Dear Dr. Theresa Tam, Dr. Deena Hinshaw, Hon. Patty Hajdu and Hon. Tyler Shandro,
As members of the medical science community in Canada, we would like to thank you for your guidance and leadership during this challenging chapter of our country’s history. There are so many difficult decisions to be made, and we want to recognize your efforts in navigating all Canadians through these treacherous waters.
We wanted to take the opportunity to weigh in on the public masking issue, which we understand has been a point of contention amongst infectious disease and public health officials. Having reviewed the literature, which is supported by the latest WHO guidance, we wanted to offer our thoughts on the issue.
In light of the information in these scientific reviews (Review1 Review2), we as medical science professionals feel that there is 1) sufficient evidence of the utility of masks for source control 2) equivocacy of evidence on recipient protection and 3) lack of evidence of harm from masks.
Furthermore,
1) due to the incipient reopening of Canadian society,
2) strong evidence of asymptomatic, presymptomatic, and paucisymptomatic spread
3) recent data showing 48% public mask usage in Canada, with lower rates in Alberta than in other jurisdictions Leger Poll
4) evidence that a minimum of 60-80% mask use is required to have a significant impact on Ro (Reference1 Reference 2).
5) and that previous public health interventions, such as seat belts and bicycle helmets, have required laws for improved uptake of public health interventions
We are respectfully requesting that strong consideration be given to the recommendation of mandatory mask policies to help protect more Canadians. In addition to current physical distancing measures and hand hygiene, masks are critical in order to ensure a safe reopening, prevent additional outbreaks, and save lives.
Specifically, we recommend mandatory masking (or face covering) policies in ‘ACT’:
- All indoor spaces outside the home (such as schools, shops, and businesses)
- Crowds (anywhere that is difficult to distance from others)
- Transit (public transportation)
We recommend that persons with medical contraindications and/or disabilities, and young children under the age of 2, be exempt from this policy. We recommend distribution of masks to populations that may be vulnerable and/or at higher risk, in order to reduce inequity. Furthermore, we recommend minimizing fines, arrests, or criminal penalties to enforce the policy. Instead, we encourage public education to help the public understand how to wear a mask properly, and the importance of masks for health and economic recovery. We note that various transit systems in Ontario have taken this approach and mandated masks, including Toronto, Ottawa, Mississauga and Brampton. We believe that a similar approach in ACT throughout Alberta would be justified and could be a logical next step from the current policy of distributing masks to the general population.
We believe it should be at the discretion of subnational jurisdictions as to whether mandatory masking is implemented, but in locations of high population density and/or where community spread is ongoing, it should be mandated. There may also be a role in considering mandates for masks for regions where there is no community spread, in order to prevent new introduction of the virus. In particular, as Alberta is moving into Phase 2 of re-opening, we believe that a mandate for Albertans to wear face coverings in the above situations will help to mitigate the risks of increased transmission inherent in such re-opening.
We would like to assist you with this discussion in any way possible.
Thank you for your valuable time.
My mask protects you, your mask protects me, we all protect society.
From Alberta
Dr. Shushiela Appavoo MD FRCP(C) Associate Clinical Professor, University of Alberta Co-chair, Canadian Association of Radiologists Breast Imaging Guidelines Working Group Dr. Matthew Butcher MD FRCPC Radiologist, Edmonton Clinical Assistant Professor, University of Alberta Dr. Keltie Duggan MD CCFP FCFP Neurorehabilitation Hospitalist, Site Lead Foothills Medical Centre Vernon Fanning Center Clinical Lecturer, University of Calgary Dr. Sean Fair MD FRCPC Emergency Physician, Calgary Clinical Lecturer, University of Calgary Dr. Breanne Everett MD MBA BSc Plastic Surgery Resident, Calgary University of Calgary | Dr. Amy Tan MD MSc CCFP(PC) FCFP Associate Professor, Department of Family Medicine, Cumming School of Medicine, University of Calgary Dr. Joe Vipond MD CCFP(EM) BSc(Hon.) Emergency Physician, Calgary Clinical Assistant Professor, University of Calgary Dr. Charlene A. Lyndon MD FRCSC Obs and Gyne, Calgary Clinical