Jordan: So here’s a question. Claire, are we supposed to wear masks now when we go outside? You deal with government policy every day on this for us. What is the new official word?
Claire: Yeah, well, the official word has actually just changed. So the consensus now is that masks are a good thing to wear, but if you’re wearing it, it’s not going to protect you. It’s going to protect the people around you. And the reason that we’re now being encouraged to wear masks, even if we feel fine, is that a lot of people are actually asymptomatic or their symptoms just haven’t shown up yet. But in that case, you’re still contagious. And by the way, we’re talking about cloth masks here, not medical masks. We should not be wearing those. Those, as we know, are reserved for healthcare workers. So wear a cloth mask. Even if you feel fine, it’ll protect others, but it won’t protect you.
Jordan: So this is new policy and that’s confusing because it definitely contradicts the message we’ve been getting from the government for the past couple of weeks. And during that time, other countries around the world have been saying that masks indeed help and people should use them. And even some countries have had this in their culture for years.
Claire: Yeah, I mean, it’s a new virus and everything around it is new, so I think it’ll take a while for everyone to agree on some stuff, like the mask thing. What’s kinda cool though here is that people are actually making their own masks now. You can find tutorials online for making them without having to, so anything. I admittedly have not worn a mask yet during all of this, but with this new advice, I’m kind of considering wearing one.
Jordan: Well, I’ve worn a scarf outside and out to do my essential shopping, and I got that from Serge Ibaka of the Toronto Raptors. And he was making a big deal about scarfs back in February, but now that everybody’s on lockdown, he actually backed that up on a call with Public Health officials. The mask debate has gone back and forth a lot in the past few weeks, and everybody on both sides is convinced that they’re right. One thing we do know is that frontline workers need those masks and they should have all the equipment they need. But what are the advantages and disadvantages to, say, using a regular old bandana? Or sewing a mask, like Claire might do? Or using a scarf like me? Or a scuba mask? Or other contraptions that you’ve probably seen people wearing on social media? Does it work? This is kind of the heart of the great mask debate of 2020. Is it worth it? Does it help? And we’ll get into all that as soon as we get through the news from your favourite producer, Claire Brassard.
Claire: Yeah well, speaking of masks, Ontario is quickly running out of protective equipment in hospitals. And Premier Doug Ford tied this to restrictions at the US border.
Clip: We know that the US isn’t allowing supplies across the border and as the global demand escalates, getting supplies from other countries is increasingly difficult. We’re doing everything in our power. We’re exhausting every avenue available to us, turning over every single stone. But the hard truth is our supplies and Ontario are getting very low.
Claire: There is some good news in British Columbia where it appears they’ve managed to flatten the curve and the percentage of cases there is no longer increasing daily. Dr Bonnie Henry, the provinces top public health official, said this is because of luck and timing with some of the earliest cases being detected in BC and measures that were quickly put into place. She warns though that now is not the time to stop physical distancing and that the province needs to keep the firewall strong. There’s also some cautious optimism in Quebec with fewer hospitalizations, but the premier says the next few weeks will be crucial in containing the outbreak and that they must continue to do everything that they’ve been doing. In the US the death toll is now above 10,000, the third most in the world. One member of the white house coronavirus task force said this week will likely be peak hospitalizations with a high number of deaths. As of Monday evening, 16,667 cases of COVID-19 in Canada with 341 deaths.
Jordan: I’m Jordan Heath Rawlings, and this is The Big Story. Stephen Maher is a contributing editor with Maclean’s magazine and he has been following the mask issue. Hello, Stephen?
Stephen : Good morning.
Jordan: Morning. My first question to you is, did we get even a little clarity today from Canada’s government on whether we should or shouldn’t be wearing masks and when and where and et cetera.
Stephen : Yes. So Dr Theresa Tam, the Chief Public Health Officer of Canada, announced today that her advisory committee had recommended that Canadians do wear masks, including homemade masks, when they go to places where it’s difficult to socially distance. If you have to take transit, or go to the grocery store, it’s advisable to wear a mask. This is a change in policy and something that people were calling for.
