Masks: It's Just Common Sense!

Why is this still such a hardship?  When I go to the doctor (frequently), I don't want to first get sick in the overcrowded waiting room full of coughing, inconsiderate people!

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From The Toronto Star 9/18/24:

Opinion | Yes, we do need to bring back masks in medical settings 

By Iris Gorfinkel

Iris Gorfinkel is a family physician and clinical researcher in Toronto.

"Imagine you — or a vulnerable loved one — needs urgent medical care. If you’re lucky enough to have a family doctor, you head to their clinic. Like most, yours is housed in a building with low ceilings and little air filtration. You enter the waiting room where several patients sit shoulder-to-shoulder waiting.

"You have no choice but to sit alongside people sneezing, coughing and blowing their noses. Few if any, patients and health care workers are wearing a mask. While grateful for the hand sanitizer on offer, you begin to wonder if that will be enough to prevent your picking up an infection you hadn’t anticipated.

"It’s an all-too-familiar scenario. 

"The most common reason people see a GP is to assess an upper respiratory infection. They most frequently start after inhaling infected droplets or aerosols or from having touched an infected surface.

"An N95 or KN95 mask helps block transmission, whether it’s SARS CoV-2, influenza or a common cold virus like RSV. They’re not perfect, but they reduce viral transmission by 30 per cent. Yet in spite of their benefits, most health-care workers and patients no longer routinely mask, even during assessments requiring close contact with an increased risk of disease spread.

"Many of my most vulnerable patients are keenly aware of the potential health risks this presents. Yet most say nothing and would never dream of asking their clinician to wear a mask. 

"There are sound reasons for this.

"The first has to do with long wait times. A visit to the specialist is a precious commodity that cannot be risked. Several months pass before patients are seen, raising the urgency for care. 

"This is only the first of many factors to come that can silence even the most assertive of patients.

"Many don’t want to appear disrespectful by asking their health-care workers to mask. They fear being labelled “difficult” or “demanding” and become distressed at the prospect of questioning their clinician’s judgment, even if it should put them in harm’s way.

"Patients become more passive when burdened with the anxiety, dread and fatigue that accompanies illness. Deep-seated fears are ignited that further increase the dependency on health-care workers and squelch any remaining likelihood of their requesting that their clinicians mask.

"Masking policies in health-care facilities don’t have to be all-or-none edicts. Patients who are hard of hearing often benefit when they’re able to read lips. Both patients and health care workers sometimes struggle because of anxiety. Young children may not co-operate, and there are people who simply cannot — or will not — tolerate them.

"These are special cases though, not the rule. Smart policies in health care facilities need to have latitude for such exceptions. But tightening the policy on masking also recognizes that SARS CoV-2 is a stealthy virus.

"One-in-three people infected have no symptoms yet can still transmit COVID-19. It can result in serious physical and mental harms that last 3 years and possibly longer following the initial infection. Since the start of the pandemic to the end of 2023, long COVID has affected 6 per cent of adults and 1 per cent of children.

"Vaccines don’t lower viral transmission. Where they shine is at lowering the severity of cases and keeping Ontario’s hospitals from being overwhelmed, but they’re poor at reducing mild cases. It’s short-sighted to gamble on the hope that future vaccines will prove any different.

"What’s more certain is that the lack of masking in health care facilities will needlessly spread disease. As in past autumns, cooler weather will bring a spike in flu and cold viruses while kids in Ontario have settled back into crowded classrooms and COVID-19 threatens to reach a 3-year peak.   

"The duty of care doesn’t land on patients. It’s the clinicians’ job to ensure patients don’t pick up an unintended infection. Patients have a right to safety in health care facilities. In the meantime, I can only advise my concerned patients to wear an N95 or KN-95 when in health care facilities and suggest they not be shy when asking clinicians to do the same."