Dear
Honorable Councilors,
I am deeply concerned by the passage of the proposed Mask Bylaw at our Board of
Health meeting last Friday.
The proposal
for a mask bylaw within our City is not supported by science and the present
situation in our City does not warrant it.
It is an egregious affront to our civil liberties and personal autonomy and
is not likely to survive a challenge under our Charter of Rights and Freedoms. Mask use in the general public is dehumanizing,
alienating and a sign of separation and oppression that has no place in Canada,
Ontario and specifically in our great City of Hamilton which I love.
Firstly, the
situation in Hamilton does not warrant this Bylaw:
As I am
writing this letter I checked the Status of Cases information on the City of
Hamilton website and it appears there are only 14 cases left in our
community. From 860 confirmed positive
cases, 802 resolved, and there were 44 deaths, this leaves a balance of 14
remaining cases, with only one individual hospitalized.
Hamilton entered Stage 2 of the Ontario reopening plan on June 19th,
2020 – that is nearly 4 weeks ago. Since
that time there have been only 74 new cases in our City. In contrast, in the 4 week period before June
19th (May 22 to June 19th) there were 173 new cases and
during the 4 week period before May 22nd (April 24th to
May 22nd) there were 236 new cases.
Suffice to
say that although we have opened our City significantly and although we have
increased the availability of testing for Covid19 significantly, the number of
Covid19 cases has not increased. We are
on a positive trajectory and there is no reason to assume that this will change
in the near future.
On the
provincial level we can see that we are at the end of the curve of this
pandemic
There is no
reason for preemptive masking measures, as can be seen, despite our province’s
reopening, on the whole the number of cases has continued to decline. Given the potential harms that go along with
mask wearing I believe that our City should consider the option of waiting to
see whether there is any uptick in cases before enacting such strong measures
as universal masking.
Secondly, the
current science behind mask use is questionable at best as you will see in the
following paragraphs:
The science
regarding mask use pre-pandemic has always been clear – the reduction in the
spread of influenza and other respiratory illnesses due to the use of cloth
masks is not detectable.
In 2019 the
World Health Organization compiled a document entitled “Non-pharmaceutical public health measures for mitigating the risk and
impact of epidemic and pandemic influenza1”
– the purpose of this document was to provide recommendations for the use of Non-pharmaceutical interventions (NPIs)
in future influenza epidemics. The
method for the development of the document was to identify NPIs that had
potential to mitigate pandemics, evaluate the evidence for their effectiveness
and provide recommendations for their use / non-use. Masks are an NPI which was evaluated in this
document.
In order to
evaluate the effectiveness of the Masks the Who undertook a systematic review
of the scientific literature i.e. studies that evaluated the benefits of mask
use in controlled settings. Their
conclusion regarding mask use was as follows:
“Ten RCTs were included in the
meta-analysis, and there was no evidence that face masks are effective in
reducing transmission of laboratory-confirmed influenza.”
The
recommendation regarding masks in the originally published document was for use
by symptomatic people only. Since that
time the recommendation has been updated and it notes that masks are
recommended for asymptomatic people only in severe pandemics or epidemics, and
the recommendation notes:
“There is no evidence that this (wearing of
surgical masks) is effective in reducing transmission”
It is not
clear why the WHO would recommend mask wearing when they themselves admit that
there is no scientific evidence for their efficacy.
In any
case, what we have in Hamilton cannot be classified any longer as a ‘severe
pandemic’ – with only one individual in hospital, and 14 live cases identified
in the community. The spread of the
virus has been decreasing and continues to do so despite the fact that our City
is opening up.
The general
advice regarding mask wearing prior to Covid19 has always been that masks are
for the symptomatic only; or those caring for symptomatic individuals. For example the Journal of the American
Medical Association notes the following in their guidance on the use of masks:
When Should a Mask Be Used?
Face masks should be used only by individuals who have
symptoms of respiratory infection such as coughing, sneezing, or, in some
cases, fever. Face masks should also be worn by health care workers, by
individuals who are taking care of or are in close contact with people who have
respiratory infections, or otherwise as directed by a doctor. Face masks should
not be worn by healthy individuals to protect themselves from acquiring
respiratory infection because there is no evidence to suggest that face masks worn
by healthy individuals are effective in preventing people from becoming ill.
