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Dr. Kieran Moore, Ontario's chief medical officer of health makes his way to a press conference regarding the lifting of most mask mandates for indoor settings in Ontario at Queen's Park in Toronto, on March 9.Nathan Denette/The Canadian Press

Ontario is joining other provinces in removing mask mandates for most public places in an attempt to shift from two years of pandemic crisis mode to long-term management of COVID-19.

Although case numbers and hospitalizations are on the decline across Canada, public health and infectious disease experts say they are concerned removing mask mandates could lead to unnecessary illness in vulnerable people.

Alberta and Saskatchewan have lifted mask mandates and other pandemic measures. Manitoba, New Brunswick and Newfoundland and Labrador will end them next week. Nova Scotia will relax its pandemic restrictions on March 21. Quebec no longer requires masks in elementary and high schools, and is expected to loosen remaining mask rules next month. PEI has announced its mask mandate will end in early April. B.C. officials are expected to announce changes on Thursday.

Kieran Moore, Ontario’s Chief Medical Officer of Health, said on Wednesday that masks will no longer be required in most indoor places, including schools, as of March 21, but places such as public transit, long-term care and other health settings will still have them. All remaining mask rules are to be lifted on April 27.

As provinces announce an end to mask mandates, where in Canada is the rule still in effect?

Peter Juni, the scientific director of Ontario’s independent COVID-19 Science Advisory Table, said the decision was a surprise.

While trends still look positive, he said he would need at least another 10 days of data – including numbers on the amount of the virus in sewage – before being confident that ending mask mandates was the right move. The province, he said, is just a week past March 1, when it lifted most capacity restrictions on businesses such as restaurants, and more information is needed to see if that has affected the spread of the virus.

He said until now, the province has fared “pretty well by making data-driven decisions and taking it step by step, relatively slow. Today, this would not be one of those moments.”

Other jurisdictions have seen increases after they lifted mask requirements, Dr. Juni said. In Denmark, while intensive-care units remained stable, hospital occupancy and deaths exceeded Ontario’s peak numbers. In Switzerland, which recently lifted mask rules except on transit and in health care facilities, he said, cases rose sharply in just 10 days.

Ontario’s waste water sampling suggests the province still has more than 15,000 new cases a day, Dr. Juni said.

He added that he hoped Ontario would continue to strongly encourage masks in indoor public spaces and that he recommends that parents continue to send their kids to school in masks. (He said he would have to “negotiate” this with his own school-age children.)

The Children’s Health Coalition, a group of health organizations including CHEO, the Hospital for Sick Children and Children’s Mental Health Ontario, said in a statement they would have preferred mask mandates to remain in schools for two weeks after March break to determine whether classrooms were seeing a higher level of cases. The coalition said keeping masks for schools can be a relatively easy, effective way to keep transmission low so they can stay open.

Nisha Thampi, a pediatric infectious disease physician at CHEO in Ottawa, said that despite public fatigue, the pandemic is not over. She said it’s important to recognize that some groups remain at risk, such as people with certain health conditions or children under five, who aren’t eligible for vaccination.

“There is this movement with our public health measures towards living with the virus, but we have to recognize that, number one, not everyone is going to live with the virus the same way,” Dr. Thampi said.

Nitin Mohan, a public health expert at the University of Western Ontario, said it seems premature to remove mask mandates. Masks are low-cost, easy to wear and have been shown to reduce virus spread, all good arguments for keeping restrictions for the time being, he said.

Dr. Mohan, an assistant professor at the UWO Schulich School of Medicine and Dentistry, said he is not sure the removal of mask mandates “is entirely rooted in evidence.”

He added that it will be “very difficult” to reinstate them if COVID-19 spread starts to get out of control again.

Dr. Moore said on Wednesday he expects that COVID-19 cases and hospitalizations will likely rise once mask rules and other pandemic restrictions are lifted. But the province expects the overall high vaccination rate and access to antiviral medication will keep the situation under control.

If new variants emerge or if cases escalate next winter, Dr. Moore said, mask mandates may need to be reinstated.

Other changes announced by Ontario on Wednesday include lifting isolation rules for most people with recent exposure to COVID-19. Dr. Moore said that people in close contact with COVID-19 cases no longer have to isolate if they don’t live with the infected person. The province says close contacts should wear a mask, and if they work in high-risk settings such as hospitals, should stay home for 10 days after exposure.

Household contacts exposed to COVID-19 don’t need to isolate if they have been infected with the virus themselves in the previous 90 days, if they are 18 or older and have received a booster dose or if they are under 18 and have received two doses of a COVID-19 vaccine.

With a report from Dustin Cook

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