I watched it so you don't have to! I've transcribed most of it, but left out repetitive information in places. I also added timestamps to some of the more pertinent bits. And I've added in my own responses here and there. Many reporters did an amazing job with persistent questioning, except that one guy in the front, who didn't write anything down and just lobbed softballs.
TLDR - The reason kids are getting sick is because of their parent, siblings, and grandparents, who really need to do better. We're doing something really new and different today by urging people to wear masks specifically when they're around children four and under. And if we need mandates in daycare to save the children, we'll absolutely think about it.
Dr. Chris Simpson, Chief Medical Officer at Ontario Health
We are currently experiencing extraordinary pressure at our health care system. . . . The total number of children coming to hospitals is uncommonly high. . . . We have strong systems and structures that have been put in place during the pandemic for our adult community that we're now utilizing for child and youth care. We're taking action to ensure these children get the care that they need. . . . ensuring all our resources are being used.
All except N95s, Chris!!
The number of available pediatric ICU beds are being monitored closely. It's very fluid and changes rapidly. . . . What is important to emphasis is that all pediatric patients will be seen when they come to a hospital. If they require admission, then we look after them. But, in order to do this, other parts of the health system will be impacted. We're already seeing a reduction in scheduled surgeries and procedures and this will likely continue as we re-allocate our resources to focus on pediatrics. . . . Should your child become sick, parents should seek care through their family physician, go to a Cough, Cold, Flu, and Covid Assessment Center. . . . And if concerned, do not hesitate to bring your child to your local emergency department. While it's important to acknowledge that the system is extraordinarily strained, I have great faith and confidence in our health care providers across the province . . . and they will do whatever it takes to ensure all children get the care that they need.
I know THEY will do whatever it takes, but YOU, Chris, YOU have to do more to prevent transmission of these viruses that are sending kids to the ER. We need public health to focus on keeping kids OUT of hospitals instead of accepting this will continue, and merely building more capacity for caring for more sick kids.
On to Dr. Kieran Moore
The ongoing circulation of Covid-19 in our communities, in conjunction with influenza and RSV is a situation not seen before and is being experienced across the Western Hemisphere.
It's not our fault. It's everywhere.
Our Covid-19 remains high at 14.2%, and sustained activity is anticipated due to the emergence of BQ1 and BQ.1.1 Omicron sub-variants. What we are facing is a triple threat that requires our collective action to protect the most vulnerable in our communities: the very young, the very old, and those with underlying medical issues. and to ensure that our healthcare system remains able to care for Ontarians when they need it. I'm reminding Ontarians to get back to using all the layers of protection that we know work to keep ourselves and other healthy. We should all be screening daily for signs of illness and stay home when you are sick. Always practice good hand hygiene and regularly clean high-touch surfaces, which is especially important for RSV and flu viruses. Stay up-to-date with your vaccines. Get your Covid-19 bivalent booster dose and your flu shot. Both are safe and effective and can be received at the same time. . . . More than half of children 5-17 years old being tested hospital are testing positive for influenza. . . .
He's really relying on vaccinations to save the day. For a comparison, we went into our second lockdown, just after Christmas in 2020, when our positivity was about 4%, when "local hospitals warn they're at a tipping point." If you haven't heard, it's worse now.
In response to the worsening trends and existing challenges for our health care system, I'm strongly recommending that all Ontarians, not just those at high risk, wear a mask in indoor public settings, especially around our most vulnerable Ontarians: the very young and the very old. I'm also recommending that, if possible, children between two and five wear a mask with supervision if they can tolerate the mask and safely put it on and off. Applying all these layers of protection will help protect ourselves, our families, and most importantly our children under five. It is our youngest children, those under five, who are especially vulnerable to severe outcomes from RSV and Covid and influenza. And we need to ensure that we take all the necessary steps to keep them safe. . . .
Because RSV, influenza, and Covid-19 symptoms can all have varying degrees of symptoms, from minimal to severe, it is important for everyone, including parents, grandparents, and other adults to pay attention to the symptoms and avoid spreading it to others if they are sick. Older children, parents, and adults can easily pass on the virus to children with close contact. . . . Anyone with symptoms should wear a mask and practice layers of protection.
