Remember When N95 Masks Were Anti-Science?

Ontario, Canada began by properly protecting medical staff from COVID infection. Citing the WHO, it then reversed course.

I recently described how the World Health Organization (WHO) took more than a year to admit the virus that causes COVID-19 is airborne. Frontline healthcare workers paid a price for that obstinacy.

After the 2003 SARS outbreak killed 44 people here in Ontario, Canada – including two nurses and a doctor – a public inquiry was established by the provincial government. The final version of the SARS Commission report exceeds 1,200 pages, but its central conclusion is simple: err on the side of caution. When an entirely new infectious disease emerges, medical facilities shouldn’t gamble with the lives of their staff.

Those staff need to don N95 masks (as opposed to surgical masks) from the start. They need to continue wearing N95s until the new disease is well understood. The Commission concluded that one of the reasons 44 people died of SARS in Toronto while none did in Vancouver back in 2003 was that: “health workers at Vancouver General automatically go to the highest level of precautions, and then scale down as the situation is clarified.”

17 years later, Ontario did the right thing. Out of the gate, it wisely mandated N95s for medical personnel. Then, after a storm of public criticism, officials lost their nerve and reversed course.

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Mario Possamai served as Senior Adviser to the SARS Commission for the better part of four years. In 2020, the Canadian Federation of Nurses Unions lured him out of retirement by commissioning him to write a report about Canada’s response to COVID-19. Released last July, Chapter 2 is titled The World Health Organization, and How Canada Ignored the Lessons of SARS.

In January of 2020, it says, China directed “all health care workers in contact with suspect or confirmed COVID-19 cases to wear airborne precautions, including N95” masks. The WHO chose not to publicize this vital fact. It mentioned it only briefly, “buried in a technical annex at the back” of a report released in late February. Writes Possamai:

Despite China’s airborne directive…the WHO and the [Public Health Agency of Canada] continued to assert that COVID-19 does not spread through the air, and that surgical masks were sufficient.

Ontario’s initial decision to protect frontline health workers with N95 masks was loudly criticized by a contingent of infection control experts who “appeared to organize a well-coordinated media campaign to force Ontario to change course,” writes Possamai. For example, on March 3rd of last year, health reporter Carly Weeks declared in a national newspaper:

numerous infectious disease experts say mounting evidence shows COVID-19 spreads through droplets…and that airborne precautions are not appropriate nor are they supported by evidence. Instead, they say health professionals should use…regular surgical masks. [bold added]

Weeks told the public that Michael Gardam, chief of staff at a Toronto hospital, was an “infection-control expert who was on the front lines during the 2003” SARS outbreak. She didn’t mention that he appeared to have forgotten his history.

“I don’t know where the ministry gets its advice,” Gardam declared in her article. That would be the legislation adopted in response to the SARS Commission. Section 77.7(2) of the provincial Health Protection and Promotion Act, which requires Ontario’s chief medical officer to take into account the precautionary principle when deciding what forms of personal protective equipment PPE healthcare workers should wear in situations of this kind.

Weeks’ news story said Ontario was the only one of Canada’s 10 provinces “recommending airborne precautions,” and that Germany and Australia saw no need for them. Soon afterward, the Toronto Star published an article written by Michelle Ward, who is described at the bottom as “a pediatrician, associate professor and journalist in Ottawa.”

Titled Could Ontario’s rules for treating coronavirus patients make things worse? Some infection specialists think so, the article began this way:

Some of Ontario’s rules for treating COVID-19 infections are outdated, ignore good science and could put health care workers and the sickest patients at risk, say hospital infection control doctors. They are calling for the Ministry of Health to stop requiring the use of N95…masks… [bold added]

Ward’s article quoted the Public Health Agency of Canada’s position that relying on surgical masks “aligns with the recommendations of the World Health Organization.” Despite all the media talk about evidence and good science, both articles cited a shortage of N95s. (Just four weeks earlier, Canada’s federal government had shipped 16 tonnes of personal protective equipment to China to aid that country’s coronavirus efforts.)

Long story short, the critics prevailed. The same day Ward’s article appeared David Williams, Ontario’s Chief Medical Officer, caved – citing the WHO five times in a four-page document. In Possamai’s words, Williams “made a sudden 180-degree turn and fell in line with other Canadian public health agencies.”

Where did that leave hospital nurses, and nursing home personnel? Unprotected from a virus that did, indeed, spread through the air. Possamai’s report says that, during the first six months of COVID in Canada, 21,000 health care workers were infected, Compared to just five in Hong Kong, and just three in Taiwan.

In July of last year, when his report was published, health care workers accounted for nearly 20 per cent of COVID-19 infections, “a rate that is double the global health care worker infection rate.”

It isn’t enough to make smart decisions. You then have to stand your ground. Even when the media paints you as anti-science.

 

 

 

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May 26, 2021 at 06:05AM

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