National Post (National Edition)
MASKS SAVE LIVES
CANADA’S PUBLIC HEALTH OFFICIALS AND LEADERS NEED TO REVIEW THE WIDE BODY OF EVIDENCE SUPPORTING THE WEARING OF FACE MASKS
While social distancing measures may be showing early signs of flattening the curve here in Canada, there seems to be no obvious end to this disaster. We are facing a defining generational crisis that will reshape our economy and how Canadians interact in the future. It didn’t have to be this way, though. Our public health officials and federal government made serious missteps that allowed the coronavirus to spread unchecked, and continue to do so by denying the benefits of wearing a mask or scarf in public.
A growing number of front-line medical professionals, including myself, have sat back and been bewildered by the decisions made by Dr. Theresa Tam, Canada’s chief public health officer, the Public Health Agency of Canada and other federal officials over the course of this crisis. Our training as physicians does not necessarily encourage vocalization of dissent, particularly in public, and especially not of physicians in leadership positions. We are team players and it is not the Canadian way. In this instance, however, there is a growing number of us who feel it is time to break from tradition, in order to help protect the country we love.
In the early stages of this crisis, federal officials, such as Tam and Prime Minister Justin Trudeau, reassured Canadians that the border didn’t need to be closed and that gatherings were fine. They told us to wash our hands and carry on. By comparison, countries such as Taiwan and Singapore moved fast to start screening airline passengers and halt all flights from Wuhan. By acting quickly and decisively, their public health officials and political leaders lowered the number of initial cases, making the act of “flattening the curve” much easier and not destroying their economies in the process. Similar decisions by our leaders wouldn’t occur until weeks later, when it was too late to make a meaningful difference.
Canada has also failed us by not recommending the use of, and putting policies in place to support, the wearing of masks and other barriers in public. The virus is mainly spread by respiratory droplets produced when people cough, sneeze or have a runny nose. These droplets can than infect someone by coming into contact with a mucosal surface, such as the mouth, nose or eyes. This can occur by breathing in the virus, or touching one’s face. It is also becoming clear that the disease can be spread by people who don’t feel sick. A simple mask reduces the chance of this occurring.
I have been greatly impressed by the great majority of healthy Canadians who have sacrificed their jobs and their personal well-being to practice social distancing. By maintaining a distance of two metres, the frequency and amount of droplets that can be spread is greatly reduced. But a face mask acts as a significant barrier, as well. They can help reduce the chances of someone being infected by droplets that are lingering in the air. Most importantly, a mask may prevent asymptomatic carriers from spreading the disease. They act as a barrier that complements the social distancing measures we have already put in place.
In China, the greatest number of infections in health-care workers occurred amongst ear nose and throat (ENT) surgeons, as well as eye doctors. The reason for this was their proximity to the mucosal fields where such droplets are created.
As a result, Harvard University-associated hospitals have mandated that all staff should be wearing surgical masks at all times, in the understanding that spreading the virus from infected, but otherwise asymptomatic health-care workers may place patients and other staff at risk. Famed author and physician Dr. Atul Gawande recently advocated for surgical masks to be worn by health-care workers at all times, after reviewing the success of such practices in Hong Kong and Singapore.
Like all Canadians, my physician and nursing colleagues are maintaining social distancing at home and in our personal lives. But once we come to the hospital, such measures become impossible. We laugh at the irony of finding ourselves standing nearly side-by-side with another colleague or visitor, in a place where social distancing should matter the most.
Canada’s public health officials and infectious disease specialists are suffering from group think. They over rely on recommendations from the World Health Organization, which are based on politics as much as they are on science. They point to one minor study conducted in a lab setting, which showed that masks may not be effective against airborne viruses. Yet in no other part of their professional careers would they rely on one minor study — they would seek out a wide body of evidence that included real-world tests.
Not everything in medicine can be studied in real time and in controlled settings. Social distancing wasn’t put in place because we have randomized, controlled studies showing its effectiveness. It’s based on real-world experience during the Spanish flu epidemic.
And when it comes to wearing masks, it’s really a matter of common sense. You don’t have to be a critical care specialist, an ENT surgeon or a public health official to understand why they reduce the chances of infection.
Acting now will reduce the unnecessary spread of this disease in our hospitals, ensure our much-needed front-line health-care workers remain healthy, reduce the duration of our social distancing measures and prevent a resurgence of the disease once social distancing guidelines are relaxed. I call upon our public health officials and leaders to review the wide body of evidence, and for once to be ahead of the curve — something they failed at when it came to borders, early recognition of the disease and protecting Canadians.
ACTING NOW WILL REDUCE THE UNNECESSARY SPREAD OF THIS DISEASE IN OUR HOSPITALS.