Is it time to bring back COVID-19 mask rules? Provinces lag, but chances of infection 'really high right now,' experts say
In the wake of a new COVID-19 surge and a shocking flu season, many are wondering and debating whether it is time to bring back mask mandates. However, misinformation online and the lack of a coordinated public health response has left people confused about the right course of action.
Alberta’s Premier Danielle Smith said last week that she will not permit any further masking mandates of children in schools following a court ruling on the government’s decision to drop and block those mandates.
Despite a recent Canada-wide surge in respiratory viruses, flu, and COVID-19, Smith said that masking has a “detrimental effect” on the mental health of children.
"The detrimental effects of masking on the mental health, development and education of children in classroom settings is well understood, and we must turn the page on what has been an extremely difficult time for children, along with their parents and teachers."
But many public health experts in provinces such as Ontario and British Columbia are still maintaining their position that masking in indoor spaces with huge crowds provides vital protection from COVID-19.
What the experts and provinces are saying
The former head of Ontario’s COVID-19 science advisory, Dr. Fahad Razak, recently said that it’s time to bring back mask mandates as Ontario is seeing a surge in the new BQ.1 and BQ1.1 Omicron subvariants in the province.
Dr. Razak, an internist at St. Michael’s Hospital, also said that the health system is under immense strain that’s normally seen at the peak of a bad flu season.
“Personally, I would say that the criteria to require something like a mask mandate is clearly here,” said Razak, an internist at St. Michael's Hospital.
“For anyone who says, 'Let's not do that,' I would ask, 'What is the alternative at this point? How do we keep the system that has so little capacity, how do we get it to continue to run over the winter?”
According to UofT Associate Professor Dr. Tara Moriarty, the Canadian COVID Hazard Index released last Friday shows that traces of COVID in wastewater across Canada has increased nearly three-fold in the last two weeks.
Moriarty says this data shows that the number of people in Canada infected currently is 18 times higher than people infected last year at the same time.
"It means that about 1 in every 24 to 1 in every 34 people in Canada are currently infected," she said.
"This is why it's so important not just to wear masks, but also to avoid crowded indoor settings....for everyone. Your chances of picking up COVID are really high right now," she writes in her latest tweet. "Also, even if you're not worried about catching COVID yourself, about half of people in Canada are medically at higher risk from COVID, due to age or underlying health conditions. Or they live with someone who is," she added.
If everyone in a Canadian community of 1,000 people gets COVID:
1. About 17 will develop long COVID
2. About 5 will be hospitalized with COVID
3. About 1 will die
Think of the network of people you're acquainted with.
How many people do you know who have experienced this?
— Tara Moriarty (@MoriartyLab) October 29, 2022
Please wear a high quality mask and stay home when sick.
Employers, I know it's tough, but if someone feels sick, encourage them to stay home.
We just can't keep doing this anymore.
Our hospitals can't handle it. Our communities can't continue like this.
— Tara Moriarty (@MoriartyLab) October 29, 2022
University of Toronto Associate Professor and an expert in paediatrics and expert diseases Anna Banerji agrees that due to the high cases of respiratory viruses and hospitals being overwhelmed, it would be the right course of action to bring masks back.
"Yes, definitely yes," she wrote in an email to Yahoo News Canada.
All experts unanimously agree that masking combined with bivalent booster shots can help bring the cases down and relieve the pressure on hospitals.
Public health advisory on the official on the City of Toronto website also advised that staying up to vaccines and wearing a high quality, well-fitted mask can decrease the spread of COVID-19 and the flu.
'Respiratory Spread Guide' notice sent by the city:
We can layer our protection against COVID-19 and respiratory viruses with some simple steps:
Stay up-to-date with your vaccinations including a fall COVID-19 booster and flu vaccine when eligible for the best protection against getting very sick from COVID-19 and influenza.
Socialize outdoors when possible – outdoors is lower risk than indoors.
Wear a high quality, well-fitting mask, especially indoors, and based on the setting and situation. Masks are strongly recommended in indoor public settings, and especially if you are around people who are at higher risk or have a health condition.
Stay home if you are sick or have symptoms, even if they are mild.
If you have symptoms, get tested for COVID-19 and treatment if you are eligible.
Wash or sanitize your hands often, etc.
The Ontario healthcare system under immense pressure
According to latest reports, emergency rooms across the province have had to close for hours due to pressure. Doctors believe that the recent increase in COVID-19 admissions and flu admissions have created the "perfect storm" in hospitals—with wait times up to 20 hours or more.
According to the official Health Canada website, more than 21,000 cases of COVID-19 were reported last week across the country.
The Canada COVID Hazard Index also states around 7,000 people were admitted to hospitals with COVID in the last week across Canada. The data shows that in an already-overwhelmed system, 12 per cent of hospital beds are unavailable due to COVID-19 patients.
