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Ontario's top doctor 'strongly' recommends masking in indoor settings amid children's hospital crisis

Dr. Kieran Moore stopped short of mandating masking but has previously said he would recommend masking in certain indoor settings if hospitals began cancelling surgeries.
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The province’s top doctor is “strongly recommending” Ontarians mask up once again in all indoor settings, including schools and childcare centres, in an effort to help overwhelmed children’s hospitals.

Dr. Kieran Moore stopped short of mandating masking but has previously said he would recommend masking in certain indoor settings if hospitals began cancelling surgeries.

“What we are facing is a triple threat,” said Dr. Moore of COVID-19, influenza and RSV at a news conference on Monday morning. “All three are actively circulating across Ontario in all of our communities.”

“This is different from COVID. This is about protecting our children,” he said, when asked why he would not mandate masking, adding that the majority of those affected by these illnesses, children under the age of four, are not able to mask properly.

“Please parents, grandparents, siblings, if you have respiratory symptoms, you must mask around those that are vulnerable,” said Dr. Moore. “Masking may help decrease the risk at a community level, but I’m very concerned about protecting our children right now and it’s best that we protect them through masking in a home environment and in any social situation.”

Moore said this threat requires “collective action” to protect the most vulnerable in the province.

He added more than half of the children who are being tested for influenza in hospitals and emergency departments are testing positive. Over 20 per cent of children under the age of one are testing positive for RSV in hospital settings.

“It’s not COVID that’s affecting our children, it’s RSV and influenza combined that are driving our children to have to be admitted to hospital,” said Dr. Moore. He adds half the children in the ICU have RSV and the other half have Influenza.

The top doctor said it was up to the school boards whether to mandate masks in the classroom.

The province will also be expanding pediatric capacity in hospitals to 150 per cent and request that people aged 14 and up requiring critical care be treated in adult critical care beds.

Measures to manage the pediatric respiratory virus season will also include reducing non-emergent surgeries, when necessary, in most pediatric centres to create capacity.

Dr. Moore also recommended staying up to date on vaccinations, screen for respiratory symptoms daily, practice good hygiene and stay home if you are sick. Children aged two to five years old should also wear a mask when supervised.

The Children's Hospital of Eastern Ontario (CHEO) is making some adjustments and taking several measures in order to deal with an "unprecedented surge of patients."

"Like most pediatric hospitals across the country, CHEO is experiencing an unprecedented major surge," a release on CHEO's website stated. "There is a significant increase in the number of young patients with acute viral respiratory infections including respiratory syncytial virus (RSV), COVID and the seasonal flu. This means that the hospital is well beyond its capacity and wait times are, unfortunately, historically long."

To address the situation at the hospital, CHEO said it is taking the following measures:

  • Redeploying clinicians with critical care skills who may be working in other parts of CHEO to help in our intensive care unit (ICU).  
  • Focusing on our patient-facing needs, we are reassigning staff to support emergency, acute and critical care needs.
  • Hiring more staff and getting them on the floors. 
  • Scheduling staff from across the organization who have put up their hand to support care teams in non-clinical ways. 
  • Expanding staffing and clinic hours at the Kids Come First and East Ottawa Kids clinics.
  • Embedding specialized discharge planners within our clinical teams to ensure young patients get home sooner, safely. 
  • Postponing some non urgent surgeries and procedures to free up staff with the skills needed to care for the very sick children and youth needing acute care at CHEO.
  • Postponing some clinic appointments to free up staff with the skills needed to care for the very sick children and youth needing acute care at CHEO.
  • Starting our enhanced peak viral season measures on Nov. 3 for the safety of families and staff, which includes having only one parent/caregiver at the bedside.  

A second pediatric intensive care unit (PICU) has opened at CHEO

Hospitals officials said the move was made to address the overflow of critically ill babies and young children. 

Over the past few weeks, CHEO has seen an early arrival of the peak viral season driven by acute viral respiratory infections including respiratory syncytial virus (RSV), flu, COVID-19 and other viruses. These are at levels never before seen in CHEO’s 48-year history.