Jordan: Now take me back to the beginning of this, because this is an issue that’s been kind of hotly debated for a while. What was the initial directive from Canadian Public Health officials?
Stephen : So, Canadian Public Health officials, unlike the public health officials in some other countries, were not recommending masks. And Dr Tam previously said there were two reasons for that. One is that the medical professionals need the masks and there’s a shortage. The second is that there is uncertainty around the benefit of wearing masks, both because people, there may be risks associated with using them if you don’t know how to use them, and the evidence for their efficacy is unclear.
Jordan: You mentioned that that is different from other countries. Tell me a little bit about how this varies kind of around the world.
Stephen : Well, in East Asia, where some of the countries that appear to have been most successful at dealing with this pandemic, there is a cultural tradition of mask wearing. It’s traditional and a lot of these countries where if you’re ill, if you have a cold or a flu, and you’re gonna carry on going to work, for people to wear masks in those circumstances. And that’s at the heart of why Dr Tam is talking about using masks in Canada now, not because they will protect the wearer, but they may protect other people from infection by presymptomatic or asymptomatic carriers. As the pandemic has spread, we’ve seen other countries adopt the sort of East Asian philosophy of prophylactic masks. The best example may be the Czech Republic, where they’ve made it a sort of national project, with people sewing masks and sharing mask tips and that kind of thing.
Jordan: How did this manage to become even sort of before we had any directive from Dr Tam or anyone else, become such a hot button issue on social media? Because there’s been a ton of back and forth about this and it’s something that, you know, kind of seems self evident that it can help protect you from infecting other people, but also they’re needed by frontline health workers. Like it seems so simple, but there’s been a ton of debate around it.
Stephen : It’s the kind of thing that people can sort of seize on, I think. And they can say, well, it’s all obvious that everyone should wear a mask because it’s protective. And now you’re seeing people saying, well, this is a, a flip flop. And then why didn’t they act more quickly? So we’re seeing this kind of argument. But it’s not entirely clear that that masks have a benefit, or wasn’t clear. Last week I spoke with Dr Alison McGreer, an infectious disease expert at Toronto’s Mount Sinai hospital. And this is someone who spent her career studying these things, and she observed that the sort of consensus opinion was shifting. But explained to me that some of the reasons why experts have been hesitant to recommend masking until now. And part of that is because the evidence for it, in spite of a great deal of research, is not overwhelming. After SARS, she told me the Centre for Disease Control, the American experts in this, spent $15 million trying to figure out if public masking was effective and they did not get the kind of answers that allowed people to make very clear recommendations.
Jordan: So how much of this do you think is a psychological thing? That people want to be able to do something to make themselves feel more protected when they go outside. And how much of it is practical application of public health policy?
Stephen : I suspect we won’t know until this has been studied after the fact, how useful masks really are. I mean, it’s, it appears in a way to just be a sort of common sense proposition that if everyone’s wearing mask, there will be less what they call shedding. When when you talk or laugh or sneeze or cough, you share microscopic droplets, and that’s how the the disease is transmitted. So in a common sense way, it sort of makes sense. Okay, well, if everyone’s wearing a mass and there’s going to be fewer droplets around and it ought to slow it down. I suspect that’s what we’ll see in the end. But science is, you know, in science what you think is likeliest, isn’t always what’s likeliest. And Dr Tam, and not just Dr Tam, other health experts have also expressed reservations, because people have a tendency to keep touching a mask if they’re wearing it, which could potentially make things worse. And we know the physical distancing and careful frequent hand-washing make a huge difference. So I suspect that it’s kind of hard to know. And also that Dr Tam and her team have to keep in mind that risking public confidence could pose a sort of safety risk. If Canadians are feeling stressed out and want to do something and the experts are telling them not to, that could shake the confidence of the public in our public health officials.