Face masks should be reserved for those who need them because masks can be in
short supply during periods of widespread respiratory infection. Because N95
respirators require special fit testing, they are not recommended for use by
the general public3
The WHO
changed that advice on June 5, 2020 when they released the document entitled:
“Advice on
the use of masks in the context of COVID-19, Interim guidance2”
This
document notes: “Many countries have
recommended the use of fabric masks/face coverings for the general public. At
the present time, the widespread use of masks by healthy people in the
community setting is not yet supported by high quality or direct scientific
evidence and there are potential benefits and harms to consider (see below).”
The
potential disadvantages are listed as follows:
• potential increased risk of self-contamination due to the manipulation
of a face mask and subsequently touching eyes with contaminated hands;(48, 49)
• potential self-contamination that can occur if non-medical masks are
not changed when wet or soiled. This can create favourable conditions for
microorganism to amplify;
• potential headache and/or breathing difficulties, depending on type of
mask used;
• potential development of facial skin lesions, irritant dermatitis or
worsening acne, when used frequently for long hours;
• difficulty with communicating clearly;
• potential discomfort
• a false sense of security, leading to potentially lower adherence to
other critical preventive measures such as physical distancing and hand
hygiene;
• poor compliance with mask wearing, in particular by young children;
• waste management issues; improper mask disposal leading to increased
litter in public places, risk of contamination to street cleaners and
environment hazard;
• difficulty communicating for deaf persons who rely on lip reading;
The document goes on to note:
“If masks are recommended for the general public, the decision-maker
should:…
• inform/train people on when and how to use masks safely (see mask
management and maintenance sections), i.e. put on, wear, remove, clean and
dispose;
• consider the feasibility of use, supply/access issues, social and
psychological acceptance (of both wearing and not wearing different types of
masks in different contexts);
• evaluate the impact (positive, neutral or negative) of using masks in
the general population (including behavioral and social sciences).
In light of
this information, I have the following concerns:
Why is the
City of Hamilton recommending this violation of our Civil Liberties without
strong scientific support that the measures proposed will be effective?
Why is our
Board of Health using the World Health Organization as a reference in their
report to Council, when their recommendation does not match the WHO’s own
documents?
Has the
City clearly considered all the potential disadvantages to mask use as noted
above?
What is the
City of Hamilton doing to mitigate these disadvantages?
Since mask
use leads to relaxing of other measures, will this universal mask bylaw
actually have a negative effect and cause an increase in cases in our community?
How is the
City of Hamilton going to train our 600,000 citizens in the proper use of
masks?
Has the
City considered the psychological harms of mask use? Both for wearers; an increased sense of fear
and foreboding danger; and for non-wearers; vilification, shaming, shunning
etc.?
Has the
City considered the impact to deaf individuals within our City and those who
are hard of hearing who will no longer be able to lip-read in Public?
Is the City
of Hamilton opening themselves up to possible litigation due to negative
consequences of mask wearing?
I now wish
to turn my attention to the Board of Health report which was presented at the
committee meeting on Friday July 10th. I have reviewed the report and I have the
following observations and concerns:
The report
notes that the by law: “shall be reviewed
by the Board of Health every 3 months unless directed otherwise by City
Council.”
What
criteria will the Board of Health be using to determine whether this Bylaw can be
repealed? What criteria will City
Council use to direct Public Health to review this Bylaw? There is no documentation within this bylaw
to note that it is a temporary measure or that it should be repealed at the
earliest opportunity.
There is no criteria in the bylaw to call for its own removal. Given we are enacting this bylaw in a setting
in which community spread is declined, hospitalizations are nearly at zero and
there are only 14 active cases, what else can we see happen that will make our
City comfortable that this is not necessary?
The
Executive Summary of the Board of Health report notes that: “Some jurisdictions
around the world, including many in the United States, are experiencing a
resurgence of cases since re-opening.”
The primary
examples given for this in the media are Texas and Florida, however it is also being
widely reported in the media that the case counting in these States is far from
accurate. In any case, Florida and Texas
have far fewer deaths for their population that Ontario. Why should what is happening in the southern
states have any bearing on the conversation relating to our City? Hamilton has started opening and the number
of cases has declined. There are a
myriad of factors, which could be affecting case transmission in such distant
jurisdictions, and so I fail to see why this is relevant to Hamilton. Hamilton is opening and our cases are
continuing to decline, information from the southern states is irrelevant.
