Q & A with Dr. Kit Young-Hoon


Dr Kit Young-Hoon, medical officer of Health for the NWHU will be holding a weekly public Question and Answer Session, each Wednesday at 10 a.m. The sessions will be held live over Facebook on the NWHU page or GoTo Meeting. You do not need a microphone to participate – questions can be typed in. A link to the GoTo Meeting session can be found at www.nwhu.on.ca/covid19/Pages/public-sessions.aspx. The following was transcribed from her first session on July 29.

Q – With a population 86,000 and only 40 or so cases, we worked so hard to not be lumped in with the rest of Ontario. Now here we are with masks?

I recognize this is frustrating and we all want to get back to life as normal. Unfortunately, life isn’t going to be normal for a little while again. We’re in Stage 3 and Stage 3 was as a result of everybody making an effort. Everybody trying to follow public health measures, people who are ill staying home and isolating themselves and the work of public health units in doing case and contact followup and supporting workplaces and businesses to do what they need to do. So everyone’s made an effort and now it’s Stage 3. The issue with Stage 3 is that people are interacting more. So this is an added policy to help us stay in Stage 3. I think for all of us, we want to help our businesses to thrive. We want our services to stay open. We want schools to reopen, day cares to reopen, and to stay open. And in order for us to do that, recognizing that there’s going to be more interaction, and that we’re facing a winter season when the spread of illnesses tend to get worse, it’s really important for us to think about this as an added measure to help us stay in Stage 3 for as long as we possibly can, or even permanently, if that’s possible. So that’s why we felt is was important to do masks now, where we want this to be an activity that feels normal for everyone. And I know it doesn’t feel normal right now. But I think if we’re all practising it and we’re all recognizing the usefulness of doing this, and supporting each other as a community, then that might make it easier when things get really, really difficult. Especially in the winter months when we’re indoors more and it’s a little bit harder. But right now, now’s the time for us to get into the habit of putting on that face covering, so we can stay in Stage 3 and not have to put more public health measures in place.”

Why did the test results on the NWHU web page change from HUB to regional?

“That change occurred in order to enhance and maximize the privacy for individuals who have a positive test for COVID-19. This is in recognition that we release information at a certain geographical level. Then also the province at the exact same time releases information on age and gender, potential source, date of test and a number of other details on that individual. So we wanted to make sure that it was not possible to take that information and the information we provide to therefore be able to identify an individual. We do recognize that there’s a certain amount of negative stigma associated with COVID-19 and that there have been a couple of situations where people may have been treated badly because of their diagnosis. We also want to respect people’s privacy. A few cases have expressed the importance of privacy to them. They don’t want to be labelled as the person who spread COVID-19 in their community, so it’s really important to maximize privacy. I think some of the questions we’re asking is would we really want to know what our cases are. Individual case numbers don’t really change what you’re supposed to do as an individual. As an individual, you should be following all the public health measures that are recommended right now. So that is physical distancing, wearing a mask if you’re in closed spaces, hand hygiene, avoid touching your face, staying home or getting tested when you’re sick. So we want to encourage people to do those things, no matter what your case number is or the number of cases in your community. I know people get scared that they’re like “well, what if there are lots of cases in our community?” If there are lots of cases in a specific community, or a specific outbreak situation, where the risk is higher, we would be communicating that out to the public, so that people are aware. But right now with our small number of cases, the release of individual numbers and what hub area they’re in, does not actually change what you need to do as an individual.”

Q What about enclosed condo and apartment buildings with shared spaces like laundry, elevators and lobbies? Will face coverings be required in those public spaces, like how they’ve done in some larger centres?

A The instructions are about enclosed public spaces. So any area that is open to the public. So it would depend a little bit on the type of apartment building, if it is generally open to the public. Condos and apartment buildings are generally considered private space. So we would need to consider that and figure out how to best fit that into the legislation. I need to look at the legislation to see how that would apply. But you’re right. I think that has happened in some other communities but it may not involve the same legislation we’re using. We can look at that more closely to see if that fits into the instructions we’re issuing

Q: How do people handle masks in restaurants?

