be tamped down.

There will also always be groups of people who cannot be fully protected from the virus even after being vaccinated. Studies show that people who are immunocompromised (like transplant patients) do not develop full immunity. And for this reason susceptible people should be encouraged and supported in masking in public. By the rest of us maintaining masking in crowded places— on public transportation, in stores, or in other indoor locations— we destigmatize protecting the vulnerable.

Sources:

“Even while some provinces are preparing to reopen, experts say it’s not time to toss aside your mask just yet.” By Lauren Pelley, CBC News· Posted: May 27, 2021 4:00 AM ET 

“COVID-19 Transmission Through Large Respiratory Droplets and Aerosols… What We Know So Far” by Ontario Public Health, Report released May 20, 2021.