There’s no need to panic about Nova Scotia’s current COVID-19 situation.
But using N95 and KN95 masks instead of cloth and medical masks in public won’t hurt, and you should be worrying more about the number of people at your holiday gatherings instead of how many are grabbing food from the same plate of hors d’oeuvres.
That’s some of the advice Halifax-based epidemiologist Kevin Wilson has for Nova Scotians disheartened by Monday’s news that the Omicron variant is now in the province and restrictions have once again been put in place ahead of the holidays.
“If you have 20 people in a room together that are not normally with each other with the windows closed and no masks on and you’re all having a great holiday dinner, the problem is not that the food is arranged in a buffet,” Wilson said in an interview late Monday afternoon.
“If there’s a lot of spread at that event, that wasn’t the thing that caused the spread. It was really the ventilation and the sharing of air, basically.”
‘Much better place’ than this time last year
The news that there will be some restrictions in place with the appearance of the Omicron variant in the province and an outbreak in Antigonish and rising cases in the province’s central zone might be upsetting for pandemic weary Nova Scotians, but Wilson said at this point he’s optimistic things can be turned around.
“We’re in a much better place than we were this time last year where we were in the early stages of a large outbreak in the Halifax area,” Wilson said.
“At a population level we’re in a much better place, and individually most of us are in a much better place. All the rules still apply, it’s still the same kind of risk contexts, and the same kind of things you can do to make yourself safer. So, just do them.”
Wilson said while it’s “early days” in terms of understanding the science of the Omicron variant, it’s “fundamentally the same virus” and the same public health measures will help.
“The biggest thing we’re seeing is that it has a growth advantage over Delta,” he said.
“While it will grow faster and become predominant faster and lead to a large surge in cases, the safety behaviours still work.”
The province’s announcement Monday that free rapid testing kits are now available at public libraries throughout Nova Scotia was described by Wilson as “enormously helpful” as testing is a low-burden activity that pays big dividends.
He said the availability of the tests gives Nova Scotians a “huge advantage” over residents in many other provinces, and he actively encourages people to test themselves weekly to help protect others.
Cloth masks vs medical, N95/K95 masks
While Nova Scotians are used to wearing masks in public spaces, the majority likely aren’t wearing respirators (N95 and KN95 masks) or medical face masks — the kind worn by operating room personnel during surgical procedures.
The Public Health Agency of Canada (PHAC) now recommends Canadians at higher risk of COVID-19 exposure or more severe disease consider wearing medical face masks rather than non-medical masks.
•anyone who has tested positive for or has symptoms of COVID-19
people caring for someone who has tested positive or has symptoms of COVID-19
•people who live in an overcrowded setting with someone who has tested positive or has symptoms of COVID-19
•people who are at risk of more severe disease or outcomes from COVID-19
•people who are at higher risk of exposure to COVID-19 because of their living situation
The agency also advises that people who fall under those categories “could also consider using a respirator.”
On its website, PHAC notes non-medical masks can vary in terms of their effectiveness in preventing the spread of COVID-19. Factors impacting effectiveness include material, construction, fit, and proper use.
The agency states “some non-medical masks” can help prevent the spread of COVID-19 similarly to medical masks if they fit well and have multiple layers — including at least two layers of breathable tightly woven fabric such as cotton. They must also have an effective middle filter layer.
“Few non-medical masks provide information about their filtration effectiveness,” PHAC states.
“In general, while non-medical masks can help prevent the spread of COVID-19, medical masks and respirators provide better protection.
No matter which type of mask you choose, proper fit is a key factor in its effectiveness.”
Health Canada describes N95 respirators as providing 95% protection around the nose and mouth against exposure to respiratory viruses and bacteria when properly fitted.
While closely related to N95 respirators, KN95s aren’t regulated by the same organizations. In this country, those that don’t meet the 95% filtration criteria are required by Health Canada to be labelled as non-medical use face masks.
A searchable list of Health Canada authorized medical respirators for COVID-19 related uses can be found here.
‘Why not just use the masks that work better?’
So what kind of mask does an epidemiologist living in Halifax wear when out in public?
“We already have a mask mandate, and if you’re going to do it, why not just use the most effective mask? I have a bunch of KN95s lying around and that’s the de facto one that I use,” Wilson said.
“I would tend to lean more in the direction of ‘Well, why not just use the masks that work better?’”
Wilson said surgical masks or cloth masks would work well if COVID-19 were a purely droplet borne virus because the goal of those is to ensure cough, spit, and “general debris” coming out of your mouth and/or nose doesn’t get through the mask.
“Those certainly do that and that’s great. It’ll even suppress your breath to some degree so that it’s not spreading quite as efficiently, so they’re definitely not nothing,” he said.
“But things like the N95 and KN95 type respirators, what they’re designed to do is very much like breath control. Your breath really doesn’t escape that space very efficiently and so it’s much more suppressed really and filters out the environment both ways.”
‘No need to panic right now’
During Monday’s COVID-19 media briefing, Tim Bousquet asked the province’s chief medical officer of health Dr. Robert Strang about his demeanor compared to previous outbreaks. He noted that Strang appeared less worried, asking if he considered it an evolution of the pandemic that’s going in a more positive direction.
Strang said while we can be “not as acutely worried” because of vaccines, there’s still reason for concern if not managed well.
“There’s always the risk that we’ve gone for so long, people are tired, people are fatigued and they just want to just get on with life and that we just ignore the need to pay attention to COVID protocols,” Strang answered.
“That would be a mistake….I’m concerned that if we don’t respond yet again, this has the potential to have significant negative impacts. But at the same time, I’m confident that yet again we will respond and do what’s necessary to keep things controlled to the level that vaccines will protect us and minimize severe illness, minimize any risk on the health care system.”
Wilson shares Strang’s overall optimism, although he is concerned about the rapid case growth in Ontario and Quebec.
“When the rest of the country is not doing well, I immediately start to think like, ‘Oh, we also are now at an increased risk of not doing well,’ and then locally, we have that fairly large outbreak where the province is putting a lot of resources towards increased testing in the area and isolation of detected cases,” Wilson said.
“I hate picking on New Brunswick, but you don’t want it to turn into that where it’s getting into nursing homes … It’s easier to control a small campus-wide outbreak than a provincewide, kind-of-just-everywhere blob.”
His messaging to his fellow Nova Scotians echoes much of what Strang has already articulated. Ensure you are vaccinated and your eligible children are vaccinated, limit your social circles, practice social distancing, proper handwashing, and regularly test yourself.
“There’s no need to panic right now. Yes, our situation got worse over the last week or so. We have a large outbreak and we’re heading into the holidays where people are going to be moving around more,” Wilson said.
“That’s not great. It’d be great if that weren’t happening. But we’ve done this kind of thing before, we know how it works, and we just need to do the work.”