COVID: With cases expected to rise, should you wear a mask?

We are in the “omicron era” of the COVID-19 pandemic, as infectious disease specialist Isaac Bogoch puts it.

The latest Omicron variant sublineages, BQ.1/BQ1.11 and BA.2.75.2, are extremely transmissible and are driving new infections across Canada, Bogoch said.

Regarding efforts to prevent the variant from spreading, some data suggests that wearing a mask may reduce the rate of COVID-19 infections at the community level, the specialist told CTVNews.ca in a phone interview.

“But in the Omicron era, we’re seeing some weakening of that data, which means there just isn’t much room to maneuver in the Omicron era.”

By “leeway” he means that many people will become infected themselves with masks for protection and with multiple doses of the COVID-19 vaccine.

As mandates fall across the country, people are making their own decisions about whether to mask. That, combined with an already highly transmissible variant, means more infections are likely, Bogoch said.

Over the past two years, cases of the rapidly mutating disease have spiked in the fall months, with many requiring hospital treatment.

This fall, experts say, will be different.

Case numbers are still expected to rise, but most people who have tested positive for COVID-19 no longer see severe symptoms.

Recent Canadian government data shows there are fewer patients in intensive care units this fall than at the same time last year. Even fewer people are now on ventilation.

The reason for this lies in large part with vaccines and natural antibodies to the disease, Bogoch explained.

Canada’s COVID-19 Immunity Task Force estimates that at least 18.2 million Canadians were infected with COVID-19 between December 15 and July 15, but experts say it’s hard to say how accurate that estimate is.

“The actual number of newly infected (or reinfected) Canadians may have been higher because some people who became infected early in the omicron phase of the pandemic may have no detectable anti-N antibodies left,” the website reads the task force.

Despite the expected surge in cases this fall, infectious disease specialist Sumon Chakrabarti said there is no need to panic or even take many protective measures.

“I don’t think you have to do anything special this winter to avoid respiratory viruses,” Chakrabarti, who works at Trillium Health Partners in Mississauga, Ontario, said in an interview with CTVNews.ca on Tuesday. “If you’re otherwise healthy, you have immunity, whether it’s from the vaccine or from previous COVID. You should do what you did in 2018.”

Chakrabarti means that people should act as they would have done before the COVID-19 pandemic.

In the past, increased COVID-19 cases have prompted strict lockdown orders and holiday gatherings via Zoom, but Chakrabarti said the latest strain of Omicron, despite high transmission, is weak and most people who get an infection don’t get very sick.

“Omicron itself is much milder, and in fact, if you look at it, it actually has a lower mortality rate than influenza,” Chakrabarti said.

Chakrabarti has been treating COVID-19 patients at Mississauga Hospital since April 2020, so he’s seen what the situation was like at the start of the pandemic — when patients he described as “relatively healthy” who needed ventilators in middle age — compared to before like in the last few months, when few people are extremely ill.

“Even the oldest people, the median age of people who come with COVID is generally all over 80,” he said. “And even they get better and go home.”

When someone is infected with COVID-19, Chakrabarti means the symptoms they experience, which are similar to those of a bad cold, mean their immune system is “activated.”

“The symptoms you’re getting are kicking ass, they’re coming from your immune system, it’s not from the virus,” he said. “You feel like garbage for a few days, and then you can do better.”

Chakrabarti appreciates that there are people who are concerned about contracting COVID-19, particularly those with certain health conditions.

For them, he recommends wearing a mask.

But he said he no longer recommends masks to most of his patients while they have been vaccinated against COVID-19.

“These are all preventive things,” he said. “I think it’s very important that that’s not the advice I’m giving to the general population. I think if you’re otherwise young and healthy… I don’t think you’re going to do anything different this winter than any other winter, with the exception of 2020 and 2021 of course.”

Bogoch repeated the same steps and said the risk of transmission from wearing a mask was lower, even with the highly transmissible Omicron variant. He said this should be done especially for interiors.

“Think of the three Cs: It’s in crowded, cramped and closed environments that most COVID is transmitted,” Bogoch said.

The best masks, both experts agree, are surgical or KN95 masks. Bogoch says that when looking for a suitable mask, one should remember the two Fs: fit and filtration.

Chakrabarti also highlighted what those who have COVID-19 or any other illness should do.

“If you feel sick, stay home,” he said. “Once you feel better, your fever has gone down or your symptoms improve, you can go back. I think that’s just common courtesy.”