If, as is widely anticipated, COVID-19 spikes again in the fall, should Canada bring back mask mandates?
This page would say no. And yes. And maybe.
Yes to enforced masking at nursing homes, hospitals and other places where the old and medically vulnerable gather indoors. Maybe, if and when the epidemiological situation warrants it, to mask mandates in crowded spaces, like public transit. But no to mandatory masking in schools, where the rewards to students of seeing the faces of classmates and teachers outweigh the relatively low risk the coronavirus poses to children, especially vaccinated ones.
All of that, plus encouraging everyone to feel free to wear masks for any one of a long list of good reasons, doesn’t exactly fit on a bumper sticker. But it does fit the times. It recognizes that, at this stage, the pandemic is not over, but neither is it a 10-alarm emergency, and that the virus is more dangerous to some (the elderly, the unvaccinated) than it is to others (kids, boosted adults).
It also acknowledges that, no matter how much public-health officials wish it were otherwise, many Canadians are tired. The evidence is plain to see on people’s faces, which are visible now that masks are largely optional and most people have chosen to take them off.
It means that political and public-health leaders should approach another fall of pandemic policy-making the same way they need to approach the question of mask mandates: with nuance, balance – and a healthy respect for Canadians’ ability to understand nuance and balance.
With that in mind, we offer a list of COVID policy dos, and one don’t. As we wrote last week, delivering a big booster campaign is Job 1. After that, policy makers should:
Focus on COVID treatments such as Paxlovid, which can reduce the severity of infections in high-risk patients, and Evusheld, which acts as a partial prophylactic for immunocompromised patients. Neither are silver bullets. Rebound infections after Paxlovid, for example, are cause for concern and warrant further study. But the weight of evidence points to both being useful for the right patients in the right contexts, and governments should make them easier to access.
Improve ventilation, everywhere. As is well known, SARS-CoV-2 can spread through the air, and cleaning the air or pumping in lots of fresh air reduces the likelihood of transmission indoors. Don’t let plans to improve HVAC systems and to install HEPA filters fall by the wayside. Besides, fresh air is good for more than just fighting COVID.
Resume public reporting of key pandemic indicators. Over the past two-and-a-half years, the release of daily COVID data empowered people to assess their own risks. It also helped governments direct resources, including vaccines and tests, to where COVID burned hottest. Provinces that have stopped daily reporting should resume it for hospital admissions, deaths and vaccine uptake, the indicators that matter most. Case counts fell out of that category when at-home rapid tests became available, and infections stopped being routinely reported to public health.
Speaking of rapid tests, they should continue to be free in jurisdictions that give them away, and made free in those that don’t. Rapid antigen tests aren’t foolproof, but they allow mildly ill people to confirm infections without seeking a lab test from the overburdened health care system.
Policy makers should not:
Enact shutdowns of businesses or public services, and least of all schools. Catastrophic shutdowns were the least bad option – really the only option – when the new SARS-CoV-2 arrived and attacked an immunologically defenceless population. That’s no longer the case.
Widespread vaccination, plus some protection from contracting the voracious Omicron variant – which infected 17 million Canadians between December and May, according to the federal COVID-19 Immunity Taskforce – have erected a solid, albeit hardly impenetrable, wall around Canadians. For healthy, boosted Canadians, most infections this fall should be no worse than a bad cold or flu. However, much about the virus remains unknown, and long COVID needs more study, with an eye toward developing better treatments.
If a new variant sets the world back to square one, all bets are off. But for now what’s needed are nuanced measures to minimize hospitalizations, while making normal life possible and sustainable. COVID Zero is currently unattainable. But what might be called COVID Manageable is achievable.
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