As a citizen who recognizes the importance of preventative public health measures, I urge you to implement universal masking with N95 (or better) respirators. Universal masking with respirators in hospitals will prevent the numerous COVID-19 outbreaks that threaten the health of patients and healthcare workers, and lead to closed hospital emergency rooms due to staff shortages.

It is important to recognize that SARS-CoV-2 is a Level 3 biohazard, and we need to take precautions that are commensurate with the risks. I strongly urge you to consider upgrading the masks used by your organization to N95 (or better) respirators. Without universal masking with respirators, many vulnerable patients will be exposed to an airborne virus that can damage organs throughout the body. People who contract COVID-19 face risks of developing long COVID, cognitive issues, cardiovascular diseases, extreme fatigue, diabetes, an impaired immune system, and many other health issues.

Ontario’s hospitals should be the leaders in preventing the spread of SARS-CoV-2. The health of both the staff and patients is at stake. By upgrading to N95s, FFP3s, elastomeric and PAPRs, hospitals could dramatically reduce nosocomial SARS-CoV-2 infections among staff and patients[1] and help address the projected illness-related increases in staff absences and in SARS-CoV-2 complications.[2] As noted in the Forecast Report “Protecting the Workforce & Corporate Productivity: Preparing employers for the Fall 2023 contagious illness season to anticipate likely workforce disruptions” by biorisk expert Conor Browne (p. 6):

“The majority of adults infected with COVID-19 during this period will be suffering their third SARS-CoV-2 infection. This will significantly elevate risks and rates of LC [Long COVID], since multiple infections is an established risk factor for its development. In general, widespread staff absences combined with personnel working at less than full productivity from increasingly common conditions like brain fog will adversely affect productivity across the board.”

We can learn from Ontario’s experience dealing with SARS-1. It is now recognized that hospitals should have maintained requirements for N95 respirators during the SARS-1 pandemic.[3] This would have helped prevent a subsequent wave of infections.

Healthcare organizations and the Ontario government are accountable for their decisions — you can endanger the health of vulnerable citizens, or take decisive action to protect them using evidence-based public health measures. We believe that everyone has the right to access healthcare safely, without being exposed to a Level 3 biohazard. Making respirators mandatory is a clear path to reducing the risk of SARS-CoV-2 infections and their impacts on those already seeking care for other conditions.

Please take my concerns into account and implement mandatory respirator usage in all areas of your healthcare facilities. Doing so will protect the health and safety of healthcare workers and patients, and also demonstrate your commitment to evidence-based practices and community well-being.

Thank you for your attention to this matter. I look forward to your response.

[1] Globus. “Upgrading to FFP3 face masks in hospitals could save the NHS £360m a year and help slash patient waiting lists” December 15, 2022. https://globusgroup.com/newsroom/upgrading-to-ffp3-face-masks-in-hospitals-could-save-the-nhs-360m-a-year-and-help-slash-patient-waiting-lists; University of Cambridge. “Upgrading PPE for staff working on COVID-19 wards cut hospital-acquired infections dramatically.” June 29, 2021. https://www.cam.ac.uk/research/news/upgrading-ppe-for-staff-working-on-covid-19-wards-cut-hospital-acquired-infections-dramatically; Andrejko et al. (2022) ‘Effectiveness of Face Mask or Respirator Use in Indoor Public Settings for Prevention of SARS-CoV-2 Infection — California, February–December 2021’ CDC Morb Mortal Wkly Rep 71:212–216. http://dx.doi.org/10.15585/mmwr.mm7106e1: “Using a respirator offers the highest level of protection from acquisition of SARS-CoV-2 infection.”

[2] Raisonance. “Protecting the Workforce & Corporate Productivity: Preparing employers for the Fall 2023 contagious illness season to anticipate likely workforce disruptions” at p. 9. https://assets.raisonance.ai/WorkforceRiskReport_Fall-2023_FINAL.pdf.

[3] Low DE. “SARS: Lessons from Toronto.” In: Institute of Medicine (US) Forum on Microbial Threats; Knobler S, Mahmoud A, Lemon S, et al., editors. Learning from SARS: Preparing for the Next Disease Outbreak: Workshop Summary. Washington (DC): National Academies Press (US); 2004. https://www.ncbi.nlm.nih.gov/books/NBK92467/.