Throughout
the document the word ‘Enclosed’ is used, however a definition of enclosed is
not provided. Presumably, this word
means ‘indoor’ spaces, however indoor spaces vary significantly in size, space,
airflow etc. Given the differences that
can exist, why are all enclosed spaces being painter with the same ‘danger’
brush?
The
Executive Summary notes that the science on non-medical masks is not
definitive. As in my question above - How can our City Council impose a bylaw
which severely infringes the rights of Hamiltonians to personal autonomy on the
basis of science that is ‘not definitive’?
The
Executive Summary notes that jurisdictions with ‘mandates’ have seen more
people complying. Yes – the threat of
punitive measures will get you forced compliance. Make no mistake about what you are doing, you
are no longer encouraging – the passing of a bylaw means you are forcing me and
my family to wear a mask in public. I
take strong exception to this.
The
Executive Summary notes that - “More widespread wearing of masks and face
coverings may act as a visual cue that public health measures, including
maintaining a physical distance from others, are still required”
This
contradicts the idea that masks use is for enclosed areas where social
distancing cannot be practiced. This
also contradicts the WHO’s warning that masks provide a heightened perception
of ‘security’ which may lead to relaxing of other measures such as physical
distancing. It is very likely that what
you are doing will actually lead to greater spread of Covid19 due to an assumed
safety behind an ineffective mask.
Within the
Historical Background section of the Board of Health report it fails to mention
that on June 23rd Dr. Ninh Tran was quoted in the Hamilton Spectator
as saying: “We are not looking at making masking mandatory”
On June 29th
however, our Mayor, seemingly without the support of Public Health, made a
political statement together with other GTHA mayors asking the province to
enact mandatory masks.
This leaves
me wondering whether Public Health was driving the bus with respect to our
Public Safety, or was this report compiled after the fact as political support
for our Mayor, who stepped out on his own accord to score political
points? To what degree are politics
playing into this recommendation for mandatory masks? Was the Board of Health report prepared
before or after these statements from our Mayor?
Within the
Analysis and Rationale portion of the report it is noted that “the World Health
Organization strongly recommend the wearing of masks or face coverings where
physical distancing cannot be maintained”.
However if you refer to my quotations from the official WHO documents
above, this statement is a stretch. They
conditionally recommended them in severe pandemics where there is widespread
community spread, while noting the lack of evidence for their efficacy as well
as the associated dangers.
The Board
of Health report discusses the spread of Covid19 – however they do not note
significant information relating to the spread of Covid19.
The New
England Journal of Medicine has noted in a study published on May 21, 20204
that the transmission of the virus requires prolonged contact. An exerpt from the study is contained below -
The
accepted mechanism for the spread of Covid19 is prolonged contact with an
infected person for at least several minutes - the mask bylaw does nothing to
address this. The mask bylaw will cover
our faces for brief passing moments in indoor commercial settings. This is not how the virus is spreading; it
spread through long term contact with infected individuals in places like
retirement homes and Long-term Care facilities.
The
evidence provided within the Board of Health report regarding the effect of
masking in certain jurisdictions around the globe is anecdotal at best. While areas such as Hong Kong, Japan and
South Korea did better in terms of total cases, the degree to which masks
played into that outcome is unknown.
China is
also a nation which uses masks readily and culturally, however that was the
epicenter of the pandemic and the virus spread from through and around China,
and from China to the world despite China’s widespread mask use.
The Board
of Health report noted that face coverings can act as a visual cue for other
measures such as physical distancing, however the WHO has cautioned that
masking actually provides a false level of security and will lead to a decrease
in such practices as physical distancing.
This has been my observation – when people wear masks they feel safe and
don’t hesitate to get into each other’s space, when in fact a better option
would be to physically distance from each other.
The Board
of Health report notes that there are numerous potential negative unintended
consequences to universal masking, such as:
· There may be in individual level
impacts such as facial dermatitis, facial lesions, itchiness and skin
irritation, worsening acne, fogging of glasses, difficulty in clear
communication;
· If worn improperly, facial coverings
use can present the opportunity to contaminate the wearer; lack of hand hygiene
may also cross contaminate the environment
· Individuals who may not be able to
tolerate face coverings (e.g. underlying medical conditions) may be
stigmatized;
· Depending on how policies are
enforced, income and other inequities may be exacerbated (e.g. for those who
lack access to masks and face coverings); and,
· Impact on the PPE supply chain
should individuals use medical masks in non-health care settings.
These are significant consequences
and are almost certain to occur given the requirement for widespread masking.