The higher the number of social contacts, the higher the risks as we go indoors for this very social time of year. . . . The difficult and complex fall that was predicted has materialized as we deal with three major viral threats: Covid-19, influenza, and RSV. All three are actively circulating across Ontario in all of our communities and across the Western hemisphere, contributing to the strain on our pediatric healthcare system. As the risk to Ontarians increases, we have to use all of the layers of protection that we have.
Q. Can you explain why you're not going one step further and making masks mandatory?
A. Part of my responsibility as the Chief Medical Officer of Health is to inform Ontarians, and I think the first step is educating. It's not just Covid 19 anymore, we are dealing with the complexity of Covid-19, influenza, and RSV. And I'm very concerned that children are being admitted to our ICUs, principally four and under that cannot mask, so everyone around them, the parent, the sibling, the grandparent, I'm urging them to protect the most vulnerable of us, our children, by adhering to all the layers of protection. What might be a cold to you can lead to a severe resperatory infection in a child four and under. So there is a complexity that it's important that all Ontario understand and we have to get back to the basics. If you have children, and you yourself have a cold, that can be a serious and significant resperatory illness in a two-year-old or three-year-old. As we go indoors, my principle message today is to protect our children, follow all the layers of protection. Our hospital system needs us to protect our children more and more. It's not just masking, it's the layers of protection. If you have any symptoms of infection, you should mask in front of those most vulnerable individuals, you should be screening on a daily basis. .... blah blah hand hygiene blah blah ...
12:38 - Mandatory masking in a certain venue may help decrease the risk at a community level, but I'm very concerned about our children and protecting our children right now. And it's best that we protect them through masking in the home environment and in any social situation as we go into what will be a very social environment in winter.
So, No, he cannot explain why he's not going further to mandate masks. And the word "but" above, doesn't make sense in that context: mandates will help BUT I'm worried about kids??
Q - You're urging this but you're making it voluntary. Do you expect compliance? The majority out there are not masking.
A. I certainly hope Ontarios will heed the call. They've done brilliantly in the last three years, the last 1,000 days of Covid. This is new, though, this is a new call to protect those that are the most vulnerable around us. A mask in a mall will help diminish community spread, but I need - we need - us to mask around those most vulnerable in social settings, which mandates haven't worked for in the past. At family gatherings at family social situations, we have to mask to protect the youngest among us.
Okay, so, because mandates didn't force people in masks enough, we need to not have them anywhere, but instead convince parents to mask in their own homes, like, during dinner. Masking around just the vulnerable at home misses how viruses spread. We need to keep it out of the home in the first place by mask mandates in ALL necessary public places - schools, stores, hospitals, etc.
Q. 14:20 - Will you be recommending to the government to let school boards implement their own possibly mandatory masking policies as they see fit or recommending otherwise?
A - I have no jurisdiction over the school boards and what school boards put in place. So I think they can consult their local medical officers of health. I don't speak directly to school boards, but they can take into consideration the local level of activity. Siblings can bring the virus home to younger members of the community, those that are four and under. That may be one tool of a component of tools that can help diminish the spread to the four and unders. Principally, the message today is that our four and unders are the ones being driven to hospitals, and we need to decrease the burden of illness to slow the chain of transmission of viruses to make sure we can care for all of our children in our communities.
A. We are taking it day by day. We're watching the data on a regular basis. We're speaking almost daily together to monitor the capacity of our healthcare system to care for our children. The principle tool at hand, if we had to go there, would be a mask mandate. Clearly for social gatherings, I'm asking today that we be very careful around children four and under. . . .
It's hard to mandate those social environments. That's my job today, to educate Ontarians, that this is a change. This isn't Covid that's affecting our children, though it obviously can. It's RSV and influenza combined that are driving our children to have to be driven to hospitals. And we do have the tools at our disposal that can help protect our children and help protect our families. My concern is that this is spreading in social situations and families outside of the large public venues. It really comes down to families, grandparents, and siblings protecting the youngest and most vulnerable in our communities.
