October 19, 2020
Re: Mandatory Mask Policy for Vancouver Civic Facilities
Dear Vancouver City Council:
We have recently seen more Canadian cities appropriately introduce mask mandates in civic facilities. We would like to express our support for Sarah Kirby-Yung’s motion B2 for mandating masks in Vancouver Civic Facilities (1).
We cannot afford another “lockdown” which leads to devastating effects on individuals and society. We need to act now and focus on improving our use of all basic interventions to reduce both transmission, and severity of illness from COVID-19.
We recognize that non-medical masks, cloth face coverings, and surgical/medical masks are not 100% effective in protecting against respiratory viruses including SARS-CoV-2. However, the emerging data strongly support the effectiveness of masks for protecting ourselves and others from developing COVID-19 (2,3).
The evidence for mask use in preventing transmission of SARS-CoV-2 (2,3), and reducing severity of illness from COVID-19 (4) is growing. It is important to understand that the effect of masks on this pandemic is a population-level outcome where individual-level interventions have an aggregate effect on the community (5,6). Currently, the evidence supports mask mandates and the policy approach is consistent with the precautionary principle (7). Furthermore, the emerging evidence for aerosol transmission of SARS-CoV-2, emphasizes the importance of source control as one of the several interventions required in reducing transmission risk (8, 9,10). This is especially important as we approach the winter months when more time is spent indoors in public spaces.
We understand that there are perceived harms associated with mandatory mask policies. While we are aware of some potential challenges with mandates, the masking policy can be delivered effectively using harm reduction approaches to ensure high adherence. We need to give people the information to keep themselves and others safe, educate the public, and provide the tools for them to act based on scientific evidence.
We should not let perfection be the enemy of the good. We support your proposal for temporary mask mandates in Vancouver civic facilities. This can be implemented with strengthened messaging that mandatory masking be done in conjunction with other important measures including physical distancing, staying at home when sick, attention to hand hygiene, and seeking diagnostic testing and medical care when indicated.
The use of masks in public is an important and readily modifiable public health measure. We need to strengthen our approaches to prevention to reduce risk of facing another significant closure of facilities in Vancouver. We hope that other cities with ongoing community transmission will follow mask mandates which have already been passed in Delta and Richmond.
References:
1. https://council.vancouver.ca/20201020/documents/b2.pdf
2. Howard, J., Huang, A., Li, Z. et al. Face Masks Against COVID-19: An Evidence Review. Preprints 2020, 2020040203
https://doi.org/10.20944/preprints202004.0203.v3
3. Peeples, L. Face masks: what the data say. Nature 586, 186-189 (2020)
https://doi.org/10.1038/d41586-020-02801-8
4. Ghandi, M., and Rutherford, G. Facial masking for COVID-19 – Potential for “variolation” as we await a vaccine. New England Journal of Medicine. September 8, 2020
https://doi.org/1056/NEJMp2026913
5. Lyu, W. and Wehby, G. Community use of face masks and COVID-19 evidence from a natural experiment of state mandates in the US. Health Affairs. June 16, 2020.
https://doi.org/10.1377/hlthaff.2020.00818
6. Leffler, T., Ing, E., Lykins, J., et al. Association of country-wide coronavirus mortality with demographics, testing, lockdowns, and public wearing of masks. Update August 4, 2020.
https://doi.org/10.1101/2020.05.22.20109231
7. World Commission on the Ethics of Scientific Knowledge and Technology. UNESCO 2005.
https://www.eubios.info/UNESCO/precprin.pdf
8. Asadi, S., Cappa, C.D., Barreda, S. et al. Efficacy of masks and face coverings in controlling outward aerosol particle emission from expiratory activities. Sci Rep 10, 1 5665 (2020).
https://doi.org/10.1038/s41598-020-72798-7
9. Seminara, G., Carli, B., Forni, G. Biological fluid dynamics of airborne COVID-19 infection. Rend Lincei Sci Fis Nat. 2020 Aug 16 : 1–33.
http://doi.org/10.1007/s12210-020-00938-2
10. Stadnytskyi, V., Bax, C, Bax, A. The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmission. PNAS. June 2, 2020. https://doi.org/10.1073/pnas.2006874117
Disclaimer: The views of the individual participants are not intended to represent the participants’ affiliated organizations.
