Mandatory masking for high-risk settings could remain in place past April 27, Ontario's top health official says

Ontario’s top public health official says that he will recommend that mandatory masking remain in effect for some high-risk settings but he is ruling out the revival of a “broad based” mandate for the time being.

The province was set to repeal masking requirements for all remaining settings, including hospitals, long-term care homes and public transit, as of April 27 but during a briefing on Monday Chief Medical Officer of Health Dr. Kieran Moore said that he now believes that it would be appropriate to keep the requirement for the time being.

His comment comes amid a resurgence in viral activity that Premier Doug Ford has characterized as a “little spike.” Wastewater surveillance, however, has suggested that Ontario could be seeing levels of transmission comparable to the peak of the Omicron wave of the pandemic in January, raising real concerns about the potential impact on hospitals in the weeks to come.

“Clearly we think this wave is not going to be settling until the middle or end of May and as a result we're looking at an extension (of the mask mandate) for all of those high-risk facilities,” Moore said. “Our team is drafting it. We’ll present that to government and the government will make the final decision but to me that makes tremendous sense, to maintain it.”

The Ford government lifted mask mandates for most settings on March 21 but since then there has been an exponential rise in COVID-19 transmission, with the head of the province’s science table telling CP24 last week that he now believes that Ontario could be seeing 100,000 to 120,000 new cases each day.

The wave has coincided with the more infectious BA.2 subvariant becoming dominant in Ontario, though in a report released on Friday Public Health Ontario said that resurgence is, at least, partly linked to the lifting of mask mandates.

The group of scientists and epidemiologists behind the report suggested that reinstituting masking at a “population level” could be “effective at reducing transmission, while enabling community settings and activities to continue functioning.”

But Moore said during his briefing that he is not planning to recommend the return of a broad-based mandatory masking policy, at least for now.

Instead, he said that it is his “strong recommendation” that Ontarians wear masks in indoor public settings given the rise in transmission, regardless of whether or not they are required to by law.

“While we will not be reinstating a broad mask mandate at this time, we should all be prepared that we may need to resume a requirement for mask-wearing in indoor public spaces if a new variant of concern emerges, if there is a threat to our healthcare system or potentially during the winter months when COVID-19 and other respiratory viruses are likely to circulate again,” he said.

Speaking with CP24 Monday night, the scientific director of Ontario’s COVID-19 Science Table, Dr. Peter Juni, said he sees a strong recommendation to mask indoors as “a good start.”

“We could do a lot if we consistently mask again just for a few weeks, and if a lot of us would just avoid crowded indoor spaces, whatever it is, whenever they don't have to go there. It's as simple as that,” Juni said.

He said that if for example, those who don’t need to physically go into work continue to work from home for a few weeks more, it would “help tremendously.”

600 COVID patients could be in the ICU

The number of people hospitalized with COVID-19 has risen by 66 per cent over the last two weeks.

So far the jump in intensive care unit admissions has been less pronounced (from 158 to 184) but that has always been a lagging indicator and Moore said that the “current modelling” does suggest that as many as 600 people with COVID-19 could eventually end up in intensive care, approaching the peak which the province saw at the height of the Omicron-fueled wave this past winter.

Back then elective procedures were once again put on hold to preserve hospital resources, adding to Ontario’s growing surgical backlog.

Moore told reporters on Monday that he does believe that the hospital system has the necessary resources in place to handle the influx of COVID-19 patients.

But at least one hospital leader is expressing concern about the impact yet another sudden rise in hospitalizations could have on the broader healthcare system.

“We have to remember that the healthcare workforce is burnt out but also that we live in society just like everybody else, our kids go to school just like everyone else and if I get COVID from my kid, you know, I can't work for a period of time which takes me out of the rotation, which puts more pressure on my colleagues,” the medical director of critical care at Michael Garron Hospital Dr. Michael Warner told CP24.

“It really is important to minimize transmission to minimize the number of healthcare workers who aren't able to work because that puts more pressure on hospitals and we run on a knife's edge in general. You can argue that we should have more capacity but that's not going to be fixed in the next six to eight weeks.

Warner told CP24 that he understands the resistance to reintroducing a mask mandate across the board, as he believes that “people at higher risk do need to make some decisions to protect themselves,” like not going to a crowded restaurant or sporting event.

Warner, however, said that when it comes to non-discretionary activities, like grocery shopping, he would like to see masking reintroduced.

Meanwhile, at an unrelated press conference later on Monday Premier Doug Ford said that the decision on whether to wear a mask or ditch ought to come down to “common sense” and not legislation.

“We’ve been through this for two years. When you walk into a real crowded room, throw the mask on. No one is going to force you -- but I would recommend it,” he said.

First public briefing since March

Moore’s press conference on Monday marked the first time that he has spoken directly to Ontarians about the COVID-19 pandemic in more than a month.

Questioned about his absence from the public stage, Moore said that it is the responsibility of local healthcare leaders across Ontario to “disseminate” information about the pandemic “at a community level.

He said that if he has “new messaging” to provide he will “absolutely” do so, from time to time.

As for the uptick in viral activity, Moore said that it is not altogether unexpected given the spread of the BA.2 subvariant, paired with declining immunity from vaccination.

For that reason, he said that he continues to urge Ontarians who are eligible for a fourth dose to seek one out immediately.

“Over time your protection levels do fade from around 90 per cent protection against BA.2 to 80, to 70 and then to 60. Hence the reason I'm here today to really promote a booster dose of the vaccine that we announced last week,” he said.