Ontario Cities, Hospitals Discuss Bringing Back Masks Amid Child Virus Surges & Public Health Agency Declares Flu Epidemic has begun (second article below)


Courtesy of Barrie 360 and Canadian Press Published: Nov 9th, 2022

Holly McKenzie-Sutter – The Canadian Press

Toronto’s board of health asked the city’s top doctor Tuesday to consider reinstating mask mandates amid a surge in viral illnesses that’s sending children to hospital at alarming rates.  

The request came a day after the chief of staff at an Ottawa children’s hospital urged a broad return to indoor masking as the flu, COVID-19 and a childhood virus circulate, saying the public has to play a part in protecting the youngest members of the community. 

In Toronto, the public health board passed a motion asking Dr. Eileen de Villa to “urgently explore all avenues toward re-issuing mask mandates, starting with schools.”

“I think we really need a renewed sense of urgency,” board member Kate Mulligan said. 

The request was aimed at reducing the spread of viruses and preventing strain on health-care services for kids.

Mulligan recalled a recent “terrifying” experience of taking her young child to the resuscitation room of a local ER, and expressed concern about such resources becoming unavailable if children’s health services are stretched too thin.

She asked public health to look at mask mandates as parents of sick children stare down the threat of a particularly harsh viral season.

De Villa said Toronto Public Health is currently following provincial guidelines – which do not require masks in most settings – but said the city could change course if the situation calls for it.

“As we have seen over the course of the past several years, this virus has thrown some curveballs our way and we have to be prepared to respond in accordance with that,” she told the health board meeting.

In Ottawa, the chief of staff at CHEO spoke to the city’s board of health on Monday about the influx of patients at her pediatric hospital and asked the public to resume masking to protect children.

Dr. Lindy Samson said a record number of children were coming to the hospital with difficulty breathing, fevers and other conditions brought on by illnesses like influenza, respiratory syncytial virus, also known as RSV, and COVID-19.

While the hospital is doing all it can, the public has a role to play as well, Samson said.

“This is the time for our community to come together for our kids,” she said. 

“What we are asking today is for our great community to put our masks back on whenever we’re in a crowded indoor space, including schools.”

Samson said the surge in kids coming to CHEO has resulted in patients being treated in the emergency room and surgeries being postponed because there are no beds available. Other children are being sent outside the region for care, she added.

Elsewhere in the province, a hospital network called on the public to mask in indoor crowded spaces as respiratory viruses circulate.

The Huron Perth Healthcare Alliance said it is experiencing pressures in pediatrics with cases of RSV and already more cases of influenza than in all of the last flu season.

Meanwhile, an Ontario university announced Tuesday that it would reinstate a mandatory mask policy for indoor academic activities. 

The University of Waterloo said the policy set to take effect Wednesday was prompted by data showing increased levels of COVID-19 and other viruses circulating, and a desire to minimize disruptions to the fall exam season. 

Dr. Kieran Moore, the province’s chief medical officer of health, told The Canadian Press last week that he would make a decision soon about masking recommendations based on viral illness trends that are straining the health system.

Moore has said the province is contending with a “triple threat” of a bad flu season, COVID-19 and a resurgence of RSV.

He said if COVID-19 starts affecting the ability to reduce the surgical backlog he would suggest the government make a recommendation on masking in certain indoor settings, and if there are further effects he would recommend reinstating mask mandates.

Ottawa’s top doctor recommended Monday that people return to wearing masks as COVID-19 levels remain high, and other viral illnesses like influenza are spreading in an “extraordinary respiratory season.”

The city’s board of health voted Monday night to send a letter to Ontario’s premier, health minister and chief medical officer asking for data and projections on this year’s respiratory illness season and its predicted impact on the health system.

The board also voted to ask that the province “intensify the visibility and reach of a mass health communications campaign” about the benefits of masking and vaccination.

A spokeswoman for Health Minister Sylvia Jones did not say whether the province would provide the requested data, but said vaccinations for COVID-19 and influenza “remain the best tool to keep people healthy and out of hospitals.”

“The ministry, including the Office of the Chief Medical Officer of Health are working with public health units during respiratory illness season and continuing to monitor impacts on the health system,” Alexandra Adamo wrote in a statement.

