LETTER: Masks, symptom recognition can’t be forgotten

Almost as soon as the mask mandate was lifted at the end of March we can see, even without public health statistics, the numbers of community COVID infections has been rising.

Before that date I knew very few people who had contracted COVID.

Now it seems more than half of my close contacts have tested positive. Ontario’s most recent daily count of positive tests was 4,200 but wastewater estimates have place the number of new daily cases at 100,000 to 120,000.

Hospitalizations are increasing dramatically. Emergency rooms are seeing increasing cases of COVID like illness and hospital admission rates and ICU occupancy are increasing sharply. Hospitals are reporting increased staff absences due to COVID. Hospital staff have barely had a break and now they are inundated with the new wave. Fatigue and burnout among staff decrease immune response and increase the risk of COVID infection. Before the pandemic Ontario’s acute bed occupancy ran at about 92 per cent. Ontario has the lowest ICU bed availability of any OECD country with 1.7 beds/100,000 population. Just as hospitals are beginning to start catching up on delayed surgeries and tests, they are again delaying them because the need for acute care and ICU beds.

Until this week the Ontario government said there was no need for reinstating a mask mandate. Only 10 days ago Mr. Ford called the increase in numbers a “blip” and this week he said “we’ve got this” when referring to the provinces capability of handling the increased rates of illness and hospitalization in the province. This week the government is “considering” reinstatement and recommending we start wearing masks for indoor gatherings. These messages are frustrating because they contribute to increased confusion and misinformation about how we should behave in the midst of this surge.

In general there seems to be a public perception this Omicron variant (B2) is less severe so we really don’t need to worry about getting the virus. This may be true for most younger and healthy people but it’s still potentially fatal for people over 60 and those of us who are immunologically vulnerable. Younger and healthy people may not get as sick with this virus but we are still very likely to infect others if we get it and this results in increased serious illness, hospitalization and long term effect of COVID. It has become difficult, if not impossible to assess our risk of catching COVID. We don’t do enough tests to assess the prevalence. However it’s suspected that the numbers are higher than present estimates. It is likely that COVID related mortality is higher than hospital admission numbers indicate.

We have learned wearing masks, hand washing and social distancing and getting vaccinated are well known to decrease serious illness and mortality rates. Yet we don’t seem to be using this learning in this present surge. If we don’t do these things we are all still responsible for the illness, suffering and death COVID brings. When the pandemic began, our mantra was “we are all in this together”.

This appears to be a forgotten sentiment. Dr. Tam, our national public health officer said today we should all be wearing masks and getting the vaccine. The numbers of people who have had their booster is running at 50-60 per cent.

This week the Canadian Vaccine Advisory Committee strongly recommended everyone should be getting a booster. There are a number of other viruses in the community which cause symptoms similar to COVID so admittedly it can be hard which virus is causing symptoms. We have access to rapid tests and we should be using them. It is recommended we don’t rely on a single test if we get symptoms. This variant is somewhat less easy to test with the rapid test so we should be testing at least twice if we have symptoms or close contacts before being around others. Remember before the pandemic we were being advised to decrease contacts and not go into work if we had viral symptoms.

It is recommended when using the rapid test we swab the throat first and then the nostrils because this variant seems to congregate in the throat more than previous variants. It’s important now for us to re-emphasize the need to care for each other as a community.

So please wear your mask, wash your hands, maintain social distancing and get your vaccine. You will be protecting your neighbours and our health care workers, improving access to care and saving lives.

Dr. Joe Burley