Mask mandates considered by Hamilton city councillors

A Hamilton city councillor questioned what it will take for the province to mandate masks as McMaster Children's Hospital has been in an increasing crisis for months due to a surge of viral illness.

There seems to be a disconnect," said Coun. Brad Clark. We have this incredible over-capacity issue that seems to be incredibly stressful on our health-care system. Yet at the other end all we're doing is recommending that people wear masks when they're out in the public. I'm trying to figure out what is the threshold?"

City staff had no answer at Monday's board of health meeting about what would trigger the province to implement a mask mandate

The province and the cabinet clearly haven't gotten to the point where they feel making it a requirement rather than something that people make an individual decision," said Dr. Bart Harvey, a Hamilton associate medical officer of health. We're just not there."

Last week, McMaster Children's Hospital hit an unprecedented 154 per cent occupancy. Hospitals are full at 100 per cent occupancy so anything above that requires opening beds not funded by the province and finding a way to staff them.

The intensive care unit was so overcrowded that a four-year-old rescued from an east Mountain house fire Nov. 18 had to go to London for critical care.

The children's hospital has significantly cut back on surgeries that require a hospital stay, its catchment area has been temporarily reduced and it's recommending some kids go to urgent care because its emergency room wait times have shot up to 13 hours at times.

McMaster is short of staff and supplies such as cribs, infusion pumps, children's Tylenol, Advil and common antibiotics.

It left some councillors asking whether the city can take matters into its own hands.

Is the determinant to require a mandate of masking in a said jurisdiction at the feet of the province or is that within the authority of ... medical officers including our own?" asked Coun. Maureen Wilson.

While the city can bring back a masking bylaw - one was in place earlier in the pandemic - it isn't recommended by public health as the viral surge and the crisis in pediatric care is provincewide.

Currently, Ontario's chief medical officer of health, Dr. Kieran Moore, has recommended, but not mandated, masks in indoor public settings.

The notion is we're following the province for their lead," said Harvey. The message is strongly recommended."

The board of health passed a motion Monday to better promote the recommendation but ultimately didn't pursue mandating masks for Hamilton on its own.

We have a role to be public health advocates in addition to councillors," said Coun. Alex Wilson, who specifically pointed to Hamilton-Wentworth District School Board voting Nov. 21 to ask all students and staff to wear masks. What role do we have to hold up that decision, to support that decision?"

Maureen Wilson asked about whether Hamilton's medical officer of health, Dr. Elizabeth Richardson, can issue a mask mandate specifically for the school board. Education Minister Stephen Lecce said Nov. 24 that public health units have the power to implement the measure.

However, Harvey said there needs to be a health hazard that was clear and outstanding."

The provincial minister of education and the ministry of education was quite clear that they didn't want school boards on their own mandating masks," said Harvey.

Some councillors also questioned whether the city should mandate its own staff to wear masks.

If we're telling the public to wear the mask ... and we're not wearing it when we're in the city hall common areas, it's a disconnect," said Clark.

Maureen Wilson asked whether there has been an uptick in staff absences during the viral surge over the last three months.

It does not appear there is an uptick in staff illnesses currently in terms of absenteeism within the workplace," said Angela Burden, the city's general manager of healthy and safe communities.

Regardless, she said earlier in the meeting that mandating staff to wear masks in city facilities would be a potential consideration."

The surge in viral illnesses - particularly flu, respiratory syncytial virus (RSV) and COVID-19 - have increasingly overwhelmed McMaster and pediatric care across the province. McMaster included an appeal to the community to wear masks in its latest update Nov. 18.

Masks are a very impactful means of reducing spread of respiratory viruses," said Dr. Brendan Lew, resident physician at public health.

Harvey says all of Ontario's 34 medical officers of health, including Richardson, have been talking with Moore about what would trigger a provincial mask mandate.

Certainly not a new question and an ongoing question," said Harvey.

Joanna Frketich is a health reporter at The Spectator. jfrketich@thespec.com