Signed by the following BC Physicians, Dentists, Scientists, Academia, Healthcare Providers etc.:
Dr. Val Montessori MD FRCPC Head, Division of Infectious Diseases St. Paul’s Hospital | Dr. Poupak Rahmani Clinical Assistant Professor General Internal Medicine Co-Director of Thrombosis Clinic St. Paul’s Hospital | Dr. Dan Kalla MD, CCFP(EM) Department head emergency medicine St. Paul’s Hospital Clinical associate professor, UBC |
Dr. Ted Steiner MD, FRCPC Division Head, Infectious Diseases, UBC | Dr. Jake Onrot MD FRCPC Clinical Professor of Medicine University of British Columbia Staff Physician, St. Paul’s Hospital | Dr. Nick Graham MD, CCFP Lead Physician Department of Family Medicine Mount Saint Joseph Hospital |
Dr Patrick Wong MD FRCPC Clinical Assistant Professor, UBC Infectious Diseases Physician, SMH and JPOCSC | Dr. Carl J. Brown MD MSc FACS FRCSC Provincial Lead, Surgical Oncology, BC Cancer Agency, Section of Colorectal Surgery Clinical Professor of Surgery University of British Columbia | Dr. Jesse Greiner MD FRCPC Clinical Assistant Professor Department of Medicine, UBC Staff Physician and Medical Director, Post-COVID-19 Recovery Clinic St. Paul’s Hospital |
Dr. Christopher Ryerson MD FRCPC Head, Division of Respiratory Medicine, Providence Health Care Associate Professor, Department of Medicine, University of British Columbia | Dr. Gil Kimel MD, FRCPC Clinical Associate Professor of Medicine Dept. of Medicine Head Div of Palliative Care | Del Dorscheid MD, PhD, FRCPC, FACP, ATSF Associate Professor of Medicine Department of Medicine, UBC Divisions of Critical Care and Respiratory Medicine, St Paul’s Hospital Vancouver, BC |
Dr. Stephanie Tsang MD FRCPC Clinical Instructor, UBC Respirology and Internal Medicine, RMH | Dr. Moira Stillwell MD FRCPC Radiologist and Nuclear Medicine St. Paul’s Hospital | Dr. Peter Phillips MD FRCPC Clinical Professor of Medicine, UBC Infectious Diseases Physician |
Dr. Shazia Masud MD FRCPC Clinical Assistant Professor, Department of Pathology and Laboratory Medicine, UBC | Dr. David Wilkie MD FRCSC Clinical Professor, UBC Division of Gynaecologic Sciences | Dr. Victor Leung MD FRCPC Clinical Associate Professor, UBC Infectious Diseases Physician and Medical Microbiologist |
Dr Robert M. Schertzer MD, MEd, FRCSC Clinical Associate Professor UBC Dept of Ophthalmology & Visual Sciences | Dr. John D.S. Reid MD FRCSC FACS Clinical Professor, UBC Department of Surgery | Dr. Anna Wolak MBBS, MCFP Department of Family Practice University of British Columbia |
Dr Wendy Wong MD FRCPC UBC Department of Rheumatology SMH, FHA | Dr. Harman Mangat DMD Dentist, North Vancouver, BC Private Practice | Dr. Mercedeh Kiaii MD FRCPC Clinical Assistant Professor, UBC Division of Nephrology |
Dr. Myriam Farah MD FRCPC Clinical Assistant Professor, UBC Division of Nephrology | Dr. Beverly Jung MD FRCPC Clinical Assistant Professor, UBC Division of Nephrology | Dr. Xi Lisa Li MD FRCPC Clinical Instructor, UBC Department of Anesthesia |
Dr. Trina Montemurro MD FRCPC Clinical Assistant Professor,UBC Dept of Anesthesiology | Dr Kelvin Chan MD CCFP Hospital Medicine, Surrey Memorial Hospital | Dr Katherine Seligman MD D.ABA Clinical Assistant Professor,UBC Dept of Anesthesiology |