Jordan: Well, you touched on something there that I also wanted to ask you about, which is that people will touch their faces when they’re using a mask, and to me, there’s an issue there of, people aren’t used to wearing these things. They don’t know what they’re doing. And you know, how different is the knowledge in the average Canadian community from, you know, the knowledge in a hospital of exactly how to use and discard and not reuse and et cetera, these things?
Stephen : No, I mean, that’s a big issue. And in emergency rooms, when they don and doff equipment, I have read that they watch each other. Because the risk of infection through improperly using masks or gloves, is so high. It really is something that you have to be conscious of. I’m not a doctor. I have read that if you get droplets on your hands, there is little risk of the virus penetrating your skin. So washing for 20 seconds with hot soapy water ought to make you safe. If on the other hand, you’re wearing gloves or a mask and you get droplets on the mask or gloves, and then you put them in your purse or you pick up your phone, there is a risk that it could make things worse. So there’s a sort of mindfulness that people have to bring to this, I think.
Jordan: I’d also wonder about the kind of false sense of security that you get from walking around with something on your face and all of a sudden you’re not that worried about that person four feet away instead of six feet away or not that worried about getting on a crowded bus as opposed to waiting for the next one, which are all things that we’re told we need to be doing.
Stephen : Yeah, I worry about that too. You could imagine someone saying, well, should I make that trip? Well, I’ve got the mask, I might as well. That’s a danger I think. You know, again, it’s one of these things– I think that one of the things about thinking scientifically is recognizing what you don’t know. There’s a lot of people speaking very confidently about how masks are clearly a benefit to the public, and only an idiot would question that. And I’m much less certain, but I suspect that we’re going to see a lot of people masking up, and I hope that Dr Tam and her people follow up with a public education campaign to try to minimize the possible risks for mask wearing.
Jordan: What about the kind of fine line they’re trying to walk by saying, oh yeah, you can make your own mask or use a nonprofessional mask, but we really need to save these and 95s and the other medical ones for members of the frontline medical community. And you know, people should do that, but I can also easily see some people who might be sitting at home saying, well, I want the best protection for me. And you know, where there’s already a shortage of this equipment.
Stephen : Yeah. Well, I have interviewed emergency room doctors and they are so frightened to be facing the kind of hazard that they’re facing in their jobs. And it’s my strong belief that nobody facing a much lower risk should get in between those doctors and the equipment they need. Also, N95s in particular, the mask with a sort of respirator, you really need to be trained to use these, they have to be properly fitted. So the idea of members of the public getting their hands on these masks that they’re going to misuse and that emergency room doctors and nurses desperately need, I think that’s irresponsible, and I hope we won’t be seeing that. And I’m not sure we will because I don’t know how members of public would be able to get their hands on these right now, when hospitals are crying out for them. Dr Tam is recommending that people use homemade mass. There’s a lot of talk about using old t-shirts to make masks. Ultimately, when the supply issues have been resolved, which is a matter of weeks likely rather than months, I suspect that surgical mask will become more available and they offer a greater degree of protection according to studies, than homemade masks.
Jordan: What about the longterm impact on the culture in the West of mask wearing? Cause I wonder how we come out of this. This is obviously the kind of thing that can can shape mass public behaviour for years to come.
Stephen : I’ve been thinking about that as well. I mean, you see these streets in sometimes in Asia, where lots of people on the subway are wearing masks and I suspect we might see more of that in Canada in the future.
Jordan: What do you think that that looks like as, I don’t know, like a policy? I guess it wouldn’t be a policy, but these things aren’t really generally available to the public. Like unless you’re a contractor or someone who works in construction, I don’t even know that you think about where to go and buy these, and suddenly everybody’s trying to get their hands on them.
Stephen : Yeah. It is strange. It maybe a benefit in the long term, in a way. When you think about it, the idea that if you’ve got to go to work when you’ve got a cold or a flu, you know, maybe better that you wear a mask and cut down on the risk of infecting your colleagues.
