Public health messaging over face masks changed again this week when the U.S.-based Centers for Disease Control and Prevention (CDC) updated its guidance to say face coverings can help protect the wearer as well as those around them.
The new guidance, which landed on the CDC website on Tuesday, cited recent studies suggesting multi-layer cloth masks can “reduce inhalation of … droplets by the wearer.” Previous guidance said masks were useful primarily in blocking the wearer’s droplets from reaching others.
The CDC’s update now matches recommendations from both Health Canada and the World Health Organization (WHO). The Public Health Agency of Canada (PHAC) said in an emailed statement on Wednesday that “wearing a mask can help protect the wearer and others.”
However, this message seems to have been muddled due to previous conflicting guidance, which has mostly emphasized masks as a way to protect those around you.
Canadian health experts are also divided on whether the updated CDC guidance is helpful – some hope it can convince reluctant people to start wearing face masks, while others worry the message may be misinterpreted.
Dr. Amy Tan, a clinical assistant professor at the University of Calgary and member of the physician group Masks4Canada, says the “evidence has been there since August” to show that cloth masks, provided they fit well and are made of three layers with a polypropylene filter, do protect the wearer.
And if that can persuade people to wear one, so be it.
“If the small inconvenience of wearing your mask isn’t enough to appeal to the collective good, then now we can say: ‘it can protect you too, so wear it,”’ Tan said.
Colin Furness, an assistant professor at the University of Toronto’s School of Public Health, isn’t convinced the updated guidelines are accurate.
While he isn’t ruling out the possibility that cloth face masks might help protect those wearing them, he says people need to remember the caveats – three layers plus a good fit – to that claim.
“If (the CDC) is trying to appeal to peoples’ sense of self-preservation by saying: ‘masks could protect the wearer, therefore you should wear a mask,’ that could be a way to motivate people.
“But on the other hand, I don’t endorse that because it could make people think ‘OK, I can put on a mask and it’s substitutable for physical distancing.”’
The CDC update is the latest in what’s been an evolving policy on mask-wearing over the last eight months.
Face masks were discouraged by many public health officials in Canada back in March, with some saying a home-made covering could actually lead to further spread if it meant constantly touching the face to make adjustments. The discourse then shifted to say masks were useful in protecting others, but not ourselves.
Tan says changes in guidance show “science is working.” And advancements are made in all facets of medicine on a daily basis.
“We’ve never lived in a time where we had a global pandemic,” she said. “In eight months there’s been a lot more science generated…. We’re just seeing this happening publicly and in a very compressed time.”
PHAC also acknowledged that, saying “the government is continually reviewing new evidence and research” and that new evidence guides its recommendations.
Furness agrees that public health policy was expected to change as we learned more about the virus and how it’s transmitted.
He said every expert – himself included – could point to things they got wrong about COVID back in March, when a mask’s ability to “disrupt the ejection of droplets” wasn’t really taken into consideration.
“It was just a giant blind spot,” he said.
“I mean, think about our knowledge back then. Everyone was afraid and we didn’t know much.”
Dr. Christopher Labos, a Montreal-based physician, says COVID-19 was looked at in the same way as SARS or the flu in the early stages of the pandemic. With both of those viruses, people tend to be very symptomatic and infectious when showing symptoms.
“The original messaging was if you have no symptoms, there’s no point in wearing a mask because you’re probably not sick,” he said.
“But what’s changed is the growing realization that a lot of people have coronavirus and don’t know it. So guidelines shifted to suggest a universal masking policy, because you don’t know if you’re walking around with the virus.”
Labos also believes there may have been reluctance to promote face masks in the early stages of the pandemic out of fear people would confuse “the different mask categories, and what their roles are.”
N-95 respirators, worn by medical professionals in high-risk situations, offer “almost complete protection,” because of their tight seal around the face. But a surgical mask or home-made cloth face covering won’t protect the wearer to that degree.
“It probably does protect you a little bit … but in terms of quantifying it, in terms of saying it with any degree of certainty, that becomes a lot more complicated,” Labos said.
The experts say it’s important to remember that mask-wearing should be viewed as just one component of the public health strategy.
“A mask doesn’t prevent infection, but it drastically reduces the chance of infection,” Labos said. “And that certainly helps.”
This report by The Canadian Press was first published Nov. 12, 2020.
Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.
The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.
Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.
Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.
Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.
The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.
This report by The Canadian Press was first published Oct. 21, 2024.
-With files from Nicole Ireland
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.
Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.
The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.
Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.
Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.
The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.
Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.
The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.
Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.
WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
