Mask Mandates Back in Hospitals Across Canada Just Months After Being Removed

A red (COVID-19 positive) intensive care unit is shown at the Health Sciences Centre in Winnipeg on Dec. 8, 2020. (Mikaela MacKenzie/The Canadian Press)

Just months after most places across the country, including hospitals, had finally removed mandatory face mask policies, many health care facilities are citing respiratory virus season as the reason for a return to mask-wearing requirements.

British Columbia

British Columbia Provincial Health Officer (PHO) Bonnie Henry announced “medical” masks would be required in all public health care facilities as of Oct. 3. Health care workers, volunteers, visitors in patient care areas, and contractors are required to mask up, as are long-term care visitors if they are in common areas of a facility.

Masks will not be mandated for patients in most cases, or for long-term care residents, unless a health care worker directs, Dr. Henry said.

B.C. has also not dropped its mandatory COVID vaccination requirements for health care workers, including nurses. Unvaccinated health care workers are prohibited by order of Dr. Henry from working in hospitals and long-term care homes.

Nova Scotia

Just a month after being dropped, mask mandates are also back in Nova Scotia health care facilities. The province only removed masks and hospital screeners at entrances and exits on Sept. 10.

In a news release issued Oct. 10, Nova Scotia Health said masks would be required to enter health facilities and in all common areas like hallways, elevators, staircases, and cafeterias “as cases of COVID-19 increase in the community and in anticipation of circulation of influenza and other respiratory viruses in the coming weeks.”

Nova Scotia Health will also require medical masks in clinical areas where there are patients, clients, families, and caregivers as well as inpatient and ambulatory care settings.

Ontario

Ontario hospitals also started reimposing mask mandates in September. Ottawa Hospital put in place a new masking requirement on Sept. 11, after only dropping masking requirements in the summer in some public places of the hospital. Masks never stopped being mandatory in patient rooms and units, including emergency.

The hospital said the return to a mask mandate applied to all clinical areas and waiting rooms, patient rooms, nursing stations, and ambulatory care areas, and would remain “in place for the duration of the respiratory virus season.”

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Ottawa-area Perth and Smiths Falls District Hospital has also made masks mandatory at its two sites, with a hospital spokeswoman stating it was “a proactive approach to supporting safety and wellbeing.”

The Queensway Carleton Hospital and Children’s Hospital of Eastern Ontario still require masking in clinical areas and emergency rooms, as does Ontario’s Francophone hospital Montfort.

In a Sept. 13 announcement, Montfort Hospital said masks must be worn at all times by staff and visitors in all clinical areas, care units including corridors and patient rooms, the Emergency Department, ambulatory clinics, and waiting rooms. These guidelines are in effect at the hospital and at satellite sites in Prescott & Russell and Beacon Heights, as well as at the Aline-Chrétien Health Hub.

Kingston Health Sciences Centre also reintroduced mandatory masking in inpatient areas, emergency departments, the children’s outpatient clinic, and the urgent care centre, as of Sept. 28, for all patients, staff and visitors in that hospital as well as the Hotel Dieu Hospital Site.

St. Joseph’s Healthcare and Hamilton Health Sciences updated its masking policies on Sept. 27, requiring health care workers to return to wearing masks when interacting with patients. “While we anticipate requiring clinical masking through the peak of the respiratory season, we intend for this to be a temporary measure,” an internal memo sent to HHS hospital staff said, CTV news reported on Sept. 29.

Other hospitals with mandatory mask policies include Guelph General Hospital as of Sept. 11 in clinical areas, and Toronto area hospitals including Mount Sinai, North York General, Women’s College, Lakeridge, and St. Joseph’s and St. Michael’s Unity Health in patient-care areas of the facilities.

McGill University Health Care Centre in Montreal made masks mandatory for health care workers as of Sept. 14 at any time they are providing direct care to patients or when interacting with other health care workers in clinical care areas.

Alberta

Alberta became the most recent province to return to masks in health care facilities, citing hospital outbreaks of COVID-19 across the province. Alberta Health Services (AHS) said in a statement on Oct. 11 that it had issued the “Use of Masks to Prevent Transmission of COVID-19 Directive,” to come immediately into effect, which will allow zone executive leadership and site leadership of acute care centres to collaboratively decide whether to require masking by all AHS staff, doctors, midwives, students, volunteers, and workers in hospital laboratories.

Zone executive leadership is defined by AHS as the management team consisting of a chief zone officer and a zone medical director, while site leadership is the individual or individuals responsible for a specific facility of operation within AHS.

AHS said that if the “enhanced measures” are put into effect, masking will also be required for patients, visitors, family members, and designated support persons in emergency departments in acute care facilities and hospitals. The directive said masking will be required if a masking poster is posted on patient doors. Masking under the newly implemented Alberta directive will also be required for workers, family, support persons, and visitors when the Medical Officer of Health recommends masks during an outbreak, by staff with COVID-19 symptoms or a positive COVID test, or in contact with a “severely immunocompromised individual.”

AHS also said that if patients, family, support persons, or visitors “decline to mask, the health care team should work collaboratively with them to find the most appropriate and safest solution for the situation.”

“No patient shall be denied services,” stated AHS, which did not respond to requests for comment by press time. Hospitals in Alberta have only been mask-free for approximately four months—it was June 19 when AHS announced it would drop masking requirements in all AHS facilities.

‘No Discernible Difference’

In April, a study was presented at a conference in Copenhagen, Denmark, by the European Society of Clinical Microbiology and Infectious Diseases, stating that requirements to wear surgical masks in a large London Hospital during the first 10 months of the Omicron variant of COVID-19—from December 2021 to September 2022—“made no discernible difference to reducing hospital-acquired SARS-CoV-2 infections.”

“Our study found no evidence that mandatory masking of staff impacts the rate of hospital SARS-CoV-2 infection with the Omicron variant,” said lead author Ben Patterson from St George’s University Hospitals NHS Foundation Trust, London.

“Many hospitals have retained masking at significant financial and environment cost and despite the substantial barrier to communication,” added senior study author Aodhan Breathnach.