CMPA (CANADIAN MEDICAL PROTECTIVE ASOCIATION):
https://www.cmpa-acpm.ca/en/covid19/face-masks-for-patients.
https://cmpa-acpm.ca/en/advice-publications/handbooks/consent-a-guide-for-canadian-physicians#types%20of%20consent.
Section 3.2
"Patients, designated family/support persons, and visitors are not required to mask when:
ALBERTA
https://extranet.ahsnet.ca/teams/policydocuments/1/clp-ahs-use-of-masks-hcs-267.pdf.
Section 3.2
"Patients, designated family/support persons, and visitors are not required to mask when:
a) providing or receiving care or assistance where a mask would hinder that care or assistance;"
i.e. providing support and care/communication."
https://extranet.ahsnet.ca/teams/policydocuments/1/clp-ahs-use-of-masks-hcs-267.pdf.
Section 8.4
"Patients requiring health care shall not be refused care if their designated family/support person or visitor is unable or refuses to mask."
Section 5.2 a), 8.5 a), 8.5 b)
https://www.albertahealthservices.ca/assets/info/ppih/if-ppih-covid-19-how-to-support-mask-wearing.pdf.
"No patient shall be denied service in AHS because they cannot or will not wear a mask."
Link to printable handout page
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April 1st, 2023 - Screeners no longer at AHS facilities. Does this mean Masks are done? NO! They got worse...
“I think this is very frustrating to me that we here we find ourselves everybody and has moved on from COVID”
Premier Danielle Smith January 2023.
Does this look like "moved on"?
AHS Internal Update March 23, 2023 [link to PDF with comments]
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March 6th, 2023 - Continious Masking now expanded to the point you have to bring your own mask to a hospital or Care Home to get through the doors.
Other than a few typos, these are the changes.
It has actually made it WORSE for disabled people.
From:"ARE REQUIRED"
To:"MAY BE REQUIRED" (until you read on)
From:
"patient care areas, elevator, common areas, gift shops"
To:
"entrances, patient care areas and adjacent break rooms, elevators/staircases, common areas, gift shops, cafeterias"
And visitors are exempt... but only if visiting the 'elite' in the office areas. Out of Public View! Is it dangerous or not? Can you be asymptomatic OR NOT?
(see: )
And removed:
https://albertahealthservices.ca/assets/info/ppih/if-ppih-covid-19-ppe-continuous-use-guidance-masking.pdf
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And while all of this was happening (and continues) in Care Homes in Alberta...
Capital Care and AHS undetook their largest ever construction project.
That project was opened on 28th March 2023 in the greatest presentation of hypocrisy to date.
A complaint/letter to the Premier, Capital Care and AHS Patient Relations has been sent March 31st, 2023.
March 30th, 2023 - Fourth Letter to the Alberta Premier. [Download PDF Link]
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British Columbia
DROPPED APRIL 6th, 2023
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SASKATCHEWAN
DROPPED APRIL 4th, 2023
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MANITOBA
https://www.gov.mb.ca/covid19/resources/masks.html
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ONTARIO
https://www.cpso.on.ca/Physicians/Your-Practice/Physician-Advisory-Services/COVID-19-FAQs-for-Physicians
https://www.ontariofamilyphysicians.ca/news-features/news?resourceID=20&articleView=individual&articleID=253
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NOVA SCOTIA
https://cpsns.ns.ca/college-direction-to-physicians-regarding-access-to-care-for-patients-during-the-covid-19-pandemic/
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PRINCE EDWARD ISLAND
https://www.cpspei.ca/physician-info/
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NEW BRUNSWICK
https://cpsnb.org/en/
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QUEBEC
http://www.cmq.org/gcse.aspx?lang=fr&q=masking+for+patients
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NORTHWEST TERRITORIES
https://www.nthssa.ca/en/services/covid-19-updates/sick-notes-return-work-notes-work-home-exemptions-and-masking-exemptions
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Uncertified Masks/Respirators
BE(A)WARE! of NON CERTIFIED 'N95' masks with or without plastic windows.
