Value of masks clear a month ago
Until this week, Dr. Theresa Tam offered no fewer than four reasons why asymptomatic Canadians shouldn’t wear masks when they left the house. First, the Public Health Agency of Canada head told us, wearing a mask to protect you or others from COVID-19 might deplete supplies needed by front-line nurses and doctors (putting to one side the fact that relatively few of us were looking to procure medical-grade N95 models). Secondly, wearing a mask could make everything worse because “the person (could) put their finger in their e ye or touch their face under their mask.”
Third, masks would give us a “false sense of security,” and thereby encourage people to stop social distancing. Fourth, Tam told us, “most people haven’t learned how to use masks.” The profile of the ordinary Canadian that emerges here is a person so dumb that one wonders how we manage to even button our shirts or zip our pants without watching instructional videos or calling a 1-800 number.
Fortunately, that’s all old news. On Monday, Tam proclaimed Canadians maskworthy, instructing us that “wearing a non- medical mask is an additional measure that you can take to protect others around you.” She even gave us crafting tips on how to Macgyver our own units out of T-shirts and elastic bands.
This advice comes several weeks after many of us already knew that masks were beneficial. But still, it’s nice to see that Tam has caught up on her March reading.
In retrospect, the time to start questioning our federal government’s competency on COVID- 19 health- andsafety leadership was late January, when Tam told a health committee that forcing self-isolation on incoming travellers from COVID19-afflicted areas would risk “stigmatizing” members of those communities. Even if no one knew the full extent of the virus threat back then, her manner of justifying inaction symbolized a larger pattern: From the start, our public officials often seemed more concerned about political correctness than public contagion.
When pushed on the travel issue, Tam declared that “we are a signatory to the International Health Regulations, and we’ll be called to account if we do anything different.” And as recently as March 13, Health Minister Patty Hajdu was lecturing Canadians about how closing borders would “create harm.” ( The U. S.- Canada land border was closed a week later.) While most Canadians are adults who understand the importance of multilateral co-operation, we also expect our leaders to exercise independent judgment when it comes to life- or- death matters, instead of existing as a glorified out- of- office responder that passes along edicts from slow- moving international bureaucracies. I dare say we’d also be perfectly okay with Tam or Hajdu being “called to account” for regulatory non- compliance by some international entity, especially now that we know that such a move could have saved Canadian lives.
There is a reason why many independent experts all over the world started telling people to wear masks in March: The science was already persuasive. As far back as a full month ago, in fact, researchers showed that COVID-19 material can accumulate and multiply in the nasopharynx — that’s the upper part of the throat behind your nose. That’s crucial because this area of the body is vulnerable to large droplets emanating from the mouth or nose of an infected individual. You don’t need an N95 mask to protect against large droplets. While no mask is 100 per cent reliable, your old baseball-game giveaway towel will do a reasonably good job.
When it comes to droplet ballistics, the physics at play are complex. But they were well- summarized by cell biologist Sui Huang of the Institute for Systems Biology in Seattle. As Huang explained two weeks ago in a widely circulated piece, a typical social-distancing separation of two metres may help protect you from people who are merely breathing or talking in a normal fashion. But a sneeze generates air flow of about 50 metres per second — that’s half the length of a football field in the time it takes you to say “coronavirus.” As the South Koreans and Taiwanese have known for many weeks now, protecting yourself requires a physical membrane between you and the environment. These membranes are commonly known as masks.
In February, Tam wouldn’t have been entirely wrong to argue that, when it came to non- N95 mask use, the jury was still out. Much of the focus was then on small aerosol particles — which represent only a tiny fraction of the total expelled droplet volume in a typical sneeze or cough, but are tiny enough to pass deep into someone’s lungs without getting stuck in the mouth, nose or throat. But we’ve known for a month now that COVID-19 infection is a risk even if particles don’t initially make it below your neckline. ( Moreover, it’s not even clear that non- 95 masks are useless against super- fine particles: Huang points to 2008 Dutch research showing that even a tea towel could reduce the quantity of incoming aerosols — up to a diameter of 1 micrometre, one thousandth of a millimetre — by a factor of three.)
By international standards, neither Tam nor Hajdu are especially incompetent or culpable. There are plenty of other examples, in plenty of other countries, of public officials who found reasons to drag their feet or offer bad advice. A common pattern has emerged whereby such delays often were caused by government officials stubbornly hewing to political brand, ideological fixation or national neurosis — each according to his parochial circumstances.
In Canada, this meant a relentless (and often vapidly expressed) fixation on open borders and anti- racism — principles that I happen to support, though not at the expense of Canadians dying. In the United States, the reality of COVID-19 ran headlong into Donald Trump’s obsession with the stock market as an index of presidential self- worth. In the U. K., there were unconscionable delays that resulted from Boris Johnson’s populist infatuation, by which he and his entourage seemed to imagine that any problem can be managed so long as they flippantly zigged while bien pensants zagged. ( I learned that Johnson himself was admitted to intensive care around the time I wrote these words.) In China, uncountable thousands died because an authoritarian government was more interested in protecting its international reputation than its citizens.
One long- term effect of this crisis, I hope, will be to revaluate the way Canadian leaders pick the people who run important departments and agencies. Under Canada’s constitutional scheme, the primary responsibility for health care falls to the provinces. And since it is the provincial governments that do much of the heavy lifting on service delivery and policy, it always is tempting for PMS to fill prominent federal roles with figures who are more mascot than minister.
What we are living through now is a deadly reminder that there are enemies out there that don’t care about our slogans and hashtags. The COVID- 19 virus is one of them.