Toronto – Presenting a mask mandate The pressure on pediatric hospitals may not have eased when respiratory viruses surged in the fall, a public health ontario Science brief findings obtained by The Canadian Press.
The brief – which was not actively made public, unlike reports by the now-defunct Science Table predecessor – provides a glimpse of the evidence on which Dr. Kieran Moore “decided not to go beyond.” strong” recommendation on masking in mid-November.
effect of masking on the transmission of COVID-19 are strong, summarized from the end-of-November notes. Its research suggests mandates may not have delivered more benefits than recommendations.
But with influenza and respiratory syncytial virus, or RSV, spreading over that time as well as COVID-19, the benefits of the mask mandate became less clear to the group of experts.
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“Current evidence suggests that adherence to masking, in addition to other layered measures such as self-examination, staying home when sick and vaccination, is likely to prevent transmission of influenza, RSV and COVID-19 in children and young people especially in indoor community settings where transmission is high,” the PHO document concludes.
“Given the number of respiratory viruses currently in circulation, there is less certainty about the likely magnitude of the effect on transmission.
“It is also uncertain whether the potential reduction in transmission is sufficient to reduce pediatric emergency department visits, hospitalizations, and ICU admissions while preserving capacity within the health care system.”
That brief settled the debate for the province’s top doctor.
Doctor. Moore told the Canadian Press in a recent interview, “There was not a body of evidence to support strict enforcement of the mask mandate.”
“Mandatory masking has not been recommended in any jurisdiction, nor has our expert panel recommended it to us.”
Moore said he doesn’t see a mask mandate now or in the future.
In mid-November, Moore wasn’t so sure.
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There was a huge jump in young patients hospitalized due to respiratory viruses. Intensive care units and emergency departments at major children’s hospitals across the province saw historic volumes from October to December.
The surge forced children’s hospitals in Toronto, Ottawa, Hamilton and London, Ontario to cancel surgeries to free up staff and beds to deal with the problem.
On November 14, Moore held a news conference where he “strongly” recommended that children wear masks indoors to protect against the spread of respiratory viruses. He said that he is discussing and reviewing the possibility of reintroducing masks in schools.
That same day, Moore’s office requested help from Public Health Ontario.
The summary states, “The Office of the Chief Medical Officer of Health requested a summary of the evidence on the effectiveness of mask wearing in the context of the spread of influenza, RSV and COVID-19, particularly among children and young people “
“Information was also sought regarding public acceptability of covert mandates.”
Ten days later, Public Health Ontario responded with a 14-page brief.
There was little evidence in the scientific literature on the sole effects of masking on the transmission of influenza and RSV, it notes.
The document states, “We were unable to identify data on the effectiveness of community-level masking in preventing transmission of influenza or RSV.”
“However, widespread mask use in general or targeted populations can be expected to reduce the rate of transmission of viral respiratory pathogens in the community.”
The effect of masking on the transmission of SARS-CoV-2 — the virus that causes COVID-19 — is very strong, the document notes, which includes evidence from the province’s now-defunct Science Table.
“It reported that mask mandates were associated with a lower incidence of SARS-CoV-2 infection than schools without mask mandates,” the document states.
The brief reference is a synthesis of Public Health Ontario research in March 2022, which noted “the positive effects of masks in community settings and on reductions in COVID-19 case growth, hospitalizations, and deaths. However, there was limited evidence to suggest greater effectiveness of mask mandates than mask recommendations for results in reduction of COVID-19 case rates.
The scientists also looked to Google to find any polling done on the public acceptability of the mask mandate.
They found that 53 per cent of respondents to a Forum poll conducted on November 8 agreed that a mask mandate should be reintroduced in Ontario. They also found a Nano Research poll conducted for CTV News from October 30 to November 2 found that 69 percent of respondents would support a return to mask mandates to some extent.
The brief was not publicly released until the Canadian Press asked for it.
Public Health Ontario took a week to decide whether or not to release it, and the agency said it ultimately did so in the interest of transparency. Public Health Ontario declined requests for interviews and only responded to questions via email.
The email from PHO Media Relations stated, “This document was not shared publicly because it was in response to a request from (Moore’s office) and was not intended as a stand-alone document.”
Moore did not answer questions about why the document was never made public.
The former scientific director of the old voluntary science table did a brief review after it was shared by The Canadian Press.
Dr Fahad Razak calls this a “peer-scaled assessment of evidence”.
“The findings support what I believe to be true, which is that, in totality, the evidence suggests that masking reduces transmission in school settings,” said Razak, an internist at St. Michael’s Hospital and a professor at the University of Toronto.
But Razak said the brief should have been made public when it was given to Moore in late November as debate raged around the mask mandate.
The former Science Table, which was disbanded in September by Public Health Ontario, publishes all its work online, as well as its reports and recommendations to government, public health officials and the clinical community.
“As scientists and policy experts, we never believed we had to make this decision,” Razak said. “We believed that what was really important was providing timely information that allowed the best decisions to be made by the public and decision makers,” he said.
Razak said that misinformation often occupies the space left in an information vacuum.
“If you read the social media posts and blogs and the concerns of people who distrust vaccines, for example, a lot of it stems from the idea that important information is being kept behind closed doors,” he said. .
“So that’s part of the thought process that’s driving misinformation and I think that’s one of the key reasons why you as a scientific body want to have transparency and timely reporting of data and analysis.”
The province’s new science table was created late last year under Public Health Ontario and Moore said it has met only a few times.