N95 respirators are governed by OH&S and Canadian Biosafety regulations (see below).
Using an unapproved
Type 1 Medical device [by use or by design] is an offence under these regulations and can lead to prosecution, fines and closure of a premises.
If it has no NIOSH stamp, it is unlikely to be certified.
Even if certified, the use of these devices requires an up-to-date FIT test.
And remember if it is being 'forceably recommended' (coerced) for use as an alternate to an N95 or greater, it is a Type 1 medical device 'by use', if not by design.
Is the Mask FIT? The four aspects of a risk assessment.
1. FIT for Purpose
Has the mask or face covering been proven to be "FIT FOR PURPOSE" i.e. to prevent the spread of an airborne virus? The answer is most likely NO as there is no generally available mask or face covering certified to do this. What does the manufacturer of the mask or face covering state this device is capable of doing? If it does not meet the requirement by design or by use, of a viral suppressing medical intervention respirator/mask, then it is not fit for purpose.
2. Is the person FIT to wear the mask?
Have you confirmed you (or your staff/customer) will not experience any harmful effects related to the mask or face covering?
3. Is it FIT to the person?
Even if you have moved through the first two processes, any mask or face covering has to be properly FITTED to you to ensure it works for point 1, and doesn't cause issues for point 2.
4. Is it FIT for the environment?
As a mask can be taken off in many circumstances in the same environment i.e. when eating, drinking, regular breaks etc. and there is no separation of atmosphere between the mask wearing and non-mask wearing areas, the risk is not environmental. So, what is the risk?
Are you wearing (or being required to wear) a KN95 respirator in Canada?
Apart from the issues mentioned here (NIOSH stamp, FIT Test, CO2 build up, not fit for purpose etc.)
Did you know that KN95 respirators are an inferior (usually uncertified) version of the N95?
Although initially allowed (improperly) in the early part of 2020, most KN95 masks/respirators are not to be used in Canada.
"Important information about KN95 medical respirators"
https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/medical-devices/personal-protective-equipment/medical-masks-respirators/authorization.html
"The United States Food and Drug Administration (FDA) issued a revised guidance on May 7, 2020. The revised guidance indicates that certain filtering face-piece respirators, including KN95 medical respirators from China, may not provide adequate respiratory protection. Learn more about the new guidance."
(https://www.fda.gov/medical-devices/letters-health-care-providers/certain-filtering-facepiece-respirators-china-may-not-provide-adequate-respiratory-protection-letter)
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Studies on Masks, CO2 and FEAR (2009-2022)
The knowledge of the amygdala being a chemoreceptor for CO2 and fear is long known and well studied.
Now are you starting to understand the risks related to 'face coverings' worn 'as prescribed' during COVID? It is NOT about SAFETY!
"We found that youth assessed after the pandemic shutdowns had more severe internalizing mental health problems, reduced cortical thickness, larger hippocampal and amygdala volume, and more advanced brain age."
https://www.bpsgos.org/article/S2667-1743(22)00142-2/fulltext
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808123/
https://www.nature.com/articles/nature.2013.12350
https://www.nytimes.com/2013/02/04/health/study-discovers-internal-trigger-for-the-previously-fearless.html
https://www.nbcnews.com/health/body-odd/women-who-cant-feel-fear-can-still-feel-panic-study-flna1b8323185
https://medicine.uiowa.edu/psychiatry/content/human-brain-divided-fear-and-panic
https://www.frontiersin.org/articles/10.3389/fnbeh.2021.767426/full
https://molecularbrain.biomedcentral.com/articles/10.1186/s13041-021-00786-7
https://www.livescience.com/5910-carbon-dioxide-triggers-primordial-fear-suffocation.html
https://academic.oup.com/ijnp/article/23/4/268/5805187
https://www.canada.ca/content/dam/hc-sc/documents/programs/consultation-residential-indoor-air-quality-guidelines-carbon-dioxide/consultation-residential-indoor-air-quality-guidelines-carbon-dioxide.pdf
