Why one rural politican wants Dr. Mackie to make masks mandatory

A Middlesex county politician is calling on the region's medical officer of health to make face masks mandatory in all indoor public spaces as soon as possible in order to avoid a variety of rules across municipalities. 

Thames Centre Deputy Mayor Kelly Elliott says it should be Dr. Chris Mackie who makes a blanket decision for all of Middlesex County, as well as the City of London, instead of relying a patchwork of bylaws in eight different municipalities enacted by local councils. 

"It shouldn't be a political decision. It is a public health decision and if it's best for public health, it should be a public health official making that decision," Elliott told CBC News. 

"It shouldn't be a politician figuring out if this is a great idea for their ward or their city, or whether or not this will help get them elected. This isn't a popularity vote. It's a public health decision."

Although the province can mandate masks be worn in specific places, it's so far allowed different regions to determine if they want mandatory masking rules. 

That can be done by a public health ordered, issued by a medical officer of health based on risk, or by politicians passing a bylaw. 

In London, Mackie has made masks mandatory on public transit and in taxis and in Ubers, but has not expanded the order to places such as malls and grocery stores, hotels, bars and restaurants, many which re-open on Friday as part of Phase 3. 

That's prompted London councillors to consider drawing up a bylaw to make masks mandatory, and they've called on Mackie to come to a special council meeting on Monday to help them make the decision. 

Across the province, many medium and large municipalities have made masks mandatory indoors, including Windsor, Toronto, Ottawa, Hamilton and Kingston. Some have done so by public health order where the risk of infection was high, or by passing bylaws. 

But in this health region, which includes London as well as eight municipalities in Middlesex County, Elliott worries that politicians in the city passing a bylaw would force the smaller councils to have to do so as well. She wants Mackie to make a blanket health order so the entire region is on the same page. 

Patchwork approach creates 'inconsistency​'​​​​​​

"It would be great to have a regional approach and not a patchwork one," Elliott said. "You might have a mask bylaw pass in Thames Centre but not Middlesex-Centre, or one pass in Lucan-Biddulph but not Adelaide-Metcalfe, that creates inconsistency across the region."

"Imagine if London passes a bylaw, and someone there knows to wear a mask, but then they go to a store in Dorchester, and they don't have to, but then in Ilderton they do, but in Lucan they don't. People travel within the county, too, and there should be consistency," she said. 

Mackie has said the number of cases in the region doesn't meet the threshold for a public health order, but Elliott says the mandatory masking bylaw should look to the future, after people start to feel more comfortable going out during Phase 3. 

"What's going to happen in six to eight weeks when people are going into places? Do you still want to get together with your friends and family, go to restaurants? If the answer is yes to those questions, wearing a mask is one way to assure that we're going to keep being able to do that," Elliott said. "We know a second wave is coming." 

Mackie 'out of step?'

Public health officers have to base their decisions on whether masks are effective, but also whether everyone will have access to masks and whether the mask mandate is enforceable. 

"The medical officer of health has to operate within certain parameters, and when making masking mandatory they have to look at the evidence and say, without doubt, they would be beneficially, said Dr. Nitin Mohan, an epidemiologist at Western University.  

"To make them mandatory in all indoor settings, it would require the medical officer of health to look at his community and ensure that the enforcement of the protocol is equitable and provides significant impact." 

But Dr. David Fisman, an epidemiologist at the University of Toronto, said other medical officers of health are taking stronger stances on mandatory masks. 

"Widely across the province, a lot of Dr. Mackie's colleagues have looked at the same evidence that's available to him, and have decided that this is a smart thing to do in terms of the health of the population they serve and the economies of the communities they serve and I hope London does it," Fisman said. 

"I want folks from London to be protected against a resurgence of COVID-19 and I think Dr. Mackie is demonstrating that he's probably a bit out of step with the public health mainstream on this."