Dr. Ryan Latimer M.B.B.S., M. Sc Department of Anesthesiology St. Paul’s Hospital | Dr Anne-Marie Madden MD FRCPC Department of Anesthesiology St Paul’s Hospital | Dr. Alec Cheng DDS, MS, FRCDC Private Practice |
Keara Maguire RRT, CCAA Anesthesia Assistant St Paul’s Hospital | Dr. Raja Rajamohan MD FRCA FRCPC Department of Anesthesiology St. Paul’s Hospital | Dr. Pawel Martinka MD FRCPC Department of Anesthesiology Royal Columbian Hospital |
Dr. Su-Yin MacDonell MD FRCPC Department of Anesthesiology St Paul’s Hospital | Dr. Christopher Prabhakar MD FRCPC Department of Anesthesiology St Paul’s Hospital | Dr. Clinton Wong MD FRCPC MCFP (Hon.) Department of Anesthesiology, St. Paul’s Hospital |
Dr. Miguel Imperial MD MHSc FRCPC Medical Microbiologist Clinical Assistant Professor Dept of Pathology and Lab Medicine, UBC | Dr. Sadiq Abdulla MD, FRCPC Clinical Assistant Professor, UBC Department of Anesthesiology BC Women’s Hospital | Dr. Cyrus McEachern MD FRCP Department of Anesthesiology Vancouver General Hospital |
Dr. Ioana Dumitru MD, FRCPC Department of Anesthesia St Paul’s Hospital | Dr. Don Young MD, FRCPC Dept of Anesthesiology & Perioperative Care Vancouver General Hospital | Claire Wong RRT, CCAA Anesthesia Assistant St. Paul’s Hospital |
Dr. Hamed Umedaly MD FRCPC Dept of Anesthesiology & Perioperative Care Vancouver Acute Clinical Professor, Faculty of Medicine UBC | Dr Simone Schülein MD, FCA, FRCPC Dept of Anesthesia Royal Columbian Hospital | Dr Randy Hewgill MD FRCPC Department of Anesthesiology Clinical Assistant Professor, UBC Lions Gate Hospital |
Dr. Jason Wilson PhD MD FRCPC Dept of Anesthesiology & Perioperative Care, Vancouver Acute (VGH/UBCH) | Dr. Cynthia Henderson MD FRCPC Dept of Anesthesiology & Perioperative Care Vancouver Acute | Dr. Kathryn Dawson MBChB FANZCA FRCPC Dept of Anesthesiology & Perioperative Care Vancouver Acute |
Dr. Anton Chau MD FRCPC MMSc Clinical Assistant Professor Department of Anesthesia BC Women’s & St. Paul’s Hospitals | Dr. John McAlpine MD, FRCP Department of Anesthesiology Clinical Assistant Professor Lions Gate Hospital | Dr Tracey Morris MD, CCFP Clinical Instructor,UBC Department of Family and Community Medicine, St. Paul’s Hospital |
Dr. Jennifer Berezowskyj MD FRCPC Department of Anesthesiology St. Paul’s Hospital | Dr. Cynthia Yarnold MD FRCPC St Paul’s Hospital Department of Anesthesiology | Dr. Shannon Lockhart MD FRCPC, Anesthesiology BC Women’s Hospital Providence Health Care |
Dr Juliet Atherstone MD, FRCPC Dept of Anesthesiology & Perioperative Care Vancouver General Hospital | Dr. Marion MacKay-Dunn MD FRCPC Clinical Instructor, UBC Division of Geriatric Medicine Vancouver General Hospital | Dr. Evan Shao MD FRCPC Dept of Anesthesiology & Perioperative Care Vancouver Acute (VGH/UBCH) |
Dr. Rana Hamidizadeh MD, FRCPC Department of Anesthesiology and Perioperative Care, Vancouver Acute (VGH/UBCH) | Dr Tim Jen MD FRCPC Clinical instructor, UBC St. Paul’s Hospital | Dr Randall Rae BSC (Hons), MD FRCPC Dept of Anesthesiology MSJ/SPH Vancouver |
