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Should masks be mandatory in public to stop the spread of COVID-19? – CBC.ca

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This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


A growing chorus of experts is calling for the widespread use of masks to slow the spread of COVID-19 and suggesting it may be a key factor in why some countries seemingly have their outbreaks under control while others are completely overwhelmed. 

The World Health Organization does not officially recommend the general public use masks as a way to reduce spreading the virus, only saying that if they do decide to use masks, they should do so “safely and properly.” 

“We encourage countries that are considering the use of masks for the general population to study their effectiveness, so we can all learn from their experience,” a spokesperson for WHO said in a statement to CBC News. 

“Currently, there is insufficient evidence for or against the use of any type of mask among healthy people in public settings. As new information and evidence about masks and non-medical masks emerges, WHO will update existing guidance.”

WHO does recommend medical masks, respirators and other personal protective equipment (PPE) in health care settings, but says only people who are sick or caring for a sick person at home should use them in the community. 

WATCH | An epidemiologist explains why masks are effective for asymptomatic carriers

‘The point of the mask,’ says Christopher Labos, ‘is to protect others from you,’ especially if you are an asymptomatic carrier of the virus. 2:58

“Masks alone cannot stop the pandemic. Countries must continue to find, test, isolate and treat every case and trace every contact,” WHO Director-General Tedros Adhanom Ghebreyesus said earlier this month. 

“Mask or no mask, there are proven things all of us can do to protect ourselves and others: keep your distance, clean your hands, cough or sneeze into your elbow, and avoid touching your face.”

WHO’s recommendations on masks not ‘logical’

But the specific language WHO uses has come under fire from experts who suggest that even non-medical masks could be beneficial in curbing the spread of the virus — or, at the very least, couldn’t hurt.

Babak Javid, a professor at the Tsinghua University School of Medicine in Beijing and a consultant in infectious diseases at Cambridge University Hospitals in the U.K., thinks there’s a double standard in WHO’s messaging. 

Yes, he says, “there’s no direct evidence that masks can prevent transmission.” 

“But there’s no direct evidence that hand-washing can prevent the transmission of COVID or lockdowns can prevent the transmission of COVID because none of those trials have ever been done in the context of COVID.” 

One infectious disease expert says WHO’s recommendation on masks doesn’t take into account the significant number of asymptomatic or pre-symptomatic carriers of the virus in the general population. (Evan Mitsui/CBC)

Javid said there is a “logical gap” in WHO’s recommendation, because it doesn’t take into account the significant number of asymptomatic or pre-symptomatic carriers of the virus in the general population, also known as “silent spreaders.” 

Asymptomatic carriers are those who show no symptoms, while pre-symptomatic carriers are people who have not yet displayed symptoms — usually in the first few days of infection.

“What I think is indisputable is that the face covering can reduce the amount of both droplets and virus that we can transmit,” he said.  

Research on virus’s spread suggests masks could help

Emerging research has revealed more about how the virus spreads from person to person, suggesting it doesn’t just transmit through coughing but also through simply talking.

A U.S. National Institutes of Health study published as a research letter in the New England Journal of Medicine this week provided visual evidence that “speech-generated droplets” can become suspended in the air and inhaled by other people, potentially exposing them to viruses like the one responsible for COVID-19. 

That provides some preliminary evidence that the potentially deadly coronavirus, also known as SARS-CoV-2, could be transmitted between people just by speaking normally.

Emerging research has revealed more about how the virus spreads from person to person, suggesting it doesn’t just transmit through coughing but also through simply talking. (Evan Mitsui/CBC)

“There’s plenty of research showing that even just when we talk and breathe, we release these very small respiratory droplets, smaller than we can see,” said Dr. Linsey Marr, an expert in the transmission of viruses by aerosol at Virginia Tech in Blacksburg, Virginia. 

“Masks really could help make a difference because they will — if you are sick without knowing it — block those droplets from flying into the air and then staying in the air or contaminating surfaces.” 

A paper by researchers in China set to be published in July in the U.S. Centers for Disease Control and Prevention’s journal Emerging Infectious Diseases, found an infected individual without symptoms was apparently able to spread the virus to nine others at a restaurant in Guangzhou, China. 

