With that acknowledgement, it is time for the next: Canada’s current official position on face masks, that they serve no purpose for the asymptomatic general public, that they do not work for the asymptomatic general public, but at the same time are essential to protect health workers, is utterly preposterous.

It flies in the face of scientific evidence. It is illogical and confusing and takes Canadians for fools. And if attempts are made to maintain this farcical pretence in the long term, Canada may be denied a tool that has not only helped East Asian nations withstand the siege of the coronavirus well compared to elsewhere, but to continue with some forms of normal life and economic activity.

Telling Canadians not to buy masks is sound advice. Telling Canadians that masks do not work is poppycock.

The whiplash contradictions in Canada’s stance were put on full show by Canada’s Chief Public Health Officer Theresa Tam on Monday. Masks, she said, were “absolutely” needed, and “critically important”, in order “to protect our frontline health care workers”.

US starts to change its thinking on wearing protective masks

But then she turned to the public. “Putting a mask on an asymptomatic person is not beneficial, obviously, if you’re not infected,” she said, with nary a blink, let alone a wink or a nudge.

Tam said she worried about “the potential negative aspects of masks, where people are not protecting their eyes, or other aspects of where the virus could enter your body”.

She reeled off a host of other potential misuses and misbehaviours that, in combination, might render a mask not only less useful but downright harmful – increased face touching, failure to wash hands, improper handling of a face mask upon removal.

The end reason for this grand piece of misdirection is sound: Tam and other Canadian authorities, simply and correctly, do not want you to buy medical masks.

But the reasoning? It is rather pathetic.

By Wednesday, Tam was trying to soften her stance while remaining true to her theme. In a series of tweets, she conceded that home-made face masks “may stop you from touching your nose and mouth [and] could help maintain #coughetiquette”.

But it was couched with more far precautions about the potential hazards than endorsement of the potential benefits.

“The big mistake in the US and Europe, in my opinion, is that people aren’t wearing masks,” he said. “This virus is transmitted by droplets and close contact. Droplets play a very important role – you’ve got to wear a mask because when you speak, there are always droplets coming out of your mouth.

“Many people have asymptomatic or pre-symptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.”

‘Any general mask use is likely to decrease viral exposure’

While there are efforts to depict the evidence as mixed, the notion that masks have been proven, overall, ineffective or even harmful to the general public is not supported by the weight of peer-reviewed research.

But literally dozens of studies, on the other hand, provide evidence that masks work, to either protect the wearer from inhaling an infection, or to protect others from the wearer’s infected exhalations, or both.

Vancouver donates thousands of masks to Wuhan, but virus profiteers cash in

“Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence,” they concluded.

They also found that “outward protection” against potentially infected exhalations was less effective than “inward protection” against inhalations by the healthy.

Hong Kong researchers found that mask-wearing protected health workers by up to 13 times more than not wearing one during the 2003 battle against SARS (another type of coronavirus). The survey of hundreds of staff found that while some of those who became infected washed their hands or wore gloves, none wore a mask.

It isn’t just Tam doling out illogical advice on masks.

The US CDC has now been asked by the US Surgeon General Jerome Adams to re-examine its mask advice for the general public, he said on Wednesday, in a substantial climbdown from his own previous assertion on Twitter that masks “are NOT effective in preventing general public from catching coronavirus”.

Adams’ shift was prompted by a growing body of evidence and expert opinion that asymptomatic transmission has been a key factor in fuelling the Covid-19 pandemic.

“These undocumented infections often experience mild, limited or no symptoms and hence go unrecognised, and, depending on their contagiousness and numbers, can expose a far greater portion of the population to virus than would otherwise occur,” the study said.

Although people with undocumented infections tended to pass on the disease at a lesser rate than those with documented infections, they were nevertheless the primary source of all known cases, because there were so many of them.

“[Due] to their greater numbers, undocumented infections were the infection source for 79 per cent of documented cases,” the study said, posing a “particularly challenging” problem in containment of the virus.

In addition to the science on asymptomatic transmission is the anecdotal evidence, provided by such nightmare cases as that of the Skagit Valley Choir in Mount Vernon, Washington state.

Those Asian face mask wearers? They aren’t crazy or stupid, Vancouver

One way to meet the terrifying potential of asymptomatic transmission is for everyone to stay home, for indeterminate periods over an indeterminate span of time, crushing economies around the world, until a vaccine can protect us.

Another way, as outlined by the Chinese CDC’s Gao, might be for the general public to wear masks, in combination with other measures.