COVID-19 vaccination rates are relatively low among children compared with the adult Canadian population. Federal data show that just one per cent of children age four and younger have received two COVID-19 vaccine doses and 41 per cent of children aged five to 11 have had two shots.

The vaccination rate jumps to 80 per cent for teenagers who have two doses. 



Courtesy of Barrie 360 and Canadian Press Published: Nov 16th, 2022

By Sharif Hassan

Canada has entered a flu epidemic, the national public health agency said Tuesday, as some experts warned the surge of respiratory illnesses in the country will worsen.

The Public Health Agency of Canada said in its FluWatch report that the rate nearly doubled in one week, to 11.7 per cent between Oct. 30 and Nov. 5, compared to 6.3 per cent the week before.

The agency declared an epidemic, which happens most years after the threshold of a five per cent positivity rate is surpassed, though it said influenza levels are higher than would have been expected when compared to pre-pandemic years. 

The agency said there were 13 confirmed influenza outbreaks in the first week of the month, including nine in long-term care homes and one in a school or daycare.

The surge in flu cases comes as Canada’s health-care system grapples with a triple threat of respiratory viruses — COVID-19, influenza and respiratory syncytial virus. Already, pediatrics hospitals in Ontario are overwhelmed by a surge in patients with respiratory illnesses, leading to the cancellation of some non-urgent surgeries.

Dr. Alan Drummond, an Ontario emergency physician, described the current spike in flu cases as the “calm before the storm,” saying the worst is yet to come.

“I don’t have a crystal ball, but my gut sense is that we may be in serious trouble, if we end up with both concurrent COVID and resurgent influenza … with a vulnerable hospital population,” he said in an interview.

“We are clearly talking about a tridemic of influenza, COVID and RSV,” he said. “It is not going to be good.”

Drummond said measures put in place previously for COVID-19, such as masking and social distancing, decreased flu cases significantly the past two years, and could stem the current surge along with the public getting vaccinated against the flu and COVID-19.

“Those two strategies alone, will help a great deal in terms of preventing some of kind of conflagration of infectious diseases,” he said.

Ontario’s chief medical officer of health strongly recommended Monday that residents wear masks in all indoor public settings, while Quebec’s college of physicians urged people to wear masks in public as respiratory viruses there are also filling up emergency rooms.

Alberta Premier Danielle Smith has said she will not impose a mask mandate and Saskatchewan’s chief medical health officer said Tuesday he is not recommending masks.

The McMaster Children’s Hospital in Hamilton said Tuesday its pediatric in-patient unit is operating at between 130 and 140 per cent capacity and seeing a daily average of nearly 200 patients per day at its emergency department. 

Hospital president Bruce Squires said wait times are exceptionally long as a result — often in excess of 24 hours — and called the situation “truly unprecedented.”

“There’s a lot of time left in what is traditionally the children’s viral season,” said Squires. “We really have no choice but to plan for the possibility that this will continue and, in fact, get worse.

Dr. Angelo Mikrogianakis, chief of pediatrics at the hospital, recommended the public and children get the flu shot along with masking to prevent children from getting sick and overwhelming capacity in the care system.

Mikrogianakis said pediatrics goes through a respiratory illness surge that overwhelms hospitals every winter, but noted the current situation is significantly worse.

“My simplest way of describing this is: we are seeing three winter surges combined into one and we’ve started earlier than we usually do,” he said, adding that the winter surge typically starts in December but this year began in October.

“It’s going to be longer and likely require more supports from our hospital systems, and challenge our responsiveness and our supports for sick children more than we’ve probably ever seen in my career.”

Dr. Timothy Sly, an epidemiology professor at Toronto Metropolitan University, said the flu season started earlier than usual and cases have surged sharply because natural immunity against common cold viruses — such as rhinovirus, parainfluenza virus and RSV — has dropped due to COVID-19 restrictions being in place the last two winters.

“This is because the masks have worked. We have been protecting against COVID and (that) has managed to make us more vulnerable now to these seasonal viruses,” he said in an email. 

Sly said if hospitals continue to remain overcrowded with patients, it will lead to further cancellations of surgeries and delays in diagnosis of other health conditions such as cancer and heart diseases.

“We need to slow the spread of all respiratory conditions” to decrease pressure on hospitals, he said. 

Patricia Dent

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