Dr. Benjamin Mack MD FRCPC Medical Microbiologist Clinical Instructor, UBC Department of Pathology and Laboratory Medicine, Fraser Health | Dr. Stephan Schwarz MD, PhD, FRCPC Professor & Dr. Jean Templeton Hugill Chair in Anesthesia Department of Anesthesiology, Pharmacology & Therapeutics, UBC Incoming Editor-in-Chief, Canadian Journal of Anesthesia | Dr. Jil Dickie-Clark MB. ChB. FRCPC Anesthesiologist, Retired, West Vancouver. |
Dr. Mark Vu MD FRCPC Anesthesiologist, Island Health Trauma Services Island Health | Dr. Jean Chuo MD, FRCSC Clinical Assistant Professor Department of Ophthalmology, UBC | Dr. Debbie Rosenbaum MD, FRCPC Clinical Associate Professor of Medicine General Internal Medicine, Hypertension and Eating Disorders |
Dr. Clara Wong MD FRCPC Anesthesiologist | Dr. Gregory Deans MD, MHSc, FRCPC Clinical Assistant Professor, UBC Infectious Diseases Physician, SMH/JPOCSC | Dr. Neasa Coll MD CCFP Department of Family Medicine Providence Health Care |
Dr. Michelle Lee DMD MSD FRCDC Periodontist, Vancouver, BC Private practice | Dr. Shachar Ben-Zeev MBBCh, FCA(SA), FRCPC Staff Anesthesiologist, LGH | Dr Tracy Scott MD FRCSC Clinical Associate Professor, UBC Department of Surgery |
Dr. Tina Lai MD CCFP Department of Family and Community Medicine, UBC | Dr. Martin Weirich MD, FRCP(C) Department of Anesthesiology Penticton Regional Hospital | Dr. Allison Ye MD MPH FRCPC Radiation Oncology, BC Cancer Clinical Instructor, UBC |
Dr Steven Lee MD, FRCPC Dept of Anesthesiology & Perioperative Care Vancouver General Hospital | Dr. Fred Clark MD, FRCPC Anesthesiologist, Peace Arch Hospital | Dr. Roop Randhawa MD FRCPC Anesthesiologist Providence Health Care |
Dr. Ari Giligson MD FRCSC Clinical Professor of Ophthalmology, UBC | Dr. Shelley Tweedle MD, FRCPC Anesthesiologist Royal Columbian Hospital | Dr. Matthew Erskine MDCM, FRCPC Emergency Physician |
Dr. Ashley Ko MD FRCSC Dept of Ophthalmology and Visual Sciences University of British Columbia | Dr. Christa Dakin MD FRCPSC Department of Emergency Medicine Vancouver General Hospital | Dr. Christine Graf MD FRCPC Department of Anesthesiology Surrey Memorial Hospital |
Dr. Jing Wang MD, FRCPC Anesthesiologist Surrey Memorial Hospital | Dr. Laurenna Peters MD FRCPC Clinical Instructor, UBC Infectious Diseases Physician Burnaby Hospital | Dr Jillian Lusina MD CCFP Family Physician, Vancouver |
Dr. Bobby Lee MD FRCPC Clinical Associate Professor, UBC Department of Anesthesiology St. Paul’s Hospital | Dr. Clement Ho MD FRCPC Radiation Oncologist | Dr. Alana Flexman MD FRCPC UBC Clinical Associate Professor Department of Anesthesiology, Pharmacology and Therapeutics |
Dr. Kathleen Dalinghaus MD, FRCPC Whitehorse General Hospital | Dr Dayan Huang MD FRCPC Clinical Associate Professor, UBC Emergency Medicine | Dr. Nora Cummins MD FRCPC Internal Medicine Vancouver, BC |
Dr. Jacqueline Trudeau MD PhD FRCPC Department of Anesthesiology and Perioperative Care Vancouver General Hospital | Dr. Michael Copland MD, FRCPC Clinical Associate Professor, UBC Department of Medicine, Division of Nephrology Vancouver General Hospital | Dr. Ken Kaila MD, FRCPC Cardiologist and Critical Care Medicine Physician |