“Unprecedented feels like an overused word at the moment, but there’s no better term to describe the crisis facing our pediatric health-care system right now,” said Dr. Lindy Samson, CHEO’s chief of staff and chief medical officer. “We appreciate the additional funding from the Ministry of Health and Ontario Health which is making it possible for us to respond.”

CHEO is currently experiencing more than double its normal volume of younger patients. More kids are requiring admission, and this has many young patients and their families stuck in the emergency department for longer than ever before. To address this crisis, CHEO has been taking a series of measures to ensure young people in our community can still get the emergency, critical and acute care they need, including:

  • Opening a second PICU in space which has been temporarily reassigned from CHEO’s surgical day unit. This new PICU makes five more beds available for children and youth with intensive care needs.
  • Redeploying clinicians with critical care skills from other parts of CHEO to help in the PICU.
  • Focused on patient-facing needs, CHEO is reassigning staff to support emergency, acute and critical care needs.
  • Hiring more staff as quickly as possible to provide care to patients.
  • Scheduling staff from across the organization who have put up their hand to provide non-clinical support to frontline care teams.
  • Expanding staffing and clinic hours at the Kids Come First and East Ottawa Kids care clinics.
  • Embedding specialized discharge planners in clinical teams to ensure young patients safely get home sooner.
  • Only when it is safe, postponing some surgeries, procedures and clinic appointments to free up staff with the skills needed to care for the very sick children and youth needing urgent care at CHEO.
  • Adopting enhanced peak viral season measures for the safety of families and staff, which includes having only one parent or designated caregiver at the bedside.

The hospital's chief of staff spoke to the city's board of health on Monday, Nov. 7 about the influx of patients at her pediatric hospital and asked the public to resume masking to protect children.

Dr. Lindy Samson said a record number of children were coming to the hospital with difficulty breathing, fevers and other conditions brought on by illnesses like influenza, RSV, and COVID-19.

While the hospital is doing all it can, the public has a role to play as well, Samson said.

Samson said the surge in kids coming to CHEO has resulted in patients being treated in the emergency room and surgeries being postponed because there are no beds available. Other children are being sent outside the region for care, she added.

Ottawa's top doctor, Dr. Vera Etches, recommended that people return to wearing masks as COVID-19 levels remain high, and other viral illnesses like influenza are spreading in an "extraordinary respiratory season."

The City of Ottawa's board of health voted on Nov. 7 night to send a letter to Ontario's premier, health minister and chief medical officer asking for data and projections on this year's respiratory illness season and its predicted impact on the health system.

The board also voted to ask that the province "intensify the visibility and reach of a mass health communications campaign" about the benefits of masking and vaccination.

Recent data shows that the province is over capacity with pediatric ICU beds, with the number of children receiving care exceeding the number of available units.

Over the weekend, when asked about the expected masking recommendation, Premier Doug Ford said, “I encourage every single person when possible [to mask], especially people with respiratory problems.”

“Right from day one, all the way through the pandemic, I’ve always listened to the Chief Medical Officer of Ontario and I’m gonna continue to listen to Dr. Moore. And we’ll see what he has to say tomorrow,” said Ford.

Last week, a new poll found a majority of Canadians are in favour of a return to mask mandates in indoor settings if deemed necessary by public health units and government officials.

Dr. Robert Cushman, the acting medical officer of health for the Renfrew County and District Health Unit, told The Sam Laprade Show on Nov. 14 that the province should have implemented a mask mandate. 

Dr. Cushman, who is retiring at the end of the year, said it's no longer time for the provincial government, led my Doug Ford, to be cheerleaders and that the current government can use some political goodwill to help out the hospital system. 

"We find that public intervention with things like seat belts and bicycle helmets, you are lucky to get beyond 75 per cent if make them optional," he said. "Cheerleading and urging people what needs to be done and describing the situation will help but it won't get us where we want to be."

Listen to the full interview with Dr. Robert Cushman below:

With files from Michael Ranger and Lucas Casaletto of CityNews; and The Canadian Press

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