The direction the air-conditioning system was blowing may have helped transport the virus particles to other diners, who otherwise had no contact with one another, while those elsewhere in the restaurant who weren’t near the airflow didn’t get sick. 

The study has limitations because the findings were not corroborated with experiments to simulate the airborne transmission. Still, the research is raising concern.

“That was pretty strong evidence for the potential that transmission is happening through these microscopic respiratory droplets that can stay floating in the air for a long enough time to kind of go back and forth over the tables,” Marr said. 

Should masks be mandatory in public? 

Last week, Transport Canada made it mandatory for all air passengers to wear non-medical masks or face coverings over their mouth and nose during travel. 

Passengers on boats are “encouraged to wear non-medical masks or face coverings whenever possible,” while train or bus riders are also “strongly encouraged” to do the same. 

The Public Health Agency of Canada says non-medical masks are ‘not a substitute for physical distancing and hand-washing,’ but can protect those nearby ‘even if you have no symptoms.’ (Evan Mitsui/CBC)

But the Public Health Agency of Canada only recently changed course on its recommendations to Canadians on the effectiveness of non-medical masks, previously saying masks should only be worn by health care workers.

“Wearing a non-medical mask is an additional measure that you can take to protect others around you,” Canada’s Chief Public Health Officer Dr. Theresa Tam said on April 6 — while warning that a non-medical mask doesn’t necessarily protect the person wearing it.

“A non-medical mask can reduce the chance of your respiratory droplets coming into contact with others or landing on surfaces,” Tam said. “The science is not certain, but we need to do everything that we can and it seems a sensible thing to do.”

PHAC also says non-medical masks are “not a substitute for physical distancing and hand-washing,” but can protect those nearby “even if you have no symptoms.” 

Last week, Transport Canada made it mandatory for all air passengers to wear non-medical masks or face coverings during travel and ‘strongly encouraged’ passengers on boats, trains and buses to do the same. (Ben Nelms/CBC)

But some experts say that given that significant role asymptomatic and pre-symptomatic carriers of the virus play in the spread of the virus, Canada should be mandating the use of non-medical masks in public, the way other countries have. 

“Public health officials are saying there’s no evidence that the mask is going to keep you from getting the disease, but I also think it’s important to recognize that absence of evidence is not evidence of absence,” said Dr. Joe Vipond, a Calgary emergency department physician. 

“Even a small decrease in the risk of me getting the disease is still really important from a population level.”

Evidence from other countries 

Asian countries that have successfully dropped their curve of new COVID-19 cases, like South Korea, Taiwan and China, all have widespread mask usage, while the Czech Republic recently implemented mandatory mask measures and saw case fatality rates drop, Vipond wrote in a recent op-ed for Maclean’s magazine

There are numerous factors as to why a given country can become overwhelmed by the virus, including the onset of outbreaks, the accuracy of reporting, backlogs in testing, the age of the population and the effectiveness of containment measures. 

But Javid said that while this is still just correlative evidence, it could be one reason why countries like Taiwan, which doesn’t have total lockdown measures in place but does have widespread mask usage, has a much lower incidence of COVID-19 than other countries like Sweden, for example, where masks are less commonly used.

Jeremy Howard, a University of San Francisco researcher and the co-founder of Masks 4 All, said Japan is another example of a densely populated region with widespread public mask wearing and low levels of COVID-19 despite not prioritizing physical distancing or testing compared with a place like New York.

“There’s all this evidence, which strongly suggests, as part of the suite of tools we have available, wearing a mask appears to be astonishingly powerful, and the cost is nearly zero,” he said.

“And when we compare the level of evidence we have to something like washing hands, it’s vastly, vastly, vastly, vastly higher.” 

While masks are not a “magic bullet” in curbing the spread of the virus and more research still needs to be done on their effectiveness, Javid said they can be used in conjunction with other measures like physical distancing and widespread testing to slow the spread.  

“To get over the COVID problem we’re going to need a multi-pronged approach. To me, what’s attractive about masks is that they’re cheap, they’re probably effective and they allow economic activity,” he said. 

