Message shift on airborne transmission of COVID-19 seen as positive — but late – Ottawa Citizen

“In the future, people will look at photos (from the pandemic) and say, ‘What were they thinking?’ The science is clear. The science has been clear for at least a year and a half and I would argue for much longer.”
Twenty-two months into the pandemic, there is something new in the air: a heightened emphasis by the Public Health Agency of Canada that COVID-19 can spread through the air, like second-hand smoke.
As far back as last November, PHAC quietly acknowledged that COVID-19 could be spread through the air and not just through droplets. But it offered little or no advice about what that would mean to the way people and institutions prevent transmission, critics say.
On the frontlines in Ontario and elsewhere, evidence of airborne spread was often ignored, critics say, which meant health workers didn’t always get the level of protection they should have, among other things.
That could begin to change with a message shift from PHAC.
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Clear statements from Chief Public Health Officer of Canada Dr. Theresa Tam and the public health agency in recent days are being welcomed by those who have long called for better action to prevent airborne spread of COVID-19 in Canada.
“Evidence on aerosol spread of the SARSCoV2 virus shows that expelled virus particles can spread over distances and linger in fine aerosols for periods of time, much like second-hand smoke,” Tam wrote last weekend in one of a series of tweets about airborne spread of the virus that advised Canadians to wear snug fitting masks that better protect against airborne transmission and to ventilate, among other things. PHAC, meanwhile, advised that medical masks and respirators, such as N95s, provide better protection against COVID-19 than non-medical masks.
But critics say the information is not new and strong messages and guidance could have prevented hundreds of deaths — including among long-term care residents and health workers — if it had come sooner.
“I think it is a positive development, but it is heartbreakingly late in the game,” said Michael Hurley, president of the Ontario Council of Hospital Unions and regional vice-president of CUPE in Ontario. CUPE and other unions, including the Ontario Nurses’ Association, took the Ontario government to court to get access to N95 masks, which better protect against aerosol transmission.
Among leading critics of the federal and provincial governments’ failure to accept airborne spread of COVID-19 sooner is Mario Possamai, a forensic investigator who played a key role in the Ontario SARS Commission, which examined that outbreak in 2003.
Possamai served as a senior adviser to Mr. Justice Archie Campbell in the SARS Commission. A key lesson of SARS, Possamai said, was the precautionary principle. That would mean COVID-19 should have been treated as airborne from the start until more information was known.
Instead, health officials across Canada continued to insist, well into the pandemic, that it was spread primarily by large droplets. A “cultural of denial” about airborne transmission continues to exist in Ontario, Hurley said.
Good ventilation, not just distancing, and higher quality, fitted masks better protect against aerosol transmission. Possamai recently encountered some of that culture of denial when visiting a Toronto hospital. He was asked to remove his higher quality N95 mask and put on a surgical mask. “Which is nuts.” In the end, they let him put the surgical mask over his respirator.
“In the future, people will look at photos (from the pandemic) and say, ‘What were they thinking?’ The science is clear. The science has been clear for at least a year and a half and I would argue for much longer.”
Possamai wants to see public inquiries into the handling of the pandemic by public health officials, especially the failure to treat the virus as airborne.
N95 masks were frequently unavailable at the beginning of the pandemic, and, even when they were, health-care workers were often pressured into not wearing them. That continues today, Hurley said. He recently spoke with a nurse at a Niagara region hospital who said she was told she didn’t need an N95 mask, even though there was a COVID-19 outbreak in the unit where she worked.
Possamai said it had been frustrating to watch science on the aerosol spread of the virus be ignored during the pandemic.
“I thought Canada would be in very good shape heading into the pandemic because of the SARS experience and I though public health leaders would follow the science.”
Possamai said PHAC seemed to be catching up to the public when it came to the aerosol spread of COVID-19.
“The general public is becoming more aware of this.”
There has been little sign of a heightened focus on airborne transmission from the Ontario government, though. The government says N95 masks must be made available to health workers who determine they are necessary, but still refers to droplet precautions and distancing as the fall-back protections and acknowledges aerosol transmission in certain high-risk circumstances.
David Miller, a Carleton University chemist and toxicologist who was among the scientists who signed a letter to the World Health Organization in 2020, asking it to recognize the potential for airborne spread of COVID-19, said he was “pleasantly surprised” by PHAC’s recent message shift.
“PHAC has started to listen more carefully in the past month or two, for which they deserve credit.”
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