Should you be required to wear a mask? 5 key points from York Region report

Council to discuss recommendation to require COVID-19 face coverings July 9

Yorkregion.com
July 9, 2020
Kim Zarzour

York Region residents are doing a decent job of masking up for the pandemic, but it may be time to follow the lead of other municipalities and make it mandatory, according to a report released today by the region’s medical officer of health.

Regional councillors are expected to debate, at a special meeting tomorrow morning, a report that recommends a policy similar to Durham Region and other jurisdictions requiring operators of indoor establishments and organizations to prohibit people from entering premises if not wearing a face covering.

Operators of enclosed public spaces would make best efforts, “in good faith,” to allow entry only to people wearing non-medical face coverings and education, rather than enforcement, would be the principle objective.

More than a dozen municipalities have implemented such measures, including neighbouring Simcoe-Muskoka (effective July 13). Markham Mayor Frank Scarpitti has led efforts to make the move in York Region.

At a meeting June 25, council asked for a report on requiring use of masks by well individuals in settings where physical distancing cannot be maintained. Here are some key points to be discussed:

York Region is doing OK

Currently, in York Region, wearing a two-layer non-medical mask or face covering is promoted where physical distancing cannot be maintained and, as of July 2, it is required on York Region Transit.

This approach has shown some success, with the majority of individuals wearing face coverings when in public. Between June 27 and July 2, observational studies showed 82 per cent of people entering Markville Mall were wearing masks, 61 per cent at Vaughan Mills and 52 per cent at Upper Canada.

The region is starting to see reduced rates of new cases and community transmission, indicating a diminishing risk of acquiring COVID-19 when going out in the community.

At the peak of the epidemic, during the week of April 12 to 18, there were about 50 cases reported per day. By the first week of July that had dropped to an average of 12. When it reaches seven per day, the virus would be considered containable until a vaccine is produced.

Testing rates remain high through the three hospital-run assessment centres and the region is experiencing a decline in institutional and community transmissions.

There is a provincewide trend toward mandatory masks

A growing number of jurisdictions are adopting mandatory mask policies as an additional measure to supplement physical distancing, hand washing and staying home while ill.

Reasons for the mandates vary depending on the jurisdiction and include ongoing local transmission, risk of outbreaks in community or workplace, poor local compliance or concerns about reopening,

All jurisdictions to date in Ontario have excluded outdoor settings and indoor spaces not open to the public. Child care centres and day camps are exempt in all but one jurisdiction and some areas have moved beyond the commercial retail sector to include faith-based settings and community centres.

Face coverings and masks offer a variety of benefits

There is increasing evidence that face coverings can help prevent the spread of COVID-19, particularly in areas where distancing is less possible (such as transit and grocery stores).

Universal face covering policies in epicentres of the pandemic, such as Italy, Wuhan and New York, proved effective in reducing cases.

There is limited evidence that masks protect the wearer from respiratory droplets produced by others. Primarily, they help prevent the wearer -- who may be pre-symptomatic or have mild symptoms -- from posing a risk to others by spreading respiratory secretions through coughing, sneezing or talking.

Wearing masks can also be a sign of social solidarity, provide feelings of empowerment, reduce stigma against mask-wearing and help front-line workers feel more protected.

Mandatory masks may present challenges for some

Concerns include skin problems, fogging of glasses and communication difficulties.

Improper use and donning and doffing of masks can increase the risk of transmission of COVID-19.

Exemptions may be required for some people who may not be able to wear masks, such as children under aged two, under five who refuse, anyone who it would inhibit ability to breathe or who have medical reasons such as chronic respiratory diseases, mental illness, developmental challenges, elderly with cognitive impairment or facial trauma.

Workplace occupational safety and health would make decisions regarding those who work in a setting where masks increase risk of heat-related illness or safety concerns (e.g. straps getting caught in machines)

Accessing masks may present a time and cost barrier to low-income households.

Currently, the most common source of infection is close contact -- most likely in private settings, such as homes where masks would not be part of the requirement policy. Community transmission, the category most amenable to prevention through masks, is the source of transmission in less than one quarter of cases in York Region.

What’s recommended for York Region?

A mandatory mask policy should be accompanied by widespread public education campaigns explaining when and why to wear masks, who is not able to safely wear them, the correct use and handling to prevent risk of contamination to the wearer and proper disposal -- including zero tolerance for masks in the blue box and additional garbage bins in areas where they are mandated.

The implementation of face mask policies should include consideration of how to best assist low-income households to acquire face coverings

Also to be considered: masks should not be worn while swimming or during high-intensity activities, and mandating masks in child care and school settings may result in more harm than good.

Implementation and enforcement won't come cheap. It will require time and additional staffing. A four-week communication and education campaign could cost $323,000 to $428,000. Providing masks at community venues could cost at least $180,000 for disposables or $5-$20 for each nondisposable face covering.