The Withdrawal of Mask Mandates on Planes and Trains in Canada, and the associated infringement of the rights of Canadians protected by the Canadian Human Rights Act (R.S.C., 1986 c. H-6.)
My September 27, 2022, Letter to the Rt. Hon. Prime Minister, Justin Trudeau, Canadian Public Health Officer, Dr. T. Tam, and others
27 September 2022
TO: Right Honourable Prime Minister Justin Trudeau MP
Honourable Jean Yves Duclos, MP, Canadian Minister of Health
Dr. Theresa Tam, Chief Public Health Officer of Canada
Dr. Howard Njoo, Associate Chief Public Health Officer of Canada
Honourable Carla Qualtrough MP, Minister of Employment, Workforce Development and Disability Inclusion
Honourable Omar Alghabra MP, Transport Canada Minister
RE: Withdrawal of Mask Mandates on Planes, Trains in Canada and the associated infringement of the rights of Canadians protected by the Canadian Human Rights Act (R.S.C., 1986 c. H-6.)
Prohibited Grounds: Discriminatory Practices v. Age, Disability, Sex (Pregnancy)
Dear Honourable Prime Minister Justin Trudeau, Honourable Ministers, Doctor Tam, and Doctor Njoo:
I was rather surprised to hear of the decision of the Federal government to remove masking on airplanes and trains in Canada. In Ontario, the Chief Medical Officer of Health removed requirements for masking on transit in June and has since removed the requirements to isolate while contagious, 24 hours after one’s fever disappears. That approach is untested by other jurisdictions and indeed, is not in keeping with the precautionary principle or the current understanding of the airborne spread of SARS-CoV-2. This is something the CDC has not recommended nor has the Chief Public Health Officer of Canada, Dr. Theresa Tam.
An individual in Ontario may be very contagious with COVID19, board an airplane or train, and remove their mask without any regulatory impediment. If he or she sits next to a vulnerable person, especially a senior, pregnant person, organ transplant recipient, or a chemotherapy patient, then your actions have inadvertently introduced significant additional risks to-protected individuals under the Canadian Human Rights Act (R.S.C., 1986 c. H-6.). Policy decisions should not cause undue risk to persons protected by the Canadian Human Rights Act.
It is not the fault of your government that Premier Ford and the Chief Medical Officer of Ontario chose to eliminate the requirement for isolation. However, it is the fault of this government for not recognizing the serious repercussions that will occur on planes, trains or even in federal buildings, without masks in place given the circumstances.
The COVID19 pandemic may be waning if we look at global mortality and hospitalizations. However, when we look at Canada, we see a different picture. The relaxation of public health measures has caused mortality to be higher in some provinces than this time last year, including Ontario. Child mortality is higher now that at any time during the pandemic in Ontario (Professor Dr. David Fisman, Professor of Public Health and Infectious Disease Specialist, University of Toronto). We have 16 times more infections/day, 80% more deaths, and 3.4 times more hospitalizations than this time last year [Bill Comeau MSc., Statistician/ Diego Bassani Ph.D., Senior Scientist, Epidemiologist, Sick Kid’s Hospital, Associate Professor, University of Toronto, https://twitter.com/DGBassani/status/1574501493776039941?s=20&t=jct2IaSsUZkn1I-U9eqmFA]. COVID19 infection increases the risk of Type 1 Diabetes in children by 72% according to a September 23, 2022 publication in the Journal o the American Medical Association. In Ontario, for example, about 60% of children under age 12 have not had 2 vaccines. Masking is not required in school. These circumstances are worrisome.
As COVID19 enters the endemic phase, the risks have not abated greatly. Dr. David Fisman explained the change to the endemic phase as primarily, a loss of the waves of infection. We are now entering a constant state of a high number of people becoming infected, and recovering, while being replaced by the same number of new infections i.e. a R0 value of 1.0. Globally, it is still expected that COVID19 will cause millions of deaths each year going forward. The consequences of infection are still being evaluated.
On September 23, 2022, the WHO Technical Lead for COVID19, WHO Emergencies Program, Infectious Disease Epidemiologist, Dr. Maria Van Kerkhove, estimated 144 million people globally were living with a long COVID19 syndrome at the end of 2021, before OMICRON. She stated: “This disease affects the lungs, affects the circulatory system, the heart..” [in reference to acute COVID19 infection.] She acknowledged [long COVID19] is a condition that we are still learning about and encouraged significant investments into research and rehabilitation. Your government is funding a clinical trial in children for this condition. The CDC estimates that 1 in 5 people infected with OMICRON (BA1, BA4, BA5) develop a long COVID19 syndrome (symptoms persisting for more than 4 weeks). Some patients will require rehabilitation. The impact on healthcare cannot be appreciated, but it will be substantial. We are not prepared. Dr. Tara Moriarty, Associate Professor of Microbiology at the University of Toronto has carefully documented excess mortality from COVID19 in Canada. Her modelling is worrisome. It appears COVID19 will remain in the top 5 causes of death in Canada for the foreseeable future. Excess mortality remains elevated and is no doubt related to increased cardiovascular mortality especially.
