Front Burner - In Brief: Should you wear a mask?

Episode Date: April 1, 2020

The number of COVID-19 cases continues to rise around the world — and here at home. That has many wondering whether public health officials should revisit their policies on people wearing face masks. But as we learn, there are many questions with not so many definitive answers. Where is the science on wearing masks? Where should you wear a mask? How should you wear it? What about supply? Jayme Poisson tries to tackle some of these questions with Dr. Isaac Bogoch, on tonight’s Front Burner.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Jamie Poisson and this is FrontBurner's Evening Brief Edition. A few coronavirus headlines from today to get you caught up. First, Toronto is enforcing tougher measures that are likely to last another 12 weeks. This after the city's top doctor said there was a 500% increase in cases over the last two weeks.

The numbers are presently headed in the wrong direction in Toronto. And our doctor, our doctor, says it is time to act. And more restrictions for the Ontario-Quebec border. The general public won't be allowed to cross the bridge into Gatineau as of noon today, with police enforcing this with targeted checkpoints. Also, Prime Minister Justin Trudeau is urging to recall Parliament to pass enhanced COVID-19 emergency aid. This is the largest economic program in Canada's history. So I've asked the House Leader and the Deputy Minister to reach out to the other parties about bringing back Parliament.

The Prime Minister also declined to put a specific timeline on how long strict measures to fight the pandemic could last, saying they would be in place for a number of weeks and perhaps even months. OK, so tonight we're going to try and answer what should be a pretty simple question. Should you wear a mask to try and prevent the spread of COVID-19 and to try and prevent yourself from getting it? If you're in the general population and you're not sick, the recommendation from federal Canadian public health officials is no. But if you're a doctor, a nurse, healthcare or frontline worker, the answer is yes. So why are masks recommended for some but not for others? Well, that's where the simple question gets a little bit more complicated. Once again, Dr. Isaac Bogosh is

with me. He's an infectious disease physician and scientist. Hi, Isaac. Thank you so much for being here. Hey, thanks so much for having me back. So I want to start today with a big question. There is a huge debate raging around this right now. Isaac, should I wear a mask or should I not wear a mask? I think the answer here is it depends. It depends specifically what your question is, because I think there's a lot of confusion over what the question is and the related questions. But one of the questions is, if I have no infection and I put on a mask, will I reduce my likelihood of getting infected with

COVID-19? And another question is, if we all put on masks, can we reduce transmission of COVID-19 in the community? So related questions, but not the identical question. Okay, so let's do the first one first. So I have no infection. I am showing no symptoms. When I go out to do grocery shopping, should I put on a mask? So my answer to that is, if you want to wear a mask, wear a mask. However, I think people have to be aware of a few limitations. And, you know, on the one hand, public health really needs to do a bit of a better job, I think, in communicating in this realm, because many in public health have been very dismissive of mask wearing. And

it's unfortunate because there is some data that says maybe, maybe this may reduce people from getting an infection. But I think we have to balance this out with other factors as well. And those other factors are people frequently are not wearing the masks appropriately. There's data to support this. And there's also people's observation. You walk around and look at people's noses hanging out and stuff like that. So lots of people aren't wearing their mask right. Lots of people are adjusting their mask and touching their mask and moving it around their face, which completely negates the usefulness of the mask because they can be contaminating

their mouth and nose. And if you have the virus on your hand, now you put your hand in your eye or something like that. Remember, these masks are also single-purpose masks. Now, of course, the counter-argument to that is, well, you can teach people how to use a mask. And that's true. You sure can. Both sides really are digging in. You know, there's a pro-mask group that is, you know, who says we should all be wearing masks. And that's great. You know what? Wear a mask. That's fine. But I think the public health messaging about this will not help also needs to give a little bit as well. Why do you think public health officials have been so dismissive about this, though?

Like the WHO has repeatedly said, you know, you don't need to wear a mask. Why are they saying that? And to be completely fair, like, I totally agree with some of what the WHO says and with some of what other the pro mask group says. And I'm not just trying to, you know, pacify both sides, because quite frankly, at the end of this, you and I are both going to get some angry emails from from public health individuals and also from the pro mask group. But we're not here to make friends. People are so vitriolic about this. Exactly. But, you know, I don't think public health has taken the right approach. I think

they've been overly dismissive of this. You don't have to look that hard to find data. The problem is that, you know, people often point out to, you know, here's 50 studies, but like you have to look at the quality of the data as well. And it's not the highest quality data. So other people say, well, what's the harm? What's the harm? And the answer is, you know what, if you're if you are wearing it appropriately and you're not touching your nose and your mouth all the time, then there probably is little harm in in wearing a mask. then there probably is little harm in wearing a mask.