He's taking the public out of public health! We have the tools and know what works, but it's all on families to protect their kids - not the public: the people at school or daycare or on the bus or at the grocery stores. Masks work to protect kids from RSV, influenza, AND covid. But, since we can't mandate in social environments, then no point mandating anything! Since we can't prevent all drownings all the time, then we shouldn't have lifeguards at pools. We just need everyone everywhere watching over the little ones.
Q - Is mandates the most that we can do?
A. I honestly think a mask mandate will be the furthest we have to go [i.e. no lockdowns]. Ontarians are brilliant at adhering to all the recommendations of the last 1,000 days of the pandemic. This is new and I really appreciate the opportunity to speak directly to Ontarians to communicate that increasing risk, that increasing pressure on our healthcare system. It's important to know it's now across all age groups. It's the youngest that cannot mask, and we need to protect them.
Q. I'm a mom to a toddler, so if I wake up with sniffles I have to mask in my home?
A. I'm sorry, but you should. You should be doing good hand hygiene, masking to reduce the risk. . . .
How often is it that the kids bring a virus home from daycare/school to the parents?? This ignorantly ignores where the spread starts.
Q. - 18:50 - But kids are spending the bulk of their time in school or childcare setting, so why not go that extra step to introduce mandates in schools?
A. We are discussing that, reviewing that as a potential, but clearly today's message was for all Ontarians to realize that it's RSV and influenza that are driving the admissions. . . . We're moving in an incremental way. . . .
Q. You say you're looking at data. Is there a trigger point where you would initiate mask mandates?
A. We're absolutely watching it day by day. . . . We are trying to increase capacity of beds day in day out across Ontario. . . . Quebec is at 20% positivity with increasing demands, so we're learning from Quebec, learning across North America, on how best to care for our children and build capacity across the system. If the capacity is threatened, that is when we'll be advising further to government. At present, we're at 100%, and the call is across Ontario to protect our children and most vulnerable.
Building a bigger hospital so we can allow more illness in our children! His concern is whether or not capacity is threatened instead of whether or not children's health and well-being are threatened! And he says we're at 100% capacity like it's a good thing!
Q. - 21:05 - Many doctors have been telling us for weeks and that the health system is already collapsing especially in pediatrics. Many in this room have interviewed these doctors and done that story. Why did you wait this long to make this announcement, when things are already collapsing, people already at the brink, people already waiting hours and hours with their kids in ERs?
A. The health system is working full out to provide additional care to children, to increase capacity to our emergency departments, as Dr. Simpson has said. The Clinical Assessment Centers now, over 80 of them across the province, can now assess children and adults and can provide Paxlovid, the anti-viral for outpatient covid, they can also provide Tamiflu for outpatient care for influenza, and they can assess children. . . . You're absolutely right we're at a threshold, but we're not stopping now to build capacity to care for our children. . . . blah blah get immunized blah blah . . . back to basics . . . If we have to move further, it will be based on the best data, the best evidence, and informed by Ontario health capacity to care for our children.
So, as long as we have bigger hospitals, we don't need to prevent the spread!
Q - Getting buy-in is key because mask mandates are not enforceable and you point out we can't police Thanksgiving dinner, so are there other tools you can use to save the children? What do you think people are not understanding about this? I take the subway every day and hardly anyone is wearing a mask, so I can't imagine they're wearing them at home. What's the chief obstacle here for you getting this through to people?
A. We have to educate, educate, educate. That is the basic premise of our public health communication at present. I don't know if all parents realize that a common cold to them can be a serious and severe respiratory illness to someone four and under. We need to get that message across that any respiratory illnesses can be RSV or influenza. They all have similar symptoms and that can transmit to children. . . .
The message today is to get back to the basics. They will work, they have worked in the last 1,000 days to decrease the burden of RSV and influenza. Through all of those key layers of protection, masking, hand hygiene, staying home when sick, masking as you recover. Those basics will get us through.
