Wearing glasses or getting a runny nose is enough to qualify for a mask exemption under current Ministry of Health criteria - and a doctor says it's time for tougher rules.
Hearing aids, hayfever or a tendency to get dry eyes are also reasons to request the legally binding card that says you do not need to wear a mask when normally required to under Covid-19 rules.
Some doctors say the reasons are far too loose, with people simply needing to tick just one of the symptoms on the Ministry's website list to get an exemption card sent to them.
Northland medicine specialist Gary Payinda said the card was a great idea for people who had legitimate reasons for not wearing a mask.
But the current list of criteria was so wide it was absurd - almost everyone in the country would qualify, he said.
"If we've made it so easy that literally anyone can click a box and say I have a 'condition' ... we really have to ask, is it still a public health measure."
With so many other measures relaxed, masks were one of the last lines of defence against the virus, and so everyone who could wear one, should be, he said.
He told Morning Report that compromising one of the most effective public health measures was not doing the community a good service.
"We want the right people to be protected by this law and we want masks to still be a meaningful way of reducing the burden of Covid in the community."
"If we make an exemption process so easy to get that it's meaningless, we're shooting ourselves in the foot.
"I want masks to be legitimate and used and trusted, and that won't be the case if anyone can literally tick the box and say, 'face coverings give me a runny nose' and that's enough to get a mask exemption."
The criteria have come under scrutiny as the government changes the process for getting a mask exemption card.
Until now, cards were issued by the Disabled Persons Assembly, but the new ones are issued by the Ministry of Health and have legal standing.
They are intended for people to show to shops or other businesses so they do not have to explain potentially sensitive reasons why they may have an exemption.
The Ministry of Health said the list of conditions was part of the process to request a communication card - an interim measure until the new face mask exemption process is established at the end of May.
"The list is provided for guidance only," a spokesperson said in a statement.
"The key requirement is that the applicant state that wearing a face covering is unsuitable because you have a physical or mental illness or condition or disability."
The ministry said it had tried to make the process for applying for a card uncomplicated to avoid marginalising vulnerable communities. A medical practitioner would not need to sign off on the new exemption cards.
"This would have been too much of a barrier and/or additional cost for many people and wouldn't be an equitable way of ensuring those most vulnerable are able to access a card.
"It also would have placed significant pressure on GPs who are already managing the additional workloads."
The vast majority of New Zealanders had shown they wanted to do the right thing to protect their communities and only a small minority had tried to misuse the system, the ministry said.
The application system was being designed to be robust, with checks against misuse, and anyone who misuses the mask exemptions could face fines or other serious penalties.
Those proven to have misused the process would be in breach of the Covid 19 Public Health Response Act and could be sentenced up to six months in prison or fined up to $12,000.
Existing cards, issued with the current criteria, can still be used when the new ones come into effect.
The Disabled Persons Assembly welcomed the new card system, telling Midday Report the old system had been causing distress for some in the disabled community.
Prudence Walker said people had not been believed, refused service or had the police called on them.
She hoped the new card would improve things.
Dr Payinda said there were many good reasons - because of both physical and mental health - that some people could not wear masks and he supported them doing that but the current list was open to abuse.
The current criteria for requesting a card, according to the Ministry of Health website, includes having the following conditions if they make wearing a mask difficult: asthma; sensitive skin or a skin condition like eczema; wearing hearing aids; getting migraines; having glasses, dry eyes or contact lenses; hay fever; difficulty breathing; dizziness, headaches, nausea or tiredness; a runny nose from wearing a face covering; a physical or mental illness, condition or disability.
Needing to communicate with someone who is deaf or hard of hearing is also one of the criteria.
Covid-19 modeller Dion O'Neale said attempting to force those who were adamantly opposed to masks to wear one wouldn't be effective. "If they want to be difficult about it they'll manage to tick the box and say I'm wearing it, and wear it badly."
Most people did want to protect themselves and those around them, so it was important to keep the messaging clear on how masks work and when to wear them, he told Morning Report.
"It's physics. The mask, if it's well fitted, it's going to be filtering out small particles. If those particles are viruses you're not going to be infected by them, or if you're breathing in a much smaller number of those particles you're going to have a much lower exposure dose, so your infection risk is much lower."
