Will Doug Ford and Kieran Moore reinstate mask mandates?

Let’s restore mask mandates to curb the triple threat of COVID-19, flu and respiratory syncytial virus that plagues Ontario’s people and puts pressure on an already faltering hospital system.

As the number of cases is expected to skyrocket over the next two months, medical experts are increasingly arguing that simply wearing a mask can stem the flood of patients at the ER.

Health officials have hinted that a return to mask mandates may be necessary if the situation gets bad enough. Considering that you are canceling surgery and transporting your child far from home, we are asking whether that severity threshold has already been met.

But so far, moving to mandatory masking appears to be the state’s last option.

On Wednesday, Prime Minister Doug Ford said Ontarians were welcome to wear masks, but there is currently no widespread recommendation for mask-wearing, according to Chief Medical Officer for Health Dr Kieran Moore.

In a recent interview with The Star, Moore said he “strongly recommends” wearing a mask indoors for those at risk of serious illness from the three viruses, but that mandates include said to be passive.

Instead, he reminded people of the “basic layers of protection” of staying home when sick, wearing masks in indoor settings, and wearing masks while recovering from respiratory illness. Thorough hand hygiene.

“After a 1,000-day pandemic, I am very reluctant to impose obligations,” he said. You can trust us to do the right thing with all these basic layers of protection that we have adhered to very well over the past three years.

“Sometimes the public needs a reminder.”

But experts question whether reminders and recommendations will encourage enough people to wear masks to significantly reduce transmission. He said asking people to wear masks may not be enough, even as the health crisis worsens.

Despite weeks of recommendations to wear masks, they are rarely seen when walking into schools, stores, cinemas, arenas and malls.

Even record-length wait times and overcrowding in hospital emergency rooms due to the rise in people with respiratory illnesses don’t seem to scare the public into wearing masks again.

Dawn Bowdish, an immunologist at McMaster University and chair of the Canadian Research Committee on Aging and Immunity, said: “When mask mandates are lifted, people will actually take this as a signal that the pandemic is over and it’s safe. “But we now have more (COVID) deaths, more hospitalizations for COVID and other respiratory infections, and definitely more pediatric cases than earlier this year when there was a mask mandate. We are in an era where there are no masks.

“If masks make sense in early 2022, they will make even more sense in late 2022.”

After years of pandemic stress, there is little doubt that the health system is in a fragile state and struggling to meet the demands of the current virus surge. A large hospital in Toronto has repeatedly told staff in recent weeks that its ICU is at capacity. More than a dozen hospitals, mostly in rural areas, have had to close their emergency departments more than 110 times this year.

New data shows patients spent an average of 21.3 hours in the emergency room before being admitted in September. This is at least the best he’s had in a year. That means only 23% of patients admitted from the emergency department met the state’s goal of her eight-hour wait time.

And the state is not yet in peak virus season. Influenza and RSV cases are spiking early and rapidly right now and are expected to continue rising through December as COVID continues to contribute to hospitalizations.

On Wednesday, the president of the Ontario Medical Association said masks can prevent the onset of respiratory illness and recommended that Ontarians wear masks indoors.

And last week, Moore warned that Ontario has a critical two-week window to vaccinate as many people as possible with the flu vaccine to limit the spread of the flu.

Experts agree it’s important to get vaccinated against COVID and flu, but while there is no RSV vaccine, encouraging more people to take the simple step of masking can also help. says there is.

“Masking is like the simplest and easiest thing we can do,” said Matthew Miller, director of McMaster’s Michael G. DeGroot Institute for Infectious Diseases. No data available, with masking.”

The August Public Health Ontario Report highlighted a study showing that schools requiring masks were associated with lower rates of COVID compared to schools without mask precautions .

“I would have hoped that one of the lessons we learned from the pandemic was the normalization of masking.

At a press conference on Aug. 31 (the last one he gave), Moore said mask requirements would be introduced if respiratory infections were severely impacting the health care system.