A: Restaurants need to be able to ensure that there’s physical distancing when people sit down to eat, so they should be at least two metres from other people. So that would be the time, once people are sitting, and they’re eating their meal, they can take off the mask at that time, assuming that they’re not coming close to anyone else. The employees of the restaurant – the people who serve the food – would still need to wear face masks because they will be coming into contact with many people. We encourage people to wear their face masks as much as possible. The whole aim of these instructions is to encourage broad use of face masks as much as we can, recognizing that there’s some people who just are unable to. So the more we wear face masks as a general public, then that reduces the transmission of COVID-19.

Q Will masks apply to schools and board office?

For schools, which are a public space, it’s our understanding that there will be provincial guidelines for schools and that’s what they’ll be following. It would be hard to implement a face mask covering that would occupy for the entire day for school age children so I’m not imagining that’s not what they’re going to necessarily use. I’m assuming they might use face coverings as part of their overall strategy but not necessarily for the entire day. I think schools can look at other avenues, such as outdoor learning, physical distancing within the classroom. Hand hygiene and improved cleaning of schools and so on. At this time, we’re all generally waiting for some kind of provincial direction for schools.

For board offices, which is not necessarily a public space, so that’s usually a non-public space for businesses. For all employees, we do need to consider the occupational health and safety act and what’s necessary for our employees to prevent the spread of COVID-19. That’s up to each employer to think through the public health measures but the most important ones would be of course physical distancing, hand hygiene, appropriate cleaning and sanitizing, staying home if you’re sick and getting tested. Those are some of the things that all employers in general can focus on in trying to protect their employees.

Q Would employers be responsible for supplying masks, or do employees need to provide their own?

A. That’s really an organizational based policy. My understanding from occupational safety is that if it’s necessary for the safety of your staff, based on the work that they do, there’s some obligation to ensure that they have appropriate equipment to be safe, so that they’re not in an unsafe situation. But I think that is an organizational policy.

Q. What is your recommendation for children, who are not able to stop touching their masks?

A. That’s one of the concerns with wearing masks, is that it encourages you to touch your face frequently, which can also be a problem. I can imagine with small children it’s really challenging. It might require some practice. If you’re having particular difficulty with a small child, you can be exempt. Children five years and under is the cutoff we’re planning to use. You might want to rely on some of the other measures that are recommended. Avoiding non-essential visits to indoor public spaces, social distancing, and good hand hygiene, particularly for young children. Try to get a mask that fits well. One of the reasons you might want to touch a mask more often is that it’s too loose or too tight or it’s uncomfortable, so trying a few different masks that are out there. Everyone’s situation is different. It might nor be that easy to just try different masks or ask someone else to look after your kid while you do your shopping. So I think it’s about trying some of those things and see if it works. We recognize that this policy is really about shifting the social norm to most people wearing face coverings, recognizing there will be exceptions. The evidence suggests the more people who wear face coverings, the better for reducing the risk for COVID-19. If we can all just try our best in getting our children and ourselves to wear face coverings appropriately.

Q Grocery stores – can they turn away those who refuse to wear a mask.

A. Each organization can have its own policy in how they want to manage that. We are suggesting that people be given a reminder to wear a mask but if they are not wearing a mask when they are indoors, or they take it off, that they’re reminded again to wear a mask. And that not wearing a mask does not mean that grocery stores or organizations have to refuse service. That’s not what we’re suggesting. We’re working on a good faith, honour system, so if someone says “I can’t wear a mask” for whatever reason, that that’s just accepted and that person is allowed to access service. Individuals who don’t wear face covering can be encouraged to do things such as physical distancing, have good hand hygiene, and staying out of the business or delaying their use of the service if they’re sick or unwell.

Q How long do you think this mask mandate will be in place?

A. I think it’s going to be around for a while. There are some signs that there might a second wave in the fall. And then there’s going to be the winter season when respiratory illnesses tend to increase. At that time, there will be people who are unwell and it will be useful to stop the spread of even other respiratory illnesses, because they could be confused with COVID-19 and can impact on testing. We also know influenza impacts our healthcare system as well, so as we enter the influenza season, that can also affect things like hospitalization rates, and demand on our healthcare system. I’m imagining this is going to continue at least into early next year or spring next year. Then hopefully, at that point, we can reassess where we’re at.