Calgary doctor to challenge AHS mask policy change in court

An N95 mask on display at the 3M Canada factory in Brockville, Ontario on Friday, Aug 21, 2020. THE CANADIAN PRESS/Adrian Wyld

A Calgary-based doctor is planning to go to court to prevent Alberta Health Services from dropping its continuous masking policy.

On Thursday, the provincial health authority said continuing masking at AHS facilities, continuing care facilities and contracted sites will not be required after Monday. That includes Alberta Precision Laboratories, Covenant Health, CapitalCare and Carewest sites.

Dr. David Keegan set up a crowdfunding campaign to raise $20,000 to file a court injunction against AHS lifting its facility mask mandate on June 19. That gofundme hit its goal in less than 24 hours.

On Thursday afternoon, Keegan said he’s retained senior legal counsel and the court case will “move ahead” in a tweet at 4:01 p.m.

Keegan said he’s trying to look out for patients, staff and members of the public.

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“Anybody who’s on AHS premises, we need to be able to rely upon the air, to have reasonable things in place to keep it safe,” he told Global News.

“We know that COVID is airborne. It spreads just like cigarette smoke, and if people are not masking anymore, then that’s going to infect or contaminate the air.”

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The concern is especially high for people who are immune-compromised, like infants or cancer patients, for whom a COVID infection puts them at a much higher likelihood of severe outcomes.

AHS said “patients are encouraged to have conversations with their care providers regarding masking, hand hygiene, or other factors that patients feel are important to their care.”

But Keegan said it’s unrealistic to ask someone sick on a stretcher to ask their nurse or doctor to mask up.

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“I don’t know if people really understand the power differential that’s there between health care providers who are well and patients who are sick,” Keegan said. “And I’ve lived that and walked that path.

“You can’t be putting the responsibility for basic measures to protect people with disabilities and chronic disease… on them when a very minor, reasonable, easy-to-do accommodation can be just kept in place.”

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According to the latest AHS infection prevention and control annual report, patients hospitalized with COVID-19 primarily were infected in the community. But at the start of 2022, “there was a sharp rise in the rate of hospital-acquired cases from 2.12 to 14.54 per 10,000 patient-days when compared with Q3: October-December 2021.”

A recent paper from the Canadian Nosocomial Infection Surveillance Program also said that during waves five and six in the first half of 2022, transmission of COVID-19 in hospitals nationwide went up.

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“Despite a reduction in severe outcomes in waves five and six, the burden of COVID-19 on Canadian hospitals was substantial,” the report reads.

That was the same time the highly transmissible Omicron subvariant became dominant in the province and country.

The president of the United Nurses of Alberta expressed concerns about how the AHS policy changes could affect nurses’ health and wellbeing from both COVID-19 and the public.

Heather Smith said the change in policy “does not in any way remove obligations for workers to be safe, to ensure their patients, residents, clients are to be safe and that they must wear appropriate PPE to match the situation.”

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Smith pointed to the latest data release on the pandemic in Alberta that showed 352 people were in hospitals with COVID, across all AHS zones.

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The UNA president was also concerned about the message the mask use policy sends, the “perception that everything’s okay, health care workers don’t need to (wear masks).

“And I also am concerned about backlash that ‘Why are you wearing them? You shouldn’t be wearing them since the mask mandate is gone.’”

UNA has a PPE agreement with AHS, put in place at first in 2020 and amended in 2021. Smith said it was also reaffirmed this week by AHS, who she characterized as being very good at procuring and maintaining adequate PPE supply.

She said Albertans should not hesitate seeking health care as a result of the change in mask policy.

“We have an obligation not just to keep ourselves safe, but to keep members of the public safe,” Smith said. “And I would suggest that that includes masking.”

AHS said the decision to remove the masking requirement in health settings was based on several factors, including Alberta’s declining number of COVID-19 cases, wastewater data and hospital admission rates for respiratory illnesses.

The health-care provider said it consulted with stakeholders such as patients, families, advisory councils, clinicians and frontline managers in arriving at its decision.

AHS said people are welcome to wear masks if they choose, but will not be required to do so.

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AHS added it will closely monitor COVID-19 data to see if there is any need for changes to the new policy.

Keegan announced on Twitter Friday he has retained legal counsel and the court case will be moving ahead.

“I beg you to keep the mask mandate in place until a full disability-impact review can be done and accommodations implemented,” he wrote directly to AHS in the tweet.

He’s also skeptical of any assurances of all AHS HVAC systems being able to provide enough fresh air.

“The trick is we don’t know that until you test things in real circumstances,” the family doctor said.

Keegan said he measured the CO2 levels – a proxy for how fresh the air in a room is – during a 10-minute patient visit. In that time, the levels doubled from 600 to 1,200 parts per million, he said, apparently showing a lack of fresh air exchange.

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“Until we know that every place is safe and has great air quality… then we can’t just assume they are,” he said.

“Our duty is to provide a safe space for patients to seek care and to provide a safe space for our staff, physicians, contractors, learners, anybody else who might be in those places.”

Provinces like B.C., Saskatchewan and Manitoba have dropped their mandatory masking in health-care settings.

California made a similar move in April, but a Bay Area hospital had to reinstate its masking policy after a COVID-19 outbreak.

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