But some wonder if that threshold has been reached.

“What is so unique about public health is its mission and its commitment to prevention,” says Maxwell Smith, a bioethicist specializing in infectious diseases and an assistant professor at Western University.

“It’s really troubling to think we need a catastrophic metric, and it still doesn’t seem to line up with what we’re seeing in children’s hospitals before we introduce preventative measures, namely masking.

“The point of public health collective action is to prevent some of these harms to the population.”

But is there a collective will to adopt mandatory masking again?

Dr. Marcus Prescia, chief medical officer of the Association of State and Territorial Health Officials, a group representing leaders of state public health agencies in the United States, said public health interventions such as masking were implemented in part by societal pressure. said it is.

“You have to get enough people involved so that people are expected to follow the rules,” he says. “There is a perception[in the United States]right now that there will be no public buy-in for social coercion to work.

“I think people are just exhausted by the pandemic and the precautionary measures and they just don’t want the kind of change we’ve asked for in the past.”

In fact, reinstating mask mandates in other jurisdictions has recently proved to be an uphill battle. , has reinstated the requirement to wear masks in all indoor public spaces, including city buildings.

The Philadelphia Public Health Department said, “Given the rapid spread of the Omicron wave, the number of people hospitalized in Philadelphia, and the high number of deaths in the recent wave, the spread of COVID-19 We are at a critical time to delay said at the time.

It proved futile.

Just four days later, the health department immediately appealed and canceled the mandate, following strong opposition from both the public and businesses. The new mandate for a city of 1.6 million people, overwhelmingly inclined to vote Democratic, seemed like a line they could never cross.

In revoking the mandate, Philadelphia health commissioner Dr. Cheryl Bettigor said the lack of hospitalizations was also a factor.

Also in April, a Florida judge overruled the Joe Biden administration’s mask mandate for public transportation and commercial airlines.

But here in Ontario, two large municipal public health commissions are urging action on masking.

On Monday, Ottawa’s Health Commission voted to submit a letter to Ford, Health Secretary Sylvia Jones and Moore, urging the state, among other things, the benefits of masking and vaccination for the “visibility and reach of mass health communication campaigns.” to strengthen the

And on Tuesday, Toronto’s Public Health Commission told city health officer Dr Eileen de Vila to make masks mandatory, starting in schools, as the number of children showing up to hospitals with respiratory illnesses rises. It urged them to “urgently investigate” the possibility of reissuance. .

But to avoid a patchwork of mask-requiring jurisdictions, a formal mask mandate should come out of the state, says Dr. Mustafa Hilge, acting health physician for the Niagara region.

“The mask shouldn’t have been lost in the first place,” Hilge said. “It’s the simplest thing we can do to actually save lives without limiting our ability to carry out normal activities.”

He notes that Canada recorded more deaths from COVID in 2022 than in 2020 and 2021 respectively.

In addition to helping reduce COVID, RSV and flu cases, which require enormous hospital resources, masks will also reduce the high absenteeism rates reported by school nurses in the area, he said. Said.

“There are many children whose school has been suspended in the last two years. Of course it has affected their education and it has affected their social development. I am affected because I am away,” Hilji said. “Masks are a way to keep children in school.”

Higher education institutions are taking notice. To avoid disruption to the upcoming exam season, the University of Waterloo on Tuesday announced it would be reinstating mask mandates for “indoor activities that are part of academic course offerings” from Wednesday. It said it was taking this step because of trends in data showing increasing levels of airborne viruses such as .

Western University is mandating masks in study spaces this fall.

Smith, who works at a university and is a member of the WHO International Working Group on Ethics and COVID-19, said people wear masks in classrooms, but in other indoor spaces on campus where masks are encouraged but not required. So many people say they are removing their masks. .

For him, this shows why delegation may be necessary. There is now a “huge gap” between what public health recommends and how the public is responding, he says.

“Two and a half years later, we can’t rely on hope that people will act,” he says.

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