Is it safe to lift the mask mandate?

Following much resistance from protesters rallying in the US, Canada and most recently in New Zealand, the Western countries have begun lifting the mask mandate. Health officials also aligned themselves with these rather political decisions instead of relying on concrete science-based decisions. 

March 11 marked 2 years of the Covid-19 pandemic. On this fateful day in 2020, WHO declared the Covid-19 outbreak as a global pandemic. Soon the virus spread throughout continents and despite intermittent periods of lockdown and other precautionary measures, different strains of this resurgent virus claimed millions of lives.

To date, as per official count, globally a total of 472 million have been infected and over 6 million people have died and the virus remains prevalent in many parts of the world. The actual number may be much higher. 

The WHO repeatedly mentioned that the pandemic is not over yet. The virus changes its characters by changing the codes of its genome and attacks humans more aggressively with each progressive mutation leading to many people experiencing repeated infections. 

Kudos to the scientists, physicians, allied health workers, journalists and many others for their non-stop work to come up with multiple arsenals such as diagnostic tools, vaccines, antiviral agents as well as public health messaging and data sharing. 

Even during this disastrous time, some world leaders prefer to engage in war and it seems it is more important to them than the wellbeing of their people by uprooting this virus completely. War is not part of my discussion today. I would leave this to political scientists to write about it. Being a clinical scientist, I would like to write about the politics of masks. 

People in the Western developed countries have a sense of entitlement and usually have interesting opinions on any issue and Covid-19 was not any different. There have been controversies surrounding unauthorised treatments like hydroxychloroquine, the efficacy of vaccines and finally, vaccine and mask mandates.

Since the beginning of this pandemic, one minority group was always against vaccines as well as mask use. It seems this public health mandate interferes with their freedom. Public health mandate is for the common good and unless there is a legitimate medical issue, I truly do not understand what it has to do with their freedom. 

Now the question is, should we let our guard down by easing Covid-19 health guidelines and put the ordinary people, especially the elderly, the immunocompromised and the unvaccinated in danger? Or should we develop a more cautious approach, based on rigorous scientific facts, for lifting public health mandates? Being a scientist, I will support the latter. 

On one hand, many countries are beginning to lift the mask mandates. At the same time, Covid-19 is raging through many others. Countries like South Korea did a stellar job of managing the first phase of the pandemic. Unfortunately, they are now going through arguably the worst phase of Covid-19 outbreaks. On 17 March alone, the Korea Disease Control and Prevention Agency (KDCA) reported a staggering new daily record of 621,317 for Covid-19 cases and 319 deaths. 

South Korea is not alone. Other countries experiencing surges in Covid-19 cases are China, Singapore, Hong Kong, Australia, Germany, and the United Kingdom to name a few. However, most of the countries are seeing the decline of new peaks in a short time. 

All of these countries are experiencing an outbreak of the Omicron variant along with a new sub-lineage of Omicron called BA.2. It is also noticeable that the United Kingdom experienced multiple surges over the last two years despite having a robust health care system. So taking this virus lightly is not an option. 

Dr Anthony Fauci, the US White House chief medical advisor, mentioned in one of his recent TV interviews that "the BA.2 variant has a transmissibility 50% to 60% higher than the original omicron variant. This means it will, over time, become the dominant strain." 

However, the good news is, he also said "BA.2 does not seem to cause more serious illness than the original omicron variant, nor is it more resistant to vaccines or prior infections." Increased cases in any country with this BA.2 variant is likely and this sublineage is capable of causing serious infection in people who have no immunity against SARS CoV-2. 

Right now many countries are seeing the decline of Covid-19 related cases and deaths as well as hospitalisation rates and fortunately, Bangladesh is among them. 

But does that mean Bangladesh should also let its guards down like the Western nations? 

Definitely not. 

There is still no guarantee of immunity against this virus and we don't know whether Bangladesh will experience a BA.2 surge like many countries mentioned above. 

Multiple studies conducted on the use of masks found no negative health impacts of wearing masks. 

Morbidity and Mortality Weekly Report (MMWR) is one of the US CDC's main message disseminating tools where extraordinary research data are being published for the quick dissemination of information globally. Multiple studies on the uses of masks were published in MMWR and all of them showed that an appropriately fitted mask can decrease potentially infectious aerosol by about 95%. 

Further studies showed that consistently wearing a comfortable, well-fitting face mask or respirator in indoor public settings prevents infection to Covid-19 and other respiratory illnesses. 

Well-fitted masks provide added level of protection against acquisitions of SARS CoV-2 infections. Room ventilation will add further benefits. The latest MMWR article on masks also showed N95/KN95 masks offer the best protection followed by surgical masks and cloth masks respectively. 

In conclusion, I think it is too early to lift the mask mandates. When masks are worn and combined with other recommended mitigation measures, they protect not only the wearer but also the greater community. 

In circumstances with poor ventilation, typically indoor enclosed spaces where an infected person is present for an extended period, the concentrations of these small droplets and particles can build sufficiently to transmit infection. 

Older age groups with chronic infections, the immunocompromised patients as well as the unvaccinated population will be the most vulnerable if exposed for a long period in crowded indoor spaces.  I am glad to know that Bangladesh is not jumping on the mask mandate lifting bandwagon soon.

The use of masks in crowded indoor settings or dusty areas will not only help to protect from SARS CoV-2 infection, but it will also protect from many other respiratory pathogens such as Influenza viruses and tuberculosis to name a few and will provide protection against particulate matters which is way higher in big cities in Bangladesh.

Dr Muhammad Morshed is a Clinical Professor, at the Department of Pathology and Laboratory Medicine, University of British Columbia.

Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.