TOWN OF PEACE RIVER Briefing Note To: Mayor and Council Date: August 6, 2020 Presenter: Christopher Parker, CAO, Ruth McCuaig Prepared By: R. McCuaig Topic: Temporary Face Covering Bylaw File No.: BWF 2076 Attachments: DRAFT 2076 Temporary Face Covering in Indoor Public Spaces Bylaw DRAFT Public Review and Comment Period Alberta Health Services Scientific Advisory Group Report on Community Masking World Health Organization Recommendations on Mask Use Issue Administration is requesting Council's feedback (as well as the Public's) on implementing a Mask Bylaw that the Mayor will be bringing forward for adoption in approximately 30 days' time. A facsimile of the Bylaw is attached. The Mayor is aware that such Bylaws can be contentious, but as the Mayor has noted: “Without debate, without criticism, no town, no province and no country can succeed—and no constitutional monarchy or republic can survive. That is why the Athenian law-maker Solon decreed it a crime for any citizen to shrink from controversy.” Background On March 11, 2020, the World Health Organization declared a pandemic related to the novel Corona Virus COVID-19. Since that time, numerous public health measures have been put in place to reduce the spread of the disease. These measures have included requirements such as restrictions on gatherings, increased sanitation measures, and physical distancing of two meters. On June 10, 2020, the Government of Alberta added a recommendation that Albertans wear non-medical masks in public when it may not be possible to maintain physical distancing. In support of this recommendation, the Province began a program to distribute 20 million free masks to Albertans. The Province’s statement on public masking states: “Albertans are encouraged to wear non-medical masks in public when it's difficult to maintain physical distancing of 2 metres at all times. Wearing a homemade or non-medical mask is another tool to help prevent the spread of COVID- 19.” COVID-19 is transmitted through airborne droplets when a person with the virus coughs, sneezes, talks, laughs, or sings. These droplets can be breathed in by someone nearby. The droplets can also rest on surfaces and be transmitted to someone who then touches their eyes, nose, or mouth. Current guidance from the Province recommends the use of masks on public transit, in grocery stores and pharmacies, in hair salons and barbershops and some other retail stores. At this time, the Province has stated that mandatory masking remains a question for local authorities to determine. Assessment of Local Risk As of August 6, 2020, COVID cases within the region were as follows: Active case rate (per Region name Active cases Population 100,000 population) City of Edmonton 28.1 287 1,021,628 (included for reference) City of Grande Prairie 13.6 10 73,697 County of Grande Prairie No. 1 12.8 4 31,319 County of Northern Lights 27 1 3,702 Municipal District of Peace No. 135 0 0 15,922 Municipal District of Smoky River No. 130 0 0 4,410 Northern Sunrise County 0 0 3,188 Mackenzie County 223.4 54 24,171 In relation to the province, the North Zone stands at: In intensive Location Confirmed Active Recovered In hospital Deaths care Alberta 1,240 1,146 9,891 75 20 203 North Zone 614 113 483 7 3 18 Currently, the total number of cases is trending upwards, while the current number of active cases has risen somewhat. Page 2 of 8 Effectiveness of Masking While research gaps still exist regarding the efficacy of various types of face masks, the evidence that has emerged so far suggests that mask usage is beneficial for reducing the transmission of respiratory diseases like COVID-19. An April 2020 study published in Nature Medicine, examined the shedding of various respiratory viruses, including seasonal coronaviruses and influenza, by more than 100 infected individuals, as well as the efficacy of face masks in reducing the dissemination of infectious droplets. The authors found that surgical masks reduced the detection of coronavirus and viral copies in large respiratory droplets and in aerosols, suggesting that masks can reduce viral transmission. An April 2020 review published in the International Journal of Nursing Studies by MacIntyre and Chughtai analyzed 19 randomized controlled trials, among which eight were conducted in a community setting. The review concluded that, “In the community, masks appear to be effective with and without hand hygiene, and both together are more protective.” A May 2020 study published in BMJ Global Health measured the incidence of secondary COVID-19 transmission in 124 families in Beijing, China. Each family had one member with a confirmed COVID-19 infection (primary case). The authors examined whether various interventions, specifically the use of disinfectants, physical distancing, and face masks, in a household reduced the risk of secondary transmission. They found that all three interventions reduced secondary transmission of COVID-19. In particular, the authors noted that “Face mask use by the primary case and family contacts before the primary case developed