A nurse’s review of mask policy

I took this picture at 2:48 am while working a night shift in 2016. Who knew at that time, one day we would debate masks. We lived through SARS but nothing compares to what we are having now.

Here is my take on the matter of wearing masks based on scientific evidence and my public policy perspective. Public Health Ontario (June 2020) conducted a systematic review of thousands of published and unpublished scientific evidence including the grey literature. These are the key points:

  • Public mask-wearing is likely beneficial as source control when worn by persons shedding the virus and when physical distancing is not possible in public spaces (transit, grocery shopping)
  • There is emerging data from ecological studies showing a decrease in new cases in regions where mandatory public masks were implemented.
  • There is variability in the effectiveness of homemade and cloth masks. Some materials adequately filter the expulsion of viral droplets from the wearer, making them theoretically suitable for source control. Medical masks should not be used by the public to avoid shortages in personal protective equipment for healthcare workers.
  • There are theoretical risks of harms from public mask use including self-contamination from improper use, reducing physical distancing, and facial dermatitis. These risks may be mitigated by clear and consistent messaging on the importance of hand hygiene as well as the intended purpose of masking and proper use.

In terms of public policy perspective, these are the key points for me:

Mandatory Mask Wearing

We know that while the province did not make masks mandatory (due to geographical variations and enforcement issues) at the provincial level, cities passed by-laws to make masks mandatory in covered public places. Considering that we need to slowly open up businesses, I agree with the cities including Toronto and Brampton to make masks wearing mandatory to control the source.

Additional Public Health Measures

The examples from other jurisdictions show that countries who made masks mandatory controlled the spread better. Having said that we should not forget in these jurisdictions, other public health measures were implemented alongside mask-wearing measures.

Continue Hand Washing and Physical Distancing

Public health institutions and municipalities need to provide clear and consistent messaging that hand washing and physical distancing measures are the best practices to prevent the spread. Constant hand washing and physical distancing should not be compromised by the mask wearer who may have a false sense of security.

Proper Mask Wearing

Public needs continuous education on an ongoing basis on how to wear a mask. Short videos of demonstration should be released to the public online to ensure that constant touching to masks and face, improper wear and take-off should be eliminated.

Provide Masks When Necessary

No one should be denied a service if they do not have a mask with them to wear. Businesses or covered public places should provide masks to people who may not have masks with them at the entrance. Other Jurisdictions who made masks mandatory provided the public with enough resources to be able to buy masks or masks were provided directly to the public.

Public Safety

Lastly, I have to add this as a public policy argument. Media, policymakers and politicians should never again put the words “niqab” and “security breach” in the same sentence ever. Because no evidence emerged about mask-wearing being a threat to public safety. So leave these women who wear niqab alone. They are naturally wearing cloth masks.

In summary:

Wash your hands, keep your physical distancing, wear a mask where it is mandatory or where physical distancing is not possible.


IZA Institute of Labor Economics (2020). Face Masks Considerably Reduce COVID-19 Cases in Germany: A Synthetic Control Method Approach. Retrieved from ftp.iza.org.

Public Health Ontario (2020). COVID-19-What do we know so far about wearing masks in public. Retrieved from https://www.publichealthontario.ca/-/media/documents/ncov/covid-wwksf/what-we-know-public-masks-apr-7-2020.pdf?la=en