Moriarty also pointed out that although we hear COVID is getting better, the statistics say otherwise.
"COVID hospitalizations last week were 6,962. However, the average weekly COVID hospitalizations in Canada since COVID started has been 3,032. This data clearly shows that there were twice the number of COVID hospitalizations this week in Canada than there have been during all of the epidemic in Canada to date," she said.
"Even if you draw the distinction between patients who got admitted who had COVID already (the "with" cases) and patients who got admitted because of COVID (the "from" cases), we still get a number that is 1.7 times higher than what we've seen before," she adds.
Many ER's are reporting high patient volumes and long wait times, with children's hospitals in particular reporting high demand.
University of Toronto professor and epidemiologist Dr. David Fisman recently posted a memo sent out by McMaster Children's Hospital (MCH) on Twitter.
From a colleague in Hamilton, memo sent out at @McMasterU. I was requested to amplify as they cannot.
"As you are all aware, McMaster Children’s Hospital (MCH) continues to face unprecedented pressures across all its programs. Inpatient occupancy is nearing 135 per cent...
— David Fisman (@DFisman) October 31, 2022
The memo clearly states that inpatient occupancy is nearing 135 per cent and that the critical care and emergency department are facing "extreme challenges".
As a result, MCH is adopting various mitigation measures—effective Nov. 4—such as reducing the number of pedriatric surgical same-day admits to only one case per day.
The hospital is asking for volunteers across all MCH programs to assist teams at the hospital and they're looking into examining the transfer of youth and adolescents to other hospitals under Hamilton Health Sciences (HHS).
Two days ago, Fisman released another crucial UHN memo on Twitter that mentioned that the Toronto General Hospital is under Critical Care Bed Alert, which means that the CVICU, CICU, and MSICU have all reached their total bed capacity.
The memo also mentioned that the hospital has limited people to safely keep all the physical critical care beds open and running.
UHN told its staff to "avoid" accepting admissions from another hospitals that require a critical bed and to stop sending patients to the emergency department.
We will let you know when the CRITICAL CARE BED ALERT has been lifted.״
Take a moment to think through the implications of Toronto's largest teaching hospital saying, in effect, don't send patients to the ER if they're super sick, and they're gonna crash and need critical care.
— David Fisman (@DFisman) October 31, 2022
Recently, officials with CHEO, eastern Ontario's children's hospital in Ottawa, painted a stark picture of its emergency room as they said the last few months have been the busiest in the hospital's history.
The hospital is functioning well over-capacity with pediatric units seeing 134 per cent occupancy while pediatric intensive care sits at 124 per cent. The emergency department averages 229 patient visits a day while it's built for 150, said CHEO President and CEO Alex Munter.
Moreover, earlier last week, Toronto's Hospital for Sick Children reported wait times of up to 12 hours due to unseasonably high patient volumes.
Experts try to raise awareness and battle misinformation online
You know what’s really bad for kids’ mental health? Lying and telling them that there’s no risk, when they can see for themselves that kids and teachers are sicker without masks. This is Soviet Union-level lying, and causes a severe and persistent erosion of trust.
— Dak (David A. Keldsen) (@d_a_keldsen) November 1, 2022
SO important. Keep hearing "public done with masking." But much of public is making masking decisions based on communication by top officials & language typically so watered down guidance is unintelligible. Some would change behaviour if they had better counsel.@AbraarKaran https://t.co/Mq2z3y7d29
— Dr. Jillian Horton (@JillianHortonMD) November 1, 2022
It blows my mind that, after almost 3 years, people *still* talk about the pandemic as though changes in the severity of the virus drive everything. Maybe they throw in transmissibility and immune escape as well. Folks, the behaviour of hosts matters too. A lot.
— T. Ryan Gregory (@TRyanGregory) November 1, 2022
I have become a pediatrician. It’s crazy the disproportion of children I see at an adult based emergent department. What’s even crazier is the fact that none of these parents have access to liquid Tylenol or Advil for their kids fever.
— David Carr (@davidcarr333) October 31, 2022
Disabled workers. Not a coincidence. #LongCovid is going to screw us over if we allow #COVID to continue to keep spreading. Downplaying COVID is tantamount to sentencing a generation to a multi-organ debilitating disease. #CovidIsNotOver pic.twitter.com/jwOjxT8MSG
— Eric Feigl-Ding (@DrEricDing) October 31, 2022
The reasons I think it's essential for #ScienceTwitter and #MedTwitter to stay with @Twitter right now
—Spread the truth/facts/good info
—Counter & stand up to mis/dis-information
—No suitable alternative for reach
—There's still block and mute
—Don't give up hope for improvement
— Eric Topol (@EricTopol) October 30, 2022
With files from The Canadian Press