Quebec's College of Physicians is urging people to wear masks in public spaces, citing a "worrying rise" in respiratory virus cases among children — and overflowing pediatric emergency rooms.
The professional order posted the recommendation on Twitter Sunday afternoon, saying more and more people are starting to gather indoors, which is causing a number of airborne viruses to spread.
On Monday, Ontario's chief medical officer of health said he is "strongly recommending" the wearing of masks in all indoor public settings, including schools and childcare settings, but he stopped short of recommending a return to a mask mandate in the province.
Doctors across Canada have been saying an early arrival of the flu, a resurgence in respiratory syncytial virus, or RSV, and the continued spread of COVID-19 has made for a perfect storm of respiratory illness that's sending many children to the hospital — stretching an already overburdened system.
As of Sunday evening, Montreal's two pediatric hospital emergency rooms — the CHU Sainte-Justine and the Montreal Children's Hospital — were operating at 194 per cent and 125 per cent capacity, respectively.
Dr. Christopher Labos, an epidemiologist and cardiologist in Montreal, says wearing a mask is a logical step to help ease that burden.
"If you're going to be indoors breathing the same air with a bunch of other human beings, that's how these viruses spread. So if people wear masks, we'll have less people getting sick and less people showing up to the emergency room."
Labos notes that many parents can't get their hands on pediatric painkillers to treat fevers, which is forcing them to turn to children's hospitals for help. He says people don't fully understand the consequences of letting these respiratory viruses spread unchecked.
"If the emergency rooms are full, we can't treat other stuff. I mean, people end up having to wait hours to get seen and sometimes they just end up leaving because nobody's seeing them," he said.
Labos says wearing a mask — whether it's for COVID-19, RSV or influenza — has been shown to stem the spread of respiratory illness.
"When we were wearing masks, we had no influenza, right?" he said of the situation at the height of the pandemic.
"I think we've proven to ourselves that masks work. We just have to do them, even if they are just a little bit uncomfortable for some people."
WATCH | Montrealers react to recommendations about wearing masks again:
Labos says there's reason to believe cases of influenza will be especially high this year, and he encouraged Quebecers to get both their flu shot and COVID-19 booster for adequate protection this winter.
'We need more than just a recommendation'
Marc-André Dugas, head of pediatrics at Centre mère-enfant Soleil (CMES), a children's hospital in Quebec City, says his hospital is overcapacity due to viral infections, forcing surgeries to be postponed.
"In the last few weeks, we've gone up to 150 per cent of our capacity in the emergency department, with overcapacity also in the intensive care units."
He says it's gotten to a point where children who come to the hospital with non-urgent needs are being forced to wait so long for care that their situation becomes urgent.
While the Quebec government has been working to address the long waits in ERs, it has not moved to bring back mask mandates.
In an email to CBC on Monday, a spokesperson for the Health Ministry said the government is "indeed concerned about the circulation of respiratory viruses at the present time." It said that wearing masks is recommended in the presence of vulnerable people and in places when it is difficult to maintain a distance from others.
But Kim Lavoie, the Canada Research Chair in Behavioural Medecine at Université du Québec à Montréal, says these recommendations are not working.
"When the government makes a recommendation and I would say a soft recommendation … that tells the public that it's not important," she said.
"I think we need more than just a recommendation."
She says she's hoping that Quebec public health officials reinstate the mask mandate, but that they specify it be used in situations where it's most beneficial, such as in crowded indoor spaces with bad ventilation.
Lavoie, who has been studying adherence to COVID-19 measures and behaviours around them since March 2020, says a recent finding shows more than 75 per cent of Canadians would be somewhat to extremely willing to re-engage with certain measures, including mask wearing.
She says it's up to the government to help people make informed decisions and explain why the measure is necessary.
"We don't need widespread lockdowns and isolation — what we need is tools to help the public understand the risk in different situations and how to take action," she said.
Earlier this month, Quebec's public health director, Dr. Luc Boileau, said only people who have symptoms such as a sore throat, stuffy nose or a cough should wear a mask, regardless of the type of virus.
Montreal Public Health Director Dr. Mylène Drouin will be speaking with reporters on Tuesday to provide a review of how public health measures worked in Montreal during the pandemic.