Mandatory wearing of the mask and the precautionary principle

The cover face is already compulsory in all the public transport in Quebec since the 13 July and will be in all enclosed public places as of July 18.

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July 18, 2020

Updated on July 19, 2020 at 8h46

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Mandatory wearing of the mask and the precautionary principle

Mylène Ratelle

Professor of public health, University of Waterloo

The announcement of the Québec government requiring the wearing of the mask throughout Quebec, as of July 18, has provoked numerous reactions. Some fear a State is coercive, others simply do not see the usefulness of such a measure. The hashtag cofear-19 (or co fear-19), which circulates in the social media, underlines this perception of a threat little real from the COVID-19.

The debate is polarizing, but the outcome is the same: the port of the cover face will now be mandatory in confined areas, where proximity is high. This will be the case in the public places such as shops, restaurants, cinemas and public transport, to mention only those, with the exception of children 12 years of age and under, who strongly recommends the wearing of the mask, without this being compulsory.

These measures are similar to other, established in the French-speaking world. Belgium, Gabon and Cameroon have implemented a policy for the wearing of masks compulsory. For the moment, the Swiss has made the mask mandatory in its public transport system, while France will make it mandatory in public places as early as 20 July.

The figures reported regularly to the time of the balance sheet of government indicate that the death rate in Canada is approximately 8% on the number of confirmed cases, numbers very similar to what is observed at the global scale.

Of course, the citizen seeks to establish and manage its own level of risk. Many choose an individual approach to a problem population. Some justify their position by accusing the government of poor communication, mixed messages on the effectiveness of the mask, slipping in the management of accommodation centres and long-term care (CHSLD), while the cases are concentrated in this area.

A science dynamic

Good risk management requires ideally a knowledge of the existing situation. In the case of the COVID-19, the science is very recent. In addition, the scientific literature is prolific, due to the impact of the pandemic on our society, which stimulates research. From January to July 2020, the drivers of sharing scientific research indicate that more than 30 000 articles have been published on the subject of the COVID-19. It is extremely difficult in this context to keep abreast of new knowledge on the subject.

Science is dynamic, which means that our management population and individual risk will be as well. It is known that the rate of contagion is about 2.2, that is to say that an infected individual will result in a 2.2 new cases. The number of new infections can be estimated, based on many factors (social, demographic, and clinical).

The determinants surrounding the transmission are becoming more well-known. This being said, the effects in the medium and long term, the COVID-19 are not known at the present time. In addition to the mortality semi-immediate (average of 18 days between the development of symptoms and death), other health effects should also be taken into account in the management of this risk.

The uncertainty on the effects

It is now known that the effects of the COVID-19 are not limited to the respiratory tract. The virus can invade the nervous system causing STROKE and cerebral hemorrhage, even in mild cases. It is estimated currently that the people infected and symptom-free represent at least 30% of the infections, or even more.

Among the asymptomatic, 30% have lesions on the lung (ground-glass opacities). In fact, the lung function following an infection, the COVID-19 does not seem to be restored soon. According to Italian data, only 13% of the infected individuals were completely healed two months after the onset of their first symptoms, others reported still of fatigue, difficulty in breathing and pain in the joints and chest. In a child, even if the prognosis is better than in the adult, we observe similar effects. In addition, a marginal effect has been reported in children : a dysregulation of the immune system leading to inflammation exaggerated.

The prime minister of Québec, François Legault, has announced that as of July 18, the port covers-face would be mandatory in enclosed public places throughout Quebec. This regulation serves to protect us, while facilitating the return to normal.

The canadian Press

Infection the COVID-19 also seems to be associated with lower thyroid gland function. In addition, some researchers have raised the question of whether the COVID-19 could potentially have an effect on fertility, but no firm conclusion has not been established.

Finally, specific immunity is currently estimated to be only a few months. Reinfection from year to year, combined with cumulative effects, is not a scenario to be overlooked. In short, beyond death, we are swimming in uncertainty on what the COVID-19 we reserve for the long term.

The scientific world is concerned. With good reason, he is wary of this new threat, still partially unknown and wants to avoid the worst. However, when the information is missing, it is very difficult to recommend informed strategies for risk management. The precautionary principle is : it is better to prevent than to cure.

Risk management

More parameters relating to the COVID-19 are known, the easier it is to develop strategies of risk management, efficient and specific. Fear should not prevent us from acting. Because of the large impacts of the COVID-19 on our society (loss of jobs, closure of schools, alteration of social relationships, mental health problems, the pressures on the agri-food system), we all want to find a leisurely daily life comfortable.

In the meantime, the mask is a minor irritation. The rules for the wearing of the mask, medical or not, serves to protect us, while facilitating the return to normal. The experts in epidemiology and public health for the vast majority in agreement with the port of the mask required. If all the wear, it can definitely reduce the transmission community, particularly if the individual installs properly.

The mask can protect society and individuals from the effects of the virus on the long-term health. So let’s take our mask in patience while the scientists work to produce the information that will be necessary for a better risk management.

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This text first appeared on the website of the franco-canadian of The Conversation. Reproduced with permission.

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