SUNDRE — The provincial government may have lifted the majority of mandates including masks in most public places, but the two local community clinics have in order to protect their patients and staff opted to maintain their own policies as per College of Physicians and Surgeons of Alberta guidelines.
“This is not like going to a bar or restaurant, it’s a clinic,” said Dr. Michelle Warren, who alongside husband Dr. Rob Warren runs the Moose & Squirrel Medical Clinic.
“We’ve got pregnant women and immunocompromised patients. We take their health seriously,” said Warren, who is also the 2021-22 Alberta Medical Association president. “That’s what masks are about.”
Anyone who prefers not to wear a mask will be offered an opportunity to book a virtual appointment, she said.
“The physician will then determine if they need to be seen in person,” she said. “We wouldn’t want to have a bad outcome that gets traced back to the clinic.”
With Albertans now mostly testing at home, positive cases are not being thoroughly tracked, recorded and are subsequently not being reported about in headline news, she said.
“We look at the science. Because the risk is still very much there,” said the physician, adding she in one afternoon alone had dealt with six cases. “I’m not going to put my patients at risk.”
When there are zero cases in the community, then will be the time to review and reconsider whether to abandon the masking policy altogether, she said.
But that milestone hasn’t yet been reached, she said.
According to the provincial government’s website, mask mandates were lifted across Alberta as of March 1 with the exception of municipal and intra-provincial public transit for anyone aged 13 or older, as well as Alberta Health Services-operated and contracted facilities, and all continuing care settings.
Seeking clarification regarding what falls under the description of AHS-operated and contracted facilities and continuing care settings, an AHS spokesperson told the Albertan those include “acute care, hospice settings, long-term care facilities and licensed supportive living facilities, including seniors lodges and group homes.”
But that does not include community clinics.
“Although it is no longer mandatory, individuals may be asked to wear a mask when accessing health care in other community health-care settings” such as clinics that deem it necessary, the spokesperson said.
Community and private clinics are essentially the same, said Warren, adding family medicine in Alberta tends to be operated by business people.
“They are clinics that are run by the physicians that work there,” she said. “So, the government can’t tell me what to do.”
Prioritizing safety
Private businesses — like patients or patrons — can make their own choices, she said, adding that in her experience, people have been understanding of what the clinic is doing to keep everyone safe.
Over at Greenwood Family Physicians, the other community clinic in Sundre, Dr. Dana Rich spoke with the Albertan about their COVID-19 policies now that restrictions have eased.
“My understanding is (the mask mandate exception) only includes AHS-run clinics. So, it doesn’t include us,” Rich said on Thursday, March 3 during an interview.
“We’re not allowed to mandate that patients wear masks anymore, but we do strongly encourage it,” she added.
However, the CPSA released a guidance framework for community medical clinics on how to approach the situation, she said, adding they are following those protocols.
“Basically, it says that we can no longer mandate that patients wear masks, but we can take precautions to protect our staff and our patients if patients choose not to wear a mask,” she said. “If we can do anything virtually to mitigate the risk to our staff and patients, then we will."
She added that appointments to accommodate patients who opt not to wear a mask might also be booked at the end of the day.
“To prevent the spread of COVID-19 to our staff and patients, Greenwood Family Physicians is still strongly encouraging all patients to wear a mask while at our clinic. Greenwood staff will continue to wear masks at all times while at work,” reads a portion of a statement prepared by the clinic to keep the public informed, adding that approach is in accordance with the CPSA’s guidelines
Asked how patients were adapting to the changes, Rich said she herself had recently been isolating at home recovering from COVID-19 after testing positive on Feb. 27 and so had not yet been back at work. But she was coming out of isolation and expected to be back in by March 4.
Having experienced a mixed bag of symptoms ranging from headaches and muscle aches to fevers and a runny nose, Rich, who is fully vaccinated with a booster, said she was doing well.
Although impossible to know for certain whether being immunized alleviated a potential worst-case outcome, the doctor felt lucky to have experienced only mild symptoms and expressed no regrets over deciding to get vaccinated.
Unintended consequences
That’s a point the public might not always consider, said Warren, adding that when a physician falls ill, there’s a ripple effect that impacts many other people, such as the patients the doctor can no longer see during the recovery period as well as colleagues who might have to step up to fill shifts at the emergency room.
“It’s those other unintended consequences to a decision that other people then have to live with,” said Warren, adding she at one point covered a shift for Rich to ensure the Sundre hospital had continued emergency room coverage.
Regardless of whether there are mandates, the reality is the virus is still out there and has the potential to impact those who are at risk, said Warren.
“And even for some healthy people. You never know if you’re going to be that unlucky one that has a significant outcome,” she said, adding ignoring a problem doesn’t make it go away.
People have largely grown weary of the public health measures, but that doesn’t mean caution should be thrown to the wind and along the way risking repeating the harmful restrictions cycle, she said.
“The concern I have is wearing a mask, social distancing, staying home when you’re sick, is really not difficult to do,” she said. “What’s hard to do, is to have the roller coaster of opening and closing — that’s what’s taxing emotionally, mentally, physically.”
Understanding of the reasons behind trying to ease restrictions, Warren said, “I also appreciate knowing that other countries have tried, and it has not worked well.”
Denmark, which Premier Jason Kenney has used as an example of jurisdictions that lifted most mandates, has for example recently experienced a surge in new cases.
Careful monitoring might avoid past mistakes
Even so, she is hopeful today’s situation does not lead to a repeat of the Best Summer Ever.
The difference between last year and now, Warren said, is a commitment from Health Minister Jason Copping to monitor the situation very closely and that “if we start seeing significant issues, like Denmark is currently experiencing, that we act.”
“I think what happened last summer wasn’t that we tried to open, but it was when those warning signals began to present, nothing happened — there was a delay in action,” she said.
A virus doesn’t care about people’s holiday plans or an elected official's political aspirations, she said.
“All it cares about is making more viruses,” she said.
Steering clear of commenting on politics or people’s freedoms and choices, Warren said from a doctor’s point of view that, “This is an illness that is carried in the air that puts people at risk, is very much in circulation, and our duty as physicians is to first do no harm, which means that we will not knowingly put people at risk.”
That philosophy was front of mind when the Warrens built their clinic long before the pandemic in 2013 to include anti-viral high efficiency particular air (HEPA) filters in all of the exam rooms to substantially reduce the risk of infection by airborne contagions like influenza that have always been around.
They are now looking at obtaining additional air purification systems to install in the clinic’s common areas, she said.
Wearing a mask is a small ask above and beyond other measures, she said, adding if health-care workers can wear one for an entire shift, donning one for a 15-minute stop at the grocery store shouldn’t be a big deal.
“I’m wearing this mask for eight to 10 hours a day — don’t tell me that it’s uncomfortable, I get it,” she said. “I’m not doing it because I self flagellate and enjoy being uncomfortable. I do it because I want to keep you safe.”