Personally, I have mild asthma;
however it is exacerbated by mask use and especially in hot temperatures. I have seen the vitriol in online forums
against those who question the need for universal masking and I am anticipating
that I will be the subject of vilification, shaming and shunning if I am unable
to wear my mask.
As I noted above – the question as to
what degree the City are opening themselves to legal challenges and lawsuits
due to negative impacts from masks within our City needs to be considered. If residents sue the City of Hamilton who
will ultimately be paying for their settlements? The tax-payers, or the Board of Health and
city councilors who enacted this Bylaw despite the protests of tax paying
citizens?
Other questions that I have related
to these possible negative impacts are as follows:
To what degree is the City providing adequate
training for the proper wearing of masks?
To what degree will the City be held
liable for not providing proper training?
What about those citizens who cannot
afford masks?
The Board of Health report notes that
the science on face coverings continues to evolve, they then go on to cite
numerous studies that were completed since the start of the Pandemic.
While I
understand the need for ‘live-science’ in such a situation as our Pandemic, the
‘Hard-science’ i.e. random control tests which were designed to remove bias
have always shown that masks DO NOT work.
Science does not change just because there is a pandemic, the rush to
publish new work without peer-review and without oversight leaves these studies
very open to possible biases and unrepeatable conclusions.
The Board of
Health study also references ‘modelling studies’ however after the debacle
which was our province’s reliance on modelling I hope we are not continuing to
base public policy on models. We were
told that we could experience up to 100,000 deaths in our province based on ‘modelling’
– that number now appears so ridiculous that it was a crime for it to be
presented to the public. I deny that the
City should or can even legally curtain our rights to personal autonomy based
on theoretical modelling, and in the face of the ‘Hard-science’ that shows that
masks do not work.
At best the
masks will provide some source control for coughing and sneezing. However, those who are coughing and sneezing
should be tested for Covid19 and stay home as these are symptoms of the
virus. In any case, your sleeve or elbow
are just as effective in blocking a cough or sneeze as a mask. Masks need to be discarded after you cough
into them or sneeze into them as they become a wet breeding ground for bacteria
and other viruses.
On a personal
note:
Personally I
find masks to be dehumanizing and alienating. Showing your face is a beautiful
part of our culture that I value highly. You cannot connect with someone or
communicate well on a personal and empathetic level with your face covered.
Face coverings are for thieves and robbers aren't they? Not for open, healthy,
friendly Canadians with nothing to hide - they are a sign of separation and
oppression.
To overcome
the fears we need to keep opening up and getting back to normal so people can
see there is little to be afraid of. We
have a City that is paralyzed by fear and a presentation of the facts, such as
where we are on the curve, the decrease in cases and the decrease in
hospitalizations – these items are better ways to encourage our City to get
back to business.
Given the
facts I have outlined above I wish to summarize as follows:
1.
The
requirement for universal masks is a violation or personal autonomy, our Civil
liberties and Charter rights, it is dehumanizing, alienating and a sign of separation
and oppression that has no place in Canada, Ontario and specifically in our
great City of Hamilton which I love.
2.
The
situation within Hamilton and our Province does not warrant the proposed measures
we are doing fine as we continue to open up and cases continue to decline.
3.
The
science regarding mask use is clear that they do not work. The evidence provided by the Board of Health
in support of mask use is anecdotal at best and contradicts other valid Health
authorities such as the New England Journal of Medicine, the Journal of the
American Medical Association and the World Health Organization.
4.
It
is very problematic that there is no clear metric within the Board of Health
Report or the Bylaw itself to note when this bylaw will be repealed. The Bylaw is not even noted specifically as a
temporary bylaw. How will Council
determine that these measures can be ended?
5.
Due
to the potential negative impacts of masks, their disadvantages and problems
noted by various health authorities the City of Hamilton is opening the public
up to lawsuits and litigation which will have to be settled by tax payer
contributions. Our City cannot afford
this in our weakened fiscal position due to the virus.
6.
The
City is not valuing equity and the rights of those who cannot afford masks or
cannot wear masks due to health reasons.
Your bylaw has the effect of vilifying and shaming those who cannot wear
masks due to the cost or other health issues.
Given these
facts, I ask that our Council reconsider universal mask use within our
City. It is unjustified and unwarranted
and I and my family am strongly against these measures. I want what is best for my City and this bylaw
is not in the best interests of the City of Hamilton.
Thank you for
your consideration.
Best Regards, Andrew Smith
