Alberta Health Services announced Wednesday it will dump the responsibility for masking to slow the spread of COVID-19 in its acute care facilities on the leadership of its regional zones throughout Alberta and individual sites.
In a memorandum on “enhanced masking at AHS sites” published on the province-wide health authority’s website, AHS indicated it will now leave the responsibility for determining whether enhanced masking is necessary to local or regional leadership.
The statement contains a link to a more technical and detailed “Use of Masks to Prevent Transmission of COVID-19” directive, which took effect Wednesday.
The memorandum says in part “this directive supports zone and site leadership to determine if enhanced masking for staff, physicians, midwives, students, volunteers and contracted providers is necessary.” A press release also published Wednesday makes the same statement.
This seems misleading, though, as the directive arguably does the opposite, leaving zone and site leaders who are aware of the hostility of Alberta’s United Conservative Party (UCP) government to public health measures to mitigate the spread of COVID-19 on their own in the event they perceive a need to require enhanced masking on their sites.
Isn’t the result of this more likely to be paralysis and unwillingness to adopt more stringent infection controls, even when clearly necessary, to placate Premier Danielle Smith and the COVID-denying, anti-vaccine Take Back Alberta faction that now appears to dominate the UCP?
In turn, the new localized policy suggests hesitation to stand up for sound infection control and public health practice among the current top executive leadership of AHS, put in place by the Smith Government.
In other words, even though the details of Health Minister Adriana LaGrange’s plan to “decentralize,” “reconfigure” or plain dismantle AHS are not yet known by the public – and may never be in full – this sure sounds like an early instance of local decision-making, whether or not it’s in the interest of patient or public safety.
While there is some direction about where enhanced masking can be required – “patient care areas, elevators/staircases/hallways, common areas, gift shops and cafeterias where patient contract could occur in acute care facilities” – the policy suggests no one at the top is likely to take responsibility for the decision.
The policy does advise zone and site leaders that “where the enhanced masking is implemented,” it will be required for patients, designated support persons, and visitors in Emergency Departments.
The actual directive document defines Zone Executive Leadership as “the leadership team consisting of a Chief Zone Officer and a Zone Medical Director, which shares responsibilities and accountabilities for the clinical and operational decision-making of their designated zone.” Site leadership is defined as “individual(s) responsible for a specific facility of operation within AHS.”
The memorandum also indicates sites where masking is “NOT required” – boldface and all-caps in the original. These include anywhere not within an Emergency Department or acute-care facility.
The memo and press release also include bromides encouraging visitors and designated family support persons to stay at home if they’re sick, and to wait 10 days after the onset of COVID-19 symptoms before returning to the facility.
The press release also says somewhat ambiguously that where the enhanced measures are implemented, “no patient shall be denied services.” Presumably this includes patients who refuse to wear masks as supposedly required.
The message between the lines of these documents is that in Alberta today, health care policies are driven more by political considerations than public health and patient safety.
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