Experts unanimously back continued mask use and most say mandates should stay even after Omicron peaks, Marc Daalder reports
As the Government prepares to ease Covid-19 restrictions, experts say mask use remains a critical tool in the fight against the virus and should be maintained.
Prime Minister Jacinda Ardern is expected to make an announcement on Wednesday about the future of vaccine mandates, vaccine passes and the traffic light system. At least some of these restrictions are expected to be phased out, while the traffic light system will be reworked to better tackle the Omicron variant.
Ardern told Radio New Zealand on Monday that masks will stay for a while longer.
"Masks are really important," she said. "You've seen in other places, as they continue to manage waves of Omicron, masks do make a really big difference."
However, she added that there may be a stage later in the pandemic where mask use is scaled down.
"There will be times, during our management, even of Omicron, where we may not need them as much. But certainly when you've got a large number of cases, it is something that makes a difference, it is something that keeps you and others safe."
National and the ACT Party have also called for repealing restrictions, but both support existing mask requirements for indoor venues.
A range of experts who spoke with Newsroom backed the ongoing use of masks and several said mandates were key to maintaining high uptake.
Amanda Kvalsvig, an epidemiologist at the University of Otago who has agitated for mass masking since June 2020, said the country needs a more comprehensive mask strategy.
"We’re two years into the pandemic and it’s time for New Zealand to move out of crisis mode. We need a sustainable public health response that can keep New Zealanders safe through the next highly uncertain period," she said.
"The time for rapid reviews and ad-hoc policy around mask wearing is over. Masks work and we need to think about how best to use this vital public health protection and how to ensure that mask policies are working well for everyone."
An ideal mask strategy would provide clear guidance about when and where to wear masks and ensure that high-quality, N95- or P2-style respirators are affordable and accessible for all.
Lucy Telfar-Barnard also works in the University of Otago's Department of Public Health and helped author a study last year into the efficacy of different kinds of masks. She told Newsroom that mask mandates would still be needed after the Omicron wave fades for a number of reasons.
"Countries that have had strong masking did much better at controlling the coronavirus. We are still in the pandemic," she said
This isn't likely to be our last wave of virus cases. We can expect more peaks as immunity wanes, new variants arrive or the virus finds its way into communities that it hadn't yet reached.
"I would expect masks to have that curve-flattening effect. If no one was masking, I would expect the peaks and troughs to be [steeper]. You'd get these bursts of people being infected, whereas when people are masked, you don't have quite the same burst."
In the short-term, once we come down from the peak of Omicron cases, we'll enter a period of stabilised case numbers. Those daily cases could be much higher without the use of masks.
Emily Harvey is a principal investigator at Te Pūnaha Matatini and also works at Covid-19 Modelling Aotearoa. She said masks help limit spread of the virus beyond close social and family circles.
"They play a role in stopping spread to your wider connections. When we're at home, the majority of us are not going to be wearing masks. When we have social gatherings with close family and friends, we're not going to wear masks in those situations," she said.
"That is a much smaller group of people who count as your day-to-day community. Whereas, as soon as you are going to a shop, or going to school, or going on a bus, that is a much wider group of people. They're never going to know if you get sick to be a bit more careful. A lot of those people are there for work, they don't have a choice in being there."
Paediatrician Jin Russell said masks play a critical role in protecting school kids, many of whom aren't vaccinated.
"From a public health point of view, masks are a very important layer in our multi-layered approach in schools. If you still have a lot of Covid-19 circulating in the community, you basically have to rely more on other layers."
Russell said it might be harder to justify mandatory masking for students if Covid-19 cases fell to low levels. However, she added that any attempt to roll back mask mandates for students should be accompanied by the boosting of other parts of the protection framework - particularly ventilation and filtration. Public health advice should still clearly encourage or recommend that students wear them as well.
Any removal of mandatory masking in schools should be coupled with concerted efforts to improve ventilation and air filtration in schools, she said.
Harvey and Telfar-Barnard both said that wearing a mask as an individual can protect you, but that masks are most useful when everyone is wearing them. The chance of the virus transmitting between two masked people is exponentially smaller than the chance of it spreading between a masked and an unmasked person.
"Masking is most effective when it's universal," Harvey said. That's why she's concerned about any potential repeal of mandates.
"As we've seen overseas, as soon as it's not required, people won't wear masks as often."
In Great Britain, when mask mandates were first lifted in July, uptake fell from above 95 percent to a low of 82 percent. Masks were reinstated during the Omicron outbreak and repealed again in late January.
A mid-March survey found just 74 percent of Brits had worn a mask in the past week - the lowest level since the study began in January 2021.
That's one of the key differences between repealing vaccine mandates and mask mandates. Once the vaccine mandate goes, 96 percent of the 12+ population will still be vaccinated. They'll be just as protected on the last day of the mandates as the first day without them.
When mask mandates are withdrawn, however, people take off their masks. They become less protected as soon as they don't have to mask up.
Telfar-Barnard doesn't want to see mask use wane too much at all in New Zealand.
"I know that some people are still taking some time to adjust to the idea of wearing masks. But there are parts of the world where wearing masks through infectious disease periods is really normal - and we can do that too."