5 NIH/National Library of Medicine studies from 2004-2020.
https://pubmed.ncbi.nlm.nih.gov/29395560/
https://pubmed.ncbi.nlm.nih.gov/32590322/
https://pubmed.ncbi.nlm.nih.gov/15340662/
https://pubmed.ncbi.nlm.nih.gov/26579222/
https://pubmed.ncbi.nlm.nih.gov/31159777/
Cloth Mask Study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/
SOME of the mask studies on efficacy:
https://www.medrxiv.org/content/10.1101/2020.04.01.20049528v1
https://www.medrxiv.org/content/10.1101/2020.03.30.20047217v2
https://www.nejm.org/doi/full/10.1056/NEJMp2006372
https://jamanetwork.com/journals/jama/fullarticle/2749214
https://www.cmaj.ca/content/188/8/567
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779801/
https://pubmed.ncbi.nlm.nih.gov/19216002/
https://aaqr.org/articles/aaqr-13-06-oa-0201.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/
https://academic.oup.com/cid/article/65/11/1934/4068747
https://www.jstage.jst.go.jp/article/bio/23/2/23_61/_pdf/-char/en
https://link.springer.com/article/10.1007/BF01658736
https://www.journalofhospitalinfection.com/article/0195-6701(91)90148-2/pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2493952/pdf/annrcse01509-0009.pdf
https://web.archive.org/web/20200717141836/https://www.cidrap.umn.edu/news-perspective/2020/04/commentary-masks-all-covid-19-not-based-sound-data
https://www.nap.edu/catalog/25776/rapid-expert-consultation-on-the-effectiveness-of-fabric-masks-for-the-covid-19-pandemic-april-8-2020
https://www.nap.edu/read/25776/chapter/1#6
https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article
https://academic.oup.com/annweh/article/54/7/789/202744
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599448/
https://www.acpjournals.org/doi/10.7326/M20-1342
https://link.springer.com/article/10.1007/s00392-020-01704-y
https://clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-6-130.php?jid=jide
https://www.sciencedirect.com/science/article/abs/pii/S1130147308702355
https://www.mdpi.com/1660-4601/18/8/4344/htm
Further References
Centers for Disease Control and Prevention. (2021). N95 respirators. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirator-use-faq.html
Wargocki, P., Wyon, D. P., Sundell, J., Clausen, G., & Fanger, P. O. (2000). The impact of elevated carbon dioxide levels on decision-making performance. Environmental Health Perspectives, 108(9), 853-858.
Li, L., Lin, L., & Chen, W. (2013). The effect of elevated CO2 on cognitive function in a classroom. Environmental Research Letters, 8(4), 1-9.
Chew, G. L., Daneshkhah, A., & New, M. (2016). Climate change and health: An updated review of CO2 and other greenhouse gas emissions. Environmental Science & Technology, 50(7), 3713-3723.
National Heart, Lung, and Blood Institute. (2021). Hypercapnia (high carbon dioxide in the blood). National Institutes of Health. Retrieved from https://www.nhlbi.nih.gov/health-topics/hypercapnia
Lu, Q., & Hyde, D. M. (2014). Hypercapnia: A review. Respiratory Care, 59(9), 1486-1492
Risbey, K. S., Boulter, S. L., & Dessai, S. (2009). The health impacts of high carbon dioxide concentrations: A review of the evidence. Environmental Health, 8(1), S5.
WHO. (2018). Carbon dioxide (CO2). World Health Organization. Retrieved from https://www.who.int/ipcs/features/co2/en/
The Lancet Countdown on Health and Climate Change. (2021). The Lancet Countdown: Tracking Progress on Health and Climate Change 2021 Report. The Lancet. Retrieved from https://www.thelancet.com/countdown
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