Face masks do’s and don’ts

Quebec is making it mandatory to wear a mask in indoor public spaces effective July 18th to stem the spread of coronavirus. Face masks do’s and don’ts will apply to people age 12 and older, with exceptions for people with specific medical conditions yet to be determined. “We’re not going to ask people to walk around with a medical certificate,” said Quebec’s director of public health Horacio Arruda, specifying that typically it would be people with severe cardiac or respiratory illnesses, adding that it’s up to people’s judgment. “It’s not because you have a bit of asthma that you can’t wear a mask.”

What are the Medical exemptions in wearing a face mask?

Medical exemptions for wearing a mask generally include respiratory problems, other medical conditions, mental health problems, disability, age, and pregnancy. Other factors,  such as race and ethnicity, have a bearing on the discussion. Kate Mulligan, an assistant professor at the Dalla Lana School of Public Health at the University of Toronto who studies health policy and equity, has expressed concern about mandatory masks and enforcement. She said people with breathing difficulties, such as asthma, may have trouble with masks, and certain groups, such as Black and Indigenous men, may face discrimination when wearing a mask. “They may be perceived as a safety risk, and that could create a safety risk to themselves.” 

Online petition to stop wearing face masks

This is coming at a time when there are at least two online petitions calling on the government to revoke its stance on mandatory masks. More than 56,000 Quebecers have signed a CHANGE.ORG petition calling on the Legault government to reverse its decision on mandatory masks. Berthierville resident Geneviève Sénécal, the petition sponsor, argues that the science of wearing masks isn’t consistent in its conclusions. She cites several studies and says information provided by Premier Legault and public health director Dr. Horacio Arruda is often contradictory. In addition to calling for the order to be rescinded, Sénécal contends that forcing people to wear a mask violates the Charter of Rights and Freedoms.    

Mandatory masks aren’t in line with the Canadian government’s policy which emphasizes a balanced and voluntary approach. In late May, Canada’s chief public health officer Dr. Theresa Tam said non-medical masks or cloth face coverings are not for everyone. “Don’t judge people not wearing a mask. Some people have trouble breathing and should not be wearing masks,” said Dr. Tam. “We have to be understanding that for some, wearing a mask is not possible.”  She said non-medical masks should not be used on children under the age of two, anyone who has trouble breathing, is unconscious, incapacitated, or otherwise unable to remove it on their own. 

However, Quebec appears to be adopting a more restrictive approach to medical exemptions at a time when Dr. Tam has broadened Canada’s public health advisory to include anyone finding it difficult to wear a mask in hot, humid weather. On June 19, Canada’s top doctor tweeted this message: ”Non-medical masks or cloth face coverings can make breathing difficult in high heat & humidity. When outside in a #heatwave, 2m. #PhysicalDistancing is best. Save the mask for indoors when you can’t keep your distance.” 

The Legault government’s decision to make it compulsory to wear a mask in indoor public settings runs afoul of civil liberties. Cara Faith Zwibel, a lawyer and Director of the Fundamental Freedoms Program at the Canadian Civil Liberties Association says that over-zealous regulation could have negative impacts on vulnerable individuals. “Wearing a mask is not medically recommended for some people and may be counter-productive for others, for example, young children who may be more likely to touch their faces if they are wearing a mask.” Zwibel has also expressed concern about people with disabilities, such as hearing impairments, who need to see people’s faces to read their lips or people on the autism spectrum who may have trouble with masks. 
ON June 26th, the Canadian Civil Liberties Association issued a statement on mandatory masks, cautioning public authorities from going “overboard” on mask regulation. “At this point, the CCLA does not support generalized mandatory mask policies that require the wearing of non-medical masks in all indoor public settings.” The CCLA says that governments have to justify restrictions on liberty, such as forcing people to wear masks, as being both reasonable and, based on evidence. “The scientific evidence on the effectiveness of non-medical masks is mixed. This is nothing like mandating seat belts in the 1970s. A legal requirement that masks be worn in all indoor public spaces is an attempt at massive, and perhaps permanent, behaviour modification for the entire population. A legal change of this magnitude must be based on stronger evidence than we currently have.” 

What is the fine for not wearing a face mask in public places

Quebec is leaving it up to merchants to enforce the rule in their establishments and those who don’t could face fines ranging from $400 to $6,000. The decision has drawn criticism from business owners who are tasked with applying mask rules. Rather than providing comprehensive regulation, Legault has directed businesses to call the police if their customers refuse to comply with wearing a mask. Business groups have questioned that rationale, asking why the burden falls to them. “We’re not equipped for that,” said Marc Fortin, president of the Quebec branch of the Retail Council of Canada (RCC). In some areas of the country where masks have become mandatory, retail workers have faced physical threats and been spit on for trying to enforce mask rules. 

While mandatory mask requirements (including store policies) can create exceptions for people, meaningful enforcement may require invasive questioning to see who can benefit from such exceptions, creating concerns about privacy rights and the sharing of confidential medical information. The CCLA states, “The task of enforcement will likely land on businesses and individuals who may be ill-equipped for the task (e.g. requiring a greeter at a grocery store to question customers about their health and determine who should be permitted entry without a mask) and may put both those responsible for enforcement and those subject to it at increased risk.” 

Masks have been mandatory on public transit in Quebec since July 13th. However, bus drivers do not have to wear a mask, a blatantly discriminatory application of the regulation which makes for a very fraught situation. In addition to demonstrations and boycotts, there has been violence in jurisdictions that have brought in mandatory masks. In France, a bus driver who asked riders to wear a mask was taken off the bus and beaten to death by a group of youths. In the US, a security guard was shot and killed by a man when an altercation occurred over wearing a mask.

People with mental health problems and intellectual challenges who aren’t able to articulate their needs run the risk of being harassed and bullied by other passengers if they aren’t wearing a mask. “As with the enforcement of many rules and laws, we are concerned about who will be most impacted and whether racialized and marginalized communities will be disproportionately affected,” Zwibel says. The CCLA is inviting the public to consult its report released in June 2020, Stay Off the Grass:  CCLA and Policing the Pandemic Mapping Project on Ticketing During COVID.
Legault says that mandatory masks are better than lockdown and until a vaccine is developed this is it. A recent Quebec public service announcement aimed at building support for mandatory masks presents the issue in similarly binary terms: wear a mask in public indoor spaces or be home alone and lonely. Not quite. People can enjoy relationships with their family and friends at home and backyard barbeques. They can chat with their neighbours at a safe distance from their balconies and over the fence. There is such a thing as the telephone and people are communicating virtually more than ever before. They can work from home, opt-out of public transportation – drive, carpool, cycle, or walk to work. Many people have discovered that they actually prefer shopping online to navigating crowded malls and big-box stores. There is no law that says Quebecers have to vacation or take in cultural activities in Quebec and they can always escape to other places without onerous mask regulation. 

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