Mask mandates are lifting in hospitals, long-term care homes and other health-care facilities across the country, marking an end to some of the last remaining public health restrictions against COVID-19 in Canada.
But what changes for patients and health-care workers may not be clear-cut, as the lifting of mandates doesn’t mean an end to masking altogether — and health officials stress that mandates could return to health care in the future, if COVID levels take a turn for the worse.
“Clearly masks are important in health-care settings, we’ve used them always, and I’ve been a big supporter of mask wearing when it’s appropriate,” Dr. Bonnie Henry, B.C. provincial health officer and chair of the council of chief medical officers of health, told CBC News.
“Nobody is telling you not to wear a mask, what we’re saying is it’s no longer mandatory by a provincial health officer order that everybody do it all the time.”
Canadians can expect many areas of hospitals to still encourage masking in emergency rooms and departments with particularly vulnerable patients, like burn units and cancer wards — and health-care workers will still likely wear them in many patient-facing settings.
“If you want to or your provider wants to, masks will certainly be available. So I think it’s going to be a gradual transition,” Dr. Saqib Shahab, Saskatchewan’s chief medical health officer, told CBC Saskatchewan last week.
“We really hope outbreaks won’t rise as a result of this policy … but it’s something that I think all of us have a role to play in minimizing that risk.”
But reaction to the policy change has been mixed, with some health-care worker unions and advocates arguing the move will shift public health responsibilities onto individuals and could even equate to a violation of human rights for high-risk patients.
Registered nurse Janelle Van Haltren prepares to attend to a patient in the Humber River Hospital emergency departing on Jan. 13, 2022. Canadians can expect many areas of hospitals to still encourage masking — and health-care workers will still likely wear them in many patient-facing settings. (Evan Mitsui/CBC)
Lifting mandates could reduce health-care burnout
Part of the reasoning behind the shift in policy is to remove the need for health-care workers, who have faced severe burnout throughout the pandemic, to constantly mask in every area of the hospital — while also still allowing them the freedom to continue to do so.
“We know that most of our staff, when they got infected, weren’t getting infected at work, they were getting infected in the community,” said Dr. Michael Gardam, an infectious disease specialist and CEO of Health P.E.I.
“And so really the time has kind of come and gone for this and we need to get to a new state where we are masking when we need to — but not routinely, everyday, everywhere.”
Dr. Alon Vaisman, an infection control physician at Toronto’s University Health Network (UHN) and assistant medical professor at the University of Toronto, said removing universal mask mandates in all health-care settings would likely help to ease health-care worker burnout.
“I absolutely see the reasoning there, because it seems like a very low-risk manoeuvre. I think it’s important to recognize that if you take health-care workers, for example, they’ve been working extremely hard the last three years,” he said.
“And if there’s anything we can do to try to alleviate the stress, if you could remove masking where it’s no longer necessary and where the risk is extremely low, I think if you could do that it’s very helpful to reduce burnout.”
Mask mandates lifted at Sask. Health Authority facilities
Mask mandates at Saskatchewan Health Authority facilities have been lifted.
Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security in Baltimore, said hospitals should be able to independently set policies on masking depending on local COVID levels and expert advice.
“When you’re talking about non-patient facing activities, I don’t think that there’s much benefit in having masks in place,” he said.
“There is benefit in patient-facing activities to having people wear masks, but I think it’s something that each hospital needs to make a determination on based on the local metrics and not really something for the government to necessarily be involved in.”
Alberta is still requiring masks in patient-facing settings, Quebec and Ontario are leaving masking rules up to individual hospitals, while Manitoba has opted to still require masks in health-care settings for the time being.
“If you’re in an immunocompromised-facing service, these policies make sense,” said Dr. Abraar Karan, an infectious diseases fellow at Stanford University and physician and researcher in Stanford, Calif.
“Now whether we should keep mask mandates in place at all hospitals, for all patients, in all services, that’s more debatable.”
Surgical oncologists Dr. Usmaan Hameed, right, and Dr. Peter Stotland, left, walk to the operating room at North York General Hospital in May 2020. (Evan Mitsui/CBC)
Ethical debate over removing mask mandates in hospitals
B.C.’s Human Rights Commissioner Kasari Govender raised concerns about the decision to lift mandatory masking in health-care settings, saying they are the one space vulnerable people should be able to rely on to prioritize their safety — particularly in long-term care facilities.
“The removal of mask mandates has a disproportionate impact on marginalized people, seniors, and those who are clinically extremely vulnerable,” Govender said in a statement this week.
“This represents a violation of their rights to equal participation in our communities.”
B.C. lifts mandatory masking in health care and proof of vaccination for long-term care visitors
B.C. is ending its universal mask mandate in health care settings, Provincial Health Officer Dr. Bonnie Henry announced Thursday. Visitors to long-term care and assisted living facilities will also no longer need to show proof of a COVID-19 vaccination.
The Canadian Union of Public Employees, which represents over 200,000 health-care workers across the country, said in a statement to CBC News it’s not acceptable for governments to allow employers to “download workplace safety onto front-line workers.”
