Last week’s announcement that the Nova Scotia Health Authority and IWK Health Centre were lifting the masking requirement in most areas of their facilities came as a grave disappointment to those who have been working to reduce the ongoing risks of airborne pathogens, including SARS CoV-2, the coronavirus that causes COVID-19, in public spaces.
It’s hard to understand what prompted the change, given that doing away with mask requirements in other jurisdictions has led to much more disease transmission in healthcare facilities but, on closer examination, it seems yet another example of failed leadership on the part of our political and health care leaders.
The memo issued to NSHA staff states that the new directive “aligns with Public Health guidance,” and that the “safety of [NSHA’s] patients and people remains [its] priority”.
I have questions.
What Public Health guidance? On its website, Nova Scotia Public Health has this to say about protecting people at higher risk:
Some people, like those who are older or immunocompromised, are at higher risk of severe disease. If you’re around vulnerable people (or if you’re at higher risk) you should maintain healthy habits like gathering safely, wearing a mask and COVID-19 rapid testing. [Emphasis added.]
The last time I checked, there were lots of older, immunocompromised and otherwise vulnerable people in hospitals. How exactly does dropping universal masking requirements in hospitals align with Public Health’s guidelines for protecting them?
The second statement – that the safety of patients and staff remains the priority – is equally questionable.
If safety were truly the priority, why would hospitals drop the one precautionary measure that’s inexpensive, easy to implement, and proven to reduce infection rates? When something is a priority, we choose that thing over other less important things. In this case, it appears health leaders have prioritised comfort over the safety of patients and staff.
I visited local hospitals twice last week.
My first visit was to South Shore Regional Hospital early Wednesday morning for a post-surgery physiotherapy appointment. I called ahead to check that my therapist would mask since I planned to do so, and was initially advised I would have to ask her to mask if I wished her to do so.
I reminded the staff person I spoke with that the memorandum said staff were required to don a mask if a patient arrived wearing one, and she admitted she hadn’t yet read the memorandum in detail, and doubted anyone else had either. Once she did read it (at my request), I was assured my therapist would mask, and indeed that’s what happened.
Unfortunately, my therapy session was held in a large, open room, with another patient and physio working just a few feet away, a fabric curtain dividing the space between us.
Apparently, while the new policy ensures that the physio working directly with me wears a mask, it doesn’t require other physios working a few feet away to do so. Given that, it seems the new policy fails to protect elderly and immunocompromised patients wherever ambulatory treatment involves sharing space with other patients.
My second visit was to the Fisherman’s Memorial Hospital in Lunenburg on Thursday to visit an elderly relative being temporarily housed in the Veteran’s Unit.
I was pleased to be met at the entrance by staff enquiring as to whether I had symptoms of COVID-19. I was less pleased when the staff person, eyeing my N95 mask, advised that masks were no longer required so I should not get upset if I saw unmasked people in the course of my visit.
Two aspects of the interaction troubled me. First, allowing unmasked visitors to wander about the Veteran’s Unit will certainly put vulnerable and elderly residents at greater risk of being infected with airborne pathogens than if visitors were required to mask, once again undermining any claim that the new policy protects those who are most vulnerable.
Second, I was irritated at the suggestion that my attitude or behaviour towards unmasked staff and visitors was something that needed to be managed simply because I had chosen to wear a mask myself. To my mind, that time and energy would have been better spent encouraging those entering the hospital to mask even when they aren’t required to do so.
Based on these interactions, it’s clear to me that the recent changes in policy are about something other than patient care and safety.
In a friendly conversation with a health care worker who herself continues to mask, I asked what she thought motivated the shift in policy. She confided that she thought it was likely driven by people, including many health care workers, who prefer to believe the pandemic is over and don’t like to be reminded that it isn’t.
I get it. We all want the pandemic to be over. What I don’t understand is why leaders in our health care system are prioritising the “feelings” of those who prefer not to think about COVID-19 over the physical safety of patients, staff and visitors.
In Scotland, doctors and other health care workers are calling for the return of masks to protect staff and patients. An estimated 4% of health care workers there have been sidelined by Long COVID, placing even greater pressure on a system that’s already in crisis.
