Mask mandates or awareness drives? Experts weigh in amid fourth wave fears

With Covid-19 cases increasing in Delhi and its neighbouring regions, masking mandates have been brought back in at least nine dricts across Uttar Pradesh and Haryana. The Delhi Disaster Management Authority is also likely to take a call on enforcing masking norms in the Capital in its meeting on Wednesday. This comes just two weeks after fines for not wearing masks in public were withdrawn.
Experts say that the current surge could be because of restrictions being lifted, and though masking in public places – especially crowded markets and enclosed spaces such as cinemas – is necessary, there is no need to panic.

“We are seeing a surge in India. It is only to be expected. Our team has been tracking these metrics for more than two years. We are all tired, but the virus is still there. Time to elevate your personal preventions, combat COVID with caution. Choose prudence over panic,” professor of epidemiology at University of Michigan’s School of Public Health Bhramar Mukherjee said in a tweet.
As per Delhi-based doctors, while the number of cases is on the rise, “hospitalisations are not”. Most of the affected people are reporting to outpatient clinics with fever, cough, sore throat, and head and body ache. “I do not think that this is a separate wave. The numbers are going up because people aren’t masking up anymore; this was expected. The symptoms that we are currently seeing in patients are similar to what was seen during the surge in January,” said Dr Rajesh Chawla, senior consultant of respiratory medicine at Indraprastha Apollo hospital.

Dr G C Khilnani, former head of the department of pulmonology at the All India Institute of Medical Sciences, New Delhi, and chairman of pulmonary, sleep and critical care medicine at PSRI Hospital said “it is a good idea to bring back the mandates now.”
“Once the infection has spread, there is no use of the restrictions. And, the benefits of masking in public has been seen time and again. If we look at the example of the United States, they withdrew masking mandates and paid a heavy price for it last year,” he said, adding that “It is the time to be cautious and watch out for the trends.”
“Over 75% of the people in India were found to be seropositive in the ICMR survey last year, even before the wide proliferation of vaccination. With over 60% of the population being fully immunised now, there is a hybrid immunity which is protective against severe disease. That being said, the infection is still likely to cause complications in the old, highly comorbid, and those with a compromised immune system such as people who have undergone transplants. The use of masks will prevent the spread and protect these people,” he explained.

Dr Jacob John, former professor of virology at Chrian Medical College, Vellore, however, believes that India needs to take a “different approach”: health education instead of mask mandates. “The cases continue to remain low in most parts of the country; the increase in cases is a local phenomenon. So, it is time to switch from masking mandates to ensuring masking in public places through health education. There is no need to panic right now; there is unlikely to be a fourth wave,” he said.
He also urged governments to be watchful of the increase in the numbers “but strive to keep life as normal as possible”. “Genomic surveillance is necessary to spot any surprise variants and it is also time to push for the booster dose in all. Now, people have to pay for the shot which will act as a deterrent; it is too soon to do that,” he said.