Does Moore know he's not talking about a subway sandwich?? Has he every been on public transportation? People really aren't masking in public and won't until they're directed to in an enforceable way. We did it for much of the 1,000 days only because we had to, but we're just really not as brilliant as he claims.
Q - Did we not expect to get hit by pediatrics cases? Was RSV a surprise?
Chris took this one:
A. At the beginning the pressure was to have personal protective equipment. Then in wave 3, the pressure was in ICUs. Later on in the pandemic, the pressure was on wards for adults. Now the significant pressure, and ironically it's not covid this time, it's RSV and influenza, is on pediatrics. We've been seeing 200-300% increase numbers of respiratory symptomatic presentations to emerg. We've seen the ICUs be filled to capacity for pediatrics. We've seen the community beds, the 29 hospitals with pediatric beds, those have gone to full capacity. And the system is not working in a coordinated way to try to increase forward flow. As kids recover from illness, and their ICU stay, so they can get to the ward quickly to create capacity for the kids that are becoming sick. So the capacity has been built. But we're not at capacity, and we're now at mitigating factors.
To the earlier point on how to motivate people, the other thing I would add is that certainly the message around protecting kid is powerful. The other message is that it can't be forgotten, that in order to accommodate this, and we will accommodate it, but in order to accommodate it, other things have to stop. And you'll recall over the summer there was a lot of conversation around how we're going to manage surgical back-logs and all of the deferred care so we can't forget that this kind of extreme pressure on the system is going to create more of those kinds of deferred care in less time sensitive areas that are going to need to be caught up. So for those out there who need some motivation to help protect kids, remember that the healthcare system needs to be there for everybody and for it to be firing on all cylinders, we need to be protecting the system from this extreme surge.
Q. Is there enough capacity by sending kids 14+ to adult hospitals? How much will that help with the pressure?
A. It will help, but it's a small amount....
Back to Moore:
Q. - 28:43 - I think about parents with a couple children, one at home and one in school. If you're a parent would you try to get your 6-year-old to voluntarily wear a mask at school? What should a parent do in this situation?
A. If you've got any vulnerable child in the home, I think it's best we in essence we try to cocoon that child with masking as best we can. Four and under are very susceptible to RSV and influenza. First, if you have any symptoms, absolutely you should be masking in the home setting, and staying home until you're fully recovered, practicing good hand hygiene in the home setting. But if you've got anyone vulnerable in the home, it's best, as the risk goes up, for all three of these pathogens, to mask around anyone vulnerable.
So... about that 6-year-old masking in school....??
Q - 29:20 - Should daycare staff be masked? Should children voluntarily mask in schoools?
A. We're asking more people to mask up. That's one of the key messages today, especially around our most vulnerable children four and under. And if we have to put that as an order around daycares, we absolutely will consider that.
What's that called again when you do the same thing over and over but expect different results?
Q. Whether it's population wide or daycares or schools, do you have the legal authority to recommend that?
A. The CMOH has some authorities, mainly over the health system. The Minister of those respective jurisdictions - education, children services - has jurisdiction over those services as well. If we had to mask up, we would do it based on best evidence and we would follow it through clearly as we go into the most social time of year going indoors. I'm very concerned that the risk is going to go up for our children. And we'll be monitoring that situation very closely.
Q. Are we heading into that direction?
A. I don't think it's inevitable. I do think the options for families are, and best practices have been pronounced today of how to get back to those basics that will help protect our families and protect our children.
Q - 30:50 - You're talking about masking around the vulnerable. Are you not recommending people mask in all indoor settings??
A. Absolutely, with a particular focus on our children and protecting our children as best we can. Those are public settings. The social setting is also where the virus is spreading. So you're hearing there's a complexity. Masking in public places will bring the overall burden of influenza, RSV, and Covid down, BUT if it gets into the family and affects them, that the additional risk. So you have to mask in those public space, but be very careful around our children because this is obviously spreading in social networks as well.
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