Similar stories of hospital-acquired infection have unfolded in other countries. None of us should want that for Nova Scotia, and yet our health leaders appear poised to move further in that direction.
By contrast, the government of New Zealand still publishes helpful information regarding the value of masks in preventing the transmission of airborne viruses and urges people to consider masking to reduce risks to themselves and others, under the tagline “Unite against Covid-19.”
The comparison couldn’t be starker. While Nova Scotia’s political and health leaders prioritize the “rights” (never the responsibilities) of those who choose to disregard the health and safety of others — even in health care settings where they insist health and safety is the priority — New Zealand officials call on the public to work together to care for one another.
I find myself wondering how we went from “Nova Scotia Strong” — working together to flatten the curve under the strong leadership of our former premier and health officials — to “everyone for themselves” under a premier who seems mostly uninterested in demonstrating leadership in any form. An even better question may be “why?”.
As the impacts of the climate crisis become more obvious by the day, I can’t help thinking the shift wasn’t accidental.
Nova Scotia’s initial response to the pandemic proved we were capable of working together to mitigate an enormous danger, with particular emphasis on protecting many (though certainly not all) of our most vulnerable residents for nearly two years.
Certainly, we were more successful than places like the United Kingdom, Sweden, BC, Alberta, and Ontario, where governments let the virus rip through their populations and a much larger percentage of people fell ill and died. Articles about our successes were published internationally, and thousands were motivated to immigrate here because of them.
From the outset of the pandemic, it was clear our successful response was as much a function of strong and compassionate leadership as a function of history and culture. While most Nova Scotians genuinely care about their neighbours and communities and are happy to step up to help, we still needed sound leadership to organize and guide our efforts in order to effectively address the many new and profound challenges posed by the pandemic.
But, of course, there were those who perceived those many months of strong leadership and social solidarity as threatening. If Nova Scotians could work together successfully to deal with a pandemic, what else might we achieve?
Perhaps we could wrest control of our forests and other natural resources from destructive corporations bent on pillaging them, build new green infrastructure to satisfy our energy needs, demand fairer treatment of employees, develop and implement responsible by-laws and regulations regarding the development of our coastlines, incorporate recognition of housing as a human right into municipal and provincial planning rules, and provide real support to those who are struggling.
The fact is, we face enormous environmental, social and economic challenges in this province. Since the so-called “free market” has created and/or exacerbated many of them, it’s ludicrous to believe that same market will magically fix them.
Our only real hope lies in re-learning how to work together to build communities that function well for everyone, not just the rich and powerful.
The Houston government doesn’t appear interested in helping us do that. Its actions to date suggest it’s mostly focused on serving the interests of its friends rather than supporting average Nova Scotians.
Further, its performance in relation to the pandemic — not to mention affordable housing, poverty, the climate crisis, and a series of terrifying natural disasters — suggest its leadership failures are a feature, not a bug.
In too many instances, the government has actively avoided exercising any real leadership, leaving individuals and communities to muddle through the best way they know how — perhaps to demonstrate to an already cynical and exhausted electorate that government can’t work, and provide justification for further privatizing public services, minimizing regulation, and maximizing incomes of its friends and allies.
Whatever the government’s true motivations, it’s time Nova Scotians demanded better.
The pandemic isn’t over, and allowing people to pretend it is won’t end well. Heading into the fall and winter months when COVID-19 is bound to begin circulating at higher levels once again, we need strong, evidence-based, compassionate leadership from our politicians and health system leaders to prevent the worst from happening.
They should start by developing more effective campaigns to educate the public on the very real risks associated with repeated COVID-19 infections and the value of masking, testing and vaccination for reducing those risks.
They should also take immediate steps to improve indoor air quality in public spaces, provide guaranteed sick days to, and implement sensible infection control measures in long term care facilities, hospitals, and schools.
Infection rates will only remain at safer levels if Nova Scotians follow New Zealand’s lead and “unite against Covid-19” in the coming months, and strong and effective leadership from Premier Houston and his government is needed to make that happen.