The complaint came to the Durham Region Health Department by a worried resident, nervous about her risk of contracting COVID-19 from unmasked colleagues working in an office.
The advice that health officials returned was blunt: She was safe as long as they stood at least two meters apart. “Current evidence does not support airborne transmission,” a Durham health official told him on April 8.
This advice contradicts growing research and safety advice from some of the world’s largest healthcare organizations. The Public Health Agency of Canada began warning in November 2020 that SARS-CoV-2 can be spread from one infected person to another through aerosols, tiny particles that can linger in the air.
A Torstar review of the websites of 10 public health departments in the GTA and surrounding area – including Durham – found that seven made no mention of aerosol transmission in the spread fact sheets of COVID-19. Four of the 10 agencies continued to disseminate outdated security information that some experts say could in fact be dangerous.
Up-to-date information from health units provides “people with the tools to protect themselves from this virus,” said David Fisman, epidemiologist at the University of Toronto’s Dalla Lana School of Public Health.
“When wrong information comes out of the health units, it both robs people of these tools and also undermines the credibility of the health unit.”
A spokesperson for the Durham Region Health Department said the April email was a ‘specific response’ to a resident concerned about wearing a mask at work, but was not responding directly to questions about the ministry’s position on airborne transmission of COVID-19.
The Durham Department of Health website says COVID-19 is spread primarily person-to-person through close physical contact, containing no reference to airborne transmission.
“Now that the aerial nature of COVID-19 is accepted around the world, we can say with certainty that close contact and airborne transmissions are contributing to the spread of COVID-19,” said Dasantila Golemi-Kotra, microbiologist at the ‘York University.
Leading medical journals – the Journal of the American Medical Association, The Lancet, and the National Academy of Sciences of the United States of America (PNAS) – have published papers identifying aerosols as the dominant mode of transmission of COVID – 19.
Public health units say they are seeking advice on the virus from Public Health Ontario (PHO), an independent government agency, and are considering public health and workplace safety measures established by the government.
A recent Star investigation found that these provincial public health guidelines minimized the risk of aerosol transmission, which health professionals say has led to a significant lack of workplace protections. crucial.
Although the provincial government says it has recognized aerosol transmission in crowded workplaces for months, its safety precautions continue to focus on droplet contact measures that are not strong enough to prevent airborne hazards. , revealed the investigation.
The Durham Region Health Department and many other Ontario public health units appear to have followed provincial guidelines and have continued to say that people are not required to wear a mask when working at indoors without public access if they can maintain a safe distance.
More than 7.5 million Ontarians – about 51% of the population – had received at least one dose of COVID-19 vaccine as of May 22. Ontario recorded nearly 1,700 new infections and 15 other deaths that day.
Workplaces are the primary setting for COVID-19 outbreaks in Ontario. The province has experienced 252 active workplace outbreaks as of May 23.
The exemption from indoor masking where a physical distance can be maintained has been in place since the onset of the pandemic, before aerosol transmission was widely accepted.
A spokesperson for the Department of Health said COVID-19 “is not an airborne infection” like measles and tuberculosis, noting that the evidence strongly supports that personal protective equipment to protect against the spread of droplets / contacts in hospitals are effective.
“It’s a ridiculous response from the government,” Fisman said.
He noted that there had been more than 400 deaths caused by acquired COVID-19 in hospitals and more than 500 outbreaks of COVID-19 in hospitals, resulting in thousands of infections.
The “stubbornness” of public health authorities in refusing to admit that they were wrong about how COVID was transmitted comes at a high cost to health workers, patients and society in general, a- he declared.
Fisman was one of many global experts who, in the early stages of the pandemic, expressed doubts about the route of aerosol transmission. But as the evidence changed, his opinion changed, he said.
“Over the past few months, we’ve really seen a mountain of evidence emerge,” he said. “It’s not really a scientific question anymore.”
Toronto Public Health, Canada’s largest local public health agency, previously said in its COVID-19 fact sheet that airborne transmission was “not a common way” of spreading the virus. After the Star asked about the statement, the agency revised it to list aerosol transmission as one of the common routes of transmission.
Prior to the May 13 update, the Toronto Public Health website also stated that “the virus is not known to spread by air in community settings” – a statement that has since been suppressed.
“These are the types of sentences that confuse people,” Golemi-Kotra said.
She noted that numerous outbreaks of COVID-19 have been reported in community settings such as weddings, birthdays and gyms which have led to outbreaks.
In York Region, where there have been more than 50,000 confirmed cases of COVID-19, public health authorities continue to say COVID-19 is “not known” to spread in community settings on his website.
A spokesperson said the York public health unit was aligned with the provincial definition of COVID-19 transmission routes and the changes would be addressed by Public Health Ontario.
PHO, the agency that recognized aerosol transmission last December, updated its COVID-19 guidelines on May 20 to state that SARS-Cov-2 is transmitted “most frequently and easily” to the both by respiratory particles and aerosols.
The COVID-19 page from Peel Region, one of the hardest-hit areas in Ontario, says the virus can be spread by touching something with the virus on it or through respiratory droplets. These droplets, emitted by talking, singing, shouting, coughing or sneezing, are larger and heavier than aerosols, so they quickly fall to the ground and do not linger in the air.
While Peel Public Health acknowledged the spread of the aerosols in an email response to The Star on May 18, mention of the route of transmission continues to be non-existent on its COVID-19 page for the public.
In Halton, an area that recently saw a spike in new cases of COVID-19 at popular retail stores including Walmart and Real Canadian Superstore, public health says on its site that the airborne spread has not been a “Dominant or common mode” of transmission.
In Durham Region, the complainant who was told there was no evidence of airborne transmission said a follow-up call from the public health department informed her she was unmasked at her office and that wearing a mask all day could cause “unnecessary fear” among co-workers.
Durham Public Health told The Star its advice was in line with provincial rules for Stage 1 of the reopening, which require masking indoors but exempt those who are not accessible to the public and can maintain a distance physical at least two meters in the interior area. .
While the health ministry said local health units should follow step 1 requirements when ordering home support, Golemi-Kotra said the rules “do not reflect the current situation.” .
These guidelines – originally introduced a year ago and revised in the fall – are in dire need of an update – in order to prevent the spread of aerosols, Golemi-Kotra said.
Infectious aerosols linger longer in the air in confined and poorly ventilated spaces, and closed areas that are not overcrowded could still pose a risk of infection, she said, adding that all workers at the site indoors should wear masks.