“We can’t stay in lockdown forever, so to me, the downsides are so minimal compared to the potential upsides.” 

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Nova Scotia reports no new cases of COVID-19 for first time since March – Brandon Sun

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HALIFAX – Nova Scotia increased its social gathering limit on Friday as the province reported no new cases of COVID-19 for the first time since its initial infections were identified in mid-March.

Dr. Robert Strang, the chief medical officer of health, called the development a “significant and encouraging milestone” in a province that has seen a continuing downward trend in new cases over recent weeks.

It kept the total number of confirmed cases at 1,055, including 978 people who have recovered from the virus. Eight people are currently in hospital and three of them are in intensive care.

“It hasn’t been easy but we are seeing positive results,” said Strang.

Nova Scotia announced more details of a reopening plan set for next Friday, even as neighbouring New Brunswick put the brakes on expanding the current phase of its plan. That province is dealing with a growing cluster of new cases in the Campbellton area, allegedly caused by a health-care worker who returned from Quebec and didn’t self-isolate.

Strang was asked about what lessons Nova Scotia could take from the Campbellton outbreak.

“The message in that is really about the importance of self-isolation when you cross borders,” he said. “What it shows us is the importance of very closely monitoring our borders. We need to be very thoughtful and careful about how we lift those border restrictions.”

Premier Stephen McNeil announced a new gathering limit of 10 people effective immediately — a doubling from a limit of five that was imposed when health restrictions were put in place in late March.

Physical distancing of two metres would still be required, except among members of the same household or family “bubble.” The limit is the same indoors and outdoors, with exceptions for outdoor weddings and funeral services which can have 15 people.

Strang clarified that when it comes to weddings, that limit of 15 would have to include photographers and caterers if that’s what couples wanted in their ceremonies.

He said the gathering limit also applies to arts and culture activities such as theatre performances and dance recitals, faith gatherings, and sports and physical activity. Businesses such as theatres, concerts, festivals and sporting activities would also have to adhere to the 10-person limit.

“We are watching our epidemiology and will consider expanding the way people can have close social interaction when we see how this first stage in the reopening is going,” said Strang. “It’s very important that we don’t introduce too much risk of COVID-19 at any one time and we have the capacity to monitor the effect of any steps.”

McNeil said that private campgrounds would also be allowed to open, but would only operate at 50 per cent capacity and must ensure public health protocols are followed, including adequate distancing between campsites.

Provincial campgrounds are scheduled to open June 15 at reduced capacity to ensure a minimum of six metres between individual sites.

The latest measures came two days after McNeil announced that most businesses required to close under a public health order in late March would be allowed to open next Friday, provided they are ready with a plan that follows physical distancing protocols.

The list of businesses includes bars and restaurant dining rooms, hair salons, barber shops, gyms and yoga studios, among others.

Some health providers would also be allowed to reopen, including dentistry, optometry, chiropractic and physiotherapy offices. Veterinary services can also operate along with some unregulated professions, such as massage therapy, podiatry and naturopathy.

Earlier Friday, the province announced it would add 23 new long-term care beds because of a need resulting from some facilities slowing or stopping admissions during the pandemic.

It said it is entering into an agreement with Shannex RLC Ltd. to convert a floor at the Caritas Residence, a private assisted-living home in Bedford, N.S., into nursing home beds.

Residents would be able to move into the facility in early June and will be tested for the virus before being admitted.

According to the government, there are 132-long term care facilities in Nova Scotia.

This report by The Canadian Press was first published May 29, 2020.

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Nova Scotia reports 1 more death at Northwood, 1 new case of coronavrius – Globalnews.ca

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“Our thoughts are with those who are mourning at this time. I recognize how difficult it can be for family and friends to grieve with restrictions in place,” said Premier Stephen McNeil, in a press release.“As these restrictions are loosened over the next week, I ask all Nova Scotians to continue to respect the rules and follow public health advice.”As of Saturday, Nova Scotia confirmed one new case of novel coronavirus, bringing the total number of cases to 1,056.“This summer will look very different. I know there are things people want to do and can’t,” said Dr. Robert Strang, Nova Scotia’s chief medical officer of health.READ MORE: Nova Scotia to allow 10-person gatherings as no new coronavirus cases announced Friday“I continue to ask for people’s patience, understanding and cooperation. No matter what you do, please respect the rules – practise good hygiene, stay home if you’re feeling unwell, limit large groups and wear non-medical masks when and where appropriate.”The province said the QEII Health Sciences Centre’s microbiology lab completed 694 Nova Scotia tests on May 29 and is operating 24-hours.To date, Nova Scotia has 41,391 negative test results, 1,056 positive COVID-19 test results and 60 deaths.