Dr. Victor Tsang MD FRCSC General Surgeon Providence Health Care | Dr. Janice Lynn Wong MD, CCFP, FCFP Family Physician, East Vancouver Medical Coordinator, Brock Fahrni Pavilion | Dr. Kristin Prabhakar MD CCFP Family Physician, Vancouver |
Dr. Olwyn Johnston BMedSci, MBBChBAO, MRCPI Nephrologist Vancouver General Hospital | Dr. Alexander Pitfield MD FRCPC Department of Anesthesiology and Perioperative Care Vancouver Acute | Dr. Stan Marchuk DNP, MN, NP(F), CNeph(c), FAANP Nurse Practitioner, Nephrology Adjunct Professor, UBC St. Paul’s Hospital |
Belinda-Ann Furlan Adjunct Professor, UBC Nurse Practitioner, Cardiology St. Paul’s Hospital. | Dr. Raymond McConville Family Physician Vancouver BC | Dr Zoë Brown MB ChB MD FRCPC Clinical Assistant Professor, UBC Anesthesiology, BCCH |
Dr. Jessica W. Chan MD, CCFP, FCFP Family Physician, Downtown Vancouver Clinical Instructor, UBC Family Medicine | Dr. Alex She MD, CCFP (COE), FCFP Family Physician, Downtown Vancouver Attending Physician, SUCCESS Simon KY Lee Long Term Care | Dr Eleanor Reimer MD, FRCPC Clinical Professor, UBC Pediatric Anesthesiologist BC Children’s Hospital |
Dr. T. Kuan Chuah MD FRCSC Clinical Assistant Professor, UBC General Surgeon Surrey Memorial Hospital | Dr. Paul Sahota MD FRCPC Anesthesia BC Women’s Hospital | Dr. James Kim MD FRCPC Anesthesiology Providence Health Care |
Dr. Jacek Jastrzebski MD, FRCP(C) Vancouver General Hospital Clinical Associate Professor ,UBC | Dr. Nadia Zalunardo MD, SM, FRCP(C) Clinical Associate Professor UBC Division of Nephrology Vancouver General Hospital | DR. Angela Nguan MD, Family physician Copeman Healthcare |
Dr. Sahil Jain MD, CCFP, DABFM, MS(BioEng), MBA Hospitalist, Vancouver Acute & Fraser Health Family Physician, Copeman Healthcare Clinical Instructor, UBC | Connie Game RRT, CCAA Anesthesia Assistant St Paul’s Hospital | Dr. Kara Solmundson MD, MSc, CCFP (SEM), FCFP, CASEM Dip Sport Med UBC Clinical Instructor Family Physician and Sports & Exercise Medicine Physician Copeman Healthcare |
Dr. Asef G. Javan MD Clinical instructor, Family Medicine Dept, UBC | Dave Aulenback RRT, CCAA Anesthesia Assistant St Paul’s Hospital | Steve Pottie RRT, CCAA Anesthesia Assistant St Paul’s Hospital |
Kelly Chauhan RN, Clinical Nurse Leader Perioperative ENT St. Paul’s Hospital | Dr. Kelly Kasteel MD, CCFP-EM, RCH hospital Emergency Medicine | Dr. Arman Abdalkhani MD FRCSC Clinical Instructor of Otolaryngology UBC School of Medicine |
Dr. Muxin (Max) Sun MD, FRCPC Rheumatology | Dr Giorgia Tropini MD MSc Family Practice Resident, UBC | Michelle Bech Nurse Practitioner |
Dr. Elisaibet Joa MD, FRCSC Clinical Professor UBC Department of obstetrics/gynecology | Dr. Thomas Wong MD, CCFP, FCFP Family Physician Clinical Associate Professor, UBC Family Medicine | Karen Sims MN-ACNP, NP(A) Nurse Practitioner Adult Bleeding Disorders Program of BC St. Paul’s Hospital |
Dr. Hsuan Pang DDS Dentist , Vancouver , BC | Dr. Jeff Yoo MD FRCPC ABEM Emergency Medicine Providence Health Care | Cathy Martin RN, Patient Care Manager St. Paul’s Hospital |
Dr Manoj Raval General Surgery St. Paul’s hospital | Dr. Yuan Yuan Chen MD MSc FRCPC Gastroenterology | Dr. Yue Wang MD CCFP Family Physician Clinical Instructor, UBC Family Medicine |