But I think the other thing to factor in is if you're socially or, sorry, physically distancing from one another, then what do you think the actual incremental gains are of wearing a mask? I mean, is that going to protect you from droplets if you're more than two meters apart from people? No, not really. You know, one question I have when I hear public health officials be dismissive about masks is whether one of the reasons why they're saying this is because they're trying to preserve stockpiles of masks for frontline workers, for health care workers. Is it fair that I'm thinking that? So I think that's an extremely important point. And we need to do everything we can, of course, to protect our frontline health care me from getting this infection? Yeah, right. You could ostensibly say, look, there's evidence that a mask can protect you.

It's not necessarily always as strong as evidence, but also at the same time, we have a mask shortage. So please, we're trying to preserve these for health care workers. That would be like radical honesty. I think radical honesty is the correct approach. And I couldn't have said it any better. I mean, that would be my message. And, you know, it would be helpful if we saw a little bit of give from public health authorities and the messaging on that front, but also a lot of give as well from this, you know, rather vigorous pro-mask crowd. I wonder if I could pick up to on the second

question that you highlighted at the beginning, you know, maybe we should all wear masks, and perhaps that would also help stop the spread of COVID-19. You know, one of the reasons why I raise this is because the CDC, the Center for Disease Control, is saying now that 25% of carriers in the U.S. have no symptoms. New data out of Iceland shows 50% of people who tested positive said they were asymptomatic. Dr. Anthony Fauci in the U.S., who many call that country's most trusted voice, says, you know, again, there is a degree of transmission from asymptomatic individuals. So, you know, should we be moving towards making enough masks for everybody to wear masks?

The answer is maybe, just like the answer to the first one is maybe. And, you know, I'm all for data driven policy. And people that are clinging to the data to drive this are looking at data that is that is incomplete and that is, you know, of moderate quality at best. That's probably being generous. And just because there are policies put in place, it doesn't make them good policies. Having said that, if there were enough masks for every single person in a population, and if every single person wore the mask and wore the mask appropriately, you know, could we reduce transmission? Maybe. Maybe we could. Maybe we could. And I think we need to be open minded about that. And I think public health officials need to be open minded about that possibility. Isaac, you know, apologies if I sound a bit frustrated here. But like, why do we not know the answers to this? Why isn't there more data? You

know, I'm with you that we should make data driven decisions. But you know, this isn't the first outbreak that the world has seen. We've dealt with SARS. We've dealt with H1N1. We've dealt with Ebola. Why are there so many question marks around this? Yeah, I wish I had a good answer to that. But really, a short answer is, you know, there's not enough research dollars to go around. And a lot of times these line items are crossed off on budgets and not prioritized because there's other more pressing things.

And, you know, I think it just takes, you know, something like this to wake people up and say, you know, there are some very important infectious diseases and public health questions that really need to be answered. One question I have before we go is on the type of mask. So if I'm interested in perhaps, you know, using a mask and trying to use it properly, does it have to be made out of like a specific material? I'm a skeptic at heart. You know, I'm open-minded, but I think we have to be very careful because a lot of the masks that we purchase are medical grade masks. I mean, they're flimsy, but they still are medical grade masks. And many of these are single purpose masks. If people are making their own

masks, it'd be very challenging to look someone in the eye and let them know that they're getting a blank degree of protection by wearing something like this. I think the variability is going to be tremendous. And the concern, and I've said this all along, is that there's a false sense of security with that mask. And people still have to be mindful about impeccable hand hygiene and physical distancing measures, because truly, truly, at the end of the day, that's going to be doing the heavy lifting. Okay. Do you see any possibility that our governments are going to start changing their positions a little bit more on masks? In Austria, for example, the government is going to distribute free face masks at the entrances

to supermarkets. The German government may enforce a similar measure when it considers relaxing a lockdown and perhaps our government will take that on and then teach people how to wear these masks properly is that a possibility here i i think anything's on the table i mean we've seen things happen in this pandemic that uh we didn't think was was possible you know it's not clear if they're truly going to pivot uh but i know that they're discussing this at least but i also think that we have to remember that, A, we should be open minded to data. And these are answerable questions. But people who think that these questions are answered are mistaken. And number two, just because there's a policy change does not make it scientifically sound. You know, obviously, there's some very

strong opinions on both sides. I think that public health needs to stop digging in their heels and at least acknowledge that there may be some benefit of masks in certain situations. But I think this, the pro mask crowd also has to, you know, give in a little bit as well and not pretend that these are the be all end all solution and if everyone wears a mask, suddenly this is going to go away. Okay, Dr. Isaac Bogosh, thank you. As always, we'll talk to you again soon. Anytime. Have a great day. In the Dragon's Den, a simple pitch can lead to a life changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization.

Empowering Canada's entrepreneurs through angel investment and industry connections. All right, that's it for tonight. Tomorrow on the show, we're going to talk about COVID-19 and prisons. We've been speaking to inmates inside a number of institutions. We're talking to them about their fears. I'm Jamie Poisson. Thanks so much for listening and talk to you in the morning.