New Brunswick's decision to focus on COVID-19 vaccination alone in the face of rising COVID cases fuelled by the highly transmissible Omicron subvariants BA.5 and BA.4 is a "bad strategy," according to an infection control epidemiologist.
It's one Colin Furness predicts will fail and put children under five, who are currently unvaccinated, at greater risk.
"Every government the world over that has relied on one way to control this has failed," said Furness, an assistant professor at the University of Toronto. "One strategy isn't enough."
As COVID cases rise and the coronavirus becomes more prevalent in the community, infants and preschoolers will face an increased risk of infection, he said.
"So you've got a lot of child illness that would be completely avoidable if we worked on lowering prevalence," he said.
Furness was reacting to comments earlier this week by the province's chief medical officer of health, who said a return to mandatory masking or other protective restrictions is not being considered.
"At this point … we're not having that conversation," Dr. Jennifer Russell told CBC News.
"The message right now is about vaccination, because that's the thing that's going to decrease people's risk of having severe outcomes and requiring hospitalization."
On Tuesday, the province announced it's now offering a fourth dose of a COVID-19 vaccine to anyone 18 and older, as long as five months have passed since their last dose.
The decision to lower age eligibility from 50 comes as COVID claimed the lives of four more New Brunswickers in the past week, the number of hospitalized COVID-19 patients has nearly doubled to 95, seven of whom require intensive care, and almost 2,500 new infections have been reported, figures released Tuesday show.
Furness agrees with expanding eligibility for second boosters, but is disappointed by the change in public messaging, urging those who are particularly at risk to get the extra dose instead of encouraging everyone to get the shot to help protect those who can't.
After more than two years of the pandemic, Furness called it a "gigantic mistake" to not recognize that a "multi-modal strategy" is needed.
Ontario is taking a similar approach, "which is, we're not going to do anything. We're just going to sit back and watch and hope it doesn't get really bad, even though we know health care is really strained. And we're going to suggest that vaccination might be a good thing," according to Furness. "And it's not adequate."
Still, Furness is not surprised New Brunswick is not considering mandatory masking. Mask mandates have become a political decision, he said.
"And there doesn't seem to be any political appetite anywhere to introduce that kind of protection, or reintroduce that kind of protection."
That too, he contends, is a mistake.
One of the problems, said Furness, is "there has been so much public confusion and changing science around masks that there's a lot of room for people to say, 'Oh, masks don't work.'"
In addition, while the federal government and many countries have acknowledged COVID is airborne, he doesn't know of a single province that has.
"That's a problem because if you haven't acknowledged it, then you're not actually educating the population that they actually need to be wearing respirator masks" to protect from an airborne pathogen.
"And so to me, it's a little wrong-minded to limit the conversation to, do we need mask mandates or not, because if we're going to mandate the wrong kind of masks, or if we're going to mandate a rule without explaining to people how these things work and why, well, we're going to get [many] people not understanding, not getting it, pointing out that lousy masks don't work and therefore masks don't work," he said.
"You increase the cacophony, the confusion, the resistance, and you also miss a real opportunity for people to genuinely stay safe.
"So it's not just about, should we compel masks? We need to provide respirator masks. We need to educate people on them. And that's what's not happening. And that is, I think, really short-sighted."
With mask knowledge, mask mandates might not be necessary, Furness suggested.
Behavioural scientist weighs in
People will wear masks if they know of any good reason to do so, according to Simon Bacon, a behavioural scientist at Concordia University in Montreal.
It's not surprising that many people are not wearing masks in spite of a resurgence of COVID-19, he said.
By removing mandates and not providing more information about risks and benefits, the government has sent the message that masking is not important and everything's fine.
"You know, masks have been very politicized. And, you know, we've heard a lot of political rhetoric around masks. So, you know, they come with some degree of baggage at this point in time," said Bacon.
"So people have to sort of evaluate their own personal risk. They have to evaluate the risk that they're putting other people in that they interact with.
"Someone might be young and healthy and vaccinated and be willing to roll the dice about whether they get COVID or not. But they need to think about who they interact with. What would be the consequences if they got COVID? Who would they transmit it to?
"You may not end up in the hospital, but a lot of people are sort of knocked out for a week. Well, we're just about [in] the holiday season. Does anybody want to feel, you know, sluggish and have symptoms and be thinking about going on holiday? Probably not."
As case numbers rise, Bacon expect more people will start wearing masks again and being more careful about handwashing and keeping their distance from others. That's what has happened during peaks earlier in the pandemic, he noted.