“That ignores the fundamental responsibility of employers to provide a safe work environment,” CUPE’s National President Mark Hancock said.
“Leaving the decision over infection controls in the work environment to individual employees is never okay. It’s especially concerning in a health-care setting where people are already ill and at risk.”
Vaisman said the overall benefit derived from universal mask mandates in all health-care settings at this point in the pandemic isn’t as strong as it once was.
“What we’ve seen throughout the pandemic is that the morbidity and mortality associated with COVID, the likelihood that you’ll be admitted to hospital if you get COVID, has substantially fallen over the last few years,” he said.
“Our primary objective is always to keep patients safe … but it’s important to recognize that the risk to patients has dramatically changed over the last few years because of vaccination, because of previous infection, because of therapeutics.”
Surgical oncologists Dr. Usmaan Hameed operates on a patient in North York General Hospital on May 26, 2020. (Evan Mitsui/CBC)
Vaisman said masking will remain in all traditionally high-risk areas in UHN hospitals, and patients entering emergency departments will still need to mask up — but fewer people will likely be wearing them in common spaces such as lobbies, hallways and elevators.
“So in certain settings where we think the risk is lower, you won’t see health-care workers masked as often as you did in the past,” he said. “I think the Canadian public will start to notice that masking is becoming less and less common in health-care settings.”
“We no longer need that additional level of protection all the time, because of what we’re seeing with the epidemiology in the community and our health-care settings — we don’t have any outbreaks in long term care right now of influenza or COVID [in B.C.],” she said.
“So the setting is different and we need to adapt to that, we need to get back to a more normal way of interacting.”
A nurse gowns up before attending to a patient in the intensive care unit of Humber River Hospital in Toronto, on Jan. 25, 2022. (Evan Mitsui/CBC)
Mask mandates could return if COVID levels worsen
Canada avoided a severe winter COVID-19 wave despite a lack of most of public health restrictions, a busy indoor holiday season and a rapidly mutating virus — largely thanks to high levels of hybrid immunity from vaccination and prior infection.
A Canadian study of health-care workers in Quebec published in The Lancet Infectious Diseases in January found that two doses of an mRNA vaccine and a previous Omicron infection offered substantial protection against future infection from Omicron subvariants.
Bivalent vaccines, which were designed to target the BA.4 and BA.5 Omicron subvariants, were also associated with a lower risk of severe infection with several later members of the Omicron family, researchers wrote in new correspondence in the New England Journal of Medicine.
But COVID hospitalization levels still remain stubbornly high in Canada, with 3,268 hospital beds occupied by COVID patients across the country according to the latest federal data, despite continuing to gradually decline since mid-January.
“We’re not done with this yet. COVID is going to be around and it’s an additional infection that is causing illness — particularly in older people, particularly in people who have immune-compromising conditions,” Henry said.
“It’s going to be really important when we get to next respiratory season, that we’ll be looking again at whether universal masking through that period of time when the risk is high, not just for COVID, but for influenza, for RSV, for other respiratory viruses as well.”
Gardam said that while it makes sense to lift mask mandates in hospitals for now, a worsening situation with COVID or other respiratory illnesses later could change that.
“If we have a large outbreak of influenza or RSV or COVID in the future as we get into the winter seasons, I think it’ll be quite reasonable to bring back masking in hospitals in certain areas, then taking it away again when the epidemiology suggests that it’s safe,” he said.
“There’s no doubt masks had benefit during the pandemic, along with the other pandemic control measures that we had … we need to figure out what that middle ground is.”
Nova Scotia RCMP say their investigation into two suspicious deaths earlier this month has concluded that one man died by homicide and the other by suicide.
The bodies of two men, aged 40 and 73, were found in a home in Windsor, N.S., on Sept. 3.
Police say the province’s medical examiner determined the 40-year-old man was killed and the 73-year-old man killed himself.
They say the two men were members of the same family.
No arrests or charges are anticipated, and the names of the deceased will not be released.
RCMP say they will not be releasing any further details out of respect for the family.
This report by The Canadian Press was first published Sept. 16, 2024.
For the first time in their history, members of the Cree community of Nemaska received a visit from a sitting Quebec premier on Sunday and were able to share first-hand the story of how they were displaced by a hydroelectric project in the 1970s.
François Legault was greeted in Nemaska by men and women who arrived by canoe to re-enact the founding of their new village in the Eeyou Istchee James Bay region, in northern Quebec, 47 years ago. The community was forced in the early 1970s to move from its original location because members were told it would be flooded as part of the Nottaway-Broadback-Rupert hydro project.
The reservoir was ultimately constructed elsewhere, but by then the members of the village had already left for other places, abandoning their homes and many of their belongings in the process.
George Wapachee, co-author of the book “Going Home,” said community members were “relocated for nothing.”
“We didn’t know what the rights were, or who to turn to,” he said in an interview. “That turned us into refugees and we were forced to abandon the life we knew.”
Nemaska’s story illustrates the challenges Legault’s government faces as it looks to build new dams to meet the province’s power needs, which are anticipated to double by 2050. Legault has promised that any new projects will be developed in partnership with Indigenous people and have “social acceptability,” but experts say that’s easier said than done.