Assistant Professor, University of Calgary Dr. John O’Connor MB ChB BAO Family Physician/Hospitalist Fort McMurray Clinical Lecturer University of Alberta Dr. Fangyi Liu MD BSc Family Medicine Resident, Edmonton Dr. Jasmin Fauteux MD CCFP(EM) Emergency Medicine University of Calgary | Dr. Christine Gibson MD FCFP MMedEd Department of Family Medicine, Clinical Assistant Professor, University of Calgary Dr. Kenneth Kui Sai Lam MBBS FRCPC FRCS(Glasgow) Physical Medicine and Rehabilitation, Calgary Clinical Assistant Professor, University of Calgary Dr. Huiming Yang MD MSc FRCPC Public Health & Preventive Medicine Clinical Assistant Professor Department of Community Health Sciences Cumming School of Medicine University of Calgary Dr. Anoop Manocha MD CCFP(EM) Emergency Medicine Clinical Assistant Professor University of Calgary Dr. Charles Wong MD CCFP(EM) Emergency Medicine University of Calgary |
Media enquiries: Dr. Joe Vipond (@jvipondmd) or Dr. Amy Tan (@AmyTanMD)
From Ontario
Dr. David Fisman MD FRCPC MPH Epidemiology and Infectious Diseases Professor, Dalla Lana School of Public Health, University of Toronto Dr. Neil Maharaj MD FRCPC Internal Medicine, Respirology Chair, Section of Respiratory Disease, Ontario Medical Association Adjunct Professor, of Medicine, McMaster University Dr. Shady Ashamalla MD FRCSC Assistant Professor, University of Toronto Head of General and Colorectal Cancer Surgery Sunnybrook Health Sciences Centre Dr. Mathew Plant MD FRCSC Plastic and Reconstructive Surgeon, Toronto Dr. Edith Hui MD CCFP Family Medicine Physician, Toronto Dr. Anh Tran MD CCFP Family Medicine Physician, Vaughan Dr. Yvonne Ho MD CCFP FRCPC Diagnostic radiology, Trillium Health Partners Dr. Paul Wu MD FRCS(C) Obstetrician and Gynecologist, Burlington Dr. Christopher Leighton MD FRCPC Radiation Oncologist (ret) Adjunct Professor, Department of Oncology Schulich School of Medicine & Dentistry Western University, Windsor Campus Dr. Grace Lun MD CCFP Family Medicine Physician, Oakville Dr. Hayman Buwan MD Fellow, Physiatry, Toronto | Dr. Jennifer Kwan MD CCFP Family Medicine Physician, Burlington Dr. Hemant Shah MD MScCH HPTE FAASLD Gastroenterology and Hepatology Clinical Director, Francis Family Liver Clinic University Health Network, Toronto Assistant Professor, University of Toronto Dr. Yvonne M. Buys MD FRCSC Professor, Dept of Ophthalmology University of Toronto Co-director, Glaucoma Unit, UHN President, Canadian Ophthalmological Society Dr. Martin J. Yaffe PhD CM DSc(Hon.) Senior Scientist, Physical Sciences Tory Family Chair in Cancer Research Sunnybrook Research Institute Professor, Depts. Medical Biophysics and Medical Imaging, University of Toronto Dr. Samir C. Grover MD MEd FRCPC Division of Gastroenterology St. Michael’s Hospital Associate Professor, University of Toronto Dr. Angela M. Cheung MD PhD FRCPC Professor, Dept of Medicine, University of Toronto Staff General Internist, University Health Network and Sinai Health System Dr. Yvonne Leung PhD Assistant Professor of Psychiatry, University of Toronto Clinical Investigator, Princess Margaret Cancer Centre Dr. Chi Cheong Terry Poon MD, CFPC, FCFP Family Physician, Markham Dr. Daielle Gentile MD CCFP Family Physician, Oakville | Dr. Abdu Sharkawy MD FRCPC Internal Medicine & Infectious Diseases Assistant Professor, University of Toronto Dr. Alykhan Abdulla MD FCFP DIPSPORTMED CCPE MCPL ICD.D Chair, Section on General and Family Practice OMA Lead Physician Manotick Rideau River South FHO Assistant Professor Department of Family Medicine Faculty of Medicine, University of Ottawa Dr. Joseph Y.K. Wong MD CM DSc(Hon.) Family Physician, Toronto Founder and Chair Emeritus, Yee Hong Centre for Geriatric Care Dr. Kashif Pirzada MD CCFP(EM) Emergency Physician, Toronto Assistant Clinical Professor, McMaster University Dr. Karen Wang MEd MD FRCPC Psychiatrist Sunnybrook Health Sciences Centre Assistant Professor, University of Toronto Dr. Andrew Chow MD FRCPC Internal Medicine and Rheumatology Trillium Health Partners, Lecturer, University of Toronto Dr. Soojin Yi MD, CCFP-EM Emergency Physician University Health Network and Michael Garron Hospital Lecturer, University of Toronto Dr. Angeli Vohra MD CCFP Family Medicine Physician, Burlington Dr. Jason Lee MD FRCPC FAAAAI FACAAI Internal Medicine, Clinical Immunology & Allergy, Toronto Dr. Candice Kung MD Psychiatry Resident, University of Toronto |
Media enquiries: Dr. Jennifer Kwan (@jkwan_md), Dr. Kashif Pirzada (@kashprime) or Dr. Abdu Sharkawy (@sharkawyMD)
Disclaimer: The views of the individual participants do not necessarily reflect the perspective of their corresponding organization.
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