Click here to download a PDF of the Chief Medical Officer Update.
Dr. Mark Joffe
Chief Medical Officer of Health, Alberta
c/o [email protected]
Dear Dr. Joffe,
In light of the impact of this severe viral season on Alberta’s children, and in the context of the heavy strain on pediatric health services, on behalf of the executive members of the Alberta Medical Association’s Section of Pediatrics urges you to institute protective health measures to mitigate viral transmission. We also request that public health provides increased messaging around the safety and efficacy of influenza and COVID-19 vaccines for children and ensures accessibility to these vaccines for all populations. These steps are necessary to optimize the quality and timeliness of care for all pediatric patients.
As per the Immunization Monitoring Program Active (IMACT) network, the number of weekly influenza-associated pediatric hospitalizations in Canada is already higher than levels typically seen at the peak of the influenza season (Government of Canada Flu Watch Report, 2022). Alberta currently has the highest influenza activity in Canada (Government of Canada Flu Watch Report, November 20 to November 26, 2022).
RSV activity is also higher than average within Canada (Government of Canada Respiratory Virus Detection Report, November 20 to November 26, 2022), and rates of RSV-associated hospitalizations in children have increased in the US compared to pre-pandemic years (CDC Rates of RSV-Associated Hospitalization, 2022-2023).
COVID-19 continues to contribute to pediatric hospitalizations, with three times more children in the 1-9 year age group admitted to hospital with COVID-19 in the first eight months of 2022 than in the entire 20 months prior (Government of Alberta, COVID-19 Alberta Statistics: Total Hospitalizations, ICU admissions and deaths (ever) among COVID-19 cases in Alberta by age group). Along with high rates of viral illness, ongoing pediatric drug shortages are exacerbating the strain on the health system.
We strongly recommend immediate mitigation measures, including:
- Increased public messaging around the safety and efficacy of influenza and COVID-19 vaccines in children to create awareness of their importance in decreasing severe outcomes/hospitalization.
- Increased accessibility to vaccines, especially amongst marginalized populations by offering school vaccine clinics or mobile vaccine services.
- A temporary mask requirement in schools for children and educators with provision of high-quality medical grade masks. (Boutzoukas AE et al., 2021; Boutzoukas AE et al., 2022, Rader et al., 2021).
- Approval and support of the placement of HEPA purifiers in school classrooms.
- Increased messaging around optimizing ventilation and filtration when having indoor gatherings by opening windows or using HEPA purifiers when feasible (Edmonton Public Libraries now offer a CO2 monitor lending program to assess ventilation in homes/schools) (Greenhalgh et al., 2021).
- Encouragement of frequent hand washing, access to sanitizer and sanitization of high-touch surfaces in schools and essential indoor public spaces.
- Increased messaging around staying home from work and school when sick.
These protections will help decrease the spread of multiple viral illnesses, including RSV, influenza and COVID-19, that are increasing at alarming rates in our community and leading to increased school absenteeism as well as unprecedented wait times in Emergency Departments and overcapacity pediatric inpatient units throughout the province. Pediatric outpatient clinics are also overwhelmed. Waitlists to see pediatric consultants are increasing, with care for other conditions being deferred to manage the current viral crisis.
We encourage the adoption of the protective measures as outlined above with reassessment of the masking requirements after the peak of the respiratory virus season later this winter.
Sincerely,
Dr. Sam Wong
President
AMA Section of Pediatrics
Dr. Tehseen Ladha
Executive Member-at-Large
AMA Section of Pediatrics