This is the first time I have ever written a letter to my MLA. As a constituent who is a healthcare professional, a parent, and a recent cancer survivor, I feel compelled to reach out after the removal of mask mandates in BC hospitals, and I ask you, as my elected representative, to hear and, I hope, understand how serious this issue is, and how urgently change is needed in our provincial government’s pandemic management strategy.
The lesson of the first two years of the pandemic should have been: those of us who work in healthcare ought to have been wearing masks routinely, even before Covid. Health care providers can and did adapt to wearing masks at work all the time rather than just in the OR or when entering particular patients’ rooms. It is not an undue hardship. I am not old enough to have been working age back in the 80s, but I am aware that there was a time when we didn’t routinely wear gloves. We learned better, and we did better. Quite apart from Covid, masking in healthcare facilities could have eliminated hospital-acquired infections from seasonal influenza and many other respiratory pathogens.
Evidence has been building since early in 2020 that SARS-CoV-2 spreads largely through airborne transmission— tiny aerosolized particles produced by breathing and talking that spread and linger in the air like smoke. Cloth and surgical masks are at best minimally effective in reducing transmission of an airborne pathogen. After the Omicron variant of SARS-CoV-2 became widespread in Canada in late 2021, we should have been upgrading the standard of masking in healthcare settings (those of us who work in hospitals were always required to have a current N95 fit test on file, because before the pandemic there was no controversy about how to protect against airborne pathogens!) We should have been educating the public on the difference between loose-fitting masks and fit tested N95 respirators (there was no longer any supply shortage by the time Omicron emerged), and we should have been urgently upgrading ventilation and air filtration in public indoor spaces including healthcare settings (especially hospital hallways that are often poorly ventilated, and break rooms where nurses and physicians — when they are lucky enough to have time for a break— must remove masks in order to eat and drink during long shifts), as well as community centres and schools. We did not prioritize these measures, and BC saw more deaths from Covid in 2022 than in 2020 and 2021 combined.
When I checked into the hospital for my cancer surgery in February 2022, the only person besides myself who I saw wearing a fit tested N95 was my anesthesiologist. (I am speculating here, but would not be surprised if he’s also the only member of my care team who has never had a Covid infection.) I brought my own HEPA filter to keep by my bedside for my 5-day hospital stay. I knew that as a cancer patient I was at very high risk of severe disease if I caught Covid in the hospital, and I knew that because of the extensive precautions I and my family had been taking, the hospital was where I was at greatest risk of exposure. I had a lot of time to read journal articles while on medical leave from work.
I knew that at least 30% of patients who test positive for Covid while in the hospital were infected in the course of their hospital stay, and I knew that the death rate for hospital acquired Covid is around 10% — not a risk I wanted to take, but this was not exactly an optional surgery. Given the dire outcomes for patients who catch Covid in the hospital, I find it difficult to express the depth of betrayal that I would have felt if masks had not still been universally required in healthcare settings in BC at the time of my surgery.
While I was receiving cancer treatment, my family and I did everything in our power to protect me from a Covid exposure. My teenage children did school from home, my husband had thankfully already been working from home before 2020, we did online shopping and curbside grocery pick-up, and we chose video chats or masked, outdoor visits rather than in-person indoor interactions with friends and extended family. We wore N95 masks if we could not avoid being in an indoor public space, but since even with an N95, masking doesn’t work as well if no one else is doing it, whenever possible, our strategy was to avoid exposures rather than relying on masks for protection. Hospitals and other healthcare settings are not places that medically vulnerable, immunocompromised, and higher-risk patients can choose to avoid. No one should ever come to the hospital for necessary medical care and leave with a new, possibly life ending or disabling infection.
No one should lose a beloved family member or friend because the health care system, which was intended to help them, failed to protect them from a preventable infection.
Our family’s most extreme protective measures were temporary, for the duration of my cancer treatment. My 15 year old is now happily back in in-person classes, though still wearing an N95 mask daily. She considers it a minimal inconvenience to avoid the risks of getting and spreading Covid. Now that I am fully recovered and cancer free, I am back at work. When I walk in the door to the hospital I am wearing an N95 mask that doesn’t come off until I am back in my car. I no longer worry that I might not survive a Covid infection, but I don’t want to gamble with Long Covid, and— most importantly— I am not wearing a mask only for my own protection.
I work in maternity care. I know that my pregnant patients are at higher risk of complications from Covid than the general population, and that their newborns, with immature immune systems, can neither wear masks nor receive a vaccine. We know that for some, even a mild case of Covid results in long term damage. I spent my medical leave reading studies. There is ample evidence that this virus can affect the heart, the brain, the immune system, the kidneys, and the pancreas; can increase rates of preterm labour and stillbirth; can increase risk of heart attacks, strokes, and diabetes; and can cause Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Hospital acquired Covid is preventable, and hospitals and healthcare workers have a duty of care and an ethical obligation to protect our patients.
I was always taught that the principle of “do no harm” is foundational in modern healthcare.
I will continue to wear an N95 respirator at work because I refuse to be the vector through which one of my vulnerable patients is harmed. I never would have imagined when I started my career that this would be a controversial or a minority opinion.
Thanks for reading. Please do whatever you can as my MLA to help our province change course on this misguided decision. We should be improving, (upgrading from surgical masks to N95 or elastomeric respirators) not removing masks in healthcare settings.
Sincerely,
A concerned constituent