symptoms was 79% effective in reducing transmission.” A systematic review and meta-analysis by Chu et al., published June 2020 in The Lancet, examined the efficacy of three interventions—physical distancing, face masks, and eye protection—in reducing the transmission of coronavirus infections (SARS, MERS, and COVID-19). The authors evaluated 39 studies on the efficacy of various face masks in reducing disease transmission and found that face masks reduced the risk of coronavirus infection compared to no mask wearing, and that N95 respirators “might be associated with a larger reduction in risk compared with surgical or similar masks.” Notwithstanding the above noted studies suggesting that masks have a beneficial effect in reducing the spread of respiratory diseases like COVID-19, it is important as Dr. Deena Hinshaw, the Province’s Medical Officer of Health (MOH), alluded to in the attached AHS document, masks do not provide complete protection from infection and people must still continue to practice physical distancing of two metres (about 6 feet) or more and good hand hygiene. A masking requirement should not be allowed to distract from other critical measures such as physical distancing and handwashing. Administration has attached an AHS and a WHO document for Council’s reference and has attempted to summarize the key findings both for and against community masking from the two documents into this report. The AHS report states: “With a focus on recovery and relaxation of social distancing in the context of the stabilization of the initial wave of the pandemic, the general population is returning to community and workplace settings where social distancing will not always be possible, which is driving interest in, and controversies around the use of cloth and home-made masks.” Page 3 of 8 Considerations supporting mandatory public masking 1. There is a segment of the population who strongly support public masks. A mandatory mask requirement would meet the needs of this portion of the community. While reasons for supporting public masks vary, they include: a. A belief in the efficacy of masks to prevent disease transmission overall; b. A desire to prevent inadvertent transmission in the event they are asymptomatic or otherwise ill; and c. That the mask may reduce their own risk of becoming infected. 2. Some persons may feel safer – and thus more likely to access local shops and services – if a masking requirement is in place. 3. There is little evidence of harm related to community mask wearing. 4. The Town of Peace River serves as a service hub for the local region. This increases the risk of transmission as visitors move in and out of town. In addition, there is substantial traffic by residents between Peace River and larger urban centres such as Grande Prairie and Edmonton. This is an additional risk to the community. 5. A concern has been raised that there may be potential legal liability if masks are not required. Specifically, if courts were to find that masks are a “reasonably practicable” action that protects workers and customers from hazards posed by infectious diseases. Without a municipal Bylaw, a business requiring customers to wear masks may risk driving away customers, but a business failing to mandate masks may risk violating the Occupational Health and Safety Act. 6. Use of masks may reduce transmission of diseases other than COVID. If this is the case, a reduction in colds and flus could conceivably mean a person’s immune system is stronger, which may be a benefit in the event they are exposed to COVID. 7. The WHO, Health Canada and AHS have mandated the use of masks in settings (such as aircraft) where physical distancing is not possible. 8. AHS’s Scientific Advisory Group (SAG) agreed that “. the use of masks in the community is likely to be useful in reducing transmission from community based infected persons, particularly those with symptomatic illness.” 9. The recommendation of AHS’s SAG was that “In settings where social distancing cannot be maintained, medical masks or high-quality non-medical masks should be encouraged as a form of protection for those vulnerable to severe COVID-19 infection outcomes.” 10. AHS noted that if mask wearing were widespread, it could reduce the stigma of mask wearing and increase the likelihood that ill individuals would wear masks. 11. AHS also noted that masks have been found to provide a visual cue to others to respect physical distancing. Page 4 of 8 12. The WHO updated its advice on mask use by the public on 5 June 2020: “Taking into account the available studies evaluating pre-[symptomatic] and asymptomatic transmission, a growing compendium of observational evidence on the use of masks by the general public in several countries, individual values and preferences, as well as the difficulty of physical distancing in many contexts, WHO has updated its guidance to advise that to prevent COVID-19 transmission effectively in areas of community transmission, governments should encourage the general public to wear masks in specific situations [e.g.