There is now a growing grass-roots movement in many Western countries to encourage the use of various forms of face masks, counter to their governments’ advice.

But the most convincing advocates are the experts.

“It is time for governments and public health agencies to make rational recommendations on appropriate face mask use to complement their recommendations on other preventive measures,” they said.

Coronavirus: Go home Vancouver. Social distancing is not a party

The scientists singled out the World Health Organisation for its recommendations that only people with respiratory symptoms, or those caring for someone with symptoms, should wear masks.

“Perhaps it would also be rational to recommend that people in quarantine wear face masks if they need to leave home for any reason, to prevent potential asymptomatic or presymptomatic transmission.,” they said.

“In addition, vulnerable populations, such as older adults and those with underlying medical conditions, should wear face masks if available.”

And if supplies allowed? Consider the universal use of face masks, they advised.

Canada’s non-existent path to normality

The Lancet commentary noted there was a “cultural paradigm” at play, in which many Asian countries regard mask usage as laudable hygienic behaviour, while in the West it is seen as a sign of sickliness, inducing “stigmatisation and racial aggravations”.

Canada would do well to overcome this, and not just as a matter of decency.

Without a vaccine, for all the epic curve-flattening it may achieve, for all the billions in recovery funds being spent, Canada currently has no viable path towards normality, economic or otherwise, in the time of Covid-19.

‘No mask, no service’ in Vancouver despite supply fears for health workers

Pressure will inevitably mount for an easing of the anti-pandemic measures that are simultaneously flattening Canada’s economy. But to weigh economic losses against the catastrophic potential consequences of simply returning to business as usual – something measured not in dollars but in tens of thousands of lives – is no choice at all. This is not an option.

But masks may be.

The societies of Hong Kong, Taiwan, mainland China, Japan and South Korea have used a wide range of different anti-coronavirus tactics, but what they all have in common is face masks, extensively and uncontroversially worn by the healthy general public.

And, at various times and to various degrees, and in combination with an array of virus-fighting weapons, they have been able to maintain or return to semblances of normal life, a distant prospect for Canada.

Flattening the curve, to spread out the impact of Covid-19 over time, is the only option available to the world right now. But many Canadians have fallen into a starry-eyed delusion that flattening the curve means beating Covid-19.

Suggestions that Canada’s physical-distancing rules might last until the end of June have even led to ludicrous cheerleading, that the July 1 Canada Day celebrations should turn a giant curve-flattening party, like some sort of in-your-face-coronavirus mosh pit.

Reality check, Canada. Even if the curve is comprehensively flattened, squashed and pulverised … you still won’t be immune to Covid-19.

And until a vaccine can protect us, or just about everyone has been infected, the re-emergence of Covid-19 is not just a risk – it is a certainty.

In the short term, yes, Tam et al are correct in trying to deter the general population from rushing out to buy face masks.

But in the long term, Canada should consider the acquisition of face masks with the same sense of urgency as China, which de facto nationalised face mask production via various incentives and directives and ramped up output by about 500 per cent.

It isn’t just China. South Korea and Taiwan also staged massive interventions into their face mask markets, securing supplies and directing their distribution, as matters of primary importance for the healthy general public.

Canada has yet to publicly acknowledge this possible role, let alone wade in itself.

In the even longer term, Canada must consider another certainty – that novel diseases will continue to emerge, posing new pandemic risks. Yet Canada currently must rely of foreign factories – yes, mostly in China – to provide face masks.

China is now using face mask diplomacy as a form of international largesse, shipping off much-needed masks and other gear abroad to great fanfare. (Jack Ma, founder of Alibaba, which owns the South China Morning Post, has also donated millions of masks around the world.)

But is this reliance on Chinese goodwill a long-term answer, to safeguard Canada’s health workers, if not the general public?

Some Canadians, to their credit, have decided to take matters into their own hands by crafting a wide array of home-made face masks (likely with a wide range of efficacy).

But Canada cannot depend on an Etsy-led recovery. Craft baskets and sewing circles are not the answer to a shortage of face masks. Face-mask factories are.

A couple months ago, most Canadians likely gave not a moment’s thought to the technicalities of face mask supply. But this is not some matter of arcane medical policy or logistics.

And if Canada can spare billions to try to prop up its economy, it should also consider throwing some of that at building face mask factories, as a matter of long-term national safety, but with Chinese warlike urgency.

The Hongcouver blog is devoted to the hybrid culture of its namesake cities: Hong Kong and Vancouver. All story ideas and comments are welcome. Connect with me by email [email protected] or on Twitter, @ianjamesyoung70 .