Dr. John A. Duncan MSc MD FRCPC Clinical Associate Professor Nephrology Vancouver General Hospital University of British Columbia | Dr Amélie Pelland Clinical instructor, Department of Anesthesiology, Pharmacology & Therapeutics, UBC St. Paul’s Hospital & Lion’s Gate Hospital | Dr. Rose Hatala MD, MSc, FRCPC Professor Department of Medicine UBC and St. Paul’s Hospital |
Dr Jane Lea Clinical Associate Professor, UBC Dept of Surgery, Otolaryngology-Head & Neck Surgery | Dr Annnabel Mead MBBS FACHAM | Dr. Claire Harris MD, FRCPC, MHA Clinical Assistant Professor UBC Division of Nephrology Vancouver General Hospital |
Dr. Mark Gelfer MD, Department of Family Practice, UBC Copeman Healthcare Centre Vancouver | Dr Alexandra Kisilevsky Clinical Assistant Professor, UBC Dept of Anesthesia Vancouver General Hospital | Dr Eric Shin, MSc MD FRCPC Dept of Anesthesia Lions Gate Hospital |
Dr. Kwang Yang MD CCFP FCFP LM Clinical Associate Professor, UBC Family Medicine President of Canadian Health Awareness Society | Dr. Nadine Hewitt Family Physician – Palliative Care Clinical Instructor, UBC Family Medicine | Dr. Andrew Han DMD FRCDC Periodontist, Vancouver, BC Private practice |
Dr. Susan Kwan MBBS FRCPC Internal Medicine and Respirology Clinical Associate Professor, UBC | Dr. Lik Hang Lee Pathology and Laboratory Medicine Clinical Assistant Professor, UBC | Dr. Youwen Zhou MD, PhD, FRCPC, FAAD Dermatology Professor of Medicine, UBC Vancouver General Hospital and BC Cancer Agency |
Dr. James Heilman MD, CCFP(EM) Emergency Medicine Clinical Associate Professor, UBC Wikipedian | Dr. Mattias Berg MD, CCFP (EM) Emergency Physician St Paul’s Hospital / Surrey Memorial Hospital | Dr. Sean Bristol MD, FRCSC Division Head, Plastic Surgery Clinical Assistant Professor, UBC Providence Health Care |
Dr. Andrea Thamboo MD, BPSc, CCFP Family Medicine | Dr. Tamim Umran MD, FRCSC Orthopaedic Surgery Clinical Associate Professor, UBC | Dr. Norman Hwang MD FRSC Ophthalmologist, Burnaby |
Dr. Monica Beaulieu MD FRCPC Division Head Nephrology, SPH | Dr. Abeed Jamal MD FRCPC Nephrologist | Dr. Susan Chow DMD General Dentist Private Practice, Vancouver, BC |
Dr Hetesh Ranchod MD FRCPC Division of Geriatric Medicine Providence Health Care | Dr. Angela Law MD FRCPC DABD Dermatology | Dr. Alison Lee MD FRCPC Pediatrics, BC Children’s Hospital University of British Columbia |
Dr. Scott Apperley MD FRCPC Division of Respiratory Medicine, Providence Health Care | Dr. Muzumel Birlik MD FRCPC Department of Psychiatry St. Paul’s Hospital | Dr. Lauren Fineman, MBBS, CCFP Family Physician Copeman Healthcare Centre |
Dr. Anush Evans MD, FRCPC Psychiatry, PHC | Dr. Carlos Nunez MD, FRCPC, DABPN Psychiatry, PHC | Dr. Katherine Wrixon MD, FRCPC Psychiatry PHC |
Dr. Nicholas Ainsworth MD, FRCPC Psychiatry, PHC | Dr. Grant Millar MD, FRCPC Psychiatry, PHC | Dr. Simon Bow MD, FRCPC Psychiatry, PHC |
Dr. Karl Torbicki MD, FRCPC Psychiatry, PHC | Dr. Pulkit Singh MBBS, FRCPC Psychiatry, PHC |
Disclaimer: The views of the individual participants are not intended to represent the participants’ affiliated organizations.
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