Primary care physicians, BC health officials disagree on masks
Rising childhood respiratory infections — with an unprecedented number of BC youths dying just weeks into flu season — have frontline health workers calling for the resurgence of mask use, something the county health official remains lukewarm about.
Some doctors are advocating for mask mandates in the most high-risk public environments, such as closed-off buses at close quarters. Others are advocating for Joe and Jane Public to do what public health doesn’t require: voluntary masking to curb the spread of all respiratory viruses.
“I would absolutely love it if everyone would take the time to think about children who are suffering, children who are sick, and put on a mask,” said Vancouver family physician Dr Anna Wolak.
Provincial Health Officer Dr. Bonnie Henry expressed no outspoken support for masks on Monday, suggesting they are only necessary in “certain situations”. And she reiterated her long-held position on mandates.
“A mandate is a rather heavy-handed measure that we use as a last resort when it is something that is absolutely necessary anytime, anywhere,” she reiterated, recommending vaccinations and staying home when sick as primary lines of defense.
Her Ontario counterpart, Dr. Kieren Moore, was unequivocal last month by “strongly recommending that all Ontario residents, not just those at high risk, wear a mask in indoor public areas.”
While recent polls showed that 79 percent of Canadians would support the return of face masks to some degree, there are no province-wide mask mandates in the country, and any jurisdiction is unlikely to face renewed opposition first.
POLITIZED BUREAUCRATIC APPOINTMENT
The recently retired Prime Minister John Horgan had repeatedly pointed to Henry as the person who makes decisions about mandates. Now that his successor David Eby has been sworn in with a new cabinet, CTV News asked the Prime Minister’s Office if he wanted the public health officer to take charge, or if he would take a more active role in pandemic decisions. The agency has not responded.
A report analyzing the provincial government’s handling of the pandemic — which had been criticized for precluding any investigation by the provincial health office — nevertheless made several observations, including poor communication with stakeholders and repeated complaint communication did not improve after the initial crisis period.
“After the initial phase, there was strict central control of reporting, including actively discouraging any questioning or challenge from the PHO,” the report’s authors wrote.
Hamish Telford, an associate professor of political science at Fraser Valley University, credited Henry for gaining the public’s trust in the early days of the pandemic, but is now concerned that her position is becoming increasingly politicised.
“As we enter the final stages of the pandemic, the public health officer does not seem to be directly giving medical advice to the government, but combining that advice with political and economic considerations, effectively taking over the responsibility of making these decisions for the government, and the government has gone along with it,” he said.
Telford agreed that there is a contrast between the messages from community doctors – often one of desperation and dismay at personally treating sick youth – and public health officials in their government offices.
“Ultimately, she’s a doctor who, in my opinion, should listen to the medical community and the advice they give from the front lines,” he said. “She shouldn’t be so concerned about public opinion, especially the emails coming into her inbox from concerned citizens. She really needs to put that aside and focus on the medical dimensions of the crisis we are in.”
SCHOOL MASK STUDY
Last month, Henry was asked about masks in schools, especially in the wake of a study showing they reduce the spread of COVID-19, which she rejected.
The lead researcher on the study, which was published in the New England Journal of Medicine, grew up in Metro Vancouver and still monitors her old stomping grounds. She expressed surprise at Henry’s comments.
“The things that happened in the first eight, 10 months of the pandemic in BC really worked,” said Boston University epidemiologist Dr. Ellie Murray, referring to restrictions on masking, distancing and gathering.
“We can’t do all those things again, but what things can we do that are sustainable from that set of things or can be replaced in a more sustainable way?”
Masking, she suggests, is a minimally invasive way to do that. Her research found that when the Boston school district lifted the mandates and allowed schools to set their own masking policies, about half lifted the requirements, while the others did so gradually, allowing for a “natural experiment.”
Murray, who is an expert on causation, was surprised to find that schools that lifted the mandates had 30 percent more COVID-19 infections than schools that didn’t. However, masks are just as politicized in Boston as they are in BC, and despite the results, the mandates were eventually removed entirely there as well.