COVID19 is a zoonotic respiratory virus. Its seriousness doesn’t always come from the infection per se. The virus can appear anywhere within the body but prefers the brain, lungs, liver, heart, and kidneys. It causes an autoimmune inflammatory response which results in severe scarring and long-term fibrosis. In the brain, the lasting effects can be loss of smell to brain shrinkage (ie atrophy). Alzheimer’s like dementia has been associated with infection. In the lung, diffuse destruction of the air sacs can occur, causing loss of function permanently. Heart disease has been the most prevalent problem, however. The virus causes small blood vessel inflammation which is especially problematic for those with underlying coronary artery blockages. Cardiovascular mortality has increased significantly. Vulnerable groups have been identified for over 18 months, and [antiviral] therapies have been targeted preferentially for them.
The precautionary principle was an overarching theme in the Honourable Mr. Justice Archie Campbell’s SARS Commission reports. I am afraid we are once again tossing this aside despite growing concerns about the risks that COVID19 poses to the unvaccinated and the vulnerable. Mortality should not be the only yardstick we use to gauge the risk.
Earlier this month I submitted a brief to the Chief Commissioner of the Ontario Human Rights Commission requesting a Section 31 Inquiry OHRC into the changes in Ontario public health guidance, and their negative impacts on Code-protected groups. I did so on behalf of 47 physicians, scientists, nurses and educators, all of whom contributed to the brief or signed the letter in support. Removing isolation and masking simultaneously is in stark contrast to everything we have learned about a highly pathogenic airborne virus.
Link: https://drive.google.com/file/d/1ceci-kYmOLz19LZHdNCLijnP4Ux4WxRb/view?usp=sharing
The Canada Human Rights Act protects individuals from discriminatory policies on the basis of age, sex (pregnancy), and disability. It is my belief that by eliminating mask mandates on planes and trains, you have preferentially placed these individuals, and perhaps other groups, at an excessive and disproportionate risk of serious COVID19 infections compared to individuals who are younger and without medical frailties or developmental conditions. Of course, the impoverished in Canada cannot afford N95 masks — The quality of masks necessary to provide some protection from infection. However even if available to them, these will not be fit tested, and if 20% of the train or plane occupants are actively shedding the virus, then the risks to the vulnerable will remain high. Indeed, there is no proof that a strategy of “wear a mask, if it’s right for you”, is sound or ethical. It is not based on the philosophy or science of public health. Professor Maxwell Smith is an ethicist and Public Health expert, at Western University, and is already affiliated with Health Canada. I would urge you to consult with him regarding these changes, at least for his informed feedback.
I fully support the removal of the Can Arrive app and vaccine passports at the border. However, if we are not testing or screening for COVID19, and no longer isolating those who are infectious, the only weapon we have left is masking. It reduces the circulating virus effectively and has been proven to reduce COVID19 transmission in schools. With upgraded ventilation, we can make travel safe. Via Rail could offer mask-only cars and require portable HEPA filtration in each car to reduce circulating virus. That would be a terrific first step to addressing these concerns shared by hundreds of thousands of Canadians.
I am an immunocompromised physician with a neuroimmune disorder. I am with several million Canadians who are extremely vulnerable to COVID-19. I see people celebrating that COVID-19 is over. That is a failure of the Canadian and Ontario governments. I don’t enjoy masking. However, I want to stay well, keep my family and community well, and have ready access to healthcare providers. That has not occurred this past year. A family member had a stroke syndrome and could not be assessed within 18 hours at the Hamilton General Hospital, despite facial weakness and a gait problem. We can pretend the risks are gone. But we all know that is not true.
This government could strongly condemn the relaxation of isolation periods by all or any provincial governments. It could penalize those provinces and territories that do so. It can also ensure that Rapid Antigen Tests are readily available to every Canadian.
Today we learned that countries with mask mandates or policies had an 80% reduction in COVID19 mortality (https://doi.org/10.1016/j.amepre.2021.09.019) compared to countries without such mandates. The evidence grows each day in support of precautions rather than accepting additional risks for which the vulnerable in our country will suffer disproportionately. In a few weeks, absent significant improvements in this government’s present stance, I will file a Complaint with the Canadian Human Rights Commission on behalf of the hundreds of thousands of Canadians who may be harmed by the failure to keep mask mandates on federally regulated travel or in federal buildings. I will gather a consensus of opinions and contributions from experts as I did with our petition to the Chief Commissioner of the Ontario Human Rights Commission.
I congratulate your government on championing disability rights in Canada, including the Canadian Disability Benefit, and adding the role of Ms. Stephanie Cadieux, the Chief Accessibility Officer. Nothing would please me more than not feeling compelled to write another brief to speak on behalf of vulnerable persons including those with disabilities, whose well-being has been discounted during the COVID19 pandemic.
These comments are my own.
Most Sincerely,
Christopher Leighton MD, FRCPC
Radiation Oncologist (ret)
note errata in [ ]s; yes I had to send a letter with corrections 😞
