Wednesday, November 9, 2022

Medical Officers of Health - Can't They Save the Day??

 The Peterborough Medical Officer of Health, Dr. Thomas Piggott, wrote, 

I would agree and add my voice to the numerous health system leaders who are concerned with capacity of the health system in the face of COVID and other respiratory viruses and have been calling for a return of masking in recent days. If we have not reached the threshold from a health system capacity impact to reinstate required masking in key indoor locations, we need to understand when exactly that would be. I have said before and I'll say again, a multi-layer approach is needed (especially we need to see improved COVID/influenza vaccination rates, and improvements in in indoor air quality/ventilation) but masking in indoor locations is a key effective strategy with no associated health harms. It should be the first preventive measure to be returned and the last to leave as we continue to learn to live with COVID, keep kids in school, keep businesses open, and prevent health system collapse. 

What we are seeing affecting paediatric hospitals and children is the sentinel event for more broad community transmission. We usually see transmission in younger first. In coming weeks, I anticipate other populations, including older adults, to be more severely affected as well. There is a broad, not localized crisis facing our health system. It should have a coordinated provincial, not local, response. This is needed for clarity of message and coordination/feasibility of implementing. I believe it will soon come, but I sincerely hope the decision on return of required masking comes before the worst period to prevent it, not when we've already reached that point.

It's a fine message, but you really see the problem when a MOH obviously has zero power to change this system. I'm not sure it's about courage. He's very clear that we need mask mandates. But he can't make it happen without Ford/Jones on board. He needs permission from his Board of Health, which takes direction from the Minister of Health, Sylvia Jones, and Minister of LongTerm Care, Paul Calandra. 

BUT, the local Medical Officers of Health do have the power to enact a section 22 under the Health Protection and Promotion Act (HPPA), which says they can "require a person to take or to refrain from taking any action that is specified in the order in respect of a communicable disease." So surely there has to be some reason someone like Piggott isn't using that section 22. Some axe hanging over his head. 

If it all comes down to Ford, then I don't think we'll see masks mandates regardless the number of children dying or hospitalized. And there's so much misinformation out there, I can't see the average person able to figure out that we all need to wear masks whenever we leave home, even when case numbers are low (since they're artificially low from lack of testing and we have to mask low to prevent numbers from getting high). 

Just yesterday I posted that André Picard article on Facebook, and immediately someone - an intelligent person I know - responded that it's a double-edge sword because if kids wear masks, they'll get immunity debt! 

Wha...?!?

I responded with a quote from the very article she was responding to:

There are those arguing that this spike is due to an “immunity deficit” – that children are getting sick now because they were deprived of infections during lockdowns and school closings. Let’s be clear: that theory is made-up nonsense, perpetuated by the same people who opposed COVID mitigation measures. As epidemiologist Dr. Colin Furness explained eloquently on Twitter last week, the immune system is not a muscle. You don’t have to “use it or lose it.” What we are likely seeing, he says, is “immunity robbery,” where COVID infection stealthily hobbles the immune system, even in those who don’t suffer severe illness, like many children.

What this says to me is that even the intelligent people out there don't read or at least aren't reading carefully and taking time to look into things. They're believing what they hear, whatever sounds about right, and we. are. doomed. 

Tara Moriarty just posted that "If 80% of us mask (as we did this time last year) by February 3, we could liberate 54,000 hospital beds and prevent 4,000 deaths." See the math at the link. But my WLU class can't get much better than 40-50% masked even with a mask mandate! I mentioned it to the unmasked student next to me, and she explained that she's concerned about immunity debt. I just opened the window wider. Good luck out there!

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