While cases of respiratory illnesses are surging elsewhere in Canada — and starting to tick upward in Newfoundland and Labrador — the provincial chief medical officer of health says she can't implement a mask mandate since the situation isn't a public health emergency.

But Dr. Janice Fitzgerald said she still recommends wearing a mask in places where there's high risk for contracting a respiratory illness, including COVID-19.

"That recommendation continues to be there for public health, and of course in our health-care facilities we are still asking that people will mask. It is required there," Fitzgerald said at a media briefing Tuesday afternoon.

"The recommendation may become stronger as time goes on and as we see changes. Obviously as we monitor and make our decisions based on the evidence, that may change."

Some of Fitzgerald's equivalents in other provinces are urging the public to begin wearing masks again as respiratory illness, influenza and respiratory syncytial virus — or RSV — cases rise, adding further pressure to already overwhelmed emergency departments and children's hospitals.

In October, Fitzgerald said there would have to be a significant impact to the health system, and an exhaustion of all other measures, to bring back COVID-19 restrictions like a mask mandate.

Fitzgerald said Newfoundland and Labrador is seeing "some activity" in flu and other respiratory illnesses but not to the same extent as in other places.

She said there have been increased calls to the provincial health line and more visits to emergency rooms for respiratory illness.

"We expect an increase this time of year and continue to monitor," she said.

But Fitzgerald says the current evidence doesn't support reintroducing a mask mandate in Newfoundland and Labrador.

"We've had a few sporadic cases of flu. We're not seeing the same increases that they're seeing elsewhere," she said.

"We have to have the evidence, before you start infringing on peoples' rights, that you have the evidence to support doing so and that there's really no other way to mitigate that risk."

Nationally, however, influenza cases are above expected levels for this time of year.

Fitzgerald said this could mean N.L. could see an earlier start on influenza cases.

But COVID-19 activity is steady, she said.

"Indicators, including test per cent positivity, the number of new cases and hospitalizations are relatively stable," she said.

"Over the last two years we have developed the tools we need to respond to anticipated surges and respiratory viruses. Thankfully what works for COVID will also work against flu, RSV and others."

The provincial government will begin distributing free rapid COVID-19 tests through the mail in the coming weeks, said Fitzgerald.

Each household will get two test kits — 10 tests — in two separate deliveries.

Fitzgerald said kits will start showing up in mailboxes near the end of November and early December.

"Residents who do not receive kits via Canada Post, or who run out of supply, will be able to pick up free tests at constituency offices for MHAs and from all Newfoundland and Labrador public libraries," she said.

"Rapid antigen tests are quite reliable if they return a positive result. Therefore, if you get a positive result, you have to assume you have COVID and we ask that you follow public health guidance found on our website."

In the spring, there were calls from opposition MHAs and advocates to make free rapid tests readily available for the general public as was being done in other provinces. Newfoundland and Labrador did provide them to schools, health-care centres, congregate living facilities and corrections services.

Fitzgerald said that approach was focused on keeping kids in school and trying to protect the most vulnerable population.

"I think now, the way that we've changed dealing with COVID going forward, how we've changed the public health management of COVID, this approach is more suited to that," she said.

"It's allowing people to make that decision and be able to make informed risk assessments and informed decisions about their activities. As COVID has changed, we have changed in our response."

Under current public health guidelines, testing is not recommended for anyone who does not have symptoms, including close contacts of positive tests. PCR tests will continue to be used for outbreak management and within acute-care settings.

In a press release, the Health Department said public health surveillance and predictive modelling will continue. Fitzgerald said public health encourages anyone who has a positive rapid test result to report it using the provincial government's COVID-19 assessment and test reporting tool.

"This will help public health follow disease prevalence and that will assist in critical decision-making on public health recommendations going into the winter season," she said.