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Newswatch COVID-19 Digest: Saturday May 30, 2020 – Cornwall Newswatch – Cornwall Newswatch

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(Newswatch Group/Bill Kingston, File)

Here are the latest local, regional and national headlines on the novel coronavirus (COVID-19) for Saturday, May 30, 2020:

  • There have been 27,210 confirmed cases of COVID-19 across Ontario, an increase of 344 cases (or 1.3 per cent) from the previous day. There are 20,983 people recovered from the virus while 2,230 people have died. The number of Ontario people tested is 680,687 of which 13,351 have pending results.
  • Canada’s coronavirus case total is 89,418. The country has 6,979 deaths from the virus – 164 in British Columbia, 143 in Alberta, 10 in Saskatchewan, seven in Manitoba, 2,230 in Ontario, 4,363 in Quebec, three in Newfoundland & Labrador and 59 in Nova Scotia.
  • A person who has been weeks in an Ottawa intensive care unit has been released and is on the regular floor of the hospital. There are still a total of three in hospital with one other person still in ICU. The number of confirmed cases stayed steady Friday at 147 with 11 deaths and 92 recoveries. Local testing jumped by 273 on Friday to 8,378 tests. The breakdown of cases are 15 in Cornwall (15 resolved), 25 in SD&G (20 resolved) and 107 in Prescott-Russell (57 resolved). There are two active nursing home outbreaks.
  • The Leeds, Grenville and Lanark District Health Unit added another case Friday to a total of 342 confirmed cases. There was also another death bringing that total to 50. Ninety per cent of COVID-19 cases (264) have recovered.
  • Officials with Public Health Ontario outlined their next phase of novel coronavirus testing across Ontario. Testing will concentrate on first responders, more essential workers and those in prison settings. It will also concentrate on hot spot areas, where Ontario Public Health would send a strike team into a business, for example, where there’s increased COVID-19 activity.
  • Premier Doug Ford says the government is looking at a regional reopening of the economy. “It’s an option that we’re looking at. Everything is on the table.” Ford says they are getting a better picture of the spread of the disease through more testing and mobile testing units.
  • New York Gov. Andrew Cuomo announced Friday that the North Country and Central New York could move to the next phase – phase two – of reopening. That includes St. Lawrence County (home to Massena, Potsdam and Canton) and Franklin County (home to Malone). New York’s phase two includes reopening office-based business, in-store retail shopping, and limited barber and hairdressing services. St. Lawrence County has had 201 positive cases to date, which 183 recovered and two deaths.
  • The Children’s Treatment Center will resume in-person counselling with children and parents on Monday, June 8. The center says it will “implement all necessary measures” to provide safety for children, parents and staff members. Executive Director Robert Smith reduced his counselling hours and the center has hired another counsellor, Ashley Dicintio, who previously had a private practice in Cornwall and works at the Ottawa Carleton Detention Center as a women’s social worker.
  • A ban on cruise ships entering Canadian waters has been extended until October. The ban was to expire on July 1.
  • The federal government has rolled out an additional $650 million for First Nations, Inuit and Metis communities across Canada. It will go to public health, income assistance and shelters for women and children. That’s in addition to the $305 million already promised.
  • A health care worker in New Brunswick has been suspended after travelling to Quebec and not self-quarantining after returning, choosing instead to go to work. There’s now an outbreak in the Campbellton area with at least six new cases, including two in ICU. The RCMP is investigating.

Have a story or news release related to COVID-19? Send it along for possible inclusion in a future digest on Cornwall Newswatch. Email editor@cornwallnewswatch.com. Please put “COVID-19 Digest” in the subject line.

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