François Bouffard, an associate professor of electrical engineering at McGill University, said the earlier era of hydro projects were developed without any consideration for the Indigenous inhabitants living nearby.
“We live in a much different world now,” he said. “Any kind of hydro development, no matter where in Quebec, will require true consent and partnership from Indigenous communities.” Those groups likely want to be treated as stakeholders, he added.
Securing wider social acceptability for projects that significantly change the landscape — as hydro dams often do — is also “a big ask,” he said. The government, Bouchard added, will likely focus on boosting capacity in its existing dams, or building installations that run off river flow and don’t require flooding large swaths of land to create reservoirs.
Louis Beaumier, executive director of the Trottier Energy Institute at Polytechnique Montreal, said Legault’s visit to Nemaska represents a desire for reconciliation with Indigenous people who were traumatized by the way earlier projects were carried about.
Any new projects will need the consent of local First Nations, Beaumier said, adding that its easier to get their blessing for wind power projects compared to dams, because they’re less destructive to the environment and easier around which to structure a partnership agreement.
Beaumier added that he believes it will be nearly impossible to get the public — Indigenous or not — to agree to “the destruction of a river” for a new dam, noting that in recent decades people have come to recognize rivers as the “unique, irreplaceable riches” that they are.
Legault’s visit to northern Quebec came on Sept. 15, when the community gathers every year to remember the founding of the “New Nemaska,” on the shores of Lake Champion in the heart of the boreal forest, some 1,500 kilometres from Montreal. Nemaska Chief Clarence Jolly said the community invited Legault to a traditional feast on Sunday, and planned to present him with Wapachee’s book and tell him their stories.
The book, published in 2022 along with Susan Marshall, is filled with stories of Nemaska community members. Leaving behind sewing machines and hunting dogs, they were initially sent to two different villages, Wapachee said.
In their new homes, several of them were forced to live in “deplorable conditions,” and some were physically and verbally abused, he said. The new village of Nemaska was only built a few years later, in 1977.
“At this time, families were losing their children to prison-schools,” he said, in reference to the residential school system. “Imagine the burden of losing your community as well.”
Thomas Jolly, a former chief, said he was 15 years old when he was forced to leave his village with all his belongings in a single bag.
Meeting Legault was important “because have to recognize what happened and we have to talk about the repercussions that the relocation had on people,” he said, adding that those effects are still felt today.
Earlier Sunday, Legault was in the Cree community of Eastmain, where he participated in the official renaming of a hydro complex in honour of former premier Bernard Landry. At the event, Legault said he would follow the example of his late predecessor, who oversaw the signing of the historic “Paix des Braves” agreement between the Quebec government and the Cree in 2002.
He said there is “significant potential” in Eeyou Istchee James Bay, both in increasing the capacity of its large dams and in developing wind power projects.
“Obviously, we will do that with the Cree,” he said.
This report by The Canadian Press was first published Sept. 16, 2024.
NEMASKA – For the first time in their history, members of the Cree community of Nemaska received a visit from a sitting Quebec premier on Sunday and were able to share first-hand the story of how they were displaced by a hydroelectric project in the 1970s.
François Legault was greeted in Nemaska by men and women who arrived by canoe to re-enact the founding of their new village in the Eeyou Istchee James Bay region, in northern Quebec, 47 years ago. The community was forced in the early 1970s to move from their original location because they were told it would be flooded as part of the Nottaway-Broadback-Rupert hydro project.
The reservoir was ultimately constructed elsewhere, but by then the members of the village had already left for other places, abandoning their homes and many of their belongings in the process.
George Wapachee, co-author of the book “Going Home,” said community members were “relocated for nothing.”
“We didn’t know what the rights were, or who to turn to,” he said in an interview. “That turned us into refugees and we were forced to abandon the life we knew.”
The book, published in 2022 by Wapachee and Susan Marshall, is filled with stories of Cree community members. Leaving behind sewing machines and hunting dogs, they were initially sent to two different villages, 100 and 300 kilometres away, Wapachee said.
In their new homes, several of them were forced to live in “deplorable conditions,” and some were physically and verbally abused, he said. The new village of Nemaska was only built a few years later, in 1977.
“At this time, families were losing their children to prison-schools,” he said, in reference to the residential school system. “Imagine the burden of losing your community as well.”
Legault’s visit came on Sept. 15, when the community gathers every year to remember the founding of the “New Nemaska,” on the shores of Lake Champion in the heart of the boreal forest, some 1,500 kilometres from Montreal. Nemaska Chief Clarence Jolly said the community invited Legault to a traditional feast on Sunday, and planned to present him with Wapachee’s book and tell him their stories.
Thomas Jolly, a former chief, said he was 15 years old when he was forced to leave his village with all his belongings in a single bag.
Meeting Legault was important “because have to recognize what happened and we have to talk about the repercussions that the relocation had on people,” he said, adding that those effects are still felt today.
Earlier Sunday, Legault had been in the Cree community of Eastmain, where he participated in the official renaming of a hydro dam in honour of former premier Bernard Landry.
This report by The Canadian Press was first published Sept. 16, 2024.
