Ontario will urge indoor masking as ‘three-headed monster’ strains hospital resources

Mandatory masking is not coming back at this point, but Ontario's chief medical officer will appeal Monday for people to mask voluntarily with flu cases surging and pediatric intensive care units under severe strain.

The advice from Dr. Kieran Moore comes with tough weeks ahead" in the health-care system because of the flu, respiratory syncytial virus (RSV) and COVID-19, a senior government source told the Star.

It's the three-headed monster you've heard about," added the source, speaking confidentially Friday to discuss internal deliberations. Our government is working with pediatric hospitals on what we can do to stretch capacity."

CHEO, a children's hospital in Ottawa, opened a second pediatric ICU this week and other children's hospitals have been moving critically ill teens to adult ICUs in other hospitals to free up beds.

It's a recognition of the flu surge," said the source, noting the influenza season has arrived early after being held at bay in the last two pandemic years because of COVID-19 restrictions.

Premier Doug Ford said earlier this week that people should mask up if they feel vulnerable and get their flu and COVID-19 booster shots as soon as they are able. The opposition New Democrats and Greens recommended the government take immediate steps amid the crunch in ICU beds for children but did not call for mask mandates.

The government must take urgent action to address the distress signals coming out of hospitals," said New Democrat health critic France Gelinas (Nickel Belt).

RSV, which can cause breathing problems in children and the elderly, is also at high level and impacting hospitals already stretched thin by staff shortages, while provincial statistics show the number of people in hospital testing positive for COVID-19 is down 4.1 per cent in the last week.

Moore warned of the looming flu situation on Nov. 2, saying the province had a critical two-week window for as many people as possible to get their free flu shots and blunt a surge of infections that could swamp the hospital system.

This year's dominant flu strain is more virulent and it does cause increased hospitalizations as compared to other strains," he said in issuing an urgent call" for Ontarians over six months of age to get their shots. Once the test positivity rate for flu hits five per cent, it is expected to spread aggressively across the province.

Calls for a return to mandatory masking have been increasing in some medical circles, but a recent poll suggested the population is evenly split for and against - raising questions about how well a return to difficult-to-enforce mask mandates would work.

A Forum survey conducted Tuesday for the Star found 53 per cent of respondents strongly or somewhat agree that the province should bring back a mask mandate, and 47 per cent said they disagreed somewhat or strongly.

Fully 28 per cent said they would not follow a masking rule and only 16 per cent said they wear masks, according to the interactive voice response poll of 1,007 randomly selected Ontarians over 18. It is considered accurate within three percentage points, 19 times out of 20.

Rates of masking in indoor public places remain low despite encouragement from health officials for people to wear masks when they feel at risk, particularly in crowded situations. On TTC subway cars, for example, the proportion of passengers wearing masks is typically tiny.

At a meeting of Toronto's public health board earlier this week, the city's associate medical officer Dr. Michael Finkelstein said vaccinations do the most to contain the flu and COVID-19, the Star's David Rider reported.

In Ontario, almost 84 per cent of residents have had two doses of COVID-19 vaccine but only 52.2 per cent have gone on to a third dose - a rate that has risen only two percentage points this fall.

There's no big vaccination campaign to get shots into arms," said Liberal MPP Dr. Adil Shamji (Don Valley East), an emergency room physician who is critical of Moore for not holding more news conferences on the province's health-care situation.

Rob Ferguson is a Toronto-based reporter covering Ontario politics for the Star. Follow him on Twitter: @robferguson1