As COVID-19 transmission rate plunges, experts feel it’s time for mandatory masking to go

Representative image.

After a drastic fall in COVID-19 infections, medical experts are starting to debate whether the use of masks to protect against the coronavirus should be made optional rather than mandatory.

Since the end of March 2020, the government has been urging everyone above 5 years of age to wear a mask when around others outside their home as part of COVID-19-appropriate behaviour.

Research has established that a properly fitted mask considerably reduces the risk of transmission of respiratory diseases like COVID-19. Non-surgical N95 masks offer the most protection followed by KN95 and surgical masks.

Masks made of cloth do not provide the same level of protection against transmission of the virus from an infected individual but are still better than not wearing a mask at all, experts say.

With cases of COVID-19 plummeting, some epidemiologists and virologists say it’s time to end mandatory masking in public places.

In India, the COVID-19 situation has been getting better since the January end this year and on Monday, the country saw the active infections dropping to 23, 913-the lowest since April 30, 2020.

To mask or not to mask  

Several European countries and a few states in the US have already ended mask mandates. In India, where compliance with the mandate has not been very high, particularly in small towns and rural areas, experts are suggesting it is time for the government to follow suit and lift the mandate.

“I see no benefit in continuing a mask mandate for all given the low transmission scenario,” said epidemiologist Dr Chandrakant Lahariya, adding that to begin with, children in all settings and adults who are in outdoor settings can be made exempt from the rule.

The results can be observed for some time before the mask mandate is withdrawn completely, Dr Lahariya said.

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In the current, low-transmission scenario, it makes sense to ask only those who are particularly vulnerable to severe COVID-19, such as immunocompromised people, to wear masks and spare others from mandatory masking, said Dr Naman Shah, another epidemiologist.

There are also those who say that in a hot and humid country like India, a mask mandate only translates into a public inconvenience.

To be sure, there’s a school of thought that given the pandemic is still raging in parts of the world outside India, it’s better to err on the side of caution to keep the risk low.

“Since currently available COVID-19 vaccines only confer protection against severe disease, preventive strategies such as wearing masks are critical to keep citizens safe,” said Dr Oommen John, a public health researcher with George Institute for Global Health in New Delhi.

Erring on the side of caution 

Senior virologist Dr T Jacob John said that while wearing a mask at all times should not be compulsory for healthy adults, in a densely populated country like India, it’s better to err on the side of caution especially, during when people are commuting by public transport.

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“I would suggest that people wear masks while in buses, trains, flights or in crowded places,” he said. “Many people have developed a habit of putting on mask while leaving homes and it is good as it prevents the entry of pollutants, common cold and influenza viruses from entering the respiratory system.”

Those not wearing masks should not be penalised, Dr John said.

A nuanced approach 

Dr Viswesvaran Balasubramanian, a consultant in interventional pulmonology and sleep medicine at Yashoda Hospitals in Hyderabad, too, suggested a nuanced approach to the issue.

In most countries, whether to wear a mask or not is left to the personal preference of residents in neighbourhoods with low transmission risk, he said. In areas with a medium rate of risk, masks are advised for immunocompromised people or those at high risk of severe illness.

“However, for people living in high-risk areas, strict adherence to wearing of well-fitting mask indoors and in public regardless of vaccination status or individual risk is emphasized,” said Dr Balasubramanian.

Wearing of masks would be advisable at least outdoors, in crowded places, especially for the elderly or those ailing with comorbidities in a densely populated country like India, he added.