Jordan: Tell me about what’s next in this. Cause we’ve seen this policy evolve from like, there’s no need to wear a mask, it’s not necessary, it’s not good for you to, okay. Where some if you need them. Once the shortage is cleared up, do you think we’ll be seeing directives that, you know, give these things out publicly and say you need to wear these if you’re going anywhere crowded?
Stephen : I think that, you know, in this instance, Canada is following a change in the advice from the Centre for Disease Control in the United States and from also European countries. So I suspect that there will be an evolving scientific consensus on this kind of thing. These are, this is a very tough circumstance that we’re facing, this worldwide pandemic. One thing though that’s sort of cheering or encouraging about it, is that a lot of the smartest people in the world with tremendous resources are applying themselves to this problem. And I think if you study human history, when that happens, it can be extraordinary what people will come up with. And one of the things that they will likely come up with is better consensus on the science around mask wearing. So if that consensus shifts to recommending masks, then you could easily imagine a circumstance a month from now where anyone walked down the street without a mask will be seen as being irresponsible. That’s quite possible, that a month from now, two months from now, when we’re trying to reopen society a little bit, but haven’t got a vaccine, that will be seeing everyone basically being forced to wear masks.
Jordan: See, that’s a picture I have in my head of like the return of the NHL in Scotiabank arena or whatever is packed, but everybody’s got something over their face.
Stephen : And I’m not sure how that works with the beer and popcorn.
Jordan: Right. See, the whole world is changing.
Stephen : Yes, it’s true.
Jordan: Stephen, thanks for joining us today. My last question I guess is, was there anything as you dug into this that really shocked you, that you weren’t expecting to find given the debate that was happening before?
Stephen : I find it interesting the way that people seize on this with great certainty. I’ve been frustrated or exasperated with people who decide to a crusade for public mask wearing, sort of questioning Dr Tam. And it’s hard to know how to feel about that entirely. Debate is an important part of how we shift policy in a country like Canada. But it also changes the sort of threat environment that public officials face. You know, I’ve thought about that a lot. How come some people seem so certain when the evidence is anything but?
Jordan: Thanks Stephen.
Stephen : My pleasure!
Jordan: Stephen Maher is a contributing editor at Maclean’s. That was The Big Story, if you’d like more or at thebigstorypodcast.ca, now and always. We are on Twitter scrolling and scrolling at @thebigstoryfpn and of course we’re in your podcast players, every one of them, Apple, Google, Stitcher, Spotify, dozens more. And if you’d like to send us some audio, you can do so by recording a clip with the voice memo on your phone or just taking a video. We’ll only use the audio, point it at a wall, I don’t care, and you can send it to firstname.lastname@example.org we would love to hear how you’re getting on. Thanks for listening. I’m Jordan Heath Rawlings. Here’s one of our listeners now and we’ll talk tomorrow.
Melissa: Hi, this is Melissa from Alberta. I’ve been self isolating for quite a while now. I actually got a flu, not COVID-19, but, so I started self isolating really early. I’ve been doing lots of stuff as I’ve been slowly getting better. It started off with lots of knitting, making gifts for friends. Then I started adding my Spanish classes in. And then my sister, who is an artist actually started up an online art challenge for 30 days, and each day you get a new topic, and then whatever, however you interpret that topic is what kind of art you can produce. You don’t have to do anything super detailed, you don’t have to have artistic talent. All sorts of art, including dance apply. But I’ve been doing my, I’ve been practicing watercolours. And now that I’m starting to feel even better, I’ve been spending lots of time with my dogs, my husband and my cat. And we have started being able to go out for some dog walks. And from there I’m hoping to get back into my garage and continue my woodworking and then also start up some exercising, cause I was exercising every day, and now that’s not part of my routine. So I’m really looking forward to getting back to running and exercising at home. So those are my plans.
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